The evidence base, however, is often much stronger for clinical medicine in the NHS than the equally important area of decisions for public health and social care in local government. Over the past year, I have visited local authorities across England to hear, first-hand, about the public health challenges they face and research that can help address them.
What struck me during these visits was the inspirational people who are working tirelessly to improve people’s lives locally.
As well as being Chief Medical Officer for England, I lead the National Institute for Health Research (NIHR), the nation’s largest funder of health and social care research. One of the aims of the NIHR is to produce research evidence that can help shape new clinical, public health and social care interventions.
Despite learning about many remarkable innovations, I was surprised by the lack of evidence around many public health programmes and the limited evaluation of their effectiveness.
Universities and the research sector are not as well integrated into local authorities as they should be. We must do what we can to make this easier. Many great ideas do not work as planned: others do, but without a formal independent assessment, it is unlikely they will be adopted elsewhere.
Two of the key challenges in generating evidence that is useful to local authorities are infrastructure and capacity. For clinical research, the NIHR actively supports linkages between universities and NHS trusts by funding research infrastructure and joint staff appointments between both.
“I was surprised by the lack of evidence around many public health programmes and the limited evaluation of their effectiveness
This is something the NIHR is keen to address in terms of how local authorities and universities work together. As well as universities working with their local authorities, academic researchers across the country should be working with a broad range of local authorities to address public health challenges.
Not having a connection between universities and local authorities can have many impacts. On the most simple of levels, it means public health practitioners and policy-makers cannot access the evidence often locked away in subscription journals in university libraries.
In terms of the bigger picture, research carried out by academics at universities may not address the public health needs of the local authority where the research is being conducted. One of the best ways of tackling this issue is through the co-production of research – an approach in which researchers, practitioners and the public work together to shape a project.
I was accompanied on some of my council visits by Dame Anne Johnson, Chair of the Strategic Coordinating Body of the Health of the Public Research (SCHOPR) group. One of its key activities was to produce, at the request of the UK Chief Medical Officers, public health research principles and goals to guide funding decisions. The purpose of the principles and goals is to increase the impact of the UK’s offer on health of the public research, so we are better able to tackle the public health challenges we face, now and in the future.
Our experience around the country has highlighted some of the fantastic research taking place, but the discussions really brought home that the NIHR needs to be doing even more with local authorities to support this work.