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Nestor Serrano-Fuentes RN, PhD student and Research assistant for the Long-Term Conditions Research Group, Health Sciences, University of Southampton < Back Traveling back in time: exploring the Netley Red Cross Hospital during World War I Nestor Serrano-Fuentes Nestor Serrano-Fuentes RN, PhD student and Research assistant for the Long-Term Conditions Research Group, Health Sciences, University of Southampton November is remembered as the month in which the First World War ended; a time to remember our loved ones who fell in battle. Between 1914 and 1918, many stories unfolded: stories of life, death, love, births, feelings and emotions. Those feelings flourish today when walking through the green park and woodland at Netley on the Southampton shoreline. I look at the sea, that little orange chapel in the middle of the great esplanade, I close my eyes and visualise the protagonists of this story, talking among themselves, laughing, shouting, touching and hugging… My name is Nestor, I am a young man, nurse and researcher at the University of Southampton. Two years ago, while running on a cold winter morning along the south coast at Netley, something drew my attention. What was a lonely chapel doing here? I stopped to read some information panels and discovered that, in that place had been the Netley Hospital or Royal Victoria Hospital. According to some books, this was the largest British military hospital of all time. Furthermore, with the arrival of the war-wounded its capacity grew yet further Leading to the building of the British Red Cross Hospital just behind the main building and the recruitment of volunteers in the UK and overseas. Netley Hospital in 1918 Sister Harvey and some of the patients from 41 Hut A Japanese nurse who worked at Netley in 1918 - unnamed I needed more information and began to browse the historical archives online. Later I came across a treasure; The Netley British Red Cross Magazine . It was December and I was combing the historical archives in Winchester and there in my hands were prints of those magazines from 1918. They were filled with poems written by soldiers and nurses, cartoons, real photos and countless stories told in the first person. A few days later, I phoned my friend Elena Andina, lecturer of nursing at the University of Leon (Spain). She is a dreamer, humanist, and a person with whom I share a passion for the history of the nursing profession. I said: “You’re not going to believe what I have found! We’ve got some work to do!” We decided to read those six issues of the magazine. We were filled with great affection for the people and stories. We set about starting to analyse and contextualise the data and information, and began to write an article on the history of nursing telling the story of how care was delivered to soldiers during World War I. We were so lucky, it was like travelling in a time machine, an incomparable feeling. After a first analysis, we realised that there was a relationship between what was happening at Netley and the revolutionary thinking and ideas of Florence Nightingale, who is considered the creator of modern nursing. The focus on the environment on care - sunlight, humidity, fresh air, silence during a night shift, empathy, the smallest details that nurses took care of, such as the size of pyjamas for their patients, the use of small boats as a source of leisure for patients and nurses, are just some of the aspects that we glimpsed between those pages. Throughout history, wars and pandemics have shaped and changed the way nursing care has been delivered. If we look back, many of the measures that were applied we continue to use today. During this covid19 pandemic, the importance of open spaces and physical spaces between people, fresh air or sunlight are the same – echoes of the voices speaking from the pages of the Netley magazines in 1918. They say history tends to repeat itself, for better or for worse. What can we learn from it? Let us continue to lovingly preserve it and keep it in mind to acknowledge our ancestors and as inspiration in the search for current and future answers. Nestor Exploring The Netley British Red Cross Magazine: An example of the development of nursing and patient care during the First World War - Nestor Serrano-Fuentes& Elena Andina-Diaz (download below) serranoandina_2020_netley-hospital .pdf Download PDF • 768KB Elena Andina-Diaz - co-researcher Previous Next

93e2e1bd-cd98-479a-93a0-a105e734b0c3 ADOPTED: 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 Lead research ers: Ms Ruth Halkon and Dr Michael Skidmore, The Police Foundation; Professor Mark Button, Director of the Centre for Cybercrime and Economic Crime, University of Portsmouth; Dr Amy Meenaghan, School of Criminology and Criminal Justice, University of Portsmouth. Aims We aim to help the police find those who are most likely to suffer the worst damage to their mental and physical health from falling victim to fraud and make sure they receive the support they need to prevent that damage happening. Background Fraud is the most common and fastest growing crime in England and Wales. Many people do not report fraud and those who do often don’t receive help to reduce the crime's impact on their wellbeing. People affected by fraud can suffer serious physical and mental health problems which can lead to poor physical health, anxiety, depression and suicide. Many factors can shape how victims are affected: stress caused by losing what to them are big sums of money feeling betrayed by someone they thought was their friend or partner blaming themselves feeling friends, family and service providers do not understand them struggling to recover due to existing social or health needs. The police know less about the needs of fraud victims than victims of other crimes like domestic abuse. They are under pressure to improve the service they offer but there are many gaps: Fraud is common crime and can affect victims in many ways, which hinders finding victims who need the most support Those police think are most likely to be harmed, known as ‘vulnerable’, may not suffer the worst effects It is not clear what being 'vulnerable' in a crime context actually means Current systems to address 'vulnerability' mainly focus on cutting crime rather than victim health Research by Which? suggests the impact of fraud on victims' wellbeing amounts to £9.3bn, but we need more data Design and methods Our research will focus on two police forces who work jointly to provide support to victims which is widely seen as the best in the country. The project will focus on their systems, data and services to measure their success and produce a case study for understanding and addressing fraud's health impacts. This will be done via: Reading research papers to find out more about fraud victim impact, vulnerability and victim needs Looking at police and health and welfare data to learn about health impacts of different fraud types Talking to those working for the police, social services, victim support services and key health services Interviews with national subject matter experts Interviews with fraud victims who have been given support after fraud impacted their health to learn how this helped them Patient and public involvement Our overall aim is to involve fraud victims in finding a support framework that works for them Dissemination The report will be launched at an event and published on the Police Foundation website. It will be promoted on our blog, newsletter and social media channels. This fact finding project is a first step to creating a new framework that will be used to find those who need the most help to stop their mental and physical health being badly hit and make sure they are given it. The future project would involve: Organising roundtable events with people Bringing police, health and welfare services together to trial the framework Sharing findings and learning points across the country

