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Screening and brief interventions for hazardous and harmful alcohol consumption delivered by general medical practitioners and other frontline professionals

Summary of the impact

Professor Nick Heather pioneered the use of opportunistic screening and brief intervention (SBI) by general medical practitioners (GPs) against hazardous and harmful alcohol consumption in their patients and conducted the first randomised controlled trial (RCT) of this procedure. With colleagues at Northumbria University and Newcastle University, he subsequently carried out translational research on implementing SBI in the routine practice of GPs and other frontline professionals. The benefits of SBI have now been recognised nationally and internationally and incorporated in health policies of governments in the UK and in many other parts of the world.

Submitting Institution

Northumbria University Newcastle

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Screening and brief interventions reduce alcohol consumption in England

Summary of the impact

Newcastle research into practical methods to reduce alcohol-related risk and harm has underpinned national policy, including the Government's Alcohol Strategy and a National Audit Office report. This has shaped public health practice concerning alcohol across England. A UK-specific screening and brief intervention (SBI) programme was developed by Newcastle University for use by GPs and nurses in primary care. This programme, which was designed to reduce alcohol-related problems, has been widely recommended and adopted. An evidence review commissioned by the National Institute for Health and Care Excellence (NICE) found that the use of SBI reduces alcohol consumption, mortality, morbidity and alcohol-related injuries. Department of Health figures show that SBI provides an estimated annual healthcare saving of around £100 million.

Submitting Institution

Newcastle University

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Development of national guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder

Summary of the impact

We have developed the first ever physiotherapy guidelines (2008-) for contracted (frozen) shoulder (CFS). CFS is painful and disabling, affects c.9% of the UK working-age population,1 and costs the NHS > £13.5 million annually.2 Appropriate physiotherapy could improve outcomes and reduce costs by up to £2,000 per case.b

Endorsed by the Chartered Society of Physiotherapy (CSP), the guidelines have generated great interest and already influenced practice and will improve the quality and cost-effectiveness of clinical management, as well as patients' experiences. They will also provide a better framework for research into the condition and, as a `live', electronic document, will evolve with future research.

Submitting Institution

Teesside University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Nursing, Public Health and Health Services

Influencing Emergency Healthcare Policy and Practice

Summary of the impact

The emergency care team at Warwick Medical School has a strong track record of high-quality health sciences research encompassing evidence synthesis, health-services research and clinical trials. Our trials of a 03b2-agonist (salbutamol) in acute respiratory distress syndrome (ARDS) have influenced therapeutic recommendations in the International Sepsis Guidelines (2013), reducing the use of this potentially detrimental therapy. Our cardiac arrest research informed the 2010 international guidelines on cardiopulmonary resuscitation (CPR) led to the generation of new intellectual property, and prompted industrial collaborations to build new technologies, such as TrueCPRTM (2013). These have led to improved CPR practice and improved patient survival. Furthermore, our research has led to major policy changes and to a redesign of UK emergency healthcare, improving cost efficiency, the patient experience and clinical outcomes (e.g. 95% of patients were treated within 4 hours - up from 65%; and people leaving without been seen reduced to less than 5%).

Submitting Institutions

University of Warwick,Liverpool School of Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

A clinical management service for stroke prevention

Summary of the impact

Helicon Health is a UCL spin-out company providing a stroke prevention clinical management service (Helicon Heart) developed through UCL health informatics research. In partnership with Whittington Health, a large north London hospital, Helicon Heart provides stroke prevention management to 5 NHS Clinical Commissioning Groups (CCG) across north London and Hertfordshire, covering 2 Hospital Trusts, 30 General Practice delivery sites and 3 Community Pharmacies. The system underpins clinical care for 3,000 at-risk patients, and Helicon Health has secured additional contracts to extend this to 4,500 patients in 2014. Every prevented stroke saves the NHS £16,000 per annum; the estimated saving to each CCG is approximately £500,000 per annum, to which the Helicon Heart service makes a significant contribution.

