Policy making is hard. Those responsible must account for a wide range of interests and ideas, as well as understanding the political issues relevant to the area. Evidence, therefore, can only ever be one aspect of what goes into the policy making ‘pot’. This can be hard for researchers to get to grips with – especially those of us who come from a medical or science background, where evidence is seen as the foundation on which decisions are made.
In policy, this foundation is particularly multifaceted, with public opinion, political ideologies, and individual convictions all being legitimate contributing factors to any given policy decision. This does not mean, however, that evidence is not important. Understanding what we know about a particular topic, as well as what has or hasn’t worked in the past, is crucial to the policy making process. Often, it is even more important to understand what we don’t know – sometimes, policy is required in areas where the evidence is simply not there.
Since 2010, the Policy Research Unit in Health and Care Systems and Commissioning (PRU HSSC, previously named PRUComm) has endeavoured to provide policy makers with the best evidence about how the health and care system works, the impact of previous policies, and the potential impacts of proposed changes.
We started fairly small, with just three co-directors, but over time we have expanded and brought in experts from different fields. Our management team now brings together various methods experts in social policy, health services research, and health economics. Topic experts have also become an integral part of our team, covering socio-legal studies, social care, primary care, commissioning and contracting, and system organisation and governance. Throughout the fourteen years we have expanded and evolved, there have been some invaluable lessons learned.
Firstly, building strong and lasting relationships with policy makers is vitally important. Responding quickly to queries, providing short and readable digests of pertinent evidence, and sustaining engagement throughout a project’s lifetime all help to strengthen relationships. Policy makers don’t necessarily want or need an extensive final report after three years’ work – they want rapid and digestible summaries as the project develops.
Moreover, keeping on top of the policy landscape is paramount. This means reading policy and guidance documents as they are published and thinking about how the evidence is relevant. For example, when the White Paper, on which the Health and Care Act 2022 was based, was published, we were able to provide short, evidence-informed commentaries (here, and here) for the policy makers responsible for drafting the subsequent Bill. It isn’t our role to shape legislation, but we can be part of the conversation, ensuring that those who are responsible understand the evidence landscape.
Finally, we have found enormous benefit from our longevity in the field. Having researched the implementation of Clinical Commissioning Groups in 2012, we were able to draw parallels and remind policy makers of previous successes and shortcomings . Policy making is fast paced and pressured, and staff move between departments quite regularly. We serve as an institutional memory, highlighting the cyclical nature of policy and the frequency with which the same issues resurface.
It is an exciting time to be conducting this research – integrated care systems are just bedding down, health and care services are grappling with significant performance challenges, and, as of January 2024, we received a further five years of funding. Our refreshed website provides links to all our previous research, as well as our ongoing projects.
We will regularly share updates on our work, including blogs covering important policy topics and commentaries on methods. If you are interested in our work, please get in touch and sign up for regular updates.