Below is a link to the latest published editorial in Family Practice, including parts of my work on primary care diversity data and its challenges. Many thanks to Carolyn Tarrant and Emma Angell.
I presented on the topic of “non-clinical patient needs: mapping diversity in primary care”. Department of Health guidelines continue to emphasise the importance of seeing the patients as customers to a service, listening to them and catering to their requirements. For this to be done effectively within primary care organisations, they will need to have certain knowledge about their patients’ characteristics. There has been on-going interest to reduce health inequalities through using data intelligently, but less focus had been placed on non-clinical data (e.g. age, sex, spoken language, ethnicity, employment status, learning difficulties, visual impairments etc.) and the inequalities to health that arise through patient cohorts with these diversity characteristics. The annual GP surveys have reported a trend in certain patient cohorts who continually report back as being ‘underserved’. Therefore the idea of mapping out a practice’s population based on these needs may help a practice decide how best to allocate their resources (staff time and practice money) to reduce these inequalities. This could reduce inefficiencies in service provision by moving away from a ‘one size fits all’ even spread of services, or allocating services in an ad hoc fashion (as revealed through my interviews with practice staff), to making informed decisions based on real data. It is also key to think about these issues as we move to having Clinical Commissioning Groups or CCG’s nationally. Such data may lead to the smarter commissioning of services.
The annual CLAHRC team-building day took place last week and was attended by both researchers and administrative staff members working within the collaboration. The task this year was for each team to plan, record, edit and present a video production of a five minutes based on an aspect of the CLAHRC of their choosing. The judges of the videos were part of Patient Public Involvement (PPI) groups within the area (PPI’s are open for all patients or members of the general public who are interested in health research, providing them with a platform to voice their opinions on the health services within their locality). As the judges were not health researchers themselves, it was important for all teams to communicate their ideas clearly and effectively. I’d say that the greatest challenge was the actual creation of a video from storyboard to screening in the space of a few hours, with so many team ideas to choose from and work into the final production. The idea that my team decided on was related to the importance of transferring health research into practice, communicating the value of CLAHRC-influenced health interventions to the patients. The judges were thoroughly impressed by all efforts but there could only be one winner! Many thanks to Kevin Quigley, Adelle Horobin, and Shona Aggrawal for their ideas and expertise which made the video the product of a great team effort.
I have now visited two primary care organisations for interviews with health professionals and practice staff at each site. I would say that the interviewing experience and the data collected have both been interesting in their own way. The interviews have shed light on the practices’ procedures when it comes to recording non-clinical patient information on each patient record and I look forward to analysing the responses. One thing I have noticed is just how immensely busy some health professionals are! Although the meeting times had been scheduled in advance, it was common for the responses to be short and closed (with frequent clock-glancing by the interviewee!). Although I tried to prioritise the key question areas, I can see that some follow-up meetings with a couple of health professionals will be needed to fill in the gaps. Hopefully I can pick up where I left off.
Over the next month or so, I’m scheduled to interview members of a handful of general practice teams from GPs to practice managers and other practiced employed staff. The interviews will give me an insight as to what the practices are currently doing to discover and subsequently map the diversity in their own patient population.
I decided to arrange a meeting with Clare Jackson, a member of the SAPPHIRE team possessing years of experience in interviewing. She was very helpful and able to give me tips as to how to get the most out of every interview (and how to save it when/if things start going pear-shaped!)
Clare has conducted challenging interviews as part her ongoing Oracle study, talking to children in hospital with cancer, and sometimes their parents too. Being fully aware of the interviewee’s background and circumstances was one of the central points I noted. Knowing this will help in selecting which interviewing techniques to deploy during the interview and will hopefully result in interesting responses for analysis later.
Important tip when conducting research with healthcare professionals:
Be aware of time – Many health professionals are limited to the amount of time they can spend away from dealing directly with patients and patient records. It is important to remain concious of time to contain topic digressions and to steer them back to the interview’s original focus.