The GM PSTRC is one of three national patient safety translational research centres which have been working throughout COVID-19 to improve safety for everyone during and after the pandemic across specific areas of health and social care. To do this the centres are working with NHS trusts, health and social care partners and staff, the wider research community and patients.
COVID-19 has emphasised the significance of patient safety. Behavioural science has underpinned many of the most challenging safety concerns that have emerged during this time. This includes efforts to encourage the general public to follow government guidelines on physical distancing, the importance of staff wellbeing, and infection control in hospital. Understanding why people do what they do and promoting changes in behaviour are prominent features across all three of the PSTRCs’ work.
GM PSTRC is working proactively to involve patients, from gathering their experiences to creating interventions which improve specific patient safety concerns. New safety initiatives developed are then tested or piloted in the appropriate health and/or social care setting such as a hospital, GP practice, care home or pharmacy.
COVID-19 and the work of the GM PSTRC
GM PSTRC responded quickly to the pandemic. The centre has adapted existing projects to allow them to continue to focus on pre-existing patient safety priorities or adapted projects to incorporate the impact of COVID-19 as well as developed new research to improve patient safety in response to it.
As the pandemic has evolved, the challenges in improving patient safety have also changed at a rapid pace. The centre has used data to investigate some of the most relevant patient safety concerns as they emerged such as using our expertise in examining electronic health records and using behavioural science to develop new research focusing on the direct and indirect impacts of the pandemic.
New projects in response to COVID-19
During the COVID-19 pandemic the following projects have been developed at the GM PSTRC:
- Clinical contact with health services for mental illness and self-harm before, during and after the COVID-19 pandemic
The centre’s mental health researchers are looking at primary care contact for mental illness and self-harm, as well as referrals to mental health services before, during and after the acute phase of the COVID-19 pandemic. They are examining differences by age group, gender, ethnic group and practice-level deprivation. A paper is set to be published by January 2021.
- Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic
Researchers have investigated the indirect effect of the COVID-19 pandemic on peoples’ use of general practices, and how this has affected the diagnoses of common physical and mental health conditions in a deprived UK population. Findings have been published in the Lancet Public Health and received national news coverage.
- Understanding how to sustain public adherence to UK government COVID-19 related instructions
Early evidence suggested that, on the whole, the public did follow the UK government COVID-19-related instructions. But interventions to sustain this in the long-term can only be developed if we know why people do or do not comply with government instructions. This study is assessing levels of public adherence to UK government COVID-19-related instructions. It is the first step in developing interventions to support continued public adherence to government instructions. The outcome will published in early 2021.
Adapting current research in response to COVID-19
The pandemic continues to impact health and social care and as a result studies that started before COVID-19 began to affect the UK have been adapted to increase relevance and impact:
- Patient Automated Triage and Clinical Hub Scheduling (PATCHS)
In response to the rapidly changing shift in primary care consultations from face-to-face to remote consultations, GM PSTRC researchers are working with the Innovate UK funded PATCHS feasibility study, to assess the opportunity and potential impact of using Artificial Intelligence (AI) in online primary care triage. It is an intervention that could have a positive impact while face-to-face consultations are difficult due to COVID-19.
- Homelessness and patient safety
Researchers in the Marginalised Groups, Patients and Carers sub theme have been investigating patient safety with and for people with lived experience of homelessness. In light of the pandemic this work has been adapted to explore the support available for accessing primary health care services. In addition there is a focus on the quality and safety of care during the COVID-19 pandemic for homeless populations. This work is being carried out in collaboration with Groundswell, Urban Village and Shelter.
- Co-designing a mobile application for people living with early stage dementia to improve communication, independence and patient safety
Researchers in the centre’s Patients and Carers sub theme were due to start a research project in March 2020 when lockdown began. The research aimed to discover how helpful an app that can improve communication, MyHealthGuide, would be for people living with the early stages of dementia.
As the start of the project was delayed, researchers used technology such as video calling and worked with partners to create video stories of people living in community settings with early stage dementia. The videos and written case stories will be used to highlight the challenges being faced and to show how technology may be able to help. A report will be produced and content shared.
- Co-design and evaluation of a patient safety guide app
A resource called ‘A guide for patients and carers: How to keep yourself safer in general practice, pharmacies and when going into and coming out of hospital’ supports patients and carers to address key patient safety questions and to identify key points where they can make their care safer. COVID-19 has increased the use of remote consultations in general practice, which the guide addresses. Both during and after the pandemic, this project will consider how people use remote consultations, what support they need to do this effectively, and how people from different communities have adapted.
- Treatment gaps in the care of people who self-harm
To improve services, we need to know what helps and what prevents good quality assessments following self-harm. To find out, researchers from the Marginalised Groups-Mental Health theme are interviewing staff, patients and family members during COVID-19, using this unique opportunity to capture some of the service change issues arising from the pandemic.
- Transitions to/from care homes
Researchers from the Safer Care Systems and Transitions theme are exploring the processes and concerns that shape the decision-making of care homes when transferring residents to or from hospitals during COVD-19. The results will inform the evaluation of the ‘Red Bag’ scheme, which is an initiative that aims to make hospital transfers to or from a care home safer.