New study published on how acute pain management could be improved in urgent care

Mohammad Iqbal, research fellow and PhD student at the University of Lincoln and research associate at East Midlands Ambulance Service (EMAS), together with Anne Spaight (senior research fellow at the University of Lincoln and Head of Clinical Governance, Audit and Research at EMAS) and Niro Siriwardena (professor of primary and prehospital health care) have a new study published online in the Emergency Medical Journal. The study entitled: ‘Patients’ and emergency clinicians’ perceptions of improving pre-hospital pain management: a qualitative study’  follows on from an earlier study investigating prehospital pain management which showed that under two-fifths of patients with a painful condition (heart attack or fracture) were provided with pain relief.

Although patients and staff expected pain to be relieved in the ambulance, refusal of or inadequate analgesia were common. Pain was often assessed using a verbal pain score, but practitioners’ views of severity were sometimes different from patients’ views. Morphine and Entonox were commonly used to treat pain, but reassurance, positioning and immobilisation were used as alternatives to drugs.

The authors concluded that pre-hospital pain management could be improved by addressing practitioner and patient barriers, increasing available drugs and developing multi-organisational pain management protocols supported by training for staff. These findings may be used to inform guidance, education and policy to improve the pre-hospital pain management pathway.

Niro Siriwardena co-leads the NIHR Programme Grant for Applied Research: Prehospital Outcomes for Evidence based Evaluation (PhOEBE).

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.

Publication of Nursing Text Book

Members of the academic nursing team at the university have recently completed new text book: Nursing for Public Health – Promotion, Principles and Practice. Edited by Paul Linsley, Ros Kane and Sara Owen the book includes contributions from all members of the team and from many colleagues outside the university.

The book, aimed primarily at pre-registration nursing students reflects the growing need for all nurses to become involved in the promotion of health and well-being of both their patients and of the wider population. The book seeks to provide a clear, academic and practical account of the increasing importance of public health knowledge for all nursing practice. The book was published by Oxford University Press in February 2011.

The Quality and Outcomes Framework: QOF – transforming general practice

Steve Gillam (Cambridge) and I have just had a new book released about the Quality and Outcomes Framework (QOF).  General practice in the UK faces transformation following the introduction of the Quality & Outcomes Framework (QOF), a pay-for-performance scheme unprecedented in the NHS, and the most comprehensive scheme of its kind in the world. Champions claim the QOF advances the quality of primary care; detractors fear the end of general practice as we know it. The introduction of the QOF provides a unique opportunity for research, analysis and reflection. This book is the first comprehensive analysis of the impact of the QOF, examining the claims and counter-claims in depth through the experience of those delivering QOF, comparisons with other countries, and analysis of the wealth of research evidence emerging. Assessments of the true impact of QOF will influence the development of health services in the UK and beyond. This book is essential reading for anyone with an interest in the future of general practice and primary care, including health professionals, trainers, students, MRCGP candidates and researchers, managers, and policy-makers and shapers.

The Quality and Outcomes Framework has deeply divided UK general practitioners. I commend this book and applaud its determination to scrutinise every aspect of the Quality and Outcomes Framework – good and bad and in-between.

– From the Foreword by Iona Heath.

Contributors to the book include the architects of the QOF, developers, researchers, practitioners and commentators:

New studies and researchers

Last year was a very active period for the School of Health & Social Care and the Community and Health Research Group. During 2009/10 we submitted over 30 bids to a value of over £5M. We were successful in 17 of 25 of the bids for which we were notified of an outcome to a value of nearly £1M. Successful research outputs including peer reviewed publications in national and international journals, conference outputs, editorials and books/chapters which are being posted on the Research Repository.

The group includes two new research fellows, Dr Zowie Davy and Dr Markos Klonizakis. Fiona Togher joined us as a research assistant, working on the Ambulance Services Cardiovascular Quality Initiative (ASCQI: Health Foundation, £475k).

Jo Middlemass joins us in November from Nottingham University working on a new study; Exploring social Networks to Augment Cognitive behavioural Therapy (ENACT: EPSRC, £465k) which was featured in a recent BBC article:

We are also recruiting for a new study Influenza and Pneumococcal Vaccination and risk of Stroke and TIA (IPVASTIA: Research for Patient Benefit, £103k) which follows the IPVAMI study published last month in the Canadian Medical Association Journal, “Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case-control study”: The findings have featured in international news media in the UK, Canada and USA:,32068,616179348001_2021408,00.html.