55041d82-7430-4dcd-98fd-9bd97e850e1f PREDICT-NURSE – feasibility: Predicting Patient Acuity/Dependency-Based Workload from Routinely Collected Data to Assist with Nursing Staff Planning – feasibility study Prinicpal Investigator: Christina Saville Team: Paul Meredith, University of Southampton Chiara Dall'Ora, University of Southampton Tom Weeks, Portsmouth Hospitals University NHS Trust Sue Wierzbicki, Portsmouth Hospitals University NHS Trust Peter Griffiths, University of Southampton Ian Dickerson – Patient and Public Involvement Representative Start Date: 1 September 2023 End Date: 30 September 2024 Plain English Summary of Findings Using information about patients already held by hospitals (such as patient demographics, diagnostic information and movements between wards) we estimated the number of nurses needed on the ward each shift. We found that our estimates matched closely with the currently widely-used approach. For that approach, the nurse in charge records the severity of each patient's illness, and how dependent they are on nursing care, every day or shift. In contrast our approach uses a type of regression (a tool for finding patterns in data) to automatically calculate the number of nurses needed. This would potentially save nurses time in assessing patients by using information that is already recorded. What's next? We used data from one hospital so need to find out if results are similar for other hospitals. We also need to find out whether our estimates relate to patient outcomes. We have funding for another 1-year study (PREDICT-NURSE validation and extension) to explore this using existing data from another hospital. We will also investigate whether we can use similar methods in other settings outside acute care, e.g. mental health and community settings. We have also received funding for a 2.5-year study (PREDICT-NURSE) with at least 5 hospital Trusts collecting new data to develop and test algorithms using a wider range of data and outcome measures. This study will be based on user-centred design, with a national survey and workshops to gather nurses’ and other stakeholders’ views. Background Having enough nurses to care for patients on hospital wards is critical for patient safety, but it is difficult to plan for varying numbers of patients and unknown trajectories of deterioration and recovery. Tools for assessing patients’ needs to help with staff planning are an extra nursing task, thus adding further to workload. We do not know whether ward-level demand could be accurately predicted using existing assessments and data that is already recorded electronically. The overall aim of the project was to explore the feasibility of predicting acuity/dependency-based workload measures, as assessed by nurses, from routinely collected information in patients’ electronic health records. Publications Estimating Nurse Workload Using a Predictive Model From Routine Hospital Data: Algorithm Development and Validation: https://doi.org/10.2196/71666

4d75ba35-779f-4c29-9dd6-a4bbffb8ad71 Determining the effectiveness and outcomes of innovative interventions for people who have used stalking behaviours: An extension of the exploration of the Hampshire & Isle of Wight Multi-Agency Stalking Partnership (MASP) Chief Investigator: Dr Sara Afshar Morgan, Associate Professor of Public Health, Faculty of Medicine, University of Southampton Team: Mrs Katerina Porter, Senior Research Assistant, Faculty of Medicine, University of Southampton Dr Rebecca Harris, Research Fellow, Faculty of Medicine, University of Southampton Ms Lana Weir, Senior Research Assistant, Faculty of Medicine, University of Southampton Lisa Allam, Commissioning Manager, Hampshire and Isle of Wight Office of the Police and Crime Commissioner Dr Kirsty Butcher, Principal Clinical Psychologist and Clinical Lead, Multi-Agency Stalking Partnership, Hampshire and Isle of Wight NHS Foundation Trust Detective Chief Inspector Abigail Leeson, Hampshire and Isle of Wight Constabulary Dr Andrew Bates, Regional Forensic Psychologist, South Central Probation Region (HM Prison and Probation Service) Rachel Windebank, Operations Director, STOP Domestic Abuse Partners: Hampshire and Isle of Wight NHS Foundation Trust, University of Southampton, Hampshire and Isle of Wight Office of the Police and Crime Commissioner, Hampshire and Isle of Wight Constabulary, South Central Probation Region (HM Prison and Probation Service), STOP Domestic Abuse. Start date: 1 April 2023 End date: 1 October 2026 Overview The Hampshire and Isle of Wight Multi-Agency Stalking Partnership (MASP) brings together policing, NHS services, probation, and victim/survivor advocacy organisations to respond to stalking in a coordinated way. Researchers at the University of Southampton are working with partners to evaluate MASP and understand how multi-agency approaches and psychological interventions may reduce stalking behaviours and improve outcomes for those affected. This programme of work spans multiple phases of research and evaluation, combining qualitative and quantitative approaches to build a comprehensive understanding of how MASP operates and its impact. This evaluation is co-funded by NIHR Applied Research Collaboration (ARC) Wessex, the Home Office, and the Hampshire and Isle of Wight Office of the Police and Crime Commissioner. Why This Research is Needed Stalking involves fixated, obsessive, and repeated behaviours that cause significant distress and fear. It is strongly associated with serious violence, including in cases of homicide. Despite this, there is limited evidence on how best to intervene with people who have engaged in stalking behaviours, particularly in real-world, multi-agency settings. Existing research on psychological interventions is often based on small samples and short-term outcomes. This project addresses this gap by evaluating stalking interventions delivered as part of a whole-system, multi-agency response. The MASP Approach MASP is a whole-system model that integrates: · Multi-agency case management across policing, NHS, probation, and victim/survivor advocacy services · Psychologist-led specialist interventions (PLSIs) for individuals using stalking behaviours · Use of legal and safeguarding