In 2013, the UK began a major reform to disability benefits affecting more than 1 in 20 people in the country. This reform replaced Disability Living Allowance (DLA) with Personal Independence Payments (PIP). Like DLA, PIP is a benefit meant to help with costs associated with severe health conditions or disability. However, PIP is more stringent in terms of assessment and subsequent re-assessment of eligibility. The effect of this greater stringency on physical and mental health, owing to increased stress and anxiety within a vulnerable population, is unknown. We will estimate the impact on mortality and on mental health, across different types of claimants and we will explore the mechanisms that drive this. Our project will provide credible quantitative evidence on this spillover from economic policy to population health that could improve decision-making by policy makers. The challenge addressed: what and how? A simple comparison of people claiming PIP and people claiming DLA would not reveal the causal effect of greater stringency on health and mental health. This is because there are underlying differences between the types of people who claim each benefit. Similarly, a before and after comparison of people moving from DLA to PIP would not reveal the causal effect, because there have been other determinants of physical and mental health that have changed over time since 2013. However, it is causal effects that we need to estimate in order to evaluate this reform and to provide an evidence base for future reforms. From October 2015, most existing DLA claimants with indefinite awards and without changes in circumstances were contacted by the DWP and instructed to apply for PIP. However, those recipients born before 8th April 1948 were exempted from the requirement to apply for PIP and could continue claiming DLA indefinitely. This decision generates a sharp jump in the likelihood of moving from DLA to PIP between people with very similar dates of birth who should otherwise be similar to each other. Our project will use this policy-induced jump in a Regression Discontinuity Design (RDD), a credible and widely used technique in applied econometrics, to identify the causal effect of the reform. Aims and objectives It has now been 10 years since the transition from DLA to PIP began, but this potentially impactful reform has yet to be rigorously quantitatively evaluated. Beyond providing the first attempt to do this, we will advance understanding of the determinants of mental health in this vulnerable population. We will uncover the impact that economic insecurity has on health outcomes. The findings of our project will form the basis of at least three peer-reviewed journal articles that will be widely disseminated to academic and non-academic audiences, international conference presentations, policy briefs and blogs. Potential applications and benefits Disability benefit reform is a contentious issue and an active area of policy debate within the UK and internationally. Current reforms to disability benefit in Scotland, for example, are a partial unwinding of the reform that we are studying in this project. Our results can inform likely effects of such a policy among the elderly. In addition, evidence on the impact of economic insecurity on mental health, more generally, is of interest because of policy debates in the NHS regarding waiting times, health inequalities and the challenges associated with an ageing population.

Public-private partnerships and contracted delivery arrangements for public services are ubiquitous across developed economies and yet their performance and value are increasingly questioned. High-profile failures, inefficiencies, and scandals - from the collapse of Carillion to the recent Post Office horror - highlight the need for new public contracting practices. Traditional contracting methods, focused on simple, adversarial transactions and short-term goals, are ill-equipped to address the complex, interconnected challenges faced by society, and thus fail service users, commissioners and taxpayers. This Future Leaders Fellowship Renewal advances a new form of public-private partnership that is accountable to citizens, adaptive to volatile conditions and social challenges, and purposeful in the way partners overcome barriers together. The Fellowship and Renewal pursue three objectives: 1. Advance pioneering scholarship that responds to the limited availability of cross-disciplinary studies to offer insights on alternative public contracting models. This is evidenced by high impact journal publications and a forthcoming monograph with Oxford University Press. The Fellow seeks to overcome limitations in comparative analysis by nurturing a data collaborative and pioneering open shared datasets. 2. Build bridges to impact with policymakers in central government, and practice-leads in local government by improving public service stewardship and complex contracting practice. The Fellow is recognised as one of Apolitical's 100 Most Influential Academics in Government and has presented work at Number 10 Downing Street to the Prime Minister's Policy Team. The Renewal seeks to overcome technical and cultural barriers to new forms of public contracting by advancing an executive education programme: 'Leading Cross-Sector Partnerships'. This is being piloted with 15 senior civil servants in 2024. This executive programme has the potential to sensitise officials to contracting approaches that move beyond the status quo and cultivate communities of practice. 3. Champion bold, problem-focused and discipline-spanning scholarly leadership at the intersection of complex market stewardship, contracting and frontline practice. The Fellow serves as co-Director of the Government Outcomes Lab and aims to influence both academic and policy realms bringing about outstanding research but also ensuring that this supports innovation in complex public service arrangements. The Renewal brings the opportunity to extend the Fellow's already vibrant publication record and emergent scholarly leadership. The Fellow has secured additional research grants yet these are narrow and fragmented. The Renewal brings the longevity and flexibility needed to braid together intellectual developments and invest in developing skills to manage a larger research centre. The host institution - the Blavatnik School of Government at the University of Oxford - offers strong and substantive endorsement of the Fellowship. Here Dr Carter and her current team at the Government Outcomes Lab are expected to be vital to the School's hub of expertise in public service excellence.

