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9786dc43-811c-409a-95aa-666af8766d3d ADOPTED PROJECT: Developing and testing a Patient Report Experience Measure for patients accessing Acute OnCology services: The PREMAC study Principal Investigator : Dr Richard Wagland, Senior Research Fellow, University of Southampton, School of Health Sciences Co-Investigators : Professor Alison Richardson, Professor of Cancer Nursing & End of Life Care and Director of NIHR ARC Wessex, University of Southampton & University Hospital Southampton John Defty, Advanced Clinical Practitioner in Cancer Care, University Hospital Southampton Dr Emma Brown, Medical Oncologist, Acute Oncology Lead. University Hospital Southampton Start date : January 2023 End Date: May 2024 Funder : University Hospitals Southampton (UHS) NHS Foundation Trust R&D Small Grants Award Summary People with cancer often need to access acute oncology services for serious problems caused by their disease or treatment. It is good practice for services to collect information about patients’ experiences of care to understand how they could be improved. The aim of the PREMAC study was to develop a questionnaire for patients who have used acute oncology services to feedback their experiences. The study progressed in three stages. First, a literature review to identify previous research that described elements of care important to people with cancer whilst experiencing a cancer emergency. This was followed by interviews with eight patients who had cancer and eight doctors and nurses from the acute oncology team at Southampton General Hospital to hear their thoughts about the most important elements of care. From these two activities we identified what the questionnaire should aim to measure. In the second stage, a group of patients who had a diagnosis of cancer and used acute oncology services helped the research team draft questions and response options. These questions were then tested with a further four people with cancer, to make sure the questions were easy to understand. Then we made some changes to the questionnaire. The final questionnaire had 37 questions about the quality of care and nine questions about a patients’ background and condition. Questions included aspects such as: quality of information and care they received; the quality of the care environment (whether it was clean and safe, and provided privacy; whether patients’ family and friends were supported and kept informed by staff; whether patients had long waits for care; and the ease of discharge. In the third stage, the questionnaire was sent to patients with cancer to complete one to two weeks after they had used the acute oncology service at Southampton General Hospital. Patients were sent a text to their mobile phone with a link to the questionnaire. 171 patients completed the questionnaire, the majority of whom were female (56.5%). Most participants rated their overall care experience positively, with 82.4% selecting “Very good” and 9.7% selecting “Good.” Only 4.2% of participants rated their care as “Poor” or “Very poor”. Responses to the questionnaire allowed us to test how well each of the questions worked both by themselves and in combination with others in the questionnaire. Responses provided the Trust with important information to help identify areas where care was very good and areas in need of improvement. The next study will test the questionnaire in other Trusts whose acute oncology services might be organised in different ways to the services at Southampton. Background Hospitals have established structured pathways for managing patients with oncological emergencies through acute oncology (AO) services. Whilst some Trusts have developed local questionnaires specific to that service there is no survey available to measure and compare patient experience across NHS trusts. This study will co-design a patient-reported experience measure (PREM), intended to be adaptable for use across different AO service models. Advisory Group Members : Andrew Dossett, Lead Clinical Advanced Clinical Practitioner for Acute Oncology Service, University Hospital Southampton Jane Winter, Macmillan Lead Nurse, Wessex Cancer Alliance Laura White, Head of Involvement & Participation, University Hospital Southampton Katie Hudson, Lead Advanced Clinical Practitioner for Cancer Care Wards, University Hospital Southampton Mrs Susan Restorick-Banks (PPI Representative) Mrs Anne Ongley (PPI Representative) Alison Keen, Head of Cancer Nursing, University Hospital Southampton Philippa Jones, Acute Oncology Nurse Advisor, Board Member of UK Acute Oncology Society. Prof. Ernie Marshall, Medical Oncologist, Wirral University Teaching Hospital (Clatterbridge) NHS England national lead for Acute Oncology

535f16ee-e98a-4782-81fa-97a73abd8468 ADOPTED: Improving patient safety, workforce wellbeing and NHS efficiency through improved shift patterns for nursing staff: study protocol Principal Investigator: Dr Chiara Dall'Ora, University of Southampton Funded : Academy of Medical Sciences Springboard grant Starts: 1/9/23 Ends: 31/8/24 Lay summary What is the problem? If the COVID-19 pandemic has taught us something, it is how important the wellbeing of the health workforce is. Nurses form a big part of the health workforce, yet many leave their job because of poor working conditions. In recent years, hospital managers introduced long shifts for nurses, hoping nurses would be happier with their work-life balance. However, our research found that long shifts have negative effects for nurses and patients. We still do not know what good shift patterns look like. What will we do? We will identify possible improvements to shift patterns that work for nurses, their managers and patients. We will interview nurses and their managers to understand what they value when it comes to shift rostering. We will talk with a group of patients to understand what good care looks like to them. We will then run an online experiment. In this experiment we will present staff with a series of modified shift patterns. Using statistics, we will understand which shift patterns staff prefer. Why is this important? If we find changes to shift patterns that are acceptable for nurses, managers and patients, we can trial these changes in a real-life experiment. If the experiment - called "trial"- shows that changes to shift patterns work, fewer nurses will leave their jobs. If we find how to make nurses’ work less tiring, they will make fewer mistakes that compromise patient care. In addition, if fewer nurses leave, healthcare systems will save money.

