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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.
This case study highlights a body of research around health Research Priority Setting (RPS) that assists policy makers in effectively targeting research that has the greatest potential health benefit. Empirical research on RPS led to organizational changes, and new policies within the Cochrane Collaboration along with new training resources and new RPS exercises. A research gap on inequalities in the risk of oral cancer in the English South Asian population led to an evidence synthesis exercise being carried out by the National Institute for Health and Care Excellence (NICE) and the formulation of a new public health guideline.
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.
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.
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 ECuity Project was a European Union (EU) funded research network that provided rigorous quantitative evidence on the extent of socioeconomic inequalities in health and health care across countries and over time. The Project pioneered a set of measurement tools to help understand what drives international differences and trends in health inequality. The methods developed within the Project have had a direct impact on the way in which international organisations, such as the Organisation for Economic Cooperation and Development (OECD), World Bank (WB) and World Health Organisation (WHO), define and measure health inequality and inequity. The Project provided international agencies and governments with tools to develop and target policies to address inequity and the evidence generated by the Project has extended their understanding of the issue in developed and developing countries, informing and shaping their policy advice.
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.
Research by the University of Southampton into maternal and child health in the developing world has contributed significantly to the design of better health policies by governments, international agencies, and non-governmental organisations. The research broke new ground in identifying the urban poor in developing countries as among the groups most at risk of poor maternal and child health. Its findings have informed policy and funding priorities at national and international organisations including the Department for International Development (DFID) and the United Nations; influenced health practitioners in Africa and Asia; and led to better health care outcomes in countries which were the focus of the research.
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.
Research at Northumbria has identified factors associated with trust in and intention to use Internet based health advice. A model of trust in online advice was published in 2007 that showed the importance of personalised peer-to-peer health messages — this was taken up by the press and broadcast media and led to changes in industry and public health practice around (i) the use of web material as a marketing and consumer tool for big pharma; (ii) the design of contemporary e-health sites; (iii) Government policy on the use of personal patient experience to influence patient choice.