Publications
32 results found
Lennox L, Lambe K, Hindocha C, et al., 2023, What health inequalities exist in access to, outcomes from and experience of treatment for lung cancer?: A scoping review, BMJ Open, Vol: 13, ISSN: 2044-6055
Objectives: Lung cancer (LC) continues to be the leading cause of cancer-related deaths and while there have been significant improvements in overall survival, this gain is not equally distributed. To address health inequalities (HIs), it is vital to identify whether and where they exist. This paper reviews existing literature on what HIs impact LC care and where these manifest on the care pathway.Design: A systematic scoping review based on Arksey and O’Malley’s five-stage framework.Data sources: Multiple databases (EMBASE, HMIC, Medline, PsycINFO, PubMed) were used to retrieve articles.Eligibility criteria: Search limits were set to retrieve articles published between January 2012 and April 2022. Papers examining LC along with domains of HI were included. Two authors screened papers and independently assessed full texts.Data extraction and synthesis: HIs were categorised according to: (a) HI domains: Protected Characteristics (PC); Socioeconomic and Deprivation Factors (SDF); Geographical Region (GR); Vulnerable or Socially Excluded Groups (VSG); and (b) where on the LC pathway (access to, outcomes from, experience of care) inequalities manifest. Data were extracted by two authors and collated in a spreadsheet for structured analysis and interpretation.Results: 41 papers were included. The most studied domain was PC (32/41), followed by SDF (19/41), GR (18/41) and VSG (13/41). Most studies investigated differences in access (31/41) or outcomes (27/41), with few (4/41) exploring experience inequalities. Evidence showed race, rural residence and being part of a VSG impacted the access to LC diagnosis, treatment and supportive care. Additionally, rural residence, older age or male sex negatively impacted survival and mortality. The relationship between outcomes and other factors (eg, race, deprivation) showed mixed results.Conclusions: Findings offer an opportunity to reflect on the understanding of HIs in LC care and provide a platform to consider target
Antonacci G, Ahmed L, Lennox L, et al., 2023, Oral health promotion in acute hospital setting: a quality improvement programme, BMJ Open Quality, Vol: 12, Pages: 1-10, ISSN: 2399-6641
Tooth extraction is the most common hospital procedure for children aged 6–10 years in England. Tooth decay is almost entirely preventable and is inequitably distributed across the population: it can cause pain, infection, school absences and undermine overall health status.An oral health programme (OHP) was delivered in a hospital setting, comprising: (1) health promotion activities; (2) targeted supervised toothbrushing (STB) and (3) staff training. Outcomes were measured using three key performance indicators (KPI1: percentage of children/families seeing promotional material; KPI2: number of children receiving STB; KPI3: number of staff trained) and relevant qualitative indicators. Data were collected between November 2019 and August 2021 using surveys and data from the online booking platform.OHP delivery was impacted by COVID-19, with interventions interrupted, reduced, eliminated or delivered differently (eg, in-person training moved online). Despite these challenges, progress against all KPIs was made. 93 posters were deployed across the hospital site, along with animated video 41% (233/565) of families recalled seeing OHP materials across the hospital site (KPI1). 737 children received STB (KPI2), averaging 35 children/month during the active project. Following STB, 96% participants stated they learnt something, and 94% committed to behaviour change. Finally, 73 staff members (KPI3) received oral health training. All people providing feedback (32/32) reported learning something new from the training session, with 84% (27/32) reporting that they would do things differently in the future.Results highlight the importance of flexibility and resilience when delivering QI projects under challenging conditions or unforeseen circumstances. While results suggest that hospital-based OHP is potentially an effective and equitable way to improve patient, family and staff knowledge of good oral health practices, future work is needed to understand if and how patient
Beaney T, Clarke J, Grundy E, et al., 2022, A Picture of Health: determining the core population served by an urban NHS hospital trust and understanding the key health needs, BMC Public Health, Vol: 22, ISSN: 1471-2458
