The Centre for Mental Health Policy and Evaluation is a leading international centre carrying out world-class research in the areas of evaluation and implementation of mental health initiatives. The aim of the centre is to positively influence mental health policy and practice.
We grew out of the King's College London Centre for Implementation Science. The Centre name reflects:
- The research we do along the translational pathway including observational and interventional designs to assess effectiveness and implementation
- Our research at the levels of public mental health, primary and secondary care
- Our focus on research on both mental health services and public mental health both in the UK and internationally. This focus is a continuation of work beginning in the 1990s during the development of local community mental health services.
What we do
Our centre focuses on assessing the effectiveness and implementation of policies, services and population level interventions, primarily in relation to mental health. We also aim to contribute to the advancement of methods for evaluation and implementation science, and support the capacity building work of NIHR Applied Research Collaboration (ARC) South London.
We work with policy makers, organisational leaders, practitioners and people with experience of using/surviving mental health services. We use quantitative, qualitative, mixed and participatory research methods. In addition to trials we conduct timely and inexpensive evaluation including the use of survey and routinely collected data.
We have a particular interest in participatory research and equity-informed implementation to reduce unwarranted variations in access to, experience of, and outcomes from mental health care.
Who we are
We are an interdisciplinary team with backgrounds in clinical practice, psychology and sociology, statistics, epidemiology, qualitative and participatory research methods, implementation science, and patient safety. Within the Centre there are five themes:
Climate, environmental and social change
Mental health services research
Implementation and evaluation methodology
People
Lecturer in Health Systems
NIHR Clinical Doctoral Research Fellow
Professor of Public Mental Health and Statistics
Business Support Administrator
PhD Student
Research Fellow
Projects
Scaling-up Health-Arts Programmes (SHAPER)
● Aim: To upscale effective arts interventions (Melodies for Mums with Postnatal Depression, Dance for Parkinson’s, and Stroke Odysseys) and embed them in clinical pathways. ● PI: Professor Carmine Pariante; co-I: Professor Ioannis Bakolis; Funder: Wellcome Trust ● Research Theme: Climate, environmental and social change
NIHR HealthTech Research Centre in Brain Health
● Aim: To utilise implementation science methods to expedite the development and integration of emerging technologies in healthcare, with a focus on swiftly delivering benefits to patients. ● Project Lead: Professor Ioannis Bakolis (PI: Professor Dag Aarsland) ● Funder: NIHR ● Research Theme: Climate, environmental and social change ● Dates: 1/04/2024 – 31/03/ 2029
Advance Choice Documents Implementation (ACDI)
ACDI aims to address the research-to-practice implementation gap for advance choice documents.
Air pollution and mental health over the life course
To quantify the impact of ambient air pollution on population mental health
ARC extension: peer research project in the patient and public involvement in research (PPIR) theme
Peer research is an overarching approach to research with communities that can use different methods to promote more collaborative involvement in research.
Collaboratively creating an approach to measure improvement culture at a large acute hospital
Fostering a culture that champions and empowers improvement has been a long-standing goal within the UK’s National Health Service.
Culturally appropriate advocacy, improving access, experience and outcomes for racialised people in mental health services
This study aims to build on a national scoping review, and pre-pilot concept-testing, to understand the best way to implement Culturally appropriate Advocacy
Developing a 4Pi framework-based questionnaire to evaluate service user and carer involvement
We are developing and testing a new questionnaire to evaluate service users and carers’ experiences of involvement
Developing a Theory of Change for the quality improvement training programme at King’s College Hospital
Many NHS Trusts across the UK have developed organisation-wide training programmes to give their staff the knowledge and skills to do quality improvement.
Developing and evaluating a new tool designed to assess the quality of implementation research
Implementation science is the study of methods and strategies to promote the adoption, implementation and sustained uptake of evidenced-based interventions
Development of hybrid study designs for evaluation effectiveness and implementation of population health interventions
To advance the understanding and use of methods for rapid evaluation and implementation of policies and healthcare services such as hybrid studies and trials.
