Social Care Research Impact

All posts by Anji Mehta

Sep 28
0

Local authority research feels chill wind of austerity

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by Geoff Ellis, Writer, PSSRU at LSE

Austerity has led to a reduction in the capacity of local authorities to undertake in-house research in Adult Social Care (ASC), according to a new SCEiP-funded report. While councils retain an evidence-based approach to decision-making, there are concerns that progress towards the development of a social care research infrastructure in English local authorities is being reversed.

The study, Research capacity, knowledge, skills and use in Councils with Adult Social Care Responsibilities, by Dr Chris Rainey, Dr John Woolham and Dr Martin Stevens, was based on an online survey of research oriented local government staff.

Even before the austerity programme, social care research in local authorities enjoyed a patchy and precarious existence. With increasing budgetary pressures, it is clearly vulnerable and not just in councils, for social care research activity is also at risk in the independent sector.

There is concern over the pressure on local authorities to provide quality-assured evidence across a broadening range of activities. Evidence suggests that many research staff have been gradually stripped out of local authorities as a cost-saving measure, with the result that the remaining employees have to do more research with fewer resources.

Over a third of respondents indicated that their local authority commissioned research externally. It appeared that commissioners of ASC were often also responsible for commissioning this research. The reasons for commissioning external research were predominantly the lack of availability of people with the right kinds of skills in-house. In some cases, it was also felt that external researchers offered greater perceived independence.

Decline

Cuts in numbers of staff and restrictions on training are likely to have affected both research capacity and capability. Analysis of self-assessed skill levels did suggest scope for skills improvement in some areas, particularly in research software. Predictive modelling was also identified as an area of significant need.

Respondents reported problems in attending conferences and other events and in maintaining membership of subscription organisations. They also expressed less support for secondment or study for academic qualifications. This, in all likelihood, leads to reliance on internet-based training and information and may result in a lack of exposure to critical debate and an over-reliance on received wisdom. The most common sources for research evidence were the Office for National Statistics and the Personal Social Services Research Unit.

Research Governance also appeared to be in decline. The overwhelming majority of local authorities had a named local research governance lead in 2012. But two years later, only 39% of survey respondents were certain that their local authority had a research governance lead. Numbers of named senior managers with responsibility for championing research had also declined. Previous studies have suggested that such a research champion has been a pre-requisite for successful implementation of local research programmes.

Potential

Public Health re-joining local authorities was most commonly felt to have resulted in improvements in the identification of need and use of the Joint Strategic Needs Assessment (JSNA). There was some optimism that this had the potential to improve research methods and standards. However, this finding does not take into account the 6.2% cut in councils’ public health budgets announced prior to the Budget.

Despite reduced research capacity, there appeared to be a positive commitment to using evidence in developing local policy and practice. Research activities were most often linked to performance management and local information systems. Anecdotal evidence suggested a trend towards less emphasis on the quality of practice and longer-term service improvement and more emphasis on cost-effectiveness, efficiency savings and short-term preventive measures.

It is worth noting, however, that only 16% of respondents reported that their local authority worked with service users and carer as researchers or to help with research activities, although a small proportion of respondents did refer to other forms of collaboration.

This snapshot survey has revealed the difficulties faced by local authority research, which appears to receive little support or development resources. There remains, however a number of research-like tasks, for example, the Adult Social Care Survey, that require some level of research competence. Similarly, local analysis of data returns for the Department of Health requires quantitative research skills.

The survey suggests the need for a national review of local authority research, to identify core functions and workforce requirements. This would need to take into account the different contexts of ASC departments, and the roles of academic social care research, which has developed as a topic since 1971, with more dedicated research units and developments such as the NIHR School for Social Care Research.

Aug 21
0

Musings about involvement in research…

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Almost every research funding application will now have a section asking about involvement,  be it “patient and public involvement”, “public involvement” or “user, carer, practitioner involvement”.

