Rebecca Goulding

Rebecca Goulding
The University of Manchester · Division of Musculoskeletal and Dermatological Sciences

Doctor of Philosophy

About

49
Publications
10,435
Reads
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561
Citations
Introduction
I am an experienced Health Services Researcher, with established interests in health communication, access to care, treatment burden, patient involvement and patient safety, particularly for people with long-term conditions / multiple long-term conditions (multimorbidity). I am passionate about improving patients’ interactions with and experience of healthcare services, and involving patients and other stakeholders in research.
Additional affiliations
February 2023 - present
University of Manchester
Position
  • Research Associate
Description
  • NIHR School for Primary Care Research - Supporting People to Live Well with Multiple Long-Term Conditions (SPELL): Qualitative interview study and survey to understand treatment burden for people aged 18-65, with multiple long-term conditions (multimorbidity), and how primary care services affect this burden. Data from the study will be used to refine the Single Treatment Burden Question (STBQ) designed for use in clinical settings to identify people with high treatment burden.
April 2022 - June 2023
University of Manchester
Position
  • Research Associate
Description
  • NIHR Policy Research Programme - Optimising people-centred access in primary care: Qualitative interview, observation and focus group study to explore access to primary care in the context of Covid-19 from the policy-maker, provider and patient perspective. Developing a resource set and facilitating organisational change through collaborative focus groups. Working in partnership with a Community-Based Research Team.
November 2017 - October 2020
University of Manchester
Position
  • Research Associate
Description
  • NIHR Doctoral Research Fellowship: Planned, designed and optimised a behaviour change intervention to: empower older people with multiple long-term conditions (multimorbidity), improve their communication with primary care staff and reduce risks to patient safety. Achieved objectives through a qualitative synthesis, in-depth interview study, workshops with stakeholders and a cognitive interview study. Involved public contributors throughout. Note: Role continued Aug 2021 - Dec 2021.
Education
January 2018 - March 2022
The University of Manchester
Field of study
  • Health Psychology
January 2008 - December 2009
The University of Manchester
Field of study
  • Medicine
September 2001 - June 2004
The University of Manchester
Field of study
  • Psychology

