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Research by the School of Pharmacy has been used by the UK Government in their drive to improve the nation's public health. Our evidence base was used to inform the 2008 White Paper "Pharmacy in England: Building on Strengths — Delivering the Future". Healthy Living Pharmacies, recommended by the White Paper, have been piloted leading to improved engagement with local commissioners, further training for pharmacy staff, more cost-effective delivery of public health services, and an increase in public awareness and access to these services. In addition, the Government backed Pharmacy and Public Health Forum is utilising our research in its remit to develop, implement and evaluate public health practice in pharmacy.
Ground-breaking experimental research at the University of Bristol assessing the effectiveness of standardised tobacco packaging legislation has been strongly influencing international tobacco policy and legislation since 2011. Work by scientists in the School of Experimental Psychology was the first to show, using direct, objective measures, that standardised tobacco packaging modifies relevant behaviours. Australia became the first country in the world to implement standardised packaging legislation in 2012 after reviewing the University of Bristol research in their High Court in response to legal challenges from the tobacco industry. That same year, the European Commission's update of the Tobacco Products Directive cited the same University of Bristol research to support the claim that standardised packaging would strengthen the effectiveness of graphic health warnings on tobacco products. The UK government has also used the University of Bristol research to inform the consultation on standardised packaging of tobacco products.
Research carried out by Professor Susan Michie and colleagues led to the establishment of the NHS Centre for Smoking Cessation and Training (NCSCT) in 2009 to improve the quality of national stop smoking service provision. The team won the Department of Health contract to form the NCSCT which has led to important quality improvements as demonstrated by increases in knowledge and skills of practitioners, and improvements in success rates. It is estimated that to date the NCSCT has been responsible for an additional 7,500 smokers stopping long-term, saving an estimated 6,500 life years at an incremental cost of less than £500 per life year gained.
University of Aberdeen research had impact on public policy as it was instrumental in the introduction of legislation in Scotland to restrict smoking in public places. The implementation of the legislation has impacted on the health of the public and benefited the economy through reduced use of health services.
Exposure to environmental tobacco smoke (ETS) — passive smoking — had been estimated to cause more than 1,000 deaths per year in Scotland and significant morbidity. International evidence was used to model the health and economic impacts of potential legislation to eliminate smoking in public places in Scotland, under a range of scenarios. The net present value of all the benefits and costs over 30 years was demonstrated to be positive under all the scenarios examined, with a central estimate of +£4.6 billion (ranging from +£0.056 billion to +£7.4 billion).
The research results provided convincing evidence to support the passage of legislation. Following the implementation of smokefree public places in Scotland, evidence of the resulting health benefits have been accruing from 2008. These include significant reductions in admissions for acute coronary syndrome and for childhood asthma, reductions in complications of pregnancy (pre-term delivery and small for gestational age) and improvements in bar workers' health.
The claimed impact, as defined by REF guidance, therefore includes: public health and welfare have improved; public behaviour and the control of disease has changed.
Health inequalities are recognised as a critical UK policy issue with life expectancy gaps of up to 28 years between the least and most deprived areas. This case-study demonstrates how Durham University research has led to: (a) changing health service commissioning (with County Durham and Darlington Primary Care Trust [PCT]): (b) influencing NHS funding policy (by generating Parliamentary debate); as well as (c) contributing to the development of the new public health system in England and Wales (as part of the Strategic Review of Health Inequalities in England post-2010 [Marmot Review]).
The Department of Health seeks to distribute the NHS budget to local commissioning organisations to achieve equal access for equal need and reduce health inequalities. The formula upon which it bases this distribution must be evidence-based, robust and up-to-date. We summarise four pieces of applied econometric research undertaken at the University of Manchester (UoM) and commissioned by the Department of Health that have developed the methodology for setting budgets fairly and determined the content of the formula in use in England from 2008-date. Adoption of the findings of this research by government has led to a substantial redistribution of NHS funding between areas.
Smoking is the single most important preventable cause of mortality and inequalities in health in the UK. Tobacco use causes over 100,000 deaths each year in the UK, with around 10,000 of these due to non-smokers' exposure to secondhand smoke. The total cost of smoking to society is estimated to be over £13 billion. The UoE Tobacco Control Research Group's (TCRG) research and knowledge exchange activities have significantly influenced tobacco control policy and practice in the UK (http://www.cphs.mvm.ed.ac.uk/groups/tcrg or http://tinyurl.com/nwxcpnh). More specifically, their research on smoking and non-smoking by young people has influenced smoking prevention and cessation policy at the national level in Scotland and England and at regional/local levels. Their evaluation studies of the national smoke-free legislation in Scotland and England provided important evidence on the legislation's positive public health impact, thereby undermining the case for repealing or diluting the legislation. Their research on reducing smoking in the home has influenced national policy and practice on this issue in Scotland including national mass media campaigns.
The UCL Dental Public Health Group have made a significant contribution to oral health policy in the UK and internationally through their research on oral health inequalities and the need for a reorientation of dental services towards a more evidence based, integrated preventive approach addressing common risks for oral diseases and other chronic conditions. Our work has influenced local national oral health policies and the development of clinical practice guidelines to reduce oral health inequalities and provide the opportunity for dental professionals to prevent both oral and systemic disease.
Evidence about the need for and provision of health visiting services generated through research undertaken at King's College London (KCL) has underpinned major changes in national policies for health visiting. Our findings about health visitors' practice, availability and distribution of services and effectiveness in terms of parenting/child outcomes, revealed both shortfalls in provision and opportunities for improvement and led to the development of a new caseload weighting tool and funding model for service planning. The accumulated evidence from this research helped convince the UK Government in 2010 to commit to 4,200 more health visitors by 2015 — a workforce expansion of nearly 50% — in a time of austerity and restraint elsewhere in the public sector.
In November 2008, Professor Sir Michael Marmot and his team at UCL were asked by the Secretary of State for Health to chair an independent review to propose the most effective evidence-based strategies for reducing health inequalities in England. The Marmot Review, published in 2010, has fundamentally shifted discourse on health inequalities in the UK and internationally. It has shaped public health services across England and around the world, guided government and international policy, and has given rise to a new commitment from service providers and health professionals to reducing health inequalities and addressing the social determinants of health.