RPP 19 1 Workshop Report

Research Policy and Planning: The journal of the Social Services Research Group – Vol 19 (1) 2001

Workshop Reports

Promoting the Research Friendly Workplace

Hove Town Hall, Friday June 15th 2001. Jointly organised by SEARIG (South East Area Research and Information Group) and SSRG.

This well-attended one-day event provided an interesting mix of plenary and workshop sessions, with some ‘big picture’ national overviews, as well as information about initiatives at a more local level. Some of the presentations at the conference will feature as papers in future issues of this journal, but in the meantime, here is a personal view of the day.

Allan Bowman, Director of Social Care and Health for Brighton SSD, chaired the day. His brief opening introduction looked at the need for a discipline in setting aims and objectives for new services, which should be monitored, and use of information from that monitoring to change services if necessary. He identified the need for self-aware, learning organisations, committed at both management and practice levels, to evidence-based practice rather than relying on beliefs and experience, and promoted the use of ‘whole systems approaches’ to this end.

Presentations:

Workshop reports:

The first speaker in opening plenary was Amanda Edwards of the Department of Health, who is leading on the Quality Strategy. She spoke primarily about the role of the forthcoming Social Care Institute for Excellence (SCIE) in the context of the government’s overall quality and modernisation strategies.

She outlined the broad policy environment in which SCIE needed to be seen: the Cabinet Office’s White Paper ‘Modernising Government’ (with its themes of inclusiveness, convenience and smart knowledge management); the DFEE Lifelong Learning policy (and its focus on continuous updating of knowledge and skills); the Modernising Social Services strategy (in particular the new institutional structure of NCSC, GSCC, SCIE, TOPSS); Best Value; the NHS Plan and its challenges with respect to partnership; the move towards mixed public and private sector delivery, including small private sector organisations; and the drive for more user controlled services.

The main themes in the Quality Strategy for Social Care were described as: knowledge driving quality improvement, and awareness that we may know more than we think we do; tackling existing problems and preparing for the new (wherever services are delivered, independent of organisational structure); the need for a skilled and competent workforce

In speaking about the feedback on Quality Strategy Consultation, Edwards provided a few examples of positive aspirations: SCIE needs to be seen as a knowledge partner; to draw on practitioner creativity, to have a user focus; and not to be too ambitious.

The aims of SCIE are to tackle variations in quality, making services consistently better – not a ‘one size fits all’ approach, but through employing a range of options; to spread knowledge of what works, and to transfer that knowledge into practice, which is a complex process; and to help develop a more confident workforce.

SCIE would undertake work itself and commission work, in partnership with users and carers, the private sector, health and social care organisations, including the General Social Care Council and the National Care Standards Commission.

The functions of SCIE are multiple: the creation of a knowledge base of what works through review and synthesis; to act as a review point in respect of the quality of a range of evidence; the development of a methodology (which would be a challenging task); to translate that knowledge into tools for practice; and to disseminate, both electronically, through the likes of the electronic Library for Social Care, and pro-actively through talking to people and having established links with other organisations.

In order to support the impact of SCIE, attention will need to be paid to the research capacity in the field; the Information for Social Care strategy; the reform of social work education to a three year degree programme, as announced in March 2001; investment in training to ensure continuous professional development; the new institutional frameworks in social care; and the need to ensure recruitment and retention of staff.

Sarah Buckland described the work of the Consumers in the NHS Project, which aims to promote active involvement of consumers in R&D in the NHS and, more recently, social care.

Key issues for the research included identifying ‘Who are consumers?’ and debating a new name for the new unit taking this forward. Buckland provided an insight into the thinking behind the project – research needs to be relevant, and needs to be done in partnership; research should be with users, rather than about users. Different degrees of involvement were needed – from consultation through to collaboration to control.

A database of projects in the NHS is being developed, including details of various types of research, including RCTs, and those which cover a wide range of different populations, and different situations.

The benefits of consumer involvement were seen to be facilitation of the ‘right questions’ – relevant questions leading to useful outcomes; asking the questions in the most appropriate way to ensure meaningful information is gathered; getting research into practice, and working with service users in implementing research findings.

This project has commissioned a review of consumer participation in other fields, and expects to draw heavily on expertise in the social care field.

Professor Jane Tunstill, of the University of London, provided a lively presentation entitled ‘Making Evidence Count in a Climate of Constant Change’. She argued that there was no ‘magic fit’ in delivering evidence based practice and that there was, at times, a fundamental conflict of interest across policy, research and practice.

She highlighted the challenges and opportunities of the current policy context, including those of new managerialism. Three issues concerned her. First, the emphasis on monitoring and the use of PSAs/PIs and so forth, the monitoring being time consuming and not relevant to practice. Second, the key issue of the outcomes being measured (whose outcomes?) and the lack of a shared vocabulary in this area. Third, the issue of assigning costs – how to measure the impact of complicated services with long-term effects such as early intervention. The difficulty in doing this leads to counting only that which can be counted – such as the number of children on a child protection register.

