3a061229-d16f-48eb-aa36-30056ba5bad5 INVOLVing pEople with cognitive impaiRment in decisions about their hospital nursing care (INVOLVER): a pilot study Principal Investigator: Professor Jackie Bridges Team members: Professor Jackie Bridges (Professor of Older People's Care, School of Health Sciences, University of Southampton), Dr Jo Hope (Lecturer, School of Health Sciences, University of Southampton), Dr Tula Brannely (University of Bournemouth). Professor Katie Featherstone (University of West London) Ended: 31 December 2022 Partners: University of Southampton, Solent NHS Trust, University of Bournemouth, University of West London Collaborations developed through project: Alex Iles (grant co-applicant/film contributor) and the Treat Me Well Group (Southampton Mencap) (grant development and film contributors) The Grow Project, Southampton (film contributors) Different Strokes (Southampton) (film contributors) Mayes Bahrani (Hampshire and Isle of Wight Healthcare NHS Foundation Trust Patient Experience Group) (grant co-applicant) Catherine Mead (Portsmouth Hospitals NHS Trust, grant collaborator) Rosalynn Austin (Portsmouth Hospitals NHS Trust, grant collaborator) Francesca Lambert (University of Southampton) (grant co-applicant/film project co-applicant) Sofy Bazzini (Digital Learning Team, University of Southampton) (film project co-applicant) Pippa Collins (University of Southampton) (film project co-applicant) Anthony and Caroline Scott-Gall (film contributors) Lay summary We want to help nurses look after their patients in hospital. We want to help them find out how each patient likes to do things like getting clean, going to the toilet, eating and drinking. Some people have to go into hospital to get better. Sometimes, when they are in hospital, the nurses don’t ask them enough about the way they like to do things. For example, if they like a bath or a shower. Or if they need help going to the toilet. Or if they would like to walk about. Or what food or drink they like. Not being asked about these things is not helpful. It might mean that people end up getting sicker and staying in hospital longer. Or they may go home needing more help from their family. People with dementia, learning disabilities or stroke may not be asked these questions about what they like. Sometimes the nurses don’t know how to do this well. Sometimes they know how to do it but can’t do it. The reasons they can’t do it are not well understood. We are a group of people who want to make this better. Some of us work at a university finding things out. Some of us are nurses. We want to include people with dementia, learning disabilities or stroke in our group. This will help us think about how to make things better. We think we can help nurses by using ideas that have worked in other places. When people like us have an idea about how something can be made better, we try the idea out and see if it works. Summary of findings: We have been looking for good examples of how hospitals have changed what they do to make sure people with dementia, people with learning disabilities and stroke survivors are included in making care decisions in hospitals. We looked at all the research in this area and found only 11 studies that did this! Many more studies said they were making care ‘person-centred’ but did not look at how they could directly include people in decisions about their care. We are currently looking in detail at these studies to see what works well, what can go wrong and which bits work best. We will also check if the people who use or might the service were also involved in the design of the changes and testing them. We will report back soon! Our set of short films, Good Care For Me Is… were co-created with people with learning disabilities, stroke survivors and somebody living with Alzheimer’s. We won funding for this from the University of Southampton’s Public Engagement with Research unit (PERu) PER Development Funding Call 2020/21. These have been used in teaching nursing students at the University of Southampton and we are exploring where else they might be used to teach healthcare staff at the University and other good places. They will also be used in research to help design changes to services with patients and staff. Dr Jo Hope won funding from the NIHR’s RfPB (Research for Public Benefit) grant to follow the care of people with learning disabilities in hospitals, to try to understand why care between wards varies so much ( Improving the care people with learning disabilities receive in hospital: an ethnographic study examining the experiences of people with learning disabilities and the organisation and delivery of their care - NIHR Funding and Awards ). Dr Jo Hope has been developing ideas on how to involve people with profound learning disabilities in research and has published about this with her PhD team. What did we achieve? Good Care For Me Is… films are part of the pre-registration nursing curriculum at the University of Southampton, supporting future nurses to understand how they can improve care for people living with dementia, people with learning disabilities and stroke survivors We have found new collaborators in the health service, and people with lived experience who are co-applicants on our successful Stage 2 NIHR Research for Patient Benefit grant called: Improving the care people with learning disabilities receive in hospital: an ethnographic study examining the experiences of people with learning disabilities and the organisation and delivery of their care. Our papers on the inclusion of people with profound learning disabilities in research are challenging research orthodoxy on who can and cannot be directly involved in research We have shared findings from our previous research in Nursing Times, which explores what makes it difficult for patients to ask for help in hospital and why this is more difficult for people with dementia Publications doi.org/10.1111/1467-9566.13435 doi.org/10.3390/socsci11040159 https://onlinelibrary.wiley.com/doi/10.1111/jan.15637 doi.org/10.3390/socsci13010037 What's next? We will be publishing our systematic review into interventions to engage people living with dementia, people with learning disabilities and stroke survivors in nursing care decisions in hospital settings We will explore how our films about care experiences among people living with dementia, people with learning disabilities and stroke survivors might enable more healthcare students and workers to develop their understanding of supporting these patient groups Dr Jo Hope is developing a research programme to explore how hospital care can be improved for people with learning disabilities We will explore and share practical strategies of how people with more profound communication and understanding difficulties can be involved in research and care decisions

