A research team drawn from the Faculty of Business Law at the Open University and Healthcare Improvement at UCL Partners, led by Prof John Storey, is currently carrying out a major 3 year research project, funded by the NHS. 

In March 2014 the NHS in England moved to a new organisational structure, in which the bulk of acute services are commissioned by new bodies, Clinical Commissioning Groups (CCG).  As their name implies, these are led by clinicians, mainly GPs.  An important element of the Coalition government’s policy leading to this reorganisation was to put such clinicians in charge of shaping how health services are provided to patients.

The research project aims to examine the variety of ways and the extent to which CCG address the challenge of engaging clinicians and deploying clinical leadership in the redesign of health services.  

Dr Richard Holti is one of the co-investigators of this project.  In this presentation he will elaborate on the research design and the various communities involved.  Since he and the rest of the research team are as yet ‘digital dabblers’, he hopes to take full advantage of the expertise of those present in generating ideas as to how various forms of digital engagement might enrich this research over the coming two years.  The complexity and significance of this £500k research project will hopefully provide an interesting basis for discussions that may prove of wider relevance.

The methodology alternates case studies with large-scale.  During 2014, a first round of 10 exploratory studies of CCGs identified some of the main mechanisms and organisational forms being used to engage clinicians, and informed a national survey of over 216 CCGs to map the national picture.  During 2015 further case studies will use qualitative and quantitative methods to understand how approaches to clinical engagement and the issues they have encountered have shaped service outcomes.  Findings from these cases will inform the design of a further national survey, to be completed during 2016.

 

The research project involves engaging in very different ways with different groups. For example:

 


Case study participants expect feedback and involvement in the development of insights concerning what they have been attempting to achieve and how well their efforts have worked out, as well as some control over what is reported to wider audiences

Survey participants expect summary reports on the national picture emerging

The academic and health service policy communities expect to be kept informed of emerging findings and will probably be willing to engage in debates about them

Particular patient groups or communities may also be strongly interested.


There are undoubtedly opportunities to use various forms of digital engagement to stimulate debate and test out insights, but these need to be balanced by a need to establish clear boundaries of who is involved at what stage.  In particular, data collection, analysis, and feedback need to be managed with close attention to confidentiality within the case studies.

How can all of this be managed?

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