18fd758f-b147-4294-acb1-07c88dc1baa9 PUNDIT – Predicting hospital Usage Numbers via a DIgital Twin Principal Investigator: Dr Carlos Lamas-Fernandez , Associate Professor in Business Analytics/ Management Science in Southampton Business School / Faculty of Social Sciences, University of Southampton. Team : Professor Christine Currie , School of Mathematics, Faculty of Social Sciences, University of Southampton. Dr Dan Burns , Innovation Centre, Electronics & Computer Science, University of Southampton. Dr Chris Duckworth , Innovation Centre, Electronics & Computer Science, University of Southampton. Professor Michael Boniface , I nnovation Centre, Electronics & Computer Science, University of Southampton. Professor Peter Griffiths , School of Health Sciences, University of Southampton. Dr Mark Wright , University Hospital Southampton NHS Foundation Trust. Starts: 1 April, 2024 Ends : 30 September 2024 Summary Hospitals in the UK are in crisis with high levels of occupancy. The percentage of occupancy in England during July-September was 88%, and in UHS it reached 92.2% . These levels exceed the safety threshold for hospital occupancy, which sits at around 85%. Together with difficulties to ensure a smooth patient flow across the hospital, this results in adverse effects for patients: elongated hospital stays, increasing the backlog of elective procedures, increasing delays in ambulance handovers and increased mortality. In practice, hospitals try and control high occupancy levels by certain interventions, such as dedicated discharge teams, re-scheduling or cancelling elective procedures or repurposing hospital wards. These measures, however, are reactive, i.e. when the occupancy is already reaching unsafe levels, rather than proactive, that is, when anticipating a high occupancy in the near future. Further, it is not clear whether occupancy levels have an effect on treatment and discharge times, but from frontline clinicians at UHS, there is the hypothesis that higher occupancy could make them longer (as clinicians are busier prioritising the sick over the well patients who could go home), compounding the occupancy issues. Higher occupancy also decreases likelihood of patients being in the optimal location. A related research project (PROCED) has shown early evidence that frequent ward/team changes increase delays in patient discharge. The aim of this project is to investigate the feasibility and build the foundations of a simulation model that can predict accurately future, short-term, hospital bed occupancy to inform interventions. The project will have a special focus on investigating the feasibility of a model to be tailored to use in practice as a “Digital Twin” (DT), which can anticipate hospital occupancy under different scenarios, some of which can reflect proposed interventions.

Welcome ARC Wessex ran from October 2019 until March 31st 2026 - This is our legacy website The new ARC Wessex will run from 1 April 2026 until March 31st 2031 - It's website is here Over the six and a half years ARC Wessex managed to leverage £** Million in addition to the initial £14 Million awarded by the National Institute for Health and Care Research You can read about it's research impact here

Knowledge Mobilisation What is Knowledge Mobilisation (KM)? "It's about getting the right information to the right people in the right format at the right time - by actively collaborating" 1/6 These web pages are here to help share the learning our Knowledge Mobilisation Fellows are accumulating through our ARC Wessex Knowledge Mobilisation (KM) Programme. We will be developing this page into a hub of resources. Please get in touch with any questions and share your thoughts about KM via this email Click to jump to the section you want on this page KM Fellows - This is us KM Resources (in development) KM Action Learning Projects As part of a £7.8 Million investment from the NIHR in October 2024, ARC Wessex appointed a Knowledge Mobilisation team including four KM Fellows. ARC Wessex worked with Hampshire & Isle of Wight (HIoW) and Dorset Integrated Care Boards, provider organisations and Health Innovation Wessex to create a programme directly relevant to needs of patients, service users, carers and health and care systems. The programme is supported by an advisory group of stakeholders, which meets regularly and monitors the delivery of the programme’s objectives: Develop the capability of the KM fellows through increased awareness of training needs and tailored capability development programmes Deliver multiple Action Learning Projects to capture insights about KM practices and learning about what works or does not work to share more widely Develop a cohort of KM Practitioners across Wessex to support capability and capacity building with our partners and systems Actively contribute to ARC Greater Manchester national meetings and Communities of Practice to work in partnership cross-ARCs. This is us Knowledge Mobilisation Fellows Phillipa Darnton is our Implementation and Knowledge Mobilisation Lead Rachel Tobin is our Knowledge Mobilisation Programme Manager Email the team at: arcwessex@soton.ac.uk Download the Knowledge Mobilisation poster Dr Jenny Roddis is a Research Fellow and is an Associate Professor in Community Health at the University of Portsmouth Dr Nicola Andrews is a Research Fellow based in Southampton and is interested in care fo older people and frailty Dr Kate Lippiet is a Senior Research Fellow based in the School of Health Sciences, University of Southampton Mirembe Woodrow is a Senior Research Felloow in Public Health based at the School of Health Sciences, University of Southampton This is our resources and tools section We are busy creating lots of useful tools and resources for you to download and they will appear here as we develop them, so keep an eye out. Please share your thoughts of KM and/or sign up to the KM mailing list using this form Download If you like our KM umbrella above you can download the image here by clicking the box to the left Download Download - 6 Ideas about KM - Steps to Good Action Learning Projects The KM Fellows are ‘learning by doing’ and documenting their findings as Action Learning Projects. Each fellow has their own projects in which they are trialling different KM activities to learn about what works in which circumstances. This learning will help them to build KM capability and capacity within the ARC Wessex health and social care research system. Current Mental health: learning from providing support to the ARC Wessex Mental Health Hub to adopt knowledge mobilisation strategies for selected projects. Skills and knowledge: identifying the skills and knowledge needed for good knowledge mobilisation and developing a national framework for KM professionals and researchers. Co-producing clinical academic pathways in Dorset. Working with knowledge and information services across Wessex to develop a knowledge mobilisation community of practice Mapping what influences decision-making and use of evidence in residential care and home care. Supporting care home staff to understand the current evidence base on dehydration risk assessment and apply this to the care home setting, with development of resources to support staff in this setting undertake robust evidence reviews. Completed Working with Hampshire and Isle of Wight Integrated Care Partnership to develop and deliver a research assembly. Understanding research priorities for care home and home care providers in Wessex.

