d6ac5aeb-4d91-4adb-8844-1811307fb89b SOCIAL CARE: Building Bridges: Elevating Research Culture in Social Care through Collaboration, Qualitative Insight and Relationship-Driven Impact Principal Investigator: Dr David Raper (University of Winchester) Team: Rachel Harrison & Deborah MaCartney (University of Winchester) Start Date: 1 October 2022 End Date: 30 September 2024 Background Adult social care is currently dealing with a range of challenges with staff resources being stretched. Research, as an activity is difficult to maintain and embed in this context, but acknowledged to be fundamental in improving practice and finding new and creative ways to overcome challenges. In order to support an increase in social care research capacity, universities and social care agencies can engage collaboratively to explore strategies and processes that aim build capacity and space for research activity. This move to co-production will enable learning partnerships to be established, and opportunities for knowledge exchange enhanced. The outcome will be to engage, collaborate and find the means for professional development for social care professionals in research. Alongside this greater understanding of research cultures and contexts for local authorities and adult social care providers will help to develop future partnerships and opportunities for research initiatives. Aim(s) of the programmes of activity To develop contacts and communication routes between university and local authority, to help facilitate research and evaluation relationships. To provide support for research processes and the development of the role of research as an important part of the social care sector. To provide support and mentoring for a range of projects across local authorities and independent sector. To create new platforms for research training for social care practitioners, and growing confidence and experience in this area. Developing an understanding of research cultures with social care and local authority contexts. What we discovered To create a research culture for social care we found that…. •Collaboration takes time, effort, patience, resources, flexibility, compatible personalities and commitment to the project •There must be a shared clear commitment that social care has value •There must be a shared clear commitment that qualitative research has value •Research and impacts must be defined and understood as a joint endeavour •Enhancing research culture in social care is a shared, respectful journey leading to new insights What we are doing with this Knowledge? We are developing an innovative change management model to guide UK organisations in making person-centred transformations successfully, even amidst significant financial constraints The Local Authority are going to use our research to inform their current and future practice in meeting the needs of people who need physical care in their homes and people with learning disabilities We developed training courses to empower social care workers across the UK to conduct their own research We are writing international research articles with Local Authority staff We are holding public events to celebrate this social care research We are setting up a supportive research network for social care staff Where Next? There is a critical lack of research and research culture within social care sectors. We all need to work to create an environment where research in social care becomes a standard practice, shaping the future of service delivery. We will continue to champion the need and value of social care and social care research by extending our research activities, expanding our research short courses, supporting research networks, strengthening our partnerships with Local Authorities through joint funding bids and disseminating our findings more widely. We will continue to evaluate how our collaborative approach to research impacts social care outcomes. You can find a video detailing our findings here: Social care | NIHR ARC Wessex

f1f73a06-b3fc-4e9d-b46d-0ecc2e946c91 PARIEDA - Prediction of Acute Respiratory Infection outcomes prior to Emergency Department Attendance Principal Investigator: Dr Daniel Burns, Senior Research Engineer, University of Southampton, d.burns@soton.ac.uk Team: Professor Michael Boniface, Professorial Fellow of Information Systems, University of Southampton, m.j.boniface@soton.ac.uk Professor Matthew Inada-Kim, National Clinical Director-Infection, AMR & Deterioration-NHS England & Improvement, National Clinical Lead COVID NHS@home Visiting Professor, University of Southampton Chair COVID pathways group, matthew.inada-kim@nhs.net Dr Stephen Kidd, Lead Healthcare Scientist, Hampshire Hospitals Foundation Trust, stephen.kidd@hhft.nhs.uk Starts: 1/4/2023 Ends: 30/9/2024 Aim: We will help community doctors and nurses decide how best to care for patients with serious respiratory illness. The right care depends on how ill a patient is and if they will get worse. Care may include home monitoring or hospital visits. We aim to use computer algorithms to help doctors and nurses make these decisions. We expect patients to avoid unnecessary trips to hospital and to feel more supported. Background: Hospitals have had record number of emergency departments visits. Respiratory infections are almost half of the visits. Many of these patients were not admitted to hospital. This means that some patients could be cared outside of the hospital in the community. COVID-19 is a serious respiratory illness. During the COVID-19 pandemic a new way to care for patients was created. Instead of patients going straight to hospital, they were assessed in the community. Only the most serious cases were then sent to hospital. Community care and assessment is now being considered for other respiratory illnesses. Approach: We will use computer algorithms to help community doctors and nurses decide which patients are at most risk of serious respiratory illness. Risk assessment will be done using machine learning. Machine learning is a way to train a computer to categorise patients into groups using data about patients and services they use. We will use historical hospital data to identify patients in high-risk groups. The patient categories will then be used to inform community decisions before attendance at hospital. Patient and Public Involvement: Patients and public have helped develop the research through evaluation pilots for community assessment hubs. PPI will influence data usage and the use of risk groupings within care pathways. Two public members will participant in a Steering Committee. A PPI Committee will organise three workshops involving ten patients and public in the research. Dissemination: Communication will engage the public and decision makers. We will work with patients and the public to design engaging communication and seek acceptance. Our results will be published and will inform national policy.