tools alongside therapeutic support · Close collaboration between agencies to manage risk and support victim/survivors How MASP is Being Evaluated This research combines multiple strands of work to understand both how MASP operates and its outcomes. The evaluation includes: · Qualitative research with professionals and individuals who have engaged in stalking behaviours · Longitudinal follow-up of people who have completed psychologist-led interventions · Analysis of police data to examine reoffending and ongoing risk · Comparison of perspectives across individuals, victim/survivors, and practitioners · A planned health economic analysis (in collaboration with colleagues at the University of Sheffield) Together, these approaches aim to identify what works, for whom, and in what contexts. What We Have Learned so Far Over a 26-month period of implementation, MASP identified nearly 1,500 individuals using stalking behaviours across Hampshire and the Isle of Wight. Key findings include: · Individuals ranged in age from 13 to 87 at referral · Victim/survivors ranged from 14 to 87 · Stalking behaviours had typically been ongoing for several months prior to referral, with some cases lasting many years · Around 30% of individuals were offered a psychologist-led intervention · Children appear to be underrepresented in current data, highlighting an important gap for future work Ongoing analysis is examining whether engagement with MASP activities reduces further stalking behaviours. Outputs and Impact This work is already contributing to national policy and practice: Standards and Guidance Co-created standards for interventions with perpetrators of stalking have been developed with multi-agency partners and shared with the Home Office. These represent one of the first publicly available frameworks of this kind (available as a preprint ) Research Outputs: A series of papers are being developed, including: · A whole-system model of MASP (manuscript in preparation) · A psychological framework for measuring change in stalking interventions (available as a preprint ) · An evaluation of intervention outcomes, involving data linkage between police and health services · Qualitative research exploring lived experiences of MASP Knowledge Sharing: Alongside presentations at local, national, and international conferences, two animations have been developed as part of knowledge exchange activities: · The first animation outlines how professionals can work safely and effectively with people who have engaged in stalking behaviour, highlighting the role of psychological approaches and evidence-informed interventions. · The second animation provides an overview of the whole-system MASP model. The team also engages in public awareness activities, including participation in Stalking Awareness Week, with on-campus events involving practitioners such as Independent Stalking Advocates and police safeguarding leads to raise awareness and share learning. Policy Relevance · Findings are informing Home Office work on national standards and commissioning of stalking interventions. · The work also responds directly to recommendations from the super-complaint on the police response to stalking . Ongoing and Future Work The project is continuing to examine whether, and how, MASP activities reduce the risk of further stalking. Planned work includes: · In-depth qualitative research with individuals who have engaged in stalking behaviours · Exploration of how MASP can better identify and support children affected by stalking · Co-development of improved measures of behavioural change alongside service users · Continued evaluation of long-term outcomes following intervention Further Information For more information about this project, please contact: MASPinfo@soton.ac.uk Additional information about the MASP service can be found via partner organisations, including Hampshire and Isle of Wight Healthcare NHS Foundation Trust and Hampshire and Isle of Wight Police and Crime Commissioner .

84be43ab-b507-48d9-88f1-af7fc1ff89d7 ADOPTED PROJECT: INvolvement and engagement to build capacity and CO-create research into Digital INterventions for Gambling that harms (INCODING) Principal Investigators: Professor Sam Chamberlain and Dr Jeremy Solly University of Southampton/Hampshire and Isle of Wight Healthcare NHS Foundation Trust Start Date: July 2025 End Date: June 2026 Summary We planned to increase our ability to engage with people with lived experience of gambling harms and improve our future research projects. We achieved this through three types of activity over the course of a year: 1. We set up a Lived Experience Advisory Group and substantially increased the number and diversity of its members. We developed new and more inclusive ways to tell people about the group and for them to sign up. 2. We identified >100 organizations across our catchment area relevant to gambling harms. We have developed new relationships with local authorities and charities to learn from their expertise and raise the profile of our service. 3. Our Lived Experience Advisory Group has helped us to develop six research grants. What we did with our new knowledge Our Lived Experience Advisory Group has already contributed to a number of ongoing service development projects, including those related to treatment pathways and digital communication with patients. The Group is currently working with us to co-produce a new workbook for one of our treatment programmes. By working with local authority and charity partners, we have focused on learning how to better support those experiencing digital exclusion, those experiencing homelessness, and those who are going through criminal justice proceedings. Our Lived Experience Advisory Group is now a key part of our service and we aim for the group to have a voice in all our future service development and research activities. We have initiated new service evaluation projects looking specifically at digital inclusion and homelessness, so we can identify new ways to effectively support people. We will continue to build our network across the region, to learn from partner organisations and ensure that people working to support those affected by gambling harms are aware of our service.

