‘Developing safer health and care systems’ theme in the NIHR GM PSRC

Professor Caroline Sanders and Dr Tom Blakeman are leading the ‘Developing safer health and care systems’ theme at the National Institute for Health and Care Research Greater Manchester Patient Safety Research Collaboration (NIHR GM PSRC). Here, Tom introduces the new theme of work.

At the GM PSRC we are committed to looking at the way services are delivered to identify how to make them safer, particularly for those who are vulnerable. We’ve designed and developed the ‘Developing safer health and care systems’ theme with the input of patients, carers, and healthcare staff to help increase the ability of our research to narrow the gap in health inequalities.

Alternative care models

Alternative care models have become increasingly important in the delivery of health and social care services. Essentially, they are new ways of working that aim to deliver care in a more efficient and effective way.

NHS England has recognised the potential of alternative care models to improve the safety and wellbeing of patients. However, it has also identified the impact of these models on patient safety as a challenge faced by health and social care providers. Our research is aimed at addressing this challenge and we will focus on models of care for vulnerable and underserved patient groups across three priority areas:

• The impact of virtual wards on the safety of older people living with frailty
  Our research on virtual wards for older people living with frailty has the potential to transform the way patients receive care. By identifying new models of care that prioritise their needs, we can help to reduce hospital admissions and improve safety outcomes for this vulnerable patient group.
• Approaches to improve discharge care and follow up for people who have had a hospital admission affected by Acute Kidney Injury (AKI)
  This research has the potential to reduce the risk of harm. By examining alternative service models that prioritise patient safety, we can ensure patients receive the support they need to recover and avoid any unnecessary readmissions.
• Models of service delivery for people with Learning Disabilities and/or Autism
  This area of our research aims to identify new models of care that prioritise the needs of patients and carers. This work has the potential to transform the way healthcare services are delivered for this underserved patient group and improve their overall quality of life.

Our approach

Our research programme is designed to ensure the voices of patients, carers, and healthcare staff are at the centre of our work.

In combination with this approach, our Systems Thinking perspective aims to enhance the ability of people, organisations, and systems to adapt and achieve safer and fairer care. This means that we are not only focused on identifying alternative service models, but also on understanding the broader systems in which they operate and how they can be improved to prioritise patient safety and wellbeing.

The research team

This theme is led by Professor Caroline Sanders and Dr Tom Blakeman at the University of Manchester. Our work around Learning Disability and/or Autism (LD&A) is led by Professor Umesh Chauhan:

• Caroline is Professor of Medical Sociology and leads on Public and Community Involvement and Engagement for the Manchester Academic Health Science Centre (MAHSC) and the NIHR Applied Research Collaboration Greater Manchester (ARC-GM). She leads qualitative and participatory research focused on patient and carer experiences of health and social care with a particular focus on marginalised and underserved groups.

• Tom leads our kidney health research. He is a GP and Clinical Senior Lecturer in Primary Care. He was a member of the NHS England Think Kidneys Programme Board (2014-2017) and was Royal College of General Practitioners’ (RCGP) Clinical Champion for Acute Kidney Injury (2017-2020) where he led the development of national guidance to improve post-discharge care following AKI. He is currently a member of the NHS England Renal Services Transformation programme. Aligned with the theme, he currently leads the NIHR funded study AsterAKI study 

• Umesh is the Chair of the Society of Academic Primary Care (SAPC) LD&A Special Interest Group. Umesh also has considerable expertise around care for people with LD&A, which is particularly useful when implementing change to improve the safety and care for people with LD&A.

Our theme aligns with the NHS Long Term Plan of building ‘strong and effective integrated care systems across England’ that reduce health inequalities and improve safety outcomes. And, by involving patients, carers, and staff in our research, we can better understand their experiences and identify alternative service delivery models that prioritise their needs. Our goal is to build strong and effective integrated care systems that reduce health inequalities and improve safety outcomes for everyone.

‘Preventing suicide and self-harm’ theme in the NIHR GM PSRC

Professor Nav Kapur and Professor Roger Webb are co-leads for the ‘Preventing suicide and self-harm’ theme at the National Institute for Health and Care Research Greater Manchester Patient Safety Research Collaboration (NIHR GM PSRC). Here, they introduce the new theme.

“People at risk of suicide and self-harm are some of the most vulnerable and improving the safety of their care is essential. Patient safety research is a critical part of preventing self-harm and suicide in mental health services. Our new research programme is dedicated to making a difference to this area of healthcare by identifying, refining, and evaluating new ways of delivering services.

The work that we plan to do will build on what we have discovered about provision of psychosocial assessment following a self-harm episode and enhanced family involvement for patients in specialist mental health services.

