Medicine, Nursing and Allied Health Professions

Quality and Safety

Providing high-quality clinical care is a clear priority for healthcare systems. Quality of care is a complex and multidimensional construct. One commonly accepted definition conceptualises the quality of health care as to whether individuals can access the health structures and processes of care which they need and whether the care received is effective, thereby focusing on the domains of access and effectiveness. Although there is substantial variation in the domains proposed in the different definitions, it has been traditionally considered to be a characteristic of the process of healthcare delivery, as assessed in relation to standards. Ideally, there should be empirical evidence that care that adheres to such standards contributes to the delivery of efficient and effective health care.

Patient safety is a specific aspect of the quality of health care and it constitutes a current priority for the NHS. Much of the previous work on patient safety has concentrated on hospital and specialist care, and not on primary care. A stronger emphasis on primary care patient safety research is needed because many safety incidents identified in hospitals actually originate in primary care, an environment in which the overwhelming majority of healthcare contacts take place. 

Antibiotic prescribing and dispensing for acute respiratory tract infections: An updated and expanded meta-ethnography. NIHR Pen CLAHRC. 1 June 2016-30 December 2016. Member of research team (PI: Prof. Nicky Britten, University of Exeter, UK) 

The development of an online patient safety questionnaire for primary care. East Midlands Academic Health Science Network; 1 April 2017-30 December 2018. Role: Local Co-Lead: Prof Valderas for South West (PI: Prof. Tony Avery, University of Nottingham, UK). The development of an online patient safety questionnaire for primary care.  East Midlands AHSN. (PI: Prof Tony Avery, University of Nottingham, UK 

Patient Engagement for Safer Primary Care: a roadmap for change. World Health Organisation & University of Exeter. 1 January 2015-16 December 2016. Role: PI

Modelling of the quality of primary healthcare in England based on structure, process and intermediate outcomes: a structural equation modelling approach. University of Exeter; 15 September 2013-15 September 2016. Role: PI

Care at the interface between Primary Care and Secondary Care in Turkey: the perspective of Family Physicians and Family Practice nurses. Ministry of Health, Turkey. 2 months (start date 1/12/2016). Role: Member of research team

Development of two short versions of the Patient Reported Experiences and Outcomes of Patient Safety (PREOS-PC). University of Nottingham 15 April 2016-15 September 2016. Role: PI 

Introducing standardised and evidence based thresholds for hip and knee replacement surgery - the arthroplasty candidacy help engine (the ACHE tool). National Institute for Health Research, Health Technology Assessment Programme, UK.  1 September 2013-31 August 2016. Co-applicant (PI: Prof. Andrew Price, University of Oxford, UK).

Systems of care and outcomes in TIA and minor stroke in the Hunter Valley, New South Wales. National Health and Medical Research Council, Australia APP1027794; 1 January 2012-31 December 2015. Co-applicant (PI: Christopher Levi, University of Newcastle, Australia)

Developing, testing and implementing the NSPCR Patient Safety Toolkit in general practices in England. NIHR School for Primary Care Research, England; 1 October 2011-31 Dec. 2013. Role: Co-applicant (PI: Prof. Tony Avery, University of Nottingham, UK)  PI 

An investigation of the Quality and Outcomes Framework (QOF) using the General Practice Research Database (GPRD).  NIHR School for Primary Care Research 2012-2014. Role: Co-applicant (PI: Dr. Evan Kontopantelis, University of Manchester, UK)

Patients’ perspectives and understanding of high-performing, safety conscious general practice: an exploratory study. NIHR School for Primary Care Research 2012-2013. Role: Co-applicant (PI: Dr. Stephen Campbell, University of Manchester, UK)

Arias-de la Torre J, Valderas JM, Evans JP, Martín V, Molina AJ, Muñoz L, Pons-Cabrafiga M, Espallargues M, Catalan Arthroplasty Register Steering Committee (RACat). Differences in risk of revision and mortality between total and unicompartmental knee arthroplasty. The influence of hospital volume. J Arthroplasty. 2019;34(5):865-871. doi: 10.1016/j.arth.2019.01.046. Epub 2019 Jan 29. PubMed

