Stephen Abbott

• BA, MA (Econ)
• Research Associate at City, University of London

In order to address urgent workforce considerations and changing demographics, in 2017 the National Health Service in the United Kingdom introduced a new role in healthcare, the Nursing Associate. Education for the new role was delivered by work-based learning in partnership with local universities. This paper reports on a qualitative longitudinal...

The shortage of healthcare professions is a global issue, which has highlighted the need to establish effective practice learning. In 2015 the UK government introduced a change to the way that healthcare education is funded. A subsequent fall in applications to healthcare programmes and high levels of vacancies across the sector in the UK have led...

Aims To explore Nursing and Midwifery Council (NMC) revalidation as a process experienced by nursing and midwifery academics and its impact on their sense of professional identity. Background The introduction of revalidation nurses and midwives in the UK in 2016 caused some anxiety amongst registrants in higher education. Design A qualitative stu...

Abstract The way student nurses and midwives perceive their professional identity has changed considerably since the move from hospital-based to university-based education. Students develop a professional identity in a variety of ways, including through their interactions with registered professionals working as academics, but we know little about...

Social capital, social networks, social support and health have all been linked, both theoretically and empirically. However, the relationships between them are far from clear. Surveys of social capital and health often use measures of social networks and social support in order to measure social capital, and this is problematic for two reasons. Fi...

Purpose – Disproportionately high numbers of young people in the British criminal justice system also have mental health problems. Relevant services often struggle to meet such complex needs, particularly as children become adults. The purpose of this paper is to discover the qualities of services valued by such young offenders. Design/methodolo...

Objectives The purpose of this study is to explore how medical students with Specific Learning Difficulties perceive and understand their Specific Learning Difficulty and how it has impacted on their experience of medical training. Method A purposive sample of fifteen students from one medical school was interviewed. Framework Analysis was used to...

Effective engagement with people who experience mental health care services, as research participants and as research leads, is presented. A group of volunteer mental health survivors, called INFORM, worked for 6 years to develop and complete a research project, exploring service user experience of a home treatment and crisis resolution service. Wi...

One strategic health authority, NHS London, initiated a pilot return to health visiting/nursing practice scheme in London in 2010. This paper reports on the experiences of the first three cohorts of returnees on the City University London programme, one of the London programmes, and the adaptations that have been made to the programme to help provi...

This paper describes a partnership between a university and a college of further education, whereby first-year nursing students administered health checks to college students. Despite many challenges, the experience was positive for both sets of students and has been mainstreamed. Many lessons were learnt about how best to support nursing students...

Patient safety concerns have focused attention on organisational and safety cultures, in turn directing attention to the measurement of organisational and safety climates. First, to compare levels of agreement between survey- and observation-based measures of organisational and safety climates/cultures and to compare both measures with criterion-ba...

Health care services that show evidence of a safety culture demonstrate effective communication and good situation awareness. This article reports observational research looking at these characteristics in two delivery units, undertaken as part of a study of safety culture. Contrasting team styles evident in daily routines (calm and cohesive in one...

The purpose of this paper is to examine perceptions of local service change and concepts of change amongst participants in a UK nationwide randomised controlled trial of informal, structured, reciprocated, multidisciplinary peer review with feedback to promote quality improvement: the National Chronic Obstructive Pulmonary Disease Resources and Out...

Objectives To explore attitudes to and beliefs about childhood overweight and obesity among Bangladeshi mothers and to check maternal perceptions of their children’s weight status. Design Mixed methods cross-sectional study. Setting A general practice in East London, UK. Methods Qualitative interviews with 14 mothers; weighing and measuring 22 c...

Knowledge and skills relating to cardiopulmonary resuscitation tend to be lost over time. The combination of simulation sessions with online video records and online feedback allows for an enduring record of skills sessions to assist students in retaining and revising their learning. This paper reports a qualitative evaluation of such a combination...

With 360° appraisals integral to professional life, learning how to give constructive feedback is an essential generic skill. To use a formative objective structured clinical examination (OSCE) for skills acquisition and development in giving feedback, whilst facilitating awareness of the importance of communication skills in clinical practice. Med...