a7ea3c51-ca08-45ba-a500-e478bca6eb43 Motivating and sustaining engagement of young people in improving their health and that of their communities Prinicpal Investigator: Professor Mary Barker Team: Kathryn Woods-Townsend, University of Southampton, James Toop, Bite Back 2030, Matthew Ryan, University of Southampton, Joanna Sofaer, University of Southampton, Pathik Pathak, University of Southampton Start Date: 1 April 2023 End Date: 30 September 2024 Background Calls by young people for increased involvement in decisions about their health and futures are echoed by WHO and UNICEF. These reflect threats to their health from inequalities and climate change, exacerbated by COVID-19. To be “architects of their own future” and have decision-making power, young people need training and opportunities to build confidence, and structures and processes that allow them to be involved in decision making. Aims We aim to explore how best to engage and maintain engagement of young people in these activities with a view to improving their health and well-being and that of their communities Our specific objectives are to: develop and test a training course for young people in skills to support participatory action research into health and well-being; test the effectiveness of arts-based approaches in engaging young people in health improvement; understand how to create a reliable, scalable and sustainable model for effective youth activism; evaluate democratic innovations to engage young people in decision making processes to influence health policy. What did we find out? Through our project we found that young people can meaningfully participate in decision making on topics that are important to them. During the year young people were engaged in two separate ways: Firstly, BiteBack 2030’s youth advocacy programme was analysed and essential components of its success extracted. Those factors included establishing open two-way channels for communication, Working to create an environment where young people’s and staff views are equally valued, Supporting staff to develop excellent facilitation skills, Investing in young people’s skills, Campaigning on issues that young people feel are important and current and Reviewing success and challenges of each campaigns and adapt activities in response. Secondly, young people were successfully trained in research skills, advocacy and democracy during a 12-week Young Researcher Training Programme. The training programme allowed young people to investigate a health topic that was important to them and collect data from their peers and community. Their projects ranged from looking at exam stress, vaping, benefits of youth participation, to women’s health issues, failures in the PSHE curriculum and vaccine hesitancy. The results from their research went towards creating a set of health recommendations that young people felt should be prioritised for the improved health and wellbeing of young people in Southampton. A Youth Jury was held in July 2024 where the recommendations were refined based on collaboration with the Hampshire and Isle of Wight Integrated Care Partnership. The 12 amended recommendations formed the basis of a manifesto for health which included the following points to be addressed by decision makers: 1.Expand Extra-Curricular Wellness Activities. 2. Improve our methods of handling young people’s mental health by creating accessible services. 3. Respond to Vaping Proactively. 4. Deliver a comprehensive digital health platform for young people. 5.Review the PSHE Curriculum. 6. Encourage the mixed teaching of Sexual and Reproductive Education (SRE) . 7. Cultural & Religious Sensitivity . 8. Information to Parents. 9.Deliver Youth Engagement. 10. Diversify and Expand Work Experience and Financial Support for Prospective Professionals. 11. Establish Panels to Honestly Inform Young People about NHS Careers. 12. Produce Youth- Led Marketing. Evaluation of the effectiveness of the training programme, Youth Jury and Assembly at engaging young people in decision making and the resultant responses from decision makers is still ongoing. Final results will be available from spring 2025. You can see Young People talking about their recommendations here What did we do with this Knowledge? • The recommendations created by the young people within the manifesto for health were presented to the Integrated Care Partnership (ICP) and wider stakeholders in health and wellbeing at the Hampshire and IoW ICP Youth Assembly on 13th November 2024. An action plan was drawn up in collaboration with decision makers to implement the recommendations in practice. These recommendations will go towards informing the delivery of health services for young people In Hampshire and the IoW. • The criteria for a successful youth advocacy/ activism programme provide BiteBack with evidence-based conclusions that they can use to replicate and grow the success of their programmes. The links between youth health and wellbeing and participation in activism programmes was highlighted The findings from this investigation also went towards informing how we run the Young Researcher Training Programme to make sure young people are getting the most out of the experience for their health, wellbeing and future quality of life. See the BiteBack poster image BiteBack poster[83] .png Download PNG • 1.08MB BiteBack visual report (PDF What Next? The learning from this project will go towards informing how future YRTP sessions will be structured and run. For example, the advocacy and links to decision making in this project will be replicated in the next iteration. The next iteration of YRTP begins in December 2025, with a focus on developing a Southampton Youth Voices service. The learnings from BiteBack’s youth activism programme will aid other youth organisations to successfully engage young people in improving their health. This work adds to the growing body of research around the importance of youth participation and its long-term health and wellbeing benefits. Talitha McCleery, 17, took part in the programme and said: "Young people want to and deserve to be, involved in decisions that impact their health and futures. We believe that the people who sit in positions of power must prioritise consulting with young people if they want their decisions to have real change and make a positive impact." Libby Tickner, 17, who also took part, added: "We must all work together - school boards, local government, local charities and national non-governmental organisations - to ensure no opportunity is left wasted." Source: Hampshire youth assembly shares health and wellbeing ideas | Daily Echo

