Our Research

The proposed research responds to the call for research into the ‘Quality, Efficiency and Solidarity of Health Systems’. European countries are reforming their health systems to improve health care delivery. One of the ways they are doing this is by changing skill mix within teams delivering health services: extending the roles of existing health professions and introducing new ones. This project will undertake a systematic evaluation of the impact of these ‘new professional roles’ on practice, outcomes and costs in a range of different health care settings within European Union and Associate Countries. It will detail the nature, scope and contribution of the new professional roles, evaluate their impact on clinical practice and outcomes, and identify their scope to improve the integration of care. It will conduct economic evaluation to identify the cost effectiveness of the new professional roles, identify optimal models for delivery of health care and the consequences of these for management of human resources and workforce planning. Study design is cross-sectional and multi-level. A mixed methods approach will combine analysis of routinely collected data and primary data generated through interviews and questionnaires to health professionals, managers and patients. Data analysis will employ multi-level modelling techniques.

The project consists of 13 work packages (WP) with the first 10 focused towards the research. Within the WPs there are also milestones and deliverables to be achieved.

Work Package 1:

To conduct a rigorous examination of the evidence in order:

  • To detail the key features of the health delivery systems in the countries of the EU, associate and applicant countries
  • To provide a context for the subsequent analysis
  • To identify the potential for generalising the results of this project to the countries of the EU

Work Package 2:

  • To describe the detailed skill mix of the health workforce in the primary and secondary care sectors in the EU, Associate and Applicant countries
  • To identify the new professional roles, the numbers working in them and the clinical areas of employment
  • To identify the contribution of the new professional roles to the delivery of health care
  • To identify and evaluate a framework for mapping the skills and competencies of the health workforce
  • To collect secondary data required for the economic evaluation in WP8
  • To review Project Membership in light of the evidence gathered in WP1 and WP2

Work Package 3:

  • To select from among the clinical areas identified in WP2 two specific care pathways as the focus of the research to be undertaken in this project
  • To conduct case studies in order to inform construction of the questionnaires in WP4 to be used in WP5, 6, 7.

Work Package 4:

To develop the empirical framework for the project by:

  • Developing the questionnaires, accompanying documentation and sampling frames
  • Finalising the detailed study protocol to be submitted to either national or local ethical committees (as appropriate) for approval.

Work Package 5:

  • To conduct a questionnaire survey of health care professionals and managers
  • To extract and process the data generated by the questionnaire and build databases
  • To analyse the data
  • To generate a report on the impact of the new professional roles on clinical practice and the organisation of care.

Work Package 6:

  • To conduct a questionnaire survey of patient experience and satisfaction
  • To extract and process the data generated by the questionnaire and build databases
  • To analyse the data
  • To generate a report 'The impact of the new professional roles on patient experience and satisfaction'.

Work Package 7:

  • To collect and analyse new data on hospital processes, productivity and health outcomes which can be used to assess the impact of the new professional roles
  • To construct a detailed study protocol which will be submitted to either national or local ethical committees (as appropriate) for approval.
  • To produce a report on hospital processes, productivity and health outcomes

Work Package 8:

  • To undertake an economic evaluation to model the costs and effects associated with the new professional roles.
  • To distinguish whether employing the new professional roles has or might result in cost containment
  • To investigate the balance of cost and benefits and to identify incentives for an increased role for the new professional roles.

Work Package 9:

  • To synthesise the results of the previous analysis
  • To detail how the new professional roles might be employed to improve the integration of care within care pathways.
  • To describe new optimal models of care for the selected care pathways
  • To identify solutions to barriers identified at organisational and team level informed by examples of good practice
  • To produce examples of care integration and of the costs associated with financing these pathways

Work Package 10:

  • To build a workforce planning model for each care pathway that reflects the dynamic interaction between workforce skill mix (including different approaches to labour substitution) and the quality and cost of care for patients.
  • To provide a skill mix benchmark for previously identified optimal models of care against which service providers can evaluate the efficiency of existing skill mix
  • To detail any improvements in data on skill mix and in methods using this data that are required for improved workforce planning

Work Package 11:

  • Will ensure that European and country level stakeholders are engaged at all stages of the research and ensure results have maximum impact at policy and practitioner levels

Work Package 12:

  • Will ensure efficient and effective delivery of the scientific programme over the 4 year life of the project

Work Package 13:

  • Will establish a project co-ordinating centre to support the Project Management team over the 4 year life of the project