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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.
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.
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.
We have achieved significant and far reaching impact in the field of public health outcomes, policy and practice. For the first time, age/sex disaggregated estimates of smoking and ex-smoking prevalence were made available for approximately 7700 electoral wards in England and around 1000 postcode sectors for Scotland. The information has influenced national tobacco control policies (e.g. the ban of smoking in enclosed public spaces in England) and has impacted on national smoking-related health inequalities by targeting delivery of cessation services where they are most needed. Findings have also informed anti-smoking campaigns led by health authorities, charities and pressure groups.
Research at Lancaster has had significant, cumulative impacts on public sector thinking about, and approaches to, public involvement in health policy, practice and research locally, nationally and internationally. As a result the public in the UK and internationally is now significantly better engaged in influencing health policy and practice, in particular those from disadvantaged communities, leading to improved health and wellbeing, and enhanced employability. This research shaped the network of NHS Patient and Public Involvement Forums established in England 2003-2007, and reframed how social exclusion and vulnerability were addressed in the report of the Global Commission on The Social Determinants of Health (Marmot report) and the WHO EURO Health 2020 Strategy.
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.
Healthy Living Pharmacies (HLPs) represent a new concept in community pharmacy services designed to meet public health needs through a nationally agreed but locally commissioned tiered framework. The White Paper, Pharmacy in England: Building on strengths, delivering the future, published in April 2008 described the role community pharmacy could play in supporting public health: "Pharmacies will become healthy living centres: promoting and supporting healthy living and health literacy; offering patients and the public healthy lifestyle advice, support on self care and a range of pressing public health concerns; treating minor ailments and; supporting patients with long-term conditions". A national framework for HLPs was developed then ratified by the National Public Health Leadership Forum for pharmacy (PHLFP) in January 2010. This was tested in Portsmouth Primary Care Trust. Findings of the project led to the HLP concept being rolled out across England in 2012 to 20 pathfinder sites (areas, regions, site sounds like an individual pharmacy) involving 100 pharmacies. As of March 2013, there were 478 HLPs across 28 areas and presently there are 721 HLPs in over 35 areas. There are a range of impacts that can be demonstrated from this research including changes to community practice and government policy; increase in public use of pharmacies and improved patient outcomes.
Research undertaken at the Centre for Intellectual and Developmental Disabilities(CIDD), has significantly impacted upon:
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.