Dr Helen Lloyd
Profiles

Dr Helen Lloyd

Lecturer in Psychology

School of Psychology (Faculty of Health)

Role

Lecturer, School of Psychology.

Prior to joining the school of Psychology I spent 5 years working for the south west Peninsula Collaboration for Applied Heath and Care focusing on complex interventions and experiences of care. In addition to lecturing I remain involved in the Person Centred Coordinated Care (P3C) collaborative with Professor Richard Byng. 

Qualifications

I am primarily a qualitative researcher with a grounding in medical anthropology. I particularly enjoy innovating with mixed methods and have a passion for action research that applies and integrates qualitative and quantitative methodologies to create health and social improvements.  My research to date has explored how notions of race, ethnicity and self and community identity influence health behaviour and the experiences and outcomes of care. I am also particularly interested in how micro, meso and macro factors interact to shape and potentially change health inequalities. 

My research experience spans the health sciences from occupational health,psychiatry, epidemiology, health services research and public health. In 2003 I completed an MSc in medical anthropology at UCL, followed by the successful completion of my D.Phil. at the University of Oxford in 2007.

Following this I established a research consultancy based in Oxford to promote and integrate medical anthropology as an applied approach in UK public health research. This was achieved by securing research contracts with a range of clients including the Department of Health and various UK Primary Care Trusts. My public sector contracts included a novel qualitative synthesis for the Department of Health to investigate drivers of health inequalities across a range of health concerns including, childhood obesity,smoking, alcohol and drug use, sexual health and teenage pregnancy, and mental health. An outstanding example of this applied work is the Sub-21 project to reduce under age street drinking in North Tyneside. This research used participant observation sessions with youths engaging in street drinking and depth interviews to shape the subsequent intervention. Young people and retailers were placed at the heart of the intervention development process to create a two pronged approach; a rolling program of youth activities designed by and for local youths combined with a retailer’s campaign providing new tools to help them reduce illegal and proxy alcohol sales. The project has now reached over 3000 young people and resulted in a 30% decrease in anti-social behaviour and alcohol-related incidents. This project has been independently evaluated by the London School of Hygiene and Tropical Medicine.

In 2010 I joined the Nuffield Department of Population Health as Research Advisor for the Research Design Service South Central and as Research Associate. During this time I worked with Professor Ray Fitzpatrick and Professor Crispin Jenkinson on several projects related to PROMS and patient experiences of care.


Professional membership

I am a member of the British Psychological Society and a visiting lecturer at the Centre for Person Centred Care (GPCC), University of Gothenburg, Sweden. 

Roles on external bodies

I am an NIHR grant application reviewer. 

Teaching interests

Module lead/lecturer:

PSYC577 – Advanced Interpretive Methods (MSc)

PSYC108PP – Introduction to Psychology for non-psychology students (BSc)

Lecturer:

PSYC515 – Health and Wellbeing S2 (BSc)

PSYC519 – Research Skills in Practice S2 (BSc)

PSYC783 – Applied Health Research and Service Evaluation (MSc)

PSYC416 – Connecting Psychology S1: Art and Psychology (BSc)

Project Supervision:

Currently supervising:

- 19 students (12 UGs, 7 MScs)

Research interests

I am a qualitative and mixed methods researcher with training in medical anthropology. I have a particular interest in action research that applies and integrates qualitative and quantitative methodologies to create health and social improvements.  My research to date has explored how notions of race, ethnicity and self and community identity influence health behaviour and the experiences and outcomes of care. I am also particularly interested in how micro, meso and macro factors interact to shape and potentially change health inequalities. 

