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Southampton's research into the management of depression highlighted deficits in the way GPs were assessing and treating depression, and demonstrated failure to improve their performance through education alone. The findings were included in guidelines drawn up by the National Institute for Health and Care Excellence (NICE) and led to incentives for questionnaire assessments of depression being introduced into the GP contract Quality Outcomes Framework (QOF). UK-wide QOF data from 2008-2013 demonstrated questionnaire assessments in 2.2 million cases of depression. Subsequent Southampton-led research showed that improved targeting of treatment resulted from questionnaire assessments, and trial evidence shows such assessments improve patient outcomes.
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.
Research by the University of Southampton has contributed significantly to reducing the global threat of antibiotic resistance. A series of both conventional placebo-controlled and novel open design trials has influenced a number of important national clinical guidelines for Respiratory Tract Infections (RTIs) and the implementation of novel prescribing strategies that discourage unnecessary antibiotic prescription. As a direct result of the research, delayed prescribing for all acute respiratory infections is a tool in the everyday practice of the UK's GPs. Southampton's work in this field has informed international guidelines currently in place in the United States, Israel and the European Union.
Research into primary care insomnia by the Community and Health Research Unit (CaHRU) has led to broad improvements in healthcare provision for insomnia, improved patient quality of life, informed national/international policy and practice in insomnia care and impacted directly on health professional practice and insomnia sufferers, initially in Lincolnshire spreading across the UK and internationally from 2008 to 2011. Direct effects on practice include changes in sleep management and reduced hypnotic prescribing through seminars, workshops, conferences and e-learning developed by the team; inclusion in UK policy, practitioner information, training materials and guidance on hypnotics has led to greater professional and public awareness of sleep management internationally.
Two major national studies, conducted by staff in the Unit and colleagues from a number of other institutions, provide the most comprehensive estimate to date of the prevalence of prescribing errors in general practice in England. These studies identified a number of strategies for reducing these prescribing errors that have been endorsed by the General Medical Council (GMC). Other impacts from these studies include increased public understanding and debate through media coverage, changes to GP education to be implemented by the Royal College of General Practitioners (RCGP), improvements to computerised prescribing decision support for general practitioners and increased awareness of the medication safety role of primary care pharmacists.
Osteoarthritis affects 8.5 million people in the United Kingdom, accounting for a third of all years lived with disability. Our research has provided commissioners and third-sector organisations with accurate estimates of the size of the problem, policy-makers with evidence on groups at particularly high-risk, and clinicians with original evidence on better approaches to assessing and managing osteoarthritis in patients presenting to primary care. These key insights have supported advances in public health and health care policy debate, changes in legislation, and improvements in the quality of patient care through training and new national, European, and global guidelines for health professionals.
Our ground-breaking research has driven major changes in non-medical prescribing (NMP) legislation. As a result of our research, over 19,000 nurses and 2,000 pharmacists now independently prescribe medicines directly to patients across the most comprehensive range of medicines in the world. This amounts to four million prescriptions per year in England. NMP has improved the quality and efficiency of health care: patients can now access prescribed medicines faster and NMP has reduced the number of professionals required. Study results have also contributed significantly to a recent extension of independent prescribing powers to physiotherapists and podiatrists. Our research is widely cited in international NMP policy development, and our survey methods and evaluation measures are used to assess NMP quality and safety internationally.
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.
Depression is a major public health problem producing substantial decrements in health and well-being, with 15% lifetime prevalence, affecting 350 million people worldwide. The Mood Disorders Centre (MDC) has improved treatment for depression by (i) understanding psychological mechanisms underpinning depression; (ii) translating this into innovative treatments and prevention interventions, evaluated in clinical trials; (iii) improving dissemination, delivery, and access to treatments. This research has improved patient care and quality of life, influenced national policy (NICE Depression Guidelines), informed national service and training provision (Improving Access to Psychological Therapies IAPT programme, with 680,000 people completing treatment 2008-2011) and achieved international impact on clinical practice.