December 2019 How the risk of brain damage and death of premature babies may be reduced if they are born in specialist hospitals Luke Charles Rummel By Jodie Gullickson - CC
December 2019 In October, we held the launch event for the NIHR Applied Research Collaboration (ARC) for NW London. Over 100 people attended; included academics, members of the public and NHS staff. Over the next five years, as part of the ARC programme, we will be working with a wide range of stakeholders to improve healthcare, patient experience and clinical outcomes in NW London. The programme will interface with the excellent work members of the department and the School of Public Health are already doing in these areas, and with Imperial College’s societal engagement strategy. Professor Azeem Majeed Head of Department of Primary Care and Public Health Imperial College London We welcome feedback on the ARCHIVE PRIVACY NOTICE newsletter and are taking submissions for future issues. Email your news, events, achievements and stories to us. [email protected] PCPH eMagazine Team Subscribe Unsubscribe Javier Gallego Mehrosa Memood Copyright © 2019 Department of Primary Care & Public Health, Imperial College London
SHOULD THE UK ENFORCE CHILDHOOD VACCINATIONS? According to New Scientist, the UK is seriously considering the compulsory vaccination of schoolchildren in England. Health Secretary Matt Hancock discussed this at the recent Conservative party conference, saying “When the state provides a service to people then it’s a two-way street. You have to take your responsibilities too”. This was in light of some recent figures showing a troubling decline last year in all routine vaccinations for under-5s in England. Opinion is divided with some researchers, for example, Stefano Merler, Bruno Kessler Foundation, making a case for mandating. This is particularly in relation to measles, as it is predicted that the risk to the overall proportion of the UK population will rise from 3.7 per cent in 2018 to 5.5 per cent by 2050. Prof Sonia Saxena, PCPH Child Health Unit, has said there is “not really great eveidence” to support the mandating of vaccinations. This is supported by Prof Helen Bedford, UCL, who says there can be unwelcome consequences from making them compulsary such as children being excluded from school. Read article by Adam Vaughan in New Scientist. Photo by Marco Verch - CC
DEPARTMENT NEWS SPHR HIGHLY CITED On October 17, the School of Public Congratulations Professor Kosh Ray, who Health Research (SPHR) Children and is a Highly Cited Researcher for 2019. Each Young People programme met with year, the Web of Science Group identifies colleagues from the University of the world’s most influential researchers. The select few who have been most Liverpool and University College London frequently cited by their peers over the for a research show and tell event. It was last decade. In 2019, fewer than 6,300, or a constructive morning with sharing and 0.1%, of the world's researchers, across 21 discussion of ideas for collaborative research fields, have earned this exclusive research outputs within and between the distinction. SPHR schools. Presentations on evolving research were given and constructive Prof Ray is among this elite group suggestions made. Conversation recognized for his exceptional research throughout the event centred on how this influence, demonstrated by the work-stream and wider networks can production of multiple highly-cited papers encourage to develop research to improve that rank in the top 1% by citations for child health. field and year in Web of Science. NEW ARTICLE RESEARCH David Mummery published an article in ‘Developing routinely recorded clinical GP Pulse that considers how GPs are data from electronic patient records as a promoting self-care. The article considers national resource to improve neonatal the important role of self-care for health care: The Medicines for Neonates common everyday conditions and self- research programme’ limiting illnesses in individuals, and the important role that self-care can play in This research programme showed it is helping reduce pressure on NHS resources possible to obtain high-quality extracts whilst promoting mental wellbeing though from electronic patient records to use as a empowerment and the rational use of research resource, depending on quality products and resources. and completeness of patient records. View the full report Online Education Tree Concept By @macrovector_official - Freepik
ARC WHO CC FOR PUBLIC HEALTH TRAINING & EDUCATION The ARC team had two abstracts accepted to the Public Health England Delegates joined health professionals Annual Conference in Warwick in from the UK healthcare system to learn September. They showcased the about the NHS management, during 5 quality improvement work in both intensive days at Chelsa and Westminster antenatal smoking cessation, and also Hospital. The course has been designed to alcohol harm reduction. By working deliver an interactive learning experience with the community partners, they based on contemporary theories and were able to demonstrate that they extensive practical experience. can achieve better population health outcomes. Going forward, they will be ‘Great leaders can manage today’s working to align with the NIHR ARC complex health services and health research themes and collaborate on systems’ is a training programme built evaluating programmes such as these – around the WHO framework, which aims both at trust level and across the NW to help trainees develop their leadership London sector. skills and knowledge. Topics covered include Situational Leadership, Leadership ASPIRING DIRECTORS Styles, Effective Communication, Resource Allocation, Problem Solving and Critical Sophie Coronini-Cronberg has been Thinking, Health System Strengthening, awarded a PHE-funded place on the 9 Change Management, Health Service month leadership programme, 21st Management and Political Challenges. Century Aspiring Directors Public Servant Leadership Programme, run by WHO CC have the privilege of organising the University of Birmingham and ‘Achieving Excellence’ meetings with delivered in partnership with PHE. The Public health enthusiasts every programme focuses on supporting Wednesday at PCPH. The platform creates future senior public leaders working in room for communication to take place challenging contexts to find ways of amongst, fellows, lecturers and public collaborating successfully within health experts, with interest in public complex systems to deliver health health related topics. The presented improvements and better outcomes for topics cover a vast array of public health local communities. concerns, followed by a group discussion. GOODBYE MORE INFO ON BECOMING A FELLOW WHO CC WEBSITE FOR MORE NEWS Lizzie Cecil, Research Associate in CHU and DFU Units, has left PCPH to go to CONGRATULATIONS! King’s College. We also had Mahsa Mazidi, Senior Database Manager since Well done Alex Bottle of the Doctor Foster 2014, leave the department in early and Child Health Units. He is now a October, to start a new role as a BDAU Professor of Medical Statistics. Head of Data Management in Cancer & Surgery at St Mary's. We wish them both very well in their new jobs!
