About The Third Gap

This programme's main purpose is to address the 'third gap in translation' which is the way in which evidence based treatments and management strategies are used - or not - in patients' everyday lives. It aims to promote good communication and to enable health professionals in supporting patients more effectively.

The research takes the perspective of the lay person as well as the professionals treating them, because we recognise that lay and professional perspectives often diverge, and patient-centred care requires an understanding of the former. In particular, we conceptualise the resources available to people in managing their own health and illness as comprising a range of pharmaceutical and non pharmaceutical treatments. Pharmaceutical treatments may be accessed by a prescription or purchased over the counter. Non pharmaceutical treatments include orthodox treatments such as physiotherapy or counselling as well as complementary and alternative medicine (CAM). They also include self care strategies, such as traditional and home remedies, dietary changes, and rest or exercise. Lay people draw on a wide range of resources, which are differentially available to them depending on their social and cultural context, in ways which may or may not be professionally recommended or sanctioned. To be effective, professional advice needs to engage with patients' own self management and self care strategies. Similarly, the implementation of new research findings depends on appropriate take up by patients, and relevance to their own situations.

Most previous research has examined the ways in which people use treatments arising in one particular sector (for example prescribed medicines, or CAM treatments) rather than looking at the use of treatments across the board. This programme investigates and supports the integration of health care as it occurs at the level of the individual patient, within the wider context of their lives. Consequently most of this work is based in primary care and community settings. This differs from other research into 'integrative health care' which is concerned with integrating service provision in an organisational context. Methodological work includes patient-centred outcome measurement and the synthesis of qualitative research. The group collaborates with researchers in Europe, North America, China and Australia.

At the heart of the programme is a commitment to work with patients, rather than on them, and to build a knowledge base on which they can make their own informed decisions about how to assemble their individualised packages of care.

Members of this team are leading the patient and public involvement activities of PenCLAHRC PPI.