Policies often fail to achieve their intentions. While much has been written about this, and how to avoid it, knowledge and insight is somewhat siloed. In collaboration with the Centre for Evidence and Implementation, we undertook a review to understand the latest thinking on the policy-implementation gap and identify how insights from implementation science can be integrated into policy work. We reviewed studies of policy implementation and policy resources that offer guidance for integrating an implementation focus into policy making and delivery.
To support the review we developed a framework, drawing on and adapting existing frameworks from the literature. Under this model, successful implementation depends on the interaction between the policy content (the ‘why’, ‘what’ and ‘how’ of the policy) and the implementation context (the social, cultural , political, economic infrastructure operating at different levels). This interaction is mediated by implementation strategies (specific measures that seek to embed or deliver policy) and implementation support approaches – activities identified through our review that help to ensure alignment of policy content with implementation context, mitigate barriers from misalignment, and leverage facilitators for implementation.
Our report describes seven implementation support approaches, and their role in reducing policy ambiguity and increasing alignment to context. It outlines how and when these can be employed to mitigate policy failure – and show that it is possible to make up ground or compensate later for approaches that were not employed sufficiently at earlier stages.