The NHS at 70

Celebrating York’s role in the rise of evidence-based healthcare

Today, the University of York’s Department of Health Sciences, CHE, along with the Centre for Reviews and Dissemination and the fast-expanding Hull York Medical School, combine to form a powerful collaborative teaching and research asset for all those who work in the NHS or need its services.

Add in the health economics teaching activities of the Department of Economics and Related Studies, providing residential and distance learning courses for decades, and York makes good claim to be the undisputed go-to place for health and healthcare research and education.

Professor Karen Bloor

Professor Karen Bloor, who is the University’s Research Champion for Health and Wellbeing, notes that York has been instrumental in changing the way decision makers think about health and healthcare, not just in the UK but around the world.

“We have introduced the language of economics to policy and practice, and with it a more rigorous way of understanding problems and developing the tools to deal with them.”

Professor Karen Bloor, Research Champion for Health and Wellbeing

York has also educated a global cadre of health economists, and contributed to related scholarly debate in many ways, including creating the journal Health Economics. York’s thought-leadership is to be found in many major health and NHS initiatives, Professor Bloor says, including regulating the internal market, developing GP fundholding, measuring productivity, and refining hospital performance ratings, payment systems and incentive mechanisms for hospitals.

The Director of CHE, Professor Maria Goddard, says York’s role in the formation of the National Institute for Health and Clinical Excellence (NICE), is a special case.

“Researchers with expertise in evidence synthesis and economic evaluation provided the crucial methodological underpinning for NICE, and were instrumental in its formation. Our research teams continue to provide evidence on the effectiveness and value for money of particular interventions, helping to improve access to efficient healthcare interventions across the country.”

Professor Maria Goddard

But we don’t have to take Professor Goddard’s word for this. Professor Sir Michael Rawlins, former Chair of NICE, confirms that York made an “extraordinary contribution” to the development of new ways of understanding the complexities of health and healthcare.

“Its contributions to the work of NICE have been so very important that I doubt we would have achieved anything without the rigour and expertise provided by CHE and its staff.”

Professor Sir Michael Rawlins GBE, Kt

Professor Karl Atkin, sociologist and Head of the Department of Health Sciences, believes it is not only the rigour of York’s research that makes it such a crucial partner for policy makers: “We are a fiercely independent team, prepared to speak truth to power.”

It can be a very uncomfortable position to tell a major drug company that its latest product doesn’t provide value for money, or to suggest that the food and drinks industry is behaving like the tobacco lobby in denying its role in a global health problem.

“But that independence gives us credibility and integrity,” says Professor Atkin, whose own research into sickle cell disorders revealed difficult ethical issues around antenatal screening.

Take the work of the University’s Professor Karl Claxton. His research revealed the damage the then Prime Minister, David Cameron, was doing to the health service with his much lauded Cancer Drugs Fund for expensive new cancer treatments.

“There is no doubt that the fund has done more harm than good for NHS patients overall. The real winners are the manufacturers, who have been able to sell their drugs to the NHS at unrealistic prices.”

Professor Karl Claxton, Department of Economics and Related Studies and Centre for Health Economics

Two years later, Professor Claxton’s withering critique was vindicated by a King’s College London and the London School of Hygiene and Tropical Medicine report which concluded that less than half the drugs provided by the fund had undergone adequate clinical trials before being used, and the average median life extension they afforded was just 3.2 months. In short, it was a ‘quick-fix’ election promise that wasted more than a £1bn.

Professor Goddard believes it is this rigour and independence that has led to every major committee of NICE having had one or more panel members from York since it began: proof of the value placed upon York’s contribution to the delivery of more effective, efficient and equitable healthcare. No surprise then that bibliometric analysis puts York as the only UK institution in the world top ten in health economics, alongside Harvard, Stanford and Berkeley. Or that CHE’s Queen’s Anniversary Prize for Higher Education described York as “a global leader in developing new economic approaches for national healthcare systems.”

At York, we draw on a wide range of academic skills and disciplines to discover, refine and apply new interventions to improve health and wellbeing.

Our research involves partnerships with UK public sector organisations including the Department of Health, the NHS and social care organisations; the voluntary and community sector; and companies including pharmaceutical and device manufacturers.