Our research team in the GM PSRC includes people from a broad range of academic and clinical disciplines, including psychiatry, clinical psychology, primary care, health economics, health services research, epidemiology, statistics, informatics, and behavioural science.

Designing our programme of research

Researching this topic can be especially challenging.  When we were designing and developing our programme of research, we worked with people with lived experience and healthcare staff to gain a deeper understanding of some of these challenges.

Therefore, our research aims to improve patient safety by identifying interventions that help to prevent self-harm and suicide in mental health services. We recognise that there are many different ways to deliver mental health services and that some approaches may be better at reducing the risks of self-harm and suicide than others.

For example, our research will examine innovations in specialist mental health services, in secondary hospital emergency departments, and in general practice. We are committed to identifying which approaches have the most potential to reduce the risks of self-harm and suicide in these different healthcare settings.

Delivering our programme of research

To meet our objectives, we will be working closely with service providers and patients, carers and healthcare staff to investigate the most effective interventions and refine them further to increase their potential impact. This will involve large-scale studies which include several services and a high number of patients to ensure the results are relevant to a wide range of mental health settings. As a result, we aim to better understand any potential barriers to successfully rolling out the interventions that we’ll be testing.  This type of study can also provide us with valuable insights into how the interventions can be adapted to work well across different mental health services and settings.

Impact and outcomes

Our research has the potential to make a significant difference to patient safety. By identifying and implementing effective interventions, we can help prevent suicide and self-harm and improve the outcomes for people who are experiencing mental health illness. We want to assure affected individuals that there is support available and encourage them to seek help if they need it.

At the heart of our research is the recognition that mental ill health can affect anyone, and that everyone deserves access to high-quality care. Inequality in mental health services is a complex issue and can be influenced in various ways, including by social, economic, and cultural factors, as well as differences in how services are offered. For instance, people from ethnic minority backgrounds may be more likely to experience stigma and discrimination when accessing mental health services, while people from socially disadvantaged backgrounds may face other barriers that hinder their access to treatment. 

We are committed to identifying interventions that work for everyone, regardless of their background or circumstances. By identifying the most effective interventions and refining them, we can work towards reducing the risks of suicide and self-harm, improving patient safety, and ensuring that everyone has access to the effective care that they need.”

‘Improving medication safety’ theme in the NIHR GM PSRC

Medication-related problems are one of the most common reported causes of patient safety incidents across the NHS. Over the last 25 years, teams of researchers from the universities of Manchester and Nottingham have been working with NHS colleagues and patients to increase understanding of these problems and to find effective solutions.

We are excited to continue working to improve medication safety through our NIHR Greater Manchester Patient Safety Research Collaboration (PSRC). In the first two years we are going to focus on three areas of work in addition to our ongoing projects:

• Firstly, we are going to use the large amount of research that’s already been done to identify the best and most cost-effective ways of improving prescribing safety in primary care.
• Secondly, we will build on our existing research to find out how electronic prescribing safety systems can be improved.
• Thirdly, we will test methods to identify and correct potentially unsafe prescribing, focusing on the medicines used for mental health problems and pain.

The research will take place across primary care (such as GPs and pharmacies), secondary care (such as hospitals) and social care settings (such as care homes). The work will be led by Professors Darren Ashcroft and Tony Avery, who have a proven track record of using research findings to improve patient safety.

Most of our studies will be done in the North-West and East Midlands, and in some cases across England. They will be tested in settings where interventions will eventually be delivered, making the most of our strong working relationships with NHS providers, particularly in primary care.

Patients and members of the public will continue to have an essential role in our research, from deciding the questions that are most important to patients through to the design of studies, interpreting the findings, and sharing the most important messages. As Jill Beggs, one of our PPI colleagues, says:

“As a patient and public involvement member who has been involved with the research team setting up this work, I am encouraged to see the focus on addressing medication safety events that could have a positive impact on the lives of patients and their carers. I look forward to working with the team and other patient representatives to see this study develop into actionable interventions’.

And Anthony Chuter, another PPI colleague, says:

“The ‘Improving medication safety’ theme will help to ensure that health professionals have the best information available for prescribing medicines safely. This is vitally important for patients who want to be more involved in decisions where their safety may be at risk.”

Improving organisational safety culture across health and social care: Meet the ‘Enhancing cultures of safety’ theme team

by Dr Jennifer Creese, SAPPHIRE, University of Leicester

NHS England define “a positive safety culture as one where the environment is collaboratively crafted, created, and nurtured so that everybody (individual staff, teams, patients, service users, families, and carers) can flourish to ensure … safe care.”

