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Our research on free personal care and, subsequently, self directed support in Scotland has influenced policy across the UK. It has influenced the continuing cross-party support for free personal care (£111m during 2011-12) in Scotland, and informed recent legislation, and has influenced debates in England about how to pay for the costs of long term care in the context of population ageing. In Wales, the detailed research on the actual costs of care influenced the decision not to take forward free personal care, due to its high costs. Internationally, the continuing research on the case of Scottish policy, especially the development of the costs, has informed wider policy debates, involving stakeholders in Europe and the USA.
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.
Although essential for coping with escalating health and social care demands, adoption of `remote care' — telecare and telehealth — has been slow. Professor Barlow's research group provided evidence to establish how remote care can be sustainably and efficiently embedded into healthcare. They then helped design and evaluate the Department of Health's Whole System Demonstrators, the world's largest trial of remote care. As a consequence, the government launched the 3 Million Lives programme in January 2012, with an estimated potential net benefit to the NHS of £450m over the next 5 years. Research taken up by the Audit Commission and TSB/DTI has further influenced UK remote care policy by developing the evidence base and evaluating gaps in basic research.
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.
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.
A major element of modernising English adult social care is the introduction of individual, user-directed budgets. The Social Policy Research Unit (SPRU) led a major, multi-method and multi-centre research programme evaluating the Individual Budget (IB) pilot projects in England; and a linked study of the impact of IBs on family carers. Through this, SPRU has influenced: the content of the Department of Health's (DH) good practice guidance for personal budgets; the DH's approach to piloting and evaluating NHS Personal Health Budgets; the Department for Work and Pensions (DWP) piloting and evaluation of `Right to Control' trailblazer projects; and, the agenda for an Audit Commission investigation into financial management of personal budgets. Most importantly, it has helped shape the agenda for national and local organisations striving to successfully implement personal budgets, particularly for older people.
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 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 by Professor Les Mayhew and Professor Ben Rickayzen at City University London on the question of how the public sector and the private market might jointly establish a better way of funding long-term care for the elderly has influenced policy thinking and development within the Treasury, the Department of Health, the Dilnot Commission, the actuarial profession and among ministers and parliamentarians. Evidence is provided here that shows that their research on population ageing has had an impact at the highest levels in Whitehall. In addition, Mayhew's work on integrated health and social care for Brent Council has helped to transform services at local level and provides a model that could be replicated more widely.
Research findings have informed the development of training and support for care home inspectors and toolkits for use by caring professionals, all of which are provided through the Care Quality Commission (CQC) website. Findings have also been disseminated nationally and internationally through a book aimed at practitioners and policy makers that has now been published in German and Polish and is selling strongly in Australia and the USA. The study has furthered professional and public awareness of the need for improved night-time care in care homes, in particular improved communication (from staff to residents) and training.