Hamish Laing

Swansea University | SWAN · School of Management

To develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges. Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical model for an OBA i...

Details Abstract Title Using PROMs to optimise ambulatory management and improve outcomes for patients with Heart Failure

Objective To develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges. Methods Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical...

An extended version of the UTAUT model is tested in the context of the utilisation of services' user feedback in healthcare. The aim is to investigate the effect of seven factors on professionals' and managers' intention to use patient feedback as possible determinants. The factors are performance expectancy, effort expectancy, social influence, fa...

Purpose: Outcome-based pricing models which consider domains of value not previously considered in healthcare, such as societal outcomes, are of increasing interest for healthcare systems. Societal outcomes can include family-reported outcome measures (FROMs), which measure the impact of disease upon the patient’s family members. The FROM-16 is a g...

https://www.europeanallianceforvalueinhealth.eu/library/a-compass-for-collaboration-navigating-stakeholders-roles-in-transitioning-to-value-based-healthcare/

User feedback is crucial for improving service quality and innovation across various sectors, including healthcare. This study focuses on understanding the determinants that prevent or encourage healthcare professionals and managers to use user feedback. To explore these determinants, we adopted the Unified Theory of Acceptance and Use of Technolog...

Objective To evaluate the feasibility of recruiting participants diagnosed with atrial fibrillation (AF) taking oral anticoagulation therapies (OATs) and recently experiencing a bleed to collect health-related quality of life (HRQoL) information. Design Observational feasibility study. The study aimed to determine the feasibility of recruiting par...

This report covers a project commissioned by the Welsh Government to develop a Minimum Digital Living Standard for Wales (W-MDLS). It builds on a UK wide project funded by the Nuffield Foundation and Nominet to develop a UK Minimum Digital Living Standard (MDLS). In developing an MDLS for Wales we are examining one of the key issues that the pa...

Objectives: Outcome-based agreements (OBAs) have the potential to align incentives of payers and providers of therapeutics around patient and population health. Many barriers prevent their routine implementation, including translation of clinical outcomes into financial parameters for reimbursement. Assessing variable type, weighting, volatility, a...

IntroductionHealthcare systems face rising demand and unsustainable cost pressures. In response, health policymakers are adopting Value-Based Health Care (VBHC), targeting available resources to achieve the best possible patient outcomes at the lowest possible cost and actively disinvesting in care of low-value. This requires the evaluation of long...

Background Oral anticoagulation therapies (OATs) are often prescribed in conjunction with medications to restore normal heart rate rhythm which can limit the risk of an atrial fibrillation (AF) related stroke and systemic thromboembolism. However, they are associated with the serious side effect of bleeding. Both clinically relevant nonmajor bleedi...

Background Advance Therapeutic Medicinal Products (ATMPs) are a novel class of therapeutics to provide more effective treatment of conditions or diseases that have not responded to conventional treatment. However, ATMPs are generally very expensive, limiting their availability. Indicated conditions are usually chronic and severe and can have an imp...

Objectives The aim was to outline the challenges of implementing outcomes-based contracts (OBCs) in Europe.MethodsA scoping review was conducted, building on the searches of a previous systematic review and updating them for December 2017 until May 2021. The combined results were screened, based on inclusion and exclusion criteria. All identified s...

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia. Oral anticoagulation therapies (OATs) are often prescribed in conjunction with medications to restore normal heart rate rhythm which can limit the risk of an AF-related stroke and systemic thromboembolism. However, they are associated with the serious side effect of bleeding...

The UK Government-funded National Health Service (NHS) is experiencing significant pressures owing to the complexity of challenges to, and demands of, healthcare provision. This situation has driven government policy level support for transformational change initiatives, such as Value-Based Health Care (VBHC), through closer alignment and collabora...

Background Achilles tendinopathy is a common pathology that is considered difficult to treat. At a time of austerity in the NHS it is essential to have carefully designed pathways that are monitored in terms of cost and effectiveness. However, a paucity of evidence exists for what the “best value” dedicated “joined up” pathway of care is for this d...

