Durvalumab (MEDI 4736) in combination with extended neoadjuvant regimens in rectal cancer : a study protocol of a randomised phase II trial (PRIME-RT)

Acknowledgements We are grateful to Mr George Davidson and Ms Monica Jeffers for their input with writing the PRIME-RT protocol and patient information sheet. This study is co-sponsored by the University of Glasgow and NHS Greater Glasgow and Clyde. Funding PRIME-RT is funded by Astrazeneca and receives core funding from CRUK Clinical Trials Unit Glasgow for the purposes of trial set-up and data collection. The trial is co-sponsored by the University Of Glasgow and NHS Greater Glasgow and Clyde.Peer reviewedPublisher PD

Prison health in NHS Greater Glasgow & Clyde : A health needs assessment 2012

Scotland has one of the highest rates of imprisonment in Western Europe and the prison population is rising [1]. In the last decade the average daily prison population in Scotland increased by 27% [1]. The burden of physical and mental illness in the prison population is high; disproportionately so when compared to the general population [2]. This has variably been attributed to socioeconomic disadvantage and lifestyle and behavioural factors such as substance misuse, smoking and poor nutrition which are common in the prison population [2,3]. Prisoners suffer from multiple deprivation [2,3]. Many are a product of the care system, have experienced physical, emotional or sexual abuse and have difficulties forming and maintaining relationships. Levels of educational attainment are low and unemployment high. Homelessness is common. Prior to incarceration prisoners rarely engage with health care services in the community; during imprisonment demand for health care services is high [3,6,7]. Traditionally health care services in Scottish prisons were provided by the Scottish Prisons Service (SPS). On 1st November 2011 responsibility for the provision of health care to prisoners was transferred from SPS to the National Health Service (NHS). The aim of the transfer was to ensure that prisoners received the same standard of care and range of services as offered to the general population according to need. The guiding principle is that of ‘equivalence’ of care. The aim of this Health Needs Assessment (HNA) was to provide a systematic baseline assessment of the health and health care needs of prisoners in NHS Greater Glasgow and Clyde (NHSGGC) and to identify gaps in the current service provision to inform service future planning and development. It focuses on the two operational publicly owned prisons within NHSGGC: HMP Barlinnie and HMP Greenock. A third prison, HMP Low Moss, falls under the remit of NHSGGC but it was under renovation at the time of this HNA. Information about the prison population was drawn from published literature and reports provided by staff from the Justice and Communities Directorate of the Scottish Government. Information about the prisons from HMP Inspectorate reports, direct observation and interviews with members of staff in each prison. To fully understand the level and nature of existing services a service mapping was undertaken jointly with nominated staff from the prison health teams using direct observation and extensive staff and prisoner interviews and focus groups. Overall the findings are in line with other national and international studies on prison health. Despite characteristic differences between the prisons within NHSGGC there was a high level of consensus amongst both prisoners and staff groups about health needs and priorities. The report acknowledges the thoughtful contribution of prison staff and the positive approach to improving health services that they expressed. This has impacted on the formation of recommendations that both validate existing approaches and identify opportunities and 10 priorities for health gain. In addition to more fundamental changes they identify opportunities for quick wins that do not require significant financial outlay

Risk factors associated with biochemically detected and hospitalised acute kidney injury in patients prescribed renin angiotensin system inhibitors

Acknowledgments: The authors would like to thank Claire MacDonald from NHS Greater Glasgow and Clyde Safe Haven for technical assistance with the project. Funding: This work was funded by the Chief Scientist Office Scotland (grant HICG/1/1)Peer reviewedPostprin

Cognitive behaviour therapy-trained staff’s views on professional accreditation

Many cognitive behaviour therapy (CBT) trained mental health professionals seek non-mandatory accreditation with the British Association for Behavioural and Cognitive Psychotherapies (BABCP), despite self-regulation of talking therapies being a divisive issue. This raises the question: what views do CBT-trained mental health professionals have towards BABCP accreditation and what motivates them to become accredited? This qualitative study recruited seven postgraduate CBT-trained mental health professionals from NHS Greater Glasgow and Clyde during 2015. Individual semi-structured interviews were completed and verbatim transcripts produced. Thematic analysis revealed the value participants place on accreditation, and that an absence of motivating factors and barriers during the application process means that not all CBT therapists become accredited

NHS Greater Glasgow & Clyde Acute Pharmacy Redesign Program : Report for the Pharmacy and Prescribing Support Unit, NHS Greater Glasgow and Clyde

