The movement to translate research evidence into healthcare policy and practice is well established [ 1, 2, 3]. Delays in the uptake of research evidence can prolong the provision of ineffective, low-value, and even potentially harmful healthcare interventions [ 4, 5]. In response, governments, organisations, and health professionals are increasingly expected to ensure policy, and practice is informed by high-quality, contemporaneous research. Implementation research has been promoted as one way to facilitate the translation of research into practice [ 6]. This developing field of research evaluates the success of strategies such as knowledge brokering [ 7, 8], algorithms [ 9], and multifaceted approaches [ 10, 11] for individual and organisational change. Health service researchers have increasingly recognised implementation research as a field of science [ 12], although the benefits of many implementation attempts remain unclear [ 7, 13]. Hearsay is not explicitly defined in the CJA but the opening words of s.114(1) taken together with s.115(3) effectively define it as a representation of fact or opinion made by a person, otherwise than in oral evidence in the proceedings in question, when tendered as evidence of any matter stated therein. Statement Article 6(3) (d) of the European Convention on Human Rights states that a person charged with a criminal offence has a right "to examine or have examined witnesses against him and to obtain the attendance and examination of witnesses on his behalf under the same conditions as witnesses against him". However, as decided by the Supreme Court in the case of Horncastle the safeguards built into existing English law (including those enacted in the CJA itself) are adequate to ensure that a defendant has a fair trial.

The witness making any statement which is admissible by reason of Sections 116,117,119 or 120 must have the capability to make the statement, i.e. he must be capable of understanding the questions put to them about matters stated and giving answers which can be understood: Section 123.Boström AM, Kajermo KN, Nordström G, Wallin L. Barriers to research utilization and research use among registered nurses working in the care of older people: does the BARRIERS scale discriminate between research users and non-research users on perceptions of barriers? Implement Sci. 2008;3:24. Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. Knowledge translation of research findings. Implement Sci. 2012;7:50. https://doi.org/10.1186/1748-5908-7-5016. A counterbalanced implementation study design provides a promising model for concurrently investigating the success of research implementation strategies across multiple health context areas such as community-acquired pneumonia and nutrition for critically ill patients.

All common law exceptions not explicitly preserved under section 118 are abolished. The remaining common law exceptions which are most likely to be encountered are as follows: Res GestaePrevious inconsistent statements made by a witness are admissible as evidence of the truth of the matters stated therein under this section. This changes the position at common law whereby an inconsistent statement could only go to the issue of the weight to be attached to the witness' oral evidence and was not evidence of the truth of its contents. Westfall J, Kenny DA, Judd CM. Statistical power and optimal design in experiments in which samples of participants respond to samples of stimuli. J Exp Psychol Gen. 2014;143(5):2020. Grol R, Wensing M. What drives change? Barriers to and incentives for achieving evidence-based practice. Med J Aust. 2004;180(6 Suppl):S57. evidence of any matter (with the court's leave) on which, had the witness been present and cross-examined, their answer in cross-examination would have been final;

There is no absolute principle that a conviction based solely or decisively on hearsay evidence is unfair as there are counter balancing measures in the hearsay framework of the CJA to make the trial fair ( R v Horncastle[2010] 2 AC 373 ). Despite the advantages to conducting a counterbalanced implementation trial presented, there are limitations to applying this study design in some circumstances. The main limitations identified and described below relate to the feasibility and potential sources of bias. FeasibilityGlasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322–7.

We recommend the selection of implementation strategies for examination that involve the application of an evidence-based framework, model, or theory [ 51]. Evaluation of implementation strategies can be aimed at describing the process of translating research into practice, understanding different variables which influence implementation outcomes, or examining strategy success depending on the overall aims of the study [ 52]. Process models such as the knowledge to action framework can specify the stages to guide the process of translating research into practice [ 53]. The Promoting Action on Research Implementation in Health Service (PARIHS) framework [ 54], theory of diffusion [ 55], and the Capability, Opportunity, Motivation, and Behaviour (COM-B) model [ 56] are all examples of understanding what influences implementation outcomes, where the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) model focuses on examining the implementation strategy success [ 57]. Once an overall theory is established, implementation strategies can then be tailored to the trial organisation or individuals, as studies have shown tailored strategies may be more effective than generic strategies [ 58, 59]. Beynon P, Chapoy C, Gaarder M, Masset E. What difference does a policy brief make?: Institute of Development Studies and 3ie; 2012.

A party may apply to the court to exclude the statement (and thereby require that the maker is called if it is to be relied upon by the expert) in the interests of justice. A non-exhaustive list of considerations for the court is set out at section 127(5). Confessions by co-accused Bohman TM, Kulkarni S, Waters V, Spence RT, Murphy-Smith M, McQueen K. Assessing health care organizations’ ability to implement screening, brief intervention, and referral to treatment. J Addict Med. 2008;2(3):151–7.