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4f21e11e-3fe7-460c-9bc0-113a56eec7a5 COMPLETED: The ImPACt study - Improving physical activity of older people in the community Club members at Brendoncare joining in group exercise Principal Investigator: Dr Stephen Lim Team members: Dr Stephen Lim (NIHR Clinical Lecturer in Geriatric Medicine, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Professor Helen Roberts (Professor of Medicine for Older People, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Dr Samantha Meredith (Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton) , Dr Kinda Ibrahim (Senior Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Esther Clift (Consultant Practitioner in Frailty, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Lymington New Forest Hospital), Samantha Agnew (Head of Clubs Services, The Brendoncare Foundation , Winchester), Pam Holloway (Patient representative) Start: 1 February 2020 Ended: 31 October 2021 Project Partners: University of Southampton, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Brendoncare. Lay summary Physical activity is important for older people. It has many benefits including maintaining older people’s ability to perform activities of daily living, be independent, and improve their well-being. However, many older adults living in the community do not engage in regular physical activity. Findings We found that we could train volunteers to support older people during the COVID-19 pandemic to stay active by performing exercises that help strengthen their muscles. Trained volunteers from Brendoncare led the online group exercises for older people who attended online community clubs during the COVID-19 pandemic. This was a challenging time when social distancing and lockdown rules were in place, which limited opportunities for older people to stay active. We recruited 19 volunteers, and 15 volunteers completed the training. The volunteers were mainly female (78%), with an average age of 68 years. The exercises were seated exercises and older adults were given exercise bands to increase the exercise intensity. Halfway through the study, lockdown restrictions were lifted, and some groups continued the group exercise in a face-to-face setting. The volunteers led 184 group weekly exercise sessions (127 online and 57 in-person). Thirty older adults participated in the group exercises. We interviewed volunteers, older adults and Brendoncare staff to find out more about what they thought of the online group exercise. The older adults enjoyed the intervention and understood the benefits of exercising. Additionally, they felt that they could exercise in a relaxed way with their peers without fear of being judged. The group exercises helped reduce social isolation and motivated older adults to engage with the exercises. Volunteers were enthusiastic to support the exercise groups. They appreciated the training and opportunity to lead the group exercises. One volunteer reported that the role gave her a sense of purpose by playing an active role the community club. Brendoncare staff members were a great help to the older adults and supported them with any issues, in particular those who were less familiar with the internet. At six months, we found that older adults who participated in the group exercise had an improved physical activity level. The time spent in light physical activity per week improved from an average of 1530 minutes per week to 1620 minutes per week. Only two minor incidents happened during the group exercises. Two participants experienced worsening of old injuries while performing the exercises. The programme trainer ensured the participants were safe and adapted the exercise for them. Overall, we found that volunteers can be trained to lead online group seated exercises. The exercises were safe and older adults enjoyed the exercises as well as the social interaction in the group setting. What we did with the new knowledge We supported Brendoncare in continuing the exercise groups after the study had ended. We presented our study findings to the board of trustees and demonstrated the exercises. Brendoncare has since employed an activity coordinator to continue to role of training volunteers and supporting volunteer-led exercise groups within Brendoncare. We trained the activity coordinator and shared our exercise sheets and other study materials to help Brendoncare develop their own training package. They are now actively recruiting more volunteers to lead group exercises in their community clubs. https://www.brendoncare.org.uk/get-involved/support-us/volunteering/#:~:text=Chair%20Based%20Exercise%20Volunteer,improving%20their%20health%20and%20wellbeing . We have developed a volunteer toolkit which is available to share with other volunteer organisations. The toolkit has recently been shared with Valley Leisure Ltd, a charitable leisure organisation, who have developed their offer of volunteer-based community clubs in Test Valley. Where next? Having explored how we can train volunteers to engage with healthy community-dwelling older adults to stay active through online group exercises, we collaborated with researchers from the Southampton Biomedical Research Centre and Bournemouth University to further develop this volunteer-led online intervention. We successfully secured research funding (£51,000) from University Hospital Southampton NHS FT to conduct a study to explore a multimodal intervention consisting of exercise, nutrition and behaviour change support, to engage with older people living with frailty who have been discharged from hospital, to stay active and eat well. This research has now been completed (10/01/2024) and we showed that it was feasible to translate the programme to support older people living with frailty ( COMPLETED: Wessex Frail2Fit – A feasibility and acceptability study of a virtual multi-modal intervention delivered by volunteers to improve functional outcomes of older adults with COVID-19 discharged from hospital ). What did people say about the work? Volunteer : “We do it because we want to help others…. we enjoy it. I'm gonna go back to belonging again, I feel that I'm benefiting from the group. Because again, I feel like I belong to that group….. I get so much out of it.” Club member: ‘We are not self-conscious when they (volunteers) are around. We have a laugh as well.’ Club member: ‘I’ve really enjoyed it because it keeps you in touch with people, especially during this COVID….. I still feel as if I’m part of a group.’ NEWS: ImPACT volunteers recognised for their wor k ImPACt exercise video IMPACT Exercise with Steve and Esther from NIHR ARC Wessex on Vimeo . Impact Exercise video using Resistance bands - Dr Sam Meredith watch the video on Vimeo Publications doi.org Volunteer-led physical activity interventions to improve health outcomes for community-dwelling older people: a systematic review - Aging Clinical and Experimental Research Background Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. There is strong evidence to support the benefits of physical activity interventions on the health outcomes of older adults. Nonetheless, innovative approaches are needed to ensure that these interventions are practical and sustainable. Aim This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers describing eight studies (five papers reported different outcomes from the same study) were included in the review. All eight studies included strength and balance exercises and frequency of PA ranged from weekly to three times a week. Volunteer-led exercises led to improvements in functional status measured using the short physical performance battery, timed up and go test, Barthel Index, single leg stand, step touch test, chair stand test, and functional reach. Frailty status identified by grip strength measurement or the use of long-term care insurance improved with volunteer-led exercises. Interventions led to improvement in fear of falls and maintained or improved the quality of life. The impact on PA levels were mixed. Conclusion Limited evidence suggests that volunteer-led PA interventions that include resistance exercise training, can improve outcomes of community-dwelling older adults including functional status, frailty status, and reduction in fear of falls. More high-quality RCTs are needed to investigate the effects of volunteer-led PA interventions among older people. https://doi.org/10.1007/s12603-020-1442-0 https://doi.org/10.7861/clinmed.2022-0283 doi.org Detecting low-intake dehydration using bioelectrical impedance analysis in older adults in acute care settings: a systematic review - BMC Geriatrics Background Dehydration is a frequent cause of excess morbidity and poor health outcomes, particularly in older adults who have an increased risk of fluid loss due to renal senescence, comorbidities, and polypharmacy. Detecting dehydration is key to instigating treatment to resolve the problem and prevent further adverse consequences; however, current approaches to diagnosis are unreliable and, as a result, under-detection remains a widespread problem. This systematic review sought to explore the value of bioelectrical impedance in detecting low-intake dehydration among older adults admitted to acute care settings. Methods A literature search using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane Library was undertaken from inception till May 2022 and led to the eventual evaluation of four studies. Risk of bias was assessed using the Cochrane tool for observational studies; three studies had a high risk of bias, and one had a low risk. Data were extracted using systematic proofs. Due to insufficient reporting, the data were analysed using narrative synthesis. Results One study showed that the sensitivity and specificity of bioelectrical impedance in detecting low-intake dehydration varied considerably depending on the total body water percentage threshold used to ascertain dehydration status. Other included studies supported the technique's utility when compared to conventional measures of hydration status. Conclusions Given the scarcity of literature and inconsistency between findings, it is not possible to ascertain the value of bioelectrical impedance for detecting low-intake dehydration in older inpatients. https://bmjopen.bmj.com/content/13/3/e069533 https://www.sciencedirect.com/science/article/pii/S2260134125000854[SM1] doi.org Evaluating the feasibility and acceptability of virtual group exercise for older adults delivered by trained volunteers: the ImPACt study protocol Introduction Physical activity is important for healthy ageing. Despite strong evidence on the benefits of physical activity for health and well-being, physical inactivity remains a significant problem among older adults. This study aims to determine the feasibility and acceptability of implementing an online volunteer-led group exercise for older adults. Methods A quasi-experimental mixed-methods approach will be used in this study. A training programme will be developed to train volunteers to deliver online group exercises to older adults aged >65 years (n=30). The primary outcome is the feasibility of implementing the intervention. This will be assessed by the number of volunteers recruited, trained, and retained at the end of the study, and the number of exercise sessions delivered and completed by participants. Secondary outcomes include physical activity levels measured using the Community Health Model Activities Programme for Seniors questionnaire, Barthel Index, EQ-5D-5L as a measure of health-related quality of life, SARC-F to determine sarcopenia status, and PRIMSA-7 to determine frailty status. Outcomes will be measured at baseline and at 6 months. Qualitative interviews will be conducted with volunteers(n=5), older adults (n=10) and family members (n=5) to explore their views on the intervention. Analysis Simple descriptive statistics will be used to describe participant characteristics, the feasibility of the study and the impact of the intervention on health outcomes. Parametric(t-test) or non-parametric(Mann-Whitney U test) statistics will be used to analyse continuous variables. χ2 test will be used for categorical variables. Qualitative data will be analysed using an inductive thematic analysis approach. Ethics and dissemination This study received ethical approval from the University of Southampton Faculty of Medicine Ethics Committee and Research Integrity and Governance committee (ID: 52 967 .A1). Study findings will be made available to service users, voluntary organisations and other researchers who may be interested in implementing the intervention. Trial registration number [NCT04672200][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04672200&atom=%2Fbmjopen%2F12%2F2%2Fe052631.atom · 40 Faces of Brendoncare - Sharon Green · 40 Faces of Brendoncare - Dr Sam Meredith · 2022 Winners | Pride of Andover Awards · https://www.linkedin.com/posts/karen-lewis-6b009665_ahpsday-activity-7385000352397385728-8v1K?utm_source=share&utm_medium=member_android&rcm=ACoAAGAmYqMBCL-wtu3ZnECr4UsylRfjAyKeGFY · https://youtu.be/nMSQR7kp9ec · https://youtu.be/6vxyL4OenmQ?si=RiOBz-yU7tO09fwX

