Health care improvement research
This research theme is about how to get evidence into routine practice: specifically the development and use of clinical practice guidelines and performance measures. Tim’s interest is in understanding and promoting how research findings become embedded in routine health care in clinical, organisational and policy contexts.
Tim has conducted a number of systematic reviews in this area and is co-investigator on several ongoing NIHR funded studies that aim to promote the development of more rigorous NICE guidance and better implement clinical guideline recommendations in primary care:
• Are NICE clinical guidelines for primary care based on evidence from primary care? (PI: Nick Steele, University of East Anglia; NIHR Research for Patient Benefit Programme)
• Informing the development of NICE Quality Standards through secondary analysis of qualitative, narrative interviews on patient experiences (PI: Sue Ziebland, University of Oxford, NIHR Health Services and Delivery Research Programme)
• Targeted and sustainable implementation of high impact clinical practice recommendations in general practice (ASPIRE)” (PI: Robbie Foy, University of Leeds, NIHR Programme Grant for Applied Research)
Patient – practitioner relations research
A second research theme is practitioner-patient relations in primary care, including continuity of care, personal care and ‘difficult’ doctor-patient relationships. A key element of this work has been collaboration with social scientists and the conduct of theoretically informed qualitative research. His PhD research, funded by the Royal College of General Practitioners, argues that the removal of a patient from a GP’s list offers insight into the ending of the doctor-patient relationship both in terms of implications for GP practices and in advancing social theory in this area.
Postdoctoral research has addressed:
• the nature of professional-patient encounters in patients dying from malignant and non malignant (COPD/Heart Failure) disease in primary care
• patients’ expectations of care provided by nurse practitioners and general practitioners
• GPs’ views on continuity of care through an international survey
• the use of game theory to understand GP-patient encounters over time (PhD student supervision)