Expertise
Primary Care and Community Mental Health
Biography
In addition to my role as Plymouth-based Deputy Director for ARC South West, I lead the University of Plymouth Community and Primary Care Research Centre and NIHR Mental Health Research Group (MHRG). I am a Professor in Primary Care Research and a General Practitioner at Adelaide Street and St Levan Surgery. I have been a clinical researcher since 1995 and have experience of service development, management, policy development and teaching.
My specific areas of expertise and interest include shared care for long-term mental illness, management of common mental health problems and offender health care. I have been involved in projects related to access, commissioning, inter-professional working and implementation of evidence-based practice; becoming experienced with a range of quantitative and qualitative methodologies relevant to health services research. I have developed a particular interest in developing and field testing theoretical models (programme theory) based on realist approaches. This is of particular relevance for the development and evaluation of both innovative interventions, programmes for translating evidence into practice and understanding systems as whole.
Projects
- Helping to Optimise Pain control in the Elderly experiencing Analgesic Overprescribing (HOPE-AO)
- Evaluation of the Cornwall Community Health and Wellbeing Worker (CHWW) Service
- Coastal and Rural Mental Health Realist Study (CARMHRS)
- Enhanced Reconnect Evaluation
- PARTNERS3
- Medical Research Council Project
- Community Mental Health Framework Pilot Evaluation
- The Development of Research Knowledge and Culture in Care Homes
- The Enhanced Health in Care Homes Framework Study
- Hidden in Plain Sight
- The Peninsula Mental Health Research Initiative (PenMHRI)
- Peninsula Adult Social Care Research Collaborative (PARC)
- Implementing effective primary care responses to poverty-related mental distress (DeSTRESS-2)
- Remote-by-Default Care in the COVID-19 Pandemic
- General Practice Hubs
- Social Prescribing – Cornwall and Plymouth Researcher in Residence
- D-PACT: Dementia – PersonAlised Care Team
- Researchers in residence
- Sharing Evidence Routine for a Patient Centred Plan of Action (SHERPA)
- DeSTRESS
- PROGROUP: ImPROving GROUP treatment for people with severe obesity
- Social Prescribing – Effective Mechanisms for Social Prescribing
- Effectiveness of interventions to reduce ordering of thyroid function tests: a systematic review
- Engager
- Patient-initiated clinics (PIC) for people with long-term conditions
- PARTNERS2
Publications
- Practitioners’ ability to remotely develop understanding for personalised care and support planning: a thematic analysis of multiple data sources from the feasibility phase of the Dementia Personalised Care Team (D-PACT) intervention
- A group-based behavioural intervention for weight management (PROGROUP) versus usual care in adults with severe obesity: a feasibility randomised controlled trial protocol
- Interrogating intervention delivery and participants’ emotional states to improve engagement and implementation: A realist informed multiple case study evaluation of Engager
- ‘Do I have the capacity to make capacity judgements?’ Researcher reflections from a person-centred dementia support study
- Engaging Stakeholders in Realist Programme Theory Building: Insights from the Prospective Phase of a Primary Care Dementia Support Study
- Economic evaluation of a complex intervention (Engager) for prisoners with common mental health problems, near to and after release: a cost-utility and cost-consequences analysis
- The role of trust and hope in antipsychotic medication reviews between GPs and service users a realist review
- Evaluation of a primary care-based collaborative care model (PARTNERS2) for people with diagnoses of schizophrenia, bipolar, or other psychoses: study protocol for a cluster randomised controlled trial
- Asking about self-harm and suicide in primary care: Moral and practical dimensions
- GP trainee responses to using SHERPA for multimorbidity consultations
- Poverty-related distress is on the rise, but is medical intervention the answer?
- Avoidable Acute Admissions
- Patient Initiated Clinics
- Offender Mental Health: helping to break the cycle of reoffending
- Hospital readmission among people experiencing homelessness in England: a cohort study of 2772 matched homeless and housed inpatients
- Asking about self-harm and suicide in primary care: Moral and practical dimensions
- Integrating the voluntary sector in personalised care: mixed methods study of the outcomes from wellbeing co-ordination for adults with complex needs
- Integrating the voluntary sector in personalised care: mixed methods study of the outcomes from wellbeing co-ordination for adults with complex needs
- Integrating the voluntary sector in personalised care: mixed methods study of the outcomes from wellbeing co-ordination for adults with complex needs
- What approaches to social prescribing work, for whom, and in what circumstances? A realist review
- A longitudinal evaluation of a countrywide alternative to the quality and outcomes framework in UK general practice aimed at improving person centred coordinated care
- Understanding interpersonal process recall to understand empowerment processes in a collaborative care intervention for people with a diagnosis of psychosis
- A worked example of initial theory-building: PARTNERS2 collaborative care for people who have experienced psychosis in England
- Reflection on the researcher-in-residence model co-producing knowledge for action in an integrated care organisation: a mixed methods case study using an impact survey and field notes
- From mental disorder to shared understanding: a non-categorical approach to support individuals with distress in primary care
- Validation of the Person Centred Coordinated Care experience questionnaire (P3CEQ)
- A new Model for Clinical Decision Making in Patients with Multimorbidity: SHERPA (Sharing Evidence Routine for a Person-centred plan for Action)
- Pilot randomised controlled trial of the ENGAGER collaborative care intervention for prisoners with common mental health problems, near to and after release
- Engaging seldom heard groups in research and intervention development: Offender mental health.
