E-Newsletter ~ @Official_NIHR #NIHRCLAHRC Developing better health in the community @BTHFT @BiBresearch @jo_cooke73 #CLAHRC_Impact

NIHR CLAHRC Community e-newsletterDeveloping better health in the community Issue 78

 

Welcome to the community e-newsletter for the NIHR CLAHRCs, bringing you news from across the thirteen collaborations and the health services research community. This issue showcases initiatives that the NIHR CLAHRCs are implementing in their regions to develop better health in the community, from projects to improve the lives of disadvantaged groups, campaigns to deliver healthy lifestyle messages, to training programmes to develop the workforce, increase capacity and more.

 

Newsflash

CLAHRC Director to present at international diabetes summit – What has been your experience of being involved in NIHR research? Take this 15-minute survey to give your opinion! – Check out this new podcast from CLAHRC GM and hear about their projects, concepts and ideas – CLAHRC NT is offering a workshop Introduction to Evaluation aimed at staff who have limited experience of conducting service evaluations – This CLAHRC-supported study informed new NHS plans to trial very low calorie diets for the first time – CLAHRC West has a new Director – Download this brochure from CLAHRC YH, packed with examples of the local, national and international impact of their projects!

CLAHRC East Midlands

East Midlands prostate cancer campaign

Four community events were organised in venues in Leicester city. As a result of these events, the need to carry out more awareness and to offer support targeting predominately African Caribbean men was identified. ‘Play Domino Talk Prostate’ was launched on the 10th March 2018, which attracted over 80 people and was televised by Central News. As a result of the ‘Play Domino Talk Prostate’ campaign, weekly group sessions have been ongoing since the 17th March with approximately 20 men attending every week. In addition, an awareness video has been made.

Wellbeing project with the Gypsy and Travellers Community in the East Midlands

There is a growing evidence of research that Gypsies and Travellers (G&T) have significantly poorer health status, greater gap in life expectancy and significantly more self-reported symptoms of ill-health than other ethnic minorities. The project aims to enhance the understanding of those needs, identify gaps in primary research, and seek community feedback on the specific interventions that lead to reduction of health inequalities. For more information about the project, contact Barbara Czyznikowska on bmc15@leicester.ac.uk.

Leicester’s campaign to prevent type 2 diabetes

The global initiative Cities Changing Diabetes was launched in response to the dramatic rise of diabetes within urban areas. As part of this programme, two exciting pilot schemes have been launched in Leicester involving the Centre for BME Health. Walking Cricket is a partnership project with Leicestershire County Cricket Club who provide coaches for these sessions. The scheme is open to over 50s and has proved very popular. Healthy Goals is the other project launched in September. This programme focuses on both empowering participants with healthy lifestyle education sessions as well as physical activity sessions led by coaches from LCFC.

CLAHRC East of England

Reviewing and developing the evidence-base for community end of life careAs an experienced Community Nurse, Ben Bowers explored the evidence-base during his CLAHRC Fellowship to help understand how effective and acceptable anticipatory prescribing is to all involved. Working with Dr Stephen Barclay, Dr Richella Ryan and Isla Kuhn at the Primary Care Unit of University of Cambridge, Ben systematically reviewed the published evidence.

This review, recently published in Palliative Medicine, shows that anticipatory prescribing is based largely on the beliefs of healthcare professionals that it will reassure patients and their families, effectively control symptoms and prevent hospital admissions. But these beliefs are based on insufficient evidence. The views and experiences of patients and their family carers have not been adequately investigated; neither has the clinical-effectiveness, cost-effectiveness or safety of anticipatory prescribing. Ben’s NIHR School for Primary Care Research PhD Studentship, researching community anticipatory prescribing practice and patient and family carer views, will help address some knowledge gaps and improve patient-centred care in the community.

CLAHRC Greater Manchester

GM-SAT re-launch

CLAHRC-GM identified that the original Greater Manchester Stroke Assessment Tool  (GMSAT) needed further development for those living in care homes. In response, the toolkit was modified through collaboration with a group of professionals experienced in carrying out reviews. A mixed-methods evaluation study then explored the value, acceptability and feasibility of delivery of the modified GM-SAT in a care home setting. The toolkit has been further refined, and the Greater Manchester Stroke Assessment Tool- Version 2 (GM-SAT2) developed.

Internships at CLAHRC Greater Manchester

Developing NMAHPs research capability has the potential to improve patient care. This can be seen in the work of CLAHRC GM interns who are working in clinical practice and their project questions directly relate to current challenges within the NHS. The impact of their work is immediate. They select a topic, review the evidence, conduct a small scale evaluation, and implement the findings. In addition to research skills, staff also get time out to think and reflect on their work, the opportunity to meet colleagues from different fields, and work with research colleagues in their organisations and with researchers at local universities.

