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The University of Nottingham's Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care has enhanced the understanding, implementation and uptake of advance care planning for end of life care. Its work has shaped public policy and influenced national initiatives that have improved quality of life and reduced the number of deaths in hospitals. The research has been cited as an exemplar by the World Health Organisation and has helped inform policymaking at European level. It has guided professional practice, educated care staff and contributed to a more positive public attitude towards talking about end of life issues.
Quality of care for the increasing numbers of frail older people is an issue of international concern. Led by Professor Meyer at City University London, in partnership with Age UK and Dementia UK, My Home Life (MHL) is a collaborative movement of people involved with care homes for older people. It was established to improve the quality of life of everyone connected with care homes for older people and has become the recognised voice for the sector. The original underpinning research and ensuing projects all focused on knowledge translation, in particular the factors that enhance quality improvement in care homes. MHL actively works with care homes to progress quality improvement and share the lessons learned throughout the system. The programme has had a significant impact on both policy and practice in health and social care, influencing Government policy and supporting practice improvement across national and international borders.
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.
The ability of healthcare professionals to empathise with patients has been shown to enhance patient satisfaction, improve symptoms and promote well-being. Research at University of Glasgow has developed the Consultation and Relational Empathy (CARE) Measure — the first validated, patient-rated questionnaire developed in a primary care setting that measures patient perceptions of healthcare professionals' empathy and quality of care. The CARE Measure is formally embedded into healthcare professional training standards through its inclusion in Scottish General Practitioner (GP) appraisals and the Royal College of General Practitioners Membership (MRCGP) and Interim Membership by Assessment of Performance (iMAP) processes; through these means more than 8,000 GPs are using the CARE Measure. It has also been incorporated into the Scottish Government's policy on Healthcare Quality and adopted by the General Medical Council and the Chartered Society of Physiotherapy.
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.
The research has had significant impact in the UK on the development of social and spiritual support for people at the end of life and their families. With Professor Holloway as Social Care Lead on the National End of Life Care Programme (NEoLCP) since 2009, the research has underpinned the launch of a framework for the delivery of social care at the end of life which is now in its second phase of implementation. The framework is endorsed by the Association of Directors of Adult Social Services and has led to local and regional Action Plans and social care practice initiatives. The research on spirituality has led to scoping and training initiatives in healthcare practice and in the funerals industry within the UK and internationally.
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.
Adult Social Care (ASC) is a growing sector which currently employs 1.6 million care workers and benefits 1.8 million care recipients. Research carried out by Manchester Metropolitan University (MMU) into the recruitment, development and retention of ASC workers has had a direct impact on ASC policy, management practice and human resource (HR) practice.
In the area of health, welfare and public policy, the primary research impact was on the Adult Social Care Recruitment and Retention Strategy 2011. Among ASC managers and HR practitioners, the research findings informed and stimulated debate over the conduct of ASC work and the benefits of good HR practice.
Research on the financing of adult social care in England resulted in the development of a full simulation model of the social care economy. This has allowed for the quantification of the costs and benefits of different funding reform options. The research has hence allowed for identification of the limitations of the current financing of social care, and has been relied on by the Government and by the Dilnot Commission in the formulation of new funding policies. It has also been used by social care groups (such as Age UK) to highlight the problems facing the funding of social care.
Research carried out by Professor Christopher Newdick in the School of Law, University of Reading, explored the ways in which individualistic `rights-based' models of healthcare cause problems within areas of finite public resources, such as NHS treatment rationing and priority-setting. By developing a new ethical model to help settle individual competing rights claims, the research produced impact by changing the policies and practices of a series of NHS Primary Care Trusts (PCTs) who implemented new Ethical Frameworks informed by Newdick's findings. By reframing the treatment rationing debate, and working directly with PCTs, his research produced a new, more robust and defensible way of balancing individual and collective interests within NHS decision-making.