The NHS generates huge amounts of data but using it to track patient flow and pathways of care requires sophisticated mathematical modelling. CLAHRC PhD student, Ryan Palmer, is “embedded” within one of our partner organisations – North East London Foundation Trust (NELFT) – where part of his work involves offering support and guidance to managers and staff interested in getting the most out of the data they routinely collect.
An example of Ryan’s visualisation of referral patterns between hospital and community services in a busy NHS Trust.
Ryan ran a successful workshop hosted by our research partners NELFT training healthcare professionals how to use network mapping methods for understanding referral data in community healthcare. Care leads who attended came from a range of healthcare disciplines and services, including paediatrics, adult physical health, mental health services and social care.
The two-hour session involved: how to prepare data, how to create network diagrams and the beginnings of discussions as to how these methods may be used to inform service planning. Interest was generated during the session, with many realising the benefits of these methods.
Visualising referral data helps researchers and care managers to work together and understand otherwise overwhelming and hard to interpret data for complex systems. These network maps highlight important characteristics of referral activity and can help identify services that exhibit interesting dynamics. Sharing this work with healthcare professionals, they helped to stimulate further conversations around the analysis and organisation of referrals in community healthcare services.
Our collaborators are currently seeking to implement a single point access (SPA) for older adult community services. This session formed part of the ongoing work with our collaborators to help inform their thinking in designing this SPA.
Palliative care for children and young people with life-limiting conditions and life-threatening illnesses is a relatively new discipline, and one where current practice in services has developed beyond the evidence base available. Barriers to conducting research in this area are numerous, and span the entire length of the research process.
CLAHRC researchers from the BRAVES project, based at the Louis Dundas Centre, are working to identify these barriers to recruiting children with life-limiting conditions to research, and to develop solutions.
“Establishing robust evidence is going to require concerted effort on everyone’s part: clinicians, parents, patients, and researchers.”
Professor Myra Bluebond-Langner, principal investigator on the BRAVES project, has recently recorded a podcast with the journal Palliative Medicine, discussing the need for an increased understanding of barriers to research in paediatric palliative care, findings from the project so far, and outlining the future research planned by the team.
Initial findings from the study, and previous work at the Louis Dundas Centre, have suggested that fundamental barriers exist at both the individual level, e.g. clinicians’ attitudes to involving young people in research, as well as at the institutional level, e.g. ethics committees and resource constraints, even though children and young people want to participate in research.
“So, why, if we no longer accept paternalism in clinical practice, are we willing to accept it, indeed demur to it, in research practice?
The overall goal of the BRAVES project is to develop guidance based on the experience of all stakeholders, which in turn will help to develop the evidence base in the field of paediatric palliative care.
Based on the findings outlined in the podcast, the research team has since conducted a study investigating the experiences and difficulties of chief investigators recruiting children and young people with life-limiting conditions and life-threatening illnesses to research. The findings from this study are expected to be published soon. The next step for the CLAHRC researchers is to analyse data collected from a nationwide research groups’ applications to Research Ethics Committees, and to interview members of these committees to develop further insights.
Click here to read the journal article on which this podcast is based.
A new CLAHRC publication offers valuable insight into the types of evidence used by decision-makers working in public health. In 2013, responsibility for public health services and planning shifted from the “health” boundary to local authority control. These services can range from health checks to open access sexual health.
CLAHRC researchers examined English local public health decision-making in a new review of what evidence is used and how by those planning, designing and commissioning services.
The review, published in a new paper in the Journal Implementation Science identifies three clear trends in evidence use
- the primacy of local evidence
- the important role of local experts in providing evidence and knowledge, and
- the high value placed on local evaluation evidence despite the varying methodological rigour.
Barriers to the use of research evidence included issues around access and availability of applicable research evidence, and indications that the use of evidence could be perceived as a bureaucratic process.
This is part of a wider project entitled Exploring decision-making processes and knowledge requirements in public health
Read the full paper
Kneale et al. Implementation Science (2017) 12:53
The use of evidence in English local public health decision-making: a systematic scoping review