Impact of electronic palliative care coordination systems (EPaCCS) on care at the end of life across multiple care sectors, in one clinical commissioning group area, in England: a realist evaluation protocol by Lydia French, Richard Morris, Lucy Pocock, Michelle Farr

“…This paper presents a protocol of a mixed-methods study, to understand how, and by whom, EPaCCS are being used and whether EPaCCS are enabling Healthcare Professionals (HCPs) to coordinate patients’ EOL care.Methods and analysis This is a mixed-methods study, carried out within a realist paradigm, to evaluate the impact of an EPaCCS on EOL care as provided by a Clinical Commissioning Group (CCG) in England. This study has two aims: (1) Describe the socio-demographic characteristics of patients who die with an EPaCCS record, their underlying cause of death and place of death and compare these with patients who die without an EPaCCS record. (2) Explore the impact of an EPaCCS on the experience of receiving EOL care for patients and their carers, and understand HCPs’ views and experiences of utilising an EPaCCS to coordinate care for their patients. …”
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Cohort profile: the East London Health and Care Partnership Data Repository: using novel integrated data to support commissioning and research by George Howard, Kamaldeep Bhui, Amy Ronaldson, Evangelos Chandakas, Qiongwen Kang, Katie Brennan, Aminat Akande, Irene Ebyarimpa, Eleanor Wyllie, Richard Fradgley, Mark Freestone

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Study protocol for an investigation of the effectiveness of the pain toolkit for people with low back pain: double-blind randomised controlled trial by Gillian Findley, Cormac Ryan, Amy Cartwright, Denis Martin

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Optimising laboratory monitoring of chronic conditions in primary care: a quality improvement framework by Alex J Walker, Richard Croker, Jessica Watson, Andy Brogan, Darunee Whiting, Tom Lewis

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Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care by Imran Mohammed Sajid, Kathleen Frost, Anand Parkunan

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Reducing urinary tract infections in care homes by improving hydration by Charles Vincent, Katie Lean, Rasanat Fatima Nawaz, Sundus Jawad

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Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study by Scott Wilkes, Rosie Dew

“…Objective Exploring the views of stakeholders to the referral management systems (RMS) used by GP practices in Northumberland, UK to evaluate its perceived effectiveness.Design This was an in-depth qualitative semi-structured interview study.Participants and setting 32 participants (GPs, hospital consultants, referral support, hospital managers, Clinical Commissioning Group manager) in the North East of England, UK.Method Interviews using a grounded theory approach and thematic analysis.Results The main benefit of RMS mentioned by participants was that it allowed for unnecessary referrals to be vetted by consultants, and helps ensure patients are sent to the correct clinic. …”
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Social determinants of Health and Alcohol consumption in the UK by Sheeraz Ali Rajput, Muhammad Owais Aziz, Muhammad A Siddiqui

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Impact of the introduction of falls risk assessment toolkit on falls prevention and psychotropic medicines’ utilisation in Walsall: an interrupted time series analysis by Mohammed Ibrahim Aladul, Stephen Robert Chapman, Bharat Patel

“…Objective To determine the impact of the introduction of a falls risk assessment toolkit (FRAT) in a UK medical centre on the number and cost of non-elective admissions for falls and psychotropic medication utilisation.Design Interrupted time series analysis quantifying the number and cost of non-elective admissions for falls and primary care use data for Rushall Medical Centre before and after the implementation of FRAT at July 2017.Setting Data on the monthly number and cost of non-elective admissions for falls and number of referrals and assessment to the falls service were provided by Walsall Clinical Commissioning Group. Primary care prescribing cost and volume data for Rushall Medical Centre was derived from the Openprescribing.net website for prescriptions dispensed between April 2015 and November 2018.Primary and secondary outcome measures The number and cost of non-elective admissions for falls and number of referrals and assessment to the falls service, and the volume of utilisation of psychotropic medicines.Results Following the implementation of FRAT at Rushall Medical Centre in July 2017, the number of non-elective admissions for falls decreased at a rate of 0.414 admissions per month (p<0.033, 95% CI –0.796 to –0.032). …”
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Intercontinental translatability of a peer-led GP education model from New Zealand to the UK: a pilot study by Ben Hudson, Matthew Walmsley, Susan Bidwell, Louise Kennedy

“…Aim: An international collaboration between South Tyneside Clinical Commissioning Group in the UK and Pegasus Health in Canterbury, New Zealand aimed to determine whether the Canterbury model of Small Group professional development for GPs was transferrable to the South Tyneside context. …”
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Understanding variation in unplanned admissions of people aged 85 and over: a systems-based approach by Andrew Wilson, Richard Baker, John Bankart, Ran Bhamra, Stoyan Kurtev, Kay Phelps, Emma Regen, Stephen Rogers, Justin Waring

