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About the research on how NHS commissioners use research evidence

What is the research that this highlight is based on?

This Highlight is based on the following NIHR-funded published studies:

And one project which has not yet completed:

Do you want to read more?

This section gives a bit more context about wider research, including NIHR studies and other landmark studies which have shaped what we know about how managers use evidence. It also signposts general resources for individuals and organisations, including training and networks supported by NIHR.

There is a growing evidence base on how evidence is used. This field is variously known as knowledge mobilisation, knowledge transfer and implementation science. NIHR-funded studies have contributed to this wider evidence base, from an influential 2004 review of diffusion of innovations (Greenhalgh) to a scoping review of management theories (Crilly 2013).

There is an interesting debate about the differences between the use of evidence for clinicians and for managers. While some have argued that evidence-based management is overdue (Rousseau), a seminal paper (Walshe and Shortell 2001) noted distinct differences in how different the evidence base and decision types were for clinicians and managers.

A recent NIHR study also highlighted the pressures on middle and frontline managers in the NHS, many of which could be characterised as 'extreme jobs' given intense and changing demands and pressures (Buchanan 2013). This is part of a wider body of NIHR research on management and leadership, including clinical hybrid management roles.

A related and much studied field is around the uptake of guidelines and mechanisms to facilitate this, such as audit and feedback. Resources in terms of published reviews are available through the NIHR-funded Cochrane review group on effective practice and organisation of care (EPOC), with a thread on implementation strategies http://epoc.cochrane.org/our-reviews.

A number of organisations have produced useful guidance for researchers to make their research more attractive to managers and other health service leaders. This includes a recent toolkit on communicating research by the Health Foundation in July 2017 http://www.health.org.uk/collection/communications-health-research-toolkit.

What else has NIHR done to support greater use of evidence by managers?

The NIHR has also funded collaborations between universities and health organisations, in the form of Collaborations for Leadership in Applied Health Research and Care (CLAHRCs), which include an investment in the knowledge broker role. These new forms of partnership have also been evaluated in NIHR-funded studies, including a focus on the knowledge mobilisation role (Rycroft-Malone).

NIHR has also invested in particular knowledge mobilisation fellows, supporting projects and people interested in how evidence is used in practice. More details are given here about these projects – and a useful background reading section, which provides a good introduction to the field.

From 2007-2013, the NIHR also funded a network for managers, hosted by the NHS Confederation, including research briefings for managers and linkage events, like research seminars and forums for chief executives https://www.journalslibrary.nihr.ac.uk/programmes/hsdr/081718202/#/.

Many CLAHRCs and others offer tailored training for managers on making use of evidence and reviewing research critically. Academic Health Science Networks (AHSNs) also play a role in spreading innovation and connecting healthcare managers to research.

There is increasing interest in how commissioners use evidence, with a ten-point manifesto developed by Sian Jones and Alison Turner http://blogs.bmj.com/ce/2016/10/27/a-call-for-action-improving-decision-making-in-the-commissioning-of-health-services/.


Buchanan D et al (2013) How do they manage? A qualitative study of the realities of middle and front-line management work in health care. NIHR Journals Library; 2013 Jun. Health Services

Crilly T et al (2013) http://www.netscc.ac.uk/netscc/hsdr/files/project/SDO_FR_09-1002-13_V07.pdf

Davies HTO, Nutley SM (2000). Developing learning organisations in the new NHS. British Medical Journal 2000, 320:998-1001

Ferlie E, Crilly T, Jashapara A (2010). Research utilization and knowledge mobilization: a scoping review of the literature. SDO project 08/1801/220.

Gabbay, J., le May, A. (2004). ‘Evidence based guidelines or collectively constructed "mindlines?" Ethnographic study of knowledge management in primary care’. BMJ 329(7473):1013.

Greenhalgh T, Robert G, Macfarlane F, Bate P and Kyriakidou O (2004). Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations. Milbank Quarterly, 82: 581–629

Rousseau, D. M. (2006) Is there such a thing as evidence-based management"? Academy of Management Review, 31,256-269.

Walshe, K., Rundall, T. (2001). ‘Evidence based management: from theory to practice in healthcare’. Milbank Quarterly, 79(3):429-457


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