ANALYSING PERFORMANCE ASSESSMENT IN PUBLIC SERVICES: HOW USEFUL IS THE CONCEPT OF A PERFORMANCE REGIME?

Approaches to performance assessment have been described as 'performance regimes', but there has been little analysis of what is meant by this concept and whether it has any real value. We draw on four perspectives on regimes - 'institutions and instruments', 'risk regulation regimes', 'internal logics and effects' and 'analytics of government' - to explore how the concept of a multi-dimensional regime can be applied to performance assessment in public services. We conclude that the concept is valuable. It helps to frame comparative and longitudinal analyses of approaches to performance assessment and draws attention to the ways in which public service performance regimes operate at different levels, how they change over time and what drives their development. Areas for future research include analysis of the impacts of performance regimes and interactions between their visible features (such as inspections, performance indicators and star ratings) and the veiled rationalities which underpin them.

Improving skills and care standards in the support workforce for older people: a realist review.

INTRODUCTION: In the context of a population that is growing older, and a number of high-profile scandals about care standards in hospital and community settings, having a skilled and knowledgeable workforce caring for older people is an ethical and policy imperative. Support workers make up the majority of the workforce in health and social care services for older people (aged 65 years and over), and yet little is known about the best way to facilitate their development. Given this gap, this review will draw on evidence to address the question: how can workforce development interventions improve the skills and the care standards of support workers within older people's health and social care services? METHODS AND ANALYSIS: As we are interested in how and why workforce development interventions might work, in what circumstances and with whom, we will conduct a realist review, sourcing evidence from health, social care, policing and education. The review will be conducted in four steps over 18 months to (1) construct a theoretical framework, that is, the review's programme theories; (2) retrieve, review and synthesise evidence relating to interventions designed to develop the support workforce guided by the programme theories; (3) 'test out' our synthesis findings and refine the programme theories, establish their practical relevance/potential for implementation and (4) formulate recommendations about improvements to current workforce development interventions to contribute to the improvement of care standards in older people's health and social care services, potentially transferrable to other services. ETHICS AND DISSEMINATION: Ethical approval is not required to undertake this review. Knowledge exchange activities through stakeholder engagement and online postings are embedded throughout the lifetime of the project. The main output from this review will be a new theory driven framework for skill development for the support workforce in health and social care for older people. TRIAL REGISTRATION NUMBER: CRD42013006283.

An exploration of the roles of nurse managers in evidence-based practice implementation.

BACKGROUND: Internationally, nurses face ongoing difficulties in making a reality of evidence-based practice. Existing studies suggest that nurse managers (NMs) should play a key role in leading and facilitating evidence-based practice, but the nature of this role has not yet been fully explored or articulated. This is one of the first studies to investigate the roles of NMs in evidence-based practice implementation. METHODOLOGY AND METHODS: Using a case study approach the study explores five propositions in relation to the NMs' potential evidence-based practice role and the extent to which their attitudes, knowledge, and skills support such a role. In doing so, it draws on interviews (n= 51), documentary analysis and observational data. FINDINGS: Data analysis reveals that the role of NMs in facilitating evidence-based practice is under-articulated, largely passive and currently limited by competing demands. Progress in implementing evidence-based practice in the case study sites is largely explained by factors other than the role played by NMs. As such, the findings expose significant discrepancies between NMs' actual roles and those espoused in the literature as being necessary. Contextual factors are important and it is clear that the role of the contemporary NM places considerable emphasis on management and administration to the detriment of clinical practice concerns. CONCLUSIONS: The study reveals that NMs are only involved in evidence-based practice implementation in a passive role, not the full engagement described in the literature as being necessary. This study adds previously lacking detail of the roles of NMs. It elucidates why exhortations to NMs to become more involved in evidence-based practice implementation are ineffective without action to address the problems identified.

Why 'knowledge transfer' is misconceived for applied social research.

'Knowledge transfer' has become established as shorthand for a wide variety of activities linking the production of academic knowledge to the potential use of such knowledge in non-academic environments. While welcoming the attention now being paid to non-academic applications of social research, we contend that terms such as knowledge transfer (and its subordinate sibling, knowledge translation) misrepresent the tasks that they seek to support. By articulating the complex and contested nature of applied social research, and then highlighting the social and contextual complexities of its use, we can see that other terms may serve us better. Following from this analysis, we suggest that 'knowledge interaction' might more appropriately describe the messy engagement of multiple players with diverse sources of knowledge, and that 'knowledge intermediation' might begin to articulate some of the managed processes by which knowledge interaction can be promoted. While it might be hard to shift the terminology of knowledge transfer in the short term, awareness of its shortcomings can enhance understanding about how social research can have wider impacts.

Increasing research impact through partnerships: evidence from outside health care.

There is growing interest in using closer partnerships between researchers and research users to increase the appropriate application of research evidence in policy and practice. While this supplement reports and assesses a number of these initiatives in health care, this article reviews the evidence in support of partnerships from elsewhere. Drawing on a substantial cross-sector review of research impact initiatives, we extract lessons for health care from partnership evaluations in social care, education and criminal justice services. A reasonable and robust evidence base supports the use of partnerships as one means of increasing research uptake. Although requiring substantial investments of time, resources and commitment, and suffering from a number of possible pitfalls, we conclude that such partnerships offer great potential for increasing research use.