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Quality management

Occupational health research - improving the health of workers

The occupational health service at Guy’s and St Thomas NHS Foundation Trust contributes to the further advancement of translational evidence-based research in occupational medicine. It  and is committed to bridging the gap between clinical practice and research in order to improve the health of workers. Our research projects take place across the National Health Service (NHS) and within academic health centres. We also work in close partnership with multi-disciplinary teams across the UK and abroad. 

Our main areas of research interest include: employee mental health, occupational irritant dermatitis, sickness absence and return to work, musculoskeletal health, occupational outcomes relating to specific diseases and occupational epidemiology.      

Meet the research team:

  • Dr Ira Madan (consultant and reader in occupational medicine)
  • Dr Vaughan Parsons (research manager, postdoctoral research fellow)
  • Dr Gill Gilworth (postdoctoral research fellow)
  • Dr Dorota Juszczyk (postdoctoral research fellow)
  • Farhan Quadri (PA/research administrator)

Our research projects

1. SCIN (skin care intervention in nurses) trial

Chief investigator: Dr Ira Madan, Project lead: Dr Vaughan Parsons

Synopsis: A multi-centre cluster randomised controlled trial testing the hypothesis that a behaviour change intervention to improve hand care, coupled with the provision of hand moisturisers, can produce a clinically useful reduction in the occurrence of hand dermatitis when compared with standard care in at-risk nurses working in the NHS.

Primary objective: To measure the difference between intervention plus and intervention light sites in the change in point prevalence of visible hand dermatitis from baseline to 12-15 months after the intervention as assessed by the study dermatologists. More information can be found at www.scintrial.org.

Funded by the National Institute of Health Research (grant ref: 11/94/01)

2. Ways back to Work feasibility study

Chief investigator: Dr Ira Madan, Project lead: Dr Dorota Juszczyk

Synopsis: A mixed methods study to develop and test the feasibility of an intervention to improve the return to work in NHS staff who go on sick leave with a mental health disorder.

The study comprises two complementary phases.

  • Phase 1 will test the feasibility and acceptability of a new novel intervention.
  • Phase 2 will inform the preparation for a future multi-centre trial in the UK.

A significant amount of preparatory work was completed prior to phase 1/2.

Funded by the National Institute of Health Research (grant ref: 15/107/02)

3. e-Fit Note

Chief investigator: Dr Ira Madan, Project lead: Sarah Harrison

Synopsis: A descriptive study examining the quality and completeness of e-fit notes issued in secondary care only across GSTT trust.

Primary objective: To identify if the advice provided by secondary care doctors on e-Fit Notes complies with Department of Work and Pensions guidance.

4. Impact of Disease Severity on Occupational Functioning in Long-Term Conditions (IMPARTS Data)

Chief investigator: Dr Ira Madan, Project lead: Dr Sarwar Shah

Synopsis: A cross-sectional quantitative study investigating the impact of disease severity on occupational functioning in people with long-term conditions when adjusted for anxiety and depression.

5. Patterns and drivers of sickness absence in an NHS trust

Chief investigator: Dr Paul Grime, Guy’s and St Thomas NHS Foundation Trust

Synopsis: To describe and explore patterns and drivers of sickness absence across a large NHS organisation.  

The research team also collaborates and provides an OH perspective on the following studies:

1. Lower Back Pain study

Chief investigator: Prof Alison McGregor, Imperial College London

Synopsis:Examining whether it is possible to predict which people with acute low back pain are likely to develop chronic LBP, from a baseline biomechanical assessment.

Primary objective: Development of a protocol for assessing spinal posture and function during activities of daily living and to assess portable technologies for assessing spinal posture and function clinically

Funder: Arthritis Research UK and the Medical Research Council

2. Manualising Individualised Placement Support for people with unemployment due to chronic pain and testing the feasibility of a randomised controlled trial (Southampton)

Chief investigator: Prof Karen Walker-Borne, University of Southampton

Synopsis: To test the feasibility of adopting individualised placement support (IPS) for people unemployed with chronic pain and lay the groundwork for a definitive RCT (main trial)

Primary objective: To develop the knowledge and understanding required to inform the future delivery of a trial to assess the clinical and cost-effectiveness of IPS for people unemployed with chronic pain, who wish to work. In addition, to test the feasibility of delivery of an IPS-based intervention in the NHS.

Funder: National Institute of Health Research (grant ref 15/108/02)

3. Development of an online interactive decision aid on disclosure and help seeking for medical students with health problems and disabilities (KCL)

Chief investigator: Dr Claire Henderson, King’s College London

Synopsis: Is a decision aid for health professionals experiencing health problems i. useable; ii. acceptable and iii. potentially effective in supporting decisions about disclosure and help-seeking

Primary objective: To investigate and explore attitudes and beliefs of medical students surrounding the disclosure of health problems and evaluation of a decision aid. A decision aid has been developed as a guide to help students evaluate the pros and cons of seeking help and to provide info on services available to them.