Background: NHS hospitals do not have clearly defined geographic populations to whom they provide care, with patients able to attend any hospital. Identifying a core population for a hospital trust, particularly those in urban areas where there are multiple providers and high population churn, is critical to understanding local key health needs especially given the move to integrated care systems. This can enable effective planning and delivery of preventive interventions and community engagement, rather than simply treating those presenting to services. In this article we describe a practical method for identifying a hospital’s catchment population based on where potential patients are most likely to reside, and describe that population’s size, demographic and social profile, and the key health needs. Methods: A 30% proportional flow method was used to identify a catchment population using an acute trust in West London as an example. Records of all hospital attendances between 1st April 2017 and 31st March 2018 were analysed using Hospital Episode Statistics. Any Lower Layer Super Output Areas where 30% or more of residents who attended any hospital for care did so at the example trust were assigned to the catchment area. Publicly available local and national datasets were then applied to identify and describe the population’s key health needs. Results: A catchment comprising 617,709 people, of an equal gender-split (50.4% male) and predominantly working age (15 to 64 years) population was identified. 39.6% of residents identify as being from Black and Minority Ethnic (BAME) groups, a similar proportion that report being born abroad, and over 85 languages are spoken. Health indicators were estimated, including: a healthy life expectancy difference of over twenty years; bowel cancer screening coverage of 48.8%; chlamydia diagnosis rates of 2,136 per 100,000; prevalence of visible dental decay among five-year-olds of 27.9%. Conclusions: We define
Coronini-Cronberg S, 2020, Picture of Health: profile of our trust's local population, Picture of Health: profile of our trust's local population
Beaney T, Clarke JM, Coronini-Cronberg S, 2020, Who is responsible? Defining a hospital catchment population in the English National Health Service
There is a growing emphasis on National Health Service hospitals in England promoting population health. Patients can access any hospital, making it complex to define the population a hospital is responsible for. Defining this 'catchment' population is fundamental to provide a population denominator from which to evaluate service provision such as unmet need and the effect of prevention initiatives. Using Chelsea and Westminster Hospital NHS Foundation Trust (CWFT), a large hospital in London as a case study, methods to define the population that has potential to attend the hospital were compared.Inpatient, outpatient and emergency attendances were identified using Hospital Episode Statistics from 1st April 2017-31st March 2018. Lower Layer Super Output Areas (LSOAs), consisting of 1,500 people on average, were used as the geographic unit. Catchment populations were constructed using 3 different methods. Under First-Past-The-Post (FPTP), LSOAs were allocated if a greater proportion of patients attended CWFT than any other hospital trust. Under 30% Proportional Flow (30PF), LSOAs were allocated if more than 30% of patients attended CWFT, while under Stratified Proportional Allocation (SPA), patients were assigned in accordance with the proportion from each LSOA that attended CWFT, by gender and 5-year age strata.Under FPTP, 30PF and SPA, a total of 303, 326 and 10,636 LSOAs were assigned to CWFT, respectively, with corresponding populations of 530,980, 569,682, and 484,249 and median ages of 36, 36 and 29 years. Under FPTP, the catchment area did not overlap with that of any other hospital, while under 30PF, 13.2% of the LSOAs were also allocated to another hospital catchment. Maps were constructed for FPTP and 30PF.The 3 methods produced different catchment populations, with differing characteristics. Understanding the relative merits of each method has implications for hospitals in how they engage in and evaluate population health.Engagement in and evaluation of pu
Grundy E, Suddek T, Filippidis F, et al., 2020, Smoking, SARS-CoV-2 and COVID-19: a review of reviews considering implications for public health policy and practice, Tobacco Induced Diseases, Vol: 18, Pages: 1-11, ISSN: 1617-9625
IntroductionThere has been significant speculation regarding the association between Severe Acute RespiratorySyndrome Coronavirus 2 (SARS-CoV-2) pathogen, coronavirus disease (COVID-19) and smoking.We provide an overview of the available literature regarding the association between smoking, risk ofSARS-CoV-2 infection, and risk of severe COVID-19 and poor clinical outcomes, with the aim ofinforming public health policy and practice in England.MethodsPublications were identified utilising a systematic search approach on PUBMED and Google Scholar.Publications presenting a systematic review or meta-analysis considering the association betweensmoking and SARS-COV-2 infection or COVID-19 outcomes were included.ResultsEight studies were identified. One considered the relationship between smoking and the probability ofSARS-CoV-2 infection, three considered the association between COVID-19 hospitalisation andsmoking history and six reviewed the association between smoking history and development ofsevere COVID-19. One study specifically investigated the risk of mortality. The studies consideringrisk of severe disease indicate that there is a significant association between COVID-19 and currentor ever smoking.ConclusionsThis is a rapidly evolving topic. Current analysis remains limited due to the quality of primary data,although early results indicate an association between smoking and COVID-19 severity. We highlyrecommend public health messaging to continue focusing on smoking cessation efforts.
