Implementation of care within economic evaluation: a case study based on the SilverCloud Target Trials (Ref: ARC26/HW/CE/POTHOFF)

About the project

About the Project NHS Talking Therapies services face continuing pressure to improve access to effective mental health care. Internet-delivered cognitive behavioural therapy (iCBT) for depression and/or anxiety offers a potentially scalable response. Research has demonstrated clinical benefits and potential cost-effectiveness within NHS services (Richards et al., 2020), but questions remain about its comparative effectiveness and value for money across routine settings and against other CBT delivery formats. How interventions become embedded in practice can influence outcomes and resource use. Economic evaluations may underestimate the resources needed to implement and sustain interventions, including staff training, supervision, digital infrastructure and local adaptation. Better integration of implementation research and economic evaluation is needed to inform decisions about effective and sustainable care (O’Leary et al., 2022). This PhD studentship will be embedded within the NIHR-funded SilverCloud Target Trials project https://target-trials-mental-health.sites.sheffield.ac.uk/silvercloud-target-trials , led by the University of Sheffield, with Northumbria University leading the implementation evaluation. The project applies “target trial emulation” methods to routine NHS data to estimate the real-world effectiveness and cost-effectiveness of digital, individual and group CBT across NHS Talking Therapies services in England. This provides a platform for the PhD to explore how implementation quality and context shape clinical and economic outcomes. The PhD project aims to: 1. Examine how implementation processes and costs influence the effectiveness and cost-effectiveness of digital mental health interventions, with a focus on iCBT. 2. Develop and test methodological approaches for integrating implementation science concepts and data within health economic evaluations. 3. Generate practical guidance for researchers and policymakers on incorporating implementation into economic evaluation frameworks for complex care interventions. A mixed-methods, multi-stage approach will include: • A systematic review of methods used to integrate implementation research and economic evaluation. • Case study analysis using qualitative and quantitative data from the SilverCloud Target Trials project to examine how implementation factors, such as acceptability, adoption and context, relate to clinical outcomes and cost-effectiveness. • Framework development to produce practical guidance and tools for integrating implementation assessment into economic evaluations of digital mental health interventions. Supervision will be provided by Dr Sebastian Potthoff and Professor Tim Rapley at Northumbria University, Dr Bethany Nichol at Newcastle University and Dr Matthew Franklin at the University of Sheffield, bringing together expertise in implementation science, psychology and health economics. You will be based in the School of Communities and Education at Northumbria University and join the Innovation and Implementation Research Group (IIR), a friendly, multidisciplinary community focused on implementation and knowledge mobilisation in health and social care. Through IIR, the NIHR Applied Research Collaboration North East and North Cumbria, and the SilverCloud Target Trials project, you will have opportunities to engage with researchers and health and care partners. Connections with other PhD students will provide opportunities for peer support, shared learning and collaboration. Academic Enquiries This project is supervised by Dr Sebastian Potthoff, Prof Tim Rapley, Dr Matthew Franklin and Dr Bethany Nichol. For informal queries, please contact sebastian.potthoff@northumbria.ac.uk . For all other enquiries relating to eligibility or application process please use the email form below to contact Admissions. Eligibility Requirements: Academic excellence i.e. 2:1 (or equivalent GPA from non-UK universities with preference for 1st class honours); or a Masters (preference for Merit or above); or APEL evidence of substantial practitioner achievement. Appropriate IELTS score, if required. Applicants cannot apply if they are already a PhD holder or if currently engaged in Doctoral study at Northumbria or elsewhere. To be classed as a Home student, candidates must: Be a UK National (meeting residency requirements), or have settled status, or have pre-settled status (meeting residency requirements), or have indefinite leave to remain or enter. If a candidate does not meet the criteria above, they would be classed as an International student and would not be eligible. Applicants will need to be in the UK and fully enrolled before stipend payments can commence. For further details on how to apply see https://www.northumbria.ac.uk/research/postgraduate-research-degrees/how-to-apply/ In your application, please include a research proposal of approximately 1,000 words and the advert reference (e.g. RDFC26/…). Deadline for applications: Monday 19 October 2026, 23:59 UK time Start date of course: January 2027 Northumbria University is committed to creating an inclusive culture where we take pride in, and value, the diversity of our postgraduate research students. We encourage and welcome applications from all members of the community.The University holds a bronze Athena Swan award in recognition of our commitment to advancing gender equality, we are a Disability Confident Leader, a member of the Race Equality Charter and are participating in the Stonewall Diversity Champion Programme. We also hold the HR Excellence in Research award for implementing the concordat supporting the career Development of Researchers and are members of the Euraxess initiative to deliver information and support to professional researchers.

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