Epistemic Exclusion and Patient Safety Participation Evaluation (EPSPE)
Tackling epistemic exclusion in patient safety by co-producing a patient-centered framework for evaluating medical harm and risk.
Evaluation of remote monitoring in rheumatology outpatients across three NHS trusts in south-east London
Rheumatoid arthritis is a chronic, inflammatory joint disease affecting around one per cent of the UK population.
Implementation Research Development (ImpRes) tool and supplementary guide update and validation
To update the ImpRes tool and supplementary guide to support the design of implementation research.
Implementation Science Research Project Appraisal Criteria (ImpResPAC)
To develop a quantitative tool to appraise the conceptual and methodological quality of implementation research.
Improving adoption of mental health interventions among low-income university students in Brazil
Digital interventions can increase access to care in a scalable and low-cost way and reduce burden on health systems
Mental Health Implementation Network
The Mental Health Implementation Network aims to drive national collaborations and changes in mental health practice and is funded by the NIHR.
Patient preferences and experiences of waiting for heart surgery
Being on a waiting list for heart surgery could be difficult and anxiety-provoking.
Prescribing Antidepressants in Primary care: Ethnic inequalities in tReatment - The PAPER Study
This project aims to understand the treatment of depression in South Asian patients.
Recovery Colleges Characterisation and Testing (RECOLLECT)
To address how Recovery Colleges can provide the most benefit to people who use mental health services.
Research Cafés: Co-producing inclusive health research with diverse communities in integrated care systems
To understand how ‘research cafes’ can act as a mechanism for increasing the diversity of participation and involvement in research
Social Care Implementation Research (SC-ImpRes) guide
To implement the ImpRes tool and supplementary guide to support the design of implementation research.
The Effects of extreme heat events on mental health in vulnerable urban communities: Towards evidence-based policy and practice
To examine how extreme hot weather impacts population mental health and mental health services on those living in urban environments
Understanding And Measuring Dementia Stigma In Different Cultural Contexts
To advance the understanding of dementia stigma in different cultures
Understanding infectious disease mortality in people with severe mental illness
This project aims to answer a number of questions about the complex interplay between severe mental illness, different infections and external factors.
News
Public attitudes to mental health decline for the first time in 10 years
Research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and commissioned by Mind warns that public attitudes...
People with severe mental illness more than four times as likely to die from pneumonia compared to the general population
New research suggests that people with severe mental illness face an increased risk of death due to infectious disease.
Events
A Life Less Safe: invitation to a special screening at Brixton Ritzy
A film exploring the experiences of Black and other racially minoritised people living with severe mental health conditions during Covid-19.
Please note: this event has passed.
Completed projects
Emilia: assessing the WHO Mental Global Action Programme intervention guide for use on digital devices
The aim of the Emilia project was to assess if it is possible to produce an e-version of the World Health Organization (WHO) Mental Health Global Action Programme Intervention Guide (e-mhGAP IG) that is easily usable on smartphones and tablet devices by primary care staff in Nepal and Nigeria.
The project assessed if this electronic form of guidance is suitable for use in low and middle income countries (LMICs), where over 85 per cent of the world’s population live. The development of the e-mhGAP IG will offer significant improvements over the printed paper version by surpassing limitations such as slow and irregular updating, and creating new opportunities for remote supervision.
To evaluate fidelity, the researchers interviewed practice managers and service users who attended the clinics to assess their knowledge and their experience of how the e-mhGAP intervention guides is applied in practice by primary healthcare staff, and collect service user/patient service satisfaction data through a brief structured form. In each clinic the research team gathered patient service satisfaction data from all attending service users over three separate one-week periods.
This strategy allowed the researchers to evaluate implementation fidelity and its change over time. The study was led by Professor Sir Graham Thornicroft, working with colleagues in the Centre of Implementation Science and researchers from Nepal, Nigeria, Ethiopia and the WHO.
ASPIRES: reduction of surgical site infection rates and improved antibiotic prescription and utilisation in perioperative care globally
Researchers from the Centre for Implementation Science led on one of four work-packages of the global ASPIRES project (Antibiotic use across Surgical Pathways - Investigating, Redesigning and Evaluating Systems).
