Improving safety and quality in mental healthcare
Start Date: 01/09/2019
Award: 1 fully funded 3 year full time THIS Institute PhD fellowship
Project:
Mental health patients die 12-15 years earlier compared to the general population. 78% of excess deaths within this cohort are attributable to comorbid physical conditions which are often untreated or treated late such that the prognosis worsens significantly. There is further evidence of problems that occur whilst patients are hospitalised to receive treatment: 10% of all hospital inpatients suffer an error or adverse event in their care, 50% of which are typically clinically judged preventable. Taken together, this evidence suggests that mental health patients are at high risk of lower quality care compared to patients not treated primarily for mental health problems; and that these patients when hospitalised are also likely to suffer further patient safety incidents.
Project aims:
This PhD project aims to (i) study the nature of safety and quality of care problems that mental health patients face, (ii) shortlist potential interventions to address these, and (iii) conduct a proof-of-concept investigation of at least one of these interventions.
Project methods:
Study 1: In a first phase, the Fellow will review the evidence on the scale and nature of safety and quality of care problems in mental health patient care. The review will cover problems of both mental and physical care nature. In a second phase of the review, the Fellow will identify evaluated interventions and appraise the strength of evidence and implementability of each one of them.
Study 2: This will be a mixed methods study, including (i) rapid ethnography in mental and physical health settings (e.g., primary care practices, and A&Es), (ii) in-depth interviews with a purposive sample of mental health service users and inpatients and their families/carers, and frontline providers (physicians, nurses, allied health professionals) and service managers. This study will contextualise and triangulate the findings of the review within current NHS practices. It will offer observational and also self-reported evidence of problems and lapses in care – but also instances where mental health patients were suitably examined, investigated and treated (or referred for treatment). The study will be carried out across our local mental and acute care NHS Trusts (e.g., South London &
Maudsley Mental Health Trust; King's Hospital NHS Trust); and community-based services.
Study 3: This study will move the Thesis towards effective and feasible interventions. Co-production methodology, with a purposive sample of patients/carers and providers, will aim to derive a shortlist of 2-3 promising safety/quality improvement interventions emerging from Studies 1-2. The Fellow will coordinate an expected 4-5 co-production workshops following a standardised approach (as per King’s Fund current methodological guideline).
Study 4: Proof-of-concept testing in situ of at least one of the interventions derived in Study 3. For the purposes of the Thesis, this study is envisaged as a small scale implementation evaluation, carried out in maximum 2 services/service settings. The Fellow will design and execute assessment of a battery of standard implementation outcomes, including acceptability, feasibility, and reach. Mixed methods will be used for data collection, including survey, interview and potentially observational methods in situ.
Supervisors:
Dr Claire Henderson and Profesor Nick Sevdalis
Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF
Entry requirements:
Standard PhD entry requirements: Applicants should have a Bachelor’s degree with 2:1 honours (or Overseas equivalent). A 2:2 degree may be considered only where applicants also offer a Masters with Merit.
Award Types and Eligibility:
Fully funded for three years full time, Home/EU tuitions fees (overseas applicants will only be eligible if they can pay the difference in fees), annual stipend and research, dissemination and travel costs.
Further Information:
Please note, this studentship is also being offered as a clinical salaried role if you have a medical qualification. There is only one position available and the best candidate, clinical or non-clinical, will be appointed.
Information about the Institute of Psychiatry, Psychology & Neuroscience please follow this link: https://www.kcl.ac.uk/ioppn/index.aspx
Information about the Health Service & population Research Department is available by following this link: https://www.kcl.ac.uk/ioppn/depts/hspr/index.aspx
Information about the Centre for Implementation Science is available by following this link:
https://www.kcl.ac.uk/ioppn/depts/hspr/research/cis/about.aspx
How to apply:
Applicants must complete and submit an online admissions application, via the admissions portal by midnight (23:59 GMT), Tuesday 21st May 2019.
On the ‘Choosing a programme’ page, please select ‘Research degrees’ and enter the keywords Health Services and Population Research MPhil/PhD (Full time).
In your application, you will be asked to include:
• Academic Transcripts – where applicable, academic transcripts must be submitted with the online admissions application
• Details of your qualifications (you will need to attach copies)
• Details of previous employment
• A personal statement describing your interests and why you wish to apply for this project. Please include this as an attachment rather than using the text box.
• Academic References – all admissions applications require two supporting references. If the applicant is relying on his/her referees to submit references directly to the College after he/she has submitted his/her admissions application, then the applicant must ensure that their chosen referees are made aware of the funding deadline.
In the Funding section, please tick box 5 and include the following reference: NS-THIS-2019
Please note there is no need to complete the Research Proposal section in your application as the project has already been set.
You are welcome to email Dr Claire Henderson (claire.1.henderson@kcl.ac.uk) and Professor Nick Sevdalis (nick.sevdalis@kcl.ac.uk) (supervisors) for more information regarding the project and studentship.
If you have any queries regarding the application process, please contact the Postgraduate Research Administrator.
Only shortlisted applicants will be contacted.
Closing Date: Tuesday 21st May 2019
Interviews: 31st May 2019