Title: Knowledge brokering in Sheffield: commissioning community organisations to address the health and wellbeing agenda
Funder: Department of Health and Social Care

Abstract: Knowledge brokering may be a useful approach to not only foster exchange of information, but also generate relevant evidence on the utility of community programmes. While knowledge brokering has been shown to facilitate evidence informed decision making (Lomas, 2007), the research also indicates that linkages promoting knowledge exchange can be constrained where there are formal contractual arrangements and competition for scarce resources (Ward et al, 2014). Collaboration can also be affected by the fault lines' that arise when trying to combine research evidence with technical and prudential knowledge the wisdom and experience which are represented by community organisations in the design and implementation of their services (Ward et al, 2014). Although the valuing of different types of knowledge can bridge this gap, very little research has been done where KB is used to work across disciplines (Currie & White, 2012). Only one study has explored knowledge brokering across organisations (Ward et al, 2014) and there has been no research yet looking at the interactions between community organisations, patients, the public, providers and local authorities in the commissioning of services. In the Department of Health's vision for a public health system for the 21st century', public health is expected to support local political leaders in assessing needs related to health and wellbeing. This requires working across diverse services such as adult social care, children's services, transport, housing and leisure to promote joint commissioning of services that will benefit disadvantaged groups.Local authorities and universities are now challenged to develop new ways of working with and incorporating public health into community development, which include enabling public health to contribute knowledge and expertise about what works in health reconciling the narrow NHS definition of health' with a wider community development remit which focuses on social conditions and psychosocial capabilities acknowledging the practitioner-based evidence of community organisations who have decades of experience in promoting wellbeing and resilience combining research-based and experiential evidence on what works in community development with the requirements for accountability across local authority and health service sectors This proposal aims to explore how knowledge brokering can facilitate linkages and exchange of evidence, explore research partnerships, and develop strategies for building capacity to generate local evidence that can be used to make evidence-informed decisions about future commissioning of community services for health and wellbeing. The project will have 3 phases - Preparation, Execution and Translation. In the first phase, we are finding providers who have an interest in creating an evidence base for community programmes. Community providers (CPs) are aware that their clients access multiple services in Sheffield for issues relating to employability, long term conditions, education and training, health and mental health. They would like to produce a bigger picture of how multiple interventions may create a community-wide support network for clients. At the same time, clinical commissioners are interested specifically in health outcomes, while the Local Authority is interested in wellbeing. Pictures of what works' across community programmes for clients who use many services will be constructed by obtaining stories from clients and working with them to produce a map of their journey. The journey map will showing the services they were linked with along the way and the outcomes they valued from each service. It will also show how community providers currently work with each other, and where they may be gaps in service. These client outcomes will be fed back to community programmes and commissioners, and compared to the health outcomes that clinical commissioners want to fund as well as the wellbeing outcomes that the Local Authority funds. An agreed list of outcomes will be produced, and used to develop a plan for routine evaluation of community programmes. Academics will identify tools that can be used to measure client health and wellbeing outcomes which are appropriate for community programmes. The participating programmes will pilot the agreed approach for evaluation and review whether it is feasible. The final product will be an agreed approach to monitoring and evaluating community programmes that will provide the sort of evidence needed by commissioners.

Lay abstract: Knowledge brokering may be a useful approach to not only foster exchange of information, but also generate relevant evidence on the utility of community programmes. While knowledge brokering has been shown to facilitate evidence informed decision making (Lomas, 2007), the research also indicates that linkages promoting knowledge exchange can be constrained where there are formal contractual arrangements and competition for scarce resources (Ward et al, 2014). Collaboration can also be affected by the fault lines' that arise when trying to combine research evidence with technical and prudential knowledge the wisdom and experience which are represented by community organisations in the design and implementation of their services (Ward et al, 2014). Although the valuing of different types of knowledge can bridge this gap, very little research has been done where KB is used to work across disciplines (Currie & White, 2012). Only one study has explored knowledge brokering across organisations (Ward et al, 2014) and there has been no research yet looking at the interactions between community organisations, patients, the public, providers and local authorities in the commissioning of services. In the Department of Health's vision for a public health system for the 21st century', public health is expected to support local political leaders in assessing needs related to health and wellbeing. This requires working across diverse services such as adult social care, children's services, transport, housing and leisure to promote joint commissioning of services that will benefit disadvantaged groups.Local authorities and universities are now challenged to develop new ways of working with and incorporating public health into community development, which include enabling public health to contribute knowledge and expertise about what works in health reconciling the narrow NHS definition of health' with a wider community development remit which focuses on social conditions and psychosocial capabilities acknowledging the practitioner-based evidence of community organisations who have decades of experience in promoting wellbeing and resilience combining research-based and experiential evidence on what works in community development with the requirements for accountability across local authority and health service sectors This proposal aims to explore how knowledge brokering can facilitate linkages and exchange of evidence, explore research partnerships, and develop strategies for building capacity to generate local evidence that can be used to make evidence-informed decisions about future commissioning of community services for health and wellbeing. The project will have 3 phases - Preparation, Execution and Translation. In the first phase, we are finding providers who have an interest in creating an evidence base for community programmes. Community providers (CPs) are aware that their clients access multiple services in Sheffield for issues relating to employability, long term conditions, education and training, health and mental health. They would like to produce a bigger picture of how multiple interventions may create a community-wide support network for clients. At the same time, clinical commissioners are interested specifically in health outcomes, while the Local Authority is interested in wellbeing. Pictures of what works' across community programmes for clients who use many services will be constructed by obtaining stories from clients and working with them to produce a map of their journey. The journey map will showing the services they were linked with along the way and the outcomes they valued from each service. It will also show how community providers currently work with each other, and where they may be gaps in service. These client outcomes will be fed back to community programmes and commissioners, and compared to the health outcomes that clinical commissioners want to fund as well as the wellbeing outcomes that the Local Authority funds. An agreed list of outcomes will be produced, and used to develop a plan for routine evaluation of community programmes. Academics will identify tools that can be used to measure client health and wellbeing outcomes which are appropriate for community programmes. The participating programmes will pilot the agreed approach for evaluation and review whether it is feasible. The final product will be an agreed approach to monitoring and evaluating community programmes that will provide the sort of evidence needed by commissioners.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE