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New learning materials to help GPs prescribe medicine more safely are now available to members of the Royal College of General Practitioners (RCGP) via their website.  The materials have been developed by our Medication Safety theme in collaboration with the RCGP and the Medical Defence Union.
 
Within six weeks of their launch the e-learning materials have been accessed by over 1200 users and it is the best performing stand-alone course that the RCGP has launched (over the same timescale).  The materials have met with an enthusiastic response from RCGP members who have scored it highly on a five-star rating scale, suggesting it is valued highly by those who have completed it.
 
The Medication Safety theme will now evaluate the learning materials to look at how widely they have been used and whether they are helping to improve GPs knowledge in relation to safe prescribing.

Focus your attention on issues relating to medication safety with the NHS Medicine Safety app.
 
This free app is designed to be used by doctors, pharmacists, pharmacy technicians, nurses, non-medical prescribers and undergraduate trainees and is a quick way to test your own knowledge on high risk areas for medication safety incidents.  
 
The format is quick and easy to use and can be completed in a spare five minutes.  It provides a quiz with a series of 10 multiple choice questions chosen randomly from a bank of questions for each topic.   Topics so far include; insulin, allergies, opioids, anticoagulation and medicines safety with more to be added during the course of the year.
 
The questions are designed to stimulate further learning to improve practice and safety and can be used to generate ideas for Continuing Professional Development (CPD) portfolios.  You can even request a certificate of completion at the end! 
 
Funded by Health Education North West and developed by the University’s Centre for Pharmacy Postgraduate Education, the app is currently available free from the App Store for iPhone/iPad users and an Android version will be released later this year.  

Earlier this year saw the introduction of a new NHS campaign “The earlier, the better”.  Designed to reduce the increased pressures experienced by GP surgeries and A&E departments, the campaign hopes to change public behaviour.  Professor Keith Willett, NHS England’s Director for Acute Care said, “We have to do better at helping people stay well, not just picking up the pieces when they fall seriously ill.”
 
But what does this mean for the general public? How do we know when to visit the pharmacy and when to visit the doctor?  In this blog post, Christian Thomas (PhD student, GM PSTRC) discusses the new campaign and why visiting the pharmacy sooner rather than later when unwell is helpful in more ways than one. 

The MAXIMUM (Maximising Patient and Carer Involvement in Multimorbidity) study aims to understand the ways in which multimorbidity can lead to safety problems and to identify ways of reducing these problems.  It is the main project of the Multimorbidity theme and has recently received research ethics approval and authorisation from the NHS.  Participant recruitment will start with GPs over the coming weeks.

The researchers are involving and working closely with their aligned Research User Group (RUG) members, who are piloting the use of tablet computers to collect patients' healthcare diaries.  Along with information from observations and interviews, these diaries will be used to develop case studies of people with multimorbidity. Information on how patients, carers and services respond to potential safety issues will then be used to provide solutions to minimise safety problems.
 

by Dr Sudeh Cheraghi-Sohi (Research Fellow)
 
I wanted to update you about our first public engagement event held at the end of March on ‘Never Events’ or ‘What should never happen in your GP surgery’.  My presentation gave an overview of our Never Events work. 
 
To give a quick summary, never events are defined as ‘serious patient safety incidents that should be preventable if the available measures are put in place’. The types of things that would fit this definition are for example wrong site surgery (e.g. operating on the wrong leg). 
 
In my presentation I talked about the fact that there is a list of never events for UK hospitals and how it is compulsory for hospitals to report the occurrence of any of these events,  It was recently announced by NHS England that as of April 2014, each hospital trust in England will publish its never events on a monthly basis.  The important point of this list and reporting however is that the organisation should learn from these mistakes and act to prevent them from happening again.
 
Whilst there are 25 Never Events for hospitals there are currently none for General Practice.  In collaboration with colleagues at NHS Education for Scotland who developed the preliminary list of events for General Practice, we are just about to survey all the GPs of Greater Manchester and a quarter of all GPs in Scotland to get some idea of the frequency of these events and whether they think these events are actually Never Events.
 
After my presentation we had some really good discussions about what the audience thought of our never events work and patient safety issues in general practice more generally, some of which may feed into generating ideas for new research.  A full report of the event and the things people told us will be available shortly – please see article below for more information.
 
You can find out more about Never Events from my blog.

Our Interface and Informatics (I&I) theme has two aims:

• To help the other themes use data and informatics to improve the safety of care; for instance we are helping support the Medication Safety theme by looking at issues in prescriptions, utilising healthcare data.
• To translate the understanding of where and how safety issues arise into ways to help develop future information systems.

The I&I theme works in partnership with the Health e-Research Centre (HeRC) to share knowledge and best practice.  HeRC is a collaboration between the Universities of Manchester, Liverpool, Lancaster and York and was established in 2013 by a consortium of funders led by the Medical Research Council.
 
