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  1. Article ; Online: Implementing learning health systems in the UK NHS

    Sarah Scobie / Sophie Castle‐Clarke

    Learning Health Systems, Vol 4, Iss 1, Pp n/a-n/a (2020)

    Policy actions to improve collaboration and transparency and support innovation and better use of analytics

    2020  

    Abstract: Abstract Learning health systems (LHS) use digital health and care data to improve care, shorten the timeframe of improvement projects, and ensure these are based on real‐world data. In the United Kingdom, policymakers are depending on digital innovation, ...

    Abstract Abstract Learning health systems (LHS) use digital health and care data to improve care, shorten the timeframe of improvement projects, and ensure these are based on real‐world data. In the United Kingdom, policymakers are depending on digital innovation, driven by better use of data about current health service performance, to enable service transformation and a more sustainable health system. This paper examines what would be needed to develop LHS in the United Kingdom, considering national policy implications and actions, which local organisations and health systems could take. The paper draws on a seminar attended by academics, policymakers, and practitioners, a brief literature review, and feedback from policy experts and National Health Service (NHS) stakeholders. Although there are examples of some aspects of LHS in the UK NHS, it is hard to find examples where there is a continuous cycle of improvement driven by information and where analysis of data and implementing improvements is part of usual ways of working. The seminar and literature identified a number of barriers. Incentives and capacity to develop LHS are limited, and requires a shift in analytic capacity from regulation and performance, to quality improvement and transformation. The balance in priority given to research compared with implementation also needs to change. Policy initiatives are underway which address some barriers, including building analytical capacity, developing infrastructure, and data standards. The NHS and research partners are investing in infrastructure which could support LHS, although clinical buy in is needed to bring about improvement or address operational challenges. We identify a number of opportunities for local NHS organisations and systems to make better use of health data, and for ways that national policy could promote the collaboration and greater use of analytics which underpin the LHS concept.
    Keywords analytics ; digital policy ; implementation ; innovation ; learning health system ; transparency ; Medicine (General) ; R5-920 ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher Wiley
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Are the needs of people with multiple long-term conditions being met? Evidence from the 2018 General Practice Patient Survey

    Eilís Keeble / Lucina Rolewicz / Charlotte Paddison / Sarah Scobie

    BMJ Open, Vol 10, Iss

    2020  Volume 11

    Abstract: Objectives To investigate individual, practice and area level variation in patient-reported unmet need among those with long-term conditions, in the context of general practice (GP) appointments and support from community-based services in England.Design ...

    Abstract Objectives To investigate individual, practice and area level variation in patient-reported unmet need among those with long-term conditions, in the context of general practice (GP) appointments and support from community-based services in England.Design Cross-sectional study using data from 199 150 survey responses.Setting Primary care and community-based services.Participants Respondents to the 2018 English General Practice Patient Survey with at least one long-term condition.Primary and secondary outcome measures The primary outcomes were the levels of unmet need in GP and local services among patients with multiple long-term conditions. Secondary outcomes were the proportion of variation explained by practice and area-level factors.Results There was no relationship between needs being fully met in patients’ last practice appointment and number of long-term conditions once sociodemographic characteristics and health status were taken into account (5+conditions−OR=1.04, 95% CI 0.99 to 1.09), but there was a relationship for having enough support from local services to manage conditions (5+conditions−OR=0.84, 95% CI 0.80 to 0.88). Patients with multimorbidity that were younger, non-white or frail were less likely to have their needs fully met, both in GP and from local services. Differences between practices and local authorities explained minimal variation in unmet need.Conclusions Levels of unmet need are high, particularly for support from community services to manage multiple conditions. Patients who could be targeted for support include people who feel socially isolated, and those who have difficulties with their day-to-day living. Younger patients and certain ethnic groups with multimorbidity are also more likely to have unmet needs. Increased personalisation and coordination of care among these groups may help in addressing their needs.
    Keywords Medicine ; R
    Subject code 360
    Language English
    Publishing date 2020-11-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease

    Sarah Scobie / Sue Jowett / Tosin Lambe / Smitaa Patel / Rebecca Woolley / Natalie Ives / Caroline Rick / Christina Smith / Marion C Brady / Carl Clarke / Cath Sackley

    Pilot and Feasibility Studies, Vol 7, Iss 1, Pp 1-

    preliminary cost-consequence analysis of the PD COMM pilot randomised controlled trial

    2021  Volume 11

    Abstract: Abstract Background The PD COMM pilot randomised controlled trial compared Lee Silverman Voice Treatment (LSVT® LOUD) with standard NHS speech and language therapy (SLT) and a control arm in people with Parkinson’s disease (PwPD) with self-reported ... ...