Publications

Publications (49)
Article
Full-text available
The risk of depression is increased in people with long term conditions (LTCs) and is associated with poorer patient outcomes for both the depressive illness and the LTC, but often remains undetected and poorly managed. The aim of this study was to identify and explore barriers to detecting and managing depression in primary care in people with two...
Article
Full-text available
Objective: Studies of patient safety in health care have traditionally focused on hospital medicine. However, recent years have seen more research located in primary care settings which have different features compared to secondary care. This study set out to synthesize published qualitative research concerning patient safety in primary care in ord...
Article
Full-text available
Objectives: Primary care records have traditionally served the needs and demands of clinicians rather than those of the patient. In England, General Practices must promote and offer registered patients online access to their primary care record, and research has shown benefits to both patients and clinicians of doing so. Despite this, we know littl...
Article
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To explore the effectiveness of interventions delivered with the aim of involving older patients with multimorbidity in decision-making about their health care during primary care consultations.
Article
Full-text available
Background In primary care, older patients with multimorbidity (two or more long-term conditions) are especially likely to experience patient safety incidents. Risks to safety in this setting arise as a result of patient, staff and system factors; particularly where these interact or fail to do so.Recent research and policy highlight the important...
Article
Full-text available
Background Older people with multiple long-term conditions (multimorbidity) (MLTC-M) experience difficulties accessing and interacting with health and care services. Breakdowns in communication between patients and staff can threaten patient safety. To improve communication and reduce risks to patient safety in primary care, we developed an interve...
Article
Full-text available
Background Treatment burden represents the work patients undertake because of their healthcare, and the impact of that effort on the patient. Most research has focused on older adults (65+) with multiple long-term conditions (MLTC-M) but there are more younger adults (18-65) living with MLTC-M and they may experience treatment burden differently. U...
Poster
Full-text available
Background Current policy recommends primary care practitioners improve empowerment by delivering efficient person-based care. Yet, older people (65+ years) with multiple long-term conditions often have complex and unmet needs, and may feel disempowered. However, there is a lack of guidance on how to achieve this. The Empowerment Scale (ES) was pre...
Presentation
Background: Older people (65+) with multimorbidity are more likely to experience patient safety incidents. In primary care, threats to patient safety often arise as a result of breakdowns in communication between patients and staff. Thus, interventions to improve communication could help reduce risks to patient safety. Research and policy regardi...
Article
Background Primary care records have traditionally served the needs and demands of clinicians rather than those of the patient. GP contracts in England state practices must promote and offer registered patients online access to their primary care record and research has shown benefits to both patients and clinicians of doing so. Despite this, we kn...
Article
Objective To assess the effects of interventions aimed at involving older people with multimorbidity in decision-making about their healthcare during primary care consultations. Methods Cochrane methodological procedures were applied. Searches covered all relevant trial registries and databases. Randomised controlled trials were identified where i...
Article
Background: Older patients with multiple health problems (multi‐morbidity) value being involved in decision‐making about their health care. However, they are less frequently involved than younger patients. To maximise quality of life, day‐to‐day function, and patient safety, older patients require support to identify unmet healthcare needs and to...
Article
Full-text available
Aim To identify discrete approaches to specialist healthcare support for older care home residents in the UK and to estimate their prevalence. Background Internationally, a range of new initiatives are emerging to meet the multiple and complex healthcare needs of care home residents. However, little is known about their relative effectiveness and,...
Presentation
The problem: Older people with multimorbidity are likely to experience more patient safety incidents. In primary care, threats to patient safety often arise as a result of breakdowns in communication between patients and staff. Thus, interventions to improve communication could help reduce risks to patient safety. Such interventions are commonly ai...
Presentation
Problem: Life expectancy is predicted to continue to rise globally and the prevalence of long-term conditions also increases with age. The consequences of ageing with multimorbidity include functional decline with poor quality of life, high healthcare utilisation and costs, and reduced life expectancy. Our previous work identified that older patien...
Article
Full-text available
Background: In primary health care, patient safety failures can arise in service access, doctor-patient relationships, communication between care providers, relational and management continuity, or technical procedures. Through the lens of multimorbidty, and using qualitative ethnographic methods, our study aimed to illuminate safety issues in pri...
Article
Purpose A growing ageing population with complex healthcare needs is a challenge to the organisation of healthcare support for older people residing in care homes. The lack of specialised healthcare support for care home residents has resulted in poorer outcomes, compared with community-dwelling older people. However, little is known about the form...
Article
Full-text available
Background: Multimorbidity, defined as the presence of two or more long-term conditions, is increasingly common in primary care, and patients with multimorbidity may face particular barriers to quality of care and increased safety risks due to the complexity of managing multiple conditions. Consistent with calls to directly involve service users i...
Presentation
Background: Many people aged 65+ live with multimorbidity, have frequent interactions with healthcare services, and manage complex treatment regimes. Some face additional challenges including deprivation and depression. Consequently, older, multimorbid patients likely experience more risks to patient safety. We sought to identify how risks arise i...
Presentation
Background: Approximately half of people aged 65 or over live with multiple long-term conditions (multimorbidity). These patients interact frequently with healthcare, have complex treatment regimes, and can face challenges such as deprivation and depression. Thus, they are likely to be at increased risk of patient safety failures. However, there is...
Article
Full-text available
Background: Large, integrated datasets can be used to improve the identification and management of health conditions. However, big data initiatives are controversial because of risks to privacy. In 2014, NHS England launched a public awareness campaign about the care.data project, whereby data from patients’ medical records would be regularly uploa...
Poster
Full-text available
Background: Digital technology is increasingly being used to monitor and manage health. People with multiple long-term conditions (multimorbidity) can have more to manage than most as they have complex needs and frequently interact with healthcare services. As such, they are also likely to be at risk of healthcare safety failures. Methods: Risks...
Article
Full-text available
Introduction: Increasing numbers of older people are living with multiple long-term health conditions but global healthcare systems and clinical guidelines have traditionally focused on the management of single conditions. Having two or more long-term conditions, or ‘multimorbidity’, is associated with a range of adverse consequences and poor outco...
Article
Conference Proceedings from the British Geriatrics Society (BGS) Autumn Scientific Meeting, Harrogate 2013: http://ageing.oxfordjournals.org/content/43/suppl_1/i31.3.abstract
Article
Rapid response: http://www.bmj.com/content/348/bmj.g2408/rr/692631 Re: Health secretary announces plan to cut NHS litigation costs
Presentation
Full-text available
Introduction and Aims: Increasing numbers of people are living with multiple long-term conditions. Patients with multimorbidity are likely to be at increased risk of safety failures or “adverse outcomes or injuries stemming from the processes of health care” (Vincent, 2006). Patients who have mental health as well as physical health problems may ac...
Article
Managing the physical healthcare needs of care home residents presents a considerable challenge to national healthcare systems. A range of local, specialist support initiatives are emerging to address this. A study is being conducted to identify what services are being provided, how they are organised and delivered, and the relative worth of each c...
Article
Full-text available
To develop an explanatory framework of the problems accessing primary care health services experienced by British South Asian patients with a long-term condition or mental health problem. This study used meta-ethnographic methods. Published qualitative studies were identified from a structured search of six databases and themes synthesized across s...
Data
CLAHRC Interview topic guide - Professionals. Description: Topic guide used with professionals during in-depth interviews.
Data
CLAHRC Interview topic guide - patients. Topic guide used with patients and carers during in-depth interviews
Presentation
Background: Compared with healthy adults, depression is two to three times as prevalent in people with diabetes and coronary heart disease, and is associated with greater morbidity/mortality and significantly worse health related quality of life. Depression is under-recognised and under-treated in primary care and this may be compounded by the pres...
Presentation
Background: Compared with healthy adults, depression is two to three times as prevalent in people with diabetes and coronary heart disease (CHD), and is associated with greater morbidity/mortality and significantly worse health related quality of life. Depression is under-recognised and under-treated in primary care and this may be compounded by t...
Article
Full-text available
As part of a national co-ordinated and multifaceted response to the excess suicide rate, the Choose Life initiative, the Highland Choose Life Group launched an ambitious programme of training for National Health Service (NHS), Council and voluntary organisation staff. In this study of the dissemination and implementation of STORM (Skills-based Trai...

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