CAPE policy fellowship case study: Women’s Health Strategy for England

4th July 2023 News

⌚ Estimated reading time: 5 minutes

In this case study report, Jane McDermott (University of Manchester) reflects on her CAPE policy fellowship in the Science, Research and Evidence Directorate at the Department of Health and Social Care. The case study reports on her work developing the Women’s Health Strategy for England including the key priorities and commitment to co-production which helped to shape the work. The case study reveals Jane’s own reflections on her experience of the fellowship, outlines key challenges, lessons learned and the benefits it has brought to herself and her policy partners.

What was the challenge or gap you were addressing?

The Women’s Health Strategy for England published in July 2022 set out a commitment to boost all health outcomes for women and girls and radically improve the way in which health and care systems engage and listen to women and girls. These 10-year ambitions would be achieved by taking a life course approach: focusing on women’s health and policy services throughout their lives, embedding hybrid and wrap-around services as best practice and boosting representation of women’s voices and experiences in policymaking and at all levels of the health and care system.

The strategy features a 6-point plan:

Ensuring women’s voices are heard.
Improving access to services.
Addressing disparities in outcomes among women.
Better information and education.
Greater understanding of how women’s health affects their experience in the workplace.
Supporting more research, improving the evidence base and spearheading the drive for better data.

Leading on strategic area six, the Science, Research and Evidence (SRE) directorate of the Department of Health and Social Care (DHSC), in partnership with policy teams and the National Institute for Health and Care Research (NIHR), identified key priority areas to support the achievement of this specific ambition. These co-developed priorities were as follows:

To increase the representation of women1 in research, including clinical trials and disaggregation of results.
To increase representation of women across NIHR awards and committees.
Research that prioritises women’s health, care and wellbeing and addresses the evidence gaps identified through the call for evidence.
The dissemination of research to women, practitioners, decision makers, community leaders and the general public.
To continue to work together with research funders to identify opportunities to align and join up in women’s health research.

Why was it necessary now / what was the policy need?

Colleagues within SRE were keen to work with a representative from the NIHR Older People and Frailty Policy Research Unit (OPFPRU – one of 15 Policy Research Units) as they were keen to include an alternative viewpoint from the academic world to enhance and develop their ways of working. Having been involved in the call for evidence for women’s health which preceded the strategy by delivering a rapid response piece for the DHSC, a Fellowship opportunity from a member of the OPFPRU team was identified.

What did your project do?

The work undertaken within the Fellowship was vast and far reaching. It is listed here in relation to the priority areas which were co-created with the SRE, policy and wider stakeholders:
i. To increase the representation of women in research, including clinical trials and disaggregation of results. a. Organising, recruiting and supporting the delivery of a roundtable chaired by Prof. Lucy Chappell – Exploring the best ways to tackle the under-representation of women across the life course in health and care research.

ii. To increase representation of women across NIHR awards and committees. a. Attendance and presentation to the NIHR Strategy Board to raise the profile of the research and evidence priority areas, rallying support and engagement.

iii. Research that prioritises women’s health, care and wellbeing and addresses the evidence gaps identified through the call for evidence. a. Developing an understanding of NIHR research prioritisation processes aimed at addressing research gaps, as identified in the women’s health call for evidence and by the women’s health policy team.

iv. The dissemination of research to women, practitioners, decision makers, community leaders and the general public.

a. Working to understand good practice in relation to dissemination and engagement of women, in particular those from underrepresented groups.
b. Advancing and developing novel methods for communicating research and evidence with women and girls throughout England, such as Wikipedia.

v. To continue to work together with research funders to identify opportunities to align and join up in women’s health research.

a. Extensive stakeholder engagement work across the complex and extensive NIHR infrastructure and beyond, including health research councils and funders (e.g., Medical Research Council, UK Research and Innovation, Wellcome Trust, etc.).
b. Engagement with devolved nations and identification of aligned policy and practice approaches to women’s health.

Collectively from the above key activities, the team have also drafted an action plan to take forward key co-created recommendations which is currently being reviewed by senior colleagues.

How did it embed co-production / what did coproduction look like in this project?

Co-production and collaboration have been at the heart of the project, both within the immediate SRE team where the Fellowship placement sat, as well as throughout the vast stakeholder engagement activities which we were engaged in. The development of priorities, associated activities and outcomes were co-created in a proactive way: from hosting a roundtable, unpacking cross-country alignment on women’s health policy and practice priorities to co-creating templates for evidence based best practice.

What’s worked and what hasn’t? What were the challenges and how did you tackle these?

Integration into the SRE team matched with my prior knowledge and experience of working with DHSC and NIHR which allowed us to quickly develop trusting relationships resulting in a fast pace of work. Having a set day each week to undertake the Fellowship also supported the consistent and continued advancement of priority work, keeping the team on track. This protected time enabled my full engagement with the Fellowship and associated work tasks for the successful delivery and completion of objectives. The different IT systems used were problematic at times, in particular when sharing documents and resources.

From DHSC’s perspective, the administrative processes internally to onboard the Fellowship secondment were resource intensive and would benefit from being streamlined for future secondment opportunities.

What has happened / is happening as a result of the project?

As a result of the Fellowship, I have developed a number of new relationships, increased collaboration and informed my understanding of DHSC/NIHR infrastructure.

Through the Fellowship I have developed a number of new trusted relationships across the policy landscape, improving the potential for future collaboration and cross-working. My understanding of the DHSC/NIHR infrastructure and priorities, alongside associated health and care research councils and funders, and the devolved nations work has been strengthened. Insight and appreciation of the health and social care policy landscape, including the constraints in which policy teams operate and the environmental drivers, will directly inform future strategic and operational processes within the OPFPRU.

From a University of Manchester perspective, I offered a wider geographical perspective to colleagues which was enhanced by knowledge of healthy ageing research landscape within our institution. I was able to put forward colleagues as key contributors at the roundtable discussion as well as influence the decision to hold the event virtually to maximise geographical representation and access. All of which increased knowledge mobilisation and transfer in my role as ambassador for Manchester.

What lessons would you share for others based upon your experience?

Having protected time to focus on the Fellowship was a critical aspect of my success in the role, it gave both myself but also colleagues whom I worked with in SRE a specific resource commitment that resulted in regular weekly catch up meetings. These meetings were key in enabling the whole team to continually drive forward the policy ambitions through supporting activities undertaken. It also gave me permission to step away from my day-to-day responsibilities on a set day(s) each week to work with SRE and with policy teams directly.

What benefits has the project had for those involved or the intended beneficiaries?

Over the past twelve months I have developed extensive insight into the workings of a large Government Department, enhancing my understanding of how policy works and the pressures/tensions within which policy teams operate. I have also developed a vast network of new relationships with the potential for future collaboration which will have a direct benefit on the work of the OPFPRU, amongst other things.

“Having a CAPE Fellow working with us in SRE from one of our Policy Research Units provided us with an alternative viewpoint, informing how we approached the research and evidence priorities set out in the women’s health strategy. Jane’s expertise, alongside her previous work with policy, meant she was able to bring a valued perspective, novel ways of working and add resource to the team which supported our work across DHSC, NIHR and devolved nations.”

Dr Gail Marzetti, Director of Science, Research and Evidence at the Department of Health and Social Care (DHSC) and Deputy CEO of the National Institute for Health and Care Research