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.

Professor Lee-Ann Fenge - lfenge@bournemouth.ac.uk Dr Andy Pulman – apulman@bournemouth.ac.uk < Back Realities of adult social care recruitment and retention World Social Work Day 2024 Professor Lee-Ann Fenge - lfenge@bournemouth.ac.uk Dr Andy Pulman – apulman@bournemouth.ac.uk Social Work Week is an opportunity to celebrate the value that social work brings to society as well as acknowledging the challenges the profession faces. The theme of World Social Work Day is ‘Buen Vivir: shared Future for Transformative Change’, calling for social workers to adopt innovative, community-led approaches that are grounded in indigenous wisdom and harmonious coexistence with nature. This is an important focus as we recover in a post-COVID world, where budgets continue to be constrained and social workers increasingly draw on their creativity and innovative practice to provide excellent support for those they work with. To transform practice, it is important that we build an evidence base of what works and why, developing social work and social care research that evidences the value of the approaches taken. To date social work has lacked an established culture of research within social care organisations, resulting in limited high-quality research evidence alongside a limited culture of staff development focused on research opportunities. Practitioners may wish to develop a practitioner-researcher focus to their work, but this is often not supported or developed by their employer. This results in a missed opportunity to develop ground-up inclusive research practice driven by the insights and priorities of practitioners and service users which is essential to underpin high quality care. 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 all 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. One such project explored local recruitment and retention issues in adult social care (ASC) from the perspective of four populations of interest collecting data from n=131 participants across the four populations of interest: ( POI 1 ) Social care practitioners - social workers, allied health professionals, unregistered and other social care practitioners - currently working in adult social care at two local authorities (LAs) ( POI 2 ) Social care staff with responsibility for performing exit interviews with LA staff currently working at the two LAs ( POI 3 ) Students currently enrolled in social work undergraduate and postgraduate programmes within the Wessex region ( POI 4 ) Service users with lived experience of receiving services in either LA and advocates drawn from Wessex Region LA contracted services Realities of retention So what does our data tell us about the day-to-day realities of people currently working within adult social care? What pressures are they currently experiencing and what might make them question whether they want to stay working within the profession? Within POI 1, n=97 practitioners working in adult social care at two local authorities completed our online survey on recruitment and retention with n=25 subsequently being interviewed. We found: Within next three years, n=17 (17.5%) were planning on leaving social care Career change decisions included changing area of practice, independent working, moving sectors to the NHS/Third Sector and leaving the profession to go to other employment – the biggest response at n=7 (41.2%) The most important reasons for those wanting to leave social care within the next three years were ranked by number of responses and the highest ranked themes were then corroborated within the data collected from all participants as being ongoing issues of concern for LAs. Below we reflect on a number of the challenges, pressures and demands on ASC at the moment. Demands of administrative tasks Participants described support posts being reduced, causing them to spend more time on administerial processes. Additionally, more time-consuming paperwork was required and constantly changing processes created ongoing frustration. Workload demand The increasing demands on roles in terms of a rising number of cases within LAs and subsequent increased caseloads caused immense pressure on being able to process work in a timely manner. Inadequate staffing levels Staffing levels in some teams was not deemed to be adequate. Inadequate pay and benefits Pay was often equated to a lack of value in the profession when compared to other health professionals. Pay was viewed frequently as being less than equivalent to what could be obtained in the retail sector (with a view of that work also being less stressful in comparison). Concerns were also raised about the use of agency staff by LAs and the pay discrepancies between agency and permanent posts, alongside additional impacts on continuity and team stability. Perceived rationing of/limited resources for service users Struggles to provide adequate services to service users was a continual source of frustration in the face of current budgetary pressures. This could also be apposite to the personal ethics of working within the sector. Isolation/too much working from home The effects of hybrid working was viewed positively or negatively, depending upon the individual. Positives included the ability to concentrate more, better productivity with less interruptions and the inherent flexibility of choosing where and when an individual worked. Negatives included feelings of isolation and lack of support - a particular risk for new entrants. A lack of a team culture was also described in some cases. Additionally, management seemingly became more distant in some instances. Poor support and induction for newly qualified staff The induction process was viewed as being