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A team led by a Manchester Metropolitan University researcher developed the PROBE (Project Review, Objective Evaluation) methodology for evaluating healthcare information technology systems. This became a core part of the National Health Service (NHS) information strategy; in 1996, PROBE was accepted by the NHS Executive and HM Treasury as a central method for project review. PROBE has therefore brought significant benefits to clinical users, patients and NHS decision makers. Impacts described here relate to the use of PROBE to evaluate an electronic blood transfusion system. Specifically, through enabling the effective evaluation of the system, decisions by a health authority have been informed by research, clinical practices have improved, and levels of patient safety and confidentiality have risen.
The University of Liverpool (UoL) team at the WHO Collaborating Centre for Policy Research on Social Determinants of Health (Liverpool WHO CC) has made a leading, internationally recognised contribution to addressing the adverse health consequences of household air pollution, a problem responsible for an estimated 4 million premature deaths among 2.8 billion of the world's poorest people. Impacts include (i) generating global awareness of a hitherto poorly recognised problem through defining the disease burden, (ii) leading development of new WHO Guidelines on the issue, (iii) providing key evidence for intervention and policy studies in low-income countries and (iv) helping to formulate strategy for global initiatives to address the problem.
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.
The emergence of new psychoactive substances (NPS) in Europe over the last decade (including performance and image enhancing drugs), poses challenges to policy makers. These are substances which are frequently not controlled under law, and governments have struggled to address potential societal and health harms of use. We have analysed this drugs market, described the potential health harms of NPS, and generated evidence on effective intervention responses for some of these. Our findings have provided the necessary evidence to support the development of robust, responsive and predictive policy making at both national and international levels.
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.
The NHS spends about £11bn annually on pharmaceuticals, of which £8bn is on branded drugs, representing about 13% and 10% respectively of available NHS resources. Research at York has been central to the public and policy debate about how branded pharmaceuticals ought to be priced and has made a material contribution to the development of government policy to introduce a value based pricing (VBP) scheme for all new pharmaceuticals. VBP has significance for the prices that the NHS pays for pharmaceuticals, access to new drugs for NHS patients, and the return that manufacturers can expect from future research and development. There is also an international impact in two respects: UK prices are estimated to influence 25% of the world market and York has contributed to a wider policy debate about international pharmaceutical pricing and the potential role of value based pricing in European, North American, South American and South East Asian health care systems.
The `Impacts 08' research programme was inherently, in and of itself, designed to impact upon policy-makers and practitioners by documenting the process of hosting major cultural events and providing robust evidence of their social, economic and cultural impact. Between 2006 and 2010 regular and easily accessible research based reports were shared with stakeholders and the public. The impact of the work is evidenced in the development of local, UK and EU policy on cultural regeneration and events. These policy developments have addressed approaches to funding, promoting and assessing the value of cultural events.
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.
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.