62657f5f-1a8d-4fc4-8b32-bd364cb93d3a ADOPTED PROJECT - PREMAC 2 STUDY Development and application of Patient Report Experience Measure for patients accessing ACute oncology services: Aim This study will test a newly designed patient report experience measure (PREM) questionnaire for acute oncology (AO) across three NHS Trusts. Objectives The study will test: i) the acceptability of the PREM instrument to patients; ii) how well the PREM questionnaire performs, its validity and reliability, when completed by patients who have received care from different clinical teams; iii) the capability of the PREM instrument to identify variations of patient experience between participating trusts, and; iv) how easily the PREM questionnaire can be used to collect information across several trusts that might deliver services in different ways. Background People with cancer often need to access AO services for serious problems caused by their disease or treatment. Although trusts are required to obtain feedback from patients who receive AO services, there is currently accepted way of collecting this information. A preceding study, the PREMAC study, designed the new PREM questionnaire that we will test in this subsequent study. Design and Methods The study will include three NHS Trusts, and a sample of at least 100 completed responses will be required for statistical analysis from each site. Patients who have accessed AO services will be sent an electronic link to the questionnaire by text message or email, between one and two weeks following their care. Participants will be eligible if they: have a confirmed diagnosis of cancer; are 18 years old and above; have sought urgent care/advice for problems for cancer or its treatment; have accessed AO service via a triage helpline, a bespoke AO unit or via ED. Only anonymised information will be collected from respondents. Study outputs The main study output will be a validated PREM, which can be used to explore and benchmark the quality of AO services at trusts across England with different service delivery models.

00ac00f7-6a45-413d-9354-92f1eb973632 Testing the effects of food product placement on customers’ visual attention and intended product purchases: a randomised trial in a virtual supermarket setting (Phase II) Principal Investigators: Janis Baird and Christina Vogel, Professor of Public Health and Epidemiology and Principal Research Fellow in Public Health Nutrition respectively, MRC Lifecourse Epidemiology Centre, University of Southampton Team: Dr Sarah Muir, Senior Research Fellow, University of Southampton Dr Sarah Crozier, Senior Statistician, MRC Lifecourse Epidemiology Centre, University of Southampton Dr Hayward Godwin, Associate Professor of Psychology, University of Southampton Professor Marcus Munafo and Dr Olivia Maynard, Bristol University Ravita Taheem, Southampton City Council, Sure Start Children’s Centres Started: 1st March 2022 Ends: 30th September 2024 Background Poor diet is linked to an increased risk of obesity, diabetes and heart disease. Most adults in England consume too much salt, saturated fat and free sugar, and do not eat the recommended five daily portions of fruit and vegetables. People with lower education and income levels are more likely to have poor diet and to experience health problems as a result. Women of childbearing age are primarily responsible for domestic food tasks such as shopping and cooking, and their diets are closely linked to those of their children. Most families buy their food from supermarkets and their food choices can be influenced by placement of items in-store and by promotions. Our research This project follows on from COMPLETED: Testing the effects of food product placement on customers’ visual attention and intended product purchases: a randomised trial in a virtual supermarket setting (Phase I) We want to find out how the placement and packaging of healthy and unhealthy foods influence the foods that women choose to buy. We will do this by creating a ‘virtual’ supermarket layout that participants will interact with on a computer screen. We will recruit women attending Sure Start Children’s Centres in Hampshire and those whose children attend early years settings. Hampshire is a county within the Wessex region with some relatively deprived areas. We will choose centres and early years settings located in areas of higher deprivation. Local data suggests that 70% of families with young children are engaged with the centres. Women using the virtual supermarket will be shown images of healthy and unhealthy foods and non-food items that are placed in noticeable locations in the supermarket like checkouts. We will measure the specific aspects of the images women look at using experimental techniques such as eye tracking, which records their gaze point and gaze duration. The eye tracker is positioned close to the computer screen allowing it to record where women look. We will then ask women to tell us the products that they saw for sale, the name of the products they considered purchasing, and aspects of the supermarket that took their interest, and why. Our findings will tell us how people respond to the placement and packaging of different types of food products and whether these reponses differ if families are poorer or more wealthy. These findings help us to design ways to layout supermarkets to help all families eat more healthy foods. Our research will begin in March 2022 and end in late 2022. We will share the findings from our study with local families attending Sure Start Children’s Centres and early years settings. We will inform local and national government employees about our findings which could help to refine current government policies to address childhood obesity. The Study • 68 mothers took part in an eye-tracking study at the University of Southampton. •The women viewed scenes from a virtual supermarket which showed healthy, unhealthy and non-food products. •Scenes focused on the areas in a store where most shoppers usually pass through including the store entrance, end-of-aisles and checkouts. •Eye tracking software captured their eye movements to measure their attention. Participants were also asked to click on items on the screen that they wanted to purchase. •Twelve women also took part in interviews. mothers took part in an eye-tracking study at the University of Southampton. What did we learn? •We compared women’s attention to healthy, unhealthy and non-food items by showing them images of products side by side. Women showed higher levels of attention to healthy products over unhealthy and non-food items. Healthy products were viewed for 0.10 more seconds than unhealthy products and 0.15 more seconds than non-food items. The eye-tracking study also showed that the women had higher intention to purchase healthy foods over unhealthy and non-food items. Interviews with the women showed they used strategies like shopping lists and avoiding aisle ends to avoid unhealthy purchases. They wanted more healthy snacks or products they might have forgotten (such as paracetamol or batteries) at checkouts. What difference can this new Knowledge make? Supermarkets usually place unhealthy foods in noticeable places to make profits. Replacing these unhealthy foods with healthy or non-food items will just as likely, if not more successfully, lead to purchases. This can help families lead healthier lives. Why is this important for patients, health and care providers and policy makers? Placing unhealthy foods in noticeable locations can lead to impulse purchases of foods that can lead to obesity. Our study shows that women do not intend to buy these foods and would prefer healthier alternatives. Since 2022, UK policy has banned the placement of some unhealthy foods at noticeable locations in supermarkets. This research provides evidence that customers are likely to support this policy as they would like to buy healthy and non-food items from these locations. What Next? We are creating an infographic to share our findings with families via Sure Start Children’s Centres, Facebook and local schools. These results support our ongoing evaluation of the Food (Promotion and Placement) Regulations. Data will be shared in ongoing conversations with local authorities and via an academic publication. We have received funding to expand our study from mothers to young people. Adolescence is a time when young people may start to make independent food purchases. We aim to further understand what environmental factors influence young people’s purchases on their journey to and from school.