c7fa8be0-4046-4345-a82a-ce4a38e05e07 COMPLETED: Social network facilitated engagement in people who are Homeless to address InEqualities in alcohol related Liver Disease - The SHIELD feasibility study Principle Investigator: Dr Ryan Buchanan, University of Southampton Team: Professor Salim Khakoo, University of Southampton, Dr Mark Wright, University of Southampton, Dr Yun J Kim, University Hospital Southampton NHS Foundation Trust. Starts: 1/4/22 Ends: 1/4/23 Aim: To develop and assess the feasibility of a social network-based intervention to engage people who are homeless and at risk of alcohol-related liver disease with Hepatology services Background: Mortality in people who are homeless (PWAH) is eight times higher than the general population and liver cirrhosis is the third commonest cause of death. PWAH infrequently access hospital based Hepatology services for assessment. Alcohol consumption is a socially perpetuated behaviour that is known to cluster within human social networks. What we did Recruitment continued from February to July 2022 of people who are homeless with high risk of alcohol dependence (AUDIT score) were identified in hostels and at a homeless day centre in Southampton. Those people were then asked to take part in tests and to refer thier drinking partners to the programme. They were given supermarket vouchers as an incentive. Those homeless people who took part, filled in a survey and took part in an interview. They also had a test on their liver and were referred to liver health services. What did we find out? Fifty six peoople took part, all were from homeless hostels. Almost 20% of the group had a new diagnosis of cirrhosis, and there was a link between people who had type 2 diabetes or lived house where alcohol was present. Homeless people with hazardous alcohol consumption are socially connected to others that drink dangerously. This programme of referral can identify undiagnosed disease, however, engagement via trusted staff may be just as effective. The study highlights the importance of working with community organisations supporting underserved populations to overcome inequalities in liver disease and manage multi-morbidity. What's next? Identifying liver disease in people experiencing homelessness is progress but… Sustaining underserved populations with liver health care services after a diagnosis is made is crucial – we have since been awarded a further NIHR research grant in investigate how to approach this problem: To find out more: Follow @liverchampions https://www.southampton.ac.uk/research/projects/nihr-liver-disease-research-partnerships-liver-champions

Web-based Implementation Toolkit (WIT) Quick links: 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 Web-based Implementation Toolkit (WIT) is designed to be easy to use and intended for a variety of users, projects and settings where implementation is planned or being considered. Implementation is the attempt to introduce a new intervention, innovation or policy developed through research and apply it to health and/or social care and the third sector. WIT provides you with an interactive Implementation Wheel, Checklist and bite-size Webinars (average 10 minutes) to support you through your implementation journey. Who is WIT for? WIT recognises the need to provide freely available, accessible and simple to use tools that focus on key implementation considerations at the outset of a project. WIT was co-produced through interactive workshops with health and social care professionals, third sector organisation professionals, academics and members of the public. Anyone looking to understand more about or engage in implementation. Why use WIT? When to use WIT From the beginning – when first considering and designing a project Throughout all stages of your implementation journey and beyond To guide you through implementation considerations for your project There are six wheel domains to help you consider what is required for implementation. Click on a domain segment to find out more. 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 How to use WIT Use the interactive Implementation Wheel, Checklist and bitesize Webinars to support you on your implementation journey and beyond. The six Wheel domains can be used iteratively, and in no particular order. The Checklist is downloadable and consists of the same domains as the Wheel. You can use this to complete with your team and check progress of your implementation journey. The Webinars , approximately 10 minutes duration, provide sessions relating to the six Wheel and Checklist domains and also to an introduction to implementation and implementation theories and frameworks. Hover on keywords to see definitions Other words in bold represent key learning points The Resources section provides suggestions for other resources you may find helpful. Feedback via our short survey If you fulfil the criteria on the attached poster , Researchers from the School of Health Sciences, University of Southampton/NIHR ARC Wessex would like you to test WIT by providing feedback via a short survey . Or alternatively scan the QR code. Thank you. Contact us If you have any questions about WIT, please contact: C.F.Brooks@soton.ac.uk Disclaimer The development of WIT has been supported by the NHS Insight Prioritisation Programme (NIPP). The views expressed are those of the authors and not necessarily those of the NHS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of this website. How to cite Brooks, C.F., Lund, S., Kryl, D., and Myall M. (2023) Web-based Implementation Toolkit (WIT). University of Southampton. Available at: www.arc-wx.nihr.ac.uk/web-implementation-toolkit Accessibility We are committed to providing a website that is accessible to as many people as possible. We are actively working to increase the accessibility and usability of the website.

