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af50ff28-5b02-41fa-bc1f-f9689464860e EnTech (Enabling Technology): Investigating the enabling and inhibiting factors to the use of internet-based support tools for caregivers of people with dementia, and how to promote engagement. Chief investigator: Prof Chris Kipps Neurologist, Clinical Director R&D University Hospital Southampton Dr Sarah Fearn Senior Research Fellow NIHR ARC Wessex (Ageing & Dementia) University of Southampton Team: Prof Cathy Murphy, Professorial Fellow Research, School of Health Sciences University of Southampton Prof Eneida Mioshi Professor in Dementia Care Research University of East Anglia NIHR ARC East of England Jane Ward Dementia Friendly Hampshire Amanda Wollam Public contributor with personal and professional (social care) experience of caregiving to people with dementia Start: 1 October 2024 End: 31 March 2026 Partners: Do rset HealthCare University NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, University of Southampton, University of East Anglia / NIHR ARC East of England, Dementia Friendly Hampshire, My Dementia Support. Our research This research aims to identify the factors that help or hinder caregivers of people with dementia to use online support tools. It also aims to create strategies to support caregivers to use them. We will use two internet-based resources as examples in our work: the DemCon website, which provides advice on dementia and continence, and FTDToolkit, which will be a psychoeducational intervention to support management of behavioural symptoms in people with frontotemporal dementia (FTD) and FTD with Motor Neurone Disease (FTDMND). Whilst some previous research in this area exists, it has been based mostly on surveys and has not included caregivers who do not go online. We will use interviews and focus groups so that caregivers can discuss all of the factors that affect their use of online support tools. This could include their personal situation and attitude towards online support tools, as well as thoughts about the tool itself. We will ensure that caregivers who are less confident or less able to use online websites are also included. We will also investigate the factors that help or hinder caregivers of people with a specific type of dementia – young onset dementia or frontotemporal lobar degeneration, which includes, but is not limited to, FTD. These sub-types of dementia often affect people at a younger age and can have different symptoms to other, more common types of dementia. This specific group of caregivers has not previously been discussed in existing research on this topic. We will use our findings on the factors that help or hinder caregivers of people with dementia to use online support tools to create strategies to support them. We will do this in workshops with caregivers so that we create them together. Managing continence issues and behavioural changes can be difficult topics for caregivers to discuss. This project will provide insight into how online support tools can help support conversations about challenging topics. Public involvement We are working with caregivers of people with dementia and local dementia charities in this project. On our team, we have two public contributors who both have lived experience of caring for someone with dementia. They will help us to design and carry out the research, to make sure it is relevant to caregivers and benefits them. 60 caregivers will participate in the research in interviews, focus groups or workshops. Outcomes This research will inform the roll-out of DemCon and development of FTDToolKit, to promote their successful adoption by caregivers. Our findings will also be relevant to the development and roll-out of other online support tools for caregivers of people with dementia. We will share our findings with caregivers, academics, support tool developers and others involved in the care of people with dementia. We will produce reports, write scientific articles, present at conferences, and work with national and local dementia organisations to share our findings. Email lead researcher

Ageing & Dementia Publications A European paramedic curriculum for geriatric emergency medicine developed via a modified Delphi technique Krohn JN, Barrett J, Heeren P, Lim S, Moloney E, Nickel CH, van Oppen J, Sandig N, Ünlü L, Singler K. Older emergency patients currently account for most European emergency medical service dispatches. Due to demographic changes and increasing comorbidities in advanced age, this number is expected to rise substantially in the coming years. Prehospital professionals require specialised training to provide high-quality care for complex, multimorbid patients. The aim of this study is to define minimum competencies for paramedic education in Europe on the management of emergencies in older adults. https://doi.org/10.1186/s13049-026-01550-3 January 2026 Ageing & Dementia Focussing on appetite decline to optimise management of undernutrition in later life- A geriatric medicine perspective Cox NJ, Jones L, Lim SE. Undernutrition is common amongst older people and can lead to adverse health outcomes and increased dependence. This review focuses on an aspect of undernutrition that is often overlooked, namely loss of appetite, and will discuss the challenges in this under-researched field from the perspective of geriatric medicine. Appetite decline is common in later life and predicts undernutrition in older populations. As such, timely identification and intervention on poor appetite could delay onset or progression of undernutrition to optimise healthy ageing and maintain independence. In addition, management of undernutrition ultimately requires the individual to meet their nutritional requirements. However, unless attention is paid to mitigating appetite decline, strategies to improve intake are likely to be ineffective. Treatment for appetite decline is challenging due to the multiple and complex underlying mechanisms. Current evidence is limited to a few trials targeting older people including flavour enhancement and fortification or supplementation, lifestyle measures such as increasing physical activity and social interaction, and medications, all with mixed results. Progress on treatments for appetite decline has been hampered by a lack of distinction from