Purpose. We report a technique of finite-element multidimensional modeling that was used to help with the planning of and the resection of an angiosarcoma in a single patient. Description. A patient was referred to our department with suspected aortic angiosarcoma. We visualized and reconstructed the computed tomography and magnetic resonance imagi...

To promote early diagnosis of cancer, NICE published updated guidelines ‘Suspected cancer: recognition and referral – NICE guidelines NG 12 in June 20151. It is our opinion that the new guidelines on sarcomas need urgent review/update to provide clarity on recognition and referral and our response was published on 26th July 20152 Soft tissue lumps...

We present a case of successful artery only total nose replantation in an 18-month-old child, with 10 years of follow-up and full sensory recovery despite no nerve repair. The common absence of veins for anastomosis does not prevent successful replant, as demonstrated with the use of Hirudo medicinalis use in this unique case. We comprehensively re...

Introduction: Significant controversy surrounds the effectiveness of negative pressure wound therapy although it has been in use for decades. Although many clinicians favor this modality in relation to its practicality, ease of use especially in complex wounds, it has faced the same challenges as other dressings in relation to evidence base of eff...

Health Commission Wales (Specialist Services) [HCW] are responsible for resource allocation and demand management in plastic surgery for the population of Wales (2.9 M). Since 2004, all low priority plastic surgery referrals have been screened by a single HCW Case Officer against clinical inclusion criteria before the referral is passed to the prov...

A syndrome now known as Ehlers-Danlos, comprising laxity and fragility of the skin associated with hypermobility of the large joints, was published in 1892 by Tschernogobow. Ehlers-Danlos type VIIA is an extremely rare form of the syndrome. While the UK-based Ehlers-Danlos Support Group recommends that the surgical management of patients with Ehler...

We report a case of congenital constriction band of abdomen associated with limb pseudarthrosis. The constriction band around the abdomen, though may cause initial difficulty with ventilation and parental distress, does not interfere with feeding, bowel movements, and growth. It heals spontaneously with supportive treatment though surgery may be ne...

Hand injuries are the main cause of work-related disability in young adults. We have devised the Modified Hand Injury Scoring System to quantify hand, wrist and forearm injuries. This study aims to determine its value in predicting ability and time taken to return to work after such injury. Prospectively-assigned MHISS at presentation was compared...

Acute injury to the flexor and extensor tendons in the hand and forearm is common and requires careful assessment and management. A sound knowledge of the functional anatomy, allied with good surgical technique, is essential. Flexor tendon injuries are often associated with neurovascular injury, which must be examined for. Extensor injuries may inv...

There is little information in the literature regarding the clinical features, investigation, diagnosis and treatment of closed rupture of the deep transverse metacarpal ligament. We demonstrate a case with previously undescribed features and describe the surgical management.

We report a prospective study examining the prognostic significance of the c-myc oncoprotein, p53 tumour suppressor gene and proliferation rate measurements in malignant melanoma. Flow cytometry (FCM) was used to measure the expression of c-myc, p53 and proliferation parameters in patients who had received an injection of the thymidine analogue bro...

The perceived benefits of bandaging for 10 days following pinnaplasty have been questioned by previous studies. The problems arising from these dressings are many [Powell BWEM. The value of head dressings in the postoperative management of the prominent ear. Br J Plast Surg 1989; 42:692–4. Bartley J. How long should ears be bandaged after otoplasty...

As the population ages, more elderly patients are being selected for day surgery. We attempted to investigate any historical change in the proportion of day case plastic surgical procedures undertaken in the very elderly and to examine outcomes in this group. A retrospective analysis of postoperative complications, unanticipated admission and in-ho...

Vascular malformations are not often considered in the differential diagnosis of digital lesions presenting acutely, but they do occur, and can present difficulties in diagnosis leading to delays in definitive treatment. We highlight the challenges in managing such patients, who often require multi-disciplinary and multi-centre care, and we hope to...