My doctoral research investigated caregiving in UK Punjabi Indian Sikh and White British parents with a son or daughter with schizophrenia. It explored the clinical, family and service use variables associated with caregiver burden, and if burden predicted one-year patient outcome. This cross-disciplinary study integrated a quantitative psychological and anthropological methods to explore the local, social, and cultural factors that shaped perceptions and experiences of burden and caregiving. The findings from this study suggest that parental burden in schizophrenia is influenced by contextual and domestic features over and above ethnicity. Furthermore, many parents with stabilised offspring do not perceive their role as burdensome and community patients with the right support can live independently, work, and maintain quality relationships with their families. More importantly, the findings remind us how local socio-environmental factors shape human experience, and that while Indian Punjabi parents and White British parents differ in a number of respects, they share fundamental characteristics that exist above and beyond ethnicity, race or religion.   

Current Research:

Person Centred Coordinated Care (P3C):

I established and led the P3C programme with the aim of improving the experiences and outcomes of care for people with long-term conditions. This work has been selected as a Research Excellence Framework (REF) impact case study for Unit 4, entitled ‘Improving long term conditions (LTCs) and multiple long term conditions (MLTCs) through data driven practice change using a newly developed P3C model’. This work continues through national and international collaborations and through the development and intersection of the following themes:

·   Culturally Relevant Person Centred Care: ‘Forced to Flee: a Peer led Community Mental Health Intervention’

Research bid submitted to NIHR HSDR (9 Jan 2020) in partnership with the refugee community, START, Livewell and Headspace to design a person centred and culturally relevant community health intervention for refugees. If funded this project will commence in late 2020 in collaboration with SW ARC, UoP Medical School, Bristol ARC and the University of East London. 

·   Cultural Validation Of The P3CEQ

A paper reporting the utility of the P3CEQ across Europe (Germany, Spain, Finland, Estonia & Netherlands) is being prepared in collaboration with a team of EU researchers (Sustain/SelFIE/Nivel). We are also working on an analysis of a large the UK and Dutch data set with Dutch Institute for Health Services Research.

·   Optimising Person Centred Care: Theory, Narrative, Measurement and Implementation

A paper presenting a theory of engagement for person centred care developed with Debra Westlake (Medical School) is in the final stages of preparation. A successful collaboration with Professor Prof Nicky Britten (Exeter) has seen the extension of our GPCC Narrative Project for an extra year. We have published one paper from this project and three others are in preparation. The Mosaic project with Anna Dencker (funded by GPCC) aims to create a state of the art measure of PCC through two interlinked PhDs. My work on the EU wide COST CAREs project led By Professor Inger Ekman (GPCC) is developing policy and guidance for the implementation of Person Centred Care across Europe. I have led the work of the evaluation group, which is due to complete next spring. Two papers outlining our work are near completion and we have identified four possible implementation sites (Poland, Spain, Sweden and Portugal) for future work.

The Health and Psychology of Online Gambling-Gaming:

In addition to the above, I have also begun to develop research in under-researched areas of national and societal importance with colleagues from the University of Wolverhampton (J Lloyd), the medical school (James Close) and the school of Government and Law (Ollie Smith). Our Gamble Aware funded in collaboration with Wolverhampton commenced in December 2019 to explore the relationship between online gaming and gambling and related harms. 

Art, Psychology and Creative Recovery:

I am also working in collaboration with Dr Sana Murrani on the ‘Creative Recovery: Mapping Refugees’ Memories of Home’ project, funded by the European Cultural Foundation. This project used three-dimensional maps as narrative devices to access memories of home in recently arrived refugees and asylum seekers. A manuscript detailing this work is underway.

Research degrees awarded to supervised students

I am currently supervising four PhD students:

·   A realist evaluation of UK health interventions focused on patients with Multimorbidity: Jose Valderas (Dos), Professor Rob Anderson (2nd), Dr Helen Lloyd (3rd) and Dr Christopher Dickens (4th), Ms Charlotte Bramwell (Phd Student)

·   A nursing student-led intervention to improve digital health of patients with long-term conditions. Professor Ray Jones (DoS), Dr Helen Lloyd (2nd) and Dr Graham Williamson (3rd). Toni Page (PhD Student). Submitted.

