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6b068013-6ee6-484b-88bf-12a053cec877 Wessex SNSDE Study (SETT Centre) Project lead: Professor Chris Kipps, University Hospital Southampton NHS Foundation Trust Development and Testing of Collaborative Data Science Approaches with the Southampton Emerging Therapies and Technologies Centre and the Wessex Secure Data Environment The Southampton Emerging Therapies and Technologies (SETT) Centre, in partnership with NIHR ARC Wessex, has awarded support to four early-stage data science projects. This is a collaborative initiative to develop and test data science approaches addressing compound pressures across health and care systems. The project aims to build analytic capacity by bringing together clinical, academic, and data science expertise from University Hospital Southampton (UHS), the University of Southampton, and other regional partners with a focus on 4 use cases. Central to this work is the Wessex Secure Data Environment (SDE), part of a national programme to provide safe, secure access to clinical data. The SETT data team curates and onboards health data into the SDE, enabling secure and effective data analysis. Substance Use Disorder: Analysing electronic health records to understand how substance use impacts hospital services and to inform more effective interventions. Neurocritical Blood Pressure Control: Comparing the effectiveness of two drugs (labetalol and nicardipine) in managing blood pressure in very unwell patients, with a focus on clinical outcomes and resource efficiency. Liver Monitoring in IBD: Assessing liver function test monitoring in patients with inflammatory bowel disease (IBD) to improve early detection of liver disease and clinical pathways. Digital Tools for Rare Liver Disease: Evaluating how digital tools can improve care and screening for primary sclerosing cholangitis (PSC), a rare and progressive liver disease. This initiative has a focus on improvements in patient care and resource efficiency, while also building data science capacity to enable innovation in health and care delivery.

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.

d94081d4-7fee-46f1-acf1-61bd1a5364fc Understanding barriers and enablers of using the Living with Long Term Conditions scale as part of routine care for people from under-served groups living with type 2 diabetes Chief investigator: Dr Leire Ambrosio, Lecturer, School of Health Sciences, University of Southampton. Team: Professor Mari Carmen Portillo, School of Health Sciences, University of Southampton Dr Lindsey Cherry, School of Health Sciences, University of Southampton Dr Kinda lbrahim, Associate Professor, Faculty of Medicine. University of Southampton Dr Michelle Myall, Principle Researcher, School of Health Sciences, University of Southampton Ms Rashmi Kumar, PPI representative Partners: Ha mpshire and Isle of Wight Integrated Care Board, Hampshire and Isle of Wight NHS Foundation Trust, University of Southampton, Diabetes UK, SO:Linked (Southampton Voluntary Services). Started: 1 October 2024 End: 31 March 2026 Why is this research important? In the England over 15 million people are living with at least one long-term conditions (LTC). People from under-served groups, are at greater risk of having one or more than one LTCs. This not only affects a person’s physical health, but other aspects of their lives, such as emotional, cultural, and socio-economic wellbeing. It is key for healthcare professionals, to understand and assess how a person is living with an LTC to provide person-centred care. We recently developed the Living with Long Term Conditions (LwLTCs) scale for English-speaking populations. This is a person-centred questionnaire to evaluate how well a person lives with a long-term condition, to inform care for people based on their individual needs. What we found We found that adults with LTCS face a "daily burden" because their symptoms fluctuate unpredictably, often leading to social isolation and a feeling of being "left behind" by a fragmented healthcare system. While both Adults and Healthcare Professionals felt the LwLTC scale is a valuable "communication bridge" that can highlight hidden mental health and social struggles, some barriers remain. For the tool to work in real life, it must be flexible—offering paper and digital versions or help from a staff member—rather than being a "one-size-fits-all" tick-box exercise. Ultimately, the findings show that while the scale helps make invisible struggles visible, its success depends on building trust, ensuring cultural sensitivity, and making sure that the information gathered actually leads to obvious changes in a patient's care. What we did with the new Knowledge By discovering the deep emotional and physical challenges real people face, we are supporting patients with LTCs to have a voice in their own care. We used this new knowledge to help the healthcare system move toward truly individualised and flexible care by highlighting that the scale works best as a "communication bridge" to uncover invisible mental health and social struggles. Our findings will help NHS move away from generic digital pathways by advocating for a "digital-choice" framework that offers paper, Braille, or face-to-face assistance for those who need it. By collaborating across the SCALE project, we are discovering how to build trust with underserved communities and ensuring the care system respects the "real-life" expertise of the patient. Where next? Building on these findings, we view this not as a conclusion but as a vital first step toward transforming how the NHS handles LTC care. A major next step is addressing the "readiness gap" in current practice by developing formal guidelines for facilitated engagement, where staff are trained to help patients navigate the tool face-to-face to prevent digital exclusion. We plan to take these learnings further by advocating for the scale to be used over time to track a person's health journey, rather than relying on a single snapshot. While it remains a struggle to shift traditional clinical systems away from rigid pathways, these findings create a sense of urgency: if we do not adopt these flexible, person-centered tools, we risk leaving the most vulnerable patients with LTCs far behind.

Clare Phillips - Hepatology Nurse Specialist, MSc Global Health < Back My journey into research My interest in research came as a bit of a surprise. Clare Phillips - Hepatology Nurse Specialist, MSc Global Health My interest in research came as a bit of a surprise. In 2016, I started an MSc in Global Health part-time at BSMS. I had previously completed the Diploma of Tropical Nursing at London School of Health and Tropical Medicine and was working as a clinical nurse specialist in viral hepatitis at the time. I started the MSc thinking I’d be more interested in the policy side of the course or, where it might take me from a clinical perspective. But, it was working with Prof Gail Davey’s research group, for my MSc dissertation, that was the game changer. Prof Davey’s work in Ethiopia had shed light on the neglected tropical disease, podoconiosis , in quite a remarkable way - improving care for those living with the condition, giving a voice to the seldom heard, influencing national policy, challenging stigmatising attitudes and building research capacity (across disciplines) within Ethiopia. It was hugely inspiring and a clear example of how research had enormous scope to influence change. Having completed my MSc, I began voluntarily joining various research projects that were going on at work – collecting data for some, writing manuscripts for others. This helped me build my CV and confirmed that a career in research was right for me. I moved back to Southampton in summer 2019 and began working for the Alcohol Care Team at University Hospital Southampton. Inadvertently, I stepped into a research-focused team, who wanted to use research to make a difference to our patient group. And it made all the difference. In 2021, with my manger, Anya Farmbrough, and Richard Darch from Adult Safeguarding, I wrote a paper challenging perceptions of self-neglect in patients with alcohol use disorder ( More than a ‘lifestyle’ choice? Does a patient's use of alcohol affect professionals' perceptions of harm and safeguarding responsibilities when it comes to self-neglect? A case study in alcohol-related liver disease | Gastrointestinal Nursing ( magonlinelibrary.com ) ). With support from Anya and our medical lead, Prof Julia Sinclair, I applied for the ARC Wessex Mental Health (Alcohol) Internship in 2022. My internship focused on older adults with alcohol use disorder (AUD), analysing some pre-collected service evaluation data and working on a systematic review of AUD interventions in this cohort. The internship gave me the time (and funds) to focus on developing gaps in my skillset e.g. I took an online statistics course and had the opportunity to work 1:1 with the ARC statistician to refresh my statistics skills. I am not sure how or when I would have been able to do this without the internship. The internship also provided opportunities to present my work, from academic conferences to departmental meetings and PPI groups. This allowed me to get familiar with answering direct questions about my research, and how to deal with the trickier ones! As a result of the ARC Wessex Internship, I had 2 abstracts accepted at national conferences this year ( 1586 OLDER AGE IS AN IMPORTANT PREDICTOR OF NON-REFERRAL TO COMMUNITY ALCOHOL SERVICES FOLLOWING AN INPATIENT EPISODE: FINDINGS FROM | Age and Ageing | Oxford Academic ( oup.com ) , P28 Mortality and cause of death in patients aged 50–59, 12 months after review by an alcohol care team | Gut ( bmj.com ) ). The internship also got me thinking about my next steps and enabled some key conversations to take place. I am certain my future career is a research-focused one and am currently working on my application for Round 11 of the NIHR Doctoral Fellowship programme. I have an important research question that needs answering, and so its full steam ahead! More about Clare Previous Next

