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Evidence-based commissioning in the English NHS : who uses which sources of evidence? A survey 2010/2011
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Clarke, Aileen, Taylor-Phillips, Sian, Swan, Jacky, Gkeredakis, Emmanouil, Mills, Penny, Nicolini, Davide, Powell, John, Roginski, Claudia, Scarbrough, Harry and Grove, Amy L. (2013) Evidence-based commissioning in the English NHS : who uses which sources of evidence? A survey 2010/2011. BMJ Open, Volume 3 (Number 5). Article number e002714. doi:10.1136/bmjopen-2013-002714 ISSN 2044-6055.
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Official URL: http://dx.doi.org/10.1136/bmjopen-2013-002714
Abstract
Objectives:
To investigate types of evidence used by healthcare commissioners when making decisions and whether decisions were influenced by commissioners’ experience, personal characteristics or role at work. Design: Cross-sectional survey of 345 National Health Service (NHS) staff members.
Setting:
The study was conducted across 11 English Primary Care Trusts between 2010 and 2011.
Participants:
A total of 440 staff involved in commissioning decisions and employed at NHS band 7 or above were invited to participate in the study. Of those, 345 (78%) completed all or a part of the survey.
Main outcome measures:
Participants were asked to rate how important different sources of evidence (empirical or practical) were in a recent decision that had been made. Backwards stepwise logistic regression analyses were undertaken to assess the contributions of age, gender and professional background, as well as the years of experience in NHS commissioning, pay grade and work role.
Results:
The extent to which empirical evidence was used for commissioning decisions in the NHS varied according to the professional background. Only 50% of respondents stated that clinical guidelines and cost-effectiveness evidence were important for healthcare decisions. Respondents were more likely to report use of empirical evidence if they worked in Public Health in comparison to other departments (p<0.0005, commissioning and contracts OR 0.32, 95%CI 0.18 to 0.57, finance OR 0.19, 95%CI 0.05 to 0.78, other departments OR 0.35, 95%CI 0.17 to 0.71) or if they were female (OR 1.8 95% CI 1.01 to 3.1) rather than male. Respondents were more likely to report use of practical evidence if they were more senior within the organisation (pay grade 8b or higher OR 2.7, 95%CI 1.4 to 5.3, p=0.004 in comparison to lower pay grades).
Conclusions:
Those trained in Public Health appeared more likely to use external empirical evidence while those at higher pay scales were more likely to use practical evidence when making commissioning decisions. Clearly, National Institute for Clinical Excellence (NICE) guidance and government publications (eg, National Service Frameworks) are important for decision-making, but practical sources of evidence such as local intelligence, benchmarking data and expert advice are also influential.
Item Type: | Journal Article | ||||
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Alternative Title: | Evidence-based commissioning in the English National Health Service : who uses which sources of evidence? A survey 2010/2011 | ||||
Subjects: | R Medicine > R Medicine (General) | ||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Social Sciences > Warwick Business School > Industrial Relations & Organisational Behaviour Faculty of Social Sciences > Warwick Business School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Great Britain. National Health Service, Evidence-based medicine -- Great Britain, Evidence-based medicine -- Research | ||||
Journal or Publication Title: | BMJ Open | ||||
Publisher: | BMJ | ||||
ISSN: | 2044-6055 | ||||
Official Date: | May 2013 | ||||
Dates: |
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Volume: | Volume 3 | ||||
Number: | Number 5 | ||||
Page Range: | Article number e002714 | ||||
DOI: | 10.1136/bmjopen-2013-002714 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) | ||||
Date of first compliant deposit: | 24 December 2015 | ||||
Date of first compliant Open Access: | 24 December 2015 | ||||
Funder: | National Institute for Health Research (Great Britain) (NIHR) | ||||
Grant number: | 08/1808/244 | ||||
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