Understanding and evaluating restorative approaches in response to patient safety incidents

We invite UK applicants for this fully funded PhD scholarship based in the School of Healthcare.<br /> <br /> Do you want to improve the quality and safety of care in the NHS? Do you want to do cutting-edge research with interdisciplinary supervisors and develop a career as a safety scientist? Do you want to make a difference for patients and their families? If so, this studentship opportunity will appeal to you. <br /> <br /> This fully funded PhD scholarship is an exciting opportunity to pursue postgraduate research in patient safety and safety science, with an emphasis on mixed-methods.<br /> <br /> We are inviting applications from prospective postgraduate researchers who wish to commence study for a PhD (December 2024 - March 2025). This studentship will be hosted in the NIHR Yorkshire and Humber Patient Safety Research Collaboration (PSRC) and the research setting will be a mental health and community care provider in the Yorkshire region.<br /> <br /> The award is open to full-time candidates (UK only) who meet the eligibility for a place on a PhD degree at the School of Healthcare.

<p>Patient safety remains a persistent worldwide issue across healthcare, despite an explicit policy, practice and research focus on patient safety for many years. Indeed, it was estimated that 1 in 10 patients in British hospitals experienced avoidable harm (Vincent et al., 2001) and over two decades later, research suggests limited overall improvement over time (Panagioti et al., 2019; World Health Organisation, 2023; Lin, 2024).</p> <p>There has been a growing recognition of the failure of organisational responses to acknowledge the wide-ranging human impacts on those affected by patient safety incidents, beyond learning, which can sometimes feel worse than the original harm itself (Ramsey et al., 2022; Wailling, Wilkinson & Marshall, 2019; Martin, Chew & Palser., 2017). In addition to the initial harms resulting from patient safety incidents, ‘compounded harm’ can extend the harmful experience for everyone involved (Wailling, Kooijman, Hughes & O’Hara, 2022). Compounded harm refers to the harm that can be created after a safety incident, due to the processes that follow by “neglecting to appreciate and respond to human impacts” and has been argued to be especially the case “when people feel unheard or invalidated” (Wailling et al., 2019; Moore & Mello, 2017).</p> <p>Restorative approaches offer promise to repeated calls to re-humanize such investigation processes (Wailling et al., 2022; Wu et al., 2020; Wailling, Marshall & Wilkinson, 2019; Martin, Chew & Palser, 2017; Mira et al., 2017). Wailling and colleagues’ (2022) argue that “a restorative response is likely to reduce the level of compounded harm experienced by all the people affected”, and that the “risk [of compounded harm] may be reduced when investigations provide the opportunity for healing alongside models that seek system learning, with the former having been consistently neglected”. Wailling et al., (2020) proposed three justice needs as the basis of this approach (1) substantive needs – the actual harm that needs to be remedied, (2) procedural needs – the process of interacting, communicating and making decisions about the harms, and (3) psychological needs - the way one is acknowledged, respected and treated throughout the process, ensuring those affected can honestly communicate their differences, concerns and potential similarities with each other in a safe way.</p> <p>A restorative just culture approach has been piloted in a mental healthcare context in Australia (Turner et al., 2020; Turner et al., 2024) and England (Kaur et al., 2019). The New Zealand Ministry of Health also applied a restorative approach to the context of surgical mesh harm (Wailling et al., 2019). In arguing for the use of a restorative approach, Nickson and Neikirk (2024) suggested that a fundamental principle is voluntariness, further supporting calls for divergent conceptions of justice to be acknowledged and considered (Cribb, O’Hara & Waring, 2022).</p> <p>The scientific literature is yet to fully explore restorative approaches to healthcare harm and their acceptability and feasibility within current healthcare systems. Therefore, this PhD studentship will seek to understand the form, function and contribution of restorative approaches to healthcare harm. This will include a review of the current literature as well as empirical work within a mental health and community care provider in the Yorkshire region aiming to improve their processes via a restorative lens using a formative evaluation approach. The final output of the studentship will be a set of core recommendations based on what the NHS can learn from restorative approaches to healthcare harm, and how their potential can be maximised.</p> <p>This PhD studentship will support a wider programme of work seeking to understand the systems of safety within healthcare services, drawing on our existing academic/health service partnerships. It is expected that the candidate will develop methodological skills in reviewing evidence, mixed-methods methodological skills, as well as specialist knowledge in patient safety incident response and safety science. The student would be expected to shape the full plan for the thesis with support from the supervisory team.</p> <h5>Environment</h5> <p>The studentship will be based at the <a href="https://medicinehealth.leeds.ac.uk/healthcare">School of Healthcare</a> at the University of Leeds and the <a href="https://psrc-yh.nihr.ac.uk/">NIHR Yorkshire and Humber Patient Safety Research Collaboration</a> (YH PSRC). </p> <p>The YH PSRC is a collaboration between Bradford Teaching Hospitals NHS Foundation Trust and the Universities of Leeds and Bradford. The YH PSRC is hosted within the <a href="https://yqsr.org/">Yorkshire Quality and Safety Research Group</a> at the <a href="https://www.bradfordresearch.nhs.uk/">Bradford Institute for Health Research</a>.</p> <p>Our mission is to deliver research to make healthcare safer. We are one of six NIHR Patient Safety Research Collaborations in England. Our work draws on the knowledge and expertise of well-established networks of researchers, patients, carers, clinicians and industry partners to develop ideas that adderss patient safety problems.</p> <p>As a YH PSRC PhD student you will become an NIHR trainee and will benefit from a range of training support and resources to develop knowledge and health research skills. The YH PSRC focusses on four themes: <a href="https://psrc-yh.nihr.ac.uk/psrc_themes/safer-systems-cultures-and-practices/">Safer systems, cultures and practices</a>; <a href="https://psrc-yh.nihr.ac.uk/psrc_themes/de-cluttering-safely-for-safety/">De-cluttering (safely) for safety</a>; <a href="https://psrc-yh.nihr.ac.uk/psrc_themes/supporting-safe-care-in-the-home/">Supporting safe care in the home</a>; and <a href="https://psrc-yh.nihr.ac.uk/psrc_themes/rethinking-safety-intelligence-for-improvement/">Rethinking safety intelligence for improvement</a>. This PhD aligns to the Safer systems, cultures and practices theme of work led by Professor Jane O'Hara and Professor Carl Macrae.</p> <h5>Supervision Team</h5> <p>Dr Gemma Louch (University of Leeds)</p> <p>Dr Laura Sheard (University of York)</p> <p>Dr Lauren Ramsey (NIHR Yorkshire and Humber Patient Safety Research Collaboration)</p> <p>Dr Charlotte Overton (NIHR Yorkshire and Humber Patient Safety Research Collaboration) </p> <h5>Other conditions:</h5> <p>•    Applicants must not have already been awarded or be currently studying for a doctoral degree.<br /> •    Awards must be taken up by 31st March 2025.<br /> •    Applicants must live within a reasonable distance of the University of Leeds or the Bradford Institute for Health Research whilst in receipt of this scholarship and will be expected to join in with our thriving research community.</p>

