Policy-makers and researchers must understand each other better if practice is to be truly influenced by evidence. By Jon Glasby
As money gets tighter, doing things that really work becomes even more important. Although successive governments have championed evidence-based practice we still do too many things because this is how we’ve always done them.
The same is true with new policies, which can often be based on pre-conceived ideology rather than genuine evidence of what works. A good example, some would argue, is the current NHS reorganisation. Whatever the pros and cons, the evidence suggests the need for caution given that structural change by itself rarely delivers stated objectives, often doesn’t save money and can reduce morale and productivity. While the recent “listening exercise” did a good job of improving the previous White Paper, this might not have been necessary if we had learned previous lessons.
While policy-makers and researchers need each other, my own experience is that they rarely have much meaningful contact with each other and do not always understand each other’s worlds. Ask an academic a yes or no question, and you could easily get an “it depends” response – and even this might take us three years and £300,000. Equally, it’s dispiriting to be asked to conduct a national evaluation when you know the decision to roll out will be taken long before you finish and that the question to be answered at the end will be different to that at the start.
Against this background, a new book from The Policy Press reviews the relationship between evidence, policy and practice to identify where we’ve gone wrong and what we could do about it. Above all, evidence needs to influence policy upfront and we need to ask the right questions. There is no point looking for evidence after we’ve decided what to do, or to ask if something works when we’re going to do it anyway and what we really want to know is how best to make it work.
This requires much better relationships between policy-makers and researchers, and greater knowledge of each other’s priorities and ways of working.
People assume that policy is formed by looking at evidence and choosing the best way forward. In this model, the process is rational and linear, and all we need to do is conduct good research and disseminate it well. In practice, policy is messier than this, and researchers need to be actively involved in policy debates, aware that their evidence is only one of many voices competing for influence.
Another assumption is that policy-makers specify what to do and people on the ground simply implement this. In practice, policy is often incoherent or partially formed when it is launched, and there is a key role for local leaders and practitioners in making sense of and adapting it locally.
Many organisations also know what might work best, but struggle to deliver this. Thus the task isn’t telling them what works, but helping build their capacity to review and make sense of the evidence, decide what to do and implement this in practice.
Finally, we should revisit large-scale national evaluations, using these sparingly. If we’re not really interested in hearing the answers having asked the question, then we should look to a new approach. Here, we suggest a “due diligence model”, where researchers rapidly review the evidence, engage key stakeholders and help policy-makers think through what might happen, lessons from history, opportunities and barriers.
Ultimately, evidence and policy need each other now more than ever, and something fundamental in the relationship has to change.
Evidence and policy tips
● Evidence is only one voice competing for attention, so researchers need to be committed and passionate.
● Evidence needs to influence policy early on – not after the policy is formulated or rolled out.
● Policy-makers and researchers need to understand each other’s worlds and priorities.
● Sometimes it may be necessary to gather the best evidence in the time available rather than all the evidence.
● Simply “disseminating” more research won’t necessarily help to embed evidence in practice. Instead it may be more fruitful to support local leaders to make sense of emerging policy and help to create receptive local contexts.
● Asking the right question is crucial – asking “does this work?” requires a different approach from asking “if I do this, what might be the implications”.
Professor Jon Glasby is director of the Health Services Management Centre, University of Birmingham, and the editor of Evidence, Policy and Practice, which is published by The Policy Press.
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