bd39e9d4-a228-4123-b44c-d499a7f27a45 Prevention schemes for female vicitms and offenders in Hampshire and Dorset Principal Investigators: Dr Sara Morgan Team members: Dr Sara Morgan ( Lecturer in Public Health School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Fiona Maxwell (Public Health Registrar School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Sergeant Ali Attwood (Hampshire Constabulary, Restorative Justice Lead) , Debbie Willis ( Hampton Trust charity, Domestic Abuse Service Manager), Vicky Atkinson (Hart District Council, Domestic Abuse Project Coordinator), Patricia Durr ( One Small Thing ), Mona Samiy ( Stop Domestic Abuse charity , Project Manager) Start: 11 November 2019 Ends: 11 November 2021 Project Partners : University of Southampton, University Hospital Southampton NHS Foundation Trust, Hampshire Constabulary, Hampton Trust, Hart District Council, One Small Thing, Stop Domestic Abuse. Lay summary: Background and study aims Compared to the previous year, in 2018 there was an overall 8% increase in theft in England and Wales and a 6% increase in crimes involving sharp instruments or knives. In order to tackle this increase in crime, many believe that more needs to be done to address the reasons why people commit crime in the first place, as well as the damage it causes to peoples’ lives. This means working together in the community to offer solutions to those affected by crime, including victims and offenders. When we discussed possible solutions with local service providers, it was felt that a tailored approach is needed for women, as their needs are unique. Women in prison are very likely to be both victims and offenders whilst, in the general population, one in four women are also victims of abuse within the home and more than half the women in prison have experienced domestic abuse themselves. In response, three projects are being piloted in Hampshire and Dorset to address the needs of women affected by crime. What does the study involve? To understand how these projects are working, we plan to carry out group interviews with those delivering the pilot intervention projects in the community. This will primarily be to understand how the projects are working. We will also use information gathered from the project staff about the women using the service to understand whether women go on to seek further assistance in the community, what sort of women engage with the project, and what changes for them as a result of using the service. This study proposal was developed in collaboration with public representatives; including offenders, victims, social care workers, domestic abuse service manager, and police officers. They have all shaped the design of the study; by informing us what types of research questions we should be asking. Going forward, we will continue to involve similar representatives throughout the research study; for example, to co-produce the materials used in the study, such as information sheets, and to gain feedback on the write up of the study. What will we do with the study findings? It is important that the information gained from the study reaches the widest number of people. We will therefore consider who to engage, and how to reach them, from the very start of the study. The main findings will be developed into a short summary report, which will be accessible to the general public through our public representatives and collaborators. They might include charitable organisations in the community (e.g. Stop Domestic Abuse, Hampton Trust) or services that work directly with women affected by crime (e.g. NHS, probation services).