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

de23ed25-467a-496e-b29a-68a949839608 ADOPTED: FLOWS Planning for Frailty: Optimal Health and Social Care Workforce Organisation Using Demand-led Simulation Modelling Principal Investigator: Dr Bronagh Walsh, Associate Professor, School of Health Sciences, University of Southampton. Team: Professor Peter Griffiths , School of Health Sciences, University of Southampton: Dr Carole Fogg, School of Health Sciences, University of Southampton: Mr Mike Hepburn, Southampton Business School, University of Southampton: Dr Abigail Barkham, Southern Health NHS Foundation Trust: Honorary Professor Martin Vernon, Tameside and Glossop Integrated Care NHS Foundation Trust: Professor Lee-Ann Fenge, Department of Social Work and Social Sciences, Bournemouth University: Professor Jane Ball, School of Health Sciences, University of Southampton: Professor Sally Brailsford, Southampton Business School, University of Southampton: Ms Francesca Lambert, PPI lead, School of Health Sciences, University of Southampton. Start: 01/11/2022 End: 31/10/2025 Background: As the population ages, robust workforce planning to meet future demands for health and social care by older people is needed. A lack of evidence in this area has led to a mis-match between the health and social care demand from the ageing population and the current workforce capacity. The proposed study will use demand-led simulation modelling of the workforce required to address the specific challenge of providing health and social care for the growing numbers of older people living with frailty. Aims & Objectives: The aim of the study is to use simulation modelling to explore long-term trends in frailty-related health and social care use in the ageing population and its implications for future workforce size and competencies to support high quality care. The primary objective of this study is the creation of a simulation model that will inform service and workforce planning to meet health and social care needs associated with frailty. Methods: The study will use a System Dynamics design to develop and test the simulation model. Work packages comprise a scoping review, gathering of public and professional perspectives on service provision via a survey and stakeholder engagement activities, and analysis of linked health and social care data, all of which inform the simulation modelling work package and development of a workforce planning toolkit. Timelines for delivery: The scoping review will be completed in year 1. Routine health and social care data specification and extraction will occur in year 1, as will service mapping and classification and survey preparation. Survey data collection and analysis will occur in year 2. Simulation modelling will commence in year 2, with validation, sensitivity analyses and scenario modelling in year 3. Development of workforce guidelines and toolkit will occur in. year 3 Stakeholder engagement, including patient public involvement, will run throughout the study, reviewing study results and informing development of the other work packages. Anticipated impact & dissemination: This study will provide new, direct evidence about the impact of frailty on health and social care workforce requirements within the ageing population The improved understanding of workforce requirements offered by this study will inform workforce planning for frailty services across health and social care, ensuring future benefit for patients through provision of timely and appropriate care and a workforce planning toolkit to support local decision-making.

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

3ace18ec-d7ab-47b5-898a-8030d0eb53f7 POST DOCTORAL PROJECT: Early detection of chronic liver disease in community settings Chief Investigator: Dr Kate Glyn-Owen – University of Southampton Project Team Members: Julie Parkes – University of Southampton, Dr Richard Aspinall – Portsmouth University Hospitals NHS Trust Organisations Involved: British Liver Trust, Portsmouth Football Club (Pompey In The Community), Portsmouth City Council public health team Background: Liver disease is the third biggest cause of early death in the UK. Two of the main causes of liver disease are drinking too much alcohol, which directly damages the liver, and being overweight, which can lead to fat building up in the liver and causing damage. If liver disease is detected early, it is possible to prevent disease progression, and in some cases to reverse damage done. This benefits patients and reduces impact on the healthcare system. The best way to detect liver disease early is not known. Tests and risk scores are available which use a simple blood test and information about the patient. These were developed in hospital settings, for people with known liver disease. They have not been used sufficiently in general population settings and we do not know how good they are at detecting liver disease in these settings. This project is investigating how these tests and scores perform in general population settings, using data from the UK Biobank, a big dataset from general population volunteers. We are exploring whether combining tests/scores with information about people’s risk factors, may improve detection of disease.We are going out to community settings, performing a risk assessment and simple scan for liver disease in populations at high risk. We are working with Portsmouth Football Club, the British Liver Trust and Portsmouth City Council public health team, to target populations at risk and to find out how effective we can be at early detection of disease in these settings.

