Guide The New Health Bioeconomy: R&D Policy and Innovation for the Twenty-First Century

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  1. Maximising value from a United Kingdom Biomedical Research Centre: study protocol
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All have strengths and limitations and will need to be adapted as we apply them to the emerging case study. We describe these in turn. In their Triple Helix model, Etzkowitz et al.

Maximising value from a United Kingdom Biomedical Research Centre: study protocol

The consensus space: building relationships and supporting dialogue among university, industry, healthcare staff, policymakers and citizens; and. The innovation space: collaborations and activities to achieve the goal of implementing and where appropriate, commercialising research discoveries, by combining academic or technical expertise with business expertise and public or private venture capital.

Indeed, the study of the Triple Helix may focus fruitfully on the emergence and behaviour of these new organisational actors for example, the entrepreneurial university still trains individuals in classrooms, but it also has a more contemporary role of training organisations in incubators. Etzkowitz and Leydesdorff [ 53 ] emphasise that the Triple Helix rests on an active, questioning civil society in which public debate over values and scientific priorities, and bottom-up initiatives of various kinds, feed into the emergent decisions and actions of macro-level stakeholders.

The exchange of ideas, knowledge and perspectives is facilitated by free movement of individuals between the different strands of the helix, for example, through placements for students in industry or policy and, conversely, university secondments and honorary lectureships for people from industry, government or the civil service.

Such a model depends on reflexivity, that is, ongoing appraisal by the university of its evolving relationships with industry, government and civil society.


The Triple Helix metaphor is presented positively by its protagonists as enhancing the potential for innovation and economic growth in a knowledge-based society. Perhaps another way of expressing this criticism is that civil society was included as part of the context for the Triple Helix but not as an equal and integral strand within it. Our second theoretical influence is Gibbons et al.

As summarised previously:. In this space, problems are identified, questions debated, methodologies developed, and outcomes disseminated. There are many players, many experts of different kinds , and an evolving collective view though rarely a consensus on what the questions and challenges are. However, such an approach constitutes a significant challenge to the norms of academic science, as set out back in by Merton [ 63 ], which include disinterestedness, objectivity and organised scepticism.

The question of how best to harness the co-creative potential of Mode 2 without overly distorting the research agenda with commercial and other powerful interests is one of the leading challenges of contemporary health systems research. The third theoretical framework on which we seek to draw is an adaptation of Ramaswamy et al. We have adapted the Value Co-creation model to fit a setting in which the main partners are public sector health and education institutions Fig.

Adapted Value Co-creation model. Adapted for a public sector setting from Ramaswamy and Ozcan [ 67 ]. Ramaswamy and Ozcan [ 67 ] offer four key principles for co-creation of value across sectors:. Stakeholders will not wholeheartedly participate in the co-creation process unless it produces value for them;.

Stakeholders must be able to interact directly with one another preferably face to face at least some of the time ;. Central to the model are platforms of various kinds, formal and informal for bringing stakeholders together. The co-creation process is supported through two key activities [ 67 ]:. Engagement of individuals in which people who will be key to the enterprise are engaged and offered support and open-source resources ; and. Support for enterprise, which brings organisations together to work on particular projects and programmes and provides a range of resources for this purpose.

As Fig. Individuals circulate within and between their various communities of practice — business, professional, natural e. Individuals and groups value different things; communication and dialogue, including but not limited to the formal governance processes of the programme s , ensure that each stakeholder gets something of what they value and comes to understand and contribute to what others value. Although the Value Co-creation model originated in business studies, the theoretical ideas of co-creation can be applied to the co-creation of knowledge within the Triple Helix of university—industry—government relations resting on an active civil society [ 69 ].

To our knowledge, there has been only one published application of value co-creation in a healthcare setting in Australia [ 62 ]. One approach that could potentially bring all three of these perspectives together is what Carayannis et al.

This framework adds a fourth strand — civil society — to the triple helix and also extends the work of Gibbons et al. This hybrid approach will be explored further, with pilot data, in a separate publication. Engagement platforms are many and varied; they include formal governance structures, physical spaces, informal networking events and virtual interaction spaces.


Examples of engagement platforms both formal and informal that are already in place for the Oxford BRC include 1 the inter-sectoral Strategic Partnership Board, which has a Joint Executive Group and specialist committees. Via its website www. Importantly, these social media outlets also serve as a mechanism for inviting feedback and external peer review both academic and lay on emerging activity.