- Using realist approaches to explain the costs and cost-effectiveness of programmes.
- Women offenders: Promoting a holistic approach and continuity of care across criminal justice and health interventions
- Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform
- Evaluation of a complex intervention (Engager) for prisoners with common mental health problems, near to and after release: study protocol for a randomised controlled trial
- General practitioner contributions to achieving sustained healthcare for offenders: a quantitative study
- Identifying enablers and barriers to individually tailored prescribing: a survey of healthcare professionals in the UK
- Adapting QOF to focus on wellbeing and health
- Creating and Facilitating Change for Person Centred Coordinated Care (P3C): The Development of the Organisational Change Tool (P3C-OCT)
- Bridging the second gap in translation: a case study of barriers and facilitators to implementing Patient-initiated Clinics into secondary care
- From programme theory to logic models for multispecialty community providers: a realist evidence synthesis
- Not all waits are equal: An exploratory investigation of emergency care patient pathways
- Variation in referral and access to new psychological therapy services by age: an empirical quantitative study
- Bridging the discursive gap between lay and medical discourse in care coordination
- Factors associated with study attrition in a pilot randomised controlled trial to explore the role of exercise-assisted reduction to stop (EARS) smoking in disadvantaged groups
- The social, relational and mental health characteristics of justice-involved men in the south-west England
- What approaches to social prescribing work, for whom, and in what circumstances? A protocol for a realist review
- Efficacy and moderators of mindfulness-based cognitive therapy (MBCT) in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials.
- How can frontline expertise and new models of care best contribute to safely reducing avoidable acute admissions? A mixed-methods study of four acute hospitals.
- Implementing a patient-initiated review system for people with rheumatoid arthritis: a prospective, comparative service evaluation
- What IAPT services can learn from those who do not attend
- Using realist review to inform intervention development: Methodological illustration and conceptual platform for collaborative care in offender mental health
- Integration and continuity of primary care: polyclinics and alternatives – a patient-centred analysis of how organisation constrains care co-ordination
- Pathways to suicide attempts among male offenders: the role of agency
- Fit for work? How GPs’ decisions about fitness to work can improve health
- Solutions to problematic polypharmacy: learning from the expertise of patients
- An Exploratory Analysis of the Smoking and Physical Activity Outcomes From a Pilot Randomized Controlled Trial of an Exercise Assisted Reduction to Stop Smoking Intervention in Disadvantaged Groups
- Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial
- Implementing a patient-initiated review system in rheumatoid arthritis: a qualitative evaluation
- Invest in community-based solutions that address individuals’ needs: not more beds
- Improving community health networks for people with severe mental illness: a case study investigation
- Core outcome sets for use in effectiveness trials involving people with bipolar and schizophrenia in a community-based setting (PARTNERS2): study protocol for the development of two core outcome sets
- Practices used for recommending sickness certification by general practitioners: A conversation analytic study of UK primary care consultations
- Treatment Resistant Depression in primary care: Co-constructing difficult encounters
- “The Work and Social Adjustment Scale: Reliability, Sensitivity, and Value”
- The Work and Social Adjustment Scale: Reliability, Sensitivity, and Value
- Update to the study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment depressive relapse/recurrence: the PREVENT trial
- Learning from people with long-term conditions: new insights for governance in primary healthcare
- Staff and Patient Experience of Improving Access to Psychological Therapy (IAPT) Group Interventions
- People and Teams Matter in Organizational Change: Professionals’ and Managers’ Experiences of Changing Governance and Incentives in Primary Care
- Watchful waiting’ or ‘active monitoring’ in depression management in primary care: Exploring the recalled content of general practitioner consultations
- The effectiveness and cost-effectiveness of shared care: Protocol for a realist review
- Guided self-help concreteness training as an intervention for major depression in primary care: a Phase II randomized controlled trial
- (COCOA) Care for Offenders Continuity of Access
- Financial and clinical risk in health care reform: a view from below
- Recognition of distress and depression in primary care: how far should we go?
- Care for common mental health problems: applying evidence beyond RCTs
- What we talk about when we talk about depression: doctor-patient conversations and treatment decision outcomes
- Psychiatry in Primary Care (3rd edition)
- Estimating probability of sustained recovery from mild to moderate depression in primary care: evidence from the THREAD study
- Improving access to psychological therapies: implications for mental health care in general practice
- The Consolations of Going Back to Prison: What ‘Revolving Door’ Prisoners Think of Their Prospects
- Randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of selective serotonin reuptake inhibitors plus supportive care, versus supportive care alone, for mild to moderate depression with somatic symptoms in primary care:
- Guided self-help supported by paraprofessional mental health workers: an uncontrolled before-after cohort study
- Exposing the key functions of a complex intervention for shared care in mental health: case study of a process evaluation
- Mindfulness-based cognitive therapy to prevent relapse in recurrent depression