Funded by the ESRC, the project asked how can antibiotic use be optimised along the entire surgical pathway such that surgical outcomes improve. The approaches taken to address this question involved developing behavioural, structural and technological interventions which are context specific – and applied in hospital settings in India, Rwanda, South Africa and the UK.
The Friendship Bench: Optimizing implementation strategies of the first scale-up of a primary care psychological intervention for common mental disorders in Sub-Saharan Africa
This research was funded by the Medical Research Council (MRC) and was jointly led by Professor Ricardo Araya (Centre for Global Mental Health, King's College London) and Professor Dixon Chibanda (University of Zimbabwe). CIS provided health economic expertise.
The project evaluated the comparative performance of health clinics in Zimbabwe in terms of their success in implementing the Friendship Bench, a lay-worker-delivered psychological therapy for improving symptoms of depression and anxiety. This will be used as a basis for testing promising implementation strategies to maximize the reach, effectiveness, adoption, implementation, and maintenance of the Friendship Bench into the future.
ASSET: HeAlth System StrEngThening in Sub Saharan Africa: A five-year programme funded by the NIHR to address the “how to” component of bringing to scale complex interventions to achieve high-quality care for Universal Health Coverage
Centre scientists led on one of several work packages that constituted the ASSET global health research programme. Funded by the National Institute for Health Research (NIHR), ASSET was a Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa.
We were working in four countries; Ethiopia, South Africa, Sierra Leone and Zimbabwe; and across three healthcare platforms: integrated primary health care; maternal care and surgical care. Part of the Government’s wider Official Developmental Assistance (ODA) budget, the aim of this research was to improve the health of patients and public in low and middle-income countries.
CIS scientists led on the Improvement and Implementation cross-cutting work-group, aiming to strengthen and harmonise implementation strategies across ASSET countries and platforms.
Evaluating the HARPdoc trial – aimed at helping people with type 1 diabetes avoid hypoglycaemia
Researchers in the Centre of Implementation Science worked closely with researchers in CLAHRC South London’s diabetes theme to help them evaluate two new educational programmes aimed at helping people with type 1 diabetes to avoid hypoglycaemia.
This work was part of the ‘HARPdoc’ randomised controlled trial, which was designed to address the motivations and barriers to hypoglycaemia avoidance. It used educational and psychological techniques, such as motivational interviewing and cognitive behaviour theory delivered by specially trained diabetes educators to small groups of patients. The trial will compared two interventions designed to help change patients’ thoughts and behaviours around hypoglycaemia to improve detection, treatment and prevention.
Postdoctoral research associate Dr Tayana Soukup led a process evaluation of the HARPdoc trial, in collaboration with other implementation scientists in the Centre. ‘While the trial is concerned with understanding which intervention is more effective, the process evaluation is focused on understanding the way in which the programmes are implemented and assessing their impact at study sites. Ultimately the aim is to inform the scale-up of the effective programme after the trial is complete,’ said Dr Soukup.
EQUIP: Developing capacity and capability for perioperative improvement within UK urology training
Researchers from the Centre, the University of East Anglia and Barts Health, jointly with patients, medical education and improvement experts, trainees and the charitable Urology Foundation set up a training programme aiming to provide urology trainees across the UK with the skills and expertise they need to carry out successful and impactful quality improvement projects as part of their training rotations.
Launched in 2017, the ‘Education in Quality Improvement Programme’ (EQUIP) was a research project supported by the Urology Foundation at the interface of improvement and implementation sciences and surgical education. The programme aimed to develop an evidence-based, user-informed, practical and scalable quality improvement skills training curriculum for urology trainees surgical residents in the UK.
To-date, EQUIP has: (i) delivered a review of published evidence regarding how best to teach improvement skills to healthcare personnel; (ii) designed a pragmatic core improvement skills curriculum for urology trainees, deliverable within half a day of face to face teaching. The curriculum has been evaluated and found feasible and offering positive immediate educational impact; (iii) carried out a national needs assessment across urology training programmes in the UK.