e8875589-cdeb-4504-8e6c-2c5922e46645 ADOPTED PROJECT: Breast Cancer Choices: Evaluation and implementation of a digital patient-centred decision aid to support genetic testing in mainstream care. ADOPTED PROJECT: Breast Cancer Choices: Evaluation and implementation of a digital patient-centred decision aid to support genetic testing in mainstream care. Principal Investigator: Dr Katherine Morton, Senior Research Fellow Team: Dr Gillian Crawford, Consultant Genetic Counsellor, University Hospital Southampton NHS Foundation Trust, Dr Lucy Side, Consultant and Lead Clinician in Clinical Genetics, University Hospital Southampton NHS Foundation Trust, Dr Jackie Chandler, Evaluation Programme Manager (Qualitative), Wessex Academic Health Science Network, Dr Kate Lippiett, Senior Research Fellow, Wessex Cancer Alliance, Prof Diana Eccles, Dean of Medicine, Professor of Cancer Genetics, Faculty of Medicine, University Hospital Southampton, Prof Claire Foster, Professor of Psychosocial Oncology, University of Southampton, Mrs Lesley Turner, Patient and Public Involvement contributor, Ms Kelly Kohut, Consultant Genetic Counsellor, St George’s University Hospitals NHS Foundation Trust Start date: 1 May 2022 End date: 1 May 2024 Background The demand for genetic testing for inherited cancer susceptibility is rising and services are increasingly being provided in mainstream care. In Wessex last year, more than 180 genetic tests were offered to cancer patients in mainstream care, and this will increase in 2022 as more genetic services become mainstreamed and eligibility criteria are expanded. This means that genetic testing is offered by clinicians such as oncologists, surgeons and cancer nurse specialists rather than Clinical Genetic services. It is part of a move to routinely offer genetic testing to all cancer patients where there may be clinical benefit. The results of genetic testing can improve health outcomes by informing optimal treatment pathways and facilitating cancer prevention or early detection in family members. However, deciding whether to have genetic testing is a complex, personal decision with potentially life-changing implications for the patient and family. Many people with cancer are faced with this decision shortly after diagnosis, at an already stressful time. Without the support of specialist genetic counsellors to discuss the medical, psychological and social consequences of genetic testing, it is essential that these patients are given accessible and appropriate support as a complement to clinical conversations. Mainstream clinicians feel they lack the necessary skills and time to support patients in this complex decision process. Web-based decision aids could offer an effective solution, giving patients the flexibility to reflect on and discuss information about genetic testing in their own time, in light of their own personal values. Breast Cancer Choices is one such web-based decision aid which was developed through a two-year research project funded by Breast Cancer Now involving extensive patient input and a review of evidence. By evaluating the implementation of Breast Cancer Choices in mainstream services, we would not only provide improved support to breast cancer patients currently undergoing this difficult process, but also identify wider-reaching implications regarding how best to support patients with other cancers in the national move towards genetic testing. As 1 in 2 people in the UK are expected to develop cancer in their lifetime, with 5-10% of these cancers estimated to be due to inherited predisposition, a clear implementation strategy for mainstream genetic testing is essential. Overall, the project aims to evaluate the impact of Breast Cancer Choices on patient’s decision making and clinician experiences in mainstream care, and to understand how web-based decision aids can be effectively implemented across mainstream cancer care.

