Article type
Year
Abstract
Introduction/Objective: This paper is based on a qualitative study, which aimed to identify factors which facilitate or impede evidence-based policy-making in the National Health Service (NHS). We consider how models of research utilisation drawn from the social sciences and from policy documents (notably the NHS R&D strategy) map onto empirical evidence from this study.
Methods: The study involved a literature review and case studies of social research projects which were initiated by NHS health authority managers or GP fund-holders. Data were collected through in-depth interviews with lead policy-makers, GPs and researchers working on each of the case studies and analysis of project documentation.
Results: Although researchers were often disappointed by the lack of visible impact of their work on policy, research commissioners did "use" research. However, the direct influence of research evidence on decision-making was tempered by factors such as financial constraints, shifting time-scales and decision-makers' own experiential knowledge. Research was more likely to impact on policy in indirect ways. The study highlights the importance of sustained dialogue between researchers and the users of research in getting research into policy. Those involved in developing policy at different levels were open to research evidence, even if it was critical, provided it came from an informed and credible source.
Discussion: We found little to support the "problem-solving" model of research utilisation which underpins much policy-making - including the NHS R&D strategy. Rather an "interactive" model is more realistic. Advocates of this model suggest there is limited opportunity for researchers to ensure that research findings are implemented directly. However, in outlining a "dialogical" model of research utilisation, we argue that there is potential for maximising the indirect benefits of research which include shaping policy debate and mediating dialogue between service providers and users. This discussion will be situated in the context of recent UK primary care policy initiatives.
Methods: The study involved a literature review and case studies of social research projects which were initiated by NHS health authority managers or GP fund-holders. Data were collected through in-depth interviews with lead policy-makers, GPs and researchers working on each of the case studies and analysis of project documentation.
Results: Although researchers were often disappointed by the lack of visible impact of their work on policy, research commissioners did "use" research. However, the direct influence of research evidence on decision-making was tempered by factors such as financial constraints, shifting time-scales and decision-makers' own experiential knowledge. Research was more likely to impact on policy in indirect ways. The study highlights the importance of sustained dialogue between researchers and the users of research in getting research into policy. Those involved in developing policy at different levels were open to research evidence, even if it was critical, provided it came from an informed and credible source.
Discussion: We found little to support the "problem-solving" model of research utilisation which underpins much policy-making - including the NHS R&D strategy. Rather an "interactive" model is more realistic. Advocates of this model suggest there is limited opportunity for researchers to ensure that research findings are implemented directly. However, in outlining a "dialogical" model of research utilisation, we argue that there is potential for maximising the indirect benefits of research which include shaping policy debate and mediating dialogue between service providers and users. This discussion will be situated in the context of recent UK primary care policy initiatives.