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

8d9b12a7-5110-4e7e-9e3b-5c358feb6e17 ADOPTED PROJECT: Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) ADOPTED PROJECT: Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) Start date: 1st June 2022 End date: 28th Feb 2025 Contact: s.fraser@soton.ac.uk - link to southampton site listing Lay summary: A growing number of people are living with several long-term health conditions like diabetes, heart disease, depression or dementia. We call this multiple long-term condition multimorbidity (MLTC-M). Many things throughout a person’s life influence the chances of developing health conditions. This includes their biology (e.g. age, ethnicity), things that happen to them (e.g. infections, accidents), behaviours (e.g. smoking, diet) and broader experiences (e.g. the environment people grew up in, their education, work, income). People from more disadvantaged backgrounds and/or certain ethnicities are more likely to develop MLTC-M and to develop it earlier. The impact (or ‘burden’) of MLTC-M, and the order that people develop conditions, also vary. Our research will help understand when MLCT-M becomes ‘burdensome’ and the best opportunities for intervention. Aim To use an Artificial Intelligence (AI) enhanced analysis of birth cohort data and electronic health records to identify lifecourse time points and targets for the prevention of early-onset, burdensome MLTC-M. Plan To achieve this aim, our study is composed of five work packages: Undertake a qualitative evidence synthesis and a consensus study (Delphi) to develop deeper understanding of what ‘burdensomeness’ and ‘complexity’ mean to people living with early-onset (by age 65) MLTC-M, carers and healthcare professionals Develop a safe data environments and readiness for AI analyses across large, representative routine healthcare datasets and birth cohorts. In those safe data environments, using the WP1 burdensomeness/complexity indicators and applying AI methods, identify novel early-onset, burdensome MLTC-M clusters. Also in this work package, we will match individuals in birth cohorts into routine data MLTC-M clusters and then identify determinants of burdensome clusters and model trajectories of long-term conditions (LTCs) and burden accrual. By characterising clusters of early-life (pre-birth to 18 years) risk factors for early-onset, burdensome MLTC-M and sentinel conditions (the first LTC to occur in the lifecourse), we will define population groups in early life at risk of future MLTC-M, identify critical time points and targets for prevention, and model counterfactual prevention scenarios of interventions acting on combined risk factors at key timepoints. Engage key stakeholders to prioritise timepoints and targets to prevent/delay specified sentinel conditions and early-onset, burdensome MLTC-M. Partnering with our PPI Advisory Board, and through further stakeholder engagement, we will co-produce public health implementation recommendations Impact We will work with our stakeholders to use the findings from our research to influence policy and practice, and to co-produce public health advice, on preventing burdensome MLTC-M. Team: Nisreen A Alwan Associate Professor in Public Health (University of Southampton), Ashley Akbari Senior Research Manager (Swansea University) Mark Ashworth Reader in Primary Care (King’s College London), Ann Berrington Professor of Demography and Social Statistics (University of Southampton), Michael Boniface Professorial Fellow of Information Systems (University of Southampton), Jessica Enright Senior Lecturer in Computing Science (University of Glasgow), Nick Francis Professor of Primary Care Research (University of Southampton), Simon DS Fraser Associate Professor of Public Health (University of Southampton), Martin Gulliford Professor of Public Health (King’s College London), Emilia Holland Specialty Registrar in Public Health/Visiting Academic (University of Southampton), Rebecca Hoyle Professor of Applied Mathematics (University of Southampton), Sara Macdonald Professor of General Practice and Primary Care (University of Glasgow), Frances MairNorie Miller Professor of General Practice (University of Glasgow), Rhiannon Owen Associate Professor, Health Data Science (Swansea University), Shantini Paranjothy Professor and Clinical Chair in Public Health (University of Aberdeen), Ruben Sanchez-Garcia Associate Professor of Pure and Applied Mathematics (University of Southampton), Sebastian Stannard PhD student in Demography and Social Statistics, Becky Wilkinson Consultant in Public Health (Southampton City Council), Zlatko ZlatevSenior Enterprise Fellow, Electronics & Computer Science (University of Southampton) Publications Cohort profile: creation of the SAIL MELD-B e-cohort (SMC) and SAIL MELD-B children and young adult e-cohort (SMYC) to investigate the lived experience of the ‘burdensomeness’ of multimorbidity | BMJ Open The impact of living with multiple long-term conditions (multimorbidity) on everyday life – a qualitative evidence synthesis | BMC Public Health | Full Text Mapping domains of early life determinants of future multimorbidity across three UK longitudinal cohort studies | Scientific Reports Risk factors for ill health: How do we specify what is ‘modifiable’? | PLOS Global Public Health A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity - Sebastian Stannard, Ann Berrington, Shantini Paranjothy, Rhiannon Owen, Simon Fraser, Rebecca Hoyle, Michael Boniface, Becky Wilkinson, Ashley Akbari, Sophia Batchelor, William Jones, Mark Ashworth, Jack Welch, Frances S Mair, Nisreen A Alwan, 2023

