of Health Policy
15-17 Tavistock Place
I have diverse experience in the field of health policy. Before coming to the School I had worked in the National Health Service in England (with spells in public health and in representing consumers' interests), in academic health services research (at the Universities of Leicester and London (St Thomas' Hospital Medical School), and the Queen's University of Belfast), in the independent sector (with a think-tank, the King's Fund, where I was director of health services research) and as a civil servant (as a policy adviser with the New Zealand Treasury). I joined the School in May 2003 after almost five years in New Zealand. I maintain a direct involvement in health and wider social policy-making by continuing to provide periodic advice to the New Zealand Ministry of Health and the Treasury.
I direct the National Institute for Health Research (NIHR) Policy Research Programme-funded Policy Innovation and Evaluation Research Unit (PIRU) which is a collaboration between LSHTM, the Care Policy and Evaluation Centre (CPEC) at the London School of Economics and Imperial College Business School (http://www.piru.ac.uk/).
I co-organise the Evidence-Based Public Health Policy and Practice module for students on the Doctor of Public Health Programme which is the School's professional doctorate in public health. I also teach at Masters level on the Health Policy, Process and Power, Health Systems and other modules.
I am co-author with Kent Buse and Gill Walt of a text book on understanding the policy process called, Making health policy. I have published other methods texts including Synthesizing qualitative and quantitative evidence: a guide to methods with Cathy Pope and Jennie Popay in 2007, also published by Open University Press. The fourth edition of the introductory textbook, Qualitative research in health care edited with Catherine Pope, was published in 2020 by Wiley.
I am interested both in the rigorous analysis of contemporary health policy issues (research 'for' policy) as well as research designed to improve understanding of how and why health and wider public policy is made and implemented in the way that it is (research 'on' policy). My research 'on' the policy process includes an analysis of the policy making style under the Labour Government of Tony Blair, a case study of the formation of the NHS Plan 2000 (http://onlinelibrary.wiley.com/doi/10.1111/1467-856X.12005/pdf) and a study of major policy pilots in health and social care, and how they have been evaluated.
My main research activity 'for' policy relates to directing the Policy Innovation and Evaluation Research Unit (PIRU) which undertakes a mix of primary evaluation studies of new health and long term care policies and policy pilots in England, together with advice on the development and evaluation of pilots and demonstration programmes. The idea behind the Unit is to attempt to develop early stage engagement between researchers and policy makers in the development of policy innovations so that innovations are designed in ways that facilitate rigorous evaluation.
PIRU is currently undertaking or has recently undertaken evaluations in England of the Public Health Responsibility Deal, the National Cold Weather Plan, the Heat Wave Plan for England, the UK Antimicrobial Resistance Strategy, 2013-18, the General Practice Patient Choice Pilot, the Social Impact Bond Trailblazers, Direct Payment in Residential Care Pilots, the Children and Young People's Mental Health Trailblazers and the Integrated Care and Support Pioneer Programme, as well as methodological work to improve the handling of selection bias in quasi-experimental evaluations using improved methods of matching. The Unit is also studying the way in which evaluations of pilots are commissioned, designed and used in health and social care in England.
One of my main programmes of research 'for' policy was as scientific coordinator of a Department of Health-funded programme of evaluation of the major reforms of the English NHS undertaken by the Labour Government from 2003 to 2010 which involved patient choice, provider competition through a mixed economy of provision and a new activity-based reimbursement system for hospital services. The programme extended from 2006 to 2013 (http://www.lshtm.ac.uk/hsru/hrep/) and resulted in two supplements of the Journal of Health Services Research & Policy plus a book published by the King's Fund entitled Understanding New Labour's market reforms of the English NHS (http://www.kingsfund.org.uk/publications/understanding-new-labours-market-reforms-english-nhs).
In terms of health system comparisons, I am especially interested in the potential for comparative policy analysis of the divergence that has occurred between the NHS in the constituent parts of the United Kingdom since political devolution. My most recent report was published by the Nuffield Trust in 2014 (http://www.nuffieldtrust.org.uk/sites/files/nuffield/4_countries_report.pdf).
I have a longstanding interest in the role of primary health care in health systems, with a recent focus on the emergence of 'at scale' general practice organisations, including Primary Care Networks, in England. I recently collaborated on a review of the evidence on their development and effectiveness http://www.nuffieldtrust.org.uk/sites/files/nuffield/publication/large-scale_gps_literature_final.pdf