Further project aims EQUIP researchers were to: (i) develop a train-the-trainers approach to facilitate the scale-up of the EQUIP curriculum nationally in the UK; (ii) establish national consensus regarding the requirements of trainee improvement projects, in terms of project scope and quality assurance criteria; (iii) develop a national web portal for the sharing of trainees’ improvement projects at national level; (iv) explore the potential for EQUIP to reach out to surgical specialities outside urology.
Using smartphone technology to enhance patient safety in surgical care
Research suggests that around one in ten patients entering NHS hospitals will experience an unintended error (termed an ‘adverse event’) in their care. These events can result in harm and have catastrophic implications, not only for the patient and their family, but for the healthcare staff involved and for the NHS organisation as a whole (at both a reputational and financial level).
Adverse event rates are higher for surgery than other healthcare specialties. This may be a reflection of the risk profile of the patients receiving surgery; the complexity of the procedure and/or the operating theatre environment; or simply higher rates of reporting errors by surgical staff. Either way, improving surgical safety is a priority for NHS England.
This research project aimed to explore how we can effectively translate what the evidence tells us about the causes of error in surgery into a format that patients can use to improve their safety. Specifically, the project looks at the use of smartphone apps to address this problem.
An app, called MySurgery, has been designed to help patients and their carers understand the risks associated with having surgery and inform them of the specific actions they can take to improve their safety and recovery.
Improving safety and quality in mental healthcare
A team of Centre for Implementation Science experts was involved in this doctoral project, aimed at the interface of patient safety and improvement sciences.
Funded by the Healthcare Improvement Studies Institute (THIS) for three years (2019-22), the project (i) studied the nature of safety and quality of care problems that mental health patients face, (ii) shortlisted potential interventions to address these, and (iii) conducted a proof-of-concept investigation of at least one of these interventions.
The project utilised a range of methods – including: evidence review to identify the nature and scale of the problem within mental health services; rapid ethnography and further qualitative methods to establish the views of providers, patients and their carers and families; and a multi-stakeholder approach to intervention development, implementation and evaluation, to evaluate interventions that are potentially effective in improving patient safety in this patient population.
The project was carried out in close collaboration with the South London and Maudsley NHS Foundation Trust.
The concept and determinants of return on investment for quality improvement in mental health NHS Foundation Trusts
Researchers in the Centre for Implementation Science developed a measurement system for evaluating return on investment (ROI) of quality improvement projects in mental health services of the South London and Maudsley NHS Foundation Trust.
Quality improvement in healthcare has seen a surge of investment amidst times of austerity in the UK. Very little guidance exists for evaluating return on investment, particularly in mental health NHS Foundation Trusts. This impedes communication with healthcare leaders and boards regarding the extent to which quality improvement is achieving its full potential within the organisation.
A robust ROI measure makes it possible to generate regular reports for healthcare leaders which can be used to give them strategic insights and inform their decisions about investment strategies for capacity building, training and support. The research is supported through a London Interdisciplinary Social Science Doctoral Training Partnership.
Advance Statements for Black African and Caribbean people (AdStAC)
● Aim: To improve Black service users’ experiences in mental health services in South London by co-producing and testing an advance choice document (ACD) implementation resource with Black service users, mental health professionals and carers/supporters of Black service users.
● Project Lead: Professor Claire Henderson
BME Faith Communities and Mental Health Care
● Aim: To address healthcare disparities for the Black community in Southwark and Lambeth.
● Project Lead: Professor Claire Henderson
Culturally Adapted Family Therapy for Psychosis (CAFI)
● Aim: To evaluate the effectiveness of Culturally-adapted Family Intervention (CaFI) for Black and Mixed heritage people diagnosed with schizophrenia or psychosis and their families
● Project Lead: Professor Claire Henderson
Every Mind Matters Campaign Evaluation
● Aim: To enhance mental health literacy in the adult population of England
● Project Lead: Professor Claire Henderson
International study of discrimination and stigma outcomes (Indigo)
● Aim: To develop and test stigma reduction methods in China, Ethiopia, India, Tunisia, and Nepal. Additionally, the research aims to enhance scientific understanding of how individuals with mental illness experience stigma.