The first response for some will then be what does the funder want me to write. For others it’ll be I will have an advisory group with one carer, one user, one practitioner representative and they will meet every 6 months. Some will slowly drift towards, what I’ll call, tokenistic involvement to keep the funder happy (or just to be able to write something in that particular section) and hope it’s enough.

That’s not necessarily because those completing that research funding application don’t care about involvement. They might not feel involvement works for their proposed study and the default fall back is having an advisory group. For others it may just be not knowing what does work.

There are, of course, many conversations and issues around involvement: not least defining it, how to do it well, whether involvement improves the research or the impact from the research. These are, by their nature, complex discussions and to different interest groups raise a number of sensitive issues. For me perhaps the difficulty with entering these discussions is the current lack of knowledge and evidence on what does work, how and the outcomes for research, impact and on those involved themselves.

Yet, our learning from the SCEiP project suggests research needs to be involve relevant stakeholder’s to have an effect on policy or practice. Trying to garner interest in research findings after a three year study is difficult at best. This is something many funders already know, research that involves relevant non-academic groups is more likely to lead to impact. So, we know that… it’s nothing new… so why aren’t we seeing more of it?

SCEiP activities

Two of the many activities within the SCEiP project included bringing people who use social care services together to discuss involvement in research. This also provided an opportunity for academics, professionals, users and carers to work together to develop their own research proposals for mini project funding.

Becki Meakin from Shaping Our Lives discussed the first activity at our final conference last year. About 25 people got together, discussed key areas of practice they would like to research, and worked to develop a research funding application. Some of them were (at the time or previously) already involved in research studies; others had academic links or background. The group met twice before submitting their proposal. A number of issues were discussed in the first workshop: some of the discussion focused on what user-led research should be, questions were asked about whether academics had to be involved in proposals for them to be considered robust by funders, and issues aired around the potential barriers that arise for service users to develop proposals including the perceived lack of organisational/university support for such proposals and complex funding application processes.

An ideas swop shop was also organised providing an opportunity for academics, professionals and others to get together, discuss their research interests and pitch a project application to us. Funding of up to £5,000 was made available for those project applications. One project pitched to us and subsequently developed into a formal proposal involved the Campaign to End Loneliness and the University of Kent. The project – Hidden Citizens – drew together interests around social isolation and led to a successful collaboration which Adrian Adams presented at our final conference.

Our key messages from the project have been set out before. The project wasn’t aiming to evaluate involvement or knowledge exchange approaches. We’re not able to say involvement through one form or another works best, or that co-production of research proposals is a necessity for impact. However, our aim was to explore ways to improve knowledge exchange between researchers and professionals, and to test out ways methods for doing this. Some thoughts about this follow.

Musings

Co-production may, or may not be, the answer to a more evidence-informed policy and practice environment. To me it still feels as though we need more evidence on this and case study examples to review. In reality, given the nature of funding and of academia, it’s perhaps a way off. But as we’ve said earlier, knowledge exchange can, and should, take place throughout a research study, and research proposals should be developed and undertaken in discussion with key stakeholders to improve their relevance and subsequent impact. Research of value to practice has to have been formulated knowing what is of value to practice (and the same for policy). We’ve discussed before issues around expectations and contexts, and ideally those need to be discussed and aired before a research question is formulated.

It’s probably very easy for me to say there’s a lack of evidence around involvement but most funders expect it, and co-production is generally accepted as useful (especially for increasing relevance), so think about that in your future funding proposals.

In a recent meeting a carer spoke about her expectations for a role she may could have in research projects, it was clear that she didn’t want to be researcher doing the fieldwork necessarily but felt she had valuable experience and expertise on the question itself, the design, interpreting the findings and so on. There are great examples of service users being involved in research – such as service users as research advisors within a study on homeless women and the QORU Public Involvement Implementation Group– and others of practitioners engaging in research.