4. Menopause at Work: improving the quality of life for working women

Chief investigator Dr Myra Hunter, King’s College London

Synopsis:  The project involves two main phases: 1) a pilot phase; and 2) the main study phase. The pilot phase to gather initial information to help use develop the interventions and refine methods for collecting the data quickly and efficiently to minimise disruption.

Primary objective: To test the feasibility of implementing a self help intervention (booklet) based on CBT for menopausal women (study 1). To develop a brief intervention (workshop, booklet) to increase awareness of menopause amongst employers, and to evaluate both intervention with respect to feasibility, outcomes and acceptability.

5. PRINCE Secondary Trial

Chief investigator: Dr Trudie Chalder, King’s College London.

Synopsis: The test the effectiveness of CBT vs usual care for patients with Medical Unexplained Symptoms

Primary objective: The intervention aims to test whether CBT improves symptoms management and daily functioning, compared to standard medical care.

Dissemination outputs

Conference proceedings

SCIN trial
  • Parsons, V SCIN trial results. To be presented at the Society of Occupational Medicine conference in London in June 2018 (invited speaker).
  • Madan, I and Juszczyk, D. Ways Back to Work (systematic review). To be presented at the Society of Occupational Medicine conference in London in June 2018 (invited speaker).
  • Madan, I and Juszczyk, D. Ways Back to Work (intervention development). To be presented at the Society of Occupational Medicine conference in London in June 2018 (invited speaker).
  • Harrison, S. e-Fit-Note.  To be presented at the Society of Occupational Medicine conference in London in June 2018 (invited speaker).
  • Parsons, V SCIN trial results. To be presented at the Health and Safety Executive (South East England) in Maidstone in October 2018 (invited speaker).
  • Madan, I SCIN trial results. To be presented at the European Society of Contact Dermatitis scientific meeting in Milan (Italy) in October 2018 (invited speaker).
  • Parsons, V SCIN trial results. Presented at the ‘Hand in Glove’ launch event at the Royal College of Nursing in London in April 2018 (invited speaker).
  • Juszczyk, D. Ways Back to Work.  Presented at International Congress in Occupational Health conference in Dublin (Ireland) in May 2018 (invited speaker).
  • Parsons, V SCIN trial results. Presented at International Congress in Occupational Health conference in Dublin (Ireland) in May 2018 (invited speaker)
  • Madan, V., Parsons, V., Ntani, G., Harling, K., McCrone, P., Brough, C., Akintade, E., Hashtroudi, A., John, S., & Taylor W. Presentation of the SCIN trial results. Presented at the SCIN trial dissemination conference. Series of oral presentations 2017. London (UK).
  • Madan, I., Parsons, V. Development of the hand photography protocol. Oral and poster presentation. STANDERM workshop 2017. Berlin (Germany).
  • Madan, I., Parsons, V. Update on the conduct of the SCIN trial. Oral presentation. Eczema and contact dermatitis: An evidence-based update meeting. Nottingham 2017 (UK).
  • Madan. I., Parsons, V., Cookson, B., English. J., Lavender, T., McCrone, P., Murphy, C., Ntani, G., Rushton, L., Smedley, J., Williams, H., Wright, A., Coggon, D.  The SCIN (skin care intervention in nurses) trial. A cluster randomised trial. Oral presentation at Epidemiology in Occupational Health (EPICOH) conference. 2016. Barcelona (Spain).
  • Weston, D., Parsons, V., & Madan. I. The use of mixed methods of contact to improve response rate to a postal questionnaire. Poster presentation at the Epidemiology in Occupational Health (EPICOH) conference 2016. Barcelona (Spain).
  • Madan. I., Parsons, V., Cookson, B., English. J., Lavender, T., McCrone, P., Murphy, C., Ntani, G., Rushton, L., Smedley, J., Williams, H., Wright, A., Coggon, D.  The SCIN (skin care intervention in nurses) trial. A cluster randomised trial. Poster presentation at the 13th Congress European Society of Contact Dermatitis (ESCD) conference 2016. Manchester (UK).
  • Parsons V., Madan, I. Overview and update of the SCIN trial. Oral presentation at the Eczema and Contact Dermatitis: An evidence-based updated scientific meeting 2016. Nottingham (UK).
  • Parsons, V., Coggon, D., Cookson, B., English, J., Lavender, T., McCrone, P., Madan, I., Murphy, C., Ntani, G., Rushton, L., Smedley, J., Williams, H., & Wright, A. The SCIN (Skin Care Intervention in Nurses) Trial. A cross-sectional feasibility study in Wales (Stage 1). Poster presentation at the ISAD 8th Georg Rajka Symposium on Atopic Dermatitis 2014. Nottingham (UK).
  • Parsons, V., Din, S., Wright, A., Coggon, D., Ntani, G., Williams, H., English, J., Madan, I., & Smedley, J. The SCIN (Skin care intervention in nurses) Trial. A cross-sectional feasibility study in Wales. Poster presentation at the Society of Occupational Medicine scientific meeting 2014. London (UK).