Guidance for publications As an NIHR researcher you are required to acknowledge NIHR ARC Wessex and inform ARC Wessex when you have submitted a publication. Notification should be sent to arcwessex@soton.ac.uk . When acknowledging the NIHR, please use the relevant statement below ARC Wessex funded projects This study is funded by the National Institute for Health and Care Research ARC Wessex. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care. ARC Wessex adopted projects This study is supported by the National Institute for Health and Care Research ARC Wessex. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care. Academic Career Development Awards (Name) received(s) support from the NIHR Applied Research Collaboration ARC Wessex and funded through an {insert name of award e.g. NIHR ARC Wessex Internship/PhD fellowship, Post Doctoral Fellowship). The views expressed are those of the authors and not necessarily those of the NIHR, NHS or Department of Health and Social Care. For individuals listed as co-funded ARC investigators and where the research output is linked to the ARC Wessex portfolio please use the following This study is supported by the National Institute for Health and Care Research ARC Wessex. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care. Download the Funded by NIHR logo Download

Workforce & Health Systems publications Evaluation and Enhancement of the Prognostic Ability of the Eighth Edition of TNM Staging in Cutaneous Malignant Melanoma: A Population-Based Study of 111,871 Cases Using Machine Learning Mortagy M, Cliff-Patel N, Askary R, Bologan AM, Abdelhameed A, Burns D, Ramage J, Akhras V Melanoma is the fifth most common cancer in the United States (US) and the United Kingdom (UK), with global incidence on the rise. The TNM staging system guides treatment decisions and predicts patients' outcomes. This study aims to evaluate the prognostic ability of the 8th edition TNM (TNM-8) staging system to predict overall and melanoma-specific survival (OS and MSS) in cutaneous malignant melanoma (CMM), and to explore the potential of machine learning (ML) methods to enhance melanoma prognostication. https://doi.org/10.1093/bjd/ljag018 January 2026 Workforce & Health Systems Icu Staffing and Patient Outcomes in English Hospital Trusts: A Longitudinal Observational Study Examining Icu Length of Stay, Re-Admission and Infection Rates Nwanosike E, Griffiths P, Dall'Ora C, Monks T, Pattison N, Yapa TD, Saville C Intensive care units (ICUs) are high-stakes environments where patient outcomes are heavily influenced by the quality and quantity of nursing care. The increased risk of mortality has been widely studied in terms of relationships with RN staffing, but other important outcomes, including length of stay (LoS), unit-acquired infections, and readmissions much less so. The risk of poor patient outcomes, including unit-acquired infections in ICUs, is high, with prevalence rates reaching up to 20 % in some hospitals. Also, patient readmissions to the ICU are another important outcome, with rates as high as 25 % in some hospitals. The importance of nurses being involved in management has been shown indirectly through studies of Magnet hospital accreditation. A recent systematic review of longitudinal studies including ICU settings reported mixed findings on the association between RN staffing levels and LoS, infections and readmissions. The reviewed studies have a serious risk of bias due to inadequate risk-adjustment. This means that any detected association between staffing levels and patient outcomes might be at least partly explained by high patient acuity and existing co-morbidities. In addition, the COVID-19 pandemic introduced unprecedented challenges, including surges in patient acuity, resource constraints, and rapid changes in care protocols, which may have altered these relationships beyond the pandemic period. Although prior research has examined RN-to-patient ratios, limited evidence exists regarding how RN team composition (e.g. RN skill-mix and presence of nurse managers) influences ICU outcomes such as the development of unit-acquired infections, increased LoS and readmissions to the ICU. Therefore, this study aims to fill these gaps by exploring longitudinal associations between RN staffing, skill mix, and patient outcomes in English ICUs over almost four years, encompassing the pre-pandemic, pandemic, and post-pandemic periods. By providing insights into the impact of staffing on ICU outcomes prior to, during and after the pandemic, this study offers valuable evidence for optimising ICU staffing strategies in both crisis and non-crisis settings. https://doi.org/10.1016/j.iccn.2025.104314 December 2025 Workforce & Health Systems Here’s something we prepared earlier: Development, use and reuse of a configurable, inter-disciplinary approach for tackling overcrowding in NHS hospitals Crowe S, Grieco L, Monks T, Keogh B, Penn M, Clancy M, Elkhodair S, Vindrola-Padros C, Fulop NJ, Utley M Overcrowding affects hospital emergency departments (ED) worldwide. Most OR studies addressing overcrowding develop bespoke models to explore potential improvements but ignore the organisational context in which they would be implemented, and few influence practice. There is interest in whether reusable models, for ED crowding and in healthcare generally, could have more impact. We developed a configurable approach for tackling ED overcrowding. A reusable queuing model for exploring drivers of ED performance was augmented by a qualitative approach for exploring the implementation context and a generic framework for assessing the likely compatibility of interventions with a given organisation. At the hospital where the approach was developed it directly informed strategy. We describe reuse of the approach at three hospitals. The primary contribution of this work is its novelty in considering, alongside quantitative modelling, evidence-based interventions to overcrowding and qualitative assessment of a hospital’s aptitude and capability to adopt different interventions. A secondary contribution is to further the debate on model reuse, particularly by introducing more complex, modelling-centred approaches that acknowledge how models must relate to tangible interventions with reasonable prospects of being adopted