WE INVESTIGATED THE EFFECTS ON COLLABORATIVE WORK WITHIN THE UK NATIONAL HEALTH SERVICE (NHS) OF AN INTERVENTION FOR SERVICE QUALITY IMPROVEMENT: informal, structured, reciprocated, multidisciplinary peer review with feedback and action plans. The setting was care for chronic obstructive pulmonary disease (COPD). THEORY AND METHODS: We analysed sem...

Participation in groups and associations is regarded as one of the key components of social capital. Given the evidence that levels of social capital correlate with levels of health, it is reasonable to assume that participation levels are similarly associated. There is mixed evidence for this. However, most survey research, which forms the bulk of...

Medical and nursing students are often anxious about communicating with patients with mental health problems, even when they have received general communication skills training. Communication is particularly challenging when patients are compulsorily admitted to hospital. The study reported here sought to explore medical and nursing students' attit...

Final Report to the Trust, March 2009. City University, London.

Contemporary health research is becoming increasingly formalised, regulated and institutionalised. In the UK, this has manifested itself in the development of a framework for 'governing' health research. The framework is often presented as a neutral decision-making tool guiding elements of research (such as ethical and peer review) through formal g...

Aim: This paper describes an initiative in North East London that aimed to facilitate access to training for care-home staff by using a mobile skills-centre in the form of an adapted bus. Background: It has proved difficult to take a strategic approach to quality assurance in care homes and the first comprehensive national training strategy for the...

Primary care organizations (PCOs) in the National Health Service in England and Wales are required to purchase most hospital-based health care for their populations. This ‘quasi-market’ in health care can be seen as ‘relational’, characterized by an emphasis on cooperative long-term relationships rather than on true competition. The English governm...

Social capital is widely considered to influence health. It is usually defined as a list of components such as social networks, social participation, trust and reciprocity. It is trust and reciprocity that are the subjects of this article. The presumed relationship of each with health is rarely explained in social capital studies. Trust is usually...

This article examines the contribution of Professional Executive Committees (PECs) to Primary Care Trusts (PCTs). It looks at the balance of clinical and corporate discussions in PEC meetings, and how their contribution and functions are perceived by PEC members and other PCT personnel.

Background Front-line NHS staff undertake small research projects to answer questions about local patients and services, but these projects often face considerable challenges. This paper reports on one such project.Aims and methods of study The study used structured interviews in order to find out about the knowledge of nutrition among Bangladeshis...

In response to recommendations in the National Service Framework for children with long-term conditions, a programme was developed based on the Expert Patient Programme for adults. Children who were heavy users of primary care, hospital care or both were invited to attend one of two programmes: the first for young people aged between 12 and 18; the...

In response to recommendations in the National Service Framework for children with long-term conditions, a programme was developed based on the Expert patient programme for adults. Children who were heavy users of primary care, hospital care or both were invited to attend one of two programmes: the first for young people aged between 12 and 18; the...

The purpose of this paper is to explore the variety of mechanisms applied since 1991 to engage English and Welsh general practitioners (GPs) in local health services planning and implementation. Three qualitative case studies. The paper identifies three types of mechanism: separation, alliance and integration. "Separation" characterises the relatio...

The role of boards in the public sector is unclear, particularly at a time of increased control of services by central government. This paper looks at the case of primary health care organizations, which are responsible for providing or commissioning the health care required by their local populations. Documentary analysis of board papers from 15 s...

To explore the views of primary care staff about delivering services to the local Bangladeshi community. Qualitative case study. Six focus groups, each with a different healthcare profession: speech and language therapists; child development team; health advocacy team; salaried general practitioners; school nurses; and occupational therapists. The...

To explore the emerging role of nurse consultant in an English primary care setting. Nurse consultants have been introduced in England since 1999 as senior, non-managerial nurse leaders. They have generally found it that it takes time to negotiate manageable work-loads. Four qualitative case studies Semi-structured interviews with stakeholders with...

Background Various initiatives have been tried to improve the quality of primary care in England and Wales in the last fifteen years. Such initiatives can be divided into quality improvement (QI) and quality assurance (QA). Purpose This paper looks at three contrasting models, drawn from data from 48 semistructured interviews with personnel from t...

