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Introducing the Health Policy and Evaluation Institute
King’s Health Partners, London
1.
Introduction
This briefing paper summarises the newly launched Health Policy and Evaluation Institute at
King’s Health Partners in London. King’s Health Partners (KHP) is an Academic Health Science
Centre which brings together four strong partners: King’s College London, Guy’s and St.
Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, and the South
London and Maudsley NHS Foundation Trust. KHP is organised into 21 Clinical Academic
Groups, and each is charged with achieving excellence in research, teaching and clinical practice. KHP also contains 2 over-arching groups, the Basic Science Institute and the Health
Policy and Evaluation Institute (HPE).
2.
Purpose of the Health Policy and Evaluation Institute
The HPE Institute brings together wide ranging expertise to find innovative solutions to real world health and social care challenges by:
• co-ordinating and enabling interdisciplinary research
• extending worldwide networks to learn from excellence
• bringing together KHP/KCL knowledge of policy, research, implementation and practice
• providing a forum for imagination, creativity and risk taking
• membership of the HPE Executive is given at Appendix 1.
3.
Structure of the Health Policy and Evaluation Institute
HPE contains four focussed Programme Groups on:

Health and social care policy (lead Professor Sube Banerjee)

Implementation science (lead Professor Graham Thornicroft)

Public health and primary health care (lead Professor Charles Wolfe)

Public and patient involvement in research (lead Dr Diana Rose)
3.1 Health and social care policy
This programme group will provide the capacity to organise activities and knowledge to offer independent, authoritative and timely contributions to policy questions of regional (London), national and international importance. Such activities can include:

Smaller, closed symposia and seminars by invitation, focussing upon very specific policy related issues

The facility to arrange brief or longer secondments in both directions between governmental ministries and KHP teams

Brief visits or clinical/social care attachments for policy makers wishing to understand the challenges facing practitioners

In some cases this can be supported by the capacity to offer honorary contracts at KCL or within the KHP Trusts for senior policy makers

Developmental work needed to explore whether partnership arrangements will be advantageous for specific events

Such a capacity will both address the need to ‘horizon scan’ and to arrange events on issues of long-term importance, and to be able to respond very quickly to rapidly developing policy questions, or consultation exercises.

The selective production of policy papers by KHP staff, designed to have clear policy impact

3.2 Implementation/Improvement Science
Figure 1. Five phases and three blocks in the translational medicine continuum
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The translational medicine continuum can be envisaged as shown in Figure 1. Nevertheless this model is somewhat asymmetric in emphasising health rather than social care. The key research domains of HPE will include applied health and social care (some aspects of which are referred to as ‘health service research’) and health and social care related policy. While for some purposes this may include Phase 2 studies, the main focus of such research will be upon
Phases 3 and 4, and the associated knowledge ‘roadblocks’ at T2 and T3. Implementation
Science (sometimes referred to as Improvement Science) refers to the growing area of scientific enquiry concerned with understanding the transfer of scientific knowledge into routine clinical and social practice. In this vision, the T3 block commonly interrupts what is distilled from the peer reviewed literature into clinical/practitioner guidelines. Such scientific work includes direct reference to relevant fundamental research which informs understanding of fundamental knowledge about human behaviour, and health related behaviour, for example from the fields of psychology, sociology and bioethics.
Key issues to research related to implementation science include:

Organisational, clinical team and practitioner characteristics associated with greater or lesser concordance with guidelines in health and social care

Better understanding of the motivations and incentives for practitioner behaviour change

Development and research of decision aid tools

Practitioner and organisational processes necessary to improve patient experience

Whether greater guideline concordance is associated with improved patient experience and outcome

Barriers to proper assessment and treatment of the physical and mental health needs of patients

The conditions under which specific elements of evidence based practice are: (i) adopted in principle by organisations, (ii) initiated in practice, and (iii) sustained in the long term.

