Tag Archives: Evidence-based medicine

Why don’t policymakers listen to your evidence?

Since 2016, my most common academic presentation to interdisciplinary scientist/ researcher audiences is a variant of the question, ‘why don’t policymakers listen to your evidence?’

I tend to provide three main answers.

1. Many policymakers have many different ideas about what counts as good evidence

Few policymakers know or care about the criteria developed by some scientists to describe a hierarchy of scientific evidence. For some scientists, at the top of this hierarchy is the randomised control trial (RCT) and the systematic review of RCTs, with expertise much further down the list, followed by practitioner experience and service user feedback near the bottom.

Yet, most policymakers – and many academics – prefer a wider range of sources of information, combining their own experience with information ranging from peer reviewed scientific evidence and the ‘grey’ literature, to public opinion and feedback from consultation.

While it may be possible to persuade some central government departments or agencies to privilege scientific evidence, they also pursue other key principles, such as to foster consensus driven policymaking or a shift from centralist to localist practices.

Consequently, they often only recommend interventions rather than impose one uniform evidence-based position. If local actors favour a different policy solution, we may find that the same type of evidence may have more or less effect in different parts of government.

2. Policymakers have to ignore almost all evidence and almost every decision taken in their name

Many scientists articulate the idea that policymakers and scientists should cooperate to use the best evidence to determine ‘what works’ in policy (in forums such as INGSA, European Commission, OECD). Their language is often reminiscent of 1950s discussions of the pursuit of ‘comprehensive rationality’ in policymaking.

The key difference is that EBPM is often described as an ideal by scientists, to be compared with the more disappointing processes they find when they engage in politics. In contrast, ‘comprehensive rationality’ is an ideal-type, used to describe what cannot happen, and the practical implications of that impossibility.

The ideal-type involves a core group of elected policymakers at the ‘top’, identifying their values or the problems they seek to solve, and translating their policies into action to maximise benefits to society, aided by neutral organisations gathering all the facts necessary to produce policy solutions. Yet, in practice, they are unable to: separate values from facts in any meaningful way; rank policy aims in a logical and consistent manner; gather information comprehensively, or possess the cognitive ability to process it.

Instead, Simon famously described policymakers addressing ‘bounded rationality’ by using ‘rules of thumb’ to limit their analysis and produce ‘good enough’ decisions. More recently, punctuated equilibrium theory uses bounded rationality to show that policymakers can only pay attention to a tiny proportion of their responsibilities, which limits their control of the many decisions made in their name.

More recent discussions focus on the ‘rational’ short cuts that policymakers use to identify good enough sources of information, combined with the ‘irrational’ ways in which they use their beliefs, emotions, habits, and familiarity with issues to identify policy problems and solutions (see this post on the meaning of ‘irrational’). Or, they explore how individuals communicate their narrow expertise within a system of which they have almost no knowledge. In each case, ‘most members of the system are not paying attention to most issues most of the time’.

This scarcity of attention helps explain, for example, why policymakers ignore most issues in the absence of a focusing event, policymaking organisations make searches for information which miss key elements routinely, and organisations fail to respond to events or changing circumstances proportionately.

In that context, attempts to describe a policy agenda focusing merely on ‘what works’ are based on misleading expectations. Rather, we can describe key parts of the policymaking environment – such as institutions, policy communities/ networks, or paradigms – as a reflection of the ways in which policymakers deal with their bounded rationality and lack of control of the policy process.

3. Policymakers do not control the policy process (in the way that a policy cycle suggests)

Scientists often appear to be drawn to the idea of a linear and orderly policy cycle with discrete stages – such as agenda setting, policy formulation, legitimation, implementation, evaluation, policy maintenance/ succession/ termination – because it offers a simple and appealing model which gives clear advice on how to engage.

Indeed, the stages approach began partly as a proposal to make the policy process more scientific and based on systematic policy analysis. It offers an idea of how policy should be made: elected policymakers in central government, aided by expert policy analysts, make and legitimise choices; skilful public servants carry them out; and, policy analysts assess the results with the aid of scientific evidence.

Yet, few policy theories describe this cycle as useful, while most – including the advocacy coalition framework , and the multiple streams approach – are based on a rejection of the explanatory value of orderly stages.

Policy theories also suggest that the cycle provides misleading practical advice: you will generally not find an orderly process with a clearly defined debate on problem definition, a single moment of authoritative choice, and a clear chance to use scientific evidence to evaluate policy before deciding whether or not to continue. Instead, the cycle exists as a story for policymakers to tell about their work, partly because it is consistent with the idea of elected policymakers being in charge and accountable.

Some scholars also question the appropriateness of a stages ideal, since it suggests that there should be a core group of policymakers making policy from the ‘top down’ and obliging others to carry out their aims, which does not leave room for, for example, the diffusion of power in multi-level systems, or the use of ‘localism’ to tailor policy to local needs and desires.

Now go to:

What can you do when policymakers ignore your evidence?

Further Reading

The politics of evidence-based policymaking

The politics of evidence-based policymaking: maximising the use of evidence in policy

Images of the policy process

How to communicate effectively with policymakers

Special issue in Policy and Politics called ‘Practical lessons from policy theories’, which includes how to be a ‘policy entrepreneur’.

See also the 750 Words series to explore the implications for policy analysis

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Evidence based medicine provides a template for evidence based policy, but not in the way you expect

Guest post by Dr Kathryn Oliver and Dr Warren Pearce to celebrate the publication of their new Open Access article ‘Three lessons from evidence-based medicine and policy‘ in Palgrave Communications,

Part of the  Open Access series ‘politics of evidence based policymaking‘ (for which we still welcome submissions).

Evidence-based medicine (EBM) is often described as a ‘template’ for evidence-based policymaking (EBPM).

Critics of this idea would be 100% right if EBM lived up to its inaccurate caricature, in which there is an inflexible ‘hierarchy of evidence’ which dismisses too much useful knowledge and closes off the ability of practitioners to use their judgement.

In politics, this would be disastrous because there are many sources of legitimate knowledge and ‘the evidence’ cannot and should not become an alternative to political choice. And, of course, politicians must use their judgement, as – unlike medicine – there is no menu of possible answers to any problem.

Yet, modern forms of EBM – or, at least, sensible approaches to it – do not live up to this caricature. Instead, EBM began as a way to support individual decision-makers, and has evolved to reflect new ways of thinking about three main dilemmas. The answers to these dilemmas can help improve policymaking.

How to be more transparent

First, evidence-informed clinical practice guidelines lead the way in transparency. There’s a clear, transparent process to frame a problem, gather and assess evidence, and, through a deliberative discussion with relevant stakeholders, decide on clinical recommendations. Alongside other tools and processes, this demonstrates transparency which increases trust in the system.

How to balance research and practitioner knowledge

Second, dialogues in EBM help us understand how to balance research and practitioner knowledge. EBM has moved beyond the provision of research evidence, towards recognising and legitimising a negotiation between individual contexts, the expertise of decision-makers, and technical advice on interpreting research findings for different settings.

How to be more explicit about how you balance evidence, power, and values

Third, EBM helps us think about how to share power to co-produce policy and to think about how we combine evidence, values, and our ideas about who commands the most legitimate sources of power and accountability. We know that new structures for dialogue and decision-making can formalise and codify processes, but they do not necessarily lead to inclusion of a diverse set of voices. Power matters in dictating what knowledge is produced, for whom, and what is done with it. EBM has offered as many negative as positive lessons so far, particularly when sources of research expertise have been reluctant to let go enough to really co-produce knowledge or policy, but new studies and frameworks are at least keeping this debate alive.

Overall, our discussion of EBM challenges critics to identify its real-world application, not the old caricature. If so, it can help show us how one of the most active research agendas, on the relationship between high quality evidence and effective action, provides lessons for politics. In the main, the lesson is that our aim is not simply to maximise the use of evidence in policy, but to maximise the credibility of evidence and legitimacy of evidence advocates when so many other people have a legitimate claim to knowledge and authoritative action.

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What do we need to know about the politics of evidence-based policymaking?

Today, I’m helping to deliver a new course – Engaging Policymakers Training Programme – piloted by the Alliance for Useful Evidence and the UCL. Right now, it’s for UCL staff (and mostly early career researchers). My bit is about how we can better understand the policy process so that we can engage in it more effectively.  I have reproduced the brief guide below (for my two 2-hour sessions as part of a wider block). If anyone else is delivering something similar, please let me know. We could compare notes. 

This module will be delivered in two parts to combine theory and practice

Part 1: What do we need to know about the politics of evidence-based policymaking?

Policy theories provide a wealth of knowledge about the role of evidence in policymaking systems. They prompt us to understand and respond to two key dynamics:

  1. Policymaker psychology. Policymakers combine rational and irrational shortcuts to gather information and make good enough decisions quickly. To appeal to rational shortcuts and minimise cognitive load, we reduce uncertainty by providing syntheses of the available evidence. To appeal to irrational shortcuts and engage emotional interest, we reduce ambiguity by telling stories or framing problems in specific ways.
  2. Complex policymaking environments. These processes take place in the context of a policy environment out of the control of individual policymakers. Environments consist of: many actors in many levels and types of government; engaging with institutions and networks, each with their own informal and formal rules; responding to socioeconomic conditions and events; and, learning how to engage with dominant ideas or beliefs about the nature of the policy problem. In other words, there is no policy cycle or obvious stage in which to get involved.

In this seminar, we discuss how to respond effectively to these dynamics. We focus on unresolved issues:

  1. Effective engagement with policymakers requires storytelling skills, but do we possess them?
  2. It requires a combination of evidence and emotional appeals, but is it ethical to do more than describe the evidence?
  3. The absence of a policy cycle, and presence of an ever-shifting context, requires us to engage for the long term, to form alliances, learn the rules, and build up trust in the messenger. However, do we have and how should we invest the time?

The format will be relatively informal. Cairney will begin by making some introductory points (not a powerpoint driven lecture) and encourage participants to relate the three questions to their research and engagement experience.

Gateway to further reading:

  • Paul Cairney and Richard Kwiatkowski (2017) ‘How to communicate effectively with policymakers: combine insights from psychology and policy studies’, Palgrave Communications
  • Paul Cairney and Kathryn Oliver (2017) ‘Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy?’ Health Research Policy and Systems (HARPS), DOI: 10.1186/s12961-017-0192-x
  • Paul Cairney, Kathryn Oliver, and Adam Wellstead (2016) ‘To Bridge the Divide between Evidence and Policy: Reduce Ambiguity as Much as Uncertainty’, Public Administration Review, Early View (forthcoming) DOI:10.1111/puar.12555 PDF

Part 2: How can we respond pragmatically and effectively to the politics of EBPM?

In this seminar, we move from abstract theory and general advice to concrete examples and specific strategies. Each participant should come prepared to speak about their research and present a theoretically informed policy analysis in 3 minutes (without the aid of powerpoint). Their analysis should address:

  1. What policy problem does my research highlight?
  2. What are the most technically and politically feasible solutions?
  3. How should I engage in the policy process to highlight these problems and solutions?

After each presentation, each participant should be prepared to ask questions about the problem raised and the strategy to engage. Finally, to encourage learning, we will reflect on the memorability and impact of presentations.

Powerpoint: Paul Cairney A4UE UCL 2017

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A 5-step strategy to make evidence count

5 stepsLet’s imagine a heroic researcher, producing the best evidence and fearlessly ‘speaking truth to power’. Then, let’s place this person in four scenarios, each of which combines a discussion of evidence, policy, and politics in different ways.

  1. Imagine your hero presents to HM Treasury an evidence-based report concluding that a unitary UK state would be far more efficient than a union state guaranteeing Scottish devolution. The evidence is top quality and the reasoning is sound, but the research question is ridiculous. The result of political deliberation and electoral choice suggests that your hero is asking a research question that does not deserve to be funded in the current political climate. Your hero is a clown.
  2. Imagine your hero presents to the Department of Health a report based on the systematic review of multiple randomised control trials. It recommends that you roll out an almost-identical early years or public health intervention across the whole country. We need high ‘fidelity’ to the model to ensure the correct ‘dosage’ and to measure its effect scientifically. The evidence is of the highest quality, but the research question is not quite right. The government has decided to devolve this responsibility to local public bodies and/ or encourage the co-production of public service design by local public bodies, communities, and service users. So, to focus narrowly on fidelity would be to ignore political choices (perhaps backed by different evidence) about how best to govern. If you don’t know the politics involved, you will ask the wrong questions or provide evidence with unclear relevance. Your hero is either a fool, naïve to the dynamics of governance, or a villain willing to ignore governance principles.        
  3. Imagine two fundamentally different – but equally heroic – professions with their own ideas about evidence. One favours a hierarchy of evidence in which RCTs and their systematic review is at the top, and service user and practitioner feedback is near the bottom. The other rejects this hierarchy completely, identifying the unique, complex relationship between practitioner and service user which requires high discretion to make choices in situations that will differ each time. Trying to resolve a debate between them with reference to ‘the evidence’ makes no sense. This is about a conflict between two heroes with opposing beliefs and preferences that can only be resolved through compromise or political choice. This is, oh I don’t know, Batman v Superman, saved by Wonder Woman.
  4. Imagine you want the evidence on hydraulic fracturing for shale oil and gas. We know that ‘the evidence’ follows the question: how much can we extract? How much revenue will it produce? Is it safe, from an engineering point of view? Is it safe, from a public health point of view? What will be its impact on climate change? What proportion of the public supports it? What proportion of the electorate supports it? Who will win and lose from the decision? It would be naïve to think that there is some kind of neutral way to produce an evidence-based analysis of such issues. The commissioning and integration of evidence has to be political. To pretend otherwise is a political strategy. Your hero may be another person’s villain.

Now, let’s use these scenarios to produce a 5-step way to ‘make evidence count’.

Step 1. Respect the positive role of politics

A narrow focus on making the supply of evidence count, via ‘evidence-based policymaking’, will always be dispiriting because it ignores politics or treats political choice as an inconvenience. If we:

  • begin with a focus on why we need political systems to make authoritative choices between conflicting preferences, and take governance principles seriously, we can
  • identify the demand for evidence in that context, then be more strategic and pragmatic about making evidence count, and
  • be less dispirited about the outcome.

In other words, think about the positive and necessary role of democratic politics before bemoaning post-truth politics and policy-based-evidence-making.

