How are policy makers using evidence? Models of research utilisation and local NHS policy making

Study objective-This paper is based on a qualitative study that aimed to id entify factors that facilitate or impede evidence-based policy making at a local level in the UK National Health Service (NHS). It considers how model s of research utilisation drawn from the social sciences map onto empirical evidence from this study. Design-A literature review and case studies of social research projects tha t were initiated by NHS health authority managers or GP fundholders in one region of the NHS. In depth interviews and document analysis were used. Setting-One NHS region in England. Participants-Policy makers, GPs and researchers working on each of the soci al research projects selected as case studies. Main results-The direct influence of research evidence on decision making w as tempered by factors such as financial constraints, shifting timescales a nd decision makers' own experiential knowledge. Research was more likely to impact on policy in indirect ways, including shaping policy debate and med iating dialogue between service providers and users. Conclusions-The study highlights the role of sustained dialogue between res earchers and the users of research in improving the utilisation of research -based evidence in the policy process.