Timing can be everything. A policymaker once said to me that a perfect piece of analysis arriving the day after a decision has been taken is useless. Obvious, but worth repeating. Because in discussing how we maximise the impact of research, we often overlook the role of serendipity and timing. We advise researchers on careful planning, identifying audiences, and tailoring findings to particular communities and making use of different platforms. But sometimes it can be about providing “good enough” evidence at the right time in the right form to the right people.
For instance, who would have predicted the way in which a technical piece of analysis on seven-day working would have been at the centre of a political storm? Agreed, the issue of providing specialist cover across the week has been an important operational issue for the service for some time. But researchers proposing work in 2013 with careful analysis of HES and other routine data could not have anticipated how the “weekend effect” would become frontpage news. Indeed, that research would be at the centre of disputes between the government and junior doctor contracts during 2016. To the extent that an academic output from the research team studying admissions and mortality across the week became the focus of a Health Select Committee grilling. This is worth checking out, if only for the impressive and forensic cross-examination of evidence by an MP with a previous life as a breast surgeon.
With hindsight, we can see that seven-day working ticks a number of boxes for rising high on the policy agenda. In policy analyst terms this includes an issue which has reached crisis proportions; achieved particularity (that is, is focused and understandable); is emotive and engages human interest; has wide impact; and raises questions about power and legitimacy. [Hogwood and Gunn] In this case, all these factors came together at a particular political moment.
Some research of course makes its own weather. For instance, the NIHR cohort study of 60,000 births—the largest study of its kind in the world—providing new evidence on the quality, safety and costs of giving birth in different settings was always going to generate interest. There hardly needs to be a “hook.”
But in some cases, when findings are released can really make a difference. Results published in August 2014 from a large, ongoing NIHR programme of work on stroke configuration provided data on additional lives saved which made the case at the right time for more radical centralisation of services in Manchester.
So what are the lessons for researchers and research funders?
Those investing in research need to encourage interim findings which are still robust before study end. Many funders are now testing faster routes for reviewing and publishing funded work.
Researchers need to go to where their audience is, using many platforms. In the case of a recent NIHR project on staff engagement, this included a podcast and briefing for trust human resource managers on the NHS Employers website.
For both researchers and research funders, the key is engaging early and often with relevant stakeholders. This is essential to get the right question which is a real and pressing problem. But also to understand the particular service context and landscape in which this research sits. There may be an important “policy window” where evidence is needed. [Kingdon 1995] The trick for researchers is to stay close to service leaders to be ready when that window opens and let it fly.
Tara Lamont is deputy director of the NIHR Dissemination Centre. The views expressed here are her own.
Competing interests: None declared.
References:
Hogwood BW and Gunn LA (1984). Policy Analysis for the Real World. Oxford University Press, Oxford.
Kingdon J (1995). Agendas, alternatives and public policies. Harper Collins, New York (2nd edition).