Making Inclusion a Reality: Lessons from developing a System-Level Research Strategy
There is general agreement that health research should be inclusive but who is actually making it happen, and how? Members of the Inclusive Research Methods team share insights from building a co-produced Inclusive Research Strategy across the National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC): Manchester and NIHR Clinical Research Facility (CRF): Manchester. They set out practical lessons for turning inclusion from a good intention into everyday practice.
Health research has long recognised the importance of inclusion, yet delivering genuinely inclusive research in practice remains a challenge. Despite strong policy direction, many studies continue to under-represent key populations, limiting the relevance and impact of findings. The question is no longer why inclusive research matters, but how it can be embedded across the research ecosystem.
Together, the NIHR BRC: Manchester and NIHR CRF: Manchester have responded to this challenge by creating a co-produced, system-level Inclusive Research Strategy designed to move inclusion from an aspiration to operational reality.
Rather than treating inclusion as an add-on, the strategy integrates it across the research lifecycle. It is structured around five core principles: mapping inequalities, building capacity, developing community partnerships, strengthening delivery routes, and embedding inclusive methods. These principles reflect a shift from isolated initiatives to a coordinated, strategic approach.
A defining feature of the strategy is its co-production. The NIHR BRC: Manchester and NIHR CRF: Manchester developed the strategy by holding workshops, one-to-one consultations, and engagement activities with a wide range of stakeholders, including public contributors, researchers and practitioners. This was not simply about consultation, but about shaping priorities and practices collaboratively. The process was underpinned by systematic thematic analysis of ideas raised, ensuring that the strategy was grounded in both evidence and lived experience.
Equally important is the governance model. The NIHR BRC: Manchester and NIHR CRF: Manchester established the Inclusive Research Oversight Board (IROB), which brings together leaders in equality, diversity and inclusion (EDI), patient and public involvement, engagement, and participation (PPIEP), and inclusive research methods, to provide a mechanism for accountability, coordination, and ongoing learning. IROB aims to address inclusivity and health equity in the research that the NIHR BRC: Manchester and NIHR CRF: Manchester prioritises, designs, undertakes and disseminates. In large, multi-partner research environments, structures such as IROB are essential to ensure that inclusion is consistently implemented rather than unevenly applied.
For system leaders and policy makers, this work highlights that inclusive research is achievable at scale, but only with the right conditions in place. Alignment across existing frameworks (such as EDI, and PPIEP) helps avoid duplication and confusion. Investment in capacity and capability is also critical, as inclusive approaches require time, skills, and sustained effort.
At the same time, our work underscores the challenges. Evidence of long-term impact is still emerging, and implementation depends on resources, leadership buy-in, and organisational culture. Measuring inclusivity in meaningful ways remains difficult, particularly in complex systems where outcomes are influenced by multiple factors.
Key recommendations
Reflecting on the learnings from implementing this model across the NIHR BRC: Manchester and NIHR CRF: Manchester, we propose the following priorities to embed inclusive research:
- Make inclusive research a core strategic requirement – Embed inclusion within research governance, funding criteria, and organisational strategy, rather than treating it as an additional consideration.
- Invest in infrastructure and workforce capability – Support training, dedicated roles, and resources to enable researchers and practitioners to deliver inclusive approaches in practice.
- Strengthen governance and accountability mechanisms – Establish oversight structures, such as dedicated boards or committees, to monitor progress, ensure consistency, and drive continuous improvement.
- Enable meaningful community partnerships – Move beyond consultation to co-production, investing in sustained relationships with communities to enhance relevance, trust, and impact.
- Develop robust approaches to evaluation and learning – Prioritise the development of metrics and methods to assess inclusivity, and support iterative learning across organisations and systems.
These actions recognise that inclusion is not a single intervention, but a system-level shift requiring coordination, leadership, and long-term commitment.
Moving forward
Our work suggests that a structured, co-produced strategy can provide a practical and transferable model. As health systems increasingly prioritise reducing inequalities, inclusive research offers a vital pathway to ensuring that evidence reflects and benefits the populations it is intended to serve.
For further information see our article in PLOS ONE.
Anna Coleman, Sheela Medahunsi, Joanne Elliott, Jedidah Mould, Abin Thomas, Eliza Varga and Arpana Verma are part of the Inclusive Research Methods Team and part of the Inclusive Research Oversight Board, which supports the promotion of inclusivity in healthcare research across the NIHR BRC: Manchester and NIHR CRF: Manchester and the Health Determinants Research Collaborative (HDRC). They are based in the Public Health and Community Medicine Group, Division of Medical Education, School of Medical Sciences in the Faculty of Biology, Medicine and Health at The University of Manchester.
Banner image shows the Inclusive Research Methods Team at the International Festival of Public Health in July 2026.