Current Research

Partners At Care Transitions (PACT)
Funded by: NIHR Programme Grants for Applied Research
(1st January 2017 – 1st July 2022)
Principle Investigator: 
Rebecca Lawton    (Email:

Older people are the highest users of the NHS and, with the number of people in the UK aged 75 and over set to double in the next 30 years, this group of patients is an important target for support to improve transitions of care. The aim of this research is to improve the safety and experience of care for older patients as they move from hospital to home.

NIHR CLAHRC – Evidence-Based Transformation with the NHS
(January 2014 – December 2018)

Over the past 15 years efforts to improve patient safety in the NHS have been many, but most have focused on identifying and eradicating harm to patients. This approach to safety can, for some, be a relentlessly negative task where the recording and investigating of patient safety events becomes the goal, rather than improvement. Here we take a more positive approach, attempting to understand what healthcare teams do to deliver exceptionally safe care. As this ‘positive deviance’ approach is relatively new within the NHS, our research aims to develop methods for doing this work as well as produce findings of interest to a national and international audience.

We will test the positive deviance approach in the following areas:

  • Elective hip and knee surgery – Study information available here and here.
  • Elderly care medicine
  • Primary care
  • Transitions of care

Project information available here.
Or for further information please visit the CLAHRC Yorkshire & Humber website.

NIHR HS&DR – Understanding and enhancing how hospital staff learn from and act on patient experience data
(November 2015 – Present)

Patients are increasingly being asked for feedback about their experiences of the healthcare they have received. However, healthcare staff often find it difficult to act on this feedback in order to make improvements to services. The Quality & Safety research team have been funded by NIHR HS&DR to conduct a 32 month study to understand, and then enhance how ward staff can make better use of patient experience feedback. This research will be conducted with six teams of ward staff across six wards in three hospital Trusts. The core objectives are:

  1. To understand what patient experience measures are currently collected, collated, and used to inform service improvement and care delivery.
  2. To co-design and implement a patient experience improvement toolkit (PEIT) using an action research methodology.
  3. To identify transferable learning about how wards use the PEIT and the factors that influence this.
  4. To refine and disseminate the patient experience improvement toolkit.

We will conduct a scoping review of the academic and grey literature and qualitative data collection (focus groups, interviews and observations) with ward staff and board members will address the first objective. The second objective will be achieved through action research underpinned by a participatory design process where a patient experience improvement toolkit (PEIT) will be co-designed by patients and ward staff.  A process evaluation of the implementation of the PEIT will produce transferable and generalizable learning about how the toolkit is used in practice, and what factors influence its use (objective 3). The final stage of the research project involves the refinement and dissemination of the toolkit through collaboration with local and national networks (objective 4).

Project information available here.
The study protocol can be accessed here.
March 2017 progress report can be accessed here.
Restricted Access – Reflection-in-Action.

Nurse wellbeing, burnout and patient safety
(August 2016 – July 2017)

There is growing interest in the relationships between depressive symptoms and burnout in healthcare staff and the safety of patient care. Depressive symptoms are higher in healthcare staff than the general population and overlap conceptually with burnout, but very little research has investigated these variables in nurses. To address these issues, we conducted research to investigate the relationships between depressive symptoms, burnout and perceptions of patient safety in nurses. A mediation model was proposed and supported, with associations between depressive symptoms and patient safety perceptions fully mediated by burnout. These results suggest that symptoms of depression and burnout in hospital nurses may have implications for patient safety.

Project information available here.

Putting the patient at the heart of patient safety – Implementing the PRASE intervention
Funded by: The Health Foundation, Closing the Gap in Patient Safety
(June 2014 – December 2016)

The PRASE intervention was developed by researchers in the region, to gather views from patients and their families about the safety of care within hospitals.  The intervention then asks staff to come together to look at the feedback from patients and use it to make patient-centred changes to how they deliver care on the ward.  This two year project aims to understand how we might involve hospital volunteers in both collecting the feedback from patients, and also working with staff to make changes using this feedback.  The project has an anticipated completion date of December 2016.

