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- PROCED: PROactive, Collaborative and Efficient complex Discharge
32e7d264-0fc5-4abd-9de2-3d80f41ddbb6 PROCED: PROactive, Collaborative and Efficient complex Discharge Joint Lead: Dr Carlos Lamas Fernandez and Professor Michael Boniface . Co Applicants : Antonio Martinez-Sykora (CORMSIS), Professor Peter Griffiths, Abigail Barkham (Southern Health NHS FT), Eleanor Corbett Partners: University of Southampton, Southern Health NHS Foundation Trust & University Hospital Southampton NHS Foundation Trust. Lay Summary Aims: PROCED aims to improve complex hospital discharge by using computer algorithms to support the way community and social care services are planned for patients fit to leave hospital. The goal is to avoid patients staying in in hospital longer than needed when they are well enough to be discharged. Leaving hospital at the right time is better for patients for many reasons. It reduces physical and mental deconditioning and chance of hospital infections. It also allows patients to recover with families, friends, and carers. By planning care earlier during hospital stays, PROCED aims to provide more time for patients and families to discuss care needs with care workers. Also, integrated care services are expected to be more efficient as resources can be planned using better predictions of patient needs. Background : In 2018/2019 patient discharges from hospital in the UK were delayed by over 1.5 million days. Almost 75% of delays were due to arrangements for community care not being in place. Plans require many services including further non-acute care, residential homes, nursing homes, care packages, community equipment and public funding. Avoiding delays to discharge from hospital is desirable as it leads to better outcomes. The University Hospital Southampton has recently developed a digital system supporting complex discharge. The system allows patients, families, and care providers to share information about a care needs and resources during discharge decisions. PROCED will now extend this system with advanced computer algorithms to support better decisions making. Approach: PROCED will develop computer algorithms that can predict care needs and schedule care services. Predictions will be developed using machine learning. Machine learning is a way to train a computer by using data about patients and services they use. Scheduling will use optimisation algorithms to find the best use of resources from available options. The prediction and scheduling algorithms will be integrated within a discharge decision process. The process will be part of a patient journey co-designed with patients and healthcare workers. The algorithms will be tested to ensure they are accurate and useful.The approach will be assessed by patients and the workforce for acceptance and overall satisfaction. Patient and Public Involvemen t: Patients and public have helped develop the research concept and will be involved in co-design, testing and evaluation. PPI will influence data usage, patient journey, algorithms, and visualisation. The public will participant in a Steering Committee. A PPI Committee will organise eight workshops to involve patients and public in the research. Dissemination: Communication materials will engage the public and decision makers.Evidence of effectiveness, safety and acceptance will be published. A complex discharge system with computer-based decision support will be demonstrated. The outcomes will be championed with institutional, regional, and national implementation teams.
- FORTH – FORecasting Turbulence in Hospitals
d1fc46a9-cf57-4dda-98fb-a4ccb44fa87b FORTH – FORecasting Turbulence in Hospitals Chief Investigator: Edilson Arruda, Associate Professor, University of Southampton Team: Christine Currie University of Southampton Alexandra Hogan NHS Salisbury/ University of Southampton Jamie MacNamara University Hospital Southampton Mark Wright University Hospital Southampton Michael Boniface University of Southampton Carlos Lamas-Fernandez University of Southampton Partners: Salisbury Hospitals NHS Foundation Trust, University of Southapton, University Hospital NHS Foundation Trust. Start: 1 October 2024 End: 31 March 2026 Summary Over time, health systems face changes. Population grows older or hospitals can perform new treatments. It is difficult to match the resources of hospitals with population needs. If they do not match, waiting times for treatment increase and hospitals become fuller. Hospitals being too full can result in worse care for patients. For example, hospitals might need to cancel surgeries. Aim(s) of the research When the usual demand for hospital resources changes, it becomes difficult for hospitals to provide care. We call this turbulence. Our first objective is to define how turbulence can be measured from data. Then, we will use artificial intelligence to understand the causes of turbulence. We will also create models for short-term prediction of turbulence. This will help hospital plan better. Design and methods used This project will look at the records of patients in hospitals to understand what resources they use. The data will give us an understanding of how long certain activities take. For example, the recovery from surgery. We will predict when these times are changing using artificial intelligence. This can help hospitals be alert of upcoming changes, so they choose the best way to react. Patient, public and community involvement (PPCI) We will engage with the views of public, patients and communities during the project execution phase. We will hold workshops with patient groups that have been to hospital. We will understand their views on the planning services. We will also take into account their ideas when defining turbulence. Dissemination This project was co-designed and will be supported by University Hospital Southampton (UHS) and Salisbury Hospital. The results will be disseminated and championed within the partnering institutions, and further presented in workshops involving neighbouring NHS Trusts in Wessex and in the south east and south west of England. We will also publish papers and reports to disseminate the work to a larger audience within the UK and internationally.