Improving Leg Ulcer Management In community Nursing and Podiatry (ILUMIN)The ILUMIN project aims to optimise the assessment and treatment of leg management in NHS community services, improving outcomes for patients through the implementation of as set of quality markers. The ILUMIN team has been working together to implement the plan through a co-design approach, to ensure that the project operates optimally in each location.

PenCLAHRC

Early Learning Communities

The PenCLAHRC team will synthesise and evaluate current evidence and practices for supporting children’s early learning in poverty and find the most effective ways to promote it through interventions, policy and practices. This will allow the team to identify strengths and weaknesses, and priorities for change. Using this information from the evidence review and consolation, PenCLAHRC will work with Save the Children and four Early Learning Communities to co-produce a toolkit for achieving while system change. Read more about the project here.

HeLP – the Healthy Lifestyles Programme
The Healthy Lifestyles Programme seeks to deliver healthy lifestyle messages to encourage children to seek their parents’ support and effect change within the family. Behavioural and weight status outcomes 18 and 24 months from the exploratory trial of the Programme showed consistency in the direction of effects, all in favour of HeLP, demonstrating ‘proof of concept’. Watch the video here, and read more about the project here.

DE-STRESS

The DE-STRESS project aims to examine how moralising narratives relating to individual responsibility and welfare entitlements influence the medicalisation of mental distress caused by material deprivation and social disadvantage. In particular the project will look at why and how people’s ability to cope with poverty-related issues has become increasingly pathologised, the impact of high level antidepressant prescribing on the health and wellbeing of low-income communities, and also identify good practices and alternative responses to mental distress. Watch the video here, and read more about the project here.

Public involvement in suicide prevention

This study seeks to address the public health challenge of supporting members of the public to recognise and respond to possible suicidal intent in an unknown person in a public setting. Research undertaken will underpin the development of an educational campaign, which will include a leaflet (including an online version), and a script for a 90 minute face-to-face training session for staff who are likely to encounter vulnerable individuals. The team also have aspirations to develop the script for television, enabling greater audience reach. Read more about the project here.
CLAHRC Wessex

Steady together – reducing the risks of falling in people with Parkinson’s Disease

The results from a mixed methods feasibility study to assess a paper-based guide for community-based people with Parkinson’s who fall and their caregivers are currently being analysed. The guide, titled ‘Steady Together’, aims to support the effective self-management of falls and was developed with people with Parkinson’s. Through interviews, participants discussed how the guide had increased their understanding of their symptoms, and how the guide acted as a facilitator to implement change.  Many participants described how using the guide led to increased confidence in managing falls, and some reported reduced fear of falling arising from enhanced awareness of fall risk or adaptations that they had instigated. Participants suggested ways to further improve the guide. For more details, contact C.L.Owen@soton.ac.uk or look at the website of CLAHRC Wessex.
CLAHRC West Midlands

Obesity risk in migrants and minority ethnic groups

Research undertaken examining obesity risk in migrants and in minority ethnic groups in Coventry demonstrates the multitude of factors contributing to differences in vulnerability to, and prevalence of obesity in these groups compared with the white British population. The work included evidence synthesisquantitative analysis of the Coventry National Child Measuring Programme data and qualitative work with the local population. Important factors identified include genetic and epi-genetic predisposition, as well as socio-economic factors, body size preferences and the difficulties of maintaining a healthy traditional diet and physical activity practices within the modern UK context.

To disseminate these findings and give the research a legacy of improving health in Coventry’s diverse local community, CLAHRC WM are planning a Community Café Event in February 2019. This will bring communities, individuals and groups together from a range of backgrounds and age groups to create a Coventry Food Initiative. The aim is to achieve a sense of community ‘belonging’ through cultural exchange of recipes- as well as giving participants the tools to improve the healthiness of the food they make and consume

CLAHRC Yorkshire and Humber

Ambulatory care

Located at Bradford Teaching Hospitals NHS FT, a new ambulatory care project for children and young people (ACE) has been running since 2017. Over 85% of referrals to ACE have been managed in the community whereas before they would have been seen and managed in hospital. The majority – nearly 60% of referrals – have come from primary care. There have been no adverse events and feedback has all been very positive. ACE has resulted in greater collaboration across community and secondary care services and has been possible because of the development of new clinical roles within nursing and medical teams. It has been the model to trial other innovative shared system wide clinical pathways. It is hoped that the service will be replicated in other areas.

