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Volume 6 - Issue 6 by Susan Hampshaw
The Rycroft-Malone paper states that co-production relies on 'authentic' collaboration as a conte... more The Rycroft-Malone paper states that co-production relies on 'authentic' collaboration as a context for action. Our commentary supports and extends this assertion. We suggest that 'authentic' co-production involves processes where participants can 'see' the difference that they have made within the project and beyond. We provide examples including: the use of design in health projects which seek to address power issues and make contributions visible through iteration and prototyping; and the development of 'actionable outputs' from research that are the physical embodiment of co-production. Finally, we highlight the elements of the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) architecture that enables the inclusion of such collaborative techniques that demonstrate visible co-production. We reinforce the notion that maintaining collaboration requires time, flexible resources, blurring of knowledge producer-user boundaries, and leaders who promote epistemological tolerance and methodological exploration.
Papers by Susan Hampshaw
This short report describes some of our experiences of a recent evaluation of the attachment of s... more This short report describes some of our experiences of a recent evaluation of the attachment of social services assessment officers to clusters of general practices in Kingston-upon-Hull. Whilst some practices were able to realise the expected benefits of such a scheme in terms of improved communication between health and social services, speedier access to services and so on, some practices
British Journal of Midwifery
Quality in primary care
Modernisation is usually thought of as an NHS phenomenon but already its influence has spread. He... more Modernisation is usually thought of as an NHS phenomenon but already its influence has spread. Here we outline the development of modernisation in prisons. From our experience of supporting a local prison in undertaking health needs assessment and developing its health improvement planning we have been able to observe modernisation beginning to work in prison healthcare and taking effect over a relatively short period of time. Although it is too early to provide conclusive evidence of direct benefits to prisoner-patients we have found some encouraging signs. Here we report on a brief survey of how prison healthcare staff currently view modernisation and its perceived benefits for patients, and discuss the need to initiate systematic robust evaluations of some of the small-scale initiatives that modernisation has generated. Keywords : health needs assessment, health planning, modernisation agenda, prison health
Background: Obesity is a Health and Well Being priority in Doncaster and there are a number of in... more Background: Obesity is a Health and Well Being priority in Doncaster and there are a number of initiatives tackling overweight and obesity. We need to ensure that evaluation systems are in place to inform future priorities/commissioning. SROI (Social Return on Investment) has been used as part of a Public Health development project supported by CLAHRC-South Yorkshire. SROI aims to capture the broader value of activities and services by measuring their social, environmental and economic outcomes. Aims: to demonstrate the full impact of the Cook and Eat programme, establish effective systems to capture and report data; and inform the future commissioning of nutrition/prevention initiatives. Methods: pre and post course participant questionnaires; focus groups (course participants; staff interviews. Findings: The outcomes established for the participants included: improvements in diet, gaining a social element from the course, increasing in confidence with food, going on to further tra...
British Journal of Healthcare Management, 2005
ABSTRACT There is high-level commitment in the UK to addressing the historical weaknesses in the ... more ABSTRACT There is high-level commitment in the UK to addressing the historical weaknesses in the delivery of prison health care, and for prisons to work with their NHS colleagues in order “to give prisoners access to the same quality and range of healthcare services as the general public receives from the National Health Service” (National Health Service Executive 1999).
British Journal of Midwifery, 2002
ABSTRACT One of the major challenges in evidence-based health care is the wide gap between resear... more ABSTRACT One of the major challenges in evidence-based health care is the wide gap between research and practice. The aim of this study was to review local screening programmes systematically to assess the extent to which the services were informed by available best evidence. The information on local screening practices was collected, using a structured questionnaire and follow-up telephone interviews with local key informants. Best evidence for practice was identified by collating findings of systematic reviews and guidance from authoritative sources. Twenty-three antenatal screening programmes were identified. ‘Decision sheets’ for all the programmes were developed to facilitate the decision-making process and summarise areas of variation locally and with respect to best practice. Currently, authoritative guidance exists for 22 programmes and is followed locally for the most part. On occasions, the authoritative sources gave different guidance which resulted in variations in practice locally. In two programmes we considered that variations in local practice needed to be addressed (Down’s Syndrome and neural tube defect). This approach was much valued by both health professionals and lay representatives. Using the decision sheets, the Maternity Strategy Group formed a view on how to align services for Down’s Syndrome screening. This article suggests a generic approach to narrow the research-practice gap. Further evaluation of the decision sheets is required
Journal of Clinical …, 2002
... Thanks are also due to Karen Chapman (Research Nurse) and Carol Brearley (Research Midwife) f... more ... Thanks are also due to Karen Chapman (Research Nurse) and Carol Brearley (Research Midwife) for their clinical input. We also acknow-ledge with gratitude the support of Peter Campion, Professor of Primary Care Medicine, at the Uni-versity of Hull. ...
