Welcome to our research community! Each month, our Research Ambassadors dive into a new and exciting research article, sharing their insights, reflecting and discussing together in our WhatsApp community. This is a space for learning, asking questions, and exploring research in and informal and supportive way. This blog post summarises the key takeaways from our latest journal club discussion.
This month’s featured article:
This month, Research Ambassador Katie shared an article titled ‘Tackling Health Inequalities on NHS Waiting Lists: Learning from Local Case Studies’.
This report by Ruth Robertson, Nicola Blythe and Danielle Jefferies explored the approaches taken by NHS trusts and systems to recover their services and manage their waiting lists following the first wave of the Covid-19 pandemic. The research involved three stages:
- Initial exploration of what was already known about taking an inclusive approach to tackling waiting lists.
- Looking at three case study trusts and integrated care boards (ICBs) to identify the progress they’ve made when implementing NHS England guidance on ‘taking an inclusive approach to reducing elective care backlogs’
- Conducting a workshop with stakeholders to discuss the findings and implications of them.
If you would like to read this month’s report, please visit the link below:
Key discussion points:
To start this month’s discussion, Katie provided an initial reflection on her thoughts around the report and posed questions for the rest of our journal club to think about when reading the report:
“I didn’t have much understanding before on how wait time worked and it was interesting to learn how wait times are managed (p.12). And it was interesting to learn how different trusts managed them (p.25 & 26).
One of the most interesting sections for me was the case studies of NHS trusts analysing how they reduce wait times inclusively. The report explains how the case studies prioritise exploring different areas and types of trusts rather than for a direct comparison”. – Katie
Questions:
- Did anything in the report surprise you?
- What did you think about the methodology used? I.e. would you have added or changed anything.
- Do you think AI has a place in this scenario or healthcare more broadly?
- Do you think any additions perspectives or models for analysis could have been useful?
- Did this research give you any ideas for further research or topics?
These questions prompted interesting discussion from our ambassadors. Some of the common themes from ambassadors’ reflections are outlined below:
- The complexity of NHS prioritisation: ambassadors reflected that waiting list management was shaped by wider social, ethical and political factors beyond just organisational.
- Variation across NHS Trusts: we also had discussion about the inconsistencies that were highlighted across trusts and the lack of clear national guidance on addressing these inequalities.
- Range of research methods: when commenting on the research methods, ambassadors appreciated the variety, including case studies, interviews and workshops. They did however highlight that a patient’s perspective may provide additional insight on the topic.
- The use of AI (Artificial Intelligence): when commenting on the use of AI, ambassadors recognised the potential of using this as a tool but were also apprehensive of the overreliance on automated decision-making in healthcare.
Ambassador insights:
What did our Research Ambassadors say?
“…maybe not to my surprise but more of a quite shocking statistic the difference in waiting times for people from the least to the most deprived areas! “– Beth
“I like how after the interview stage the researchers held an online workshop to get different perspectives on their initial findings and potential implications. I can imagine this helped to provide balanced recommendations that were evidence-driven, as well as realistic and achievable.
I think AI could potentially be used for waiting list reprioritisation by providing quick, consistent summaries or assessments of individuals by drawing together a range of data, such as socio-demographic information. However, I’m sceptical about AI deciding who is most ‘at risk’ – I think individuals’ information would still need to be reviewed, but perhaps AI could help speed up the initial process of data retrieval. I’m assuming there would also need to be an alternative (manual) process in place for individuals who refuse for their data to be used in automated decision making under their rights in the Data Protection Act (someone correct me if I’m wrong!)”. – Molly
“I think it might be interesting to approach this topic from a philosophical/ethical perspective to try to unpick some of the points of contention around fairness and responsibility in relation to health inequalities. In fact, one of the things I took from the paper is that there is a lack of public buy-in, mixed views among clinicians and a lack of political will to enforce the policy – all factors that are obstacles to its implementation. Exploring these issues is probably necessary in order for the policy to be operationalised successfully”. – Hattie
“I also found the variation between trusts interesting. It makes sense that local context matters but it does raise the question of how consistent care really is depending on where you are.
I liked the methodology overall. It gave a good mix of policy and what’s happening in practice. But I did feel like it was quite top-down. It would’ve been interesting to hear more directly from patients on waiting lists, as their priorities might look quite different”. – Elli
Valuing our journal club
Thank you for sharing this month’s Journal Club report Katie, it’s been interesting to learn about the approaches taken to reduce waiting lists! Thank you also to everyone who has taken the time to engage this month.
Our Journal Club is open to all our Research Ambassadors, it is a space for curiosity, sharing knowledge, and asking questions to build our confidence reading academic articles. You do not need to have experience in reading articles, just an interest in hearing about new topics!
Our Research Ambassador Network is currently closed to new members, but you can find out more about our research opportunities in our Research Network Newsletter. You can sign up to the newsletter by emailing our Research Officer Joe: [email protected]