Policy embedded research
Much of our research is embedded within existing institutions and processes to maximise its influence on policy. Many projects and programmes of research, including RESYST in Kenya and South Africa and the Integra Initiative in Kenya and Swaziland work closely with Ministries of Health to enhance policy and practice on enabling health systems to be more resilient and responsive.
Staff and Centres also collaborate in Global networks and with WHO to embed their research into policy. For example, The Centre for Global Mental Health at LSHTM jointly coordinates the Mental Health Innovation Network, a global online community with WHO which has influenced international initiatives such as the 2016 / WHO high-level meeting on global mental health.
The School’s Centre for Global Non- Communicable Diseases and the World Heart Federation have co-produced ‘Roadmaps’ identifying health system roadblocks and solutions on the road to effective prevention, detection and management of various cardio- vascular diseases in low and middle income countries, which are now used to promote development of national policies and health systems strategies for reducing premature mortality. A recent study on funding priorities for TB control identified critical gaps and contributed to WHO’s decision to set up a global R&D observatory to track spending and prioritisation of research, with the School’s TB Centre developing a prototype R&D prioritisation tool that can be applied to different disease areas.
Working with UK policy bodies
Staff across the School regularly give evidence to Parliamentary Select Committees and enquiries, to All Party Parliamentary Groups and Parliamentary Hearings influencing, for example, the UK Government’s decision to support family planning research once again and to combine its reproductive health and HIV programmes within DFID. In addition, LSHTM has long tradition of engagement with national health policy making bodies. It is part of the NIHR School for Public Health Research (SPHR) funded by the National Institute for Health Research and led by Mark Petticrew. SPHR identifies and undertakes research that highlights
the public health costs and benefits of local government policies, including in the areas of housing, transport, policing and public safety, licensing, education and other local authority systems. SPHR research explicitly takes a system focus, and is developing new approaches to evaluating change in complex systems.
The Policy Innovation Research Unit (PIRU) directed by Nicholas Mays and Bob Erens, is a Department of Health- funded multi-disciplinary collaboration between LSHTM, LSE and Imperial College London Business School. It negotiates its commissioned projects directly with officials in the department of health and the other arm’s length bodies trying to take account of both their immediate needs and longer term strategic issues. Evaluation findings are typically communicated throughout the research process.
This approach has achieved impact in: raising the government temperature threshold for triggering a cold weather alert; improving the invitations to tender for evaluations by the Department of Health and therefore ensuring better value for money from subsequent evaluations; and an internationally used report on indicators of progress in integrated care. It is currently examining the long-term effects of participating in national policy pilots on local implementers of health and social care policy.
The Policy Research Unit on Commissioning and the Healthcare System (PRUComm) led by Stephen Peckham and Pauline Allen has a mandate to provide evidence to the Department of Health to inform the development of policy on commissioning – the state purchasing of healthcare in the English NHS quasi market – as well as more general issues in respect of the healthcare system in England, as well as undertaking responsive research as requested by the Department of Health with recent research informing policy on general practice. Recent PRUComm research has been used by NHS England to support the development of the GP Forward View published in 2016 and also as evidence by the GP pay review board.
The Public Health Research Consortium directed by Mark Petticrew at the School, funded by the UK Department of Health, co-ordinates researchers across eight universities, a survey research agency, and a children’s charity, with the aim of strengthening the evidence base for interventions to improve public health, with a strong emphasis on tackling socioeconomic inequalities in health. The consortium’s research programme is developed in consultation with the Department of Health and is informed by current priority needs identified by the Department of Health policy teams.
Influencing research agendas in the EU and the European region
Key to the mission of the European Observatory on Health Systems and Policies is its role as a high- quality knowledge broker based on the principles of transfer (bridging between policy makers and researchers and between information users and producers), trust (providing high-quality evidence and a neutral stance recognising the real context and pressures of health systems), tailoring (to the specific needs of policy makers) and timeliness (responding to policy maker’s needs and requests when and where required). Staff engaged in direct policy engagement through policy dialogues which are particularly useful in times of transition when policy-makers take stock of past achievements and explore strategic options for further health system reform.
Staff involvement in influential European panels also influences policy. Martin McKee, as president of the European Public Health Association (EUPHA) has steered the field of public health to encompass health systems issues and research questions. He has been a member of the European Commission’s Expert Panel on Investing in Health and is a former chair of WHO’s European Advisory Committee on Health Research.
Global advisory and advocacy roles
The London School of Hygiene & Tropical Medicine is actively involved in international advocacy and agenda setting for health systems research through leadership and participation in organisations, societies and networks. Staff at all levels are involved with donor, technical and implementing agencies—as members and invited speakers of technical panels and advocacy efforts related to health systems, such as WHO expert groups and technical consultation panels. For instance, Lucy Gilson sits on the Scientific and Technical Advisory Committee of the Alliance for Health Policy and System Research; and Andy Haines is a member of DFID’s Research Advisory Group. Work by Cicely Marston and team in the UK NHS on how community participation can improve health systems has been incorporated into the Global Strategy for Maternal, Newborn and Adolescent Health.
Staff members have sought to raise the profile of health systems research and knowledge translation through participation in diverse public health and medical services organisations. Bayard Roberts has contributed to promoting and shaping the health systems research for NCDs with Médecins Sans Frontières. School staff serve on key on key funding panels including the ESRC, MRC and the Wellcome Trust.