Social science & medicine (1982), 2017
This paper explores how commissioners working in an English local government authority (LA) viewe... more This paper explores how commissioners working in an English local government authority (LA) viewed a health economic decision tool for planning services in relation to diabetes. We conducted 15 interviews and 2 focus groups between July 2015 and February 2016, with commissioners (including public health managers, data analysts and council members). Two overlapping themes were identified explaining the obstacles and enablers of using such a tool in commissioning: a) evidence cultures, and b) system interdependency. The former highlighted the diverse evidence cultures present in the LA with politicians influenced by the 'soft' social care agendas affecting their local population and treating local opinion as evidence, whilst public health managers prioritised the scientific view of evidence informed by research. System interdependency further complicated the decision making process by recognizing interlinking with departments and other disease groups. To achieve legitimacy wit...
Prevalence of maternal obesity is increasing, with health risks for mother and infant. Effective ... more Prevalence of maternal obesity is increasing, with health risks for mother and infant. Effective health promotion depends on sufficient knowledge and appropriate communication skills. We aimed to explore women's, midwives' and health visitors' perceptions of current practice in helping women manage their weight and supporting healthy behaviour change during pregnancy, and their perceived training needs. A modified grounded theory methodology was adopted, based upon critical realist assumptions. Following consultation events with fifty six practitioners to inform data collection tools, twenty (different) practitioners and nine women participated in focus groups. Comparative analysis generated four themes: A core theme, "Discouraging discourses", described health professionals' negative beliefs and reactive approach to communicating about weight. "Staff resources" identified limitations in and requirements for practitioner knowledge, skills and tools for effective communication. "Contextual influences" were social factors, which hindered practitioners' efforts to achieve healthy behaviour change. "Communicating as a Team" identified the importance of and challenges to a team approach. Findings have implications for weight management in pregnancy, practitioner resources, teamwork, and national health promotion campaigns.
The Health Service Journal, Sep 1, 2002
A scheme attaching social workers to general practices to improve services for older people is th... more A scheme attaching social workers to general practices to improve services for older people is thought to have cut delays and increased communication between social services and primary care. The engagement of practice managers is key to the success of the venture. Seeing a social worker in general practice is thought to lessen the stigma some older people feel about referral to social services.
ABSTRACT Background There is increasing expectation that midwives should develop the public healt... more ABSTRACT Background There is increasing expectation that midwives should develop the public health aspects of their role to contribute to the reduction of health inequality (Midwifery 2020). Evidence (Furness et al., 2012) suggests midwives may lack the skills and confidence to discuss public health issues, such as weight and lifestyle, with pregnant women. In Doncaster, UK, rates of smoking during pregnancy, obesity, and low birth weight are significantly higher than the National average. Aims To explore the need for; and to develop educational resources for staff working with pregnant women to enable them to discuss health and lifestyle issues timely, effectively and sensitively. Method A consultation event was held with community midwives to collect qualitative data on current practices in addressing public health issues, barriers to effective discussion, and appetite for additional training. Thematic analysis (Boyatzis, 1998) was used and subsequent focus groups were held to look at emerging themes in greater detail. Key findings · Clinical matters are often prioritised over discussions around health behaviours · Sensitivity concerns and fears of losing rapport with the woman and the importance of using the right language · CO2 monitors and ‘Green Notes’ good ways to start conversations around health behaviours · Experience of talking to women about these issues was valued over training and education tools. A training tool might be useful for those with less experience · Best practice guidelines are not always practicable. Implications for education and practice Findings suggest several barriers to discussing public health issues with women. Experience and practice alongside tools for opening conversations were seen as important to overcome some of these barriers. Any training tool developed should address identified barriers and incorporate examples of good practice. This project was supported by "Collaboration for Leadership in Applied Health Research and Care for South Yorkshire".
