Theorising Social Work Research
Social Work: Who owns the research process? 20th September 1999, Belfast Making research count - A strategic model for improving research-informed practice Mike Stein, David Johnstone, Marilyn Crawshaw & Liza Bingley Miller
The Government is committed to modernising the NHS, Local Government and Social Services. One of the main drivers by which this will be achieved is through a skilled and well-informed workforce using research informed knowledge and evidence where it is available. (Department of Health. The New NHS: Modern and Dependable 1997; Department of Health. Modernising Social Services, 1998; Department of Health. A First Class Service: Quality in the new NHS. 1998, Department of Health, Saving Lives: Our Healthier Nation, 1999)
Making Research Count is a national initiative intended to increase awareness of research findings and contribute to the development of a culture which takes account of the existing evidence base in policy and practice across all service user groups. It is based on a network of four Universities with each centre developing links with agencies regionally.
Making Research Count (York)
Making Research Count (York) has been commissioned by ten Social Services Departments in the Northern Region of the Association of Directors of Social Services (ADSS), Northern & Yorkshire NHS(E) Region and the regional Social Services Inspectorate (SSI) to help them develop ways of increasing their use of research in the field of joint working in health and social care. A pilot phase of this work is now underway and will run until the end of March 2000.
The Making Research Count (York) strategic model for delivery both disseminates research and takes account of the available evidence and experience to help managers and practitioners implement research evidence in policy and practice changes. The commissioning of this work has come at a time when major central government initiatives are being announced and implemented. The development and delivery of the Programme will relate closely to central government philosophy as well as to the resulting National Priority Guidance and frameworks.
The effective use of research
Training events and conferences may increase individual participants' knowledge. However, evidence and experience suggests that attendance at training events and conferences has only a limited impact in achieving sustained changes in policy direction or practice unless clearly linked into agency-agreed implementation strategies (Lomas J 1991, 1993; Oxman AD et al. 1995). Making Research Count (York) is therefore piloting a model which seeks to link the dissemination of research findings to an implementation strategy. The model will be fully evaluated to establish how far this approach helps participants retain research findings and use them in their practice and the development of policy.
Developing the programme
A central principle guiding the development work is the importance of involving commissioning agencies and potential participants as fully as possible at all stages of planning. To this end, Making Research Count (York) has linked in with the six Regional Working Groups already set up by the Northern ADSS. There is a group for each main service user group (people with learning disabilities, people with mental illhealth, older people, people with physical disabilities, chronic health and sensory impairment, and children & families), with the sixth group covering human resources.
Each Regional Working Group has a Lead Person who is responsible for organising the group, and a Link Director of Social Services. Making Research Count (York) has liaised with the five service user-focused groups in order to determine the programme. The programme will comprise two modules for each group, one being delivered in the autumn and one in the spring.
The groups, with the help of the NHS(E) Research and Development and Public Health sections, have each been responsible for identifying representatives from Health to be involved in this process.
The making research count (York) model:
The Making Research Count (York) model has two major stages:
Stage 1: Setting Up the Programme
The Making Research Count (York) team works in collaboration with the ADSS Regional Working Groups, Health representatives, and the SSI to draw up a programme of Research Dissemination Days for each service user sector. Each module of the programme is annotated according to national performance indicators for both Health and Social Care.
The Making Research Count (York) team then commissions researchers to work in partnership with them to deliver the specific modules of the Programme.
Stage 2: Programme Delivery
Each module takes place over a 4-6 week period with participants receiving two days input from researchers and Making Research Count (York) staff. These are a Research Dissemination Day and an Implementation Strategy Day. There is preparation work to be undertaken by participants in their agencies prior to each day.
Prior to the Research Dissemination Day
- participants set up a schedule for consultation within their agency (and inter agency if appropriate) to take place following the first day.
The Research Dissemination Day
- usually comprises two sessions delivered on the same day. Each session takes a particular focus - for example, user consultation for older people, young people leaving care or inter-agency work with mentally disordered offenders. Making Research Count (York) brings researchers who are both well versed in the current research in a particular field of study and able to enter into dialogue with practitioners about the implications for implementation.
The audience is usually the same at each session, though changes to the audience between sessions may be specifically requested by an agency. The ten participating Social Services Departments each send two staff, making a total of 20 places; Health have 20 places drawn from Health Authorities, Trusts and Primary Care Groups; and the Social Services Inspectorate have one place.
The main focus of the Research Dissemination Day is on outlining research findings, including what seems to work, what seems not to work and what has not been researched. These sessions are interactive. Participants need to clarify their understanding of the research as fully as possible in order to be able to move on to consultation with their colleagues afterwards.
Consultation in Agencies
- participants return to their agencies with the remit of cascading the key messages from the research through meetings with colleagues within their agencies and externally, if appropriate.
At this point agencies are in a position to assess the implications of the research evidence for the policies and practice in their agencies and to set potential goals for change in preparation for the Implementation Strategy Day. Participants can contact the Making Research Count (York) staff for consultation during this interval.
The Implementation Strategy Day
- is the follow up session in the module and is run four to six weeks after the Research Dissemination Day. It is facilitated by the researchers and Making Research Count (York) staff with the objective of helping participants use a research-informed focus to move towards an implementation strategy.
By running the Implementation Strategy Day twice, double the number of staff can attend. Staff need to be identified by their senior managers as being of central strategic importance to working on an implementation strategy. In most cases, staff who attended the first day return to the follow up day with additional colleagues. By this stage, some agencies may have decided that they wish to collaborate with each other in moving towards an implementation strategy and hence they would attend the same Implementation Strategy Day.
- an evaluation of each session and of the overall programme is carried out by Making Research Count (York).
Although the Implementation Strategy Days end the agreed commitment by Making Research Count (York), consideration will be given to running some follow up support sessions for those agency staff who are seeking to move forward with implementation, if funding allows. There is evidence to suggest that such 'change agents' will need support to maintain momentum and direction (Dunning M et al. 1998).
As the project develops, some agencies may wish to move to a third stage and seek further consultation from the University of York or elsewhere, on aspects of implemented changes. This is not part of this phase of the Making Research Count (York) programme of work and will therefore be subject to separate funding arrangements.
Department of Health. The New NHS: Modern and Dependable, Stationery Office 1997
Department of Health. Modernising Social Services, Stationery Office December 1998
Department of Health. A First Class Service: Quality in the new NHS. London Health Circular HSC 1998/113)
Department of Health. Saving Lives: Our Healthier Nation, Stationery Office 1999
Dunning M, Abi-Aad G, Gilbert d, Gillam S, & Livett H (1998) Turning Evidence into Everyday Practice London, Kings Fund Publishing
Lomas J (1991) Words without actions? The production, dissemination and impact of consensus recommendations. Annual Review of Public Health, 1991; 12:41-65
Lomas J (1993) Retailing Research: Increasing the role of evidence in clinical services for childbirth Milbank Q 1993, 71:439-75
Oxman AD, Thompson MA, Davis DA (1995) No Magic Bullets: A Systematic Review of 102 Trials of Interventions to Improve Professional Practice CMAJ, 1995, 153:1423-31