Organisation and workforce

The focus in this theme is health and care policy and its impact upon service organisation and the health and care workforce.

Research issues

Health professionals, one stood up and the rest sat round a table in a meeting

The context within which health and care services operate, in common with systems across the world, is one of growing demand driven by an ageing population, technological change and rising public expectations. In response, health and social care services are undergoing considerable policy-driven system transformation at a number of different levels:

  • Across the UK: since the devolution of responsibility for health services to Scotland, Wales and Northern Ireland, there has been a growing divergence in policies and approaches to service organisation between the devolved nations.
  • Within England: the Five Year Forward View, published in 2014, set in train a process of service reorganisation with a focus upon integration and collaborative working between health care organisations and between health and social care.
  • Within the North West region: responsibility for health and social care service delivery was devolved to Greater Manchester (GM) in 2016. Under this initiative, health and social care commissioners and providers are working together across GM in order to improve population health and service delivery.

These major changes demand extensive and intensive academic research to analyse, critique and inform emergent health and care policy.

Future agenda

This Institute provides the opportunity to expand our reach to explore comparative international approaches to health and care policy. Important research issues include:

  • What can we learn about the optimum approach to health policy from comparisons between the devolved nations of the UK and other regions internationally?
    Issues include diverse approaches to collaborative working and workforce development, distinct attitudes to the role of competition in service improvement, and innovative forms of contractual mechanism to support change.
  • How can integrated care best be facilitated?
    Issues include questions of structural versus functional integration, uses of diverse incentives and contractual mechanisms, new forms of governance and accountability, novel approaches to workforce development and outcomes measurement and regulatory/legislative challenges.
  • What is the optimum balance between centralisation and delegation of responsibility for health and social care services?
    Issues include tensions between local innovation versus wider equity of service provision, the challenge of identifying a meaningful population base for delegation, and questions of oversight, assurance, and accountability.
  • How does spending on policy, organisation and workforce interventions compare to spending on new health technologies in terms of value for money?
    Issues include new approaches to estimating the costs and benefits of policy, organisation and workforce interventions, identification of wider system effects and unintended consequences, and debates over the optimal allocation of scarce healthcare resources.

Theme leads