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In the name of safety: Identifying, understanding and stopping low value safety practices


Project Description

This is an exciting opportunity to undertake a PhD in the first cohort of THIS Institute Fellows. The aim of THIS Institute is to create an evidence base that supports replicable and scalable improvements to healthcare delivery and patient experiences. This prestigious and generous award is available to an exceptional candidate who can demonstrate excellent academic ability, an enthusiasm for healthcare improvement, the drive and determination to undertake a PhD and an ambition to work in a multi-disciplinary team to deliver research that makes healthcare safer.

Within an NHS that has an acute shortage of time and resources, the often heard demand is ’to do more with less’. The NHS is characterised by a tendency to add more initiatives, protocols and interventions in an attempt, at least in part, to make care safer. Such processes and practices are not always evidence based but they may become embedded in the culture of the institution.

There is increasing recognition that some clinical procedures are unnecessary and can do more harm than good. Indeed, the Choosing Wisely campaign focuses on the removal of health technologies (Haas et al, 2012), clinical tests and treatments that offer little or no benefit (see for example Bekelis et al 2017). However, it is also important to consider the necessity of non-clinical safety practices (Norton et al 2017).

Whilst a common language for the process of removing practices that are no longer useful is still lacking (Davidoff, 2015; Bekelis 2017), terms such as decommissioning and disinvestment are often used. These reflect the top-down strategies most often deployed for this purpose by which external policy makers and commissioners decide what practices are least cost effective or evidence based and discourage health professionals from their use, based on funding disincentives and guidelines (Roosenhas et al 2015). This approach to influencing the clinical practice of health professionals is challenging and difficult to implement (Haas et al, 2012) with limited success thus far.

It is plausible, however, that the staff themselves might know which safety practices are not fit-for-purpose, do not result in benefits for safety or are just not possible to implement. While the use of bottom-up processes may prove more promising, there is little evidence on how to do this work or whether healthcare staff are able to identify low value safety practices that might represent opportunities for ’disinvestment’ in the context of safety. This PhD Fellowship will use mixed methods to identify and prioritise potential low-value safety practices and develop and test the feasibility of an intervention for stopping these practices.

Environment:
Working in the School of Psychology you will also be embedded within the NIHR Yorkshire and Humber Patient Safety Translational Research Centre (www.yhpstrc.org). The University of Leeds, a member of the Russell Group of research-intensive universities is one of the top 10 Universities in the UK and is ranked in the top 100 universities in the QS World University Rankings 2019.

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 health related subject.You will be enthusiastic, 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 that is of value to the NHS.

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 scholarship applicants should complete a Faculty Scholarship Application form using the link below http://medhealth.leeds.ac.uk/download/4087/fmh_scholarship_application_form_2018_19 and send this alongside a 300 word research proposal based on the project brief given above, a full academic CV, degree certificates and transcripts (or marks so far if still studying) to the Faculty Graduate School

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 23 November 2018.

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: Professor Rebecca Lawton () or Professor Mark Conner ().



Funding Notes

This PhD scholarship is available for UK and EU citizens only. The scholarship is supported by the Health Foundation’s grant to the University of Cambridge for The Healthcare Improvement Studies Institute (THIS.Institute) and will attract an annual tax-free stipend of £17,500 in the first year, £18,025 in the second year and £18,566 in the third year, subject to satisfactory progress. It will also cover the UK/EU tuition fees. The anticipated start date is early 2019. For more information about THIS.Institute see View Website

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