NHS Greater Glasgow and Clyde are in the midst of a major pharmacy redesign programme that aims to maximise the application of technology in the medicines supply chain and to release staff to deliver improved patient care through the Making the Most of your Medicines (MMyM) service. This report discusses the findings from a study undertaken by a team of researchers from the University of Strathclyde and the Pharmacy and Prescribing Support Unit (PPSU) in support of this redesign programme. In particular, the study focuses on the implementation of a new approach to in-patient medicines management designed by the PPSU. This approach takes the form of a robotic pharmacy distribution system, installed in a newly-built centrally-located Pharmacy Distribution Centre (PDC). The study was conducted from January to September 2010. The aims of the study were, first, to develop a suitable metrics framework for the new pharmacy distribution system and, second, to capture the organisational learning gained from the implementation phase of the PDC. However, as the project progressed it became clear that the primary focus would be on capturing organisational learning and providing expert advice to support implementation before a more effective performance measurement system could be designed. The report makes three sets of recommendations relating to: (1) standardising processes, improving quality and sharing best practice; (2) improving staff morale; (3) analysing and improving inventory management procedures. These recommendations are complemented by a proposal for a new, multi-layered performance measurement framework. This would consist of a Balanced Scorecard for strategic control (quarterly, monthly), into which feeds an Operational Dashboard (weekly, daily, all of which would be underpinned by a Lean Six Sigma improvement framework (incorporating FMEA and HACCP techniques where possible)

Does admission prevalence change after reconfiguration of inpatient services? An interrupted time series analysis of the impact of reconfiguration in five centres

Acknowledgements We are grateful to the following individuals who kindly provided admission data: Toby Tipper and Helen Rhodes (NHS Lothian), Graham Stewart and John Mullen (NHS Greater Glasgow and Clyde), Carole Angus and Donald Macgregor (NHS Tayside) and Rochelle Morgan (NHS Grampian). Availability of data and materials The dataset used and analysed during the current study is available from the corresponding author on reasonable request.Peer reviewedPublisher PD

The variation in acute and community service provision of care of the elderly services across the Scotland: Findings from the Scottish Care of Older People (SCoOP) National Audit initial scoping survey

We gratefully acknowledge the support of the British Geriatrics Society (BGS) in raising awareness of this work and the BGS Scotland Council for dissemination of the scoping survey. We also would like to thank Mr Tiberiu Pana, Mr Jesus Perdomo, Dr Maryam Barma and Dr Adrian Wood for their assistance with the project. We would also like to thank the SCoOP Steering Committee Members and Dr Claire Copeland (NHS Forth Valley) for their contribution. The SCoOP Steering Group includes: Dr Louise Beveridge (NHS Tayside), Professor Corri Black (University of Aberdeen), Ms Penny Bond (Healthcare Improvement Scotland), Dr Jennifer Burns (NHS Greater Glasgow and Clyde), Dr Tony Byrne (NHS Forth Valley), Dr Andrew Coull (NHS Lothian), Dr Alison Donaldson (University of Aberdeen), Dr Alice Einarsson (NHS Grampian), Professor Graham Ellis (NHS Lanarkshire, Glasgow Caledonian University and Co-Chair), Ms Karen Goudie(Healthcare Improvement Scotland) , Dr Graeme Hoyle (NHS Grampian), Dr Allan MacDonald (NHS Highland), Dr Christine McAlpine (NHS Greater Glasgow and Clyde), Dr Morven McElroy (NHS Greater Glasgow and Clyde), Professor Phyo Kyaw Myint (University of Aberdeen, Co-Chair), Dr Terence J Quinn (University of Glasgow), Professor Sir Lewis Ritchie (University of Aberdeen), Dr Susan Shenkin (University of Edinburgh), Dr Ralph Thomas (NHS Fife) and Dr Andrew Watt (NHS Ayrshire and Arran).Peer reviewedPublisher PD

Overcoming change fatigue: lessons from Glasgow's National Health Service

Structured Abstract Purpose of this paper This paper explores the practicalities of organizational change in complex settings where much change has already occurred. It therefore offers insights into tackling and overcoming change fatigue. Design/methodology/approach The paper uses a longitudinal study of change within a healthcare organization. The paper draws on interviews, focus groups and observations during a 2.5 year long action research project. Findings The paper reports findings on the speed at which change takes place, the importance of communication and the burden placed on senior officers during such communication and consultation processes, the use of appropriate external resources and expertise, the benefits of sharing best practice across sectors and the role of academic researchers in change processes. What is original/value of paper The paper offers valuable insights to those charged with effecting organizational change in change fatigued settings