1. Professor Siobhan McClelland

2.  Fitting the Context  Speaking the Language  Ticking the Boxes  Making the Case  Defining Success

3. The Context...........

4. Political: Elections/New Governments/New Ministers/New Organisations Economic: Stringency/austerity/competing resources/value for money Strategic: “Preventative, primary and community led”

5. 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

6.  Fierce and smart  Robust evidence base  Speaks the language of key decision makers  Captures the policy community

7. Politicians  National and Local  Elections and Constituencies  Short timeframes  Personalities and beliefs  Priorities  Effective campaigns  Individual testimony

8. Civil Servants and Managers P45 Targets  Achieving strategic objectives  Responding to ministers  Avoid embarrassment  Standards and Targets  Accommodating vested interests  Balancing the Books

9.  Professionals  The Media  Pressure Groups  Third Sector  Private Sector

11. 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

12.  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

13.  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

14.  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...

15.  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