● Project Lead: Professor Sir Graham Thornicroft
Lifeguard Pharmacy
● Aim: To develop and pilot a training package and service to enable community pharmacies to respond to people in danger from domestic violence or feeling suicidal
● Project Lead: Professor Claire Henderson
Time to Change Anti-Stigma Program Evaluation
● Aim: Population-level program targeting mental health stigma reduction in England
● Project Lead: Professor Claire Henderson
People
Lecturer in Health Systems
NIHR Clinical Doctoral Research Fellow
Professor of Public Mental Health and Statistics
Business Support Administrator
PhD Student
Research Fellow
Projects
Scaling-up Health-Arts Programmes (SHAPER)
● Aim: To upscale effective arts interventions (Melodies for Mums with Postnatal Depression, Dance for Parkinson’s, and Stroke Odysseys) and embed them in clinical pathways. ● PI: Professor Carmine Pariante; co-I: Professor Ioannis Bakolis; Funder: Wellcome Trust ● Research Theme: Climate, environmental and social change
NIHR HealthTech Research Centre in Brain Health
● Aim: To utilise implementation science methods to expedite the development and integration of emerging technologies in healthcare, with a focus on swiftly delivering benefits to patients. ● Project Lead: Professor Ioannis Bakolis (PI: Professor Dag Aarsland) ● Funder: NIHR ● Research Theme: Climate, environmental and social change ● Dates: 1/04/2024 – 31/03/ 2029
Advance Choice Documents Implementation (ACDI)
ACDI aims to address the research-to-practice implementation gap for advance choice documents.
Air pollution and mental health over the life course
To quantify the impact of ambient air pollution on population mental health
ARC extension: peer research project in the patient and public involvement in research (PPIR) theme
Peer research is an overarching approach to research with communities that can use different methods to promote more collaborative involvement in research.
Collaboratively creating an approach to measure improvement culture at a large acute hospital
Fostering a culture that champions and empowers improvement has been a long-standing goal within the UK’s National Health Service.
Culturally appropriate advocacy, improving access, experience and outcomes for racialised people in mental health services
This study aims to build on a national scoping review, and pre-pilot concept-testing, to understand the best way to implement Culturally appropriate Advocacy
Developing a 4Pi framework-based questionnaire to evaluate service user and carer involvement
We are developing and testing a new questionnaire to evaluate service users and carers’ experiences of involvement
Developing a Theory of Change for the quality improvement training programme at King’s College Hospital
Many NHS Trusts across the UK have developed organisation-wide training programmes to give their staff the knowledge and skills to do quality improvement.
Developing and evaluating a new tool designed to assess the quality of implementation research
Implementation science is the study of methods and strategies to promote the adoption, implementation and sustained uptake of evidenced-based interventions
Development of hybrid study designs for evaluation effectiveness and implementation of population health interventions
To advance the understanding and use of methods for rapid evaluation and implementation of policies and healthcare services such as hybrid studies and trials.
Epistemic Exclusion and Patient Safety Participation Evaluation (EPSPE)
Tackling epistemic exclusion in patient safety by co-producing a patient-centered framework for evaluating medical harm and risk.
Evaluation of remote monitoring in rheumatology outpatients across three NHS trusts in south-east London
Rheumatoid arthritis is a chronic, inflammatory joint disease affecting around one per cent of the UK population.
Implementation Research Development (ImpRes) tool and supplementary guide update and validation
To update the ImpRes tool and supplementary guide to support the design of implementation research.
Implementation Science Research Project Appraisal Criteria (ImpResPAC)
To develop a quantitative tool to appraise the conceptual and methodological quality of implementation research.
