Professor Richard Byng
Profiles

Professor Richard Byng

Professor in Primary Care Research

Clinical Trials & Health Research - Translational & Stratified Medicine (Peninsula Schools of Medicine and Dentistry)

Role

I have worked as a part-time researcher since 1995 in a range of research settings and since 2009 have been developing the Primary Care Group in Plymouth. My main area of research is complex care for complex needs and within that I have developed specific areas of expertise and interest:

  • Shared care for long-term mental illness
  • Content of consultations for mental illness
  • Management of common mental health problems
  • Care for individuals with multi-morbidity
  • Offender health care
  • Organisational systems of health care

Qualifications

I am a General Practitioner and researcher with a particular interest in primary care mental health and care of individuals with complex needs. My PhD involved the development and evaluation of shared care for long-term mental illness utilising a cluster randomised controlled trial and a Realistic evaluation-based process evaluation. I have significant experience of service development, management, policy development and teaching.

I continue to work as a GP at Mount Gould Primary Care Centre and a GP with special interest in mental health, for the Icebreak team at The Zone.

2009  GP with Special Interest in Mental Health accreditation

2004  PhD, University of London, Health Services Research

1996  Masters in Public Health (MPH), University of Birmingham

1992-1993  MRCGP, Oxford (Banbury) Vocational Training Scheme

1985-1988  M.B. B.Ch. (Cambridge), The Royal London Hospital Medical College,

1982-1985  B.A. (Hons) Medical Sciences Degree (2:1), Queens' College, Cambridge University

Teaching interests

I teach medical students at the Mount Gould Primary Care Centre and our outreach service for homeless and offenders.

I run special study units for research.

I have taught and facilitated three ‘Trailblazer’ work based learning courses for primary care and specialist clinicians. (2005-7)

Work at Rushey Green involved teaching of medical students regularly during years one, two and four of the undergraduate course; it included seminar teaching and clinical contact. (1996-2002)

I supervised the GP registrar working at a hostel on the Homeless and Rootless GP training rotation. (1995-99) and and support supervision of GP registrars at Mount Gould.

My post in the South Sudan involved developing an integrated problem oriented curriculum for Medical Assistants, covering clinical care, health promotion, management and teaching skills. (1991-92) 

Research interests

I have been involved in projects related to access, commissioning, inter-professional workng and implementation of evidence-based practice.I have worked as a generalist researcher and become experienced with a range of quantiative and qualitative methodologies relevant to health services research, including:

  • Randomised controlled trials
  • Studies involving qualitative interviews
  • Mixed methods analysis
  • Conversation analysis

I have developed a particular interest in developing and field testing theoretical models (programme theory). This is of particular relevance for the development and evaluation of both innovative compled interventions and programmes for translating evidence into practice.

Research degrees awarded to supervised students

Alex Georgiadis. PenCLAHRC PhD studentship, Offenders with common mental health problems and their care: examination of the perspectives of offenders and practitioners in a qualitative study. 2012-16

Hannah Storey. ESRC/MRC PhD studentship, The Institutional structure of consultations for depression in primary care. (Peninsula Medical School) From 2007-2011.

Kaj Gohal. D Clin Sci Thesis. Ethnic differences in the content of consultations for depression. (University of Exeter). From 2009-2011.

Grants & contracts

Grants as Chief Investigator

Enagager 2 Offenders with Common Mental Health Problems.  NIHR Programme Development Grant (ENGAGER). 2013-2018 (£2M). This project is developing and evaluating an intervention for prison leavers, incorporating an explorotory RCT

How can frontline expertise and new models of care best contribute to safely reducing avoidable acute admissions? NIHR, SDO funded.(£429k) 2012-2014 (Co-Chief investigator with Professor Jonathan Pinkney). This ethnographicstudy aims to describe decision making for potentially avoidable admissions to acute hospitals. 