Step 2. Reject simple models of evidence-based policymaking

Policy is not made in a cycle containing a linear series of separate stages and we won’t ‘make evidence count’ by using it to inform our practices.

cycle

You might not want to give up the cycle image because it presents a simple account of how you should make policy. It suggests that we elect policymakers then: identify their aims, identify policies to achieve those aims, select a policy measure, ensure that the selection is legitimised by the population or its legislature, identify the necessary resources, implement and then evaluate. Or, policymakers aided by expert policy analysts make and legitimise choices, skilful public servants carry them out, and, policy analysts assess the results using evidence.

One compromise is to keep the cycle then show how messy it is in practice:

However, there comes a point when there is too much mess, and the image no longer helps you explain (a) to the public what you are doing, or (b) to providers of evidence how they should engage in political systems. By this point, simple messages from more complicated policy theories may be more useful.

Or, we may no longer want a cycle to symbolise a single source of policymaking authority. In a multi-level system, with many ‘centres’ possessing their own sources of legitimate authority, a single and simple policy cycle seems too artificial to be useful.

Step 3. Tell a simple story about your evidence

People are ‘cognitive misers’ seeking ‘rational’ and ‘irrational’ shortcuts to gather information for action, so you won’t get far if you bombard them with too much evidence. Policymakers already have too much evidence and they seek ways to reduce their cognitive load, relying on: (a) trusted sources of concise evidence relevant to their aims, and (b) their own experience, gut instinct, beliefs, and emotions.

The implication of both shortcuts is that we need to tell simple and persuasive stories about the substance and implications of the evidence we present. To say that ‘the evidence does not speak for itself’ may seem trite, but I’ve met too many people who assume naively that it will somehow ‘win the day’. In contrast, civil servants know that the evidence-informed advice they give to ministers needs to relate to the story that government ministers tell to the public.

how-to-be-heard

Step 4.  Tailor your story to many audiences

In a complex or multi-level environment, one story to one audience (such as a minister) is not enough. If there are many key sources of policymaking authority – including public bodies with high autonomy, organisations and practitioners with the discretion to deliver services, and service users involved in designing services – there are many stories being told about what we should be doing and why. We may convince one audience and alienate (or fail to inspire) another with the same story.

Step 5. Clarify and address key dilemmas with political choice, not evidence

Let me give you one example of the dilemmas that must arise when you combine evidence and politics to produce policy: how do you produce a model of ‘evidence based best practice’ which combines evidence and governance principles in a consistent way? Here are 3 ideal-type models which answer the question in very different ways

Table 1 Three ideal types EBBP

The table helps us think through the tensions between models, built on very different principles of good evidence and governance.

In practice, you may want to combine different elements, perhaps while arguing that the loss of consistency is lower than the gain from flexibility. Or, the dynamics of political systems limit such choice or prompt ad hoc and inconsistent choices.

I built a lot of this analysis on the experiences of the Scottish Government, which juggles all three models, including a key focus on improvement method in its Early Years Collaborative.

However, Kathryn Oliver and I show that the UK government faces the same basic dilemma and addresses it in similar ways.

The example freshest in my mind is Sure Start. Its rationale was built on RCT evidence and systematic review. However, its roll-out was built more on local flexibility and service design than insistence on fidelity to a model. More recently, the Troubled Families programme initially set the policy agenda and criteria for inclusion, but increasingly invites local public bodies to select the most appropriate interventions, aided by the Early Intervention Foundation which reviews the evidence but does not insist on one-best-way. Emily St Denny and I explore these issues further in our forthcoming book on prevention policy, an exemplar case study of a field in which it is difficult to know how to ‘make evidence count’.

If you prefer a 3-step take home message:

  1. I think we use phrases like ‘impact’ and ‘make evidence count’ to reflect a vague and general worry about a decline in respect for evidence and experts. Certainly, when I go to large conferences of scientists, they usually tell a story about ‘post-truth’ politics.
  2. Usually, these stories do not acknowledge the difference between two different explanations for an evidence-policy gap: (a) pathological policymaking and corrupt politicians, versus (b) complex policymaking and politicians having to make choices despite uncertainty.
  3. To produce evidence with ‘impact’, and know how to ‘make evidence count’, we need to understand the policy process and the demand for evidence within it.

*Background. This is a post for my talk at the Government Economic Service and Government Social Research Service Annual Training Conference (15th September 2017). This year’s theme is ‘Impact and Future-Proofing: Making Evidence Count’. My brief is to discuss evidence use in the Scottish Government, but it faces the same basic question as the UK Government: how do you combine principles of evidence quality and governance principles? In other words, if you were in a position to design an (a) evidence-gathering system and (b) a political system, you’d soon find major points of tension between them. Resolving those tensions involves political choice, not more evidence. Of course, you are not in a position to design both systems, so the more complicated question is: how do you satisfy principles of evidence and governance in a complex policy process, often driven by policymaker psychology, over which you have little control?  Here are 7 different ‘answers’.

Powerpoint Paul Cairney @ GES GSRS 2017

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The Politics of Evidence

This is a draft of my review of Justin Parkhurst (2017) The Politics of Evidence (Routledge, Open Access)

Justin Parkhurst’s aim is to identify key principles to take forward the ‘good governance of evidence’. The good governance of scientific evidence in policy and policymaking requires us to address two fundamentally important ‘biases’:

  1. Technical bias. Some organisations produce bad evidence, some parts of government cherry-pick, manipulate, or ignore evidence, and some politicians misinterpret the implications of evidence when calculating risk. Sometimes, these things are done deliberately for political gain. Sometimes they are caused by cognitive biases which cause us to interpret evidence in problematic ways. For example, you can seek evidence that confirms your position, and/ or only believe the evidence that confirms it.
  2. Issue bias. Some evidence advocates use the mantra of ‘evidence based policy’ to depoliticise issues or downplay the need to resolve conflicts over values. They also focus on the problems most conducive to study via their most respected methods such as randomised control trials (RCTs). Methodological rigour trumps policy relevance and simple experiments trump the exploration of complex solutions. So, we lose sight of the unintended consequences of producing the ‘best’ evidence to address a small number of problems, and making choices about the allocation of research resources and attention. Again, this can be deliberate or caused by cognitive biases, such as to seek simpler and more answerable questions than complex questions with no obvious answer.

To address both problems, Parkhurst seeks pragmatic ways to identify principles to decide what counts as ‘good evidence to inform policy’ and ‘what constitutes the good use of evidence within a policy process’:

‘it is necessary to consider how to establish evidence advisory systems that promote the good governance of evidence – working to ensure that rigorous, sys­tematic and technically valid pieces of evidence are used within decision-making processes that are inclusive of, representative of and accountable to the multiple social interests of the population served’ (p8).

Parkhurst identifies some ways in which to bring evidence and policy closer together. First, to produce evidence more appropriate for, or relevant to, policymaking (‘good evidence for policy’):

  1. Relate evidence more closely to policy goals.
  2. Modify research approaches and methods to answer policy relevant questions.
  3. Ensure that the evidence relates to the local or relevant context.

Second, to produce the ‘good use of evidence’, combine three forms of ‘legitimacy’:

  1. Input, to ensure democratic representative bodies have the final say.
  2. Throughput, to ensure widespread deliberation.
  3. Output, to ensure proper consideration the use of the most systematic, unbiased and rigorously produced scientific evidence relevant to the problem.

In the final chapter, Parkhurst suggests that these aims can be pursued in many ways depending on how governments want to design evidence advisory systems, but that it’s worth drawing on the examples of good practice he identifies. Parkhurst also explores the role for Academies of science, or initiatives such as the Cochrane Collaboration, to provide independent advice. He then outlines the good governance of evidence built on key principles: appropriate evidence, accountability in evidence use, transparency, and contestability (to ensure sufficient debate).

The overall result is a book full of interesting discussion and very sensible, general advice for people new to the topic of evidence and policy. This is no mean feat: most readers will seek a clearly explained and articulate account of the subject, and they get it here.

For me, the most interesting thing about Parkhurst’s book is the untold story, or often-implicit reasoning behind the way in which it is framed. We can infer that it is not a study aimed primarily at a political science or social science audience, because most of that audience would take its starting point for granted: the use of evidence is political, and politics involves values. Yet, Parkhurst feels the need to remind the reader of this point, in specific (“it is worth noting that the US presidency is a decidedly political role”, p43) and general circumstances (‘the nature of policymaking is inherently political’, p65). Throughout, the audience appears to be academics who begin with a desire for ‘evidence based policy’ without fully thinking through the implications, either about the lack of a magic bullet of evidence to solve a policy problem, how we might maintain a political system conducive to democratic principles and good evidence use, how we might design a system to reduce key ‘barriers’ between the supply of evidence by scientists and its demand by policymakers, and why few such designs have taken off.

In other words, the book appeals primarily to scientists trained outside social science, some of whom think about politics in their spare time, or encounter it in dispiriting encounters with policymakers. It appeals to that audience with a statement on the crucial role of high quality evidence in policymaking, highlights barriers to its use, tells scientists that they might be part of the problem, but then provides them with the comforting assurance that we can design better systems to overcome at least some of those barriers. For people trained in policy studies, this concluding discussion seems like a tall order, and I think most would read it with great scepticism.

Policy scientists might also be sceptical about the extent to which scientists from other fields think this way about hierarchies of scientific evidence and the desire to depoliticise politics with a primary focus on ‘what works’. Yet, I too hear this language regularly in interdisciplinary workshops (often while standing next to Justin!), and it is usually accompanied by descriptions of the pathology of policymaking, the rise of post-truth politics and rejection of experts, and the need to focus on the role of objective facts in deciding what policy solutions work best. Indeed, I was impressed recently by the skilled way in which another colleague prepared this audience for some provocative remarks when he suggested that the production and use of evidence is about power, not objectivity. OMG: who knew that policymaking was political and about power?!

So, the insights from this book are useful to a large audience of scientists while, for a smaller audience of policy scientists, they remind us that there is an audience out there for many of the statements that many of us would take for granted. Some evidence advocates use the language of ‘evidence based policymaking’ strategically, to get what they want. Others appear to use it because they believe it can exist. Keep this in mind when you read the book.

Parkhurst

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Kathryn Oliver and I have just published an article on the relationship between evidence and policy

Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy?

“There is extensive health and public health literature on the ‘evidence-policy gap’, exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems”.

We use this table to describe how the policy process works, how effective actors respond, and the dilemmas that arise for advocates of scientific evidence: should they act this way too?

We summarise this argument in two posts for:

The Guardian If scientists want to influence policymaking, they need to understand it

Sax Institute The evidence policy gap: changing the research mindset is only the beginning

The article is part of a wider body of work in which one or both of us considers the relationship between evidence and policy in different ways, including:

Paul Cairney, Kathryn Oliver, and Adam Wellstead (2016) ‘To Bridge the Divide between Evidence and Policy: Reduce Ambiguity as Much as Uncertainty’, Public Administration Review PDF

Paul Cairney (2016) The Politics of Evidence-Based Policy Making (PDF)

Oliver, K., Innvar, S., Lorenc, T., Woodman, J. and Thomas, J. (2014a) ‘A systematic review of barriers to and facilitators of the use of evidence by policymakers’ BMC health services research, 14 (1), 2. http://www.biomedcentral.com/1472-6963/14/2

Oliver, K., Lorenc, T., & Innvær, S. (2014b) ‘New directions in evidence-based policy research: a critical analysis of the literature’, Health Research Policy and Systems, 12, 34 http://www.biomedcentral.com/content/pdf/1478-4505-12-34.pdf

Paul Cairney (2016) Evidence-based best practice is more political than it looks in Evidence and Policy

Many of my blog posts explore how people like scientists or researchers might understand and respond to the policy process:

The Science of Evidence-based Policymaking: How to Be Heard

When presenting evidence to policymakers, engage with the policy process that exists, not the process you wish existed

Policy Concepts in 1000 Words: ‘Evidence Based Policymaking’

‘Evidence-based Policymaking’ and the Study of Public Policy

How far should you go to secure academic ‘impact’ in policymaking?

Political science improves our understanding of evidence-based policymaking, but does it produce better advice?

Psychology Based Policy Studies: 5 heuristics to maximise the use of evidence in policymaking

What 10 questions should we put to evidence for policy experts?

Why doesn’t evidence win the day in policy and policymaking?

We all want ‘evidence based policy making’ but how do we do it?

How can political actors take into account the limitations of evidence-based policy-making? 5 key points

The Politics of Evidence Based Policymaking:3 messages

The politics of evidence-based best practice: 4 messages

The politics of implementing evidence-based policies

There are more posts like this on my EBPM page

I am also guest editing a series of articles for the Open Access journal Palgrave Communications on the ‘politics of evidence-based policymaking’ and we are inviting submissions throughout 2017.

There are more details on that series here.

And finally ..

… if you’d like to read about the policy theories underpinning these arguments, see Key policy theories and concepts in 1000 words and 500 words.

 

 

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How far should you go to secure academic ‘impact’ in policymaking? From ‘honest brokers’ to ‘research purists’ and Machiavellian manipulators

Long read for Political Studies Association annual conference 2017 panel Rethinking Impact: Narratives of Research-Policy Relations. There is a paper too, but I’ve hidden it in the text like an Easter Egg hunt.

I’ve watched a lot of film and TV dramas over the decades. Many have the same basic theme, characters, and moral:

  1. There is a villain getting away with something, such as cheating at sport or trying to evict people to make money on a property deal.
  2. There are some characters who complain that life is unfair and there’s nothing they can do about it.
  3. A hero emerges to inspire the other characters to act as a team/ fight the system and win the day. Think of a range from Wyldstyle to Michael Corleone.

For many scientists right now, the villains are people like Trump or Farage, Trump’s election and Brexit symbolise an unfairness on a grand scale, and there’s little they can do about it in a ‘post-truth’ era in which people have had enough of facts and experts. Or, when people try to mobilise, they are unsure about what to do or how far they are willing to go to win the day.

These issues are playing out in different ways, from the March for Science to the conferences informing debates on modern principles of government-science advice (see INGSA). Yet, the basic question is the same when scientists are trying to re-establish a particular role for science in the world: can you present science as (a) a universal principle and (b) unequivocal resource for good, producing (c) evidence so pure that it speaks for itself, regardless of (d) the context in which specific forms of scientific evidence are produced and used?