1f1252b1-cfe9-4800-b5dd-f3b53069d91a Understanding psychosocial determinants of alcohol use disorder (AUD) in older adults: exploring the role of social networks and loneliness in living with AUD (OLA study 2). Project partners (charities, Universities, NHS trusts, care providers etc): University of Southampton, University Hospital Southampton NHS Foundation Trust Full team listing including PPI Professor Julia Sinclair – Chief Investigator Professor Jackie Bridges – Co-applicant Dr Becky Band – Co-applicant Dr Steph Hughes – Research Fellow Zara Linssen – Medical Student Sophie Crouzet – Medical Student Stephen Lim – Implementation Champion Melinda King – PPI advisor Start: 01/01/2023 End: 01/07/2024 Summary Alcohol use disorders (AUD) in older adults is a growing problem which is currently under-recognised and under-treated. With little research into this area, there is no in-depth understanding about the factors that may contribute to AUD in older adults, nor the lived experiences of this group. Some have suggested that factors such as social isolation, loneliness and loss associated with older age may be important in understanding alcohol use. We know that in general, limited social contact and loneliness have a negative impact on both mental and physical health. One way to understand the amount and types of social connections someone has is to map their personal social network. This might include a whole range of people such as important family, friends, neighbours and acquaintances, pets, community places, groups or activities. This helps people to think about who is important in their daily lives, the roles that different relationships play, how this might have changed over time and how this might be improved, for example, by exploring ways to obtain additional support in the future. In this study we will invite older adults who have participated in a linked study to take part in an interview. The linked study will follow-up older adults with AUD for 6 months after being admitted into hospital. The people invited to this study will be selected based on lots of different factors, such as their age, how many people they live with, or how lonely they are, to ensure we are able to capture a variety of experiences within this group. Only those who have given permission to be contacted will be approached. The interviews will be 1:1 with a researcher and might happen in person, over the phone or through an online video call. Participants will first be guided through the process of mapping their current social network with the researcher. The interview will then discuss the support received from the person’s social network, as well as talking about the participants’ daily lives (including daily routines, physical and mental wellbeing and valued activities) and additional support needs. Interviews will last around 1 hour. They will be audio-recorded, transcribed and anonymised before analysis. Plain English summary of findings Recruitment to the study was difficult. Many patients who were identified as drinking at increasing or possibly dependent levels did not have mental capacity to take part. Of those who were eligible, a large percentage declined to participate. This resulted in a small sample size of 30, 16 of which completed their follow-up questionnaire, and 7 interviews. 20% of the sample died during the study window. Results indicated: Over 50% participants showed some level of cognitive impairment Participants had an average of 4 people in their social network; usually family members Interviews revealed links between social isolation, loneliness and drinking alcohol Those who were housebound reported drinking alcohol all day long Participants stated alcohol is not, and never has been a problem for them 50% participants met the threshold for depression Participants often provided conflicting information for the follow-up questions and in the interviews Participants had poor diets; of 32 nutrients measured 22 were not consumed in-line with the government recommendations 93% participants were taking 5 medications or more What did we do with this? As a small preliminary study the new knowledge has been used to inform future research. Impact on patient care and population health will come from the future research. Recruitment was harder than expected. This learning point has informed recruitment and retention procedures in future research applications. Other findings, for example, the link described qualitatively between social isolation and increased alcohol consumption, has shaped ideas for intervention development. What's next? We have formed a stakeholder group to discuss our findings and what the most appropriate next steps should be. We are preparing an application to undertake the planning and developmental work for an intervention aimed at reducing alcohol consumption in a general population of adults aged 65 and over. We plan to test the feasibility of this intervention in a feasibility study.

5464c879-04a7-47dc-8751-6ab5a9ad6d1c ADOPTED: Incidental Interaction: Novel Technology to Support Elders-as-Athletes through Augmenting Everyday Interactions Lead: Professor M.C Schraefel Team: Professor C T Freeman, Dr M B Warner Start date: October 2022 End date: January 2024 Partner organisations: Abri Different Strokes Southampton Solent NHS Trust Z-Health Performance Solutions Background Elders classically are framed as people who are inevitably getting weaker, losing muscle and bone mass, cognitive capacity, and inevitably requiring care to manage simple "activities of daily living" such as walking, feeding, toileting and bathing. These effects limit their capacity to live independently and healthily in their own homes.To address this decline, research in even just the past five years has been looking for new molecules and therapies to slow or reverse aging, to provide if not longer life, then better quality of life throughout the life course. While these advances in science and technology promise wonders (for those who will be able to afford them), there is already established science that demonstrates how we can all improve our life quality over our lifespan. This same science can, today, improve the life quality of our elders - starting these interventions at any age. It's building strength:a well understood, human practice. No technology is required to build and maintain strength; only to move against gravity. Repeatedly. Research has repeatedly shown that resistance training for elders can improve quality of life while mitigating if not eliminating age associated co-morbidities. And yet, for all its proven effective, cheap - even free - benefits for healthful longevity, many elders are simply too weak to take care of themselves. According to a 2019 report from AgeUk on the State of Elder health, 15% of those aged 65-69, rising to 1 in 3 citizens over 85 in the UK require care.Some of the well-documented challenges to strength building are that, unlike a pill or garment or augmentation, to achieve the benefits of strength, one has to do the work oneself, actively. That takes time, effort, as well as the knowledge, skills and practices to support it. Mustering the effort can be even harder to achieve when one is already feeling weak, recuperating from an injury, a hospital stay, or from loneliness of isolation.The research in this project is specifically designed to address the challenges that keep elders from actively engaging in strength work. Our approach is to co-create interactions to help build the knowledge skills and opportunities to practice to build and preserve the strength needed to maintain healthful independence at home. Our approach is simple: design interactive technology and gestures to leverage what we - including elders - do every day that is already strength work: stand, sit, grip, pull, push, reach, balance - and translate these into activities for building strength. We call it this novel protocol "do it twice." Stand from sitting? That's strength. Do it twice. That's strength building - and that supports the knowledge skills and practice of "elder athletes" building capabilities rather than requiring assistance.Our approach is interdisciplinary: experts in Human Computer Interaction, Sensors and Physiotherapy, developing novel, affordable interactive technologies to make strength practice accessible effective and enjoyable with support to guide these activities, reflect progress, and share with friends. We call the approach "incidental interaction for everyday strength."So far, we have tested the approach for feasibility. In this small project, with our partners in sustainable, assisted living housing, NHS Trusts, professional therapy and coaching, and with participating elders as co-designers, we will be refining the interaction, the sensors and the exercise protocols. We will be able to tune our work at each stage to ensure best engagement. In three phases from design, to testing, to in-home evaluations we will together be validating the accessibility and efficacy of our approach.By realizing with this project the potential our preliminary work indicates and that our partners anticipate, we will contribute a new affordable breakthrough approach to help transform elder health and care, to enable longer, stronger elder independence@home.

