Scottish courts back minimum alcohol price

Plans to set a minimum price for alcohol in Scotland have today (21 October 2016) been backed by the Scottish courts.

Research conducted by experts from the Sheffield Alcohol Research Group (SARG)1 at the University of Sheffield have been influential in providing evidence to inform policy which now paves the way for the Scottish government to implement the new plan, passed by MSPs in 2012.

The Scottish government, health professionals, police, alcohol charities and some members of the drinks industry believe minimum pricing would help address Scotland’s “unhealthy relationship with drink”.

mainHealth gains

Experts from SARG based at the University’s School of Health and Related Research (ScHARR) estimated that implementing a 50p minimum unit price (MUP) for alcohol in Scotland would have the following effects after one year:

  • 60 fewer deaths due to alcohol
  • 1,300 fewer hospital admissions due to alcohol
  • 3,500 fewer crimes due to alcohol

The health gains will continue to increase over 20 years and researchers estimate that the full effect of the policy would be:

  • 120 fewer deaths due to alcohol each year
  • 2,000 fewer hospital admissions due to alcohol each year

Under a 50p MUP in Scotland, alcohol consumption is estimated to fall by 3.5 per cent overall and by seven per cent among harmful drinkers compared to 1.2 per cent among moderate drinkers.2

For harmful drinkers, this equates to 250 fewer units of alcohol per year – approximately equivalent to 125 pints of beer, 25 bottles of red wine or over six litres of vodka.

The Scottish Court of Session particularly examined whether equivalent benefits to public health could be achieved by increasing alcohol taxes. Analyses by the University’s research group, which were commissioned by the Scottish government, show that:

  • To achieve the same reduction in deaths as would be achieved by a 50p MUP, alcohol duties would need to be increased by an estimated 27 per cent.
  • To achieve the same reduction in deaths among harmful drinkers as would be achieved by a 50p MUP, alcohol duties would need to be increased by an estimated 36 per cent.
  • To achieve the same reduction in deaths among harmful drinkers in poverty (the group at greatest risk from their drinking) as would be achieved by a 50p MUP, alcohol duties would need to be increased by an estimated 70 per cent.

Professor Petra Meier, Director of SARG, said: “Our analyses of minimum unit pricing have consistently shown that the policy is an effective and well-targeted approach to reducing the harm caused by alcohol.

“Increasing alcohol taxation is also an effective approach but large tax increases would be required to achieve the same effects as a 50p minimum unit price. This is because minimum unit pricing targets the high-strength and low-cost alcohol which is disproportionately purchased by heavier drinkers.”

Under the plans, a price of 50p per unit of alcohol would be set, taking a bottle of spirits to a price of at least £14.

Additional information

1 Estimates of the effects of minimum unit pricing and increases in alcohol taxation are produced using the Sheffield Alcohol Policy Model. Further information can be found at the following links:

A summary of the Sheffield Alcohol Policy Model

The most recent estimates for Scotland of the impact of minimum unit pricing and taxation on health outcomes (PDF)

The most recent estimates for Scotland of the impacts of minimum unit pricing and taxation on alcohol-related crime and workplace related outcomes (PDF)

The most estimated for England of the impact of minimum unit pricing

2 Moderate drinkers are those consuming no more than 21 units per week for men and 14 units per week for women. Harmful drinkers are those consuming more than 50 units per week for men and 35 units per week for women. One unit of alcohol is 7.9g of pure ethanol. There are approximately two units in a normal strength pint of beer, 10 units in a bottle of red wine and 40 units in a litre of vodka.

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Double Research Innovation Grants from Alcohol Research UK

wineglassesResearchers in the Sheffield Alcohol Research Group in ScHARR have recently been awarded two Research Innovation Grants from Alcohol Research UK. These grants are awarded to projects which take a novel approach to address alcohol-related problems and which aim to improve public knowledge on alcohol.

In a time when increasing demands are being placed on ever more stretched NHS budgets, alcohol places a substantial burden on the healthcare system, estimated at over £3.3billion each year. Alcohol is also a major driver of socioeconomic inequalities in health, which place an additional burden on society. The successful grants, which will run for 18 months, will provide new evidence to policy makers and healthcare professionals on the impact of alcohol on Primary Care and the potential of Primary Care-based interventions to alter this.

