Following the CLAHRC Video Competition back in February of this year, I joined the new Video-Podcast team for the CLAHRC LNR’s Implementation Theme. We are currently in the process of producing a short video which will provide a concise summary of the group’s activities. Publicising and marketing any form of work to your target audience in a way that is accessible, be it an idea, a research project or the results of a health evaluation, is important in ensuring that people find out about your organisation and are provided with the opportunity to learn more about it if they so wish. As we started to create the video storyboards drafts, I began to realise the volume of high quality and potentially impactful research and collaborative work that takes place between the CLAHRC LNR and healthcare bodies, work that many outside of the projects themselves would simply be unaware of (particularly the general public, who experience the results of health research every day, knowingly or otherwise). After creating the video, I think it would be great to obtain feedback from others outside CLAHRC to see whether it was successful disseminating the group’s main aims in a clear & simple manner.
On the 5th March I attended the Society for Academics in Primary Care (SAPC) regional conference to present my work on “non-clinical patient needs: mapping diversity in primary care” a parallel session. Dr Alf Collins, Consultant in Pain Medicine at Taunton and Somerset NHS Foundation Trust, and Professor Nigel Mathers were the keynote speakers in attendance. Their talks focused on patient-centred care and, in particular, its influence in the management of long term clinical conditions. Dr Collins talked about the three principles deemed necessary for the personalisation of care: coordination of care, the engagement of patients in decision-making and thirdly, the supported self-management of care for individuals. He described how a fine balance of all three is something that the UK health system is already working towards but that it requires cultural changes within the system for it to work effectively. Following on from this, Prof. Mathers elaborated on the components needed for true patient ‘activation’; the combination of knowledge, skills and confidence which will allow patients to actively and safely manage their health.
Poster viewing sessions were scheduled throughout the day and I found one particular study’s poster quite relevant to the work that I have been doing over the past six months. It was on the feasibility and acceptability of Clinical Commissioning in general practice, drawing on evidence from interviews with GP’s, some of whom were saying that it was not their place to do so and that they had entered into the profession to help to care for people, not to ‘population-manage’ or budget for services. This was of particular interest to me as it provided a possible explanation as to why some of the practitioners I had interviewed responded apathetically to mapping out their population’s needs even though after recognising the benefits of such mapping for their patient population (i.e. informing commissioning decisions with cost implications)
Being the first presentation that I have delivered in front of an audience of health care professionals with academic interests, the planning was slightly more challenging than usual! But having the chance to run-through the presentation beforehand and to receive feedback from the SAPPHIRE group helped me to make the final adjustments. On the day it was well-received and I think it has given me the confidence to do something similar on an even bigger stage!
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.
On Monday (25/2/13) I successfully completed a two week online pilot for a new Health Services Evaluation Course created by the CLAHRC LNR (Leicestershire, Northamptonshire and Rutland). After defining the purpose for the evaluation (establishing whether the project was indeed an ‘ evaluation’ and not a clinical audit or a piece of research), the course talked me through how best to define the evaluation question, aims and objectives;the identification of the relevant stakeholders and evaluation team members, defining their input into the project; and how to select the most suitable methods of carrying out the evaluation, agreeing on timescales, resources and strategies for dissemination. The most important stage, in my opinion, was the succesful identification of all the stakeholders and recognising their appropriate levels of involvement within the evaluation. Sometimes the views of certain stakeholders are maginalised in favour of stakeholders who are more influencial to the project. This can be problematic when those individuals are the direct recievers of the particular healthcare service being evaluated, yet their voices are not heard the loudest.
Using the online interface was a good way to interact and discuss ideas with others working on a wide range of health evaluations in primary and secondary care, despite the fact that they were based in various locations. Discussion boards and the Wiki format were actively utiltised and comments posted were always on topic and constructive. I can see the online course format working well in practice when it is rolled out to health professionals in the area.
Many thanks to Tammy Holmes and Rachel Lovesy for providing me with the opportunity to take part.
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.
So, during the Departmental Conference, I particularly enjoyed the seminar by a representative of the James Lind Alliance, an organisation that I was previously unaware of. In a way they have been taking a niche approach and have turned the tables around when considering the formulation of research areas and topics. Continue reading
Storage of hospital vaccines and medicines in a cold environment is something routine and hardly a matter we tend to think about in the UK. But for many rural communities across the world, having a steady supply of electricity is yet to become a reality. Lack of refrigeration facilities can have a great impact on healthcare provision and, subsquently, the lives of people passing through rural clinics. The article looks at how one village in Mutare South, Zimbabwe has overcome this: