Log in
The decision about whether to fund new health care interventions is increasingly being informed by evidence of cost-effectiveness in terms of the cost per Quality Adjusted Life Years (QALY). The SF-6D health index is widely used internationally for calculating QALYs from patient reported health outcomes collected in clinical trials and other surveys. It contributes to health system efficiency from being used by health technology agencies around the world (including Australia, Canada, England, Scotland, Ireland and Norway) to calculate QALYs to facilitate decisions about the most efficient use of limited health care resources. The SF-6D is freely available to non-commercial bodies, including researchers and policy makers. Commercial benefits come from the licensing of the measure to pharmaceutical companies, health insurers and others to assess the cost-effectiveness of their products with 460 licenses being sold since 2008. A further 521 licenses are distributed on a non-commercial basis to academic researchers, public sector and charitable organisations.
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.
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.
Findings from research at Newcastle on health inequalities and the basis on which economic decisions are made have informed the recommendations made to and adopted by the Secretary of State of Health. These recommendations influenced two specific areas of the National Health Service (NHS) budget allocation. Formulae developed by Wildman and his colleagues are of key importance in determining the allocation of the NHS's £8 billion prescribing budget and the £10.4 billion mental health services budget.
Adults with learning disabilities (LD) often cannot adequately report illness and there is evidence that treatable illnesses go undetected. As a direct result of Cardiff University research on health checking adults in primary care, the Welsh Government and the Department of Health now provide funding for all adults with LDs across England and Wales to receive an annual health check that employs Cardiff University methods. Current data on take-up (N=78,000 per year) and evaluation of results show that nearly 250,000 adults with LDs have had new health needs identified and treatments initiated during the REF assessment period (2008-2013). Nearly 40,000 adults per year will have new health needs identified and treatments initiated as a result of the health checks, with approximately 3,500 of these being potentially serious conditions.
University of Aberdeen research has directly impacted on clinical practice with regard to the treatment of varicose veins. The University's Health Services Research Unit (HSRU) developed and validated the Aberdeen Varicose Vein Questionnaire (AVVQ), which allows patients to self-assess the severity of their varicose veins. Current national and international guidelines now recommend that as part of the assessment of outcome for patients with varicose veins, patients' self-assessment of their veins be routinely undertaken — with the AVVQ the most commonly recommended measure. The Department of Health in England also mandated the use of the AVVQ and all patients in England are now required to complete the AVVQ before and after treatment. Results from these questionnaires are being used by individual NHS providers to assess the quality of their care, to improve their services, and for planning and commissioning of services nationwide.
The claimed impact, as defined by REF guidance, therefore includes impact upon public policy and services; practitioners and professional services and health and welfare.
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.
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.
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.