For more information on HeRC and to see how you can get involved, please see article below.

We held our first public engagement event on 27 March in collaboration with Nowgen.  More than 50 members of the public attended, from diverse backgrounds including: patients, researchers, academics and healthcare professionals.  

Professor Stephen Campbell and Dr Sudeh Cheraghi-Sohi presented the work of the centre, and the latest research on ‘never events’ – potentially harmful events that are preventable –  in primary care.  Facilitated table discussions then focused on patients’ perspectives and attendees highlighted the things that are important to them and that they think shouldn’t happen when visiting their GP surgery or community pharmacy.   A personal and inspirational talk from Ailsa Donnelly (Chair, Research User Group) emphasised the crucial role of patients in the work of the centre.

A full report including feedback from table discussions will be produced and made available on our website.

For those of you on Twitter, you’ll know how hard it is to keep up with everything that’s being said around a single topic.  The Heathcare Hashtag Project was set up to help make these conversations more accessible and easier to follow.
 
The project has hundreds of registered hashtags (#) in every conceivable disease, treatment or healthcare area where you can find out what’s being said (and by whom).  The simple analytics built into the project allow you to see how many times the hashtag is used and the overall reach of the conversation.
 
As well as following the GM PSTRC on Twitter, you are now able to track everything that’s being said about our work and contributing to conversation by using our own registered hashtag: #gmpstrc.

The development of patient and public involvement within the NIHR funded Dental Quality Programme Grant has led to a range of initiatives being implemented to find out what ‘Quality Indicators’ (standards) should apply for dentistry.

Taking into consideration the views of staff, patients and the public across Greater Manchester through crowdsourcing, text surveys, video blogs and training, the data gathered will contribute to the emerging evidence for quality standards in dentistry.

For further information about the research, visit the Dental Quality Research website. 

We will involve a wide range of healthcare professionals, members of the public and patients (whether frequent or infrequent users of primary care services) in all our work and will promote opportunities for you to get involved and have your say in future editions of this newsletter.

 

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Patient Experience: Managing your medicines

Do you take two or more medicines or have you had any issues with medication?  This could be prescription medicines or those you buy over-the-counter, including tablets, creams, inhalers, sprays, pessaries or suppositories. 

We are looking for volunteers to take part in a number of focus groups and share their views and experience of taking medicines prescribed and dispensed through general practice and community pharmacy.  Your feedback will help us to understand patient and public issues around taking medicines and the challenges that might be encountered and how these might be dealt with.  Attendees will receive expenses and a £20 gift voucher. 
 
For more information or to register your interest, please contact Dr Sally Giles on 0161 306 8020.  

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HeRC Patients' Forum?

• Are you interested in the benefits of linking health information, new developments in computing and mobile phone technology?
• Could you bring a patient/public perspective to our health research?

The Health e-Research Centre (HeRC) uses computer-based methods and tools to investigate and make use of health data for the benefit of patients and the public.  They are currently looking for members of the public to join their new ‘Forum’ to inform and help shape research. 

The group will meet every three months (fees paid and expenses reimbursed).  No special knowledge of health or computing technology is needed as relevant training will be provided.  For more information and to apply, please visit the HeRC website or email Dr Lamiece Hassan.

Researchers from the University of Manchester would like to thank everyone who attended their recent focus groups on oral health for older people. 
 
Attendees found the sessions to be very informative and raised several issues which were seen to be key:

• Improving access to oral health services
• How to prevent future dental problems (eg pain and reduced function)
• Ensuring clinicians understand the personal needs of older people.

The next step is for the researchers to meet with dental and oral health specialists, followed by a final meeting made up from all of the previous groups.  Following this, feedback from all groups will be analysed to determine key priorities. A detailed report will be published via a number of routes including the Citizen Scientist website.

In this edition we introduce you to Christian Thomas, a PhD student in the Manchester Pharmacy School where she is focused on violations in primary care settings as part of the Medication Safety Theme.

Firstly, please tell us a little bit about your background and your role in the GM PSTRC.
I am currently studying towards my PhD in Pharmacy as part of the Medication Safety theme.  I started my PhD in 2013; however this is not my first time studying at the University of Manchester as I also completed my undergraduate degree in Psychology (2011) and MREs in Psychology (2013) here too. Aside from my academic career, I also work as a pharmacy dispenser in a local well-known pharmacy, and celebrated seven years with the company in October, 2013. 
 
How did you first get involved with patient safety research and what do you find most challenging about it?
My PhD is my first experience of patient safety research. I was drawn to apply for it as it is something I am passionate about not only as a researcher, but also from my experience working in a community pharmacy. A challenge that I am looking forward to tackling is ensuring patients know about the work improve to patient safety in primary care. Public and patient involvement will play a key role in making this happen.