b45fdd12-d569-4bd5-a0c4-1547cfa6f910 PARTNERS II: Testing implementation and evaluation of a digital tool for multisectoral support and management of people living with Parkinson’s disease and/or arthritis. Chief investigators: Professor Mari Carmen Portillo, Professor of Long Term Conditions, School of Health Sciences, University of Southampton. Dr Dorit Kunkel, Lecturer, University of Southampton and Research Design Service, School of Health Sciences Team: Dr Katherine Bradbury Health Psychologist, Senior Research Fellow NIHR ARC Wessex Digital Health Lead University of Southampton. Dr Lindsay Welch, Associate Professor of Nursing Practice, Bournemouth University & University Hospitals Dorset Sandra Bartolomeu Pires, PHD Researcher, School of Health Sciences, University of Southampton. Professor Christopher Edwards, Consultant Rheumatologist, Honorary Chair of Clinical Rheumatology, Associate Director Southampton NIHR Clinical Research Facility, University Hospital Southampton (NHS) University of Southampton. Dr Lindsey Cherry, Associate Professor (Podiatry Rheumatology), School of Health Sciences, University of Southampton. Francesca White, Senior Strategic lead for Partnerships, Hampshire and Isle of Wight Integrated care board. Dr Hayden Kirk, Clinical Director Adults Southampton, Solent NHS Trust ( Hampshire and Isle of Wight NHS Foundation Trust) Caroline Aylott, Head of Research, Versus Arthritis, Carolyn Fitton, Senior Research Assistant, School of Health Sciences, University of Southampton. Gillian Merritt, Service Improvement Manager, Parkinson’s UK. Peter Rhodes, Senior Programme Manager, Industry & Innovation, Health Innovation Wessex. Partners: University of Southampton, Bournemouth University & University Hospitals Dorset, Hampshire and Isle of Wight NHS Foundation Trust, NIHR Clinical Research Facility, University Hospital Southampton, Hampshire and Isle of Wight Integrated care board, Versus Arthritis, Parkinson’s UK, Health Innovation Wessex. Start: 1 October 2024 End: 30 November 2025 Summary Self-management can help people with long term conditions manage their health better. Existing self-management tools focus on healthcare (medication management, appointments) and fail to understand how people live with and adjust to their long-term conditions. This includes social support (family/friends) and other resources and networks available like the voluntary sector, industry and community groups. We have created an intervention (an action to improve a situation or prevent it getting worse) to support self-management for people with Parkinson’s Disease and/ or Arthritis and their family/carers. This intervention recognises the role of social support, charities and other organisations in adjusting to living with a condition. Based on previous study findings where we looked at the literature and talked to patients and health care professionals, we co-produced a digital tool website/app ready for testing. Aim of the research: To explore the acceptability (ease of use) and how helpful the tool is in supporting self-management by collecting data and by talking to patients and carers who have used it and health care workers. The PARTNERS tool will support professionals and other organisations to connect, share resources and optimise communication and referrals, leading to more personalised and cost-effective use of resources (beyond healthcare) in the community. Design and methods: Mixed methods acceptability and implementation study. The research will take place in community settings in Wessex. We will prioritise disadvantaged groups (those less comfortable using technology and less able to access available resources and support). We will test the PARTNERS tool with patient, carers, health professionals and voluntary organisations (Parkinson’s UK and Versus Arthritis). Testing will help understand how the tool is used and what helps or hinders its success. We will talk to people who used it to identify how useful and helpful it was and how to integrate it with their normal care. The research will support better self-management of Parkinson’s Disease and/or Arthritis, make recommendations for policy development and provide evidence for how to improve NHS services. PPI: We are working with people with Parkinson’s Disease and/or Arthritis and their families/carers. We will work together as equal partners to decide their level of involvement, roles, ways to input and training needs. We will also explore what works best or what we should do differently in their involvement. Dissemination: We will share our learning across the different groups involved. This will include presentations, policy briefings, newsletters and public events.