The first project, led by Duncan Gillespie and involving researchers at the Universities of Sheffield and Nottingham, aims to quantify the burden that alcohol places on primary care in England. The project will develop methods to estimate the financial costs of Primary Care consultations, including prescribing, that occur because of alcohol consumption. The findings will help to engage Primary Care professionals and policy makers as stakeholders in alcohol harm reduction.

This is an opportunity to understand the financial burden that alcohol imposes on primary care, and the actions that primary care practitioners are taking to reduce this burden.


The second project, led by Colin Angus and involving researchers at both the Universities of Sheffield and Newcastle, will look at the extent to which Screening and Brief Interventions (SBIs) in Primary Care impact on alcohol-related inequalities in health. SBIs form a major part of NICE guidelines on the management of hazardous and harmful drinking in Primary Care, yet delivery rates remain low. This project will analyse Primary Care records together with a range of national survey data to understand how current SBI delivery and potential alternative delivery strategies are likely to impact on population health and NHS costs as well as on health inequalities. These findings will help local and national policy makers design more effective and cost-effective SBI policies and potentially reduce inequalities in health.

We are developing new methods to make use of a vast dataset of primary care records in collaborations with partners at the Universities of Nottingham and Newcastle


Image CC BY 2.0 Kimery Davis

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Welcome to new students for ScHARR, 2016-17

We are delighted to welcome our new students for 2016-17!

Super friendly, helpful and welcoming from the first ever contact I made.

Been great so far. Intro week has been very relevant and informative.

Very extensive support services provide by ScHARR and the university – super impressed


This year, we have more than 100 new students starting on our 10 postgraduate programmes in the School, from 38 different countries. We are also welcoming many students not pictured who will be studying online. We look forward to learning with you over the coming months and years.

New ScHARR students 2016-17Welcome to ScHARR, University of Sheffield 2016

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Pioneering trial to increase breastfeeding rates nationwide


We’ve designed a scheme to get more women breastfeeding across the UK.

The project, known as the NOurishing Start for Health (NOSH) is aimed at boosting breastfeeding rates in areas where levels remain low.

As part of NOSH, women are offered shopping vouchers worth £120 if they breastfeed their baby for up to six weeks and a further £80 if they continue breastfeeding for another six months.

The scheme is already being rolled-out to 5,000 eligible women across Sheffield, Doncaster, Bassetlaw, Rotherham and areas of North Derbyshire, covering a total of 46 electoral wards.

These areas are identified as having poor breastfeeding rates and the results will be compared with those from similar regions where the scheme has not been trialled.

Principal investigator Dr Clare Relton from the University of Sheffield’s School of Health and Related Research (ScHARR), said:”For several decades now the majority of babies in the UK have not been getting enough breast milk, and despite many efforts, this situation has not improved. The trial enables us to find out whether offering vouchers for breastfeeding can significantly increase our stubbornly low breastfeeding rates.”

If more women breastfed for longer the NHS could save more than £17 million in hospital and GP visits

The health benefits of breastfeeding are well-documented. Dr Clare Relton said: “Breastfed babies are less likely to be obese when they grow up and they less likely to be hospitalised.”

If more women breastfed for longer the NHS could save more than £17 million in hospital and GP visits. But in some areas of the UK only 12 per cent of mothers breastfeed six to eight-week old babies.

“Rates tend to be worse in areas of deprivation,” said Dr Relton. “And in the UK our national rates are among the lowest in the world – far below France, Belgium and even America.”

The trial – which was designed by University researchers in collaboration with healthcare professionals – has already seen positive results. Mothers participating in NOSH said they felt acknowledged for their effort, with one mother describing her experience of the scheme as: “Getting something good for doing something good.”

Another mother taking part said: “Sometimes you think ‘should I just move on to the bottle now?’ and then I think ‘oh but then I won’t get the money to be able to treat them’, so it does help.”

Mary Renfrew, Professor of Mother and Infant Health at the University of Dundee, who collaborated in designing the trial, said: “In areas where most babies are bottle fed women need support to breastfeed. This scheme could make a difference. It’s great to be able to test it properly in a large trial.”

