United Kingdom

Managing Quality in Community Health Care Services

Community health care services provide vital care out of hospital for millions of people. From children’s services to care for older people and end-of-life support, the community sector plays a key part in meeting the challenges facing our health and care system. This report presents findings from a small-scale study into how quality is managed in community services. It explores how community care providers define and measure quality and recommends important next steps to support better measurement and management of quality. [from introduction]

Rethinking Resistance to ‘Big IT’: A Sociological Study of Why and When Healthcare Staff Do Not See Nationally Mandated Information and Communication Technologies

Our analysis focused mainly on the Choose and Book system for outpatient referrals, introduced in 2004, which remained unpopular and little used throughout the period of our research (i.e. 2007–13). We identified four foci of resistance: to the policy of choice that Choose and Book symbolised and purported to deliver; to accommodating the technology’s sociomaterial constraints; to interference with doctors’ contextual judgements; and to adjusting to the altered social relations consequent on its use.

The Role of Informal Networks in Creating Knowledge Among Health-Care Managers: A Prospective Case Study

Health and well-being services, in common with many public services, cannot be delivered by a single organisation and require co-ordination across several organisations in a locality. There is some evidence, mostly from other sectors, that middle managers play pivotal roles in this co-ordination by developing networks of relationships with colleagues in other organisations. These networks of relationships, established over time, provide contexts in which managers can, collectively, create the knowledge needed to address the challenges they encounter.

Meeting the Support Needs of Patients with Complex Regional Pain Syndrome through Innovative Use of Wiki Technology: A Mixed-Methods Study

Using online discussion forums can have a positive impact on psychological well-being through development of shared group identity and validation of thoughts, feelings and experiences. This may be particularly beneficial to people with complex regional pain syndrome (CRPS), who often become socially isolated, lack mobility and face threats to their sense of identity. We set up a peer-support online forum to identify the nature of support provided and to explore its development over time.

Developing Collective Leadership for Health Care

The [National Health Service] is confronted by radically changing demographic pressures and hugely increasing demands. Alongside these is the need to build public confidence after several high-profile scandals, to increase productivity and to promote innovation in health and social care. This all comes as public sector financial cuts are implemented on a large scale. How can health care organisations respond effectively to these challenges? [from introduction]

Empirical impact evaluation of the WHO Global Code of Practice on the International Recruitment of Health Personnel in Australia, Canada, UK and USA.

The active recruitment of health workers from developing countries to developed countries has become a major threat to global health. In an effort to manage this migration, the 63rd World Health Assembly adopted the World Health Organization (WHO) Global Code of Practice on the International Recruitment of Health Personnel in May 2010. While the Code has been lauded as the first globally-applicable regulatory framework for health worker recruitment, its impact has yet to be evaluated.

On the Buses: a Mixed-Method Evaluation of the Impact of Free Bus Travel for Young People on the Public Health

To evaluate the impact of free bus travel for young people in London on the public health. Specifically, to provide empirical evidence for the impact of this ‘natural experiment’ on health outcomes and behaviours (e.g. injuries, active travel) for young people; explore the effects on the determinants of health; identify the effects on older citizens of increased access to bus travel for young people and to identify whether or not the intervention represented value for money. [from abstract]

Being a Manager, Becoming a Professional? A Case Study and Interview-Based Exploration of the Use of Management Knowledge Across Communities of practice in health-care organisations

This study aims to investigate how NHS middle managers encounter, adapt and apply management knowledge in their working practices and to examine the factors [particularly organisational context, career background and networks of practice (NoPs)/communities of practice (CoPs)] which may facilitate or impede the acceptance of new management knowledge and its integration with practice in health-care settings. [from abstract]

The Role of Informal Networks in Creating Knowledge Among Health-Care Managers: a Prospective Case Study

This study focuses on how health and well-being managers collectively create knowledge. [from introduction]

NHS productivity challenge Experience from the Front Line

The unprecedented slowdown in the growth of NHS funding in England since 2010 required the NHS to pursue the most ambitious programme of productivity improvement since its foundation…But the strongest pressure has been applied and felt at the front line, by hospitals and other local service providers, faced with squeezing more and more value from every health care pound. [adapted from abstract]

Structured Pro-Active Care for Chronic Depression by Practice Nurses in Primary Care: A Qualitative Evaluation

This qualitative study explored the impact and appropriateness of structured pro-active care reviews by practice nurses for patients with chronic or recurrent depression and dysthymia within a nationwide randomized controlled trial which compared usual general practitioner care with structured pro-active care involving 3 monthly review appointments with practice nurses over 2 years for patients with chronic or recurrent depression. [adapted from abstract]

Support Matters: A Mixed Methods Scoping Study on the Use of Assistant Staff in the Delivery of Community Nursing Services in England

This study evaluated the roles, contribution and impacts of community nursing assistants to the delivery of care and services for patients with chronic conditions and complex care needs. [adapted from author]

I Think This Is Maybe Our Achilles Heel, Exploring GPs' Responses to Young People Presenting with Emotional Distress in General Practice: A Qualitative Study

This exploratory study investigated general practitioners’ (GPs’) views and experiences of consulting with young people (aged 12–19 years) presenting with emotional distress in general practice. [from abstract]

How Do United Kingdom (UK) Medical Schools Identify and Support Undergraduate Medical Students Who Fail Communication Assessments? A National Survey

