Scaling Up Improvement
Frequently Asked Questions
Lead organisation and eligibility
Q 1. How many organisations need to / can be involved in the project?
There are no restrictions in the number of organisations comprising the project team. The
partnership should be set up in a way that supports the most appropriate and efficient
delivery of your project. You may want to consider which organisations are core to your
delivery, such as evaluation partner, spread partner, patient representation partner etc. and
ensure you have their commitment at the time of the application.
Depending on how you intend to select your adopter / local sites, you may or may not have
their commitment of active participation and thus they may or may not be included as
partners at the application stage. If that is the case, please include an explanation in the
appropriate part of your application as to how you intend to select and engage your local
sites.
Q 2. Is the lead organisation based in the Jersey Island eligible to apply?
No, the Scaling Up Improvement programme is open only to applicants from the UK. The UK
is defined as England, Scotland, Wales and Northern Ireland. It excludes the Isle of Man,
Channel Islands, and Gibraltar.
Q 3. We are a large secondary care provider and it will be impossible to know of all
groups that might be applying for this call. Can we apply with more than one
application?
Yes – more than one team in an organisation can apply. We would recommend that lead
organisations are only involved in one application or in a small number of very different
applications. We will only accept one application per named project lead.
We may choose to fund more than one project from the same organisation, providing they are
very distinct from each other and are not reliant on each other, i.e. if one project is funded it
needs to be able to go ahead completely independently of the other. We would also need to be
reassured that if the same team members were involved in more than one successful
application they could contribute effectively to both projects.
Q 4. We are a Ltd company. Can we apply as a lead organisation?
Yes, if you are a not for profit organisation (i.e. company limited by guarantee), a social
enterprise, a company limited by shares or a community interest organisation. You will also
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need to demonstrate that you are commissioned, or in an authorised position to provide the
NHS services free at the point of delivery in primary, secondary or tertiary care and through
appropriate channels across the UK (e.g. registered with the Care Quality Commission in
England). You will need to demonstrate that more than 50% of your work is with NHS funded
patients.
If the constitution allows the lead organisation to make a profit, the Health Foundation would
have to be convinced that it is not supporting private profit making companies delivering only
a small benefit to the NHS. Where a ‘not for profit’ organisation has another arm that is profit
making, the Health Foundation would need to be convinced that our funding is going to the
non-profit making arm.
Q 5. Can a Local Authority Public Health team be the lead organisation for a
partnership bid that includes GP Networks, the CCG, and third sector partners, or
does the lead applicant need to be an NHS organisation?
We ask that a lead organisation either provides, commissions, supports or delivers direct health
care services free at the point of delivery. For example, if a Public Health team, funded by
Department of Health funding, was delivering health services then they would be eligible to
apply as lead organisation.
If the partnership includes a GP network or federation or CCG you should consider who is best
placed to lead the application, and we would suggest that the lead role sits with the
organisation that will have most influence over the intervention or is where that intervention is
taking place. Please note that if the GP network or federation was to be the lead organisation it
would need to be legally constituted and able to receive funds.
Q 6. We are a hospice, with 50% of our funding from the NHS and the remaining
funding through fundraising as a charity. Are we eligible to be a lead organisation?
As the majority of your services are delivered to NHS service users and are free at the point
delivery and your services regulated by the CQC, we would consider you eligible to apply as
a lead organisation.
Q 7. We are a GP federation but not established in a way that can directly employ or
manage funding. Instead, it is the lead practice that employs and holds the funds for
the federation. Can we apply as a lead organisation?
GP federations can be the lead organisation, as long as they can be a recipient of funding,
so there is an element of infrastructure and legal constitution required in that.
If you are a GP federation, network or cluster and don’t have that status, we would advise
that one of the GP practices under your federation be the lead organisation and the GP
federation to be an equal partner in the project.
Q 8. Would an organisation that conducts research in health service be eligible to
lead an application?