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Faculty of Medicine, Dentistry and Health Lecture Series – 6th Annual Pemberton Lecture


“Alcohol:  evidence-based policies and practical implementation – mind the gap”

Professor Sir Ian Gilmore

Monday 3 October 2016 at 17.30 followed by a wine reception

The University of Sheffield Students’ Union Auditorium

Western Bank, Sheffield, S10 2TG

Free admission, by ticket only:  Please register here

‘Alcohol has been part of human culture for more than five thousand years and remains a topic of continuing interest – everyone is an expert on why we drink and how much. There is now a wealth of scientific analysis of consumption and harm in populations that differ in ethnicity, gender, age, equity and other variables, and this has allowed a clear picture of what works and doesn’t work in optimising our troubled relationship with alcohol. However there are so many vested interests in our favourite drug that putting this evidence into practice has met with challenges that remain unresolved but infinitely fascinating.’

Professor Sir Ian Gilmore is an honorary consultant physician at the Royal Liverpool University Hospital and holds an honorary chair at the University of Liverpool. He is a past-president of the Royal College of Physicians (RCP) and the British Society of Gastroenterology. He is chairman of Liverpool Health Partners, created to promote an Academic Health Science System in the city and he chairs the UK Alcohol Health Alliance. He is also President of Alcohol Concern and is a member of the Climate and Health Council.

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ScHARR Inaugural Lecture: “Assessing the evidence: a NICE journey” – Professor Eva Kaltenthaler


“Assessing the evidence: a NICE journey”

Professor Eva Kaltenthaler

Professor of Health Technology Assessment

Wednesday 21 September 2016

5.15pm-6.00pm (followed by a wine reception)

Lecture Theatre 4, The Diamond

In her inaugural lecture, Professor Eva Kaltenthaler will describe her work as a systematic reviewer undertaking technology appraisals for the National Institute for Health and Care Excellence (NICE), the process used to assess new treatments for use in the NHS. Professor Kaltenthaler will discuss changes to research methods in systematic reviewing as well as changes to the NICE technology appraisal process over the past 15 years. She will outline her involvement in a range of research projects exploring the methods used in technology appraisal.
Professor Kaltenthaler will also briefly outline her earlier work using mixed methods research to study hygiene behaviour.

Admission Free – Register to attend here

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Public Health Newsletter – Issue 2 September 2016

Welcome to the second edition of our Public Health Section newsletter. Other than the continual noise of workers sawing through stone it’s been a quiet summer here in ScHARR. I hope everybody has been able to get a break!
Even though July and August have been quiet, plenty of good things have happened since the last newsletter. People have taken on new roles, awards have been received and grants have been won.
In this edition of the newsletter the two main stories are from Sarita Panday, one of our PhD students from Nepal, and from Michelle, who discusses the work of the EVIDENT partnership.
We’ve also included a selection of recent publications (I’m sure there are many more that are not listed!).

Thanks again to Karen for putting the newsletter together, and please do let Karen know of any news that you would like to go in the next edition.

All the best for the coming semester.

News and Congratulations

Congratulations to Prof Liddy Goyder, who has been appointed Director of Research at the National Centre for Sport and Exercise Medicine (NCSEM) in Sheffield.

The NCSEM aims to improve the health and well being of the nation through physical activity and was established in 2012 as a legacy to the Olympic Games. The Sheffield-based NCSEM brings together researchers and institutions from across the city who are working to create a culture of physical activity in the region.

Read More

We have two new HEA Fellows through the Learning and Teaching Professional Recognition Scheme – Congratulations to Prof Sarah Salway, SFHEA (Personal Pathway) and Dr Liz Such, FHEA (Personal Pathway).

Dr Lindsay Blank has been elected as a staff member of the University Senate (for one year applicable from 1 Oct 2016 to 30 Sep 2017). The Senate is responsible for regulating and directing the academic work of the University and meets quarterly.

Congratulations to Louisa Shilton who now works for the Faculty based in the Medical School, Louisa passed her viva on 13 July with no corrections or amendments – well done!

