Project:

NHS Cochrane Collaboration Programme Grant: Effective Practice and Organisation of Care in the NHS

From September 2007 to August 2010
Project Leader(s): Prof. Martin Eccles
Staff: Dr Katherine Deane, Dr Heather Dickinson, Fiona Beyer, Jan Legge
Sponsors: NIHR
Partners: Dr Sasha Shepperd, Dr Marcia Kelson, Prof Jeremy Grimshaw, Dr Eugene Milne, Dr Gillian Leng
Homepage: http://www.epoc.cochrane.org/en/index.html

Background

Clinical and health services research is continually producing new findings to contribute to more effective patient care. However, the transfer of research findings into routine patient care is unpredictable and can be a slow and haphazard process as illustrated by a review of quality of care studies from UK primary care that concluded “in almost all studies the process of care did not reach the standards set out in national guidelines or set by the researchers themselves.” The recognition of the failure to consistently translate research findings into practice led the government to propose the introduction of clinical governance to “assure and improve clinical standards at local level throughout the NHS”. This includes “action to ensure … good practice is rapidly disseminated and systems are in place to ensure continuous improvements in clinical care”. The proposed programme will review active implementation strategies to promote evidence-based health care.

EPOC reviews have, over a number of years, synthesised evidence to address some of the major problems facing the NHS. This reflects the large number of EPOC reviewers (106 of the 303 review authors) who are based in England with a further 25 based in other countries in the UK.  Examples include interventions to improve hand hygiene compliance (supported by a Department of Health Bursary); and interventions to improve the organisation and delivery of health care, for example a review of alternatives to inpatient mental health care for young people (commissioned by NHS SDO R&D Programme). EPOC reviews have provided key advice to the NHS about the implementation of research findings, for example the NSF on ischaemic heart disease; and formed the basis of two Effective Health Care Bulletins, notably Getting Evidence into Practice.

The wide range of review topics identified by our NHS partners (NICE and NHSNE) will address some of the major questions facing clinical and public health practice. These include the organisation of health services, financial incentives, IT to support evidence based practice, and interventions to reduce unwanted pregnancies. These reviews, combined with a synthesis of evidence of interventions to overcome identified barriers to change, will support the further development of evidence based practice.

The products of the programme will highlight evidence-based strategies that the NHS can routinely use to promote the uptake of effective clinical practices. As well as this being directly available through the Cochrane Library and disseminated through the North East SHA this will be achieved at a national policy level via the Implementation Programme at NICE.

Staff

Fiona Beyer
Research Associate

Dr Heather Dickinson
Strategic Research Advisor

Professor Martin Eccles
Professor of Clinical Effectiveness