This blog post is based on the Evidence & Policy article ‘Empathy is key: addressing obstacles to policy progress of ‘work-focused healthcare’’.
Pre-pandemic, the UK government estimated that work loss due to ill-health costed around £100bn per year. This problem places an unsustainable burden on health, employment and welfare systems, and is a major cause of socioeconomic disadvantage and inequality. The potential for healthcare to reduce this burden has been reflected in numerous UK policy initiatives and clinical guidance ever since 2008, when Dame Carol Black published her seminal report Working for a Healthier Tomorrow.
However, over a decade later, avoidable work disability remains a leading public health concern. One key concept – healthcare professionals discussing work with their patients during routine consultations – has remained elusive in practice. There are clearly significant obstacles to translating ‘work-focused healthcare’ policy into practice. Our Evidence & Policy article sheds light on what those obstacles are and how they may be addressed. It raises wider concerns about how scientific evidence is used and understood by policymakers, making a novel contribution to the expanding literature which suggests that researcher-policy-practice relationships are key factors in mobilising the evidence.
We illuminate and expand on research commissioned by Public Health England in 2019 to further inform the ‘work-focused healthcare’ policy agenda. Building on our position as ‘trusted allies’, we took the unusual step of engaging with the funders to revise the original research commission and to work in close collaboration throughout. This is because, as experts in the field, we knew the commission reflected some key misunderstandings and incorrect assumptions that would not have resulted in meaningful findings. It was not feasible to make this process explicit in the commissioned report. In detailing it in this article, we are able to point to the opportunities for academics to build open and empathic relationships with policymakers, enabling the exchange and collaborative production of knowledge which is integral to evidence-based policy change.
We used findings from the commissioned research – a review of the literature on work conversations in healthcare, augmented with a qualitative study of key healthcare professionals (HCPs) – to show that a robust implementation of ‘work-focused healthcare’ policy was lacking. A narrative was constructed to both highlight this and reveal the consequences of it in the final report to the funders (as policymakers). Namely, that HCP awareness, engagement, and adoption remained low, resulting in limited empirical evidence, misguided directives and slow policy progress. The qualitative data were instrumental in this respect, with HCPs revealing various interpretations of, and discourse on the policy. As such, we provide valuable insights into the less apparent, relational elements of knowledge transfer that matter for decision-making in both the short- and longer-term.
Post-pandemic, ‘work-focused healthcare’ will be even more of a priority, but accepting that does not diminish the challenge it presents. After more than a decade, it remains an evidence-informed policy aspiration rather than an evidence-based practice. Long term, mutualistic, collaborative working will be central to addressing barriers to improving evidence use and mobilising this policy into practice.
Dr Serena Bartys is a Principal Research Fellow at the University of Huddersfield. Her research focuses on innovation in researcher-policy-practice relationships and knowledge mobilisation.
You can read the original research in Evidence & Policy:
Bartys, S. Martin, R. Parker, C. Edmondson, A. and Burton, K. (2021) Empathy is key: addressing obstacles to policy progress of ‘work-focused healthcare’. Evidence & Policy, DOI: 10.1332/174426421X16340308463939.
Image credit: Unplash.com
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