Dr Ferhana Hashem BA, MA, PhD, PGCE
Reader in Health Services Research, NIHR RDS SE Kent Site Lead & Research Adviser
- 01227 824887
I am a Senior Research Fellow at CHSS. My research activity has been extensive and wide-ranging, focused on patient involvement in social prescribing, self-management and preferences in recovery interventions, and also decision-making, access issues and resource implications in the NHS. I was recently awarded funding from Public Health England/Work and Health Unit, for the project ‘Developing Curriculum Resources on Health and work in Medical Undergraduate Education’.
I became Kent Academic Site Lead for the NIHR Research Design Service South East (RDS SE) in September 2019 and I have been an RDS SE Research Adviser since 2011.
Since 2017 I have been course leader for the National Institute for Health Research/Health Education England (NIHR/HEE) Integrated Clinical Academic Programme. Funding was awarded over several consecutive years from Health Education England, Kent Surrey and Sussex.
I joined the University of Kent in 2006. I previously worked at Anglia Ruskin University (2004-2006) at the Department of Humanities and Social Sciences for a two year post-doctoral research. Previously, I taught social sciences at the University of Durham (2001-2004) and the University of Sunderland (2000-2003).
I completed my BA in Politics from the School of Oriental and African Studies (1997) and completed my MA in History from King’s College London. I received a PhD stipend from the University of Sunderland (1999-2003) to undertake my PhD research in Political Sociology.
Previous Research includes:
Economic and Social Research Council (ESRC) on the “Ethnic options of mixed-race people in Britain‟ (PI: Mr Peter Aspinall; CO: Dr Miri Song & second CO: Dr Ferhana Hashem) (March 2006-May 2008; grant reference: RES-000-23-1507) (£155,405.73)
Nuffield Foundation Small Social Science Grant “What kind of language services should public authorities provide to minority ethnic groups: the case of Bangladeshis in London‟ (PI: Dr Ferhana Hashem; CI: Mr Peter Aspinall) (February 2008-November 2009) (£9,025)
I have been teaching for the School for Social Policy, Sociology and Social Research (SSPSSR) on two modules; for the undergraduate module SO537 (Racism) and a postgraduate module SO884 (Race, Difference and Belonging). I am currently providing supervision for two MA students for the School.back to top
Also view these in the Kent Academic Repository
Evaluation of the benefits of the British Lung Foundation's 'Breathe Easy' peer support network. ‘Integrated Breathe Easy’ is a two year evaluation undertaken on behalf of the British Lung Foundation (BLF) funded by the Cabinet Office through Nesta. It will assess whether integrating Breathe Easy groups into local respiratory care pathways results in better health and well-being outcomes for patients and carers. More than 230 BLF ‘Breathe Easy’ voluntary patient groups meet monthly across Britain. They aim to develop knowledge and increase self-management levels among those with long term lung disease including COPD, asthma and sarcoidosis. They offer support from health professionals and social activities. The study compares three cohorts to measure impact and assess outcomes: groups not integrated into the NHS care pathway new groups which are integrated control group - patients not attending Breathe Easy, but would be willing to. The focus is on patient understanding and self-help. Data collection in year one will explore patient self-efficacy levels, and their knowledge of where to seek help and advice. Carers will also be questioned about their confidence and burden of care. Year two will focus on cost effectiveness of the groups. Rowena Merritt leads and project manages the CHSS research team which includes Research Fellow Ferhana Hashem, Health Economist Olena Nizalova and Statistician Tracy Higgins. Start date: 01/04/2014 End date: 30/04/2016 Funder: British Lung Foundation Funding: £74,725
DOLPHIN-II: Development Of a haemophiLia PHysiotherapy INtervention for optimum musculoskeletal health in children
A three-year study looking at whether muscle strengthening helps improve the long-term health of children with haemophilia. Boys with haemophilia will be allocated at random to two groups: a group that is asked to complete the 12-week exercise routine to strengthen their leg muscles, and another group that does not do exercises. Boys will be monitored throughout the study by measuring their muscle strength, how far they can walk in six-minutes and time taken to ascend and descend 12 steps. A wrist band will be used to record how physically active the boys are as well as how satisfied they are with their health. The study will be managed by a group of health care professionals and researchers with experience and expertise in carrying out this type of research. Development Of a haemophiLia PHysiotherapy INtervention for optimum musculoskeletal health in children (DOLPHIN-II) - a randomised controlled trial Start date:October 2020 End date:October 2023 Award: £343,536 Funder: NIHR for Patient Benefit via East Kent Hospitals University NHS Foundation Trust More information on the NIHR website.