Examining growth and adiposity of children in Bradford

Researchers at CLAHRC YH’s Healthy Children and Healthy Families Theme have been leading a programme of research with Born in Bradford  (BiB) to examine the growth and adiposity of children in Bradford. The National Child Measurement Programme (NCMP) provides height and weight data to monitor trends in Body Mass Index (BMI) in English primary schools, but evidence from the BiB cohort suggests that for a given BMI, South Asian children have greater total and central fat than White British children. This may be important to the higher risk of heart disease and diabetes seen in South Asian adults. Therefore, BiB have been working with school nurses to collect additional information such as skinfold thickness in Reception Year and Year 3. They have also been working to develop culturally appropriate interventions to prevent obesity and improve the health of children in Bradford, such as a trial of using standing desks in schools, and by working with Islamic Religious Settings.

Prison Network

Researchers from the Public Health and Inequalities (PHI) theme of NIHR CLAHRC YH have worked with Nat Wight (honorary GP Consultant) in developing a research network establishing pathways into prisons in order to undertake research. This is in recognition of the ingrained health inequalities of this cohort.This culminated in an inaugural network meeting. The findings were then presented at the Prison Health Symposium. have been invited to lead on the offender health theme of the national Contact, Help, Advice and Information Network (CHAIN) network.

Help at Home – Use of assistive technology for older people @NIHR_DC @TaraJLamont #HelpatHome

 Help at home front cover

Summary

More people are living longer with complex conditions and needs. Technology can help people to stay living well and safely at home as they get older. But technology is changing rapidly and it can be challenging to get the right technology for the right person with the right support. There has been considerable investment recently in developing and evaluating assistive technologies for older people. But this is a relatively new field and there are important gaps in what we know.

This review presents a selection of recent research on assistive technology for older people funded by the National Institute for Health Research (NIHR) and other government funders. This has been selected with help from an expert steering group. In this review we focus on research around the use of technology in the home, remote monitoring systems and designing better environments for older people.

This review provides a selection of recently published research funded by the NIHR and other government funders related to the use of assistive technology to help older people live independently at home. A number of research projects are highlighted which should be of particular interest to those delivering, planning or using adult health and social care services. These have been identified with input from an expert group of relevant stakeholders listed under Acknowledgements. Our approach to identifying and selecting relevant studies is given in the Search strategies section.

Related links:

You can download a PDF version of this report here.

 

Funding ~ Research for older people, small projects, pump priming, PhD #AbbeyfieldResearchFoundation @TheAbbeyfield

Welcome to the Abbeyfield Research Foundation – research for older people

Research is one of the fundamental pillars that supports and maintains best practice in all forms of social and health care. It provides evidence to inform decisions, directs policy development and upholds the sector’s credibility.

Promoting and funding research is one of the many ways that we can contribute towards ensuring that individuals over the age of 55 are given every opportunity to enhance their quality of life. We believe that funding this research is critical and as such, The Abbeyfield Research Foundation was created, to focus specifically on this issue.

We see the potential that funding research has in the development of high quality services for older people. We aim to support individuals at varying levels in their career, from PhD students at the beginning of their research journey to established senior academics looking to support their own research teams.

The Abbeyfield Research Foundation awards grants to eligible individuals and organisations through a two stage, peer reviewed process. Here you can find all the information you need about our research priorities, types of grants and how to apply.

http://www.abbeyfieldresearchfoundation.org/ 

If you have any questions or would like more information, please contact the research department at research@abbeyfield.com

 


Abbeyfield Research Foundation is seeking application to fund ideas of high quality services for older people in any area of social and health care.

Types of grants:

  • PhD Studentships

Applications are sought from prospective supervisors in institutions providing graduate training programmes for grants providing stipendiary funding for the student, university            bench fees and project running costs. Level of award at current costings typically around £20-30k per year over 3 years

  • Small project grants

Grants in this category will cover applicant salary, running costs and possibly items of essential equipment. Award typically up to £50k per year over 2 years

  • Pump-priming grants

Grants in this category will cover preliminary evaluation of an innovative concept over a maximum 12-month period to underpin a subsequent more substantial application for              research funding. Level of award typically up to £20k on a one-off basis

Strategic objectives: http://www.abbeyfieldresearchfoundation.org/articles/information_for_applicants/567/strategic_objectives/567

Research priorities: http://www.abbeyfieldresearchfoundation.org/articles/information_for_applicants/567/research_priorities/563

How to apply: http://www.abbeyfieldresearchfoundation.org/articles/information_for_applicants/567/how_to_apply/570

Deadline for submission is Friday 11th Jan 2019, 5pm.