860cb5e1-0b96-40d2-ae12-634f4a925c64 ADOPTED PROJECT: Exploratory research to examine the health impact of scams and fraud and the current knowledge and systems in the police and partner agencies for targeting and delivering victim support services Team: Ruth Halkon Dr Michael Skidmore Dr Felicity O'Connell Dr Amy Meenaghan Professor Mark Button Start Date: 1st May 2024 End Date: 30th November 2024 Project Partners: Police Foundation and University of Portsmouth This research explores how being a victim of fraud affects people’s health and wellbeing and what help they need to recover. We used surveys and interviews to reach fraud victims and spoke to the professionals who support them. How fraud affects health Most fraud victims have emotional or mental health problems. In the study, 92% had at least one symptom. Common issues included worry (58%), stress (56%), fear of becoming a victim again (52%), and feelings of anger (46%), weakness (46%), or distress (45%). Victims also had more serious symptoms like depression (18%), hopelessness (16%), panic attacks (8%) and feeling out of control (14%). Physical health was also affected. Over half (58%) of victims had symptoms such as trouble sleeping (45%), headaches (27%), or tiredness (24%). Changes in behaviour were common too. Victims often became distrustful (44%) or stopped going out (19%). We found that symptoms often happened together. Victims with emotional symptoms often also had physical ones. We found six separate patterns or “clusters” of symptoms, such as a “worry and distrust” group, and a more severe “hopelessness and self-harming” group. The impact varied widely. Some felt only mild, short-term symptoms. Others felt long-term effects that lasted for years. These were worse among the old or those in poor health. Nearly 19% said their daily lives were seriously affected. Some stopped using technology or thought of taking their own lives. Why some victims are more affected than others We found many things can impact how much a victim is affected including: the tactics used by fraudsters (e.g. building fake relationships or using threats), the amount of money lost, any pre-existing health issues, feelings of shame or self-blame, and lack of a support network. Victims who had a mix of these factors often suffered more. What support do victims want or need ? Many victims wanted practical help – such as advice on avoiding further fraud or help getting their money back. Others wanted help to come to terms with what had happened. But only those the police deemed "vulnerable" received further support. The report highlights a mismatch between what victims want, what they need, and what is available. Some people who could benefit from support don’t qualify or don't think they need or deserve it. The concept of "vulnerability" is also vague and needs to be better defined. How services should improve Many victims felt blamed, ignored or treated with suspicion by the police, banks and tech companies. This often made their health worse. Those who got the right help from family and friends, case workers or peers were best able to recover from the fraud. Recommendations include: •Keep support options open beyond the initial police report. •Define vulnerability more clearly in policy. •Adopt trauma-informed approaches across all service •Launch public campaigns to challenge victim-blaming attitudes and explain how fraud happens. In short, we need better understanding and better support to help fraud victims recover and reduce long-term harm. What did we do with this new knowledge This study has been completed but has not yet been published. It has been submitted to an academic journal and will also be published by the Police Foundation in the autumn. The research study was presented at Portsmouth University’s 2025 Counter Fraud, Cybercrime and Forensic Accounting Conference in June, where it was the keynote speech. Through this conference we shared our findings with public health experts, academics, police leaders and representatives from the private sector. We also hope to present the work at the Australasian and the Pacific Conference on Law Enforcement and Public Health, having been invited to present because of the global impact this research could have. Where next? This project was an exploratory study which we are planning to use as the basis of a much larger study. This is particularly important as while the impact of fraud is beginning to be known amongst specialist circles, it is a struggle to get this issue noticed in general policing/policy circles who do not realise there is a problem let alone understand the impact that our poor responses to fraud is having on millions of victims. •We are currently in the purpose of drawing up a proposal for a follow up study. This study will explore a) the sheer scale of fraud, its impact on health, evidence gaps in relation to both; b) what is known about the policy response/interventions (e.g. what exists, what's known about the effectiveness of responses) Methodology: •Phase 1: Review of: a) the evidence and theory to explain and account for the impact of fraud on victim health; b): of policy responses/interventions •Phase 2: Empirical research: (not just the health impact of fraud but also policy responses/interventions) •Phase 3: Develop a risk assessment tool and health toolkit to guide frontline support staff •Phase 4: Preliminary evaluation of the toolkit The project team for the new research proposal would include the Police Foundation and Portsmouth University along with Professor Mike Levi of Cardiff University and Thara Raj, Director of Public Health for Warrington.