    Abstract Abstract Background The PD COMM pilot randomised controlled trial compared Lee Silverman Voice Treatment (LSVT® LOUD) with standard NHS speech and language therapy (SLT) and a control arm in people with Parkinson’s disease (PwPD) with self-reported problems with voice or speech. This analysis compares costs and quality of life outcomes between the trial arms, and considers the validity of the alternative outcome measures for economic evaluations. Methods A comparison of costs and outcomes was undertaken alongside the PD COMM pilot trial involving three arms: LSVT® LOUD treatment (n = 30); standard NHS SLT (n = 30); and a control arm (n = 29) excluded from receiving therapy for at least 6 months after randomisation unless deemed medically necessary. For all trial arms, resource use and NHS, social care and patient costs and quality of life were collected prospectively at baseline, 3, 6, and 12 months. Total economic costs and outcomes (EQ-5D-3L, ICECAP-O) were considered over the 12-month follow-up period from an NHS payer perspective. Quality of life measures for economic evaluation of SLT for people with Parkinson’s disease were compared. Results Whilst there was no difference between arms in voice or quality of life outcomes at 12 months, there were indications of differences at 3 months in favour of SLT, which need to be confirmed in the main trial. The estimated mean cost of NHS care was £3288 per patient per year for the LSVT® LOUD arm, £2033 for NHS SLT, and £1788 for the control arm. EQ-5D-3L was more strongly correlated to voice impairment than ICECAP-O, and was sensitive to differences in voice impairment between arms. Conclusions The pilot did not identify an effect of SLT on disease-specific or economic outcomes for PwPD at 12 months; however, there appeared to be improvements at 3 months. In addition to the sample size not powered to detect difference in cost-consequence analysis, many patients in the control arm started SLT during the 12-month period used for economic analysis, in line with the study protocol. The LSVT® LOUD intervention was more intense and therefore more costly. Early indications suggest that the preferred economic outcome measure for the full trial is EQ-5D-3L; however, the ICECAP-O should still be included to capture a broader measure of wellbeing. Trial registration International Standard Randomised Controlled Trial Number Register: ISRCTN75223808. Registered 22 March 2012.
    Keywords Parkinson’s disease ; Pilot randomised controlled trial ; Speech and language therapy ; Cost-consequence analysis ; Medicine (General) ; R5-920
    Language English
    Publishing date 2021-08-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: The UK experience

    Sarah Scobie / Richard Thomson

    Italian Journal of Public Health, Vol 2, Iss 3-

    the National Patient Safety Agencyís Patient Safety Observatory

    2005  Volume 4

    Abstract: The National Patient Safety Agency (NPSA) was set up in 2001 in order to make changes at a national level, and lead work on improving patient safety in England and Wales. A core function of the NPSA is to identify trends and patterns in patient safety ... ...

    Abstract The National Patient Safety Agency (NPSA) was set up in 2001 in order to make changes at a national level, and lead work on improving patient safety in England and Wales. A core function of the NPSA is to identify trends and patterns in patient safety problems, using its own National Reporting and Learning System (NRLS) and data from other sources. Almost all reports to the NRLS come directly from local risk management systems; staff can also report directly to the NPSA via an electronic form. By the end of August 2005, nearly 230,000 incidents had been reported to the NRLS; 76% of these were reported from acute/general hospitals. The analysis of data in the NRLS is a function of the NPSA’s Patient Safety Observatory (PSO), which has been established to quantify, characterise and prioritise patient safety issues in order to support the NHS in making healthcare safer. The PSO works with key national organisations which hold data relevant to patient safety, such as healthcare regulators, patient’s organisations, clinical negligence bodies and national information and statistics functions. Triangulating information from different data sources enables a fuller picture of the nature and severity of patient safety incidents to be obtained. The key challenges for the PSO are to strengthen the quality of NRLS data, extend the ways in which feedback from the NRLS is provided, and continue to develop methods and tools for the systematic analysis of the huge volumes of incidents reported to the NRLS.
    Keywords patient safety ; incident reporting ; epidemiology ; surveillance ; data sources ; Public aspects of medicine ; RA1-1270 ; Medicine ; R ; DOAJ:Public Health ; DOAJ:Health Sciences
    Subject code 300
    Language English
    Publishing date 2005-12-01T00:00:00Z
    Publisher Prex spa
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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