Deadline 13/01/2019 ~ Submit your abstract for the @HSRN_UK

HSRUK19 conference is open to everyone interested in health services and systems research, and offers you the opportunity to hear about the latest research, build your network and meet the agenda-setters.

SUBMIT YOUR ABSTRACT BEFORE 13 JANUARY

Deadline 13 January! The 2019 call invites submissions for individual abstracts (for oral presentation and/or poster presentation) or for whole sessions (comprising a number of linked oral presentations within one session). We welcome abstracts on all aspects of health services, systems and policy research, especially research that will have a positive impact on patients and the health service, builds research capacity in the NHS or advances research methodology.

Upload your proposal now: www.eventsforce.net/hsruk2019.

REGISTER TO ATTEND

Registration is now open! Book your place today and benefit from early bird fees, until 31 March. HSRUK members get significant discounts on registration. If you’re not an organisational member, join HSRUK today, and you and your colleagues will save £100 per person on registration fees. Get in touch if you’d like to roll this into your conference registration payment.

PLENARIES TO LOOK FORWARD TO

We have some great plenaries confirmed, including:

  • The impact of health research: future priorities and strategies
  • Social care research, policy and practice
  • Using patient experience data for service improvement
  • Researching the healthcare workforce: what do we need to know?

We hope you’ll join us at HSRUK19 for two days of cutting-edge research in an exciting programme of presentations, posters, themed sessions and workshops.

Best wishes,
The HSRUK team

Survey ~ What’s it like being involved in NIHR research? #PublicInvolvement #PI #PPIE @CMSmith215 @NIHRINVOLVE

Survey: What’s it like being involved in NIHR research? 

https://www.surveymonkey.co.uk/r/2KQZCDQ 

Welcome to NIHR’s Public Involvement Feedback Survey

Thank you for taking part in this short survey of your experiences as a patient, carer, service user or member of the public of being involved in National Institute for Health Research (NIHR) research and other activities over the past 12 months.

The survey is anonymous and should take about 15 minutes to complete. It is for patients, service users, carers or members of the public who have been involved in NIHR’s work including:
·     at one of our centres or facilities
as a member of a local advisory group
·     reviewing research applications
·     being a co-applicant on a research study
·     helping design, deliver and disseminate a research project
as a Patient Research Ambassador

The survey is not about people’s experience of being a participant in a research study.

We want to hear from as many people as possible across our many activities so please do pass it on to others who might be interested.

Our aim is get a good picture of what has been happening so we can strengthen and improve how the NIHR works with you. This includes using the results of the survey (which will be made public by the end of March 2019) to establish a benchmark of people’s experiences against which we will review and publicly report our progress.

Please reply to this survey by Monday 7 January 2019. 

Thank you again for your help and for your continued involvement with the NIHR.

https://www.surveymonkey.co.uk/r/2KQZCDQ 

#Testbed Overview Report ~ @Perfect_pathway #Sheffieldcityregion Wave 1 #NHSEngland @Devices4Dignity

The Perfect Patient Pathway Test Bed is delighted to share with you the Test Bed Overview Report, which provides a high level summary of the work that has been undertaken as part of our ‘Perfect Patient Pathway Test Bed’.

We have been proud to be one of the first wave of NHS England Test Beds since 2016. Partnership has been a core element of our achievements and the programme has touched so many people across Sheffield and the City Region. We have had national and international collaboration with our industry partners and I want to thank every one of our contributors for their input and support.

The Test Bed has been an amazing journey of innovation – the first of its kind in the UK – encompassing real world testing of new products, re-design of services, new models of learning, novel evaluation methods, with co-production at its heart. The learning from the programme has been enormous and we will take that legacy forward as a basis for future work and plans.

Integration and system-wide approaches are essential for the future sustainability of health and care. The Test Bed has demonstrated both the benefits and challenges of working across multiple partners as well as what can be achieved through genuine and meaningful collaboration. The value of patients and the public as equal partners has been notable and we could not have achieved the outcomes without their input.

There is much that sits behind this report which is not visible but which we would be happy to share if you require more detail.

Click here to see the Report 

With kind regards,

Professor Wendy Tindale OBE

Scientific & Innovation Director, Sheffield Teaching Hospitals NHS Foundation Trust

SRO for ‘Perfect Patient Pathway Test Bed’

Sheffield Teaching Hospital NHS Foundation Trust

Young people with dementia need new approaches to care @JaneMcKeown1 #YoungOnsetDementia @ShefSNM @DemCareResearch @elspeth_mathie @CRIPACC1 #CLAHRC_Impact

Young people with dementia need new approaches to care

27 November 2018

Research conducted by academics at the University of Hertfordshire outlines new approaches to care for people diagnosed with young onset dementia.

