This document discusses health research in Ireland and the role of the Health Research Board. It notes that healthcare is a knowledge industry but that health research capacity is not strong in Ireland's healthcare system currently. It provides examples of the Health Research Board's work, including funding health research, providing evidence for policymaking, and establishing research infrastructure like clinical research facilities. The document emphasizes that the transition to new healthcare groups/trusts presents an opportunity to better centralize and support health research within each region.

1. Whither Health Research in Ireland?
Graham Love
Chief Executive
Health Research Board
West/North West Hospitals Group Conference, 09-09-14
From Groups to Trusts – Reforming the Health Service

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3. Sample R&D Intensities
• Healthcare is a KNOWLEDGE industry!
• Expectations & costs are rising out of sync with resources. This is not sustainable.
• We need a much smarter use of our resources, people, processes & technology to meet
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healthcare needs/expectations.
• Our healthcare system needs a much greater self-learning capacity: an ability to research &
develop people/processes/technology both in Ireland and to absorb them from abroad.
• That capacity is not strong in our healthcare system at present.
• And should we be surprised?
€14,000,000,000
€43,000,000
0.31%
£109,000,000,000
£2,400,000,000
2.20%
$53,000,000,000
$2,800,000,000
5.28%
Total spend
R&D spend
R&D as % of total

4. Health Research Board
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• State agency under Department of Health.
– Budget €43m, funding portfolio €150 - €200m, staff of 61
• Providing evidence for policy
– Public Health Alcohol Bill, Food Pyramid, Fluoridation
• Information for service planning
– Drug use, disability, mental health
• Funding health research
– Clinical, Population Health, Health Services Research
– Infrastructure, capacity building, specific projects.
internal
external

5. Providing Evidence for Policy
HRB Alcohol Diaries 2013
We drink too much
We drink in a harmful pattern
We don’t know it
Public Health Alcohol Bill 

6. Information systems & evidence
for policy

7. HRB Health Information Systems
• Service planning National Intellectual Disability Db database for intellectual disability
Established 1995
c.27,000 records
• Service planning database for physical and
sensory disability
National Physical & Sensory Disability Db
Established 2002
c.25,000 records
• Epidemiological database recording treated drug
and alcohol misuse
National Drug Treatment Reporting System
Established 1990
c.20,000 cases p.a
• Database recording admisssions to and discharges
from psychiatric hospitals
National Psychiatric Inpatient Reporting System
Established 1963
c. 18,000 admissions & 18,000 discharges
National Drug Related Deaths Index • Census of drug and alcohol related deaths
Established 2005
c. 1,400 p.a

8. Cochrane: systematic review
infrastructure
HRB provides
• Cochrane library access
nationwide
• Cochrane fellowships
• Cochrane Ireland Convenor
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evidence for
Clinical Care Programmes

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€50 million
from HRB
over past
decade

10. ICORG Infrastructure Story:
Oncotype DX Public Usage Oct 2011-Sept 2012
Analysis carried out by GHI and presented at St Gallen 2013
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70
60
50
40
30
20
10
0
St Vincents Mater UCHG/ West St James's Waterford Beaumont CUH Midwestern
Patients Tested
Patients Receiving Chemo
Over 4 year clinical trial: €5M saving i.e. €3M in avoided chemotherapy and €2M in free oncotype DX tests for the 690 participating patients.

11. HRB Centre for Advanced
Medical Imaging
• €4m for MRI scanner
to be used solely for
patient focused
research
• Available to
researchers
nationwide to
conduct range of
studies

12. HRB - Perinatal Ireland
• €3.9m for ultrasound equipment and
support staff across 7 hospitals
• Created a research collaboration
harnessing combined medical expertise
and access to large cohorts (75,000)
babies for studies that would have
otherwise been impossible
• Already led to new national guidelines to
protect small babies in womb
• John Foley (Superman), diagnosed with
intrauterine growth restriction and born 11
weeks premature weighing just 2 pounds 6
ounces at birth – now 19 months old, with
his big brother Martin (4 years).
• Grainne Foley (Superman’s mother) was a
participant in Perinatal Ireland research;
• ‘Taking part was a bit of a no-brainer really.
Knowing that there was potential for some
difficulties was a definite worry, but it was
very reassuring to be able to avail of the
resources, monitoring and surveillance that
the research team brought to the hospital.’

13. HRB Clinical Research Facilities
Original Vision
 infrastructure, physical space
 facilities
 expertise
• Optimally support patient-focused
research studies and clinical
studies
• Translating the knowledge to
reimbursed, regulatory-approved
advances in patient care as
speedily as possible
Benefits for
• Researchers and health
professionals
• Patients/population
• Policy makers
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14. HRB Clinical Research Facility -
Galway
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15. Wellcome Trust-HRB Clinical Research Facility –
Dublin

16. HRB Clinical Research Facility -
Cork
Opening of Cork CRF, 2012

17. The Groups & the CRFs are
aligning...
Dublin North East
Dublin Midlands
South/South West Dublin East
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West/North West

18. So it’s nice to have CRFs in all
the right places….
• But the greatest value is probably not the physical
buildings (facilities are a prerequisite…....)
• BUT the processes and people that will wrap
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around them add the greatest value
• Research Governance
• Quality
• Safety
• Resources, capacity & skill to link and translate
research into practice

19. Research & the Groups-to-Trust
transition
• The Groups (Trusts) represent a fantastic opportunity to
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‘centralise’ research within each region
• Increased
– Visibility/Transparency
– Quality
– Safety
– Translation from research to practice
?? Make research a criteria for Group to Trust transition??