SPOTLIGHT ON SCHOOL FOR PUB Imperial College London joined the The Public Mental Health National Institute for Health Research Programme, led at ICL (NIHR) School for Public Health Research by Dr Shamini Gnani, (SPHR) program in 2017. SPHR is a unique has been carrying collaboration between eight leading out a scoping academic centres of excellence in England. review of Its remit is to conduct high quality research community- to build robust evidence for effective and based cost-effective public health policy and interventions, practice to improve population health and specifically reduce health inequalities. As a member looking at institution of SPHR, Imperial College interventions London has been actively developing its targeting research programme in collaboration with black and the other member institutions. minority ethnic groups The research programme within SPHR has been and developed carefully around these goals, with improvements three primary programmes becoming the focus. in their mental These programmes are: health and wellbeing. Dr Gnani The Children and Young People Programme at will be undertaking a ICL is led by Prof Sonia Saxena. In the U.K. there mapping exercise of are large and increasing inequalities in child public health health. To address this, the programme is interventions available in harnessing data to evaluate systems-based one local authority in North approaches for improving outcomes for children West London working with and young people. They will assess the changing colleagues across the NIHR input and outputs of health at a local level to SPHR and working with look at inequalities in child health. They hope to departmental colleagues Ms Cleo identify the components of a local system-wide Baskin and Dr Geiske Zijlstra. The approach that promotes cost-effective and next phase of the programme will equitable local policies. As part of this, Dr Hanna include evaluating in-depth Creese’s focus is on using routine data to several specific public mental explore to what extend early years pathways can interventions, and how these can reduce subsequent chronic conditions in be delivered on a larger scale. children and young people. In addition to this Programme-wide meetings have work, SPHR PhD student Tishya Venkatraman is been also recently held as part of evaluating the Daily Mile program using routine developing a conceptual framework data. Her research focuses on understanding and outcomes data set for public what school characteristics are associated with mental health as well as detailed Daily Mile uptake, examining the equity of the discussion on the next steps in Phase 2 intervention, and studying physical activity levels of the research programme. of children in schools that take part in The Daily Mile. Light bulb with drawing graph by @jannoon028 – freepik.com
BLIC HEALTH RESEARCH The Places and Anthony Laverty are also looking at road user Communities charging in England, as a range of localities in programme is led by England are considering implementing or Prof Chris Millett amending current Road User Charging schemes. and Dr Eszter Popular support for these schemes may increase Vamos. Local the reflecting growing concerns about air authorities pollution and more general harms of motor operate under vehicle use. increasing financial For her industry interactions project, Dr Vamos constraints will be recruiting a Research Associate for a 24- that can affect month contract. If there is any interest for this how they position, please contact Dr Vamos or the SPHR address crucial Research Coordinator, Jennifer Landmann. decisions about prioritising Additionally, Dr Laverty is the ICL lead on the investment and Equal England project within SPHR’s Health utilising Inequalities theme, which will build a regulatory powers. community of academics, researchers and Often there is practitioners who share a common interest in insufficient evidence addressing health and social inequalities. The to inform these project is expanding the current SPHR project decisions. The Places and ‘Equal North’ network nationally across England, in collaboration with the other SPHR member Communities Programme institutions and the PHE national health consists of two major work inequalities team. streams to address this. The first focuses on evaluating the Dr Kiara Chang has been awarded a Research impact of different place-based Network (ResNet) award to look at the uptake public health strategies and and outcomes associated with Universal Infant interventions, and how they can Free School Meals in England. Excitingly, best be delivered in the context of Imperial College London was one of only three scarce and changing local institutions within SPHR that was awarded a resources. The second work stream ResNet award. takes a deeper look at specific interventions by evaluating In addition to these programmess, SPHR is innovative and locally affordable committed to fostering training and interventions focusing on food and development opportunities in public health. This transport. Dr Vamos is exploring the includes our current SPHR PhD studentships interactions of English local program as well as the SPHR pre-doctoral and governments with harmful commodity postdoctoral fellowships we are currently industries to better understand the recruiting for to begin in January 2020. nature and extent of these interactions Furthermore, SPHR sponsors summer in local government. Dr Vamos and Dr studentships in public health research. SPHR is committed to encouraging high quality public health research in every area to improve population health and reduce health inequalities.
