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Current debates on e-cigarette policy in the UK are highly acrimonious and are framed in terms of evidence-based policymaking. Aims and objectives: The article aims to understand the use of evidence in policymaking in the context of both political controversy and limited policy-relevant evidence via a case study of UK e-cigarette debates. Methods: The study draws on a series of semi-structured interviews with policy actors to examine their positions on e-cigarette policy process and their use of evidence to support this. Findings: Policy actors articulate a strong commitment to evidence-based policymaking and claim that their positions are evidence-based. Some actors also claim emerging consensus around their positon as a rhetorical tool in the debate. Respondents argued that actors adopting opposing policy positions fail to follow the evidence base. This is attributed to a lack of understanding or disregard for the relevant evidence for political or ideological reasons. Discussion: Respondents adhere to a rationalist understanding of policymaking in which policy disputes can be settled by recourse to 'the evidence'. Interpretative policy analysis suggests that multiple legitimate framings of policy issues, supported by different bodies of evidence, are possible. Policy differences are thus not due to bad faith but to policy actors framing the issue at stake in different terms and thus advocating different policy responses. Conclusions: Process of 'frame reflection' may help to overcome the acrimony of current policy leading to more effective engagement by public health actors in the e-cigarettes policy debates.

In this paper we reflect on our experience of providing a rapid response facility for international healthcare policy comparisons to the English Department of Health. We examine the challenges of developing sustained relationships with policy officials while providing an "on-demand" service in an environment with high turnover of policies and staff. It may be easier for policy makers to draw on researchers in such a setting than for researchers to foster "linkage and exchange" relationships with policy makers. Under the facility, knowledge transfer has mostly been from researchers to policy officials, affording us little insight into the policy process or the impact of our work.

This paper examines how care home managers in England conceptualised the approach to delivering personalised care in the homes they managed. We conducted interviews with care home managers and mapped the approaches they described on two distinct characterisations of personalised care prominent in the research and practitioner literature: the importance of close care relationships and the degree of resident choice and decision-making promoted by the care home. We derived three 'types' of personalised care in care homes. These conceptualise the care home as an 'institution', a 'family' and a 'hotel'. We have added a fourth type, the 'co-operative', to propose a type that merges proximate care relationships with an emphasis on resident choice and decision-making. We conclude that each approach involves trade-offs and that the 'family' model may be more suitable for people with advanced dementia, given its emphasis on relationships. While the presence of a range of diverse approaches to personalising care in a care home market may be desirable as a matter of choice, access to care homes in England is likely to be constrained by availability and cost. [ABSTRACT FROM AUTHOR]

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Health technology assessment is frequently credited with making difficult resource allocation decisions in health care fairer, more rational and more transparent. In Germany, a constitutional 'right to health' allows patients to challenge decisions by sickness funds to withhold reimbursement of treatment excluded from public funding because of insufficient evidence of effectiveness. The ability to litigate was qualified by the Constitutional Court in its 2005 'Nikolaus decision' that sets out criteria to be applied to these cases. Treatment must be made available if (1) the condition is life-threatening, (2) no alternative treatment is available and (3) there is an indication that the treatment could benefit the patient. This paper examines how courts struggled to apply these criteria based on an analysis of cases of patients who sought treatment for cancer between 2005 and 2015, and explores the implications of applying a constitutional 'right to health' to treatment decisions. [ABSTRACT FROM AUTHOR]