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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 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.
York research has, continuously since the early 1990's, underpinned the methods by which a substantial proportion of the total NHS budget is allocated by the Department of Health to the organisations providing or arranging healthcare. Despite numerous NHS reforms, our research has produced formulae appropriate to each new system. These formulae have driven NHS policy on allocations across geographical areas and health care administrative entities in England, thereby ensuring that the population of approximately 55 million people receives a share of over £90 billion of healthcare resources that is fair and better reflects relative health care needs.
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]).
Swansea-led research on Thailand's universal healthcare coverage (UHC) reforms (1) helped change perceptions by showing researchers and policy makers in governmental and non-governmental organisations that UHC was viable in a lower-middle income country, (2) provided lessons about implementation challenges for other countries planning UHC reform, and (3) led to improved funding mechanisms in Thailand through the adoption of ring-fenced budgets for health centres and national priority services, and area-based commissioning. The study influenced the fine-tuning of Thailand's demand-side financing system to help develop a sustainable funding model that other aspiring UHC countries are emulating. Research recommendations were incorporated into the recent 10-Year Assessment of the Universal Coverage Scheme (UCS), which informed the Thai government health sector plan for 2013-15.
Research by the School of Pharmacy has been used by the UK Government in their drive to improve the nation's public health. Our evidence base was used to inform the 2008 White Paper "Pharmacy in England: Building on Strengths — Delivering the Future". Healthy Living Pharmacies, recommended by the White Paper, have been piloted leading to improved engagement with local commissioners, further training for pharmacy staff, more cost-effective delivery of public health services, and an increase in public awareness and access to these services. In addition, the Government backed Pharmacy and Public Health Forum is utilising our research in its remit to develop, implement and evaluate public health practice in pharmacy.
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.
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.
Evidence about the need for and provision of health visiting services generated through research undertaken at King's College London (KCL) has underpinned major changes in national policies for health visiting. Our findings about health visitors' practice, availability and distribution of services and effectiveness in terms of parenting/child outcomes, revealed both shortfalls in provision and opportunities for improvement and led to the development of a new caseload weighting tool and funding model for service planning. The accumulated evidence from this research helped convince the UK Government in 2010 to commit to 4,200 more health visitors by 2015 — a workforce expansion of nearly 50% — in a time of austerity and restraint elsewhere in the public sector.
We have achieved significant and far reaching impact in the field of public health outcomes, policy and practice. For the first time, age/sex disaggregated estimates of smoking and ex-smoking prevalence were made available for approximately 7700 electoral wards in England and around 1000 postcode sectors for Scotland. The information has influenced national tobacco control policies (e.g. the ban of smoking in enclosed public spaces in England) and has impacted on national smoking-related health inequalities by targeting delivery of cessation services where they are most needed. Findings have also informed anti-smoking campaigns led by health authorities, charities and pressure groups.