undernutrition, but also perhaps the approach to it as a concept. Categorising appetite decline in ageing as a geriatric syndrome could aid progress in the unification of approaches to mechanistic research, assessment and management strategies, which are likely to be most effective when in multi-component form and underpinned by the principles of Comprehensive Geriatric Assessment (CGA). https://doi.org/10.1017/s0029665125102115 January 2026 Ageing & Dementia An intervention to provide nutritional care for people living with dementia at home receiving home care (TOMATO): study protocol for a single-arm feasibility study Yinusa G, Surr C, Thomas S, Fenge LA, Howdon D, Major J, Heward M, Taylor G, Knight H, Townson J, Murphy J. In the UK, over 980,000 people are living with dementia, and two-thirds of them live in their own homes. Up to 60% of this population is estimated to be at risk of or already experiencing malnutrition, with 45% facing significant weight loss. As dementia progresses, ensuring that people eat and drink well becomes challenging. Many families affected by dementia access home care services, with home care professionals playing a vital role in supporting and enhancing overall quality of life. Training in identifying nutritional problems and supporting family carers to prevent malnutrition is an identified research need; however, research on the contribution of home care professionals in this area is limited. This study aims to assess the feasibility and acceptability of a nutritional intervention for people living with dementia receiving home care from the perspectives of people with dementia, family carers (dyads), and home care professionals (including home care managers). https://doi.org/10.1186/s40814-025-01722-5 November 2025 Ageing & Dementia The Importance of a Relationship-Centred Approach to Deprescribing for People with Dementia or Mild Cognitive Impairment in Primary Care: A Qualitative Study Andrews N, Brooks C, Amin J, Lim R, Board M, Latter S, Fraser S, Ibrahim K Polypharmacy (taking five or more regular medications) is common in people with dementia or mild cognitive impairment (MCI) and is associated with poor outcomes such as decline in cognitive and physical functioning, falls and hospital admission. Reducing or stopping unnecessary medications (deprescribing) can help improve outcomes but limited research has been undertaken with people with dementia or MCI, especially in primary care. This study explored the perspectives and experiences of people with dementia or MCI, informal carers and healthcare professionals on deprescribing decision-making in this setting https://doi.org/10.1177/14713012251376227 November 2025 Ageing & Dementia Potentially inappropriate prescribing and falls-risk increasing drugs in people who have experienced a fall; a systematic review and meta-analysis O'Reilly T, Gómez Lemus J, Booth L, Clyne B, McCarthy C, Ibrahim K, Thompson W, McAuliffe C, Moriarty F As certain medications increase risk of falls, it is important to review and optimise prescribing in those who have fallen to reduce risk of recurrent falls. The obective of this study was to systematically review evidence on the prevalence and types of potentially inappropriate prescribing (PIP), including falls-risk increasing drug (FRID) use, in fallers. A systematic search was conducted in July 2024 in MEDLINE, EMBASE, CINAHL and Google Scholar using keywords for fall events, inappropriate prescribing and FRIDs. Observational studies (cohort, case-control, cross-sectional, before-after) and randomised trials were included. Studies were eligible where participants had experienced a fall and PIP (including FRID use) was reported. Random-effects meta-analyses were conducted to pool prevalence of inappropriate prescribing and mean number of inappropriate prescriptions across studies. https://doi.org/10.1093/ageing/afaf300 October 2025 Ageing & Dementia Implementing a digital physical activity intervention for older adults: a qualitative study. Boxall C, Dennison L, Miller S, Joseph J, Morton K, Corser J, Kesten J, Electicwala A, Western MJ, Lim S, Grimmett C, Yardley L, Bradbury K Physical activity (PA) in older adults can prevent, treat, or offset symptoms and deterioration from various health conditions and help maintain independence. However, most older adults are insufficiently active. Digital interventions have the potential for high reach at low cost. This paper reports on the implementation of "Active Lives," a digital intervention developed specifically for older adults. https://doi.org/10.2196/64953 October 2025 Ageing & Dementia Frail2Fit study: it was feasible and acceptable for volunteers to deliver a remote health intervention to older adults with frailty Meredith SJ, Holt L, Varkonyi-Sepp J, Bates A, Mackintosh KA, McNarry MA, Jack S, Murphy J, Grocott M, Lim S Approximately 47 % of older people in hospital aged over 65 are affected by frailty. Frailty is characterised by a cumulative decline in biological reserves leading to impaired homoeostatic recovery following stressor events. It is associated with increased risk of post-hospitalisation, disability, and mortality. Key interventions for frailty management and to address deconditioning post-hospitalisation include exercise, and nutrition support, underpinned by behaviour change strategies. However, in practice, access to models of care, such as multidisciplinary reablement services to support older people on discharge, is restricted by the health system’s capacity to deliver these services. This study aimed to explore the feasibility and acceptability of training volunteers to deliver a remote multimodal intervention, including exercise, behaviour change and nutrition guidance, for older people living with frailty after hospital discharge. https://doi.org/10.1016/j.tjfa.2025.100092 October 2025 Ageing & Dementia Deprescribing Anticholinergic Medications in Hospitalised Older Adults: A Systematic Review Griffiths R, Lim S, Lin J, Bates A, Jones L, Ibrahim K. Anticholinergic medication use is increasing, particularly among older adults due to polypharmacy and comorbidities. High anticholinergic burden is linked to adverse outcomes such as reduced mobility and increased dementia risk. Acute hospital stays may offer an opportunity to address this often-overlooked issue. The aim of this