Evidence at a glance on how commissioners use research
Core findings and questions arising from the research
- Managers of all backgrounds find it hard to make sense of and apply evidence in their everyday work
- Studies show that managers tend to make less use of formal research. They value examples and experience of others, as well as local information and intelligence
- Senior managers rely on a small conversational circle and trusted colleagues to identify and interpret evidence
- Evidence does not speak for itself. Organisations need skills, not just technical around critical appraisal capacity, but also to engage experts and frame research for different audiences
- One study evaluating a service providing evidence briefings for commissioners found poor uptake and use of research for decision-making
- Having skilled individuals, like public health staff, on the spot to contextualise and interpret evidence helps managers use evidence when making decisions about systems and services
- Timing is key - having good enough evidence at the right time trumps perfect research which arrives too late for decision makers to use
Questions for staff and commissioning organisations
- Do we pause when making strategic decisions to see if and how evidence could be used?
- How can we best bring research together with other evidence (such as health needs or population data) to make decisions?
- Who could help us inside or outside the organisation to make sense of research for particular important problems?
- Can staff access training or expertise about understanding and using evidence? What library or information services can we use?
- Do we share our learning, including unexpected results of service changes, with others?
Extract from Evidence at a glance on how commissioners use research NIHR Dissemination Centre, March 2018
Key research
Flodgren 2019 Local opinion leaders: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews 2019, Issue 6. Art. No.: CD000125. DOI: 10.1002/14651858.CD000125.pub5. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000125.pub5/full
May R 2019 Lifecycle of a research project 6: how research might guide policy. Nursing Times (online); 115:6,36-37. https://www.nursingtimes.net/roles/nurse-educators/lifecycle-of-a-research-project-6-how-research-might-guide-policy/7028861.article
van der Graf P 2018 Localising and tailoring research evidence helps public health decision making, HILJ 2018 v35 p202-212. https://onlinelibrary.wiley.com/doi/epdf/10.1111/hir.12219
NIHR Dissemination Centre 2018 How commissioners use research https://www.dc.nihr.ac.uk/highlights/health-commissioners-research-evidence/
Health Foundation 2018 The Spread Challenge https://www.health.org.uk/publication/spread-challenge
Tate et al 2018 Learning to lead: a review and synthesis of literature examining healthcare managers' use of knowledge. J Health Serv Res Policy. 2018 Jul 25:1355819618786764. https://www.ncbi.nlm.nih.gov/pubmed/30044150
Petkovic et al 2018 “Do evidence summaries increase health policymakers’ use of evidence from systematic reviews?” Campbell Systematic Review 2018:8 https://campbellcollaboration.org/library/evidence-summaries-for-policymakers.html
Curry et al 2018 The capacity of health service commissioners to use evidence: a case study. Health Services and Delivery Research v6 (12), March 2018. https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr06120/#/abstract
van der Graaf 2018 Localising and tailoring research evidence helps public health decision making. Health Information and Libraries Journal v35 (3) p202-212 September 2018. https://onlinelibrary.wiley.com/doi/full/10.1111/hir.12219
Kelly et al 2017 Evidence based medicine meets democracy:the role of evidence based public health guidelines in local government Journal of Public Health 2017.
Wilson et al 2017. Effects of a demand-led evidence briefing service on the uptake and use of research evidence by commissioners of health services: a controlled before-and-after study. Health ServDeliv Res 2017;5(5). https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr05050#/abstract
Health Foundation 2016 Simpler, clearer, more stable: Integrated accountability for integrated care. http://www.health.org.uk/publication/simpler-clearer-more-stable
Wye 2015 BMC Health Services Research (2015) 15:430 http://www.biomedcentral.com/1472-6963/15/430
Kyratsis 2014 Making sense of evidence in management decisions: the role of research-based knowledge on innovation adoption and implementation in health care. Health Services and Delivery Research 2014;2(6) http://www.journalslibrary.nihr.ac.uk/hsdr/volume-2/issue-6#abstract
Bresnen 2014 Being a manager, becoming a professional? A case study and interview-based exploration of the use of management knowledge across communities of practice in health-care organisations. Health Services and Delivery Research Volume: 2, Issue: 14, https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr02140/
Clarke 2013 et al Evidence-based commissioning in the English NHS: who uses which sources of evidence? A survey 2010/2011. BMJ Open2013;3:e002714
Dopson 2013 Health care managers' access and use of management research . http://www.nets.nihr.ac.uk/projects/hsdr/081808242
Edwards et al 2013 Explaining Health Managers’ Information Seeking Behaviour and Use. Final report. NIHR Service Delivery and Organisation programme; 2013) http://www.nets.nihr.ac.uk/projects/hsdr/081808243
NHS Commissioning Board 2012. Commissioning Intelligence Model https://www.england.nhs.uk/wp-content/uploads/2012/12/comm-int-model.pdf
Swan 2012 Evidence in Management Decisions ( EMD ) - Advancing Knowledge Utilization in Healthcare Management. Health Services and Delivery Research 2012 08/1808/244. http://www.nets.nihr.ac.uk/projects/hsdr/081808244
MacDonald & Booth 2008 Healthcare Services Managers : What Information do They Need and Use? Evidence Based Library and Information Practice. Health Informatics Journal 2008; 14 (4); 247-258
Tools to support evidence based commissioning
Thoughts from CCG commissioners
“As commissioners we are influenced by a vast range of competing factors…research evidence is one of those factors which I value highly, but it doesn’t always help us out as commissioners.”
This blog post by a CCG commissioner describes the real life issues around using research evidence in policy making.
Evidence-based policy-making: the view from a commissioner. Rachel Anthwal, Delivery Director at Bristol CCG, 10 April 2017
"Often its evidence on specific subject matters, and needed to further inform decision making. It may be national i.e. what others are doing, it may be guidance for commissioners, or it may be clinical and best practice evidence. Of course I also want to source local evidence about what’s been done in the county and this is often difficult to find for the usual reasons- who to go to, and particularly just finding leads for topics."
"Where do I go for evidence- well I subscribe to a number of national bodies across health and social care so always look at their stuff, I also belong to an International Network so look wider than the UK, then I may also do random google searches, and speak with colleagues-both commissioner and provider. "
"What does good evidence look like? Firstly it must have current relevance, and provide final conclusions/recommendations. I want to do know why it was done, what they did, and what they found so lessons learnt. In terms of format I like reports, presentations and easy read data. I get frustrated if there is no exec summary/findings up front. Also if the report is not really getting to the point quickly. It can lay the findings behind this, but tell me quickly whats the purpose, outcomes. "
(LTC commissioner CCG]
Synthesis and packaging
“Highlights …with an overview but also a link so I can go into more depth if interested.
For busy people, as we all are, the snippets are great as you don’t have to wade through a whole load of words to understand what the info is about
Having everything in one email instead of having to remember where I saw this that and the other!!!”
[Ass Dir CCG]
Wiki created by Anne Gray, Knowledge Officer, Arden GEM CSU.
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