Faculty of Education, Social Sciences and Law

Sociology and Social Policy

Contact Details

Dr Joanne Greenhalgh

Associate Professor

I’m interested in applying realist evaluation and realist synthesis to the evaluation of healthcare policy and practice.  I have a first degree in psychology, a Masters in public health and a PhD in health services research. I am also Deputy Director of the Centre for Health, Technologies and Social Practice

Research Interests

My current research is focused on applying realist methods to the evaluation of health and social care policies and programmes.  Current projects include a realist synthesis of the feedback of patient reported outcome measures (PROMs) funded by NIHR and a realist process evaluation of robotic surgery, funded by NIHR.  

We have also recently completed a realist synthesis of demand management for planned care, funded by NIHR

Previously, my research has focused on applying a range of social research methods to the design and evaluation of patient reported outcome measures (PROMs) and explored their application and use within routine clinical practice.  This has included an ESRC funded observational study how multidisciplinary neurorehabilitation teams make sense of and use standardised outcome measures.  I am also interested in broader aspects of patient choice in the NHS and clinician-patient communication. 


I have previously taught a range of research methods at undergraduate and postgraduate level.  I am currently module leader for the Level 3 dissertation module and co-lead (with Ana Manzano) the Evaluation Research module as Masters level.

PhD Supervision

I have supervised 2 PhD students and one DClin student to completion. I am currently supervising one NIHR funded pre-doctoral fellow using realist methods to evaluate the use of radiographers in mammography image interpretation for symptomatic breast cancer.   I would be interested in supervising students in the following areas:

  • Application of realist evaluation or synthesis to evaluate complex interventions
  • Evaluation of the use of PROMs by clinicians and clinical commissioning groups
  • Implementation of PROMs in clinical practice
  • Patient’s views on the use and impact of PROMs in routine clinical practice

Key Publications

Journal articles

  • Greenhalgh J, Dalkin S, Gibbons E, Wright J, Valderas JM, Meads D, Black N, ‘How do aggregated patient-reported outcome measures data stimulate health care improvement? A realist synthesis’, Journal of Health Services Research and Policy, 23.1 (2018), 57-65
    DOI: 10.1177/1355819617740925, Repository URL: http://eprints.whiterose.ac.uk/124989/

  • Wong G, Westhorp G, Greenhalgh J, Manzano A, Jagosh J, Greenhalgh T, ‘Quality and reporting standards, resources, training materials and information for realist evaluation: the RAMESES II project’, Health Services and Delivery Research, 5.28 (2017)
    DOI: 10.3310/hsdr05280, Repository URL: http://eprints.whiterose.ac.uk/123531/

  • Alvarado N, Honey S, Greenhalgh J, Pearman A, Dowding D, Cope A, Long A, Jayne D, Gill A, Kotze A, Randell R, ‘Eliciting Context-Mechanism-Outcome configurations: Experiences from a realist evaluation investigating the impact of robotic surgery on teamwork in the operating theatre’, Evaluation, 23.4 (2017), 444-462
    DOI: 10.1177/1356389017732172, Repository URL: http://eprints.whiterose.ac.uk/119561/

  • Randell R, Honey S, Hindmarsh J, Alvarado N, Greenhalgh J, Pearman A, Long A, Cope A, Gill A, Gardner P, Kotze A, Wilkinson D, Jayne D, Croft J, Dowding D, ‘A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making’ 2017
    Repository URL: http://eprints.whiterose.ac.uk/119562/

  • Probyn J, Greenhalgh J, Holt J, Conway D, Astin F, ‘Percutaneous coronary intervention patients' and cardiologists' experiences of the informed consent process in Northern England: A qualitative study’, BMJ Open, 7.6 (2017)
    DOI: 10.1136/bmjopen-2016-015127, Repository URL: http://eprints.whiterose.ac.uk/118728/

  • Greenhalgh J, Dalkin S, Gooding K, Gibbons E, Wright J, Meads D, Black N, Valderas JM, Pawson R, ‘Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of patient-reported outcome measures data to improve patient care’ 2017
    Repository URL: http://eprints.whiterose.ac.uk/111151/

  • Porter I, Gonçalves-Bradley D, Ricci-Cabello I, Gibbons C, Gangannagaripalli J, Fitzpatrick R, Black N, Greenhalgh J, Valderas JM, ‘Framework and guidance for implementing patient-reported outcomes in clinical practice: evidence, challenges and opportunities’, Journal of comparative effectiveness research, 5.5 (2016), 507-519
    DOI: 10.2217/cer-2015-0014, Repository URL: http://eprints.whiterose.ac.uk/102917/