study was to examine the effects of deprescribing anticholinergic medications on outcomes in older hospitalised patients. https://doi.org/10.1111/bcpt.70103 September 2025 Ageing & Dementia Treatment Considerations for Severe Osteoporosis in Older Adults See H, Gowling E, Boswell E, Aggarwal P, King K, Smith N, Lim S, Baxter M, Patel HP Osteoporosis, a chronic metabolic bone disease, increases the predisposition to fragility fractures and is associated with considerable morbidity, high health care cost as well as mortality. An elevation in the rate of incident fragility fractures will be observed proportional with the increase in the number of older people worldwide. Severe osteoporosis is currently defined as having a bone density determined by dual-energy X-ray absorptiometry that is more than 2.5 standard deviations (SD) below the young adult mean with one or more past fractures due to osteoporosis. Nutrition, physical activity and adequate vitamin D are essential for optimal bone strength throughout life. Hormone (oestrogen/sex steroid) status is also a major determinant of bone health. This review explores mechanisms involved in bone homeostasis, followed by the assessment and management of severe osteoporosis, including an overview of several treatment options in older people that range from anti-resorptive to anabolic therapies. https://doi.org/10.1007/s40266-025-01205-5 April 2025 Ageing & Dementia Development of a complex multidisciplinary medication review and deprescribing intervention in primary care for older people living with frailty and polypharmacy Radcliffe E, Saucedo AR, Howard C, Sheikh C, Bradbury K, Rutter P, Latter S, Lown M, Brad L, Fraser SDS, Ibrahim K Reducing polypharmacy and overprescribing in older people living with frailty is challenging. Evidence suggests that this could be facilitated by structured medication review (SMR) and deprescribing processes involving the multidisciplinary team (MDT). This study aimed to develop an MDT SMR and deprescribing intervention in primary care for older people living with frailty. Intervention development was informed by the Medical Research Council framework for complex intervention and behaviour change and implementation theories. Intervention planning included: 1) a realist review of 28 papers that identified 33 context-mechanism-outcome configurations for successful MDT SMR and deprescribing in primary care, 2) a qualitative study with 26 healthcare professionals (HCPs), 13 older people with polypharmacy and their informal carers. The intervention's guiding principles were developed and intervention functions proposed, discussed and refined through an iterative process in four online co-design stakeholder workshops. https://doi.org/10.1371/journal.pone.0319615 April 2025 Ageing & Dementia Factors influencing fall prevention programmes across three regions of the UK: the challenge of implementing and spreading the Falls Management Exercise (FaME) programme in a complex landscape Ventre JP, Manning F, Mahmoud A, Brough G, Timmons S, Hawley-Hague H, Skelton DA, Goodwin VA, Todd CJ, Kendrick D, Logan P, Orton E Factors influencing fall prevention programmes across three regions of the UK: the challenge of implementing and spreading the Falls Management Exercise (FaME) programme in a complex landscape The occurrence of falls in adults 65+ years remains a common and costly issue worldwide. There is current evidence to suggest that falls can be prevented using evidence-based strength and balance interventions, such as the six-month Falls Management Exercise (FaME) programme. Perspectives of multiple key partners and providers of the FaME programme could inform future implementation and fall prevention strategies. Partners and providers involved in local community fall prevention pathways were purposefully recruited from three geographical areas across the UK. Semistructured interviews were conducted to gain a broad understanding of factors affecting the adoption, implementation and spread of FaME. Data were analysed using an inductive thematic approach and mapped to the Consolidated Framework for Implementation Research (CFIR). https://doi.org/10.1093/ageing/afaf083 March 2025 Ageing & Dementia Social prescribing for people living with dementia (PLWD) and their carers: what works, for whom, under what circumstances and why - protocol for a complex intervention systematic review Marshall J, Papavasiliou E, Fox C, Hawkes M, Irvine A, Moniz-Cook E, Pick A, Polley MJ, Reeve J, Robinson L, Rook G, Sadler E, Wolverson E, Walker S, Cross JL; SPLENDID Collaboration Dementia is a complex medical condition that poses significant challenges to healthcare systems and support services. People living with dementia (PLWD) and their carers experience complex needs often exacerbated by social isolation and challenges in accessing support. Social prescribing (SP) seeks to enable PLWD and their carers to access community and voluntary sector resources to support them address such needs. Existing research, however, does not describe what SP interventions are currently in place in dementia care. Little is known about the needs these interventions are designed to address, the reasons that lead PLWD and their carers to participate in them, their effectiveness and the extent to which they could increase positive health outcomes if adopted and how. https://bmjopen.bmj.com/content/14/4/e080551 April 2024 Ageing & Dementia

