Improving choices for care

This is a collaborative research project between the University of Kent and the Institute of Health & Society, Newcastle University.  Professor Stephen Peckham University of KentProfessor Bob Hudson, Visiting Professor, University of Kent,  Professor David Hunter, Newcastle UniversitySam Redgate, Research Associate, Newcastle University and Greg White, Research Associate, University of Kent

The difference between formulating a policy and making it work in practice, the ‘policy-implementation gap’, has long been recognised as a problem by policy makers and those responsible for putting policy into practice. To date, little attention has been paid to identifying the best ways of improving successful implementation in practice. The Department of Health, together with other central and local government organisations and professional bodies, developed a partnership programme for the Care Act 2014 involving innovative implementation support systems at national and regional levels to ensure local areas were well-placed to deliver the changes required. We will evaluate the extent to which these support arrangements have been successful and identify those elements that supported successful implementation and explore how they can be replicated for other major government policy programmes and initiatives.

We will review what has been done previously in other national programmes to assess their respective strengths and weaknesses. We will consider what constitutes good practice across a range of centrally driven national programmes designed to support the introduction of new social care related policy initiatives. We will also undertake research in a number of local authorities to examine the experiences and impact of the Care Act implementation support arrangements. We will examine evidence at four levels – national, regional, local strategic and local frontline, including the views of users and carers – in order to build a comprehensive picture of what works under what circumstances when viewed by policy makers, local service providers and the users of services and their carers.

Finally, we will pull all this evidence and learning together to develop guidance for central and local governments for supporting new policy initiatives in social care and health. We are especially keen to establish links between the Care Act support and the early experience of NHS Improvement – the new NHS agency for supporting service improvement in the healthcare sector. We recognise that any framework will have to be adapted to specific contexts and issues, but anticipate that the components will serve as a guide to governments on actions most likely to bring about favourable results.

The key research objectives are to:

  • identify key lessons from previous implementation support methods and improvement research
  • evaluate the impact and effectiveness of the national and regional level support arrangements
  • understand the implementation issues at local level, including cultural, organisational and operational issues
  • develop a framework for understanding the requirements of a successful implementation programme and improvement service
  • spread knowledge transfer between improvement support for the Care Act and the methodology underpinning the emerging NHS ‘success regimes’ and new models of care being developed by the Vanguard sites as well as other policy support programmes across the public sector.