This sort of organisation would be eligible as a partner on an application and most likely as
an evaluation partner. We are looking to fund improvement in NHS organisations or those
organisations that are delivering NHS services. An application which is about research
rather than implementing an intervention would not be eligible.
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Someone working as a health services researcher may apply as part of a team if the
proposed project fits the criteria and is focused on improvement in the service rather than a
research study.
Q 9. Can I apply with a similar application if I was unsuccessful in the previous
rounds of the Scaling Up Improvement programme?
Yes you can, however we would expect you to have made significant improvements to your
application and addressed all the issues that may have been communicated to you (if you
reached the full stage in the first round).
If you choose to submit the exact same application as in the previous rounds it is quite likely
that your application is not going to be successful.
Clinical input
Q 10. What level of clinical involvement / expertise are you looking for in the Scaling
Up projects?
We would expect a relatively high level of clinical leadership, enough to be able to
implement your project in a clinical and operational setting. Quite often we find that projects
without strong clinical leadership really do find that they hit a bit of an obstacle without that
because you need clinical buy-in. We expect the awarded projects to have a clinical lead
who has dedicated time allocated to the project. The clinical lead should be operationally
supported by a full time project manager for the duration of the project.
Evidence base
Q 11. How do you define “robust evidence”?
What we mean by this is evidence that is reliable and can be substantiated, explained and
justified. You should be able to say where and how your proposed approach was tested and
what evidence substantiates your claim.
The evidence base for the interventions could be from a local, national or international
setting, and from research or practice. It could be from small scale improvement projects or
obtained through appropriate research evidence. It could also be from a small scale
intervention in the applicant’s own organisation that has been shown to work, has resulted in
improvements, and is now ready to be implemented at scale. Ideally, we would expect to
see that earlier work has been published or presented beyond the local setting.
Project plan / timelines
Q 12. We may need more time to put things in place to start the set up phase in
November 2017. Is that problematic and are we able to start in January 2018?
We do expect projects to stick to the programme timeline in the main and would not be able
to offer a 2- month extension for project to start. In order to benefit from being part of the
programme through either the support package or collaborative ways of working across the
cohort, you would be required to follow the same timeline over a 30- month period as other
teams.
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Set up phase (6 months) is designed to allow the teams to put building blocks in place, such
as recruitment, local sites engagement, research approvals, data governance etc. so they
are ready to start the implementation in May 18.
Funding
Q 13. Is matched funding a requirement for applicants?
Matched funding is not a requirement for the programme, and you can be looking towards
the Health Foundation to fund the entirety of a project if it fits within the £500k budget.
If you intend to include matched funding in your application you will note in the budget
section of our application form we do ask whether or not any other sources of funding have
been secured. Although, you may submit your application if matched funding is not yet
secured but give as much information as possible.
Irrespective of whether or not additional partnership funding is being sought, the Health
Foundation wants to be able to see the impact of the funding that we are offering so we
would ask you to be mindful of that when making your application.
Q 14. The guidance says that partner organisations can be commercial, however only
15% of the funds can be paid to a commercial partner. Why is this?
As a charity we must ensure the public benefit of our funding. As part of that we do not want
to support commercial companies.
Q 15. What happens if costs change over the two and a half year funded period or if
unanticipated costs arise?
The Health Foundation and the successful project teams can discuss this situation if it
arises. In our experience of supporting projects running for a number of years, the budgetary
parameters can change and the Health Foundation will work with the successful teams to
manage this. However, we are unlikely to approve additional funds. We may explore with the
applicant whether funds can be moved from one budget line to another or if funds can be
moved from one year to another to provide the team with time to secure some additional
funding from other sources.
Evaluation
Q 16. What type of evaluation is required for the Scaling Up Improvement?