1810d0c8-e9bb-4a7c-9947-bbac48f4dd69 Mental Health, Workforce and Well-being Research Framework - ARC Collaboration More details on ARC Greater Manchester website What are we trying to do? The purpose of the document is to propose a pan National Insititue of Health Research (NIHR) Applied Research Collaboration (ARC) workforce focused mental health and well-being research framework. The aim is for the research framework to serve as a reference point to: Create coherence and comparability across the research carried out by NIHR ARCs Reduce duplication of work to reduce workforce burden. Adopting a coherent approach with an agreed purpose and broad aims will maximise the potential for cross-ARC collaboration, synergy and impact. While the focus of this research has a COVID-19 focus, the ambition is that this framework should facilitate research beyond the current pandemic, ensuring programme sustainability and longevity across the lifetime of this 5-year NIHR ARC funding cycle. This framework is not intended to be prescriptive, rather, it is a call to colleagues doing research under the NIHR ARC umbrella to use the framework as a point of reference in the development of research projects and programmes. It is a modular approach which allows flexibility to fit the scientific questions and data collection to the needs of the specific workforce and context being studied. Why is it important? The NIHR has invested £135 million to support 15 collaboratives covering every region within England. The NIHR ARC collaborative provides a framework within which key stakeholders are brought together locally and nationally with a mandate to tackle difficult issues facing our health and care system including: patient outcomes, effectiveness of our health and care system, system sustainability, and carrying out research with an applied focus to facilitate the rapid translation of research into practice. Moreover, the designation of ARC South London and ARC East of England as national leads for mental health and the establishment of a National Mental Health Priorities Network provides a further opportunity for effective collaboration. The NIHR ARC network presents a unique opportunity to develop a coherent and consistent approach to workforce mental health and well-being research which embodies these principles. What will we do? The framework is available for any NIHR ARC to review and align with, to guide the development of work that aligns to the fundamental principles of the NIHR ARC programme. Who are we working with? The NIHR ARCs and their research themes are set out in a table included in the document. In line with the framework, colleagues are encouraged to work collaboratively to maximise synergy, impact, and reduce duplication and burden. The origins of this framework arose out of conversation with colleagues from across NIHR ARC sites between April 2020-June 2020. The framework has been developed by: Kirsten Windfuhr (ARC Greater Manchester), Jane Ball (ARC Wessex), Karina Lovell (ARC Greater Manchester) Penny Bee (ARC Greater Manchester). Additional contributions and comments were gratefully received from ARC colleagues, and in particular Kristy Sanderson (ARC East of England). More information For further information about this work, please contact Alison Littlewood (Programme Manager). (ARC GM) Download - Mental Health, Workforce and Well-being Research Framework

Dr Preeti Dhuria (University of Southampton) and Professor Christina Vogel (The Centre for Food Policy, City St George’s, University of London) discuss how weak enforcement lets retailers bypass UK obesity regulations < Back Chocolate at the checkout Weak enforcement of obesity regulations is undermining public health Dr Preeti Dhuria (University of Southampton) and Professor Christina Vogel (The Centre for Food Policy, City St George’s, University of London) discuss how weak enforcement lets retailers bypass UK obesity regulations It’s far too easy to choose unhealthy options in retail stores in the UK. This isn’t just a personal challenge for citizens, it’s a public health crisis. The places we shop shape our food choices and quite frankly, the odds are stacked against us in selecting healthy food. There is a growing momentum for strong policies to rein in the aggressive promotion of unhealthy foods, and that’s a positive step. In fact, the UK government introduced a ban on placing unhealthy foods at checkouts, aisle-ends and store entrances in 2022. But you wouldn’t necessarily know it as a shopper. Our research shows there is a significant lack of resources for adequate enforcement. This situation means we still see chocolate at checkouts in some stores and alcohol at the aisle-ends in others because stores are either breaking the rules or using loopholes to continue making money at the expense of the country’s health. Regulating the food retail environment is an important part of the solution to lower levels of obesity but weak enforcement can undermine health goals. The Food (Promotion and Placement) Regulations 2021 are designed to limit the promotion of unhealthy foods in most retail stores and online equivalents in England. When 22 local government officers were asked about their approach to enforcement before the regulations came into effect, the clear narrative was that these regulations would not be robustly enforced because of a lack of staff and training. Our research showed the key obstacles to enforcing these regulations include: Staffing Constraints : There is limited capacity within local authority enforcement teams to enforce these regulations. Their scarce resources are used for immediate threats to life like knife crime rather than assessing breaches, issuing notices and processing fines for these anti-obesity regulations. Inadequate financial support: Funding constraints further hinder enforcement because only £281k in funding has been allocated across the 317 local authorities in England to support these enforcement tasks, leading to inconsistencies across regions. Minimal training: Enforcement officers are likely to rely on personal judgment and experience due to limited training and guidance on how to interpret the definitions in the regulations, leading to significant variations in the interpretation and enforcement of the rules across regions. Despite the regulations’ long-term health goals, it is clear that they are ranked as a low priority and the process of issuing infringement notices is cumbersome. This situation is leading to patchy enforcement, and businesses not being held accountable uniformly. The processes for reporting breaches are also unclear meaning even action by the public is usually difficult. A freedom of information request covering a three-month period showed that no improvement notices had been issued despite instances of non-compliance being observed. A Call for Stronger Enforcement Our research outlines actions at the national and local levels that could help to improve the level of enforcement being undertaken. National-level actions Provide adequate and dedicated funding to local authorities to recruit and allocate staff specifically for compliance assessment of these regulations. Provide centralised training and detailed guidelines for enforcement