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Academic

Professor Richard Harding

Herbert Dunhill Professor of Palliative Care & Rehabilitation

 HARDING Richard

Phone: 0207 848 5518

Fax: 0207 848 5517
Email: richard.harding@kcl.ac.uk


Research

Outcome measurement and tool validation, HIV/AIDS, heart failure, family caregivers, sub-Saharan Africa, Global Health, audit and quality improvement, mixed methods, intervention development and testing, paediatrics.

Biography

Richard Harding did his first degree in Social Anthropology and Sociology (including a EC ERASMUS scholarship), followed by a Masters degree in Social Policy and Social Work studies with a Diploma in Social Work (UK Home Office Award), and a PhD in Public Health (competitive studentship awarded). He worked as an HIV/palliative care Care Manager before taking up his PhD studentship.

Key Leadership Roles

Professor Harding is Director of the Centre for Global health Palliative Care, a post-Graduate Degrees co-ordinator, and a member of the King’s Global Health Institute Faculty. He is a Board member of the International Association for Hospice Palliative Care, a member of the World Health Organisation Palliative Care Technical Working Group, and Leader of the Who Collaborating Centre. 

Selected Publications
  • Investigation of the practices, legislation, supply chain and regulation of opioids for clinical pain management in Southern Africa: A multi-sectoral, cross-national, mixed methods study. Namisango E, Allsop MJ, Powell RA, Friedrichsdorf SJ, Luyirika EB, Kiyange F, Mukooza E, Ntege C, Garanganga E, Ginindza-Mdluli MN, Mwangi-Powell F, Mondlane LJ, Harding R. Journal of pain and symptom management (E-Publication)

  • The impact of antiretroviral therapy on symptom burden among HIV outpatients with low CD4 count in rural Uganda: nested longitudinal cohort study. Wakeham K, Harding R, Levin J, Parkes-Ratanshi R, Kamali A, Lalloo DG. BMC Palliative care. 2017; 13(1):8.

  • Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study. Bristowe K, Hodson M, Wee B, Almack K, Johnson K, Daveson BA, Koffman J, McEnhill L, Harding R. Palliative Medicine. [Epub ahead of print]. DOI: 10.1177/0269216317705102.

  • ‘They will be afraid to touch you’. LGBTI people and sex workers’ experiences of accessing healthcare in Zimbabwe: an in-depth qualitative study. Hunt J, Bristowe K, Chidyamatare S, Harding R. BMJ Global Health. [Epub ahead of print]. DOI: 10.1136/bmjgh-2016-000168.

  • What are the communication skills and needs of doctors when communicating a poor prognosis to patients and their families? A qualitative study from South Africa.Ganca LL, Gwyther L, Harding R, Meiring M. South African Medical Journal.2016;106 (9):940-4.

  • Evaluation of a physiotherapy-led group rehabilitation intervention for adults living with HIV: referrals, adherence and outcome. Harding R, Claffey A, Brown, D. AIDS Care. 2016; 28(12):1495-1505.

  • Home care by general practitioners for cancer patients in the last 3 months of life: An epidemiological study of quality and associated factors. Pivodic L, Harding R, Calanzani N, McCrone P, Hall S, Deliens L, Higginson IJ, Gomes B; on behalf of EURO Impact. Palliative Medicine. 2016; 30(1):64-74.

  • How should we manage information needs, family anxiety, depression and breathlessness for those affect-ed by advanced disease: development of a clinical decision support tool using a Delphi design. van Vliet LM, Harding R, Bausewein C, Payne S, Higginson IJ; on behalf of  EUROImpact. BMC Medicine. 2015; 13:263.

  • Nurse-led palliative care for HIV-positive patients taking antiretroviral therapy in Kenya: a randomised controlled trial. Lowther K, Selman L, Simms V, Gikaara N, Ahmed A, Ali Z, Sheer L, Higginson IJ, Harding R. Lancet HIV. 2015; 2(8): e328-e334.

  • 'We had to change to single beds because I itch in the night': A qualitative study of the experiences, attitudes and approaches to coping of patients with Cutaneous T-Cell Lymphoma (CTCL). Beynon T, Selman L, Radcliffe E, Whittaker S, Child F, Orlowska D, Morgans C, Morris S, Harding R. British Journal of Dermatology. 2015; 173(1):83-92.
  • Quality of life and wellbeing among HIV outpatients in East Africa: a multicentre observational study. Harding R, Simms V,  Penfold S, Downing J, Namisango E, Powell RA, Mwangi-Powell F, Moreland S, Gikaara N, Atieno M,  Higginson IJ. BMC Infectious Diseases. 2014; 14:613.