Improving adoption of mental health interventions among low-income university students in Brazil
Digital interventions can increase access to care in a scalable and low-cost way and reduce burden on health systems
Mental Health Implementation Network
The Mental Health Implementation Network aims to drive national collaborations and changes in mental health practice and is funded by the NIHR.
Patient preferences and experiences of waiting for heart surgery
Being on a waiting list for heart surgery could be difficult and anxiety-provoking.
Prescribing Antidepressants in Primary care: Ethnic inequalities in tReatment - The PAPER Study
This project aims to understand the treatment of depression in South Asian patients.
Recovery Colleges Characterisation and Testing (RECOLLECT)
To address how Recovery Colleges can provide the most benefit to people who use mental health services.
Research Cafés: Co-producing inclusive health research with diverse communities in integrated care systems
To understand how ‘research cafes’ can act as a mechanism for increasing the diversity of participation and involvement in research
Social Care Implementation Research (SC-ImpRes) guide
To implement the ImpRes tool and supplementary guide to support the design of implementation research.
The Effects of extreme heat events on mental health in vulnerable urban communities: Towards evidence-based policy and practice
To examine how extreme hot weather impacts population mental health and mental health services on those living in urban environments
Understanding And Measuring Dementia Stigma In Different Cultural Contexts
To advance the understanding of dementia stigma in different cultures
Understanding infectious disease mortality in people with severe mental illness
This project aims to answer a number of questions about the complex interplay between severe mental illness, different infections and external factors.
News
Public attitudes to mental health decline for the first time in 10 years
Research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and commissioned by Mind warns that public attitudes...
People with severe mental illness more than four times as likely to die from pneumonia compared to the general population
New research suggests that people with severe mental illness face an increased risk of death due to infectious disease.
Events
A Life Less Safe: invitation to a special screening at Brixton Ritzy
A film exploring the experiences of Black and other racially minoritised people living with severe mental health conditions during Covid-19.
Please note: this event has passed.
Completed projects
Emilia: assessing the WHO Mental Global Action Programme intervention guide for use on digital devices
The aim of the Emilia project was to assess if it is possible to produce an e-version of the World Health Organization (WHO) Mental Health Global Action Programme Intervention Guide (e-mhGAP IG) that is easily usable on smartphones and tablet devices by primary care staff in Nepal and Nigeria.
The project assessed if this electronic form of guidance is suitable for use in low and middle income countries (LMICs), where over 85 per cent of the world’s population live. The development of the e-mhGAP IG will offer significant improvements over the printed paper version by surpassing limitations such as slow and irregular updating, and creating new opportunities for remote supervision.
To evaluate fidelity, the researchers interviewed practice managers and service users who attended the clinics to assess their knowledge and their experience of how the e-mhGAP intervention guides is applied in practice by primary healthcare staff, and collect service user/patient service satisfaction data through a brief structured form. In each clinic the research team gathered patient service satisfaction data from all attending service users over three separate one-week periods.
This strategy allowed the researchers to evaluate implementation fidelity and its change over time. The study was led by Professor Sir Graham Thornicroft, working with colleagues in the Centre of Implementation Science and researchers from Nepal, Nigeria, Ethiopia and the WHO.
ASPIRES: reduction of surgical site infection rates and improved antibiotic prescription and utilisation in perioperative care globally
Researchers from the Centre for Implementation Science led on one of four work-packages of the global ASPIRES project (Antibiotic use across Surgical Pathways - Investigating, Redesigning and Evaluating Systems).
Funded by the ESRC, the project asked how can antibiotic use be optimised along the entire surgical pathway such that surgical outcomes improve. The approaches taken to address this question involved developing behavioural, structural and technological interventions which are context specific – and applied in hospital settings in India, Rwanda, South Africa and the UK.
The Friendship Bench: Optimizing implementation strategies of the first scale-up of a primary care psychological intervention for common mental disorders in Sub-Saharan Africa
This research was funded by the Medical Research Council (MRC) and was jointly led by Professor Ricardo Araya (Centre for Global Mental Health, King's College London) and Professor Dixon Chibanda (University of Zimbabwe). CIS provided health economic expertise.
