Dr Ian Litchfield PhD

Ian Litchfield

Institute of Applied Health Research
Research Fellow

Contact details

IOEM Building
University of Birmingham
B15 2TT

Ian Litchfield is a Research Fellow in the Institute of Applied Health Research, University of Birmingham, with a background in occupational medicine and interests in health service delivery. He uses qualitative and quantitative research methods in the evaluation of service delivery interventions in both primary and secondary care. Ian leads the research group, Service Redesign in Primary Care and Hospital Settings with a particular interest in applying engineering principles in improving the quality and safety of care. He uses collaborative improvement methodologies, with a variety of stakeholders to design, implement, and evaluate strategies for improved health care delivery.


  • PhD in Occupational Medicine 2007
  • MSc in Environmental Monitoring 1993
  • BSc in Biological Sciences (hons) 1990


Deputy Programme Lead MSc in Occupational Health

  • Lectures on research methods MSc in Occupational Health
  • Module lead Safety Technology Module MSc Safety, Health and the Environment
  • Lectures on evaluation methodologies MSc Safety, Health and the Environment
  • Dissertation supervisor (>25)

IAHR/Computer Science - Building on the close links with Computer Science a collaborative MSc Programme has begun, completed dissertations include: 

  • Developing a dashboard for laboratory reports 
  • Creation of a mapping tool for health care pathways

Postgraduate supervision

Current PhDs

  • The use of process improvement methodologies to better equip receptionists for their clinical role in General Practice. PhD Fellowship funded by the Health Foundation Trust
  • Models of care for multi-morbidity in the UK: A mixed methods evaluation


Ongoing projects include:

  • Automated conflict resolution in clinical pathways (EPSRC)
  • The National Register of RF Workers (Industry/HSE)
  • Supporting adults with Type 1 Diabetes (T1DM) to undertake exercise; Developing and piloting an Education programme for exercise in Type-1 diabetes EXTOD (RfPB)
  • Treatment of Fatigue with physical Activity and Behavioural change support in Vasculitis – feasibility study FAB-V study (Arthritis Research UK)
  • The use of process mining in primary health care to automatically determine car pathways (BSol CCG)
  • General practice receptionists' attitudes to and experiences of patient triage (Dudley CCG)
  • The use of Patient Report Outcomes in the management of long term, chronic conditions in Primary Care (Wellcome Trust).

Recent projects include

  • Implementing and evaluating a patient safety toolkit in primary care (National School Primary Care).
  • Exploring the role of primary care clinicians in preventing Hospital Associated VTE. (NIHR).
  • MyDay: A personalised schedule of care events for inpatients (Health Foundation) 
  • The use of rapid approach analysis in the evaluation of complex interventions (CLAHRC)
  • Hydrate 4 health: The use of an assistive drinking device in improving hydration in secondary care settings (West Midlands Academic Health Science Network)
  • The PEGASUS study. A feasibility study and open pilot two-arm randomised controlled trial comparing Pressure Garment Therapy with no Pressure Garment Therapy for the prevention of abnormal scarring after burn injury (HTA).
  • Study for the improvement of test result communication in Primary Care (RfPB)
  • Qualitative study of non-clinical motives in test ordering behaviour of GPs (HTA )
  • Environmental Nitric Oxide and Respiratory Syncytial Virus Epidemics (Abbot Pharmaceuticals, Sheffield Children’s Hospital)
  • Impact of air pollution on sudden infant death syndrome (The Lullaby Trust)




Addressing the transition to a chronic condition: exploring independent adoption of self-management by patients with ANCA-associated vasculitis, Ian Litchfield, Sheila Greenfield, Lorraine Harper, the FAB(V) Trial team, Rheumatology Advances in Practice, Volume 5, Issue 3, 2021, rkab075,

Types of laser injury by occupation and their prevalence: a systematic review T, Chawpoonperism, I Litchfield Dis Control J Vol 47 No. 3 Jul – Sept21 

Impact of COVID-19 on the digital divide: a rapid reviewLitchfield I, Shukla D,. Greenfield S, BMJ Open 2021;11:e053440. doi: 10.1136/bmjopen-2021-053440

From policy to patient: Using a socio-ecological framework to explore the factors influencing safe practice in UK primary careLitchfield I, Perryman K, Gill P, Campbell S, Avery T, Greenfield S,. Soc Sci Med. 2021 May;277: 113906

A comparative assessment of two tools designed to support patient safety culture in UK general practice Litchfield I PK, Marsden K, Doos L, Avery T, Greenfield S. BMC Fam Pract. 2021 May 21;22(1):98.

