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Evidence-informed policy and practice

Building substantially on the earlier, landmark text, What Works? (Policy Press, 2000), this book brings together key thinkers and researchers to provide a contemporary review of the aspirations and realities of evidence-informed policy and practice. The text is clearly structured and provides sector-by-sector analysis of evidence use in policy-making and service delivery. It considers some cross-cutting themes, including a section of international commentaries, and concludes by looking at lessons from the past and prospects for the future.

This book will be of interest to a wide range of social science researchers, students and practitioners as well as those interested in supporting more evidence-informed policy and practice.

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Policy makers and practitioners have many questions about what they do and how it could be improved. They also have many different sources of evidence, as well as other forms of data, information and knowledge at their disposal to inform these questions. This chapter outlines some of the challenges faced by policy makers and practitioners in eliciting what they might want or need to know. It asks: how do we generate fresh empirical evidence? And how can this empirically derived evidence be synthesised (across similar studies) and then integrated with other forms of data and information to create new knowledge for application in policy and practice? This latter challenge is explored in two parts: research-based evidence synthesis is covered in this chapter, and broader knowledge integration is examined in more depth in Chapter Eleven.

Often the process by which new knowledge is gleaned from empirical study is referred to as research. But, as already noted in the introduction to this cross-cutting section, we cast the net widely to include any systematic and transparent gathering and analysis of data, whether construed as formal research or not. Such a view opens the door to a consideration of a much wider array of analyses than simply those produced by universities and other research institutes. This has implications for evidence quality, forcing considerations of validity, reliability and bias (see Box 10.1), and places new demands on would- be users to attend carefully to the critical appraisal of the underlying empirical work (again, developed further in Chapter Eleven).

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This chapter suggests that evidence is well to the fore in healthcare, with an emerging consensus as to what constitutes evidence and a willingness to consider evidence as an essential component of decision making. Nonetheless, many obstacles remain in bridging the gap between what is known about effective care and the care that patients actually receive. Many of the larger policy questions – such as the formation of fundholding general practices, and their subsequent abandonment – are not so well supported as the more detailed service issues, such as choice of first-line therapy. The chapter focuses primarily on evidence relating to effectiveness, and is largely confined to exploring how evidence is used in health service delivery.

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Within the criminal justice system, there is renewed interest in the role that evidence can play in shaping crime reduction policies and practices. This chapter charts the shift from the conclusion in the 1970s that ‘nothing works’ to the active search for ‘what works’ in the 1990s. Criminal justice research is characterised by its methodological plurality and, particularly in the UK, a belief in the need for a theory-driven approach to evaluation. One of the issues highlighted by the chapter is the potential danger of adopting tentative research results as firm effective practice principles. An evidence-based approach requires the implementation of current evidence to be carefully balanced and integrated with ongoing evaluations of effectiveness.

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For all the growth in a robust evidence base over recent decades, it has repeatedly been shown that such evidence often fails to have the impact that it might. Studies in healthcare show that it can take more than a decade before research evidence on the effectiveness of interventions passes through the system to become part of established practice. Other parts of the public sector – such as education, social care, and criminal justice services – are only beginning to grapple with what it means to be ‘evidence-based’. This chapter focuses more on service delivery and professional practice. It uses a diverse set of ideas from the social sciences – such as the diffusion of innovations and theories of individual and organisational learning – to explore how evidence might impact on services in a more timely and organised manner.

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Evidence-based policy and practice in public services

What counts is what works - but how can we actually tell what works? And what can we do with such knowledge to influence policy and practice? As all parts of the public sector embrace ‘evidence’ as a means of providing more effective and efficient public services, this book provides a timely and novel contribution to such debates. The authors consider the role of evidence in specific public policy areas (healthcare, education, criminal justice, social care, welfare, housing, transport and urban renewal), using experts in each field to explore the creation, dissemination and use of evidence within each. They consider in particular: How is research evidence of service effectiveness created? How does such evidence shape policy and influence service delivery? What efforts are being made to encourage greater utilisation of evidence in policy and practice? The rich cross-sectoral accounts of the many and diverse activities in each sector provide an insight into the ebb and flow of evidence as guidance to policy and practice. ‘What works?’ develops perceptive analyses of outstanding problems, and raises challenging agendas for service development and future research. The authors conclude with the all-important question of the implementation of evidence-based practice and lead the way to the reinvigoration of innovative thinking. With its relevance to both cutting-edge practice and research, this book is important reading for a wide range of managers and professionals in different sectors, as well as students and academics studying public policy, public administration, and social policy and management.

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How research can inform public services

This book provides a timely and novel contribution to understanding and enhancing evidence use. It builds on and complements the popular and best-selling “What Works?: Evidence-based policy and practice in public services" (Davies, Nutley and Smith, Policy Press, 2000), by drawing together current knowledge about how research gets used and how this can be encouraged and improved. In particular, the authors explore various multidiscipliary frameworks for understanding the research use agenda; consider how research use and the impact of research can be assessed; summarise the empirical evidence from the education, health care, social care and criminal justice fields about how research is used and how this can be improved and draw out practical issues that need to be addressed if research is to have greater impact on public services. “Using evidence" is important reading for university and government researchers, research funding bodies, public service managers and professionals, and students of public policy and management. It will also prove an invaluable guide for anyone involved in the implementation of evidence-based policy and practice.

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Despite a burgeoning literature and the development of new theories about knowledge mobilisation in the past 15 years, findings from this online survey in 2014 of over 100 research agencies (n=106; response rate 57%) show the challenges of making effective use of formal and informal learning. Many agencies rely on traditional knowledge ‘push’ activities; formal use of theoretical models and frameworks is patchy; and knowledge-sharing between agencies and the comprehensive evaluation of knowledge mobilisation programmes are limited. Closer links between research agencies, and between these and knowledge mobilisation researchers, could enhance future knowledge mobilisation practice and theory.

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This article presents results from a systematic review of the effectiveness of different mechanisms for promoting research use across the health, social care, criminal justice and education sectors. Findings suggest that research use is enhanced by interactions between researchers and research users, and by providing a supportive context for the uptake of research or research-based practice. Strategies using multiple mechanisms to encourage research use are also often successful. More research is needed to draw firm conclusions about the effectiveness of other approaches or of combining specific strategies. Despite this, some key lessons emerge about effective methods for implementing evidence-based policy and practice (EBPP).

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Given the diversity of approaches to creating evidence described in the previous chapter, an evident challenge is the need for a broadly shared understanding about what forms of evidence provide useful, legitimate or even compelling underpinnings for policy and practice. Yet reaching a workable consensus on appropriate ways of identifying and labelling good evidence is far from straightforward. In this chapter we consider some of the main ways in which evidence-promoting organisations have responded to this challenge, discussing examples of the different evidence standards that have emerged and commenting on their relative merits and implications.

The introduction to Section Three argued that it is appropriate to pay particular attention to research-based evidence when considering these issues, and many promoters of evidence do indeed place research at the centre of their deliberations. This privileging of research is due in part to the transparency and scrutiny that comes from the requirement that research studies should be explicit about their methods and must undergo rigorous peer review. Following on from this, Chapter Ten explored various approaches to gathering and analysing data, many but not all of which may come under the rubric of ‘research’, and concluded that there is often a need to combine a range of methodologies to answer the many interconnected questions that arise with policy makers and practitioners. However, combining evidence from different sources and different methodological approaches adds another layer of complexity and can be contentious – particularly when the aim is to make an overall judgement on the quality and strength of evidence in support of a novel proposition (such as a policy prescription or a practice innovation).

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