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How was it for you? Reflections on involvement

1 Aug

This edition, we meet Andrew Grundy, who is involved in the Safer Transitions project in our Safer Care Systems and Transitions research theme.

Why did you decide to become involved in the Safer Transitions project?

I accepted an invitation to become involved in the Safer Transitions project because I am a mental health service user with lived experience of mental health service transitions myself; community to inpatient, and back again, on a number of occasions.

I also have research interests this area – my interests are in service user’s experiences of mental health services. My PhD is focussed on service users’ experience of risk assessment and management in an acute setting, which (among other things) involved sitting in and observing ward rounds and discharge meetings.

I wanted to use my lived and learned experience to make a difference in this area of hospitalisation discharge. We know that staff can become so focussed on the process that they lose sight of the person, and service users often feel lost in the system. So I feel it is important to constantly remind people that it is service users and carers who we hope will benefit from the research we do.

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

My involvement has focussed on assisting with the design and conduct of a study on the development of a Core Outcome Set for mental health hospitalisation discharge interventions – that is, a fundamental set of outcomes that we hope would be used in all future research into mental health discharge. This involved making the online study information sheet and surveys accessible and acceptable to a lay audience.

I have also been involved in co-producing an intervention to improve the service user experience of hospitalisation discharge. I’ve been involved to bring the service user experience and perspective into consideration when coming up with potential ideas in this area, and I’m excited about the next steps (watch this space!).

How do you feel you have benefitted from your involvement?

I’ve definitely picked up more research understanding and skills, particularly around developing a Core Outcome Set and the Delphi method – the process for producing the Core Outcome Set via an online panel completing various surveys, and then a face-to-face consensus meeting to agree the final outcome set.

I’ve also been able to use some of the most difficult experiences of my life (such as inpatient admissions) to make a difference to the research.

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

I would recommend being involved in the design and conduct of research, particularly if you have first-hand experience of a mental health condition (with all that entails) because you have a form of knowledge and expertise that people with only an academic knowledge-base don’t have.

The same is true if you are a friend or family member supporting someone with a mental health condition – that knowledge and experience is invaluable to academic researchers.

If you’re a health professional, your experience of clinical practice is also really helpful.

You may not feel like an ‘expert’ but clinicians, carers and service users have such a wealth of different kinds of knowledge that can make a real difference throughout the research process.

Developing prescribing safety indicators for the prison setting

17 Jul

by Richard Keers

pharmacy store interior with medicine on medical shelves blur background

A project has just begun which aims to develop and test prescribing safety indicators in prison healthcare.

Prescribing safety indicators describe prescribing and drug monitoring practices that may place patients at risk of harm, and which should generally be avoided. Whilst these indicators have been successfully introduced into hospitals and general practices in the UK, they have not been developed specifically for use in prisons, where research tells us the needs of patients and the way in which medicines are used differs from other health care environments.

The project team hopes that this work will lead to the implementation of prescribing safety indicators across prisons to help improve care for prisoners.

The project team will work closely with prison pharmacists to develop, input and test the prescribing safety indicators within prison healthcare records. Testing will take place in cycles to maximise learning and to help ensure that the indicators capture the right information. Following this exercise, the project team aim to run an event with prison staff and researchers to explore the potential for these indicators to be deployed on a national scale.

The project team are aiming to use the findings of this work to plan and submit a funding application to continue building on this research area.

If you would like to learn more about this study please contact Richard Keers.

Improving injectable medicines administration safety in hospitals

16 Jul

by Richard Keers

Row of medical syringes with blue lids

A new project has recently got underway to explore whether a new intervention to reduce injectable medicines administration errors in hospitals would be practical and welcomed by nursing staff. It is hoped that this NIHR Greater Manchester PSTRC work will identify how this intervention will be best designed and introduced into hospitals so it has the highest chance of success.

The intervention involves changing the way staff perform ‘second checks’ on injectable doses, which research tells us can be a task that is vulnerable to mistakes leading to medication errors. It is also known that errors involving injectable medicines pose a risk to patient safety and that it is therefore important to support the staff responsible for the complex process of preparing and administering them.