There are currently around 42,000 people under the age of 65 living with young onset dementia (YOD) in the UK. Their support needs are different to the care required by older people. However, little is known about what should be put in place to provide age-appropriate care.

In order to understand how services could be improved, academics from the University of Hertfordshire ran discussion groups to explore perceived service priorities with people with (or with experience of) YOD. They also conducted a literature review, focusing on services available for people affected by YOD. Of the 31 discussants, 11 had a diagnosis of YOD and 20 were spousal caregivers. Academics also interviewed representatives of service providers.  Findings of this study were published in Dementia: The International Journal of Social Research.

The research found the best way to improve services for younger people with dementia is for people affected by YOD to work closely with service providers to co-design and co-ordinate support that is locally sustainable.

Michael Walker, Old Age Psychiatrist at the NHS’ Hertfordshire Partnership Foundation Trust and co-author on the paper, commented on the challenges of providing age appropriate care for people diagnosed with YOD: ‘In the past we’ve been unsuccessful in trying to recreate services for older people to look the same but with a younger patient group. One challenge is the relatively small number of younger people with dementia in a given locality, another is how to keep up a group for younger people with dementia when the original members may no longer be so young. We need to look at how services can work together to ensure a consistency of service for those diagnosed with young onset dementia.’

Suggestions from the research

There were suggestions that charities and service centres could act more as a catalyst for self-organisation of peer support groups, as well as a safety net for those who struggled to make connections. Organisations could offer an ‘introduction service’ where people with YOD and their family carers could ‘opt in’ to be introduced to each other and still be in line with the new General Data Protection Regulations, to help develop peer support networks.

One discussion group suggested that charities could act as ‘anchors’ and ‘meeting hubs’, enabling peer support through initiatives such as ‘skills swapping’ – where transport (driving skills) might be traded for home cooked meals (cooking skills) – or gender-specific support around leisure activities such as swimming, shopping and watching football games.

It was felt that voluntary organisations had an equally important role to play as advocates to liaise with local clubs, restaurants and buses to make their services more accessible and dementia friendly. Practical suggestions included: negotiating reduced rates for leisure centres for people with YOD, organising ‘slow swimming lanes’ during quiet times of the day, providing a closed-off room in a restaurant a few evenings a month and negotiating reduced rates on buses for families affected by YOD.

The ‘right’ services

Dr Andrea Mayrhofer, Senior Research Fellow in Dementia Care at the University of Hertfordshire, said: ‘People with young onset dementia do not necessarily ask for more services, but for the ‘right’ services that allow them to maintain their independence for as long as possible. Long-term support becomes increasingly important when families’ needs change as the illness progresses, but our study found that continuity of care was lacking the most.

‘The support currently available is designed for individuals who develop dementia much later in life, and is largely unsuitable for younger people who are physically fit, active, and carry financial responsibilities for children and/or an older parent. Age therefore is a factor when designing support for younger people diagnosed with dementia as the challenges they face are very different to those of older individuals. Interviews with service providers showed that some good quality age-sensitive services are being offered, but often only regionally and therefore not accessible more widely for younger people with dementia.’

Issues for people with YOD and their carers

The research also highlighted issues relating to specific service provision; service providers outlined difficulties in delivering services specifically for people with YOD and their carers.

Roma Mills, from Carers in Hertfordshire, a countywide charity providing free advice and services to unpaid carers, said: ‘Carers who are looking after a relative with YOD often struggle to find services or activities that match their age and interests. This can be even more difficult when looking for a respite service or a residential care home. Carers have told us how distressing it is to leave their husband or wife in the company of people who may be more than 20 years older than them, who are far more frail and consequently much less active. Carers are asking for holistic, person-centre services which match the needs of someone with YOD.’

The full paper can be found here: http://journals.sagepub.com/doi/abs/10.1177/1471301218793463 

The study was funded by the NIHR CLAHRC (Collaboration for Leadership in Applied Health Research and Care) East of England, co-funded by the NIHR CLAHRC Yorkshire and Humber.  The study was carried out in collaboration with the University of Sheffield, the University of East Anglia, the Alzheimer’s Society in Hertfordshire and Sheffield, Carers in Hertfordshire, and the Hertfordshire Partnership Foundation NHS Mental Health Trust.

Press Officenews@herts.ac.uk+44 (0)1707 285 770