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A patient in a wheelchair being attended by a doctor and a nurse.

Safer Care Systems and Transitions

This is a new theme for the 2017-2022 NIHR Greater Manchester PSTRC that responds to the growing need to understand how safety is assured as patient care is transferred between different care providers, specialists and organisations.

The theme builds on research we carried out between 2012 and 2017 that showed that patients with more than one health condition (multimorbidity) often face challenges to their safety when being cared for or treated by more than one organisation or care provider.

Our previous research shows that care pathways often involve many transitions, where the responsibility for patient care is transferred or handed over from one team, department or organisation to another along the patient pathway.

A patient pathway is the route that a patient will take from their first contact with an NHS member of staff (usually their GP), through referral, to the completion of their treatment. It may also cover a stay in hospital.

In such transitions, patients can feel vulnerable and there is a risk that patient safety could be compromised because of the difficulties of coordinating the transfer of care between different carers. While we know more about what makes for safety within care settings, we know less about what makes for safety between care settings.

The theme looks specifically at the safety of care transitions, from the ways patients move across their care pathway, the flows of information, and the roles of different technologies in supporting the coordination of different specialists and carers.

We will look at these transitional issues across primary and secondary care, in mental health services, in chronic conditions, cancer care, and end of life care, to ensure learning and innovations are shared across the health and social care sectors.

Specific projects will focus on cancer transitions (managed local follow-up of long term lymphoma survivors – the ADAPT programme) with the Christie and Cancer Vanguard. We will then take learning from lymphoma and apply it to other cancer. Other projects will look at:

  • interventions to support the coordination of specialists before, during and after hospital discharge;
  • the co-design and feasibility testing of 'patient-held care records';
  • understanding and testing solutions to the threats to safety in the 'inpatient to community' circuit of care in mental health services and offender healthcare.

We will develop indicators for transitional safety and will develop and test new systems of routine data collection and analysis for transitional safety as a cross-theme project.

Theme leads

Key staff