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3.3 Public health and primary health care
HPE support the further strengthening of public health and primary health care research.
Recent discussions have identified the key public health priorities as (i) cardio-vascular/stroke,
(ii) mental health and wellbeing. (iii) diabetes/obesity. The challenges to be addressed include:

Convening new and imaginative consortia across the health care, local government, NGOs, and for profit sectors to develop and evaluate interventions intended to have major beneficial public health impact

Understanding basic psychological and social processes that act as drivers for population and community level behaviour changes that influence health status and outcomes

Contributing to the routine assessment of health outcomes in primary and specialist care, and creating the necessary informatics infrastructure to access and link these data to assess the impact of public health interventions

Forming effective consortia with borough level public health practitioners as they move to the local authorities
3.4
Public and patient involvement in research
While the intended beneficiaries of health and social care are the patient and clients who receive such services, relatively rarely are such people directly involved in the underpinning research upon which health and social care interventions can be based. KHP/KCL is an exception in that there are already pockets of outstanding practice related to public and patient involvement (PPI) in research. This Programme Group plans to:

Further develop, apply, publish, and disseminate key PPI methodologies including best practice in ethics and consent procedures

Develop more effective methods to recruit participants to research studies

Formulate culturally appropriate approaches to specific communities in giving research related information

Bring patient and population representatives in the centre of discussions about proper governance of linked health and social care datasets, and data linkage

Pioneer effective methods to involve carers and family members, for example, in relation to share care and decision aid tools for people with long-term conditions

Further refine measures of patient and carer experience, put these into routine practice, and research factors which contribute to improving such experience

Provide research training pathways for service users and carers able to develop high level research skills via these stages: o Initial familiarisation with the work of research teams and then more detailed introduction to the research process for those actively interested in becoming involved in research o Attendance at short courses on specific research themes o Masters level programmes o Pre-doctoral preparatory fellowship and doctoral fellowships o Post-doctoral research positions and opportunities.

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Appendix 1. HPE Executive Membership
1.
Prof. Graham
Thornicroft (chair)
Professor of Community Psychiatry and Head of Health Service and
Population Research Department
Consultant Psychiatrist, South London and Maudsley NHS
Foundation Trust
King’s College London
2.
Prof. Sube Banerjee Professor of Mental Health and Ageing
Head, Centre for Innovation and Evaluation in Mental Health
3.
Prof. Brendan Delaney Professor of Primary Care Research
4.
Prof. Naomi Fulop Director, NIHR King’s Patient Safety and Service Quality Research
Centre
King’s College London
Kings College London
King’s College London
5.
6.
Dr. Karen Glaser
Dr. Clare Herrick
Reader in Gerontology and Director of the Institute of Gerontology King’s College London
Lecturer in Human Geography King’s College London
King’s College London 7.
Prof. Elizabeth Kuipers Professor of Clinical Psychology
Head of Department of Psychology
8.
Prof. Denise Lievesley Head of the School of Social Science & Public Policy King’s College London
King’s College London 9.
Prof. Jill Manthorpe Professor of Social Work
Director of the Social Care Workforce Research Unit
10.
Prof. Alison Metcalfe Professor of Health Care Research
Florence Nightingale School of Nursing and Midwifery
11.
Ms. Frances
O’Callaghan
Director of Performance and Delivery for King’s Health Partners
King’s College London
King’s Health Partners
12.
Prof. Anne Marie
Rafferty
13.
14.
15.
Dr. Diane Rose
Prof. Jane Sandall
Mr. Oliver Smith
Professor of Nursing Policy and Dean of the Florence Nightingale
School of Nursing & Midwifery
Co-Director, Service User Research Enterprise, IoP
Professor of Midwifery
Director of Strategy and Innovation
King’s College London
King’s College London
King’s College London
Guy’s and St Thomas’
Charity
King’s College London 16.
Prof. George Szmukler Professor of Psychiatry and Society
Co-Director, King's Health and Society Centre
17.
Prof. Andre Tylee Professor of Primary Care, IoP, and Clinical Director Mood, Anxiety and Personality Disorder CAG, KHP
18.
Mr. Jacob West
19.
Prof. Til Wykes
King’s College London
Director of Strategy King's College Hospital
NHS Foundation Trust
Professor, Department of Psychology and Vice Dean (Research), and King’s College London
Co-Director, Service User Research Enterprise, IoP
20.
Prof. Charles Wolfe Professor of Public Health, Head of Department of Primary Care and
Public Health Sciences
Director of R&D Guy's & St Thomas' Foundation Trust
King’s College London