Author: CLAHRC

Samantha Machen

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Samantha completed an undergraduate Masters of Nursing Science (MNurSci) degree at the University of Nottingham before working as qualified Intensive Care nurse at the East Midlands Major Trauma Centre in Nottingham. She later completed a MSc at The London School of Economics and Political Science in International Health Policy before joining UCL for her PhD. Her research interests include patient safety, specifically avoidable harm, quality improvement and the role of external and internal governance systems- having previously worked with the Care Quality Commission as an Inspector of NHS Trusts in the UK.

Project Summary

This PhD aims to carry out observational research on wards to ascertain the attitudes and cultures of safety in regards to medicines safety. The methods will be ethnographic in nature, involving spending an extended period of time in each clinical setting to acquire a detailed understanding of the tacit conventions and social relations practiced within and between different professional communities that constitute different ‘safety cultures’. In each setting, non-participant observations and formal and informal interviews will be used to study the everyday practice of medication safety and develop ideas for the intervention in consultation with healthcare professionals. Different settings within the hospital will be studied (for example surgery, admissions areas and intensive care) to ascertain the importance of ward culture upon safety cultures and medicines safety.

Reaching out to COPD sufferers – patient experience and priorities

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A project under our Innovations in systems and models of health and health care theme is looking at the effectiveness of interventions in general practice to manage one of the UK’s biggest long-term conditions – chronic obstructive pulmonary disease (COPD).

The Innovations to improve pathway for people with COPD project is evaluating what works to better manage this respiratory condition. The team are measuring whether a variety of interventions will make GPs’ management of patients with the condition more effective and efficient in the long-term.

As part of our engagement with patients the project’s Senior Research Associate and Research Associate visited Havering Breathe Easy Group. The Breathe Easy network provides support and information for people living with a lung condition, and those looking after them.

As well as getting insight on living with COPD and variations in service patients’ can experience,  researchers wanted to get a feel for what aspects of GP care were most important to patients’ health and quality of life.

We asked patients to identify what they thought were the most important interventions general practices provided to support COPD sufferers.

Our choices were based on a list of activities that the National Institute for Health and Care Excellence (NICE) – the independent organisation which decides which drugs and treatments are available on the NHS in England and Wales – has recommended should be delivered as part of COPD care from general practice.

What GP service patients valued most

What GP services patients valued least

Annual reviews with their GP

Smoking cessation advice

Pulmonary rehab (exercise and education and to manage their condition)

Spirometry Testing/Diagnosis (to diagnose a condition and monitor lung function)

Rescue Packs (of emergency medicines)

Medication/Inhalers

Self-management of care

Vaccination


How this will help our research

  • If we need to decide what weight we give to different outcomes, patients’ views of their relative importance could be one factor we consider.
  • Whether the measures we are using in our research are the ones patients consider most important
  • Patients’ views will provide useful pointers and questions for interviews with general practice staff that are part of our research

Dr Natalia Lewis

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Dr Natalia Lewis is a Research Fellow at the Centre for Primary Care and Public Health, QMUL. She was trained as a physician and completed her PhD at the North-Western State Medical University, Russian Federation, investigating prevalence and associations of domestic violence and abuse among women patients attending Russian general practice. Her post-doc projects included longitudinal analysis of HPA axis functioning in abused women (CEASE study), evaluation of a training intervention for general practice on domestic violence and child safeguarding (RESPONDS study) and review of grey literature on interventions for children exposed to domestic violence and abuse (IMPROVE study). She is a member of the IRIS/ CLAHRC research team working on post-implementation evaluation of IRIS intervention in five northeast London boroughs (https://www.clahrc-norththames.nihr.ac.uk/iris/).