A strong organisational safety culture is the key to helping healthcare organisations reach their highest potential in patient safety. As part of our vision to make health and care systems safer, our team of experts in patient safety and organisational culture in health and social care will be researching key issues within the “Enhancing cultures of safety” theme.

Prof Natalie Armstrong

Prof Carolyn Tarrant

Professors Natalie Armstrong and Carolyn Tarrant, from the University of Leicester lead this theme. Both Carolyn and Natalie are recognised global experts in qualitative (research that’s informed by hearing from those with lived experience) healthcare improvement research. The work draws on their experience of sociology and psychology. Their research group, SAPPHIRE (Social Science, Applied Healthcare & Improvement Research) is internationally renowned for its methods in healthcare quality and safety research.

They are joined by four colleagues at the University of Leicester with expertise in healthcare organisational cultures, workforce issues and patient safety:

• Dr Jennifer Creese: a sociocultural anthropologist with a special interest in cultures and identities of healthcare professions
• Dr Kate Kirk: a practicing Emergency Department nurse and researcher interested in organisational behaviour in healthcare, and particularly workforce wellbeing
• Associate Professor Nicola Mackintosh: a sociologist with a background in critical care nursing, interested in local patient safety cultures and organisational response systems
• Dr Farhad Peerally: a clinical-academic gastroenterologist with interests in health services and patient safety.

Dr Jennifer Creese

Dr Kate Kirk

Assoc Prof Nicola Mackintosh

Dr Farhad Peerally

A collaborative approach is central to this theme. The Leicester-based researchers are joined by seven expert colleagues from the University of Manchester, with expertise in healthcare management, law, human factors and psychology:

• Professor Sharon Clarke: an organisational psychologist with interests in safety culture, safety leadership and wellbeing in organisations, especially in safety-critical contexts.
• Dr Sarah Devaney: a senior lecturer in health law and regulation with a particular interest in the law’s role in enhancing patient safety.
• Dr Jane Ferguson,: a lecturer in healthcare management with a particular interest in the working lives of healthcare professionals
• Dr Victoria Moore: a lecturer in healthcare law with interests in healthcare law and regulation, and patient safety
• Dr Denham Phipps: an organisational psychologist and lecturer with interests in human factors, ergonomics and risk management in healthcare
• Professor Catherine Robinson: Professor of Social Policy Research with a particular interest in social care services
• Professor Kieran Walshe: Professor of Health Policy and Management with a particular interest in health professions regulation.

Prof Sharon Clarke

Dr Sarah Devaney

Dr Jane Ferguson

Dr Victoria Moore

Dr Denham Phipps

Prof Catherine Robinson

Prof Kieran Walshe

Patient experiences, perspectives and priorities are at the heart of this research and its goals. The academic research team is complemented by two Public and Community Involvement and Engagement (PCIE) experts whose lived experiences help to drive research priorities, design and impact:

• Mr Manoj Mistry: a family carer with more than 35 years’ experience including 12 years of involvement in health education, training and research
• Ms Khudeja Amer Sharif: CEO of Shama Women’s Centre, with more than 30 years’ professional experience leading service improvement and programmes to address health inequalities.

Mr Manoj Mistry

Ms Khudeja Amer Sharif

We’re excited to be collaborating with experts from diverse disciplines and backgrounds to develop and deliver research projects that have the potential to make a positive difference to patient safety.

We are working collaboratively with local, national and international health service partners and staff to guide policy and practice in improving organisational safety culture. We believe our approach helps to ‘close the gap’ between academic research and practice.

Our research includes:

1. Working with teams and groups across a wide range of different health and social care contexts, to understand different ways patient safety is understood and put it into practice.
2. Following the journey of patient safety guidance from where it is drafted at a national level to when it is implemented locally within a healthcare organisation. This helps us to design policies that connect with safety cultures in local settings.
3. Working to amplify the voices of health and social care staff from minority ethnic groups. The aim is to help them to feel safer in raising concerns about patient safety, which contribute to improving safety culture.

In addition to improving policy and practice in healthcare organisations, we’re dedicated to developing expertise in this area of research to help ensure developments continue in the future. This will help to ensure new health services and improvement researchers can continue to make a difference to patient safety policy and practice.

Development of a ‘best practice’ guide on the safe use of medicines after discharge from mental health hospitals

Richard Keers is a Senior Clinical Lecturer in Pharmacy at The University of Manchester with experience as a mental health pharmacist. He has been part of the Medication Safety theme at the Greater Manchester Patient Safety Translational Research Centre for a number of years. He will be working in the new Improving Medication Safety theme as part of the NIHR Greater Manchester Patient Safety Research Collaboration which begins on 1^st April 2023.

