BRACE – NIHR Rapid Service Evaluation Centre for health and social care in England

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What is the issue?

Across the NHS, there is great interest in looking at current and new services and how they could be delivered in a way that improves people’s experiences of care and their overall health, while ensuring that the funding is used as efficiently as possible. Efforts to change services are widespread across the NHS in England, but there is a pressing need to understand if these are working or not and whether new services that are effective in one area of the country could work elsewhere.

As a result, the National Institute of Health Research (NIHR), the largest national clinical research funder in Europe, awarded nearly £3 million of funding over five years, starting April 2018, to a team of researchers to create and operate the Birmingham, RAND and Cambridge Evaluation (BRACE) centre, which conducts rapid service evaluations.

The aims of BRACE

BRACE, a research partnership between RAND Europe, the Health Services Management Centre (HSMC) at the University of Birmingham and the Health Services Research Group (HSRG) at the University of Cambridge, delivered rapid and rigorous service evaluations of promising new innovations and services within the NHS. All of the evaluations carried out by the research team addressed real-world concerns of NHS managers, staff and patients.

How did we help?

Throughout the five-year grant period 2018-2023, BRACE’s activities included:

  • Finding and choosing promising innovations and services to be evaluated.
  • Designing research projects that ask the following three questions:
    1. How could they be put into practice?
    2. Did they achieve their goals?
    3. Could they be introduced across the NHS?
  • Sharing findings that provide the kind of information that frontline NHS and social care managers and staff need to help them change and improve services.

The BRACE research team used a theory-based approach to service evaluation. This goes beyond assessment of whether something works and look more closely at the reasons for its success or failure; for example, if a service works, how does it work; if it doesn’t work, why doesn’t it work? To answer these questions, the team brings together evidence from different perspectives, sources and research methods

The BRACE team was advised by a health and care panel, which was consulted with at all stages of the evaluation projects: from decisions about what to evaluate through to plans for sharing the findings. Patients and the public were involved in the centre and its work; in the health and care panel and in the delivery of individual evaluation projects.

BRACE was led by Professor Judith Smith, Professor of Health Policy and Management and Director at the HSMC, University of Birmingham; and supported by Dr Jo Ellins, Senior Fellow at the University of Birmingham; and Jon Sussex, Chief Economist at RAND Europe.

Learn more about BRACE

BRACE Projects

  • New and emerging technology for adult social care

    RAND Europe researchers, along with University of Birmingham partners in the NIHR funded BRACE Rapid Evaluation Centre, evaluated home-based sensors with AI capabilities intended to help with adult social care.

  • Evaluating the Children and Young People's Mental Health Trailblazer programme

    An early evaluation of the Children and Young People’s Mental Health Trailblazer programme examined the development, implementation and early progress of the 25 mental health support teams created as the first step of the programme.

  • The impact of vertical integration of health services

    In several locations across England and Wales, NHS organisations responsible for managing acute hospitals have also taken over the running of primary care medical practices. Vertical integration is a valuable option to consider when GP practices look likely to fail due to recruitment and financial difficulties, but it is not an option that should be imposed from the top down.

  • Evaluating collaborations between primary care general practices in the UK

    Primary care networks can help GPs run a wider range of services for their patients and make changes that are needed in response to the COVID-19 pandemic. It will be important to have additional clarification and support around the role of primary care networks in the wider NHS in England.

  • Identifying innovations in adult social care and social work

    Researchers identified 158 innovations for potential evaluation and held a workshop with 23 stakeholders to prioritise a shortlist of top innovations to evaluate in adult social care and social work.