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Evidence

Evidence . 10 th October 2012. Presenter : Dr J Greenacre. Areas to cover. Evidence Services Review The Observatory Evidence Service Evidence based / informed public health practice in Public Health Wales. Evidence Services Review: Overview. Reasons for review Approach taken Key themes

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Evidence

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  1. Evidence 10th October 2012 Staff Conference 9th October 2012 Presenter: Dr J Greenacre

  2. Staff Conference 9th October 2012

  3. Areas to cover • Evidence Services Review • The Observatory Evidence Service • Evidence based / informed public health practice in Public Health Wales Staff Conference 9th October 2012

  4. Evidence Services Review: Overview • Reasons for review • Approach taken • Key themes • Issues and solutions • Conclusions and next steps Staff Conference 9th October 2012

  5. Reasons for review • Historical: multiple existing structures • New functions: Observatory & Institute • Rising demand for services • Anecdotal evidence varied approaches • Varied stakeholder feedback • Part of Observatory project Staff Conference 9th October 2012

  6. Approach to review • Project management approach • Observatory project team • Review group of key stakeholders • Defined aims, objectives & tasks for review Staff Conference 9th October 2012

  7. Review Aims • to consider and make recommendations for the strategic direction, operational priorities and configuration of resources for evidence services within Public Health Wales Staff Conference 9th October 2012

  8. Objectives / tasks (1) • Define the scope of evidence services • Describe context within which evidence services are delivered • Stakeholder identification    Staff Conference 9th October 2012

  9. Objectives / tasks (2) • Survey of evidence service users to assess needs and current use of services • Survey to describe current provision of evidence services within Public Health Wales • Write up work of review, including conclusions and recommendations for further action    Staff Conference 9th October 2012

  10. Services considered • Library & Knowledge Management Service (LKMS) • ATTRACT • Health Care Quality evidence services • (Primary Care Quality & Information Service –PCQIS) • (Not Health Promotion Library) Staff Conference 9th October 2012

  11. Key themes • Lack of clarity over terminology • Evidence base for public health action • Increasing demand for services • Confusion over roles of different teams and products offered • Service quality Staff Conference 9th October 2012

  12. Theme 1: Terminology • All terms used variably: no clear consensus between stakeholders • Particular issues: • Evidence • Evidence services • Evidence based public health (action) • ’evidence /research synthesis’ Staff Conference 9th October 2012

  13. And when we try to define ‘evidence’ … we find it very difficult. —R.G. Collingwood, The Idea of History Staff Conference 9th October 2012

  14. ‘Evidence’ working definition of evidence: ‘information documented in such a way so as others can identify it through appropriate searching techniques and use it to inform public health action.’ Staff Conference 9th October 2012

  15. ‘Evidence based public health’ ‘The process of distilling and disseminating the best available evidence (whether from research, practice or experience) and using that evidence to inform and improve public health policy and practice.’ (Ciliska, Thomas, & Buffet, 2008) Staff Conference 9th October 2012

  16. Evidence services • evidence retrieval • e.g. literature searches, librarianship • evidence appraisal, • e.g. critical appraisal, systematic review • evidence dissemination, • e.g. signposting, communicating findings Staff Conference 9th October 2012

  17. Contexts • Purpose: e.g. • decision making, academic research, information for the public etc • Processes: • retrieval, appraisal, dissemination • Types of evidence: e.g. • peer reviewed published research to experience and informed opinion. • Products: e.g. • Instant ‘Google’ to systematic review Staff Conference 9th October 2012

  18. Theme 2: evidenced based practice • Public Health Wales aims to achieve a healthier happier and fairer Wales • ‘Providing health intelligence to guide and underpin public health action’ is essential to the achievement of PHW aims and objectives. • http://howis.wales.nhs.uk/sitesplus/888/document/261198] • the intelligence used should be ‘evidence based.’ evidence services review

  19. Evidence based practice? • Agreed methods? • Outcome / performance measures? • Quality assurance? • Learning / development needs? • Take seriously or lip service? Staff Conference 9th October 2012

  20. Theme 3: service demand • Demand rising overall: • General increasing awareness • New challenges • Evidence services seen as key providers: • Anecdotal confirmation through service and stakeholder surveys, but • Concerns over how work is prioritised and allocated by different teams evidence services review

  21. Theme 4: confusion over team roles • Varied awareness of different PHW evidence services • only half internal staff knew about all services • confusion over what different services offered and how to access them • Evidence of areas duplication and omission evidence services review

  22. Theme 5: service quality • Generally evidence services valued, but: • Concerns over timeliness and quality of product content for some services • Responsiveness and flexibility were also mentioned as areas for improvement • Quality standards and operating procedures variable across services Staff Conference 9th October 2012

  23. Recommendations (1) • Clear definitions and terminology for evidence and evidence services should be agreed by the Board and adopted across Public Health Wales • There should be further discussion and agreement on evidence base for public health practice Staff Conference 9th October 2012

  24. Recommendations (2) • Dedicated evidence teams should be brought together into a single managed service, with clear: • aims, functions and structure • set of products • access and delivery pathways • system for work prioritisation and allocation • quality assurance and management processes Staff Conference 9th October 2012

  25. Recommendations (3) • The new Evidence service should become a leader it its field, proactive in: • assessing needs for evidence based products and services • achieving excellence in evidence synthesis • finding new and imaginative ways of making evidence available to those who need it, in formats appropriate to the purpose and audience in question • Linking to national and international evidence centres Staff Conference 9th October 2012

  26. Recommendations (4) • Mechanisms are needed to support those who access, retrieve and appraise evidence outside of the evidence service including: • Skills development and training for accessing and appraising evidence, • Providing direct support for more complex tasks • Development of common tools and standards Staff Conference 9th October 2012

  27. Recommendations (5) • Mechanisms are also needed to embrace new technologies for evidence services, including: • Moving from paper to electronic based systems as far as possible • Use of social media and other networking evidence services review

  28. The Public Health Wales Observatory Evidence Service Staff Conference 9th October 2012

  29. aim To improve health and reduce inequalities by providing and promoting the best available public health evidence in a manner that maximises the impact of public health action in Wales. Staff Conference 9th October 2012

  30. objectives • deliver excellence in public health evidence • maximise use of evidence for public health action • be innovative in the delivery of evidence services Staff Conference 9th October 2012

  31. objectives • be coherent and accessible to users • be responsive to the needs of users but also proactive in defining and delivering evidence • provide support for the workforce including skills development Staff Conference 9th October 2012

  32. Supporting the integrated public health system • Work closely with local teams, DsPH and other Directorates • Align activities to priorities • Prioritise areas of high impact • Links to Policy and Research Division Staff Conference 9th October 2012

  33. Evidence service Staff Conference 9th October 2012

  34. Health Intelligence Division Director of Health Intelligence Staff Conference 9th October 2012

  35. Structure • Single integrated service • One Head of Service • Detailed structures for discussion • Consultant support Staff Conference 9th October 2012

  36. Evidence based public health practice Staff Conference 9th October 2012

  37. Evidence based pubic health Vision and leadership from here… …to here = senior strategic leadership in public health! Staff Conference 9th October 2012

  38. Staff Conference 9th October 2012

  39. For discussion… • Should all public health practice be evidence informed / based? • Can we do more to strengthen evidence informed decision making? • Scientific vs ‘non scientific’? • What agreement is there on terminology (how important is this?) • Other points for Evidence Service? Staff Conference 9th October 2012

  40. Thank youjudith.greenacre@wales.nhs.uk

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