Posted on by

New CaHRU study on Community First Responders in Lincolnshire published

vhp2An interview study exploring the experiences of Community First Responders (CFRs) in Lincolnshire as well as their relationship with patients and the ambulance service (http://rdcu.be/GkCl) was published this month in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine The study entitled, ‘Perceptions and experiences of community first responders on their role and relationships: qualitative interview study‘ was undertaken by Viet-Hai Phung, Ian Trueman, Fiona Togher, Dr Roderick Ørner and Professor Niro Siriwardena, with valuable input from Dr Simon Topham, medical director of LIVES. It follows on from a scoping review of CFR schemes that was published in the same journal in 2017.’

The interviews reinforced the themes that the scoping review identified. Participants became CFRs mainly for altruistic Nreasons, to help others and put something back into their community. Ths contributed to their sense of personal satisfaction and helped maintain their involvement over time. CFRs valued scenario-based training and while some were keen to access additional training to enable them to attend a greater variety of incidents, others stressed the importance of maintaining existing practice and improving their communication skills. They were often first on scene, which they recognised could take an emotional toll, but for which they found informal support mechanisms helpful. Participants felt a lack of public recognition and sometimes were undervalued by ambulance staff, which they thought arose from a lack of clarity over their purpose and responsibilities.

NIn terms of future development, CFR schemes should consider the varying training, development and support needs of staff. CFRs wanted schemes to be complementary but distinct from ambulance services. Further information on outcomes and costs of the CFR contribution to prehospital care is needed to inform future how schemes operate. It is important that they maintain their local identity. To do so, they will need to respond to local needs.

By Viet-Hai Phung

Posted on by

Comparing national multimorbidity policies and guidelines

CaHRU_logotypePeople living with a long-term condition often have more than one condition to contend with. This is known as ‘multimorbidity’, commonly defined as the co-occurrence of two or more chronic conditions within one person. In this situation it is important that the person, not the disease, is the focus. Policies referring to multimorbidity are considered a crucial element in safe health systems.

NadeekaChandraratneThe CaHRU team of Dr Nadeeka Chandraratne and Dr Ravindra Pathirathna, international visiting fellows attached to CaHRU from the Postgraduate Institute of Medicine at the University of Colombo, Sri Lanka, together with Prof Niro Siriwardena and Dr Christopher Harrison from the University of Sydney conducted a content analysis of policy documents and guidelines on multimorbidity from the UK, Australia and Sri Lanka. Despite considerable differences in healthcare structure and financing, all three countries face the challenge of multimorbidity. An understanding of how each country is addressing this challenge was considered important for identifying policy initiatives, gaps and opportunities for further improvement.

RavindraPathirathneThe article describing the study and its findings, ‘A comparison of policies and guidelines related to multimorbidity in the UK, Australia and Sri Lanka‘, was published this month in the first issue of the Australian Journal of General Practice 2018 with an accompanying editorial on Multimorbidity written by Niro Siriwardena and Christopher Harrison.

The team found overall a lack of health policy and guidance for multimorbidity: the guideline ‘Multimorbidity: Clinical assessment and management’ from The National Institute for Health and Care Excellence (NICE), UK was the only specific guideline on multimorbidity. Australia and Sri Lanka lack specific national documents addressing multimorbidity. The promising features observed in Australia were policies that are directly concerned with the health of socially disadvantaged groups, which are at higher risk of multimorbidity. Policies in Sri Lanka were more concerned with preventing chronic conditions, and on community mobilisation and empowerment.

lilyThe paper highlights that Sri Lanka needs to focus on policies that emphasise integration and patient-centred healthcare delivery for people with multimorbidity, whereas in the UK and Australia, policies on community-based approaches to address determinants of multimorbidity are needed.