257ff9a8-4656-4b12-a5fc-4ef46bb650ab Neuro Online (Formerly From Clinic to E-Clinic): Evaluating the Implementation of the My Medical Record Platform in Young-Onset Dementia and Huntington’s Disease. Principal Investigator: Dr Chris Kipps Team members : Dr Chris Kipps, Neurologist and Hon Senior Lecturer, University of Southampton Dr Sarah Fearn, Senior Research Fellow, University of Southampton Dr John Spreadbury, Senior Research Fellow, University of Southampton Dr Alex Young, Senior Research Assistant, University of Southampton Dr Rachel Chappell, Project Manager Start : 1 June 2020 Ends : 31 May 2027 Project Partners : University of Southampton, University Hospital Southampton NHS Foundation Trust, The Health Foundation Lay summary: Digital health platforms can improve care and support self-management, but only if they actually work and if people make use of them. The Neuro Online study aims to better understand how the online platform My Medical Record can be used to support and improve care for people with long-term neurological conditions. Aims: We want to better understand the factors that influence the uptake, use, and effectiveness of an online care and self-management platform for patients with long-term neurological conditions, their carers and the healthcare professionals who care for them. Design and Methods: The Neuro Online study will use surveys and My Medical Record system data to better understand how and why people use the Neuro section of My Medical Record. We will recruit 2000 patients, carers and healthcare professionals to participate for up to 7 years. During this time we will track how they use the online platform and their thoughts on it. We will also ask patients and carers about their well-being and their patient activation measure so that we can compare their experiences with the platform to this information. Participants will have the opportunity to participate in a number of additional sub-studies, which focus on particular issues such as quality of life, what individual characteristics are associated with use (or not) of the platform, and whether certain functions of the platform such as care planning are useful. A small number of patients will be asked to participate in face-to-face interviews to assess their use of the platform. NHS staff will be surveyed to see if platform use changes how they deliver care. As online platforms are increasingly being developed for the NHS, we hope the study will help understand how to make them relevant, useful and appealing to use. The findings should help to optimise the design and usefulness of these online tools, with the aim of supporting and improving the delivery of care. What did we learn? What Next? • We will continue to recruit to the study until 2027 •Look at other characteristics e.g. years since diagnosis; education • Link to: literature review qualitative work work on digital healthcare in general (Neuro Digital) outcome measures optimisation of outpatient care • Feedback to stakeholders Related publication: A Comprehensive Literature Search of Digital Health Technology Use in Neurological Conditions: Review of Digital Tools to Promote Self-management and Support

9e2c7f6f-813a-4237-9695-46d21cbe9cea Development, evaluation and provision of an intervention for primary and community NHS staff to help carers and homecare workers supporting people living at home with dementia with their continence. NIHR Three Schools Dementia Research Programme: NIHR School for Social Care Research, NIHR School for Primary Care Research and NIHR School for Public Health Research Team Lead investigator : Dr Cathy Murphy, Senior Research Fellow, School of Health Sciences, University of Southampton Co-i: Prof Mandy Fader, Professor of Continence Technology, School of Health Sciences, University of Southampton Co-i: Prof Miriam Santer, Professor of Primary Care Research, Faculty of Medicine, University of Southampton, NIHR School for Primary Care Research, Bournemouth based GP Co-i: Dr Leanne Morrison, Lecturer in Health Psychology, School of Psychology & Primary Care Research Centre, University of Southampton, NIHR School for Primary Care Research Co-i (PPI): Jane Ward, Alzheimer’s Society Research Network Member, co-founder of Dementia Friendly Hampshire, Patient Research Ambassador Co-i: Prof Jill Manthorpe, Professor of Social Work, Director of NIHR Policy Research Unit in Health & Social Care Workforce, King’s College London – Associate Director of NIHR School for Social Care Research Start date: 1st June 2022 End date: 28th Feb 2024 We found that Healthcare professionals wanted an easy and quick to use intervention to sign-post carers to continence care guidance. Homecare workers would welcome resources aimed at having difficult continence conversations The findings led us to develop the first evidence-based website to support healthcare professionals to provide continence advice to the carers of people living with dementia. The intervention also provides carers with detailed, practical self-management guidance. The website is www.demcon.org.uk A summary of the work can be found in this article: C Murphy, B Bradbury, M Fader, L Morrison, M Santer, J Ward, H Chester. Supporting continence care for people living at home with dementia. 22 APRIL, 2024. Nursing Times What we did with the new knowledge The findings have led to the first evidence-based intervention to support healthcare professionals to provide continence advice to the carers of people living with dementia. The intervention supports healthcare professionals to initiate conversations and then to sign-post carers to detailed, evidence based self-management guidance. The website can be accessed here: www.demcon.org.uk What are we doing next? The project has provided foundational findings for the next phase of work which includes developing a new intervention to support homecare workers to initiate continence conversations with people living at home with dementia. This work (DemCon2) is being funded by NIHR Three School’s Dementia Research Programme and will start Autumn 2024.

