Research: at the heart of healthcare performance

NHS reform remains at the top of the political agenda. It’s a period of uncertainty for healthcare managers and frontline staff
alike but one thing is clear – change is coming.

What won’t change, though, is the health sector’s need to understand the requirements of patients, and have insights into how services can be delivered most effectively. With politicians and public scrutinising how every penny is spent, this knowledge is vital.

This is where research can add real value. It gives decision makers the understanding they need to deliver an effective service. An informed view from research helps healthcare professionals make critical decisions on the basis of solid evidence.

For best results, organisations that want to truly benefit from research should use accredited suppliers who keep to professionally agreed guidelines when they conduct their research. In this way, it can be ensured that findings are accurate and stand up to scrutiny.

The research sector is proud of its robust methodologies and professional credibility, which is reflected in the MRS code of conduct and guidelines which set out the ethical principles which underpin good research practice. MRS members have to abide by the MRS code of conduct, which provides a step-by-step guide to providing effective, fair and ethical research. The MRS code is also fully compatible with the requirements of the Data Protection Act. The MRS code and the act together offer a strict set of frameworks which can help prevent ‘cowboy’ research.  

Vanella Jackson, MRS Chairman, says: “Some people still have a view that market researchers are people who stop you on the street, asking a series of ‘tick box’ questions and writing the answers on a clipboard. That’s outdated. Modern market research is about understanding what questions to ask, who to ask them of, and how to ask them so as to get accurate, meaningful and useful results.

“Some organisations can be tempted to take shortcuts and go for ‘quick and dirty’ research but all too often that means they spend money on the wrong sort of service. It doesn’t give the results they need and it wastes money.”

Supporting healthcare
The ways in which research can support the health sector are many. Mark Speed at IFF Research highlights how it can help in the decision-making process and understanding where to prioritise resource. “These are fundamental issues for the health sector and getting the opinions of users can be crucial when formulating policy,” he says. “Attitude and behaviour change is another important area. Campaigns which encourage better health and lifestyle choices must be targeted at the right people, using language they understand with a message that they can find salient. If you end up speaking to the wrong people, or in the wrong way, it’s potentially money down the drain.”  

The future
How will reform in the health sector change the role of research? For Mark Speed, the industry is responding to a changed financial landscape: “Some health providers may consider taking their research in-house to save money but this can be a false economy as the cost of employing new staff or buying in research software can wipe out any potential savings. There’s still a strong role for MRS-accredited agencies who have the sector expertise and infrastructure to deliver insightful health sector research and it is important that both the agencies and health providers work closely together to facilitate this.”

Kunzmann says: “The NHS will be undergoing sweeping reform and, while the details are to be finalised, it seems likely that there will be GP commissioning to some degree. Responsibility for purchasing will evolve. However, what will remain the same is the importance of understanding patient journeys, and identifying potential hurdles and a breakdown in service – not necessarily related to the care itself.

Research will provide support by identifying what’s really happening in their area and signposting how patient access and services could be delivered better, faster, cheaper.”

Case study
From April, 1 2011, the management of community health services in Lambeth and Southwark transferred from the local Primary Care Trusts to Guy’s and St Thomas’ NHS Foundation Trust.

FreshMinds Research has worked very closely with Guy’s and St Thomas’ NHS Foundation Trust Community Health Services (formerly known as Lambeth Community Health) over the last three years to run a service user opinion survey.

The survey was designed not only to help the customer services team collect customer satisfaction information, but also to provide a unique opportunity to measure service delivery performance across 28 different service lines and understand areas for improvement.

A customer satisfaction survey is not the most innovative concept in market research but, as is often the case, innovation lies in the incremental changes and unique thinking that is applied to a study, which refreshes the methodology and provides clients with the insight they need.

In this case, the research was about making sure that comparable information could be collected from widely disparate service lines that included anything from Adult Community Nursing – a relatively easy service to access – through to the more difficult services such as the Brixton Prison Pharmacy and Homeless Support teams.

The success of the survey was also partly about staying nimble in the researchers approach – from working flexibly with service providers that changed location on a daily basis, to mixing research methodologies by combining telephone interviews, face-to-face interviews and paired interviews with children and parents.

FreshMinds also worked with the team to interview refugees in its Refugee Health centre, which required special interpretation services to be present as very few of the refugees could speak English.

As a result of the study, Guy’s and St Thomas’ NHS Foundation Trust Community Health Services has been able to better understand discrepancies in service level performance and take appropriate action to provide additional support to teams that needed it. “The personal stories included in the report really highlighted what patients needed from us, which often didn’t have anything to do with the customer service metrics we’d set out to measure,” says Siobhan McCollum, head of customer services. “For example, the Children’s Physiotherapy Unit is now involving patients more in their care plan, and they’re focusing on delivering more of their services after-hours and during school holidays.”