The project evaluated the comparative performance of health clinics in Zimbabwe in terms of their success in implementing the Friendship Bench, a lay-worker-delivered psychological therapy for improving symptoms of depression and anxiety. This will be used as a basis for testing promising implementation strategies to maximize the reach, effectiveness, adoption, implementation, and maintenance of the Friendship Bench into the future.
ASSET: HeAlth System StrEngThening in Sub Saharan Africa: A five-year programme funded by the NIHR to address the “how to” component of bringing to scale complex interventions to achieve high-quality care for Universal Health Coverage
Centre scientists led on one of several work packages that constituted the ASSET global health research programme. Funded by the National Institute for Health Research (NIHR), ASSET was a Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa.
We were working in four countries; Ethiopia, South Africa, Sierra Leone and Zimbabwe; and across three healthcare platforms: integrated primary health care; maternal care and surgical care. Part of the Government’s wider Official Developmental Assistance (ODA) budget, the aim of this research was to improve the health of patients and public in low and middle-income countries.
CIS scientists led on the Improvement and Implementation cross-cutting work-group, aiming to strengthen and harmonise implementation strategies across ASSET countries and platforms.
Evaluating the HARPdoc trial – aimed at helping people with type 1 diabetes avoid hypoglycaemia
Researchers in the Centre of Implementation Science worked closely with researchers in CLAHRC South London’s diabetes theme to help them evaluate two new educational programmes aimed at helping people with type 1 diabetes to avoid hypoglycaemia.
This work was part of the ‘HARPdoc’ randomised controlled trial, which was designed to address the motivations and barriers to hypoglycaemia avoidance. It used educational and psychological techniques, such as motivational interviewing and cognitive behaviour theory delivered by specially trained diabetes educators to small groups of patients. The trial will compared two interventions designed to help change patients’ thoughts and behaviours around hypoglycaemia to improve detection, treatment and prevention.
Postdoctoral research associate Dr Tayana Soukup led a process evaluation of the HARPdoc trial, in collaboration with other implementation scientists in the Centre. ‘While the trial is concerned with understanding which intervention is more effective, the process evaluation is focused on understanding the way in which the programmes are implemented and assessing their impact at study sites. Ultimately the aim is to inform the scale-up of the effective programme after the trial is complete,’ said Dr Soukup.
EQUIP: Developing capacity and capability for perioperative improvement within UK urology training
Researchers from the Centre, the University of East Anglia and Barts Health, jointly with patients, medical education and improvement experts, trainees and the charitable Urology Foundation set up a training programme aiming to provide urology trainees across the UK with the skills and expertise they need to carry out successful and impactful quality improvement projects as part of their training rotations.
Launched in 2017, the ‘Education in Quality Improvement Programme’ (EQUIP) was a research project supported by the Urology Foundation at the interface of improvement and implementation sciences and surgical education. The programme aimed to develop an evidence-based, user-informed, practical and scalable quality improvement skills training curriculum for urology trainees surgical residents in the UK.
To-date, EQUIP has: (i) delivered a review of published evidence regarding how best to teach improvement skills to healthcare personnel; (ii) designed a pragmatic core improvement skills curriculum for urology trainees, deliverable within half a day of face to face teaching. The curriculum has been evaluated and found feasible and offering positive immediate educational impact; (iii) carried out a national needs assessment across urology training programmes in the UK.
Further project aims EQUIP researchers were to: (i) develop a train-the-trainers approach to facilitate the scale-up of the EQUIP curriculum nationally in the UK; (ii) establish national consensus regarding the requirements of trainee improvement projects, in terms of project scope and quality assurance criteria; (iii) develop a national web portal for the sharing of trainees’ improvement projects at national level; (iv) explore the potential for EQUIP to reach out to surgical specialities outside urology.
Using smartphone technology to enhance patient safety in surgical care
Research suggests that around one in ten patients entering NHS hospitals will experience an unintended error (termed an ‘adverse event’) in their care. These events can result in harm and have catastrophic implications, not only for the patient and their family, but for the healthcare staff involved and for the NHS organisation as a whole (at both a reputational and financial level).