Of course not. Instead, we are trying to privilege the role of science and scientific evidence in politics and policymaking without always acknowledging that these activities are political acts:

(a) selling scientific values rather than self-evidence truths, and

(b) using particular values to cement the status of particular groups at the expense of others, either within the scientific profession (in which some disciplines and social groups win systematically) or within society (in which scientific experts generally enjoy privileged positions in policymaking arenas).

Politics is about exercising power to win disputes, from visible acts to win ‘key choices’, to less visible acts to keep issues off agendas and reinforce the attitudes and behaviours that systematically benefit some groups at the expense of others.

To deny this link between science, politics and power – in the name of ‘science’ – is (a) silly, and (b) not scientific, since there is a wealth of policy science out there which highlights this relationship.

Instead, academic and working scientists should make better use of their political-thinking-time to consider this basic dilemma regarding political engagement: how far are you willing to go to make an impact and get what you want?  Here are three examples.

  1. How energetically should you give science advice?

My impression is that most scientists feel most comfortable with the unfortunate idea of separating facts from values (rejected by Douglas), and living life as ‘honest brokers’ rather than ‘issue advocates’ (a pursuit described by Pielke and critiqued by Jasanoff). For me, this is generally a cop-out since it puts the responsibility on politicians to understand the implications of scientific evidence, as if they were self-evident, rather than on scientists to explain the significance in a language familiar to their audience.

On the other hand, the alternative is not really clear. ‘Getting your hands dirty’, to maximise the uptake of evidence in politics, is a great metaphor but a hopeless blueprint, especially when you, as part of a notional ‘scientific community’, face trade-offs between doing what you think is the right thing and getting what you want.

There are 101 examples of these individual choices that make up one big engagement dilemmas. One of my favourite examples from table 1 is as follows:

One argument stated frequently is that, to be effective in policy, you should put forward scientists with a particular background trusted by policymakers: white men in their 50s with international reputations and strong networks in their scientific field. This way, they resemble the profile of key policymakers who tend to trust people already familiar to them. Another is that we should widen out science and science advice, investing in a new and diverse generation of science-policy specialists, to address the charge that science is an elite endeavour contributing to inequalities.

  1. How far should you go to ensure that the ‘best’ scientific evidence underpins policy?

Kathryn Oliver and I identify the dilemmas that arise when principles of evidence-production meet (a) principles of governance and (b) real world policymaking. Should scientists learn how to be manipulative, to combine evidence and emotional appeals to win the day? Should they reject other forms of knowledge, and particular forms of governance if the think they get in the way of the use of the best evidence in policymaking?

Cairney Oliver 2017 table 1

  1. Is it OK to use psychological insights to manipulate policymakers?

Richard Kwiatkowski and I mostly discuss how to be manipulative if you make that leap. Or, to put it less dramatically, how to identify relevant insights from psychology, apply them to policymaking, and decide how best to respond. Here, we propose five heuristics for engagement:

  1. developing heuristics to respond positively to ‘irrational’ policymaking
  2. tailoring framing strategies to policymaker bias
  3. identifying the right time to influence individuals and processes
  4. adapting to real-world (dysfunctional) organisations rather than waiting for an orderly process to appear, and
  5. recognising that the biases we ascribe to policymakers are present in ourselves and our own groups

Then there is the impact agenda, which describes something very different

I say these things to link to our PSA panel, in which Christina Boswell and Katherine Smith sum up (in their abstract) the difference between the ways in which we are expected to demonstrate academic impact, and the practices that might actually produce real impact:

Political scientists are increasingly exhorted to ensure their research has policy ‘impact’, most notably in the form of REF impact case studies, and ‘pathways to impact’ plans in ESRC funding. Yet the assumptions underpinning these frameworks are frequently problematic. Notions of ‘impact’, ‘engagement’ and ‘knowledge exchange’ are typically premised on simplistic and linear models of the policy process, according to which policy-makers are keen to ‘utilise’ expertise to produce more effective policy interventions”.

I then sum up the same thing but with different words in my abstract:

“The impact agenda prompts strategies which reflect the science literature on ‘barriers’ between evidence and policy: produce more accessible reports, find the right time to engage, encourage academic-practitioner workshops, and hope that policymakers have the skills to understand and motive to respond to your evidence. Such strategies are built on the idea that scientists serve to reduce policymaker uncertainty, with a linear connection between evidence and policy. Yet, the literature informed by policy theory suggests that successful actors combine evidence and persuasion to reduce ambiguity, particularly when they know where the ‘action’ is within complex policymaking systems”.

The implications for the impact agenda are interesting, because there is a big difference between (a) the fairly banal ways in which we might make it easier for policymakers to see our work, and (b) the more exciting and sinister-looking ways in which we might make more persuasive cases. Yet, our incentive remains to produce the research and play it safe, producing examples of ‘impact’ that, on the whole, seem more reportable than remarkable.

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Filed under Evidence Based Policymaking (EBPM), Public health, public policy

Why doesn’t evidence win the day in policy and policymaking?

cairney-southampton-evidence-win-the-dayPolitics has a profound influence on the use of evidence in policy, but we need to look ‘beyond the headlines’ for a sense of perspective on its impact.

It is tempting for scientists to identify the pathological effect of politics on policymaking, particularly after high profile events such as the ‘Brexit’ vote in the UK and the election of Donald Trump as US President. We have allegedly entered an era of ‘post-truth politics’ in which ideology and emotion trumps evidence and expertise (a story told many times at events like this), particularly when issues are salient.

Yet, most policy is processed out of this public spotlight, because the flip side of high attention to one issue is minimal attention to most others. Science has a crucial role in this more humdrum day-to-day business of policymaking which is far more important than visible. Indeed, this lack of public visibility can help many actors secure a privileged position in the policy process (and further exclude citizens).

In some cases, experts are consulted routinely. There is often a ‘logic’ of consultation with the ‘usual suspects’, including the actors most able to provide evidence-informed advice. In others, scientific evidence is often so taken for granted that it is part of the language in which policymakers identify problems and solutions.

In that context, we need better explanations of an ‘evidence-policy’ gap than the pathologies of politics and egregious biases of politicians.

To understand this process, and appearance of contradiction between excluded versus privileged experts, consider the role of evidence in politics and policymaking from three different perspectives.

The perspective of scientists involved primarily in the supply of evidence

Scientists produce high quality evidence only for politicians often ignore it or, even worse, distort its message to support their ideologically-driven policies. If they expect ‘evidence-based policymaking’ they soon become disenchanted and conclude that ‘policy-based evidence’ is more likely. This perspective has long been expressed in scientific journals and commentaries, but has taken on new significance following ‘Brexit’ and Trump.

The perspective of elected politicians

Elected politicians are involved primarily in managing government and maximising public and organisational support for policies. So, scientific evidence is one piece of a large puzzle. They may begin with a manifesto for government and, if elected, feel an obligation to carry it out. Evidence may play a part in that process but the search for evidence on policy solutions is not necessarily prompted by evidence of policy problems.

Further, ‘evidence based policy’ is one of many governance principles that politicians should feel the need to juggle. For example, in Westminster systems, ministers may try to delegate policymaking to foster ‘localism’ and/ or pragmatic policymaking, but also intervene to appear to be in control of policy, to foster a sense of accountability built on an electoral imperative. The likely mix of delegation and intervention seems almost impossible to predict, and this dynamic has a knock-on effect for evidence-informed policy. In some cases, central governments roll out the same basic policy intervention and limit local discretion; in others, it identifies broad outcomes and invites other bodies to gather evidence on how best to meet them. These differences in approach can have profound consequences on the models of evidence-informed policy available to us (see the example of Scottish policymaking).

Political science and policy studies provide a third perspective

Policy theories help us identify the relationship between evidence and policy by showing that a modern focus on ‘evidence-based policymaking’ (EBPM) is one of many versions of the same fairy tale – about ‘rational’ policymaking – that have developed in the post-war period. We talk about ‘bounded rationality’ to identify key ways in which policymakers or organisations could not achieve ‘comprehensive rationality’:

  1. They cannot separate values and facts.
  2. They have multiple, often unclear, objectives which are difficult to rank in any meaningful way.
  3. They have to use major shortcuts to gather a limited amount of information in a limited time.
  4. They can’t make policy from the ‘top down’ in a cycle of ordered and linear stages.

Limits to ‘rational’ policymaking: two shortcuts to make decisions

We can sum up the first three bullet points with one statement: policymakers have to try to evaluate and solve many problems without the ability to understand what they are, how they feel about them as a whole, and what effect their actions will have.

To do so, they use two shortcuts: ‘rational’, by pursuing clear goals and prioritizing certain kinds and sources of information, and ‘irrational’, by drawing on emotions, gut feelings, deeply held beliefs, habits, and the familiar to make decisions quickly.

Consequently, the focus of policy theories is on the links between evidence, persuasion, and framing issues to produce or reinforce a dominant way to define policy problems. Successful actors combine evidence and emotional appeals or simple stories to capture policymaker attention, and/ or help policymakers interpret information through the lens of their strongly-held beliefs.

Scientific evidence plays its part, but scientists often make the mistake of trying to bombard policymakers with evidence when they should be trying to (a) understand how policymakers understand problems, so that they can anticipate their demand for evidence, and (b) frame their evidence according to the cognitive biases of their audience.

Policymaking in ‘complex systems’ or multi-level policymaking environments

Policymaking takes place in less ordered, less hierarchical, and less predictable environment than suggested by the image of the policy cycle. Such environments are made up of:

  1. a wide range of actors (individuals and organisations) influencing policy at many levels of government
  2. a proliferation of rules and norms followed by different levels or types of government
  3. close relationships (‘networks’) between policymakers and powerful actors
  4. a tendency for certain beliefs or ‘paradigms’ to dominate discussion
  5. shifting policy conditions and events that can prompt policymaker attention to lurch at short notice.

These five properties – plus a ‘model of the individual’ built on a discussion of ‘bounded rationality’ – make up the building blocks of policy theories (many of which I summarise in 1000 Word posts). I say this partly to aid interdisciplinary conversation: of course, each theory has its own literature and jargon, and it is difficult to compare and combine their insights, but if you are trained in a different discipline it’s unfair to ask you devote years of your life to studying policy theory to end up at this point.

To show that policy theories have a lot to offer, I have been trying to distil their collective insights into a handy guide – using this same basic format – that you can apply to a variety of different situations, from explaining painfully slow policy change in some areas but dramatic change in others, to highlighting ways in which you can respond effectively.

We can use this approach to help answer many kinds of questions. With my Southampton gig in mind, let’s use some examples from public health and prevention.

Why doesn’t evidence win the day in tobacco policy?

My colleagues and I try to explain why it takes so long for the evidence on smoking and health to have a proportionate impact on policy. Usually, at the back of my mind, is a public health professional audience trying to work out why policymakers don’t act quickly or effectively enough when presented with unequivocal scientific evidence. More recently, they wonder why there is such uneven implementation of a global agreement – the WHO Framework Convention on Tobacco Control – that almost every country in the world has signed.

We identify three conditions under which evidence will ‘win the day’:

  1. Actors are able to use scientific evidence to persuade policymakers to pay attention to, and shift their understanding of, policy problems. In leading countries, it took decades to command attention to the health effects of smoking, reframe tobacco primarily as a public health epidemic (not an economic good), and generate support for the most effective evidence-based solutions.
  2. The policy environment becomes conducive to policy change. A new and dominant frame helps give health departments (often in multiple venues) a greater role; health departments foster networks with public health and medical groups at the expense of the tobacco industry; and, they emphasise the socioeconomic conditions – reductions in smoking prevalence, opposition to tobacco control, and economic benefits to tobacco – supportive of tobacco control.
  3. Actors exploit ‘windows of opportunity’ successfully. A supportive frame and policy environment maximises the chances of high attention to a public health epidemic and provides the motive and opportunity of policymakers to select relatively restrictive policy instruments.

So, scientific evidence is a necessary but insufficient condition for major policy change. Key actors do not simply respond to new evidence: they use it as a resource to further their aims, to frame policy problems in ways that will generate policymaker attention, and underpin technically and politically feasible solutions that policymakers will have the motive and opportunity to select. This remains true even when the evidence seems unequivocal and when countries have signed up to an international agreement which commits them to major policy change. Such commitments can only be fulfilled over the long term, when actors help change the policy environment in which these decisions are made and implemented. So far, this change has not occurred in most countries (or, in other aspects of public health in the UK, such as alcohol policy).

Why doesn’t evidence win the day in prevention and early intervention policy?

UK and devolved governments draw on health and economic evidence to make a strong and highly visible commitment to preventive policymaking, in which the aim is to intervene earlier in people’s lives to improve wellbeing and reduce socioeconomic inequalities and/ or public sector costs. This agenda has existed in one form or another for decades without the same signs of progress we now associate with areas like tobacco control. Indeed, the comparison is instructive, since prevention policy rarely meets the three conditions outlined above:

  1. Prevention is a highly ambiguous term and many actors make sense of it in many different ways. There is no equivalent to a major shift in problem definition for prevention policy as a whole, and little agreement on how to determine the most effective or cost-effective solutions.
  2. A supportive policy environment is far harder to identify. Prevention policy cross-cuts many policymaking venues at many levels of government, with little evidence of ‘ownership’ by key venues. Consequently, there are many overlapping rules on how and from whom to seek evidence. Networks are diffuse and hard to manage. There is no dominant way of thinking across government (although the Treasury’s ‘value for money’ focus is key currency across departments). There are many socioeconomic indicators of policy problems but little agreement on how to measure or which measures to privilege (particularly when predicting future outcomes).
  3. The ‘window of opportunity’ was to adopt a vague solution to an ambiguous policy problem, providing a limited sense of policy direction. There have been several ‘windows’ for more specific initiatives, but their links to an overarching policy agenda are unclear.

These limitations help explain slow progress in key areas. The absence of an unequivocal frame, backed strongly by key actors, leaves policy change vulnerable to successful opposition, especially in areas where early intervention has major implications for redistribution (taking from existing services to invest in others) and personal freedom (encouraging or obliging behavioural change). The vagueness and long term nature of policy aims – to solve problems that often seem intractable – makes them uncompetitive, and often undermined by more specific short term aims with a measurable pay-off (as when, for example, funding for public health loses out to funding to shore up hospital management). It is too easy to reframe existing policy solutions as preventive if the definition of prevention remains slippery, and too difficult to demonstrate the population-wide success of measures generally applied to high risk groups.