6bbcedc2-84c3-4fab-84e5-93672150e077 ADOPTED: Social Prescribers In Deprescribing Role (SPiDeR) Team: Dr Kinda Ibrahim, Pharmacist and Lecturer, Faculty of Medicine, Deputy Lead Ageing and Dementia, ARC Wessex Dr Sara McKelvie, NIHR Clinical Lecturer in General Practice Dr Eloise Radcliff, Research Fellow, Faculty of Medicine Emma Ward, 3rd Year Medical Student Lizzie Wimbourne, PhD candidate and Policy Intern (supported by Gareth Giles) Dr Laura Bryant, GP and School of Primary Care Apprentice Pam Douglas and Neil Wilson, Public Contributors and Co-applicants Senior Support Prof Hazel Everitt, Dr Stephanie Tierney, Prof Peter Griffiths and Prof Joanne Reeve Starts: April 2023 Ends: September 30, 2024 In the UK, a third of all people aged 65 years and above regularly take five or more medications, known as polypharmacy. Polypharmacy can increase the risks of side effects and hospital admissions. One of national priorities for NHS England set by the Chief Pharmacist, is to reduce prescribing unnecessary medication (overprescribing) by 10% for patients being treated by their GPs. One important way to identify and stop harmful medication is called a Structured Medication Review (SMR) but only half of older patients attended their GP practice for this in 2018-19. Instead of medicines, some people might benefit from other activities such as changes in diet, ways to reduce stress, increasing exercise or participating in group activities. Social prescribers are starting to work within GP teams to direct people to some of these activities. The Chief Pharmacists report on overprescribing suggested that NHS England should expand the use of SMRs in GP practices to benefit patients most at risk of overprescribing. They also recommended the involvement of trained social prescribing link workers as part of GP teams to support patients during and after a SMR. We currently don’t know how social prescribers can be integrated in the SMR process or whether this will have an impact on overprescribing for older people. The aim of this study is to explore the role of social prescribers in the SMR process and identify any training needs or resources required to enable their active involvement in the process. We will hold focus groups with healthcare professionals (GPs, pharmacists and social prescribing link workers) and interview older people who have experience of taking several medicines and/or their caregivers to: 1- Understand whether there is a role for social prescribers in SMR in Primary Care teams 2- Identify training needs for social prescribers to be actively involved in Primary Care teams who are doing SMR reviews 3- Identify factors that might prevent or improve social prescribers’ involvement in SMR 4- Consider what older people and healthcare professionals felt about alternatives to medications and map relevant activities and guidance that could be used as a substitute to medications such as dietary advice, exercise groups or cognitive behaviour therapy 5- Develop a model to describe how social prescribers can be best involved in SMR Understanding the role of social prescribing link workers in the SMR process might increase the use of non-medical solutions for health-related problems and reduce overprescribing. This study could help develop the role of social prescribers and understanding how they could work in primary care to support SMR. We hope this research will help us design and test different models of how social prescribers can work within GP teams to support deprescribing. This project is linked to STOP-DEM and MODIFY SPiDeR project for ARC Wessex 18.9.23 .pptx Download PPTX • 6.89MB

c1c3e509-fcbe-4039-a8f6-143f962aecbd Improving community health care planning Improving community health care logistics using Operational Research Principal Investigator: Dr Carlos Lamas-Fernandez Team members: Dr Carlos Lamas-Fernandez, (Research Fellow in Operational Research, University of Southampton), Professor Peter Griffiths (Chair of Health Services Research. University of Southampton), Dr Antonio Martinez-Sykora (Associate Prof of Business Analytics. Southampton Business School, University of Southampton), Dr Tom Monks (Associate Professor of Health Data Science, University of Exeter) Start: 1 October 2019 Ended: 30 September 2021 Partners: University of Southampton, Solent NHS Trust and Abicare Lay summary Operational Research (OR) is the application of computer and mathematical modelling to support decision making. In health services research, OR aims to improve patient outcomes, increase efficiency and enhance health professionals and citizens understanding of how an NHS service achieves good performance. In this study, we will use OR to improve the quality of patient care by supporting community nursing teams organise how they visit people in their own home. What did we acheive? We found that it is possible to develop algorithms that create routes and schedules automatically for district nurses. These algorithms can incorporate many practical constraints that nurses encounter during planning, and produce solutions that are optimised to use their time efficiently. We found out that, with minor modifications, the algorithm can also support social care workers in a similar manner. What difference can this new knowledge make? These algorithms are a stepping stone that bring closer the academic research (typically on idealized problems that do not work on practice) to the reality of nurses that currently organise their workload on a laborious manual process. Both their planning time and the extra time spent on the road (e.g. by doing a route larger than it could have been) can be saved and utilized to care for patients. Why is this important? Patients will benefit from a more efficient workforce, who can as a result have more time to care for them. Further, they might also benefit from better planned visits which might include their preferences. Care providers can use these kind of tools to plan their workload more efficiently, save costs on their operations and reduce the burnout of the nurses in charge of doing manual planning. Policy makers can run these kind of tools to test hypothetical scenarios (e.g. how does service delivery change with an increase of the demand, when we hire more district nurses or if we train part of our staff?). Care providers can also assess What's next? We continue working to improve our algorithms and liaise with social care companies to explore how they can be used in practice. We are looking into integrating them as demand estimation tools in other relevant problems, such as complex discharge from hospital. Publications https://www.nursingtimes.net/news/community/home-healthcare-are-nurses-wasting-their-time-on-the-road-26-04-2021/ A flexible mathematical model for Home Health Care Problems - ScienceDirect Useful Models (Open source): Reproduced exact models from the literature: https://github.com/c-lamas/hhcrsp Our own contribution: https://github.com/miguelreula/MILP_HHCRSP Synthetic Datasets: https://github.com/c-lamas/instances_hhcrsp

