We appraise and synthesise evidence on effectiveness, cost-effectiveness, patient experience, service delivery, implementation, resource use and equity to inform the organisation and delivery of health services.
We summarise the evidence in formats to make it as straightforward as possible for decision makers to use research evidence.
Topics address key areas of importance to the NHS. Ongoing and completed topics are detailed below.
The York Evidence Synthesis Centre has been asked to rapidly scope the evidence on the regulation and inspection of integrated health and social care.
Currently there are a number of professional regulators that oversee the conduct of different health and social care professionals (e.g. doctors, nurses, pharmacists, dentists, social workers). These organisations’ responsibilities include maintaining a public register of professionals, establishing standards for professional competence, and investigating complaints. In addition, there are a number of regulatory bodies responsible for overseeing the quality of health and social care services across the four countries of the UK. Among other activities, these bodies conduct inspections in different health and social care settings.
In recent years, in the UK and other countries, there has been a move toward a more “integrated” way of delivering health and social care. This involves better co-ordination between different parts of the NHS, and between the NHS and other organisations.
In some cases, having a more joined-up health and social care system has changed the ways in which care professionals work with each other and with the public. It also means that care is sometimes provided outside traditional settings. These changes have raised questions about how the traditional regulation and inspection of health and social care services should also change.
Researchers at CRD will scope the international literature to identify approaches to the regulation and inspection of integrated care, information about how well they work (or not), and whether such approaches could be implemented in the UK. A report will then be shared with the UK organisations that undertake regulation and inspection.
Advance care planning is a voluntary process of discussion about future care between an individual and their care providers. It might include an individual’s concerns and wishes, their important values or personal goals for care, their understanding about their illness and prognosis, preferences and wishes for types of care or treatment in the future and the availability of such treatment. Current national guidance documents state that advance care planning should be offered to anyone who is at risk of losing capacity (eg a life-limiting illness) as well as those who have fluctuating capacity (e.g. mental illness). For people living with dementia and their carers, there should be early and ongoing opportunities to discuss the benefits and processes of advance care planning and giving individuals the opportunity to review and change any decisions made.
We want to identify the existing research evidence that looks at how well advance care planning works, and what the barriers and facilitators to implementing it are. We know from our initial searches that many reviews of the research evidence have been published quite recently. We aim to fully map this existing evidence, to highlight the key issues and identify gaps in the evidence which future research should address.
The health and wellbeing of staff working in the NHS is a significant and longstanding issue in UK healthcare. There have been various initiatives including the NHS Healthy Workforce Programme which was established in 2016 to identify best practice in relation to promoting staff health. The findings of this programme informed the NHS Health and Wellbeing Framework which was introduced in 2018 with a focus on promoting healthy lifestyles in addition to addressing mental health and musculoskeletal health.
We have been asked to identify evidence relevant to the promotion of healthy lifestyles amongst NHS staff. We will undertake an iterative and responsive process to address this, initially mapping existing evidence reviews that focus on promoting health and wellbeing in workplace settings. The map will seek to characterise existing reviews and identify potential gaps in the evidence base. Additional work will be undertaken as necessary, if specific additional questions arise from the findings of the initial work.
NHS England uses the term ‘digital-first primary care’ to refer to delivery models through which a patient can receive the advice and treatment they need from their home or place of work via online symptom checking and remote consultation. In these models, the patient’s first point of contact with a GP is through a digital channel rather than face-to-face consultation, though the latter may remain an option if required.
NHS England initially approached the York HS&DR Evidence Synthesis Centre to help identify published evidence of potential relevance to digital-first primary care. An iterative process of scoping the literature was agreed. The first stage to scope and summarise existing evidence was undertaken and the findings discussed with NHS England, resulting in further refinement of the research questions of interest to be undertaken in a second stage evidence synthesis.
Conference poster presented at HSRUK 2019: Digital-first primary care (PDF , 249kb)
The objective of this project was to undertake an evidence synthesis to identify the evidence base for models of police-related mental health triage interventions. We aimed to identify which models have been described in the literature and any evidence on their effectiveness, acceptability and feasibility, alongside evidence on the barriers and facilitators relating to implementation.
Conference poster presented at HSRUK 2019: Police-related mental health triage (PDF , 251kb)
The objective of this topic is to address the following questions:
1. What is the evidence base on models of supportive self-management for individuals with mild to moderate frailty?
a. Are there differential effects between subgroups (eg. differing levels of frailty, specific long term conditions, different ethnic groups)?
b. Is there any evidence on uptake or engagement for self-management interventions?
2. What is the best method in routine clinical practice of identifying individuals with frailty who might benefit from supported self-management?
During scoping work to develop the protocol for this topic we identified relevant ongoing research. Consequently this work is currently on hold; we will return to it once the results of the ongoing research are available.
This report summarises our experience and learning from the first three years of the evidence synthesis centre programme which ran from early 2014 to early 2017. It was led by the team at the University of Sheffield and was developed from information contained in the available protocols and reports from both our centres, and from extensive reflection and discussion by team members both within and between the two centres.
Web report (Link will take you to the University of Sheffield’s NIHR project homepage - see Web Report (21 Aug 2017))
This qualitative scoping study has been undertaken to inform future research into physical, occupational and speech and language therapy support used by children with neurodisabilities.
As this is primary research not evidence synthesis, this topic was developed separately from the ongoing programme of work for the Evidence Synthesis Centre. The study was led by Professor Bryony Beresford of the Social Policy Research Unit (SPRU) at the University of York. For full details of the project, please see the SPRU project page.
The objective of this project was to undertake a rapid evidence review to explore what is known about current service provision; establish which models of care may be effective; indicate the particular types of treatment that show promise; and signpost where further research may be needed.
Conference poster presented at Cochrane Colloquium 2018: Services for UK armed forces veterans with PTSD (PDF , 198kb)
Conference poster presented at HSRUK 2019: Services for armed forces veterans with PTSD (PDF , 202kb)
The objective of this project was to update an earlier review (Parker, Arksey and Harden 2010) looking at the evidence base on outcomes and cost-effectiveness of support for unpaid carers of sick, disabled or older people. It was envisaged that updating this work would be an effective way of informing both the NHS and possible future research commissioning in relation to the needs of different types of carer and support interventions.
The objective of this project was to undertake a rapid scoping review to identify systematic reviews evaluating how organisations (within and related to the NHS or social care system in England) can provide support for staff to manage patients with cognitive impairment and to provide a map of the evidence.
The objectives of this project were to identify existing models for the provision of integrated care specifically to address the physical health needs of people with severe mental illness (SMI) when accessing mental health care services; identify facilitators and barriers to their implementation; and outline priority areas for further research.
Conference poster presented at HSRUK Symposium 2016: Integrated care for the physical health needs of people with SMI (PDF , 522kb)
The objective of this project was to synthesise the literature on methods of case study research and used a Delphi process to identify common reporting standards for organisational case study research, with particular application to the NHS.
Conference poster presented at SSM 2016: Organisational case studies poster (PDF , 187kb)
The objective of this project was to assess what is known about effective patient and public engagement in reconfiguration processes and identify implications for further research.
Conference poster presented at HSRUK Symposium 2016: Engaging service users in major health service change (PDF , 533kb)