New clinical roles are being developed in the NHS across existing professional boundaries. This paper considers the similarities and differences between three roles in primary care: the new roles of physician assistant and advanced nurse practitioner, and the established role of GP. It draws on a process evaluation of a pilot conducted by a primary...

Socioeconomic inequalities are thought to impair health in a way that is independent of the effect of material deprivation on health. But the mechanisms whereby inequalities have such an effect have not been thoroughly explained or explored. Two linked but distinct mechanisms have been suggested: social comparison and hierarchical conflict. In the...

An NHS male circumcision service has been established for Muslim families in Tower Hamlets, London. Boys in the area have usually been circumcised when aged between five and 11, by unregulated private practitioners. The new service is offered to boys aged under five months. A charge is made. An evaluation (20 semi-structured interviews with parents...

Self-monitoring of blood glucose (SMBG) is commonly recommended to patients with diabetes, although the rationale for this is unclear. This small research project was designed to explore the reasons why nurses working in the community recommend SMBG. Seven interviews were carried out with community nurses caring primarily for housebound patients. T...

Self-monitoring of blood glucose (SMBG) is commonly recommended to patients with diabetes, although the rationale for this is unclear. This small research project was designed to explore the reasons why nurses working in the community recommend SMBG. Seven interviews were carried out with community nurses caring primarily for housebound patients. T...

This study explored 'informal' learning opportunities in three health economies, both for National Health Service (NHS) staff and lay people wishing to promote and support breastfeeding and for new mothers wishing to breastfeed. The word 'informal' indicates local learning opportunities that are not part of recognized academic or professional train...

This paper summarizes the findings of the learning needs assessment described in this issue. Limitations and strengths are discussed. The paper describes a national, multi-sectoral, multidisciplinary picture. Our respondents may over-represent those with an interest in breastfeeding; if so, the true picture may be even more problematic than describ...

City and Hackney Teaching Primary Care Trust has introduced mandatory clinical supervision for all front-line nursing staff (district nurses, health visitors, school nurses, staff nurses, health care assistants). A group model is used, with sessions occurring monthly and lasting 90 minutes. Groups include a mixture of qualified and unqualified staf...

Re-organization of the English National Health Service (NHS) has fragmented the public health workforce, relocating teams from about 100 health authorities into over 300 primary care trusts (PCTs). The UK Government announced the setting up of public health networks (PHNs) as a solution to the problems created by fragmentation. Fifty-seven semi-str...

To explore the roles of Patient Advice and Liaison Services (PALS) in their interactions with service users. Every National Health Service health-care provider in England now has a PALS, which provides service users with information and help in resolving concerns and dissatisfactions with health care. Longitudinal qualitative study, 2002-4. This pa...

Objective To explore the roles of Patient Advice and Liaison Services (PALS) in their interactions with service users. Context Every National Health Service health-care provider in England now has a PALS, which provides service users with information and help in resolving concerns and dissatisfactions with health care. Design Longitudinal qualitati...

Welfare benefits advice services are increasingly being provided on primary care premises. It is assumed that the relief of financial deprivation will also relieve ill health, although there is only limited evidence to support this. This paper reports the findings of a study designed to measure changes in individual health associated with income in...

Background There is strong evidence associating poverty with poor health, and welfare benefits are an important means of maximising the income of deprived people in the United Kingdom (UK). The welfare benefits system is complex, and many need help in understanding their entitlements and in completing the applications. Research has shown that prima...

This paper explores user-driven organizational change in the National Health Service (NHS). The NHS Plan (Department of Health, 2000) created Patient Advice and Liaison Services (PALS) to provide information, solve problems and drive user-led change. Evidence is drawn from a study of PALS in London acute, primary care, mental health and specialist...

Inner city primary care trusts (PCTs) often have difficulty in recruiting nursing staff, while newly qualified nurses are often unaware of what opportunities community settings offer. This article reports the development of a rotational scheme designed to reduce recruitment problems and to assist understanding by newly qualified nurses of the inter...