What happens when attitudes to two key principles – evidence based policy and localism – play out at the same time?

A lot of discussion of the politics of EBPM assumes that there is something akin to a scientific consensus on which policymakers do not act proportionately. Yet, in many areas – such as social policy and social work – there is great disagreement on how to generate and evaluate the best evidence. Broadly speaking, a hierarchy of evidence built on ‘evidence based medicine’ – which has randomised control trials and their systematic review at the top, and practitioner knowledge and service user feedback at the bottom – may be completely subverted by other academics and practitioners. This disagreement helps produce a spectrum of ways in which we might roll-out evidence based interventions, from an RCT-driven roll-out of the same basic intervention to a storytelling driven pursuit of tailored responses built primarily on governance principles (such as to co-produce policy with users).

At the same time, governments may be wrestling with their own governance principles, including EBPM but also regarding the most appropriate balance between centralism and localism.

If you put both concerns together, you have a variety of possible outcomes (and a temptation to ‘let a thousand flowers bloom’) and a set of competing options (outlined in table 1), all under the banner of ‘evidence based’ policymaking.

Table 1 Three ideal types EBBP

What happens when a small amount of evidence goes a very long way?

So, even if you imagine a perfectly sincere policymaker committed to EBPM, you’d still not be quite sure what they took it to mean in practice. If you assume this commitment is a bit less sincere, and you add in the need to act quickly to use the available evidence and satisfy your electoral audience, you get all sorts of responses based in some part on a reference to evidence.

One fascinating case is of the UK Government’s ‘troubled families’ programme which combined bits and pieces of evidence with ideology and a Westminster-style-accountability imperative, to produce:

  • The argument that the London riots were caused by family breakdown and bad parenting.
  • The use of proxy measures to identify the most troubled families
  • The use of superficial performance management to justify notionally extra expenditure for local authorities
  • The use of evidence in a problematic way, from exaggerating the success of existing ‘family intervention projects’ to sensationalising neuroscientific images related to brain development in deprived children …

normal brain

…but also

In other words, some governments feel the need to dress up their evidence-informed policies in a language appropriate to Westminster politics. Unless we understand this language, and the incentives for elected policymakers to use it, we will fail to understand how to act effectively to influence those policymakers.

What can you do to maximise the use of evidence?

When you ask the generic question you can generate a set of transferable strategies to engage in policymaking:

how-to-be-heard

ebpm-5-things-to-do

Yet, as these case studies of public health and social policy suggest, the question lacks sufficient meaning when applied to real world settings. Would you expect the advice that I give to (primarily) natural scientists (primarily in the US) to be identical to advice for social scientists in specific fields (in, say, the UK)?

No, you’d expect me to end with a call for more research! See for example this special issue in which many scholars from many disciplines suggest insights on how to maximise the use of evidence in policy.

Palgrave C special

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Filed under Evidence Based Policymaking (EBPM), Prevention policy, Public health, public policy, tobacco, tobacco policy

The Science of Evidence-based Policymaking: How to Be Heard

I was interviewed in Science, on the topic of evidence-based policymaking, and we discussed some top tips for people seeking to maximise the use of evidence in a complex policy process (or, perhaps, feel less dispirited about the lack of EBPM in many cases). If it sparks your interest, I have some other work on this topic:

I am editing a series of forthcoming articles on maximising the use of scientific evidence in policy, and the idea is that health and environmental scientists can learn from many other disciplines about how to, for example, anticipate policymaker psychology, find the right policymaking venue, understand its rules and ‘currency’ (the language people use, to reflect dominant ways of thinking about problems), and tell effective stories to the right people.

Palgrave C special

I have also completed a book, some journal articles (PAR, E&P), and some blog posts on the ‘politics of evidence-based policymaking’.

Pivot cover

Two posts appear in the Guardian political science blog (me, me and Kathryn Oliver).

One post, for practitioners, has ‘5 things you need to know’, and it links to presentations on the same theme to different audiences (Scotland, US, EU).

ebpm-5-things-to-do

In this post, I’m trying to think through in more detail what we do with such insights.

The insights I describe come from policy theory, and I have produced 25 posts which introduce each of them in 1000 words (or, if you are super busy, 500 words). For example, the Science interview mentions a spirograph of many cycles, which is a reference to the idea of a policy cycle. Also look out for the 1000-word posts on framing and narrative and think about how they relate to the use of storytelling in policy.

If you like what you see, and want to see more, have a look at my general list of offerings (home page) or list of books and articles with links to theirs PDFs (CV).

how-to-be-heard

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We all want ‘evidence based policy making’ but how do we do it?

Here are some notes for my talk to the Scottish Government on Thursday as part of its ‘inaugural ‘evidence in policy week’. The advertised abstract is as follows:

A key aim in government is to produce ‘evidence based’ (or ‘informed’) policy and policymaking, but it is easier said than done. It involves two key choices about (1) what evidence counts and how you should gather it, and (2) the extent to which central governments should encourage subnational policymakers to act on that evidence. Ideally, the principles we use to decide on the best evidence should be consistent with the governance principles we adopt to use evidence to make policy, but what happens when they seem to collide? Cairney provides three main ways in which to combine evidence and governance-based principles to help clarify those choices.

I plan to use the same basic structure of the talks I gave to the OSF (New York) and EUI-EP (Florence) in which I argue that every aspect of ‘evidence based policy making’ is riddled with the necessity to make political choices (even when we define EBPM):

ebpm-5-things-to-do

I’ll then ‘zoom in’ on points 4 and 5 regarding the relationship between EBPM and governance principles. They are going to videotape the whole discussion to use for internal discussions, but I can post the initial talk here when it becomes available. Please don’t expect a TED talk (especially the E part of TED).

EBPM and good governance principles

The Scottish Government has a reputation for taking certain governance principles seriously, to promote high stakeholder ‘ownership’ and ‘localism’ on policy, and produce the image of a:

  1. Consensual consultation style in which it works closely with interest groups, public bodies, local government organisations, voluntary sector and professional bodies, and unions when making policy.
  2. Trust-based implementation style indicating a relative ability or willingness to devolve the delivery of policy to public bodies, including local authorities, in a meaningful way

Many aspects of this image were cultivated by former Permanent Secretaries: Sir John Elvidge described a ‘Scottish Model’ focused on joined-up government and outcomes-based approaches to policymaking and delivery, and Sir Peter Housden labelled the ‘Scottish Approach to Policymaking’ (SATP) as an alternative to the UK’s command-and-control model of government, focusing on the ‘co-production’ of policy with local communities and citizens.

The ‘Scottish Approach’ has implications for evidence based policy making

Note the major implication for our definition of EBPM. One possible definition, derived from ‘evidence based medicine’, refers to a hierarchy of evidence in which randomised control trials and their systematic review are at the top, while expertise, professional experience and service user feedback are close to the bottom. An uncompromising use of RCTs in policy requires that we maintain a uniform model, with the same basic intervention adopted and rolled out within many areas. The focus is on identifying an intervention’s ‘active ingredient’, applying the correct dosage, and evaluating its success continuously.

This approach seems to challenge the commitment to localism and ‘co-production’.

At the other end of the spectrum is a storytelling approach to the use of evidence in policy. In this case, we begin with key governance principles – such as valuing the ‘assets’ of individuals and communities – and inviting people to help make and deliver policy. Practitioners and service users share stories of their experiences and invite others to learn from them. There is no model of delivery and no ‘active ingredient’.

This approach seems to challenge the commitment to ‘evidence based policy’

The Goldilocks approach to evidence based policy making: the improvement method

We can understand the Scottish Government’s often-preferred method in that context. It has made a commitment to:

Service performance and improvement underpinned by data, evidence and the application of improvement methodologies

So, policymakers use many sources of evidence to identify promising, make broad recommendations to practitioners about the outcomes they seek, and they train practitioners in the improvement method (a form of continuous learning summed up by a ‘Plan-Do-Study-Act’ cycle).

Table 1 Three ideal types EBBP

This approach appears to offer the best of both worlds; just the right mix of central direction and local discretion, with the promise of combining well-established evidence from sources including RCTs with evidence from local experimentation and experience.

Four unresolved issues in decentralised evidence-based policy making

Not surprisingly, our story does not end there. I think there are four unresolved issues in this process:

  1. The Scottish Government often indicates a preference for improvement methods but actually supports all three of the methods I describe. This might reflect an explicit decision to ‘let a thousand flowers bloom’ or the inability to establish a favoured approach.
  2. There is not a single way of understanding ‘improvement methodology’. I describe something akin to a localist model here, but other people describe a far more research-led and centrally coordinated process.
  3. Anecdotally, I hear regularly that key stakeholders do not like the improvement method. One could interpret this as a temporary problem, before people really get it and it starts to work, or a fundamental difference between some people in government and many of the local stakeholders so important to the ‘Scottish approach’.

4. The spectre of democratic accountability and the politics of EBPM

The fourth unresolved issue is the biggest: it’s difficult to know how this approach connects with the most important reference in Scottish politics: the need to maintain Westminster-style democratic accountability, through periodic elections and more regular reports by ministers to the Scottish Parliament. This requires a strong sense of central government and ministerial control – if you know who is in charge, you know who to hold to account or reward or punish in the next election.

In principle, the ‘Scottish approach’ provides a way to bring together key aims into a single narrative. An open and accessible consultation style maximises the gathering of information and advice and fosters group ownership. A national strategic framework, with cross-cutting aims, reduces departmental silos and balances an image of democratic accountability with the pursuit of administrative devolution, through partnership agreements with local authorities, the formation of community planning partnerships, and the encouragement of community and user-driven design of public services. The formation of relationships with public bodies and other organisations delivering services, based on trust, fosters the production of common aims across the public sector, and reduces the need for top-down policymaking. An outcomes-focus provides space for evidence-based and continuous learning about what works.

In practice, a government often needs to appear to take quick and decisive action from the centre, demonstrate policy progress and its role in that progress, and intervene when things go wrong. So, alongside localism it maintains a legislative, financial, and performance management framework which limits localism.

How far do you go to ensure EBPM?

So, when I describe the ‘5 things to do’, usually the fifth element is about how far scientists may want to go, to insist on one model of EBPM when it has the potential to contradict important governance principles relating to consultation and localism. For a central government, the question is starker:

Do you have much choice about your model of EBPM when the democratic imperative is so striking?

I’ll leave it there on a cliff hanger, since these are largely questions to prompt discussion in specific workshops. If you can’t attend, there is further reading on the EBPM and EVIDENCE tabs on this blog, and specific papers on the Scottish dimension

The ‘Scottish Approach to Policy Making’: Implications for Public Service Delivery

Paul Cairney, Siabhainn Russell and Emily St Denny (2016) “The ‘Scottish approach’ to policy and policymaking: what issues are territorial and what are universal?” Policy and Politics, 44, 3, 333-50

The politics of evidence-based best practice: 4 messages

 

 

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Filed under ESRC Scottish Centre for Constitutional Change, Evidence Based Policymaking (EBPM), public policy, Scottish politics, Storytelling

How can political actors take into account the limitations of evidence-based policy-making? 5 key points

These notes are for my brief panel talk at the European Parliament-European University Institute ‘Policy Roundtable’: Evidence and Analysis in EU Policy-Making: Concepts, Practice and Governance. As you can see from the programme description, the broader theme is about how EU institutions demonstrate their legitimacy through initiatives such as stakeholder participation and evidence-based policymaking (EBPM). So, part of my talk is about what happens when EBPM does not exist.

The post is a slightly modified version of my (recorded) talk for Open Society Foundations (New York) but different audiences make sense of these same basic points in very different ways.

  1. Recognise that the phrase ‘evidence-based policy-making’ means everything and nothing

The main limitation to ‘evidence-based policy-making’ is that no-one really knows what it is or what the phrase means. So, each actor makes sense of EBPM in different ways and you can tell a lot about each actor by the way in which they answer these questions:

  • Should you use restrictive criteria to determine what counts as ‘evidence’? Some actors equate evidence with scientific evidence and adhere to specific criteria – such as evidence-based medicine’s hierarchy of evidence – to determine what is scientific. Others have more respect for expertise, professional experience, and stakeholder and service user feedback as sources of evidence.
  • Which metaphor, evidence based or informed is best? ‘Evidence based’ is often rejected by experienced policy participants as unrealistic, preferring ‘informed’ to reflect pragmatism about mixing evidence and political calculations.
  • How far do you go to pursue EBPM? It is unrealistic to treat ‘policy’ as a one-off statement of intent by a single authoritative actor. Instead, it is made and delivered by many actors in a continuous policymaking process within a complicated policy environment (outlined in point 3). This is relevant to EU institutions with limited resources: the Commission often makes key decisions but relies on Member States to make and deliver, and the Parliament may only have the ability to monitor ‘key decisions’. It is also relevant to stakeholders trying to ensure the use of evidence throughout the process, from supranational to local action.
  • Which actors count as policymakers? Policymaking is done by ‘policymakers’, but many are unelected and the division between policymaker/ influencer is often unclear. The study of policymaking involves identifying networks of decision-making by elected and unelected policymakers and their stakeholders, while the actual practice is about deciding where to draw the line between influence and action.
  1. Respond to ‘rational’ and ‘irrational’ thought.

Comprehensive rationality’ describes the absence of ambiguity and uncertainty when policymakers know what problem they want to solve and how to solve it, partly because they can gather and understand all information required to measure the problem and determine the effectiveness of solutions.

Instead, we talk of ‘bounded rationality’ and how policymakers deal with it. They employ two kinds of shortcut: ‘rational’, by pursuing clear goals and prioritizing certain kinds and sources of information, and ‘irrational’, by drawing on emotions, gut feelings, deeply held beliefs, habits, and familiarity, make decisions quickly.

I say ‘irrational’ provocatively, to raise a key strategic question: do you criticise emotional policymaking (describing it as ‘policy based evidence’) and try somehow to minimise it, adapt pragmatically to it, or see ‘fast thinking’ more positively in terms of ‘fast and frugal heuristics’? Regardless, policymakers will think that their heuristics make sense to them, and it can be counterproductive to simply criticise their alleged irrationality.