Coronini-Cronberg S, John Maile E, Majeed A, 2020, Health inequalities: the hidden cost of COVID-19 in NHS hospital trusts?, Journal of the Royal Society of Medicine, Vol: 113, Pages: 179-184, ISSN: 0141-0768
Coronini-Cronberg S, Cullinane M, Cumber E, 2019, Raising the profile of public health in an acute trust: collaborative working and changing perceptions., Public Health England Conference 2019
A population health approach has not traditionally featured in the work of acute hospitals. Chelsea and Westminster NHS Foundation Trust (CWFT) is working to challenge perceptions and demonstrate the opportunity acute trusts have to lead the way in population health. Evidence suggests that CWFT's seven local clinical commissioning groups have 10% more emergency-specific 30-day readmissions than national rates. National data demonstrates alcohol-related attendances increases up to 70% of all weekend attendances. CWFT established an Alcohol Collaboration group to proactively address this alcohol burden. Led by a public health consultant, the group consists of seven local authorities, commissioners, third sector organisations, clinicians and a patient representative. The group engages monthly to support and direct the strategic development of hospital alcohol services. A trust audit suggested that 33% of our population consume alcohol at risky levels, 3% higher than national data, with 2% considered dependant. These findings have been used to engage and prompt discussions with clinical and non-clinical staff and feature as part of a trust-wide alcohol education programme targeting all frontline staff. Our staff and community partners increasingly recognise the opportunity in addressing health at a population level. The most significant achievement to date has been the launch of a 7-day alcohol support service without investment of additional resource. The groups collaborative approach is actively impacting perceptions at an acute trust and ultimately improving patient outcomes at a population level.
Coronini-Cronberg S, Cullinane M, Cumber E, 2019, Raising the profile of public health in an acute trust: collaborative working and changing perceptions., Public Health England Annual Conference 2019
A population health approach has not traditionally featured in the work of acute hospitals. Chelsea and Westminster NHS Foundation Trust (CWFT) is working to challenge perceptions and demonstrate the opportunity acute trusts have to lead the way in population health. Evidence suggests that CWFT's seven local clinical commissioning groups have 10% more emergency-specific 30-day readmissions than national rates. National data demonstrates alcohol-related attendances increases up to 70% of all weekend attendances. CWFT established an Alcohol Collaboration group to proactively address this alcohol burden. Led by a public health consultant, the group consists of seven local authorities, commissioners, third sector organisations, clinicians and a patient representative. The group engages monthly to support and direct the strategic development of hospital alcohol services. A trust audit suggested that 33% of our population consume alcohol at risky levels, 3% higher than national data, with 2% considered dependant. These findings have been used to engage and prompt discussions with clinical and non-clinical staff and feature as part of a trust-wide alcohol education programme targeting all frontline staff. Our staff and community partners increasingly recognise the opportunity in addressing health at a population level. The most significant achievement to date has been the launch of a 7-day alcohol support service without investment of additional resource. The groups collaborative approach is actively impacting perceptions at an acute trust and ultimately improving patient outcomes at a population level.
Coronini-Cronberg S, Patel S, Banks-Smith J, et al., 2019, Smokefree pregnancies: experiences of a partnership based approach between a large NHS maternity unit with local authority partners, Public Health England Annual Conference 2019
Day AC, Wormald R, Coronini-Cronberg S, et al., 2016, The Royal College of Ophthalmologists' Cataract Surgery Commissioning Guidance: executive summary, Eye, ISSN: 1476-5454
Coronini-Cronberg S, 2016, The cataract surgery access debate: why variation may be a good thing, Eye, ISSN: 1476-5454
Coronini-Cronberg S, Bixby H, Laverty AA, et al., 2015, English National Health Service’s Savings Plan May Have Helped Reduce The Use Of Three ‘Low-Value’ Procedures, Health Affairs, ISSN: 0278-2715
Royal College of Opthalmologists, 2015, Commissioning Guide: Cataract Surgery, London, Publisher: Royal College of Opthalmologists
Coronini-Cronberg S, Bixby H, Laverty AA, et al., 2014, Financial austerity and disinvestment in low clinical value procedures in England: a time-trend analysis., 7th European Public Health Conference