The use of market-inspired instruments for steering public service delivery has become ubiquitous across developed economies and yet the experience with contracting for complex services suggests that we are still in the steep portion of the learning curve on how to do this well. Under such approaches there are pervasive risks of wholesale market failure (as seen in the case of Carillion) as well as market malfunctioning, experienced in the repeatedly poor performance of more complex, cross-cutting public service delivery. The primary government response to this outsourcing dilemma acknowledges that large amounts of tax-payers' money will continue to be channelled through private sector and voluntary sector providers and offers recommendations for tightening up market stewardship and contract terms. This return - to what has elsewhere been described as a "byzantine tower of rules and regulations" (Brown et al., 2018, p. 740) - fails to connect with the latest empirical contracting practice from the private sector (as illustrated through emergent 'formal relational contracting' practice) or from smaller local experiments with networked governance arrangements (for example, City Region-level coordination via integration boards with prime 'outcome' contracts (Whitworth & Carter, 2018) and local authorities' use of social impact bonds). This Fellowship seeks to deploy a novel selection of research methods to identify and inform alternative governance and contracting practices that may be deployed to more effectively and efficiently coordinate service provision. The proposed project aims to investigate alternative commissioning approaches available when there is an ambition to foster collaboration and collective accountability across an interwoven network of provider organisations. The animating research question asks: How can government better steward complex networks of service provision to more holistically and better support citizens with complex lives and who currently interact with a range of public service actors? Crucially, the way the quasi-market and contracts are structured will have important implications for attuning the attentiveness of service providers to the priorities of either the state, service users, or providers themselves. This in turn is expected to have important implications for the quantity, cost, quality, distribution and cohesiveness of services and consequently on the lived experience and 'outcomes' of citizens engaged in social programmes. This ambitious, discipline-spanning Fellowship proposal seeks to entwine theoretical developments at the interface of public administration, applied economics and social policy, with empirical work facilitated through collaboration with two British central Government departments. Partnership with the Department for Work and Pensions and the Government Inclusive Economy Unit within the Department for Digital, Culture, Media & Sport will elevate research impact and substantively enhance our understanding of the key mechanisms for successful public service contracting and stewardship. The planned Fellowship brings the opportunity to extend the applicant's already vibrant publication record and emergent scholarly leadership. The host institution - the Blavatnik School of Government at the University of Oxford - offers strong and substantive endorsement of the Fellowship. Here Dr Carter and her current team at the Government Outcomes Lab are expected to be vital to the School's future hub of expertise in public service excellence. Crucially, the UKRI Future Leaders Fellowship brings the opportunity for Dr Carter to carve time to further develop an independent academic identity. The duration and explicit emphasis on the development of leadership potential make this Fellowship the ideal scheme for Dr Carter to bolster the intellectual underpinning of this emergent field at the intersection of social policy and public management.

