Activities
Our activities are organised within three principal themes:
1. Management of common chronic disorders in primary care and at the interface with secondary care
- Work within the sub-theme of epidemiology and management strategies includes surveys of the management of GI diseases in the UK and in Europe. This has contributed to a national strategy for GI services (Primary Care Society for Gastroenterology 2006) and a review of primary care GI services in Europe, to be undertaken by the European Society for Primary Care Gastroenterology on behalf of the United European Gastroenterology Federation.
- Decision support aids have been evaluated for colorectal cancer (DH) and for gastroesophageal reflux disease (Altana Pharma). Other chronic conditions being studied include infertility, with an NHS-RDA funded PhD study of a new approach to its management, obesity (Newcastle PCT) and diabetes, with an evaluation of a lifestyle intervention for persons at high risk of the disease. Colin Waine has given evidence to the House of Commons select committee on the management of obesity and is currently Chair of the Obesity Forum. Wilkes' work on fertility has already resulted in open access to hysterosalpingography being mainstreamed in 3 PCTs.
- Therapeutic approaches to the management of GI disease have been addressed through primary research on laxatives (funded by the NHS HTA) and the drug management of IBD, and through secondary research (Cochrane reviews of drug and non-drug therapies for IBS, chapters for Clinical Evidence on constipation in children and IBS). Our Cochrane review of drug therapies in IBS informed Rubin's co-authorship of the recent British Society for Gastroenterology's Guidelines on IBS.
- Health beliefs and healthcare-seeking behaviours are being studied through research on patients with IBD, coeliac disease (Hall), diabetes (King) (Crosland), IBS (Rubin) and colorectal cancer (Hall). Beliefs and attitudes to physical activity have been addressed in relation to diabetes and cardiac rehabilitation, and among children and adolescents. We have described the extent of non-adherence in IBD, the health beliefs that underpin this (Hall) and have described strategies for modifying this. Quality of life and its impact on health care utilisation in IBD has been described and a Short IBDQ developed for use in patient care. We are currently researching the impact of health beliefs on adherence to anti-depressant medication.
2. Health and social inequalities
We have an expanding portfolio of public health research. A programme of work over the past six years, led by Griffin, to understand health inequalities using the technique of rapid participatory appraisal has been funded by Gateshead Metropolitan Borough Council and Gateshead PCT. As a result, we participated in the development of the Gateshead PCTs Centre for Health Improvement and informed a series of successful bids by Gateshead Council for regional development funding.
We also work closely with North Tyneside PCT on the evaluation of their public health innovations and some of our research staff are located within that Trust. The development and evaluation of new roles to tackle health inequalities such as the graduate mental health workers in primary care (Crosland) forms a key part of our research in this area.
We host the North East Teaching Public Health Network (NETPHN), which is currently engaged on mapping public health education provision across education providers in the North East with a view to identifying how this relates to service needs and the Skills for Health competency framework. The NETPHN is also using case study approaches to support and understand critical issues in the development of the public health workforce to tackle specific areas of inequality for example in relation to the needs of children.
3. Quality improvement in health care
Our primary focus here is on patient safety, in collaboration with the Pharmacy Policy and Practice Research Group, with Professor Jim Smith's report as Chief Pharmaceutical Officer for the DH 'Building a safer NHS for patients' and publications on drug safety, a Cochrane review (Fraser) and the first large scale UK study of errors in general practice (Rubin).
We have published important evidence on patient priorities for access to general practice, alongside a systematic review of reasons for non-attendance. An example of our close collaboration with the clinical governance processes of PCTs is our research on A&E attendance in Newcastle and consequent service redesign (Weaver). We have also looked at the application of approaches taken from other environments and how they apply to health care settings, an example being the application of whole systems methodology to improve primary care mental health services (Crosland).