locally. https://doi.org/10.1080/01605682.2023.2199094 July 2023 Workforce & Health Systems Fatigue risk management in healthcare: A scoping literature review Fox S, Dall'Ora C, Young M Occupational fatigue among healthcare professionals is a complex, multifaceted issue associated with increased likelihood of medical error, compromised patient safety and negative impacts on staff mental and physical health. While safety-critical sectors such as aviation and rail have implemented formal systems to manage fatigue-related risks, it remains unclear whether similarly structured approaches exist or operate effectively within healthcare. This scoping literature review aimed to examine the current state of knowledge regarding fatigue risk management strategies and countermeasures in healthcare and explore the barriers and facilitators to their implementation. This review sought to highlight gaps and provide insights into advancing fatigue risk management practices within the healthcare context https://doi.org/10.1016/j.ijnurstu.2025.105282 November 2025 Workforce & Health Systems Nurse staffing configurations and sickness absence in English intensive care units: A longitudinal observational study Nwanosike E, Dall'Ora C, Griffiths P, Saville C, Monks T, Pattison N et al Staff wellbeing in intensive care units is essential for quality patient care, and nurse staffing configurations can impact nurse sickness absence. The COVID-19 pandemic imposed additional strain on nurses, potentially affecting sickness absence rates. The objective of this study is to examine the association between registered nurse staffing levels, skill mix, and staff sickness absence in intensive care units spanning prepandemic (01/19–02/20), early pandemic (03/20–02/21), later pandemic (03/21–02/22), and post-pandemic (03/22–12/22). https://doi.org/10.1016/j.ijnsa.2025.100451 November 2025 Workforce & Health Systems A flexible mathematical model for Home Health Care Problems Reula M, Parreño-Torres C, Lamas-Fernandez C, Martinez-Sykora A In the health and social care sectors it is common for some specialized teams to travel to patients homes to provide care. These teams are typically made up of by a number of staff members with varying skills, starting locations and working hours. Patients require different types of care, during specific time windows, and may have special requirements, such as needing two staff members, or multiple visits with some sort of temporal dependency between them. Since teams need to decide which staff member will visit each patient, as well as the routes they will take to do so, this kind of planning problem is known in the literature as the Home Health Care Routing and Scheduling Problem (HHCRSP). We introduce a new mixed integer linear programming formulation for the HHCRSP that extends previous models. Our formulation can readily be adapted to address more specific variants in the scientific literature, proving a larger number of optimal solutions and stronger lower bounds on benchmark instances using the same computational framework. We further propose an instance generator for producing scenarios that closely resemble those of the National Health Service in the United Kingdom. https://doi.org/10.1016/j.ejor.2025.05.055 November 2025 Workforce & Health Systems Pretrained language models for semantics-aware data harmonisation of observational clinical studies in the era of big data Dylag JJ, Zlatev Z, Boniface M In clinical research, there is a strong drive to leverage big data from population cohort studies and routine electronic healthcare records to design new interventions, improve health outcomes and increase the efficiency of healthcare delivery. However, realising these potential demands requires substantial efforts in harmonising source datasets and curating study data, which currently relies on costly, time-consuming and labour-intensive methods. We explore and assess the use of natural language processing (NLP) and unsupervised machine learning (ML) to address the challenges of big data semantic harmonisation and curation. https://doi.org/10.1186/s12911-025-03055-y October 2025 Workforce & Health Systems Mapping the evidence on occupational exoskeleton use for the workforce in healthcare, social care, and industry: A systematic scoping review Bhat S, Gavin J, Warner M, Myall M Musculoskeletal disorders remain a leading occupational health challenge in physically demanding sectors such as healthcare, social care, and industry. Exoskeletons – wearable devices designed to mitigate physical strain are increasingly explored as potential solutions; however, factors affecting their adoption in real-world settings remain underexplored. This novel scoping review systematically maps the existing evidence on the application of commercially available exoskeletons within real and simulated work environments, focusing on usage patterns, user experiences, and factors influencing implementation. https://doi.org/10.1017/wtc.2025.10033 November 2025 Workforce & Health Systems Perceived usefulness and effectiveness of game-based learning when revising and preparing for written exams in nursing education - a feasibility study Tavares N, Jarrett N Studying for final exams is often regarded as difficult for nursing students, therefore, activities using game-based learning methods may increase student satisfaction. Therefore, this study aimed to understand the feasibility of a game-based learning activity on nursing students' learning and revision processes. A one-group pre and post-questionnaire design was undertaken to evaluate the effectiveness of a game-based learning activity. All nursing students found the game-based learning activity valuable when preparing for written exams. The learning activity increased the levels of knowledge retention and the final grades. Although two students found the activity somewhat distracting, most students believed that game-based learning should be embedded into the nursing curriculum. The game-based learning activity was well-accepted when revising for written exams in nursing. However, research at a larger scale is required to confirm the effectiveness of the activity on students' knowledge, grades and long-term retention. https://doi.org/10.1371/journal.pdig.0001043 October 2025 Workforce & Health Systems A flexible