Re: Mark Radcliffe and Health Technology Assessment

[Guest guest]

Dear Liz,

The HTA programme website is now inviting electronic submissions of new topics

for health technology assessment (cf Ruth Elkan, Jane et al). I have

just tried to suggest 2 school nursing topics (one around public health in

mainstream schools and one around special needs) but unfortunately the etherial

interface between my UCL system and the HTA software kept crashing before I

could submit my proposals. If you and other Senate members can communicate

effectively with the HTA site, they have more discretionary research funding

than any other NHS R & D programme (>10 million per annum) and can fund

significant RCTs, for example: do send in some hot HVSN topics.

Regards,

Woody.

> It's often diificult to tell when Mark Radcliffe is being whimsical or

> when he is trying to make serious point, but when he asks (2

> August) in relation to health visiting 'Who is going to secure funding

> to research the all-round pointlessness of their profession?' and

> states that 'No profession will ever embark on research that might

> possibly suggest it should not exist' I feel it deserves some

> response.

>

> The Primary and Community Care Panel of the Health Technology

> Assessment programme of the NHS Executive in the mid 1990s

> decided that health visiting was a priority topic. The panel could

> hardly be described as one which would entertain special pleading

> for health visiting or any other group; its membership is given in the

> HTA report for interested readers. A team at Nottingham University

> won the competitive tender for a systematic review, which is

> published as R Elkan et al (2000) The effectiveness of domiciliary

> health visiting, Health Technology Assessment vol 4 no 13.

>

> Conclusions include

>

> - the content, duration and intensity of home visits should be

> appropriate and sensitive to the needs of clients

>

> - professional judgement is valid for decisions about where to target

> HV resources

>

> - more broadly based interventions which address the multiple

> needs of individuals and families are more effective

>

> - non-professional home visitors can play a role, but under

> supervision and not for more complex difficulties

>

> -expectations should be realistic- home visiting by itself can be

> insufficient to bring about radical improvements.

>

> Given the lack of investment in research on HV to date, of course

> further research is needed, and Mark's conclusion that 'citing bits

> of inconclusive research' is 'dumbing down the profession' is really

> rather nihilistic. The report concludes that studies are needed on

> cost effectiveness, and a full economic evaluation using an RCT.

> Ann Oakley has made similar points about the evaluation of health

> promotion interventions in general.

>

> I hope Mark enjoys reading the report; it's 339 pages,so perhaps a

> bit heavy for his holiday suitcase.

[Guest guest]

Dear

The HTA homepage is http://www.hta.nhsweb.nhs.uk/

Most of their commissions for original research are for RCTs, but they

also commission systematic reviews of the existing evidence (like Jane

's HV review) and occasionally other types of study (e.g. on

methods for action research). Because their grants can be big

(> £200K), they are the main NHS source to support RCTs on a

meaningful scale.

This morning, I have crashed again trying to enter a school nursing

research suggestion, but am pretty sure the fault is at my end, when I

try to move pages along their website.

Good luck,

Woody.

> > > It's often diificult to tell when Mark Radcliffe is being

whimsical or

> > > when he is trying to make serious point, but when he asks (2

> > > August) in relation to health visiting 'Who is going to secure

funding

> > > to research the all-round pointlessness of their profession?'

and

> > > states that 'No profession will ever embark on research that

might

> > > possibly suggest it should not exist' I feel it deserves some

> > > response.

> > >

> > > The Primary and Community Care Panel of the Health Technology

> > > Assessment programme of the NHS Executive in the mid 1990s

> > > decided that health visiting was a priority topic. The panel

could

> > > hardly be described as one which would entertain special

pleading

> > > for health visiting or any other group; its membership is given

in the

> > > HTA report for interested readers. A team at Nottingham

University

> > > won the competitive tender for a systematic review, which is

> > > published as R Elkan et al (2000) The effectiveness of

domiciliary

> > > health visiting, Health Technology Assessment vol 4 no 13.

> > >

> > > Conclusions include

> > >

> > > - the content, duration and intensity of home visits should be

> > > appropriate and sensitive to the needs of clients

> > >

> > > - professional judgement is valid for decisions about where to

target

> > > HV resources

> > >

> > > - more broadly based interventions which address the multiple

> > > needs of individuals and families are more effective

> > >

> > > - non-professional home visitors can play a role, but under

> > > supervision and not for more complex difficulties

> > >

> > > -expectations should be realistic- home visiting by itself can

be

> > > insufficient to bring about radical improvements.

> > >

> > > Given the lack of investment in research on HV to date, of

course

> > > further research is needed, and Mark's conclusion that 'citing

bits

> > > of inconclusive research' is 'dumbing down the profession' is

really

> > > rather nihilistic. The report concludes that studies are needed

on

> > > cost effectiveness, and a full economic evaluation using an RCT.

> > > Ann Oakley has made similar points about the evaluation of

health

> > > promotion interventions in general.

> > >

> > > I hope Mark enjoys reading the report; it's 339 pages,so perhaps

a

> > > bit heavy for his holiday suitcase.

> >

> >

> >

> >