a8af900b-b089-4b7b-8da9-b042b753eab0 The feasibility of community pharmacies testing for Hepatitis C in people who inject image and performance enhancing drugs Principal Investigators: Dr Ryan Buchanan Team members: Dr Ryan Buchanan (Academic Clinical Lecturer Hepatology, Faculty of Medicine, University of Southampton), Professor Salim Khakoo (Professor of Hepatology, Faculty of Medicine, University of Southampton), Dr Charlotte Cook (Hepatology Research Fellow, University Hospital Southampton), Dr Mark Wright (University Hospital Southampton NHS Foundation Trust), Charlotte Matthews (Southampton City Council), Dr Gemma Ward (Public Health England) , Colin McAllister (Southampton City CCG), Stuart Smith ( Hepatitis C Trust ), Mark Wright (NHS England, Wessex Operational Delivery Network for Hepatitis C ), Pamela Campbell (Solent NHS Trust, Homeless Healthcare Team) Start: 1 December 2019 Ends: 1 January 2024 Project Partners : University of Southampton, University Hospital Southampton NHS Foundation Trust, Solent NHS Trust, NHS England, Public Health England, Southampton City CCG, Southampton City Council, Hepatitis C Trust. Lay summary: The people at highest risk of Hepatitis C (HCV) in the United Kingdom (UK) are those who are sharing needles, syringes or injecting equipment. This includes people who inject performance and image enhancing drugs (PIEDs) such as steroids.This population are high users of needle and syringe programmes, however, the risks taken by this population and their access to testing for HCV are poorly understood. The information that is available is not consistent, with the proportion of people with HCV varying widely but may be as high as one in seven PIED users. The study has been discussed in detail with bodybuilders, a gym owner, pharmacists and people who work at needle and syringe programmes (NSPs). The bodybuilders were very keen to be involved in the study as they want to have accurate, scientifically performed studies. They feel strongly that the information that is out there currently is not representative of their community that use PIEDs. They also felt that it was important that to have a focus on HCV but they were keen to be involved in a study that also addresses at other elements of liver health. The methodology for the study were discussed and adapted after patient and public involvement (PPI) meetings.The aim of this study is to see if widening access to testing of HCV based in community pharmacies with a pathway into specialist care is able to provide improved and acceptable access to testing and treatment compared with standard care. We also want to gain a better understanding of the burden of HCV in this group of people who are using PIEDs, and an understanding of risk behaviours. We will also investigate knowledge of liver disease caused by other factors (e.g. alcohol and obesity). This will be done via interviews with bodybuilders to understand more about their behaviour and the risks they take. This will be followed by a survey with an associated HCV test and measurement of liver scarring. The information gained from the interviews, surveys and tests will give a far greater understanding of this population and their risk of HCV. This information can then be used to target at-risk groups and to adapt current approaches with the aim of elimination. The results will be disseminated in medical journals and presented at medical conferences. Publications doi.org/10.1111/jvh.13207 https://doi.org/10.1111/jvh.13554 https://doi.org/10.1093/ijpp/riac064 http://dx.doi.org/10.1136/gutjnl-2022-BASL.130 http://dx.doi.org/10.1136/gutjnl-2021-BASL.40 https://doi.org/10.1111/jvh.13786 https://doi.org/10.1016/S0168-8278(20)32040-7

7c1c5828-e040-4058-a214-a3f1d860532c CLECC Toolkit and background: Creating Learning Environments for Compassionate Care (CLECC) CLECC is a training and development programme that has been tested and measured over several years in different care environments. It is designed to help improve the wellbeing of health and care staff and make a difference to patient care. It’s easier for you to care for patients when you feel well cared for yourself An important part of feeling well cared for is working in a team that supports you, where members care about how you are and want to help you It’s hard to provide good care to patients when you feel stressed, isolated and unsupported CLECC aims to provide the conditions in which every team member feels able to be compassionate with each other and with patients We have developed and tested CLECC in real-life health and care settings to see how practical it is to use and to understand its impact in different settings. Our results to date indicate its promise for supporting staff learning and wellbeing, and the delivery of compassionate care. Professor Jackie Bridges Professor Jackie Bridges, a nurse by background and now Professor of Older People’s Care at University of Southampton in the UK, has led this work for over a decade. She has worked closely with experts from different fields, particularly in nursing practice, to develop the CLECC programme and the accompanying research. This page contains a facilitator guide and accompanying resources to help health and care teams learn about CLECC and use it in a practical real-world setting. CLECC is constantly being improved and revised with feedback from nursing, care staff and managers so please get in contact with any feedback. You can fill out the form below or contact us direct. Contact us Email arcwessex@soton.ac.uk Or via our Twitter page Let’s start with the basics What is CLECC and what evidence do we have that it works? Our two videos below can answer those questions https://vimeo.com/786850064 https://vimeo.com/786850368 Guides – How do we do that? I want to use CLECC A guide for facilitators – 101834 A4 Brochure - CLECC Facilitator Manual AMENDS - Jackie Bridges - FINAL .pdf Download PDF • 1.14MB I want to show CLECC to a team and get them thinking about how to use it Slideshow to accompany facilitator guide – download PDF here (32 pages) CLECC Whole Team Introductory Learning Activities slideset .pdf Download PDF • 13.63MB I want to tailor how I use CLECC based on understanding people’s experiences at work Download the questionnaires below: Workplace Learning Questionnaire – for use by teams to identify team learning climate strengths and issues Team CLECC Workplace Learning questionnaire for care settings .pdf Download PDF • 108KB Climate for Care Questionnaire – for teams to evaluate team working climate CLECC Team Climate for Care questionnaire .pdf Download PDF • 107KB Please take time to tell us why you are using CLECC

Sandra Bartolomeu Pires is a Research Sister in Neurodegenerative diseases at University Hospital Southampton and PhD Candidate at the University of Southampton < Back Don't do it! Sandra Bartolomeu Pires Sandra Bartolomeu Pires is a Research Sister in Neurodegenerative diseases at University Hospital Southampton and PhD Candidate at the University of Southampton From 2018 to 2020 I cowboyed through fellowships and awards, trying to keep a percentage of my time academically focused, in pursuit of the Holy Grail – PhD funding. These varied from 9% to 50% with interim periods of zero (keeping the work going, though). “I just need some funding, my foot in, then I will make it work”. In September 2020, alleluia, PhD scholarship secured! I made a happy dance while holding my 3-year-old daughter and she laughed loudly without understanding why mummy was making such a fuss over a phone call (now that I think about it, she was probably just mocking my lack of dance skills…). I couldn’t believe it. Starting September I would be a PhD student at the University of Southampton! “So how does that work Sandra?”