Health Services Research, down under

Warm greetings from Wellington, New Zealand!

Last week I had the pleasure of attending the 8th biannual Australian and New Zealand Health Services Research conference. I thought I’d share a few of my favourite highlights:

(1) Indigenous and first nations health services research

The conference kicked off with a pōwhiri from local hosts (Te Āti Awa), and this set the tone for much of the conference. This brought tears for me, remembering my great friend and mentor the late whaea Ephra Garrett (Te Āti Awa). There was a great representation from Māori and Pacifica researchers, as well as a strong Canadian contribution which included a moving keynote from Jeff Reading (RIP Brian Sinclair). Simon Royal (National Hauora Coalition) presented a great example of innovation in HSR through a focus on payment by outcomes, and better alignment of funder requirements and community expectations so that Māori providers don’t become the meat in an uncomfortable sandwich where what funders want doesn’t match well with what local Māori desire from health services. I was humbled to be included in a great session on Pacific Health, presenting on diabetes among Pacific people.

(2) Strengthening the future of primary care, and HSR broadly

Concerns about the harms of fragmented care, and what to do about this, featured in great keynote by Rebecca Rosen (Nuffield Trust) who spoke on the challenges and promises of integrated care. Her presentation was a masterclass in maintaining the difficult balance between optimism, and acknowledging uncertainty in the evidence base at present. I couldn’t help wondering if in the UK we had reflected enough on learning opportunities from the national integrated care pilots, before rushing into the newly launched ‘integrated care pioneers’? I also enjoyed the challenge laid down by Nick Mays to the primacy of randomised controlled trials, this ‘one-size fits all’ mentality to evidence provision often doesn’t work well in health services research and while RCTs are highly appropriate when comparing, for example, non-inferiority and cost-effectiveness of new pharmaceuticals, they are often inappropriate as a design that can be used to answer questions about the impact of new policies in health. Personally, I’d like to see timely conversations between policy makers and health service researchers so that the roll out of new policies is done in a way that makes them more amenable to rigorous evaluation (not always the case, in my observation).

(3) Beyond patient surveys: Using patient experience to improve quality of care

The last, but no means least, keynote was delivered by Karen Luxford from the Clinical Excellence Commission, Australia. She explained that patient surveys are really only a first step in our journey to make use of the patient’s or user’s perspective in health care. The really exciting challenge is to see how we can use patient experiences not only to evaluate care, but also to drive improvements in quality by helping to redesign the delivery of health services, a sentiment I agree with. Karen shared some great examples of this, as part of the Partnering with Patients programme she is leading on. I’ve come home inspired to think more on how we might develop similar programmes of work in the UK.

My final conference highlight has nothing to do with highfalutin ideas, and more to do with the simple pleasures of good company (thank you Mike Green, Queen’s University Canada) and a beautiful sunset with native birds giving us the final chorus of the day. Stunning!

Thanks to Professor Jackie Cummings and her team for such a superbly organised and enjoyable conference.

 

My conclusion? Health Services Research ‘down under’ is alive and well!

Looking forward to seeing you all in Melbourne in 2015

– Charlotte

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  • The Cambridge Centre for Health Services Research (CCHSR) is a thriving collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by conducting research and evaluation studies of organisation and delivery of healthcare, including safety, effectiveness, efficiency and patient experience.