·   PREM-CAT: A Person Centred Patient Reported Experience Measure for people with multiple complex conditions using Computer Adaptive Tests. Professor Adrian Taylor (interim Dos), Helen Lloyd (2nd), James close (3rd) and Professor Anna Dencker GPCC (4th) and Professor Chris Gibbons (Harvard/Cambs).


Grants & contracts

2019-2021

J Lloyd, H Lloyd, J Close, T Rayman, O Smith, M. Uther, C Fullwood.

Gamble Aware

A mixed-method investigation of the gaming/gambling interface and health related harms.

 

UK total grant £300K

2018-2021

H Lloyd & A Dencker.

University of Gothenburg Centre for Person Centred Care)

Methodological solutions to support the Assessment of Individualised Care: The Mosaic Project.

£150K

 

2018-20

H Lloyd, N Britten, A Wolf, & O Naldermirici

University of Gothenburg Centre for Person Centred Care.

Narrative for Person Centred Care.

£26K

2016-2017

H Lloyd,

National Health Service for England (NHSE)

Metrics for Person Centred Care: A knowledge Portfolio, Policy and Commissioners Guide

£100K

2014-2017

H Lloyd (Phase 1),

H Lloyd & J Close (Phase 2)

Somerset Clinical Commissioning Group, Academic Health Science Network, NHSE:

Somerset System Evaluations; Phase I&II Evaluation of the Somerset Practices Quality Scheme (removal of QOF for Person Centred Care); Test and Learn. 2014-2016. Principal Investigator.

£222K

2016-2017

H Lloyd

South West Academic Health Science Network & PenCLAHRC

Research Support/Pump priming, Person Centred Care (P3C).

£78K.

2016-2018

R Sheaff, R Byng, H Lloyd, J Valderas, M Pearson

Funded by NIHR Health Services Delivery Research

A Realist Review of Multi-Specialty Teams.

£100K.

2016-2017

R Lillford, R Byng, F Griffiths, H Lloyd,

Co-applicant. NIHR Programme Development Grant led by

Education and facilitation to improve clinical decisions and multidisciplinary team working with older adults with multimorbidity. 2016.

£100K

2016-2017

H Lloyd

Academic Health Science Network for NHSE.

An Evaluation of the SW Integrated Person Commissioning Pilot (IPC).

£170K

2014-2015

H Lloyd

South Devon and Torbay       Joined Up Board.

A Formative Evaluation of South Devon and Torbay’s Pioneer Hubs.