To describe the management of neonatal accessory digits, comparing views of paediatricians with those of hand surgeons, giving particular emphasis to the form of partial, ulnar duplication of the little finger (ulnar or postaxial polydactyly type B) which has a narrow pedicle. Postal questionnaire of management preference using three photographs of...

This prospective study investigated the clinical significance of cell kinetics, measured using bromodeoxyuridine injection and flow cytometry, in primary and metastatic cutaneous malignant melanoma. The findings illustrate that melanoma is a relatively slowly proliferating tumour, with a median potential doubling time (T(pot)) of 8.6 days. There we...

A case of a degloving injury to the foot is presented in a patient who also sustained severe contralateral lower-limb trauma. We report a technique for salvaging the foot by replacing the degloved skin as a full-thickness graft and securing it using the vacuum-assisted closure (VAC) device. A good outcome was achieved and technical tips are provide...

Accurate coding is essential for local and national data reporting and for contracting. It is also integral to clinical governance. This study aimed to assess the accuracy of coding in Morriston Hospital plastic surgery theatres and coding office, to reaudit and address poor practice. A third coding system, a computerised logbook developed by the s...

L

More than 200 surgical techniques have been advocated for hypospadias repair and perfection is still eluding us. The purpose of this paper is not to comment on a surgical technique, but to highlight the importance of postoperative care on the eventual surgical outcome. Two hundred six children undergoing primary hypospadias surgery from 1984 to 199...

A surgical technique has been developed for the correction of established unilateral palsy in man. A long (20 cm or more) sural nerve graft is anastomosed to a facial nerve branch on the unaffected side and its distal end left lying free in the cheek of the affected side. After regeneration times of 5.5-14.5 months, the distal end of the graft is j...

To study the relation between traumatic birth and the development of permanent facial palsy in the newborn. Retrospective case control study of children with 'congenital' facial palsy. Two tertiary referral centres for patients with facial palsy. 61 children with established facial palsy. Odds ratios of recognised factors for birth injury: maternal...

Otoplasty is popular in the United Kingdom to relieve the teasing that prominent ears provoke. “Bat ears,” “wing nut,” and “Dumbo” are common in the English vernacular. In China, physiognomists consider that prominent ears indicate the need “to draw on inner reserves of strength and ability,”1 and Hindus find them desirable because of …

Cutaneous malignant melanoma (CMM) is a recognized feature of the Lynch type II cancer-family syndrome and the Li-Fraumeni's syndrome. A significant contribution of these syndromes to the total burden of CMM would be reflected in an increased risk of nonmelanoma cancers in first degree relatives. Pedigrees were taken from 85 patients with CMM using...

Concern about the use of silicone gel as a filler for breast prostheses has stimulated interest in other materials. We have evaluated the Misti Gold prosthesis which contains a "bio-oncotic" gel of low molecular weight Polyvinylpyrrolidone (PLASDONE 24AUK). Our experience of its use in breast augmentation is that the aesthetic results obtained with...

We have examined proliferative activity in a series of pilar and trichilemmal cysts using an antibody to proliferating cell nuclear antigen. In benign lesions proliferative activity was confined to the basal layers of the squamous epithelium. Lesions showing malignant change showed increased proliferative activity and were not confined to the basal...

The two techniques of flow cytometry analysis (FCM) and immunohistochemical localisation of bromodeoxyuridine (BrdUrd) incorporation after in vivo administration, were combined to study proliferation in squamous cell carcinoma of the head and neck region. Care was taken in this study to ensure that similar material was processed using both techniqu...

The increased frequency of total knee replacement arthroplasty (TKRA) has been reflected in the number of patients with exposed prostheses referred to this unit. An algorithm has been developed to assist in the preoperative assessment of the wound and this has been tested on 25 patients with wound breakdown following TKRA. The grade of exposure so...

Accurate assessment of the extent of thermal injury in the accident and emergency (A&E) department is essential if appropriate resuscitation and referral to a specialist unit is to occur. However, review of 100 referrals to a regional burns unit confirms that assessment is often inaccurate, and usually undertaken by no one more senior than a casual...