Professor Fonagy is one of the key international figures in the evaluation of mental health interventions. He holds Chairs at UCL, Harvard, Yale and Baylor, and is a NIHR Senior Investigator. In the 1990’s, he co-led the NHS Review of Psychotherapies, evaluating all outcomes data which provided the basis for the radical policy change, Improved Access to evidence-based Psychological Therapies (IAPT), now an important part of the NHS mandate. The report ‘What Works for Whom’ has over 3,000 scholarly citations. Since 2010, he has led the Children and Young People’s Programme for IAPT and achieved a doubling of the Government’s financial commitment to this service transformation programme for CAMHS services to be restructured using evidence based, patient centred therapies. He is a key figure in developing NHS mental health strategy through NICE guidance and chaired the Depression in Children and Young People GDG and co-ordinated the prevention section of guidelines for Antisocial Personality Disorder and Conduct Disorder. He led the development of National Occupational Standards for Psychological Therapies and Chaired the Advisory Group leading to the introduction of routine outcomes assessment in mental health services (HoNOS). He served on several UK Government panels and on the Academic Advisory Board of the Presidential Commission on Violence Prevention, chaired panels at NIMH and the German Research Foundation, and was a UK representative on the Expert Psychological Panel of the European Science Foundation EIRH Programme. He is PI or co-PI on evaluation research programmes in excess of £15M, is Programme Director on the UCLP mental health programme and is leading the largest Clinical Psychology Department and training scheme in the UK, with 150 doctoral students.
Dr Werner Leber, an East London GP with a passion for driving earlier identification and diagnosis of HIV, has seen his work recognised by the European agency responsible for the continent’s defences against infectious disease – the European Centre for Disease Prevention and Control (ECDC).
Dr Leber (above) is a practising GP in Tower Hamlets as well as being an NIHR Clinical Lecturer in Primary Care. His work with the CLAHRC, based at the Queen Mary University of London, aims to improve the identification and management of people with HIV.
Werner’s research among East London’s GP practices will now have a Europe-wide impact after being highlighted as good practice by the ECDC in its first integrated European hepatitis B virus (HBV) hepatitis C virus (HCV) and HIV testing guidance. The trial is summarised on page 71 of the guidance.
“The results support the hypothesis that an education programme promoting rapid HIV testing in general practice leads to increased and earlier HIV diagnosis.”
Public health guidance on HIV, hepatitis B and C testing in the EU/EEA;
An integrated approach
European Centre for Disease Prevention and Control, 2018
The project consortium and a panel of experts highlighted work published by Dr Leber and his team – Promotion of rapid testing for HIV in primary care (RHIVA2): a cluster-randomised controlled trial as a case study to support the published evidence and advice for implementation for the new guidance.
Read the RHIVA2 case study as a stand-alone document.
In this trial in Hackney, general practices were randomly assigned to offer either opt-out rapid HIV testing to newly registering adults or continuing usual care. The study found that promotion of opt-out rapid testing in general practice led to an increased rate of diagnosis, and might increase early detection, of HIV.
In developing the guidance the ECDC looked for excellent examples of HBV, HCV and HIV testing services across EU/EEA Member States, reviewing the latest evidence and putting out two published calls for submissions of good practice.
Promotion of rapid testing for HIV in primary care (RHIVA2): a cluster-randomised controlled trial
Lancet HIV. 2015 Jun;2(6):e229-35. doi: 10.1016/S2352-3018(15)00059-4. Epub 2015 Apr 28.
Leber W, McMullen H, Anderson J, Marlin N, Santos AC, Bremner S, Boomla K, Kerry S, Millett D, Mguni S, Creighton S, Figueroa J, Ashcroft R, Hart G, Delpech V, Brown A,
Rooney G, Sampson M, Martineau A, Terris-Prestholt F, Griffiths C
Professor Kamaldeep Bhui is Professor of Cultural Psychiatry & Epidemiology at Queen Mary University of London and an Honorary Consultant Psychiatrist in East London Foundation Trust. He is an psychoanalytic psychotherapist. He is Editor of the British Journal of Psychiatry and the International Journal of Culture and Mental Health. Professor Bhui trained at University College London and at Guys and St Thomas’ qualifying in 1988. He proceeded to train in London, completing his higher psychiatric training by 1992, secured a Wellcome Training Fellowship to progress research and secured a first consultant appointment in 1999 followed by a Senior Lecturer and Professorial post at Queen Mary University of London in 2000 & 2003 respectively. His research and practice interests on health include social exclusion, work characteristics, cultural psychiatry, epidemiology, health services research and psychological therapies. He has undertaken original research with communities to understand this complex process called radicalisation and provides evidence on how it works and who is vulnerable.
Professor Bhui heads the Centre for Psychiatry at Barts & the London Medical School. He is also the Director of the Cultural Consultation Service (Culturalconsultation.org), Director of the QMUL MSc Programme, the co-founder of Careif (www.careif.org), an international mental health charity based in London that promotes work for young people and their health through culture, sport and arts and, more recently, the Director of the Synergi Collaborative Centre, a new initiative to transform ethnic inequalities in mental health services, (synergicollaborativecentre.co.uk).