Photo copyright Imperial College London
Visitors were treated to soaring temperatures as the Festival got underway, with more than 750 researchers, scientists and clinicians attending. The Great Exhibition Road Festival 2019 has been a celebration of science and the arts in the spirit of Queen Victoria and Prince Albert’s vision for the Great Exhibition, 200 years on from when they were born. This year’s Festival brought together The beating heart of the event was the more than twenty institutions in and 11 interactive themed zones packed full around South Kensington for the first of creative activities, live experiments time, including Imperial College London, and friendly experts from the partner the Royal Commission of 1851, Royal organizations, including a Nature Zone, Albert Hall, V&A, Natural History Museum of Food, Robot Zone and Design Museum and the Science Museum. With Zone. over 150 live events, the Festival transformed the area, which was closed A street food market offered visitors to to traffic, as activities spilled out into the eat their way around the world, from surrounding streets. Japanese to Spanish, Vietnamese to Italian.
Photo copyright Imperial College London
Photo copyright Imperial College London
What was on: The Great Exhibition Road Festival builds on the success of the Imperial Festival, which is now in its eighth year, and has led to collaboration between scientists, artists and other creative partners. It aims to highlight Prince Albert’s role in organising the Great Exhibition and, with the funds it generated, establishing Exhibition Road as a world- leading centre of interdisciplinary study and research. Full article on Imperial College London News Site
The Primary Care Education Team led on the stall, ‘Calling Dr Bones’ in the ‘Hands on Health Zone’. The stall focused on promoting community health literacy, giving visitors (young and old) the opportunity to learn about organs and bones of the body via several interactive activities. The team also explored mental wellbeing in the community via creation of a community art frieze, asking our visitors to illustrate ‘what makes you happy?’ We were privileged to be joined by artist, Sarah Christie (pictured far right with Jenna Mollaney) whose creativity and enthusiasm was key in creating this work. Over 500 postcards were completed by visitors, with the activity stimulating lots of thoughtful conversation. We would like to thank all the visitors and volunteers who contributed to the stall and made it such a great success. REQUEST MORE INFO 2020 Photos copyright Imperial College London
STAFF NEWS Human Heart Vector Illustration - Copyright Vecteezy
Professor Kosh Ray newly elected President of the European Atherosclerosis Society Prof Kosh Ray has recently been elected the new President of the European Atherosclerosis Society (EAS). He will take the position of President-Elect with effect from 1st January 2020 and will serve as President from 2021 through 2024 and then as past president from 2025 through 2028. The EAS is the largest society in the world to study Atherosclerosis. It was founded in 1964 with the aim of “advancing and exchanging knowledge concerning the causes, natural history, treatment and prevention of atherosclerotic disease”. For more than 50 years the Society’s expertise has been used to teach clinicians how to manage lipid disorders and how to prevent atherosclerosis. Prof Ray has said that this is a huge honour and an opportunity for ICL to grow some of the initiatives they have started, specifically within the field of cardiovascular disease research. This will allow ICL to shape the research questions and should open up significant opportunities for collaboration with the over 2,000 members of the EAS.
Luke Charles Rummel By Jodie Gullickson - CC The risk of brain damage and death of premature babies may be reduced if they are born in specialist hospitals
Extremely premature babies born in English hospitals with specialist neonatal intensive care units may have a reduced risk of brain damage and death, compared to premature babies born in hospitals without such specialist units. This is the finding of research, by Imperial College London and the University of Turku, Finland, that involved 17,000 infants born in England earlier than 28 weeks gestation. The study, published in the BMJ, found Dr Chris Gale, lead author of the research that transferring extremely premature from Imperial’s School of Public Health babies to a different hospital within 48 explained: “Babies born this prematurely hours after birth was associated with an are very fragile. If a mother goes into increased risk of severe brain injury, found labour at a hospital not equipped to care in 27.5% of babies that were transferred for a such a premature baby, and so does compared to 14% of babies that were not have experienced, specialist staff and born in a hospital with a specialist facilities, the baby will often be moved via neonatal unit. ambulance soon after birth to a more specialist hospital. Previous research However, the results also suggest that, in suggested moving a baby may cause extremely premature babies, staying in a complications”. hospital without a specialist neonatal unit was associated with an increased risk of “This is the largest study to date to show death; 26.3% of babies that stayed in a that for extremely preterm babies, being hospital without a specialist unit died in born in the wrong place can have grave this study, compared to 21% of babies consequences. We now need to urgently born in a specialist centre. establish national systems and processes to ensure that women are moved to the The team behind the findings say that right hospital at the first indications of organising health services so that mothers premature labour – to ensure the most give birth to the most premature babies in premature babies are born in the right hospitals with specialist neonatal services place”. could reduce the risk of brain damage and save lives. Premature birth is defined as birth before 37 weeks gestation, and around 60,000
