It is widely recognised that there are serious shortcomings in the provision of simple psychological care for patients attending secondary medical care services.

This deficit has been recently highlighted by the ‘failure of compassion’ noted in the Francis report, with the associated reports of a poor experience of care by patients and their relatives.

Existing evidence and clinical experience suggest that the delivery of such psychological care is impeded by many factors. These include deficits in the knowledge, skills and attitudes of medical and nursing staff, a lack of appropriate team clinical supervision in psychological care and aspects of staff management.

In order to identify unmet needs for psychological care and barriers that prevent the medical and nursing staff addressing these, we will conduct interviews of patients and staff. This descriptive research will be supplemented with systematic reviews of relevant publications.  We will also work with those responsible for delivering services and medical and nursing training locally (University of Oxford and Oxford Brookes University respectively).

We will develop a series of linked interventions (these are likely to include specific training and clinical supervision for individuals and teams) for ward staff.  With additional funding we will evaluate these interventions in randomised trials.

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