The Rycroft-Malone paper states that co-production relies on 'authentic' collaboration as a conte... more The Rycroft-Malone paper states that co-production relies on 'authentic' collaboration as a context for action. Our commentary supports and extends this assertion. We suggest that 'authentic' co-production involves processes where participants can 'see' the difference that they have made within the project and beyond. We provide examples including: the use of design in health projects which seek to address power issues and make contributions visible through iteration and prototyping; and the development of 'actionable outputs' from research that are the physical embodiment of co-production. Finally, we highlight the elements of the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) architecture that enables the inclusion of such collaborative techniques that demonstrate visible co-production. We reinforce the notion that maintaining collaboration requires time, flexible resources, blurring of knowledge producer-user boundaries, and leaders who promote epistemological tolerance and methodological exploration.
This short report describes some of our experiences of a recent evaluation of the attachment of s... more This short report describes some of our experiences of a recent evaluation of the attachment of social services assessment officers to clusters of general practices in Kingston-upon-Hull. Whilst some practices were able to realise the expected benefits of such a scheme in terms of improved communication between health and social services, speedier access to services and so on, some practices
British Journal of Midwifery
Quality in primary care
Modernisation is usually thought of as an NHS phenomenon but already its influence has spread. He... more Modernisation is usually thought of as an NHS phenomenon but already its influence has spread. Here we outline the development of modernisation in prisons. From our experience of supporting a local prison in undertaking health needs assessment and developing its health improvement planning we have been able to observe modernisation beginning to work in prison healthcare and taking effect over a relatively short period of time. Although it is too early to provide conclusive evidence of direct benefits to prisoner-patients we have found some encouraging signs. Here we report on a brief survey of how prison healthcare staff currently view modernisation and its perceived benefits for patients, and discuss the need to initiate systematic robust evaluations of some of the small-scale initiatives that modernisation has generated. Keywords : health needs assessment, health planning, modernisation agenda, prison health
Background: Obesity is a Health and Well Being priority in Doncaster and there are a number of in... more Background: Obesity is a Health and Well Being priority in Doncaster and there are a number of initiatives tackling overweight and obesity. We need to ensure that evaluation systems are in place to inform future priorities/commissioning. SROI (Social Return on Investment) has been used as part of a Public Health development project supported by CLAHRC-South Yorkshire. SROI aims to capture the broader value of activities and services by measuring their social, environmental and economic outcomes. Aims: to demonstrate the full impact of the Cook and Eat programme, establish effective systems to capture and report data; and inform the future commissioning of nutrition/prevention initiatives. Methods: pre and post course participant questionnaires; focus groups (course participants; staff interviews. Findings: The outcomes established for the participants included: improvements in diet, gaining a social element from the course, increasing in confidence with food, going on to further tra...
British Journal of Healthcare Management, 2005
ABSTRACT There is high-level commitment in the UK to addressing the historical weaknesses in the ... more ABSTRACT There is high-level commitment in the UK to addressing the historical weaknesses in the delivery of prison health care, and for prisons to work with their NHS colleagues in order “to give prisoners access to the same quality and range of healthcare services as the general public receives from the National Health Service” (National Health Service Executive 1999).
British Journal of Midwifery, 2002
ABSTRACT One of the major challenges in evidence-based health care is the wide gap between resear... more ABSTRACT One of the major challenges in evidence-based health care is the wide gap between research and practice. The aim of this study was to review local screening programmes systematically to assess the extent to which the services were informed by available best evidence. The information on local screening practices was collected, using a structured questionnaire and follow-up telephone interviews with local key informants. Best evidence for practice was identified by collating findings of systematic reviews and guidance from authoritative sources. Twenty-three antenatal screening programmes were identified. ‘Decision sheets’ for all the programmes were developed to facilitate the decision-making process and summarise areas of variation locally and with respect to best practice. Currently, authoritative guidance exists for 22 programmes and is followed locally for the most part. On occasions, the authoritative sources gave different guidance which resulted in variations in practice locally. In two programmes we considered that variations in local practice needed to be addressed (Down’s Syndrome and neural tube defect). This approach was much valued by both health professionals and lay representatives. Using the decision sheets, the Maternity Strategy Group formed a view on how to align services for Down’s Syndrome screening. This article suggests a generic approach to narrow the research-practice gap. Further evaluation of the decision sheets is required
Journal of Clinical …, 2002
... Thanks are also due to Karen Chapman (Research Nurse) and Carol Brearley (Research Midwife) f... more ... Thanks are also due to Karen Chapman (Research Nurse) and Carol Brearley (Research Midwife) for their clinical input. We also acknow-ledge with gratitude the support of Peter Campion, Professor of Primary Care Medicine, at the Uni-versity of Hull. ...
