Abstract
Introduction: Rise up
The James Lind Alliance (JLA) Priority Setting Partnerships bring together people who access health and care services and people who deliver them, to identify and prioritise the questions they want research to answer. In partnership with the JLA (Occupational Therapy | James Lind Alliance (nihr.ac.uk)) the Royal College of Occupational Therapists (RCOT) identified the top 10 research priorities for occupational therapy in the UK. They are presented as overarching summary questions that consider modes of intervention, effectiveness and impact, and are applicable across the lifespan and to a diverse range of conditions, contexts, groups and communities (See Figure 1). In her 2021 editorial, Watson introduced us to our UK top 10 research priorities, identifying that they “provide a framework for focusing efforts to build the evidence base demonstrating the clinical and cost effectiveness and therefore impact of occupational therapy.” (Watson 2021: p3). The top 10 research priorities for occupational therapy in the UK.
How have we risen to the challenge of responding to the top 10 priorities so far?
With immediate effect, they were linked to the annual RCOT Research Foundation grant programme, with applicants demonstrating how their proposal will address one or more of the priorities to be eligible. In the 2021 round, funding was awarded to research considering the role of assistive technology in the delivery of services to people living with dementia at home (contributing to addressing research priorities 2, 3, 6 and 9); a systematic review of the impact of occupational therapy on the self-management of rheumatoid arthritis (priorities 1, 7 and 4) and another reviewing interventions improving pro-social participation of people released from prison (priorities 1, 4 and 8). These projects are scheduled to complete in spring/summer 2022, after which each will produce an impact report for publication on the RCOT website, along with submitting academic papers for publication. They illustrate the broad applicability of the research priorities. This is something that will be explored further in the series of editorials that will follow this one. But more on that later.
The research priorities have also been aligned, where appropriate, with the 2022 RCOT Annual Awards for Learning, Development and Research. RCOT’s 10 specialist sections provide professional direction and leadership for occupational therapists working in specialist areas of practice. Where they offer their own small research awards, eligibility has also been linked to the priorities. Workshops have been held to support specialist section research and development leads to consider how to develop focused research questions relevant to their areas of practice that align to the top 10, and how to ensure that people with lived experience are actively involved in the process. More broadly, and reflecting the experience of other organisations engaged in JLA Priority Setting Partnerships (Staley et al., 2020), RCOT has built on the positive experiences and good practice modelled through the project to expand public contributor involvement across the organisation, supported by co-produced policies and processes. This includes two new public contributors being appointed to the RCOT Research Foundation Advisory Group.
One year on from that first editorial (Watson 2021), the groundwork has been laid and some progress has been made to begin to address the priorities, but there is clearly much yet to do. The priorities represent the uncertainties that matter most to people accessing and delivering occupational therapy services in the UK. Building the evidence base to resolve these uncertainties will make a meaningful difference to the lives of the individuals, groups and communities that we serve. Doing so is a shared endeavour towards which all occupational therapists have something to contribute.
The opportunities: Open up
Reflecting the key messages in the RCOT Research and Development Strategy 2019-24 (RCOT 2019), the recently published Allied Health Professions’ Research and Innovation Strategy for England (Health Education England, 2022) emphasises the importance of capacity building, capability activities, sustainable support (context) and a cultural change that recognises that “research (and innovation) is everybody’s business” (pg. 5). The development of our evidence base supports the development of our profession and each of us as individuals (Watson 2021). The importance of mentoring through support, planning and targeted strategies has been noted (Doyle et al., 2019). As occupational therapists we need to support new and aspiring researchers, make our own contributions to widening the evidence base, consider the possibility of joint funding, and engage proactively in partnership working (see resource link supplementary to editorial). The number of articles published in international health, education and occupational therapy journals, alongside other relevant publications, are testament to the expanding evidence underpinning occupational therapy. However, the top 10 (and those beyond them, see https://www.jla.nihr.ac.uk/priority-setting-partnerships/occupational-therapy/top-10-priorities.htm) highlight that there are still many unanswered questions to be addressed.
The JLA/RCOT Priority Setting Partnership was ambitious in its aims and delivery. Its rigour and inclusivity have been documented and underpin the significance and value of the top 10 research priorities the project delivered. Notably, however, their identification only signals the end of the beginning: it is now time to respond to the challenge that practitioners and the people accessing our services set.
Rising to the challenge: Lift up
As outlined in the RCOT (2019) Research and Development Strategy, there are a range of incremental steps that individual occupational therapists, or groups of occupational therapists, can take to develop research-related capability and capacity, to grow in confidence in implementing existing research evidence, contribute to the generation of new knowledge, and enhance the outcomes of people accessing services. All of that builds momentum towards achieving RCOT’s vision that, within the next decade, a UK-wide culture which embraces engaging in and with research as every occupational therapist’s business will be embedded within the profession. And it will promote recognition of occupational therapy and its contribution to health and well-being.
As a profession we need to be bold and raise our aspirations, both individual and collective, and to grasp the opportunities presented by the various sources of funding that are available to achieve these aims. There are small pockets available for those focused on building their confidence and skills to engage with the existing evidence. And there are funding pots of various sizes to support those whose focus has moved towards contributing to the expansion of the evidence base, including preliminary, pilot, intermediate and advanced research.
Work is currently underway to bring together the inaugural cohort of RCOT Research Champions. Then, with their help, we will be designing and developing an RCOT Occupational Therapy Research Network. This network will help members to learn with and from each other, to access and offer mentorship, and to develop and offer research leadership skills. It will form an important part of building RCOT’s offer to members working with us to achieve our shared goals of addressing the top 10 research priorities, enhancing the experiences and outcomes of people accessing our services, and showing the world the power of occupational therapy.
Stepping up for occupational therapy: Build up
The RCOT (2019) Research and Development Strategy lays out the challenge we have in building a values-led, evidence base to underpin occupational therapy. We need to demonstrate the clinical and cost-effectiveness and impact of the services and interventions we offer. Existing and future evidence must be embedded in practice for the benefit of the individuals, groups and communities we serve. That is what this is all about. The people accessing occupational therapy services are at the centre of practice, they are at the centre of the top 10 and they are at the centre of the need to use and expand the evidence base. The pandemic has helped to highlight the value and impact of occupational therapy and has demonstrated our ability to navigate the uncertainties and complexities of health and care. As Watson (2021) highlighted “We all have a role, and a personal stake, in contributing towards addressing these priorities.” (pg. 3). So, what are you going to do to play your part in addressing the top 10 research priorities for occupational therapy in the UK? Over the next year or so you will see a series of 10 editorials providing perspectives on how each of the top 10 priorities might be translated into researchable questions addressed via a range of methodological approaches. We hope that this will inspire you to take up the challenge of responding to them. We look forward to seeing how much further we have collectively progressed in another 12 months’ time as they are used increasingly by researchers and funders to make their research as meaningful as possible to the people who access and provide occupational therapy services.
Footnotes
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
AppendixAccompanying resource pack
2. Watson J, Cowan K, Spring H, Mac Donnell J, Unstead-Joss R (2021) Identifying research priorities for occupational therapy in the UK: a James Lind Alliance Priority Setting Partnership. British Journal of Occupational Therapy, Online First https://doi.org/10.1177/03080226211026557 3. RCOT Top 10 priorities for occupational therapy research in the UK webpage 10. Constance Owens Trust PhD funding (via the RCOT R&D webpage) 15. NIHR James Lind Alliance Priority Setting Partnerships rolling call https://www.nihr.ac.uk/documents/nihr-james-lind-alliance-priority-setting-partnerships-rolling-call/28569