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GOODNIGHT Covid-19 to care-home-based vulnerable individuals Co-Chief investigators Dr Thomas Daniels, Consultant Respiratory Physician, Honorary Senior Clinical Lecturer, University of Southampton Dr Ryan Buchanan, Academic Clinical Lecturer, Primary Care, Population Science and Medical Education, University of Southampton Partners: University Hospital Southampton NHS Foundation Trust, Southampton CTU & NIHR ARC Wessex Co-applicants Professor Julie Parkes, Professor of Public Health, University of Southampton Professor Helen Roberts, Professor of Medicine for Older People, University of Southampton Emeritus Professor Jeremy Wyatt – University of Southampton Dr Beth Stuart – Medical Statistician, Southampton Clinical Trials Unit Dr Kinda Ibrahim - Senior Research Fellow, Faculty of Medicine, University Hospital Southampton NHS Foundation Trust Dr Andrew Cook – Public Health Consultant, Fellow of Health Technology Assessment, University of Southampton Novel corona virus (COVID-19) is a virus that is spreading quickly around the world. Elderly people with other health problems have a high death rate from the infection. There are no treatments for COVID-19 so prevention of infection is very important . COVID-19 is thought to infect people via the nose and mouth. Current best practise to prevent infection focuses on good hand hygiene, the wearing of masks and by limiting social contact. However, elderly people in care homes have to come into contact with staff members who are looking after them. If you would like to know more about this study please contact Dr Ryan Buchanan

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

< Back Engaging Children and Young People in Research Community of Practice Inaugural Meeting ARC Wessex Early Career Researchers - Cara Black, Naomi Leonard, Olivia Taylor and Annabelle Prescott September 2023, University of York, UK There is a knowledge gap in our understanding about approaches and methods for meaningfully involving and engaging with children and young people in matters and decisions that impact on them. We went to a two-day meeting at the University of York with researchers from the University of York, Bristol, Hertfordshire, Southampton and Auckland, NZ as well as a representative from the International Alliance of Mental Health Research Funders. This group came together to form an international Community of Practice (CoP), with the goal of sharing learning, methods, and experience for effective ways to engage young people. It also highlighted the wide variety of opportunities for putting children and young people at the heart of research, decision making and advocacy for their mental health and well-being. Here are our reflections as early career researchers (ECRs) from the meeting: What did we gain from the meeting? We thoroughly enjoyed being with professionals who have expertise in research for youth health, wellbeing, mental health, and youth advocacy. We gained an understanding of what exactly a community of practice is, listened to the experiences of all members and contributed to the conversations. It was lovely to hear international voices and get to exchange creative ideas for involving young people and encouraging them to share their ideas, as well as learning a great deal about youth engagement in general. What were our highlights? Hearing from the Healthy Mind Apprentices; Chloe, Kenzie, Lauren & Phoebe who are a group of young people passionate about mental health who work across Bradford and Craven to support young people, communities and schools with their health and wellbeing. They reflected on their time working with Y-MHESH and spoke about what their apprenticeship meant to them and what they have learned along the way. They shared with us that the problem is not that young people don’t have a voice; they instead believe that decision makers are not listening. Therefore, it was interesting to hear that we need to take necessary steps to ensure ‘decision makers’ are able and willing to share the decision-making power with young people. Overall being involved in the CoP was positive, as we had the opportunity to be involved in discussions with leaders in the field. Often, we can become ‘stuck’ in our ideas, so having the opportunity to present new ideas and challenge our Community of Practice to think in novel ways which align with the realities for children and young people was a highlight for sure. What could have been improved? It might have been more beneficial for our CoP group if the Healthy Mind Apprentices joined us for longer, as these fabulous young people reminded us that it is about listening and valuing meaningful involvement of children and young people, so it would have been great to have more youth representation in our own decision-making processes. Youth voices should be included throughout our CoP meetings, whether this be the Healthy Mind apprentices or groups of different young people. One of the main challenges in this area is that when coproduction and research is done with young people, they often don’t see the outputs they have created or get to feel the impact of their work before they move. It’s important we consider this when setting out to do co-production work or research with children and young people. What are the advantages of involving early career researchers in research and in the CoP? We provide a fresh perspective on topical issues today and have greater freedom to think beyond our specialty areas. This gives us the ability to consider the broader picture at an international or societal level and bridge the gap between young people and established researchers, as we understand the points of view and needs of young people, while simultaneously understanding research processes. This meeting was a great way to solidify the learning from the CoP and focus us on a clear path forward to best support the goals of children and young people in research. Reflections Reflections on public engagement and engagement in research for young people From the perspective of an ECR, it seems extremely important that “brand image” and visibility are recognised by senior management at universities and funders at research centers. Engaging well with the public, in this case, young people, both heightens visibility and reinforces brand image, which is why Patient and Public Involvement and Engagement (PPIE) work with young people within schools, young people’s PPI groups and other youth groups, including the Healthy Mind Apprenticeship scheme, is so valuable. Although, it can be difficult to get PPIE work funded. The purpose of PPIE work is to get people’s views on what needs to be researched and what is important to them, so to do this after a project has been decided defeats the purpose. Young people form part of our communities, but their inputs have been historically overlooked as unimportant or uninformed. Yet, some of the most valuable insights come from our young people, because at the end of the day this is their reality, and they live it every day. It is therefore crucial to have young people be meaningfully engaged so research, funding and decisions are aligned with what people want and need – and children and young people should be no exception. If we consider and give power to the voices of young people, then perhaps we can work to meaningfully elevate the health and wellbeing of entire future communities. So with that, we leave you with this whakatauki (Māori proverb). Mā whero, mā pango ka oti ai te mahi With red and black the work will be complete Previous Next