  • Wong G, Westhorp G, Manzano A, Greenhalgh J, Jagosh J, Greenhalgh T, ‘RAMESES II reporting standards for realist evaluations’, BMC medicine, 14.1 (2016), 96-96
    DOI: 10.1186/s12916-016-0643-1, Repository URL: http://eprints.whiterose.ac.uk/101725/

  • Randell RS, Honey S, Alvarado N, Pearman A, Greenhalgh J, Long A, Gardner P, Gill A, Jayne D, Dowding D, ‘Embedding robotic surgery into routine practice and impacts on communication and decision making: A review of the experience of surgical teams’, Cognition, Technology and Work, 18.2 (2016), 423-437
    DOI: 10.​1007/​s10111-016-0368-0, Repository URL: http://eprints.whiterose.ac.uk/97794/

  • Ball SL, Greenhalgh J, Roland M, ‘Referral management centres as a means of reducing outpatients attendances: how do they work and what influences successful implementation and perceived effectiveness?’, BMC Family Practice, 17 (2016)
    DOI: 10.1186/s12875-016-0434-y, Repository URL: http://eprints.whiterose.ac.uk/102020/

  • Greenhalgh T, Wong G, Jagosh J, Greenhalgh J, Manzano A, Westhorp G, Pawson R, ‘Protocol—the RAMESES II study:developing guidance and reporting standards for realist evaluation’, BMJ Open, 2015.5 (2015)
    DOI: 10.1136/bmjopen-2015-008567, Repository URL: http://eprints.whiterose.ac.uk/88754/

  • Dalkin SM, Greenhalgh J, Jones D, Cunningham B, Lhussier M, ‘What's in a mechanism? Development of a key concept in realist evaluation’, Implementation Science, 10.1 (2015)
    DOI: 10.1186/s13012-015-0237-x, Repository URL: http://eprints.whiterose.ac.uk/85522/

  • Mehdipanah R, Manzano A, Borrell C, Malmusi D, Rodriguez-Sanz M, Greenhalgh J, Muntaner C, Pawson R, ‘Exploring complex causal pathways between urban renewal, health and health inequality using a theory-driven realist approach’, Social Science and Medicine, 124 (2015), 266-274
    DOI: 10.1016/j.socscimed.2014.11.050, Repository URL: http://eprints.whiterose.ac.uk/83101/

  • Pawson R, Greenhalgh J, Brennan C, Glidewell E, ‘Do reviews of healthcare interventions teach us how to improve healthcare systems?’, Social Science and Medicine, 114 (2014), 129-137
    DOI: 10.1016/j.socscimed.2014.05.032, Repository URL: http://eprints.whiterose.ac.uk/79346/

  • Greenhalgh J, Pawson R, Wright J, Black N, Valderas JM, Meads D, Gibbons E, Wood L, Wood C, Mills C, Dalkin S, ‘Functionality and feedback: a protocol for a realist synthesis of the collation, interpretation and utilisation of PROMs data to improve patient care’, BMJ Open, 4.7 (2014), e005601
    DOI: 10.1136/bmjopen-2014-005601, Repository URL: http://eprints.whiterose.ac.uk/80013/

  • Boyce MB, Browne JP, Greenhalgh J, ‘Surgeon's experiences of receiving peer benchmarked feedback using patient-reported outcome measures: A qualitative study’, Implementation Science, 9.1 (2014)
    DOI: 10.1186/1748-5908-9-84, Repository URL: http://eprints.whiterose.ac.uk/92562/

  • Boyce MB, Browne JP, Greenhalgh J, ‘The experiences of professionals with using information from patient-reported outcome measures to improve the quality of healthcare: a systematic review of qualitative research’, BMJ Quality and Safety, 23.6 (2014), 508-518
    DOI: 10.1136/bmjqs-2013-002524, Repository URL: http://eprints.whiterose.ac.uk/102918/

  • Randell R, Greenhalgh J, Hindmarsh J, Dowding D, Jayne D, Pearman A, Gardner P, Croft J, Kotze A, ‘Integration of robotic surgery into routine practice and impacts on communication, collaboration, and decision making: A realist process evaluation protocol’, Implementation Science, 9.1 (2014)
    DOI: 10.1186/1748-5908-9-52, Repository URL: http://eprints.whiterose.ac.uk/84778/