Congratulations to Dr Kelly MacKenzie on her success in being offered a prestigious NIHR Fellowship. Kelly is delighted and looking forward to the new challenges ahead when she starts her Fellowship from 1 October 2016.

Prof Liddy Goyder and Dr Hannah Jordan were both selected in the Editor’s Picks for their respective  poster abstracts for the forthcoming Society for Social Medicine (SSM) Annual Scientific Meeting, which featured in the SSM’s Winter Newsletter Vol 7 Issue 3 August 2016.  Liddy‘s entitled  ‘‘Horses for courses’ or ‘One size fits all’? Developing appropriate methods of stakeholder involvement to inform evaluation of complex interventions in Europe’ and  Hannah’s entitled  ‘Wild at heart: A mixed method evaluation of a wildlife-related intervention for older people.’ Well done to both!

On a more personal note, congratulations also go to Kelly MacKenzie who recently had a surprise proposal whilst on holiday in Scotland and is now engaged to fiancé Kevin!
Congratulations to Katie Powell who also recently got engaged – must be something in the air!

ScHARR Research Stimulation Award – an update from Dr Katie Powell on how the money for her project has been used to good effect

The Research Stimulation prize was used to scope out the feasibility of a study on loneliness and isolation among minority ethnic groups. The funding was helpful in facilitating a scoping review of published literature and grey sources to assess whether a systematic review was possible. We assessed the volume and quality of published literature to develop realistic timelines for a literature review and used this to inform a proposal for funding. We also used the stimulation funds to map potential stakeholders and recruit them to a consultation group – informing the development of the bid.

Meet Sarita Panday, PhD student

Hi everyone – I’m Sarita Panday from Nepal. I recently submitted my PhD thesis in Public Health at ScHARR (Faculty Scholarships) and I am awaiting my viva in September. My PhD explored the role of female community health volunteers (FCHVs) in maternal healthcare provision in Nepal from the perspectives of health workers, service users and FCHVs themselves. FCHVs are one of the most utilised, yet underrepresented groups, therefore, my study explored about their services, including the strategies they use to deliver such services, and the factors that promote or hinder their service provision in two geographical regions of the country. I will be presenting these findings at the Fourth Global Symposium on Health System Research in Vancouver, Canada this year from 14-18 November under the theme of Implementing improvement and innovation in health services and systems Symposium’s ‘field-building dimensions.

My presentation title is “Female community health volunteers (FCHVs) providing maternal health services in Nepal: health system support and barriers.” I came to know about the conference from Julie Balen and I am very grateful to my supervisors, Paul Bissell and Mark Strong for their support and encouragement to attend this international conference. The conference will also be an opportunity to engage with colleagues from around the globe who share an interest and a passion for improving health systems of low and middle income countries.

Prior to coming to the UK, I completed a combined Masters in Public Health and Health Management in the University of New South Wales, Australia and I am an alumna of Australian Leadership Awards 2009/2010. I am also a trained nurse (BSc Nursing, Distinction).

I am glad that the University of Sheffield and my department of Public Health has supported me well to acquire and develop a sound theoretical and practical knowledge, skills and experiences to contribute to the populations whose health needs are unmet. I am passionate to work for the health improvement of the most vulnerable groups in real-life settings and now, I feel ready to offer different and rich perspectives in undertaking health care research in low-income countries.

Focus on nutrition in Africa

Each issue we hope to bring you articles of interest from different areas of our business.

Here, Prof Michelle Holdsworth gives us some insights into current work undertaken on nutrition in Africa.

The EVIDENT partnership

Prof Michelle Holdsworth, Dr Robert Akparibo and Dr Andrew Booth are all part of the EVIDENT (Evidence-informed Decision-making in Nutrition and Health) partnership.  EVIDENT is an international hub of North-South partners created to strengthen capacities to address the gap between what research tells us works and local needs in nutrition and health in Africa.  This is achieved by empowering stakeholders in local, national government and others to identify and prioritise their key nutrition concerns and, providing them with a platform where these can be addressed. The network provides reviews of evidence, locally-appropriate guidance, and facilitates the translation of evidence into policy. Pilot projects are now underway in Benin, Ethiopia, Ghana and South Africa. Unlike other initiatives that aim to help improve the use of evidence in decision making in health broadly, EVIDENT focuses on nutrition. EVIDENT encompasses all issues that are at the forefront of global nutrition and health policy: stunting, underweight, maternal and child health, micronutrient deficiencies, obesity and non-communicable diseases. This initiative is important as finite resources for research and ever-increasing research waste highlight an urgent need to prioritise research agendas, especially in resources-limited settings. For us in ScHARR, the EVIDENT partnership allows us to contribute our expertise in public health nutrition with that of different systematic review methodologies.