Richard’s work focusses on the safe use of medicines across different health settings and he has a particular interest in supporting patients with mental illness to use their medicines safely and effectively. His new study, ‘Developing a framework for medication optimisation and safety in primary care following discharge from mental health hospitals’ has been awarded funding from the NIHR School for Primary Care Research. The study will begin in summer 2023 and will run for 16 months.

In this blog, Richard explains why this project is needed and how the research will be carried out, as well as the impact it could have on how medicines are used safely by health professionals and people with mental illness after they are discharged from a mental health hospital.

What problem will this research address?

When people with mental illness are discharged from mental health hospitals, we know they may be more likely to be re-admitted or need care due to problems with their medicines. They may be leaving hospital with different medicines to when they were first admitted.

Patients, carers and health professionals need more support to work together to help patientsadjust to treatment changes after they’ve been discharged. Improving the safety of mental health hospital discharge and the use of medicines are therefore seen as important priorities for patients and health services.

However, there has been little research to:

1. Understand how patients and their carers use and understand their medicines in the community after discharge,
2. Find out what support patients, carers and health professionals need, and
3. Understand who they may ask for this support. Health professionals working in communities supporting patients may lack guidance on how best to work together. This is important, as mental health, general practice, community pharmacy and social care are now expected to work more closely together.

How will the research address the problem?

Our study aims to create a ‘best practice’ guide for health professionals and patients/carers to use in the community following discharge from mental health hospitals. This is designed to help them work better together so medicines are used in the safest and most effective way.

To do this, our study will be carried out in three stages and will be guided by people with lived experience who will join our research team and project steering group:

• Stage 1

We will interview patients, carers and health professionals to find out how medicines are used and what people feel could help or hinder their safe and effective use after mental health hospital discharge.

We are also interested in understanding what support is needed with medicines and if and where this can be found.

• Stage 2

Using the results of stage one of the project, we’ll host workshops that will bring together patients, carers, health professionals and policy makers to decide on the most relevant and important content for a ‘best practice’ guide. This includes thinking about different perspectives as well as other elements that are likely to make a difference.

• Stage 3

The ‘best practice’ guide will be created and we aim to make this available as separate versions for patients/carers and health professionals.

What impact is expected from this research?

The main outcome of our research will be the ‘best practice’ guide. We hope it’ll be available online for health professionals and patients.  

The separate versions of the guide should help our research to be better understood. They will provide opportunities for people to be empowered, learning more about medicines and how to work together to use them safely after hospital discharge.

We are looking forward to raising awareness of the research and will be sharing the guide at conferences, in academic journals and across social media.

If you have any questions about this work or would like to learn more, please email Dr Richard Keers or contact him on Twitter.

Tool developed to help care home residents and their carers to be involved in improving safety

A first-of-its kind questionnaire has been developed to gather the experiences of care home residents and family members on the safety of their care, allowing their voices to be heard. The Resident Measure of Safety (RMOS), has been designed by residents and carers alongside health and care home staff with researchers at the National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre.

The RMOS is a questionnaire that encourages care home residents and their family members to be actively involved in their safety. Staff in care homes can use the feedback gathered by the RMOS to develop specific solutions tailored to the issues raised.

Drs Natasha Tyler, Sally Giles and Maria Panagioti worked on the study and talk about development of the questionnaire and its impact below.

Developing the RMOS

We identified some useful previous research in this area and pulled this together with similar staff-focussed questionnaires that already exist. We then worked with a group of residents, carers, healthcare and care home staff to help create a new questionnaire. They helped us with the design and content to ensure the RMOS includes the most important questions and is easy to understand and use.

How the RMOS is different

There are some care home safety questionnaires in use. However, they are designed from the point of view of professionals. The RMOS is the first questionnaire of its kind where feedback is collected from residents in care homes, and their family members.

This is important as the experiences of residents and their family members are valuable when looking at making improvements to safety. The RMOS allows them to comment when things actually happen allowing professionals to take action quickly. It also introduces a standardised approach to safety.

We believe that the RMOS has the potential to be used during standardised assessments, such as Care Quality Commission assessments, as a way for residents and their carers to voice their safety concerns.

Our next step will be to assess the RMOS on a larger scale to see how well each element of the questionnaire works. We believe that, if used regularly the RMOS will create safety improvements inspired by the voice of residents and family members.

Want to know more?

If you want to know more, you can read our research paper about the development of the RMOS: or email Natasha Tyler.