3020cd35-d002-4b24-bc53-5ac051771722 Adopted Project: Paramedic delivery of end-of-life care (PARAID) Study Chief Investigator: Dr Natasha Campling, University of Southampton Funder: Marie Curie Research Grants Scheme Start Date: 1st March 2023 End Date: 7th January 2026 Partners: University of Southampton, University of the West of England, South East Coast Ambulance Service NHS Foundation Trust, University of Ulster, Northern Ireland Ambulance Service Health and Social Care Trust, Marie Curie. Why did we do this work? Demand for end-of-life care (for people in the last year of life) is rising, driven by ageing population and increasing rates of people living with multiple conditions. This is causing increases in 999 calls to ambulance services with rates highest in areas of deprivation. In line with this rise in 999 calls for those at end of life, rates of ambulances transporting people to hospital are also increasing, which can lead to hospital deaths, a place where most people say they do not wish to die. Despite this little is known about paramedic practice in this context and service provision varies widely. What did we do? The study has for the first time investigated how ambulance paramedics support people in the last year of life following a 999 call, what challenges they face, and how services can best enable effective, compassionate care. More than 1,100 paramedics responded to a survey and over 100 patients, carers and healthcare professionals were interviewed. What did we find out? Ambulance paramedics provide supportive and compassionate care to individuals at end of life, but practice hampered by limited access to essential resources (specialist advice, patient records, advance care planning documents and medicines). Fear and uncertainty regarding end-of-life care undermine paramedic confidence. Limited education and training in palliative and end of life care contribute to skill and knowledge gaps. Gaps in access to other healthcare professionals mitigate against shared professional decision-making. Challenges with medicines access and administration impede symptom control by paramedics. Service shortages in primary, community and specialist palliative care services drive paramedic call outs and challenges in interdisciplinary collaboration limit quality of care. We have: Contributed evidence to Government’s consultation on proposals to extend medicines responsibilities for paramedics. Submitted written evidence to Palliative Care Commission focused on increasing paramedic confidence and coordination of paramedic delivered care at end of life. Secured follow on funding to deploy the survey developed and used in the study to understand the situation for ambulance paramedics in Northern Ireland. Marie Curie led press release November 2025 (to coincide with the publication of the ParAid policy brief) Urgent reform needed to support ambulance delivered end of life care . This led to national and regional radio interviews by the ParAid study CI and Marie Curie’s Director of Policy and Research. University of Southampton and Marie Curie press release February 2025 (following the publication of the findings of the ParAid national survey in England). This led to a wide range of news outlet outputs including BBC news online . Publications: Campling, N., Turnbull, J., Richardson, A. et al. Paramedics providing end-of-life care: an online survey of practice and experiences. BMC Palliat Care 23 , 297 (2024). https://doi.org/10.1186/s12904-024-01629-7

53b76e5e-c361-4791-8e01-f147de703463 SOCIAL CARE: Evaluation of Southampton City Council’s Male Engagement Worker (MEW) Project Chief Investigator: Dr Michelle Myall, Associate Professor, University of Southampton Co-Investigators: Dr Sophia Taylor, Senior Research Assistant, University of Southampton; Dr Susi Lund, Visiting Research Fellow, University of Southampton Partners who collaborated on the research: Anjelica Finnegan, Senior Male Engagement Worker, Southampton City Council; Caroline Bate, Domestic Abuse Coordinator, Southampton City Council; Colin McAllister, Senior Public Health Practitioner, Southampton City Council; Francesca Mountfort, Male Engagement Worker, Southampton City Council; Kate Harvey, Public Health Consultant, Southampton City Council Start Date: 19 October 2023 End date: 30 September 2024 Why is this research needed? An estimated 2.4 million adults experienced domestic abuse in 2019 in England and Wales. In April 2021 the Domestic Abuse Act was introduced in England and Wales. This created a new definition of domestic abuse to include “any incidents or patterns of incidents of controlling, coercive, or threatening behaviour, violence or abuse between those aged 16 or over, who are or have been, intimate partners or family members regardless of gender or sexuality. Domestic abuse can encompass, but is not limited to psychological, physical, sexual, financial and emotional abuse”. The Act required local authorities to expand their support and provision available to those experiencing domestic abuse. As part of a review by Southampton City Council into whether it meets the requirements of the new Act it found that alleged perpetrators of domestic abuse are not being effectively assessed or adequately supported. This is particularly true of young (step-) fathers. To address this gap, in 2020 Southampton City Council established a Male Engagement Worker (MEW) Project to work with high-risk male perpetrators of domestic abuse who have (step-) children and have local authority children’s services involved. This newly established service has yet