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
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]).
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.
Research in the area of childhood obesity has focussed on the
development, implementation and evaluation of interventions. The APPLES
Study (1996-99), the first UK school-based RCT was key in contributing to
the evidence-base through wide dissemination including 3 BMJ (2001)
publications, cited in NICE (2006) and WHO guidance (2004). Collaborations
with academics, practitioners and the RCPCH led to the development of
further community-based obesity treatment and prevention interventions
including WATCH IT; early programmes e.g. EMPOWER, HELP and HAPPY and more
recently innovative school-based initiatives involving school gardening.
There is evidence of results being disseminated and influencing research,
practice and policy.
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.
In November 2008, Professor Sir Michael Marmot and his team at UCL were asked by the
Secretary of State for Health to chair an independent review to propose the most effective
evidence-based strategies for reducing health inequalities in England. The Marmot Review,
published in 2010, has fundamentally shifted discourse on health inequalities in the UK and
internationally. It has shaped public health services across England and around the world, guided
government and international policy, and has given rise to a new commitment from service
providers and health professionals to reducing health inequalities and addressing the social
determinants of health.
Empirical evidence generated by UEL research has directly influenced the
reform of health financing in two Indian states with total populations of
154 million through changes to provider behaviour, the organisation and
use of funds, and treatment verification processes and package rates. The
impacts of this work have been commended by the UK Department for
International Development (DFID) and the World Bank, and attracted
interest from states with similar healthcare schemes. More widely, it has
helped policymakers in India and the UK recognise the importance of
including high quality comprehensive primary care in India's strategic
planning for universal health care, and the benefits to the UK in
prioritising primary care collaboration with India.
Research undertaken at the Centre for Intellectual and Developmental
Disabilities(CIDD), has significantly impacted upon:
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.
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.