  • Palliative care-related self-report problems among cancer patients in East Africa: a two-country study. Harding R, Powell RA, Namisango E, Merriman A, Gikaara N, Ali Z, Higginson IJ. Support Care Cancer. 2014; 22(12):3185-92.
  • 'Peace' and 'life worthwhile' as measures of spiritual well-being in African palliative care: a mixed-methods study. Selman L, Speck P, Gysels M, Agupio G, Dinat N, Downing J, Gwyther L, Mashao T, Mmoledi K, Moll T, Sebuyira Mpanga L, Ikin B, Higginson IJ, Harding R. Health and Quality of Life Outcomes 2013, Jun 10;11(1):94.
  • 'Burden to others' as a public concern in advanced cancer: A comparative survey in seven European countries. Bausewein C, Calanzani N, Daveson BA, Simon ST, Ferreira PL, Higginson IJ, Bechinger-English D, Deliens L, Gysels M, Toscani F, Ceulemans L, Harding R, Gomes B. BMC Cancer. 2013 Mar 8;13(1):105.
  • Multidimensional Patient-Reported Problems Within Two Weeks of HIV Diagnosis in East Africa: a Multicentre Observational Study. Simms VM, Gikaara N, Munene G, Atieno M, Kataike J, Nsubuga C, Banga G, Namisango E, Fayers P, Powell RA, Higginson IJ, Harding R. PLoS One. 2013 Feb 19; 8(2):e57203.
  • Research in palliative care in sub-Saharan Africa. Harding R, Selman S, Powell RA, Namisano E, Downing J, Meriman A, Ali Z, Gikaara N, Gwyther L, Higginson IJ. Lancet Oncology. 2013. 14:183–88.
  • Traditional healers’ views of the required processes for a ‘good death’ among Xhosa Patients pre- and post-death. Graham N, Gwyther L, Tiso T, Harding R. Journal of Pain & Symptom Management. 2013 Sept;46(3):386-94.
  • If you had less than a year to live, would you want to know? A seven-country European population survey of public preferences for disclosure of poor prognosis. Harding R, Simms V, Calanzani N, Higginson IJ, Hall S, Gysels M, Meñaca A, Bausewein C, Deliens L, Ferreira P, Toscani F, Daveson BA, Ceulemans L, Gomes B, on behalf of PRISMA. Psycho-Oncology. 2013, March 18 [Epub ahead of print]
  • The “Spirit 8” successfully captured spiritual wellbeing in African palliative care: factor and Rasch analysis. Selman L, Siegert R, Higginson IJ. , Dinat N, Downing J, Gwyther L, Mashao T, Mmoledi K, Moll T, Mpanga Sebuyira L, Ikin B, Harding R. Journal of Clinical Epidemiology 2012, 65(4): 434-43.
  • Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study. Selman L, Higginson IJ, Agupio G, Dinat N, Downing J, Gwyther L, Mashao T, Mmoledi K, Moll T, Mpanga Sebuyira L, Ikin B, Harding R. Health and Quality of Life Outcomes. 2011 April;9:21.
  • The MVQOLI successfully captured quality of life in African palliative care: a factor analysis. Selman L, Siegert R, Higginson IJ, Agupio G, Dinat N, Downing J, Gwyther L, Mashao T, Mmoledi K, Moll T, Mpanga Sebuyira L, Ikin B, Harding R. Journal of Clinical Epidemiology 2011, Aug;64(8):913-24.
  • Meeting the information needs of patients with incurable progressive disease and their families in South Africa and Uganda: a multi-centre qualitative study. Selman L, Higginson IJ, Agupio G, Dinat N, Downing J, Gwyther L, Mashao T, Mmoledi K, Moll AP, Mpanga Sebuyira L, Panajatovic B, Harding R. British Medical Journal. 2009 April 22;338:b1326. Also invited podcast interview: podcasts.bmj.com/bmj/2009/04/
  • Improving end of life care for chronic heart failure patients – “Let’s hope it’ll get better, when I know in my heart of hearts it won’t”. Selman L, Harding R, Beynon T, Hodson F, Coady E, Hazeldine C, Walton M, Gibbs L, Higginson IJ. Heart 2007, 93:963–967
Teaching
  • King’s MSc in Palliative Care: Research Methods and Statistics (core module), Psychosocial, Cultural, Ethical and Spiritual Issues (core module); Service policy and development.
  • King’s Intercalated BSc in Global Health.
Current PHD Students
Selected Grants
  • European Research Council Consolidator Award. Euros 1,799,820. 2018-2022.

    Children’s Palliative care Outcome scale.Harding R, Higginson IJ, Murtagh F, WEIGAO, Bluebond-Langner M, Farsides B, Curtis H. 

  • WHO. £39,497. 2017-2017.

    Commissioned call for rapid review of service delivery models for older people at the end-of-life that maximise quality of life.Harding R, Evans C, Maddocks M, Higginson I, Ellis-Smith C, Namisango E, Bajwah S, Yi D, Gao W. 

