Identification of patient safety indicators spanning primary and secondary care and development of a framework to guide safety monitoring

Department Name:
London School of Hygiene & Tropical Medicine, Department Health Services Research & Policy.

Supervisors names and email addresses:

1) Dr Helen Hogan  (
2) Dr Yogini Jani  (
3) Dr John Robson (

Funding Status:
Directly Funded Project (UK and EU Students Only)

Stipend: £17,803

Application Deadline: 19 April 2020

Interview date: 5 May 2020

3 years, full time

Project Description:

Digital Integrated Care Records that span the health economy have the potential to benefit patients and clinicians by enabling safer, more joined-up care through the sharing of comprehensive clinical information. There is an opportunity to use these data to improve patient safety. This approach fits well with the new models for monitoring and investigating safety issues that move away from single organisation incident collection and investigation to the more patient/ user-centric assessment of safety over time and across organisations.

There have been advances in the development of approaches to assessing patient safety in primary care (RCGP Patient Safety Toolkit) following the initial progress made in secondary care but the challenge remains as to how to join up approaches to get a better view of safety for individuals and specific groups of patients across the health and care system. Focusing on patients prescribed anti-coagulants, a family of medicines carrying a well-known risk of patient harm, this study aims to identify patient safety indicators that span community, primary and secondary care, which could be collected from a digital integrated care record. It will identify where gaps lie and some of the challenges to data collection. The findings will be used to develop a framework to guide the monitoring of the safety of patient care across organisations and time.

Patient safety indicators will be identified through a range of approaches along with the identification of measurement gaps where new indicators could be applied. The literature will be reviewed to determine the nature of incidents associated with anticoagulants reported from different organisations (primary, secondary, care sector) across the health economy, particularly those that arise at organisational interfaces. This will be supplemented with a review of national patient safety incident data and national recommended quality measures for patients with conditions that require anticoagulant treatment.

A case study will be undertaken in one locality with a digital integrated (community, primary and secondary care) record to map measures of safety followed by a structured prospective risk analysis of patient care pathways e.g. Failure Mode and Effects Analysis to develop potential indicators for future risk (leading indicators) that complement indicators of actual harm or non-compliance (lagging indicators). In addition, case scenarios developed from the national incident data will be used to identify phases of care that are high risk for harm.

Project-specific skills and experience required:

All candidates should hold a Master’s qualification (or complete their Master’s by September 2020) in an appropriate discipline and have a minimum of a 2:1 or equivalent in their first degree. Applicants should preferably have knowledge of the UK health and care system. All applicants are required to have excellent written and verbal communication skills. They should also be willing to work collaboratively in multi-disciplinary and multi-professional teams.

Enquiries email name and address:

Professor Helen Hogan (

Training opportunities
PhD students will be entitled to the full range of PhD training opportunities at their host institution. In addition, all PhD students will benefit from the training provided by the NIHR ARC North Thames Academy (The Academy). The Academy brings together PhD students from across ARC North Thames, to create a community of students training in applied health research. The Academy works alongside each host institution’s graduate training programme to equip students with the skills needed to work at the interface of academia and health services.

Our doctoral programme focuses on practical aspects of applied health research, such as the skills required to undertake research in health care and public health settings, to engage patients and the public in research, and to navigate relevant ethical and research governance approval systems. In addition, we aim to provide students with an understanding of how their work fits into current NHS structures and applied public health research environments. PhD students will be expected to attend and present at scientific meetings aimed at disseminating the findings of ARC research.

Publication and wider dissemination:
It is expected that results of the PhD research will be publishable in good quality, peer-reviewed academic journals and communicated at conferences. The research would also be expected to generate outputs tailored to applied health research, public health practitioner, and policy-making audiences.

Candidates should hold a Master’s qualification in a relevant discipline (or complete their Master’s by September 2020) and have a minimum of a 2:1 or equivalent in their first degree. Applicants should preferably have knowledge of the UK health and care system. All applicants require excellent written and verbal communication skills and should be willing to work collaboratively in multi-disciplinary and multi-professional teams.
Due to funding restrictions, applicants must be UK/EU nationals. Please refer to UK Council for International Student Affairs (UKCISA) for the criteria.

How to apply
If you have queries about potential projects or would like to discuss these in more detail, please contact the appropriate supervisors by email. In case of any difficulties in making contact, please email 

Your application should consist of:

  • A CV (to include qualifications, work experience, publications, presentations and prizes) plus contact details of two academic referees (references will be taken up for all shortlisted candidates).
  • A personal statement (300 words) describing your suitability for the proposed project including how your research experience, skills and interests relate to the topic.
  • A 1-page proposal of how you would develop the PhD project that you are applying for.

Please send your application to