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Publications

HPRU researchers possess a wide range of skills and expertise in a variety of research methods and have an excellent track record. They contributed to the University's RAE performance in 2001 and 2008 in subject areas including Nursing and Midwifery, Business and Management Studies, Politics and International Studies, Social Work and Social Policy.

The unit has collaborated with other research areas within the University, including the Centre for Comparative Housing Research; Mary Seacole Research Centre; Centre for Social Action; Local Governance Research Unit and Primary Care Unit.

  • The Value of Pharmacists in General Practice: Perspectives of General Practitioners. An Exploratory Interview Study
    The Value of Pharmacists in General Practice: Perspectives of General Practitioners. An Exploratory Interview Study Hampson, N.; Ruane, Sally Background NHS England has recently invested on a large scale in the development of the role of pharmacists in general practice. Despite this initial funding, the perpetuation of pharmacists’ roles ultimately relies on the funding and co-operation of GPs. Objective This study aimed to explore the perspectives of GPs with experience of fully funding a pharmacist in gen-eral practice, focussing on the value that GPs place on the role of the pharmacist. Setting General practice in the Midlands and East area of England. Method In-depth, face to face, semi-structured qualitative interviews were carried out with seven purposively sampled GPs. Interviews were audio recorded, transcribed verbatim and thematically analysed. Main outcome measure Main outcomes were defined themes in the data. Results GPs valued the medication expertise of the pharmacist, which enabled the pharmacists to unburden the GPs of workload. GPs also valued the capability of pharmacists to adapt their role to meet the changing needs of their individual practice. GPs supported the role of pharmacists in general practice but identified funding as a possible barrier to wider uptake of the role. Conclusion This study provides an initial insight into what GPs value in the role of pharmacists in general practice. It highlights the value of the medication-related expertise which pharmacists bring to the team. Heterogeneity in the role is necessary to meet the needs of individual practices. Sustained funding was identified as a possible barrier to wider implementation of the role. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • La experiencia internacional en la privatizacion de los servicios sanitarios publicos. El case de servicios integrados en el Reino Unido
    La experiencia internacional en la privatizacion de los servicios sanitarios publicos. El case de servicios integrados en el Reino Unido Ruane, Sally The use of market mechanisms in the NHS has long been associated with privatisation in the English National Health Service but there has been a marked shift in policy emphasis away from market competition towards ‘system integration’ since the 2012 Health and Social Care Act. This includes integration between the various parts of the health service and integration between the health care and social care sectors. The benefits of integration include greater patient satisfaction, improved access and improved quality of care but the approach to securing it in England has been riven with division and conflict. This chapter draws on documentary data to combine a critique of integrated care policies in the past five years in England, an investigation of their implications for the privatisation of clinical services and a contextual understanding of the broader international policy agenda. It argues that there are several ways in which integrated policies facilitate privatisation and applies Krachler and Greer’s 2015 privatisation framework to explore this further. Ruane S. (2019) ‘International experience in the privatisation of public health services: The case of integrated services in the UK’ in M. Sanchez Bayle (ed.) Health care privatisation: analysis and alternatives, Madrid: El Viejo Topo
  • Routines of resistance: an ethnography of the care of people living with dementia in acute hospital wards and its consequences
    Routines of resistance: an ethnography of the care of people living with dementia in acute hospital wards and its consequences Featherstone, Katie; Northcott, Andy; Bridges, Jackie Background There is little research examining resistance, refusal or rejection of care by people living with dementia within acute hospital wards despite the prevalence of dementia in adult hospital populations. Objectives To explore the ways in which resistance to care manifests within the acute setting and is understood, classified and subsequently managed by ward staff. Design Ethnography Setting Acute medical units and trauma and orthopaedic wards in five NHS hospitals in England and Wales. Participants People living with dementia and nursing team members (registered nurses and health care assistants) on participating wards. Methods Observational fieldwork and ethnographic interviews collected over a period of 20 months (155 days of non-participant observation (minimum 2 hours, maximum 12 hours, total hours: 680) focusing on staff delivering care to patients with dementia. Interviewees included patients, visitors, and staff working on and visiting the ward. Data collection and analysis drew on the theoretical sampling and constant comparison techniques of grounded theory. Results We found that resistance to care by people living with dementia was a routine and expected part of everyday care in the participating acute hospital settings. The timetabled rounds of the ward (mealtimes, medication rounds, planned personal care) significantly shaped patient and staff experiences and behaviours. These routinized ward cultures typically triggered further patient resistance to bedside care. Institutional timetables, and the high value placed on achieving efficiency and reducing perceived risks to patients, dictated staff priorities, ensuring a focus on the delivery of essential everyday planned care over individual patient need or mood in that moment. Staff were thus trapped into delivering routines of care that triggered patterns of resistance. Conclusions Nursing staff struggle to respond to the needs of people living with dementia in acute care settings where the institutional drivers of routines, efficiency and risk reduction are not mediated by clinical leadership within the ward. Cycles of resistance in response to organisationally mandated timetables of care can result in poor care experiences for patients, and emotional and physical burnout for staff. More research is needed into how institutional goals can be better aligned to recognise the needs of a key hospital population: people living with dementia. The file attached to this record is the author's final peer reviewed version.