mathematical model for Home Health Care Problems Reula M, Parreno-Torres C, Lamas-Fernandez C, Martinez-Sykora A In the health and social care sectors it is common for some specialized teams to travel to patients homes to provide care. These teams are typically made up of by a number of staff members with varying skills, starting locations and working hours. Patients require different types of care, during specific time windows, and may have special requirements, such as needing two staff members, or multiple visits with some sort of temporal dependency between them. Since teams need to decide which staff member will visit each patient, as well as the routes they will take to do so, this kind of planning problem is known in the literature as the Home Health Care Routing and Scheduling Problem (HHCRSP). We introduce a new mixed integer linear programming formulation for the HHCRSP that extends previous models. Our formulation can readily be adapted to address more specific variants in the scientific literature, proving a larger number of optimal solutions and stronger lower bounds on benchmark instances using the same computational framework. We further propose an instance generator for producing scenarios that closely resemble those of the National Health Service in the United Kingdom. https://doi.org/10.1016/j.ejor.2025.05.055 September 2025 Workforce & Health Systems "I don't think there's necessarily a one size fits all" negotiating competing priorities in nurse shift scheduling: a qualitative study Barker HR, Griffiths P, Dall'Ora C The nursing workforce globally faces significant challenges, including burnout, stress, and absenteeism, exacerbated by unsafe staffing levels and suboptimal working conditions. In England, many nursing staff express intentions to leave their roles, driven by work-life imbalance. This study explores how the preferences and constraints of nursing staff, nurse managers, and hospital directors interact to influence shift scheduling decisions within the NHS, aiming to identify strategies that reconcile individual wellbeing with organisational imperatives. https://doi.org/10.1186/s12912-025-03705-6 August 2025 Workforce & Health Systems Estimating Nurse Workload Using a Predictive Model From Routine Hospital Data: Algorithm Development and Validation. Meredith P, Saville C, Dall'Ora C, Weeks T, Wierzbicki S, Griffiths P Managing nurse staffing is complex due to fluctuating demand based on ward occupancy, patient acuity, and dependency. Monitoring staffing adequacy in real time has the potential to inform safe and efficient deployment of staff. Patient classification systems (PCSs) are being used for per shift workload measurement, but they add a frequent administrative task for ward nursing staff. https://doi.org/10.2196/71666 July 2025 Workforce & Health Systems

How we involve and engage patients and the public in our applied health and care research Patient and Public Involvement, Engagement and Participation At ARC Wessex we want to engage and involve the public throughout the research process to improve the reach, quality and impact of our research findings. John has a neurological condition. He supports our research: "I get huge benefits out of the socialisation, and just knowing I can get here easily and take part and participate. Being part of the solutions. It’s just for my mental health, hugely, hugely important" Patient and Public Involvement, Engagement and Participation (or PPIEP in short) Our vision from our strategy is: Where meaningful public and community involvement and engagement is a central part of NIHR ARC Wessex’ health and social care research activities. It is important to us that the people who are the focus of our research in health and social care have a say in how that research is identified, designed and carried out. We aim to make sure the research is relevant and meets the needs they have helped identify, in partnership with those who deliver the health and social services in our region. Your views and opinions are important. They offer a point of view that academics or service providers may not have. When everyone’s ideas and views are brought together, they can result in high quality, relevant and useable research evidence, which can improve the health, care and wellbeing of others across our Wessex region.. What is Public Involvement in research? Public involvement in research is referred to as research being carried out 'with' or 'by' members of the public rather than 'to', 'about' or 'for' them. It involves collaborative working with our public partners, working together to ensure that the voices of local people are at the heart of our Health and Care research. It is different to research participants taking part in a study. What is Engagement? By this, we mean reaching out to individuals or communities to provide the opportunity for a two-way process of sharing information, discussing and listening to ideas to help shape research. Engagement is about building working relationships. Who can be involved in our research locally? Anyone who lives across Hampshire and the Isle of Wight, Dorset and South Wiltshire (Wessex) , regardless of your level of experience or education. We work with a diverse community of people from different backgrounds and of all ages. Anyone can be involved with the National Institute for Health and Care Research (NIHR) Be Part of Research. For more information and to register please click here . For reference strategy 2019 - 2024 (updated 2024) Getting involved Glossary Researcher Resources Strategy Impact report