“…Each site comprised an acute hospital trust, its linked primary care trust/clinical commissioning group, the provider of community health services and adult social care.Participants A total of 142 representatives from these organisations were interviewed to understand how policies had been developed and implemented. …”
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Implementing post-discharge care following acute kidney injury in England: a single-centre qualitative evaluation by Thomas Blakeman, Susan J Howard, Rebecca Elvey, Anne-Marie Martindale

“…Objectives We sought to understand the factors influencing the implementation of a primary care intervention to improve post-discharge care following acute kidney injury (AKI).Design Qualitative study using semi-structured interviews and thematic analysis.Setting General practices in one Clinical Commissioning Group area in England.Participants A total of 18 healthcare staff took part in interviews. …”
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Population Health Management to identify and characterise ongoing health need for high-risk individuals shielded from COVID-19: a cross-sectional cohort study by Adrian Pratt, Richard Wood, Charlie Kenward, Sam Creavin, Jennifer A Cooper

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Effectiveness of multidisciplinary team case management: difference-in-differences analysis by Peter Bower, Kath Checkland, Jonathan Stokes, Søren Rud Kristensen

“…In secondary analyses, we stratified individual-level results by risk score.Setting Single clinical commissioning group (CCG) in the UK's National Health Service (NHS).Participants At the individual level, we matched 2049 intervention patients using propensity scoring one-to-one with control patients. …”
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Virtual online consultations: advantages and limitations (VOCAL) study by Trisha Greenhalgh, Joe Wherton, Sara Shaw, Charles Gutteridge, Emma Byrne, Isabel Hodkinson, Shanti Vijayaraghavan, Desirée Campbell-Richards, Satya Bhattacharya, Philippa Hanson, Seendy Ramoutar, Anna Collard, Joanne Morris

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Emergency admission Predictive RIsk Stratification Models: Assessment of Implementation Consequences (PRISMATIC 2): a protocol for a mixed-methods study by Mark Kingston, Helen Snooks, Alan Watkins, Christopher Burton, Jeremy Dale, Jan Davies, Alex Dearden, Bridie Evans, Bárbara Santos Gomes, Jenna Jones, Rashmi Kumar, Alison Porter, Bernadette Sewell, Emma Wallace

“…Method: We will apply multiple interrupted time-series analysis to data, aggregated at former clinical commissioning group (CCG) level, to look at changes in emergency admission and other healthcare use following EARS introduction across England. …”
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Hospital admissions for stroke and bleeding in Hounslow following a quality improvement initiative by Martin R Cowie, Bethan Davies, Thomas Woodcock, Derek Bell, Yewande Adeleke, Dionne Matthew, Bradley Porter, Sophia Hashmy, Ammu Mathew, Ron Grant, Agnes Kaba, Brigitte Unger-Graeber, Sadia Khan, Andi Orlowski, Bruno Petrungaro, Kam Ying Wong, Sara Sekelj, Jordan Wallace

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Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators by Christopher J Gidlow, Sarah Grogan, Lisa Cowap, Elizabeth Cottrell, Ruth Chambers, Naomi J Ellis, Victoria A Riley, Diane Crone, David Clark-Carter

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Health and social care experience and research perception of different ethnic minority populations in the East Midlands, United Kingdom (REPRESENT study) by Winifred Ekezie, Shabana Cassambai, Ms Barbara Czyznikowska, Ffion Curtis, Lauren L. O'Mahoney, Andrew Willis, Yogini Chudasama, Kamlesh Khunti, Azhar Farooqi

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Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records by Carol Dezateux, Kate Homer, Nicola Firman, John Robson, Gill Harper, Zaheer Ahmed, Isabel Dostal, Crystal Williams, Ana Gutiérrez, Milena Marszalek

“…Objectives To quantify the effect of the COVID-19 pandemic on the timeliness of, and geographical and sociodemographic inequalities in, receipt of first measles, mumps and rubella (MMR) vaccination.Design Longitudinal study using primary care electronic health records.Setting 285 general practices in North East London.Participants Children born between 23 August 2017 and 22 September 2018 (pre-pandemic cohort) or between 23 March 2019 and 1 May 2020 (pandemic cohort).Main outcome measure Receipt of timely MMR vaccination between 12 and 18 months of age.Methods We used logistic regression to estimate the ORs (95% CIs) of receipt of a timely vaccination adjusting for sex, deprivation, ethnic background and Clinical Commissioning Group. We plotted choropleth maps of the proportion receiving timely vaccinations.Results Timely MMR receipt fell by 4.0% (95% CI: 3.4% to 4.6%) from 79.2% (78.8% to 79.6%) to 75.2% (74.7% to 75.7%) in the pre-pandemic (n=33 226; 51.3% boys) and pandemic (n=32 446; 51.4%) cohorts, respectively. …”
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