CaHRU/LIH seminar: Consensus methods – Dr Paul Leighton

WP_20170124_11_59_23_RichThe latest CaHRU/LIH Improvement Science and Research Methods seminar was given on 24th January 2017 by Dr. Paul Leighton, Deputy Director at the NIHR Research Design Service for the East Midlands. Paul’s talk, entitled ‘The Delphi technique and other methods of consensus development in applied health settings’, focussed on useful tools for achieving consensus among experts.

WP_20170124_12_05_46_RichPaul began the seminar with an overview of the background of consensus methods and gave examples of how such techniques have been used in the past. He then presented the three most commonly used approaches to reaching consensus: the Delphi technique, the nominal group technique, and the consensus conference. He explained the different techniques, discussed issues around using them and conducting consensus events, and finished by comparing the three methods.

Paul also offered guidance on when it is best to use each technique; this covered when it was appropriate to use a particular method, choosing the correct number and most suitable members/experts for panels, agreeing on the threshold for consensus, and the proper reporting standards. At the end of the seminar, Paul reminded everyone that the key enemy of consensus methods is always dropout rates!

The seminar was very well received and raised some very important issues around consensus methods. The next Improvement Science and Research Methods seminar will be presented by Viet-Hai Phung, researcher at CaHRU, on Tuesday 28th February 2017 on the topic of scoping reviews.

By Despina Laparidou

Dr Murray Smith, health economist and econometrician, joins CaHRU

Dr Murray D Smith joined CaHRU this month in order to contribute expertise in health economics and econometrics to the work of the unit. He brings with him a collection of projects in health economics, including involvement in HEAT (helicobacter bacteria eradication in persons aged 65+ who are regularly using low dose aspirin) which is one of the largest randomised controlled medical trials ever to be conducted in this country.

Murray750Previous projects in which Murray was engaged in the capacity of health economics include a trial feasibility study amongst children with Down syndrome who have otitis media with effusion (“glue ear”), and the economic evaluation of a volunteer doula service targeted at pregnant women who are socioeconomically disadvantaged. A current project of Murray’s involves the econometric modelling of teicoplanin trough serum concentration levels, where teicoplanin, a glycopeptide antibiotic used to treat gram-positive bacterial infections, is administered daily as hospital outpatient parenteral antibiotic therapy.

Bespoke computer programming provides a major contribution to the success of this and many of Murray’s other projects. Influencing his approach to computational work has been the use of symbolic computer algebra, oriented especially to tackle problems in mathematical statistics. In a long-standing collaboration with Colin Rose, outcomes of their work include the mathStatica© software package that adds on to the Mathematica® programming language, with uses that are illustrated extensively throughout their book entitled Mathematical Statistics with Mathematica (2002; 2013).”

CaHRU hosts second East Midlands Research into Ageing Network regional seminar at University of Lincoln

Emran-png-250The Community and Health Research Unit, as part of the work of the centre’s Healthier Aging programme of research, recently hosted the second East Midlands Research into Ageing Network (EMRAN) seminar that took place at the University of Lincoln on 25 November 2015 and which focused on the care of older people in the community. The seminar started with a brief presentation by Professor John Gladman and Chris Craig on EMRAN’s purpose to facilitate collaborative applied research into ageing and older people research across the East Midlands and a brief update on EMRAN’s progress, including recent publications and projects which are being developed thanks to EMRAN’s intervention.

jo1The first part of the seminar included four ‘Elevator Pitches’. Dr Carlos Rodriguez Pascual (University of Lincoln; Lincoln County Hospital) presented his project on frailty and cardiovascular disease, exploring how a combination of a comprehensive geriatric assessment (CGA) score and frailty is a predictor of cardiovascular disease in an older person. The second pitch, presented by Dr Jo Middlemass (CaHRU, University of Lincoln), outlined findings from the ‘CArers of people with Dementia: Empowerment and Efficacy via Education’ (CAD: E3) project that aims to improve carer and patient well-being by offering carers of people with dementia a multicomponent intervention (focusing on education and skill-building). The third pitch, presented by Dr Fiona Marshall (University of Nottingham), looked at a project aimed at creating more dementia friendly areas, by gathering local information (through geo-spatial mapping) of what health, social, religious groups, community and voluntary services (amongst others) there are for older people living in the Peak District of Derbyshire. Finally, Dr Gill Garden (United Lincolnshire Hospitals NHS Trust) presented the very successful Bromhead Care Home service, which involved training care home staff so they can more confidently and effectively deliver care in care homes and reduce admissions to hospitals.

EMAS - PTS 7Professor Niro Siriwardena (Director of CaHRU, University of Lincoln) delivered the second part of the seminar, presenting the work of CaHRU and ideas for developing new projects involving ambulance services: ‘Pathways for Older People from Ambulance Services to Safe Community Care’. The aim of the presentation was to show that paramedics, apart from safely transporting patients, can also offer important treatment and refer patients who don’t require hospitalisation to community services that are often more adequately equipped to care or support them. After the successful SAFER-2 trial (Support and Assessment for Fall and Emergency Referrals), exploring how ambulance staff could assess and divert older people who had suffered a fall to appropriate community-based services, Prof Siriwardena and his colleagues at the East Midlands Ambulance Service (EMAS) are currently interested in exploring other conditions, such as hypoglycaemia, epilepsy and COPD (chronic obstructive pulmonary disease) which may also be amenable to community pathways.

After a quick recess for some much needed tea and coffee, the attendees split into small groups to discuss the projects presented earlier, focusing on possible challenges and solutions to the design and conduct of each study, and consider ideas for further research and exciting collaborations. The seminar came to a close with Chris Craig and Prof John Gladman thanking everyone for their participation and with a promise for more similar events and innovative seminars.

Despina Laparidou

Fighting for real equality in healthcare for people on probation

coralIf David Cameron is serious about his promise yesterday in Manchester to end discrimination and “finish the fight for real equality” he should examine the way that CCGs are funding healthcare in probation.

People on probation are a deprived and vulnerable group. National guidance in England exhorts Clinical Commissioning Groups to commission healthcare for those living in the community who are serving community orders. This includes ‘approved premises’ – accommodation providing enhanced supervision for offenders and individuals on bail who may present a high risk of harm to the public.

Desk1In an article published recently in Health and Social Care in the Community, researchers, including a member of the Community and Health Research Unit at the University of Lincoln present findings from a national survey of CCGs in England. This survey, sent as a freedom of information request to all CCGs and Mental Health Trusts in England, compared the extent to which healthcare services were commissioned for probationers in 2014 with similar data collected in 2013.

Findings show that the proportion of CCGs commissioning healthcare for probation reduced from 7% to 1%, and 20% of CCGs stated that funding healthcare for this group was the responsibility of the NHS England Area Teams. It is not the Area Team’s responsibility it is the responsibility of CCGs.

There was also a reduction in the proportion of Mental Health Trusts funding healthcare for probation between the 2013 and 2014 surveys – from 70% to 61%. The prevalence of mental health disorders in probation is high, so it was of concern that only 12% of Mental Health Trusts provided a service to support approved premises and just 32% provided clinics in probation.

The present Government’s policy, in April 2015, to privatise probation for low risk offenders in the community adds yet more complexity to this highly concerning scenario.


Professor Charlie Brooker and Dr Coral Sirdifield

CaHRU Summer 2015 Newsletter

The latest edition of the CaHRU Newsletter (Summer 2015) was published this week. The newsletter presents the work of the research centre over the previous three months and includes articles from the CaHRU blog covering publications, conferences and funding. The newsletter is produced by Sue Bowler, CaHRU administrator.[su_document url=”” responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]