<p>To apply for this scholarship opportunity applicants should complete an <a href="https://medicinehealth.leeds.ac.uk/faculty-graduate-school/doc/apply-2">online application form</a> and attach the following documentation to support their application. </p> <ul> <li>A full academic CV</li> <li>Degree certificate and transcripts of marks</li> <li>Evidence that you meet the University's minimum English language requirements (if applicable)</li> </ul> <p>To help us identify that you are applying for this scholarship project please ensure you provide the following information on your application form;</p> <ul> <li>Select PhD in Healthcare as your programme of study</li> <li>Give the full project title and name the supervisors listed in this advert</li> <li>For source of funding please state you are applying for an NIHR YH-PSRC Scholarship</li> </ul> <p>If English is not your first language, you must provide evidence that you meet the University's minimum English language requirements (below).</p> <p><em>As an international research-intensive university, we welcome students from all walks of life and from across the world. We foster an inclusive environment where all can flourish and prosper, and we are proud of our strong commitment to student education. Across all Faculties we are dedicated to diversifying our community and we welcome the unique contributions that individuals can bring, and particularly encourage applications from, but not limited to Black, Asian, people who belong to a minority ethnic community, people who identify as LGBT+ and people with disabilities. Applicants will always be selected based on merit and ability.</em></p>

This award is only available to applicants who are eligible to pay academic fees at the UK Home fee rate.<br /> <br /> Applicants to this scholarship in the School of Healthcare should normally have an Undergraduate degree of 2:1 or above (or international equivalent) in a relevant subject area such as a health-related subject (e.g. pharmacy, nursing etc.), psychology or social science. A Master’s degree is desirable, but not essential.

The minimum English language entry requirement for postgraduate research study in the School of Healthcare is an IELTS of 6.5 overall with at least 6.0 in each component (reading, writing, listening and speaking) or equivalent. The test must be dated within two years of the start date of the course in order to be valid.

<p>This opportunity is funded by the <a href="https://www.nihr.ac.uk/">National Institute for Health and Care Research</a> (NIHR). The scholarship will attract an annual tax-free stipend matching the UKRI rate (£19,237 for 2024/25) for up to 3 years subject to satisfactory progress. Academic fees will also be paid at the UK fee rate. Due to limited funding we can only consider applicants for this position who are eligible for UK fee status. </p>

<p>For further information about the application process please contact the Admissions team:<br /> <a href="mailto:fmhpgradmissions@leeds.ac.uk">fmhpgradmissions@leeds.ac.uk</a></p> <p>For informal enquiries regarding this project please contact the supervision team:</p> <p>Dr Gemma Louch: <a href="mailto:G.E.Louch@leeds.ac.uk">G.E.Louch@leeds.ac.uk</a></p> <p>Dr Lauren Ramsey: <a href="mailto:L.Ramsey@leeds.ac.uk">L.Ramsey@leeds.ac.uk</a></p> <p>Dr Laura Sheard: <a href="mailto:laura.sheard@york.ac.uk">laura.sheard@york.ac.uk</a></p> <p>Dr Charlotte Overton: <a href="mailto:Charlotte.Overton@bthft.nhs.uk">Charlotte.Overton@bthft.nhs.uk</a></p>