Patient opinion: The benefits of the Patient Safety Guide

by Kay Gallacher

You know how sometimes someone comes up with a deceptively simple idea and everyone thinks – why has no one done that before? Well, I feel the Patient Safety Guide is one of those ideas.  You can download it from a website and print it out, or access it via a mobile app for iOs or Android. It’s designed to help patients and carers prepare for appointments with medical professionals like GPs, nurses and pharmacists.

I think it’s probably quite common for many of us that when you sit down to talk to a medical professional, your mind can go blank. I suddenly forget everything I wanted to discuss. I did get into a habit of making notes beforehand, but sometimes I wasn’t sure what questions I should be asking. I didn’t know where to start. The Patient Safety Guide helps patients and carers to plan what they’re going to ask before an appointment. There are suggested questions and ideas that you might want to consider. There’s space to write down any concerns, as well as what you want to talk about and what you want to get out of the consultation. I feel the guide helps to make the most of an appointment.

Also, as soon the appointment ends, it’s so easy to forget everything you’ve been told. That’s why I find it so valuable that there’s space in the guide to make a note of what was said as well as any tests that have been ordered and when the results may be due.

It’s also a good way of sharing information with others who look after your health. This is invaluable if you have a carer or multiple carers. So, for example, if you have a carer who goes with you to an appointment, they can make a note of what is said, diagnosed and prescribed. These notes are then in one place and can be shared with other carers without having to keep repeating the information.

There’s also space to make a note of all medications and their doses so that you don’t have to remember all the medications you take whenever someone asks.

It’s been developed so that we, the patients, feel more in control of our contact with doctors, nurses and pharmacists (primary care practitioners). Hopefully this will also help to make the relationship more equal.

As another patient put it: “It’s just common sense really”. Get prepared for your appointment so you don’t waste time. Have a record of what happens, tests and medicines all in one place. In other words, no more scrabbling around for all this information every time it’s needed!

Tool launched to help patients and carers improve safety across health and care

A first-of-its-kind free guide that helps patients and carers to take greater control of their healthcare and improve their safety has been launched today, 7 March 2023.

The Patient Safety Guide has been co-developed by patients, carers, GPs and pharmacists with researchers from the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre (GM PSTRC). The centre is a partnership between The University of Manchester and Northern Care Alliance NHS Foundation Trust.

The guide helps patients and their carers decide on the most appropriate way to access healthcare (for example, whether they should visit a pharmacist, book a GP appointment, or visit A&E). It also provides guidance on how to plan for interactions with healthcare staff. There’s suggested questions to ask, and space to make notes both before and after an appointment. Information around any tests that may be recommended can be logged in the guide and it can be used as a place to list all the medications a person is taking.  

The guide is available to download from a dedicated website and via an app for iOS and Android phones. It includes specific advice for people with hearing loss and there is a version for people who have vision impairment.

Dr Rebecca Morris, lead for the Patient Safety Guide, said: “Involving patients in their safety is a central recommendation of NHS England’s National Patient Safety strategy and our team were looking at ways of doing this when we started work on our patient safety guide. We wanted to create something that gives patients the ability to understand and support their care while giving them confidence to ask the questions that are important to them.

“We believe our guide addresses some of the most common challenges faced by patients and carers while having the potential to narrow the gap in health inequalities. For example, we’re aware that some patients may take a number of different medications and are under the care of several different doctors. The guide helps the patient and their carer, if they have one, to keep track of all of this. Also, in situations where two family members may be caring for an older relative and are both taking them to different appointments, the guide is an easy way of sharing important information accurately. Alternatively, for someone who may struggle with verbal communication, they can use the guide as a way of helping their communication with healthcare staff. We hope that our guide can be adopted and used widely to help improve patient safety.”

The guide underwent two phases of testing. The first started before the pandemic and the second during it, when appointments were both in-person and virtual. This process involved eight GP practices across the North West of England. One of the GPs involved in the study, said: “I think the patient safety guide is a great idea. It seems doctors and patients sometimes talk at cross-purposes but can’t work out what the confusion is. I think the guide will help patients in a way that could improve their understanding of the system and doctors’ thinking. It could help empower patients.”

Kay Gallacher, a public contributor who was involved in developing and designing the guide, said: “For me, the NHS can seem like a complex system with its own language. I feel the guide can give patients and carers the tools they need to navigate it. The guide helps to ensure everyone can get the most out of an appointment with healthcare staff. I’ve found it particularly useful being able to use the guide to remind me what a doctor may have said at a previous appointment.

“Also, I do find my mind can go blank the moment I start to talk to a doctor, so being able to plan ahead and make a note of all the questions I want to ask helps me to make the most of the appointment. I can note down the answers and this makes it easier when trying to recall what the doctor said. I believe the guide is something that can make a big difference across health and social care and I’m looking forward to more people hearing about it so they can start using it and benefitting from it.”

