Joint SPCR-GM PSRC PhD Studentships
NIHR SPCR (School for Primary Care Research) and NIHR GM PSRC (Greater Manchester Patient Safety Research Collaboration) are advertising four PhD Studentships:
Decluttering primary care in England to improve patient safety
Reducing the provision of low-value interventions that expose patients to unnecessary risk of harm, both directly, and indirectly, is key to promoting patient safety and reducing healthcare costs. Over the last two decades, there has been significant attention from the policy and academic community on reducing the provision of low-value care that exposes patients to risk of harm. For example, the development of guidance (i.e. “do not do” recommendations from the National Institute for Health and Care Excellence), shared decision making (i.e. the Choosing Wisely initiative), and clinical audit and feedback systems (i.e. integrated within electronic health records). Despite this, many ineffective and harmful interventions continue to be used in routine clinical practice.
The aim of this PhD is to declutter primary care by reducing the provision of low-value interventions with limited clinical- and cost-effectiveness, and where the risk of harm exceeds likely benefit. This will be achieved by: (i) establishing a list of indicators to measure low-value care that expose patients to risk of harm in English general practice, (ii) analysing routinely collected administrative data to examine micro (i.e patient and clinician) and macro (i.e practice characteristics) factors that drive the provision of low-value care that expose patients to risk of harm, and (iii) identifying enablers and barriers to sustainable behaviour change in primary care required to reduce provision of low-value care that exposes patients to risk of harm
This PhD project will take a mixed-methods approach and the PhD candidate will develop skills and undertake training in evidence synthesis, consensus studies, quantitative analyses of healthcare administrative datasets, and qualitative research techniques. Collectively, this PhD project will develop actionable evidence that can inform policy and promote the delivery of safe, effective, and high-quality care delivery in English general practice.
Applications accepted all year round
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Investigating inequalities in the safety of artificial intelligence triage in general practice
GP practices in England provide over 30 million appointments per month. Some are for urgent medical conditions that require urgent treatment where delays in care can lead to patient harm. Since 2020, almost all GP practices in England have provided online consultations where patients can request help over the internet. Online consultations are received by GP practices unprioritised which can worsen care delays. A potential solution is for the online consultation system to triage patients using artificial intelligence (AI). AI Triage is already used in NHS GP practices despite there being little evidence for its safety or whether this varies based on patient characteristics.
The aim is to evaluate the safety of AI Triage in GP practices and whether it varies according to patient clinical and sociodemographic characteristics including age, sex, socioeconomic deprivation, and ethnicity.
Applications accepted all year round
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Can the Reboot coaching programme support general practitioners in coping with adverse events? Adaptation and evaluation of a novel intervention
Are you interested in mental health research? Would you like to support healthcare professionals to deliver safer patient care? Please see below for an exciting PhD research project which offers the opportunity to develop a range of research skills.
The overarching aim is to generate new evidence to inform the delivery of interventions to reduce burnout in GPs and to explore whether such interventions are associated with improvements in patient safety. The objectives are to 1) systematically review the literature on the prevalence and risk factors for burnout in GPs, 2) adapt the Reboot Coaching Programme for GPs and 3) evaluate the Reboot Coaching Programme in GPs.
Applications by Monday, September 30, 2024
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Knowledge Support to support clinicians to manage mental health medication in general practice
Mental health disorders are widespread and necessitate effective solutions. Mental medication such as antipsychotics have been associated with multiple adverse outcomes. A patient-centred approach is considered an effective method for addressing these challenges. GPs play an important role in supporting mental health patients. Despite this, GPs are not always aware of how best to care for each patient. However, few patient-centred tools exist to support patients and GPs with mental health care. There is research to suggest that ‘knowledge support’ tools may improve GP services. These are tools which aim to improve the knowledge of clinicians, patients and carers by providing them with personalised information during consultation. Patients with serious mental illness often have complex clinical histories, with information relevant to clinical decision-making spanning several years of healthcare records. However, time constraints mean that General Practitioners (GPs) are unable to review all records during consultations, thereby potentially overlooking important information.
The National Institute for Health and Care Excellence (NICE) highlighted that patients with both long-term physical and mental health conditions are a key group for receiving a care plan that better accounts for multimorbidity, including medication optimisation. However, tools available to support this are currently limited. There is a growing commentary on the difficulties of prescribing for mental health illness in primary care, where 90% of such patients are managed and frequently reported as receiving poorer quality care and health outcomes than those with physical illness. A lack of GP confidence in managing mental illness, poor integration of mental and physical health services, as well as inadequate resources, may mean that high-risk aspects of patients’ treatment regimens are overlooked or hard to identify. For patients that require interaction with specialist mental health, poor coordination across systems and settings creates further challenges to effectively managing prescribing. Mental health medications are responsible for a significant proportion of medication-related harm. This is a growing problem. It has been reported that emergency admissions possibly due to an Adverse Drug Reaction showed the third largest increase for sedatives, hypnotics and antianxiety drugs (73.4%) in England between 2008 to 2015.
Applications by Monday, September 30, 2024
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Manchester
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UK
Email: gmpsrc@manchester.ac.uk
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