- The ImPACt study - Improving physical activity of older people in the community
4f21e11e-3fe7-460c-9bc0-113a56eec7a5 The ImPACt study - Improving physical activity of older people in the community Club members at Brendoncare joining in group exercise Principal Investigator: Dr Stephen Lim Team members: Dr Stephen Lim (NIHR Clinical Lecturer in Geriatric Medicine, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Professor Helen Roberts (Professor of Medicine for Older People, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Dr Samantha Meredith (Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton) , Dr Kinda Ibrahim (Senior Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Esther Clift (Consultant Practitioner in Frailty, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Lymington New Forest Hospital), Samantha Agnew (Head of Clubs Services, The Brendoncare Foundation , Winchester), Pam Holloway (Patient representative) Start: 1 February 2020 Ended: 31 October 2021 Project Partners: University of Southampton, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Brendoncare. Lay summary Physical activity is important for older people. It has many benefits including maintaining older people’s ability to perform activities of daily living, be independent, and improve their well-being. However, many older adults living in the community do not engage in regular physical activity. Findings We found that we could train volunteers to support older people during the COVID-19 pandemic to stay active by performing exercises that help strengthen their muscles. Trained volunteers from Brendoncare led the online group exercises for older people who attended online community clubs during the COVID-19 pandemic. This was a challenging time when social distancing and lockdown rules were in place, which limited opportunities for older people to stay active. We recruited 19 volunteers, and 15 volunteers completed the training. The volunteers were mainly female (78%), with an average age of 68 years. The exercises were seated exercises and older adults were given exercise bands to increase the exercise intensity. Halfway through the study, lockdown restrictions were lifted, and some groups continued the group exercise in a face-to-face setting. The volunteers led 184 group weekly exercise sessions (127 online and 57 in-person). Thirty older adults participated in the group exercises. We interviewed volunteers, older adults and Brendoncare staff to find out more about what they thought of the online group exercise. The older adults enjoyed the intervention and understood the benefits of exercising. Additionally, they felt that they could exercise in a relaxed way with their peers without fear of being judged. The group exercises helped reduce social isolation and motivated older adults to engage with the exercises. Volunteers were enthusiastic to support the exercise groups. They appreciated the training and opportunity to lead the group exercises. One volunteer reported that the role gave her a sense of purpose by playing an active role the community club. Brendoncare staff members were a great help to the older adults and supported them with any issues, in particular those who were less familiar with the internet. At six months, we found that older adults who participated in the group exercise had an improved physical activity level. The time spent in light physical activity per week improved from an average of 1530 minutes per week to 1620 minutes per week. Only two minor incidents happened during the group exercises. Two participants experienced worsening of old injuries while performing the exercises. The programme trainer ensured the participants were safe and adapted the exercise for them. Overall, we found that volunteers can be trained to lead online group seated exercises. The exercises were safe and older adults enjoyed the exercises as well as the social interaction in the group setting. What we did with the new knowledge We supported Brendoncare in continuing the exercise groups after the study had ended. We presented our study findings to the board of trustees and demonstrated the exercises. Brendoncare has since employed an activity coordinator to continue to role of training volunteers and supporting volunteer-led exercise groups within Brendoncare. We trained the activity coordinator and shared our exercise sheets and other study materials to help Brendoncare develop their own training package. They are now actively recruiting more volunteers to lead group exercises in their community clubs. https://www.brendoncare.org.uk/get-involved/support-us/volunteering/#:~:text=Chair%20Based%20Exercise%20Volunteer,improving%20their%20health%20and%20wellbeing . We have developed a volunteer toolkit which is available to share with other volunteer organisations. The toolkit has recently been shared with Valley Leisure Ltd, a charitable leisure organisation, who have developed their offer of volunteer-based community clubs in Test Valley. Where next? Having explored how we can train volunteers to engage with healthy community-dwelling older adults to stay active through online group exercises, we collaborated with researchers from the Southampton Biomedical Research Centre and Bournemouth University to further develop this volunteer-led online intervention. We successfully secured research funding (£51,000) from University Hospital Southampton NHS FT to conduct a study to explore a multimodal intervention consisting of exercise, nutrition and behaviour change support, to engage with older people living with frailty who have been discharged from hospital, to stay active and eat well. This research has now been completed (10/01/2024) and we showed that it was feasible to translate the programme to support older people living with frailty ( COMPLETED: Wessex Frail2Fit – A feasibility and acceptability study of a virtual multi-modal intervention delivered by volunteers to improve functional outcomes of older adults with COVID-19 discharged from hospital ). What did people say about the work? Volunteer : “We do it because we want to help others…. we enjoy it. I'm gonna go back to belonging again, I feel that I'm benefiting from the group. Because again, I feel like I belong to that group….. I get so much out of it.” Club member: ‘We are not self-conscious when they (volunteers) are around. We have a laugh as well.’ Club member: ‘I’ve really enjoyed it because it keeps you in touch with people, especially during this COVID….. I still feel as if I’m part of a group.’ NEWS: ImPACT volunteers recognised for their wor k ImPACt exercise video IMPACT Exercise with Steve and Esther from NIHR ARC Wessex on Vimeo . Impact Exercise video using Resistance bands - Dr Sam Meredith watch the video on Vimeo Publications doi.org Volunteer-led physical activity interventions to improve health outcomes for community-dwelling older people: a systematic review - Aging Clinical and Experimental Research Background Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. There is strong evidence to support the benefits of physical activity interventions on the health outcomes of older adults. Nonetheless, innovative approaches are needed to ensure that these interventions are practical and sustainable. Aim This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers describing eight studies (five papers reported different outcomes from the same study) were included in the review. All eight studies included strength and balance exercises and frequency of PA ranged from weekly to three times a week. Volunteer-led exercises led to improvements in functional status measured using the short physical performance battery, timed up and go test, Barthel Index, single leg stand, step touch test, chair stand test, and functional reach. Frailty status identified by grip strength measurement or the use of long-term care insurance improved with volunteer-led exercises. Interventions led to improvement in fear of falls and maintained or improved the quality of life. The impact on PA levels were mixed. Conclusion Limited evidence suggests that volunteer-led PA interventions that include resistance exercise training, can improve outcomes of community-dwelling older adults including functional status, frailty status, and reduction in fear of falls. More high-quality RCTs are needed to investigate the effects of volunteer-led PA interventions among older people. https://doi.org/10.1007/s12603-020-1442-0 https://doi.org/10.7861/clinmed.2022-0283 doi.org Detecting low-intake dehydration using bioelectrical impedance analysis in older adults in acute care settings: a systematic review - BMC Geriatrics Background Dehydration is a frequent cause of excess morbidity and poor health outcomes, particularly in older adults who have an increased risk of fluid loss due to renal senescence, comorbidities, and polypharmacy. Detecting dehydration is key to instigating treatment to resolve the problem and prevent further adverse consequences; however, current approaches to diagnosis are unreliable and, as a result, under-detection remains a widespread problem. This systematic review sought to explore the value of bioelectrical impedance in detecting low-intake dehydration among older adults admitted to acute care settings. Methods A literature search using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane Library was undertaken from inception till May 2022 and led to the eventual evaluation of four studies. Risk of bias was assessed using the Cochrane tool for observational studies; three studies had a high risk of bias, and one had a low risk. Data were extracted using systematic proofs. Due to insufficient reporting, the data were analysed using narrative synthesis. Results One study showed that the sensitivity and specificity of bioelectrical impedance in detecting low-intake dehydration varied considerably depending on the total body water percentage threshold used to ascertain dehydration status. Other included studies supported the technique's utility when compared to conventional measures of hydration status. Conclusions Given the scarcity of literature and inconsistency between findings, it is not possible to ascertain the value of bioelectrical impedance for detecting low-intake dehydration in older inpatients. https://bmjopen.bmj.com/content/13/3/e069533 https://www.sciencedirect.com/science/article/pii/S2260134125000854[SM1] doi.org Evaluating the feasibility and acceptability of virtual group exercise for older adults delivered by trained volunteers: the ImPACt study protocol Introduction Physical activity is important for healthy ageing. Despite strong evidence on the benefits of physical activity for health and well-being, physical inactivity remains a significant problem among older adults. This study aims to determine the feasibility and acceptability of implementing an online volunteer-led group exercise for older adults. Methods A quasi-experimental mixed-methods approach will be used in this study. A training programme will be developed to train volunteers to deliver online group exercises to older adults aged >65 years (n=30). The primary outcome is the feasibility of implementing the intervention. This will be assessed by the number of volunteers recruited, trained, and retained at the end of the study, and the number of exercise sessions delivered and completed by participants. Secondary outcomes include physical activity levels measured using the Community Health Model Activities Programme for Seniors questionnaire, Barthel Index, EQ-5D-5L as a measure of health-related quality of life, SARC-F to determine sarcopenia status, and PRIMSA-7 to determine frailty status. Outcomes will be measured at baseline and at 6 months. Qualitative interviews will be conducted with volunteers(n=5), older adults (n=10) and family members (n=5) to explore their views on the intervention. Analysis Simple descriptive statistics will be used to describe participant characteristics, the feasibility of the study and the impact of the intervention on health outcomes. Parametric(t-test) or non-parametric(Mann-Whitney U test) statistics will be used to analyse continuous variables. χ2 test will be used for categorical variables. Qualitative data will be analysed using an inductive thematic analysis approach. Ethics and dissemination This study received ethical approval from the University of Southampton Faculty of Medicine Ethics Committee and Research Integrity and Governance committee (ID: 52 967 .A1). Study findings will be made available to service users, voluntary organisations and other researchers who may be interested in implementing the intervention. Trial registration number [NCT04672200][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04672200&atom=%2Fbmjopen%2F12%2F2%2Fe052631.atom · 40 Faces of Brendoncare - Sharon Green · 40 Faces of Brendoncare - Dr Sam Meredith · 2022 Winners | Pride of Andover Awards · https://www.linkedin.com/posts/karen-lewis-6b009665_ahpsday-activity-7385000352397385728-8v1K?utm_source=share&utm_medium=member_android&rcm=ACoAAGAmYqMBCL-wtu3ZnECr4UsylRfjAyKeGFY · https://youtu.be/nMSQR7kp9ec · https://youtu.be/6vxyL4OenmQ?si=RiOBz-yU7tO09fwX
- COVID-19 Emergency Department Project
532de301-847c-4966-bc5a-4870a7af237f COVID-19 Emergency Department Project https://video.wixstatic.com/video/6fe132_b254a8bee3f94076893f02f26b1ade08/1080p/mp4/file.mp4 NIHR ARC Wessex is supporting this research Summary The COVID-19 pandemic created an unprecedented demand for acute care services. Hospitals faced the challenge of needing to rapidly restructure care pathways and resourcing priorities to maximise survival rates for critically ill patients. University Hospital Southampton (UHS) needed evidence-based tools to support clinical and resource planning decisions in response to the pandemic. COVID-19-ED was able to provide rapid response insight to analytics questions provided by UHS. Who worked on the project? Professor Michael Boniface – University of Southampton Dr Hang Phan – University of Southampton Dr Francis Chmiel – University of Southampton Dr Daniel Burns – University of Southampton Professor Ben MacArthur – University of Southampton Professor Dave Woods – University of Southampton Dr Derek Sandeman – University Hospital Southampton NHS Foundation Trust Dr Thomas Daniels – University Hospital Southampton NHS Foundation Trust Dr Michael Kiuber – University Hospital Southampton NHS Foundation Trust Neil Tape – University Hospital Southampton NHS Foundation Trust Martin Azor – University Hospital Southampton NHS Foundation Trust Dr Matthew Stammers – University of Southampton NHS Foundation Trust What did we find out? We found that computational models of COVID-19 epidemiology could be used to help forecast COVID-19 hospital demand and support the University Hospital Southampton (UHSFT) in their response to the pandemic. We learnt how to deliver a series of models and insight throughout the phases of the pandemic first wave (alert, pre-peak, post-peak, recovery). We learnt to adapt approaches through experimentation and as new information became available to the research team: Initially a 10-day rapid response was required balancing timeliness and precision of answers. Little was known about COVID-19 and a simple approach was developed to forecast the time and size of the first peak. We then extended the model to consider actual hospital data along with the prevalence of infected people in communities and occupancy types such as general or intensive care beds. Finally, the impact of social distancing was incorporated to modify community transmission rates allowing UHS to run what if scenarios considering future assumptions about social distancing policies from the UK government. What difference did it make? COVID-19-ED provided a source of rapid insight response for UHSFT operations teams at a time when they had little information to plan resources. Why was it so important? Community disease prevalence modelling is an important tool to support capacity planning and resource planning for integrated care systems. Vital to provide rapid insights with limited information and changing disease and policy situations. What happened next? The knowledge gained about COVID-19 epidemic modelling led to UK wider leadership of data analytics for Dr Dan Burns in the COVID-19 Regulator Testing Programme Kidd, S.P., Burns, D., Armson, B., Beggs, A.D., Howson, E.L., Williams, A., Snell, G., Wise, E.L., Goring, A., Vincent-Mistiaen, Z. and Grippon, S., 2022. Reverse-transcription loop-mediated isothermal amplification has high accuracy for detecting severe acute respiratory syndrome coronavirus 2 in saliva and nasopharyngeal/oropharyngeal swabs from asymptomatic and symptomatic individuals. The Journal of Molecular Diagnostics, 24(4), pp.320-336. Ptasinska, A., Whalley, C., Bosworth, A., Poxon, C., Bryer, C., Machin, N., Grippon, S., Wise, E.L., Armson, B., Howson, E.L. and Goring, A., 2021. Diagnostic accuracy of loop-mediated isothermal amplification coupled to nanopore sequencing (LamPORE) for the detection of SARS-CoV-2 infection at scale in symptomatic and asymptomatic populations. Clinical microbiology and infection, 27(9), pp.1348-e1. Rapid analytics support to NHSE Chief Scientific Officer’s (NHSE CSO) team including: Statistical validation of the PCR technology for Project Jupiter in Leamington Spa, which now covers 300,000 PCR tests a day of the UK’s Pillar 2 testing infrastructure Development of a calculator tool for TVG which will be used to validate several COVID-19 testing technologies Research design for laboratory validation studies Publications https://doi.org/10.1038/s41598-021-02481-y
- ADOPTED: Community pharmacy alcohol-related liver disease risk identification and linkage to care through development of a complex intervention (CIP-LINC)
a0531f94-b063-4041-908b-5830a10b5f66 ADOPTED: Community pharmacy alcohol-related liver disease risk identification and linkage to care through development of a complex intervention (CIP-LINC) Prinicpal Investigator: Dr Alexander Smith Start Date: 16 February 2023 End Date: 31 March 2025 Background Liver scarring (known as cirrhosis) is a frequent and ever more common reason for dying in the United Kingdom (UK). The most common cause of liver scarring in the UK is alcohol. Death from liver scarring can be prevented if liver disease is found at an early stage. This can be hard because many people with liver scarring do not look or feel unwell until they develop liver failure. At this stage it is too late to prevent complications. Alcohol-related liver disease can be found earlier by assessing for it in people who drink too much alcohol. This is advised in national guidelines. Local pharmacists are one of the most accessible health professionals. There are over 12000 local pharmacies in England. Lots of these pharmacies are in areas where more people have alcohol problems. Local pharmacists are able to identify people who drink too much alcohol and provide them support to drink less. However, it is not known if local pharmacists can get these people assessed for alcohol-related liver disease. This study looks at how this could be done with the aim of creating a Toolkit to make it happen.
- Improving support for self-management (WASP)
f5788d42-1d65-4ac1-a9d5-00a8fcb316fd Improving support for self-management (WASP) Using the Wessex Activation and Self-Management and Personalisation (WASP) Tool to design and implement system wide improvements in self-management support for people with long-term conditions See the WASP website https://www.wasp.soton.ac.uk/ Principal Investigator: Professor Mari-Carmen Portillo Team members: Professor Mari-Carmen Portillo (Professor of Long-Term Conditions, School of Health Sciences, University of Southampton), Dr Hayden Kirk (Consultant Physiotherapist & Clinical Director Adults Southampton, Solent NHS Trust), Dr Chris Allen (Lecturer, School of Health Sciences, University of Southampton), Stephanie Heath (WASP Clinical Lead, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust), Dr David Culliford (Senior Medical Statistician, School of Health Sciences, University of Southampton), Dr Louise Johnson (WASP Project Manager, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust), Dr David Kryl (Director, Centre for Implementation Science, University of Southampton), Professor Alison Richardson (Professor of Cancer Nursing and End of Life Care, University of Southampton) Start: 1 October 2019 Ends: 30 September 2024 Project Partners: Solent NHS Trust, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight ICS Summary Good health and health care are key to a flourishing society. Focussing on what matters most to patients is essential for accessible, equitable and efficient care. In an NHS that is facing many challenges - including an increasing prevalence of multimorbidity and high levels of workforce burnout - this is easier said than done. The Wessex Academy for Skills in Personalised Care (WASP) has developed a programme to facilitate adoption of personalised care in practice. Led by the University of Southampton in partnership with NHS organisations across the Southeast, this programme supports health and social care services to embed personalised care practices – through rigorous evaluation, training, and bespoke improvement initiatives. Research is underway to evaluate the impact of the programme, and to understand how it could be spread and scaled. If adopted nationally, this programme has potential to be the catalyst for changing how we deliver and sustain services across the NHS. Impact People with multiple long-term conditions (MLTC) represent a significant proportion of the primary care population; with an estimated 14 million in England living with two or more chronic conditions. Many experience high treatment burden, fragmented care and reduced quality of life. While national policy promotes personalised care, implementation at scale has proved challenging. Services often lack the tools, skills and system support needed to embed personalised approaches into everyday practice. Difficulties in defining and measuring personalised care, add further challenge. The Wessex Academy for Skills in Personalised Care (WASP) was established