By Nadya Anscombe
Centre for Academic Primary Care
“Bridging the gap” – that was the name of the workshop I attended at a recent event organised by the Avon Primary Care Research Collaborative (APCRC).
The gap that apparently needed to be bridged is the gap between what someone called the “ivory towers of academia and the swampy lowlands of commissioning”.
I was sceptical – is there really a gap? Surely healthcare researchers and NHS commissioners are all working in the same sector; we all want to improve things; and we all want to make a difference to our population’s health and well-being. Surely the “gap” can’t be as big as some people make it out to be?
In theory, academia investigates the problems and issues of the sector, provides evidence for things that work and things that don’t; commissioners use this information to make decisions about what services to commission; and researchers than investigate if that service has been cost-effective or whether it has improved health. And the whole virtuous cycle starts again.
But it seems this virtuous cycle is not functioning as it should be. And that’s bad news for everyone involved – if research projects are not relevant to the current issues in the healthcare system, this is not good for the healthcare system but also not good for the researcher as funding could potentially be reduced. It also means that appropriate evidence is not available to commissioners and they may not always be informed by evidence. This will result in cost implications due to the commissioning of inappropriate services
It was obviously a topic that the delegates at the APCRC event thought was important as it was the most popular workshop of the afternoon. Run by a Helen Baxter, a researcher from the Centre for Academic Primary Care at the University of Bristol and Jude Carey, service improvement lead at Bristol CCG, it was a fascinating, eye-opening hour.
Helen and Jude organised us into groups, making sure that representatives from both sides of the gap were in each group. We started with a quiz, with questions designed to find out how much we really know about each other’s worlds. What does QIPP stand for? What is the REF? All very amusing and informative. Until we got to the question: “How much time would a researcher normally be given to prepare a grant application for £500,000?” and conversely: “How much time would a commissioner normally be given to prepare a business case for an initiative costing £500,000?”
After much discussion we agreed it would take a researcher around 3-6 months full-time to work up a grant application. Gasps came from the commissioners. Apparently some commissioners have prepare a business case in a matter of hours but it usually takes a few weeks. Cue gasps from the researchers.
It seems we do come from different worlds and there is a gap. Researchers and commissioners have different language, different timescales, different priorities and different measures of success.
But the APCRC is working on bridging this gap with its investment in the Knowledge Mobilisation team at the Centre for Academic Primary Care. Helen is one of two researchers that also spend time in the swampy lowlands of the local CCGs and Jude is one of the NHS management fellows that has spent time learning what we do in our ivory tower.
We hope that that by spending time in each other’s worlds, we will bridge the gap and make sure the virtuous cycle functions in the way it should.
Knowledge Mobilisation at the Centre for Academic Primary Care (a short animation)