A5025585945- Global Cancer Incidence and Screening
- Patient-Provider Communication in Healthcare
- Health Policy Implementation Science
- Mental Health and Patient Involvement
- Primary Care and Health Outcomes
- Clinical Reasoning and Diagnostic Skills
- Clinical practice guidelines implementation
- Interprofessional Education and Collaboration
- Health Systems, Economic Evaluations, Quality of Life
- Cancer survivorship and care
- Healthcare cost, quality, practices
- Psychopathy, Forensic Psychiatry, Sexual Offending
- BRCA gene mutations in cancer
- Lung Cancer Diagnosis and Treatment
- Palliative Care and End-of-Life Issues
- Mental Health and Psychiatry
- Acute Ischemic Stroke Management
- Healthcare Systems and Technology
- Hospital Admissions and Outcomes
- Personality Disorders and Psychopathology
- Electronic Health Records Systems
- Global Public Health Policies and Epidemiology
- Economic and Financial Impacts of Cancer
- COVID-19 and healthcare impacts
- Emergency and Acute Care Studies
University College London
2016-2025
Queen Mary University of London
2022-2025
Centre for Addiction and Mental Health
2022-2024
Michael E. DeBakey VA Medical Center
2024
MedStar Health
2024
The University of Texas Health Science Center at Houston
2024
Maidstone and Tunbridge Wells NHS Trust
2024
Wolfson Medical Center
2024
Wolfson Foundation
2023
University of Manchester
2019
Background Most cancers are diagnosed following contact with primary care. Patients cancer often see their doctor multiple times potentially relevant symptoms before being referred to a specialist, suggesting missed opportunities during doctor-patient conversations. Objective To understand communication around the significance of persistent or new presenting problems and its potential impact on timely diagnosis. Research design Qualitative thematic analysis based video recordings...
Background Prison telemedicine can improve the access, cost and quality of healthcare for prisoners, however adoption in prison systems worldwide has been variable despite these demonstrable benefits. This study examines anticipated realised benefits, barriers enablers telemedicine, thereby providing evidence to chances successful implementation. Methods A systematic search was conducted using a combination medical subject headings text word searches prisons telemedicine. Databases searched...
Background Over the past two decades, UK has actively developed policies to enhance early cancer diagnosis, particularly for individuals with non-specific symptoms. Non-specific symptom (NSS) pathways were piloted and then implemented in 2015 address delays referral diagnosis. The aim of this study was outline functions that enable NSS teams investigate other diagnoses patients NSSs. Methods analysis derived from a multisite ethnographic conducted between 2020 2023 across four major National...
Introduction Cancers diagnosed following visits to emergency departments (ED) or admissions (emergency presentations) are associated with poor survival and may result from preventable diagnostic delay. To improve outcomes for these patients, a better understanding is needed about how presentations arise. This study sought capture patients' experiences of this pathway in the English NHS. Methods Eligible patients were identified service evaluation invited participate. Interviews, using an...
Introduction People in prison tend to experience poorer health, access healthcare services and health outcomes than the general population. Use of video consultations (telemedicine) has been proven effective at improving access, cost quality secondary care for prisoners USA Australia. Implementation use English settings limited date despite political drivers change. We plan research implementation a new prison-hospital telemedicine model an county understand what factors drive or hinder...
Background COVID-19 has led to rapid changes in healthcare delivery, raising concern that these may exacerbate existing inequalities patient outcomes. Aim To understand how patients’ help-seeking experiences primary care for colorectal cancer symptoms during were affected by their socioeconomic status (SES). Design and setting Qualitative semi-structured interviews with males females across the UK, recruited using purposive sampling SES. Method Interviews carried out 39 participants (20...
Background Recovery Colleges (RCs) are education-based centres providing information, networking, and skills development for managing mental health, well-being, daily living. A central principle is co-creation involving people with lived experience of health/illness and/or addictions (MHA). Identified gaps RCs evaluations information about whether such co-created.Aims We describe a co-created scoping review how evaluated in the published grey literature. Also assessed were: frameworks,...
One reason for the introduction of digital technologies into health care has been to try improve safety and patient outcomes by providing real-time access data enhancing communication among professionals. However, adoption such clinical pathways less examined, impacts on users broader system are poorly understood. We sought address this studying introducing a digitally enabled pathway patients with acute kidney injury (AKI) at tertiary referral hospital in United Kingdom. A dedicated...
Background: While challenging to provide, prisoners are entitled healthcare equivalent community patients. This typically involves them travelling hospitals for secondary care, whilst adhering the prison's operational security constraints. Better understanding of equivalence issues this raises may help and prisons consider how make services more inclusive accessible prisoners. We used prisoners' accounts care experiences understand these relate principle equivalence.Methods: undertook a...
The implementation of change in health and care services is often complicated by organisational micro-politics. There are calls for those leading to develop utilise political skills behaviours understand mediate such politics, but date only limited research offers a developed empirical conceptualisation the change.A qualitative interview study was undertaken with 66 healthcare leaders from English National Health Service (NHS). Participants were sampled on basis their variable involvement...
Objective Advanced stage at diagnosis for breast cancer is associated with lower socio‐economic status ( SES ). We explored what factors in the patient interval (time from noticing a bodily change to first consultation health care professional) may contribute this inequality. Design Qualitative comparative study. Methods Semi‐structured interviews sample of women (≥47 years) higher n = 15) and educational backgrounds, who had experienced least one potential symptom. Half participants sought...
Abstract Background Safety netting in primary care is considered an important intervention for managing diagnostic uncertainty. This the first study to examine how patients understand and interpret safety advice around low-risk potential lung cancer symptoms, this affects reconsultation behaviours. Methods Qualitative interview UK care. Pre-covid-19, five were interviewed person within 2–3 weeks of a consultation symptom(s), again 2–5 months later. The general practitioner (GP) they last saw...
Background Lung cancer clinical guidelines and risk tools often rely on smoking history as a significant factor. However, never-smokers make up 14% of the lung population, this proportion is rising. Consequently, they are perceived low-risk may experience diagnostic delays. This study aimed to explore how clinicians risk-informed decisions for never-smokers. Methods Qualitative interviews were conducted with 10 diagnosticians, supported by data from 20 never-smoker patients. The analyzed...
Abstract Introduction People being investigated for cancer face a wealth of complex information. Non‐specific symptom pathways (NSS) were implemented in the United Kingdom 2017 to address needs patients experiencing symptoms such as weight loss, fatigue or general practitioner ‘gut feeling’, who did not have streamlined investigation. This study aimed explore health literacy skills needed by NSS pathways. Methods employed ethnographic methods across four hospitals England, including...
Managing diagnostic uncertainty is a major challenge in primary care due to factors such as the absence of definitive tests, variable symptom presentations and disease evolution. Maintaining patient trust during period investigative uncertainty, whilst minimising scope for error challenge. Mismanagement can lead errors, treatment delays, suboptimal outcomes.