283829ae-0e8e-40ad-96e6-9c01fa950327 COMPLETED SOCIAL CARE: Local Authority Adult Social Care Recruitment and Retention research project (BCP/Dorset) Lead: Dr Andy Pulman Post Doctoral Researcher and Professor Lee-Ann Fenge Contact: apulman@bournemouth.ac.uk Background Within the Wessex region, we have been working to support the development of social care research over the past few years. In 2022, we completed a year-long study examining social care research enablers and barriers which might prevent or limit a positive research environment for practitioners ( Pulman and Fenge, 2023 ). This built the foundation for four projects across Wessex – funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex – which aimed to build research partnerships across local authorities (LAs) and universities in the region. As part of these projects, separate funding was available to support research champions embedded within local authorities, to support activities such as lunch time research discussions, journal clubs and the development of practitioner focused research. To encourage buy-in from the LAs we developed research in partnership with them to respond to key priority areas. Aims The aims of our project were: •Explore local recruitment and retention issues in adult social care and adult social work •Helping to inform future workforce development activities undertaken by two local authorities (LAs) •Contributing research data to both the regional and national picture of adult social care recruitment and retention issues How did we do this? Data for our project was collected between February 2023 and October 2023 and explored local recruitment and retention issues in Adult Social Care (ASC) from the perspective of four populations of interest. We collected data from n=131 participants across the four populations of interest: •Social care practitioners - social workers, allied health professionals, unregistered social care practitioners - working in adult social care at two local authorities (LAs) •Social care staff performing exit interviews with staff working in the two local LAs •Social work students (undergraduate and postgraduate programmes) in Wessex •Service users receiving services in either LA and advocates drawn from Wessex LA contracted services es Pos Positive Outcomes • Practitioner demand to participate in this study was very high and we exceeded our initial recruitment targets. • Being able to shine a light on some of the current issues facing advocacy – a currently under-reported research area – as a part of our qualitative data collected from POI 4 was an enlightening and beneficial bonus. • Being able to involve and co-write with both the PPI collaborator and the two research champions from a local authority to produce two separate academic articles from the project was another highlight. • Reaching a national newspaper (both print and online in the Telegraph) with research findings from practitioners regarding hybridization and hotdesking was a very positive development in reaching an external audience. Practioner findings - Data on Staying Reasons for staying with LAs included: • Flexible working – place of work and hours worked • Love of the job and engaging with the service users supported • Supportive management • Supportive team • Training and CPD - via continuing professional development or an apprenticeship. A number of outputs from this project can be viewed below. We have also submitted a number of journal articles describing findings from the project data to the peer review process, which will hopefully be available later this year. Practioner Challenges Challenges to Retention highlighted include: Hybridisation and Hot desking Stress and Burnout Negative Perceptions of Social Care Student Reflections on Social Care • There is always focus on recruitment, but not on retention. • Social care is hugely underfunded but money is not the only answer –a place where people want to be. • Awareness that SW not seen as a fully sustainable career. Some already planning exit strategies before they started work - a perceived shelf life for a social work career. • Worries about excessive caseloads/increased admin burdens and bureaucracy. • Pay level was deemed inadequate for the demands of the job. • On placement students noticed issues with team churn, attrition and a lack of stability – one had 8 different managers over a 12 months. • Staff shortages – some vacancies can’t even be filled by locums. • COVID-19 had been the prompt for a lot of staff to move on. • Agency usage is an issue (for example, out of county managers). This is helping to create a ‘perfect storm’. • Risk of stress and burnout inherent in profession was noted: Ethical Dilemmas / Job related / Questioning of their decision making / Resilience / Coping strategies / Travel issues Students reflected on Cost of Linving Impacts that: • Increased numbers seeking hardship support / more working alongside study • Social work bursaries frozen since 2014 – more earning whilst learning • Some HEI staff do not appreciate hardships experienced or demands faced • Burnout - feeling stressed/lacking in energy after working full-time alongside course. • Longer term, reductions in students entering the profession have major implications for meeting rising level of vacancies in social work. • Cost of living issues an increasingly influential factor for prospective students when choosing route/retraining as mature student. Service User reflections on Social Work Relationships • Changing role - onus now on the carer more to be the lead professional though not through choice. • Biggest issue is lack of money in the system. • Money over empathy – it often feels like carers and SUs cost money. • Inertia - one participant described this feeling as : “It doesn't matter how I am, you're not going to do anything about it”. • Whole structure needs an overhaul. Social work/social care is a societal issue and priority Service User reflections on staff turnover • Previous continuity of same worker no longer exists. Rapid changeover / staffing issues causing upset for carers and SUs. • Churn obliterates previous working relationships • Depersonalisation – team rather than individual; now you don’t usually have a designated social worker. It's a group. • Less frequent contact. • Out-of-hours - service is overstretched and doesn’t cover the whole area effectively for time precious situations. Impact on Advocates · Safeguarding caseloads for advocates have increased. Crisis situations due to lack of early intervention. After discharge there is no pick-up or continuity from the community – loss of advocate, a new LA social worker or unqualified social care practitioner assigned, or the case is closed as it is classified as ‘not in crisis’. · Increased caseloads now have greater complexity. There are more Section 21A challenges – a review under a Deprivation of Liberty Safeguards (DoLS) as SUs unable to care package in the community. · Community advocacy - which prevents crisis in a lot of cases - has been reduced as statutory work always comes first. SUs need be in receipt of an LA commissioned service or NHS secondary care before they can get issues-based advocacy. · Increased complexity causes settled cases to be visited less regularly as advocates now deal with more complex court proceedings and safeguarding issues. Increased caseloads - Social work / NHS overflow · Social work seems to be moving away from relationship-based practice to procedurally driven form-filling with advocates picking up some of this work instead. · “ Hold on, this is not actually my role” - Advocates are doing part of the social worker’s job because, for whatever reason, they are not able to. · There is a greater expectation of monitoring conditions done by the supervising body, when actually it’s not their role as an advocate, but it has become their role. · Less time for IMHA within hospitals as advocates now have little or no time to do it. Further reading – blogs: A blog for World Social Work Day (19/03/24) Further reading – reports: Recruitment and retention in adult social care Executive Summary. Bournemouth: NCCDSW, Bournemouth University. Recruitment and retention in adult social care. Bournemouth: NCCDSW, Bournemouth University. Further viewing: NIHR ARC Wessex Social Care Lunchtime Seminar – Realities of adult social care recruitment and retention in 2023 (18/01/24) Publications Full article: Advocacy in Practice: Who Advocates for the Advocates? Evolving Workplace: The Possible Impacts of Hybrid Working and Hotdesking on Retention of Social Workers | The British Journal of Social Work | Oxford Academic Full article: Impacts of Workplace Stress on the Retention of Social Workers: A Qualitative Study Full article: Struggling with studying and earning – realities of the UK's cost-of-living crisis on students on social work programmes

98ea6e39-72b8-439c-baa8-0843050c271b ADOPTED: SPLENDID Social Prescribing for people to Live ENjoyably with Dementia/memory problems In Daily life Research lead: Professor George Christopher Fox, University of East Anglia ARC Wessex team: Dr Euan Sadler, University of Southampton, Dr Katherine Bradbury, University of Southampton. Partner organisations: NHS Norfolk and Waveney CCG, University of Hull, University of Nottingham, University of Exeter, King's College London, University of Newcastle upon Tyne, Meaningful Measures Ltd. Start: 01/05/2022 End: 30/04/2027 What is the problem? Nearly one million people in the UK will be living with the affects of dementia by 2030 including poor well-being and quality of life. Social prescribing is a prescription of activities for a person to use to link with others and undertake something they might enjoy, this could be a walking or singing group, flower arranging class, visit to a museum or putting them in touch with other people to help them feel better. People meet with staff called Link- Workers, who have a conversation with them to help them think about what they enjoy and might help. The Link Worker might then introduce them to a group or activity or support them to find information to make links. Family members can be involved too. Research shows social prescribing has better effects than just taking medicine and is happening more often. This study (called SPLENDID) aims to understand how we ensure social prescribing is useful and helpful to people with dementia. What we will do SPLENDID researchers will talk with people with dementia, family carers and staff working in social prescribing to understand what people want, what works well and what could be improved. We will use this to design, with people with dementia, what looks like the best way for social prescribing with people with dementia. We will create some tools (online and face-to-face) to help workers and people with dementia talk and think together about what might help them. We will test it with a small group of people to see if it helps and look at what training Link- Workers need to offer the best support for people with dementia and their families. We then decide if this should be taken forward and tested in a larger study to see if it improves peoples’ well-being and is value for money. Working with patients and carers Our team met 8 people with dementia and 8 family carers to design this study. We have 2 co-researchers (Mr Rook and Mrs Bingham) who are living with dementia. 150 people with dementia were surveyed to see what social prescribing is currently being offered and found people were doing a range of outdoor and indoor activities, some with family which they enjoyed and found helpful. People with dementia and carers will be on our Committees, and several dementia charities support this work. Dissemination Our website will offer free resources put together with people with dementia and carers. Our findings will be shared locally and nationally using links we have with universities, clinical experts, press, social media, workshops with people who commission and provide. NIHR ARC East of England study site Publications Social prescribing for people living with dementia (PLWD) and their carers: what works, for whom, under what circumstances and why – protocol for a complex intervention systematic review | BMJ Open

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).

