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Enhancing financial management and accountability in market-orientated public services in England

Summary of the impact

Sheila Ellwood (at Bristol from 2006) examined how managerial freedoms created through the trend to decentralise public service organisations need to be tempered through `better' accounting. Her research has led to her appointment as a non executive director (2000-2005) and a Treasury Panel member (2009-11). The research impacts on both national policy and local financial management. Her impact is seen in the financial reporting policy in local public bodies; the policy on auditing local public bodies and in the costing/ pricing of healthcare. Her work has been used in UK parliamentary committees and incorporated into government accounting manuals. International recognition includes dissemination of her work by the Chinese Treasury.

Submitting Institution

University of Bristol

Unit of Assessment

Business and Management Studies

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Commerce, Management, Tourism and Services: Accounting, Auditing and Accountability

Using targets and incentives to improve the quality of public services

Summary of the impact

Gwyn Bevan's research used the `natural experiment' whereby each of the four countries of the UK applied a different model of governance to its `National' Health Service. From 2000, each devolved government allocated unprecedented increases in health spending, each set similar goals for improved performance, and yet performance was transformed only in the NHS in England. Bevan's research explained why and changed the understanding of key policy actors about the use of targets to achieve performance goals. The evidence base it created also influenced the governance of health services, notably a general shift to the use of targets for all the UK National Health Services.

Submitting Institution

London School of Economics & Political Science

Unit of Assessment

Business and Management Studies

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Economics: Applied Economics

How research on Thailand’s healthcare reforms changed perceptions, influenced policy and impacted on the resource allocation mechanism.

Summary of the impact

Swansea-led research on Thailand's universal healthcare coverage (UHC) reforms (1) helped change perceptions by showing researchers and policy makers in governmental and non-governmental organisations that UHC was viable in a lower-middle income country, (2) provided lessons about implementation challenges for other countries planning UHC reform, and (3) led to improved funding mechanisms in Thailand through the adoption of ring-fenced budgets for health centres and national priority services, and area-based commissioning. The study influenced the fine-tuning of Thailand's demand-side financing system to help develop a sustainable funding model that other aspiring UHC countries are emulating. Research recommendations were incorporated into the recent 10-Year Assessment of the Universal Coverage Scheme (UCS), which informed the Thai government health sector plan for 2013-15.

Submitting Institution

Swansea University

Unit of Assessment

Social Work and Social Policy

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Economics: Applied Economics
Studies In Human Society: Policy and Administration

2) Management of Change and Health Management

Summary of the impact

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.

Submitting Institution

University of Aberdeen

Unit of Assessment

Business and Management Studies

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Nursing, Public Health and Health Services
Commerce, Management, Tourism and Services: Business and Management

Healthcare Assistants and the Modernisation of the Nursing Workforce

Summary of the impact

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.

Submitting Institution

University of Oxford

Unit of Assessment

Business and Management Studies

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Nursing, Public Health and Health Services
Economics: Applied Economics

The Ensuring Council: An Alternative Vision for Local Government

Summary of the impact

The Local Governance Research Unit (LGRU) undertook a Knowledge Transfer Partnership (KTP) with the Association for Public Service Excellence (APSE), a not-for-profit local government association that provides policy and operational advice to over 300 councils. This partnership informed APSE's strategic policy review, co-producing a new model of the Ensuring Council, which was adopted by its national council, and used to brand and position APSE within local government. Seven evidence-based policy tools were created through the partnership and taken up and used by APSE for consultancy and membership services. Externally, APSE used these outputs to increase its influence over national policy.

Submitting Institution

De Montfort University

Unit of Assessment

Business and Management Studies

Summary Impact Type

Political

Research Subject Area(s)

Studies In Human Society: Policy and Administration, Political Science, Sociology

Empowering French Front-line Hospital Nursing Managers to Deal Positively with the Pressures of Modernisation.

Summary of the impact

Front-line nursing managers in French hospitals are often perceived, by themselves and others, as cogs in an administrative machine, trapped between conflicting demands for increased economic efficiency and health-care quality. Vaughan Rogers' work with ca. 180 managers, trainees and training officers in the Rhône-Alpes region's hospital service has challenged this perception. Within the framework of continuing professional development, he has enhanced nursing management's awareness of its capacity to influence the conduct of change in the profession and has inspired reinvigoration of the design of training programmes for this staff at the major Teaching Hospital for healthcare professionals in Grenoble.

Submitting Institution

University of Edinburgh

Unit of Assessment

Modern Languages and Linguistics

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Nursing, Public Health and Health Services

Public Policy and Public Debate – the role of markets in health care provision

Summary of the impact

Paton's research on health policy and the politics of health policy has had specific impacts at local, national and international levels between 2008 and 2013. The research on health policy has made a substantial and critical impact to understanding the implications of `market reform' to the English National Health Service (NHS), set in the context of evaluation of superficially-similar reform elsewhere in Europe. This has led to:

  1. Nationally: impacts on UK/English NHS policy decision-making, particularly in debate of the 2011 Health Bill.
  2. Regionally: impacts on the Public Inquiry into the Mid Staffordshire NHS Foundation Trust and recommendations following this.
  3. Internationally: impacts on organisations beyond the UK, including on: bilateral and unilateral organisations; Shanghai Health Bureau; and the European Union.

Submitting Institution

Keele University

Unit of Assessment

Social Work and Social Policy

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Economics: Applied Economics
Studies In Human Society: Policy and Administration

Case study 1 - Changing evidenced-based policy

Summary of the impact

As a direct result of methodological research led by Professor Ray Pawson at Leeds, `realist evaluation' has provided a new lens through which to assess and develop social programmes. It has critically changed the apparatus of evidenced-based policy and the way in which policy research is commissioned and utilised. Through advisory work, training package provision, partnership-research and professional exchange, this `realist' perspective has formed a new standard in social programme evaluation, and is used by commissioners in the UK and internationally to frame their interventions across policy domains, including education, environment, criminal justice, and health and social care.

Submitting Institution

University of Leeds

Unit of Assessment

Social Work and Social Policy

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Studies In Human Society: Policy and Administration

5. Improving local government performance assessments

Summary of the impact

Research conducted by Members of the Centre for Local and Regional Government Research (CLRGR) in Cardiff Business School (CBS) concerning the use of targets, performance indicators and external inspection to assess council performance and drive improvement in local services, has had a direct, significant and on-going impact on government policies in England and Scotland. In England, the research informed the Labour Government's decision to reduce the number of national performance indicators. It was also used by the Conservative Party in developing its 2010 manifesto commitment to reduce local government inspections and informed the local government policies implemented by the Coalition Government. In Scotland, the research directly influenced the design of a new inspection methodology introduced by Audit Scotland in 2009.

Submitting Institution

Cardiff University

Unit of Assessment

Business and Management Studies

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Economics: Applied Economics
Studies In Human Society: Policy and Administration

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