Engaging Offenders with Common Mental Health Problems. NIHR Programme Development Grant (ENGAGER). 2010-11 (£100k). This project is testing the feasibility of engaging offenders in prison, collecting outcomes and following them up in the community.

 A research evaluation of the south west Improving Access to Psychological Therapies programme. NHS southwest. 2009-11 (£300k). This research will use qualitative case studies alongside a large naturalistic regional data base incorporating validated baseline, process and outcome data to examine the predictors of better access and improved mental health.

Care of Offenders: Continuity of Access (COCOA). Service Delivery and Organisation (SDO). 2008-2010 (£493,000). This study described health care for offenders across the system, involving 8 case studies and interviews with 200 offenders. 

NHS R&D Researcher Development Award, 2001-5. 1) The ‘Realistic Evaluation of Mental Health Link’ made up the second part of my PhD. 2) ‘Impact of consultations for depression’ examined real time consultation data to show an association between expression of emotions, GP activity and better outcomes. This unusual data base continues to be exploited in two research degrees which I am supervising.

Evaluation of the Lewisham Depression Programme. Lewisham Research Unit. 2004-5. (£35,000). This research used another theory based evaluation, Theories of Change, to help understand the mechanisms underpinning translation of evidence into practice.

An evaluation of the introduction of evidence-based interventions to the field of mental health in primary care. NHS North Thames R&D Directorate.1998-2001:  (£48,158). This study examined care provided as practitioners aimed to integrate evidence into every day consultations.

A Randomised Controlled trial of shared care (Mental Health Link) between GPs and secondary services for care of the Long Term Mentally Ill. 1998-2001. NHS Primary-secondary interface R&D programme.  (£184,650).  A Randomised Controlled trial of shared care between GPs and secondary services for care of the Long Term Mentally Ill. NHS Primary-secondary interface R&D programme. Pilot Year 1997-98 (£71,762). I conceived the design, and managed the development of both the intervention and the trial process.

Research projects as co-applicant/investigator

Co-applicant. PCT commissioning practice and health system governance. NIHR, SDO. 2009- 11 (Led by Prof Rod Sheaff, University of Plymouth)

Co-applicant. Preventing depressive relapse in NHS practice through mindfulness-based cognitive therapy (MBCT). NIHR Health Technology Assessment. (£2.3 million, awarded but under contract negotiation). (Led by Prof  Willem Kuyken, Mood Disorder Centre, Exeter University). 2009-2013.

Investigator, International study of conceptual models of consultations for depression (with Prof Chris Dowrick, Liverpool, Alison Karasch, New York, Prof Evelyn Weel-Baumgarten, Netherlands). Unfunded collaboration.

Co-applicant and supervisor, ESRC/MRC PhD studentship, The Institutional structure of consultations for depression in primary care. (With Rebecca Barnes, Peninsula Medical School). 2007-11.

Investigator, ‘Randomised controlled trial of cognitive training’, MRC Experimental Medicine trial (led by Prof Ed Watkins, Mood Disorder Centre, Exeter University) 2006-9.

Co-applicant and Plymouth Lead for a three site SDO project: ‘The professional experience of governance and incentives: meeting the needs of people with complex conditions in primary care’. 2006-8. (Led by Prof Fiona Ross, St Georges.) 

Study Group member. ‘Randomised controlled trial of Mindfulness based cognitive group therapy for recurrent depression’. 2006-7, MRC. (Led by Prof Willem Kuyken)

Lead researcher and investigator, ‘A research and development programme for suicide prevention: I: The needs of offenders on release from prison. II: Development of a suicide audit toolkit for PCTs.’  2005-6. (Principle investigator, Prof John Campbell)

Study Group Member. ‘Randomised controlled trial to determine the clinical and cost-effectiveness of selective serotonin reuptake inhibitors plus supportive care, versus supportive care alone, for mild to moderate depression with somatic symptoms in primary care’. The THREAD Study. (2004-8 HTA funded, led by Prof Tony Kendrick)

 ‘Improving the quality of care for older people with depression: a cross cultural study’. 2001-4. (Led by Prof Shube Banerjee,)

Development of The Lewisham Primary Care Research Consortium

In 1997 I was the lead applicant in a successful bid along with six other practices in applying for R&D research support moneys (following the Culyer report). The consortium was awarded £192,000 over a three year period to support research activity in primary care.