inconsistent across LAs. Providing initial support for new staff can be complicated by the effects of hybrid working, limiting support and team building opportunities for new entrants. Suggestions for improving consistency included mentoring, shadowing and standardising the structural induction process. Stress and COVID-19 burnout Stresses caused by working in the sector and lowered resilience over a prolonged period of time could contribute to burnout. Stress caused by the nature of the job was mentioned by a number of participants. COVID-19 and post pandemic effects contributing to stress were noted. This also impacted on staff working from home during and after this period. Stress was also caused by the ethical challenges of working within the constraints of the current social care system. Office environment/hot-desking issues As with hybrid working, both the pros and cons of attending the office were discussed by participants – with travel and parking costs described as factors which might influence office attendance. There was an acknowledgement that hub office space had been lost since the pandemic, which some thought had been detrimental. Both home and work environments had their supporters, depending on working preferences. For some, the office was preferred for providing deeper and broader opportunities for networking and helping to build a positive team culture. Open plan offices could be a problem due to their nature – be it issues of noise, a lack of privacy and storage space in some cases. Also a lack of locations to debrief or chat in private. Hot-desking could also prevent a team culture from developing. Next Steps Social Work England’s State of the Nation report (2023) suggested that high demand for health and care services, a rising complexity of needs and increases in vacancies continues to put pressure on a system that is already stretched. Workforce challenges around the recruitment and retention of staff alongside increased reliance on agency social workers constantly proves challenging for employers. Although social workers are adaptable and innovative in the ways they deliver social work, ultimately pressure in the system can undermine the stability of relationships which can have a direct bearing on people’s care (Social Work England, 2023). Similarly, Skills for Care (2021) concluded that a well-led, supported and developed ASC workforce were more likely to stay in post and deliver consistent, high quality, personalised care. Conversely, a workforce that was under-funded, under-developed, suffering from poor wellbeing and not supported to advocate for themselves and the people they cared for was likely to result in poor care or worse. Our research highlights that unless employers, and the government, recognise the current concerns of front-line practitioners, recruitment and retention will continue to be a challenge. Addressing these concerns, alongside wider consideration of career paths that may include the opportunity for research engagement for practitioners, is essential to stem the tide. Thanks to: The authors wish to thank all participants who took part in the online survey and gave up their time to be interviewed. This work was supported by the NIHR Applied Research Collaboration (ARC) Wessex More information on our project: Professor Lee-Ann Fenge - lfenge@bournemouth.ac.uk Dr Andy Pulman – apulman@bournemouth.ac.uk https://nccdsw.co.uk/clusters/research/building-research-capacity-in-social-care https://www.arc-wx.nihr.ac.uk/research-areas-list/social-care%3A-local-authority-adult-social-care-recruitment-and-retention-research-project Further viewing: Pulman, A. 2024. NIHR ARC Wessex Social Care Lunchtime Seminar – Realities of adult social care recruitment and retention in 2023 References: Pulman, A. and Fenge, L. A. (2023) Building Capacity for Social Care Research - Individual-Level and Organisational Barriers Facing Practitioners. The British Journal of Social Work. bcad117). Skills for Care. (2021). Evidence review and sector consultation to inform Skills for Care strategy: Final sector report. Available from: https://www.skillsforcare.org.uk/resources/documents/Adult-social-care-workforce-data/Evidence-review-and-consultation-analysis.pdf (accessed February 22, 2024). Social Work England (2023) Social work in England: State of the nation 2023. Available from: https://www.socialworkengland.org.uk/about/publications/social-work-in-england-state-of-the-nation/ (accessed February 29, 2024). Previous Next

Justin Strain < Back Thinker, sailor, author, physio Justin's journey so far.. Justin Strain Justin Strain I began my healthcare career a little later than most. At the age of thirty, after a short career in the Royal Navy, I took my first steps into the University of Southampton’s School of Health Professions. I was interested in research from day one. The importance of evidenced-based practice was drummed into us throughout our time at university. From the moment we first wielded a tendon hammer or a stethoscope we were encouraged to ask ourselves those all-important questions: What is the best treatment? Does it work? Why am I doing this? Starting out as a musculoskeletal physiotherapist, I threw myself into clinical practice, desperate to learn every treatment technique and test I could get my hands on. I believed that being a great clinician was about perfecting those tricky manual techniques and learning everything there was to know about anatomy. Or so I thought. Thinking differently Later, as I developed in confidence, I began to think differently about my practice. It seemed to me that what made most difference to my patients was the therapeutic relationship. Understanding the patient’s experience and learning to listen more and