Coronini-Cronberg S, Bixby H, Laverty AA, et al., 2014, Financial austerity and disinvestment in low clinical value procedures in England: a time-trend analysis, Society for Social Medicine Annual Scientific Conference 2014
Coronini-Cronberg S, Bixby H, Laverty AA, et al., 2014, Are we squeezing the pips? Financial austerity and disinvestment in low clinical value procedures in England: a time-trend analysis, Society for Social Medicine Annual Meeting 2014
Coronini-Cronberg S, Appleby J, Thompson J, 2013, Application of patient-reported outcome measures (PROMs) data to estimate cost-effectiveness of hernia surgery in England, Journal of the Royal Society of Medicine
Appleby J, Buck D, Coronini-Cronberg S, et al., 2012, Health policy under the coalition government: a mid term assessment, London, UK, Publisher: The King's Fund
Coronini-Cronberg S, Appleby J, Thompson J, 2012, From PROMs to cost per QALY, Patient Reported Outcome Measures (PROMS) Research Conference
Coronini-Cronberg S, Millett C, Laverty A, et al., 2012, The impact of free older persons' bus pass on active travel and regular walking in England, EUROPEAN JOURNAL OF PUBLIC HEALTH, Vol: 22, Pages: 106-106, ISSN: 1101-1262
Coronini-Cronberg S, Millett C, Laverty AA, et al., 2012, The impact of free older persons’ bus pass on active travel and regular walking in England, American Journal of Public Health
Coronini-Cronberg, Millett, Laverty A, et al., 2012, A cross-sectional assessment of the effect of the free older persons' bus pass on active travel and regular walking among adults ≥60 years in England using data from the National Travel Survey 2005-2008, Society for Social Medicine 56th Annual Scientific Meeting
Coronini-Cronberg S, Lee H, Darzi A, et al., 2012, Evaluation of clinical threshold policies for cataract surgery among English commissioners, Journal of Health Services Research & Policy
Lee H, Coronini-Cronberg S, Darzi A, et al., 2012, PCT restriction of cataract surgery funding: a cross sectional evaluation, International Surgical Congress of the Association of Surgeons of Great Britain and Ireland (ASGBI), ISSN: 0007-1323
Lee H, Coronini-Cronberg S, Darzi A, et al., 2012, PCT restriction of cataract surgery funding: a cross sectional evaluation, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 46-46, ISSN: 0007-1323
Coronini-Cronberg S, Heffernan C, Robinson M, 2011, Effective smoking cessation interventions for COPD patients: a review of the evidence, JRSM short reports, Vol: 2
Objectives To review the effectiveness of smoking cessationinterventions offered to chronic obstructive pulmonary disease (COPD)patients, and identify barriers to quitting experienced by them, so that amore effective service can be developed for this group.Design A rapid systematic literature review comprising computerizedsearches of electronic databases, hand searches and snowballing wereused to identify both published and grey literature.Setting A review of studies undertaken in north-western Europe(defined as: United Kingdom, Ireland, France, Germany, Benelux andNordic countries).Participants COPD patients participating in studies looking at theeffectiveness of smoking cessation interventions in this patient group, orexploring the barriers to quitting experienced by these patients.Method Quantitative and qualitative papers were selected according topre-specified inclusion and exclusion criteria, critically appraised, andquantitative papers scored against the NICE Levels of Evidencestandardized hierarchy.Main outcome measure Percentages of successful quitters andlength of quit, assessed by self-report or biochemical analysis. Amongqualitative studies, identified barriers to smoking cessation had to beexplored.Results Three qualitative and 13 quantitative papers were finallyselected. Effective interventions and barriers to smoking cessation wereidentified. Pharmacological support with Buproprion combined withcounselling was significantly more efficacious in achieving prolongedabstinence than a placebo by 18.9% (95% CI 3.6–26.4%). Annualspirometry with a brief smoking cessation intervention, followed by apersonal letter froma doctor, had a significantly higher ≥1 year abstinence rate at three years among COPD patient smokers, compared to smokerswith normal lung function (P < 0.001; z = 3.93). Identified barriers tocessation included: patient misinformation, levels of motivation, healthbeliefs, and poor communication with health professionals.Conclusion D
Coronini-Cronberg S, Ramsey M, Amirthalingam G, et al., 2011, How responding to a Hepatitis A incident highlighted that national vaccination policies are not routinely being implemented in London’s special needs institutions, Health Protection 2011
Coronini-Cronberg S, Woodman J, 2011, Child Poverty Needs Assessment, NHS Hounslow & London Borough of Hounslow
Coronini-Cronberg S, Heffernan C, Robinson M, 2010, Pack-ing it in: what effective smoking cessation services for COPD patients should look like, Annual LKSS Public Health Trainee Conference 2010
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