UK Parliament POST note on innovation in adult social care

The UK Government’s 2021 People at the Heart of Care white paper identified innovation as key to delivering “outstanding quality” in adult social care in England. This POSTnote gives an overview of innovation in adult social care. It provides a summary of the types of innovation in the sector and evidence on key barriers to and facilitators of innovation. It also presents lessons from the COVID-19 pandemic. It focuses on England but also includes examples fromall four UK nations. • Innovations in adult social care can deliver improved quality of life, less need for health or social care support and greater carer satisfaction. • Many innovations exist in adult social care, but there is often little robust evidence about their effectiveness and successful ideas may not be widely adopted. • Enhanced staff retention, better training and less risk averse leadership may increase levels of innovation. • Building data and digital capacity, such as improving internet connections and digital skills, would facilitate innovation. • Collaboration between organisations, financial stability and regulator support can boost innovation. • Extensive innovation has been achieved during the pandemic but infrastructure, pay, funding and data are key to sustaining this

Improving the use of evidence in legislatures: the case of the UK Parliament

Despite claims that we now live in a post-truth society, it remains commonplace for policy-makers to consult research evidence to increase the robustness of decision-making. Few scholars of evidence-policy interfaces, however, have used legislatures as sites of study, despite the fact that they play a critical role in modern democracies. There is thus limited knowledge of how research evidence is sourced and used in legislatures, which presents challenges for academics and science advisory groups, as well as to others interested in ensuring that democratic decisions are evidence-informed. Here, we present results from an empirical study into the use of research in the UK Parliament, obtained through the use of a mixed methodology, including interviews and surveys of 157 people in parliament, as well as an ethnographic investigation of four committees. Here we are specifically interested in identifying the factors affecting the use of research evidence in Parliament, with the aim of improving its use. We focus on providing advice for the Higher Education Sector, which includes improving knowledge of, and engagement in, parliamentary processes, reform of academic incentives to stimulate the production of policy relevant information and to assist engagement, and working with trusted knowledge brokers. Implementing this advice should improve the chances that parliamentary decision-making is informed by research evidence

Vaccines against Vice: A constructive technology assessment of immunotherapies for addiction

This thesis examines the development of active immunotherapies or ‘vaccines’ for drug addiction, within the framework of constructive technology assessment. Drawing on post-structuralist and Foucauldian critiques of medicine and constructivism derived from Science and Technology Studies it explores how addiction has come to be understood and regulated in the twenty first century in the different socio-political contexts of the UK and the US. It argues that vaccines for addiction can be seen to combine ‘old’ and ‘new’ modes of biopolitics in a flexible way, representing neither the abdication of sovereign power nor a simple continuation of the well-known biopolitical strategies of advanced liberal democracies. Part I of the thesis assesses the role of the technology as a form of anatomo-politics aimed at disciplining and normalising the individual addicted body through voluntary and coerced treatment. Part II looks at the role of prophylactic vaccination as a form of biopolitics of the population and the ways in which technologies of domination are internalised and reproduced by individuals in the context of their parental role as guardians of their children’s future health and happiness. The study is a comparative UK/ US qualitative research design, focusing on two case studies of an illegal drug (cocaine) and a legal drug (nicotine). 31 interviews were conducted in the UK and the US with key actor groups involved in the development, and potential regulation and deployment of the vaccines, and 8 focus groups with potential users in the UK. The data analysis examines the discursive construction of addiction by these groups in order to guide empirically grounded interpretations of the potential benefits and drawbacks of the use of the technology in different settings. It also considers how lay participants in the UK respond to, or challenge, the dominant clinical gaze both as active participants in the medicalisation of addiction and as sites of potential resistance. This thesis challenges the notion of the neo-liberal individual which underpins the dominant discourses of biomedicine and bioethics. It is argued that the dualism of autonomy and subjugation marginalises the subjective experiences of the patient. Specifically, it suggests that the construction of the vaccines as life-long and 100% effective directs political attention away from the benefits of harm reduction whilst also excluding alternate technologies of the self from consideration. It concludes that there is a need to widen debate in order to develop a more integrated approach to drug use and addiction

LEARNING FROM RESEARCH: SYSTEMATIC REVIEWS FOR INFORMING POLICY DECISIONS A QUICK GUIDE Systematic Reviews for Informing Policy Decisions: A Quick Guide. A paper for the Alliance for Useful Evidence. London: Nesta. 3 SYSTEMATIC REVIEWS FOR INFORMING POLIC

"Instead of just mooching through the research literature, consciously or unconsciously picking out papers here and there that support [our] pre-existing beliefs, [we] take a scientific, systematic approach to the very process of looking for scientific evidence, ensuring that [our] evidence is as complete and representative as possible of all the research that has ever been done." (Ben Goldacre 2012) Systematic reviews provide a vital tool for policy makers and practitioners to find what works, how it works -and what might do harm. Whether it is policing, teaching, social care or any other area of social policy, reviews can inform us about what is known, how it is known, how this varies across studies. It also tells us what is not known from previous research. It now seems extraordinary that only a few decades ago it was acceptable practice to review research by ad hoc literature reviews or panels of experts. Summaries of research were not done in a systematic way and all sorts of biases crept in: reviewers did not attempt to identify all the relevant research, check that it was reliable, or write up their results in an accountable manner. But over the last forty years, we have a more rigorous systematic approach has been refined to review what is known and not known, as described so well by Ben Goldacre above. But let's also dispel a myth about systematic reviews. These are not just technical and statistical exercises appropriate for medicine and health. They include qualitative research and are highly relevant across a wide range of social policy areas. This guide succinctly outlines all these different approaches and will support those thinking of commissioning a review of research to take the best course of action. Even though the idea is simple -bringing together all the best available research -the practice is fraught with challenges. This guide will help anybody navigate those challenges. Systematic reviews have made a vital contribution to the history of science. They inform decisions that affect people's lives in many domains, from the way we teach our children to preventing crime. We thus have a responsibility to make sure reviews are done well. This guide will help us do that. Dr. David Halpern What Works National Adviser, Cabinet Office SYSTEMATIC REVIEWS FOR INFORMING POLICY DECISION