Clinical research within the ALF agreement

As from 2019, quality aspects will form the basis for parts of the remuneration that the seven regions in the ALF agreement receive for participating in the training and education of medical doctors, for implementing clinical research and for developing health and medical care. The Swedish Research Council evaluates the clinical research conducted in these regions.

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





Region Stockholm

Karolinska Institutet, KI

Västra Götaland

Region Västra Götaland

University of Gothenburg


Region Skåne

Lund University


Region Uppsala

Uppsala University


Region Västerbotten

 Umeå University


Region Östergötland

Linköping University

Örebro (from 2015)

Region Örebro County

Örebro University

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.

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:

  1. The quality of scientific output
  2. Clinical significance and societal impact of the clinical research
  3. The prerequisites for clinical research

The Swedish Research Council presented the results of the evaluation in March 2018.

Evaluation of the quality of clinical research in the regions covered by the ALF agreement (in Swedish)

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 herePDF (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 dayPDF (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.

National Board of Health and Welfare’s report of its assignment external link

PublISHED ON 18 May 2018

UpDATED ON 10 February 2020

Pdf / Printout

The Office for ALF coordinates

The Swedish Research Council has a designated Office for ALF, which coordinates quality evaluations of the clinical research and coordinates contacts between the various actors on matters relating to the ALF agreement. The Office also provides administrative support to the national ALF steering committee.


Office for ALF


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