Resources should be allocated based on quality
Alf is the abbreviation of an agreement between national government and seven regions. The agreement regulates, among other things, the amount of government funds the regions receive for participating in the education and training of doctors, implementing clinical research and developing health and medical care. The funds are disbursed by the Ministry of Education and Research.
The agreement comprises seven regions
Each region covered by the ALF agreement is linked to a university. Together, they assume joint responsibility for clinical research and form an ALF region.
Regions and universities in the ALF regions
Karolinska Institutet, KI
Region Västra Götaland
University of Gothenburg
Örebro (from 2015)
Region Örebro County
The ALF regions are presented on the basis of the proportion of ALF funds they are awarded – the region that receives the most funds is listed first.
The latest ALF agreement came into effect in 2015. In the agreement, national government and regions agreed that as from 2019, 20 per cent of the ALF remuneration for clinical research will be allocated based on the quality of clinical research.
The main purpose is to identify, highlight and reward good examples. In this way, regions that are able to distinguish themselves through their quality work can serve as role models. The long-term goal is to lift all of Sweden’s clinical research.
The Swedish Research Council is responsible for evaluating the quality of clinical research conducted in the seven regions covered by the ALF agreement. The national ALF steering committee has determined the starting points applicable in the evaluations.
The list presents the proposals that form the basis for the evaluations.
Summary of proposals
Utvärderingsmodellen (pdf, 99.6 kB)
Resursfördelningsmodellen (pdf, 61.7 kB)
Datafångst bibliometri (pdf, 400.9 kB)
Exempel utvärderingsunderlag (pdf, 219.6 kB)
Exempel självvärdering (pdf, 523.6 kB)
Kliniska studier ALF utvärdering (pdf, 224.6 kB)
Utdrag ur protokoll 30 augusti 2016 (pdf, 318.6 kB)
(pdf, 324.8 kB)
The steering group has also decided on guidelines for the design and implementation of evaluations of medical care in university hospitals. The National Board of Health and Welfare is responsible for these evaluations.
Definition av universitetssjukvård (pdf, 517.9 kB)
Three areas are evaluated
An initial evaluation was made in 2017. Three external international expert panels assessed, independently of each other, the quality of the following principal areas:
- The quality of scientific output
- Clinical significance and societal impact of the clinical research
- The prerequisites for clinical research
The Swedish Research Council presented the results of the evaluation in March 2018.
Dialogue meetings with representatives of the ALF regions
Dialogue meetings have been held in which the ALF regions have been given the opportunity to comment on the evaluation work. The viewpoints put forward by the participants mainly concerned the scope and scheduling of the evaluations.
Following the meeting, the Swedish Research Council implemented measures to reduce the workload for the regions and faculties without affecting the schedules, intention or quality of the evaluations.
Download the entire document with information and measures here (pdf, 429.1 kB)
In May 2018, we held a new dialogue meeting. This time, the panel chairs for the Swedish Research Council’s evaluations shared their reflections on the assignment of evaluating the clinical research. Representatives from the National Board of Health and Welfare also took part, and gave their views on the assignment of evaluating the university healthcare units in Sweden.
Download the presentation of the day (pdf, 1.3 MB)
The National Board of Health and Welfare evaluates medical care at the university hospitals
While the Swedish Research Council was commissioned to evaluate clinical research, the National Board of Health and Welfare was simultaneously tasked with evaluating the structures, processes and results of medical care at the university hospitals with relevance to research, education and development. The aim is to increase the quality of medical care at the university hospitals. The Swedish Research Council also coordinates the evaluation work of the National Board of Health and Welfare.
A national ALF steering committee has been in place since 2015. The committee supervises how the agreement is implemented and proposes adjustments where necessary.
Composition of the steering committee
The steering committee has 14 members. They represent the seven regions covered by the ALF agreement, as well as the Ministry of Education and Research, the Ministry of Health and Social Affairs, the Swedish Research Council, Vinnova - Sweden’s Innovation Agency, and the medical faculties at Karolinska Institutet KI, Lund University and Umeå University.
- Jenny Fernebro (Chair), Government Offices, Ministry of Education and Research
- Jan Andersson, Region Stockholm
- Patrik Danielson, Umeå University
- Johan D Söderholm, Linköping University
- Lars Grip, Region Västra Götaland
- Mats G Karlsson, Region Örebro County
- Hannie Lundgren, Region Skåne
- Agneta Holmäng, University of Gothenburg
- Andreas Muranyi Scheutz, Region Uppsala
- Kerstin Nilsson, Örebro University
- Torkel Nyman, Government Offices, Ministry of Health and Social Affairs
- Mats Ulfendahl, Region Östergötland
- Eva Tiensuu Jansson, Uppsala University
- Mikael Wiberg, Region Västerbotten
Each ALF region has appointed two contact persons – one from the region and one from the university’s faculty of medicine.
These regional correspondents are as follows:
Kristina Åkesson, firstname.lastname@example.org
Gavyn Edmunds, email@example.com
Anna Liljestam Hurtigh, firstname.lastname@example.org
Martin Wahlén, email@example.com
Kerstin Nilsson, firstname.lastname@example.org
Helena Sävenstrand, email@example.com
Peter Garvin, firstname.lastname@example.org
Anette Philipsson, email@example.com
Anna Humble, firstname.lastname@example.org
Maria Schönnings, email@example.com
Malin Sund, firstname.lastname@example.org
Clas Ahlm, email@example.com
Lars Grip, firstname.lastname@example.org
Henrik Hagberg, email@example.com