2bde6957-3a7b-4fc1-81e9-51f920491c2f Developing a core cohort of community researchers in Wessex: towards a sustainable Wessex Community of Practice for public health research co-production Chief Investigator: Professor Nisreen A Alwan, Professor of Public Health, Centre for Population Health Sciences, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust Team: Dr Donna Clutterbuck, Research Fellow, University of Southampton Megan Barlow-Pay, PPIE Lead, NIHR Research Support Service Professor Julie Parkes, Professor of Public Health, University of Southampton, University Hospital Southampton NHS Foundation Trust and Health Education England Wessex Dr Kath Woods-Townsend, Associate Professor (Research) and Lifelab Project Manager, University of Southampton Mirembe Woodrow, Senior Public Health Practitioner, Southampton City Council and PhD student, University of Southampton Partners: Hampshire and Isle of Wight NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Bournemouth University, University of Portsmouth, University of Southampton, Southampton City Council, NIHR Research Support Service Specialist Centre for Public Health, LifeLab, University of Southampton / NIHR Southampton Biomedical Research Centre, Health Determinants Research Collaboration, Southampton, Southampton Centre for Research Engagement & Impact (SCREI), Centre for Seldom Heard Voices, Bournemouth University, HDRC Portsmouth Start: 1 October 2024 End: 31 March 2026 Summary Public health research priorities must stem from the needs of the communities served by such research, particularly those most socially and economically disadvantaged, as well as community groups that are seldom heard. Therefore, community members with lived experience of health conditions and the various factors shaping health and wellbeing have a central role in shaping such research. Co-creating research with the public can lead to research findings that are more relevant to population health and wellbeing, leading to a reduction in heath inequalities. The purpose of this project is to develop a core ‘cohort’ of community public health researchers using an approach that considers the multiple social forces that shape people’s identities to inform research design that is meaningful to Wessex local communities. This cohort will form a Community of Practice (CoP) for research co-design that can help us reach those seldom heard groups in our local communities and understand underrepresented perspectives to inform relevant and meaningful health research priorities, questions and methods. People from such communities are more likely to feel comfortable to inform research that is led or co-led with community researchers. This project will be a Partnership between the NIHR Research Support Service (RSS) National Specialist Centre for Public Health (NSCPH) which aims to support the generation of high-quality research evidence aimed to inform decisions about which interventions have the greatest likelihood to improve population health and reduce health inequalities, and the Healthy Communities Theme of the NIHR ARC Wessex. In the first stage of the project, we will engage with stakeholders, including members of the public, voluntary organisations, Local Councils and health services to shape the project protocol and to co-develop its strategy, key milestones and outcomes. In the second phase of the project, we envisage a group of community researchers being recruited and trained in participatory research (or other research methods of their choice) and be provided with opportunities to link in with health researchers. In the third phase of the project, the community researchers will then choose a pathway (or more) that suits their needs from conducting community-based research, linking with other community members to inform further research projects, co-creating research ideas, or informing research proposals developed by researchers within the ARC or through the RSS. In the fourth phase of the project, we will evaluate the above activities and synthesise and disseminate lessons learnt from the project towards sustainability of our CoP framework. The project’s Research Fellows will also work with public contributors to disseminate findings in ways that are meaningful, alongside preparing publication materials for journals and conferences, and producing infographics. The CoP will help us to co-design health research based on local and regional need; provide stakeholder input into public health research proposals in Wessex; contribute to governance and delivery of NSCPH; and support meaningful and equitable research partnerships with community stakeholders and the public.

Dr Naomi Klepacz & Professor Jane Ball (School of Health Sciences, University of Southampton) < Back Addressing underlying workforce challenges is essential to meet the nation’s mental health care needs Mental Health Dr Naomi Klepacz & Professor Jane Ball (School of Health Sciences, University of Southampton) What is it like to be part of the mental health nursing workforce? We argue that it is only by understanding the reality of the job – its highs and its lows – that we will be able to grow the mental health workforce and hold on to experienced nurses needed to deliver care well. Demand for mental health services is at an all-time high, yet many people cannot access vital services and face long waits for treatment ( 1) . Nurses comprise one-in-three of the NHS mental health workforce (2) . They are fundamental to providing mental health services and a positive patient experience. However, mental health nursing vacancies represent a third of all nursing vacancies (3) , and while there has been a welcome increase in the number of mental health nurses in recent years, the rate of increase still falls behind that seen in adult and children’s nursing (2) . There are also significant regional differences in mental health nurse staffing that seem disconnected from the level of demand for services (2) . The bottom line is that both now and, in the future, we need more nurses working in mental health – which means expanding supply and ensuring we have the conditions needed to retain the experienced staff we already have. The NHS Long Term