Medicine Safety and Effective Healthcare Research

Work package 4

Generating recommendations for national roll-out of prescribing safety indicator based interventions i.e. CDS software (WP2) and PINCER (WP3) by developing learning about the key technical, organisational and policy factors that influence sustained implementation and operation in general practice settings.


  • Develop learning about the key technical, organisational and policy factors that influence the sustained implementation and operation of CDS (WP2) and PINCER (WP3) interventions
  • Understand the contextual factors that influence the nature and extent of translation, implementation and sustained use of the two interventions in different practice settings over prolonged time periods (post 18 months)
  • Evaluate how the two interventions are delivered, experienced and have evolved over time in diverse contexts to achieve different degrees of success, including how delivery might be improved, and
  • Produce recommendations from objectives 1 and 2 along with learning from the wider PRoTeCT programme, relevant policies and the perspective of stakeholders for nationwide implementation and sustainable delivery of the interventions which are tailored to different audiences

Setting and participants

Purposively sampled GP practices in the East Midlands and Greater Manchester

Key stakeholders: regional stakeholders and leaders (CCG level); Practice staff with varying roles; Patient interviews 


  • A case-based, longitudinal and comparative qualitative process evaluation and implementation study
  • Damschroder’s Consolidated Framework for Implementation Research and the Normalisation Process Theory will be used with the latter informing  the design of data collection and analysis

WP4 team members

  • Dr Richard Keers (lead)
  • Professor Aziz Skeikh (lead) 
  • Dr Mark Jeffries
  • Dr Libby Laing
  • Dr Ndeshi Salema
  • Professor Darren Ashcroft
  • Professor Tony Avery
  • Mrs Mindy Bassi
  • Mr Antony Chuter
  • Professor Rachel Elliott
  • Dr Sarah Rodgers


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Medicine Safefy and Effective Healthcare Research

The University of Nottingham
School of Medicine

telephone: +44 (0) 115 823 0209