Alignment with Health and Social Care Priorities 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 how implementation of your project output(s) fit with the changing needs of the health and social care systems and local, regional and national directives and policy. 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 Staff Wellbeing (SWP) project “We knew that senior managers were keen to understand the wellbeing needs and priorities of staff, but we did not know how to address this. By consulting with colleagues from a partner organisation, we were able to understand how they approached this. They informed us that they had conducted an anonymous survey with staff to ascertain key needs and priorities for wellbeing. With their guidance we collaborated with a local research and evaluation partner who helped us design the questions for a survey administered within our organisation. In this way we could make sure any initiatives arising from the project were aligned to staff needs. When we conducted the survey, we realised one key factor impacting on staff wellbeing was influenced by a national policy initiative which had resulted in changes to working practices within our organisation. We reflected that we should have reviewed national policies more closely at an early stage, to ensure that our survey questions considered the potential impact of these. We have since adapted the survey to include questions relating to the impact of these policies. The survey findings have provided important insights into how national policies impacted on staff wellbeing at an organisational level as well as reinforcing the importance of wellbeing initiatives being aligned to local, regional and national priorities.” Take away tips Implementation is more likely to be successful when it aligns with the priorities of all relevant stakeholders Understanding how implementation may align at local, regional, and national levels is key

7fc9e212-9328-4765-add4-7315e187c43b Workforce Evaluation Toolkit project (WET) Outline: This is a commissioned piece of work from the ARC Wessex Workforce & Health Systems (WHS) theme to support them with regular requests from healthcare providers. The project is to iteratively develop a generic toolkit for the evaluation of new workforce roles across healthcare. The aim during the current project is to build a first trial version to prove the toolkit concept and generate buy-in from system partners. The Bakker’s Workforce engagement model Burnout forms the conceptual basis for evaluation toolkit. The deliverable for this project is a minimal viable product, in the shape of a workforce evaluation toolkit. Team: Ruth Barker Programme Manager – Insight Health Innovation Wessex . Cheryl Davies, Senior Programme Manager Innovation Adoption, Health Innovation Wessex. Rachel Bailey Senior Programme Manager - Insight, Health Innovation Wessex. Ends: 30 June 2024 More detailed outline or project and partners Workforce Evaluation Project Work Packages 011223[99] .docx Download DOCX • 390KB

Fit with Health and Social Care Systems 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 how implementation of your project output(s) fit with the changing needs of the health and social care systems and local, regional and national directives and policy. 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 Parkinson’s disease Charity Community Outreach Project (PCCOP) team "We took time to understand how the aims of our project related to local and national policy and research on improving awareness of Parkinson’s disease in the community. We also spoke to other people within our local networks about their awareness of projects relating to the topic. Because of this, early on we realised there was a project with similar aims being undertaken by another local organisation. Though this was a challenge, as we had taken time to speak to people within our local networks, we had the opportunity to consider whether our project would be able to offer something different. We realised that though the projects had similar aims they were involving different stakeholder groups. We were also able to attend learning events from the other project to understand which steps may be helpful to repeat and avoid in our own project. This was invaluable as it saved both time and resources of those involved. It also ensured that our project fitted with local and national aims and provided something of real benefit and value to our local community.” Take away tips Implementation has a greater chance of success if it fits with the changing needs and priorities of the health and social care systems into which it is being introduced Involvement of stakeholders is key to identifying and understanding fit

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

2bde6957-3a7b-4fc1-81e9-51f920491c2f Developing a core cohort of community researchers in Wessex: towards a sustainable Wessex Community of Practice for public health research co-production Chief Investigator: Professor Nisreen A Alwan, Professor of Public Health, Centre for Population Health Sciences, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust Team: Dr Donna Clutterbuck, Research Fellow, University of Southampton Megan Barlow-Pay, PPIE Lead, NIHR Research Support Service Professor Julie Parkes, Professor of Public Health, University of Southampton, University Hospital Southampton NHS Foundation Trust and Health Education England Wessex Dr Kath Woods-Townsend, Associate Professor (Research) and Lifelab Project Manager, University of Southampton Mirembe Woodrow, Senior Public Health Practitioner, Southampton City Council and PhD student, University of Southampton Partners: Hampshire and Isle of Wight NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Bournemouth University, University of Portsmouth, University of Southampton, Southampton City Council, NIHR Research Support Service Specialist Centre for Public Health, LifeLab, University of Southampton / NIHR Southampton Biomedical Research Centre, Health Determinants Research Collaboration, Southampton, Southampton Centre for Research Engagement & Impact (SCREI), Centre for Seldom Heard Voices, Bournemouth University, HDRC Portsmouth Start: 1 October 2024 End: 31 March 2026 Summary Public health research priorities must stem from the needs of the communities served by such research, particularly those most socially and economically disadvantaged, as well as community groups that are seldom heard. Therefore, community members with lived experience of health conditions and the various factors shaping health and wellbeing have a central role in shaping such research. Co-creating research with the public can lead to research findings that are more relevant to population health and wellbeing, leading to a reduction in heath inequalities. The purpose of this project is to develop a core ‘cohort’ of community public health researchers using an approach that considers the multiple social forces that shape people’s identities to inform research design that is meaningful to Wessex local communities. This