Identifying and Improving the Capacity of Health Service Staff to Conduct Research
Studies suggest that clinician engagement in research has the potential to improve healthcare processes and performance .Where research is led by the professionals who will use it, the resultant research has the potential to improve clinical practice. Eengagement in research can enhance job satisfaction, professional confidence and contribute to enhanced attitudes towards research. Building research capacity and supporting research engagement are key strategic goals for many healthcare organisations. While clinical engagement is seen as beneficial there are concerns that many health care practitioners are unable to be engaged in as much research as they would like. This Cancer Research UK-funded project is aimed at meeting the challenge of boosting research capacity in the NHS workforce. CHSS Director Professor Stephen Peckham leads a multi-disciplinary research team at CHSS in collaboration with the Kent Surrey and Sussex Clinical Research Network. It aims to find out what barriers and facilitators help or hinder health service staff to conduct research. It will propose practical solutions to improve and boost capacity within the current workforce, optimise the NHS research environment and support research at individual, organisational and systemic levels. Start date: February 2017 End Date: January 2020 Funder: Cancer Research UK Funding: £101,961
Optimum Hospice at Home services for end of life care
What are the features of Hospice at Home models that work, for whom, and under what circumstances? Offering people a choice about where they receive their care at the end of life is central to UK policy and the numbers of people wishing to die at home is increasing. We also know from work undertaken with the general public that care at home is an important concern for many people. Much effort has been invested in health services to support care at home, including services called “Hospice at Home” (HAH) which aim to offer hospice care in the individual’s home. The aim of hospice care is to improve the quality of life of people who have an incurable illness up to the point of death. This includes medical, emotional, social, practical, psychological, and spiritual care, as well as addressing the needs of the person’s family and carers. Currently a range of different HAH services exist in the UK and it is unclear which features of these services enable better care and outcomes at the end of life for patients and families. Professor Claire Butler based at CHSS is leading a national study to answer: What are the features of Hospice at Home models that work, for whom, and under what circumstances? The project is led by the University of Kent in collaboration with the University of Cambridge, University of Surrey, Oxford University Hospitals NHS Foundation Trust, Pilgrim’s Hospice and the National Association for Hospice at Home. The project is spearheaded by a team of post-doctoral researchers based at the University of Kent and the University of Cambridge. Start date: 01/02/2017 End date: 22/03/2021 Funding: National Institute for Health Research: Health Services and Delivery Research (project 14.197.44) £760,162 More about this project: 1. Study Design The study started with a national telephone survey of all HAH services to find out about the services they provide. We contacted hospice at home service managers identified through the Hospice UK and National Association of Hospice at Home directories to take part in a survey. We asked the service managers to provide information on how they are funded, which health care professionals work for them and what kind of roles they have, and whether they provide care overnight and at weekends. We had a fantastic response to our phase 1 survey with 70 HAH services taking part (see map of survey responders left). The results of this survey helped us to understand the different types of HAH services running nationally and to select a number of HAH services as case study sites for in depth investigation in Phase 2 of the project. A method called ‘realist evaluation’ is being used to gain an understanding of how the services delivered within the different models impact on patients and carers and whether they are supported and cared for as well as possible. We will also compare the costs of delivering services in the different models, and talk to providers of services about local issues that help or hinder the delivery of a good service. The final phase of the project (Phase 3) will involve presentation of our initial findings and discussion with stakeholders in two workshops to validate interpretation of the data and to refine our understanding of what works, for whom, and under what circumstances. These consensus events will help to develop our findings into guidelines for services and commissioners for developing HAH services matched to local needs. 