to address this gap. Funded and commissioned by Hampshire and Isle of Wight and Dorset Integrated Care Boards (>£710K), WASP has developed an evaluation and training approach, focused on cultural and system-level change rather than isolated interventions. Led by the University of Southampton and working in close partnership with NHS organisations, WASP supports health and social care services to embed personalised care in a sustainable way. Training is accredited by the Personalised Care Institute and WASP is a partner with the Coalition for Personalised Care. Being hosted within NIHR ARC Wessex has enabled WASP to bring together research expertise, service improvement skills and frontline clinical experience. This collaboration underpins a structured programme built around three core elements: evaluating current practice, building skills through accredited training, and supporting services to make sustained improvements. A co-produced service evaluation tool enables teams to reflect on how personalised care is experienced by staff, service users and the wider system; enabling understanding of not just what happens in practice, but why. Training builds staff confidence and capability, while improvement support helps translate learning into measurable change. This work has had broad impact. To date, 45 clinical services across Hampshire, the Isle of Wight, Dorset and Sussex have completed the WASP programme. Over 1,400 healthcare staff have taken part in training, and more than 2,000 people, including clinicians, managers, commissioners and service users, have engaged with the service evaluation. Teams report shifts in mindset, with greater focus on “what matters” to individuals and increased confidence in delivering flexible, responsive care. People using services benefit from care that better reflects their priorities and circumstances, while staff gain shared language, clearer frameworks and practical tools. Commissioners and system leaders benefit from robust evidence to guide investment and improvement. WASP has also influenced practice beyond participating services, contributing to NHS England South East guidance; providing regional leadership on Patient Activation Measure use for NHS England; and contributing to ICB values-based care steering boards. NIHR ARC Wessex has been critical in enabling this impact by supporting programme development, evaluation and dissemination. ARC infrastructure has provided methodological and statistical expertise, mentorship, impact capture guidance and communications support, enhancing credibility and enabling scale-up. Through ARC Wessex, WASP accessed expertise across the University of Southampton, including business intelligence and the Business School, securing two development grants in 2023: the Southampton Enterprise Development Fund (£8,550) and Higher Education Innovation Fund (£10,000). Engagement has also taken place through WASP conferences in 2023 and 2024, with over 100 delegates including clinicians, commissioners and national policy stakeholders. The team is now collaborating with colleagues from UCL, Bristol, Leeds and Exeter to develop a programme grant focused on a scalable and sustainable personalised care intervention. This partnership demonstrates how NIHR investment can translate evidence into meaningful improvements for people living with long-term conditions. “It was good that we were able to focus on how shared decision making can work for continuing healthcare joint working on assessing challenges and positives- in a structured way. The idea of the need was there, and it helped to provide the framework to address the need ” [Programme Participant] https://www.wasp.soton.ac.uk/ We have now held 3 regional conferences, with attendance from 100+ delegates and a range of regional and national speakers – photos can be found on the conference page of our website. https://www.linkedin.com/company/wessex-academy-for-skills-in-personalised-care A scoping review followed this project to provide the rationale for the WASP assessment tool of personalised care practices – this has now been published: Johnson et al (2025) Next? WASP II is now evaluating and collecting evidence of the impact of the Wessex Academy for Personalised Care programme. We are conducting a secondary data analysis on existing WASP survey data, to better understand the behavioral factors impacting personalised care practices. We are seeking for further NHS teams to complete the training beyond Wessex. We are planning an NIHR PGfAR Submission in April 2026 – focussing on sustainable and scalable development and national evaluation of the programme. We are collaborating with UCL, Bristol, Leeds and Exeter, as well as the Personalised Care Institute. Now there's a series of FREE webinars to develop skills supporting personalised care, for health and care professionals in the Isle of Wight, Hampshire. More here
- Dem Comm Research Fellows | NIHR ARC Wessex
DEM-COMM programme Building Capacity in Dementia Research DEM-COMM has been a successful capacity-building scheme for post-doctoral researchers working in applied dementia research. The scheme launched on October 1st, 2022, with funding from the National Institute for Health and Care Research and the Alzheimer’s Society, and will run until March 31st, 2026. The aim of DEM-COMMhas been to prepare a future cohort of researchers for the role of Chief Investigator in applied dementia research. This is an important and specialised role that carries with it the expectation that the lives of people living with (or at risk of) dementia will improve because of research. The scheme supported the development of more than 70 early to mid-career researchers working in one of the 15 Applied Research Collaborations (ARCs) across England. Read the full report Supporting the future generation of Chief Investigators in Applied Dementia Research Independent report on Mapping Dementia Research Capacity - Mapping career development opportunities in applied dementia research Dementia Festival 2025 report DEM-COMM is led by Professor Ruth Bartlett with ARC Wessex as the host and coordinating centre. In 2026 we celebrated the end of the DEM-COMM programme at an event in Southampton - below are just some of the videos and images from that day Southampton Test MP Satvir Kaur explains how important the work of the Dementia Fellows has been and how personal it is to her. Lisa Hammond from the Alzheimer's Society who part funded the Dem-Comm fellowships praises their impact on the lives of people with dementia and their carers and families. Watch the DEMCOMM showreel created to celebrate all the hard work and achievements of the NIHR Dementia Fellows DEM-COMM Research Fellows Dementia Post Doctoral Awards NIHR ARC East of England NIHR ARC East Midlands NIHR ARC Greater Manchester NIHR ARC Kent, Surrey and Sussex NIHR ARC North East and North Cumbria NIHR ARC North Thames NIHR ARC Northwest London NIHR ARC North West Coast NIHR ARC Oxford and Thames Valley NIHR ARC South London NIHR ARC Wessex NIHR ARC West NIHR ARC West Midlands NIHR ARC Yorkshire and Humber NIHR ARC South West Peninsula
- Long Term Conditions | NIHR ARC Wessex