We’re perhaps in a chicken and egg situation. Someone has to take the lead in identifying a potential research area (inevitably something they are personally interested in) when a call for research proposals comes out. With a short timeframe in some cases to develop proposals, they might invariably look to their existing relationships to develop a proposal. At the same time we know it takes many months to develop relationships and its difficult to do that without funding and without knowing if funding will follow at some stage in the future.

Perhaps my naïve starting point would be to say involvement should be planned as best for the proposed project, but that implies the project comes first contradicting the idea of co-production. In an ideal world we would have a vibrant research culture in adult social care where such relationships exist to share knowledge and exchange ideas, with practice, policy and research continually learning from each others’ expertise.

So what’s the answer?

Well I can’t honestly say I know… but a few key recommendations come to mind

1. We need to be better at building relationships between research, practice, policy, services users, carers etc without these being tied to a specific research project or funding opportunities. We should be developing approaches that allow us to share knowledge and expertise, and should a funding opportunity arise be well placed to respond to it. There are already a number of networks available and perhaps we need to be better at engaging with those. Such relationships could also build from involvement in earlier studies – relationships don’t have to stop when studies finish. In doing so, we need to improve our understanding of each other – our expectations, our requirements and our reasons for being involved in research.

2. A number of funding opportunities are time-limited. But there are also open calls (such as ESRC’s open research calls) which allow for proposals to be submitted at any time during the year. We need to try to be better at identifying and developing proposals to such calls to allow us to take as much time as needed to develop relevant relationships or collaborations.

3. Research funders need to make smaller seed fund budgets available to allow people to use these to develop their proposals and collaborations – in much the same way as the NIHR’s research proposal development grants work. Funders also need to be more open about what has worked or hasn’t in terms of involvement in the projects they are funding.

4. Those involved in research projects need to share their experiences – more critical reflection from both researchers and those involved in studies seems vital.

5. And I couldn’t end without saying… we need more research on involvement, co-production, what works and doesn’t and – perhaps a more objective evidence-based discussion around this.

Aug 05
4

Blogging… a piece of cake… isn’t it?

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Blog cake I’ve been meaning to blog since April… I have 5 or 6 drafts of different blogs exploring some of the findings and themes emerging from the SCEiP project, and another few post-it notes with thoughts for other blogs…

It’s now August and I haven’t quite managed to finish those drafts and post the blogs (probably much to the annoyance of two colleagues who dedicate a lot of their time to this website and the aim behind it, although they’re too kind to say so!). But blogging is easy. Takes a couple of hours to draft a blog (for me and I’m not saying it’s any good), a few more to come back to it later and see if it makes any sense, work on it further, login to WordPress and post it. And there’s excellent encouragement on this site too! Yet somehow I haven’t managed to find the time to do this in about 4 months (more if you consider our project ended before then).

In the meantime I’ve been in meetings where some of the themes from those draft blogs have been discussed, and some of those meetings I’ve left frustrated that the discussion hasn’t moved forward (not for the lack of trying!) and I’m making points that everyone should already know… until I realise that I’m expecting others to know what our findings were and how they answered some of the points being raised without ever having put all of them down somewhere publicly. It’s not that we haven’t discussed the findings (we held a conference in November for example) or that there won’t be reports and papers from our project and the various subprojects and activities since then (I’m almost done on those!), but they were not necessarily out there for those participating in the meetings to know about or consider before we met. It’s worse if they didn’t know that information even existed (albeit in my head for some of it).

We’ve spent a lot of time in the SCEiP project encouraging researchers to share their findings openly with blogs being one method, not just 8-9 months after a study ends and the journal paper is published (a minimum guestimate assuming the paper was written before the project ended or the day after…) but regularly and throughout the research process. And no doubt there must be instances when they themselves go to conferences or meetings and feel their research has already provided the answers to some discussion points… but the journal paper hasn’t quite been published or circulated or they didn’t have time (or think to) write a blog on their initial findings (or couldn’t in case it affected whether a journal would accept the paper if findings had already been shared elsewhere). So they raise their findings at those meetings and aim to schedule a further meeting, or hope to find ways to link back with those they networked with, to take the discussion further.

