Service evaluation: A grey area of research?

The National Health Service in the United Kingdom categorises research and research-like activities in five ways, such as 'service evaluation', 'clinical audit', 'surveillance', 'usual practice' and 'research'. Only activities classified as 'research' require review by the Research Ethics Committees. It is argued, in this position paper, that the current governance of research and research-like activities does not provide sufficient ethical oversight for projects classified as 'service evaluation'. The distinction between the categories of 'research' and 'service evaluation' can be a grey area. A considerable percentage of studies are considered as non-research and therefore not eligible to be reviewed by the Research Ethics Committee, which scrutinises research proposals rigorously to ensure they conform to established ethical standards, protecting research participants from harm, preserving their rights and providing reassurance to the public. This article explores the ethical discomfort potentially inherent in the activity currently labelled as 'service evaluation'.