Robert discussing his ideas on realist evidence synthesis at a project meeting in Ethiopia.

You can find greater detail on the EVIDENT project website at:

The programme co-ordinator of EVIDENT (Roos Verstraeten from the Nutrition team in the Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium) will be spending the month of September in ScHARR. Roos is a nutritionist  with a particular interest in review methodologies and diet related NCDs in low and middle income countries. You can contact Roos directly ( or via Michelle ( if you would like to arrange to meet up with her whilst she is here.

Recent Publications

Barnes A, Brown Garrett W, Harman S. Understanding global health and development partnerships: Perspectives from African and global health system professionals. Journal of Social Science & Medicinedoi:10.1016/j.socscimed.2016.04.033
S. Moffatt, S. Lawson, R. Patterson, E. Holding, A. Dennison, S. Sowden, J. Brown. A qualitative study of the impact of the UK ‘bedroom tax’. Journal of Public Health
doi: 10.1093/pubmed/fdv031
Angie Clonan, Katharine E. Roberts, Michelle Holdsworth. Socioeconomic and demographic drivers of red and processed meat consumption: implications for health and environmental sustainability. Cambridge Journals, Proceedings of the Nutrition Society
Whittingham K, Barnes S, Dawson J.  Methodological challenges of a mixed methods study with a complex carer population. Nurse Researcher

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Knowledge mobilisation can improve equality impact assessments

Acas (the UK advisory, conciliation and arbitration service) describes an equality impact assessment (EIA) as “a practical tool to identify discrimination.”  Its managers’ guide to EIAs describes how carrying out an EIA can identify and reduce unintended discrimination and promote equality by removing barriers and improving participation.

Yet all too often an equality impact assessment ends up being a bureaucratic, box-ticking exercise that doesn’t lead to any change.  A quick google search just took me to newspaper articles decrying the waste of tax payers’ money on bureaucratic nonsense and box ticking along with government briefing papers and Local Authority guidance documents which aim to ensure that EIAs are not just about ticking boxes.

So the danger that carrying out an equality impact assessment won’t actually lead to improved services and reduced inequalities is well recognised but, in my experience at least, support to actually do EIAs better is a bit thin on the ground.

That’s why we’ve just produced a briefing paper on how thinking about an equality impact assessment as a process of gathering together what we know to:

  1. Describe an inequality
  2. Understand why the inequality has happened
  3. Prescribe action to tackle that inequality.

The briefing paper shows how our Evidence and Ethnicity in Commissioning knowledge mobilisation tools can help to generate knowledge not only to describe an inequality but also to understand it and to identify effective interventions.  They can also help to ensure an appropriate range of stakeholders are involved.

Do have a look at the briefing paper and if you’re interested in discussing anything in it and in learning with me about how to better move knowledge about ethnicity and health to action, please join my new Community-of-Practice

So what exactly is knowledge mobilisation and how can it help to reduce ethnic health inequalities?

To put it simply, knowledge mobilisation is about closing the gap between what we know and what we do.  In a health context, it aims to make sure that research evidence and other types of knowledge lead to benefits for patients and populations.

In my last blog post I wrote about what I learnt from being involved in the Evidence and Ethnicity in Commissioning research project.  It became clear to me that evidence generated through academic research, about any subject, often doesn’t make any difference to policy or practice or if it does, it can take a very long time.  Other sorts of knowledge like the experiences of people using services or of the staff providing them is also often not used to develop and improve those services.

I particularly like this definition of knowledge mobilisation that was coined in Canada:

“a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the healthcare system.”

Over the last year, I’ve looked at lots of different ways of describing the knowledge mobilisation process and the one the works best for me at the moment is Ian Graham’s map.