 

Research groups

  • Clinical Trials and Health Research
  • Health
  • Plymouth Inequalities Group

Key publications are highlighted

Journals
Articles
Byng R 2012 'Care for common mental health problems: applying evidence beyond RCTs' Fam Pract 29, (1) 3-7 Author Site , DOI
Smith P, Mackintosh M, Ross F, Clayton J, Price L, Christian S, Byng R & Allan H 2012 'Financial and clinical risk in health care reform: A view from below' Journal of Health Services Research and Policy 17, (SUPPL. 2) 11-17
Watkins ER, Taylor RS, Byng R, Baeyens C, Read R, Pearson K & Watson L 2012 'Guided self-help concreteness training as an intervention for major depression in primary care: a Phase II randomized controlled trial' Psychol Med 42, (7) 1359-1371 Author Site , DOI
Byng R 2012 'Recognition of distress and depression in primary care: how far should we go?' Fam Pract 29, (1) 1-2 Author Site , DOI
Byng R 2011 'What makes a realistic evaluation?' Fam Med 43, (2) 112-113 Author Site
Kuyken W, Byford S, Byng R, Dalgleish T, Lewis G, Taylor R, Watkins ER, Hayes R, Lanham P & Kessler D 2010 'Study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment in the prevention of depressive relapse/recurrence: the PREVENT trial' Trials 11, Author Site , DOI
Farrand P, Confue P, Byng R & Shaw S 2009 'Guided self-help supported by paraprofessional mental health workers: an uncontrolled before--after cohort study' Health Soc Care Community 17, (1) 9-17 Author Site , DOI
Byng R & Gask L 2009 'Improving access to psychological therapies: implications for mental health care in general practice' Br J Gen Pract (59) 640-641
Kendrick T, Chatwin J, Dowrick C, Tylee A, Morriss R, Peveler R, Leese M, McCrone P, Harris T & Moore M 2009 'Randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of selective serotonin reuptake inhibitors plus supportive care, versus supportive care alone, for mild to moderate depression with somatic symptoms in primary care: the THREAD (THREshold for AntiDepressant response) study' HEALTH TECHNOLOGY ASSESSMENT 13, (22) 1-+ Author Site
Byng R, Norman I, Redfern S & Jones R 2008 'Exposing the key functions of a complex intervention for shared care in mental health: case study of a process evaluation' BMC Health Serv Res 8, Author Site , DOI
Kuyken W, Byford S, Taylor RS, Watkins E, Holden E, White K, Barrett B, Byng R, Evans A & Mullan E 2008 'Mindfulness-based cognitive therapy to prevent relapse in recurrent depression' J Consult Clin Psychol 76, (6) 966-978 , DOI
Riley AJ, Byng R, White C & Smith S 2008 'Utilising theories of change to understand the engagement of general practitioners in service improvement: a formative evaluation of the Lewisham Depression Programme' Qual Prim Care 16, (1) 17-26 Author Site
Farrand P, Duncan F & Byng R 2007 'Impact of graduate mental health workers upon primary care mental health: a qualitative study' Health & Social Care in the Community 15, (5) 486-493
Farrand P, Duncan F & Byng R 2007 'Impact of graduate mental health workers upon primary care mental health: a qualitative study' Health Soc Care Community 15, (5) 486-493 Author Site , DOI
Byng R, Bury C & Weaver L 2007 'Patients' experiences of consultations for depression and predictors of adherence to antidepressants' Primary Care & Community Psychiatry 12, (3-4) 109-115
Byng R, Bury C & Weaver L 2007 'Patients' experiences of consultations for depression and predictors of adherence to antidepressants' PRIMARY CARE & COMMUNITY PSYCHIATRY 12, (3-4) 109-115 Author Site , DOI
