An evidence synthesis programme commissioned by the UK’s National Institute for Health Research from two academic teams produced a diverse range of outputs and methodological insights in its first three years of operation. The programme was subsequently re-commissioned for two further cycles. Scoping the topic and involving stakeholders were key to its success.
Matthew Johnson, Elliott Johnson, Laura Webber and Kate Pickett
The COVID-19 pandemic has increased interest in Universal Basic Income (UBI) as a means of addressing a range of socio-economic insecurities. While previous trials of cash transfer schemes have often focused on low-level transfers inadequate to satisfy the needs for which the policy was originally developed, emerging pilots are moving toward a position of increasing generosity. Our multidisciplinary project, Examining the Health Case for UBI, has brought together colleagues in behavioural science, public health, epidemiology and economics to establish pathways to health impact outlined in Figure 1 below. Our work suggests the potential for significant health impact and attendant economic benefit via reduced healthcare costs and increased economic activity. The model suggests that elements of impact may only be felt if payment is set at a more generous level. This could create greater return on investment and, ironically, a more cost-effective system.
Sheena Asthana, Rod Sheaff, Ray Jones and Arunangsu Chatterjee
In an article published in Evidence & Policy last year, ‘eHealth technologies and the know-do gap: exploring the role of knowledge mobilisation’, we described the eHealth Productivity and Innovation in Cornwall and the Isles of Scilly (EPIC) project, which aims to support the development of a sustainable innovation ecosystem. We found that, in order to build practically useful links between user (and/or carer) groups and those developing new eHealth technologies, the EPIC team had to invest significant resources in knowledge sharing, one-to-one networking, building focused linkages and capacity building; that financial support can play a key role in supply-side dynamics; but that the contextual and organisational barriers to eHealth innovation in England should not be underestimated.
We find that the adoption of evidence-based policies in US states is driven more by Machiavellianism than altruism. Although engagement with evidence-based policymaking (EBP) can produce more efficient and effective government, it can also supply new levers of control to politicians and bureaucrats, which can be used to produce electoral benefits. An appeal to EBP can be used to centralise control of executive functions, as well as to manipulate budgets, that incentivise adoption. Further, the construction, purpose and outcomes of these laws are influenced by the institutions, parties and officeholders who craft them. Our study finds that Democratic governors, Republican legislatures and state innovativeness are significant predictors of EBP adoption in the American states.
Complexity in healthcare systems presents knowledge translation (KT) challenges but also opportunities. Our Evidence & Policy article, ‘Connecting knowledge and action in complex health systems: examples from British Columbia, Canada’, illustrates ways we have harnessed complexity to narrow the gap between knowledge and action. We work across different health authorities and funding agencies building strong relationships with those who use research, fostering innovation, supporting evidence-based decision-making and helping people to de-implement obsolete practices. We share a commitment to building strong connections between knowledge and action, and our work is enhanced by embracing the inherent intricacies of the systems in which we work.
We share examples from our practice areas of how we navigate the demands of knowledge translation using responsive solutions and relationship building to support KT that promotes health. While many health systems leaders continue to perceive researchers and research as irrelevant and disconnected from their realities, we have found that when research is undertaken with people who use it, reciprocal and responsive relationships can overcome this barrier and lead to collaborations that support healthcare improvements. Embracing research as a public good requires reimagining the relationships and structures of both research and KT, and we are encouraged by the many ways we’ve seen this happen.
How are you doing? You told me how you could not stop binging on COVID-19 news. So, I am sending you something different: “Risk, uncertainty and medical practice: changes in the medical professions following disaster” by Sudeepa Abeysinghe et al. I can see you wince, complaining that a paper written about a nuclear disaster that happened 9 years earlier has nothing to do with what we are undergoing now (note: this piece was written in March-April 2020). Well, I would argue that the paper is quite relevant today because it gives us perspective on how the medical professionals stretched their roles/responsibilities in times of crisis. You told me of your deep respect for these professionals, and I believe this paper will increase your understanding of their challenges and even deepen your appreciation.
Accounts of medical professionals performing triage due to the over-burden of healthcare systems during the COVID-19 pandemic are hard to hear. They are a microcosm of dynamics that are occurring globally, where public health authorities and governments are attempting to simultaneously understand and respond to a swiftly moving global pandemic. In this article, the European Centre for Disease Prevention and Control Public Health Emergency team* offer lessons from recent history for decision making during this difficult time.