Welcome to the Research Institute for Primary Care & Health Sciences Blog

This blog was created to keep healthcare professionals, researchers, methodologists, and patients up to date with the latest primary care research. For more information about the Research Institute, visit our website; keele.ac.uk/pchs

Thursday, 28 June 2018

Inspiring innovative research within primary care

Written by Robyn Till | www.keele.ac.uk/pchs | @PCHS

The Royal College of General Practitioners (‘RCGP’) asked the Keele University’s Research Institute for Primary Care and Health Sciences to host this year’s Midlands Faculty Research Symposium. 

Delighted to take on the exciting but somewhat daunting challenge, a team of willing researchers and support staff worked hard to put together an engaging programme which hoped to inspire not only general practitioners but health care professionals, academics, and students to get involved with primary care research. 

Hosted at Keele Hall on the 17th May 2018, over 60 people from a broad range of backgrounds joined us to enjoy the glorious sunshine beaming in from across the beautiful Italian gardens, as they engaged in a truly inspirational day. 

David Fitzmaurice, Professor of General Practice at Warwick University, really set the tone for the day with his introductory keynote speech. As the first appointed academic GP, David was a great advocate to have at the event, flying the flag for research within general practice. 

David's presentation first focussed on his work on anticoagulants, showcasing his dedication to implementing his research over the years, which has led to a 10% increase each year of patients prescribed anticoagulation medication.

He wasn't shy in endorsing that it's all well and good being published somewhere like the BMJ, but the thing that really matters is ensuring that your research is implemented into practice. 

After a quick break, participants made their way to listen to the various parallel sessions, which were delivered by those whose abstracts had been shortlisted prior to the event. These sessions were a great way to hear about current research taking place in primary care across the West Midlands and gave researchers the opportunity to answer questions about their research that they may not have considered.  

The next keynote speech was presented by Professor Roger Jones, Editor of the BJGP and Emeritus Professor of General Practice at Kings College London. Roger took us through his career as a GP, an academic GP, and then through to his current role as editor. 

Roger went into detail about the state of primary care research through the ages, or rather, the absence of primary care research. It has certainly come a long way since the 1% of NHS budget invested in research and development, but it is clear that there is still a long way to go. 

In 2010, Roger moved into editing and hasn't looked back since. He advised that anyone who is not involved in peer reviewing, to certainly consider it. 

After an afternoon of more parallel sessions, the day ended on a very high note, with a keynote speech from the 'nations favourite GP', and first female chair of the RCGP, Professor Helen Stokes-Lampard. 

Helen summarised the importance of general practice very eloquently, explaining that it's about the whole person, and what matters to them, not what is a matter with them - advocating the notion of 'Enid-shaped care.

It would take me quite some time to summarise everything Helen had to say, and unfortunately, we're all very busy people so I won't keep you here for much longer. Instead, I'll summarise the key takeaways from each of these keynote sessions, for anyone starting out in primary care research; 

1) Be topical. Be Realistic. Be Resilient. 

Roger explained that you need to read a lot and find something that stimulates your interest. Once you're passionate about something, you need to be realistic, so conduct a 'who cares' and 'so what' approach to your research ideas. Does it matter? Do your friends think it matters? Make sure it's worth doing because you don't want to go off on an internally driven plight. 

If you've done your reality check, and really think your research could make a difference, then be resilient and don't let people put you off.  David advised that you've got to be consistent if you believe in the idea and believe that there will be a patient benefit. Helen echoed this notion, advising that you should never underestimate your own power to make a difference and make a change - so get topical, get realistic, and stick with it. 

2) Network and Collaborate 

This really was a resounding theme throughout the whole conference. All our keynote speakers advised that meetings like this are crucial,  giving you the opportunity to pick each other's brains. You can't do an entire study by yourself, so you need to collaborate with experts and your ideas will be improved. There is more and more to learn about healthcare research, and you can only have so much in your head, so share it. 

Roger Jones gave a sound piece of advice for people starting out - contact the Academy of Medical Sciences, who have a network experienced academics to call upon. 

3) Mentorship 

Mentors can be a fountain of knowledge and information, will perhaps see where you can improve where you can often can not, be aware of which progression and development pathways with will stimulate your growth as a researcher, and offer the encouragement you may sometimes need to keep going. 

