Health Sciences
The MoTIF Study: Mixed-Methods Evaluation of the Targeted Investment Fund for Elective Recovery
Information about the trial
The COVID-19 pandemic placed unprecedented pressure on elective care services in England, leading to long waiting times for planned treatment. In response, the NHS introduced the Targeted Investment Fund (TIF), which invested substantial capital funding into infrastructure and service improvements aimed at increasing capacity and productivity. While much of this funding supported surgical hubs, around £326 million funded 36 diverse non-surgical projects, including new day-case units, expanded theatres, diagnostic upgrades, critical care capacity, and estate improvements.
This study is the first national evaluation of these non-surgical TIF projects. It will examine how these initiatives were implemented, their impact on healthcare services, and their implications for staff, patients, and carers.
How the study will be run
The evaluation will use a mixed-methods design structured around the Consolidated Framework for Implementation Research (CFIR). It consists of four work packages:
- WP1: Qualitative interviews with national, regional, and NHS Trust stakeholders to understand how TIF projects were implemented and identify barriers and facilitators.
- WP2: Quantitative analysis using national Hospital Episode Statistics data to assess impacts on activity, waiting times, length of stay, and care quality, including inequalities.
- WP3: In-depth case studies (up to six sites) exploring staff, patient, and carer experiences through interviews, observations, and documentary analysis.
- WP4: Cost-consequence analysis to assess value for money by comparing costs with outcomes
Findings from these components will be integrated to provide a comprehensive understanding of what works, for whom, and in which contexts.
Who is being invited to participate
Participants will include:
- National, regional, and NHS Trust staff involved in TIF implementation
- Clinical and operational staff at case-study sites
- Patients and carers with experience of services supported by TIF funding
Location
The study covers NHS organisations across England, including national bodies, regional NHS teams, and up to six detailed case-study sites.
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Funding
| Funders(s) | NIHR Policy Research Programme (Targeted Investment Fund Evaluation) |
|---|---|
| Start Date | January 2026 |
| End Date | March 2028 |
Members
YTU Team
External Team
- Peter Sivey (Centre for Health Economics, University of York)
- Matt Sutton (University of Manchester)
- Yiu-Shing Lau (University of Manchester)
PPIE
Public Involvement and Engagement (PPIE): Patients and carers will be actively involved throughout the study. A flexible involvement model will be used, drawing on experience from the MEASURE study. Contributors will support study design, recruitment, interpretation of findings, and dissemination activities to ensure the research reflects patient priorities and experiences
Other information
- Close collaboration with NHS England and the Department of Health and Social Care
- Findings will be shared via reports, policy briefings, academic publications, and stakeholder engagement