  • Subirana M, Long A, Greenhalgh J, Firth J, ‘A realist logic model of the links between nurse staffing and the outcomes of nursing’, Journal of Research in Nursing, 19.1 (2014), 8-23
    DOI: 10.1177/1744987113481782, Repository URL: http://eprints.whiterose.ac.uk/102919/

  • Reeve BB, Wyrwich KW, Wu AW, Velikova G, Terwee CB, Snyder CF, Schwartz C, Revicki DA, Moinpour CM, McLeod LD, Lyons JC, Lenderking WR, Hinds PS, Hays RD, Greenhalgh J, Gershon R, Feeny D, Fayers PM, Cella D, Brundage M, Ahmed S, Aaronson NK, Butt Z, ‘ISOQOL recommends minimum standards for patient-reported outcome measures used in patient-centered outcomes and comparative effectiveness research’, Quality of Life Research, 22.8 (2013), 1889-1905
    DOI: 10.1007/s11136-012-0344-y

  • Greenhalgh J, McCluskey S, Takeuchi E, Velikova G, ‘How do doctors refer to Patient Reported Outcome Measures (PROMS) in oncology consultations?’, Quality of Life Research 2012
    DOI: 10.1007/ss11136-012-0218-3

  • Tyson SF, Greenhalgh J, Long AF, Flynn R, ‘The influence of objective measurement tools on communication and clinical decision making in neurological rehabilitation’, J Eval Clin Pract, 18.2 (2012), 216-224
    DOI: 10.1111/j.1365-2753.2010.01555.x

  • Snyder C, Aaronson N, Choucair A, Elliott T, Greenhalgh J, Haylard M, Hess R, Miller D, Reeve B, ‘Implementing Patient-Reported Outcomes Assessment in Clinical Practice: A Review of the Options and Considerations’, Quality of Life Research 2011
    DOI: 10.1007/s11136-011-0054-x

  • Tyson S, Greenhalgh J, Long AF, Flynn R, ‘The use of measurement tools in clinical practice: an observational study of neurorehabilitation’, CLIN REHABIL, 24.1 (2010), 74-81
    DOI: 10.1177/0269215509341527

  • Greenhalgh J, ‘The applications of PROs in clinical practice: what are they, do they work, and why?’, QUAL LIFE RES, 18.1 (2009), 115-123
    DOI: 10.1007/s11136-008-9430-6

  • Greenhalgh J, Long AF, Flynn R, Tyson S, ‘It's hard to tell": The challenges of scoring patients on standardised outcome measures by multidisciplinary teams: a case study of neurorehabilitation’, BMC HEALTH SERV RES, 8 (2008)
    DOI: 10.1186/1472-6963-8-217

  • Greenhalgh J, Flynn R, Long AF, Tyson S, ‘Tacit and encoded knowledge in the use of standardised outcome measures in multidisciplinary team decision making: A case study of in-patient neurorehabilitation’, SOC SCI MED, 67.1 (2008), 183-194
    DOI: 10.1016/j.socscimed.2008.03.006

  • Greenhalgh J, ‘An assessment of the feasibility and utility of the MS Symptom and Impact Diary (MSSID)’, Quality of Life Research, 14.5 (2005), 1363-1374
    DOI: 10.1007/s11136-004-5389-0

  • Greenhalgh J, Long AF, Flynn R, ‘The use of patient reported outcome measures in routine clinical practice: lack of impact or lack of theory?’, Social Science and Medicine, 60.4 (2005), 833-843
    DOI: 10.1016/j.socscimed.2004.06.022

  • Greenhalgh J, Ford H, Long AF, Hurst K, ‘The MS Symptom and Impact Diary (MSSID): psychometric evaluation of a new instrument to measure the day to day impact of multiple sclerosis’, J NEUROL NEUROSUR PS, 75.4 (2004), 577-582
    DOI: 10.1136/jnnp.2003.020529, Repository URL: http://eprints.whiterose.ac.uk/247/

  • Greenhalgh J, Meadows KA, ‘The effectiveness of the use of patient based measures of health in routine practice in improving the process and outcomes of patient care: a literature review’, Journal of Evaluation in Clinical Practice, 5.4 (1999), 401-416

  • Brettle A, Long A, Grant M, Greenhalgh J, ‘Searching for information on outcomes: do you need to be comprehensive?’, Quality in Health Care, 7.3 (1998), 163-167

  • Firth-Cozens J, Greenhalgh J, ‘Doctors' perceptions of the links between stress and lowered clinical care’, Social Science and Medicine, 77.7 (1997), 1017-1022

© Copyright Leeds 2018