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Methods for valuing quality of life developed by Professor Devlin at City University London are used internationally to help governments make healthcare decisions. Her research focuses on a widely-used questionnaire for measuring patient reported health, the European Quality of Life 5-Dimensions (EQ-5D). Government organisations routinely use the EQ-5D to judge whether new medicines work and are cost-effective. Over 15 countries are undertaking EQ-5D studies using Professor Devlin's methods to inform decisions on pricing and provision of new medicines. These developments have been achieved through active dissemination to the academic community and governments and through Professor Devlin's scientific leadership of the European Quality of Life (EuroQol) Group. The impact of this research is highly significant in improving health and health care decision-making and has had wide reach throughout the UK and in many other countries.
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]).
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.
This case study highlights a body of research around health Research Priority Setting (RPS) that assists policy makers in effectively targeting research that has the greatest potential health benefit. Empirical research on RPS led to organizational changes, and new policies within the Cochrane Collaboration along with new training resources and new RPS exercises. A research gap on inequalities in the risk of oral cancer in the English South Asian population led to an evidence synthesis exercise being carried out by the National Institute for Health and Care Excellence (NICE) and the formulation of a new public health guideline.
Empirical evidence generated by UEL research has directly influenced the reform of health financing in two Indian states with total populations of 154 million through changes to provider behaviour, the organisation and use of funds, and treatment verification processes and package rates. The impacts of this work have been commended by the UK Department for International Development (DFID) and the World Bank, and attracted interest from states with similar healthcare schemes. More widely, it has helped policymakers in India and the UK recognise the importance of including high quality comprehensive primary care in India's strategic planning for universal health care, and the benefits to the UK in prioritising primary care collaboration with India.
Research by the University of Southampton into maternal and child health in the developing world has contributed significantly to the design of better health policies by governments, international agencies, and non-governmental organisations. The research broke new ground in identifying the urban poor in developing countries as among the groups most at risk of poor maternal and child health. Its findings have informed policy and funding priorities at national and international organisations including the Department for International Development (DFID) and the United Nations; influenced health practitioners in Africa and Asia; and led to better health care outcomes in countries which were the focus of the research.
The `People in Public Health' (PIPH) study and related research on health trainers, health champions and volunteers has brought together evidence on rationales for lay engagement, effectiveness and models of support. Dissemination activities, supported by a Department of Health grant, have achieved reach into various policy arenas and national networks. At the same time there is evidence of research utilisation in public health practice. One of the impacts has been the establishment of `Active Citizens for Health', a national network of partner organisations to bring together evidence and learning that has been hosted by Leeds Metropolitan University.
Globally, many health research-funding organisations, public and charitable, felt the need to demonstrate to policymakers and the public how their investments in research were benefitting society. HERG's research on developing techniques for assessing the payback (or impact) from health research tackled this need. The payback stream of research itself has had significant, wide- reaching and cumulative impacts. First, internationally, health research funding bodies adopted the framework in their evaluation strategies, including to provide accountability. Second, many stakeholders made extensive use the findings of payback studies in public debate and private lobbying for public expenditure on health research. Third, governments, public research funding bodies and medical research charities, from the UK to Australia, used the findings from payback studies to inform decisions regarding the levels and distribution of health research funding, with the aim of increasing the health and economic benefits that come from investments in research.
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.
This case study concerns a body of research by Dr Julie Ridley, Dr Helen Spandler and Dr Karen Newbigging into Self-directed Support (SDS) and Direct Payments (DPs), which examines perspectives and experiences of policies to promote choice, control and flexibility in social care, and provides a critique distinguishing between rhetoric and reality. Early qualitative and action research focused specifically on mental health, including work for the Scottish Executive (Ridley) and the Department of Health (Spandler), leading to cutting-edge policy critiques (Spandler), engagement with the field to distil key implementation themes (Newbigging) and later, to broader based evaluation of SDS policy implementation in Scotland. Collectively and over time, this work has had a direct influence on social care policy and law across the UK, as outlined below.