Project information available here.
Or more information about the PRASE intervention available here.

Improving the Safety and Continuity of Medicines management At Transitions of care (ISCOMAT)
Funded by: NIHR Programme Grants for Applied Research
(14th March 2016 – 13th November 2021)
Lead Investigators:
Prof. Alison Blenkinsopp and Prof. Gerry Armitage, University of Bradford

Making the use of medicines as safe and effective as possible are priorities for patients and healthcare providers. When a patient moves (e.g. from hospital to home) medicine problems are common and planned changes are not always followed through. Patients particularly at risk are those with long-term illnesses taking several medicines – especially when medicines have been started or changed in hospital. We aim to improve the use of prescribed medicines when patients move from one setting to another, including reducing harm from medicines. We will study patients with heart failure – chosen because they need a number of medicines. Also, some of these medicines need careful monitoring – making sure doses are increased gradually to the level where they work best. We will work closely with patients and healthcare staff to fully understand what happens now when patients move between hospitals and their own home. We will then use this understanding to develop and test ways of improving how medicines are used.

A novel Computer Aided Risk Score for acutely ill patients: Combining physiological and biomedical data into a novel computer-aided risk score to support near real-time clinical decision making and determine its impact on quality/safety of care in two hospitals
Funded by: Health Foundations Insight 2014: Informatics in health care improvement
(February 2015 – November 2017)

Lead Investigator: Prof. Mohammed A Mohammed, University of Bradford

Around 5% of deaths in English hospitals would be  prevented if care was optimised. Data suggests that clinical teams are not always aware of the patient’s actual risk of dying but if they were this could enhance patient safety. Most clinical teams do not have a statistically calculated score that gives practitioners a warning of risk of deterioration or death and the opportunity to take timely action to prevent this. The aim of this research is to develop, implement and evaluate the impact of a Computer-Aided Risk Score to support clinical decision making.

Project information available here.
More information is available on the Improvement Academy and Health Foundation websites.

RCF Funded Research

Positive deviance and the Care Quality Commission: What makes an ‘outstanding’ general practice?
Funded by: RCF West Yorkshire CCGs 

(April 2016 – April 2017)
Project Team: Ruth Baxter, Gail Opio-Te, Rebecca Lawton, Robbie Foy, Peter Davies

The positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance despite facing the same constraints as others. General practices that are rated ‘outstanding’ by the Care Quality Commission (CQC) could be considered to be positive deviants. This research seeks to explore how positively deviant general practices, that have been rated as ‘outstanding’ by the CQC, facilitate the delivery of exceptionally safe, high quality patient care. RCF funding will be used to:

  1. Analyse CQC inspection reports of ‘outstanding’ general practices to explore the common structures, processes and behaviours that facilitate the delivery of exceptionally safe patient care.
  2. Interview CQC inspectors to explore their perceptions about how multidisciplinary teams within ‘outstanding’ general practices deliver exceptionally safe patient care.
  3. Combine findings to generate robust hypotheses about the positively deviant strategies that are used to succeed, and explore potential options for further funding.

Project information available here.

Patient involvement in diagnosing cancer in primary care
Funded by: Research Capability Funding: Yorkshire and Humber Commissioning Support, 
and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH)
(July 2015 – March 2017)
Project Team:
Jane Heyhoe, Caroline Reynolds, Gail Opio-Te, Ian Watt, Rebecca Lawton

There is growing interest in the role that patients may play in helping to achieve an earlier diagnosis of cancer. This work set out to understand how this could be achieved in primary care. We did this by:

  1. Reviewing the existing literature on current interventions for patient involvement in diagnosis in primary care.
  2. Interviewing patients and health professionals to assess the acceptability, feasibility, cost and burden of patient involvement in cancer diagnosis in primary care and to identify potential interventions to assist an earlier diagnosis of cancer.

Conference Presentation:
Heyhoe J, Reynolds C, Opio-Te G, Watt I, Lawton R. Patient involvement in diagnosing cancer earlier in primary care: potential strategies and key components. Science of Improvement Conference, Harrogate, UK, 2016

Project information available here.