The PHIRST scheme (Public Health Intervention Responsive Studies Teams) is funded by the National Institute for Health and Care Research (NIHR).
The NIHR is the health and social care research arm of the nation. It drives life-changing research for the health and wealth of our society.
NIHR introduced the PHIRST scheme in 2020 to enable local government to access timely and robust evaluations of the public health initiatives they manage. The scheme is made up of academic teams based at Universities across the UK comprising researchers that are experts in evaluative methods and public health.
The scheme accepts applications from across the UK: England, Wales, Scotland and Northern Ireland. It applies a broad definition of public health and welcomes proposals from any relevant topic. PHIRST research findings provide evidence to guide interventions aimed at improving population health and reducing health inequalities, inform public health policies, and shape healthcare practices.
PHIRST connect based at the University of Hertfordshire works in partnership with colleagues at the University of East Angla and Queen Belfast University. Initially funded in 2020, PHIRST Connect has now begun its second round of funding which started in 2025. This funding consists of £2.5m to deliver up to 10 evaluations across 5 years.
During the first period of funding, the team completed 9 different evaluations, looking at public health interventions ranging from drug and alcohol services, exercise referral schemes, NHS health checks, and Whole System Approaches (WSA) to Obesity.
Public and Patient involvement and Engagement (PPIE)
Co-production sits at the heart of PHIRST Connect. As part of our team, we have the PHIRST Public involvement in research group (PIRg). The PHIRST PIRg is led by co-investigator Amander Wellings, who has a wealth of experience in patient and public involvement in research. The PIRg is chaired by Julia Jones who leads the Public Involvement and Engagement in Health and Care research theme in CRIPACC. The PIRg is an integral part of our team and research process and comprises of 5 members who provide oversight across all PHIRST projects through monthly meetings, document review and working directly with project leads.
In addition to the PIRg, where possible we involve members of the local community to consult on research processes and findings.
How are the PIRg involved?
The PIRg team are involvement includes attendance of advisory board meetings and consultation on research findings, to ensure the research is relevant to and useful for local populations.
Some PIRg members have been involved in analysis, including framework analysis and Realist analysis. In addition to this, individuals have reviews academic outputs and are co-authors on several research articles. PIRg members have also been involved and co-presented at conference presentations, including a Creative methods conference.
Evaluations (2020-2025)
Evaluation of the move to remote models of service delivery by drug and alcohol services in Leeds during the COVID-19 pandemic.
This was a mixed-methods evaluation that examined how changes in service delivery as a result of the COVID-19 pandemic affected drug and alcohol support services in Leeds as they shifted from face-to-face to remote modes of delivery. The evaluation found that, while remote delivery improved accessibility for some users, it also presented challenges such as digital exclusion and difficulties building rapport and ultimately recommended a hybrid model combining both remote and in-person support to optimise service delivery.
Adaptation of the Welsh National Exercise Referral Scheme (NERS) to virtual delivery: Evaluation of impact and opportunities.
Working in partnership with Public Health Wales and the Welsh Local Government Association, this was a mixed-methods evaluation looking at the transition of the national exercise referral scheme in Wales from face-to-face exercise sessions to remote delivery during the COVID-19 pandemic. The evaluation combined routinely collected quantitative programme data, with qualitative data from service users and providers. It aimed to determine: whether remote delivery influenced uptake and completion of the 16-week exercise referral intervention; identify factors that facilitated or impeded engagement across different groups; examine differences in health and wellbeing results and delivery costs between virtual and in-person modes; and explore implications for a future blended delivery model and public health practice more broadly.
The evaluation found that virtual delivery of NERS improved accessibility and reach for some participants, particularly those facing mobility, caring or transport barriers, but also introduced challenges around digital exclusion, reduced social interaction, and safety monitoring, indicating that a blended model combining virtual and face-to-face provision was likely to offer the greatest benefit.
Whole Systems Approach to Diet and Healthy Weight – Community Pilots Project, Scotland
This Evaluation look at how two local authority areas in the East of Scotland implemented a whole systems approach (WSA) to address complex drivers of unhealthy diet and weight by engaging councils, partners and communities to map systems, coordinate action and embed collaborative working over time. Using longitudinal mixed methods including interviews, focus groups, surveys and process data, the evaluation explored enablers (such as belief in the approach, positive relationships, funding, communication and governance) and barriers (including limited funds, high staff turnover, variable stakeholder engagement and challenges sustaining new ways of working). The evaluation found that while WSAs strengthened multi-agency collaboration, improved local understanding of system influences and helped align priorities around healthy weight, progress was uneven, stakeholder involvement varied and longer-term commitment and resources are needed to fully realise system-wide changes that improve diet and weight outcomes.
