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What are the personal, clinical and social impacts of longer waiting times? A multi-methods study.

Project Description

Waiting times for elective surgery remain an important topic for health policy and health services research. The standard national treatment time guarantee in Scotland is 12 weeks. However, NHS Grampian has also developed an Elective Surgery Categorisation System (ESCatS), which provides new maximum waiting times for three different prioritisation categories across all surgical specialties.

Evaluation so far of ESCatS suggests that people waiting up to a year in lower priority categories seem to experience no substantial difference in their eventual clinical outcomes, or require more emergency admissions. However, we do not know what other impacts longer waits for some people may have. These might be system impacts on the wider NHS, such as increased drug use or extra burden on GPs, or health and social impacts on individuals and families, such as depression, lost days at work/lost income, leisure and social activities foregone, additional demands on family carers. Understanding these potential impacts better would help in designing services.

The University of Aberdeen and NHS Grampian have created a PhD studentship to investigate the impact of waiting times on different groups of people, to support the most clinically effective and least harmful prioritisation. The project will focus particularly on waiting times for hip and knee replacements as a high volume area.

We anticipate a mixed methods PhD, potentially including a systematic review, interviews with patients and family members, PROMS and other survey data, healthcare utilisation data, and linkage to clinical outcomes. There may also be scope for a secondary analysis of existing quantitative data from the C-GALL trial of laparoscopic surgery versus observation/conservative management for gallstone disease to broaden the clinical focus. The successful candidate will be involved in shaping the exact design of the study.

Applications are welcome from candidates with an existing Masters degree in a health-related field, from either a social science or clinical background. An interest in mixed methods health services research is essential.

The studentship will be based in the Health Services Research Unit, an internationally recognised centre for health services research which receives core funding from the Chief Scientist Office of the Scottish Government. Supervision will be provided by the Director of the Unit, Prof Craig Ramsay, an expert in health technology assessment and evaluation, and Prof Louise Locock, a specialist in qualitative research into patient experience and patient involvement.

The study has been planned with close involvement from NHS Grampian, particularly the Acute Medical Director, Mr Paul Bachoo, and NHS Grampian colleagues will continue to offer support and guidance with the study to maximise its relevance for the NHS.

There will also be opportunities to link with colleagues in Health Economics and Epidemiology as the study design develops.

Formal applications can be completed online: You should apply for Degree of Doctor of Philosophy in Applied Health Sciences, to ensure that your application is passed to the correct person for processing.


Funding Notes

This studentship is funded by the University of Aberdeen School of Medicine, Medical Sciences and Nutrition. Full funding is available to UK/EU candidates only. Overseas candidates can apply for this studentship but will have to find additional funding to cover the difference between overseas and home fees (approximately £15,680 per annum).

Candidates should have (or expect to achieve) a minimum of a 2.1 Honours degree in a relevant subject. Applicants with a minimum of a 2.2 Honours degree may be considered provided they have a Merit/Commendation/Distinction at Masters level.

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