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How was it for you? Reflections on involvement

21 Feb

This edition’s reflection comes from Stephen Barlow, a member of the public who is involved in the Marginalised Groups: Mental Health theme’s research advisory panel.

Stephen Barlow_Reflections on Involvement_cropped

Why did you become involved in the ‘Mutual Support for Mental Health’ research advisory panel (supporting the mental health workstream  in the PSTRC)?

I’ve had mental health problems for years and frankly the treatment I’ve received has mostly been poor. There are a range of reasons for this from lack of funding to frankly incompetence. If I can do anything to make future treatment better I will always get involved.

How do you think the Greater Manchester PSTRC has benefitted from your involvement – what difference do you feel that you made?

To me the benefit to the university is that myself and the rest of the group look at the project as members of the public, by which I mean that we look at what has been written ‘normally’ not in ‘uni speak’. In that way we translate the jargon into normal terms understandable to the whole public, not only academics.

How do you feel that you have benefitted from your involvement?

I feel that I’m part of something important and helping future treatment, and meeting people with similar stories to me.

Would you recommend becoming involved in research to other patients? If so, why?

Yes, simply because you could be part of something that could shape better treatment in the future.

Babylonian patient safety

11 Oct
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One of the twelve stone displaying the Code of Hammurabi

by Stephen Campbell

Every patient, every person, deserves safe quality care. The quality and safety of care varies between countries and within countries; even within hospitals or general practices, dental practices or pharmacies. Some people will benefit from exemplary care (both clinical and inter-personal) whereas most will experience safe quality care. However, the reality is that some people / patients will receive poorer care and, in a minority of cases, unsafe, or unacceptable quality of, care.

How should this be addressed? Quality and safety improvement literature refer to various forms of incentives and rewards or penalties to reflect the safety and quality of care delivered. These can relate to financial, professional, regulatory and reputational standards and reflection of performance. It’s important to emphasise that care is provided within organisations within systems and usually as part of a team. Most unsafe and poor care is often the result of systems errors.

The idea that there will be incentives or consequences for the safety and quality of care delivered is new…is wrong. There have been some interesting approaches over the centuries. Do they have anything in common with health and social care today? Yes – they reflect the fact that it’s been recognised that care varies and patient outcomes vary and that there is an arbiter (a regulatory body or an individual) of safety and quality who will decide on the consequences for patient outcomes. Leaving aside issues of ethics, morals and legality…not to mention fairness…

Between the fifth and third centuries BC, the Hippocratic Oath required a new physician to swear, by a number of healing Gods, to uphold specific ethical standards. In essence, “First do no harm” (Latin: Primum non nocere). The “do no harm” was not new. King Hammurabi (B.C.1795-1750) was king of Babylonia who is credited with the legal Code of Hammurabi (a set of 282 laws written on twelve stones and displayed publicly for all to see). These were designed to regulate Mesopotamian society. Perhaps the most well-known is: “Eye for eye, tooth for tooth.” Delve deeper and one law stipulates that “If a doctor has opened an abscess of the eye and has cured the eye, he shall take ten shekels of silver”… however…“If a doctor has opened an abscess of the eye and has caused the loss of the eye, the doctor’s fingers shall be cut off”.

The focus on quality and safety of healthcare is mostly a post-war agenda. While it would not be appropriate to compare any existing health and social care regulatory body such as the Care Quality Commission to Mesopotamian society, it’s interesting to reflect on the fact that “regulation” of healthcare and patient outcomes is certainly not new. Thankfully, however, the current focus on “each person receives appropriate person-centred care and treatment” does not require anyone to have their fingers chopped off.

Using Artificial Intelligence to help primary care triage

5 Oct

Working on laptop, close up of business man

by Ben Brown

Researchers at The University of Manchester and Spectra Analytics are developing an Artificial Intelligence (AI) system to help support GP practices triage requests for appointments – the Patient Automated Triage and Clinical Hub Scheduling (PATCHS) system.

It’s often difficult to get an appointment with a GP, and it’s estimated that over a quarter of GP appointments could have been dealt with in an alternative way, for example by another clinician (such as a nurse) or through patient self-care. One solution may therefore be to allocate GP appointments to patients that really need them.

While receptionists at GP practices can direct patients to the most appropriate care provider, not all practices do this, and often patients are unwilling to disclose their problems to them. PATCHS plans to tackle this by providing an online tool that will efficiently direct patients to the right place, 24 hours a day. Patients will input their reasons for requesting a GP appointment, and PATCHS will analyse this request, taking into account the patient’s medical history, in addition to other factors such as the weather, to come to a triage decision. It is hoped the system could ultimately be integrated into practice websites and medical records, ensuring effective triage at the beginning of a patient’s care pathway.

The project is funded by Innovate UK and is currently in the development stage: PATCHS is currently learning from existing data about how patients are triaged when booking a GP appointment. However, the team are looking for volunteers – both patients and doctors – to participate in the project. If you’d like to know more please contact Dr Ben Brown on benjamin.brown@manchester.ac.uk.

How was it for you? Reflections on involvement

2 Aug

This edition’s reflection comes from Kay Gallacher, a member of the public who is involved in the NIHR Greater Manchester PSTRC Patient Safety Guide.

Kay Gallacher PSG_lightened_cropped

Why did you become involved in the Patient Safety Guide project?

I have long been aware of the issues that elderly family and neighbours, in particular have experienced trying to manage contact with their GPs and pharmacies.  The brilliant, simple idea behind this Patient Safety Guide seems to address many of the concerns in a practical and tangible way.  I was also attracted by the fact that this was a collaborative project where patients, carers and medical professionals all have an equally important input into the design and delivery of both the paper- based Guide and the mobile app, hopefully making it a 360 degrees (all round) useful tool.

How do you think the Greater Manchester PSTRC benefitted from your involvement – what difference do you feel that you made?

I guess it’s for others to judge what impact, if any, I’ve had on the project.  However, I’ve brought a genuine understanding of the problems patients face when coming into contact with primary care and producing leaflets and guides was bread and butter for me in my marketing career.  So, I hope I’ve been helpful in producing and delivering an effective product.

How do you feel that you benefitted from your involvement?

I am involved with several projects, but this one in particular has sharpened my understanding of how the GP/ patient dynamic operates.  I came to this project with a patient’s viewpoint but I now have a better insight into the challenges GPs face in establishing and maintaining effective communication with patients.  Also, the deep personal satisfaction of feeling that I’ve made a positive contribution.  Importantly, I can’t overstate the pleasure I’ve derived from being part of a cohesive, effective and well-led team composed of great people from a wide range of backgrounds.

Would you recommend becoming involved in research to other patients and carers? If so, why?

Definitely!!  What you get from being involved largely depends on what you put into it but I can absolutely guarantee that, regardless of your starting point, you will have a better understanding of the workings of medical research and the wider world of medicine in general.