How proximity and trust are key factors in getting research to feed into policymaking

Policymakers frequently fail to use research evidence in their work. Academia moves too slowly for the policy world and its findings do not translate easily into policy solutions. Using the Department of Health as a case study, Jo Maybin outlines how research most likely has an impact as a result of personal interactions between individual researchers and policymakers. But this can limit the range of knowledge being used to inform policy and be problematic when individuals change or leave jobs

Documents, Practices and Policy

What are the practices of policy making? In this paper, we seek to identify and understand them by attending to one of the principal artefacts – the document – through which they are organised. We review the different ways in which researchers have understood documents and their function in public policy, endorsing a focus on content but noting that the processes by which documents are produced and used have been left largely unexamined. We specify our understanding of the document as an artefact, exploring aspects of its materiality in both paper and electronic forms. The key characteristic of the policy document, we suggest, is the way it is produced and used collectively, in groups.</jats:p

Knowledge and knowing in policy work: a case study of civil servants in England’s Department of Health

Contemporary English health policy is saturated with claims about what the world is like and how it might be otherwise. These claims span the wide range of subject matters covered by health policy, from hospital waiting times to our preparedness for major disease outbreaks; from structures for the planning and purchasing of healthcare to requirements around the sharing of patient records. Despite this, empirical studies of health policymakers working at the national level in the UK suggest that research evidence plays only a very limited role in policy development (Lavis et al. 2005; Dash 2003; Dash et al. 2003; Innvær et al. 2002; Petticrew et al. 2008). This apparent contradiction was the starting-­‐point for this project. If civil servants are not drawing on research knowledge in their work, how is it that they are able to devise policy about such complex and technical policy issues? Policy-­‐making requires knowing the world in some way in order to act upon it. My research asks, what kinds of knowledge are civil servants in England’s Department of Health using in their work, and what forms does this use take? This thesis is situated in an emerging field of interpretive policy analysis which treats policymaking as realised in the daily work practices of communities of individuals (Wagenaar & Cook 2003; Wagenaar 2004; Colebatch 2006; Colebatch et al. 2010; Freeman et al. 2011). I have adopted an ethnographic approach, conducting 60 hours of original data collection in the form of interviews and meeting observations among mostly mid-­‐ranking civil servants working on various high-­‐profile health policies in 2010-­‐11. By analysing my fieldwork experiences and the resulting data, and by relating these to insights from theoretical resources in sociology, psychology and philosophy, I offer an account of the different forms of knowing and knowledge entailed in the practice of policy-­‐making. I identify three forms of knowledge and knowing that were integral to the work of the civil servants I studied: the ‘practices of knowing’ by which they came to understand the objects of their policies and think through the possibilities for their reform; the ‘pragmatic use of knowledge claims’ in which facts, figures and stories were invoked to generate support for policies and to defend decisions taken; and the ‘know-­‐how of policymaking’, which was the most important form of knowledge for the civil servants’ professional identities. In the conclusion, I reflect on the aspects of knowledge and knowing which are shared by the civil servants’ practices and my own work in producing this thesis

Caring for quality of care: symbolic violence and the bureaucracies of audit.

BACKGROUND: This article considers the moral notion of care in the context of Quality of Care discourses. Whilst care has clear normative implications for the delivery of health care it is less clear how Quality of Care, something that is centrally involved in the governance of UK health care, relates to practice. DISCUSSION: This paper presents a social and ethical analysis of Quality of Care in the light of the moral notion of care and Bourdieu's conception of symbolic violence. We argue that Quality of Care bureaucracies show significant potential for symbolic violence or the domination of practice and health care professionals. This generates problematic, and unintended, consequences that can displace the goals of practice. SUMMARY: Quality of Care bureaucracies may have unintended consequences for the practice of health care. Consistent with feminist conceptions of care, Quality of Care 'audits' should be reconfigured so as to offer a more nuanced and responsive form of evaluation

Accountability in the NHS: Implications of the Government's Reform Programme

The Health and Social care Bill sets out a radical series of reforms for the National Health Service in England. We focus on the implications for accountability by comparing and contrasting current accountability arrangements and practices with how they are likely to operate within the reformed NHS. Different types of accountability are defined. Using the typology a close analysis is made of the nature of accountability of providers and commissioners under the proposed arrangements. Areas for concern are identified