officers to ensure consistency and build confidence among enforcement teams. Streamline compliance assessments by requiring manufacturers to disclose nutrient profile scores for their products and retailers to provide key details, such as store square footage and employee count, to their local authorities. Local-level actions Instigate linkages within local authorities by supporting cross departmental activity between trading standards, environmental health and public health officers to make enforcement efficient. Raise regulations’ priority by incorporating into joint strategic needs assessment within local authorities to increase buy-ins from councillors and Directors of Public Health. Lack of enforcement compromises impact Investing in enforcement is essential to securing regulation compliance and achieving the level playing field that food businesses and public health advocates called for. Early enforcement ensures that businesses fully understand their obligations, comply with the rules, and help build a precedent for healthier retail environments. Proactive enforcement sends a clear message- the regulations are here to stay, and compliance is non-negotiable. But local authorities cannot achieve strong compliance without adequate funding and the right tools. A lack of enforcement risks being misinterpreted as a sign of regulatory failure and withdrawal of the regulations. This outcome would be detrimental to the health of British children and families. Here are a few instances recently where our research team have spotted non-compliance but do not know how to effectively report the instances, and even approaching the store manager has not led to an immediate removal of products from restricted areas. To truly make an impact, future food policies must incorporate robust enforcement strategies and dedicated funding from the outset to maximise the regulations’ impact and safeguard public health. Previous Next

Research areas Key research themes Ageing and Dementia Read More Long Term Conditions Read More Healthy Communities Read More Workforce & Health Systems Read More Cross-cutting research projects Mental Health Hub Read More Social Care Read More

Long Term Conditions publications Co-Design of a New Integrated Care Model With People Affected by Huntington's Disease: A Mixed Methods Study Pires SB, Kunkel D, Manera K, Goodwin N, Kipps C, Portillo MC People living with neurological conditions have needs that require an integrated care approach. Existing models of integrated care have often emphasized system structures but neglected the micro-level interactions that matter most to people. The objective of this project was to develop a micro-level model for integrated care that represents the care components most valued by people affected by Huntington's disease (HD). https://doi.org/10.1111/hex.70584 February 2025 Long Term Conditions Ignoring and conflating sex and gender in cardiovascular research limits the application of evidence-based interventions Wierenga KL, Austin RC Until early in the 1900’s interventional research participation was mainly limited to men. Currently there continues to be a sex and gender mismatch between populations and research. Which includes historical and landmark cardiovascular studies limited to men, the absence of sex-disaggregated data, and limited use of biological variables. Research shortfalls continue despite evidence that both sex and gender impact outcomes. Sex and gender are important consideration to health and decision making. It is critical that we advance cardiovascular science with studies and interventions that consider both to decrease health inequalities. There are broad differences in biologic, roles, identities, and behaviours that are influenced by sex and gender. To create optimal interventions for a diverse population there is a pressing need to identify diverse needs, use research methodology as defined by SAGAR, and careful design of interventions responsive to these findings. https://doi.org/10.1093/eurjcn/zvaf221 January 2026 Long Term Conditions A mixed-methods study to explore the modifiable aspects of treatment burden in Parkinson’s disease and develop recommendations for improvement Tan QY, Ibrahim K, Roberts HC, Amar K, Fraser SDS People with Parkinson's (PwP) and their caregivers have to manage multiple daily healthcare tasks (treatment burden). This can be challenging and may lead to poor health outcomes. The objective of this study was to assess the extent of treatment burden in Parkinson's disease(PD), identify key modifiable factors, and develop recommendations to improve treatment burden. https://doi.org/10.1371/journal.pone.0338620 December 2025 Long Term Conditions eHealth interventions to support colorectal cancer patients' self-management after discharge from surgery-an integrative literature review Husebø ALM, Søreide JA, Kørner H, Storm M, Wathne HB, Richardson A, Morken IM, Urstad KH, Nordfonn OK, Karlsen B Colorectal cancer (CRC) creates elevated self-management demands and unmet support needs post-discharge. Follow-up care through eHealth post-primary surgery may be an effective means of supporting patients' needs. This integrative review describes the evidence regarding eHealth interventions post-hospital discharge focusing on delivery mode, user-interface and content, patient intervention adherence, impact on patient-reported outcomes and experiences of eHealth. https://doi.org/10.1007/s00520-023-08191-7 Dcember 2023 Long Term Conditions A Co-Produced Stakeholder Workshop to Identify Key Time Points and Targets for Life-Course Prevention of Multiple Long-Term Conditions Stannard S, Wilkinson R, Gill JK, McMahon J, Welch J, Fraser SDS, Alwan NA The MELD-B project is a multidisciplinary research consortium with one of its aims focused on identifying childhood targets for the prevention of multiple long-term conditions (MLTCs). Drawing upon the expertise of policy and practice stakeholders can inform research questions, data analysis, and contribute to meaningful and practical outputs. In pursuit of this collaborative approach, a stakeholder workshop, co-designed with people with lived experience, was conducted to inform the next steps of the early prevention workstream of the MELD-B project. https://doi.org/10.1111/hex.70475 December 2025 Long Term Conditions Understanding the