babies are born prematurely in the UK The researchers add that the study shows every year. Out of these premature births, the importance of ensuring babies are around one in 20 in the UK are born at born in a suitable hospital, equipped with less than 28 weeks gestation. a neonatal intensive care unit (NICU). These babies need to be looked after by Dr Kjell Helenius, first author of the study, experienced, specialist neonatal doctors from the University of Turku, Finland said: and nurses. They often need intensive “This research suggests that the UK needs care, such as being placed on a respiratory to prioritise the development of a more support like a ventilator to help them effective national system of moving breathe, soon after birth. Not all hospitals women at risk of premature birth to have these facilities, meaning the new suitable hospitals before they give birth. born baby must be transferred, by a Countries with much larger distances specialist ambulance team, to a different between hospitals, such as Finland and hospital. Australia, are more effective at ensuring babies are born in the The latest research, funded by the right hospital. We need to look Medical Research Council and the at the systems used in other Foundation of Neonatal Research of countries to assess how Southwest Finland, suggests transferring they could be an extremely premature baby between implemented in the hospitals in the 48 hours after birth was UK”. associated with over double the risk of severe brain injury, and 40 per cent lower chance of the baby surviving without severe brain injury. Mirtel 4 by Margus Kulden - CC
The researchers examined 17,577 without a NICU. extremely premature babies born in the UK between 2008 and 2015. The team Babies who remained at hospitals without found one in five of these babies were a NICU did not have a significantly higher transferred within 48 hours, and that this rate of severe brain injury. The proportion has been gradually increasing researchers explained that this result (the number of babies transferred could be due to the babies dying before increased from 18 per cent in 2008 to 21 brain injury was detected as babies in this per cent in 2015). Out of 17,557 babies, group had a higher rate of death than 10,866 were in the control group, and those born in hospitals with specialist born at a hospital with a NICU; 2,158 were neonatal intensive care units. transferred to another hospital, The research team also studied 306 babies while 2,668 born in a hospital with a NICU but remained at a transferred to another similarly specialist hospital hospital due to a lack of available cots. These babies did not have an increased risk of severe brain injury or death, but the researchers urge caution with these findings as this group was very small. This also suggests that there are not enough specialist neonatal intensive care beds in England, and this can lead to the most premature babies being moved between hospitals unnecessarily. The researchers accounted for other factors that might explain differences in death and brain injury between the groups of babies, such as whether the mother had been given treatments such as steroids before birth (which help protect a premature baby’s lungs and brain), as well as the baby’s sex and gestational age. The team added that the research was only possible using data held in the National Neonatal Research Database, which holds anonymised data about babies that received neonatal care across the UK and thanked the NHS staff who record the data held in the database, and the parents who agreed for their babies anonymised data to be used.
WHAT HAPPENS ON OUR WATCCH? The Undergraduate Primary Care Education Team have been delighted to welcome students to the third year of our innovative widening access programme, WATCCH (widening access to community careers in healthcare). WATCCH supports young people from diverse and disadvantaged backgrounds who are keen to pursue a career in healthcare. Our WATCCH students are enjoying learning about a diverse range of healthcare careers via campus-based education days and work experience in the primary care setting. This year, we have partnered with the student society Vision who are offering mentoring for our WATCCH students, following bespoke coaching and mentoring training from our in-house coaching lead, Dr Arti Maini. The students have now all attended their drive and motivation to join the their work experience placements and healthcare workforce. showed impressive reflection on primary care-based careers. We are We look forward to expanding now running a series of student-led WATCCH further in upcoming years and mentoring workshops throughout the would like to thank the schools, year on topics including admissions teachers, Imperial College students, tips, finances and personal skill and our WATCCH students for the development. enthusiasm and dedication they bring to the scheme. This popular programme supported by HEE NWL, has hosted one hundred WATCCH sits within the Diversity and students over the last three years and Inclusion theme of the newly- has sparked interest in universities established Medical Education and nationally. Our evaluation to date Research Innovation Centre (MEdIC) shows that WATCCH increased based within Undergraduate Primary students’ awareness of the range of care Education Team in the School of healthcare careers available and has Public Health. MEdIC aims to translate generated new thinking about career the medical education evidence-base options. The programme also increased into robust educational innovations participants’ self- confidence in their and research which strengthen our ability to pursue their career choice, medical workforce and have a and importantly has given students sustainable, equitable and access to relatable healthcare transformational impact on society. professional role models, increasing For further information on WATCCH, please contact Nina Dutta.
