Members of the Community and Health Research Unit from the University of Lincoln recently attended the combined Society of Academic Primary Care and RCGP Annual Scientific Meeting in Glasgow where they were selected to give five oral presentations on some of the team’s current research into cardiovascular disease, adult vaccination and insomnia treatment. The conference provided a wonderful opportunity for junior and senior members of the team to present work at an international conference. 
Category Archives: News
To be or not to be LGBT in Primary Health Care
An analysis and commentary paper on lesbian, gay, bisexual and transgender primary care has been published in the British Journal of General Practice.
Lesbian, Gay, Bisexual and Transgender (LGBT) primary healthcare will, increasingly, be a feature of the primary care repertoire. Pride in Practice, which is supported by the RCGP, provides a rating system that judges primary care surgeries on a welcoming environment, access, the general practitioner (GP) – patient consultation, staff awareness and training and health promotion for LGBT people. For those surgeries signed up to the initiative, plans to address shortfalls will be developed in consultation with the Lesbian and Gay Foundation.
Returnee back to join the CaHRU team again!
Jo Middlemass returns to join the research team this October 2012 as Research Assistant on the CHROMED (Clinical tRials fOr elderly patients with MultiplE Disease) study which is a three-year, international, European Commission funded study investigating the effectiveness and costs of telecare for patients with long-term conditions including COPD and heart failure. Previously Jo worked on the ENACT study (Exploring Social Networks to Augment Cognitive Behavioural Therapy for people with insomnia).
Improvement science and methods seminars: case control and self controlled case series designs
A new series of Improvement Science and Method Seminars led by Zahid Asghar, senior lecturer in health, began with our first workshop on 19 October 2012. Zahid led the attendees, which included academic and health service staff working with the Community and Health Research Group, through case-control studies and touched 
on the self-controlled case series method. There have been only forty or so studies published using this novel method in the worldwide literature including one study published by the team last year in the prestigious Vaccine: Gwini SM, Coupland C, Siriwardena AN. The effect of influenza vaccination on risk of acute myocardial infarction: self-controlled case-series study. Vaccine 2011; 29: 1145-1149.
Zahid is currently working on an NIHR Research for Patient Benefit study looking at the possible association between influenza or pneumococcal vaccination and stroke or transient ischaemic attack (TIA) (IPVASTIA), which he used to illustrate the two study types. There have been a number of studies investigating the link between respiratory infections as a trigger for heart attack or stroke and the possible protective effect of influenza vaccination including a study published by the group in the Canadian Medical Association Journal two years ago: Siriwardena AN, Gwini S, Coupland C. Influenza vaccination, pneumococcal vaccination, and the risk of acute myocardial infarction: matched case-control study. Canadian Medical Association Journal 2010; 182 (15): 1617- 1623.
Pay-for-performance with caution: new systematic review published in Annals of Family Medicine
A new systematic review of the UK Quality and Outcomes Framework (QOF) is published in the Annals of Family Medicine today. The QOF, a controversial program of financial incentives and information technology to promote structured and team-based care, is the most comprehensive national primary care pay-for-performance (P4P) program in the 
world.
The authors, Steve Gillam (University of Cambridge), Niro Siriwardena (University of Lincoln) and Nick Steel (University of East Anglia) found, despite an annual investment of over a billion pounds per year in incentives, only modest improvements since the QOF was introduced in 2004. The systematic review follows on from a book, co-edited by Steve Gillam and Niro Siriwardena entitled ‘The QOF: transforming general practice’ published in 2010.
The QOF has also contributed to reduced continuity of care and may have detracted from patient-centred care. In view of the findings policy makers should be cautious about implementing similar P4P programs. Systems need to be developed which improve quality while minimizing costs and unintended consequences.