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Suicide is one of the most serious adverse outcomes in mental health services. NCISH research is based on a comprehensive and internationally unique database (99,000 suicide deaths; 25,000 patient suicide deaths). NCISH impacts upon practice and policy by providing definitive figures on suicide to clinical services and government, producing data-driven safety recommendations and demonstrating that these recommendations reduce suicide. Based on NCISH research, overall patient suicide rates fell by 26% (2004-11), in-patient deaths fell by 58% (2001-2010), and individual recommendations may have prevented between 200-300 patient suicide deaths per year. A new vehicle for impact delivery is the social enterprise Safer Care Ltd (founded 2013), which has already reviewed 4 Trusts and, by reinvesting future income in the social enterprise, we will continue to meet the specific needs of mental health services.
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).
Newcastle research into practical methods to reduce alcohol-related risk and harm has underpinned national policy, including the Government's Alcohol Strategy and a National Audit Office report. This has shaped public health practice concerning alcohol across England. A UK-specific screening and brief intervention (SBI) programme was developed by Newcastle University for use by GPs and nurses in primary care. This programme, which was designed to reduce alcohol-related problems, has been widely recommended and adopted. An evidence review commissioned by the National Institute for Health and Care Excellence (NICE) found that the use of SBI reduces alcohol consumption, mortality, morbidity and alcohol-related injuries. Department of Health figures show that SBI provides an estimated annual healthcare saving of around £100 million.
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.
The Whole System Demonstrator (WSD) research programme is a project funded by Policy Research Programme Department of Health and led by academic staff at City University London which investigates how technology can help people manage their health and safety while maintaining their independence. The WSD evaluation provides scientific evidence that has influenced and continues to influence public policy debate in the UK and internationally. It has shaped UK Department of Health policy and strategies regarding deployment of tele-assistive devices to meet the growing health and social care demands in a changing population. And it is helping to shape manufacturers' design of services with the user in mind and how health and social care providers offer tele-assistive services.
The Department's impact on health and care has two strands that are mutually enriching: creative interventions in health and social care designed to benefit NHS service users and therapeutic client groups, and the application of innovative arts methodologies to health settings. The research impacts on health professionals, `user' groups and charities by:
Research undertaken at the Centre for Intellectual and Developmental Disabilities(CIDD), has significantly impacted upon:
Patient safety research from Manchester Pharmacy School at the University of Manchester (UoM) has reduced prescription errors in primary and secondary care. Pharmacists using our indicators with patients' electronic health records (aimed at preventing drug-related morbidity in general practices) reduced the odds of prescribing and monitoring problems by at least 22%. These indicators are now incorporated into `medicines optimisation' software for general practice computer systems. The EQUIP study led changes in the recommended design of hospital prescription charts, an annual national assessment of prescribing competence of medical students and the employment of extra hospital pharmacists to prevent the 9% of prescriptions with errors from harming patients.
University of Nottingham research in the field of recovery has had a major influence on changes in mental health policy. It has led to a new model of service provision both in the UK (including through NICE guidance and the NHS's outcomes framework) and internationally (including in Western Europe, Scandinavia, Canada, Australia and Asia). The work has contributed to a reduction in the use of mainstream services and has enhanced the quality of life enjoyed by people with mental health problems. It has also been central to the Department of Health's Implementing Recovery through Organisational Change programme, which has pioneered the use of Recovery Colleges and peer support workers in mental health care in the UK.
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.