CONFERENCE Discussing Self-Care in the Far East
Beijing Cuisine by LWYang – Creative Commons
Self-Care from Cradle to Grave at Global Self-Care Federation Conference In October, SCARU contributed to the 12th Global Self-Care Federation Conference which was held in Beijing. The Global Self-Care Federation (previously the World Self- Medication Industry Alliance) exists to create a healthier world through better self-care. The Federation is an alliance of regional and national associations, and manufacturers and distributors of effective over-the- counter (OTC) medicines. Austen El-Osta, Director of Self- products and resources Care Academic Research Unit (including OTC medicines and (SCARU), presented a talk antimicrobial stewardship) in entitled ‘Self-care: from Cradle to helping people self-care for Grave’ in which he highlighted common and everyday self- the importance of adopting good limiting conditions in the health-seeking behaviours from a community setting. young age, and to self-care throughout the life-course to The conference was presided by prevent, manage or delay the Dr Margaret Chan, former appearance of chronic ‘lifestyle’ Director General of the WHO, in non-communicable diseases which she welcomed the including Type 2 diabetes, landmark publication of WHO cardiovascular disease & Consolidated Guidelines for Self- hypertension. Care Interventions for health, and the rising academic interest The talk also illustrated the in the self-care space. importance of the rational use of
The Golden Pavillion – Kinkakuji Kyoto Old Beijing King Noodle Shop by Herry Lawford (cropped & graded) – Creative Commons
Coaching: Collaborations with Harvard and the Institute of Coaching Conference Dr Arti Maini and Dr Molly Fyfe have had a very busy and productive visit to Harvard Medical School in Boston during October 2019. Arti was invited to train Harvard’s cohort of second year medical students undertaking the Cambridge Integrated Clerkship, as well as the faculty leading the clerkship, in ‘Coaching Skills for Success and for Health’. At the invitation of Professor David Hirsh and the Academy of Educators, Arti also lead an institution-wide Harvard Medical Education Grand Round on ‘The art and practice of coaching in medical education’, as part of Harvard’s mission to foster high quality teaching and curricular design, which attracted over 130 registrants. Artwork: Problematic Communication from one mind to another by Jurgen Appelo - CC
Molly spent time working with Professor Hirsh’s team on a collaborative research project looking at Mindset Theory within medical education. Arti and Molly attended the Coaching in Leadership and Healthcare Conference hosted jointly by the Institute of Coaching and Harvard Medical School. Arti delivered a well-received presentation titled: ‘Bringing a health coaching mindset into medical consultations: a qualitative exploratory study on the impact of training medical students in health- coaching’ (based on research undertaken by Arti and Molly as well as Dr Sonia Kumar). Molly presented a related research poster on ‘The use of real-play to support development of a coaching mindset’, which drew great interest at the conference and was singled out for a prestigious award. The conference itself included highly acclaimed speakers and innovative workshops exploring cutting edge topics related to diversity and inclusion, leadership, healthcare and the neuroscience of emotion. “We have been inspired and enthused by the many conversations we have had with colleagues during our visit and by the many innovative ideas that have been shared, and we very much look forward to continuing our Imperial-Harvard educational and research collaborations”
WHERE FRIENDSH In 2018, the Department received a President’s Excellence grant award in Teaching and Learning The Bench by Gael Perier - Creative Commons
HIP RESTS Exploring the power of friendship through the MPH Course. In 2018, the Department received a President’s Excellence grant award in Teaching and Learning Innovation, focussed on assessing and, where necessary improving, the geographic diversity of teaching materials that we use in the Masters in Public Health programme. There was a particular emphasis on encouraging the use of literatures from under-represented regions, such as Low-Income Countries, and within this was included an essay competition for students on the Masters in Public Health (2019 cohort) to engage with innovations from, in particular, Low- Income Countries, that could have potential benefit for the UK NHS. The winning entry was by Theodora Goodwin and details the Friendship Bench, a low-cost intervention from Zimbabwe to address mental health issues in the community. On receipt of her award, a £200 Amazon voucher, Theodora said: “Having worked in the NHS, I have experienced the pressures on the system first-hand and seen how simple and innovative solutions are needed to meet the rising demands for healthcare. I was interested by the idea of so-called ‘reverse innovations’ that, inspired by creative and simple solutions to healthcare needs in resource-constrained settings, seek to apply them to high-income countries. It seemed to me that as we seek to provide mental health care with finite resources, such innovations could be vital in the UK. I really enjoyed thinking about how we can learn to find new solutions to old problems by taking inspiration from other settings and cultures”.
An abridged version of the essay by Theodora can be read below. Full version is available upon request from Dr Matthew Harris, Clinical Senior Lecturer in Public Health and lead for the Excellence grant award. Last year in the UK, one in six people recommended for low-resourced were estimated to have a ‘common settings. The LHW’s are elderly women mental disorder’ (CMD) like anxiety or known as ‘community grandmothers’ depression at any one time, and and their advice, which is highly mental health spending reached £11.9 respected and valued in Zimbabwe, billion. Currently, NICE recommends leverages their talent, making them talking therapies as the mainstay of ‘specialists’ in their field. treatment for CMDs. One million people receive psychological therapy The LHW’s deliver six 45-minute through the NHS ‘Improving Access to sessions of PST to clients over 4-6 Psychological Therapies’ (IAPT) weeks, in discrete areas outside of programme annually. However, primary care clinics on specially placed pressure on services means over 50% ‘Friendship Benches’. This keeps costs wait three months for treatment. This low, and clients with anxiety and is harmful and can have costly effects. depression for