. Well, I get 50% of my time funded to do the PhD. I have funding for four years. “So you need to do a part-time PhD in four years, with a toddler, no family support... (*crickets chirping*) If someone can do it, that person is you!” “Do you have any advice before I start? Something you wished you knew from the beginning?” “Don’t do it”. I have heard this multiple times. Don’t do it; Why would you do it?; Have all your children first, let them go through school, and then do it. Oh please, what do you people know about this? Well, people that are now postdocs and know the pits of despair very well. I really appreciate their advice. They took the time to meet me, share their experience with me, and advise me when I asked for it. But then Seinfeld’s voice in my head “I am special, my mother was right” (yes, I say this joke too many times). “So you need to do a part-time PhD in four years, with a toddler, no family support... If someone can do it that person is you!”“Do you have any advice before I start? Something you wished you knew from the beginning?”“Don’t do it” Our lovely Jamie Stevenson, from the ARC Wessex communications team, challenged us to write how we (PhD scholars) feel in the beginning, and then see how the PhD relationship evolves through the years. The most prevalent thought is “I am not good enough.” – There are plenty of resources and podcasts on imposter syndrome, it’s a big thing, go look it up. My advice on this is something Hugh Kearns said: focus on facts, not feelings. One really needs to be able to balance those internal voices to juggle the daily pressures and workload. This year was more challenging than I could have predicted, worse than the people that had advised me imagined. And I still had it so much easier than many people. In the first COVID wave I paused my SHAPE award, which was so hard to get, to go back full-time clinically. How could I focus knowing all that was happening? So that meant preparing the ARC PhD funding application in my own time, while working full-time in COVID research. In the second wave I thought “Let’s make a tradition out of this!”, deciding to apply for a NIHR Clinical Doctoral Research Fellowship. A lot of my funded PhD time went into preparing this Everest application (while clinically I was once again moved to COVID research but this time inpatients). March was horrible. Deaths from young patients, deaths from colleagues, working clinically in an area out of my comfort zone, and this huge application, the cherry on top of the cake. I was broken and needed help. My supervisors were incredibly supportive, and the Staff helpline was my lifeline. Then, stomach pain. Daily, unable to eat properly without feeling uncomfortable (I LOVE FOOD!!). “That is stress!”. My reply was “I always had a stressful life and never had stomach pain”. Thinking back, it probably is “just” stress. I mean, I am not 20 anymore… After telling my husband “I have sent you an email with my login details, if I end up in the resus room (wouldn’t be the first time), please submit the application. Otherwise, I will come back to haunt you!” I actually managed to submit the application, at 2am. At 9am, all the kind souls that were my signatories and participatories, had signed (Thank you so much!) and off I went to Bournemouth beach with my mother and sister, who had travelled in the middle of a pandemic to see us, and whom I had barely laid eyes on. Freedom Day, 11th June (Sorry, Boris!). I could really have used some holidays then - or an induced coma for a week - but no can do. Diving back into my systematic literature review and thanking my past self for keeping good records. I am now past my first viva/First PhD review progression, straight out of the oven (23rd July 2021) and received overwhelming positive feedback “You seem to think you are delayed Sandra, but you are excelling at the PhD” (I hope the assessor and the supervisors didn’t notice my watery eyes). I write this as I am flying to Portugal to see my lovely family. My daughter and husband have been there for a week. So on the day of my viva I was actually alone all day. Not to worry though, plenty of wine in Portugal (Omeprazole and Rennie in the bag) and time to celebrate with those who support me most on this crazy journey. How was this first academic year? It was absolutely amazing! So (SO) hard, but thrilling, challenging, just the way I like it (I am sure it is some disease and I am just going undiagnosed all these years). The taste of victory is addictive: pressing that “Submit” button, reading my assessor’s report on PGR Tracker, having my long surname in papers (soon to come), the validation from my patient population, my supervisors proud of me, and the hope of making change happen for the best care of patients and carers. I am so excited for the next steps. Knowing that I pushed my boundaries, I am doing what I love, working towards a career that I dream of, surrounded by an incredible support network. For now, out of office “ON” on Hospital and Uni accounts. Breaks are important and I have earned my two weeks off. Let’s see what year 2 brings 😉 “I have sent you an email with my login details, if I end up in the resus room (wouldn’t be the first time), please submit the application. Otherwise, I will come back to haunt you!” Previous Next

645a116d-e831-40de-9fe9-20f74864feba < Back Top banners Previous Next

< Back Our journey in partnership Why Pat and Julia became involved in research Pat Walkington and Julia Burton have been working with researchers from across England as part of a National Priority Research Programme in Ageing, Dementia and Frailty . The programme is a collaboration between ARCs which has been working to improve care for people with dementia and prevent falls in older people. Pat and Julia were supported in their work with researchers by Vikki and Naomi from the University of Exeter as part of ARC South West Peninsula, The overall programme had been initially led by Professor Helen Roberts based in Southampton as part of the ARC Wessex. Five years later, Pat and Julia have reflected on their continuing work: Pat writes: I have been a member of the public and community involvement and engagement panel for the Applied Research Collaboration (ARC) for Greater Manchester for about 12 years and later also became a member of the Health Innovation Greater Manchester panel. I have worked on many different health research projects where I have been able to offer a public/patient perspective. This includes writing plain English summaries for funding bids, sitting on advisory panels, being involved in different workshops and focus groups in my community as well as advising on information leaflets for the public. In November 2020, I was asked to review funding bids for Healthy Ageing, Dementia and Frailty National Priority Areas. Normally my involvement would end here but then in 2022 when a public panel member for the ongoing projects retired, I was invited to join the Programme Management Group overseeing the 3 projects. I was welcomed by the team, helped to be brought quickly up to speed with progress so that I felt comfortable and valued as part of the team. The meetings were well-managed and, like Julia, I felt comfortable about asking questions, asking for clarification if there was something that I didn’t understand, and being able to give a patient/public perspective. I valued the support of Vikki Goodwin and Naomi Morley , the PPI lead members of staff, who offered to meet with Julia and me before and after the Programme Management Group meetings so that we could get to know each other, discuss progress, ask questions and share ideas. This was a positive experience which I have now asked to be introduced