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In 2008 the Philosophy Department decided to organise its impact strategy around the research activities of the Essex Autonomy Project (EAP). EAP research has been conducted in two distinct strands with different research outputs and impacts. This case study summarises the impact of our work concerning the legal concept of best interests decision-making. Through EAP public policy roundtables, EAP technical reports, and through work with public organisations and public officials, EAP research has informed professional and public discussion of the law of best interests, has had impact in the development of public policy guidelines for implementing legal requirements, and has played a role in the review and reform of existing regulatory frameworks.
The research has led to the design of a new clinical pharmacy service model, centred on community pharmacies, to improve the care of patients with palliative care needs living in the community. This resulted in better provision of information for patients (and their carers) and new training resources and staff development opportunities for the multi-disciplinary palliative care team. Funding has been secured to rollout the new service across NHS Greater Glasgow and Clyde Health Board (NHS GGC - 1.2M population) in 2013. The research has also supported a successful bid to explore the service model in a remote and rural Health Board (NHS Highland) and has informed specific programmes of Macmillan Cancer Support UK, pharmacy workforce planning, and the Boots Macmillan Information Pharmacists initiative.
Professor Trevor Bailey of the University of Exeter led the methodological and computational development of new improved mathematical models to more fairly allocate resources, and particularly mental health resources, to GP practices in the UK within an interdisciplinary research team from the universities of Plymouth, Southampton and St Andrews. The mental health services component of NHS Practice based commissioning (PBC) introduced by the Department of Health (DoH) from 2007 onwards, deals with resource allocation for specialist healthcare for some 400,000 patients with severe mental illness. From 2009 to 2011, the team's mental health estimates, based upon the modelling efforts of Bailey, were used to set practice-level PBC budgets accounting for around £8 billion of NHS funding, the DoH describing this as a `step-change improvement' in how mental health needs are modelled.
Research undertaken at the University of Manchester (UoM) considers legal guidelines as they relate to the Care of Extremely Premature and/or Sick Neonates and has sought to identify deficiencies in the law, clarify the issues at stake in policy debates and make proposals for constructive responses. Impact has occurred through the utilisation of research in an influential Nuffield Council on Bioethics (NCOB) report. This has led to uptake within guidance provided to health professionals and parents, and ultimately the implementation of report recommendations — most notably the timetable that correlates the decision process on resuscitation to set stages in gestational age, alongside a more holistic approach to best interests — by the British Association of Perinatal Medicine (BAPM) in 2008. The BAPM guidance continues to have a significant impact on clinical practice.
Research by Professor David Archard on the moral and legal status of children has improved health policy and care for extremely premature babies through its contribution to the Nuffield Council on Bioethics report Critical Care Decisions in Fetal and Neonatal Medicine: Ethical Issues, released in late 2006. During 2008-13 the report's guidelines have come to be followed across the NHS in the clinical care of extremely premature babies and are regarded by doctors as the best available advice. Through its contribution to the Nuffield report, Archard's research has helped to bring improved and more consistent health care provision to extremely premature babies and their families across the UK.
Methods developed at the University of York for measuring NHS productivity have changed how the Office of National Statistics values the NHS in the national accounts. Our methods, which take into account improvements in the quality of care, have been incorporated into submissions to the Comprehensive Spending Reviews that determine the NHS budget and are internationally influential. Research on productivity at hospital level has influenced the tariffs set by the Department of Health for reimbursement of specialist hospital care. Research on the productivity of hospital consultants influenced the reviews of doctors' pay and rewards by the Doctors' and Dentists' Pay Review Body and the National Audit Office and formed the basis of benchmarking tools distributed for use in the NHS.