Bringing evidence to the front line of adult social care

By Professor Jon Glasby, director, IMPACT

When I was training as a social worker, someone who went on to be very senior said: “You’ll make a good social worker, but the trouble is you think too much.”  I know what they meant: you have to walk before you can run, you should listen before talking, and you have to ask questions in ways that people can hear.  I was probably a very irritating student!

However, framing this as “you think too much” is really interesting. With something as important as adult social care, with something that touches people’s lives in such difficult, emotional, intimate ways – how can we ever “think too much?”  All too often, we see practice (‘doing’) and evidence/research (‘thinking’) as separate worlds, when really they’re two sides of the same coin. With scarce resources and severe financial and service pressures, we need services based on the best evidence of what works, but we also want evidence that answers questions that are genuinely important to practice and that makes a real difference in people’s lives.

Deep down, I suspect that the young me: (a) wanted to know whether things could be better, and (b) how to actually achieve this.  These questions should be at the front of every professional’s mind. After all, we’d be alarmed if we went for complex surgery, and the person performing the operation wasn’t up to speed with best practice and latest evidence.  Indeed, as one of our stakeholders pointed out, rather than just reading the latest research paper, we’d want the surgeon to have helped write it.

Implementing evidence is difficult in any public service, but there are particular issues in adult social care. From funding pressures to the fragmentation of current services, and from workforce shortages to the implications of Covid, it’s a huge challenge creating the time, space and conditions needed to implement evidence in the realities of practice. Many people are probably burnt out trying.

Bringing evidence to the front line 

Against this background, a new £15 million UK centre for implementing evidence in adult social care has been commissioned. IMPACT (Implementing Adult Care Together) will offer a brand new approach, and has funding for seven years from the Economic and Social Research Council and the Health Foundation.

It will be an ‘implementation centre’, supporting use of evidence to make a difference to front-line services and to people’s lives. Working within and across the four nations of the UK, IMPACT will draw on different types of research evidence, the lived experience of people who use services and their carers, and the practice wisdom of social care staff. We believe that all of these are important ways of understanding the world, and need to be brought together if we are to agree on what needs to change and how to bring this about.

IMPACT is getting up and running between April and June. Our leadership team of 13 policy, practice and academic partners includes people with experience of using services and organisations working with and for carers and frontline workers. Wider consortium members range from Age UK to the Office for National Statistics, and from the United Kingdom Homecare Association to Citizens Cymru Wales. We also have international advisors based in similar centres in Sweden and The Netherlands.

From June until the end of the year, we’ll be talking to the whole of the sector, in all its diversity, to identify the priorities we should be addressing and co-design a work programme that fills key gaps and adds value to what already works well. We’ll consult widely on delivery models and approaches that can really make a difference.

Delivering change on the ground

For example, we’ve suggested that one approach could be to set up a series of ‘change and improvement demonstrator sites’, where IMPACT funds a team of coaches to support a local area to implement a really significant change project (creating integrated health and social care teams might be one possible topic, or perhaps supporting people with learning disabilities to leave long-stay hospitals and live more ordinary lives in the community).

These coaches might be on the ground in a local area for 12-18 months, facilitating the local improvement project, supporting a local evaluation and working to make sure that lessons learned are embedded in national policy and future practice. This is just a hypothetical example to be debated during co-design – but hopefully it demonstrates one possible way in which IMPACT might work alongside local services to make a real difference in practice.

Shape our priorities

Central to this is our national survey to capture the views of everyone affected by social care. This will contribute directly to how we allocate the funding we’ve received, so this is an opportunity for everyone who reads Community Care to have a direct say about what happens next.

From summer 2021, we’ll also hold national and regional ‘assemblies’, bringing users, carers and people who work in adult social care together to help design what we do. We’ll also be meeting social care organisations, professions, membership bodies and other stakeholders to learn from their experience.

Once our full work plan is ready (late 2021), IMPACT will be getting ready to go in 2022, delivering practical improvement projects on the ground, working with local services to deliver hands-on support and learning with the sector how to use evidence effectively in practice. We’ll be working hard too to feed tested solutions into policy and practice and spread effective practices so everyone can benefit.

This is a massive agenda – but going back to where we started, one of the tests of IMPACT’s success will be that if a future student asks “why do we do it like that”, their manager won’t just say “you think too much”.  They’ll say “because there’s really good evidence (from research, from practice and from people’s lived experience) that it makes a difference to people’s lives” – and that’s what we believe IMPACT can achieve.

Jon Glasby is the director of IMPACT (Improving Adult Care Together), the new UK centre for implementing evidence in adult social care. You can help shape the centre’s work by completing its short survey.