to similar work Greater Manchester. I had never heard of a Community of Practice so this was a new and interesting learning experience for me. Like Julia, I found this so valuable in being able to openly discuss project progress, ideas and issues with other PPI teams working on similar projects across the ARCs in different areas of the country. I was disappointed when funding for this ended and our work could not continue. However, now that I know that Communities of Practice can be so valuable I would not hesitate to encourage these to be set up for other research projects. Finally, I am also involved as a PPI member/research partner in one of the 3 projects, the Flexi (Falls Exercise Implementation) Study, in Greater Manchester. This has been another learning experience for me from writing the plain English summary and working on the funding bid, being an equal partner, to now being involved in PPI workshops with members of the public who have taken part in the exercise classes. This morning we were listening to their ideas for public leaflets for the project extension and the positive experiences of how much stronger, fitter and confident that they felt from doing the exercises. They also said how much they had enjoyed the social aspects of exercising together. Pat Walkington public contributor I feel that as a PPI member I have made a difference and I have been able to give something back to the society and health service that has supported me. Julia: I have been involved as a patient/public contributor since the very start and, supported by Vikki Goodwin and Naomi Morley (Exeter), have been enabled to contribute at every stage. I attended all the very regular management team meetings where it was very clear that Helen Roberts valued our input and ensured that the meetings were run in a way that made the content accessible to non-academics like me. Julia Burton public contributor I do have some years of public patient involvement and co-production in research, initially volunteering with the Alzheimer’s Society with lived experience of my mother’s dementia, but terminology, acronyms and on occasions, scientific content can need explanation. It was very interesting to be involved in the programme of three research projects that are aimed at providing interventions for my age group. In my opinion, a very valuable and positive experience was the Community of Practice where the three funded project leaders and PPI leads met outside of the Management Group. Set up by the Management Group and facilitated by Naomi Morley we had regular meetings where issues involved in the progression of the research were discussed together and information, support, contacts and ideas shared. This community became more useful as time went on and resulted in cooperation and problem solving across the ARC s as the three projects were addressing the same NIHR priority. I was disappointed when the funding for this was not extended although Pat Walkington and myself are still involved in the management group. PPI contribution can be seen as a respected part of the entire programme. This was highlighted when Naomi, Pat and I spoke about patient and public involvement across the programme and development of a community of practice at the British Geriatrics Society Autumn Conference in November 2023. We were the only public contributors at the conference and I hope we were pioneers to be followed by others in the future. Previous Next

09039be4-7f54-4e52-b415-7d6e49acfe67 Predicting nurse staffing requirements -validation and scoping extension study (PREDICT-NURSE validation and extension) Chief Investigator: Paul Meredith, Senior Research Fellow, University of Southampton Team: Christina Saville, Senior Research Fellow, University of Southampton Chiara Dall’Ora, Associate Professor in Health Workforce, University of Southampton Zlatko Zlatev, Senior Enterprise Fellow, University of Southampton Peter Griffiths, Chair in Health Sciences Research, University of Southampton Ian Dickerson, PPI Representative Tom Weeks - E Systems Implementation Manager Tom.Weeks@porthosp.nhs.uk Sue Wierzbicki - Lead Nurse - Workforce Sue.Wierzbicki@porthosp.nhs.uk Partners: Hampshire and Isle of Wight Integrated Care Board, Hampshire Hospitals NHS Foundation Trust, Portsmouth Hospitals University NHS Trust, Salisbury NHS Foundation Trust. Start: 1 October 2024 End: 30 September 2025 Our aim We aim to show that a computer algorithm we have developed which uses information that is already collected about patients can provide good estimates of the number of nurses needed on hospital wards to provide safe care for the patients. Background information It is important to have enough nurses to care for patients on hospital wards. If there are too few nurses, patients may take longer to recover, suffer complications, or die, and the capacity of the hospital to cope with new admissions is reduced. Also staff well-being is affected by high workloads and there is more staff sickness. Many hospitals use the Safer Nursing Care Tool (SNCT) to help them manage staffing levels. This involves surveying all the patients in a ward perhaps three times a day. Assessing each patient in this way is an extra nursing task and in itself adds to the workload. We have developed a computer algorithm using data from one hospital which can provide similar estimates of nursing staff requirements to SNCT but we need to check that these estimates would keep patients safe if they were followed. What we will do We shall use data collected for a previous study as input to the algorithm to produce estimates of nurse staffing requirements for each ward shift using information which could be known at the time. We will compare actual staffing with the algorithm’s estimate to see if there is a deficit or surplus of staff. For each admission we will examine how these deficits and surpluses relate to patient outcomes. We will compare using the algorithm to set a threshold for safe staffing with using the SNCT estimates as a threshold. Our comparisons will include looking at how good the methods are for wards with higher numbers of under-served groups such as the over 75s, those with learning disabilities and those with mental health conditions. We will measure the effect of staff shortfalls on the number of staff sickness absences. The performance of the algorithm will be checked using data from a second hospital in the database. We shall work with our partners to find out what tools are used to determine nurse and other staffing requirements on a day-to-day basis in community and mental health settings and what data on care requirements and outcomes is electronically recorded. We will discuss with partners what opportunities, potential benefits and practical considerations there are to implementing a predictive tool of staffing requirements. Communicating results We will write an academic paper, produce an article for the Nursing Times, create a poster for display at conferences, and publicise the results on social media. Involving the public We will involve local PPIE group members in evaluating and commenting on the possible uses of a predictive tool to support decisions in the day-to-day management of nurse staffing levels on wards.

