Research and Evaluation in HSMC

Leadership is a complex and ever-evolving phenomenon, and is central to all aspects of designing, improving, managing and innovating in healthcare environments. 

Healthcare leadership has both a theoretical foundation and exists as applied practice. There is a growing awareness that effective leadership creates environments where people can flourish, and in so doing improve both clinical outcomes and patient or service user experience. At HSMC, our work around healthcare leadership encompasses research and evaluation, delivering accredited programmes for the NHS Leadership Academy, and forming strategic partnerships locally, nationally and increasingly internationally. 

Our work in this area aims to both learn more about and promulgate great leadership in healthcare. Leadership is the foundation upon which every aspect of good healthcare practice, be that clinical or managerial, is based. We are all, in some form or other, leaders; and we all have stories, for better or worse, about leadership.

Contact: Steve Gulati 

Our research

• An evaluation of Health Education England South West Clinical Leadership Mentors scheme
• "Yellow Hats are not just for Builders" An Improvement Lab for University Hospitals Birmingham NHS Trust
• Compassionate Leadership in Palliative and End of Life Care-A Focus Group Study
• Evaluating the Leading with Compassion Recognition Scheme in the West Midlands
• Surgical Leadership Programme 

 

Our work in this area includes both research for policy and research of policy, from the national/ system level to the organisational level. In particular, we focus on the stages of health policy including policy formulation, implementation and evaluation.

In our policy work, we collaborate with a range of regional and national health and care organisations in the statutory, voluntary and private sectors, in order to maximise the impact and reach of this activity.

HSMC seeks constantly to act as a bridge between research and practice. Our policy work is a key part of this process, and includes:

• research-based workshops and seminars for senior NHS leaders;
• briefings on new and emerging policy ideas;
• round table research discussions for policy makers;
• analytical support and advice to health service organisations; and
• regular series of Viewpoint articles on current health and social care topics on the HSMC website. 

Contact: Russell Mannion

Our research

Current and recent research projects include:

• Children and young people’s mental health trailblazer project (BRACE evaluation)
• Early Implementation of Primary Care Networks  (BRACE evaluation)
• Integrated care and support pioneers programme evaluation (2015-2020)
• Phronesis and the medical community (2015-2018)
• Decommissioning in health care: The view of patients, service users, carers and the public (2015-2017)
• Understanding employee whistleblowing in health care (2015 - 2017)

Members of this theme

• Professor Mark Exworthy
• Professor Nicola Gale
• Professor Russell Mannion
• Dr Ross Millar
• Professor Catherine Needham
• Professor Martin Powell
• Professor Judith Smith
• Iain Snelling
• Professor Iestyn Williams

Our work in this area focuses on the ways in which decisions are made and services are strategically planned in a context of financial pressures and multiple goals. 

It covers topics such as:

• The challenge of achieving equitable health care access and outcomes and the role of evidence in this.
• The commissioning and/or strategic planning function as a means of securing desired health care outcomes for populations.
• The role of public and other engagement activities in priority setting in health and care.
• The challenges of decommissioning medicines, services and health care organisations.

To this end, HSMC works to develop theory, empirical understanding and practical wisdom on the theme of decision making and strategic planning. This means collaborating nationally and internationally with academic, policy and practitioner partners.

Contact: Iestyn Williams

Our Research

Current and recent research projects from this work area include:

• The Impact of priority setting on pandemic preparedness and response: A Global comparative analysis of the role of priority setting and equity during the COVID-19 pandemic’ (led by McMaster University) 2020-2022.
• HealthcareLeadership with Political Astuteness (HELPA): a qualitative study of how service leaders understand and mediate the informal 'power and politics' of major health system change: developing lessons on the acquisition, use and contribution of political astuteness   (2017-2020)
• Commissioning, Co-commissioning and Being Commissioned; the NHS and Third Sector Organisations (2019-2022)
• Phronesis, Medical Leadership and ethical decision making: an educational video series (2015-2018)
• Diverse health care providers: Behaviour in response to commissioners, patients (2015-2017)
• Decommissioning: learning from best practice in the NHS (2014-2016)
• Decommissioning in health care: The views of patients, service users, carers and the public (2015-2016)
• Community Hospitals Research Programme (2014-2016)

Members of this theme

• Professor Mark Exworthy
• Professor Russell Mannion
• Professor Judith Smith
• Professor Iestyn Williams

The core focus of clinicians, practitioners, managers and organisations is how best to improve the support that they provide to patents and their communities.

Over recent years it has been recognised that in addition to delivering better outcomes, health and care services must also address the other ‘triple aims’ of increasing health equality and ensuring that resources are used efficiently.

There is now considerable evidence and theory regarding service improvement and the translating knowledge about what works from research into practice. Despite this accumulated wisdom, health and case services can struggle to successfully introduce and sustain improvements in the longer term.  Working across professional, service and organisational boundaries is a particular challenge.

The difficulties are many – competing priorities, unreceptive cultures, lack of resources, insufficient improvement skills and fragmented thinking. So too though are the solutions, and with careful planning, design and delivery it is possible to achieve benefits for the long-term.