There are a number of mentorship opportunities available for primary care researchers, which should definitely be utilised. Roger did advise though, that you don't want to rush into a portfolio career before you've mastered your clinical role, because you'll always feel like you're on the back foot, and mentors are there to help you identify when its the right time to take the next step. 

After a robust Q&A session with Helen, we reached the best part; celebrating the research which had been presented throughout the day. Of course, it was only fitting to have the Chair of the RCGP to hand out awards to the top scoring poster and oral presenters. 

Charlotte Ratcliff, a ST2 GP Trainee, was awarded for 'best poster' which focussed on 'training the next generation of leaders'. Marrigje Nell, an intercalating medical student, won the prize for 'best oral presentation' entitled 'Prevalence of persistent low back pain in emerging adults: results from the 1970 British Cohort Study.' Finally, Nafiu Ishmail went on to win the 'David Morgan' prize for his presentation 'Bleeding complications post-acute coronary syndrome within the English primary care setting.'

All in all, even as a non-academic or a GP, I can honestly say that the day was truly inspiring and I left feeling rather excited about the future for primary care research. I think it would only be fitting to draw upon a lasting comment from David's keynote speech; primary care is certainly the 'lynchpin' of health care and the NHS, and research is ultimately the only way in which we will change healthcare for the better. So holding events such as this, are crucial for bringing together both the 'old and new' in order to showcase research, exchange knowledge, network, collaborate, and inspire the future generation of primary care researchers. 

To see the full programme visit the website. You can also sign up to our mailing list to ensure that you hear about next year's event. 

Friday, 1 June 2018

Engaging with the rural community for future research

Written by Laura Campbell | www.keele.ac.uk/pchs | @PCSciences

As part of an upcoming funding proposal around rural mental health, researchers at the Research Institute for Primary Care and Health Sciences, Keele University, recently held a successful community engagement morning.

One challenge of achieving good Patient and Public Involvement and Engagement (PPIE) in research is making sure that we endeavour to include broad range people. Having input from several different social, professional, economic and ethnic backgrounds helps to produce high quality healthcare research which is relevant for more people. That is why it is so important to reach out to the so-called ‘seldom-heard’ groups, such as rural communities and people with mental health conditions.

Working with Staffordshire Fire and Rescue Service, on Friday, 10th May, Professor Carolyn Chew-Graham and PPIE Project Support Laura Campbell met with members of the community in Leek, Staffordshire, to discuss early ideas around a potential research project. The aim of the meeting was primarily to see if the research team’s ideas made sense to the group, and also to find out if anyone would be interested in being a co-applicant on the grant application.

Having publically advertised the event previously, we were delighted to see a variety of people attend the meeting. This included representatives from Approach Staffordshire (a dementia Support group), local town councilors, artists, local community figures, retired mental health practitioners, the fire service and the local Women’s Institute.

At the start of the meeting, Laura took the opportunity to talk to the group in more detail about what Patient and Public Involvement and Engagement in research entails and how their contributions could help shape research studies. The group were informed that how Keele support, encourage and nurture PPIE through our Research User Group (RUG) which is made up of over 110 members, each with their own experiences of health conditions such as osteoarthritis, chronic pain, inflammatory arthritis, mental ill health and long term conditions. This “Expertise by Experience” has been an integral part of health research at Keele for the last 12 years and helps our research to stay patient focussed.

The group were very interested to hear that lay people can be involved in lots of different ways, from participating in a Patient Advisory group to being a co-applicant on a grant application or contributing to a study steering committee.

From there Prof. Chew-Graham explained a project idea to the group, which aims to investigate the potential role of “Safe and Well” visits by the Fire and Rescue Service (FRS) in identifying mental health problems in older people. Working with the fire service and other community groups in a more ‘joined up’ service was strongly supported by the group, who were very passionate that researchers and community groups should all engage in conversation more regularly in order to provide the best possible for care for people, especially those who may be more isolated in the rural community. Local knowledge was championed, with an emphasis on ‘prevention rather than cure’.

