Sandra can pinpoint exactly when her interest in evidence-based health care started: “It was a conversation I had with my colleague and co-author Huw Davies (Professor of Health Policy and Management at the University of St Andrews). Sandra can pinpoint exactly when her interest in evidence-based health care started: “It was a conversation I had with my colleague and co-author Huw Davies (Professor of Health Policy and Management at the University of St Andrews).
Sandra Nutley is Professor of Public Management at the University of Edinburgh and Director of the Research Unit for Research Utilisation (www.ruru.ac.uk).
She spent eight years working in local government in England before moving into higher education as a lecturer in the 1980s. Since then, her academic career has been interspersed with periods of secondment to work with various public service organisations.
With an international reputation for her work on research use and evidence-based policy and practice, PACEsetterS was keen to catch up with Sandra to talk about her work with the Research Unit for Research Utilisation (RURU).
RURU was established in 2001 and its role is to conduct research on research use and to provide a research resource for all those interested in using research to improve public policy and public services. Sandra thinks that it has achieved a lot in its short life.
“Our cross-sector reviews of what works in achieving research impact have attracted a lot of attention from policy-makers, practitioners and researchers in the UK and abroad. Talking about these issues has taken me to Australia, New Zealand, Denmark, Norway, Sweden and the US.”
“In addition, the work that we've done in social care around models of research-informed practice has been picked up by social care organisations, professional bodies and individual social workers in the UK and in several Scandinavian countries.”
RURU maintains a fully searchable library of references on research utilisation and the implementation of evidence-based policy and practice, which can be accessed via the RURU website. The database draws on papers from four key sectors - criminal justice, education, health care and social care - so we asked Sandra about the main similarities and differences across these sectors.
“There are many similarities which is not surprising given that each of these sectors not only consume high levels of government resource and political attention but they also display some structural similarities, such as the employment of staff with professional qualifications to provide services to individuals or groups.
“There has also been extensive debate in these four areas around the importance of evidence in shaping policy and practice and each has seen very significant investment in growing and synthesising a relevant research base.
“There are, of course, also some important differences between these sectors, particularly in the ways in which research is understood, created, synthesised and used.”
Across all four sectors there are discussions about 'what counts' as evidence, which Sandra believes is vital. Her view is that the answer to this question must point to more than research evidence.
“Evidence from a range of research and evaluation studies sits alongside routine monitoring data, expert knowledge and information from stakeholder consultations. Under this broader view “fitness for purpose” acts as the main criterion for determining what counts as good evidence.
“It is important to remember that policy makers and practitioners are interested in more than just what works. They also want to know about the nature of the problem, why it occurs and how might it be addressed.”
Sandra can pinpoint exactly when her interest in evidence-based health care started: “It was a conversation I had with my colleague and co-author Huw Davies (Professor of Health Policy and Management at the University of St Andrews).
“I had been doing some work on the introduction of the “what works” agenda into probation services in the UK and we began to compare and contrast my experiences with his experiences of evidence-based practice in health care. We decided to write a paper, that paper then expanded into our first book (What Works? Evidence-based policy and practice in public services, The Policy Press, 2000) and the rest, as they say, is history.”
Her latest book, Using Evidence: How Research Can Inform Public Services (The Policy Press, 2007), is described by Carol Weiss (Harvard University) as a sophisticated book that “will challenge some current beliefs and offer better grounded and more realistic aspirations". It draws together current knowledge about how research gets used and how this can be encouraged and improved.
When looking to the future of research utilisation, Sandra says, “Let me just focus on one important aspect of the future agenda, understanding how research enters policy and practice at the organisational or systems levels.
“The dominant model of research use - for much conceptual work as well as for many empirical studies of the field - envisages individual policy makers and practitioners consciously seeking out and keeping up-to-date with research, and then applying the evidence they thereby glean in their day-to-day work.
“The potential roles that research may play at the organisational and systems levels remain relatively unexplored, although the evidence we have suggests such uses of research may well be important. We thus need to move beyond individualised framings of the research use process and capture what using research might mean within wider organisations and systems, and for groups and communities as well.”
Sandra doesn't just study research use she is also keen to ensure that her own research has an impact on policy and practice. One example of this is her membership of the Scottish Funding Council's Knowledge Transfer and Innovation Group, which is looking at how the knowledge transfer activities (better termed knowledge exchange activities) of the Higher Education Institutions (HEIs) in Scotland can be improved in order to impact more fully on economic development, cultural engagement and public policy.
Sandra chairs the Public Policy sub-group, which is looking at the supply incentives for knowledge transfer activities in HEIs and how these can be enhanced, what can be done to stimulate public policy and practice demand for the knowledge available from HEIs, and what is needed to improve the interaction between the supply and demand sides of this equation. In this latter area, the group is focusing its attention on the role of networks and the need for intermediary agencies and knowledge brokers.
She is also a member of the Scottish Executive's 'Changing Lives: Practice Governance' group, which is addressing how practice governance needs to change in social care.
“The overall aim of the group is to develop practice governance that ensures and supports the delivery of safe and effective practice and that allows professionals to deliver services in an innovative, responsible and accountable way. My input into the group focuses on how best to ensure that practice is informed by the best available evidence.”
Not all of Sandra's research is on research utilisation issues. She is also involved in a comparative study of audit and inspection regimes in the UK (comparing the regimes in England, Scotland and Wales).
Again, however, she is keen to ensure that the emerging findings from this research feed into policy advice. She is a member of the expert panel advising the Scottish Executive's Scrutiny Review. The Review is evaluating the regulation, audit, inspection and complaints handling of public services in Scotland. In summer 2007 it will make recommendations to ministers on a framework for the future external scrutiny of public services in Scotland.
With the many hats Sandra currently wears, we wondered whether she finds any time to relax.
“Spare time - now there is an interesting concept! I do try to preserve some leisure time. For my summer holidays and during some weekends in the summer, I go sailing.
“I love walking and I have a favourite loop through the woods and down to the sea near where I live. I also read as much fiction as I can - I find a good novel is a great form of escape.”
We hope she continues to find ways to escape, but with all of the great work she is involved with we hope she doesn't go too far!