Ways back to Work

  • Juszczyk, D. Presentation of the intervention development. International Congress in Occupational Health in Dublin (2018) (Oral)
  • Juszczyk, D Building a return to work intervention. Society of Occupational Medicine in London (2018) (invited speaker).
  • Juszczyk, D., See, B., Parsons, V & Madan, I. Presentation of a survey to determine usual care in the UK NHS Occupational Health (OH) department in managing staff who go on sick leave with common mental health disorders. Society of Occupational Medicine in London (2018) (poster)  
  • Juszczyk, D., See, B., Parsons, V., & Madan, I. Presentation of the development of an intervention to facilitate return to work of healthcare staff with common mental health disorders. Society of Occupational Medicine in London (2018) (poster)  
  • Madan, I. Systematic review completed during stage 1 of the study. Epidemiology in Occupational Health (EPICOH) conference in Edinburgh (2017) (oral)
  • Juszczyk, D., See, B., Parsons, V., & Madan. Results from the survey of usual care completed in stage 1. Epidemiology in Occupational Health (EPICOH) conference in Edinburgh (2017) (poster)

Fit Note

  • Harrison, S. Using fit note data to build research themes. Society of Occupational Medicine in London (2018) (invited speaker).

List of publications from 2015 onwards

SCIN trial

Parsons, V., Williams, HC., English, J., Llewellyn, J., Ntani, G., & Madan, I. (2018). The development of a protocol for diagnosing hand dermatitis from photographic images. Contact Dermatitis. (Published on 4 July 2018 as doi: 10.1111/cod.13053)

BurkeKM; WrightAJ; Parsons V; MadanI. (2018). Influences on use of hand moisturisers in nurses. Accepted for publication in Occupational Medicine [in press]

Madan, I., Parsons, V., Cookson, B., English, J., Lavender, T., McCrone, Murphy, C., Ntani, G., Rushton, L., Smedley, J., Williams, H., Wright, A., & Coggon, D. (2016). A behavioural change package to prevent hand dermatitis in nurses working in the National Health Service. (SCIN trial): study protocol for a cluster randomised controlled trial. Trials, 17.

Weston, D., Parsons, V., Ntani, G., Rushton, L., & Madan, I. (2017). Mixed contact methods to  improve response to a postal questionnaire. Occupational  Med (Lond), 67(4), 305-307.doi:10.1093/occmed/kqx032

General OH

Petrie, K., Gayed, A., Bryan, B., Deady, M., Madan, I., Savic, A., Wooldridge, Z., Counson, I., Calvo, R., Glozier, N., & Harvey, S. (2018). The importance of manger support for the mental health and well-being of ambulance personnel. PLOS One. doi/10.137

Grme, P., McElvenny, D. (2018). Evidence for policy and practice. Occupational Medicine. 68. 296-298.

Gayed, A., Milligan-Saville, J., Nicholas, J., Bryan, B., LaMontagne, A., Milner, A., Madan, I., Calvo, R., Christensen, H., Mykletun, A., Glozier, N., & Harvey, S (2018) Effectiveness of training workplace managers to understand and support the mental health needs of employees: a systematic review and meta-analysis. Occupational and Environmental Medicine. published on March 21, 2018 as 10.1136/oemed-2017-104789.

Gayed A, Milligan-Saville JS, Nicholas J, Bryan BT, LaMontagne AD, Milner A, Madan I, Calvo RA, Christensen H, Mykletun A, Glozier N, Harvey SB. Effectiveness of training workplace managers to understand and support the mental health needs of employees: a systematic review and meta-analysis. Occup Environ Med. 2018 Mar 21. [Epub ahead of print] 

Harvey SB, Wang MJDorrington SHenderson MMadan I, Hatch SLHotopf M. NIPSA: a new scale for measuring non-illness predictors of sickness absence. Occup Environ Med. 2018 Feb;75(2):98-104. Published online doi:10.1136/oemed-2017-104382

Milligan-Saville, JS, Tan, L, Gayed, A, Madan I, Harvey SB. Workplace mental health training for managers and its effect on sick leave in employees: a cluster randomised controlled trial. Lancet Psychiatry. 2017 Nov;4(11):850-858.

Seaton, A., Madan, I., 2016. Can I get compensation, doctor? Br J Gen Pract, 66(652), pp.572-572.

Occupational health at work

Parsons, V., & Madan, I. (2015). From vision to action Part 1: Building an evidence-base in occupational health.Occupational Health at Work. 12 (4).

Parsons, V., & Madan, I (2015). Developing a successful national occupational health research proposal. Part 2. Occupational Health at Work. 12 (5).

Parsons, V., Madan, I. (2016). Implementing a national OH clinical trial. Part 3: the national SCIN trial – roll out and lessons learned. Occupational Health at Work. 13 (5).

Interested in collaborating in research?

We welcome enquiries from researchers who are interested in collaborating on future projects. Please contact Vaughan.parsons@gstt.nhs.uk