Long Term Conditions Long Term Conditions Theme The Long Term Conditions (LTC) Theme, led by Professor Mari Carmen Portillo with Deputy Lead Dr Dorit Kunkel, delivered a broad programme of research and implementation designed to improve the lives of people living with long‑term conditions and multiple long‑term conditions. The theme’s work spanned deprescribing, medicines optimisation, treatment burden, physical activity, service improvement, co‑production, and person‑centred care. A major area of impact is medication deprescribing and optimisation. The MODIFY project has significantly enhanced safety and quality of life for frail older adults by adopting a structured, multidisciplinary approach to medication reviews. It supports clinicians through training, tools, and collaborative working models, and is now embedded within wider system initiatives such as the Wessex Health Innovation Network’s Polypharmacy Action Learning Sets . Public engagement activities—including creative outputs like a deprescribing song—have helped raise awareness and encouraged culture change in medicines optimisation. Further medicines‑related research has identified ongoing risks related to inappropriate prescribing of anti-inflammatory painkillers for older adults and those with conditions such as kidney or heart disease. A GP‑focused risk‑identification tool was developed to address this. Another study highlighted that many people on disease‑modifying drugs undergo high‑frequency monitoring despite long‑term normal results, suggesting opportunities to reduce unnecessary burden and NHS workload. The Treatment Burden Study , involving more than 800 Dorset adults, showed that high burden is common and often driven by lifestyle challenges, appointment access, financial pressure, and complex medication regimens. Its follow‑on project, SPELL, produced short, practical measures for clinical use. The findings also informed improvements for Care Coordinators in Southampton, enabling them to better identify and support individuals struggling with their conditions while reducing demand on GP time. The theme optimised community‑based support systems, developing a Link Worker framework for social prescribing and piloting the LifeBoost app to guide people with LTCs to personalised resources. The European Optim Park project expanded access to Parkinson’s support via the REPISALUD directory, now used internationally. Policy influence is another key outcome. Research on COVID‑19, physical activity, and mental health has shaped recommendations adopted by bodies including Sweden's Health Technology Assessment Agency and the European Commission. Findings from Optim Park have informed NICE guideline NG252. Additional impacts include shaping national and international understanding of Huntington’s disease care needs, advancing person‑centred assessment tools such as the Living with Long Term Conditions Scale, and contributing to workforce development through the Wessex Academy of Skills in Personalised Care , which has trained more than 1,500 professionals. Finally, work on physical activity maintenance has expanded understanding of the barriers and enablers affecting digital health engagement among NHS staff, strengthening regional partnerships. Research projects ARC Wessex programme of research on Medicines Optimisation (MODIFY SPiDeR STOP-DEM) Read more ADOPTED: Personalised social and self-management support for better living with multiple long-term conditions in the community (CO-ACTION) Read more Social Prescribing Link Workers framework: supporting complex needs of adults living with physical and mental health long term conditions Read more Evaluating impact of personalised care at service at service and system levels: Learning from the Wessex Academy for Skills in Personalised Care (WASP) programme. Read more Understanding barriers and enablers of using the Living with Long Term Conditions scale as part of routine care for people from under-served groups living with type 2 diabetes Read more PARTNERS II: Testing implementation and evaluation of a digital tool for multisectoral support and management of people living with Parkinson’s disease and/or arthritis. Read more Avoiding care escalations through targeted care coordination for people with multiple long-term conditions – a knowledge mobilisation project Read more Deprescribing and Optimisation of Medicines IN Older people with Heart Failure and Frailty (DOMINO-HFF) Read more Change in treatment burden among people with multimorbidity: Protocol of a follow up survey and development of efficient measurement tools for primary care Read more ADOPTED: Treatment burden in people below the age of 65 with multimorbidity in primary care: A mixed methods (SPELL) Read more ADOPTED: (SIFT) Sensors in Fatigue Tracking in Parkinson’s. Exploring the relationship between perception of Fatigue and the performance of physical activities in people with Parkinson's with fatigue using wearable sensors Read more Reframing responsibility through public empowerment: examining environmental cues influencing poor diet Read more Non-digital support for maintaining physical activity in people with long-term conditions – within Maintenance Of physical acTivity beHaviour (MOTH) programme Read more Digital support for maintaining physical activity in people with long-term conditions Read more Development of policy recommendations to reduce the impact of COVID-19 on physical activity and mental health in individuals with multimorbidity: a mixed method study. Read more ADOPTED PROJECT: Understanding risk stratification of patients with chronic kidney disease (CKD) in primary care Read more ADOPTED PROJECT: Development of a decision aid for offloading device selection for people with diabetic foot ulceratio Read more ADOPTED PROJECT: Breast Cancer Choices: Evaluation and implementation of a digital patient-centred decision aid to support genetic testing in mainstream care. Read more ADOPTED PROJECT: Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) Read more ADOPTED PROJECT: MELD Read more POST DOCTORAL PROJECT: Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study Read more Testing the living with chronic illness scale Read more Medicines optimisation Read more Interventions to support physical activity for adults (MOTH) Read more MODIFY: The development and iMplementation Of a multidisciplinary medication review and Deprescribing Intervention among Frail older people in primarY care Read more PARTNERS Project: Development and implementation of a digital tool for multisectoral support and management of long-term condition Read more ADOPTED PROJECT: EnablExercise in Crohns: A qualitativE study to uNderstAnd the Barriers and faciLitators to physical activity and Exercise IN children and adolescents with CROHN’S disease Read more ADOPTED PROJECT: ExACT-CF: Exercise as an Airway Clearance Technique in people with Cystic Fibrosis – A randomised pilot trial Read more ADOPTED PROJECT: Happier Feet Read more OPTIM Park - Optimization of community resources and systems of support to enhance the process of living with Parkinson’s Disease: a multisectoral intervention Read more Improving support for self-management (WASP) Read more Mental health hub projects Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study Read more Role of patient-assessed functioning as a predictor of health service use in patients with long term mental health conditions Read more Read our publications here Read more Publications Collaborative project: Improving review appointments for people with long-term conditions
- ADOPTED PROJECT: Supported remote rehabilitation post Covid-19
