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- Clinical Director for Research and Development, Oxfordshire Clinical Commissioning Group
- GP Principal
I aim to facilitate closer integration of research, clinical and commissioning perspectives in order to achieve high quality patient-centred care.
My current research activities include a diagnostic accuracy study to determine whether there is a better screening tool than pulse palpation for identifying atrial fibrillation (AF) in primary care, an RCT testing whether point-of-care computer reminders for GPs increase the number of patients with AF who are appropriately anticoagulated, a Cochrane review of the effectiveness of BNP monitoring for heart failure, and an analysis of national data to describe the extent and impact on morbidity and health care utilisation of inappropriate inhaler prescribing in primary care.
As a member of the Centre for Evidence-based Medicine, I teach practitioners from a range of professional backgrounds and countries with the aim of empowering them to think critically about clinical effectiveness and to use available evidence to enhance their practice. My teaching interests also include the integration of cognitive-behavioural interventions into routine clinical care.
My role as Clinical Director for Research and Development for the Oxfordshire Clinical Commissioning Group, has allowed me to facilitate strong links between the two organisations and to build collaboration between colleagues. This has achieved useful outcomes such as a joint retrospective evaluation of 'case management' using a matched control group which has directly influenced present and future commissioning. We are also rolling out and evaluating the local implementation of patient self-management of their blood pressure, which research has shown to be more effective than usual care, using text messaging to facilitate patient engagement.
The timely implementation of research evidence - whether this means using interventions which have been shown to be effective or not using interventions which have been shown to be ineffective –is particularly important in areas where it would have a substantial impact on health services and patient outcomes. For example, within Oxfordshire a successful commissioning priority has been to enhance the number of patients with atrial fibrillation who are anti-coagulated in order to prevent stroke, because this a highly effective intervention which prevents an expensive and disabling condition.