Decentering health research networks: Framing collaboration in the context of narrative incompatibility and regional geo-politics

DOI10.1177/0952076720911686
AuthorBridget Roe,Amanda Crompton,Justin Waring,Charlotte Overton
Published date01 January 2022
Date01 January 2022
Subject MatterSpecial Issue Articles
2022, Vol. 37(1) 105 –125
Special Issue: Decentred State
Decentering health
research networks:
Framing collaboration in
the context of narrative
incompatibility and
regional geo-politics
Justin Waring
Health Services Management Centre, University of
Birmingham, Birmingham, UK
Amanda Crompton,
Charlotte Overton and Bridget Roe
Nottingham University Business School, University of
Nottingham, Nottingham, UK
Abstract
Research innovations and breakthroughs are increasingly realised through collaborative
networks amongst state and non-state actors. This article investigates the utilisation of
such networks in the field of applied health services research, where policy narratives
repeatedly emphasise the importance of collaboration between university researchers,
clinical and health service leaders, patient representatives and industry. The translation
of policy into practice suggests that these networks are not always designed and man-
aged in line with policy aspirations. Taking a decentred approach, the study reported in
this article examines how local policy actors translate national policies for collabora tive
health research networks in the context of their own histories of applied research,
including local narratives and priorities for health research. The study shows that
local actors face key dilemmas and opportunities for situated agency, as they experience
three competing policy narratives, first, for carrying out world-class research; second,
for ensuring research meets local needs and third, for developing new understanding
Corresponding author:
Justin Waring, University of Birmingham, Park House, 40 Edgbaston Park Road, Birmingham B15 2TT, UK.
Email: j.waring@bham.ac.uk
Public Policy and Administration
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about the implementation of research into practice. Although these expectations might
appear coherent to policy-makers, at the regional level, they provide the basis for dis-
agreement and negotiation amongst local policy actors through which the local narrative
of collaborative research is framed to regional stakeholders. The study shows how the
tensions between elite and local narratives can be reconciled through re-framing activ-
ities, especially the articulation of ‘parallel frames’ within a ‘cascade framing’ process.
Keywords
Health research, narratives, networks, policy implementation
Introduction
Research policies increasingly see technological innovations and research break-
throughs as realised through the formation of collaborative networks between
state and non-state actors; commonly described as a ‘triple-helix’ between industry,
universities and government (Bozeman, 2000; Etzkowitz and Leydesdorff, 2000;
Gibbons, 1994; Powell et al., 1996). Such collaborations are exemplif‌ied in bio-
medical, clinical and health services research where government funders, university
academics, bio-tech industries and service providers work together to develop, trial
and implement evidence-based therapies and interventions. A major factor in the
promotion of collaborative research networks is the recognition that evidence-
based interventions do not easily ‘translate’ into frontline care, with reports
describing time-lags of up to 15 years (Grimshaw et al., 2012). In some cases,
delays ensure the safety of new therapies, but where they become too long and
systemic, there is potential for wasted investment and prolonged delivery of sub-
optimal care. Such time-lags have been interpreted as ‘translation gaps’ between
the discovery of basic science and its application (T1) in product testing, and then
between proven interventions being implemented (T2) into routine practice
(Cooksey, 2006). The networked model of health research aims to close these
gaps by building closer links between knowledge producers and service users in
the co-production of evidence-based interventions.
In the UK, a variety of networked research infrastructure has been established
to close the translation gaps in health research, such as Biomedical Research
Centres (BRCs) and Academic Health Science Networks (AHSNs). In this article,
we examine the introduction of Collaborations for Leadership in Applied Health
Research and Care (CLAHRCs) as regional multi-agency research networks. In
2008, nine ‘pilot’ CLAHRCs were introduced across England to bring together
university researchers, NHS leaders and other public stakeholders to undertake
‘applied health research’ (T2), i.e. research that can directly impact on the way
services are organised and delivered. A ‘second wave’ of 13 CLAHRCs was intro-
duced in 2014, which provide the focus for our study. These initiatives received in
excess of £200 m public research funding, with ‘match funding’ from NHS,
2Public Policy and Administration 0(0)

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