potential role of Social Prescribing Link Workers in supporting identified needs of people with physical and mental long-term conditions: a qualitative study Linceviciute S, Ambrosio L, Baldwin DS, Portillo MC The Social Prescribing Link Worker (SPLW) approach is a means for supporting individuals and communities with diverse needs, with its reach and impact widely recognised in health and community systems. However, SPLW support for people with long-term physical and mental health conditions (P + MH LTCs) has been variable and there are knowledge gaps such as unheard voices of those with a varied engagement in SPLW support. We undertook a study to better understand the potential relevance of SPLW support for addressing the needs of individuals with P + MH LTCs. Its aim was to explore a range of health and psychosocial needs of people living with P + MH LTCs and to examine perspectives on how the SPLW role supports the complex needs of this group. https://doi.org/10.1186/s12875-025-02990-z November 2025 Long Term Conditions, Mental Health Modelling the joint impact of early-life interventions on adult health: an illustrative example of multiple long-term conditions with role limitations in midlife using the 1970 British Cohort Study (BCS70) Stannard S, Berrington A, Ziauddeen N, Fraser SDS, Paranjothy S, Owen RK, Alwan NA Evidence on how policy interventions early in childhood can prevent or delay multiple long-term conditions (MLTCs) is limited. We modelled prevention scenarios using five early-life domains on the outcome of MLTCs with role-limitation using effectiveness data of combined real-life early interventions. https://doi.org/10.1186/s12916-025-04467-3 November 2025 Long Term Conditions Management of Parkinson's in the Community: Interests and Expectations of People Living with Parkinson's, Family Carers, Healthcare Professionals and Stakeholders in Spain. Pedraz-Marcos A, Palmar-Santos AM, Portillo MC, Navarta-Sánchez MV This study aimed to explore the interests and expectations of people living with Parkinson’s disease (PD), family carers, health and social care professionals, and key stakeholders regarding relevant systems of support and community resources for PD management. As part of the OPTIM-PARK project (Optimisation of Community Resources and Systems of Support to Enhance the Process of Living with PD), an exploratory qualitative study was conducted in Spain. Forty-one participants completed a GENIE concentric circles mapping exercise to identify existing support systems and community resources. These maps informed subsequent semi-structured interviews. All interviews were digitally recorded and transcribed verbatim for thematic analysis. Participants identified several barriers to effective collaboration across healthcare and social care systems, including poor understanding of PD, limited financial resources, and insufficient communication among professionals and sectors. Facilitators for improved community-based PD management included personalised care pathways, shared decision-making, improved access to professional services and local resources, and the strategic use of Information and Communication Technologies (ICTs). Participants emphasised the need for long-term investment and strong institutional commitment to reinforce community-based support networks for individuals living with PD. https://doi.org/10.1177/23333936251384434 November 2025 Long Term Conditions Safety, feasibility and efficacy of exercise as an airway clearance technique in cystic fibrosis: a randomised pilot feasibility trial Urquhart DS, Taylor E, Cunningham S, Lewis S, Neilson AR, Soilemezi D, Ensor H, Vogiatzis I, Allen LJ, Saynor ZL; ExACT-CF Study Group Cystic fibrosis (CF) is an inherited disorder characterised by thick mucus accumulation in vital organs. Clearing secretions from the lungs through airway clearance techniques (ACTs), such as chest physiotherapy, combined with mucoactive agents, is essential to prevent recurrent infections and airway inflammation that may lead to airway obstruction and mucus plugging, airway damage, loss of respiratory function and eventual respiratory failure. ACTs employ various methods and devices to remove excess mucus secretions, aiming to alleviate airway obstruction and prevent respiratory tract infections, as well as to re-expand atelectatic areas, improve gas exchange and reduce inflammation. For over 60 years, performing regular chest physiotherapy has been central to CF care. Standard practice globally involves at least daily chest physiotherapy, increasing during exacerbations. To meet the diverse needs of people with CF (pwCF), chest physiotherapy as ‘usual care’ for airway clearance encompasses a variety of techniques, including positive expiratory pressure, oscillating devices, active cycle of breathing techniques and autogenic drainage. Despite the range of available options, chest physiotherapy is often performed with low quality. Many pwCF find it both time-consuming and burdensome,leading to poor adherence. The landscape of CF has changed with widespread availability of highly effective modulator therapy (HEMT), which reduces exacerbations and improves life expectancy, prompting exploration of alternative approaches to reduce treatment burden. Exercise is emerging as a potential alternative to ACT, acting to enhance mucociliary clearance and facilitate secretion removal. Structured exercise is already a recommended component of ‘usual care’ for pwCF, with aerobic exercise capacity being an important survival predictor. While current usual care recommendations advocate exercise in addition to chest physiotherapy, pwCF are already changing their approach based on preference to either incorporate exercise into their airway clearance regimens or to omit chest physiotherapy if they exercise. This preference underscores the need to investigate exercise as a primary ACT, engaging with patient priorities to address the question of whether exercise could replace chest physiotherapy, a priority highlighted by the James Lind Alliance. Whether exercise alone can serve as an effective ACT remains unknown. A recent UK Delphi consensus defined a bespoke exercise as an ACT (ExACT) intervention, proposing it as a potential substitute for chest physiotherapy during stable periods, that warranted further study. ExACT involves >20 minutes of aerobic exercise inducing deep breathing and is performed by predominantly weight-bearing exercise types that incorporate vibration. Huffing and coughing (forced expiratory techniques) are integral to ExACT, with pre- and post-session breaths to check for, and remove mucus. ExACT is self-administered, promoting independence and flexibility. Combining daily exercise and ACT recommendations as ‘ExACT’ could yield significant time savings and health benefits. With the widespread availability of HEMT, such as Elexacaftor/Tezacaftor/Ivacaftor (ETI), realigning treatment burden is now a top priority in CF care. High-quality evidence is needed to guide clinical practice. The ‘Exercise as an Airway Clearance Technique in CF (ExACT-CF)’ randomised pilot trial aimed to test the primary hypothesis of the feasibility and acceptability of the ExACT intervention when compared with usual care, together with safety and early signals of efficacy. https://doi.org/10.1136/thorax-2025-223080 October 2025 Long Term Conditions Design and deployment of digital health interventions to reduce the risk of the digital divide and to inform development of the living with COVID recovery: a systematic scoping review. Hamilton FL, Imran S, Mahmood A, Dobbin J, Bradbury K, Poduval S, Scuffell J, Thomas F, Stevenson F Digital health interventions can support health-related knowledge transfer, for example through websites or mobile applications, and may reduce health inequalities by making health care available, where access is difficult, and by translating content to overcome language barriers. However, digital health intervention can also increase health inequalities due to the digital divide. To reach digitally excluded populations, design and delivery mechanisms need to specifically address this issue. This review was conducted during the evolving COVID-19 pandemic and informed the rapid design, deployment and evaluation of a post-COVID-19 rehabilitation digital health intervention: 'Living with COVID Recovery' (LWCR). LWCR needed to be engaging and usable for patients and to avoid exacerbating health inequalities. LWCR was introduced as a service into 33 NHS clinics, was used by 7679 patients, and evaluation ran from August 2020 to December 2022. https://doi.org/10.3310/gjhg1331 October 2025 Long Term Conditions Understanding the tightrope walk between interoception sensibility and hypervigilance in cardiovascular diseases Burnett D, Austin RC Self-care of cardiovascular diseases (CVD) has been recommended as a core competent to treatment strategies for years. Although self-care is not a new concept, studies on interventions to improve self-care in those with CVD often have mixed results. The recent publication lead by Giulia Locatelli presented data on the associations between interoception and self-care in people with CVD. The aim of this commentary is to provide a summary of their article, discuss the tightrope between interoception and hypervigilance, critically examine the paper, and finally discuss how this research contributes to the evidence base. https://doi.org/10.1093/eurjcn/zvaf180 October 2025 Long Term Conditions Mapping how responsibility for poor diets is framed in the United Kingdom: a scoping review Serrano-Fuentes N, Ellett L, Vogel C, Baird J, Tavares N, Portillo MC The United Kingdom (UK) has diets with the highest proportion of ultra-processed food in Europe . The population’s diet is also too high in carbohydrates, total fats, saturated fats, salt and free sugars, and does not meet fibre, protein and potassium recommendations. This suboptimal nutrition underlies an increase in diet-related conditions, such as obesity, type 2 diabetes, cardiovascular disease, and several types of cancer, and the financial costs attached to them. In the UK, the combined cost of obesity and associated health issues in reducing life expectancy, National Health Service (NHS) funds, and lost workforce productivity is £98 billion yearly. A major cause of poor diets is the influence of the obesogenic food environment. This term describes settings in which unhealthy food is widely accessible, available and affordable, creating conditions that drive people to make unhealthy food choices and fuelling obesity at a population level. Evidence shows that government enforced regularatory approaches improve obesogenic food environments by levelling the playing field. In contrast, industry-led voluntary or corporate social responsibility initiatives like the Public Health Responsibility Deal (2011-2015) have proven ineffective. While many working in the field of public health are calling for stronger government regulation of the food industry, this effort faces significant barriers without greater public support for these policies. Public support may be limited by a critical disconnect. While research evidence demonstrates that environmental and commercial factors are primary drivers of poor diets, many citizens may largely perceive that individuals are responsible for their food choices. Understanding this disconnect requires examining how responsibility is framed across the key domains that shape public understanding in their everyday lives. If responsibility framing fails to acknowledge societal barriers and instead emphasises individual choice, it may perpetuate stigma and reduce support for policies that could address the root causes of dietary inequalities This study aims to address these evidence gaps by conducting the first systematic synthesis of how responsibility for poor diets is framed across public perceptions, mass media, and government policy in the UK, with particular attention to the representation of socioeconomically disadvantaged groups. https://doi.org/10.1017/s1368980025101079 September 2025 Long Term Conditions

