Health Services Research Centre

DEcisions in health Care to Introduce or Diffuse innovations using Evidence


This study, led by researchers at The University of Manchester and University College London and funded by the Health Foundation, has been examining the role of evidence in decisions to introduce innovations. A range of evidence informs healthcare decision-making, from formal research findings to ‘soft intelligence’ or local data, as well as practical experience or tacit knowledge. However, cultural and organisational factors often prevent the translation of such evidence into practice. Using a multi-level framework, this project will analyse how interactions between the evidence available and processes at the professional, organisational and local system level influence decisions to introduce or diffuse innovations in acute and primary care within the National Health Service in the UK.

This study is using a mixed methods design, combining qualitative and quantitative methods, and involves four interdependent work streams:

  1. rapid evidence synthesis of relevant literature with stakeholder feedback;
  2. in-depth case studies of ‘real world’ decision-making in acute and primary care;
  3. a national survey and discrete choice experiment;
  4. development of guidance for decision-makers and evaluators to support the use of evidence in decision-making. View DECIDE guidance.

The case studies are examining: responses to evidence on reconfiguring stroke services; uptake of new national guidance in primary care to improve early diagnosis of suspected cancer; and use of evidence to inform development of an extended organisational network of eye services.

This study will enhance understanding of decision-makers’ use of diverse forms of evidence. The findings will provide insights into how and why some evidence does inform decisions to introduce health care innovations, and why barriers persist in other cases. It will also quantify decision-makers’ preferences, including the ‘tipping point’ of evidence needed to shift stakeholders’ views. Practical guidance will be shared with health care decision-makers and evaluators on uses of evidence to enable the introduction and diffusion of innovation.


DEcisions in health Care to Introduce or Diffuse innovations using Evidence (DECIDE) is part of the Health Foundation’s Evidence-informed decision making in health service innovation and improvement programme. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK.

Principal investigator

Dr Simon Turner  - Senior Lecturer in Health Policy & Organisation, University of Manchester

Co-investigators (UCL)

Naomi Fulop, Steve Morris, Jessica Sheringham, Emma Hudson


DECIDE project summary >>

DECIDE investigator team (2018) ‘DECIDE guidance, version 1, May 2018’. View DECIDE guidance Available at:

Turner S. (2018) ‘Accelerating innovation in new ways of delivering health and social care’, Manchester Policy Blog, published 28 March 2018.

Turner S, D’Lima D, Hudson E, Morris S, Sheringham J, Swart N, Fulop N. (2017) ‘Evidence use in decision-making on introducing innovations: a systematic scoping review with stakeholder feedback’, Implementation Science 12:145. View bite-size summary

Turner S, Morris S, Sheringham J, Hudson E, fulop NJ. (2016) 'Study protocol: DEcisions in health Care to Introduce or Diffuse innovations using Evidence (DECIDE)', Implementation Science 11:48.

Turner S, Morris S, Sheringham, J, Swart N, D’Lima D, Richey R, Hudson E, Ahmed M, Fulop NJ. (2019). DEcisions in health Care to Introduce or Diffuse innovations using Evidence (DECIDE). Final report for The Health Foundation. April 2019. Download here