  • Integrated care systems in the English NHS: A critical view
    Integrated care systems in the English NHS: A critical view Ruane, Sally The article offers those working in child health care an examination of the evolution of the broader health policy context in England since 2012. While policy has attempted to transform the English NHS into what is described as a more integrated, less fragmented service, it has encountered numerous obstacles. The article traces the development of policy from the 2012 Health and Social Care Act, through Vanguard projects and Sustainability and Transformation Plans to Accountable Care Organisations and Integrated Care Organisations. The obstacles encountered include severe funding constraints, planning assumptions which lack a solid evidence base, a legislative framework antithetical to integration and the controversial character of a policy innovation which, it has been suggested, is derived from an international project under the auspices of the World Economic Forum. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • Hard currency, solidarity and soft power? The motives, implications and lessons of Cuban Health Internationalism
    Hard currency, solidarity and soft power? The motives, implications and lessons of Cuban Health Internationalism Baggott, Rob; Lambie, George This article explores Cuba’s health assistance and support for other countries. It explores the rationale and motivations for Cuba’s internationalism in health. It then details the various aspects of its health interventions, including emergency relief, strengthening of health systems, treatment programs, training of health professionals, engagement in multilateral cooperation, and biotechnology. The article analyzes the benefits of Cuba’s health internationalism for Cuba and for others. It also explores potential adverse consequences and criticisms of Cuba’s approach. The article concludes by noting that Cuba has been ahead of the game in integrating foreign policy and health policy and that its experience may hold lessons for other countries seeking to develop global health strategies.
  • Report on University Hospitals of Leicester NHS Trust Full Business Case for relocating Intensive Care Unit Level 3 beds out of Leicester General Hospital
    Report on University Hospitals of Leicester NHS Trust Full Business Case for relocating Intensive Care Unit Level 3 beds out of Leicester General Hospital Underwood, Janet; Ruane, Sally; Reynolds, Kathy The report analyses proposals by University Hospitals of Leicester to relocate level 3 intensive care beds out of the Leicester General Hospital. The report identifies a number of concerns and recommends the proposals be submitted to scrutiny by the joint scrutiny committee of Leicester, Leicestershire and Rutland and be subject to full public consultation.
  • Representing Whom? UK Health Consumer and Patients' Organizations in the Policy Process
    Representing Whom? UK Health Consumer and Patients' Organizations in the Policy Process Baggott, Rob; Jones, Kathryn L. This paper draws on nearly two decades of research on health consumer and patients’ organizations (HCPOs) in the United Kingdom. In particular it addresses questions of representation and legitimacy in the health policy process. HCPOs claim to represent the collective interests of patients and others such as relatives and carers. At times they also make claims to represent the wider public interest. Employing Pitkin’s classic typology of formalistic, descriptive, symbolic and substantive representation, the paper explores how and in what sense HCPOs represent their constituencies. We found that policy makers themselves are less concerned with formal mechanisms adopted by groups and are more concerned with credibility, in particular whether HCPOs carry the confidence of their constituents. While some concerns about legitimacy remain, particularly in relation to funding from commercial interests, we argue that HCPOs bring a unique perspective to the policy process and to focus purely on formalistic representation provides only a partial understanding of their representative role and a constrained view of their collective moral claims. The file attached to this record is the author's final peer reviewed version.
  • Submission to the House of Commons Health Select Committee in response to its Inquiry into Integrated Care: Organisations, Partnerships and Systems
    Submission to the House of Commons Health Select Committee in response to its Inquiry into Integrated Care: Organisations, Partnerships and Systems Ruane, Sally The submission outlines a number of concerns relating to Sustainability and Transformation Plans and Accountable Care Systems/Organisations.
  • Submission from the Leicester Mercury Patients' Panel to the House of Commons Health Select Committee in response to its Inquiry into Integrated Care: Organisations, Partnerships and Systems
    Submission from the Leicester Mercury Patients' Panel to the House of Commons Health Select Committee in response to its Inquiry into Integrated Care: Organisations, Partnerships and Systems Ruane, Sally The Leicester Mercury Patients' Panel submission to the Committee raises a number of concerns regarding engagement of the public in the STP process in Leicester, Leicestershire and Rutland.
  • Regulating the regulators: the rise of the United Kingdom Professional Standards Authority
    Regulating the regulators: the rise of the United Kingdom Professional Standards Authority Allsop, Judith;; Jones, Kathryn L.

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