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Research Questions

  1. What types of research evidence do boards need and use?
  2. What sources of evidence do boards view as most relevant and trustworthy?
  3. What influences the use of research evidence by boards?
  4. What could improve the use of research evidence by boards?
  5. What use is being made by boards of research evidence in response to COVID-19 and what might future needs be?

What is the issue?

Boards in health and care organisations in England play a key role in the governance, strategy, direction and culture of an organisation. It is therefore important to ensure that board decisions are informed by the best available evidence from a range of sources, including service evaluations, organisational performance data, research and evidence-based guidelines.

However, there is a scarcity of evidence about how boards use research evidence, defined as evidence stemming from generalisable empirical research, to carry out their roles.

How did we help?

THIS Institute commissioned RAND Europe and the Health Services Management Centre (HSMC) at the University of Birmingham to conduct a scoping study on how health and care boards use research evidence. The focus was on NHS Trust boards and the boards of Sustainability and Transformation Partnerships (STPs) or Integrated Care Systems (ICSs). The principal data collection method was qualitative interviews with diverse members of health and care boards to obtain insights into the perceptions and experiences of board members in a range of roles and circumstances. The findings are predominantly based on evidence from 17 interviews.

Given the importance of the COVID-19 pandemic at the time of this research, we were also asked to consider whether and how research evidence was used by boards in shaping their response to COVID-19. We focused on two areas specifically: (i) personal protective equipment (PPE) and (ii) the use of remote consultations and remote patient monitoring.

Key Findings

  • The board members involved in our study engage with research evidence in various capacities, but there are differing views on the extent to which boards use research evidence as part of their activities.
  • Many interviewees described research evidence being used in sporadic and opportunistic ways, rather than being systematically and routinely embedded in board functions.
  • The types of research evidence used are diverse, and include clinical research evidence, evidence from healthcare services research and organisational and management research.
  • The use of research evidence is context dependent. For example, during the COVID-19 pandemic, boards needed to make pragmatic decisions quickly, which meant that little research evidence was either available or directly consulted by boards. However, boards relied on evidence-based guidelines around COVID-19 to make decisions, among other factors.
  • Boards access research evidence through different routes. While some interviewees reported engaging with research papers directly, research evidence seemed more often to be fed to the board through intermediary channels such as sub-committees or to other organisational experts such as clinical teams.
  • There was significant appetite among board members to engage with research through simpler and more accessible formats than academic journal articles. Some examples included presentations, bespoke workshops, seminars, summaries of research and discussion papers.
  • We identified several influences on the use of research. These relate to the nature of research evidence, the types of decisions being made, external circumstances that impact decision making and the function, structure and composition of boards.

Research conducted by

This research was commissioned by The Healthcare Improvement Studies Institute (THIS Institute), University of Cambridge and conducted by RAND Europe.

This report is part of the RAND Corporation Research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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