bfee6430-aafd-44b2-bd89-074b9c7bf0b9 ADOPTED PROJECT: ADAPT: The cross-sector implementation of NICE-recommended CBT-based interventions for young people in care: Framework Chief Investigator: Dr Rachel Hiller– University of Southampton Project Team Members: Dr Gretchen Bjornstad– University of Exeter, Dr Tim Clarke – Norfolk & Waveney Children and Young People Care Group, Dr Kristian Hudson– Improvement Academy Bradford Teaching Hospital NHS Foundation Trust, Professor John Macleod– University of Bristol, Dr Ruth McGovern– Newcastle University, Dr Hugh McLeod– University of Bristol, Professor Richard Meiser-Stedman– University of East Anglia, Dr Sara Morgan– University of Southampton, Dr Beverley Slater– Bradford Institute of Health Research, Professor Paul Stallard– University of Bath, ProfessorJohn Wright– Bradford Institute of Health Research, Dr Patrick Smith– King’s College London. Organisations Involved: Swindon Borough Council, Bath and North East Somerset (BaNES) Children’s Services, Thinking Allowed specialist-service, Bristol, Newcastle City Council Children’s Social Care, Child and Adolescent Mental Health Services (CAMHS) (East) Background: Young people in care (care-experienced young people; CEYP) have substantially higher rates of mental health difficulties compared to their peers. Their unaddressed mental health needs have been identified as a key driver of a range of poor outcomes that categorise this group. For example, CEYP they are five times more likely than peers to be excluded from school, comprise 50% of the young male prison population, and 25% of the homeless population. Such outcomes are not inevitable. Yet services are often struggling to effectively address the mental health needs of this group, and thus prevent some of these wide-ranging consequences. To begin to address this complex issue, we are proposing a pilot implementation project, working with CAMHS, social care and third- sector mental health services across four target ARCs. Our pilot project aims to address this via overlapping stages that form the essential framework for a full-scale implementation trial. These are: (1) A scoping review and consultation with CEYP, carers, and services to develop an initial implementation framework, based on the consolidated framework for implementation research (CFIR) (2) The development of our implementation resources, including training materials What did we find out? We found that young adults aged 18-25 did not engage with the RADAR/ADAPT programme, and may not engage with perpetrator services, if they do not have motivation to do so. The implications are that this poses a risk to victims, particularly if perpetrators have high risk behaviours. To address this, more work should be done to disrupt high risk individuals and refer them on to workshops that require less time commitment; in order to initiate self-awareness around their behaviors and their impact on others. Given that children were a strong motivation for completing a programme, it seemed almost paradoxical that there were no specialist services made available for children within the DAPP model. Although there is compelling evidence to suggest that men changed their behaviours following the programme, police reoffending data suggests that, for a minority of individuals, more work is required to fully embed positive behaviours. A mentoring service may support such aims. To further support evidence on behavioural change, long term outcomes related to victim harm should be measured; for example, through a short questionnaire filled out by current or former partners. The RADAR/ ADAPT programme is specific to the domestic abuse experienced between intimate partners within heterosexual relationships. The implications are that a number of individuals may not find the programmes appropriate to their context. Therefore pilot programmes should be developed to tackle different relationship dynamics and types of abuse, including lesbian gay bisexual transgender queer (LGBTQ) relationships, and Elder Abuse. Finally, to full achieve a community coordinated response, and make the most of the resources available, pathways of referrals and a mutual understanding of roles and responsibilities should be clearly set out, to cover both statutory and non-statutory organisations. What did we do with this knowlege? •The findings from the research were communicated with the commissioners of future services in Domestic Abuse in Hampshire. •The next commissioned service considered the findings of the research in the tender. •For example, given the risk of non-engagement of younger adults, a specific service for 18-24 year olds, was set up that working on the specific needs of this population group. •The findings added to the limited knowledge around voluntary community perpetrator programmes. •It was published in the Open Access journal PloS ONE https://doi.org/10.1371/journal.pone.0218408 •Dr Sara Morgan was interviewed alongside Tracy Rutherford (Hampton Trust) on the Patrick Sisson show (BBC Radio Solent) Where next? •The work on ADAPT has led to further research in this area through existing partnerships, including a national evaluation of CARA •We have continued relationships with police partners who were interested in further evaluation work, which led to co-funding of other projects including Operation Foundation and MASP •Personally, Chief Investigator is interested in the findings around younger perpetrators, and how to engage them better in the health and social care system, and improve their life-chances. •Where many perpetrators on ADAPT have experienced domestic abuse as children, and they themselves have children, I’m interested in pursuing work around preventing the intergenerational transmission of domestic abuse. Publications Baseline characteristics and outcomes of the main perpetrator programme within the Hampshire Domestic Abuse Prevention Partnership, UK: A mixed methods study | PLOS One

13151434-a7e4-409a-b026-23a834ceed8f IDA: Implementing a Digital physical Activity intervention for older adults Principal Investigator : Dr Kat Bradbury Project team : Dr Max Western , Dr Stephen Lim , Linda Du Preez , Fay Sibley , Dr Judith Joseph , Professor Lucy Yardley , Dr Chloe Grimmett , Dr Neil Langridge , Christian Brookes , Helen Fisher, Cynthia Russel, Asgar Electricwala, Tom Stokes, Professor Maria Stokes , Dr Paul Clarkson , Cherish Boxall, Dr Katherine Morton , Sara Bolton , Dr David Attwood. Partners: Hampshire and Isle of Wight Healthcare NHS Foundation Trust (Southern Health NHS Foundation Trust), Dorset County Hospital NHS Foundation Trust , Oxford Health NHS Foundation Trust, Health Innovation Wessex (Wessex AHSN), University of Southampton, NHS England, Energise Me, Active Partnerships, Live Longer Better. Publication: Implementing a Digital Physical Activity Intervention for Older Adults: Qualitative Study Summary This Active Lives website has been shown to help older people to increase physical activity. This study aimed to roll out Active lives to make it available to older people living in the community. The steps involved in the project included: Identify, approach and influence organisations interested in helping older people to be active in order to find places that could help us roll out Active Lives. Monitor how many people used active lives and how many were actively engaged enough to have what we think was a sufficient ‘dose’ of the intervention to be likely to change their behaviour. Interview people implementing Active Lives and study what happens in meetings to formulate a list of barriers and facilitators to the roll out of active lives. Results We worked with a wide range of organisations including AHSNs/HINs, charities which serve older people, physical activity organisations, NHS trusts and NHS England. The website reached 5002 people. 