example, are referred Innovative thinking is needed to solve from the neighbouring clinics. Sessions the challenge of supplying prompt consist of identifying problems and treatment to increasing patient goals, solution-finding and setting numbers. action plans. LHW’s are supervised with support available from clinical In Zimbabwe, a quarter of the teams. Following completion of the population suffer from anxiety or sessions, clients can attend peer-led depression, but services are limited group circles with previous Friendship with only 20 psychologists serving a Bench clients, to get extra support and population of 13 million. Recognising encouragement. the need for an innovative way of delivering mental health treatment, The Friendship Bench has robust Dixon Chibanda (a Zimbabwean evidence of effectiveness. Compared Psychiatrist) developed the Friendship to enhanced usual care, Friendship Bench project. Aiming to be ‘no-cost’, Bench attendees had a 36.2% lower the Friendship bench recruits lay risk of anxiety and depression health-care workers (LHW’s) that are symptoms. Additionally, qualitative trained in ‘problem-solving’ therapy studies show positive reactions from (PST) for common mental health clients, and from LHW’s regarding their disorders, adapted to local culture. A roles. Following an initial pilot, the simplified variation of cognitive behavioural therapy, it requires less training and has traditionally been
A client receives problem-solving therapy from a LHW or ‘community grandmother’ Photos: https://www.friendshipbenchzimbabwe.org/. Friendship Bench project has been restrict PST taking place outside, scaled to 70 communities and 30 000 proximity to GP surgeries, (perhaps people now receive treatment utilising their spare rooms) would be annually. The Friendship Bench could beneficial in the NHS. It would be be applied within the NHS. Existing convenient for patients and facilitate health-care assistants (HCA) and coordination and supervision by health-care workers (HCW) in primary clinical teams. Same day Friendship care could be trained to deliver this bench appointments at the surgery intervention to high volumes of could improve access whilst also patients at low costs. As with reducing GP appointments needed for Grandmothers in Zimbabwe, mental health problems, currently 40% HCA’s/HCW’s knowledge of their of appointments. This innovation could community and its culture could also be cost-effective, reducing both GP be exploited. PST has the advantages appointments and the need to of being proven effective (including in commission IAPT services, whilst primary care), simple and easily utilising existing infrastructure and adaptable. Although weather might personnel.
The NHS has made a commitment to there might not be available space in increase access to psychological GP surgeries. Since PST is only suitable therapies by 25% in 2020/21. MIND for those with mild/moderate has called for expansion in the sources symptoms, the need for high-intensity of psychological therapy commissioned interventions would still remain. by CCG’s, including from community Resistance to change can always sectors. This approach could increase threaten NHS adoption of innovations competition in the psychological but by being simple and compatible therapies market, presenting an with existing primary care structures, opportunity to drive up quality whilst adoption and diffusion of the driving down costs. Evidence is Friendship Bench is feasible. The emerging for the use of PST in older Friendship Bench provides a low-cost adults, and those with diabetes for innovative solution to bridging the gap example. of psychological therapies in the UK. Its success in Zimbabwe, mirrored here, Implementation challenges include a could bring effective treatments into lack of willingness, time or resources the community and so provide to pilot the intervention. It will require sustainable and prompt treatment for some clinical support, and therefore many. GP’s will need supervision training and The peer-led circle. A previous client of the Friendship Benches provides support to other clients. As they share their experiences, they crochet bags from recycled plastic, a skill that can then be used to generate income. Photos: https://www.friendshipbenchzimbabwe.org/.
Re-designation for WHO Collaborating Centre for Public Health Education and Training Following their formal designation in 2007, the WHO CC Unit is happy to announce that the WHO Collaborating Centre for Public Health Education and Training has been re designated for a further 4 years. As they commence this journey, further in supporting the work of the World Health Organisation, this new stage will be guided by the following work principles: 1. At the request of WHO, they will review and propose good public health practices based on WHO evidence to strengthen health systems and health workforce in advancing UHC. 2. They will support WHO in development and evaluation of public health training and education, including in the areas of technology and innovation, in order to address the UN Sustainable Development Goals (SDG3). Their main subject remains health systems research & development and they will continue advocating for the relevance of primary care within these systems. WHO CC want to help countries to achieve equitable integrated, people-centred service delivery systems, as well as to strengthen public health and health workforce strategies oriented towards universal health coverage. Health Care Graphic Design by gstudioimagen - Freepik
AWARDS L-R Nina Dutta, Nadine Engineer & Steve Platt Royal College of GPs ‘Inspire’ awards The Imperial College student GP Society were presented the ‘most improved GP society’ award at the annual RCGP Inspire awards 2019. Additionally, the Undergraduate Primary Care teaching placements which have impacted Education team were shortlisted for the positively on the student experience. ‘Outstanding Teaching in General Practice’ award in recognition of the team being one of These awards celebrate the invaluable the UK-leading sites in the development of contribution of RCGP members and the longitudinal placements, both in GP and difference they make to better general integrating primary and secondary care. practice. The team focuses on the delivery and The awards ceremony was held in Liverpool at expansion of undergraduate primary care the iconic Anfield football stadium, and was community teaching, harnessing the skills of attended by Dr Nina Dutta, Ms Nadine GP teaching fellows within the team to design Engineer, Mr Steve Platt and Dr Camille and develop innovative new community Gajria.