£70K


Key publications are highlighted

Journals
Articles
Lloyd HM, Ekman I, Rogers HL, Raposo V, Melo P, Marinkovic VD, Buttigieg SC, Srulovici E, Lewandowski RA & Britten N 2020 'Supporting Innovative Person-Centred Care in Financially Constrained Environments: The WE CARE Exploratory Health Laboratory Evaluation Strategy' International Journal of Environmental Research and Public Health 17, (9) 3050-3050 , DOI PEARL
Naldemirci O, Wolf A, Britten N & Lloyd H 2019 'The potential and pitfalls of narrative elicitation in person‐centred care' Health Expectations , DOI PEARL
Close J, Fosh B, Wheat H, Horrell J, Lee W, Byng R, Bainbridge M, Blackwell R, Witts L & Hall L 2019 'Longitudinal evaluation of a countywide alternative to the Quality and Outcomes Framework in UK General Practice aimed at improving Person Centred Coordinated Care' BMJ Open 9, (7) e029721-e029721 Author Site Publisher Site , DOI PEARL
Lloyd H, Byng R, Laura G & John A 2019 'A worked example of initial theorybuilding: PARTNERS2 collaborative care for people who have experienced psychosis in England' Evaluation , DOI PEARL
Wheat H, Horrell J, Valderas JM, Close J, Fosh B & Lloyd H 2018 'Can practitioners use patient reported measures to enhance person centred coordinated care in practice? A qualitative study' Health and Quality of Life Outcomes 16, (1) Author Site Publisher Site , DOI PEARL
Lloyd H, Fosh B, Whalley B, Byng R & Close J 2018 'Validation of the person-centred coordinated care experience questionnaire (P3CEQ)' International Journal for Quality in Health Care 31, (7) 506-512 Author Site Publisher Site , DOI PEARL
Close J, Byng R, Valderas JM, Britten N & Lloyd H 2018 'Quality after the QOF? Before dismantling it, we need a redefined measure of ‘quality’' British Journal of General Practice 68, 314-315 Publisher Site , DOI PEARL
Sheaff WR, Brand S, LLoyd H, Wanner A, Fornasiero M, Briscoe S, Valderas J, Byng R & Pearson M 2018 'From Programme Theory to Logic Models for Multispecialty Community Providers: A Realist Evidence Synthesis' Health Services and Delivery Research PEARL
Lloyd H, Wheat H, Horrell J, Sugavanam T, Fosh B, Valderas JM & Close J 2018 'Patient-Reported Measures for Person-Centered Coordinated Care: A Comparative Domain Map and Web-Based Compendium for Supporting Policy Development and Implementation' Journal of Medical Internet Research 20, (2) Publisher Site , DOI PEARL
Sugavanam T, Fosh B, Close J, Byng R, Horrell J & Lloyd H 2018 'Codesigning a Measure of Person-Centred Coordinated Care to Capture the Experience of the Patient: The Development of the P3CEQ' Journal of Patient Experience Author Site , DOI PEARL
Lloyd H, Pearson M, Sheaff WR, Asthana S, Wheat H, Sugavanam T, Britten N, Valderas J, Bainbridge M & Witts L 2017 'Collaborative action for person-centred coordinated care (P3C): an approach to support the development of a comprehensive system-wide solution to fragmented care' Health Research Policy and Systems , DOI PEARL
Horrell J, Lloyd H, Sugavanam T, Close J & Byng R 2017 'Creating and facilitating change for Person-Centred Coordinated Care (P3C): The development of the Organisational Change Tool (P3C-OCT)' Health Expectations: An International Journal of Public Participation in Health Care and Health Policy 21, (2) 448-456 Publisher Site , DOI PEARL
Lloyd J, Lloyd H, Fitzpatrick R & Peters M 2017 'Treatment outcomes in schizophrenia: qualitative study of the views of family carers' BMC Psychiatry 17, (1) , DOI PEARL
Lloyd H, Lloyd J, Fitzpatrick R & Peters M 2017 'The role of life context and self-defined well-being in the outcomes that matter to people with a diagnosis of schizophrenia' Health Expectations , DOI PEARL
Behrman S, Wilkinson P, Lloyd H & Vincent C 2016 'Patient safety in community dementia services: what can we learn from the experiences of caregivers and healthcare professionals?' Age and Ageing 46, (3) 518-521 , DOI PEARL
Lloyd HM, Tafoya AE & Merritt RK 2014 'Underage Drinking and Antisocial Behavior: Research to Inform a U.K. Behavioral Intervention' Journal of Child & Adolescent Substance Abuse 24, (1) 46-53 , DOI
