Mobile menu icon
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 Safer Care Systems and Transitions theme builds on research carried out between 2012 and 2017. That research showed how 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.

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 end of their treatment. It may also cover a stay in hospital. The centre’s previous research revealed how care pathways often involve care being transferred between different organisations, teams or departments.

During transitions, patients have reported feeling vulnerable. There is a risk to patient safety because of the difficulties of coordinating the transfer of care between different carers. While researchers know more about what increases safety within care settings, we know less about what makes care safer between settings.

Safer Care Systems and Transitions theme looks at the safety of care transitions. This includes:

  • The ways in which patients move across their care pathway.
  • The flow of information between all the professionals involved across care pathways.
  • The role played by making organisational improvements.
  • The different technologies used to support the coordination of all the specialists and carers involved in a particular care pathway.

The theme is looking at these transitional issues across:

  • Primary (for example general practice) and secondary care (hospitals).
  • In-mental health services.
  • Nursing homes/elderly residential care homes.
  • Cancer care pathways and end of life care, to ensure learning and innovations are shared across the health and social care sectors.

Behavioural Science subtheme

The Safer Care Systems and Transitions theme hosts the Behavioural Science subtheme. Research in the subtheme uses theory and evidence to suggest, test, and help to embed behaviour interventions in health and care settings.

Visit the Behavioural Science webpage for more information.

The research and impact

An example of one of the research projects underway is the ADAPT programme which researchers from both the Safer Care Systems and Transitions and Safety Informatics themes are working on, along with The Christie NHS Foundation Trust and Cancer Vanguard. It aims to improve outcomes for long term survivors of lymphoma. Once this has been completed, researchers will use what they’ve learnt to look at other types of cancer.

The following work is also underway:

  • SAFER Patient Flow Bundle for patient discharge

Developing ways to refine SAFER and make it safer for patients when they are discharged from mental health hospitals into the care of general practice in the community.

  • Transitions between care homes and hospitals

Developing a handover intervention scheme to improve the transfer of information to and from hospitals and nursing homes/elderly residential care homes within Salford Clinical Commissioning Group (CCG).

  • Prison healthcare transitions

Understanding the safety issues when managing medications for people going into prisons, moving between prisons or leaving prison. As a result opportunities for improvements to interventions will be identified.

  • Transitions between hospital and the community

Interventions to support the coordination of specialists before, during and after patients are discharged from hospital.

  • Patient-held care record

The co-design and feasibility testing of a paper version of a patients medical record held by them or their carer known as a 'patient-held care records'.

  • Inpatient to community transitions in mental health and offender healthcare

Understanding and testing solutions to the threats to safety in the 'inpatient to community' circuit of care in mental health services and offender healthcare.

  • NHS improvement intervention for making healthcare transitions safer

Researchers will evaluate this pilot and develop and test new ways of routine data collection and analysis for safety along with other research themes at the GM PSTRC.

Theme Lead

Key staff

Affiliated staff

  • Dr Andrew Grundy
  • Dr Richard Keers (also Medication Safety)
  • Professor Catherine Robinson

PSTRC PhD Fellow

  • Victoria Moore

Christie/PSTRC PhD Fellow