Log in
Research on professionals' discussions about clinical trials of cancer therapy has identified the major barriers to patient recruitment to clinical trials. This research was used to create an educational intervention to improve patient experiences and willingness to participate in a variety of clinical trials worldwide, resulting in increased participation in prostate, colorectal, renal and breast-cancer trials. It also involved educating members of UK cancer teams to the best ways to approach, communicate and maximise trial planning.
Work on better management and identification of Medically Unexplained Symptoms (MUS) has led to the introduction of new treatments in primary care in England through the Improving Access to Psychological Treatment (IAPT) programme as well as having an impact on service planning and commissioning. These approaches have also been implemented into the routine training and practice of General Practitioners (GPs) in parts of Europe. A clinical and economic evaluation of a psychosocial approach to chronic fatigue syndrome using general nurses and development of a cognitive behaviour therapy approach has changed general practice and enhanced the patient experience for those with MUS.
Because of the arduous nature of recruit training, high wastage (due to failure or withdrawal) has always been a problem for the Armed Services. A ten year programme of research funded by the Ministry of Defence (MoD) led to changes in the delivery of training across the three Armed Services (especially the Army), the formation of a new Army training establishment, a new tri-service monitoring and training body, better mental health in military recruits, and significant reductions in wastage rates (up to 15%). The model developed by this research has also informed training in the Canadian and United States Armed Services.
Since 1992 and 2004 respectively, Salmon and Young at the University of Liverpool (UoL) have led work which has influenced national and international guidelines and practitioner practice in two areas of clinical communication: first, reducing iatrogenic effects during practitioner consultations with patients with `unexplained symptoms'; and second, modifying practitioner behaviour to increase recruitment of children to clinical trials. The research has influenced the Royal Medical Colleges' reports and guidelines, NIHR practice guidelines, and several regional NHS policy documents. It has also had international impact on an NIH-funded clinical trial. The group has increased public awareness of these issues through podcasts and patient information publications.
Maternity staff from hospitals in the UK and around the world have benefited from training to improve their communication and team-working skills in emergency situations. This has been achieved through input into a standard training manual now in wide use, and through the development of course content used in `train-the-trainer' sessions for consultant obstetricians, consultant anaesthetists and senior midwives who have in turn been able to train their colleagues. Research findings at UWE, Bristol, contributed to showing that clinically better results correlate with specific linguistic behaviours. The findings of the work made a direct contribution to this training content.
Between 1996 and 2013 researchers at Swansea University evaluated service initiatives and changing professional roles associated with the management of patients with debilitating gastrointestinal disorders. This work showed the clinical and cost effectiveness of two main innovations: open access to hospital services for patients with inflammatory bowel disease; and increased responsibility for nurses, particularly as endoscopists. Our evidence has had a broad, significant impact on: national policy through incorporation in NHS strategies, professional service standards and commissioning guides; service delivery through the provision of increasing numbers of nurse endoscopists and the wide introduction of nurse-led open access to follow-up; and patient care, as documented in sequential national audits in 2006, 2008 and 2010.
Fears of recurrence (FoR) are the major concern for cancer patients. The Adjustment of Fear, Threat or Expectation of a Recurrence (AFTER) was initiated in Liverpool and developed significantly at the University of St Andrews by the originator (Prof. Humphris) and colleague Dr Ozakinci for general cancer patients, including an innovative validated Fear of Recurrence measure. The measure identifies patients with high FoR in NHS oncology services to enable psychological therapeutic treatments to be targeted. AFTER is being widely employed with cancer survivors successfully in UK cancer services and international oncology centres to reduce their FoR and depression.
Work led by Professor Nick Barber at the UCL School of Pharmacy showed that a majority of patients have problems soon after starting a new medicine for a chronic condition, and this led to the development of a post-consultation intervention by pharmacists that was shown to be more effective and cheaper than normal care. This entered Department of Health policy for pharmacy in 2008 and Barber helped design the New Medicines Service that was launched in October 2011. This service is offered by community pharmacists in England and by the end of May 2013 over a million patients had received the service. The intervention increases patient adherence to medication, thus improving quality of care, and reducing cost to the NHS from wastage. It also improves patient safety through better identification and resolution of adverse effects.
As a consequence of a research-based training programme developed at the University of Bristol, the rates of perinatal hypoxia and intrapartum fetal injury in Bristol and two pilot units in Australia and the US are now among the lowest in the world. The improvements achieved in Bristol, the US and Australia have also been successfully achieved in a low resource setting in Zimbabwe.
In response to demand from maternity units across the world, the Bristol team has developed PROMPT — a PRactical Obstetric Multi-Professional Training package, which has been successfully implemented in over 20 countries worldwide. PROMPT has had a major health and welfare impact on more than a million mothers and their babies, as well as bringing substantial economic benefits and supporting international development.
Up to 10% of stroke patients experience persistent hemispatial neglect, a lack of perception of space in one half of their visual field, despite their eyesight functioning properly. University of Glasgow researcher Dr. Monika Harvey has led the development of a vision rehabilitation method that was implemented by German stroke units (2011) and applied to over 60 stroke patients. In July 2011 Harvey formulated content for an advanced training module called `Vision after Stroke', a Scottish Government supported online training resource for stroke healthcare professionals provided by the Stroke Training and Awareness Resources (STARs) Project. In just eight months since launch (December 2012) the module series has had 17 473 unique visitors nationally and internationally with `Vision after Stroke' the second most popular module in Scotland. To date, 152 healthcare professionals have successfully completed the `Vision after Stroke' module certificate.