CLAHRC Director Professor Rosalind Raine has been invited to be part of a major new independent inquiry considering the future of the NHS.
Professor Raine joins the Future of the NHS Commission which launched on November 30th and is organised by the London School of Economics and The Lancet. It will investigate and report on options for relieving the growing pressures on the system and ensuring that the service has governance, care, operating, and funding models fit-for-purpose in the 21st Century.
Professor Raine will draw on her expertise in evaluations of NHS interventions and research experience in inequalities in the distribution of health care, its causes, impact on health inequalities and policy responses. She has long advised national, international and regional policy makers, her research being highly valued due to its diversity (spans acute & chronic conditions and all NHS settings), representativeness (national datasets, long time periods) and applied nature, allowing direct policy translation.
Calls for a rational, considered view of the NHS have come from across the political spectrum (see below) and the Commission will draw on a range of views and perspectives in its work. In April 2017 The Lancet argued that “An independent inquiry is needed to bring together clinical and policy experts, and the voices of the public and patients, to answer the question: what sort of NHS do we want and need in 2020, 2025, and 2030?”
Brian Turley Awards for Patient and Carer Involvement
Collaboration for Leadership and Applied Health Research and Care Programmes in London
Based at St Mary’s Hospital in Paddington, the PREPARE team, is a programme for patients undergoing oesophago-gastric surgery that aims to improve their surgical outcomes by improving their physical and mental well-being prior to and after their surgery. Each patient receives a personalised programme to match their individual needs, abilities and goals.
The programme provides coaching and tailored support in the areas of:
- Physical fitness
- Respiratory exercises
- Eating well
- Psychological wellbeing
- Asking about medications
- Removing bad habits
- Enhancing recovery
Patients are involved at a strategic level in the development of the PREPARE programme, working with the clinical team to co-design the structure and goals through formal workshops and informal interactions.
An example of meaningful outcomes from patient involvement include the creation of a training clinic 1-2 weeks prior to surgery to teach patients and their carers on home jejunostomy feeds. This replaced post-surgery in-hospital training which patients described as too intimidating and did not involve carers. Patients’ views have also contributed plans to develop a PREPARE centre where the whole programme can be delivered and patients can benefit from peer-to-peer support.
On announcing the award winners the judges said: “This is a superb example of integrated, meaningful, well planned patient involvement which is central to the project. While PPI is often an added afterthought to projects, collaboration with patients is at the heart of PREPARE”
CLAHRC behaviour change researchers and PhDs Caroline Katzer and Marissa Mes were a big hit at the recent in ESPACOMP conference in Budapest Hungary. Caroline and Marissa presented to an audience of clinicians and allied health professionals interested in adherence
ESPACOMP (European Society for Patient Adherence, COMpliance and Persistence) promotes science concerned with the assessment of what patients do with medicines they have been prescribed – and the implications when they adhere, or don’t adhere to them. Their 2017 conference brought together behaviour change practitioners and researchers from across the world and both Marissa and Caroline’s presentation generated much interest and a host of questions from the audience.
Both Caroline and Marissa are conducting their PhDs as as part of our wider work examining the effectiveness of the ‘Perceptions and Practicalities Intervention’ (PAPI) in improving adherence to asthma medication.
Marissa (above) is investigating the effectiveness of pharmacists as the delivery channel of a theory-based intervention to support medication adherence in adults with asthma.
Caroline is focusing her PhD on developing the PAPI intervention to support adherence to maintenance treatment in adult asthma patients.
Both fielded questions from pharmacists interested in how their research/academic findings were going to be translated into pharmacy practice, and how feasible this would be.
Three CLAHRC researchers were among those presenting their work at the Lancet’s prestigious event Public Health Science: A National Conference Dedicated to New Research in UK Public Health held in London on November 24th.
Each of the CLAHRC’s researchers presented a poster about their work, and the topics highlight the breadth of our research. Their abstracts are now published in a special edition of the journal.
Dr Chiara De Poli presented projections of the likely impact of the various interventions currently being used to prevent diabetes across England.
Dr Esther Kwong presented her work exploring the potential for patient reported outcomes measures (PROMs) – patient questionnaires used to measure measures health gain in patients undergoing a number of surgeries – to be used when patients were admitted as an emergency.
Jennifer Martin presented her work on participatory learning and action cycle in resource-limited settings.
Impact of interventions to prevent diabetes in England: a simulation model
De Poli, Chiara et al.
The Lancet , Volume 390 , S36
Can patient reported outcomes measures (PROMs) be used in emergency admissions? Comparison of retrospective and contemporaneous PROMs after hip and knee replacement: a cohort study
Kwong, Esther et al.
The Lancet , Volume 390 , S55
Adaptations to the participatory learning and action cycle in resource-limited settings: an observational study
Martin, Jennifer S et al.
The Lancet , Volume 390 , S63
A new Government green paper offers good news for those calling for joined up care between schools and local mental health services for children and young people.
Health economics and economic evaluations of care are a key theme within our CLAHRC, and the subject of one of our successful Academy short course for front-line NHS and Public health professionals.
CLAHRC researcher and health economist Dr Elena Pizzo gave a lecture at the Royal Society of Medicines September event – the ‘4th breast cancer forum: screening, metastatic breast cancer and living with and beyond‘
This is now available to view via this link or clicking on the image below
Dr Pizzo’s presentation examined how money is best spent in patient treatment. Elena considered the average cost of breast cancer care per patient and outlines the challenges faced by health professionals and economists when deciding how treatment funding is allocated.
Dr Pizzo made a plea for health professionals, policy makers, industry and patients to work closely with health economists when making difficult decisions about where to allocate resources. In this case the topic was cancer but the message applies equally to many other specialties when NHS budgets are under pressure.
Decision-makers in public health can be confronted with a huge volume of data, evidence, reviews and summaries – from local and national sources. There is also an acknowledged gap between evidence and policy in public health.
In a recent blog on the EPPI centre website CLAHRC researchers Dylan Kneale and Antonio Rojas-García reflect on their work exploring the use of evidence in local public health decision-making – and raise the question – How much research is being wasted because it is not generalisable in local settings?
While reduced resources make judicious use of evidence more important than ever when deciding how and where to apply resources, researchers also need to understand, and better communicate, the generalisability of their research evidence to decision-makers working locally.