The guide is now available for anyone to access via the app and online, and researchers are encouraging organisations interested in rolling it out to get in touch: Dr Rebecca Morris.

Hidden LIVE – a young person’s experience of creating a performance and podcast about mental health

A free immersive experience was first performed in May 2022 at The Royal Northern College of Music in Manchester. It is a project that’s funded by two National Institute for Health and Care Research (NIHR) research centres, the Applied Research Collaboration Greater Manchester (ARC-GM) and the Greater Manchester Patient Safety Translational Research Centre (GM PSTRC).

The research centres worked with not-for-profit organisation, Made by Mortals, to recruit ten young people who together created a podcast and performed the show.

One of the young people, Ashgan, 21, talks about their experience working on this project here.

“I personally heard about getting involved through an email that I was sent from the University of Manchester, so I found the Made By Mortals website and called the number about the opportunity. I was emailed with the details straight after our conversation! What excited me about the opportunity was that it was both something creative and to do with mental health. As someone studying Psychology at the time and who also does photography, it was perfect for me. It was an incredible opportunity to gain experience with such a profound organisation. I was also really enthusiastic at the prospect of working with other young people. I felt we needed our voices amplified, which is something I had in common with the other young people in the group.

When I found out we would be recording a podcast as part of the project, I was a bit worried as I’d never done this before. I later found out that it was completely different to what I thought we’d be doing. We made the story ourselves, and we didn’t need to worry about doing anything technical, as this was sorted for us.

We were all from a mixture of backgrounds. For example, Ameir studies Dentistry, Shuhaney is in college and wants to be a teacher, and Sadia works with the council, and, me, Angel, and Annie all studied Psychology at the time. There were differences between us, but lots of similarities, that we built into the storyline.

We all loved the diversity in the group, it really put everyone at ease. We were a mix of ages and genders and from different backgrounds and ethnicities. This really helped when we were creating the characters, and all of the details around their lives. We all had such a range of experiences from our real lives that we could draw on due to the differences in our cultures and unique backgrounds. For example, we decided on the name Adam as it was ethnically ambiguous, so anyone could listen to the podcast and relate to it. We all felt this was important.

The way we were eased into creating the podcast was great, it made the whole experience more fun and less daunting. At first, it was all meetings on Zoom, which was a good way to start and allowed us to bond before we met in person. It was very productive over Zoom, and it was easy to use. The team helped to ease meetings with relaxed introductions, and we had ice breakers to help people become more confident and open. For example, one of the games we played, involved making up a headline for a random image. It was a fun way to start the meeting because there wasn’t any pressure. There was also music to begin with whilst people were joining, so it was never awkward.

I remember being late to the first meeting because of another commitment, but everyone was so welcoming, it was a great environment. I think working in Psychology, Mental Health etc, can have that stereotype of everyone being ruthless and nonchalant, but it was the opposite. It was the most comfortable, caring, and understanding environment I have worked in, and I’m happy I was able to take part and meet amazing people who I’d probably not usually cross paths with.

Building the podcast story was set up in such a way that it almost felt like all we were having meetings, it was fun and we had relaxed conversations. We would talk about our lives, what we liked, who we spent our time with, the experiences we’ve had, and that subtly blossomed into a storyline. I remember Ameir was talking about how he and his best friend had bought cheap silver necklaces to commemorate their friendship. That was added to the script with Adam and his best friend doing the same thing. Another example was when we were talking about how we value our memories, and I mentioned how I hoard receipts from road trips. This found its way into the script as well. Having those personal experiences in there helps the story to feel real even though Adam himself is fictional.

Adam’s story is made up of all the experiences, we as a group, have been through. We felt this made the podcast so relatable for any audience because it’s realistic. Even when it was a potentially upsetting topic about mental health, we were supported and the conversation was so relaxed, it was easy to be open. In that sense, creating the podcast was so positively impactful towards our wellbeing, it was nice for everyone to share experiences in a judgment-free space. All of the little experiences were threaded together to create the podcast by Paul and Chris at Made by Mortals

We met in person for the first time to read through the script, which was exciting. Again, it was a really comfortable environment. I remember, I was fasting for Ramadan, and one of members of staff emailed me beforehand to make me aware that there was a prayer room if I needed to head out. She also let me know the times I could come so I wasn’t surrounded by everyone having their lunch if I wanted. Also, a wheelchair accessible taxi was ordered for Shuhaney. So many efforts were made to make sure we were comfortable, and we all appreciated it.

