Log in
The PCI is a carefully designed Head & Neck (H&N) cancer pre-clinic consultation checklist and comprises aspects of care and outcomes that patients might wish to raise with the multi-professional healthcare team. The PCI is an innovative and effective tool whose development has been optimised for touch screen devices. (Full details on use of the PCI is given at http://www.patient-concerns-inventory.co.uk/PCI/Home.html.) The PCI has improved patient experiences of clinic consultations, helped development of quality indicators and improved professional practice. The impact of the programme of work has led to its wider implementation nationally as exemplified by its adoption by the British Association of Head and Neck Oncologists (BAHNO), its inclusion in the National H&N Cancer dataset, its emerging use internationally, and its development in other chronic conditions.
It is now widely recognised that the evaluation of treatments for chronic conditions needs to consider impacts on quality of life as well as quality of health. Research in the Health Psychology Research Unit since 2011, and for over 20 years previously in the Department of Psychology at Royal Holloway, has generated a series of Patient-Reported Outcome Measures (PROMs) validated in over 100 languages. These PROMs have been used by every major pharmaceutical company in the world to measure the impact of new treatments on quality of life and other patient reported outcomes, and have delivered major benefits to people with diabetes and other long-term medical conditions. These PROMs have also delivered substantial economic and commercial impacts through cost-saving in the NHS, licence fee income raised through the spin-off company Health Psychology Research (HPR) Ltd, and contributions to the development of best-selling drugs.
Research conducted by the National Primary Care Research and Development Centre (NPCRDC) at the University of Manchester (UoM) has shaped the design of pay-for-performance schemes in primary health care in the UK and overseas. Specifically, the NPCRDC developed methodologies to: 1) design and test new indicators of care quality; 2) revise and retire existing indicators; 3) structure the financial incentives awarded for indicator achievement to maximise quality improvement and minimise harm. These methodologies have been implemented by the National Institute for Health and Care Excellence (NICE) in the UK, where they have generated improved clinical care and a reduction in inequalities in the quality of care for people with common chronic conditions (e.g. asthma, cardiovascular disease, diabetes) managed in general practice. Findings from the research have been disseminated internationally, where they have influenced pay-for-performance schemes in Germany and the United States of America.
Research carried out by LSHTM to develop and test patient reported outcome measures (PROMs), which measure health outcomes from the patient perspective, has demonstrated the feasibility of routinely collecting such measures before and after elective operations. In 2009, the Labour government mandated that PROMs should be collected on all NHS patients in England undergoing one of four surgical operations, a policy endorsed by the coalition following the 2010 election. This remains the only nationwide programme of its kind worldwide, providing essential data for comparing providers' performance, patient choice and other quality improvement approaches.
Aphasia is a language disorder, typically caused by stroke. It affects about 250,000 people in the UK and numbers are likely to grow with the ageing population. Research at City University London has had a major impact on the treatment of aphasia and on the way that treatment outcomes are assessed. Specifically, our research has:
Our therapy approaches and assessment tools are widely used across the world and are recommended in National and International Clinical Guidelines. As a result, we have enabled people with aphasia to express the impact of aphasia on their lives and helped practitioners to address the language needs that arise from aphasia. We have also helped to establish quality of life as a primary focus for intervention.
Improving patient experience of health services is a policy priority worldwide. The University of Manchester (UoM) has conducted research on patient experience since 1995, leading to the development of a series of validated measures for assessing patient experience of quality of care in primary care, including access to care and the degree to which services are patient-centred. Our measures have been in routine use in the NHS since 2004, sent to samples of several million patients. The data have been used to provide incentives for the highest quality practices, and to inform policy makers about current care throughout the UK.
Researchers at the University of Leeds have designed and developed new approaches and technologies for cancer patients to self-assess their symptoms and quality of life. The work focused on electronic methods for collecting patient-reported outcome measures (PROMs), developing PROMs for neglected areas of patient care, and running trials of these techniques. These approaches produced sizeable patient benefits including improved symptom control and better quality-of-life. These findings have influenced clinical guidelines in the UK and Canada, NHS policy and the endorsement of PROMs in the Health and Social Care Act (2012). Electronic PROMs systems based on the Leeds research have been implemented locally, nationally and internationally, making measurable improvements to patient welfare and health, such as a reported significant increase in completion of chemotherapy treatment.
The Work-Related Quality of Life (WRQoL®) scale and its derivatives have been used to assess and enhance the quality of working life in 10% of UK universities, ten NHS Trusts, five Trade Unions, 15 schools, a professional body (the British Psychological Society) and parts of other large national organisations (Police, BBC, RNLI). The research and data provided by the Quality of Working Life (QoWL®) team at the University of Portsmouth also now forms a significant element of the UK Government's definition and approach to tackling organisational stress. The WRQoL® scale is available in 11 languages and 50+ countries, and is directly and indirectly saving organisations thousands of pounds and helping contributing to the improved wellbeing of millions of employees.
The World Health Organisation's (WHO) Surgical Safety Checklist is the culmination of over 5 years of concerted research effort to better understand, model and intervene in human factors that affect clinical performance and patient safety in operating theatres and surgical care. Imperial researchers were instrumental in the set up and implementation of the WHO `Safe Surgery Saves Lives' working group, launched in 2006, from which the Checklist was a primary outcome. Subsequently, we were co-investigators, and UK-lead, in a global study the implementation of the Checklist in 8 pilot hospitals across 7 continents. The Checklist was demonstrated to significantly improve patient outcomes and was modified and mandated for use in all NHS surgical procedures in England by the National Patient Safety Agency. We have since lead a national study that evaluated the implementation of the Checklist within the NHS and successfully delivered a team training programme aimed at optimising use of the Checklist in our hospitals.
University of Aberdeen research has directly impacted on clinical practice with regard to the treatment of varicose veins. The University's Health Services Research Unit (HSRU) developed and validated the Aberdeen Varicose Vein Questionnaire (AVVQ), which allows patients to self-assess the severity of their varicose veins. Current national and international guidelines now recommend that as part of the assessment of outcome for patients with varicose veins, patients' self-assessment of their veins be routinely undertaken — with the AVVQ the most commonly recommended measure. The Department of Health in England also mandated the use of the AVVQ and all patients in England are now required to complete the AVVQ before and after treatment. Results from these questionnaires are being used by individual NHS providers to assess the quality of their care, to improve their services, and for planning and commissioning of services nationwide.
The claimed impact, as defined by REF guidance, therefore includes impact upon public policy and services; practitioners and professional services and health and welfare.