Martin Utley

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BACKGROUND In the United Kingdom, clinical guidelines recommend that services for depression and anxiety should be structured around a stepped care model, where patients receive treatment at different 'steps,' with the intensity of treatment (i.e., the amount and type) increasing at each step if they fail to benefit at previous steps. There are very limited(More)
The traditional separation of the producers of research evidence in academia from the users of that evidence in healthcare organisations has not succeeded in closing the gap between what is known about the organisation and delivery of health services and what is actually done in practice. As a consequence, there is growing interest in alternative models of(More)
OBJECTIVE To implement routine in-house monitoring of risk-adjusted 30-day mortality following paediatric cardiac surgery. DESIGN Collaborative monitoring software development and implementation in three specialist centres. PATIENTS AND METHODS Analyses incorporated 2 years of data routinely audited by the National Institute of Cardiac Outcomes Research(More)
OBJECTIVES To explore changes over time in the 30-day mortality rate for paediatric cardiac surgery and to understand the role of attendant changes in the case mix. METHODS SETTING AND PARTICIPANTS Included were: all mandatory submissions to the National Institute of Cardiovascular Outcomes Research (NICOR) relating to UK cardiac surgery in patients aged(More)
Outcomes following paediatric cardiac surgery have long been the subject of clinical , regulatory, media and public scrutiny. There are several reasons for this. The work is among the most technically challenging , resource intensive and emotionally charged clinical activity undertaken. In the UK, past events, public inquiries and intentions to reduce the(More)
OBJECTIVES Sarcoma has a predilection to metastasis to the lungs. Surgical excision of these metastases (pulmonary metastasectomy) when possible has become standard practice. We reviewed the published selection and outcome data. DESIGN Systematic review of published reports that include survival rates or any other outcome data. Survival data were put in(More)
OBJECTIVES Many infants die in the year following discharge from hospital after surgical or catheter intervention for congenital heart disease (3-5% of discharged infants). There is considerable variability in the provision of care and support in this period, and some families experience barriers to care. We aimed to identify ways to improve discharge and(More)
BACKGROUND The availability of new vaccines can prompt policy makers to consider changes to the routine childhood immunisation programme in the UK. Alterations to one aspect of the schedule may have implications for other areas of the programme (e.g. adding more injections could reduce uptake of vaccines featuring later in the schedule). Colleagues at the(More)