Alonso AM, Valderas JM, Solomon J. Being tested but not educated - a qualitative focus group study exploring patients' perceptions of diabetic dietary advice. BMC Fam Pract. 2019;20(1):1. doi: 10.1186/s12875-018-0892-5. PubMed

Campbell SM, Bell BG, Marsden K, Spencer R, Kadam U, Perryman K, Rodgers S, Litchfield I, Reeves D, Chuter A, Doos L, Ricci-Cabello I, Gill P, Esmail A, Greenfield S, Slight S, Moore M, Valderas JM, Sheikh A, Avery AJ. A patient safety toolkit for family practices. Pat Safety 2018;16(3):e182-e186 doi: 10.1097/PTS.0000000000000471 PubMed

Ferguson RJ, Prieto-Alhambra D, Walker C, Yu D, Valderas JM, Judge A, Griffiths J, Jordan KP, Peat G, Glyn-Jones S, Silman AJ. Validation of hip osteoarthritis diagnosis recording in the UK Clinical Practice Research Datalink. Pharmacoepidemiol Drug Saf  2018;28(2):187-193. doi: 10.1002/pds.4673 PubMed

Germeni E, Frost J, Garside R, Rogers M, Valderas JM, Britten N. Antibiotic prescribing for acute respiratory tract infections in primary care: an updated and expanded meta-ethnography. Br J Gen Pract 2018 Sep;68(674):e633-e645 doi:10.3399/bjgp18X697889. PubMed

Ricci-Cabello I, Stevens S, Dalton AR, Griffiths RI, Campbell JL, Valderas JM. Identifying primary care pathways from quality of care to outcomes and satisfaction using structural equation modeling. Health Serv Res 2018 Feb;53(1):430-449. doi: 10.1111/1475-6773. PubMed

Sheaff R, Brand SL, Lloyd H, Wanner A, Fornasiero M, Briscoe S, Valderas JM, Byng R, Pearson M. From programme theory to logic models for multispecialty community providers: a realist evidence synthesis. Health Serv Deliv Res;2018;6.24.;doi:10.3310/hsdr06240 PubMed

Gibbons C, Richards S, Valderas JM, Campbell J. Supervised machine learning algorithms can classify open-text feedback of doctor performance with human-level accuracy. J Med Internet Res 2017;19(3):e65. doi: 10.2196/jmir.6533. PubMed

Kontopantelis E, Springate DA, Ashcroft DM, Valderas JM, van der Veer SN, Reeves D, Guthrie B, Doran T. Associations between exemption and survival outcomes in the UK’s primary care pay-for-performance programme: a retrospective cohort study. BMJ Qual Saf 2016 Dec;25(9):657-70. doi: 10.1136/bmjqs-2015-004602. PubMed

Ricci-Cabello I, Avery AJ, Reeves D, Kadam UT, Valderas JM. Measuring patient safety in primary care: The development and validation of the “Patient Reported Experiences and Outcomes of Safety in Primary Care” (PREOS-PC). Ann Fam Med 2016;14(3):253-61. doi: 10.1370/afm.1935 PubMed

Stevens S, Valderas JM, Doran T, Perera R, Kontopantelis E. Analysing indicators of performance, satisfaction, or safety using empirical logit transformation. BMJ 2016;352:i1114. doi: 10.1136/bmj.i1114. PubMed

Ble A, Masoli JAH, Barry EH, Winder RE, Tavakoly B, Henley WE, Kuchel GA, Valderas JM, Melzer D, Richards SH. Any versus long-term prescribing of high risk medications in older people using 2012 Beers Criteria: results from three cross-sectional samples of primary care records for 2003/4, 2007/8 and 2011/12. BMC Geriatrics 2015 Nov 5;15:146. doi: 10.1186/s12877-015-0143-8. PubMed

Esmail A, Valderas JM, Verstappen W, Godycki-Cwirko M, Wensing M. Developing a research agenda for patient safety in primary care. Background, aims and output of the LINNEAUS collaboration on patient safety in primary care. Eur J Gen Pract 2015 Sep;21 Suppl:3-7. doi: 10.3109/13814788.2015.1043122. PubMed