Papers & Posters - REGenableMED, The University of York

The above list is not exhaustive. We will capture the emergence, development and attrition of key engagement platforms using ethnographic and narrative methods. Each sub-theme will select specific case studies from the NIHR Oxford BRC research themes and clusters, to which they will provide both longitudinal support and help with evaluation.

We will ensure that cases are selected to ensure maximum variety in size, structure, duration, academic discipline s , clinical field, nature of support requested and success metrics, and that all cases have potential to contribute data to address the research questions listed above. The study will use a variety of qualitative and quantitative data, including the empirical studies within individual BRC research themes, narrative accounts from stakeholder interviews, ethnographic field notes, documents, and quantitative indicators and metrics of success.

In keeping with the principles of action research and Mode 2 knowledge production, we will engage from the outset with the intended end users of our research. This will maximise the value of our research by increasing its usability and impact while reducing the need for a separate dissemination phase.

We will also use social networking and social media to increase transparency and broaden outreach. In terms of outputs, our short-term goal is to bring together university, industry and NHS partners in strategically targeted projects focused on supporting innovation and escalating promising discoveries.

We will develop and strengthen links with clinical trials units and theme-specific projects to ensure that researchers receive methodological support at design stage. In the longer term, we anticipate that our work will add significant value to the NIHR Oxford BRC by unpicking the complexity of multi-stakeholder research partnerships and providing generalisable insights on how to optimise it.

This study protocol has described the rationale and methodology for a novel approach to building and strengthening the various partnerships in the NIHR Oxford BRC and beyond as it embarks on its third 5-year period of NIHR funding from to We have presented our BRC as a crucial case study — a setting in which many of the preconditions for success are already in place, hence a good place to test a new approach for enhancing that success.

The New Health Bioeconomy

We have introduced three linked theoretical perspectives Triple Helix, Mode 2 Knowledge Production and Value Co-creation relevant to the operation of large, multi-stakeholder health research partnerships. Finally, we have emphasised the importance of creating an ongoing narrative of progress to aid collective sense-making and maintain an over-arching and evolving vision. Previous sociological studies of multi-stakeholder research partnerships have shown that they are inevitably characterised by structural complexity, competing interests, ambiguous loyalties and colliding institutional logics [ 64 , 65 , 72 , 73 ].

Synergy may increase as co-governing partners work together, leading to convergence of perspectives by progressive alignment of purpose, values and goals, and growth of mutual understanding and respect. Multi-stakeholder health research partnerships have been widely studied using ethnographic case study methods [ 64 , 65 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ]. Another strength of this study is in using the principles of action research to inform real-time action and system change while also making a generalisable contribution to the knowledge base.

However, this study also has potential limitations. Key data may not exist or may not be fully accessible to the research team. Ongoing access to undertake research on a multi-stakeholder research partnership, and real-time feedback of emerging findings in a way that shapes the work of that partnership, have both been shown to depend on the development of democratic relationships and mutual trust, which in turn stem from a smooth set-up phase and acknowledged early wins [ 79 ].

This model, favoured by leading organisational scholars as the most appropriate one for studying complex systems [ 38 , 71 ], is designed to generate illuminative insights and naturalistic generalisability through the use of thick description and reflexive theorising.

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The study design will not generate statistically representative data, nor is it primarily intended to produce cross-case theoretical insights as would occur, for example, in a small-n realist evaluation. The single case study design has been chosen because the NIHR Oxford BRC is a unique, dynamic and continuously evolving research system that will be influenced by future research policy developments and organisational changes.

As we write this, the United Kingdom faces a changing context for scientific research, drug regulation and health services delivery as a result of its decision to leave the European Union. The unfolding of research partnerships will need to be carefully analysed with relation to what may turn out to be dramatic changes in their external context. We believe the use of the single case study for such a study is amply justified on theoretical grounds and have provided detailed philosophical explanation elsewhere [ 37 , 80 ].

However, the n of 1 organisational case study is not well understood by many in the biomedical research field. The case study appears to contain many of the key ingredients for success, but there are also many unknowns, finite resources and an unstable external context. Collective action for knowledge mobilisation: a realist evaluation of the Collaborations for Leadership in Applied Health Research and Care. Health Services and Delivery Research.

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National Institute for Health Research. Biomedical Research Centres. Accessed 3 March Walshe K, Davies HT.