This project involves carrying out workshops with nursing staff across hospitals within one NHS trust to find out what they think about the intervention, how they think it might be introduced and work day-to-day in the hospital, and what factors might influence how successful it is.

The work will also explore how the staff members think the intervention should be tested to see if it is successful in improving medicines safety and being adopted into everyday clinical practice.

The project team are aiming to use the findings of this work to plan and submit a funding application to continue exploring the potential of this intervention.

If you would like to learn more about this study please contact Richard Keers.

PhD Fellow Focus: Rebecca Musgrove

1 Jul

by Rebecca Musgrove

Rebecca Musgrove_Photo

Rebecca Musgrove joined the University of Manchester as an NIHR Greater Manchester PSTRC-funded PhD student in January 2019.  As part of the ‘Safety in Marginalised Groups’ theme, she is focusing on the epidemiology (how often and where diseases or healthcare events happen) of suicide and self-harm after discharge from Mental Health inpatient care.  She is particularly interested in the role of primary care and specialist mental health services in protecting against suicide in the period shortly after discharge.  She hopes to use the Clinical Practice Research Datalink (CPRD), a large UK dataset derived from a large network of GP practices, linked with hospital admission, mental health and mortality records to define a cohort.

Prior to taking up the studentship, Rebecca worked as a Senior Analyst with the Mental Health policy team at NHS England.  She used data from the Mental Health Services dataset and other relevant national collections to provide monitoring tools and analysis to support the implementation of the Five Year Forward View for Mental Health and the more recent Long Term Plan.  She holds a Master’s degree in Demography and Health from the London School of Hygiene and Tropical Medicine.  Prior to this Rebecca worked as a trainer and in operational management in community Sexual Health in London and as a Child Protection Manager in war affected communities internationally.

She is passionate about improving health outcomes and reducing premature mortality for people who experience mental ill health and hopes her PhD will provide evidence to support and further develop existing UK policy.  After completing her PhD she hopes to continue working closely with the NHS in a mental health-care research capacity.

Developing a resource to help healthcare professionals implement NICE guidelines for self-harm

1 Jul

by Jessica Leather


Jessica Leather joined the NIHR Greater Manchester PSTRC Marginalised Groups theme as a PhD Fellow in September 2018. Before coming to the University of Manchester she completed a MSc in Health Psychology at Liverpool John Moores University. Following her masters, she worked as a research assistant for a bowel cancer screening intervention for Black and Asian Minority Ethnic populations in Liverpool. Her main interests lie in behaviour change interventions, particularly involving healthcare professionals as recipients or agents.

Jessica’s PhD focuses on the development of an intervention to aid healthcare professionals in implementing the NICE guidelines for self-harm, supervised by Prof Christopher Armitage, Prof Navneet Kapur and Prof Stephen Campbell. Self-harm is a key risk factor for suicide; approximately half of people who die by suicide have a lifetime history of self-harm. Presentations in primary care for self-harm are a critical setting for healthcare professionals to identify suicide risk and intervene. However, it is unclear:

  1. what is the rate of patients presenting with self-harm
  2. whether healthcare professionals are aware of the guidelines for self-harm, and
  3. which factors may influence whether or not healthcare professionals implement the guidelines.

Therefore, this project aims to understand the experiences of healthcare professionals when encountering patients at risk of self-harm, and develop an intervention to facilitate the implementation of NICE guidelines for self-harm.

Study 1 comprises a representative survey in which healthcare professionals will report how frequently they encounter patients, and how they typically respond when they believe someone is at risk of self-harm. The survey will capture details about any training or tools they have received to aid their assessment and management of self-harm, and whether or not these resources were sufficient. Existing scales will be used to measure specific factors that could be associated with implementing the guidelines, such as a dislike of them, or an over-confidence in clinical judgement. Finally, the survey will use models of behaviour change to identify the issues that need addressing to improve the implementation of the guidelines.

Study 2 comprises of semi-structured telephone interviews in which healthcare professionals will be able to suggest acceptable solutions to the specific barriers they face when trying to implement the guidelines, while expressing whether or not they think an intervention would be useful and feasible for them in their professional role. This work will form the basis for an intervention to facilitate the implementation of NICE guidelines for self-harm by healthcare professionals.