QIC Diabetes Awards The North West London Diabetes Transformation Team won the ‘Quality in Care’ award for ‘Sustaining Quality Improvement and Patient Outcomes’ - In the Best Practice in Dissemination and Sustainability Award category at the QIC Diabetes Awards 2019. All the brilliant efforts, the vision, the consistent hard work, the partnership working, the dedication, the patient’s always in our minds approach; the care, pays off and this is a truly commendable achievement via good teamwork, excellent partnerships in the region and the hard work of all professionals involved in diabetes care in North West London. The North West London (NWL) Diabetes Improvement Programme began in 2014 in five Clinical Commissioning Groups (CCGs) and has now spread to eight. It has achieved continued quality improvement in key diabetes metrics. The programme operates ongoing clinician education, including 10-point training in secondary care. The Know Diabetes information and support service is about to relaunch, providing a single point of referral, diabetes education and multi-channel campaigns to all patients with diabetes and Non-diabetic hyperglycaemia (NDH) in NWL. Outcomes include an 8% reduction in diabetes foot admissions in 2018/19 and reductions in myocardial infarction, acute kidney injury and renal failure. \"The North West London Health and Care Partnership’s entry is very impressive, and it was incredible how much work they have done to collaborate and get this project progressed. They recognised the challenges involved and were clear about what they wanted to achieve. They’ve grown the work and kept it going. It is sustainable and transferable and truly remarkable\" Judges’ comments
During Year 3, all Imperial College medical students rotate through 9-10 weeks on a general practice placement as part of their ‘Medicine in the Community Apprenticeship’ (MICA). As part of this placement, all students complete a ‘Community Action Project’ (CAP), which aims to improve an aspect of health and welfare of the communities in which they are based. This involves students working in pairs to assess local community needs and deliver and evaluate a sustainable healthcare intervention using quality improvement principles.
Photo: Community Building by Bob Cotter - CC
Community Action Projects Students are encouraged to engage with members of the community (including patients, community groups, third sector organisations and health professionals). The projects are peer-assessed at a CAP presentation morning at the end of the placement where students present a poster in their pair detailing their project to their peers and then mark each other’s work. An Imperial College Department Tutor facilitates each session and also marks the projects and provides personalised feedback. Based on peer and tutor assessment, one project is awarded the CAP term winner, with other high scoring projects receiving highly commended certificates. Since 2017, there have been over 170 student projects completed encompassing a range of topics and several students have gone on to present their projects at national conferences and won prizes for their work. Some of the recent successes include: • Keerthanaa Jayaraajan and Burhan Waheed’s project on creating a home exercise programme for use in general practice for COPD patients unable to attend pulmonary rehabilitation, which won best poster at the Primary Care Respiratory Society. • Alec Raines and Aida Abdelwahed recently delivered an oral presentation at The King's Fund: Community is the Best Medicine Conference. They spoke about how they worked in partnership with the community to improve GP access for Southall’s homeless population and raising mental health awareness in an Arab patient population. • Alec Raines and Thomas O'Conner won the BJGP best poster for their work on improving access to primary care for the homeless population in Southall. • Kajal Ruparell and Isabel Raynaud won the RSM Child Health Promise award for their work on empowering young adults to have a voice in primary care. • Ashleigh Sahota and Sarah Jeyaprakash presented a poster on their work on empowering patient self-management of medication at the RCGP annual conference. • Carmen Traseir Pedraz and Ioanna Zimianiti presented a poster on their work on enhancing access to primary care services for patients with mental health concerns at the RCGP annual conference. As these examples illustrate, the CAP has allowed our students to engage in meaningful community engagement and make real impact on the health and welfare of the communities in which they are working. The Undergraduate Education Primary Care team are now carrying out research addressing the impact of the projects on both the student learning experience and impact on local communities.
Burhan Waheed, left, accepting his award for Best Poster at PCRS
MEDIA MENTIONS Epilepsy Awareness Symbol – Photo Copyright Freepik
National award for research on quality of paediatric care and risk of post-transition deaths for young people with epilepsy A study published in the Lancet Child and Adolescent Health showed that adolescents who were managed within paediatric units that met national guidelines on involving paediatric neurologists, were less than half as likely to die in the period following transition to adult services, compared with patients managed in units that did not meet these guidelines. In absolute terms, fully meeting guidelines for involving paediatric neurologists was associated with 4·6 (95% CI 1·2–8·0) fewer deaths per hundred patients. This received extensive national project in the Office for National coverage, including a section on Statistics Research Excellence Channel 4 news featuring Dougal Awards. This is a prestigious Hargreaves, Child Health Unit. national award for research that combines methodological Dougal’s project was also Runner innovation with major societal Up and highest ranked health impact.
