Decision-makers in public health can be confronted with a huge volume of data, evidence, reviews and summaries – from local and national sources. There is also an acknowledged gap between evidence and policy in public health.
In a recent blog on the EPPI centre website CLAHRC researchers Dylan Kneale and Antonio Rojas-García reflect on their work exploring the use of evidence in local public health decision-making – and raise the question – How much research is being wasted because it is not generalisable in local settings?
While reduced resources make judicious use of evidence more important than ever when deciding how and where to apply resources, researchers also need to understand, and better communicate, the generalisability of their research evidence to decision-makers working locally.
Read Evidence use in public health – make-do and mend?
The Getting it Right First Time (GIRFT) programme has completed a review of general surgery and stated that the NHS could see a significant reduction in the amount of people unnecessarily admitted for emergency general surgery if more acute hospitals introduced consultant-led surgical assessments at their ‘front door’.
Analysis by the GIRFT team shows this change could lead to up to 30% fewer general surgery emergency admissions a year where no operation is delivered, and could cut the NHS’s annual cost for this (£361million) by £108m.
CLAHRC North Thames is evaluating the planned changes to orthopaedics, to identify lessons to inform future efforts to improve the organisation and delivery of services.
A new report from healthcare think tank the King’s Fund sets out progress in delivering the Getting It Right First Time (GIRFT) programme deliver improvements in quality and reductions in the cost of orthopaedic care in England.
Tackling variations in clinical care Assessing the Getting It Right First Time (GIRFT) programme gives an overview of the programme, how clinicians have responded and what it has already highlighted in terms of variations of care across the NHS.
The CLAHRC is carrying out an evaluation of the planned changes to orthopaedics, to identify lessons to inform future efforts to improve the organisation and delivery of services.
A new CLAHRC publication offers valuable insight into the types of evidence used by decision-makers working in public health. In 2013, responsibility for public health services and planning shifted from the “health” boundary to local authority control. These services can range from health checks to open access sexual health.
CLAHRC researchers examined English local public health decision-making in a new review of what evidence is used and how by those planning, designing and commissioning services.
The review, published in a new paper in the Journal Implementation Science identifies three clear trends in evidence use
- the primacy of local evidence
- the important role of local experts in providing evidence and knowledge, and
- the high value placed on local evaluation evidence despite the varying methodological rigour.
Barriers to the use of research evidence included issues around access and availability of applicable research evidence, and indications that the use of evidence could be perceived as a bureaucratic process.
This is part of a wider project entitled Exploring decision-making processes and knowledge requirements in public health
Read the full paper
Kneale et al. Implementation Science (2017) 12:53
The use of evidence in English local public health decision-making: a systematic scoping review
Helen is a consultant in public health medicine and a health services researcher. She is a member of the CLAHRC research partnership team, and Deputy Director of the CLAHRC Academy. Her research uses qualitative and quantitative methods to evaluate health care and public health services.