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‘Patient work-as-imagined’ versus ’patient work-as-done’: How do patients and families ’reach in’ to support the resilience of cancer care pathways?


Project Description

This is an exciting opportunity to undertake a PhD within the Yorkshire and Humber Patient Safety Translational Research Centre a partnership between the University of Leeds and Bradford Teaching Hospitals Foundation funded by the National Institute for Health Research (NIHR).

Project Aim: To explore, document and understand how patients and their families support the effectiveness and safety of cancer care pathways.

A strategy for improving diagnosis of, and survival with, cancer is an integral part of the NHS 10-year plan, in part due to the UK’s poor survival rates when compared with most of Europe. Indeed, the UK’s top 10 research priorities for living with and beyond cancer include improved strategies for preventing its short and longer term effects. Therefore, improving our understanding of how partnering with patients and families to increase the safety and effectiveness of care from diagnosis, through treatment and beyond is desirable.

Resilience in healthcare systems is an exciting new approach gaining traction in patient safety theory and practice (Hollnagel, Braithwaite and Wears, 2015). This approach proposes that our current ways of managing safety have focused too much on things that have gone wrong, and that instead, we should try to understand how systems support or hinder adaptations to inevitable changes in demand or resource. This new approach has received a lot of attention in the healthcare community, yet little is known about how patients and families can contribute to healthcare systems ‘resilience’: https://qualitysafety.bmj.com/content/qhc/early/2018/05/15/bmjqs-2018-008216.full.pdf. This PhD studentship will be the first to apply this exciting new conceptual framework to the understanding of how patients and families help to create safety within cancer care pathways.

This will be a mixed methods PhD including interviews, observations, and modelling of healthcare systems using the Functional Resonance Analysis Method (Hollnagel, 2012). The studentship would begin with a systematic review of the literature on how patients and families introduce, and reduce variation in cancer diagnosis and treatment, including articles on ‘invisible labour’ undertaken by patients and their carers. This would be followed by two qualitative studies examining first, the perspective of patients and families in the work undertaken by them that supports resilience; and second, the perspective of staff on how patients and families support safety and quality care. In the final study, the Functional Resonance Analysis Method (FRAM) will be used to draw these data together. Interview data may be supplemented with observational data to support the modelling. The final developed model will support future efforts to understand how to partner with patients and families to support the resilience of cancer care ‘systems’.

Environment:

You will work with Dr Jane O’Hara and Dr Kate Absolom at the University of Leeds, and Dr Laura Sheard and Dr Ruth Baxter at the Bradford Institute for Health Research. Further support will be provided by an expert in resilient healthcare – Dr Janet Anderson – at Kings College London.

Eligibility:

You should hold a first degree equivalent to at least a UK upper second class honours degree, or suitable postgraduate degree in psychology, social science or a health-related subject. You will be organised and motivated with experience in, or knowledge of healthcare services. Importantly, you will be committed to fully engaging with staff and patients and a wider multi-disciplinary team to conduct high-quality research.

The Faculty minimum requirements for candidates whose first language is not English are:
• British Council IELTS – score of 6.5 overall, with no element less than 6.0
• TOEFL iBT – overall score of 92 with the listening and reading element no less than 21, writing element no less than 22 and the speaking element no less than 23.

How to apply:

To apply for this project applicants should complete a Faculty Scholarship Application form using the link below https://medicinehealth.leeds.ac.uk/downloads/download/78/fmh_scholarship_application_form_2018_2019 and send this alongside a 300 word research proposal based on the project brief, a full academic CV, degree certificates and transcripts (or marks so far if still studying) to the Faculty Graduate School at

We also require 2 academic references to support your application. Please ask your referees to send these references on your behalf, directly to by no later than Friday 26 April.

Any queries regarding the application process should be directed to .

If you would like to know more about this scholarship or the work of the Yorkshire and Humber PSTRC, please contact: Dr Jane O’Hara Lawton (j.o’).

Funding Notes

This PhD scholarship is available for UK and EU citizens only, commencing on 1 October 2019. The scholarship will attract an annual tax-free stipend of £14,777, increasing each year subject to satisfactory progress, and will cover the UK/EU tuition fees.

This project is supported by the National Institute for Health Research

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