to be evaluated. What were the aims? To evaluate Southampton City Council’s new domestic abuse service focusing around the newly created Male Engagement Worker Project. How was the study carried out? We carried out interviews with key informants and relevant stakeholders and analysed audit data collected about the service. What we found Overall, the MEW project was seen as valuable in supporting early intervention, improving safety, and helping individuals reflect on and change harmful behaviours. The referral process, particularly case consultation, was viewed positively for improving communication between professionals. As a small, non-statutory service, MEW faced challenges around funding, visibility, and capacity, and its work was complex, requiring long-term engagement. Integration into the Family Safeguarding Model which was introduced by the Council in September 2024, and brings together expert practitioners in multi-agency teams who can support parents who are experiencing domestic abuse, mental ill-health, alcohol and substance use, to address issues that could result in children and young people being at risk of harm or needing to come into care has strengthened multi-agency working but also created challenges, particularly around maintaining relationships and ensuring access to the service. Outcomes We shared findings with stakeholders through a presentation. We also produced a report and executive summary of findings and recommendations for Southampton City Council and shared learnings with other relevant local authority and third sector organisations. Findings were also shared at the Southampton City Council’s Domestic Abuse and Violence against Women and Girls Strategic Partnership Board to inform further funding and commissioning decisions of the MEW project.

bd368e62-bd41-4d7a-a7ea-673ea3582964 ADOPTED PROJECT: High Harm Domestic Violence Perpetrator Pilot Evaluation Chief Investigator: Dr Sara Morgan – University of Southampton Project Team Members: Mrs Katerina Porter – University of Southampton, Mrs Fiona Maxwell – University of Southampton, Professor Julie Parkes – University of Southampton Organisations Involved: Hampshire County Council, Hampshire Constabulary, Office of the Police and Crime Commissioner, Hampshire, The Home Office, Hampton Trust Background data Domestic violence & abuse remains a pressing public health concern In the UK, 18% of adults aged 16+ have experienced domestic abuse from an intimate partner 1 In Southampton, domestic abuse accounts for 33% of violent crime Methods Analysis of routinely-collected anonymised quantitative data on all individuals meeting the Operation’s inclusion criteria (n=321) Interviews with key professionals (n=12) 11,751 individuals identified as perpetrators of domestic abuse in 2 policing districts over 14 months 131 individuals included in the Operation Foundation cohort, for allocation to High-Harm Teams, who attempt to engage perpetrators into a specialist behaviour change programme, ADAPT Results Operation Foundation identifies the domestic abuse perpetrators who pose the highest risk of the highest harm to their victims, and most require Police attention 10% of the Operation Foundation cohort were referred to ADAPT 2% of the cohort completed the ADAPT programme over 24 weeks High-Harm Team officers used new working practices to attempt to engage perpetrators and provide support to make healthy behaviour changes Where perpetrators were unwilling or unable to engage with the behaviour change intervention, High-Harm Team officers relentlessly pursued those perpetrators to disrupt their potential to pose a risk to their victims Qualitative data from High-Harm Team officers suggests that the Operation Foundation method had had positive and worthwhile effects regarding reoffending rates and reduction in risk to victims Further research is needed to determine the effectiveness of the Operation Foundation method CONTACT: k.a.porter@soton.ac.uk s.a.morgan@soton.ac.uk REFERENCES: 1. Robinson, A. L. and Clancy, A. (2017). New initiatives to tackle domestic violence using the Priority Perpetrator Identification Tool (PPIT). Cardiff: Cardiff University. 2. Crime Survey for England & Wales, 2022 3. Southampton Data Observatory, 2022 4. ADAPT programme, run by Hampton Trust

Talia Emmanuel is a PhD candidate in the Health Workforce & Systems research group at the University of Southampton. < Back What do nurses want? Improving nurses’ shift patterns - where do we start? Talia Emmanuel is a PhD candidate in the Health Workforce & Systems research group at the University of Southampton. Talia Emmanuel is a PhD candidate in the Health Workforce & Systems research group at the University of Southampton. In this blog, she summarises some key results from her recent research paper that explored nurses’ views and values around their shift patterns and working time. Talia Emmanuel -University of Southampton. As a PhD student, one must be well-prepared to answer the question…“What is your research about?”