2. How will we make sure the research is on the right track for patients and families? We are aware that the project needs to be conducted sensitively and we are experienced in undertaking research with bereaved people. We are working closely with patients and members of the public to advise us on the most sensitive approaches. Our team includes two lay co-applicants who are members of the project team and involved in co-producing the research with us. Both have experienced bereavement as a carer and they have a key role in the team to ensure a thoughtful and ethically sound approach. One of our lay co-applicants recently presented with Charlotte Brigden (Pilgrims Hospice), at the RDS South East/INVOLVE UK event in London. They showcased the OPEL H@H study as an example of public co-production in research. The project also benefits from input from independent experts and public members who sit on the Project Oversight Group for the study. This group oversees the project progress and ensures the study delivers on its objectives, produce findings relevant to the public and national healthcare services. It also ensures that the study has involved public and patient input throughout. Throughout the project we have been reviewing and documenting the PPI input in to the project and how this has changed the project and our approach over time. See a link to this overview below. PPI feedback Year 1 PPI feedback Year 2 3. How will we make the research findings available? Publication of the full and complete account of the research will be in the NIHR HS&DR Journal. This will allow the research to be freely and publically available via the NIHR journals library website. We will also publish our findings as they arise in peer reviewed journals such as BMJ, Social Science and Medicine and British Journal of General Practice to reach broad audience coverage in community services, and Health Services Journal to reach service commissioners. See below for links to what we have published so far. We will present our findings through presentations or posters at existing research forums such as the European Association of Palliative Care Congress; Clinical Research Network forums; Cicely Saunders Institute, King’s College, London; Hospice UK annual conference; National Association for Hospice at Home (NAHH) conference. See posters we have already below. Guidelines will be developed for services to help plan HAH services in the future. We also aim to engage with commissioners through the links and influence of our commissioner co-applicant, Professor Bee Wee as National Clinical Director for End of Life Care for NHS England. At the end of the project, a report and summaries for lay audiences will be produced. The draft report was submitted to NIHR on 22/3/21 and we expect it to be publicly available in early 2022. The study data will also be available to researchers and the NHS on completion in line with national and international recommendations to benefit wider society. This will also be disseminated to our research participants. In addition, dissemination of findings aimed at the public will be facilitated through links with specific organisations including the National Council for Palliative Care, Hospice UK and the National Association for Hospice at Home (NAHH). These links with National organisations may also assist with bringing the results of the research to the attention of National Policy makers. Case Study Site Newsletters: Feb 2018 May 2018 July 2018 Sept 2018 Dec 2018 Mar 2019 May 2019 June 2019 Study Publications: Hashem, F., Brigden, C., Wilson, P. and Butler, C. (2020) "Understanding what works, why and in what circumstances in Hospice at Home Services for End of Life Care: applying a realist logic of analysis to a systematically searched literature review", Palliative Medicine. Sage, pp. 16-31. doi: 10.1177/0269216319867424. Abstract | View in KAR Rees-Roberts, M., Williams, P., Hashem, F., Brigden, C., Greene, K., Gage, H., Goodwin, M., Silsbury, G., Wee, B., Barclay, S., Wilson, P. and Butler, C. (2019) "Hospice at Home services in England: a national survey", BMJ Supportive and Palliative Care. BMJ Publishing Group, pp. 1-7. doi: 10.1136/bmjspcare-2019-001818. Abstract | View in KAR Butler, C., Brigden, C., Gage, H., Williams, P., Holdsworth, L., Greene, K., Wee, W., Barclay, S. and Wilson, P. (2018) "Optimum hospice at home services for end-of-life care: protocol of a mixed-methods study employing realist evaluation", BMJ Open. BMJ. doi: 10.1136/bmjopen-2017-021192. Abstract | View in KAR Selected Conferences, posters and presentations: Abrahamson V, Butler C, Wilson