Lloyd H, Jenkinson C, Hadi M, Gibbons E & Fitzpatrick R 2014 'Patient reports of the outcomes of treatment: a structured review of approaches' Health and Quality of Life Outcomes 12, (1) 5-5 , DOI PEARL
Woodhouse L, Bussell P, Jones S, Lloyd H, Macdowall W & Merritt R 2012 'Bostin Value' Social Marketing Quarterly 18, (3) 221-233 , DOI
Lloyd H, Singh P, Merritt R, Shetty A, Singh S & Burns T 2011 'Sources of parental burden in a UK sample of first-generation North Indian Punjabi Sikhs and their white British counterparts' International Journal of Social Psychiatry 59, (2) 147-156 , DOI
Lloyd H, Singh P, Merritt R, Shetty A, Yiend J, Singh S & Burns T 2010 'A Comparison of Levels of Burden in Indian and White Parents With a Son or Daughter With Schizophrenia' International Journal of Social Psychiatry 57, (3) 300-311 , DOI
Davies LM, Barnes TRE, Jones PB, Lewis S, Gaughran F, Hayhurst K, Markwick A & Lloyd H 2008 'A Randomized Controlled Trial of the Cost-Utility of Second-Generation Antipsychotics in People with Psychosis and Eligible for Clozapine' Value in Health 11, (4) 549-562 , DOI
Jones PB, Barnes TRE, Elton P, Davies L, Dunn G, Lloyd H, Hayhurst KP, Murray RM, Marwick A & Lewis S 2007 'First- vs Second-Generation Antipsychotic Drugs in Schizophrenia—Reply' Archives of General Psychiatry 64, (8) 979-979 , DOI
Davies LM, Lewis S, Jones PB, Barnes TRE, Gaughran F, Hayhurst K, Markwick A & Lloyd H 2007 'Cost-effectiveness of first- v. second-generation antipsychotic drugs: results from a randomised controlled trial in schizophrenia responding poorly to previous therapy' British Journal of Psychiatry 191, (1) 14-22 , DOI
Jones PB, Barnes TRE, Davies L, Dunn G, Lloyd H, Hayhurst KP, Murray RM, Markwick A & Lewis SW 2006 'Randomized Controlled Trial of the Effect on Quality of Life of Second- vs First-Generation Antipsychotic Drugs in Schizophrenia' Archives of General Psychiatry 63, (10) 1079-1079 , DOI
Lewis S, Davies L, Jones P, Barnes T, Murray R, Kerwin R, Taylor D, Hayhurst K, Markwick A & Lloyd H 2006 'Randomised controlled trials of conventional antipsychotic versus new atypical drugs, and new atypical drugs versus clozapine, in people with schizophrenia responding poorly to, or intolerant of, current drug treatment' Health Technology Assessment 10, (17) , DOI
Lewis SW, Davies L, Jones PB, Barnes TRE, Murray RM, Kerwin R, Taylor D, Hayhurst KP, Markwick A & Lloyd H 2006 'Randomised controlled trials of conventional antipsychotic versus new atypical drugs, and new atypical drugs versus clozapine, in people with schizophrenia responding poorly to, or intolerant of, current drug treatment' Health Technology Assessment 10, (17) 1-94 , DOI
Lewis SW, Barnes TRE, Davies L, Murray RM, Dunn G, Hayhurst KP, Markwick A, Lloyd H & Jones PB 2005 'Randomized Controlled Trial of Effect of Prescription of Clozapine Versus Other Second-Generation Antipsychotic Drugs in Resistant Schizophrenia' Schizophrenia Bulletin 32, (4) 715-723 , DOI
Lloyd HM, Markwick AJ, Page ER, Lewis S & Barnes TRE 2005 'Attitudes to atypical and conventional antipsychotic drug treatment in clinicians participating in the cutlass study' International Journal of Psychiatry in Clinical Practice 9, (1) 35-40 , DOI
Burns T & Lloyd H 2004 'Is a team approach based on staff meetings cost-effective in the delivery of mental health care?' Current Opinion in Psychiatry 17, (4) 311-314 , DOI
2001 'Case-Referent Survey of Young Adults with Mesothelioma: I. Lung Fibre Analyses' The Annals of Occupational Hygiene , DOI
2001 'Case-Referent Survey of Young Adults with Mesothelioma: II. Occupational Analyses' The Annals of Occupational Hygiene , DOI
Books
2002 Outcome of Psychiatric Admission Through the Courts.
Reports
Lloyd H, Close J, Horrell J, Wheat H & Valeras J 2017 How To Use Metrics, Measures & Insights To Commission Person Centred Coordinated Care: A Guide for Commissioners. National Health Service for England (NHSE) NHSE PEARL
Close J, Witts L, Horrell JL, Blackwell R, Fosh B, Powell C & Lloyd H 0 EVALUATION OF THE SOMERSET PRACTICE QUALITY SCHEME (SPQS): PHASE 2. Author Site