  1. Think about how to engage in complex systems or policy environments.

Policy cycle’ describes the idea that there is a core group of policymakers at the ‘centre’, making policy from the ‘top down’, and pursuing their goals in a series of clearly defined and well-ordered stages, such as: agenda setting, policy formulation, legitimation, implementation, and evaluation. In this context, one might identify how to influence a singular point of central government decision.

However, a cycle model does not describe policymaking well. Instead, we tend to identify the role of less ordered and more unpredictable complex systems, or policy environments containing:

  • A wide range of actors (individuals and organisations) influencing policy at many levels of government. Scientists and practitioners are competing with many actors to present evidence in a particular way to secure a policymaker audience.
  • A proliferation of rules and norms maintained by different levels or types of government. Support for particular ‘evidence based’ solutions varies according to which organisation takes the lead and how it understands the problem.
  • Important relationships (‘networks’) between policymakers and powerful actors. Some networks are close-knit and difficult to access because bureaucracies have operating procedures that favour particular sources of evidence and some participants over others, and there is a language – indicating what ways of thinking are in good ‘currency’ – that takes time to learn.
  • A tendency for certain ‘core beliefs’ or ‘paradigms’ to dominate discussion. Well-established beliefs provide the context for policymaking: new evidence on the effectiveness of a policy solution has to be accompanied by a shift of attention and successful persuasion.
  • Policy conditions and events that can reinforce stability or prompt policymaker attention to lurch at short notice. In some cases, social or economic ‘crises’ can prompt lurches of attention from one issue to another, and some forms of evidence can be used to encourage that shift, but major policy change is rare.

For stakeholders, an effective engagement strategy is not straightforward: it takes time to know ‘where the action is’, how and where to engage with policymakers, and with whom to form coalitions. For the Commission, it is difficult to know what will happen to policy after it is made (although we know the end point will not resemble the starting point). For the Parliament, it is difficult even to know where to look.

  1. Recognise that EBPM is only one of many legitimate ‘good governance’ principles.

There are several principles of ‘good’ policymaking and only one is EBPM. Others relate to the value of pragmatism and consensus building, combining science advice with public values, improving policy delivery by generating ‘ownership’ of policy among key stakeholders, and sharing responsibility with elected national and local policymakers.

Our choice of which principle and forms of evidence to privilege are inextricably linked. For example, some forms of evidence gathering seem to require uniform models and limited local or stakeholder discretion to modify policy delivery. The classic example is a programme whose value is established using randomised control trials (RCTs). Others begin with local discretion, seeking evidence from stakeholders, professional groups, service user and local practitioner experience. This principle seems to rule out the use of RCTs, at least as a source of a uniform model to be rolled out and evaluated. Of course, one can try to pursue both approaches and a compromise between them, but the outcome may not satisfy advocates of either approach to EBPM or help produce the evidence that they favour.

  1. Decide how far you’ll go to achieve EBPM.

These insights should prompt us to see how far we are willing, and should, go to promote the use of certain forms of evidence in policymaking

  • If policymakers and the public are emotional decision-makers, should we seek to manipulate their thought processes by using simple stories with heroes, villains, and clear but rather simplistic morals?
  • If policymaking systems are so complex, should stakeholders devote huge amounts of resources to make sure they’re effective at each stage?
  • Should proponents of scientific evidence go to great lengths to make sure that EBPM is based on a hierarch of evidence? There is a live debate on science advice to government on the extent to which scientists should be more than ‘honest brokers’.
  • Should policymakers try to direct the use of evidence in policy as well as policy itself?

Where we go from there is up to you

The value of policy theory to this topic is to help us reject simplistic models of EBPM and think through the implications of more sophisticated and complicated processes. It does not provide a blueprint for action (how could it?), but instead a series of questions that you should answer when you seek to use evidence to get what you want. They are political choices based on value judgements, not issues that can be resolved by producing more evidence.

 

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Evidence Based Policy Making: 5 things you need to know and do

These are some opening remarks for my talk on EBPM at Open Society Foundations (New York), 24th October 2016. The OSF recorded the talk, so you can listen below, externally, or by right clicking and saving. Please note that it was a lunchtime talk, so the background noises are plates and glasses.

Evidence based policy making’ is a good political slogan, but not a good description of the policy process. If you expect to see it, you will be disappointed. If you seek more thoughtful ways to understand and act within political systems, you need to understand five key points then decide how to respond.

  1. Decide what it means.

EBPM looks like a valence issue in which most of us agree that policy and policymaking should be ‘evidence based’ (perhaps like ‘evidence based medicine’). Yet, valence issues only command broad agreement on vague proposals. By defining each term we highlight ambiguity and the need to make political choices to make sense of key terms:

  • Should you use restrictive criteria to determine what counts as ‘evidence’ and scientific evidence?
  • Which metaphor, evidence based or informed, describes how pragmatic you will be?
  • The unclear meaning of ‘policy’ prompts you to consider how far you’d go to pursue EBPM, from a one-off statement of intent by a key actor, to delivery by many actors, to the sense of continuous policymaking requiring us to be always engaged.
  • Policymaking is done by policymakers, but many are unelected and the division between policy maker/ influencer is often unclear. So, should you seek to influence policy by influencing influencers?
  1. Respond to ‘rational’ and ‘irrational’ thought.

Comprehensive rationality’ describes the absence of ambiguity and uncertainty when policymakers know what problem they want to solve and how to solve it, partly because they can gather and understand all information required to measure the problem and determine the effectiveness of solutions.

Instead, we talk of ‘bounded rationality’ and how policymakers deal with it. They employ two kinds of shortcut: ‘rational’, by pursuing clear goals and prioritizing certain kinds and sources of information, and ‘irrational’, by drawing on emotions, gut feelings, deeply held beliefs, habits, and familiarity, make decisions quickly.

I say ‘irrational’ provocatively, to raise a key strategic question: do you criticise emotional policymaking (describing it as ‘policy based evidence’) and try somehow to minimise it, adapt pragmatically to it, or see ‘fast thinking’ more positively in terms of ‘fast and frugal heuristics’? Regardless, policymakers will think that their heuristics make sense to them, and it can be counterproductive to simply criticise their alleged irrationality.

  1. Think about how to engage in complex systems or policy environments.

Policy cycle’ describes the idea that there is a core group of policymakers at the ‘centre’, making policy from the ‘top down’, and pursuing their goals in a series of clearly defined and well-ordered stages, such as: agenda setting, policy formulation, legitimation, implementation, and evaluation. In this context, one might identify how to influence a singular point of central government decision.

However, a cycle model does not describe policymaking well. Instead, we tend to identify the role of less ordered and more unpredictable complex systems, or policy environments containing:

  • A wide range of actors (individuals and organisations) influencing policy at many levels of government. Scientists and practitioners are competing with many actors to present evidence in a particular way to secure a policymaker audience.
  • A proliferation of rules and norms maintained by different levels or types of government. Support for particular ‘evidence based’ solutions varies according to which organisation takes the lead and how it understands the problem.
  • Important relationships (‘networks’) between policymakers and powerful actors. Some networks are close-knit and difficult to access because bureaucracies have operating procedures that favour particular sources of evidence and some participants over others, and there is a language – indicating what ways of thinking are in good ‘currency’ – that takes time to learn.
  • A tendency for certain ‘core beliefs’ or ‘paradigms’ to dominate discussion. Well-established beliefs provide the context for policymaking: new evidence on the effectiveness of a policy solution has to be accompanied by a shift of attention and successful persuasion.
  • Policy conditions and events that can reinforce stability or prompt policymaker attention to lurch at short notice. In some cases, social or economic ‘crises’ can prompt lurches of attention from one issue to another, and some forms of evidence can be used to encourage that shift, but major policy change is rare.

These factors suggest that an effective engagement strategy is not straightforward: our instinct may be to influence elected policymakers at the ‘centre’ making authoritative choices, but the ‘return on investment’ is not clear. So, you need to decide how and where to engage, but it takes time to know ‘where the action is’ and with whom to form coalitions.

  1. Recognise that EBPM is only one of many legitimate ‘good governance’ principles.

There are several principles of ‘good’ policymaking and only one is EBPM. Others relate to the value of pragmatism and consensus building, combining science advice with public values, improving policy delivery by generating ‘ownership’ of policy among key stakeholders, and sharing responsibility with elected local policymakers.

Our choice of which principle and forms of evidence to privilege are inextricably linked. For example, some forms of evidence gathering seem to require uniform models and limited local or stakeholder discretion to modify policy delivery. The classic example is a programme whose value is established using randomised control trials (RCTs). Others begin with local discretion, seeking evidence from service user and local practitioner experience. This principle seems to rule out the use of RCTs. Of course, one can try to pursue both approaches and a compromise between them, but the outcome may not satisfy advocates of either approach or help produce the evidence that they favour.

  1. Decide how far you’ll go to achieve EBPM.

These insights should prompt us to see how far we are willing, and should, go to promote the use of certain forms of evidence in policymaking. For example, if policymakers and the public are emotional decision-makers, should we seek to manipulate their thought processes by using simple stories with heroes, villains, and clear but rather simplistic morals? If policymaking systems are so complex, should we devote huge amounts of resources to make sure we’re effective? Kathryn Oliver and I also explore the implications for proponents of scientific evidence, and there is a live debate on science advice to government on the extent to which scientists should be more than ‘honest brokers’.

Where we go from there is up to you

The value of policy theory to this topic is to help us reject simplistic models of EBPM and think through the implications of more sophisticated and complicated processes. It does not provide a blueprint for action (how could it?), but instead a series of questions that you should answer when you seek to use evidence to get what you want. They are political choices based on value judgements, not issues that can be resolved by producing more evidence.

ebpm pic

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We need better descriptions than ‘evidence-based policy’ and ‘policy-based evidence’: the case of UK government ‘troubled families’ policy

Here is the dilemma for ‘evidence-based’ ‘troubled families’ policy: there are many indicators of ‘policy based evidence’ but few (if any) feasible and ‘evidence based’ alternatives.

Viewed from the outside, TF looks like a cynical attempt to produce a quick fix to the London riots, stigmatise vulnerable populations, and hoodwink the public into thinking that the central government is controlling local outcomes and generating success.

Viewed from the inside, it is a pragmatic policy solution, informed by promising evidence which needs to be sold in the right way. For the UK government there may seem to be little alternative to this policy, given the available evidence, the need to do something for the long term and to account for itself in a Westminster system in the short term.

So, in this draft paper, I outline this disconnect between interpretations of ‘evidence based policy’ and ‘policy based evidence’ to help provide some clarity on the pragmatic use of evidence in politics:

cairney-offshoot-troubled-families-ebpm-5-9-16

See also:

Governments think it’s OK to use bad evidence to make good policy: the case of the UK Government’s ‘troubled families’

Early intervention policy, from ‘troubled families’ to ‘named persons’: problems with evidence and framing ‘valence’ issues

In each of these posts, I note that it is difficult to know how, for example, social policy scholars should respond to these issues – but that policy studies help us identify a choice between strategies. In general, pragmatic strategies to influence the use of evidence in policy include: framing issues to catch the attention or manipulate policymaker biases, identifying where the ‘action’ is in multi-level policymaking systems, and forming coalitions with like-minded and well-connected actors. In other words, to influence rather than just comment on policy, we need to understand how policymakers would respond to external evaluation. So, a greater understanding the routine motives of policymakers can help produce more effective criticism of its problematic use of evidence. In social policy, there is an acute dilemma about the choice between engagement, to influence and be influenced by policymakers, and detachment to ensure critical distance. If choosing the latter, we need to think harder about how criticism of PBE makes a difference.

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The Politics of Evidence-based Policymaking in 2500 words

Here is a 2500 word draft of an entry to the Oxford Research Encyclopaedia (public administration and policy) on EBPM. It brings together some thoughts in previous posts and articles

Evidence-based Policymaking (EBPM) has become one of many valence terms that seem difficult to oppose: who would not want policy to be evidence based? It appears to  be the most recent incarnation of a focus on ‘rational’ policymaking, in which we could ask the same question in a more classic way: who would not want policymaking to be based on reason and collecting all of the facts necessary to make good decisions?

Yet, as we know from classic discussions, there are three main issues with such an optimistic starting point. The first is definitional: valence terms only seem so appealing because they are vague. When we define key terms, and produce one definition at the expense of others, we see differences of approach and unresolved issues. The second is descriptive: ‘rational’ policymaking does not exist in the real world. Instead, we treat ‘comprehensive’ or ‘synoptic’ rationality as an ideal-type, to help us think about the consequences of ‘bounded rationality’ (Simon, 1976). Most contemporary policy theories have bounded rationality as a key starting point for explanation (Cairney and Heikkila, 2014). The third is prescriptive. Like EBPM, comprehensive rationality seems – initially – to be unequivocally good. Yet, when we identify its necessary conditions, or what we would have to do to secure this aim, we begin to question EBPM and comprehensive rationality as an ideal scenario.

What is ‘evidence-based policymaking?’ is a lot like ‘what is policy?’ but more so!

Trying to define EBPM is like magnifying the problem of defining policy. As the entries in this encyclopaedia suggest, it is difficult to say what policy is and measure how much it has changed. I use the working definition, ‘the sum total of government action, from signals of intent to the final outcomes’ (Cairney, 2012: 5) not to provide something definitive, but to raise important qualifications, including: there is a difference between what people say they will do, what they actually do, and the outcome; and, policymaking is also about the power not to do something.

So, the idea of a ‘sum total’ of policy sounds intuitively appealing, but masks the difficulty of identifying the many policy instruments that make up ‘policy’ (and the absence of others), including: the level of spending; the use of economic incentives/ penalties; regulations and laws; the use of voluntary agreements and codes of conduct; the provision of public services; education campaigns; funding for scientific studies or advocacy; organisational change; and, the levels of resources/ methods dedicated to policy implementation and evaluation (2012: 26). In that context, we are trying to capture a process in which actors make and deliver ‘policy’ continuously, not identify a set-piece event providing a single opportunity to use a piece of scientific evidence to prompt a policymaker response.

Similarly, for the sake of simplicity, we refer to ‘policymakers’ but in the knowledge that it leads to further qualifications and distinctions, such as: (1) between elected and unelected participants, since people such as civil servants also make important decisions; and (2) between people and organisations, with the latter used as a shorthand to refer to a group of people making decisions collectively and subject to rules of collective engagement (see ‘institutions’). There are blurry dividing lines between the people who make and influence policy and decisions are made by a collection of people with formal responsibility and informal influence (see ‘networks’). Consequently, we need to make clear what we mean by ‘policymakers’ when we identify how they use evidence.