P, Mikelyte R, Brigden C, Silsbury G, Goodwin M. 2021 International Conference for Realist Research, Evaluation and Synthesis. Feb 2021. Optimum Hospice at Home Services for End-of-Life care: realist evaluation and co-production. https://www.youtube.com/watch?v=fQX6-ka1VwU&feature=youtu.be Brigden C, Goodwin, M, Silsbury, G, Rees-Roberts M, Butler C, Greene K, Hayes C, Hashem F, Gage H, Williams P, Wee B, Barclay S, Wilson P, Mikelyte, R. Oct 2018. National Association for Hospice at home Annual Conference 2018. Patient and public involvement in hospice research: an example of co-production in action. PPI poster Brigden C and Silsbury G, July 2018 NIHR Research Design Service South East / INVOLVE. Co-production in the OPEL Hospice at Home Study Slides from RDS/INVOLVE UK co-production event – OPEL study project presentation Rees-Roberts M, Mikelyte R, Hayes C, Hashem F, Brigden C, Gage H, Williams P, Greene K, Wee B, Barclay S, Wilson P, Butler C. 2017. National Association for Hospice at Home annual conference 2017. Poster & presentation. Phase 1 poster Phase 1 findings A4 summary 4. Consensus Events 2020 Dates Leeds – 16 January 2020 Venue: The Met, King Street, Leeds, LS1 2HQ London – 23 January 2020 Venue: Wellcome Collection Event Spaces, 183 Euston Road, London NW1 2B Our findings were presented at two national workshops. At these workshops, we sought feedback on the implications of our findings from the audiences including members of the public, carers, HAH providers and health service commissioners. We combined all this information to assess which models of service provision are likely to lead to the best outcomes, represent best value for money and create guidelines for planning HAH services in the future. A summary of the consensus events can be found in the Phase 3 summary (pdf).
Undergraduate Curriculum Resources on Health and Work
CHSS and partners will design an integrated curriculum for health care professionals that addresses how to communicate with service users/patients about staying in and returning to work. To increase health professionals’ confidence in discussing health and work with patients, having acquired the skills, knowledge, tools and techniques to undertake this activity. To increase the uptake of health professionals broaching the issue of Health and Work in their patient consultations, including giving professionals the capability and confidence to use the fit note as a system for practical advice as well as a process for sickness certification To increase patients’ experience of feeling more supported by health professionals. To increase the number of patients understanding the value of work to their own health and well-being, including their expectations of the fit note, by receiving advice from health professionals. An external academic and professionals steering panel will include the following representatives: CHSS GMC Health Education England Academic Occupational Health Physician National Occupational Health Network Medical Schools Council Start date: 19/10/18 End date: 31/12/17 Funder: Public Health England Funding: £149,871
DOLPHIN - developing and piloting a physiotherapy intervention for boys with haemophilia
A three year study to develop and pilot a physiotherapy intervention for boys with haemophilia, an inherited condition (mainly in boys) affecting the blood's clotting ability. It causes bleeding into muscles and joints resulting in weakness and pain. One of the things which affects this group is being able to participate in games and activities with friends. Patients and physiotherapists are working together to design a programme of exercises to help strengthen muscles and help boys with haemophilia with their movement potential. Start date: 01/06/16 End date: 31/5/19 Funder: NIHR for Patient Benefit via East Kent Hospitals University NHS Foundation Trust Funding: £33,323
EPOP: Development of a peri-operative isometric-resistance exercise intervention programme for patients undergoing elective abdominal and thoracic surgery for cancer
A two phase, three year development study of an isometric exercise programme to benefit patients who have undergone abdominal and thoracic cancer surgery. Cancer surgery is associated with risk of some loss of physical function and muscle wastage. Isometric exercise has long been established as effective in increasing muscle strength. Phase one will consist of patient focus groups and an online Delphi survey which will develop the exercise intervention and identify suitable functional outcome measures. Phase two will be a mini pilot and evaluation (effectiveness and cost effectiveness) study, based on two groups randomised to either intervention or usual treatment. The programme will be delivered in hospital but the nature of the exercises means that patients can continue at home after discharge.The programme needs little equipment and space, so can be performed when patients are bed-bound in hospital or at home. Start date: 02/03/2015 End date: 31/03/2018 Funder: NIHR via Maidstone and Tunbridge Wells NHS Trust Funding: £76,130