1306 people were engaged enough to view the core content necessary to lead to behaviour change. NHS England were instrumental in us achieving traction in several NHS trusts. Six NHS trusts and one charity agreed to help us roll out active lives. One physical activity partnership was helpful in facilitating relationships with their local NHS trust. Their support helped influence local trusts, build clinician confidence in Active Lives and help put in place strategies to maximise uptake of older people to Active Lives. Other physical activity partnerships and the physical activity sector more broadly chose not to support the implementation of Active Lives. Barriers here were especially focused on the belief that older people are not digitally engaged, that older people will only benefit from in person groups, and some viewed this as a threat to the groups that they were locally facilitating or supporting themselves. We appeared in competition with these organisations and it prevented uptake of several NHS trusts that appeared interested at our initial meetings with us (i.e. the physical activity partnerships became a barrier to NHS uptake as they had influence in these NHS trusts). Facilitators to uptake included confidence in the team, believing in an evidence-based approach, the team being able to allay concerns around digital accessibility, providing organisations with figures on how many people used the website and providing support with how to maximise uptake to active lives. Endorsement by NHSE was also very useful in persuading some NHS trusts to take on Active Lives. Things that slowed roll out down: Complexity in the NHS trusts’ chain of command slowed the sign up to Active Lives, this was problematic in a 12-month project. NHS trusts also required complex and nuanced data security and other digital health forms to be completed and trusts were overly cautious with regards to the perceived digital security risks of the intervention. This caused long delays and used valuable resources. What have we done? We implemented Active Lives in practice across 6 NHS trusts, having direct impact on older people. 5002 used it, of which 1306 were actively engaged to a level which we believe is a sufficient ‘dose’. We’ve written a paper on the barriers/facilitators https://aging.jmir.org/2025/1/e64953 What have we learned? Despite the short nature of this project, it achieved good impact and was able to support a large amount of people in a short amount of time Support from all partners is needed to overcome barriers to implementation. Further roll out would require continued engagement work to allay concerns among the NHS and partner organisations

d4e68544-5bd2-44f6-bac8-dd9848c01967 WADE. Women and Desistence Engagement : An evaluation of a community-based, conditional caution pilot programme for women in the criminal justice system Principle Investigator: Sara Morgan, Fiona Maxwell Start Date: 20th November 2019 End Date: 30th March 2022 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 carried out group interviews with those delivering the pilot intervention projects in the community. These were primarily to understand how the projects are working. We also used 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. We continued 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 therefore considered 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). Impact of the COVID-19 Pandemic The first WaDE cautions were offered from March 2019 and workshops began shortly after. Numbers were initially fewer than expected, and although some variance throughout the year would not have been unusual, there were fewer than the anticipated 10 per month for the first months of the pilot. Unfortunately, from March 2020 the COVID pandemic and stay-at-home regulations had a very significant impact on the operation of the pilot. The pilot was suspended from March as Hampshire Constabulary temporarily ceased offering conditional cautions. From March it was also not possible to deliver the WaDE programme in its intended group format, and a small number of participants who had completed the first workshop as a group completed their second part by telephone on a 1:1 basis with a HT facilitator. As an alternative, a non-mandatory, individual telephone intervention was briefly offered from March 2020 during the first period of restrictions. Overall this had an impact on the planned evaluation, resulting in a reduction in the available quantitative data for analysis (due to fewer numbers coming through the programme). Additionally, there was a planned qualitative element to the evaluation (focus groups) which were cancelled due to the restrictions. Due to the impact of COVID-19 on both the programme operation, and the staff involved in researching, the findings of the final report cover the period of September 2021 – March 2020. Reoffending Due to the suspension of the WaDE programme and the extended period between cohort A completing their workshops and the compilation of this report, reoffending data up to 12m post-intervention is now available. From the initial 27 referrals, 4 women went on to commit further offences. These were: 1 at 35 days (common assault) 1 at 157 days (shoplifting) 1 at 229 days (bladed implement) 1 at 310 days (cannabis) Two of those who reoffended had breached (not attended) any WaDE workshops, and two had completed. A chi-square comparison of the reoffending rate between those who breached and those who attended gives a χ2 value of 2.1, indicating that this difference does not meet the threshold for statistical significance. Exit Questionnaires Hampton Trust routinely ask participants in their programmes to complete an exit questionnaire, which allows for some feedback on the perceived benefits of having attended. It also provides the opportunity for some free text comments. Ten participants answered the following questions: Q1 Since being on the workshops have you identified areas of your life in which you need support? Q2 Since being on the workshop do you have a better understanding of what led you to offend? Q3 Have the workshops helped give you tools/support to make safer more positive life choices? Q4 Since being on the workshops have you accessed other services (e.g. counselling, drugs and alcohol support) or plan to