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Research into understanding and addressing the gaps between evidence and practice in health care has been conducted and applied at the University of Manchester. Working within the Department of Health funded National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester, research teams have applied an evidence-based approach to knowledge mobilisation to improve the identification and management of two vascular related conditions: impaired glucose tolerance (IGT) and chronic kidney disease (CKD). As a result of the initial pilot projects in Greater Manchester 1863 new CKD patients have been identified with the success leading to a further implementation programme that has spread to other areas of the UK. The IGT pilot project has directly led to the improved health of targeted patients in two areas of Greater Manchester.
International Standards for Nursing Terminology is focused on supporting nursing practice internationally, through the application of theoretical informatics research, demonstrating the following impact:
Quality of care for the increasing numbers of frail older people is an issue of international concern. Led by Professor Meyer at City University London, in partnership with Age UK and Dementia UK, My Home Life (MHL) is a collaborative movement of people involved with care homes for older people. It was established to improve the quality of life of everyone connected with care homes for older people and has become the recognised voice for the sector. The original underpinning research and ensuing projects all focused on knowledge translation, in particular the factors that enhance quality improvement in care homes. MHL actively works with care homes to progress quality improvement and share the lessons learned throughout the system. The programme has had a significant impact on both policy and practice in health and social care, influencing Government policy and supporting practice improvement across national and international borders.
Life for those who have had a stroke across England has been improved through assessment of their needs six months after their stroke, followed up with support so that these needs are met. The assessment tool used was developed at the University of Manchester using knowledge from applied research into knowledge translation and service improvement, which emphasised the need for tailored, context-sensitive approaches to implementation of evidence. The flexible assessment tool (GM-SAT) that can be used by a range of practitioners is now in use across England in a range of providers, enabling the fulfilment of national strategy and improved care for these patients.
This case study demonstrates how programmes of research led by the University of Sheffield since 1995 have generated theoretical models and implementation tools that have had considerable significance and reach in a diverse number of areas.
There have been impacts on:
The Personal Social Services Research Unit (PSSRU) at the University of Manchester (UoM) has run a programme of research examining community care of older people since 1996. The findings have informed key government decision-making around two important national policy initiatives between 2008 and 2013: (1) the development and implementation of Personal Budgets in Social and Health Care and (2) National Strategies to improve Dementia Services. This has affected the national provision of social care for older people and other adult social care users. In 2011-12, there were over 1.2 million people in England receiving social care affected by these policy changes (over 800,000 aged 65+), with a cost of £6,600m spent on their care (NHS and Social Care Information Centre).
Research carried out in the International Observatory on End of Life Care (IOELC) at Lancaster University led by Professor Payne has played a major role in influencing the strategic direction of service and policy development globally. IOELC initiated the systematic collation of development data and delivered the first research-based international analysis of the development of palliative care. For example, research on access to opioids in 12 resource poor countries in central and eastern Europe via the ATOME project has delivered major impact, leading to significant changes in legislation and policy and improved access to pain medication, and palliative and end of life care for millions of people around the world.
Research conducted at the University of Manchester (UoM) has shaped the design of national systems of accreditation for general practice in the UK, Europe and beyond. Accreditation systems set standards that reflect key aspects of the organisational systems and processes in general practice that are needed to ensure delivery of good quality care. Accreditation systems also provide a kite mark of quality assurance and act as a platform for supporting continuous quality improvement. UoM developed indicators of quality in general practice structure and organisation and demonstrated how they could be used effectively to improve quality. Working in partnership with health professional organisations, governmental organisations and other universities, UoM used knowledge from the research to develop systems for general practice accreditation now used in the UK and across Europe.
Bournemouth University (BU) has facilitated improvements to health and social care practice through cultural change in care provision. Researchers developed a practice development framework for implementing and assessing the delivery of evidence-based practice in 82 UK health and social care units during the impact period. Benefits to staff include better communication and team structure. Benefits to patients include higher standards of cleanliness, privacy and dignity, as well as a decrease in length of hospital stays and appointment waiting times. Delivery has extended to cover entire NHS Trusts serving a resident population of over 3.5 million, social services departments and third sector organisations across the south of England and beyond. The research has since been applied to develop a similar system in Australia.
There are an increasing numbers of people living into very old age. At the same time there is a drive to enable people to live within their own homes for as long as possible. Consequently, health and social care services that previously would have experienced very few people with dementia now have this as part of their core function. Yet there is no tradition in these services of supporting people with dementia and there are many reports of inadequate care. For example, Valleley reports that over half of people living in extra-care housing with dementia were admitted to other care settings during the first two years due to challenging behaviour, conflicts with staff and other residents, and distress on the part of the person with dementia.i Similarly, hospital patients with acute and chronic medical conditions concomitant with dementia are consistently reported to experience poorer quality outcomes than patients with similar conditions without dementia.ii The research described below has had significant benefits for those living with dementia both in extra-care housing and in hospital settings, primarily at the national level but also internationally. It has enhanced quality of life for individuals living with dementia, improved the practice of professionals working with people with dementia and had economic benefits.