What do you think will be the biggest changes in primary care in the next five years?
I think some of the biggest changes in primary care will come from a change in perception of the services provided in community pharmacy. With NHS campaigns such as 'The earlier, the better' encouraging people to visit their community pharmacies before visiting their GP or in worst case scenarios, the hospital, I think that the pharmacy will become one of the first options when people become ill. Also, with the continued use of electronic prescriptions, I think that communication and ease of access between GPs and pharmacies will also continue to improve, benefiting the patient overall. 

What are you hoping to achieve with your research?
I'm hoping to better understand the situations in primary care that may lead to issues in patient safety and to provide practical solutions to help tackle them. 

Tell us about someone who has influenced your choice of career (and why)
Professor Sir Peng Khaw, an inspirational Professor of Glaucoma and Ocular healing at UCL, once told me that "You need to be the change you want to see", something I always keep in mind when working towards improving patient safety.

When you are away from work, how do you spend your time relaxing?
I love to spend time with my little brother and sister who are 8 and 9, and are always lots of fun!  Otherwise, I love to read anything by F. Scott Fitzgerald and listening to Britney Spears! 
 
What is your party trick (or hidden talent)?
Rydw i'n gallu siarad Cymraeg yn rhugl, a es i ysgol cynradd a ysgol uwchradd gyfrwng Cymraeg.
 
And in English… I speak fluent Welsh, and all of my education up until university was in the Welsh medium.
 
Finally, if you could give one piece of advice to those interested in a career in research, what would it be (and why)?
Act now! If you are passionate about working in research don’t stop until you are working in an area that matters to you. 

One of the key findings of both the Francis and Berwick reports was the failure of health care boards and governing bodies to measure and respond effectively to safety information. 
 
Making Safety Visible is one of ten new research projects funded by the Health Foundation as part of Closing the Gap, a £4 million programme of work to implement and evaluate tested, evidence-based patient safety interventions.
 
We will be working with our colleagues at the University of Oxford and the Imperial PSTRC and led by the Haelo (based at Salford Royal) to determine how boards and governing bodies can develop an effective safety surveillance system and to identify what support and training is required in order to implement it.
 
Throughout the programme, the team will:

 
For more information, please visit the Health Foundation website or contact GM PSTRC Centre Director Professor Stephen Campbell.

March 2014, saw the launch of a new nationwide study to improve the quality of life for patients living with multiple long-term health conditions.
 
Researchers from The University of Manchester have joined forces with those in Bristol, Glasgow and Dundee for the ‘3D Study’ – a project which will see a new management system trialled in selected GP practices.

This £1.78 million study, which will last for three years, is funded by the National Institute for Health Research (NIHR) through its Health Services and Delivery Research (HS&DR) Programme.
 
At present, patients with more than one health condition such as diabetes, heart disease or kidney disease often  attend separate appointments for regular reviews of each of their conditions, which can lead to feelings that no-one takes overall responsibility for their care.  With the new system being trialled, patients will be seen by a named nurse and doctor to oversee their care and will be invited for a comprehensive health review every six months to discuss all their health issues.  The aim is to treat the patient in a consistent, joined-up manner in order to improve their overall quality of life.

Monday 23 June 2014, 13:30-17:30
Cordingley Lecture Theatre (University of Manchester)

The first GM PSTRC Research Symposium will be open to all those with an interest in patient safety in a primary care setting, and will be chaired by Dr Maureen Baker, Chair of the Royal College of General Practitioners. Professor Rich Roberts, past President of the World Organization of Family Doctors (WONCA) and member of the GM PSTRC Strategic Advisory Group will give the keynote speech.
 
The event will provide an overview and examples of how we are addressing one of our core objectives as an NIHR Patient Safety Translational Research Centre, the development of “evidence-based approaches to patient safety in primary care” and how patient and public involvement is critical to shaping our research and potential impact.
 
Further details will be made available via our website and twitter feed.

28 April-2 May 2014 (times vary)
across Manchester

This series of events aims to raise awareness of the skin condition psoriasis by bringing together those living with the condition and those working to develop safe and effective treatments.  For more information about this unique series of events and to find out how you can get involved, please visit www.psoriasisshoutout.co.uk   

21-22 May 2014
BT Conventions Centre, Liverpool

Members of our Research and Involvement teams will be attending this year’s Patient Safety Congress at Liverpool’s BT Convention Centre, 21 and 22 May 2014.  If you are too, stop by our stand (C20/24) in the exhibition area by the central hub to say “hi” and find out more about our ground-breaking work in primary care.

For more information on the NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, please visit our website: www.gmpstrc.nihr.ac.uk or contact:

Carly Rolfe (Centre Administrator) on 0161 275 7642 or email gmpstrc@manchester.ac.uk