communicate better (and sometimes talk less!) started to seem more important than having the biggest toolbox of treatment techniques. Specialising in pain management helped me to appreciate how peoples’ experiences of health-conditions and healthcare were shaped by a complex web of social and personal interactions, making each person’s experience unique to them.The need to understand these unique experiences drew me to qualitative research. I wanted to go further than comparing different interventions. I wanted to understand the stories of the people at the heart of those interventions – our patients. The importance of narrative was not new to me. In my non-clinical life, I write children’s novels – I’ve written two so far and I’m working on a third. In my novel writing, I enjoy the magic of exploring fictional worlds from other peoples’ perspectives. I’ve always found that what brings a novel to life is the personal connection between the reader and the characters. I wanted to apply a similar approach to understanding patients’ stories - listening to, understanding and recording other peoples’ perspectives, and acknowledging the role of the researcher and the reader in interpreting those perspectives. While I was taking my first tentative steps towards qualitative research, the world of healthcare research was changing. The n=1 campaign was gathering momentum, and recognition of qualitative research was increasing. I wanted to get more involved, and found myself looking for the right opportunity. Then, at the beginning of 2020, the world turned upside down with the advent of the COVID 19 pandemic. Along with many other things, the COVID 19 situation has highlighted the need for research – to explore the impact of immediate responses to the crisis, and also to understand how the pandemic will influence longer term changes in how healthcare is delivered. One of those long-term changes is likely to be the proliferation of online healthcare. The plethora of online health interventions now on offer enables people to access consultations and courses that might previously not have been available to them, in a safe, socially distant way. I felt this area was worthy of more exploration, and I wanted to listen to the stories of service users, to understand how these changes had impacted on their experiences. I resolved to start a research project looking at patients’ experiences of online pain management in our own service, but I was struggling to find the time - alongside a busy job in clinical practice, dealing with redeployment and the current challenges of COVID 19, and being dad for our two wonderful children. The NIHR ARC Wessex Clinical Academic Internship has given me that time. It has enabled me to build and apply my skills in research as part of my clinical job, making a difference to how I can support patients within my service. So where am I now? I am in the early stages of my project – a systematic review of qualitative literature about patients’ experiences of online pain management, combined with semi-structured interviews with patients who have completed the online pain management programme within our own service.As well as time, the Clinical Academic Internship has provided a network of similarly minded people, interested in research and qualitative exploration of issues. The excellent events run by NIHR ARC Wessex have introduced me to new research concepts and skills. My supervisors, Dr Euan Sadler and Dr Lindsay Welch , have been extremely supportive and with their help my skills and confidence are growing. I am planning to complete my project in Autumn this year and I am hopeful that this will lead on to a pre-doctoral, and eventually a doctoral fellowship with NIHR ARC Wessex in the future. Dr Euan Sadler is an Associate Clinical Professor of Older People and Frailty within Health Sciences at the University of Southampton. Dr Lindsay Welch is a Lecturer in Adult Nursing and a Researcher in long term conditions. Previous Next

db9893e3-6d77-4b0c-aeda-4931a448eef5 A national evaluation of Project Cautioning And Relationship Abuse (‘CARA’) awareness raising workshops for first time offenders of domestic violence and abuse Health Inequalities National Priority Project in conjunction with ARC West, ARC NENC, ARC WM, ARC Y & H Principle Investigator: Dr Sara A Morgan , ARC Wessex, Lecturer in Public Health, School of Primary Care, Population Sciences and Medical Education Faculty of Medicine, University of Southampton Email: s.a.morgan@soton.ac.uk Publication: A national evaluation of Project Cautioning And Relationship Abuse (‘CARA’) awareness raising workshops for first time offenders of domestic violence and abuse: protocol for a concurrent mixed-methods evaluation design - read ARC North East and North Cumbria, Dr Steph Scott, NIHR ARC NENC Senior Research Fellow Email: steph.scott@newcastle.ac.uk ARC West, Dr Jessica Roy, Lecturer in Child and Family Welfare Email: jessica.roy@bristol.ac.uk ARC West Midlands, Professor Kate Jolly, Professor of Public Health & Primary Care Email: c.b.jolly@bham.ac.uk ARC Yorkshire and Humber, Professor Rachel Armitage, Professor of Criminology and Crime Prevention Background: Over one year, nearly 1,200,000 incidents relating to domestic violence and abuse (DVA) in England and Wales were documented by police, with almost half recorded as criminal offences [1]. DVA leads to an adversity package of poor health and social outcomes, such as alcohol misuse and poorer reproductive health. [2] Stakeholder consultation suggests that the criminal justice system (CJS) are struggling to constructively support victims, deter offenders or reduce reoffending, by means of an early intervention. Victims have voiced dissatisfaction and, collectively, professionals