Professor Bonnie Sibbald BSc MSc PhD FRCGP(honorary)

Bonnie's research aims to improve patient care by making health care delivery systems more efficient and effective. She has two programmes of research. The first is the "workforce" programme in the National Primary Care Research Development Centre. The second is the "co-morbidity" programme in the National Institute of Health Research (NIHR) National School for Primary Care Research.

The workforce programme investigates (1) ways to improve staff recruitment, retention and distribution, and (2) how changing the skill mix of the workforce affects health care quality and costs. The research has shown that inequalities in general practitioner (GP) distribution have persisted for decades with deprived areas suffering the greatest shortages. Consequently the team developed and evaluated strategies to improve this situation. This has included research into: ways to reward professionals who work in underserved areas; the introduction of salaried employment for GPs; the substitution of doctors for nurses; the development of new types of health workers; and recruitment of overseas health professionals.

Co-morbidity

People with co-morbidity - who have two or more chronic conditions – are not well served by health systems that have become increasingly specialised in the care of single diseases. The co-morbidity research programme aims to investigate the ways that chronic conditions may interact with each other to produce worse health outcomes for patients, develop better approaches to treatment, and improve the coordination of care for people with co-morbidity. There are four phases of work focused on people who have both depression and a chronic physical health problem such as diabetes. Phase One reviews existing knowledge of how depression can interact with chronic disease to produce worse health outcomes for patients. Phase Two investigates problems in health care delivery for people with co-morbidity from the perspective of patients and health professionals. Phase Three uses information gained in early phases to develop and test better approaches to the management of depression in patients with a chronic disease. Phase Four develops new indicators for measuring the quality of care delivered to people with co-morbidity.

Postgraduate Research

Bonnie has supervised 4 PhD and 4 MD degrees to completion, and currently has 2 doctoral students:

• Rachel Foskett Thorsby is developing better tools for measuring the coordination of care among multiple health professionals and agencies.
• Diane Whalley is studying the factors which attract doctors and nurses to work in underserved areas.

Bonnie welcomes enquiries from students wishing to study for a higher research degree (PhD, MD) in the organisation and delivery of primary health care services. Specific ideas for new doctoral research include:

•  Quantitative (e.g. social network analysis) and/or qualitative (e.g. ethnographic) studies of multi-disciplinary health care teams to determine how well they work together in coordinating care for patients with multiple chronic conditions
• Evaluation of the impact of new professional roles (e.g. general practitioners, nurses, and other “practitioners with special interests”) on the quality and cost of health care delivery.

More information about postgraduate research in the primary care research group of the School of Community Medicine can be found here.

Bonnie is Director of the National Primary Care Research and Development Centre in the Research School of Community-based Medicine, and Director of the Greater Manchester Collaboration for Applied Health Research and Care (CLAHRC).