Getting Evidence into Policy: Approaches and Tools Used in the UK

Approaches

Having highlighted the central debates surrounding the issue of EBP, this section is focused around the practical means which exist in the UK to integrate evidence into policy. The first section puts forward some general approaches which are promoted in the UK. The second section reveals some more specific tools that are used in the UK. Neither of the two sections is exhaustive; these are only some of the possible approaches and tools which are available. This is very much a work in progress and therefore feedback would be appreciated. These tools are targeted at progressive policymakers, so although there are a number of other issues which surround policymaking, this section is based on the premise that the reader is interested in implementing EBP.

Although the emphasis has been on evidence-based policymaking since 1999, this is only one factor which should be taken into consideration. In September 1999 the Cabinet Office published 'Professional Policy Making for the Twenty First Century' which sets out three themes (vision, effectiveness, and continuous improvement) and nine key characteristics which policymaking should aspire to:

• Forward looking: takes a long term view of the likely impact of policy
  
• Outward looking: takes account of influencing factors and learns from elsewhere
  
• Innovative and creative: questions the status quo and is open to new ideas
  
• Evidence based: uses the best available evidence from a wide range of sources
  
• Inclusive: is fair and takes account of the interests of all
  
• Joined up: works across institutional boundaries and considers implementation
  
• Reviews: keeps policy under review
  
• Evaluates: builds evaluation into the policy process
  
• Learns lessons: learns from experience of what works and what does not

What can policymakers do to increase the use of EBP? To change the status quo towards EBP within government departments, policymakers need to understand the value of evidence, become more informed as to what research is available, know how to gain access to it and be able to critically appraise it (Davies, 2004: 18). The relationship will only work if researchers and policymakers work more closely together to ensure that there is an agreement between policymakers and researchers, and within the research community, as to what constitutes evidence (Davies, ibid).

One possible way of achieving the increased use of evidence is by getting policymakers to 'own' evidence and therefore gain commitment and buy-in at appropriate levels; 'In central government this usually means getting Ministers and senior policy officials to sign up to the ownership of a project and the evidence that goes to support it' (Davies, 2004: 19). Importantly this involves making a commitment to use findings whether or not they support the project, and therefore not to continue with the policy or programme, if the evidence reveals that it is ineffective. This is most likely to occur in organisational structures which are non-hierarchical, open and democratic (Davies, 2004: 18).

Better incentives also need to be established to encourage the use of evidence. For example, at the level of central government departments in the UK, Public Service Agreements (PSAs) and Service Delivery Agreements (SDAs), coupled to the biennial Spending Reviews by HM Treasury, provide some incentive to establish evidence of effectiveness and efficiency. Davies (2004: 21) also highlights the use of tools such as delivery and service agreements, national and local targets, triennial spending reviews in the UK. At local level, the devolution of budgets to front line agencies and decision making bodies such as hospital trusts, primary care teams, local education authorities and school governors, has provided a similar incentive to summon and use sound evidence in resource allocation and service development (Davies, 2004: 18).

Clearly the onus also lies not only with policymakers, but also with researchers, to improve the availability and dissemination of sound research. The development of research synthesis by groups such as the Cochrane and Campbell Collaborations, the EPPI Centre, and the ESRC Evidence Network, has shown that there is often a lack of sound, conclusive evidence even when there has been considerable research activity on some topic or problem, and therefore what is perhaps needed are systematic reviews of what we already know and the increased use of routine assessments and audits (Davies, ibid). Hornby and Perera (2002: 171) reinforce this argument, drawing on their experiences in Sri Lanka, arguing that there is a need for ongoing evaluation of the health system and health policies. They do however highlight that this would necessitate substantial organisational support.

Where there are a lack of formal exchange arrangements, an alternative might be for policymakers to approach their relationship with researchers in a different way; as partners rather than contractors. Nutley (2003) does raise the important point that although 'sustained interactivity' is needed, it does raise legitimate concerns about the independence and impartiality of research. There is a danger that research priorities may become too closely allied to political priorities. Having said that, research that has no relevance for policy will not be used and is redundant.

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