feel that they could do better. Furthermore, recent evidence suggests that COVID-19 has had a huge impact on the CJS, creating a backlog of up to 10 years. Hampshire Constabulary were ambitious to test an alternative response via an early intervention that would improve outcomes for victims and their families. Project CARA was developed in 2011 as a conditional caution offered by the police to first time adult offenders of DVA of standard risk. Offenders are required to undertake two mandatory workshops that increase awareness of their abusive behaviour and the safety of partners and children. In contrast to restorative justice, CARA is an awareness raising intervention for offenders, that utilises a trauma informed approach and motivational interviewing techniques across the pair of workshops. In these workshops offenders are further signposted onto services that support improvements in the wider determinants of their offending behaviour, such as to their GP, drug and alcohol services or onto a community perpetrator programme. An initial randomised controlled trial of CARA was undertaken in Southampton custody suite, showing a reduction in the frequency of re-arrest and prevalence of domestic abuse in the intervention arm, one year following randomisation. [3] Aims: Our aim is to evaluate the impact of Project CARA following its wider rollout nationally, including in Hampshire, Avon & Somerset, Dorset, West Midlands, Leicester, West Yorkshire, Cambridgeshire and Norfolk. This will be a mixed methods evaluation study over two years aimed at examining harm to victim and their families whose partners (or former partners) took part in CARA. Methodology: Currently 1500 offenders take part in the CARA intervention annually. Of these, approximately 50% of their victims are also engaged in the process. A longitudinal qualitative study (n=30) using thematic/inductive analysis will be undertaken with offenders and survivors to explore their perceptions and experiences of CARA [4]. This will be conducted at different time points (e.g. before and after CARA). Alongside this, interviews with police staff (n=20) will be conducted in order to explore the barriers and facilitators to implementation, and feasibility of rollout in further areas, and therefore sampling will be stratified to include wider areas that are not delivering CARA. The main quantitative outcomes will relate to reoffending of DVA. Using the IMPACT Toolkit questionnaire during victim contact, the safety of the victim will be assessed prior to completing and up to 3 months following the workshops [5]. This data will be triangulated with DVA reoffending data collected by the police, reporting incidents as suspects or charged. Alongside descriptive analysis of reoffending data nationally, the rates of DVA for eligible offenders will be compared retrospectively using historical data; between counties in the North East, where currently CARA is not being delivered, and at least two other counties including Hampshire and the West Midlands. Using regression adjustment of covariates, such as index multiple deprivation scores, the association of DVA reoffending across the two comparison groups will be examined alongside a time to first event analysis. Co Investigators: Professor Rachel Armitage Professor of Criminology and Crime Prevention School of Human and Health Sciences University of Huddersfield Huddersfield HD1 3DH Email: r.a.armitage@hud.ac.uk Dr Joht Singh Chandan, NIHR Academic Clinical Lecturer in Public Health, Murray Learning Centre University of Birmingham Edgbaston Birmingham B15 2TT Email: j.s.chandan.1@bham.ac.uk Dr David Culliford, Senior Medical Statistician NIHR CLAHRC Data Science Hub School of Health Sciences University of Southampton Southampton General Hospital (Room AA71, MP11) Southampton SO16 6YD Email: djc202@soton.ac.uk Dr Tracey Long, Professor in Health Economics and Outcome Measurements School of Health and Related Research 208, West Court 2 Mappin Street Sheffield S1 4DT Email: t.a.young@sheffield.ac.uk Mrs Fiona Maxwell Public Health Registrar, School of Primary Care, Population Sciences and Medical Education Faculty of Medicine, University of Southampton Email: f.maxwell@soton.ac.uk Dr Ruth McGovern, Lecturer in Public Health Research/NIHR Post Doctorate Fellow Population Health Sciences Institute, Newcastle University Baddiley-Clark Building Richardson Road Newcastle upon Tyne NE2 4AX Email: r.mcgovern@newcastle.ac.uk Dr Will McGovern Senior Lecturer, Social Work, Education and Community Wellbeing M005 Manor House, Coach Lane Campus (West) Northumbria University, Newcastle upon Tyne NE7 7TR Email: william.mcgovern@northumbria.ac.uk Dr Jessica Roy, Lecturer in Child and Family Welfare School for Policy Studies, University of Bristol 8 Priory Road Bristol BS8 1TZ Email: jessica.roy@bristol.ac.uk References [1] Home Office (2019) The economic and social costs of domestic abuse. [2] Golding J.M (1999) Intimate Partner Violence as a Risk Factor for Mental Disorders: A Meta-Analysis. Journal of Family Violence. Vol 14; 99- 132. [3] Strang, H., Sherman, L., Ariel, B. et al. (2017) Reducing the Harm of Intimate Partner Violence: Randomized Controlled Trial of the Hampshire Constabulary CARA Experiment. Camb J Evid Based Polic 1, 160–173. https://doi.org/10.1007/s41887-017-0007-x [4] Braun V, Clarke V (2008) Using thematic analysis in psychology. Qualitative research in psychol-ogy 3 (2):77-101 [5]Jones, C. (2015) Implementing the IMPACT Toolkit (Part II) Accessed online at https://www.work-with-perpetrators.eu/fileadmin/WWP_Network/redakteure/Expert%20Essays/Implementing_Impact_Jones.pdf [6] Hartfiel, N., & Edwards, R.T. (2019). Cost–consequence analysis of public health interventions.

Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study Lead applicant: Prof Mari Carmen Portillo and Dr Leire Ambrosio Co-applicants: Prof David Baldwin, Dr Lindsey Cherry, Dr Kate Lippiett, Dr Pritti Aggarwal, Mr William Barnaby Jones, Dr Sara McKelvie What problem will the research address and what evidence do you have this is a major concern for the public and health and care providers of Wessex? People with long term physical conditions are 2-3 times more likely to have mental health problems than the general population: at least 30% of adults with such conditions also have mental health problems (like anxiety and depression). People living with physical and mental long term conditions experience hardships relating to health, and have complex psychosocial, environmental, financial, and spiritual needs. Healthcare professionals find it difficult to provide fully integrated care for these populations, due to systematic barriers and fragmentation of services. The NHS has incorporated an initiative involving Social Prescribing Link Workers (SPLW) in response to these complex needs. SPLWs connect people to community local services to meet needs through a comprehensive person-centred approach. However, the way in which this initiative occurs in different areas and services is variable, and there is unclear guidance for primary care services about how to integrate this novel workforce into wider efforts to address and meet the complex needs of people living with long term physical and mental conditions. Where will the research take place and who will you involve? The project will be undertaken in primary care practices in Hampshire, the Isle of Wight and Oxfordshire, and with a range of local third sector organizations (e.g., Anxiety UK, Mind). Semi-structured interviews will be undertaken with people living with long term physical and mental health conditions. Subsequent focus groups will explore the range of care provider perspectives (e.g., social prescribing link workers, GPs, nurses, practice managers). We expect to interview 20-25 individuals and conduct 4-6 focus groups with 6-8 participants per group. Maximum variation sampling will focus on sociodemographic characteristics (age, sex, ethnicity, socioeconomic background), with a sharp focus on disadvantage and deprivation. Overall aim: To determine the barriers and facilitators to successful implementation of the SPLW role in primary care for individuals living with long term physical and mental conditions. Specific objectives. Identify the range of health and social needs of people living with long term physical and mental conditions. Explore provider perspectives about social prescribing link workers role implementation and effectiveness for people living with long term physical and mental conditions. Explore user perspectives about social prescribing link workers role implementation and effectiveness Explore how, SPLW implementation methods can be adapted to better meet the needs of culturally diverse populations including those living within deprived areas. Explore potential limitations of SPLW model for people living with long term physical and mental conditions. Co-produce recommendations to enable effective implementation of social prescribing link workers to address health and social needs of people living with long term physical and mental conditions. A qualitative design, utilising semi-structured interviews and focus groups will be conducted. Patients and the public will contribute to all aspects of the research process. How will the findings inform improvements in population health and patient care. Following this study, a comprehensive tailored programme will be developed to address the complex needs of people with long term physical and mental conditions including those living in deprived areas. Plans for its implementation will be explored involving key stakeholders from and integrated Care System (ICS), Primary care Networks (PCNs), Local Authorities and any other organizations/sectors that may benefit from the findings. Read all Mental Health Hub projects

PPI/E Strategy 2021-2024 full report Below you will find the full report of the Patient and Public Involvement and Engagement (PPI/E) Strategy 2021-2024. NIHR Applied Research Collaboration Wessex Authored by Caroline Barker (Lead for PPI/E). Supported by our Public Champions and Katherine Baker (PPI Officer). Document overview: Background information Our vision Our aims Programme of activities Resources, partners and collaborators Reporting and monitoring The purpose of this strategy Patients and the public are at the heart of our vision to improve the health and well-being of people across Wessex . We need and value the voices of the communities our research serves. The knowledge, experiences and support of patients and the public are essential to ensure that our research goals and solutions are relevant, prevent waste, and bring the greatest possible benefits to society. This document outlines our strategy for Patient and Public Involvement and Engagement (termed PPI/E) in the work of ARC Wessex . Definitions We recognise there are different definitions to describe involvement and engagement activities within health and social care. For the purposes of this document we will adopt the following definitions: Patient and public involvement: research being carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them. (NIHR INVOLVE 2017). Engagement: where information and knowledge about research is provided and shared. PPI/E: an abbreviation/acronym. Used to describe patient and public involvement or engagement work and projects, or activities that connect or encompass both. Public: in this strategy we use the term ‘public’ to describe people affected by our research who do not have a professional role in health and social care services. This may include patients, service users, survivors, carers, family members or members of the general population. We also use the acronym WISeRD, which stands for Wessex Inclusion in Service Research and Design Group. This is our strategic PPI/E group. It is composed of PPI Champions (public), the PPI/E team and staff links for each research theme. As you read this document, you may come across other terms, abbreviations and acronyms that are unfamiliar to you. We have provided brief descriptions in the footnotes. There is also a glossary of terms at the end of the document. Context and opportunities ARC Wessex launched in October 2019. As part of our application to become an ARC, we had to develop an outline PPI/E strategy. CLAHRC Wessex (preceded ARC Wessex) shared our commitment to PPI/E and the work done by the CLAHRC laid good foundations for ARC Wessex to build on and progress. We are proud of the work we have done to embed PPI/E in our projects and programmes over the first 18 months. This strategy, developed in wide consultation with our partners and public communities, builds on the outline PPI/E strategy from our application. It covers activities from April 2021-Oct 2024. Our locality, Wessex, has strengths in involvement and engagement. We have the Wessex Public Involvement Network (PIN) that ARC Wessex plays a leading role in. This is a network of staff and public working with NIHR and committed to improving public involvement in research. We do this by sharing our knowledge, supporting and developing each other. We also work together on projects that would not be possible if we did not share the workload between us. These include developing PPI/E training and trialling approaches to improve diversity and inclusion in PPI/E. Our partners in NHS providers , charities and higher education institutions (e.g. Universities) have their own expertise and strengths. We are willing and committed to working together on areas of shared priority. Our Vision We aim to deliver high quality public involvement and engagement for health and social care. Our activities will meet the values and principles of good public involvement as outlined in the UK Standards for Public Involvement . Our activities will occur across, and add value to, each aspect of Wessex ARC: At project-specific level (e.g. an ARC-funded or ARC-supported research project). Across each of