Health and care infrastructure research and innovation centre (HACIRIC) extension.

HaCIRIC's vision is to be a world class centre delivering research to support better healthcare through better infrastructure. We aim to be the first call for research, help and advice for organisations involved in the redesign of their healthcare infrastructure, both in the UK and internationally. Our programme was established in 2006 and is now responding to the changing global context for healthcare. Britain and all major developed countries need to meet an expanding demand for services while simultaneously controlling rising costs, improving quality and safety, and increasing productivity. It is acknowledged that tackling the major challenges facing health systems around the world will involve: (1) shifting care patterns between different healthcare settings, (2) rethinking the use of technological and physical infrastructure to support that change, (3) developing new organisational and funding models to make it work, and (4) generating rigorous and accessible evidence to demonstrate the changes that really do work. HaCIRIC's work is addressing these challenges, with a focus on the relationships between innovation in healthcare infrastructure, services and technology.1. Shift the location of care within health and social care systemOur research is informing moves towards a general shift in care from acute, high cost and reactive models towards primary, preventative and possibly lower cost ones. We aim to help to move care down this 'pyramid' of care and, where appropriate, out of the formal system, using a strong evidence base and realising the benefits in a planned, efficient and effective way. 2. Develop creative new models combining technological and physical infrastructureEfficient, high quality care - wherever it occurs in the system - depends on achieving the best possible combinations of technology, organisation, physical infrastructure and finance. In acute healthcare, there will be increased emphasis on new roles for or closure of hospitals. In primary care the key may be to harness information and integrate services. In the informal sector, the challenge is how to support self-care, incentivise behavioural change and build support networks.3. Build innovative organisational and funding modelsAchieving new combinations of technology, organisational and physical infrastructure will require various constraints to be tackled. These include finding innovative new solutions that can be scaled-up and delivered wherever appropriate, widening access to healthcare users, and meeting world class standards and performance goals. Greater openness to experimentation in service and business models will be needed by all care systems.4. Support change managementIt is increasingly recognised that if change is to be achieved in a highly politicised field, with entrenched interests and views, policies and innovative approaches will need to be designed in a way that engages the public more effectively. Developing rigorous and accessible evidence to support policy and managerial decision-making is therefore critical.As a whole, our research programme is unique in focusing on the relationships between healthcare technology, services and infrastructure. This has not been adequately researched, making HaCIRIC's work essential - unless the key questions are researched, with solutions properly modelled and the learning effectively disseminated, health systems may not be able to accomplish the vital innovations need to meet the future demands placed on them.

HaCIRIC's work over the last 4 years has been focused on providing the evidence that can be used by government, the health services and their supply chains to make decisions about planning and delivering new infrastructure. In our next phase we aim to increase our interaction with with high quality strategic and operational stakeholders at both the national and international levels. Our objective is to increase the number of working partners in our research activity measured by the number of active partners each year. The target is to double the number of high quality partners every two years. This will largely come about as we establish the HaCIRIC brand through the quality of the outputs and engagement with users. Our work is now having a direct impact through knowledge and technology transfer activities. For example, our work with the LIFT programme in Greater Manchester has been recognised in national awards. Internationally, the Benefits Realisation project has entered a partnership with Edifer (one of the leading construction companies in Portugal) and the University of Minho to provide knowledge transfer through research and consulting services. We have been invited by the OGC and TSO to become a reviewing panel member for the new 'Managing Successful Programmes' guidelines currently under review. Our work on remote patient monitoring is directly informing government policy in this area through the Preventative Technologies Grant and Whole System Demonstrator programmes and has levered an additional c700,000 in additional funding from government. Plans are being developed to establish an implementation group built on the Procure 21+ group of contractors. At the pre competitive stage of projects we will be developing with the contractors leading edge practice, briefing strategies and project implementation based on our consolidated evidence base of internationally leading practice. With our partners in ECHAA (European Centre for Health Assets and Architecture) we are beginning to offer support for the development of major healthcare infrastructure projects overseas.