747d2c2b-5ef2-4aa3-91d2-49259acbc2a5 Refinement of an eFalls tool - a multivariable prediction model for the risk of ED attendance or in-hospital fall or fracture in individuals accessing mental health or learning disability services - eFalls Chief Investigators: Dr Luis Marino, South West Yorkshire Partnership NHS Foundation Trust Dr Stephen Lim, University of Southampton Co-investigators: Professor Andrew Clegg, ARC Yorkshire & Humber, University of Leeds Professor Sam Chamberlain, University of Southampton Professor Chris Kipps, University Hospital Southampton Start Date: 1st April 2025 End Date: 31st March 2026 Partners: University Hospital Southampton NHS Trust, South West Yorkshire Partnership NHS Foundation Trust, NIHR ARC Yorkshire & Humber, University of Leeds Our Research Falls have a significant impact on physical health with increased risk of morbidity including, dehydration, pain, chest infection and reduced ability to get on with daily activities of living. This may lead to reduced levels of activity, social isolation, depression and anxiety. Individuals with a mental health or learning disability diagnosis have an increased risk of falls. Although several falls screening tools are available, they usually need a healthcare professional to manually screen electronic health records, which may not always be done. Falls have a big impact on health and social care systems and is a leading reason for admission to hospital. Treatment for fractures also costs the NHS an estimated £4.5billion a year. This study aims to take an electronic tool (eFalls) which automatically predicts the risk of falls in older people (over the age of 65 years) and explore whether it accurately predicts the risk of falls in adults with a mental health or learning disability diagnosis. We will use routinely collected data from two health services covering the regions of West Yorkshire and Hampshire and Isle of Wight for this study. Data for patients aged 18 years and above with a known mental health diagnosis will be included in this study. We want to know whether this tool can be used to predict the falls risk among people living with mental health disorders or learning disability and how effective the tool is in predicting falls. If shown to be successful, we will share our findings with healthcare commissioners and policymakers and the following steps will be to pilot this tool in the healthcare setting to explore its impact on patient outcomes.

