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Adult Social Care (ASC) is a growing sector which currently employs 1.6 million care workers and benefits 1.8 million care recipients. Research carried out by Manchester Metropolitan University (MMU) into the recruitment, development and retention of ASC workers has had a direct impact on ASC policy, management practice and human resource (HR) practice.
In the area of health, welfare and public policy, the primary research impact was on the Adult Social Care Recruitment and Retention Strategy 2011. Among ASC managers and HR practitioners, the research findings informed and stimulated debate over the conduct of ASC work and the benefits of good HR practice.
The University of Aberdeen's Business School has built a strong programme of research focussing on managing strategic change, particularly in the healthcare sector. Using a conceptual framework which explores the complex interplay between organisational context, content and process, the University has completed a number of studies looking into patient safety, quality and service redesign, four of which are described here. Because the work routinely involves health care stakeholders across the research pipeline, from articulation of the research problem, through to recommendations and the delivery of solutions, impact is wide-ranging, including changes in staff behaviours, improvements to safety, and significant financial savings.
Research findings have informed the development of training and support for care home inspectors and toolkits for use by caring professionals, all of which are provided through the Care Quality Commission (CQC) website. Findings have also been disseminated nationally and internationally through a book aimed at practitioners and policy makers that has now been published in German and Polish and is selling strongly in Australia and the USA. The study has furthered professional and public awareness of the need for improved night-time care in care homes, in particular improved communication (from staff to residents) and training.
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.
Research at Oxford has played a central role within the recent restructuring of the nursing workforce to improve healthcare quality in a context of growing service demands and tightening resource constraints. Much of this restructuring has been heavily dependent on the use of the Healthcare Assistant (HCA) role, provoking much controversy. Presented as a flexible, low cost resource, these HCA roles are also unregulated and therefore seen as a potential source of patient risk. Oxford researchers have fed into this debate across a number of projects, strengthening the evidence base on the nature and consequences of the HCA role. Examining the role from the perspective of different stakeholders, these projects have impacted on national, regional and local policy and practice centred on the management and use of HCAs. In so doing, the research has contributed to the development of a more productive and safer nursing workforce.
Research on the effects of organizational autonomy in the NHS was conducted at Royal Holloway between 2006 and 2009, and has informed debates that have contributed to policy and practitioner decision-making. Through qualitative methods, it examined the impact of autonomy (from central government) upon local decision-making in NHS organisations. The work explained why the number of Foundation Trusts (FTs) established had not risen in line with the Department of Health's expectations, which originally sought to make all NHS Trusts become FTs. It also explained why FTs were not willing to exercise their autonomy despite being able to do so. The research has influenced policy debate and decision-making within the Department of Health, Monitor (the FT regulator), and the wider NHS.
Research at the university of ulster into the theory and practice of person-centredness has resulted in:
i. the development of person-centred practices that lead to better outcomes for patients, staff and teams.
ii. the influencing of policy for the development of person-centred services.
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.
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).
Improving patient experience of health services is a policy priority worldwide. The University of Manchester (UoM) has conducted research on patient experience since 1995, leading to the development of a series of validated measures for assessing patient experience of quality of care in primary care, including access to care and the degree to which services are patient-centred. Our measures have been in routine use in the NHS since 2004, sent to samples of several million patients. The data have been used to provide incentives for the highest quality practices, and to inform policy makers about current care throughout the UK.