Holding engagement events such as this is extremely useful and interesting for all involved. Not only did the group learn how they can actively become involved in mental health research, but also the Keele team took away valuable information from the group. For example, we learned that as a national organisation, the Women’s Institute will be concentrating on mental health going forward, with ‘Mental Health Matters’ likely to be adopted for the forthcoming year. When the discussion broadened to the problems facing older people in rural areas – for example, loneliness, social isolation, poor transport and limited or no community services, the Keele team felt it would be useful to share that we are planning two further meetings to engage with the rural community, in a bid to listen to their ideas and potentially take these forward in research.

31st May FRRESH (Forum for Rural Research on Health & well-being)
12.30-4pm Foxlowe Centre, Leek (lunch included) ‘Rural proofing’

7th June PPIE meeting 10-11.30am
David Weatherall Building, Keele University
To discuss the development of a programme of work around older adults, pain, mental health in rural areas.

Carolyn and Laura advised that all were welcome – please contact c.a.chew-graham@keele.ac.uk or l.campbell@keele.ac.uk for more information.

Monday, 30 April 2018

Knowledge mobilisation: Growing knowledge together

Written by Laura Swaithes and Dr Sue Ashby | www.keele.ac.uk/pchs | @PCSciences

March 7th saw the start of a two-day event in Bristol for the UK Knowledge Mobilisation Forum. For those of you who don’t know, knowledge mobilisation is the process of getting the right information, to the right people, at the right time, and it is a large focus of the implementation work undertaken by our own Impact Accelerator Unit, led by Professor Krysia Dziedzic.

The central theme of the forum was ‘Let’s start a conversation’ and the organisers made a point of hosting an ‘un-conferency conference’ to encourage creativity and collaborative learning. The informal atmosphere coupled with a quirky venue set a great environment for networking with an array of delegates. The venue was an old fire station, now functioning as a young person’s centre (run by the creative youth network), and still had many original features including a sloped floor in the main hall, designed for the draining of water when fire engines returned from a job.

One of the opportunities to showcase work in the field of knowledge mobilisation was an ‘Interactive poster session’, of which Dr Sue Ashby and Laura Swaithes (supported by Professor Krysia Dziedzic) represented Keele presenting two of the 12 selected posers. The interactive nature of the poster session involved delegates leaving comments/questions on each poster for the presenters to respond to in an open conversation slot, which stimulated lots of interesting discussions. One of the key themes from both posters was the role of patients and the public in knowledge mobilisation.

All delegates were paired up and invited to arrange a ‘Randomised Coffee Trial’ (RCT) which was another networking opportunity that bought health researchers together with people working in law, surveying and other industries to facilitate cross-discipline learning.

Then came the creative stuff! A fantastic session on co-production pushed us outside our comfort zones by using plasticine, Lego and other ‘Blue-Peter’ style items to embrace service design thinking in a different way. This was an enlightening session that demonstrated a unique way of how knowledge could be mobilised between academia, healthcare practitioners, and policymakers to create a space to understand and communicate real-world practical knowledge. Believe it or not, some really interesting messages came from this creative display!

Another example of alternative approaches to knowledge mobilisation came in the form of a fishbowl conversation focussing on the barriers to translating research into practice and how we overcome them. For those of you who have never heard of, or participated in a fishbowl conversation, in essence, it is a bit like a focus group with an inner circle of four chairs, and an outer circle of (in our case) approx. 25 chairs. Three people sat in the inner circle and started a conversation about the chosen topic, with only one person able to talk at a time, if they were holding Dory the fish! This created a light-hearted atmosphere and added a comedy element to the process. If at any time someone from the outer circle wanted to contribute to the conversation, they could take a seat in the inner circle and one of the three people there had to move back to the outer circle. 

Whilst it initially appeared as if it could be slightly daunting, after getting involved, it became clear that it was a really useful process that enabled great dialogue, time for reflection and consideration, and generated huge amounts of data in a small space of time.  If you want to find out more about this technique take a look at http://www.betterevaluation.org/en/evaluation-options/fishbowltechnique

Overall, it was a great event for sharing and learning as well as embracing some inner creativity! We received lots of positive comments about our work and hope to be back next year flying the flag for Keele again. In the meantime check out the UK Knowledge Mobilisation Forum http://knowledgemobilisation.net/about/ for latest news and tweets.