Listening to the script for the first time was very emotional. It was so original, and it was nice to spot personal experiences and everyone’s individual input. We were all treated like equals. It was clear that everyone had been thought of when putting the script together to ensure our voices were all equally represented. I could not believe that the script came together from all the little bits we talked about. It was surreal hearing it for the first time, and it still feels that way now. Because the conversations had been so casual, comforting and fun, it didn’t feel ‘significant’ enough to create an entire script. Sadia, one of our group, said: “It really made me aware that things like this don’t need to be formal, scary, and intimidating.”

With us all being incredibly happy and proud with the script, it was time to record it. Before recording, myself and the rest of our group expected a ‘traditional’ recording studio, and we were all worried we would mess the recording up. Tashinga, said, “I expected to be in a studio and alone in it, behind a screen, which sounded so awkward.” Sadia added that she “was relieved we were all sitting together, with mics and handheld recording devices. It was more fun!”. Andy, who helped us with the recording, was patient and comforting. Everyone was supportive. We all gave each other a mini applause after our first few recordings. It was a new experience, and I’m grateful I was able to do it in such a patient, supportive environment! There was no pressure, so we were able to record whilst actually enjoying the whole process.

The entire process was great, and the impact was huge. Seeing how other people benefitted from the podcast at the first performance was amazing. We heard how they felt like they could then be open about their experiences and the performance started a discussion between young people, families and professionals. This hugely boosted our confidence to get involved in projects like these, meet new people and share our experiences. Also, like I mentioned, creating the podcast itself and working with people with similar experiences really benefitted us in itself. Sadia spoke about it perfectly when she said it was like ‘indirect therapy’.

A huge thank you to NIHR ARC-GM, Made by Mortals, and everyone who was a part of the team, and thank you to the audience, we hope you enjoyed our immersive performance. We’re now taking it on tour and you can find details on how you can see it here: https://arc-gm.nihr.ac.uk/hidden-live

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The people involved in the podcast were: Ameir, Angel, Annie, Ashgan, Sadia, Shuhaney, and Tashinga.

Manchester team secures funding for new research collaboration to address patient safety challenges

A team led by researchers at The University of Manchester is one of just six located across England to be awarded a share of £25 million in funding by the National Institute for Health and Care Research (NIHR) to run a Patient Safety Research Collaboration (PSRC) from 2023-2028.

The Greater Manchester Patient Safety Research Collaboration (GM PSRC) will be hosted by Northern Care Alliance NHS Foundation Trust, and the University of Manchester-led team will deliver a programme of research along with the University of Nottingham and the University of Leicester.

The collaborations will address strategic patient safety challenges within the health and care system, focusing on seven strategic areas set out by NHS England. These areas cover issues such as clinical risk scores, which enable professionals to identify people who may benefit from preventative interventions, and improving the culture and practice in organisations to promote patient safety.

Professor Lucy Chappell, Chief Executive of the NIHR, said:

“Patient safety is about maximising the things that go right and minimising the things that go wrong for people receiving healthcare. We are aligning our funding with the strategic priorities from NHS England and ensuring that we are addressing the issues that really matter to patients.

“This new round of funding gives the best researchers the opportunity to assess innovations and approaches that could shift this balance for the better.”

The PSRCs will help researchers to develop and test innovations, approaches and interventions that could improve patient safety and the safety of health and care services. The funding will also enable partnerships to be built between health and care organisations, universities, local authorities, and patients and the public. 

The collaborations are an evolution of the Patient Safety Translational Research Centres (PSTRCs), which were first funded by the NIHR a decade ago. The Greater Manchester PSTRC was one of the original centres to receive funding from the NIHR as part of the scheme.

Professor Darren Ashcroft, Director of the Greater Manchester Patient Safety Research Collaboration, said:

“We are delighted to have secured funding to continue patient safety research as one of the new Patient Safety Research Collaborations. The work we’ve delivered over the last 10 years at the Greater Manchester Patient Safety Translational Research Centre has impacted the safety of care delivered by the NHS, as our innovations have been adopted by health and social care and rolled out first regionally, then nationally. The new collaboration will allow our researchers to build on this success across four key themes of patient safety, and we’re excited to get this work underway.”

The Greater Manchester PSRC will focus on the following themes:

1. Improving Medication Safety
2. Enhancing Cultures of Safety
3. Developing Safer Health and Care Systems
4. Preventing Suicide and Self-harm

An example of the impact of the GM PSTRC’s work on NHS frontline services is the set of safety indicators developed to identify patients at risk of harm from prescribing errors. In addition, researchers helped to test and implement a pharmacist-led IT-based intervention based on these indicators that could reduce prescribing errors. This intervention has now been rolled out nationally.