Contact: Dr Ross Millar 

Our research

Recent and current projects include:

• Sibling Sexual Abuse Mapping Tool: Pilot Project
• Pancreatic cancer - optimising the patient pathway - the IMPROVE collaborative
  - Service evaluation of a surgical fast-track pathway for pancreatic cancer patients
• Evaluation of the implementation and role of Freedom to Speak Up Guardians in NHS trusts in England, (HSDR 2018-2021)
• Efficiency and quality of mental health trusts in England (Health Foundation, 2017-2021)
• Publication and related bias in health services and delivery research (HSDR): Systematic review of literature, evaluation of empirical evidence and methodology and key informant interviews (2017-2019)
• Chronic disease (integrated and holistic care)
  
• Evaluation of a programme to support the implementation of Human Factors and Ergonomics in General Practice - the TeamSTEPPS model
• Critical appraisal of Pacesetters Programme in Wales
• Evaluation of the Connected Care Vanguard (in process): Scoping and early findings report
• Evaluation of Human Factors Interventions in General Practice Schemes 
• Evaluation of Compassion Recognition Scheme.
• Time to Care and Set to Care 
• “Yellow hats are not just for builders” 
• Teams and incentives: An evaluation of new models of care in Dudley 
• Integrated Care and Support Pioneers Programme Evaluation 
• Partnering for Improvement  
• Hospital Boards and Health Care Quality Project  
• Managing change in social care 

Previous research

• Integrated Care and Support Pioneers Programme Evaluation 
• Partnering for Improvement  
• Hospital Boards and Health Care Quality Project  
• Managing change in social care
• Evaluation of the Connected Care Vanguard (in process): Scoping and early findings report

Members of this theme 

• Dr Kerry Allen
• Dr Jo Ellins
• Amarpreet Kaur
• Professor Russell Mannion
• Dr Ross Millar
• Professor Judith Smith
• Iain Snelling

Our work in this area addresses the key concepts, approaches, challenges and opportunities in negotiating the relationship between health and social care as it is provided, and as it is experienced by people, patients and communities.

Governments in many countries are encouraging greater involvement of patients and the public in health care decision-making in the belief that services will be more accessible, acceptable and effective if the people who use them are involved in their planning, design and delivery.

Moreover, the experience of people using a service is increasingly recognised as a critical dimension of health care quality, and efforts to understand and improve that experience are longstanding within the NHS and many other health systems internationally.

Contact: Professor Nicola Gale

Our research

Current and recent research projects focusing on the experiences of patients and members of the public include:

• Understanding Sexual behaviours in Children and Young People in the UK (2022-2024)
• The contribution of the voluntary sector to mental health crisis care in England (2016 - present)
• Decision-making for the treatment of cancer in older people across the UK (February 2016-September 2016)
• Decommissioning in health care: The view of patients, service users, carers and the public (2015-2017)
• Who knows best? Older people's contribution to understanding and preventing avoidable hospital admissions (2014-2016)
• Does Smaller Mean Better? Evaluating micro-enterprises in adult social care (2013-2015)

We involve patients and members of the public in our research as co-researchers, as advisors, as representatives, as participants, and as a key audience for our findings.

Members of this theme

• Dr Kerry Allen
• Professor Nicola Gale
• Amarpreet Kaur
• Dr Karen Newbigging
• Professor Iestyn Williams

HSMC undertake research, teaching and evaluation issues of the health/ care workforce as they relate to the nature of work, its organisation and its delivery. It is through staff that the triple aims of health care (improving access, enhancing quality and controlling costs) are put into practice.

We develop a close understanding of the lifeworlds of health and care workers. Our research, evaluation and teaching explores the power and social structures affecting the professional lives of healthcare workers, as well as the organisational and professional cultures they are embedded in.

Contact: Mark Exworthy or Nicola Gale

Our research

These are current and recent research projects focusing on the knowledge and practices within the health sector workforce, staff experiences, motivation and impact, the organisation of work, as well as the professions and careers within the sector:

• Evaluation of the RCP Chief Registrar programme  (2016-2017)
• Wessex Chief Registrar evaluation
• Healthcare Leadership with Political Astuteness (2017 - ) 
  
• Phronesis and the medical community (2015-2018)
• Towards a sociology of Risk Work (2015 - 2016)
• Set to care-enhancing compassionate care in practice: An Action Learning Approach (2014)
• Understanding employee whistleblowing in health care (2015 - 2017)
• Diverse health care providers: Behaviour in response to commissioners, patients (2015-2017)
• The Twenty-first Century Public Servant (2013-2014) 

Members of this theme

• Dr Kerry Allen
• Mervyn Conroy
• Professor Mark Exworthy
• Professor Nicola Gale
• Amarpreet Kaur
• Professor Russell Mannion
• Dr Ross Millar
• Professor Catherine Needham
• Professor Martin Powell
• Professor Judith Smith
• Iain Snelling

Doctoral Researchers

• James Brackley
• Julie Werrett
• Chris Gowing
• Michael Burrows
• Adekemi Sekoni
• Liam Spalding

Our approach to undertaking evaluations in health and social care is underpinned by four principles: 

• The outcome is co-designed: with stakeholders, then results in more robust and relevant findings. 
• There is meaningful involvement: meaningful, valued and well supported stakeholder involvement is central to the Stakeholder engagement. 
• Our work together is reflexive and developmental: to give space and time to consider findings as they emerge, reality check assumptions, and offer a critical eye.
• Building working relationships: to add capacity and value to the existing expertise of the organisations we work with.

HSMC is also the lead for the BRACE Centre (The Birmingham, RAND and Cambridge Evaluation Centre), a NIHR funded centre carrying out rapid evaluations of innovations in health service organisation and delivery.