Yet if we don’t get the information out there and – more importantly – to the people who could use it, we’re effectively not helping to move discussions forward – perhaps going as far as stalling them – which in turn means we can’t collectively create a positive impact (be it on wider discussions on knowledge exchange or impact for social care research, or evidence use in practice, or the evidence that commissioners and providers can use for the care and support they manage, or policymakers could use for policy developments). At the end of the day then we’re still discussing things and not implementing actions to address issues, and potentially just going around in circles. Academic researchers do need those journal papers for their own career progression of course but they do need to find ways of sharing their work before and alongside that in an accessible ways. We all do.

We probably all agree with that… doesn’t quite address my problem of not having finished and posted those blogs…

But that’s then in the planning and – to some extent – the value we place on our activities. I appreciate many a researcher finishes one research project and then has to move on to the next one the following day or not receive their salary, which in turn means they submitted the report to the funder but have to find a way to balance writing their journal paper or public output while working fully on another study (or a multitude). We’ve addressed this before – by putting in funded time to proposals to allow for these outputs to be produced (which most funders will not raise concerns with) funded time could effectively be made available, and by building them into the full research process they are not getting stacked up for the last day of the project – but perhaps the day-to-day isn’t something we fully control and other priorities come up, or saying this that doesn’t help after the fact when a project is already underway.

At the same time I know of one example of a researcher whose findings were shared with a key external organisation who wanted to include them in a seminal report which may have led to policy impact. The findings paper was going through the journal submission process so wouldn’t be published for a (long) while and there was no output to cite. The organisation wanted to include the information in some way anyway. So the researcher wrote a blog post and the organisation referenced that in the report and the evidence clearly tied back to the researcher and their study. The blog post in itself was widely cited and picked up in a large number of media outlets with clear references back to the researcher; there has been policy impact and the journal paper has subsequently been well cited.

I’m not saying that that one researcher placed more importance on the impact of their research or the need to share it with others and so spent the time writing the blog post rather than any other priority on the same day(s) – and it was important to make sure the evidence included in the organisation’s report was clearly tied back to research – than any other researcher does. In the last 4 months I’ve tried to come back to the blog drafts I have but there’s always been another pressing deadline to work on first, and then another (and that’s  probably the case for other outputs too). But for me it is important that those blogs do go up, we share our findings (and wider thoughts), and we have the opportunity to have your comments and thoughts on them. Not least so that when we get to the next meeting or the next event we’ve moved the discussion forward, and hopefully have actions happening not just discussion of what action should be taken.

I’ve now revisited the drafts and worked on them further. They’ll start posting on this site over the next couple of weeks and I look forward to the discussions they generate. Similarly the final papers from our work too. Progress!

This blog was not in any way intended to explain myself or the large gap since the last blog we posted here (!!), but did get me thinking that somewhere along the line we need to balance what is shared, how and when to support progress, and to avoid those conversations with comments like “but my work addresses this very issue, let me give you a summary and we can meet up again to discuss” or “that’s great you’re starting this new project, did you know of this interesting overlap (in that it’s the same) with my own work?” with other priorities on our time. At some point surely the time spent revisiting the same discussions could be better spent on getting the outputs out and then discussing them for those who can (decision makers, policy makers, people who use services, carers) to take positive actions. Perhaps that’s me talking to myself – a key lesson in looking back at the last few months!

Next post early next week!

Feb 27
2

A balancing act? Academic impact versus practice impact? Really?

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In considering all of the issues and queries that have arisen throughout the SCEiP project, perhaps one of the ones that still surprises me is the “but I can’t do both” statement. The idea that it’s not possible to achieve both academic and practice impact, and that researchers have to focus on activities to generate one or the other, but can’t manage both.

Is that really the case? Is it impossible to aim for both?