In 2016 he received a CBE (Commander of the British Empire) in the Queen’s New Years’ Honours List for services to mental health care and research.
Healthcare systems around the world are becoming more concerned with strengthening board level governance of quality. In England, national healthcare regulators are developing approaches, resources and interventions aimed at supporting senior hospital leaders in their role in the governance of quality.
New CLAHRC research investigates the organisational response to an improvement intervention in six hospital boards across England. The research, published in a new BMJ paper and BITE-sized summary shows the results a 30-month period of fieldwork, involving interviewing NHS board members, observing board meetings and analysing relevant documentation.
The findings will be relevant to NHS Boards, the staff and clinicians they lead and all those in the NHS working to improve the quality and safety of care.
As well as researchers, the results will be of interest to policymakers, regulators, knowledge mobilisation organisations and thinkers on boards and leadership across all sectors.
Read the iQUASER paper
Explaining organisational responses to a board-level quality improvement intervention: findings from an evaluation in six providers in the English National Health Service
Background Healthcare systems worldwide are concerned with strengthening board-level governance of quality. We applied Lozeau, Langley and Denis’ typology (transformation, customisation, loose coupling and corruption) to describe and explain the organisational response to an improvement intervention in six hospital boards in England.
Read a BMJ editorial highlighting the paper as “an example of an empirical study that successfully enters into dialogue with management theory”
Repeated calls have been made for the increased use of theory in designing and evaluating improvement and implementation interventions.1-4 The benefits are argued to include identifying contextual influences on quality improvement (QI), supporting the generalisability of findings and anticipating how future phenomena might unfold.2 5 Most importantly, the ability of
Read our “need to know” summary
Within the UK, 32 out of every 10,000 children are living with a life-limiting condition or life-threatening illness (LLC/ LTI).
Research, from genetic studies to drug trials is vital to improving care for these children and their families, but the inclusion of this vulnerable population into research studies has been difficult.
Barriers to Research Access: Voices, Experiences, and Solutions (BRAVES) is a CLAHRC study focusing on improving access and participation in research for children and young people with LLC/LTI and their families.
A new BITE – a postcard “need to know” summary of our published research – shares the perceptions of clinicians and research leaders on their perceptions of the barriers preventing children and their families becoming involved in research.
The BRAVES team surveyed palliative care clinicians, often “gatekeepers” to children and their families getting involved in research asking them
‘In your experience, what have you found to be the biggest barriers to palliative care research with children?’
We also consulted Chief Investigators (CIs) – leaders of NIHR research studies involving CYP with LLC/LTI and their families. CI’s were invited to complete an anonymous, web-based questionnaire and three key barriers to research were emerged, alongside four potential solutions.
Dr Jessica Sheringham has research interests in questions that have an impact on reducing inequalities in healthcare and access to appropriate healthcare. Her research spans respiratory disease sexual health and cancer, using both qualitative and quantitative research methods. She is also an honorary consultant in public health at Barking & Dagenham, Havering and Redbridge Clinical Commissioning Groups.
Local research bodies join forces with patient partners to deliver an introduction to research
We ran our Becoming Research Active course on November 14th offering our partners in front-line care a primer in research and the research process.
CLAHRC North Thames Academy collaborated with other NIHR funded research organisations in the region – the
The day-long course is structured to reflect the research cycle – from defining a problem, through securing funding to dissemination and evaluation. Attendees, who came from across the NHS and local authorities were encouraged to bring a research idea they could develop over the course of the day.
“The course has provided me with lots of resources and a clearer sense of direction, which is what I hoped for.”
We joined forces with NIHR infrastructure across the North Thames region – the Research Design Service which provides support to those preparing research proposals for submission to peer-reviewed funding competitions for applied health or social care research; and the local Clinical Research Network which makes it possible for patients and health professionals across England to participate in clinical research studies.
The training aimed to highlight the processes involved in planning and carrying out successful research, in
We were also very fortunate to have some patients and members of the public bringing their unique lived experience – of working with researchers, leading research and being a clinical trial participant respectively to offer tips to attendees.
CLAHRC Research Advisory Panel member Ayath Ullah (below left) joined the CLAHRC’s involvement officer Steven Towndrow to offer a lay perspective on how researchers can make patient/public advisers welcome and valued.
One of the CRN’s Patient Research Ambassadors (PRAs) Phillip Wingfield spoke about his experience of taking part in two clinical trials, offering a perspective from a participants point of view.
We were also joined by community researchers Sultana and Farzana from the NEON project, where they have led research into improving nutrition practices among the Bangladeshi community in East London.
“Useful to have a range of speakers with varied experience. Great place to come prior to starting research.”
Researchers, staff and health professionals delivered a range of presentations with small group work and regular exercises to reinforce learning, and were on hand to facilitate each part of the day.
Feedback from attendees was overwhelmingly positive;
“Very useful and informative.”
“Lots of information to move forward my idea. Thank you very much.”
“A good overview of processes. Helpful to know all the help/support available.”
“Very well designed and delivered. It kept my attention throughout. The content/sessions were well balanced and provided me with the basis to build on”