do so in the near future? Q5 Do you intend to attend all or any of the follow-on 12 week programme workshops? Q6 How much have you enjoyed the WaDE workshop? Q7 In your opinion, how well presented were the workshops? Q8 To what extent have the workshops helped you with your problems? Q9 Where 10 is ‘very confident’, how confident are you of not offending in future? On the basis of these responses, the WaDE programme is evidently acceptable to, and valued, by the participants. One respondent was generally negative in her responses and indicated in the free text feedback that she felt she shouldn’t have been having to attend WaDE at all; however even she felt that the course was well presented and enjoyable. Due to the small number of responses and the limited amount of free text feedback, full thematic analysis of the responses is not likely to offer reliable identification of consistent key themes. However, for the majority of respondents the comments reflected overall high levels of satisfaction with the programme, its delivery and its usefulness in terms of helping the participants to understand and address the factors and circumstances leading to their caution. Limitations Overall The WaDE programme delivery, and consequently the size and scope of this evaluation, has been significantly impacted by the COVID-19 pandemic. Greater numbers would have added validity to our findings and allowed for meaningful associations to be explored, while qualitative research would have added a depth of understanding of the true impact of the WaDE programme on its participants. At the time of writing it is hoped that WaDE can now revert to its original model and that a steady throughput in line with original expectations on numbers will be observed. Further research is recommended, including a comparative statistical analysis with a larger cohort. Qualitative research would also be valuable to explore in-depth attitudes, towards reoffending for example, in order to provide better evidence for future decision-making. Conclusions Despite some very challenging times, the team delivering WaDE remains committed to its ongoing operation. Continuing support from the OPCC and a strong working partnership between Hampton Trust and Hampshire Constabulary has enabled the programme to ‘weather the storm’ of the pandemic and emerge ready to re-start. The flexibility and hard work of each individual throughout this time speaks to their belief in WaDE as a worthwhile and much-valued means of supporting female offenders towards a better future. Findings from the study were used to support further funding and commissioning of WaDE, while also contributing to the expansion of academic research into health and justice interventions through continued involvement of the research team This includes an evaluation of JUNO which has evolved from WaDE

eb290c7e-cd77-4244-9d45-322994af9f69 ADOPTED PROJECT: Comparing pharmacological and non-pharmacological interventions for adults with Attention-Deficit/Hyperactivity Disorder (ADHD): systematic review and network meta-analysis Chief Investigator: Professor Samuele Cortese – University of Southampton Project Team Members: Professor Andrea Cipriani – University of Oxford, Associate Professor Corentin Gosling – University of Paris Nanterre, France, Dr Luis Faraht – University of São Paulo, Brazil / Yale University Child Study Center, USA, Dr Cinzia Del Giovane – University of Modena and Reggio, Italy Project partners: Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Oxford Precision Psychiatry Lab, National Institute for Health and Care Research Oxford Health Biomedical Research Centre, Oxford, UK; Oxford Health National Health Service (NHS) Foundation Trust, Warneford Hospital, Oxford, UK. Electronic address: edoardo.ostinelli@psych.ox.ac.uk . Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Oxford Precision Psychiatry Lab, National Institute for Health and Care Research Oxford Health Biomedical Research Centre, Oxford, UK; Oxford Health National Health Service (NHS) Foundation Trust, Warneford Hospital, Oxford, UK. Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Oxford Precision Psychiatry Lab, National Institute for Health and Care Research Oxford Health Biomedical Research Centre, Oxford, UK. Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy; Institute of Primary Health Care, University of Bern, Bern, Switzerland. Hampshire and Isle of Wight NHS Foundation Trust, Southampton, UK; Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK. Psychology Services, London, UK; Department of Psychology, Reykjavik University, Reykjavik, Iceland. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Oxford Health National Health Service (NHS) Foundation Trust, Warneford Hospital, Oxford, UK. The National Attention Deficit Disorder Information and Support Services, Edgware, UK. Hampshire and Isle of Wight NHS Foundation Trust, Southampton, UK Full team listing including PPI :O stinelli EG, Schulze M, Zangani C, Farhat LC, Tomlinson A, Del Giovane C, Chamberlain SR, Philipsen A, Young S, Cowen PJ, Bilbow A (PPI), Cipriani A, Cortese S Ended: 28th February 2024 Background: It is currently unclear how different treatment options for preschool children with ADHD compare with each other in terms of efficacy and safety. We will use data from available randomised controlled trials (RCTs) and apply an advanced and innovative statistical approach (network meta-analysis) to answer this question. What did we find out? We found that Stimulant medications and atomoxetine are the only treatments that clearly help reduce the main symptoms of ADHD in the short term, based on both what patients say and what doctors observe. However, people were less likely to stick with atomoxetine than with a placebo (a dummy pill). There was no evidence available other important things like improving quality of life, and we don’t know much about how well they work in the long run. Non-medication treatments had mixed results depending on who was doing the rating. This study gives the most complete picture so far of how different treatments for adult ADHD compare to each other. It can help guide treatment choices, but those choices should always be based on a careful look at both the benefits and risks — and on what matters most to the individual. The study is already informing clinical guidelines, e.g., the ongoing guidelines from APOSARD (USA). The study has informed a freely available platform ( https://ebiadhd-database.org/ ) that has been utilised by 15,000 colleagues around the world and improved through feedback from 1,000 stakeholders worldwide See medication and treatment ratings Next Steps To test the impact of the platform on knowledge and clinical practice To contact guideline bodies in the UK (eg NICE) and abroad to bring the network meta-analysis and the related platform to their attention. Publications Comparative efficacy and acceptability of pharmacological, psychological, and neurostimulatory interventions for ADHD in adults: a systematic review and component network meta-analysis - ScienceDirect