AoPC_1

What we do

Redesigning primary care practice

Theme lead: Professor Joanne Reeve, Dr Myriam Dell’Olio, Dr James Bennett, Dr Clare Fozard

The way we work is shaped by the place we work. Modernising primary care means changing not only the work professionals do, but also the settings in which they work. This theme tackles the practice-level changes needed to support the knowledge work of every day person-centred primary healthcare.

We work with partners from around the UK and internationally to develop and evaluate innovative solutions to modern challenges of both too much, and too little, medicine.

Projects

SPLENDID: Social prescribing for people to live enjoyably with dementia

Contacts: Professor Joanne Reeve, Prof Esme Miniz-Cooke, Dr Emma Wolverson

Funding: NIHR PGfAR

Research shows that, for some people living with dementia, social prescribing offers a better approach to supporting whole person care. SPLENDID aims to design, implement and evaluate the impact of a novel social prescribing programme to enhance wellbeing for people living with dementia.

The work will start in 2022.

Tackling Problematic Polypharmacy: The Tailor Evidence Synthesis

Contact: Professor Joanne Reeve

Funding: NIHR HTA 16/79/02

If 10% of dispensed medicines are ‘overprescribed’, patients feel burdened by their medicines, and ‘compromise’ is needed to address problematic polypharmacy, how can we improve prescribing practice?

Our NIHR funded evidence synthesis used a novel evidence synthesis approach to undertake a comprehensive review of how we can best support optimal deprescribing for patients with complex multimorbidity. Our findings highlight important new implications for practitioners, practice and policy and will be published shortly in the NIHR Journals Library.

We are preparing an on-line MOOC to enable front-line clinicians to benefit from this work in supporting their own daily practice.

TIMES: Optimising Community Based Management of Sleep in People Living with Dementia

Contact: Professor Joanne Reeve, Dr Andrea Hilton

Funding: NIHR Programme Grant for Applied Research

Growing numbers of people are living with dementia and mild cognitive impairment, many of whom experience sleep disturbance with significant impact on their day to day living, carers and their family. Patients need tailored support, but sleep is often poorly managed in healthcare. TIMES will address barriers to delivery of person-centred care for this. 

Led by Professor Chris Fox at University of Exeter, this NIHR Programme Grant funded work draws on the findings of TAILOR to describe, develop, implement and evaluate a novel tailored approach to managing sleep disturbance in this population.

The project starts in early 2022.

Defining the Knowledge Work of Person-centred Care

Contact: Myriam Dell Olio

Funding: Hull University PhD Cluster Funding 

Myriam’s PhD is a qualitative study examining the changing face of primary care and its impact on people living with long-term conditions and multi-morbidity. Myriam’s work is defining the conceptual underpinnings of person-centred care, and considering the knowledge work for patient and professional alike. Her findings highlight implications for patients, professionals, practice and policy.

Her systematic review informing this work was recently published in the European Journal for Person-Centred Care – a paper for which she was awarded the 2020  ESPCH Qualitative Research prize.

Clinical Decision Making in the Ambulatory Care Setting

Contact: Professor Joanne Reeve

Funding: Oxford CLAHRC

Led by Dr Sara McKelvie (University of Oxford), this innovative work examines the Clinical Decision Making processes of doctors working in the acute ambulatory care setting.

Using observation methods, Sara is developing new insights into the daily work of clinicians in a complex and high-risk setting. Her findings will offer insights into how we train, and support clinicians to work in interface and primary care contexts – addressing both professional development, and service context changes needed.