A reference to EBPM provides two further definitional problems (Cairney, 2016: 3-4). The first is to define evidence beyond the vague idea of an argument backed by information. Advocates of EBPM are often talking about scientific evidence which describes information produced in a particular way. Some describe ‘scientific’ broadly, to refer to information gathered systematically using recognised methods, while others refer to a specific hierarchy of methods. The latter has an important reference point – evidence based medicine (EBM) – in which the aim is to generate the best evidence of the best interventions and exhort clinicians to use it. At the top of the methodological hierarchy are randomized control trials (RCTs) to determine the evidence, and the systematic review of RCTs to demonstrate the replicated success of interventions in multiple contexts, published in the top scientific journals (Oliver et al, 2014a; 2014b).

This reference to EBM is crucial in two main ways. First, it highlights a basic difference in attitude between the scientists proposing a hierarchy and the policymakers using a wider range of sources from a far less exclusive list of publications: ‘The tools and programs of evidence-based medicine … are of little relevance to civil servants trying to incorporate evidence in policy advice’ (Lomas and Brown 2009: 906).  Instead, their focus is on finding as much information as possible in a short space of time – including from the ‘grey’ or unpublished/non-peer reviewed literature, and incorporating evidence on factors such as public opinion – to generate policy analysis and make policy quickly. Therefore, second, EBM provides an ideal that is difficult to match in politics, proposing: “that policymakers adhere to the same hierarchy of scientific evidence; that ‘the evidence’ has a direct effect on policy and practice; and that the scientific profession, which identifies problems, is in the best place to identify the most appropriate solutions, based on scientific and professionally driven criteria” (Cairney, 2016: 52; Stoker 2010: 53).

These differences are summed up in the metaphor ‘evidence-based’ which, for proponents of EBM suggests that scientific evidence comes first and acts as the primary reference point for a decision: how do we translate this evidence of a problem into a proportionate response, or how do we make sure that the evidence of an intervention’s success is reflected in policy? The more pragmatic phrase ‘evidence-informed’ sums up a more rounded view of scientific evidence, in which policymakers know that they have to take into account a wider range of factors (Nutley et al, 2007).

Overall, the phrases ‘evidence-based policy’ and ‘evidence-based policymaking’ are less clear than ‘policy’. This problem puts an onus on advocates of EBPM to state what they mean, and to clarify if they are referring to an ideal-type to aid description of the real world, or advocating a process that, to all intents and purposes, would be devoid of politics (see below). The latter tends to accompany often fruitless discussions about ‘policy based evidence’, which seems to describe a range of mistakes by policymakers – including ignoring evidence, using the wrong kinds, ‘cherry picking’ evidence to suit their agendas, and/ or producing a disproportionate response to evidence – without describing a realistic standard to which to hold them.

For example, Haskins and Margolis (2015) provide a pie chart of ‘factors that influence legislation’ in the US, to suggest that research contributes 1% to a final decision compared to, for example, ‘the public’ (16%), the ‘administration’ (11%), political parties (8%) and the budget (8%). Theirs is a ‘whimsical’ exercise to lampoon the lack of EBPM in government (compare with Prewitt et al’s 2012 account built more on social science studies), but it sums up a sense in some scientific circles about their frustrations with the inability of the policymaking world to keep up with science.

Indeed, there is an extensive literature in health science (Oliver, 2014a; 2014b), emulated largely in environmental studies (Cairney, 2016: 85; Cairney et al, 2016), which bemoans the ‘barriers’ between evidence and policy. Some identify problems with the supply of evidence, recommending the need to simplify reports and key messages. Others note the difficulties in providing timely evidence in a chaotic-looking process in which the demand for information is unpredictable and fleeting. A final main category relates to a sense of different ‘cultures’ in science and policymaking which can be addressed in academic-practitioner workshops (to learn about each other’s perspectives) and more scientific training for policymakers. The latter recommendation is often based on practitioner experiences and a superficial analysis of policy studies (Oliver et al, 2014b; Embrett and Randall’s, 2014).

EBPM as a misleading description

Consequently, such analysis tends to introduce reference points that policy scholars would describe as ideal-types. Many accounts refer to the notion of a policy cycle, in which there is a core group of policymakers at the ‘centre’, making policy from the ‘top down’, breaking down their task into clearly defined and well-ordered stages (Cairney, 2016: 16-18). The hope may be that scientists can help policymakers make good decisions by getting them as close as possible to ‘comprehensive rationality’ in which they have the best information available to inform all options and consequences. In that context, policy studies provides two key insights (2016; Cairney et al, 2016).

  1. The role of multi-level policymaking environments, not cycles

Policymaking takes place in less ordered and predictable policy environments, exhibiting:

  • a wide range of actors (individuals and organisations) influencing policy in many levels and types of government
  • a proliferation of rules and norms followed in different venues
  • close relationships (‘networks’) between policymakers and powerful actors
  • a tendency for certain beliefs or ‘paradigms’ to dominate discussion
  • policy conditions and events that can prompt policymaker attention to lurch at short notice.

A focus on this bigger picture shifts our attention from the use of scientific evidence by an elite group of elected policymakers at the ‘top’ to its use by a wide range of influential actors in a multilevel policy process. It shows scientists that they are competing with many actors to present evidence in a particular way to secure a policymaker audience. Support for particular solutions varies according to which organisation takes the lead and how it understands the problem. Some networks are close-knit and difficult to access because bureaucracies have operating procedures that favour particular sources of evidence and some participants over others, and there is a language – indicating what ways of thinking are in good ‘currency’ – that takes time to learn. Well-established beliefs provide the context for policymaking: new evidence on the effectiveness of a policy solution has to be accompanied by a shift of attention and successful persuasion. In some cases, social or economic ‘crises’ can prompt lurches of attention from one issue to another, and some forms of evidence can be used to encourage that shift – but major policy change is rare.

  1. Policymakers use two ‘shortcuts’ to deal with bounded rationality and make decisions

Policymakers deal with ‘bounded rationality’ by employing two kinds of shortcut: ‘rational’, by pursuing clear goals and prioritizing certain kinds and sources of information, and ‘irrational’, by drawing on emotions, gut feelings, beliefs, habits, and familiar reference points to make decisions quickly. Consequently, the focus of policy theories is on the links between evidence, persuasion, and framing.

Framing refers to the ways in which we understand, portray, and categorise issues. Problems are multi-faceted, but bounded rationality limits the attention of policymakers, and actors compete to highlight one image at the expense of others. The outcome of this process determines who is involved (for example, portraying an issue as technical limits involvement to experts), and responsible for policy, how much attention they pay, and what kind of solution they favour. Scientific evidence plays a part in this process, but we should not exaggerate the ability of scientists to win the day with evidence. Rather, policy theories signal the strategies that actors use to increase demand for their evidence:

  • to combine facts with emotional appeals, to prompt lurches of policymaker attention from one policy image to another (True, Jones, and Baumgartner 2007)
  • to tell simple stories which are easy to understand, help manipulate people’s biases, apportion praise and blame, and highlight the moral and political value of solutions (Jones, Shanahan, and McBeth 2014)
  • to interpret new evidence through the lens of the pre-existing beliefs of actors within coalitions, some of which dominate policy networks (Weible, Heikkila, and Sabatier 2012)
  • to produce a policy solution that is feasible and exploit a time when policymakers have the opportunity to adopt it (Kingdon 1984).

Further, the impact of a framing strategy may not be immediate, even if it appears to be successful. Scientific evidence may prompt a lurch of attention to a policy problem, prompting a shift of views in one venue or the new involvement of actors from other venues. However, it can take years to produce support for an ‘evidence-based’ policy solution, built on its technical and political feasibility (will it work as intended, and do policymakers have the motive and opportunity to select it?).

EBPM as a problematic prescription

A pragmatic solution to the policy process would involve: identifying the key venues in which the ‘action’ takes place; learning the ‘rules of the game’ within key networks and institutions; developing framing and persuasion techniques; forming coalitions with allies; and engaging for the long term (Cairney, 2016: 124; Weible et al, 2012: 9-15). The alternative is to seek reforms to make EBPM in practice more like the EBM ideal.

Yet, EBM is defendable because the actors involved agree to make primary reference to scientific evidence and be guided by what works (combined with their clinical expertise and judgement). In politics, there are other – and generally more defendable – principles of ‘good’ policymaking (Cairney, 2016: 125-6). They include the need to legitimise policy: to be accountable to the public in free and fair elections, consult far and wide to generate evidence from multiple perspectives, and negotiate policy across political parties and multiple venues with a legitimate role in policymaking. In that context, we may want scientific evidence to play a major role in policy and policymaking, but pause to reflect on how far we would go to secure a primary role for unelected experts and evidence that few can understand.

Conclusion: the inescapable and desirable politics of evidence-informed policymaking

Many contemporary discussions of policymaking begin with the naïve belief in the possibility and desirability of an evidence-based policy process free from the pathologies of politics. The buzz phrase for any complaint about politicians not living up to this ideal is ‘policy based evidence’: biased politicians decide first what they want to do, then cherry pick any evidence that backs up their case. Yet, without additional thought, they put in its place a technocratic process in which unelected experts are in charge, deciding on the best evidence of a problem and its best solution.

In other words, new discussions of EBPM raise old discussions of rationality that have occupied policy scholars for many decades. The difference since the days of Simon and Lindblom (1959) is that we now have the scientific technology and methods to gather information in ways beyond the dreams of our predecessors. Yet, such advances in technology and knowledge have only increased our ability to reduce but not eradicate uncertainty about the details of a problem. They do not remove ambiguity, which describes the ways in which people understand problems in the first place, then seek information to help them understand them further and seek to solve them. Nor do they reduce the need to meet important principles in politics, such as to sell or justify policies to the public (to respond to democratic elections) and address the fact that there are many venues of policymaking at multiple levels (partly to uphold a principled commitment, in many political system, to devolve or share power).  Policy theories do not tell us what to do about these limits to EBPM, but they help us to separate pragmatism from often-misplaced idealism.

References

Cairney, Paul (2012) Understanding Public Policy (Basingstoke: Palgrave)

Cairney, Paul (2016) The Politics of Evidence-based Policy Making (Basingstoke: Palgrave)

Cairney, Paul and Heikkila, Tanya (2014) ‘A Comparison of Theories of the Policy Process’ in Sabatier, P. and Weible, C. (eds.) Theories of the Policy Process 3rd edition (Chicago: Westview Press)

Paul Cairney, Kathryn Oliver, and Adam Wellstead (2016) ‘To Bridge the Divide between Evidence and Policy: Reduce Ambiguity as Much as Uncertainty’, Public Administration Review, Early view, DOI:10.1111/puar.12555

Embrett, M. and Randall, G. (2014) ‘Social determinants of health and health equity policy research: Exploring the use, misuse, and nonuse of policy analysis theory’, Social Science and Medicine, 108, 147-55

Haskins, Ron and Margolis, Greg (2015) Show Me the Evidence: Obama’s fight for rigor and results in social policy (Washington DC: Brookings Institution Press)

Kingdon, J. (1984) Agendas, Alternatives and Public Policies 1st ed. (New York, NY: Harper Collins)

Lindblom, C. (1959) ‘The Science of Muddling Through’, Public Administration Review, 19: 79–88

Lomas J. and Brown A. (2009) ‘Research and advice giving: a functional view of evidence-informed policy advice in a Canadian ministry of health’, Milbank Quarterly, 87, 4, 903–926

McBeth, M., Jones, M. and Shanahan, E. (2014) ‘The Narrative Policy Framework’ in Sabatier, P. and Weible, C. (eds.) Theories of the Policy Process 3rd edition (Chicago: Westview Press)

Nutley, S., Walter, I. and Davies, H. (2007) Using evidence: how research can inform public services (Bristol: The Policy Press)

Oliver, K., Innvar, S., Lorenc, T., Woodman, J. and Thomas, J. (2014a) ‘A systematic review of barriers to and facilitators of the use of evidence by policymakers’ BMC health services research, 14 (1), 2. http://www.biomedcentral.com/1472-6963/14/2

Oliver, K., Lorenc, T., & Innvær, S. (2014b) ‘New directions in evidence-based policy research: a critical analysis of the literature’, Health Research Policy and Systems, 12, 34 http://www.biomedcentral.com/content/pdf/1478-4505-12-34.pdf

Kenneth Prewitt, Thomas A. Schwandt, and Miron L. Straf, (Editors) (2012) Using Science as Evidence in Public Policy http://www.nap.edu/catalog.php?record_id=13460

Simon, H. (1976) Administrative Behavior, 3rd ed. (London: Macmillan)

Stoker, G. (2010) ‘Translating experiments into policy’, The ANNALS of the American Academy of Political and Social Science, 628, 1, 47-58

True, J. L., Jones, B. D. and Baumgartner, F. R. (2007) Punctuated Equilibrium Theory’ in P. Sabatier (ed.) Theories of the Policy Process, 2nd ed (Cambridge, MA: Westview Press)

Weible, C., Heikkila, T., deLeon, P. and Sabatier, P. (2012) ‘Understanding and influencing the policy process’, Policy Sciences, 45, 1, 1–21

 

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We are in danger of repeating the same mistakes if we bemoan low attention to ‘facts’

A key theme of some of the early analysis of Brexit is that many voters followed their feelings rather than paying attention to facts*.

For some people, this is just a part of life: to describe decision-making as ‘rational’ is to deny the inevitable use of heuristics, gut feelings, emotions, and deeply held beliefs.

For others, it is indicative of a worrying ‘post-truth politics’, or a new world in which campaigners play fast and loose with evidence and say anything to win, while experts are mistrusted and ignored or excluded from debates, and voters don’t get the facts they need to make informed decisions.

One solution, proposed largely by academics (many of whom are highly critical of the campaigns) is largely institutional: let’s investigate the abuse of facts during the referendum to help us produce new rules of engagement.