< 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

54d3d6a4-2f97-4fa8-8c83-e41613f3b35d Co-POWeR - Consortium on Practices of Wellbeing and Resilience in BAME Families and Communities Principal Investigator: Professor Iyiola Solanke, University of Leeds Team: Professor Maria Stokes, School of Health Sciences, University of Southampton; Professor Sabu Padmadas, School of Economic, Social & Political Sciences, University of Southampton; Professor Monica Lakhanpaul, Institute of Child Health, University College London; Professor Claudia Bernard, Professor of Social Work. Department Social, Therapeutic and Community Studies, Goldsmiths College; Professor Shirin Rai, Politics and International Studies, University of Warwick; Professor Raminder Kaur, School of Global Studies, University of Sussex; Professor Gargi Bhattacharyya, Law and Social Sciences, University of East London; Professor Florence Ayisi, Faculty of Creative Industries, University of South Wales; Professor Anna Gupta, Department of Social Work, Royal Holloway, University of London. Duration: 18 months Summary Two viruses - COVID-19 and discrimination - are currently killing in the UK (Solanke 2020), especially within BAMEFC who are hardest hit. Survivors face ongoing damage to wellbeing and resilience, in terms of physical and mental health as well as social, cultural and economic (non-medical) consequences. Psychosocial (ADCS 2020; The Children's Society 2020)/ physical trauma of those diseased and deceased, disproportionate job-loss (Hu 2020) multigenerational housing, disrupted care chains (Rai 2016) lack of access to culture, education and exercise, poor nutrition, 'over-policing' (BigBrotherWatch 2020) hit BAMEFC severely. Local 'lockdowns' illustrate how easily BAMEFC become subject to stigmatization and discrimination through 'mis-infodemics' (IOM 2020). The impact of these viruses cause long-term poor outcomes. While systemic deficiencies have stimulated BAMEFC agency, producing solidarity under emergency, BAMEFC vulnerability remains, requiring official support. The issues are complex thus we focus on the interlinked and 'intersectional nature of forms of exclusion and disadvantage', operationalised through the idea of a 'cycle of wellbeing and resilience' (CWAR) which recognises how COVID-19 places significant stress upon BAMEFC structures and the impact of COVID-19 and discrimination on different BAMEFC cohorts across the UK, in whose lives existing health inequalities are compounded by a myriad of structural inequalities. Given the prevalence of multi-generational households, BAMEFC are likely to experience these as a complex of jostling over-lapping stressors: over-policed unemployed young adults are more likely to live with keyworkers using public transport to attend jobs in the front line, serving elders as formal/informal carers, neglecting their health thus exacerbating co-morbidities and struggling to feed children who are unable to attend school, resulting in nutritional and digital deprivation. Historical research shows race/class dimensions to national emergencies (e.g. Hurricane Katrina) but most research focuses on the COVID-19 experience of white families/communities. Co-POWeR recommendations will emerge from culturally and racially sensitive social science research on wellbeing and resilience providing context as an essential strand for the success of biomedical and policy interventions (e.g. vaccines, mass testing). We will enhance official decision making through strengthening cultural competence in ongoing responses to COVID-19 thereby maximizing success of national strategy. Evidenced recommendations will enable official mitigation of disproportionate damage to wellbeing and resilience in BAMEFC. Empowerment is a core consortium value. Supporting UKRI goals for an inclusive research culture, we promote co-design and co-production to create a multi-disciplinary BAME research community spanning multi-cultural UK to inform policy. CO-POWeR investigates the synergistic effect on different age groups of challenges including policing, child welfare, caring and physical activity and nutrition. WP1 Emergency Powers investigates these vague powers to understand their impact on practices of wellbeing and resilience across BAMEFC. WP2 Children, Young People and their Families investigates implications for children/young people in BAMEFC who experience COVID-19 negatively due to disproportionate socio-economic and psychosocial impacts on their families and communities. WP3 Care, Caring and Carers investigates the interaction of care, caring and carers within BAMEFC to identify how to increase the wellbeing and resilience of older people, and paid and unpaid carers. WP4 Physical Activity and Nutrition investigates improving resilience and wellbeing by tackling vulnerability to underlying health conditions in BAMEFC. WP5 Empowering BAMEFC through Positive Narratives channels research from WP1-4 to coproduce fiction and non-fiction materials tackling the vulnerability of BAMEFC to 'misinfodemics'.