Howerton A, Byng R, Campbell J, Hess D, Owens C & Aitken P 2007 'Understanding help seeking behaviour among male offenders: qualitative interview study' BMJ 334, (7588) Author Site , DOI
Howerton A, Byng R, Campbell J, Hess D, Owens C & Aitken P 2007 'Understanding help seeking behaviour among male offenders: qualitative interview study' British Medical Journal 334, (7588) 303-306B
Lawrence V, Murray J, Banerjee S, Turner S, Sangha K, Byng R, Bhugra D, Huxley P, Tylee A & Macdonald A 2006 'Concepts and causation of depression: a cross-cultural study of the beliefs of older adults' Gerontologist 46, (1) 23-32 Author Site
Murray J, Banerjee S, Byng R, Tylee A, Bhugra D & Macdonald A 2006 'Primary care professionals' perceptions of depression in older people: a qualitative study' Soc Sci Med 63, (5) 1363-1373 Author Site , DOI
Murray J, Banerjee S, Byng R, Tylee A, Bhugra D & Macdonald A 2006 'Primary care professionals' perceptions of depression in older people: a qualitative study' Social Science & Medicine 63, (5) 1363-1373
Farrand P, Duncan F & Byng R 2006 'Roles undertaken by graduate mental health workers across South West England' Primary Care & Community Psychiatry 11, (1) 21-27
Farrand P, Duncan F & Byng R 2006 'Roles undertaken by graduate mental health workers across South West England' PRIMARY CARE & COMMUNITY PSYCHIATRY 11, (1) 21-27 Author Site , DOI
Byng R, Jones R, Leese M, Hamilton B, McCrone P & Craig T 2004 'Exploratory cluster randomised controlled trial of shared care development for long-term mental illness' British Journal of General Practice 54, (501) 259-266
Byng R, Jones R, Leese M, Hamilton B, McCrone P & Craig T 2004 'Exploratory cluster randomised controlled trial of shared care development for long-term mental illness' Br J Gen Pract 54, (501) 259-266 Author Site
Byng R & Jones R 2004 'Mental Health Link: the development and formative evaluation of a complex intervention to improve shared care for patients with long-term mental illness' J Eval Clin Pract 10, (1) 27-36 Author Site
Byng R 2004 'Physical care for patients with mental illness' Practitioner 248, (1659) 440-445 Author Site
Byng R, Weaver L & Bury C 2003 'GPs' beliefs about their management of depression and needs for supporting change in practice' PRIMARY CARE PSYCHIATRY 8, (4) 121-125 Author Site , DOI
Byng R, Weaver L & Bury C 2003 'GPs' beliefs about their management of depression and needs for supporting change in practice' Primary Care Psychiatry 8, (4) 121-125
Byng R, Dowrick C, Flach C, Leese M, Chatwin J, Morriss R, Peveler R, Gabbay M, Moore M & Tylee A 0 'Estimating probability of sustained recovery from mild to moderate depression in primary care: evidence from the THREAD study' Psychological Medicine , DOI
Byng R, Howerton A, Burnett R & Campbell J 0 'The consolations of going back to prison: what 'revolving door' prisoners think of their prospects' Journal of Offender Rehabilitation 48, (5) 439-461
Books
Casey P & Byng R 2011 Psychiatry in Primary Care. Cambridge Univ Pr
Conference Papers
Qureshi AW, Byng R, Newbold A, Zahra D, Pooler J, Hardy G, Forber S, Weyer-Brown C, Taylor R & Henley W 2012 'Variations in access to therapy for depression and anxiety with the new Improving Access to Psychological Therapy Services' South West Society for Academic Primary Care Torquay 07/03/2012 08/03/2012