Professor Siobhan McClelland
Fitting the Context Speaking the Language Ticking the Boxes Making the Case Defining Success
The Context
Political: Elections/New Governments/New Ministers/New Organisations Economic: Stringency/austerity/competing resources/value for money Strategic: “Preventative, primary and community led”
The Opportunity: To demonstrate that services meet the context: deliver on strategic objectives, are cost effective and tick the boxes of decision makers The Danger: Competing for resources becomes fiercer; hard to change existing patterns of service delivery and resource allocation; easy to get rid of “soft” services; difficulties in securing ongoing revenue funding
Fierce and smart Robust evidence base Speaks the language of key decision makers Captures the policy community
Politicians National and Local Elections and Constituencies Short timeframes Personalities and beliefs Priorities Effective campaigns Individual testimony
Civil Servants and Managers P45 Targets Achieving strategic objectives Responding to ministers Avoid embarrassment Standards and Targets Accommodating vested interests Balancing the Books
Professionals The Media Pressure Groups Third Sector Private Sector
The Bad News: Rational policy making and resource allocation is a holy grail Lots of decisions about policy and resources are not based on evidence The Good News: It doesn’t have to be like this and it isn’t always like this We shouldn’t give up on developing a robust evidence base to inform decision making
Dominance of certain models of evidence notably bio medical model in health and ‘gold standards’ of evidence These suit pharmaceutical and technological interventions well but are more difficult for ‘softer’ services Demonstrating cost effectiveness/value for money is critical and developing methods for demonstrating this
Evaluation of nurse advisors and peer support interventions Very wide range of approaches Quality of Life Tools: ASCOT and Demqol Value for Money, Discrete Choice and Willingness to Pay Wide data set and detailed case studies In depth interviews with stakeholders, service users and carers
Need to develop and demonstrate robust range of methods which can stand against RCTs Never underestimate the power of the testimony of service users but.. It needs to be more than anecdotal The Black Arts...
A strong and defensible evidence base Fits the strategic context Meets operational imperatives Convinces decision makers at various levels Includes evaluation to further increase the evidence base