Summary of the impact

Research conducted at the School of Mathematics at Cardiff University has engineered lifesaving, improvements to UK healthcare systems. New mathematical models, accounting for the complexity and diversity of the health system, have been created and applied in a variety of contexts to markedly enhance the efficiency and effectiveness of a wide range of healthcare services — at policy, commissioning and operational levels. The extensive benefits include:

• Reducing the mortality of trauma patients across South London by 54% (equating to 0.7 additional survivors out of every 100 patients for the period 2010-2012, rising to 4.2 in 2013)
• Reducing the mortality of stroke patients across South London by 60% through the creation of a new Stroke Unit, based on the research findings (the services were rated as the best in the country by the National Sentinel Audit 2010 organised by the Royal College of Physicians).
• Realising net efficiency gains of £1.6m per year in the emergency department at University Hospital of Wales;
• Provision of hospital capacity planning tools in use across the UK

This work has been disseminated nationally and internationally, in the media and at a range of events designed to engage the public with Mathematics. Therefore the impacts claimed in this case study are health, economic benefits and public engagement.

Summary of the impact

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.

Summary of the impact

The Galatean Risk and Safety Tool (GRiST) is a clinical decision support system (CDSS) conceived and developed by computer scientists at Aston University from 2000 onwards, where it is being delivered as a cloud-computing service. It is used every day by mental-health practitioners in the NHS, charities, and private hospitals to assess and manage risks associated with mental-health problems. Between 1/1/2011 and 31/7/2013, clinicians provided 285,426 completed patient risk assessments using GRiST. It has changed organisational and clinical processes by its systematic collection of risk information, explicitly linking data to clinical risk judgements, and showing how those judgments are derived. Increasing international awareness has come through presentations to mental-health practitioners in Europe, America, and Australia.

Summary of the impact

Research undertaken at the Centre for Intellectual and Developmental Disabilities(CIDD), has significantly impacted upon:

1. The identification of health inequalities through improved health surveillance.
2. The development of a network of Health Facilitators linked to GP Practices to promote health screening/annual checks.
3. The development of accessible information to assist people with ID in making positive lifestyle choices and access healthcare services.
4. The development of health promotion interventions targeting secondary health conditions for people with ID.
5. The translation of this research into pre/post multi-disciplinary education.
6. The preparation of regional, national and international policy guidelines.

Summary of the impact

Dr Lina Gega's research has been instrumental to the development and take-up of computerised Cognitive Behavioural Therapy (cCBT) and other technology-mediated interventions for common mental health problems in the UK and internationally. Gega's adjunct on-line methods form a key foundation for the training of professionals to support cCBT, and the National Institute for Health and Care Excellence (NICE) guidelines now include cCBT for first line intervention for common mental health problems. These developments have resulted in a greater patient reach for cCBT internationally, with resultant decreases in waiting time for patients (with associated economic benefit) and improved outcomes.

Summary of the impact

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.

Summary of the impact

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]).

Summary of the impact

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.

Summary of the impact

Alternatives to acute admission in mental health are crucial, not least because of the high cost of inpatient care. We have carried out a major research programme that includes the only randomised controlled evaluation of crisis resolution teams and the only major UK study of crisis houses, which are community-based, residential alternatives to hospital admission. This programme demonstrated the efficacy of community treatment and has significantly influenced decision making at a local and national policy level, including commissioning guidance and three sets of NICE guidelines. This has contributed to changes in the way acute services for severely mentally ill adults are configured in the NHS, and internationally.

Summary of the impact

This case study presents the impact of the Health and Temperature Research Group (HTRG) at Sheffield Hallam University, led by Professor Tod. The group generates novel, collaborative, translational, interdisciplinary (e.g. health, housing and environment, energy and welfare) research with a focus on cold related ill health. The research impact is illustrated here by The Keeping Warm in Later Life Project (KWILLT). KWILLT findings provide a unique understanding of the complex environment and multiple factors influencing older people keeping warm and well in winter. Beneficiaries include NHS, local and national policy makers, and practice organisations.