7 PILLARS OF CARE
Self-Care Week (18-24 November) is a national awareness week run by the Self Care Forum UK. This annual campaign coincides with Self-Care Week in Europe (SCWiE). This year’s theme was asking people to ‘think self-care for life’. Freely available resources are available on the Self Care Forum’s website. The aim of Self-Care Week was to raise awareness about self-care, and the practical person- centred set of daily activities that people can do to promote vitality in ageing and improve quality of life. Various NHS Trusts, GP networks and pharmacy groups across the UK participated this year, and a prize was awarded for the top 3 community-facing self-care initiatives at the Annual Self-Care Conference in 2020. F This year, SCARU contributed a series of infographics about the 7 pillars of self-care, and a publication of a generic and cross-cutting self-care narrative suitable for the NHS illustrating the benefits of self-care to individuals, NHS staff and the wider health economy. SELF-CARE
HOME & AWAY Austrian Flag By natanaelginting - Freepik MEdIC Team at the 2019 AMEE experiences in longitudinal placements. Dr Ravi Parekh & Dr Andy McKeown presented The MEdIC team (Medical Education their research on how medical students’ Innovation & Research Centre), part of professional attributes are affected through the PCPH Undergraduate Primary Care clinical placements. Dr Arti Maini presented Education team, attended the 2019 AMEE the work she has led (with Dr Molly Fyfe and (International Association for Medical Dr Sonia Kumar), describing their research Education) conference in Vienna, Austria. findings of the broad impact of training medical students in health coaching. In front AMEE 2019 was a fascinating conference of an esteemed audience of medical exploring a whole host of topical issues in educators, Dr Jo Horsburgh described her PhD medical education, including threshold thesis exploring the identity of medical concepts, the conceptual framing of educators. educational research, diversity and inclusion in medical education, clinical reasoning and Aside from fascinating conference sessions, simulation amongst a whole host of other talks, plenaries and workshops, we were able areas. Our MEdIC team were able to to network with colleagues from USA, showcase a variety of our educational Australia and Europe to discuss the research projects carried out in the past year. development of future educational research Dr Andy McKeown presented his prize- & innovation collaborations. Watch this winning M(Ed) thesis looking at the role of space! educational authenticity in medical students’
Person Centred Medicine and Self-Care Conference 2020 SCARU is helping organise the 13th Geneva Conference on Person Centred Medicine, Self-Care & Well-Being (27 – 29 April 2020). The conference will be held at the WCC-Council of International Organizations of Medical Science and will conclude with a WHO Special Session on self-care to promote health & wellbeing. The proceedings of the conference, including a book on Person Centred Medicine, will be published in late 2020. HoAdvanced Leadership Course Programme WHO CC ran its very popular Advanced Leadership and Management for Health training programme in October and it was delivered in London to 19 Chinese delegates. The delegation included various clinical directors from the Huai’an Hospital, China. PCPH contribution to the First ESC Digital Summit Christophe Stevens (pictured right, presenting in the Kultuurikatel, a 106 year old power station) attended the first European Society of Cardiology (ESC) Digital Summit in Tallinn, Estonia. In a thrilling pitch session, he introduced the novel and bespoke IT solution developed by the FHSC (ICCP) to collect patient’s data on a global scale. So far, 60,000 patients from 59 countries were collected and harmonised through the platform.
Five minutes with… Sukhvinder Ubhi Department Administrative Officer What does your role involve and what do you enjoy about it? I’ve been in post since April this year and I really feel at home, as everyone is so lovely and welcoming. The role involves a variety of HR and Finance responsibilities – and it’s quite varied. I can be working on contract change requests and arranging interviews as part of morning tasks and then meeting with PI’s about forthcoming InfoEd applications for project funding later in the afternoon, not to mention logging calls to Estates for blocked toilets! I love the fact that the role is so varied, and no two days have been the same. There’s no time to be bored. What were you doing prior to this? I’ve always held positions within the education sector – I’ve worked at Senate House, University of London, UCL and at a secondary school in administrative posts. My previous post was as Data Manager, which involved analysis of school performance data (yawn!) Tell us about your interests and who you are outside of work? For the past five years, I have been studying for my Masters in Education via distance-learning, which has taken a lot of my spare time. Thankfully, I have completed the course and graduated last month. I now have time to spend with my three children who are grateful to have their mum back! I am originally from Birmingham and have managed to hold on to my accent. I graduated from University of Leicester with BSc (Hons) Sociology and moved to east London in the late 1990’s due to marriage. I’m proud of my roots, not just being a ‘Brummie’, but also being of Punjabi/Sikh heritage. I love the food, the fashion and the music (including dancing) I visited Punjab, India last year and was able to experience the serenity of Amritsar as well as taking a trip to my late grandfather’s house in Jallandhar, Punjab. In 2012, I sat my GCSE in Punjabi as it was something that I was unable to complete in my youth and was chuffed with my A grade! I am an advocate of continued professional and personal development. I love learning and I can admit that I have some sort of study bug. I recently completed my certificate in Level 3 Award in Education and Training, which is how I discovered that I also enjoy teaching/training. I am also a primary school governor, a role which I have held for a few years now and find incredibly rewarding and interesting. It allows me to stay connected to the issues faced by the education sector and I have made some great colleagues along the way. I have been fortunate to have travelled to New York, India, Spain and New York (again) over the past couple of years – making some amazing memories. I also enjoy reading and cooking (I am a feeder!), and love to binge-watch series on Netflix. Here’s our PCPH version of Desert Island discs: What 3 tunes and luxury item would you choose to be marooned with? I would have to take the Mool Mantar, the first prayer in Sikhism. It is powerful, melodious and soothing. I would also take any track by Craig David (my guilty pleasure) – my kids often make fun of me for listening to his music! Finally, a Bhangra tune - from the mid-1990s to reminisce about my Uni (party) days! My luxury item – hand cream. I never leave home without it!
Search