dcda912e-45e2-47ca-a777-aad1c26161d1 ADOPTED PROJECT: Supported remote rehabilitation post Covid-19 COMPLETED: Development, deployment, and evaluation of a digitally enabled rehabilitation programme Chief Investigator: Professor Elizabeth Murray – University College London, Dr Henry Goodfellow – University College London Institute of Epidemiology & Health Care Project Team Members: Dr Katherine Bradbury – University Of Southampton, Dr Stuart Linke – Camden & Islington NHS Foundation Trust, Mr Chris Robson – University College London, Professor Fiona Stevenson – University College London Institute of Epidemiology & Health Care, Dr Manuel Gomes – University College London Institute of Epidemiology & Health Care, Dr Fiona Hamilton – University College London Institute of Epidemiology & Health Care, Professor Ann Blandford – University College London, Professor John Hurst – University College London, Professor Delmiro Fernandez- Reyes – University College London, Professor William Henley – University of Exeter Medical School, Dr Melissa Heightman – University College London Hospitals NHS Foundation Trust, Dr Paul Pfeffer – Barts Health NHS Trust, Dr William Ricketts – Barts Health NHS Trust, Ms Hannah Hylton – Barts Health NHS, Trust Dr Richa Singh – Barts Health NHS Trust, Ms Julia Bindman – Patient and Public Involvement contributor based in England. Publication: October 2025 - D esign and deployment of digital health interventions to reduce the risk of the digital divide and to inform development of the living with COVID recovery: a systematic scoping review Organisations Involved: Living With, NHS England, various NHS trusts, AHSN Wessex, UCL Partners. Start Date: 1st October 2020 End Date: 30th September 2023 Background: Covid-19 had affected nearly 300,000 patients in the UK by 6/7/20. Many remain symptomatic with breathlessness, fatigue, and anxiety for weeks or months. These symptoms can be improved with rehabilitation, but traditional, face-to-face models of service delivery will struggle to cope with these large numbersof patients. A digital approach is likely to be needed, but there are numerous challenges with this approach, including failures of implementation; anxieties around the digital divide/health inequalities; and concerns around low engagement with such programmes. Aim: To refine, deploy and evaluate a digitally- mediated, remote, supported rehabilitation programme for patients affected by Covid-19.Methods: We will combine research methods common to engineering and computer science (focused on developing a product that is safe, stable and meets user requirements) with those familiar to biomedical and health service researchers (focused on effectiveness and population impact). Thus, we will apply the Medical Research Council (MRC) Framework for development and evaluation of complex interventions (Phases 1, 2 and 4) Publications Experiences of user-centred design with agile development for clinically supported self-management of Long Covid Trajectories of functional limitations, health-related quality of life and societal costs in individuals with Long COVID: a population based longitudinal cohort study Additional funding The work from this project led to an additional Grant from NIHR SPCR Do community-based digital health inclusion programmes contribute to tackling health inequalities in disadvantaged population groups?
- Knowledge Mobilisation | NIHR ARC Wessex
Knowledge Mobilisation What is Knowledge Mobilisation (KM)? "It's about getting the right information to the right people in the right format at the right time - by actively collaborating" 1/6 These web pages are here to help share the learning our Knowledge Mobilisation Fellows are accumulating through our ARC Wessex Knowledge Mobilisation (KM) Programme. We will be developing this page into a hub of resources. Please get in touch with any questions and share your thoughts about KM via this email Click to jump to the section you want on this page KM Fellows - This is us KM Resources (in development) KM Action Learning Projects As part of a £7.8 Million investment from the NIHR in October 2024, ARC Wessex appointed a Knowledge Mobilisation team including four KM Fellows. ARC Wessex worked with Hampshire & Isle of Wight (HIoW) and Dorset Integrated Care Boards, provider organisations and Health Innovation Wessex to create a programme directly relevant to needs of patients, service users, carers and health and care systems. The programme is supported by an advisory group of stakeholders, which meets regularly and monitors the delivery of the programme’s objectives: Develop the capability of the KM fellows through increased awareness of training needs and tailored capability development programmes Deliver multiple Action Learning Projects to capture insights about KM practices and learning about what works or does not work to share more widely Develop a cohort of KM Practitioners across Wessex to support capability and capacity building with our partners and systems Actively contribute to ARC Greater Manchester national meetings and Communities of Practice to work in partnership cross-ARCs. This is us Knowledge Mobilisation Fellows Phillipa Darnton is our Implementation and Knowledge Mobilisation Lead Rachel Tobin is our Knowledge Mobilisation Programme Manager Dr Jenny Roddis is a Research Fellow and is an Associate Professor in Community Health at the University of Portsmouth Dr Kate Lippiet is a Senior Research Fellow based in the School of Health Sciences, University of Southampton Email the team at: arcwessex@soton.ac.uk Download the Knowledge Mobilisation poster This is our resources and tools section We are busy creating lots of useful tools and resources for you to download and they will appear here as we develop them, so keep an eye out. Please share your thoughts of KM and/or sign up to the KM mailing list using this form Download If you like our KM umbrella above you can download the image here by clicking the box to the left Download Download - 6 Ideas about KM - Steps to Good Action Learning Projects The KM Fellows are ‘learning by doing’ and documenting their findings as Action Learning Projects. Each fellow has their own projects in which they are trialling different KM activities to learn about what works in which circumstances. This learning will help them to build KM capability and capacity within the ARC Wessex health and social care research system. Current Mental health: learning from providing support to the ARC Wessex Mental Health Hub to adopt knowledge mobilisation strategies for selected projects. Skills and knowledge: identifying the skills and knowledge needed for good knowledge mobilisation and developing a national framework for KM professionals and researchers. Co-producing clinical academic pathways in Dorset. Working with knowledge and information services across Wessex to develop a knowledge mobilisation community of practice Mapping what influences decision-making and use of evidence in residential care and home care. Supporting care home staff to understand the current evidence base on dehydration risk assessment and apply this to the care home setting, with development of resources to support staff in this setting undertake robust evidence reviews. Completed Working with Hampshire and Isle of Wight Integrated Care Partnership to develop and deliver a research assembly. Understanding research priorities for care home and home care providers in Wessex.