workforce plan proposes an investment in expanding training places by 2028/29, with a promised increase of 38% for mental health nursing (4) . A substantial change, but lower than that promised to other fields of nursing. Research has demonstrated the link between nurse wellbeing and patient experience of care, staff and patient safety, sickness absence, job satisfaction and leads to staff leaving the workforce (5) . Physical or mental health, burnout or exhaustion currently follow retirement as the top reason nurses leave the profession (6) . The 2022 NHS Staff Survey reports that 49% of mental health nurses felt unwell because of work-related stress in the last 12 months, 61% came to work despite not feeling well enough to perform their duties, 45% reported often or always finding their work emotionally exhausting, and 28% experienced physical violence from a patient or service user in the last 12 months. In addition, 70% work additional unpaid hours over and above their contracted hours. Therefore, understanding the working lives and wellbeing of the mental health nursing workforce is critical for patient care quality, patient nurses, and the growing nursing workforce. Change is urgently needed to meet the nation’s demand for mental health care, but change requires commitment, investment, and, above all, an understanding of, and sensitivity to, the underlying issues. NHS England made a commitment to the growth and development of mental health nursing (7) , and recommendations from this report together with those from the Nuffield Trust (2) say a more accurate and realistic image of the mental health nursing role is needed, with clarity on career options, work setting and the range of people mental health nurses care for, to challenge false stereotypes. In our research into the working lives and wellbeing of nurses in mental health, we have spoken to some truly inspirational nurses who describe working as a mental health nurse as “the best job in the world”. While both patients and nurses place value on therapeutic relationships (8) , the importance of these relationships appears to be poorly understood by those who have not been touched by this experience (9) . Yet the absence of such relationships in mental health care can impact both patients (who may feel more disconnected, alone or vulnerable) and nurses - who are less likely to feel job satisfaction or take pride in the care provided ( 8 , 10 ). Unlike other fields of nursing, mental health nurses argue that it is this patient familiarity, the knowledge and experience gained through patient interaction, rather than treatment-focused ‘skills’ that make mental health nurses unique and indispensable while also making the role of mental health nurses challenging to define and difficult to evidence. Nurses don’t just deliver the intervention; they are the intervention. This is why we are undertaking a study (with funding from the NIHR ARC Wessex Mental Health Hub ) to provide insight into the work lives, wellbeing and working context of nurses in mental health services so that action can be taken (through local changes and/or national policy) to enable a better experience of work. When nurses feel good about the work they do and are given what they need, the benefits – to staff, organisations, and patients – are many. As part of this work, a national survey of the mental health nursing workforce is currently underway. This survey is open to nurses on the Nursing and Midwifery Council (NMC Register) providing mental healthcare to any patient group, in any setting, and for any health and social care provider. It is completely anonymous and will take 15-20 minutes to complete. This study is supported by the National Institute for Health and Care Research ARC Wessex. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care. Professor Jane Ball Dr Naomi Klepacz References: 1. Care Quality Commission. Rising demand for mental health care [Internet]. 2022. Available from: https://www.cqc.org.uk/publications/major-reports/soc202021_01d_mh-care-demand 2. Palmer W, Dodsworth E, Rolewicz L. In train? Progress on mental health nurse education [Internet]. Nuffield Trust; 2023 May. Available from: https://www.nuffieldtrust.org.uk/sites/default/files/2023-05/Mental%20Health%20nursing%20update_WEB_FINAL.pdf 3. NHS Digital. NHS Vacancy Statistics England, April 2015 - March 2023, Experimental Statistics [Internet]. 2023. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-vacancies-survey/april-2015---march-2023-experimental-statistics 4. NHS England. NHS Long Term Workforce Plan [Internet]. 2023 Jun. Available from: https://www.england.nhs.uk/wp-content/uploads/2023/06/nhs-long-term-workforce-plan-v1.2.pdf 5. Maben J, Adams M, Peccei R, Murrells T, Robert G. Patients’ experiences of care and the influence of staff motivation, affect and well-being. NIHR; 6. Nursing & Midwifery Council. 2023 NMC Registere Leavers Survey (Summary Report) [Internet]. Nursing & Midwivery Council; 2023 May [cited 2023 Jul 10] p. 1–36. Available from: https://www.nmc.org.uk/globalassets/sitedocuments/data-reports/may-2023/annual-data-report-leavers-survey-2023.pdf 7. Health Education England. Commitment and Growth: advancing mental health nursing now and for the future [Internet]. Health Education England; 2022 Apr p. 37. Available from: https://www.hee.nhs.uk/sites/default/files/documents/Commitment%20and%20Growth%20Advancing%20Mental%20Health%20Nursing%20Now%20and%20for%20the%20Future.pdf 8. Simpson A, Hannigan B, Coffey M, Barlow S, Cohen R, Jones A, et al. Recovery-focused care planning and coordination in England and Wales: a cross-national mixed methods comparative case study. BMC Psychiatry. 2016;16(147). 9. Clarke L. The therapeutic relationship and Mental Health Nursing: it is time to articulate what we do! J Psychiatr Ment Health Nurs. 2012;19:839–43. 10. Coffey M, Hannigan B, Barlow S, Cartwright M, Cohen R, Faulkner A, et al. Recovery-focused mental health care planning and co-ordination in acute inpatient mental health settings: a cross national comparative mixed methods study. BMC Psychiatry. 2019;19(115). Previous Next