Implementing PROMS in routine clinical care: A qualitative exploration of GP perspectives. Litchfield I,  Greenfield S, Turner GM,  Finnikin S, Calvert MJ. BJGP Open 2021 Feb 23;5(1)

Medpath: A process-based modelling language for designing care pathways Trajano IA, Ferreira Filho JB, de Carvalho Sousa FR, Litchfield I, Weber P. Int J Med Inform. 2021 Feb;146:


Management of fatigue with physical activity and behavioural change support in vasculitis: a feasibility study Harper, L.Hewitt, C.Litchfield, I., et al, Rheumatology  (In press).

Barriers to evidence-based treatment of serious burns: The impact of implicit bias on clinician perceptions of patient adherence. Litchfield I, Moiemen N, Greenfield S.J Burn Care Res. 2020 Jul 10:iraa114. doi: 10.1093/jbcr/iraa114. Online ahead of print.

Development of the prototype concise safe systems checklist tool for general practice. Litchfield I, Spencer R, Bell BG, Avery A, Perryman K, Marsden K, Greenfield S, Campbell S.BMC Health Serv Res. 2020 Jun 16;20(1):544. doi: 10.1186/s12913-020-05396-y.

General practitioners' views on use of patient reported outcome measures in primary care: a cross-sectional survey and qualitative study. Turner GM, Litchfield I, Finnikin S, Aiyegbusi OL, Calvert M.BMC Fam Pract. 2020 Jan 24;21(1):14. doi: 10.1186/s12875-019-1077-6.

A quantitative assessment of the parameters of the role of receptionists in modern primary care using the work design framework.Burrows M, Gale N, Greenfield S, Litchfield I.BMC Fam Pract. 2020 Jul 10;21(1):138. doi: 10.1186/s12875-020-01204-y.

Automated Verification of Care Pathways Using Constraint Programming.De Figueiredo RP, Ferreira Filho JB, Sousa FRC, Weber P, Litchfield I.IEEE J Biomed Health Inform. 2020 Feb 28. doi: 10.1109/JBHI.2020.2977032. Online ahead of print.

Development of a group structured education programme to support safe exercise in people with Type 1 diabetes: the EXTOD education programme.Narendran P, Greenfield S, Troughton J, Doherty Y, Quann N, Thompson C, Litchfield I, Andrews RC; EXTOD Education Programme Development Team.Diabet Med. 2020 Jun;37(6):945-952. doi: 10.1111/dme.14064. Epub 2019 Jul 31


Patient and Healthcare Professionals Perspectives on the Delivery of Exercise Education for Patients With Type 1 Diabetes. Litchfield I, Andrews RC, Narendran P, Greenfield S. Front Endocrinol. 2019 Feb 19;10:76.

The role of self-management in burns aftercare: a qualitative research study; Litchfield I, Greenfield S, Jones L, Mathers J Burns  Burns. 2019 Jun;45(4):825-34. https://doi.org/10.1016/j.burns.2018.10.020

Development of a group structured education programme to support safe exercise in people with Type 1 diabetes: the EXTOD education programme. Narendran, P., Greenfield, S., Troughton, J., Doherty, Y., Quann, N., Thompson, C., Litchfield, I., Andrews, R. C., & EXTOD Education Programme Development Team (2020). Diabetic medicine : a journal of the British Diabetic Association37(6), 945–952. https://doi.org/10.1111/dme.14064


Automated conflict resolution between multiple clinical pathways: a technology report, Litchfield I, Turner A, Backman R, et al BMJ Health & Care Informatics 2018;25:doi: 10.14236/jhi.v25i3.986

Can process mining automatically describe care pathways of patients with long-term conditions in UK primary care? A study protocol I. Litchfield, C. Hoye, D. Shukla, R. Backman, A. Turner, M. Lee, P. Weber. BMJ Open 2018;8:e019947. doi: 10.1136/bmjopen-2017-019947 

The Impact of Status and Social Context on Health Service Co-Design: An Example from a Collaborative Improvement Initiative in UK Primary Care Litchfield I, Bentham L, Hill A, McManus RJ, Lilford R, Greenfield S BMC Med Res Methodol. 2018;18(1):136. Published 2018 Nov 16. doi:10.1186/s12874-018-0608-5

Is ambient air pollution associated with onset of sudden infant death syndrome: a case-crossover study in the UK. Litchfield IJ, Ayres JG, Jaakkola JJK, et al.BMJ Open 2018;8:e018341. doi: 10.1136/bmjopen-2017-018341

A qualitative study exploring staff attitudes to maintaining hydration in neurosurgery patients Litchfield IJ, Magill L, Flint G Nursing Open 2018 https://doi.org/10.1002/nop2.154

Influences on the adoption of patient safety innovation in primary care: A qualitative exploration of staff perspectives Litchfield I; Gill P; Avery A;  Campbell S et al BMC Family Practice. BMC Family Practice. 2018;19:72. doi:10.1186/s12875-018-0761-2.

Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? A mixed methods study comparing rapid and thematic analysis Taylor B, Henshaw C, Litchfield I, Kenyon S, Greenfield S  BMJ Open 2018;8:e019993. doi: 10.1136/bmjopen-2017-019993

Automated conflict detection between medical care pathways Weber, Philip; Filho, João Bosco Ferreira; Bordbar, Behzad; Lee, Mark; Litchfield, Ian; Backman, Ruth Journal of software : evolution and process. , 2018, Vol.30(7), p.e1898

A Patient Safety Toolkit for Family Practices.Campbell SM, Bell BG, Marsden K, Spencer R, Kadam U, Perryman K, Rodgers S, Litchfield I, Reeves D, Chuter A, Doos L, Ricci-Cabello I, Gill P, Esmail A, Greenfield S, Slight S, Middleton K, Barnett J, Moore M, Valderas JM, Sheikh A, Avery AJ.J Patient Saf. 2018 Feb 15. doi: 10.1097/PTS.0000000000000471.

Pressure garment to prevent abnormal scarring after burn injury in adults and children: the PEGASUS feasibility RCT and mixed-methods study. Moiemen N, Mathers J, Jones L, Bishop J, Kinghorn P, Monahan M, Calvert M, Slinn G, Gardiner F, Bamford A, Wright S, Litchfield I, Andrews N, Turner K, Grant M, Deeks J.Health Technol Assess. 2018 Jun;22(36):1-162. doi: 10.3310/hta22360.


Adaption, implementation and evaluation of collaborative service improvements in the testing and result communication process in primary care from patient and staff perspectives: a qualitative study Litchfield IJ,Bentham, LM, Lilford RJ, McManus RJ, Hill A, Greenfield S BMC Health Services Research 2017 Aug 30;17(1):615

Radiofrequency exposure amongst employees of mobile network operators and broadcasters Litchfield I, van Tongeren M, Sorahan T, Radiation Protection Dosimetry Volume 175, Issue 2, 15 June 2017, Pages 178–185

The future role of receptionists in primary care Litchfield IJ, Gale N, Burrows M, Greenfield S Br J Gen Pract 2017; 67 (664): 523-524

Clinical reminder alert fatigue in healthcare: a systematic literature review protocol using qualitative evidence. Backman R, Bayliss S, Moore D, Litchfield I. Systematic Reviews. 2017;6:255. doi:10.1186/s13643-017-0627-z.


Patients' perceptions and experiences of the prevention of hospital-acquired thrombosis: a qualitative study Apenteng PN, Fitzmaurice D, Litchfield I, et al BMJ Open 2016;6

Factors influencing improved attendance in UK Firefighters   Litchfield I, Hinckley P Occupational Medicine 2016 Dec; 66(9): 731–736

A protocol for the use of process improvement methodologies to explore primary care receptionist work Litchfield I, Gale N, Burrows M, Greenfield S BMJ Open (2016);6

Factors influencing the prevention of hospital acquired thrombosis: A primary care perspective Litchfield IJ, Fitzmaurice D, Apenteng P, Harrison S, Heneghan C, Ward A, Greenfield S, British Journal of General Practice 2016: 66: 421-422

Preliminary Assessment of the Role of Ambient Nitric Oxide Exposure in Hospitalization with Respiratory Syncytial Virus Mohammed, N. I., Everard, M. L., Ayres, J. G., Barker, N. J., & Litchfield, I. J. (2016). International journal of environmental research and public health, 13(6), 578.

Selected 2015 and earlier

Patient perspectives on test result communication in primary care: a qualitative study Litchfield IJ, Bentham L, Lilford RJ, Greenfield S.Br J Gen Pract 2015;March;65(632)118 

Test result communication in primary care – a survey of current practice. Litchfield IJ, Bentham L, Lilford RJ, Hill A, McManus R Greenfield S. BMJ Qual Saf. 2015 Nov;24(11):691-9.

Patient perspectives on test result communication in primary care: a qualitative study Litchfield IJ, Bentham L, Hill A, Lilford RJ, McManus R, Greenfield S. Br J Gen Pract 2015;March;65(632)118

National Register of Radiofrequency Workers: Exploring health effects of occupational radiofrequency radiation exposure. Litchfield IJ. J Environ Occup Sci. 2014; 3(4): 190-192

Test result communication in primary care: clinical and office staff perspectives. Litchfield IJ, Bentham L, Lilford RJ, McManus R, Greenfield S.  Fam Pract. 2014; Oct;31(5):592-7.

A qualitative exploration of the motives behind the decision to order a liver function test in primary care. Litchfield IJ, Lilford RJ, Bentham LM, Greenfield SM.  Qual Prim Care. 2014 Aug;22(4)


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