  • NIHR. £164,964. 2018-2019.

    Improving communication between clinicians and LGBT patients with serious illness: a national qualitative study to develop and deliver evidence-based guidance. Harding R, Rose R, Bristowe K, Johnson K, Sleeman K.

  • NIHR. £6,997,730. 2017-2021.

    careSSA. Prince M (PI), Harding R (Co-applicant) from a cross-national group of co-applicants, HARDING responsible for leading platform on palliative care and health systems strengthening cross-cutting theme on person-centred care

  • ESRC. £5,989,759. 2017-2021.

     Developing capability, partnerships and research in the Middle and Near East (RH4C-MENA). Sullivan R, Patel P, Kienzler H, Bowen W, HARDING R (Co-applicant, responsible for leading palliative care work package), Moran M, Chalkidou K, Darzi A, King L, Coutts A, Ruggeri K. 

  • Marie Curie. £185,673. 2017-2019.

    Bereavement outcomes for LGB (lesbian, gay and bisexual) and heterosexual partners: a population-based cross sectional mixed methods study.Harding R (PI), Bristowe K, Gaowei, Yi D, King M, Johnson K, Almack K, Gazzard B. 

  • The Dunhill Medical Trust. £134,798. 2015-17.

    Improving palliative rehabilitation in palliative care using goal attainment.Maddocks M, Higginson IJ, Turner-Stoke L, Siegert R, Ashford S, Harding R, Gao W, Murtagh FE. 

  • Open Society Foundations. £196,490. 2015-2018.

    BUILDcare Africa.Harding R (PI).

  • Marie Curie. £116,000. 2014-2016.

    ACCESSCare: Advanced Cancer Care Equality Strategy for Sexual minorities. Harding R (PI), Daveson B, Johnson K, Almack K, Koffman J. 

  • EC FP7. Primary health Care Support Programme. €1,155,518.74. 2011-2015.

    Health care users experience, as a focus for unlocking opportunities to access quality health. Harding R, (Co-applicant).Work Package lead for KCL. (Local PI)

Critical Impact

Richard Harding has a number of collaborations with African palliative care leaders that has brought change in outcome measure for research and clinical practice as well has significantly grown the evidence base. The APCA African Palliative Outcome Scale is now widely used across clinical care and research in sub-Saharan Africa, including in the PEPFAR Public Health Evaluation of HIV Care Services. The Spirit 8 spiritual well-being measure is also being used in studies in sub-Saharan Africa. Professor Harding’s researchis now underpinning the new UK HIV clinical care standards. 

International Links
  • Studies in Argentina, South Africa, Kenya Tanzania Uganda
  • Board member of the African Palliative Care Research Network
  • Member of the EUROImpact cross-Europe training network
  • Visiting Professor of Palliative Care at the University of Cape Town

We have been collaborating with partners in resource-poor settings to develop research capacity, activity and evidence in the quest to expand quality palliative care:

  • Our primary activity has been in Sub-Saharan Africa through collaboration with specific providers in 6 countries as well as advocacy bodies such as APCA, NHPCO, SOROS and the Diana Fund.
  • Our African work includes the UK Big Lottery funded ENCOMPASS Project in South Africa and Uganda to continue the work from our APCA/NHPCO partnership to develop and validate an APCA African Palliative Outcome Scale and move into audit cycles.
  • We have also collaborated with partners in Tanzania measuring the need for palliative care among HIV outpatients with access to ART, measuring paediatric antiretroviral therapy outcomes under specialist palliative care in South Africa, and have worked on the evaluation of the pioneering Ugandan Public Health opioid roll-out.
  • We have led a large scale evaluation of care and support for the US Government’s PEPFAR programme in two African countries
  • We are currently leading the EC-funded PRISMA project to enhance the science and practice of end-of-life cancer measurement. This collaboration is leading 12 partners in 8 countries.
  • CSI is now a representative on the European Partnership Against Cancer
  • We have also been working with partners in Cuba to assist the development of an evidence base and education for clinicians, and have worked with USA partners to evaluate pain measurement in Cambodia and Thailand.

International Conferences:

  • 11th European Association Palliative Care Congress, Vienna, 2009.
  • 9th International AIDS Impact Scientific Meeting, Botswana, September 2009.
  • XVII International AIDS Conference, Mexico City, 2008.
  • 5th Research Congress of the European Association of Palliative Care EAPC, Trondheim, 2008.
  • HIV Implementers’ Meeting, Uganda, 2008.
  • 10th European Association of Palliative Care Congress, Budapest, 2007.
  • African Palliative Care Association (APCA) Palliative Care Conference, Kenya, 2007.
  • South African AIDS Conference, Durban, 2007.
  • AIDS Impact 8th Annual Scientific Meeting, Marseille, 2007.
  • 5th Research Congress of the European Association of Palliative Care, Venice, 2006.
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