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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.
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 `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.
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.
Lancaster research has highlighted the pervasive health inequalities and inadequate services experienced by people with learning disabilities (LD). Our 2005 report commissioned by the Department of Health (DH) proposed the establishment of a specialist LD observatory for England. This proposal was taken up by a government-commissioned independent inquiry and accepted.
The same team is one of three partners who, through a competitive tender process, have since 2010 been operating the first specialist LD public health observatory in the world. The observatory collects, analyses and summarises health information to improve the data available to DH and other stakeholders thereby improving the health of people with LD.
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.
Durham University's Centre for Public Policy and Health (CPPH) has worked closely with the World Health Organisation's (WHO) Regional Office for Europe to help design the European Action Plan for Strengthening Public Health Capacities and Services. The European Action Plan (EAP) draws extensively on three major CPPH research projects on the nature and governance of the public health system in England. The EAP, endorsed by all 53 WHO Member States in September 2012, is a main pillar for the implementation of the WHO's policy framework — Health 2020 — also endorsed by Member States.
Research undertaken at the Centre for Intellectual and Developmental Disabilities(CIDD), has significantly impacted upon:
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.
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.