In fairness this doesn’t come from all researchers and the whole “non-academic impact agenda” is still relatively new… There are some great examples of researchers (across all levels) who are actively engaged in ensuring their research gets to those in practice or policy with the power to make best use of it – while still publishing regular journal papers of course. There are social care professionals studying Masters or PhDs, and working towards both academic and practice impact.

We’ve recently seen the REF2014 results come out and although still heavily weighted for academic outputs, the assessment does give consideration to impact (20%) and its evident that for many universities both the academic and the policy or practice impact is very important – an initial search found about 60 impact case studies submitted relevant to adult social care (more on those soon). There are rumours the 20% will be higher in REF2020.

So why not aim for both?

Professor Julia Black, LSE’s Pro-director for Research spoke at the SCEiP final conference and raised some interesting points. She noted that it’s not often the case that research is supply driven; a researcher can say they’ve got a fantastic piece of research, it’s obsessed them for the last 2-3 years and they think the rest of the world should be equally as interested in it and should know about it right now, only to find out that the rest of the world may not be interested or not feel this is the right time, or it’s not a priority. This may well be the case for some adult social care research.

So we go back to the suggestion that those in research and those in practice should work together to set research questions and undertake the research together. But, as Professor Black said, it can be very challenging for researchers to be told that what they think is a valid question isn’t that important for practitioners, and for practitioners to respond to academics that what they think is a practical solution, a practitioner knows is never going to work on the ground.

So they are right – it’s impossible to do both. The research and practice worlds travel on parallel tracks and can’t meet. There are different priorities and timetables: research is a long process and once completed researchers are aiming for top quality research publications to further their careers – which can take 9-12 months after the end of study to be written, submitted, accepted by a journal and revised ready for publication; professionals and decision-makers in social care need answers now, and preferably yesterday, and work within tight financial constraints and to competing demands for available funding. There are different languages and terminologies.

Well no…

Professor Black also said that these different expectations and timetables have to be managed and considered as part of the research process. It’s important to work with those who are operating in the area to ask how the world looks from their perspective and co-produce research on that basis. Constant dialogue needs to be maintained, and both researchers and professionals have to be prepared to be challenged.

This is where effective knowledge exchange plans come into play. And this doesn’t prevent a journal paper (or a few) being written and published.

What further surprises me is that some of those people state that their role is to do the research and that it’s for others to do the translating and get research out into practice or policy, yet those are also people who are translating their knowledge. They are presenting at conferences or events either organised by those in practice or policy settings or with those people in the audience, and are the very people that researchers say they are having conversations with at these events or in meetings. What’s more, when did research and impact become separated? Haven’t we always been doing “impact” but its just now labelled differently?

OK so where does that get us? Part of the issue seems to be recognising what is impact and where it is happening. Perhaps part of the issue is also that discussing the same barriers in numerous conversations is perpetuating the myth that it is academic versus practice/policy impact rather than alongside it. And that a handful of people saying they can’t do both does not suggest all researchers must feel that way.

It does seem to me that planning from the outset is key, identifying the target audience and the right knowledge exchange methods for those audiences. Funny how we’re back at our top six tips so far…

Feb 06
3

The SCEiP project …. And six lessons (to date…)

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About 29 months ago we set out to revolutionise the way in which knowledge was exchanged in social care, particularly between researchers and professionals… OK not quite what we were officially intending; we just wanted to explore what worked and how to remove the barriers that seemed to exist (or where believed by some to exist perhaps), and – with any luck – move from talking to action.

Why? We’ve had a long standing interest in how research, practice and policy work together to improve adult social care within the Personal Social Services Research Unit (PSSRU) at LSE, and various pieces of work have been undertaken exploring knowledge exchange (KE) in social care. Then along came HEFCE’s Research Excellence Framework with a view to putting impact firmly within its research assessment process, and the NIHR School for Social Care Research (which PSSRU is involved in) where the aim was to improve the evidence base for adult social care practice and to ensure that evidence was feeding into policy and practice developments. We knew of the barriers and it seemed that research and practice were moving along on parallel tracks to the same destination. So in 2012 we sought funding from the LSE’s Higher Education Innovation Fund and the SCEiP (Creating an Impact: Social Care Research in Action) project was established to test what could work and how, and provide tools to support greater KE.

