• Led by West Lincolnshire Primary Care Trust.
  • Ran from 2007 to 2010.
  • Focused on sleep treatment and encouraging treatment options other than prescribed sleeping pills.
  • Analysed prescribing data, surveys and focus groups to understand the problem of sleep management and used a range of methods to improve it.
  • Tested collaborative learning as a quality improvement model.

​​​​​​

The project worked to discourage GPs from prescribing sleeping pills as a first line response, and to encourage them to explore other treatment options first, which may be more in line with what patients actually need.

There is evidence that sleep assessment tools and psychological treatments, such as cognitive behavioural therapy, are under-used. Sleeping pills are often prescribed inappropriately and for too long with consequent side-effects.

Alternative treatments available include sleep restriction and a sleep hygiene approach which includes avoiding things like caffeine, alcohol, exercise and eating late in the evening.

The project team analysed prescribing data, surveys and focus groups to understand the problem of sleep management and used a range of methods to improve it.

The project used a multidisciplinary approach involving patients, clinicians, practices and pharmacy support. It worked with patients to understand what they need from a consultation for insomnia and tested the impact of different approaches.

The project tested collaborative learning as a quality improvement model in primary care with eight practices over a six month period.

Benefits

The team demonstrated innovative ways to respond to the management of insomnia using non-drug alternatives and showed how they could be 'normalised' in primary care.

Participating practices reported evidence of change in clinical routines, benefits to patients’ experiences of care, and significant reductions in prescribing in some practices.

The team received further funding to spread the learning through e-learning and other educational initiatives, and a grant from the Engineering and Physical Sciences Research Council to develop innovative ways of providing computerised cognitive behaviour therapy to insomnia sufferers in future.

Who was involved?

Partners included: East Midlands Mental Health Research Network Hub, Lincolnshire and Nottinghamshire Mental Health Trusts, Lincoln and Nottingham Universities, Trent Research and Development Support Unit.

Since this project was completed...

Findings, which included improvements in patients’ experiences of care, and significant reductions in prescribing sleeping pills in some practices, went on to be shared at a UK-wide event in 2011 run by the Royal Society of Medicine. Later that year, the findings were broadcast in an ITV documentary. Since then, the success of REST has led to national changes in health service policy and practice, with findings incorporated in guidance to clinicians developed by the National Prescribing Centre.

REST has also made a considerable international impact (its findings even being cited by the North American Space Agency (NASA) through a series of workshops, seminars and e-learning resources, resulting in changed behaviour among GPs, nurses and practice teams, and changed relationships with patients. Clinicians have moved away from prescribing drugs to using psychological therapies for insomnia – a cultural shift towards shared care and greater patient involvement. 

Further reading

Research report

Involving primary care clinicians in quality improvement

This is the report of an independent evaluation of our Engaging with Quality in Primary Care (EwQPC) improvement programme.

You might also like...

Invitation to tender

ITT: Summative Evaluation of the Flow Coaching Academy Programme

The deadline for responses is 12.00 on Tuesday 5 November 2019.

Apply now

Press release

New funding for diagnostic equipment falls considerably below what is needed

Health Foundation response to the Prime Minister’s announcement of funding for cancer screening.

Blog

Making time to talk: the challenge of spreading knowledge

Dr Nicola Burgess on the practical value of creating formal spaces to spread informal knowledge within organisations.

Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q Community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more