This survey aimed to consolidate practices for identifying and processes for managing students who fail communication assessments designed to test a doctor’s ability to communicate effectively (with patients, relatives, advocates and healthcare colleagues) across all UK medical schools. [adapted from abstract]

Facilitated Patient Feedback Can Improve Nursing Care: A Pilot Study for a Phase III Cluster Randomised Controlled Trial

This randomized trials was conducted to test the effectiveness of patient feedback on quality improvement of nursing care in English hospitals. [adapted from abstract]

Workplace Bullying in the UK NHS: A Questionnaire and Interview Study on Prevalence, Impact and Barriers to Reporting

The objective of this study was to examine the prevalence and impact of bullying behaviours between staff in the National Health Service (NHS) workplace, and to explore the barriers to reporting bullying. [from abstract]

Novel Method of Assessing Quality of Postgraduate Psychiatry Training: Experiences from a Large Training Programme

This article reports on a comprehensive assessment of the quality of training at a large postgraduate psychiatry training institute using non-anonymised face-to-face interviews with trainees and their trainers, which successfully elicited strengths and weakness of the program and may well provide important information to allow for targeted improvement of health training in general. [adapted from abstract]

Learning from the Brazilian Community Health Worker Model in North Wales

This article describes the rationale for the UK to learn from Brazil’s scaled-up Community Health Worker primary care strategy, starting with a pilot project in North Wales. [from abstract]

Introducing Peer Worker Roles into UK Mental Health Service Teams: A Qualitative Analysis of the Organisational Benefits and Challenges

This paper seeks to address a gap in the empirical literature in understanding the organisational challenges and benefits of introducing peer worker roles into mental health service teams. [from abstract]

Training Health Care Professionals in Root Cause Analysis: A Cross-Sectional Study of Post-Training Experiences, Benefits and Attitudes

This cross-section study evaluates the effectiveness of training programs to build the local capacity and capability of health workers in root cause analysis (RCA), used to investigate patient safety incidents and facilitate organizational learning. [adapted from abstract]

Spinning Plates: Establishing a Work-Life Balance

Increased demand for nurses means that the organisations that provide employee-friendly policies will gain a competitive edge in attracting and retaining a quality nursing workforce. This publication provides guidance on the issues affecting work-life balance to influence employers and policy-makers on workplace policies. [adapte from author]

Role of SimMan in Teaching Clinical Skills to Preclinical Medical Students

Medical simulation is considered to bridge the gap between the classroom and clinical environment, and it enables learners, from novice to expert to practice and develop clinical skills without any fear of harm to patients. This study evaluated the effectiveness of simulation training in developing clinical skills in pre-clinical medical students. [adapted from author]

Exploration of Student Experiences of Using Biology Podcasts in Nursing Training

The aim of this study was to explore nursing students’ perceptions of the usefulness of supplementary biology podcasts for their learning. [from abstract]

Mobile Technology Supporting Trainee Doctors' Workplace Learning and Patient Care: An Evaluation

This paper reports an evaluation of an initiative which provided trainee doctors in Wales with a library of texts on a smartphone. Within a wider context of use of information sources in the workplace, the evaluation sought to find out how, when and why the Smartphone library was used and the outcomes and impact on knowledge and practice. [from author]

Why Do Clinicians Not Refer Patients to Online Decision Support Tools? Interviews with Front Line Clinics in the NHS

This study assessed whether clinical teams would direct patients to use web-based patient decision support interventions and whether patients would use them. The authors found that existing evidence of patient benefit and the free availability of patient decision support tools via the web are not sufficient drivers to achieve routine use, and the most significant obstacles to referral to the tools were the attitudes of clinicians and clinical teams. [adapted from abstract]

Regulation of the Non-Medical Healthcare Professions

This document deals with the regulation of health care professionals other than doctors to strengthen procedures for ensuring the performance of non-medical health professionals and other health service staff does not pose a threat to patient safety or effective functioning of services, and to ensure effective continuing professional development and appraisal for these staff. [adapated from introduction]

Effect of UK Policy on Medical Migration: A Time Series Analysis of Physician Registration Data

This study compared the trends in new professional registrations in the UK from doctors qualifying overseas before and after the national ethical guidance on international recruitment to determine what, if any, effect these policies have had on ethical recruitment. [adapted from author]

Using Scenarios to Assess the Future Supply of NHS Nursing Staff in England

This paper examines issues related to the future supply of registered nursing staff, midwives and health visitors in the National Health Service (NHS) in England at a time when there are major public sector funding constraints and as more of these staff are reaching retirement age. [from abstract]

Systematic Review of the Links between Human Resource Management Practices and Performance

This publication assesses the results from a wide-ranging series of systematic reviews of the evidence on human resource management (HRM) and performance. It assesses evidence on use of HRM in the UK and fidelity of practice implemented and considers evidence for the impact of HRM practices on intermediate outcomes, which can impact on final outcomes, such as organisational performance or patient care. [adapted from abstract]

Improving Inpatient Postnatal Services: Midwives Views and Perspectives of Engagement in a Quality Improvement Initiative

This paper presents data on the views of midwives from one maternity unit in England following the introduction of an organisation wide quality improvement initiative to improve in-patient postnatal care and processes to transfer women home. As quality improvement initiatives are highly influenced by the context into which they are introduced and by the processes of implementation, our findings may support others to address how clinician engagement could be enhanced. [adapted from author]