Education And Debate

Increasing the impact of health services research

BMJ 2003; 327 doi: (Published 04 December 2003) Cite this as: BMJ 2003;327:1339
  1. Penelope Dash, independent consultant in health policy1,
  2. Natasha Gowman, health policy manager1,
  3. Michael Traynor, nursing and allied health professions facilitator (
  1. 1Health Foundation, London WC2E 9RA
  1. Correspondence to: M Traynor
  • Accepted 21 November 2003

A new report from the Health Foundation and Nuffield Trust suggests managers and policy makers are not able to base decisions about reforming health services on the best available evidence

Improving quality and performance in the NHS requires a developmental approach that applies research to a planned process of change. Decision makers need many questions answering. How should clinical teams be organised and resourced to deliver higher quality, safer care? How could hospital environments be improved? How should local services be configured to ensure convenient access and optimal quality? And how can recruitment and retention of healthcare staff be enhanced? Despite clarity about the questions, decision makers feel they lack the research that would help them generate answers. So what can be done to improve the use of health service research?

State of health services research

In 2002, the Health Foundation and the Nuffield Trust jointly commissioned a review of health services research in the United Kingdom.1 The aim was to examine how independent grant funders in health could enhance the contribution of health services research to improving services and policy making and to learn from the role of charitable foundations in other countries.

Research for the review, conducted during January to August 2003, included interviews with 35 senior UK health services researchers, health service managers, policy makers, or research commissioners. It also included an analysis of case studies and a review of successful initiatives in the United States and Canada. The research showed that everyone involved with health services research is dissatisfied to some extent with the current research process, albeit from different perspectives (box 1).

Improved hospital environments, such as this award-winning design (the new medical campus of the Norfolk and Norwich NHS Trust), are one result of the application of health services research

Box 1: Perspectives on problem of health services research

  • Researchers are frustrated that their work isn't used …

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