- Mental Health, Workforce and Well-being Research Framework - ARC Collaboration
1810d0c8-e9bb-4a7c-9947-bbac48f4dd69 Mental Health, Workforce and Well-being Research Framework - ARC Collaboration More details on ARC Greater Manchester website What are we trying to do? The purpose of the document is to propose a pan National Insititue of Health Research (NIHR) Applied Research Collaboration (ARC) workforce focused mental health and well-being research framework. The aim is for the research framework to serve as a reference point to: Create coherence and comparability across the research carried out by NIHR ARCs Reduce duplication of work to reduce workforce burden. Adopting a coherent approach with an agreed purpose and broad aims will maximise the potential for cross-ARC collaboration, synergy and impact. While the focus of this research has a COVID-19 focus, the ambition is that this framework should facilitate research beyond the current pandemic, ensuring programme sustainability and longevity across the lifetime of this 5-year NIHR ARC funding cycle. This framework is not intended to be prescriptive, rather, it is a call to colleagues doing research under the NIHR ARC umbrella to use the framework as a point of reference in the development of research projects and programmes. It is a modular approach which allows flexibility to fit the scientific questions and data collection to the needs of the specific workforce and context being studied. Why is it important? The NIHR has invested £135 million to support 15 collaboratives covering every region within England. The NIHR ARC collaborative provides a framework within which key stakeholders are brought together locally and nationally with a mandate to tackle difficult issues facing our health and care system including: patient outcomes, effectiveness of our health and care system, system sustainability, and carrying out research with an applied focus to facilitate the rapid translation of research into practice. Moreover, the designation of ARC South London and ARC East of England as national leads for mental health and the establishment of a National Mental Health Priorities Network provides a further opportunity for effective collaboration. The NIHR ARC network presents a unique opportunity to develop a coherent and consistent approach to workforce mental health and well-being research which embodies these principles. What will we do? The framework is available for any NIHR ARC to review and align with, to guide the development of work that aligns to the fundamental principles of the NIHR ARC programme. Who are we working with? The NIHR ARCs and their research themes are set out in a table included in the document. In line with the framework, colleagues are encouraged to work collaboratively to maximise synergy, impact, and reduce duplication and burden. The origins of this framework arose out of conversation with colleagues from across NIHR ARC sites between April 2020-June 2020. The framework has been developed by: Kirsten Windfuhr (ARC Greater Manchester), Jane Ball (ARC Wessex), Karina Lovell (ARC Greater Manchester) Penny Bee (ARC Greater Manchester). Additional contributions and comments were gratefully received from ARC colleagues, and in particular Kristy Sanderson (ARC East of England). More information For further information about this work, please contact Alison Littlewood (Programme Manager). (ARC GM) Download - Mental Health, Workforce and Well-being Research Framework
- ADOPTED: Investigating the impact of food vouchers on diet composition and the prevention of childhood obesity
74e67d37-7f00-423e-b571-0f47e11e3dca ADOPTED: Investigating the impact of food vouchers on diet composition and the prevention of childhood obesity Principal Investigator: Grace Grove Start Date: 10 May 2021 End Date: 9 May 2023 Background: Childhood obesity is increasing in the UK, and children from disadvantaged backgrounds are more likely to live with obesity. Obesity in childhood is linked to obesity in adulthood and poor health outcomes. It is therefore vital that we work to prevent and reduce inequalities in childhood obesity. We know that children from disadvantaged backgrounds are more likely to have poor diets, and children who have poor diets are more likely to be obese. Therefore, improving diet quality of young families may contribute to preventing the development of childhood obesity. Healthy Start is a scheme in England that aims to improve diet quality by providing vouchers to spend on milk, fruit and vegetables to disadvantaged families. However, the voucher value is modest and has not changed for a decade, despite increasing food prices. The scheme needs assessing to consider how it can best support families, as uptake among eligible families is very low, at 54% nationally. Health visitors support young families, and give extra support to those with increased needs, including those from deprived groups. This provides a unique opportunity to support young families who are at risk of childhood obesity and eligible for Healthy Start. The aim of this research is to understand if voucher schemes can have a positive effect on diet quality of disadvantaged families. This research will contain several elements, including reviewing the literature for evidence on the effectiveness of voucher schemes, speaking to families and health visitors, collecting diet and shopping information from families, and modelling the best approach to a modified Healthy Start scheme. Publications Systematic review of fruit and vegetable voucher interventions for pregnant women and families with young children | Public Health Nutrition | Cambridge Core