The National Service Framework for Diabetes sets the empowerment of patients as a standard. It interprets empowerment as self-management and partnership with professionals. A qualitative study of older people with diabetes found that the majority self-managed their diabetes in the limited sense of self-medication and observing dietary restrictions,...

Every NHS trust and Primary Care Trust (PCT) in England now has a Patient Advice and Liaison Service (PALS) which provides an identifiable person to whom service users can turn if they have a problem or need information while using the NHS. This paper reports data from a 2-year qualitative study of London PALS. To develop patient-centred criteria b...

Background Every NHS trust and Primary Care Trust (PCT) in England now has a Patient Advice and Liaison Service (PALS) which provides an identifiable person to whom service users can turn if they have a problem or need information while using the NHS. This paper reports data from a 2-year qualitative study of London PALS. Objective To develop patie...

Recent re-structurings of the National Health Service (NHS) in England have illustrated the British government's commitment to a policy of devolving resources and responsibilities to local levels. As a result, public health teams are now located in 303 primary care trusts, and are more numerous, and much smaller, than previously. These changes have...

Every hospital, mental health, primary care and specialist trust in the English National Health Service (NHS) should have a Patient Advice and Liaison Service (PALS), to provide information and support to NHS patients with questions or concerns. PALS should also act as a catalyst for service improvement. This article draws on findings from a qualit...

To identify issues surrounding the future training needs of the specialist public health workforce following the most recent restructuring of the National Health Service (NHS) in England. All directors of public health (DsPH) based in strategic health authorities and nine senior staff working in public health at the regional level were invited to p...

To determine the capacity and development needs, in relation to key areas of competency and skills, of the specialist public health workforce based in primary care organizations following the 2001 restructuring of the UK National Health Service. Questionnaire survey to all consultants and specialists in public health (including directors of public...

Documentary analysis has been widely used in the comparative analysis of health care policy implementation in England. However, the value of the method is rarely debated, and the process whereby it is carried out rarely described in detail, or justified. Documentary analysis has obvious appeal. Documents may be the only source of data at an early s...

It is government policy to give health visiting a 'family-centred public health' focus. This focus reflects the origins and development of health visiting. This paper reports data from interviews with senior nursing and public health personnel in primary care trusts and elsewhere, who were asked, among other things, about the public health role of...

In England, there are particularly pressing problems concerning access to adequate primary care services. Consequently, innovative ways of delivering primary care have been introduced to facilitate and broaden access. The aim of this study was to review the evidence of seven recent innovations in service provision to improve access or equity in acc...

The government has introduced the idea of public health networks as a way of addressing the problem of limited public health resources in Primary Care Trusts (PCTs). A number of different concepts of such networks have been proposed, which diverge considerably in the degree to which networks are or are not formally organised and managed. This paper...

This article reports research examining the relevance of a health visiting service to an orthodox Jewish community. Data were gathered by 14 semi-structured interviews with community members and health visitors. The community was seen by members of both groups as self-sufficient, with a very well developed network of voluntary support networks. Ort...

Stephen Abbott and Caroline Gunnell coordinated a study of diabetes patients’ experiences of health services with the aim of encouraging greater participation in research by practice nurses

As an alternative to the national contract with general practitioners (GPs), Personal Medical Services (PMS) is a way of contracting with GPs for providing primary care, intended to enable individual contracts with practices which are appropriate to the specific needs of their populations. The national plan for the NHS (2000) strongly supports the...

There is considerable interest among organisations such as primary care trusts and health action zones in commissioning welfare benefits advice services in primary healthcare settings as part of local strategies to reduce health inequalities. However, very little is known about the contribution to health of such services or about the health status...

There is increasing provision of welfare benefits advice in primary care (WBAPC). This reflects the present government's recognition of the association between socio‐economic and health inequalities. However, the assumption that increasing an individual's income will improve their health is not based on clear evidence. This paper reviews the releva...

This article provides an interim update on the progress so far of some of the new Patient Advocacy and Liaison Services (PALS) in London.

Current policy places great emphasis on the development of “partnerships”, particularly between NHS and local authority services, with the aims of increasing service coordination and delivery and improving health. To this end, primary care groups (PCGs), at the forefront of NHS organizational developments, are required to include a social services...