By Dr. Nadeeka Chandraratne

Posted on by

Professor Graham Law gives inaugural lecture on ‘Sleep, sugar and statistics’ to a packed audience

GrahamLawinauguralProfessor Graham Law delivered his inaugural lecture on 30 January 2018 to a full audience of members of academic staff and the general public. The lecture included an outline of Graham’s academic career from posts at York and Leeds Universities to his current professorship at the University of Lincoln where he is a senior member of the Community and Health Research Unit and School of Health and Social Care. During the course of his career, Graham has published almost 100 research papers, many of which have been highly cited, including papers in the prestigious New England Journal of Medicine and American Journal of Epidemiology.

brayfordnight750The lecture continued with a discussion of what epidemiology is, and its origin’s with Dr John Snow’s discovery that cholera is waterborne, through his removal of the water pump handle at Broad Street in the Soho area of London which halted the epidemic. Graham spoke about his groundbreaking work on functional data analysis which involves complex analysis of large longitudinal data over time. This has included studies on a huge range of topics including the epidemiology of diabetes, sleep, gastrointestinal and a variety of other conditions. He has also supervised 10 doctoral students to completion of their PhD and has run programmes in epidemiological statistics at Leeds University, for medical and master’s students. More recently he has been investigating the relationship between poor sleep and the risk of developing diabetes.

Desk1Another aspect of Graham’s work which was very evident during his entertaining and informative lecture was his interest in increasing the public understanding of science. He has done his through engaging in many public lectures, television, radio and popular books such as his recent publication with Dr Shane Pascoe, ‘Sleep Better: The Science and the Myths’. Graham ended by explaining why he loved Lincoln University – his new colleagues, the lack of bureacracy and the ambition of Lincoln to develop as a world-class university.

Posted on by

Dr Pradeep Ratnasekare joins CaHRU as an international visiting fellow

sigiriya2Dr Pradeep Ratnasekare joined CaHRU this January 2018 as our third international visiting fellow from the University of Colombo’s Postgraduate Institute of Medicine. Pradeep graduated as a bachelor of Medicine and bachelor of Surgery in 1996 from the faculty of Medicine, University of Ruhuna and then completed postgraduate studies at the University of Colombo, Sri Lanka, in the fields of respiratory medicine and then in medical administration where he gained his master’s in 2011 and MD in 2016.

davHe has worked for over four years as a primary care medical officer, and six years as a medical officer in respiratory medicine, health system manager and health care researcher. As a health system manager he developed experience in various fields of hospital and public health programme management. He has worked as a hospital director in many secondary and tertiary care hospitals in Sri Lanka and worked as deputy director of the Medical Research Institute, the premier national level reference and referral medical laboratory and medical research centre for public and private sectors in Sri Lanka for last 18 months. His main interests are in health technology assessment and management, modern hospital planning and architecture, health system research and quality improvement in health care. Pradeep has several publications into his credit in the Journal of Medical Administrators Sri Lanka and Sri-Lanka journal of Health Policy and Management mainly on interventions carried out to improve health systems. He is a member of several academic associations in Sri Lanka including the College of Medical Administrators of Sri Lanka and Sri Lanka Medical Association. He is a member of research evaluation committee of the Medical Research Institute.

lilypondWhile at CaHRU he plans to: study the prehospital care system in the UK with a view to adapting it to develop a suitable model for Sri Lanka; to study the primary health care system in the UK National Health Service (NHS) of United Kingdom with respect to quality improvement and clinical governance; to study the systems and methods in place for Health Technology Assessment (HTA) and Health Technology planning in the United Kingdom; to learn about hospital design and planning; and to actively contribute to CaHRU’s research programme in primary and prehospital care. Listening to classical music, singing and playing cricket are his favourite hobbies.

Posted on by

Working with Parliament

Dr Coral Sirdifield and Dr Rebecca Marples from CaHRU were invited to meet with Sam Giymah MP, Parliamentary Under-Secretary of State for Justice Duty Minister in November 2017. Coral and Rebecca discussed their current work on their Improving Healthcare Commissioning for Probation: Mapping the Landscape project, and how it fits with work that will shortly be undertaken by the department.

Parliament

Together with Professor Charlie Brooker (Royal Holloway, University of London), Coral and Rebecca have also contributed to a consultation on standards and ratings for inspecting probation services.

They also attended training (along with Dr Stephanie Armstrong, CaHRU) on working with parliament hosted by De Montfort University. Here they learnt about contributing to Select Committee enquiries, and ‘POST notes’ produced by the Parliamentary Office of Science and Technology. This was particularly useful in terms of identifying plans for a future POST note focusing on Sleep – an area that CaHRU has done a lot of research in.