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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.
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.
Paton's research on health policy and the politics of health policy has had specific impacts at local, national and international levels between 2008 and 2013. The research on health policy has made a substantial and critical impact to understanding the implications of `market reform' to the English National Health Service (NHS), set in the context of evaluation of superficially-similar reform elsewhere in Europe. This has led to:
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.
Research carried out by LSHTM to develop and test patient reported outcome measures (PROMs), which measure health outcomes from the patient perspective, has demonstrated the feasibility of routinely collecting such measures before and after elective operations. In 2009, the Labour government mandated that PROMs should be collected on all NHS patients in England undergoing one of four surgical operations, a policy endorsed by the coalition following the 2010 election. This remains the only nationwide programme of its kind worldwide, providing essential data for comparing providers' performance, patient choice and other quality improvement approaches.
The worst of institutional child care came to the attention of the public and policy-makers in the 1990s following the fall of Ceauşescu in 1989 when pictures of children in Romanian orphanages were broadcast around Europe and America. Following this, a series of projects at the University of Birmingham (funded by the European Union Daphne programme and the World Health Organisation Regional Office for Europe) charted the extent and consequences of institutionalised care for children across Europe, and devised best practice recommendations for deinstitutionalisation. Among the key findings were that institutionalisation was much more widespread across the EU than previously thought; that it is particularly harmful before the age of three; and that alternative care with superior outcomes for children is also less expensive to implement. During the REF period the research team has significantly expanded their role in disseminating their findings, producing policy reports and briefings, and in providing training. During this time their key findings have made a major contribution to changes in child-care policy recommendations by NGOs such as UNICEF and the UN. Following discussion at the UN General Assembly in 2009 specific guidelines were produced for all 193 member states, which implemented key recommendations from the research about the timing of deinstitutionalisation and how to achieve it (`Guidelines for the Alternative Care of Children', 2009). Their research has led to changes to national child-care policies in a number of countries, including the Czech Republic, Hungary and Serbia. Through the activity of UNICEF the impact is now extending beyond Europe to central and South America. These changes have demonstrable benefits for the health and psychological welfare of children, as well as bringing cost savings to the national childcare systems that implement them.
Research into service user involvement in mental health care resulted in the development of an educational intervention for registered mental health nurses to deliver effective, ethically appropriate therapeutic interventions for highly distressed and disturbed patients.
The research outputs were taken up and implemented by Halikko hospital in Finland, leading to a significant change in policy and practice, including a substantial reduction in the use of coercive techniques. Following the success of this change, other psychiatric hospitals in Finland have adopted the system.
Research carried out in the International Observatory on End of Life Care (IOELC) at Lancaster University led by Professor Payne has played a major role in influencing the strategic direction of service and policy development globally. IOELC initiated the systematic collation of development data and delivered the first research-based international analysis of the development of palliative care. For example, research on access to opioids in 12 resource poor countries in central and eastern Europe via the ATOME project has delivered major impact, leading to significant changes in legislation and policy and improved access to pain medication, and palliative and end of life care for millions of people around the world.
Research conducted at the University of Manchester (UoM) has shaped the design of national systems of accreditation for general practice in the UK, Europe and beyond. Accreditation systems set standards that reflect key aspects of the organisational systems and processes in general practice that are needed to ensure delivery of good quality care. Accreditation systems also provide a kite mark of quality assurance and act as a platform for supporting continuous quality improvement. UoM developed indicators of quality in general practice structure and organisation and demonstrated how they could be used effectively to improve quality. Working in partnership with health professional organisations, governmental organisations and other universities, UoM used knowledge from the research to develop systems for general practice accreditation now used in the UK and across Europe.
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.