Current government policy places great importance both on clinical governance and on partnership working between health and social services. Separately and together, these policy emphases require greater clarity in and between organizations about who should provide what care where than has often been achieved in the past. A study of the implementat...

Objective To explore how those working in and with primary care organisations understand the term 'health improvement'. Design Six qualitative case studies. Setting Primary Care Groups and Trusts and partner organisations. Method Semi-structured interviews with senior personnel from participating organisations. Results Informants offered a wide ran...

Organisations involved in public health welcome primary care trusts' role in the reorganised service and the establishment of public health networks. But there are concerns about shortage of specialist expertise. They believe PCTs have not yet developed their public health role. The public health role of strategic health authorities is seen as uncl...

A study of six primary care trusts showed that those most successful in tackling health improvement had certain common characteristics. Strong board-level support and leadership, combined with development funding, were the most effective. Successful PCTs also showed a corporate recognition of local health and socio-economic inequalities.

A study of six primary care trusts showed that those most successful in tackling health improvement had certain common characteristics. Strong board-level support and leadership, combined with development funding, were the most effective. Successful PCTs also showed a corporate recognition of local health and socio-economic inequalities.

In 1995 the Department of Health issued guidance on continuing health care following the health service commissioner’s finding against Leeds Health Authority for failing to provide long-term care. Under this guidance, health authorities were required to agree continuing health care policies and eligibility criteria with fundholders and local author...

Objective This study sought to track the development of Health Improvement Programmes (HImPs) from 1999 to 2000. Design A documentary analysis of pairs of HImPs produced by 26 health authorities in 1999 and 2000. Method A structured analytic tool was devised, based on government guidance on the content of HImPs. Results HImPs have become longer, an...

Evidence base: primary care nurses have previously been shown to be effective at improving urinary incontinence in women under 60 years, by teaching pelvic floor exercises. We tried to apply this finding to practice.R&D project: this development project involved devising and delivering an evidence-based training package, ideally to one nurse member...

This paper examines patients' and carers' experiences of receiving community health services, and considers the degree of patients' participation in the management of their continuing care. Care management, advocated for many years as a way of ensuring appropriate and coordinated care, emphasizes the involvement of patients and carers in care plann...

Current policy places great emphasis on the development of "partnerships", particularly between NHS and local authority services, with the aims of increasing service coordination and delivery and improving health. To this end, primary care groups (PCGs), at the forefront of NHS organizational developments, are required to include a social services...

This paper reports a qualitative study of how a multiagency residential community rehabilitation facility was perceived, and misperceived, by care professionals. Widespread misunderstandings about admission criteria meant that the service was underused, thus depriving patients of a muchvalued service.

It is not uncommon for welfare benefits advice organisations to offer services in primary care settings. Given the link between deprivation and poor health, the maximising of individual income in this way may also be expected to improve health. However, such improvement has hitherto not been successfully measured. This paper reports on a small stud...

An analysis of 36 health authorities' health improvement programmes found they reflected national priorities well. The average number of priorities was 13, with coronary heart disease/stroke, mental health and cancer being the most common. One plan set no priorities. Most programmes included some consultation with the public. Only seven HImPs inclu...

We consider how Total Purchasing helped prepare primary care organisations for the change to Primary Care Groups. PCGs’ focus in developing a public health role and addressing health inequalities is thrown into relief by the limited enthusiasm found for increased accountability, partnership-working and adopting a population-based strategy for healt...

Patients and carers were unaware of eligibility criteria for long-term care. Many patients interviewed in a qualitative study were not aware they had been assessed for services. Delays in providing rehabilitation services and mobility restrict independence.

This study explores the views and experiences of people living in the community who receive rehabilitation services. Although services were highly valued, there had been delays and interruptions in provision. Few subjects were consulted during assessment for their own ideas concerning their rehabilitation needs, resulting in inappropriate intervent...

Total purchasing in primary care (TPPC) was piloted in the mid-1990's, first by four "pioneer sites", and later by over 80 first and second waves of "pilot sites". Separate evaluations of three of the pioneers show that they faced challenges similar to those experienced by the pilot sites, namely: the need to develop organisations which were effect...