Have we improved KE between researchers and practitioners in social care (as well as others)? Do we now know the best methods to use? SCEiP tested out a number of activities involving a large number of people, and we were lucky enough to have the scope to do that. There have been numerous times when we’ve stopped, reflected and realised that we’ve barely scratched the surface. That’s partly because improving the way knowledge is exchanged is not something we can do alone. At our final conference on 26 November it was great to see a very engaged room of 120+ people from a range of backgrounds all very enthusiastic to … well make sure research “makes a difference”, and hopefully each of those people will have gone back and made some (however small) improvement in the way they approach KE or more importantly how they approach their research or their practice. Perhaps that alone is not enough and one of the key lessons we came away from the project with is the need for reestablishing the foundations of research and practice rather than perhaps just trying to patch the knowledge exchange cracks… in an ideal world of course!

We did learn a lot and have a number of recommendations – on evidence into practice (and vice versa), building research capacity, impact assessment. Some of these were drawn out in the excellent visual note from Nat Al-Tahan at our final conference, while others we will share in papers and blogs over the coming weeks. Here we share our current top six lessons.

So what would be the top six lessons we would put forward now? There are probably quite a few… but to briefly limit to six:

Plan:
Somehow KE seems to be something that gets tagged on after a research project has been fully planned out. Maybe because it’s something research funders insist on but it’s still not clear how to do it or what actually works. Ensuring that KE activities are planned within research processes – as part of each core research activity and as part of the timeline for the proposed study – is very important and places research in a better position to have impact.

Knowing that research does not end with KE:
It seems the approach taken to KE is still that it’s something that happens at the end of a study when findings are available, as dissemination. It isn’t. It can – and should – take place throughout a research study from the development of the research question/proposal, telling the world the study is starting, sharing updates throughout, discussing interim findings, and so on. If target audiences do not know a study is happening, by the time the results come out the topic or area may not be relevant to them anymore and most practice decisions will already have been made. The more engaging the research process, the more likely it is that target audiences will stay engaged and use findings.

Knowledge exchange needs time and resources: A common barrier put forward is the lack of time and resources for KE activities. Yet funders want the research they fund to have impact and will fund clearly thought through KE activities relevant to the proposed project to support that. So why not ask them for the funding and build in time for integrated KE activities in research funding proposals?

Know your audience and target knowledge exchange methods to them:
KE activities will not work if they are not targeted. Proposing to use social media for professionals without addressing the issue that some face with lack of access to social media within work settings, or writing policy briefs when a decision maker will only read 2-4 pages maximum and will want to focus on the implications of those findings for them, may look good on paper but do not work in practice. Ideally planning of the research – and integrated KE activities – will take place with those audiences.

Innovative knowledge exchange methods and traditional methods are not mutually exclusive:
A KE activity targeted to professionals – such as a workshop or findings summary – does not have to replace the production of a journal paper. Arguments about not being able to do both are incorrect; academic and non-academic impact are not mutually exclusive. If planned appropriately with the right resources (time and funding) both can be done and any research project will be the better for that.

Evaluate:
It is very important to evaluate the activities as they take place and build in an evaluation process/framework in planning stages. Not knowing that an activity did or did not work – and why – until after a research project ends will not allow for learning to support tweaks in forthcoming activities.

These are all interlinked and doing one will lead to the others quite easily. Putting the time in to think through the proposed study (what the aim is, who the target audiences are, what would work best for those audiences, and resource implications) at the research proposal development stage will require some time, as does developing a research proposal anyway, but will ensure that any proposed study has the best possible start on its impact pathway, and then … its just a case of making it happen!