. I typically answer with “I’m trying to find ways of improving shift patterns for nurses when they’re working in hospital”. Enthusiastic nods usually follow, along with a quippy reply: “Wow, that sounds important and complicated ”. Although simply put, “important and complicated” neatly summarises the nuances of this topic. We recognise the significance of improving nurses’ working conditions in the context of persistent health workforce shortages, both nationally and internationally. However, we also realise that singular cure-all solutions are non-existent – there are too many factors at play. So, where do we start? Some of those complicating factors centre around how nurses’ working hours are organised. In hospitals, nurses often have to work in shifts that cover different periods of the 24-hour day. Previous research has identified various repercussions of working shifts (and in particular, working long shifts of 12-hours or more and night shifts): increased burnout , poor work-life balance , and risk of chronic illness and cancer on the long-term. Impacts to nurses’ performance and safety while at work have also been flagged, which pose knock-on effects on the quality of care patients ultimately receive. Despite these risks, shift work is a necessary reality for many nurses working in hospitals. Therefore, administrators and managers are tasked with organising nurses’ shifts into rotas that balance staff wellbeing with service demands and operational costs - and this is no easy feat. Further complications come from recent increased pressure on NHS employers to offer staff more say over their working patterns as a way of improving job satisfaction and their experiences of work. But this raises the question: What do nurses want? More specifically, what shift patterns do they prefer, and why? While there is some existing literature on this (an excellent summary can be found here ), our understanding of the factors that lead nurses to prefer certain shift patterns needs more work. As part of my doctoral research, I was eager to do a deep-dive into this area: I know that in order to find ways to improve nurses’ shift patterns, it is crucial to ask nurses themselves about their views and values around the organisation of their working hours. Fortunately, I had access to a rich data source around this topic: a recent survey study funded by the NIHR ARC Wessex that collected responses from nurses working across the UK and Ireland. My supervisors and I were particularly interested in nurses’ responses when asked: “ If you could choose your shift patterns, what would be the most important factor in that choice?” While we expected nurses to describe many diverse factors/preferences, we were hopeful of commonalities too. Nearly 800 nurses provided their open-ended responses to this question. We analysed all of them and developed 3 overarching themes: Theme 1, “When I want to work ”: Nurses shared many preferences for when they wanted to work, and equally, how they wanted their rest days to be arranged. Even though individual preferences differed, three general scheduling practices were also repeatedly mentioned as helpful: working less ‘harmful’ shift patterns from the start, working more consistent/predictable patterns, and having more flexibility and control over when to work. “Not working consecutive shifts so that I am exhausted by the time I get a day off.” “Know what I am doing each week, either set days or set nights, so I can predict what I am working…” “Having the freedom to give myself more days to recover between weekly shifts.” Theme 2, “Impacts to my life outside work” : Many factors emerged from nurses wanting shift patterns that enable a good work-life balance and minimise disruption to their lives outside work. Their preferences and priorities related to wanting quality recreational time with family and friends, to be able to arrange childcare easily and inexpensively, and having enough rest/recovery time to protect their own wellbeing. “Quality time with my children and family without being permanently drained, exhausted, and sad” “That the pattern could stay the same each week so it would be easier for childcare needs. Many nurseries like set days and when our rota is changing from week to week this can be difficult.” “…Not mixing days and nights in a week […] this does not observe HSE best practice guidelines and messes with the body clock and sleep patterns. It should not be allowed to happen.” Theme 3, “Improving my work environment” : Some nurses mentioned job-specific factors that influenced their choices, like wanting to work the shift patterns they believed to be best for patient care, or, working the best configuration of shifts for optimal take-home pay. But other concepts, like having sufficient staffing numbers and being able to take breaks, were also stressed. “A shift where I feel I have accomplished the care I have wanted to give for my patients” “To not have so much pressure on the shift, with the right amount of staff on and to take my break when needed”. When thinking back to the question “What shift patterns do nurses prefer, and why?”, these themes provide several helpful clues. They also highlight that while there is variation in nurses’ specific shift preferences, there are also more general scheduling practices that also support their priorities. For my research, this finding is particularly striking, as it moves away from the oft-assumption that there are “countless individual preferences that are difficult to accommodate” and toward the idea that there are more universal preferences too. Moreover, when these universal preferences are used during the scheduling process, nurses’ shift patterns can be improved overall. That sounds like a good starting point! Read our full analysis of nurses’ survey responses in the open-access research paper here Follow Talia: Twitter/X | ResearchGate Follow the UoS Health Workforce & Systems team: Twitter/X | UoS website Previous Next