our four research themes and the wider ARC programme. With our partners and collaborators organisations. Our overarching aims Aligned to the UK Standards for Public Involvement, are aims are to: Listen to voices relevant to our research priorities that reflect the diversity of our local population – ensuring the underserved have a voice (UK Standard Inclusive Opportunities). Build a culture that respects different perspectives, values contributions and supports mutually respectful and productive relationships (UK Standard Working Together). Provide health research communities of Wessex (including public) adequate PPI/E training, support and learning opportunities at the right time for their project/programme and/or their own development needs (UK Standard Support and Learning). Involve the public at strategic and operational levels, ensuring best practice and supporting research transparency (UK Standard Governance). Use innovative approaches and good communication to expand the reach of our activities, maximising impact by stimulating knowledge-of, and interest-in, our research (UK Standard Communications). Capture, monitor and share learnings to feedback to those involved, avoid duplication, contribute to the evidence base and build our academic PPI/E (UK Standard Impact). We will build on our local strengths and focus on areas where we believe we can have the greatest impact. [1] [2] [3] [4] [5] [6] [7] [8] [9] Aim 1: Listen to voices relevant to our research priorities that reflect the diversity of our local population – ensuring the underserved have a voice (UK Standard Inclusive Opportunities ). Aim 2: Build a culture that respects different perspectives, values contributions and supports mutually respectful and productive relationships (UK Standard Working Together ) Aim 3: Provide health research communities of Wessex (including public) adequate PPI/E training, support and learning opportunities at the right time for their project/programme and/or their own development needs (UK Standard Support and Learning ). Aim 4: Involve the public at strategic and operational levels, ensuring best practice and supporting research transparency (UK Standard Governance ). Aim 5: Use innovative approaches and good communication to expand the reach of our activities, maximising impact by stimulating knowledge-of, and interest-in, our research (UK Standard Communications ). Aim 6: Capture, monitor and share learnings to feedback to those involved, avoid duplication, contribute to the evidence base and build our academic PPI/E (UK Standard Impact ). Resources Our PPI/E team, in partnership with our research community (including public and researchers), will deliver the programme. A Lead for PPI/E will oversee delivery. A Communications & Partnerships Manager, Administrative Officer and a PPI Officer support them. A dedicated PPI/E budget will support: expense and time reimbursement for public contributing to our work; training costs required to support public in their role; consumable and facilities costs relating to PPI/E events, including training events; development and testing of new initiatives. This is in addition to PPI/E budgets set out within each research project, and academic career development awards. Partners and collaborators We will work closely with involvement, engagement and communications teams in our partner charities, health and care providers and higher education institutions. This will enable us to maximise opportunities, minimise duplication and create economies-of-scale. Our public engagement activities wil l benefit from University of Southampton’s experienced Public Engagement in Research Unit, Public Policy Unit (connects with policy advisors and central government) and LifeLab (working with young people to engage them with research). Consolidated funding for our Lead for PPI/E facilitates strong cross-organisational working. This Lead person manages a PPI/E team working across University Hospital Southampton, including the Wessex PIN and other NIHR infrastructure (Southampton BRC and CRF ). Reporting and monitoring An annual plan is written each year that covers progress to date and plans for the next year (see footnote for full detail ). The plan is developed by the Lead, with input from WISeRD, and approved by the ARC Director. Progress against our milestones are reported to: WISeRD at our meetings (every two months). The Executive Leadership Group (every two months). Rolling theme updates (including PPI/E) are a standing item. The Lead for PPI/E provides a formal update annually and given additional time on the agenda to discuss items as required. The ARC Director at meetings with the PPI/E team (twice a year). The ARC Partnership Board (twice a year) as part of the progress reports submitted to board members. CCF vi a the formal annual reporting structures (once a year). [17] [18] [19] [20] [1] Wessex includes Dorset, Hampshire, the Isle of Wight and South Wiltshire. [2] ARC stands for Applied Research Collaboration. They support applied health and care research that responds to, and meets, the needs of local populations and local health and care systems. [3] INVOLVE was a national coordinating centre for public involvement in health and care (until March 2020). A new Centre for Engagement and Dissemination aims to build on the work of INVOLVE. [4] Collaborations for Leadership in Applied Health Research and Care [5] National Institute for Health Research [6] Any organisation that provides NHS services [7] The standards are a framework for what good public involvement in research looks like. [8] ARC Wessex has four research themes: Ageing & Dementia; Long Term Conditions; Healthy Communities and Workforce and Health Systems. Found out more on our website. [9] Underserved is the term we have chosen to use to describe people who are less well included in research. It is important to recognise that underserved groups are context-specific. There is no single, simple definition to describe all underserved groups. [10] The Microsoft Accessibility Checker is a free tool available in Office 365. It finds most accessibility issues and explains why each might be a potential problem for someone with a disability. It also offers suggestions on how to resolve each issue. [11] The equality impact assessment is a systematic and evidence-based tool, which enables us to consider the likely impact of work on different groups of people. [12] Operational leadership group. [13] This project aims to test how feasible and acceptable a childhood obesity prediction tool is. [14] The Academic Career Development Group in ARC Wessex is focused on building capacity and capability within the health and care system. [15] The ARC Partnership Board is a decision-making body for ARC Wessex. [16] A theory of change is a description of why a particular way of working will be effective, showing how change happens in the short, medium and long term to achieve its intended impact. Logic models are a way to graphically represent this theory. [17] Biomedical Research Centre [18] Clinical Research Facility [19] PPI/E annual plan covers: progress against last year’s objectives and the wider strategy; objectives, plans and milestones (with timescales) for the next year; plans for engaging our stakeholders; plans for dissemination and monitoring impact; cross ARC collaborations; plans for research and capacity building; leadership and management; finances [20] CCF = NIHR Clinical Commissioning Facility. They manage and administer the ARC funding scheme [ii] Public involvement activities describe activities where research is carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them. [iii] Engagement activities describe activities where information and knowledge about research is provided to and shared with the public. [iv] Underserved is the term we have chosen to use to describe people who are less well included in research. It is important to recognise that underserved groups are context-specific. There is no single, simple definition to describe all underserved groups. Want to know more? You can read our full strategy Have questions or comments? Email PublicInvolvement@uhs.nhs.uk

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