Additionally, cross-cutting policy developments result in multiple departmental responsibility at central government level, conflicting local departmental priorities, with no joining up of these initiatives or evaluation of them, and then no consequent allocation of outcomes to specific initiatives.

Other issues addressed by Professor Tunstill included the debates within the research community, and diversity (or rivalry) between research traditions. Tunstill argued that there should be no Berlin Wall nor paramountcy battles. When looking at what might help, she argued for an explicit value base leading to a transparency of decision making, developing research/practitioner partnerships, and furthering the involvement of service users.

Anna Gupta spoke briefly about the Making Research Count initiative, which has recently added new university partners – Keele, Warwick and Glasgow. The conference included examples of the regional work carried out by the London and Luton partners under this initiative. This work included policy seminars aimed at team managers and their seniors including – developing an evidence based practice strategy, developing a family support strategy, and leaving care services. In addition to regional conferences, there are local programmes and initiatives, such as journal clubs.

The plenary session was closed by a Question and Answer session, which included service user perspectives. One service user argued that there still remained resistance to consumer involvement. Sue Balloch responded that money for participation needed to be built into research tenders, and June Thoburn similarly argued for the need to resource user consultation to avoid token representation. The need to ensure that practitioners’ knowledge was seen as a key part of the work of SCIE was raised by Imogen Taylor of the University of Sussex.

The afternoon saw eight workshops:

Carol Lupton, Director of SSRIU, University of Portsmouth, and Malcom Barrett, Service Manager, Portsmouth City Council, described their work taking forward an internal ‘culture of evidence’ against the background of the new Research Governance Framework.

Elizabeth Clough, Deputy Director of R&D, Department of Health, outlined the new Research Governance Framework for Health and Social Care. In setting out the differences between social care and health care research, the level of financing was identified as a key issue.

The fundamental importance of clarifying responsibilities and accountabilities to research was identified. A series of useful diagrams (see SSRG website) were provided to describe the potential structures and roles within those structures which would be necessary under the Framework. It was noted that social care issues are being led by Dr Carolyn Davies of the DH Policy Research Programme, and questions from workshop attendees highlighted some of the difficulties SSDs are facing when taking forward work on the Framework.

Hazel Qureshi of SPRU, University of York, described work carried out by SPRU in introducing outcome concepts in practice. She highlighted the outcomes framework which emerged from their project, and the costs in terms of staff briefing and training, and for the analysis of aggregated data.

Roger Gomm of the Open University, echoing themes from the plenary, presented a workshop on ‘Using What You’ve Got for Evidence-Based Practice’, highlighting the need to make maximum use of locally collected information, and that knowledge of one’s own practice is key to using research evidence from other sources. He was concerned that the current focus of evidence based practice suggested a 19th century deterministic model.

In his view, publishing research in journals was not best way to influence practice, and journal articles frequently failed to provide enough information to answer the key question ‘will it work here?’

He further argued that the impact of well-funded demonstration projects was different when that model was imposed elsewhere.

David Allan, Strategic Planning Manager, Warwickshire SSD, ran a workshop which explored the work of the Joint Priorities Team at Warwickshire. This had initially considered the perceptions of research within Social Service Departments. Research was viewed as instrumental, short term, a marginal activity, out-of-date by the time findings are available and being academic rather than having practical application.

To challenge this, a joint agency team of eight workers was set up in 1999 as a three year project. This team uses project management techniques, action research, evaluation and outcome analysis to improve joint agency initiatives between health and social services. Its projects included delayed discharge and intermediate care services. There had been some discomfort in accepting and benefiting from the results of research and the point was made that timing is important in terms of the political environment to effectively communicate research results.

Elizabeth Cooke, Web Liaison Officer presented the Research in Practice website

Research in Practice is an initiative of the Association of Directors of Social Services (ADSS) with bases in Sheffield and Dartington and works with approximately 60 member agencies with Social Service Departments and large voluntary organisations across England. It aims to provide strong connections between practice and research to improve outcomes for vulnerable children and their families. The world wide web has more recently been used to provide evidence based information, alongside audiotapes and written material, including briefings and summaries of research reviews.

The workshop explored the growth of the web, the constraints and advantages of web usage, and looked at the site contents. Members and the public can access information, while members can also use the site for networking and professional development. The site plans to open up to service users in the future.

The full text of policy documents, other organisations’ weblinks, gateway websites, a database of researchers and their interests, and links to electronic journals are available on the site. Examples of other useful sites were given, including the Electronic Library for Social Care (eLSC) and its links to an Internet Social Work tutorial and research mindedness module.