A5061397072- Healthcare Systems and Technology
- Patient Satisfaction in Healthcare
- Global Health and Surgery
- Telemedicine and Telehealth Implementation
- Pharmaceutical Practices and Patient Outcomes
- Mental Health and Patient Involvement
- Global Health Workforce Issues
- Primary Care and Health Outcomes
- Surgical Simulation and Training
- Schizophrenia research and treatment
- Mental Health Treatment and Access
- Diversity and Career in Medicine
- Chronic Disease Management Strategies
- Suicide and Self-Harm Studies
- Pregnancy and Medication Impact
- Pharmaceutical Economics and Policy
- Medical Malpractice and Liability Issues
- Child and Adolescent Health
- Emergency and Acute Care Studies
- Global Maternal and Child Health
- Health, psychology, and well-being
- Psychiatric care and mental health services
- Family and Disability Support Research
- Health Systems, Economic Evaluations, Quality of Life
- Electronic Health Records Systems
British Psychoanalytical Society
2023
Cornwall Partnership NHS Foundation Trust
2010-2022
National Health Service
2021-2022
University of Leeds
2021
Nuffield Health
2020-2021
Bradford Teaching Hospitals NHS Foundation Trust
2019
University of Chester
2019
University of Bristol
2003
Blackberry Hill Hospital
1994-1995
Background The World Health Organization (WHO) ICD–10 Primary Care (PHC) Guidelines for Diagnosis and Management of Mental Disorders (1996) have not been evaluated in a pragmatic randomised controlled trial (RCT). Aims To evaluate the effect local adaptation dissemination guidelines. Method Pragmatic, pair-matched, cluster RCT involving 30 practices. Results Guideline practices were less sensitive but more specific identifying morbidity, these differences significant. patients did differ...
Abstract Background Antipsychotic medications are used among 19%–58% of adults with intellectual disabilities to manage challenging behaviour against the NICE guideline recommendations. Studies show that it is possible completely withdraw antipsychotics in about one third and a dose reduction 50% or more another third. Method In Cornwall, over three years present authors developed structured pathway which involved people their carers, GPs, community learning disability team members...
Women with epilepsy (WWE) are vulnerable in pregnancy, increased risks to mother and baby including teratogenic risks, especially from valproate. The free EpSMon mobile-phone app allows self-monitoring afford patient-centred feedback on seizure related such as sudden death (SUDEP) its users. We sought generate insights into various treatments WWE of childbearing age (16 60 years ) using EpSMon.The study utilizes a prospective real-world cohort 5.5 years. Patient reported data demographics,...
Video consultations (VCs) were rapidly implemented in response to COVID-19 despite modest progress before.We aim explore staff and patient experiences with VCs during use feedback insights support quality improvement service development.Secondary data analysis was conducted on 955 521 responses (from 4234 consultations; 955/4234, 22.6% 521/4234, 12.3%, respectively) routinely collected following a VC between June July 2020 rural, older adult, outpatient care setting at National Health...
Introduction: Laparoscopic surgery has advantages for treating many abdominal surgical conditions, but its use in low and middle-income countries (LMICs) is limited by factors, including a lack of training opportunities. The aim this study was to explore the experiences surgeons rural north-east India highlight barriers facilitators laparoscopic surgery. Methods: Eleven with experience laparoscopy were recruited using purposive convenience sampling. Ethical approval obtained from...
Background Public health strategies have focused largely on physical health. However, there is increasing recognition that raising mental awareness and tackling stigma crucial to reduce disease burden. National campaigns had some success but issues locally particularly important. Aims To assess the public's perception of monthly BBC Cornwall phone-in programmes run for 8.5 years in Cornwall, UK (population 530 000). Method A consultation, review feedback process involving a multiagency forum...
Abstract Background Video consultations (VCs) were rapidly implemented in response to COVID-19, despite modest progress prior the pandemic. Objectives To explore staff and patient experiences of VCs during use feedback insights support quality improvement service development. Methods Secondary data analysis was conducted on 955 (22.6%) responses 521 (12.3%) routinely collected following a VC between June-July 2020 rural, aging outpatient care setting at single NHS Trust. Patient summarised...
A cross-sectional survey of 794 referrals from 41 general practices working in a defined catchment area is reported. The outcomes studied were the proportion patients (1) declined on basis referral letter, (2) not attending, (3) considered 'appropriate' by clinicians carrying out assessments and (4) judged to meet 'severity' criteria based upon risk or role impairment. Forty-one (5%) their letter 221 (27%) did attend. Of remainder, 125 (28%) as inappropriate referrals. There was an...
We looked to evaluate the reporting pathways and statistics between relevant stakeholders for suicides undetermined deaths in Cornwall. checked on correlation of numbers provided open verdicts given by different national regional agencies including local Coroner's office, Office National Statistics (ONS), Cornwall Partnership NHS Trust (CPT) The Confidential Inquiry (NCI) into examined data presented these years 2000 2002. Our study shows that transfer (local Coroner, ONS, CPT NCI) can be...
Background Only 25% of people who die by suicide see mental health services. Suicide is not just a issue. Its causation and consequences lie within all society. Many erroneously believe that inevitable preventable, because its too complex. Underlying associations with are largely social. There programmes in the USA, which have combined interventions to reduce suicides. The 2014 UK rate per 100,000 was 10.8 but 11.1 South West (SW) England (pop: 5 million). A whole system approach necessary....
The aftercare of psychiatric patients discharged from hospital is currently under debate among clinicians and in the media. Our study audited planning for detained section 117 1983 Mental Health Act. completed audit cycle showed how discharge can be improved yet underlines difficulties encountered providing this vulnerable patient group.
In the UK, clinical letters are most common way for doctors to communicate information about patients but no identified national standards exist on how soon non‐urgent should be dispatched. Here, Dr Shankar and colleagues discuss their audit of time taken GPs receive a clinic letter suggest ways improving practice.
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Urgent Care services in the NHS are under huge pressure to deliver better outcomes despite increasing demand, limited resources and tightening budgets. Ninety percent of urgent care for CYP currently managed hospital can be delivered community. It costs ten times less look after a at home compared admission. <h3>Methods</h3> The intervention –Ambulatory Experience (ACE) Pilot referred ACE from Primary Care, A E Children's Assessment unit. is community staffed by 2.52 WTE band 6 children's...
<sec> <title>BACKGROUND</title> Video consultations (VCs) were rapidly implemented in response to COVID-19 despite modest progress before. </sec> <title>OBJECTIVE</title> We aim explore staff and patient experiences with VCs during use feedback insights support quality improvement service development. <title>METHODS</title> Secondary data analysis was conducted on 955 521 responses (from 4234 consultations; 955/4234, 22.6% 521/4234, 12.3%, respectively) routinely collected following a VC...