Evaluation of the Scaling Up projects is expected to be tailored to the nature of an
intervention and the context in which it is being implemented. We do not prescribe the
methodology to be used but when designing the evaluation it may be helpful for applicants to
consider the balance between:
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evaluation designed to evidence impact at scale (likely to be quantitative)
formative evaluation to help teams improve as the project progresses
process evaluation to understand what changes were introduced and why and
qualitative evaluation designed to understand the experience of the change.
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The evaluation should focus on establishing the effectiveness of the intervention at a larger
scale and/or in different contexts and explaining how, and why, this impact was (or was not
achieved). It should consider whether the intervention is likely to be transferable to different
contexts in the health care service, what constitutes the essential ‘ingredients’ of the
intervention and which elements may need to be adapted to different contexts. If
interventions which were proven successful at a small scale appear not to be scalable, the
evaluation will need to demonstrate why this was the case.
Q 17. Why do you require an Evaluability Assessment?
Evaluability Assessment (EA) is an assessment of “the extent to which an intervention can
be evaluated in a reliable and credible fashion”1 and it supports the implementation and
evaluation teams to lay solid foundations for their evaluation activity.
The Health Foundation requires applicants to have already undertaken some elements of
EA in working up their application. This involves demonstrating evidence of a clear rationale,
logic, or theory underpinning applicants’ proposed interventions, and how the proposed
interventions will bring about their intended aims and objectives, with relevant evaluation
questions having been clearly articulated.
Results of an EA should have consequences for the design of the evaluation, the design of
the measurement framework, or even the design of the project itself. The EA approach also
demonstrates that the proposed evaluation methods will be able to accommodate any
adjustments to the intervention, should they occur.
The MRC guidance2 provides a helpful set of questions, which evaluators and implementers
can ask themselves at various stages of development.
For other advice on evaluation, please refer to the Health Foundation’s Evaluation guide.
Q 18. What do you mean by “carry out an independent evaluation”? Could the
evaluation partner come from the same organisation or legal entity?
The evaluation partner can come from the same organisation or legal entity. There must,
however, be clear strategies in place to mitigate any real or perceived risk of bias in the
production of evaluation findings. Evaluation partners must take a more critical and
objective perspective and be able to provide independent challenge and reflection. Mitigation
strategies we would expect to see include: evaluation partners being from a different group
or part of the organisation with different lines of accountability; having external and
authoritative members on the evaluation advisory group; attention to how evaluation
methods will be used to minimise the risk of bias.
Q 19. We have an evaluation partner in mind but have not approached them. Are we
still eligible to apply?
The evaluation team will need to be in place at the application stage, and a named
evaluation lead from the partner organisation should be provided in the application form.
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2
OECD-DAC 2010; p.21
http://www.mrc.ac.uk/documents/pdf/complex-interventions-guidance/
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Change of evaluation partner at later stage is not permitted without the Health Foundation’s
consent.
Q 20. Would you allow additional time for the evaluation team to analyse data and
write up an evaluation? Or is that also expected within 30 month funding period?
We would expect you to have done all your implementation within the 30-month period.
However, what we typically do at the end of the 30-month period is give evaluation teams
additional 3-4 months to finalise their evaluations. Once we receive a draft copy of the
report, we would review and feedback to the evaluation team and would then expect to
receive a final copy of the evaluation report.
Getting more information and next steps
Q 21. We want to apply. What do we do now?
We recommend that you carefully read the Call for Applications and all supporting
documentation to ensure that you have all of the information you need to complete your
application.
We recommend that you start the online application process at least a week before the
closing date as you need to include signatures from partners and / or senior project
sponsors before you can submit your application.
Please visit www.health.org.uk/scalingup to access the screening tool and start your online
application. Paper application forms will not be accepted.
Please note that the AIMS will be closed for maintenance on Monday 8 and Tuesday 9 May
2017 during which time you will not be able to access your application.
The deadline for applications is 12 noon on Wednesday 17 May 2017.
If you have further questions, please email [email protected] in the first instance.
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