A strong relationship has developed between investigators in the National Bowel Research Centre (NBRC), led by Prof Charles Knowles, and PCTU. This relationship has been built over the last 5 years based on the successful delivery of several NIHR funded RCTs including the CONFIDeNT study of percutaneous tibial nerve stimulation for adults with faecal incontinence (FI) [Knowles et al., Lancet 2016]. An ongoing portfolio of 3 national and 1 international (UK/EU) RCTs have led to this cooperation being formalised into a service level agreement between NBRC and PCTU to aid development of further new studies, including senior in house statistical support. The NBRC and PCTU share a vision that complex interventions for common colorectal conditions (and indeed more general surgical problems) could be much better evaluated by new methodological approaches, including and improvements to observational studies. This drive has already led to collaborative bids for methodological funding. A team has been developed on this basis that includes a senior research programme manager (Shiva Taveri) as well as new NIHR faculty (lecturer and ACF).