Accessibility statement

‌York Evidence Synthesis Centre

From 2014-2020 we were commissioned by the NIHR Health Services and Delivery Research programme to 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.

Topics addressed key areas of importance to the NHS. All of our completed topics are detailed below.  

Regulating and inspecting integrated health and social care in the UK: scoping the literature

The York Evidence Synthesis Centre was 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 have scoped 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 has been shared with the UK organisations that undertake regulation and inspection.

Protocol regulating & inspecting integrated care (PDF , 793kb)

Full report

Evidence summary regulating integrated care (PDF , 281kb)



Advance care planning: a systematic mapping review of the evidence

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 have identified 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 have fully mapped this existing evidence, highlighted the key issues and identified gaps in the evidence which future research should address.

Protocol advance care planning (PDF , 353kb) 

Full report

Evidence summary advance care planning (PDF , 321kb)



Promoting healthy lifestyles in the NHS workforce

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 identified evidence relevant to the promotion of healthy lifestyles amongst NHS staff, mapping existing evidence reviews that focus on promoting health and wellbeing in workplace settings and identified gaps in the evidence base. 

Protocol NHS lifestyles (PDF , 695kb)

Full report

Evidence summary promoting healthy lifestyles (PDF , 322kb)



Digital-first primary care: a rapid evidence synthesis

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.

Scoping work & protocol digital-first primary care (PDF , 754kb)

Full report

Evidence summary digital primary care (PDF , 370kb)

Conference poster presented at HSRUK 2019: Digital-first primary care (PDF , 249kb)



Police-related mental health triage interventions: a rapid evidence synthesis

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.

Scoping work and protocol police-related triage interventions (PDF , 969kb)

Full report

Evidence summary (PDF , 363kb)

NIHR Signal

Conference poster presented at HSRUK 2019: Police-related mental health triage (PDF , 251kb)


NIHR HS&DR evidence synthesis centres: achievements and learning from the first three year programme, 2014–2017 

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))

Evidence summary (PDF , 362kb)

Evidence & Policy 2019 article


Therapy interventions for children with neurodisability: a qualitative scoping study of current practice and perceived research needs

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.

Protocol neurodisability (PDF , 314kb)

Full report 

The provision of services in the UK for UK armed forces veterans with post-traumatic stress disorder (PTSD)

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.

Protocol veterans PTSD (PDF , 743kb)

Full report

Evidence summary (PDF , 302kb)

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)


Updated meta-review of evidence on support for carers

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.

Protocol informal carers (PDF , 412kb)

Full report

Evidence summary (PDF , 329kb)

Journal of Health Services Research & Policy 2018 article


How can organisations best support staff to manage patients with cognitive impairment?

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. 

Cognitive impairment rapid scoping review (PDF , 723kb)

‌Integrated care to address the physical health needs of people with severe mental illness

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.

Protocol integrated care (PDF , 504kb)

Full report‌

NIHR Signal - summary report

International Journal of Integrated Care 2018 article

Conference poster presented at HSRUK Symposium 2016: Integrated care for the physical health needs of people with SMI (PDF , 522kb)

Developing a methodological framework for organisational case studies

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.

Protocol organisational case studies (PDF , 498kb)

Full report 

Evidence summary (PDF , 268kb)

Conference poster presented at SSM 2016: Organisational case studies poster (PDF , 187kb)


Service user engagement and health service reconfiguration

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.

Protocol user engagement (PDF , 192kb)

Full report

Evidence summary (PDF , 280kb)

JHSRP 2015 article‌

Conference poster presented at HSRUK Symposium 2016: Engaging service users in major health service change (PDF , 533kb)

Image evidence summary user engagement report