c07181de-349f-421b-8259-3fdae15d93ab Development of a structured deprescribing intervention for people with dementia or mild cognitive impairment in primary care (STOP-DEM) Project partners Memory Assessment and Research Centre ( Hampshire and Isle of Wight NHS Foundation Trust was a Participant Identification Centre (PIC) Portsmouth Older Person’s Mental Health (OPMH) Service (Hampshire and Isle of Wight NHS Foundation Trust) was a Participant Identification Centre (PIC) Full team Dr Kinda Ibrahim (CI), Dr Nicola Andrews, Cindy Brooks, Dr Jay Amin, Prof Sue Latter, Prof Simon Fraser (University of Southampton), Dr Rosemary Lim (University of Reading), Dr Michele Board (Bournemouth University) Assisted with the systematic review: Dr Eloise Radcliffe, Paula Sands (University of Southampton), Dr Kirsty Aplin, Dr Beth McCausland (NHS OPMH), Dr Ellen van Leeuwen (Ghent University) PPI: members of Friends of MARC group and members of Dementia Support – Hampshire and Isle of Wight’s Eastleigh support group Started: October 2022 Ended : September 2024 Jump to publications The team produced a video about their work: https://vimeo.com/1125514599 Team video about experiences of people living with dementia and their family carers Lay Summary Most people with dementia or mild cognitive impairment (MCI) have multiple chronic conditions and take five or more regular medications (polypharmacy). Polypharmacy in people with dementia/MCI can lead to increased risk of drug interactions, side effects such as falls and cognitive decline, and sometimes hospitalisation and death. Some types of medications (such as strong anticholinergic drugs) can increase risk of developing dementia and cognitive impairment. It is estimated that over £400 million is spent annually in the UK in hospital admissions related to harm from medications. Identifying harmful medications and stopping or switching to safer alternative (deprescribing) has the potential to reduce the risk of developing dementia and improve outcomes for people already living with dementia. However, to date, deprescribing interventions for people with dementia/MCI have focused on specific drug classes (e.g., anti-psychotics) or have been limited to inpatient or nursing home setting. In the UK, it is estimated that 61% of people with dementia live at home where medication is a part of daily living. Most studies also focused on medication-related outcomes (e.g. discontinuation of high-risk medications) rather than patient-centred outcomes, and did not involve the person with dementia and their carer. Therefor it is essential to understand how primary care staff could involve people with dementia/MCI and their caregivers in shared-decision making about stopping medications safely. Summary of findings We reviewed existing evidence on interventions to reduce or stop (deprescribe) medications for people with dementia or mild cognitive impairment (MCI). We found that most studies focused on medications that affect behaviour, mood, or perceptions and people in residential care. Many interventions reduced numbers of medications and improved appropriateness of medications. However, there was limited evidence on outcomes relating to safety and outcomes such as falls, quality of life and cognition. There was limited involvement of patients and informal carers in the interventions. We interviewed people with dementia or MCI, informal carers, primary care professionals and professionals working in memory clinics. We found that patients, carers and healthcare staff need to be involved in the deprescribing process. This process needs to consider patient cognitive abilities and independence. It also needs to consider carer experiences. Flexible medication management processes are needed to support successful deprescribing. These should be adapted to each person. These should involve joint working across the healthcare system. Deprescribing discussions need to be held in-person and in a safe setting. There needs to be enough time. Discussions should be led by a professional who knows the patient and can answer their questions. The possible impact of deprescribing decisions should be carefully considered. This includes impact on how medication is managed day-to-day and allso, carer burden. See the summary report Summary report for participants .pdf Download PDF • 559KB See the Key Practical Implications What we did with the new knowledge Sharing with frontline health and care professionals We shared our findings at a Hampshire and Isle of Wight Integrated Care Board (ICB) Medicines Optimisation webinar, engaging with an audience of 110 professionals, mostly pharmacists. We were invited to present the work at the RCGP Wessex Faculty Conference in March 2025 with around 100 attendees We shared our findings at a Wessex Older People’s Mental Health Academic meeting involving more than 50 professionals working in this area, primarily doctors. Meeting with the national lead for NHS prescribing to present the study. Academic Publications We have published two papers, one reporting the systematic review in Drugs and Aging and the other reporting the qualitative study in Dementia. The Importance of a Relationship-Centred Approach to Deprescribing for People with Dementia or Mild Cognitive Impairment in Primary Care: A Qualitative Study (November 20, 2025) Medicine Optimisation and Deprescribing Intervention Outcomes for Older People with Dementia or Mild Cognitive Impairment: A Systematic Review (March 2025) Oral and poster presentations at the European Geriatric Medicine Society Conference in Reykjavik, 24-26 September 2025 Presentation about using “photo elicitation” as a creative qualitative methodology at the ARC Qualitative Network Sharing with policy makers We have presented the study findings to MPs and representatives from royal colleges (RCGP, RPS, BGS) in a policy roundtable discussions in Westminster Nov 2025 We have produced a policy brief and shared it with relevant parties Nov 2025 We have presented the findings in an ARC Wessex stakeholder event Feb 2026 Sharing with the wider community including patient and public Summary findings and infographics from the qualitative study have been shared on social media, with a post on the ARC Twitter/X, LinkedIn and Facebook pages, and the ARC website. University of Southampton website link - Deprescribing for Dementia MSN News - Why good healthcare can mean stopping medications Daily Expresss coverage - Link Radio coverage - Greatest Hits Radio Video featuring members of our PPI group and other members of the dementia support group sharing the findings of the qualitative study. The video is being used in undergraduate and postgraduate teaching in Faculty of Medicine at the University of Southampton. Where Next? Grants : Dr Kinda Ibrahim (University of Southampton) and Dr Rosemary Lim (University of Reading) submitted Research for Patient Benefit grant application to develop and test and deprescribing intervention for people with dementia or mild cognitive impairment in primary care. Academic conferences: The Society of Academic Primary Care conference attended mainly by GPs and academics.