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.
BRACE – NIHR Rapid Service Evaluation Centre for health care in England
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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, has awarded £2 million of funding over five years, starting April 2018, to a team of researchers to create 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, aims to deliver rapid and rigorous service evaluations of promising new innovations and services within the NHS. All of the evaluations carried out by the research team seek to address real-world concerns of NHS managers, staff and patients.
Throughout the five-year period, BRACE’s activities will include:
- Finding and choosing promising innovations and services to be evaluated.
- Designing research projects that ask the following three questions:
- How could they be put into practice?
- Did they achieve their goals?
- 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 uses 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 is advised by a health and care panel, which is consulted with at all stages of the evaluation projects: from decisions about what to evaluate through to plans for sharing the findings. In addition, patients and the public are involved in the centre and its work; in the health and care panel and in the delivery of individual evaluation projects.
BRACE is 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 HSMC; Jon Sussex, Chief Economist at RAND Europe; and Dr Alex Georgiadis, Research Associate at the University of Cambridge.Learn more about BRACE