Author Archives: Niroshan Siriwardena

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CaHRU sleep research cited in UK parliamentary briefings on Sleep and Health

Sleep and healthResearch from CaHRU was cited in the recently published parliamentary briefing on Sleep and Health and Sleep and Long-term Health. The briefing was issued as a POSTnote from the Parliamentary Office of Science and Technology and cited CAHRU’s work on primary care for insomnia including the Resources for Effective Sleep Treatment (REST) website. Professor Graham Law and Niro Siriwardena met with one of the co-authors Lev Tankelevitch earlier this year to discuss their work.

Sleep and longterm healthThe briefing on Sleep and Health also cites two systematic reviews led by CaHRU’s Dr Coral Sirdifield on patient and general practitioner (GP) perceptions of the problems of benzodiazepine sleeping pills, an article by Prof Siriwardena providing guidance for GPs, and the OASIS trial (led by Prof Dan Freeman of Oxford University) showing the effects of treatment using digital Cognitive Behavioural Therapy for Insomnia (dCBTi) on psychiatric symptoms. The briefing on Sleep and Long-term Health  research papers on sleep assessment and the DIALS trial showing the effect of dCBTI on quality of life which is due for publication this autumn.

rest-logoThe REST project is also explicitly mentioned: ‘One strategy to improve training for healthcare professionals is through online training developed by the Resources for Effective Sleep Treatment project’ and the REST e-learning programme for GPs and healthcare staff has been accessed over 16,000 times by users in over 160 countries.

POSTnotes are distributed in paper copies to Parliamentarians, placed in the reference libraries of both Houses of Parliament and also promoted via social media using Twitter @POST_UK. CaHRU are currently collaborating in a major trial of sleep restriction therapy in primary care, the HABIT trial. You can find out more about our work on sleep from our infographic on ‘Sleep and Insomnia‘.

By Prof Niro Siriwardena

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REST project featured on ITN Tonight documentary on insomnia

The Resources for Effective Sleep Treatment (REST) project, led by Prof Niro Siriwardena, was featured on “Tonight” the flagship ITV1 documentary programme,  the highest rating current affairs series on UK television for the past decade. In the programme “Waking up to Insomnia” screened on 17 November at 7:30pm, Geraint Vincent revealed some results of the Great British Sleep Survey and found out from sufferers how it affected their lives. The programme discussed the problems of insomnia, why sleeping tablets were not a good solution and why Cognitive Behavioural Therapy for insomnia (CBTi) although effective is not widely available in the NHS. The REST project funded by the Health Foundation aimed to improve primary care for insomnia by developing primary care friendly sleep assessment and CBTi. A follow-on translational project, Improving Primary Care Resources for Effective Sleep Treatment (IPCREST) funded by East Midlands Health Innovation and Educational Cluster aims to spread the learning through seminars, workshops and an e-learning programme for healthcare practitioners. Further information is available on the University website and at the REST website. Niro is presenting on “How to provide better care for insomnia: Resources for effective sleep treatment in the general practice consultation” at the Sleep and Mental Health conference at the Royal Society of Medicine on 23 November 2011.

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Another new member of the Community and Health Research team

Hello, My name is Zahid  Asghar. I joined the Lincoln School of Health & Social Care in September 2011. My background is in mathematical modeling and medical statistics.  Currently I am working on a case control study and a self-controlled case series study to investigate the potential for influenza and/or pneumococcal vaccination to prevent against stroke and transient ischemic attack (IPVASTIA). The study is funded by the National Institute for Health Research (NIHR) Research for Patient Benefit programme and the study team led by Prof Niro Siriwardena (Lincoln) include Dr Carol Coupland (Nottingham University) and Stella Gwini (Monash University, Australia).

Zahid Asghar

Previously I have worked as an infectious disease modeler at Imperial College, London (over five years), Medical Statistician at Nottingham University for chronic liver disease and as a mathematical modeler, data analyst and statistician at Liverpool University,  forecasting  coronary heart disease and mortality projections for the UK. I have extensive experience in data management and computer programming. I developed algorithmic code to aid policy and advocacy as well as calculated the prevalence of disease burden such as HIV in different country settings.

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Review of the Quality and Outcomes framework highly commended in the BMA book awards

A book edited by Dr Stephen Gillam (University of Cambridge) and Prof Niroshan Siriwardena (University of Lincoln) and published by Radcliffe Publishing Ltd entitled “The Quality and Outcomes Framework: QOF – transforming general practice” was highly commended at the BMA Medical Book Awards 2011. Steve Gillam and Niro Siriwardena were present at the awards ceremony in BMA House in London.

Highly commended in this year's BMA Medical Book Awards 2011

Contributors to the book include the architects of the QOF, developers, researchers, practitioners and commentators. Work is currently proceeding on a systematic review of research into the QOF involving the Universities of Cambridge, Lincoln and East Anglia.

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Primary Care Transparency Conference, World Forum, The Hague, 20 May 2011

I had the great privilege of being invited to the Hague to give a keynote at a national conference on transparency in primary care in my role as an executive board member for the European Forum for Primary Care.

World Forum, The Hague, Netherlands

World Forum, The Hague, Netherlands

The Netherlands has been fortunate to have one of the best primary care systems in the world. Over the past few years their system, which combines public and insurance based funding, has been reformed to introduce greater marketisation. More recently the organisation of primary care into care groups and the introduction of bundled payments has brought even greater measurement and transparency into the Dutch health system.

The conference was about transparency and how payments could be linked more closely to performance measures and indicators. I was invited to speak about the pay-for-performance system for general practice in the United Kingdom – the Quality and Outcomes Framework (QOF) – having recently edited a book on this subject with my colleague Steve Gillam. This was published in 2010 ‘The Quality and Outcomes Framework: QOF transforming general practice’ and we were fortunate to have so many distinguished and  illustrious authors and researchers as contributors, among them sadly the late Barbara Starfield.

I spoke about the QOF, its effects on health processes and outcomes, equity, efficiency and patient experience (click here to see the presentation). In summary the system that has been developed has led to extraordinary advances in the organisation and transparency of primary care in the UK. However, this has been at huge cost (around £1 billion a year) and with relatively small improvements over and above what might have been expected given previous trends. Although the current system does provide the infrastructure for improvement, it is currently designed as a target rather than an improvement mechanism; and although I am not in favour of abolishing it I would advise against other countries adopting our system wholesale – instead they should look at what works in the QOF and try to improve on it.

I had an excellent host in Dr Marc Bruijnzeels, Director of the Jan van Es Instituut. The evening before the conference we travelled to Utrecht to meet with a group of experts, including academics, GPs and insurance organisation representatives,  to discuss the same issues more informally over dinner.

Utrecht, Netherlands

Utrecht, Netherlands

Finally, at the end of my stay I visited Madurodam – where you might just spot the giant ducks – even bigger than trees?!

Giant ducks at Madurodam, The Hague, Netherlands

Giant ducks at Madurodam, The Hague, Netherlands