Dr Ian Litchfield PhD

Dr 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


Testing Times: Handling your blood test results

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)




Research Articles

The role of self-management in burns aftercare: a qualitative research study; Litchfield I, Greenfield S, Jones L, Mathers J Burns In press

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.

Automated conflict resolution between multiple clinical pathways: A technology report   I. Litchfield, C. Hoye, D. Shukla, R. Backman, A. Turner, M. Lee, P. Weber. J Innov Health Inform. 2018;25(3):142–148.

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 

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

The Impact of Status and Social Context on Health Service Co-Design: An Example from a Collaborative Improvement Initiative in UK Primary Care Litchfield IBentham 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.

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

Below the surface: Parents' views on the factors that influence treatment adherence in paediatric burn scar management - A qualitative study. Andrews N, Jones LL, Moiemen N, Calvert M, Kinghorn P, Litchfield I, Bishop J, Deeks JJ, Mathers J; PEGASUS Study Group. Burns. 2017 Oct 11

Patients' evaluations of patient safety in English general practices: a cross-sectional study.  Ricci-Cabello I, Marsden KS, Avery AJ, Bell BG, Kadam UT, Reeves D, Slight SP, Perryman K, Barnett J, Litchfield I, Thomas S, Campbell SM, Doos L, Esmail A, Valderas JM.  Br J Gen Pract. 2017 Jul;67(660):e474-e482.

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

Automated Conflict Detection Between Medical Care Pathways, P. Weber, J. B. F. Filho, B. Bordbar, M. Lee, I. Litchfield and R. Backman.  Journal of Software: Evolution and Process, Special Issue: Software Engineering for Connected Health, October 2017 https://doi.org/10.1002/smr.1898

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

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

Patients' perceptions and experiences of the prevention of hospital-acquired thrombosis: a qualitative study. Apenteng PN, Fitzmaurice D, Litchfield I, Harrison S, Heneghan C, Ward A, Greenfield S.  BMJ Open. 2016 Dec 13;6(12):e013839..

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.

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

Routine failures in the process for blood testing and the communication of results to patients in primary care: a qualitative exploration of patient and provider perspectives. Litchfield IJ, Bentham L, Hill A, Lilford RJ, McManus R, Greenfield S. BMJ Qual Saf. 2015 Nov;24(11):681-90.

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

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.

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):201-10.

Birmingham and Lambeth Liver Evaluation Testing Strategies (BALLETS): a prospective cohort study. Lilford RJ, Bentham L, Girling A, Litchfield IJ, Lancashire R, Armstrong D, Jones R, Marteau T, Neuberger J, Gill P, Cramb R, Olliff S, Arnold D, Khan K, Armstrong MJ, Houlihan DD, Newsome PN, Chilton PJ, Moons K, Altman D. Health Technol Assess. 2013 Jul;17(28): i-xiv, 1-307 

Clinical and economic assessment of different general population strategies of pertussis vaccine booster regarding number of doses and age of application for reducing whooping cough disease burden: a systematic review.  Rodríguez-Cobo I, Chen YF, Olowokure B, Litchfield I. Vaccine. 2008 Dec 9;26(52):6768-76. doi: 10.1016/j.vaccine.2008.09.042. Epub 2008 Oct 7. Review

Assessment of occupational exposure to radiofrequency fields and radiation. Cooper TG, Allen SG, Blackwell RP, Litchfield I, Mann SM, Pope JM, van Tongeren MJ. Radiat Prot Dosimetry. 2004;111(2):191-203.


Time to get to grips with the invisible enemy of RF radiation Litchfield IJ Institute of Engineering and Technology February 2018

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

Protocol papers

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.

Burrows M, Gale N, Greenfield S, Litchfield I. Exploring the clinically orientated roles of the general practice receptionist: a systematic review protocol. Systematic Reviews. 2017;6:209. doi:10.1186/s13643-017-0612-6.

Assessing the extent of drug interactions amongst patients with multimorbidity in primary and secondary care in the West Midlands (UK): A study protocol for the Mixed Methods Multimorbidity Study (MiMMS). R. Backman, P. Weber, A. M. Turner, M. G. Lee and I. LitchfieldBMJ Open, 7(9):e016713 (8 pages), 2017. 

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


MyDay@QEHB – a personalised schedule of care events for inpatients

Conference proceedings

P. Weber, R. Backman, I. Litchfield and M. Lee. A Process Mining and Text Analysis Approach to Analyse the Extent of Polypharmacy in Medical Prescribing. Accepted to the 6th International Conference on Healthcare Informatics (ICHI 2018), New York, NY, USA, 2018.

I. Litchfield, A. Turner, R. Backman, P. Weber and M. Lee. Automated Conflict Resolution between multiple Clinical Pathways: An Aid for Family Practitioners, 45th North American Primary Care Research Group (NAPCRG) Annual Meeting, Montreal, Quebec, 2017 (Poster PDF).

Litchfield I et al Developing and improving a systems approach to diagnostic safety in primary care ISQua  London 2017

P. Weber, J. B. F. Filho, B. Bordbar, M. Lee, I. Litchfield and R. Backman.  Automated Conflict Detection Between Medical Care PathwaysIn N. Carroll, C. Kuziemsky and I. Richardson (Eds.), Software Engineering for Connected Health (Journal First Session), Proc. International Conference on Software and System Process (ICSSP), Paris, France, 2017. (DOIslides).

I. Litchfield, J. Bowles, B. Bordbar, A. Turner, R. Backman, P. Weber, M. Caminati and M. Lee. Automated Conflict Resolution between multiple Clinical Pathways: An Aid for Family Practitioners, 3rd West Midlands Health Informatics Network (WIN) Conference, Warwick, UK, 2017.

Book Chapter

Litchfield IJ, Dockery DW, Ayres JG. (2010), Health effects of Air pollution: Acute and chronic  In: Ayres JG, Marrison RM, Nichols GL, Maynard RL (eds.)  Environmental Medicine. London: Hodder Education pp141-153

View all publications in research portal