cohort will form a Community of Practice (CoP) for research co-design that can help us reach those seldom heard groups in our local communities and understand underrepresented perspectives to inform relevant and meaningful health research priorities, questions and methods. People from such communities are more likely to feel comfortable to inform research that is led or co-led with community researchers. This project will be a Partnership between the NIHR Research Support Service (RSS) National Specialist Centre for Public Health (NSCPH) which aims to support the generation of high-quality research evidence aimed to inform decisions about which interventions have the greatest likelihood to improve population health and reduce health inequalities, and the Healthy Communities Theme of the NIHR ARC Wessex. In the first stage of the project, we will engage with stakeholders, including members of the public, voluntary organisations, Local Councils and health services to shape the project protocol and to co-develop its strategy, key milestones and outcomes. In the second phase of the project, we envisage a group of community researchers being recruited and trained in participatory research (or other research methods of their choice) and be provided with opportunities to link in with health researchers. In the third phase of the project, the community researchers will then choose a pathway (or more) that suits their needs from conducting community-based research, linking with other community members to inform further research projects, co-creating research ideas, or informing research proposals developed by researchers within the ARC or through the RSS. In the fourth phase of the project, we will evaluate the above activities and synthesise and disseminate lessons learnt from the project towards sustainability of our CoP framework. The project’s Research Fellows will also work with public contributors to disseminate findings in ways that are meaningful, alongside preparing publication materials for journals and conferences, and producing infographics. The CoP will help us to co-design health research based on local and regional need; provide stakeholder input into public health research proposals in Wessex; contribute to governance and delivery of NSCPH; and support meaningful and equitable research partnerships with community stakeholders and the public.

9381b390-9efb-4b71-9879-2371689f041c ADOPTED PROJECT: EnablExercise in Crohns: A qualitativE study to uNderstAnd the Barriers and faciLitators to physical activity and Exercise IN children and adolescents with CROHN’S disease ADOPTED PROJECT: EnablExercise in Crohns: A qualitativE study to uNderstAnd the Barriers and faciLitators to physical activity and Exercise IN children and adolescents with CROHN’S disease Principal Investigator: Dr Zoe Saynor Co Applicants : Dr Nadeem Afzal , Dr Christopher Roberts , Professor Kelly Mackintosh , Dr Danielle Lambrick , Professor James Faulkner , Mr William Freer (PPI Contributor) Partners: University of Portsmouth, University Hospital Southampton NHS Foundation Trust, Swansea University, University of Winchester, For Crohns (charity), Guts UK (Charity) Duration : 12 Months Background: We know that people with inflammatory bowel disease (IBD), of which one of the main forms is Crohns, are at a high-risk of not meeting the physical activity recommendations for health, due to a combination of bowel and general physical symptoms (e.g. abdominal pain, diarrhoea and fatigue). Additionally, there are currently no physical activity and exercise guidelines for young people with IBD – making it difficult to advise what people should be doing. Researchers within our team have been monitoring the effects of COVID-19 and associated lockdowns on physical activity and mental health on a global scale, and saw negative impacts in both people with long-term conditions and in the wider population. However, there is currently no data to tell us how young people with e.g. Crohns have been impacted during this time. in our centre, we are seeing an increasing number of people with Crohns transitioning from paediatric to adult care with metabolic syndrome and we anticipate this will rise in response to the COVID-19 pandemic. Objectives: Assess the barriers to, and facilitators of, physical activity and exercise participation in young people with Crohns disease. Additionally, comparing their views to their parents/guardians and clinicians. Design and Methods: The proposed research will be a qualitative cross-sectional study consisting of individual semi-structured interviews with the three participant groups (in clinic for young people; videoconference for parents/guardians and clinicians). The interview schedule will be co-developed with people living with Crohns. Information from the interview will be digitally recorded, transcribed verbatim and thematically analysed. For the young people with Crohns involved in the study, we are interested in documenting their disease activity and nutritional/growth status at the time of interview so will use the Paediatric Crohns Disease Activity Index (PCDAI) to determine remission, mild activity, or moderate-to-severe activity and growth ‘weight height and BMI’ Z-scores for this. Clinical and Scientific Impact: Physical activity is important for both mental and physical health and is particularly important in people with a long-term condition. This work will provide important understanding of the views and experiences of young people with Crohns, their parents/guardians and clinicians surrounding physical activity and exercise. The findings from this qualitative study will provide insight as to why young people with Crohns may not undertake physical activity and exercise and will help inform the design and delivery of future appropriate physical activity and exercise programmes for this population. This information would complement our ongoing research (The ACTIVE-IBD Study), and will inform future funding applications to develop, evaluate and implement educational and interventional resources to increase the physical activity and exercise undertaken by young people living with Crohns. This funding award will help expedite our journey to the end goal of improving this provision and, ultimately, the quality of lives of people with Crohns