Managing uncertainty within NICE technological appraisals: the nature and impact of the 'social features' of decision-making
The National Health Service faces significant challenges in trying to meet people's health needs with very limited resources. While new drugs are made available which mean serious conditions can now be treated, spending money on these (sometimes expensive) products will mean that other services have to be sacrificed. NICE (the National Institute for Health and Clinical Excellence) seeks to ensure that the NHS’s limited resources are spent on drugs which are cost effective - good value. Such cost effectiveness decisions are especially important as the NHS seeks to function on increasingly constrained resources. The cost-effectiveness decisions made by NICE, known as 'technological appraisals', would appear to be highly objective and rational. Data about the cost and typical impact of the drug are collected and a decision is duly reached. Under more detailed inspection however, things are not so straightforward. There appears to be much uncertainty throughout the decision-making process - for example in terms of: whether scientific assessments of the effectiveness of a drug are relevant in everyday clinical situations; what we consider 'quality of life' to really mean; or how we make decisions about a drug's likely long term, wide-spread impact from relatively small amounts of data. Moreover, the committee members who must decide whether a drug is cost effective or not cannot be experts in every aspect of information which is presented to them. Hence, they must listen to the opinions of experts in various fields and make decisions as to how much they should heed their assessments. Some of the relevant information will also be provided by the drug manufacturer(s) or patient groups, these representatives may have other interests besides helping NICE make the most equitable decision. This research explores the ways in which various people (N=40) involved in NICE appraisal decisions, not least committee members, deal with these multiple levels of uncertainty. The key objectives are to explore the different approaches used for dealing with uncertainty and the impact of these methods on decision outcomes. The research is follow three specific drugs through the technological appraisal process - analysing the various documents produced by NICE which relate to these appraisals, observing the way evidence is presented and discussed at ‘open’ and ‘closed’ sessions of committee meetings, and interviewing a range of key actors and committee members to better understand their attitudes, beliefs and actions. By comparing the data produced from these three sources - documents, observations, interviews - we aim to develop an understanding of how uncertainty is perceived, considered, presented and tackled within these drug appraisals. From an institutional point of view this would enable more robust decision-making and therefore a more efficient use of NHS resources. At an ethical level this knowledge would help refine appraisals to assure more equitable outcome. The study is led by Professor Michael Calnan of SSPSSR and also includes a contribution from Dr Patrick Brown from the University of Amsterdam. Start date: 01/09/2011 End date: 31/08/2014 Funder: ESRC Funding: £48,679
The Ethnic Options of Mixed Race People in Britain
The research will explore the ethnic options of young (18-25) mixed race people attending colleges of further education and universities in England.The project investigates the range of identity choices potentially available to mixed-race young people in Britain. Together with Ferhana Hashem, also from CHSS, they are undertaking the largest and most detailed study of its kind in the UK and which will supply the research community, census agencies and the providers of educational, health and other public services with a comprehensive insight into the personal, group and political dimensions of mixed-race identities. There are two components to the study: (i) A questionnaire survey of around 300 students who identify as mixed race (or are of mixed race heritage); (ii) in-depth interviews with a sample of 60-80. Start date: 01/03/2006 End date: 29/02/2008 Funder: Economic and Social Research Council Funding: £156,000 Publication: The ethnic options of ‘mixed race’ people in Britain - Full Research Report
Director of Studies - Applied Health Research - MSc
Intercalated BSc in Management in Primary Careback to top