Another is more pragmatic: let’s work out how to maximise the effectiveness of experts and evidence in political debate. So far, we know more about what doesn’t work. For example:

  • Don’t simply supply people with more information when you think they are not paying enough attention to it. Instead, try to work out how they think, to examine how they are likely to demand and interpret information.
  • Don’t just bemoan the tendency of people to accept simple stories that reinforce their biases. Instead, try to work out how to produce evidence-based stories that can compete for attention with those of campaigners.
  • Don’t stop at providing simpler and more accessible information. People might be more likely to read a blog post than a book or lengthy report, but most people are likely to remain blissfully unaware of most academic blogs.

I’m honestly not sure how to tell good stories to capture the public imagination (beyond that time I put the word ‘shite’ in a title) but, for example, we have a lot to learn from traditional media (and from some of the most effective academics who write for them) and from scholars who study story-telling and discourse (although, ironically, discourse analysis is often one of the most jargon-filled areas in the Academy).

We have been here before (in policy studies)

This issue of agenda setting is a key feature in current discussions of (the alleged lack of) evidence-based policymaking. Many academics, in areas such as health and environmental policy, bemoan the inevitability of ‘policy based evidence’. Some express the naïve view that policymakers should think like scientists and/ or that evidence-based policymaking should be more like the idea of evidence-based medicine in which there is a hierarchy of evidence. Others try to work out how they can improve the supply of evidence or set up new institutions to get policymakers to pay more attention to facts.

Yet, a more pragmatic solution is to work out how and why policymakers demand information, and the policymaking context in which they operate. Only then can we produce evidence-based strategies based on how the world works rather than how we would like it to work.

See also:

The Politics of Evidence Based Policymaking:3 messages

Evidence-based policymaking: lecture and Q&A

‘Evidence-based Policymaking’ and the Study of Public Policy

Paul Cairney (2016) The Politics of Evidence-based Policymaking (London: Palgrave Pivot) PDF

Paul Cairney, Kathryn Oliver, and Adam Wellstead (2016) ‘To Bridge the Divide between Evidence and Policy: Reduce Ambiguity as Much as Uncertainty’, Public Administration Review, Early View (forthcoming) DOI:10.1111/puar.12555 PDF

* Then, many people on twitter vented their negative feelings about other people expressing their feelings.

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There is no blueprint for evidence-based policy, so what do you do?

In my speech to COPOLAD I began by stating that, although we talk about our hopes for evidence-based policy and policymaking (EBP and EBPM), we don’t really know what it is.

I also argued that EBPM is not like our image of evidence-based medicine (EBM), in which there is a clear idea of: (a) which methods/ evidence counts, and (b) the main aim, to replace bad interventions with good.

In other words, in EBPM there is no blueprint for action, either in the abstract or in specific cases of learning from good practice.

To me, this point is underappreciated in the study of EBPM: we identify the politics of EBPM, to highlight the pathologies of/ ‘irrational’ side to policymaking, but we don’t appreciate the more humdrum limits to EBPM even when the political process is healthy and policymakers are fully committed to something more ‘rational’.

Examples from best practice

The examples from our next panel session* demonstrated these limitations to EBPM very well.

The panel contained four examples of impressive policy developments with the potential to outline good practice on the application of public health and harm reduction approaches to drugs policy (including the much-praised Portuguese model).

However, it quickly became apparent that no country-level experience translated into a blueprint for action, for some of the following reasons:

  • It is not always clear what problems policymakers have been trying to solve.
  • It is not always clear how their solutions, in this case, interact with all other relevant policy solutions in related fields.
  • It is difficult to demonstrate clear evidence of success, either before or after the introduction of policies. Instead, most policies are built on initial deductions from relevant evidence, followed by trial-and-error and some evaluations.

In other words, we note routinely the high-level political obstacles to policy emulation, but these examples demonstrate the problems that would still exist even if those initial obstacles were overcome.

A key solution is easier said than done: if providing lessons to others, describe it systematically, in a form that describes the steps to take to turn this model into action (and in a form that we can compare with other experiences). To that end, providers of lessons might note:

  • The problem they were trying to solve (and how they framed it to generate attention, support, and action, within their political systems)
  • The detailed nature of the solution they selected (and the conditions under which it became possible to select that intervention)
  • The evidence they used to guide their initial policies (and how they gathered it)
  • The evidence they collected to monitor the delivery of the intervention, evaluate its impact (was it successful?), and identify cause and effect (why was it successful?)

Realistically this is when the process least resembles (the ideal of) EBM because few evaluations of success will be based on a randomised control trial or some equivalent (and other policymakers may not draw primarily on RCT evidence even when it exists).

Instead, as with much harm reduction and prevention policy, a lot of the justification for success will be based on a counterfactual (what would have happened if we did not intervene?), which is itself based on:

(a) the belief that our object of policy is a complex environment containing many ‘wicked problems’, in which the effects of one intervention cannot be separated easily from that of another (which makes it difficult, and perhaps even inappropriate, to rely on RCTs)

(b) an assessment of the unintended consequence of previous (generally more punitive) policies.

So, the first step to ‘evidence-based policymaking’ is to make a commitment to it. The second is to work out what it is. The third is to do it in a systematic way that allows others to learn from your experience.

The latter may be more political than it looks: few countries (or, at least, the people seeking re-election within them) will want to tell the rest of the world: we innovated and we don’t think it worked.

*I also discuss this problem of evidence-based best practice within single countries

 

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What does it take to turn scientific evidence into policy? Lessons for illegal drugs from tobacco

This post contains preliminary notes for my keynote speech ‘The politics of evidence-based policymaking’ for the COPOLAD annual conference, ‘From evidence to practice: challenges in the field of drugs policies’ (14th June). I may amend them in the run up to the speech (and during their translation into Spanish).

COPOLAD (Cooperation Programme on Drugs Policies) is a ‘partnership cooperation programme between the European Union, Latin America and the Caribbean countries aiming at improving the coherence, balance and impact of drugs policies, through the exchange of mutual experiences, bi-regional coordination and the promotion of multisectoral, comprehensive and coordinated responses’. It is financed by the EU.

My aim is to draw on policy studies, and the case study of tobacco/ public health policy, to identify four lessons:

  1. ‘Evidence-based policymaking’ is difficult to describe and understand, but we know it’s a highly political process which differs markedly from ‘evidence based medicine’.
  2. Actors focus as much on persuasion to reduce ambiguity as scientific evidence to reduce uncertainty. They also develop strategies to navigate complex policymaking ‘systems’ or ‘environments’.
  3. Tobacco policy demonstrates three conditions for the proportionate uptake of evidence: it helps ‘reframe’ a policy problem; it is used in an environment conducive to policy change; and, policymakers exploit ‘windows of opportunity’ for change.
  4. Even the ‘best cases’ of tobacco control highlight a gap of 20-30 years between the production of scientific evidence and a proportionate policy response. In many countries it could be 50. I’ll use this final insight to identify some scenarios on how evidence might be used in areas, such as drugs policy, in which many of the ‘best case’ conditions are not met.

‘Evidence-based policymaking’ is highly political and difficult to understand

Evidence-based policymaking (EBPM) is so difficult to understand that we don’t know how to define it or each word in it! People use phrases like ‘policy-based evidence’, to express cynicism about the sincere use of evidence to guide policy, or ‘evidence informed policy’, to highlight its often limited impact. It is more important to try to define each element of EBPM – to identify what counts as evidence, what is policy, who are the policymakers, and what an ‘evidence-based’ policy would look like – but this is easier said than done.

In fact, it is far easier to say what EBPM is not:

It is not ‘comprehensively rational’

Comprehensive rationality’ describes, in part, the absence of ambiguity and uncertainty:

  • Policymakers translate their values into policy in a straightforward manner – they know what they want and about the problem they seek to solve.
  • Policymakers and governments can gather and understand all information required to measure the problem and determine the effectiveness of solutions.

Instead, we talk of ‘bounded rationality’ and how policymakers deal with it. They employ two kinds of shortcut: ‘rational’, by pursuing clear goals and prioritizing certain kinds and sources of information, and ‘irrational’, by drawing on emotions, gut feelings, deeply held beliefs, habits, and what is familiar to them, to make decisions quickly.

It does not take place in a policy cycle with well-ordered stages

Policy cycle’ describes the ides that there is a core group of policymakers at the ‘centre’, making policy from the ‘top down’, and pursuing their goals in a series of clearly defined and well-ordered stages, such as: agenda setting, policy formulation, legitimation, implementation, and evaluation.

It does not describe or explain policymaking well. Instead, we tend to identify the role of environments or systems.

When describing less ordered and predictable policy environments, we describe:

  • a wide range of actors (individuals and organisations) influencing policy at many levels of government
  • a proliferation of rules and norms followed by different levels or types of government
  • important relationships (‘networks’) between policymakers and powerful actors (with material resources, or the ability to represent a profession or social group)
  • a tendency for certain ‘core beliefs’ or ‘paradigms’ to dominate discussion
  • shifting policy conditions and events that can prompt policymaker attention to lurch at short notice.

When describing complex policymaking systems we show that, for example, (a) the same inputs of evidence or policy activity can have no, or a huge, effect, and (b) policy outcomes often ‘emerge’ in the absence of central government control (which makes it difficult to know how, and to whom, to present evidence or try to influence).

It does not resemble ‘evidence based medicine’ or the public health culture

In health policy we can identify an aim, associated with ‘evidence-based medicine’ (EBM), to:

(a) gather the best evidence on the effectiveness of policy interventions, based on a hierarchy of research methods which favours, for example, the systematic review of randomised control trials (RCTs)

(b) ensure that this evidence has a direct impact on healthcare and public health, to exhort practitioners to replace bad interventions with good, as quickly as possible.

Instead, (a) policymakers can ignore the problems raised by scientific evidence for long periods of time, only for (b) their attention to lurch, prompting them to beg, borrow, or steal information quickly from readily available sources. This can involve many sources of evidence (such as the ‘grey literature’) that some scientists would not describe as reliable.

Actors focus as much on persuasion to reduce ambiguity as scientific evidence to reduce uncertainty.

In that context, ‘evidence-based policymaking’ is about framing problems and adapting to complexity.

Framing refers to the ways in which policymakers understand, portray, and categorise issues. Problems are multi-faceted, but bounded rationality limits the attention of policymakers, and actors compete to highlight one ‘image’ at the expense of others. The outcome of this process determines who is involved (for example, portraying an issue as technical limits involvement to experts), who is responsible for policy, how much attention they pay, their demand for evidence on policy solutions, and what kind of solution they favour.

Scientific evidence plays a part in this process, but we should not exaggerate the ability of scientists to win the day with reference to evidence. Rather, policy theories signal the strategies that actors adopt to increase demand for their evidence:

  • to combine facts with emotional appeals, to prompt lurches of policymaker attention from one policy image to another (punctuated equilibrium theory)
  • to tell simple stories which are easy to understand, help manipulate people’s biases, apportion praise and blame, and highlight the moral and political value of solutions (narrative policy framework)
  • to interpret new evidence through the lens of the pre-existing beliefs of actors within coalitions, some of which dominate policy networks (advocacy coalition framework)
  • to produce a policy solution that is feasible and exploit a time when policymakers have the opportunity to adopt it (multiple streams analysis).

This takes place in complex ‘systems’ or ‘environments’

A focus on this bigger picture shifts our attention from the use of evidence by an elite group of elected policymakers at the ‘top’ to its use by a wide range of influential actors in a multi-level policy process. It shows actors that:

  • They are competing with many others to present evidence in a particular way to secure a policymaker audience.
  • Support for particular solutions varies according to which organisation takes the lead and how it understands the problem.
  • Some networks are close-knit and difficult to access because bureaucracies have operating procedures that favour particular sources of evidence and some participants over others
  • There is a language – indicating which ideas, beliefs, or ways of thinking are most accepted by policymakers and their stakeholders – that takes time to learn.
  • Well-established beliefs provide the context for policymaking: new evidence on the effectiveness of a policy solution has to be accompanied by a shift of attention and successful persuasion.
  • In some cases, social or economic ‘crises’ can prompt lurches of attention from one issue to another, and some forms of evidence can be used to encourage that shift. However, major policy shifts are rare.

In other words, successful actors develop pragmatic strategies based on the policy process that exists, not the process they’d like to see

We argue that successful actors: identify where the ‘action is’ (in networks and organisations in several levels of government); learn and follow the ‘rules of the game’ within networks to improve strategies and help build up trust; form coalitions with actors with similar aims and beliefs; and, frame the evidence to appeal to the biases, beliefs, and priorities of policymakers.

Tobacco policy demonstrates three conditions for the proportionate uptake of evidence

Case studies allow us to turn this general argument into insights generated from areas such as public health.

There are some obvious and important differences between tobacco and (illegal) drugs policies, but an initial focus on tobacco allows us to consider the conditions that might have to be met to use the best evidence on a problem to promote (what we consider to be) a proportionate and effective solution.

We can then use the experience of a ‘best case scenario’ to identify the issues that we face in less ideal circumstances (first in tobacco, and second in drugs).

With colleagues, I have been examining:

Our studies help us identify the conditions under which scientific evidence, on the size of the tobacco problem and the effectiveness of solutions, translates into a public policy response that its advocates would consider to be proportionate.

  1. Actors are able to use scientific evidence to persuade policymakers to pay attention to, and shift their understanding of, policy problems.

Although scientific evidence helps reduce uncertainty, it does not reduce ambiguity. Rather, there is high competition to define problems, and the result of this competition helps determine the demand for subsequent evidence.

In tobacco, the evidence on smoking and then passive smoking helped raise attention to public health, but it took decades to translate into a proportionate response, even in ‘leading’ countries such as the UK.

The comparison with ‘laggard’ countries is crucial to show that the same evidence can produce a far more limited response, as policymakers compare the public health imperative with other ‘frames’, relating to their beliefs on personal responsibility, civil liberties, and the economic consequences of tobacco controls.

  1. The policy environment becomes conducive to policy change.

Public health debates take place in environments more or less conducive to policy change. In the UK, actors used scientific evidence to help reframe the problem. Then, this new understanding helped give the Department of Health a greater role, the health department fostered networks with public health and medical groups at the expense of the industry and, while pursuing policy change, policymakers emphasised the reduced opposition to tobacco control, smoking prevalence, and economic benefits to tobacco,.

In many other countries, these conditions are far less apparent: there are multiple tobacco frames (including economic and civil liberties); economic and trade departments are still central to policy; the industry remains a key player; and, policymakers pay more attention to opposition to tobacco controls (such as bans on smoking in public places) and their potential economic consequences.