An evaluation of workplace health and wellbeing support in Walsall small and medium sized enterprises (SMEs)
This mixed-methods evaluation explored how SMEs in Walsall engaged with available workplace health and wellbeing services, what helped or hindered that engagement, and how employees experienced and perceived employer-provided support. The research combined stakeholder focus groups, a survey of over 100 SMEs, and interviews with employers and staff to understand both organisational and employee perspectives on awareness, uptake and provision of wellbeing support. The findings showed that although a range of support was available, including NHS health checks, wellbeing workshops, advice on employee needs, and policy development assistance, many SMEs had low awareness of these offers and engagement was limited. Barriers including limited communication, resources, time and prioritisation, while facilitators to greater uptake included raising awareness of low-cost/free support, clearer communication of benefits and tailored guidance for specific sectors. The evaluation highlights the need for promotion, support structures and targeted strategies to improve SME engagement and better meet workforce health and wellbeing needs.
Southampton Covid Participatory Action Research and Champions initiative Evaluation (CoPACT)
This realist mixed methods examined how Southampton City Council’s COVID-19 Champions and Vaccine Champions programmes, alongside a community participatory action research (PAR) initiative, operated during the pandemic to increase awareness of COVID-19 safety and vaccination among diverse, high- risk communities. The study explored how these community led and volunteer driven models were set up, implemented and experienced by stakeholders, including peer researchers, volunteers, public health leads and residents, to identify the mechanisms and contexts that led to positive outcomes or barriers to engagement. The evaluation found that community champions and peer researchers could successfully broaden the reach of public health messaging and foster trust in underserved groups, increasing engagement with COVID-19 guidance and vaccination, but that effectiveness varied depending on how well programmes were supported, coordinated and resourced. Findings also highlighted the importance of local relationships, clear communication, training, and integration with formal public health efforts to maximise impact in future community centred interventions.
Green Health Prescription Evaluation (GRAPPEL) for Dundee, Highland, and North Ayrshire
Green health prescription pathways were evaluated operating across three areas in Scotland; Dundee, Highland and North Ayrshire. The study explored how structured referrals for nature-based activities worked in practice, who benefited and how they were delivered. The study used interviews with referrers, link workers, providers and service users and applied the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Spillover effects, Equity) framework during analysis. The evaluation found that stakeholders generally viewed green health prescriptions as acceptable and potentially beneficial, with reported improvements in physical health, mental wellbeing, social connection and physical activity for those who engaged. Additionally, activities were affordable at the point of access; however, barriers included limited awareness of the programmes among referrers and the public, challenges with referral processes and IT systems, and transport and accessibility issues for some groups. A lack of routine data capture to monitor progress and equity, highlighted the need for stronger infrastructure and systems to support ongoing delivery and evaluation.
Green Health Prescription Evaluation (GRAPPEL) for Dundee, Highland, and North Ayrshire - NIHR Public Health Interventions Responsive Studies Teams (PHIRST)
Lambeth Prevention and Promotion for Better Mental Health and Wellbeing
This Realist evaluation explored the three community-based projects delivered as part of Lambeth borough Council’s Better Mental health programme. The projects evaluated included the Outreach Worker, the Black Men’s Consortium and the Loneliness project. Through interviews with service providers and service users, the study explored what worked for whom and in what contexts. Findings highlighted 5 key demi-regularities or themes that outlines key features important when thinking about creating and implementing community-based programmes to support the prevention of mental health.
Evaluation of Live Life Better Derbyshire Health Checks with Online booking and text reminders for Wellbeing (ELBOW)
This mixed-methods study evaluated a set of modifications to the National Health Service Health Check (NHSHC) programme implemented by Derbyshire County Council to improve uptake and experience of cardiovascular risk checks for people aged 40–74. The changes tested in ten pilot GP practices included text message invitations and reminders, an online booking option, delivery of checks by dedicated wellbeing and lifestyle experts through Live Life Better Derbyshire (LLBD) with longer appointments and broader wellbeing discussions, and use of community venues alongside GP surgeries, with the evaluation combining quantitative analysis of attendance and outcomes data, interviews and focus groups with staff and clients, and a cost–resource review. The findings indicated that text message reminders and online booking were associated with increased attendance, that online booking was popular and reduced administrative burden and costs compared with phone booking, that participants valued the longer, in-depth checks and receiving immediate test results, and that having checks delivered in community settings was welcomed, while the enhanced delivery model generated positive experiences and useful follow-up support although it was more resource-intensive than standard GP delivery, offering insights to inform more accessible and effective health check practices.
Getting RREAL about implementation of a Whole Systems Approach (WSA) to obesity prevention in Northern Ireland (NI): A process evaluation
This project was a longitudinal process evaluation that examined the implementation of a Whole Systems Approach (WSA) to obesity prevention in Northern Ireland, focusing on three early adopter sites (councils). Using RREAL methodology, data collection was conducted at three time points to explore how Public Health England’s WSA guidance was implemented over time, including the barriers and facilitators to implementation, engagement with system stakeholders and joint-working spillover effects.. Findings from the evaluation indicate that using a WSA has the potential to deepen local understanding of obesity’s complex causes and build new cross-sector collaborations, while early adopter sites face common challenges such as navigating guidance for the first time, engaging diverse stakeholders, and balancing fidelity with local adaptation, suggesting that additional preparation and support, clear frameworks for implementation and communication, and attention to context are important for successfully embedding a WSA to reduce obesity in Northern Ireland.