Researchers at the Greater Manchester PSTRC also responded quickly to the COVID-19 pandemic, adapting existing studies and designing new ones. One study highlighted that fewer people asked their GP or hospital for mental health support during a lockdown. Another study that looked at the diagnosis and management of type 2 diabetes during the pandemic contributed to additional funding being made available to the NHS to support national COVID recovery through the creation of a ‘Diabetes Treatment and Care Recovery Innovation Fund’.

The new ‘Improving Medication Safety’ theme at the Greater Manchester PSRC will be led by Tony Avery, Professor of Primary Health Care at the University of Nottingham and Professor Darren Ashcroft at the University of Manchester.

Professor Sir Jonathan Van-Tam, Pro-Vice-Chancellor for Medicine and Health Sciences at the University of Nottingham, said:

“Being at the forefront of patient safety research is a priority for the University of Nottingham. The new Patient Safety Research Collaborations are a fantastic opportunity to improve patient safety. I’m excited to see what can be achieved here at the University of Nottingham where the Greater Manchester Patient Safety Collaboration’s work will focus on the theme of Improving Medication Safety.

“Professor Tony Avery aims to build on the success of his previous study at the Greater Manchester Patient Safety Translational Researcher Centre where he and his team developed a set of safety indicators to identify patients at risk of harm from prescribing errors. I’m looking forward to seeing the work that’s developed and the difference it makes to patient safety across health and social care.”

One of the four themes, ‘Enhancing Cultures of Safety’, will be led by researchers based at the University of Leicester. Professor Thompson Robinson, Pro Vice-Chancellor, Head of the College of Life Sciences and Dean of Medicine, University of Leicester, said:

“I am delighted that the University of Leicester has been invited to be part of this exciting new collaboration. Research seeking to ensure the delivery of safe, high quality healthcare is a key area of focus both here at the University and for our NHS partners.

“The ‘Enhancing Cultures of Safety’ theme, to be led by Professors Natalie Armstrong and Carolyn Tarrant, will ensure that efforts to improve organisational patient safety culture and practice are informed by high quality research.”

The ‘Developing Safer Health and Care Systems’ theme will be led by Professor Caroline Sanders and Dr Tom Blakeman. It will be based at The University of Manchester and aims to work with patients, carers and key stakeholders to improve how multiple health and care providers work together to deliver care safely.

The second theme to be based at the University of Manchester is ‘Preventing Suicide and Self-harm’. Professors Nav Kapur and Roger Webb will lead this work, which will identify, refine and subsequently evaluate service innovations that have enhanced patient safety in specialist mental health services, self-harm services across general hospitals and primary care.

Professor Graham Lord, Vice-President and Dean of the Faculty of Biology, Medicine, and Health at the University of Manchester, said:

“The University of Manchester has led a patient safety research centre since they were first introduced by the National Institute for Health and Care Research a decade ago. I’m immensely proud of the improvements to patient safety that have come about due to this work and anticipate new innovations that continue to strive to put the safety of patients first.”

The Greater Manchester PSRC will be hosted by Northern Care Alliance NHS Foundation Trust, Professor Phil Kalra Director of Research & Innovation, said:

“Research that focuses on patient safety across health and social care is vital. We have been impressed with the achievements of the Greater Manchester Patient Safety Translational Research Centre and are pleased to be hosting the new Patient Safety Research Collaboration from 2023. All four of the collaboration’s new themes are relevant to the NCA and we are looking forward to working together to improve patient safety.”

In addition to funding six PSRCs, the NIHR is also providing new, additional funding to establish a network between these collaborations. The network will provide a platform for strategic coordination and a focal point for collaboration between the PSRCs. 

For example, in times of national crises, such as the COVID-19 outbreak, the network could work with partners and respond as a single entity. The role of leading the network will be awarded through a competitive process, with further details provided soon.

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The NIHR PSRCs funded from 2023-2028 are:

Name	Host institution
NIHR Greater Manchester Patient Safety Research Collaboration	Northern Care Alliance NHS Foundation Trust
NIHR Midlands Patient Safety Research Collaboration	University Hospitals Birmingham NHS Foundation Trust
NIHR North West London Patient Safety Research Collaboration	Imperial College Healthcare NHS Trust
NIHR Central London Patient Safety Research Collaboration	University College London Hospitals NHS Foundation Trust
NIHR Newcastle Patient Safety Research Collaboration	The Newcastle Upon Tyne Hospitals NHS Foundation Trust
NIHR Yorkshire and Humber Patient Safety Research Collaboration	Bradford Teaching Hospitals NHS Foundation Trust