Further, differences between countries have largely endured despite the fact that most countries are parties to the FCTC. In other words, a commitment to evidence basedpolicy transfer’ does not necessarily produce actual policy change.

  1. Actors generate and exploit ‘windows of opportunity’ for major policy change.

Even in favourable policy environments, it is not inevitable that major policy changes will occur. Rather, the UK’s experience of key policy instruments – such as legislation to ban smoking in public places (a major commitment of the FCTC) – shows the high level of serendipity involved in the confluence of three necessary but insufficient conditions:

  1. high policymaker attention to tobacco as a policy problem
  2. the production of solutions, introducing partial or comprehensive bans on smoking in public places, that are technically and politically feasible
  3. the willingness and ability of policymakers to choose the more restrictive solution.

In many other countries, there has been no such window of opportunity, or only an opportunity for a far weaker regulation.

So, this condition – the confluence of three ‘streams’ during a ‘window of opportunity’ – shows the major limits to the effect of scientific evidence. The evidence on the health effects of passive smoking have been available since the 1980s, but they only contributed to comprehensive smoking bans in the UK in the mid-2000s, and they remain unlikely in many other countries.

Comparing ‘best case’ and ‘worst case’ scenarios for policy change

These discussions help us clarify the kinds of conditions that need to be met to produce major ‘evidence based’ policy change, even when policymakers have made a commitment to it, or are pursuing an international agreement.

I provide a notional spectrum of ‘best’ and ‘worst’ case scenarios in relation to these conditions:

  1. Actors agree on how to gather and interpret scientific evidence.
  • Best case: governments fund effective ways to gather and interpret the most relevant evidence on the size of policy problems and the effectiveness of solutions. Policymakers can translate large amounts of evidence on complex situations into simple and effective stories (that everyone can understand) to guide action. This includes evidence of activity in one’s own country, and of transferable success from others.
  • Worst case: governments do not know the size of the problem or what solutions have the highest impacts. They rely on old stories that reinforce ineffective action, and do not know how to learn from the experience of other regions (note the ‘not invented hereissue).
  1. Actors ‘frame’ the problem simply and/or unambiguously.
  • Best case: governments maintain a consensus on how best to understand the cause of a policy problem and therefore which evidence to gather and solutions to seek.
  • Worst case: governments juggle many ‘frames’, there is unresolved competition to define the problem, and the best sources of evidence and solutions remain unclear.
  1. A new policy frame is not undermined by the old way of thinking about, and doing, things
  • Best case: the new frame sets the agenda for actors in existing organisations and networks; there is no inertia linked to the old way of thinking about and doing things.
  • Worst case: there is a new policy, but it is undermined by old beliefs, rules, pre-existing commitments (for example, we talk of ‘path dependence’ and ‘inheritance before choice’), or actors opposed to the new policy.
  1. There is a clear ‘delivery chain’ from policy choice to implementation
  • Best case: policymakers agree on a solution, they communicate their aims well, and they secure the cooperation of the actors crucial to policy delivery in many levels and types of government.
  • Worst case: policymakers communicate an ambiguous message and/ or the actors involved in policy delivery pursue different – and often contradictory – ways to try to solve the same problem.

In international cooperation, it is natural to anticipate and try to minimise at least some of these worst case scenarios. Problems are more difficult to solve when they are transnational. Our general sense of uncertainty and complexity is more apparent when there are many governments involved and we cannot rely on a single authoritative actor to solve problems. Each country (and regions within it) has its own beliefs and ways of doing things, and it is not easy to simply emulate another country (even if we think it is successful and know why). Some countries do not have access to the basic information (for example, on health and mortality, alongside statistics on criminal justice) that others take for granted when they monitor the effectiveness of policies.

Further, these obstacles exist in now-relatively-uncontroversial issues, such as tobacco, in which there is an international consensus on the cause of the problem and the appropriateness and effectiveness of public solutions. It is natural to anticipate further problems when we also apply public health (and, in this case, ‘harm reduction’) measures to more controversial areas such as illegal drugs.

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The politics of implementing evidence-based policies

This post by me and Kathryn Oliver appeared in the Guardian political science blog on 27.4.16: If scientists want to influence policymaking, they need to understand it . It builds on this discussion of ‘evidence based best practice’ in Evidence and Policy. There is further reading at the end of the post.

Three things to remember when you are trying to close the ‘evidence-policy gap’

Last week, a new major report on The Science of Using Science: Researching the Use of Research Evidence in Decision-Making suggested that there is very limited evidence of ‘what works’ to turn scientific evidence into policy. There are many publications out there on how to influence policy, but few are proven to work.

This is because scientists think about how to produce the best possible evidence rather than how different policymakers use evidence differently in complex policymaking systems (what the report describes as the ‘capability, motivation, and opportunity’ to use evidence). For example, scientists identify, from their perspective, a cultural gap between them and policymakers. This story tells us that we need to overcome differences in the languages used to communicate findings, the timescales to produce recommendations, and the incentives to engage.

This scientist perspective tends to assume that there is one arena in which policymakers and scientists might engage. Yet, the action takes place in many venues at many levels involving many types of policymaker. So, if we view the process from many different perspectives we see new ways in which to understand the use of evidence.

Examples from the delivery of health and social care interventions show us why we need to understand policymaker perspectives. We identify three main issues to bear in mind.

First, we must choose what counts as ‘the evidence’. In some academic disciplines there is a strong belief that some kinds of evidence are better than others: the best evidence is gathered using randomised control trials and accumulated in systematic reviews. In others, these ideas have limited appeal or are rejected outright, in favour of (say) practitioner experience and service user-based feedback as the knowledge on which to base policies. Most importantly, policymakers may not care about these debates; they tend to beg, borrow, or steal information from readily available sources.

Second, we must choose the lengths to which we are prepared to go ensure that scientific evidence is the primary influence on policy delivery. When we open up the ‘black box’ of policymaking we find a tendency of central governments to juggle many models of government – sometimes directing policy from the centre but often delegating delivery to public, third, and private sector bodies. Those bodies can retain some degree of autonomy during service delivery, often based on governance principles such as ‘localism’ and the need to include service users in the design of public services.

This presents a major dilemma for scientists because policy solutions based on RCTs are likely to come with conditions that limit local discretion. For example, a condition of the UK government’s license of the ‘family nurse partnership’ is that there is ‘fidelity’ to the model, to ensure the correct ‘dosage’ and that an RCT can establish its effect. It contrasts with approaches that focus on governance principles, such as ‘my home life’, in which evidence – as practitioner stories – may or may not be used by new audiences. Policymakers may not care about the profound differences underpinning these approaches, preferring to use a variety of models in different settings rather than use scientific principles to choose between them.

Third, scientists must recognise that these choices are not ours to make. We have our own ideas about the balance between maintaining evidential hierarchies and governance principles, but have no ability to impose these choices on policymakers.

This point has profound consequences for the ways in which we engage in strategies to create impact. A research design to combine scientific evidence and governance seems like a good idea that few pragmatic scientists would oppose. However, this decision does not come close to settling the matter because these compromises look very different when designed by scientists or policymakers.

Take for example the case of ‘improvement science’ in which local practitioners are trained to use evidence to experiment with local pilots and learn and adapt to their experiences. Improvement science-inspired approaches have become very common in health sciences, but in many examples the research agenda is set by research leads and it focuses on how to optimise delivery of evidence-based practice.

In contrast, models such as the Early Years Collaborative reverse this emphasis, using scholarship as one of many sources of information (based partly on scepticism about the practical value of RCTs) and focusing primarily on the assets of practitioners and service users.

Consequently, improvement science appears to offer pragmatic solutions to the gap between divergent approaches, but only because they mean different things to different people. Its adoption is only one step towards negotiating the trade-offs between RCT-driven and story-telling approaches.

These examples help explain why we know so little about how to influence policy. They take us beyond the bland statement – there is a gap between evidence and policy – trotted out whenever scientists try and maximise their own impact. The alternative is to try to understand the policy process, and the likely demand for and uptake of evidence, before working out how to produce evidence that would fit into the process. This different mind-set requires a far more sophisticated knowledge of the policy process than we see in most studies of the evidence-policy gap.  Before trying to influence policymaking, we should try to understand it.

Further reading

The initial further reading uses this table to explore three ways in which policymakers, scientists, and other groups have tried to resolve the problems we discuss:

Table 1 Three ideal types EBBP

  1. This academic journal article (in Evidence and Policy) highlights the dilemmas faced by policymakers when they have to make two choices at once, to decide: (1) what is the best evidence, and (2) how strongly they should insist that local policymakers use it. It uses the case study of the ‘Scottish Approach’ to show that it often seems to favour one approach (‘approach 3’) but actually maintains three approaches. What interests me is the extent to which each approach contradicts the other. We might then consider the cause: is it an explicit decision to ‘let a thousand flowers bloom’ or an unintended outcome of complex government?
  2. I explore some of the scientific  issues in more depth in posts which explore: the political significance of the family nurse partnership (as a symbol of the value of randomised control trials in government), and the assumptions we make about levels of control in the use of RCTs in policy.
  3. For local governments, I outline three ways to gather and use evidence of best practice (for example, on interventions to support prevention policy).
  4. For students and fans of policy theory, I show the links between the use of evidence and policy transfer

You can also explore these links to discussions of EBPM, policy theory, and specific policy fields such as prevention

  1. My academic articles on these topics
  2. The Politics of Evidence Based Policymaking
  3. Key policy theories and concepts in 1000 words
  4. Prevention policy

 

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The politics of evidence-based best practice: 4 messages

Well, it’s really a set of messages, geared towards slightly different audiences, and summed up by this table:

Table 1 Three ideal types EBBP.JPG

  1. This academic journal article (in Evidence and Policy) highlights the dilemmas faced by policymakers when they have to make two choices at once, to decide: (1) what is the best evidence, and (2) how strongly they should insist that local policymakers use it. It uses the case study of the ‘Scottish Approach’ to show that it often seems to favour one approach (‘approach 3’) but actually maintains three approaches. What interests me is the extent to which each approach contradicts the other. We might then consider the cause: is it an explicit decision to ‘let a thousand flowers bloom’ or an unintended outcome of complex government?
  2. I explore some of the scientific  issues in more depth in posts which explore: the political significance of the family nurse partnership (as a symbol of the value of randomised control trials in government), and the assumptions we make about levels of control in the use of RCTs in policy.
  3. For local governments, I outline three ways to gather and use evidence of best practice (for example, on interventions to support prevention policy).
  4. For students and fans of policy theory, I show the links between the use of evidence and policy transfer.

Further reading (links):

My academic articles on these topics

The Politics of Evidence Based Policymaking

Key policy theories and concepts in 1000 words

Prevention policy

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When presenting evidence to policymakers, engage with the policy process that exists, not the process you wish existed

Paul Cairney is Professor of Politics and Public Policy, University of Stirling p.a.cairney@stir.ac.uk. This post will appear in The Guardian’s Political Science blog. It is based on his book The Politics of Evidence Based Policymaking, launched by the Alliance for Useful Evidence and developed on his EBPM webpage.

‘Evidence-based policymaking’ is now central to the agenda of scientists: academics need to demonstrate that they are making an ‘impact’ on policy, and scientists want to close the ‘evidence-policy gap’. The live debate on energy policy is one of many examples in which scientists bemoan a tendency for policymakers to produce  ideological rather than ‘evidence based’ decisions, and seek ways to change their minds.

Yet, they will fail if they do not understand how the policy process works. To do so requires us to reject two romantic notions: (1) that policymakers will ever think like scientists; and, (2) that there is a clearly identifiable point of decision at which scientists can contribute evidence to key policymakers to make a demonstrable impact.

To better understand how policymakers think, we need a full account of ‘bounded rationality’. This phrase partly describes the fact that policymakers can only gather limited information before they make decisions quickly. They will have made a choice before you have a chance to say ‘more research is needed’! To do so, they use two short cuts: ‘rational’ ways to gather quickly the best evidence on solutions to meet their goals, and ‘irrational’ ways – including drawing on emotions and gut feeling – to identify problems even more quickly.

This insight shows us one potential flaw in academic strategies. The most common response to bounded rationality in scientific articles is to focus on the supply of evidence: develop a hierarchy of evidence which privileges the systematic review of randomised control trials, generate knowledge, and present it in a form that is understandable to policymakers. We need to pay more attention to the demand for evidence, following lurches of policymaker attention, often driven by quick and emotional decisions. For example, there is no point in taking the time to make evidence-based solutions easier to understand if policymakers are not (or no longer) interested. Instead, successful advocates recognize the value of emotional appeals and simple stories to generate attention to a problem.

To identify when and how to contribute evidence, we need to understand the complicated environment in which policy takes place. There is no ‘policy cycle’ in which to inject scientific evidence at the point of decision. Rather, the policy process is messy and often unpredictable, and better described as a complex system in which, for example, the same injection of evidence can have no effect or a major effect. It contains: many actors presenting evidence to influence policymakers in many levels and types of government; networks which are often close-knit and difficult to access because bureaucracies have operating procedures that favour particular sources of evidence and some participants over others; and, a language within policymaking institutions indicating what ways of thinking are in good ‘currency’ (such as ‘value for money’). Social or economic ‘crises’ can prompt lurches of attention from one issue to another, or even prompt policymakers to change completely the ways in which they understand a policy problem. However, while lurches of attention are common, changes to well-established ways of thinking in government are rare, or take place only in the long term.

This insight shows us a second potential flaw in academic strategies: the idea that research ‘impact’ can be described as a set-piece event, separable from the policy process as a whole. It compares with the kind of advice – develop a long-term strategy – that we would generate from policy studies: invest in the time to find out (a) where the ‘action is’, and (b) how you can boost your influence as part of a coalition of like-minded actors looking of opportunities to raise attention to problems and push your solutions.

Unfortunately, these insights mostly help us identify what not to do. Further, the alternatives may be difficult to accept (how many scientists would make manipulative or emotional appeals to generate attention to their research?) or deliver (who has the time to conduct research and seek meaningful influence?). However, by engaging with these practical and ethical dilemmas, that the policy process creates for advocates of scientific evidence, we can help produce strategies better suited to the complex real world than a simple process that we wish existed.

Pivot cover

 

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