From Evidence Use to Evidencing Work: Towards a Processual View of the Role of Evidence in Commissioning Policy-Making

Evidence cannot directly lead decision-makers as evidence is not found, rather, it is assembled (“constituted”) locally through an observable negotiated social process. Evidence is thus an outcome; it is always the result of the collective work entailed in its production and use, work that we refer to as ‘evidencing work’. Adopting a processual view, in the chapter we start to unpack and make visible the evidencing work that goes into turning evidential information into evidence using illustrative data from Clinical Commissioning Groups in the UK. In doing so, we argue that much can be gained if we shift from treating evidence as an entity towards evidencing as the giving of evidential value to information in the clinical decision-making process. This has implications evidence-based health care policy and management in terms of the role that evidencing plays in the decision-making process.