MEDICINE, MARKETS AND MORALS: A MULTI-DISCIPLINARY RESEARCH NETWORK ON HEALTH AND SOCIAL CARE PRIORITISATION

The debate over health care funding in England is changing with the questioning of the founding principles of the NHS (free at the point of delivery, universal health service for all provided out of taxation). The Health and Social Care Act 2012 is arguably the greatest change in health care organisation in England since the beginning of the NHS over 60 years ago. These reforms fundamentally change the way health care is financed and provided in England, with a move towards more market mechanisms and the greater use of private and third sector organisations to deliver health care previously provided by the NHS. The network will contribute to this debate over the implications of this legislation. These reforms will undoubtedly have a significant impact on how health and social care is delivered for all NHS patients. This new health care landscape necessitates a renewed debate over what type of health service we want and how health care should and can be funded in an age of austerity.

The network will explore two main areas:
1. Theoretical debates over resource allocation and priority setting in health and social care. The network will explore the fundamental principles behind recent legislation in the UK on health and social care. With the increasing globalisation of health care these issues need to be examined in an international context and this network will locate these debates over funding mechanisms and how payment should be organised in a wider global context.
2. How the commissioning of services should be carried out in this new health care landscape ethically (fairly and equitably) within the given financial and policy constraints.

The network will organise three meetings (in Glasgow, Birmingham and London), with approximately nine speakers at each meeting.

Meeting One (Glasgow) - Setting the agenda - International and disciplinary perspectives on health and social care financing (over two days)

Meeting Two (Birmingham) - Exploring the issues - Philosophical and theoretical issues in resource allocation and commissioning (over two days)

Meeting Three (London) - Bringing it all together - Reconfiguring public sector provision of health and social care: policy and practical implications (one day)

This network will aim to have two major activities to ensure the network has an impact on policy and practice:

1. Produce a policy briefing document on the issues discussed in the network in consultation with our key network partners (Nuffield Trust and NHS England) which will be disseminated widely (see below). This document will be used to scope both policy development and areas for future research.
2. Maintain the network (through funded projects and meeting support) to continue the work and build on the links and collaborations made during the project. This will provide a tailored, multi-disciplinary and cross-professional resource for bodies such as NHS England, to aid the development of economically and ethically sound policy in this area.

This network will employ a number of strategies to ensure that both the products of the network have an impact on policy and practice and that non-academics are involved in all stages of the network. We aim to involve and disseminate to: politicians (Health Select Committee and Public Accounts Committee, political parties), journalists, members of NHS organisations (clinical commissioning groups; NHS England specialised commissioning, NHS Confederation), local authorities; patient groups (peoples' health assemblies); the Royal Colleges (both medical and nursing and midwifery); policy makers (Department of Health), think tanks (Nuffield, Kings Fund, Nuffield Council of Bioethics and the Health Foundation). These diverse groups will be called non-academics for the purpose of this summary.

Strategies for involvement and dissemination
1. The network will work closely with the Nuffield Trust, a leading policy think tank, who conduct research and policy analysis to improve health care in the UK. One of their policy fellows (Helen Crump) will be on the Advisory Board and a senior member of their policy team will speak at the final meeting.
2. The network also has support from NHS England through their Patient & Information Directorate who are currently overseeing, alongside Public Health England, the establishment of priority setting ethical guidelines (that Frith is involved with).
3. A member of Public Health England will be on the Advisory Board to provide guidance on the practical direction and relevance of the network.
4. We will aim to have good patient and public participation throughout the project by having a patient-public voice member of the Advisory Group to provide guidance on all network activities.
5. Each network event will have non-academic members of the audience to give a policy, user or health care professional perspective on the relevant issue. This will ensure that the debates are not conducted solely at a theoretical level but will seek to apply the deliberations and debates to practice.
6. We will develop a project website where the power points and abstracts from the talks will be uploaded and details of the events and other related news will be posted.
7. We will have a graphic recorder present at the final meeting to depict the main points of the discussion in graphic form, capturing the discussions in a visual poster format. This will engage the audience and cater for different learning styles and diverse delegate needs. It will also produce a visual record that will be hosted on the website and therefore can be widely shared.
8. We will create a Twitter feed with a network # to publicise the meetings and to report the discussion throughout each meeting so that wider questions and feedback can be sought during the meetings and the debate broadened.