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Evidence Reviews

Appraising the latest evidence to inform your commissioning decisions

It is important for decision makers to have the best evidence available when planning the commissioning of future healthcare services and the treatments offered to people. There are a number of ways of compiling the evidence and SPH has developed a robust, defensible methodology for providing rapid evidence reviews for local and national clients.

Our process

We follow a clear protocol – developed in-house or provided by the client.  This may include;

  • Developing ethical frameworks for decision-making which will withstand judicial review
  • Framing and scoping an appropriate question to be addressed with the client to provide precise and robust answers to commissioning or providing issues
  • Defining the population, intervention, comparator and outcome (PICO) to structure the evidence review
  • Setting up the search strategy and initiating the search assessing evidence identified by the search to establish its relevance to the review
  • Synthesising and critically appraising the evidence for specific interventions as well as whole care pathways
  • Summarising the strength of the evidence available, appraising the methodology, level of evidence, statistical and clinical significance and limitations of the evidence
  • A structured internal quality assurance process for each review
  • Consultation process with external stakeholders
  • Presentation of finalised evidence review to clients
  • Defending reviews against potential challenge where necessary and appropriate
  • Development of policy emerging from the evidence review
  • Training sessions in evidence-based decision making for stakeholders

Why choose SPH?

We are a long standing provider of rapid evidence reviews for local and national clients. Over the past 15 years we have undertaken over 400 rapid evidence reviews and have successfully defended decisions based on our evidence at judicial review. We have a strong team of experienced reviewers within SPH and can call on further expert capacity from our extensive pool of associates. Please get in touch via our contact page.

Case Studies

Evidence based case studies on reducing cardiovascular disease

SPH developed evidence-based case studies about programmes to reduce cardiovascular disease for PHE and the British Heart Foundation, by identifying successful initiatives worldwide. Programmes to identify and manage people at high risk of CVD were identified and their approach and research outcomes were assessed for relevance and applicability to a UK setting. Ten programmes were selected and a combination of methods used to collate information about the programmes including appraising published peer reviewed and grey literature and interviews with the research leads. The dynamic health systems framework was used to organise the relevant information into a case study template. SPH prepared a report, standalone case studies, presented a poster of the work at two conferences and worked with PHE to write a blog and article for dissemination. International Cardiovascular Disease Prevention case studies

Supporting General Practice to manage lipids according to the NICE-approved lipid management pathway

The updated NICE-approved lipid management pathway was published in December 2021 (and has been updated again since). New NHS England service requirements for Primary Care Networks for the management of lipids and identification of familial hypercholesterolaemia came into effect, reflecting the updated NICE guidance. Eastern AHSN (Academic Health Science Network) is responsible for supporting the adoption of the updated lipid management pathway across the East of England. The AHSN commissioned SPH to carry out a survey of General Practices in the region to help understand and develop future support for practices. Alongside this, Eastern AHSN commissioned SPH to produce an evidence map identifying published evidence about the effectiveness of tools that assist in lipid management and familial hypercholesterolaemia identification. You can read the reports here: Lipid management tools_evidence map_for Eastern AHSN_two page summary Lipid management tools_survey of GP practices_for Eastern AHSN 15th Aug 2022_final

Improving allocative value decision-making in the stroke pathway (STAR tool)

The Mid and South Essex stroke stewardship group wanted to better understand which of the interventions they delivered were high value and which were low value to inform decision-making on use of resources and investment. Arden & GEM’s Healthcare Solutions team provided training and support to enable the group to use the Socio-Technical Allocation of Resources (STAR) process in value based decision-making. As a result, the MSE stroke stewardship group has the insight needed to improve the allocation of their existing resources and improve outcomes for their patients. SPH were part of the project team, conducting a librarian review of economic evidence relating to cost-effectiveness of the stroke interventions to feed into the first workshop. This comprised a review of existing economic cost-effectiveness assessments (ideally by NICE as these are recognised as the guiding authority within the NHS). Where an economic assessment had not been undertaken then this was noted for further consideration. More detail here

Health Needs Assessment for Children & Young People

SPH carried out a Health Needs Assessment for a local authority that was recommissioning its Healthy Child Programme (HCP). The purpose was to review whether existing provision and service configuration of the HCP was meeting the needs of children and young people in the county, and to identify gaps and potential options for improvement. This is a preventative programme which includes Health Visiting and School Nursing Services, Family Nurse Partnership (FNP) Programme and healthy start vouchers and vitamins, linking with childhood immunisation services, community paediatrics, speech and language, services for children with a learning disability and complex needs and child and adolescent mental health services (CAMHS), among others. The HNA was carried out jointly by SPH and the local authority, with the epidemiological needs assessment and service description provided by the local authority. The report was compiled using a range of publicly available and locally collected epidemiological and service use data. In addition, SPH carried out a consultation of key corporate stakeholders as well as children and young people, their parents and carers. This included semi-structured interviews with key stakeholders in a range of organisations, a survey of a wider range of staff who work with children and young people and a survey of children and young people, their parents and cares which was distributed through the services.

National evidence reviews

SPH produces a number of high profile rapid evidence reviews for national clients every year assessing the effectiveness and cost-effectiveness of a wide range of treatments or potential interventions. Rapid evidence reviews for NHS England SPH has produced rapid evidence reviews for NHS England Specialised Services since 2012. These high-profile reviews consider the clinical and cost-effectiveness of treatments and interventions for a variety of conditions. The requirements of this contract include:
  • Supporting development of research questions through liaison with the commissioner and senior stakeholders
  • Supporting development of a PICOS table
  • Liaising with a healthcare information scientist in Libraries to design the literature search
  • Reviewing abstracts and selecting papers according to the agreed methodology
  • Producing the review to an agreed template
  • Internal quality assurance
  • Consultation on the review with clinical specialists
  • Producing a final report following consultation comments.
  Commissioned evidence reviews We also produce bespoke evidence reviews to assist customers address specific commissioning issues, for example:
  • Reviews to inform national policy on population screening for the UK National Screening Committee
  • Reviews to inform strategy design for preventing alcohol exposed pregnancies through understanding the predictors of alcohol consumption and the effectiveness of interventions for Blackpool Better Start
  • A review on the development and use of early warning indicators in qualitative information for the Care Quality Commission
  • A review on the contribution of community pharmacy in supporting/delivering lifestyle interventions and health protection/prevention for the Pharmacy and Public Health Forum
  • A review on the impact and cost-effectiveness of self-management programmes on chronic disease management for a Public Health team.

Supporting Priorities Committees

Our work with Priorities Committees enables NHS commissioners to balance complex choices, backed up with independent evidence reviews and ethical frameworks. We provide an end-to-end service which includes the development of an ethical framework to inform the decision-making process, topic selection, evidence reviews, consultation with clinical specialists, operational support to priorities committees and drafting of clinical commissioning recommendations. We have also worked with commissioners around the country in developing and advising on setting up their own decision-making processes. We have experience of supporting commissioners in appeals against NICE guidance and in judicial reviews.