Social science & medicine (1982), 2017
This paper explores how commissioners working in an English local government authority (LA) viewe... more This paper explores how commissioners working in an English local government authority (LA) viewed a health economic decision tool for planning services in relation to diabetes. We conducted 15 interviews and 2 focus groups between July 2015 and February 2016, with commissioners (including public health managers, data analysts and council members). Two overlapping themes were identified explaining the obstacles and enablers of using such a tool in commissioning: a) evidence cultures, and b) system interdependency. The former highlighted the diverse evidence cultures present in the LA with politicians influenced by the 'soft' social care agendas affecting their local population and treating local opinion as evidence, whilst public health managers prioritised the scientific view of evidence informed by research. System interdependency further complicated the decision making process by recognizing interlinking with departments and other disease groups. To achieve legitimacy wit...
Prevalence of maternal obesity is increasing, with health risks for mother and infant. Effective ... more Prevalence of maternal obesity is increasing, with health risks for mother and infant. Effective health promotion depends on sufficient knowledge and appropriate communication skills. We aimed to explore women's, midwives' and health visitors' perceptions of current practice in helping women manage their weight and supporting healthy behaviour change during pregnancy, and their perceived training needs. A modified grounded theory methodology was adopted, based upon critical realist assumptions. Following consultation events with fifty six practitioners to inform data collection tools, twenty (different) practitioners and nine women participated in focus groups. Comparative analysis generated four themes: A core theme, "Discouraging discourses", described health professionals' negative beliefs and reactive approach to communicating about weight. "Staff resources" identified limitations in and requirements for practitioner knowledge, skills and tools for effective communication. "Contextual influences" were social factors, which hindered practitioners' efforts to achieve healthy behaviour change. "Communicating as a Team" identified the importance of and challenges to a team approach. Findings have implications for weight management in pregnancy, practitioner resources, teamwork, and national health promotion campaigns.
The Health Service Journal, Sep 1, 2002
A scheme attaching social workers to general practices to improve services for older people is th... more A scheme attaching social workers to general practices to improve services for older people is thought to have cut delays and increased communication between social services and primary care. The engagement of practice managers is key to the success of the venture. Seeing a social worker in general practice is thought to lessen the stigma some older people feel about referral to social services.
ABSTRACT Background There is increasing expectation that midwives should develop the public healt... more ABSTRACT Background There is increasing expectation that midwives should develop the public health aspects of their role to contribute to the reduction of health inequality (Midwifery 2020). Evidence (Furness et al., 2012) suggests midwives may lack the skills and confidence to discuss public health issues, such as weight and lifestyle, with pregnant women. In Doncaster, UK, rates of smoking during pregnancy, obesity, and low birth weight are significantly higher than the National average. Aims To explore the need for; and to develop educational resources for staff working with pregnant women to enable them to discuss health and lifestyle issues timely, effectively and sensitively. Method A consultation event was held with community midwives to collect qualitative data on current practices in addressing public health issues, barriers to effective discussion, and appetite for additional training. Thematic analysis (Boyatzis, 1998) was used and subsequent focus groups were held to look at emerging themes in greater detail. Key findings · Clinical matters are often prioritised over discussions around health behaviours · Sensitivity concerns and fears of losing rapport with the woman and the importance of using the right language · CO2 monitors and ‘Green Notes’ good ways to start conversations around health behaviours · Experience of talking to women about these issues was valued over training and education tools. A training tool might be useful for those with less experience · Best practice guidelines are not always practicable. Implications for education and practice Findings suggest several barriers to discussing public health issues with women. Experience and practice alongside tools for opening conversations were seen as important to overcome some of these barriers. Any training tool developed should address identified barriers and incorporate examples of good practice. This project was supported by "Collaboration for Leadership in Applied Health Research and Care for South Yorkshire".