33e12535-88ee-441a-8d7b-06392d99b190 ADOPTED PROJECT: Understanding risk stratification of patients with chronic kidney disease (CKD) in primary care ADOPTED PROJECT: Understanding risk stratification of patients with chronic kidney disease (CKD) in primary care Principal Investigators: Professor Hazel Everitt , Head of the Primary Care Research Centre, Deputy Head of the School of Primary Care, Population Sciences and Medical Education at Southampton University and Deputy Academic Capacity Development Lead for the NIHR School of Primary Care Research. Dr Kristin Veighey , Academic Clinical Fellow in General Practice, and Honorary Senior Clinical Lecturer, University of Southampton. Co-Associate Director of the Southampton Academy of Research (SoAR). Team: Dr Simon Fraser Associate Professor of Public Health, and Consultant in Public Health Dr Kinda Ibrahim, is an Academic Pharmacist and Senior Lecturer within the Primary Care Research Centre at the University of Southampton. She is the deputy lead for the NIHR Applied Research Collaboration (ARC) Wessex Ageing and Dementia Theme and the Associate Director for career development Dr Emma Teasdale Research Psychologist and Qualitative Research Fellow in Primary Care Dr Michelle Myall, is a Senior Research and Implementation Fellow at NIHR Applied Research Collaboration (ARC) Wessex Kate Henegan-Sykes (co-applicant) is a member of the Primary Care Patient and Public Involvement and Engagement (PPIE) group Charles Pickering (collaborator) is a patient with chronic kidney disease. Starts: 01/12/2023 Ends: 30/11/2025 Funded by: NIHR School for Primary Care Research The kidneys are 2 small fist sized organs which sit in the back. Kidneys clean the blood. They take away extra water and waste and turn it into urine or ‘wee’. Chronic kidney disease (CKD) is a long-term condition. In CKD, the kidneys do not work as well. More than 1.8 million people in England are known to have CKD. It is thought there may be 1 million more who have not yet been diagnosed. This is because early CKD has no symptoms. So it's important to test for CKD in people who might have it. This includes people with diabetes, high blood pressure, and a family history of CKD. People with CKD are more likely to have, and die from, heart attacks and strokes. For a small group of people their CKD will get worse over time. This could mean that they need ‘renal replacement therapy’ (RRT). This is where a machine (dialysis) or a kidney transplant (someone else’s kidney put into them in an operation) does the job of the failed kidneys. This allows the person to survive. These treatments are very expensive. Along with transport to treatment centres they cost the NHS around £780m every year. Having CKD can also reduce a person’s quality of life. People who have, or might have, CKD should have the protein in their urine measured. This is a good way to see if kidneys are damaged. It can be used along with a blood test result to work out a ‘risk score’. This score can help to show which people are at most risk of their CKD getting worse. This means that they can be offered medicines and told about possible changes to their lifestyle and diet that might help reduce their risk. The score can also be used to reassure people who have a low risk. We want to understand why working out a person’s risk of CKD is not always done in general practice (GP) surgeries. To do this, we will first interview 20-30 GPs and practice nurses. These are the people who would do the risk scores for patients. They will come from GP practices across Wessex and Leeds. We will then hold 4-5 focus groups with GP practice teams, including GPs and nurses, but also pharmacists, practice managers, and reception/administration staff. We will ask them about how procedures could be improved to make sure CKD patients have their risk measured. This information will help us to work out how to improve the way that we measure risk in CKD.We will then plan a second study to test a new process. This new process will be developed from what we find out in this study.

55041d82-7430-4dcd-98fd-9bd97e850e1f COMPLETED: 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

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

d1fc46a9-cf57-4dda-98fb-a4ccb44fa87b FORTH – FORecasting Turbulence in Hospitals Chief Investigator: Edilson Arruda, Associate Professor, University of Southampton Team: Christine Currie University of Southampton Alexandra Hogan NHS Salisbury/ University of Southampton Jamie MacNamara University Hospital Southampton Mark Wright University Hospital Southampton Michael Boniface University of Southampton Carlos Lamas-Fernandez University of Southampton Partners: Salisbury Hospitals NHS Foundation Trust, University of Southapton, University Hospital NHS Foundation Trust. Start: 1 October 2024 End: 31 March 2026 Summary Over time, health systems face changes. Population grows older or hospitals can perform new treatments. It is difficult to match the resources of hospitals with population needs. If they do not match, waiting times for treatment increase and hospitals become fuller. Hospitals being too full can result in worse care for patients. For example, hospitals might need to cancel surgeries. Aim(s) of the research When the usual demand for hospital resources changes, it becomes difficult for hospitals to provide care. We call this turbulence. Our first objective is to define how turbulence can be measured from data. Then, we will use artificial intelligence to understand the causes of turbulence. We will also create models for short-term prediction of turbulence. This will help hospital plan better. Design and methods used This project will look at the records of patients in hospitals to understand what resources they use. The data will give us an understanding of how long certain activities take. For example, the recovery from surgery. We will predict when these times are changing using artificial intelligence. This can help hospitals be alert of upcoming changes, so they choose the best way to react. Patient, public and community involvement (PPCI) We will engage with the views of public, patients and communities during the project execution phase. We will hold workshops with patient groups that have been to hospital. We will understand their views on the planning services. We will also take into account their ideas when defining turbulence. Dissemination This project was co-designed and will be supported by University Hospital Southampton (UHS) and Salisbury Hospital. The results will be disseminated and championed within the partnering institutions, and further presented in workshops involving neighbouring NHS Trusts in Wessex and in the south east and south west of England. We will also publish papers and reports to disseminate the work to a larger audience within the UK and internationally.