Adverse event rates are higher for surgery than other healthcare specialties. This may be a reflection of the risk profile of the patients receiving surgery; the complexity of the procedure and/or the operating theatre environment; or simply higher rates of reporting errors by surgical staff. Either way, improving surgical safety is a priority for NHS England.
This research project aimed to explore how we can effectively translate what the evidence tells us about the causes of error in surgery into a format that patients can use to improve their safety. Specifically, the project looks at the use of smartphone apps to address this problem.
An app, called MySurgery, has been designed to help patients and their carers understand the risks associated with having surgery and inform them of the specific actions they can take to improve their safety and recovery.
Improving safety and quality in mental healthcare
A team of Centre for Implementation Science experts was involved in this doctoral project, aimed at the interface of patient safety and improvement sciences.
Funded by the Healthcare Improvement Studies Institute (THIS) for three years (2019-22), the project (i) studied the nature of safety and quality of care problems that mental health patients face, (ii) shortlisted potential interventions to address these, and (iii) conducted a proof-of-concept investigation of at least one of these interventions.
The project utilised a range of methods – including: evidence review to identify the nature and scale of the problem within mental health services; rapid ethnography and further qualitative methods to establish the views of providers, patients and their carers and families; and a multi-stakeholder approach to intervention development, implementation and evaluation, to evaluate interventions that are potentially effective in improving patient safety in this patient population.
The project was carried out in close collaboration with the South London and Maudsley NHS Foundation Trust.
The concept and determinants of return on investment for quality improvement in mental health NHS Foundation Trusts
Researchers in the Centre for Implementation Science developed a measurement system for evaluating return on investment (ROI) of quality improvement projects in mental health services of the South London and Maudsley NHS Foundation Trust.
Quality improvement in healthcare has seen a surge of investment amidst times of austerity in the UK. Very little guidance exists for evaluating return on investment, particularly in mental health NHS Foundation Trusts. This impedes communication with healthcare leaders and boards regarding the extent to which quality improvement is achieving its full potential within the organisation.
A robust ROI measure makes it possible to generate regular reports for healthcare leaders which can be used to give them strategic insights and inform their decisions about investment strategies for capacity building, training and support. The research is supported through a London Interdisciplinary Social Science Doctoral Training Partnership.
Advance Statements for Black African and Caribbean people (AdStAC)
● Aim: To improve Black service users’ experiences in mental health services in South London by co-producing and testing an advance choice document (ACD) implementation resource with Black service users, mental health professionals and carers/supporters of Black service users.
● Project Lead: Professor Claire Henderson
BME Faith Communities and Mental Health Care
● Aim: To address healthcare disparities for the Black community in Southwark and Lambeth.
● Project Lead: Professor Claire Henderson
Culturally Adapted Family Therapy for Psychosis (CAFI)
● Aim: To evaluate the effectiveness of Culturally-adapted Family Intervention (CaFI) for Black and Mixed heritage people diagnosed with schizophrenia or psychosis and their families
● Project Lead: Professor Claire Henderson
Every Mind Matters Campaign Evaluation
● Aim: To enhance mental health literacy in the adult population of England
● Project Lead: Professor Claire Henderson
International study of discrimination and stigma outcomes (Indigo)
● Aim: To develop and test stigma reduction methods in China, Ethiopia, India, Tunisia, and Nepal. Additionally, the research aims to enhance scientific understanding of how individuals with mental illness experience stigma.
● Project Lead: Professor Sir Graham Thornicroft
Lifeguard Pharmacy
● Aim: To develop and pilot a training package and service to enable community pharmacies to respond to people in danger from domestic violence or feeling suicidal
● Project Lead: Professor Claire Henderson
Time to Change Anti-Stigma Program Evaluation
● Aim: Population-level program targeting mental health stigma reduction in England
● Project Lead: Professor Claire Henderson
Our Partners
Group leads
Clinical Professor of Public Mental Health
Professor of Public Mental Health and Statistics