Klemp K, Dovey S, Valderas JM, Rohe J, Godycki-Cwirko M, Elliott P, Beyer M, Gerlach FM, Hoffmann B. Developing a patient safety incident classification system for primary care. A literature review and Delphi-survey by the LINNEAUS collaboration on patient safety in primary care. Eur J Gen Pract 2015 Sep;21 Suppl:35-8. doi: 10.3109/13814788.2015.1043723. PubMed

Magin P, Dunbabin J, Goode S, Valderas JM, Levi C, d'Souza M, Marshall M, Barker D, Lasserson D. Patients’ responses to transient ischaemic attack symptoms: a cross-sectional questionnaire study in Australian general practices. Br J Gen Pract 2015;65(630):e24-31. doi: 10.3399/bjgp15X683125 PubMed

Parker D, Wensing M, Esmail A, Valderas JM. Measurement tools and process indicators of patient safety culture in primary care. A mixed methods study by the LINNEAUS collaboration on patient safety in primary care. Eur J Gen Pract 2015 Sep;21 Suppl:26-30. doi: 10.3109/13814788.2015.10437. PubMed

Ricci-Cabello I, Gonçalves DC, Rojas-García A, Valderas JM. Measuring experiences and outcomes of patient safety in primary care. A systematic literature review of available tools. Fam Pract 2015; 32(1):106-119. doi: 10.1093/fampra/cmu052 PubMed

Kontopantelis E, Springate D, Reeves D, Ashcroft D, Valderas JM, Doran T. Withdrawing performance indicators: retrospective analysis of general practice performance under UK Quality and Outcomes Framework. BMJ 2014;348:g330. doi: 10.1136/bmj.g330. PubMed

Kontopantelis E, Reeves D, Valderas JM, Campbell S, Doran T. Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme: longitudinal observational study. BMJ Qual Saf 2013;22(1):53-64. doi: 10.1136/bmjqs-2012-001033 PubMed

Doran T, Kontopantelis E, Reeves D, Fullwood C, Lester H, Valderas JM, Campbell S. Exempting dissenting patients from pay for performance schemes: retrospective analysis of exception reporting in the UK Quality and Outcomes Framework. BMJ 2012;344:e2405. doi: 10.1136/bmj.e2405 PubMed

Doran T, Kontopantelis E, Valderas JM, Campbell S, Salisbury C, Roland M. Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework. BMJ 2011 Jun 28;342:d3590.  doi: 10.1136/bmj.d3590. PubMed

Ricci-Cabello I, Marsden K, Avery A, Bell B, Kadam U, Reeves D, Slight S, Perryman K, Barnett J, Litchfield I, Thomas S, Campbell S, Doos L, Esmail A, Valderas JM. Patients' evaluations of patient safety in English general practices: a cross-sectional study. Br J Gen Pract 2017 Jul;67(660):e474-e482. doi: 10.3399/bjgp17X691085. PubMed

Ricci-Cabello I, Pons-Vigués M, Berenguera A, Pujol-Ribera E, Slight SP, Valderas JM. Patients' perceptions and experiences of patient safety in primary care in England. Fam Pract 2016; 33(5):535-42. doi: 10.1093/fampra/cmw046 PubMed

Stevens S, Valderas JM, Doran T, Perera R, Kontopantelis E. Analysing indicators of performance, satisfaction, or safety using empirical logit transformation. BMJ 2016 Mar 10;352:i1114. doi: 10.1136/bmj.i1114. PubMed

Trier H, Valderas JM, Wensing M, Martin HM, Egebart J. Involving patients in patient safety programmes: A scoping review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care. Eur J Gen Pract 2015 Sep;21 Suppl:56-61. doi: 10.3109/13814788.2015.1043729. PubMed

Verstappen W, Gaal S, Bowie P, Parker D, Lainer M, Valderas JM, Wensing M, Esmail A. A research agenda on patient safety in primary care. Recommendations by the LINNEAUS collaboration on patient safety in primary care. Eur J Gen Pract 2015 Sep;21 Suppl:72-7. doi: 10.3109/13814788.2015.1043726. PubMed