Graham's map

A piece of knowledge is created using the funnel process shown in the middle of the diagram and then that knowledge is applied or moved into action. The action cycle is similar to the plan, do, study, act cycle that you might already be familiar with.  This diagram is taken from Ian Graham’s paper which describes and brings together developments in the field of knowledge mobilisation.

In the Evidence and Ethnicity in Commissioning research project we used our findings to identify the key barriers to moving knowledge about ethnicity and health into action and developed some tools to help overcome those barriers.  Some of the tools can be used in a training workshop or by a team carrying out service improvement or commissioning work.  Others can be used by a team or individual while they are doing the service improvement work.

The tools are all available on our EEiC website and link to the different stages ofknowledge mobilisation as in this diagram.

During my fellowship I am going to try out some of the tools in different contexts – more on that in future blog posts and do get in touch if you think any of the tools could be useful in your work.  I’m happy to discuss and help if I can.


By Lynne Carter, NIHR knowledge mobilisation research fellow, ScHARR

Previously published at Evidence and Ethnicity in Commissioning

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Congratulations to our summer 2016 PhD Graduates!

Five ScHARR PGR students graduated on Monday 18th July at a ceremony held in the University’s Octagon Centre. Our five graduates were:

Emily Wood PhD – A clinical replication series to investigate if EMDR has the potential to treat clients with long term depression, its acceptability to them and possible mechanisms of change

Sarah Smith PhD – Exploring the potential of touch-screen computer technology in promoting enjoyable activities for people living with dementia: A visual ethnography

Milad Karimi PhD – A mixed methods investigation of methods of valuing health: are preferences over health states matters of taste, complete, and informed?

In ScHARR, we are tremendously proud of the achievements of all our PhD students who have recently completed their degrees, five of whom attended today’s degree ceremony to celebrate.


Yagya Bhurtyal PhD – Effects of Male International Migration on Wives Left Behind in Nepal

Ros Haddrill PhD – Understanding delayed access to antenatal care: a qualitative study

Professor Petra Meier (ScHARR’s Director of Postgraduate Research) said, “Not only is a doctoral degree a great personal achievement that involves a fair amount of persistence and sacrifice, our newest alumni have between them contributed to impactful research on topics that range from the effects of international migration to the care for those with depression or dementia and from the valuation of health to access to antenatal services. Well done everyone, all the best for your next steps and we hope you stay in touch!”

Graduation July 2016

Pictured left to right are: Professor Mike Campbell (supervisor and former Chair of the Postgraduate Research Committee), Professor Jon Nicholl (Dean of ScHARR), Emily Wood PhD, Sarah Smith PhD, Milad Karimi PhD, Yagya Bhurtyal PhD, Professor Padam Simkhada (former member of ScHARR staff and supervisor), Professor Petra Meier (current Chair of the Postgraduate Research Committee) and Ros Haddrill PhD.

Well done to all our PhD graduates! To read more about PGR studies at ScHARR, click here.

Click here to watch a live stream of the University of Sheffield graduation ceremonies taking place this week.

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QALYS in public health: what are they?

The National Health Service (NHS), costs incurred by the health system and the need to undertake ‘cost-cutting’ in the NHS are frequent news stories… just currently over-shadowed by the EU referendum! Public health plays an obvious role in maintaining population health and reducing the demands on the health care system. But what evidence is required to support decision-making in the context of competing needs? Economic evaluation provides a framework to compare costs and effectiveness of different interventions in order to aid decision making.

The question then is how decision-makers compare outcomes from medical technologies with public health policies or interventions? The National Institute for Health and Care Excellence (NICE) recommends the use of the quality adjusted life year (QALY) as a key outcome measure in economic evaluations of public health interventions. Jurisdictions outside the UK will frequently report the disability adjusted life year (DALY) which is similar in some respects to the QALY. What is the QALY (or DALY) and why is it a useful measure?

Katherine Stevens, Clara Mukuria and other colleagues  in the Health Economics and Decision Science section of ScHARR have developed a free online course which outlines what the QALY is over 3 weeks from 11th July 2016. The course is an introductory level course that is suitable for anyone with an interest in public health. For more information and to register see: #FLValuingHealth #QALYs

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