08639c2e-864e-4386-adf6-510fcbb59d49 Identifying the knowledge gaps of paramedics managing patients with mental health issues Chief Investigators: Dr Ursula Rolfe. Faculty of Health and Social Sciences. Bournemouth University, Dr Natasha Campling, School of Health Sciences, University of Southampton. Implementation lead: Kirsty Lowery-Richardson, Head of Education, College of Paramedics Partners: Bournemouth University, University of Southampton, College of Paramedics CLASS Professional Publishing, Mental Health Education leads in all 11 ambulance Trusts including West Midlands Ambulance Service. Start: 1 October 2024 End: 31 March 2026 Aim of the research: To identify the knowledge gaps of paramedics when responding to people with mental health issues. Background to the research: Many people experience mental health issues in their lives and about 1 in 6 adults in England have a diagnosed common mental health illness. Mental health issues are rising, but rates are rising most for young people. Amongst 17- to 19-year olds rates of mental health illness rose from 10% in 2017 to 26% in 2022. Rising rates of mental health issues combined with pressure on community services mean that that over 1.2 million people are waiting for support and treatment from NHS community mental health services. The result of such high-level unmet demand has fallen on ambulance services and paramedics. England’s ambulance services received 524,485 mental health related 999 calls in 2018-19, but by 2021-22 this increased to 652,720, a rise of 24%. Across England, ambulance staff spend 1.8 million hours annually (or 75,000 days), responding to people with mental health issues. Paramedics express concerns attending to patients experiencing mental health issues because of a lack of education. However, the specific nature of their knowledge gaps that underpin these concerns are not known. Therefore, this research will identify these gaps and make recommendations to inform the future design of effective educational provision, to better support the paramedic workforce in delivering quality care for the rising population of individuals with mental health needs. Design and methods: The study is designed in two phases. First, university-level education (prior to paramedic qualification) and in-practice training (once qualified) from all England’s ambulance services regarding mental health care provision will be analysed. Second, interviews with up to 20 paramedics regarding their knowledge when managing patients with mental health issues will be undertaken. The interviews will use patient cases, informed by real-life examples, to explore paramedic decision-making. Patient, public and community involvement: We have worked with a dedicated group of individuals with lived experience of mental health issues who have received care from ambulance services and paramedics to design the study. The group have all backed the importance of the study, highlighting the need for “ more caring ” by paramedics when attending those with mental health needs. We will continue to work with this group throughout the study. The group will help co-design study documents, such as the interview guide and patient cases for the paramedic interviews. The group will also be given the opportunity if desired to review and input into data analysis during both study phases. Dissemination: Findings will be shared with healthcare commissioners, ambulance services and Universities. The project’s findings will form the basis of recommendations on educational delivery via both ambulance services and Universities, and further research on how best to provide education solutions to the knowledge gaps identified.

9cf70c4f-6d1c-4acf-8a29-5aa00565f951 ADOPTED (PhD): PREPARE-to-ACT study: Preparing for and Responding to Emergencies – A multi-phased qualitative investigation of Patients’ And members of their RElational networks’ decisions to use urgent and emergency care during Anti-Cancer Treatment Principal Investigator: John Defty, University Hospital Southampton NHS Foundation Trust Start: September 2022 Ends: September 2026 Background Complications of anti-cancer treatment can be life threatening . Anti-cancer treatments, including chemotherapy, radiotherapy, and immunotherapy, are increasingly provided on a day-case basis , meaning that complications occur at home and necessitate a response from urgent and emergency care services . Evidence suggests people receiving anti-cancer treatment delay seeking help despite access to dedicated emergency care (acute oncology services) . Focus of research to date has been for what reasons and when , rather than how and why, people with cancer use these services. Evidence suggests patients and informal carers rely on prior instructions from cancer specialists to identify and interpret the severity of complications but find relating to this information difficult when acutely unwell . Emergency ‘contingency planning’ was identified as a priority for improving the safety of anti-cancer treatment but, there are few studies that describe how pre-treatment emergency planning influences help-seeking for complications of anti-cancer treatment . With the number of people eligible for anti-cancer treatment expected to rise by two million by 2040, the need for research is now urgent. Results from our scoping review (completed; drafted for publication) suggest preparing for and making sense of urgent and emergency care is hard work for people with cancer. It also revealed poor understanding of how this work might differ for people receiving different types of treatment. This study aims to address these gaps by answering the question: ‘How do patients and informal carers prepare and seek help for complications of different anti-cancer treatments?’