40fed7f8-d8d0-46f4-80c3-660e33675330 PIVOT: Promoting Increased physical actiVity in hospitalised Older adults with Trained volunteers NIHR Advanced Fellowship Award: Dr Stephen Lim, Honorary Consultant Geriatrician University Hospital Southampton NHS Foundation Trust and Principal Clinical Research Fellow, University of Southampton Team : Dr Samantha Meredith Research Fellow, University of Southampton, Professor Beth Stuart Clinical Trials Co-director of the Pragmatic Trials Unit, Queen Mary University of London, Professor Carl Thompson Applied Health Research, University of Leeds Aim(s) of the research To determine whether hospital volunteers can be trained to engage older people in hospital to be more active. We want to know if this intervention will work in different hospitals and explore factors that will support or prevent it from being delivered successfully. Background to the research Between 30 and 60% of older people in hospital are at risk of losing muscle strength and function, known as deconditioning. This reduces their ability to look after themselves independently. Low physical activity level contributes to deconditioning but dedicated physical activity sessions can benefit older inpatients. In most studies, physical activity is led by paid staff. New ideas are needed to ensure additional physical activity sessions are costeffective and sustainable. The Southampton Mobility Volunteer study showed that trained volunteers can safely engage older inpatients to be more active. However, more information is needed on how to make this approach accessible to more people in more hospitals. Design and methods used Hospital inpatients aged 65 years and older will be invited to participate in the study. We will conduct the study in four hospitals. The hospitals will be different in size and from a wider region to include a range of population groups from different settings and context. This is so that different social groups are represented, and the research will be more representative of the wider population. We will use one hospital as a ‘control site’ – where patients will not get volunteer input – to compare our findings against. Volunteers will encourage participants who can walk independently to walk twice daily. Patients who need help with walking will do bedside exercises. They will be encouraged to walk once they can do so independently. We want to know whether trained volunteer delivered exercise sessions are feasible and acceptable to hospitals. We will determine this by collecting data on volunteer recruitment and training, patient recruitment and the walking/ exercises intervention. We will interview patients, staff, and volunteers as the intervention is delivered to establish what worked well and what could be improved. Other outcomes will include physical abilities, muscle strength, length of stay and readmission rates. We will analyse how much money it costs the NHS to deliver the intervention. Patient/service user, carer and public involvement The James Lind Alliance Priority Setting Partnership has highlighted promoting of independence, and physical and emotional well-being as 2 of the top 3 key research priorities for older adults. More specifically, our PPI research with 92 older people showed that 45% of them had experience with hospital volunteers and all spoke highly of their contribution. Most respondents thought volunteers could be trained to help with mobility. My feasibility study (SoMoVe study) confirmed the volunteer-led intervention was acceptable to patients, volunteers, and staff in one hospital. Patients were grateful that the volunteers encouraged them to be more active. Staff members valued the work of the volunteers. This proposal was developed with the support of 2 public researchers, the volunteer services manager and a hospital therapy lead. The study protocol and study documents will be developed with PPI collaboration. 2 public researchers will be invited to join the study steering group. PPI input will be paid at INVOLVE rates. Dissemination Findings from this study will be shared through conferences, academic papers/reports, and media/social media. In collaboration with the Academic Health Science Network, we will share our findings with commissioners, providers of care and voluntary organisations. Study findings will be of interest to voluntary services, healthcare professionals, and directorate managers. A collection of resources will be produced to encourage the adoption of this intervention in other settings.

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.

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Buy-in and Engagement Project Outputs Buy-in and Engagement Fit with Health and Social Care Systems Alignment with Health and Social Care Priorities Outcomes and Impact Adoption and Spread Checklist, webinar and resources Quick links: Project Outputs This domain helps you consider who needs to be engaged as part of the implementation process, what routes to engagement to use and how engagement will be maintained during implementation. No FAQs yet This category doesn't have any FAQs at the moment. Check back later or explore other categories. What should I consider for my project? Adoption and Spread Project Outputs Buy-in and Engagement Fit with Health and Social Care Systems Alignment with Health and Social Care Priorities Outcomes and Impact Case study “From the start, we decided it was important to use our current networks and involve key people who had established credibility and who were trusted . The commitment and drive for the project by the lead ensured others readily identified its value and were prepared to engage and commit to see the project to realisation. We involved our Communications Team at this early stage and provided regular updates both internally and to partner organisations so that they were aware and felt involved in the project. We continued to recruit key people from partner organisations so that they would spread the message and obtain buy-in within their organisations. Our stakeholder group established a clear plan, including ensuring we considered all governance processes and decisions were actioned. We also identified early on who our ‘anti-champions’ were and discussed how we would manage their resistance or if they attempted to derail implementation. It was a massive team effort that required time and input from all involved. We also confirmed our organisation was fully committed to adoption and this enabled us to show that the intervention was commissioned. This resulted in other organisations having reassurance and confidence to engage and not having to ‘take a risk’ and be the first to sign up. ” Drive Partnership Working Project (DPWP) Take away tips Buy-in and engagement is integral and should be considered at the start and throughout implementation Engagement is necessary at all levels and must be sustained