(i) Aims and objectives Pain that lasts a long time (is chronic) takes apart lives, relationships and families. Although biological signals can help understand why pain happens, they do not fully account for the experiences people have, or why pain develops the way it does. Psychological and social factors, such as thoughts and feelings, personal relationships, and lifestyle, can also affect chronic pain. However, we do not yet know which of these psychological and social mechanisms are most important, or how they combine with biological signals to affect chronic pain. Our aim is to determine the psychosocial mechanisms underpinning chronic pain. Our objective is to create a clearer account of how, and in what way, psychosocial factors (interacting with biology) affect pain: what makes chronic pain start, keep going, get better or get worse. In doing so, we will also identify ways to prevent chronic pain from happening, and reduce the negative effects that pain can have on people's lives. (ii) Data to be collected We will focus on how people think and feel about pain, how others affect their pain, and consider the wider social and environmental influences on pain. These psychosocial mechanisms will in turn be described in the context of physiological and biomedical dimensions of chronic pain. Our planned work involves people with pain at each stage to ensure our work is guided by the way pain affects people's lives. We will start by exploring the existing evidence, to identify what matters most, including what measures and methods best reflect lived experience. We will ask people with pain which of these factors matter most, and test them in existing large datasets. We will run new studies on the psychological and social factors that hold greatest promise. We will explore how the way people think and behave contributes to pain, and observe how people live their lives with pain. We will study the ways people adapt to live well with pain, and identify the part played in chronic pain by the factors we are interested in. (iii) Benefits of the consortium A consortium approach allows us to think big. It gives us a rare opportunity to change how we think about pain and how we research it. To achieve these ambitious goals, we need to bring together expertise from different scientific disciplines, alongside people with pain, and in a way that has not previously been possible. The Advanced Pain Discovery Platform (APDP) not only allows us to do this, but also offers us an unprecedented prospect of working consistently at a conceptual level, to generate data and test ideas. It also allows for cross-consortium working, to stimulate and evaluate new ideas and spot opportunities for future pain research and discovery. (iv) Legacy and/or sustainability of the network Our primary contribution will be to identify the psychological and social factors that are most important for understanding pain. We will develop new ways to study pain, new measures of pain and its impacts, and most importantly identify key psychosocial mechanisms of pain, showing how they work alongside biology to promote or limit pain. We will provide guidance about these psychosocial mechanisms, and place this resource within the APDP, for use by the wider interdisciplinary pain research community, including those who wish to incorporate psychosocial factors in medical-epidemiological, clinical, or human genotyping studies. Through our work, and the partnerships that generated it, we will open new, broad avenues of pain research that will develop better ways to help people to live well with less pain.

Our project will examine a crucial question for ageing societies: how inequalities across the life course relate to paid work in later life in the UK. This issue is of growing importance since the UK, in common with many other governments across the world, is rapidly extending the working lives of older adults through the postponement of State Pension Age (SPA) and other measures. These policy reforms affect millions of people, yet their implications for health and wellbeing are unknown. Do these policies harm, benefit or have little effect on the population? To answer this, we need to understand the lifelong drivers affecting the complex relationship between paid work in later life, health and wellbeing. Our project extends an existing UK-Canadian collaboration that is examining lifecourse influences on later life work trajectories and their implications for health and wellbeing across five countries (including the UK). We will build on this work to address the implications for health and wellbeing of undertaking paid work up to and beyond SPA in the UK. This is important because comprehending what distinguishes those who work beyond SPA from those who retire at or before SPA is key to understanding the extent to which there is scope to extend SPA without exacerbating social inequalities. In industrial societies, near universal retirement from paid labour linked to the provision of state pensions has been heralded as a significant advance in older people's wellbeing. It is increasingly clear, however, that as longevity increases social welfare systems face significant fiscal challenges. In response, many countries, including the UK, have implemented retirement reforms such as abolishing mandatory retirement and raising state pension ages. These changes have fostered tension between the desire by individuals for a funded retirement at the normative age (e.g. 60 or 65) and the perceived economic need for populations to work longer in the context of societal ageing. Moreover, there is increasing concern that these policies may have disparate effects on different segments of society. However, most prior research in this area has focused on the effect of early retirement on health. We already know something of the characteristics of those who retire early and those who work beyond SPA. For instance, in Britain, ill-health and disability are the most important reasons for early retirement. Those who work beyond SPA are more likely to be better educated, in good health and have a partner in paid work but they are also more likely to be self-employed, to work part-time and, among women, to be in low skill jobs. However, to our best knowledge, nobody has addressed the consequences for health and wellbeing of working up to or beyond SPA. We also know little about the life course trajectories that influence who works up to or beyond SPA; or how they shape the relationships between later life work and health or economic resources. There is also little understanding of the underlying biological mechanisms that might link paid work and physical and psychological health outcomes. Last, by defining how the relationship between SPA and health has changed over time, and across cohorts, we will be better placed to inform debate on the potential impact of future policy decisions. Understanding these issues is critical to the development of policy that minimizes how inequalities may be perpetuated through the lifecourse. Our interdisciplinary team will tackle these issues in projects that cover three major areas: i) a comprehensive assessment of the lifecourse determinants and consequences for health and wellbeing of working up to and beyond SPA; ii) an evaluation of whether (and how) these relationships have changed for different cohorts and over time; and iii) modelling of the financial consequences of working up to and beyond SPA for those with different lifecourse trajectories.