If you have used the ambulance service in the previous 12 months and are happy to take part in an interview for a new study we would like to hear from you.
This study is part of doctoral research being undertaken by Fiona Togher, Graduate Research Assistant at CaHRU, to develop a Patient Reported Experience Measure (PREM), a brief questionnaire for measuring experiences of ambulance service users. This will enable NHS ambulance services and their commissioners to routinely assess differences in patient experiences between and within organisations and to stimulate positive changes to the experiences of ambulance service users through feedback, training and education to clinicians; it could also be an opportunity to identify the strengths of ambulance service care and provide evidence of good practice.
The purpose of this study is to try to understand how people interpret the questions that have been developed so that we can improve them. In order to do this we are conducting interviews with ambulance service users, showing them the latest version of the questionnaire, and asking them to respond to the questions and share their thoughts and opinions of the questions.
If you would like to take part please contact Fiona Togher on firstname.lastname@example.org or 01522 837731.
A new book, Ambulance Services: Leadership and Management Perspectives by Professors Paresh Wankhade and Kevin Mackway-Jones, features a chapter on equality and diversity in prehospital care, co-authored by Viet-Hai Phung and Prof Niro Siriwardena of CaHRU together with Dr Karen Windle of the School of Health and Social Care. The new volume also refers to CaHRU’s work in developing indicators and processes for measuring and improving the quality of care provided by ambulance services.
The chapter, Responding to diversity and delivering equality in prehospital care: statutory responsibilities, best practice and recommendations, explores the impact of increasing diversity in the UK population and NHS workforce on prehospital care delivery. As public sector organisations, ambulance services are bound by The Equality Act 2010, which obliges them to promote equality and outlaw discrimination, harassment and victimisation of people with protected characteristics such as age, disability, race, gender and sexual orientation. Ambulance services use the Equality Delivery System (EDS), a voluntary toolkit that provides guidance about how they can achieve their duties set out in The Equality Act 2010. Building on the original EDS, the new EDS2 framework encourages organisations to flexibly reflect local sensitivities.
There are still significant variations in the quality of data that ambulance services possess for different protected characteristic groups, which also makes progress towards greater equality difficult to measure. The chapter summarises the current policy, problems in delivering this and potential solutions to overcome these.
Members of CaHRU, Dr Coral Sirdifield, Ana Godoy and Prof Niro Siriwardena attended the annual conference of the European Forum for Primary Care (EFPC), ‘Integrated primary care: research, policy and practice’, at the Tobacco Museum in Amsterdam from 30 August to 1 September 2015 to meet with colleagues and present an invited workshop on patient experience at the meeting. Niro Siriwardena is a member of the advisory board of the EFPC and attended a board meeting on the day before the conference.
The workshop, entitled ‘QUALICOPC in the UK, the patient perspective, took place on the first afternoon of the conference and was informed by work from CaHRU on the EU funded Quality and Costs of Primary Care in Europe (QUALICOPC) study. The session was well attended, enabling participants to discuss different approaches for measuring patient satisfaction with primary care and how satisfaction could be improved. Coral and Ana presented an innovative approach called Importance-Performance Analysis, using the QUALICOPC data from England, to demonstrate how the technique could help practitioners, researchers and policy makers to identify where one most needed to focus to improve patient satisfaction.
The conference included excellent keynotes from Prof Chris van Weel, Emeritus Professor of General Practice at Nijmegen (‘The history of Dutch General Practice or: how Primary Care saved the nation’), Dr Isabel Moulon from the European Medicine Agency (‘Bridging the gap between medicine development and clinical practice: is primary care out of the picture?’), Ellen Nolte from the European Observatory on Health Systems and Policies (‘Integrating care: what we know and what we do not know’), Prof John Øvretveit of the Karolinska Institute (‘Priorities for actionable research to speed and spread improvements in caring for chronic illnesses’), Dr Tonka Poplas Susič and Metka Žitnik Šircelj (‘Model practices in family medicine in Slovenia’) and a closing summary from Prof Marc Bruijnzeels of the Jan van Es Institute (‘Challenges for the future of integrated primary care’). A range of parallel research, debate and workshop sessions, lunch on a riverboat and an excellent conference dinner provided a full, interesting and enjoyable programme for delegates.
A new paper entitled ‘Using a narrative approach to enhance clinical care for patients with asthma‘ has been published online in the journal Chest. The paper was authored by Dr Helen Owton, previously of De Montfort University and now a lecturer at the Open University, Dr Jacqueline Allen-Collinson, Reader in the School of Sports Science at the University of Lincoln, and Professor Niro Siriwardena from CaHRU.
The paper describes an approach to foster better patient self-care in patients with asthma by enabling clinicians to empower individuals to take more control of their condition by enhancing patient-clinician communication and relationship through patients’ stories. This is based on previous work from Drs Owton and Allen-Collinson on patient narratives in asthma and work on the consultation from Prof Siriwardena.
The discussion paper, published in the Topics in Practice Management section of the journal, describes the history of narratives in asthma, outlines the evidence on how narratives can provide insights into how people perceive and manage their asthma, and discusses how these ideas might be applied. The paper finally discusses how these notions might be practically implemented in the clinical consultation and how this has potential to improve outcomes for people with asthma.
Teams from the Netherlands Institute for Health Services Research (NIVEL) and the Scuola Superiore Sant’Anna have recently published a paper in the WHO Bulletin, ‘Assessing the the potential for improvement of primary care in 34 countries: a cross-sectional survey (Schäfer et al., 2015). The paper was based on data from the Quality and Costs of Primary Care in Europe (QUALICOPC) study, funded by the EU Framework 7 programme, for which data for England were collected by Dr Sirdifield from the Community and Health Research Unit (CaHRU).
Schäfer et al’s paper draws on data from questionnaires on patient experiences and values relating to general practice assessing what patients from each of the 34 countries felt there was to improve five aspects of primary care: accessibility, continuity, comprehensiveness, patient involvement in treatment decisions, and doctor-patient communication. Overall, the authors concluded that “accessibility and continuity of care show relatively low potential for improvement, while in many countries comprehensiveness was indicated to be a priority area”. Nine countries had a moderate level of improvement potential for patient involvement in decision-making about treatment but all countries performed well on doctor-patient communication. The UK data indicate low patient-perceived improvement potential across all aspects of care with the exception of ‘comprehensiveness’, which had moderate potential for improvement.
The team from CaHRU (Dr Coral Sirdifield, Ana Godoy Caballero, Prof Niro Siriwardena and Dr Karen Windle ) are currently working with colleagues in the College of Social Science (Prof Steve McKay and Dr Christine Jackson) and Nivel (Dr Willemijn Schäfer) to further explore the data for England, investigating how satisfied patients are with primary care by identifying their expectations of care, the extent to which expectations are being met, variations in expectations and experiences, and how patient satisfaction could be improved.
Reference: Schäfer et al., (2015) Assessing the potential for improvement of primary care in 34 countries: a cross-sectional survey, Bull World Health Organ, 93: 161-168. doi: http://dx.doi.org/10.2471/BLT.14.140368