Submitting Institution

University College London

Unit of Assessment

Computer Science and Informatics

Summary Impact Type

Health

Research Subject Area(s)

Information and Computing Sciences: Artificial Intelligence and Image Processing, Information Systems
Medical and Health Sciences: Public Health and Health Services

Improving patient care experience and staff well-being: The application of novel methodological advances

Summary of the impact

Beneficiaries of this research are patients in intensive care and healthcare staff. This research has had impacts in two distinct but related areas:

  • Improving care provision for acute and critical care patients post-intensive care unit (ICU) treatment locally, nationally and internationally and through national guidelines (from the National Institute for Health and Care Excellence (NICE));
  • Improving healthcare staff well-being and understanding the links to patient experience, via NICE guidelines, influencing national and international Higher Education Institution practice.

These advances are informed by our synthesis and application of rigorous, innovative methodologies relating to questionnaire development and real-time data collection.

Submitting Institution

University of Dundee

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Nursing, Public Health and Health Services

Health related quality of life measurement in clinical trials

Summary of the impact

Ensuring that a new medicine improves or maintains a person's quality of life is important. Abbott's longstanding collaborative relationship with health professionals and service users has enabled the development of two patient-reported, quality of life instruments (CFQoL, LupusQoL). Abbott's expertise has contributed to the development of policy/guidelines concerning quality of life measurement in clinical trials for the European Medicines Agency and European Cystic Fibrosis Society. The instruments have been adopted internationally with the LupusQoL providing a global business opportunity for a US translation company. At the request of pharmaceutical companies, the LupusQoL is translated into the numerous languages required for use in their multi-national clinical trials of new medicines.

Submitting Institution

University of Central Lancashire

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Public Health and Health Services

Assessment of patient experience of NHS primary care services

Summary of the impact

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.

Submitting Institution

University of Manchester

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Economics: Applied Economics

Improvements in the Detection and Management of Glaucoma

Summary of the impact

Glaucoma affects around 2% of people over 40 years of age and almost 10% of those over 75. There are more than one million glaucoma-related outpatient visits to hospital eye services annually. Once lost through glaucoma, sight cannot be restored. Therefore early detection (mainly by optometrists) and appropriate management of the condition are crucial to maintaining a sighted lifetime. Uncertainty and variation exist in clinical practice and service delivery. Research undertaken by academic staff at City University London has led to:

  • contributions to the development of computer software used in hospital clinics globally to assess glaucoma;
  • changes in the management by the National Health Service of one group of patients (ocular hypertensives) at risk of glaucoma;
  • unique films, developed at City, of patients `driving' with vision loss resulting from glaucoma being used by the BBC and the International Glaucoma Association to increase disease awareness;
  • curricula for professional qualifications in glaucoma (based on a competency framework developed by City) becoming the national standard for optometrists.

In addition, City research on the scope of therapeutic practice by optometrists and the development of clinical management guidelines (CMGs) strongly influenced the decision to extend independent prescribing to optometrists. CMGs developed at City were incorporated into the Map of Medicine and other national ophthalmology primary care pathways. Research on a repeat-measurement-enhanced glaucoma scheme generated a National Institute for Health and Care Excellence (NICE) Quality, Innovation, Productivity and Prevention (QIPP) Case Study and informed Joint College Commissioning Guidance on Glaucoma and Local Optical Committee Support Unit (LOCSU) schemes. City's Standardised Patient research, where actors play the role of patients to collect evidence on actual clinical practice, is unique in optometric research and has been referred to by experts and relied upon in the defence of optometrists' actions in several clinico-legal cases before the General Optical Council.

Submitting Institution

City University, London

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Ophthalmology and Optometry, Public Health and Health Services

Improving quality of care through general practice accreditation

Summary of the impact

Research conducted at the University of Manchester (UoM) has shaped the design of national systems of accreditation for general practice in the UK, Europe and beyond. Accreditation systems set standards that reflect key aspects of the organisational systems and processes in general practice that are needed to ensure delivery of good quality care. Accreditation systems also provide a kite mark of quality assurance and act as a platform for supporting continuous quality improvement. UoM developed indicators of quality in general practice structure and organisation and demonstrated how they could be used effectively to improve quality. Working in partnership with health professional organisations, governmental organisations and other universities, UoM used knowledge from the research to develop systems for general practice accreditation now used in the UK and across Europe.

Submitting Institution

University of Manchester

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

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