Motivating and sustaining engagement of young people in improving their health and that of their communities Prinicpal Investigator: Professor Mary Barker Team: Kathryn Woods-Townsend, University of Southampton, James Toop, Bite Back 2030, Matthew Ryan, University of Southampton, Joanna Sofaer, University of Southampton, Pathik Pathak, University of Southampton Start Date: 1 April 2023 End Date: 30 September 2024 Background Calls by young people for increased involvement in decisions about their health and futures are echoed by WHO and UNICEF. These reflect threats to their health from inequalities and climate change, exacerbated by COVID-19. To be “architects of their own future” and have decision-making power, young people need training and opportunities to build confidence, and structures and processes that allow them to be involved in decision making. Aims We aim to explore how best to engage and maintain engagement of young people in these activities with a view to improving their health and well-being and that of their communities Our specific objectives are to: develop and test a training course for young people in skills to support participatory action research into health and well-being; test the effectiveness of arts-based approaches in engaging young people in health improvement; understand how to create a reliable, scalable and sustainable model for effective youth activism; evaluate democratic innovations to engage young people in decision making processes to influence health policy.

ADOPTED: A Study to Evaluate the Introduction of new Staffing Models in Intensive Care: a Realist evaluation (SEISMIC-R) Prinicipal Investigator: Professor Natalie Pattison, University Of Hertfordshire Team: Professor Peter Griffiths, Dr Chiara Dall'Ora, Dr Christina Saville, Dr Lisa Whiting, Dr Melanie Handley, Dr Susie Pearce, Dr Marion Penn, Dr Paul Mouncey, Professor Thomas Monks, Mrs Clare Leon-Villapalos, Professor Suzanne Bench, Professor Ruth Endacott, Mr Jeremy Dearling, Mrs Jennifer Gordon. University of Southampton, University of Hertforshire, University of Plymouth, Intensive Care National Audit & Research Centre, University of Exeter, Imperial College Healthcare NHS Trust, Guys & St Thomas' NHS Foundation Trust/London South Bank University, NIHR Clinical Research Network. Start Date: 01 May 2023 End Date: 31 August 2024 Background Staffing in intensive care units (ICU) has been in the spotlight since the pandemic. Having enough nurses to deliver safe, quality care in ICU is important. There is national guidance, re-issued in April 2021, on how many nurses should care for ICU patients. However, what the skill mix should be (how many should be qualified nurses or have an ICU qualification) is unclear. Very little research has been done to look at which nursing staff combinations and mix of skills works best in ICU to support patients (described as ‘staffing models’). Across ICUs in UK, various ratios of qualified and unqualified nursing staff are being tried (staff ratios refer to the number of nurses caring for a set number of patients). Hospitals vary; some use a high proportion of non-registered nurses and others a low proportion of ICU qualified nurses. Research shows that there is a link between the quality of nurse staffing and poor patient outcomes, including deaths. Aim : Our research plans to look at different staffing models across the UK. We aim to examine new staffing models in ICU across six very different Trusts. We will use a research technique called Realist Evaluation that examines what works best in different situations and helps us to understand why some things work for some people and not others. The design of this approach will help us to better understand the use of different staff ratios across different ICU settings. We will examine what combinations of staff numbers and skills result in better patient care and improved survival rates. Our aim is to produce a template that every ICU unit can use. To do this, we will compare staffing levels with how well patients recover, and seek to understand the decisions behind staffing combinations.

FinCH Implementation study: Falls prevention in care homes led by NIHR ARC East Midlands working with NIHR ARC North East North Cumbria, NIHR ARC West Midlands and NIHR ARC South London. Project: Falls in Care Homes (FinCH Imp2 study) Principle Investigator: Professor Pip Logan Team members: Dr Jane Horne , Dr Fran Allen, Maureen Godfrey , Professor Adam Gordon , Professor John Gladman , Dr Katie Robinson , Dr Paul Leighton , Dr Janet Darby , Michael Fletcher, Professor Gillian Manthorpe , Professor Barbara Hanratty , Professor Dan Lasserson , Professor Elizabeth Orton . Partners: Nottingham University Hospitals (NHS) Trust; Leicestershire County Council (Local Government); University of Newcastle, Kings College London; NHS Bromley CCG; Northumbria-Healthcare NHS Trust. Research sites: East Midlands , North East (North Cumbria), West Midlands and South London. Starts: 1/10/2021 Ends: 30/9/2023 Lay Summary People who live in care homes are at great risk of falling. Falls are common, harmful, costly, and difficult to prevent. The Guide to Action for Falls Prevention Care Homes (GtACH) programme trains and supports care home staff to identify the reasons why residents fall and then guides them to complete actions to reduce falls. In a large multicentre randomised controlled trial called the FinCH trial (1), the GtACH programme was cost-effective and reduced falls by 43%. We now need to research how to deliver the GtACH programme in ‘real life’ outside a research trial. We will work with three regions – East Midlands, South London and the North-East - to develop and research ideas about taking up the GtACH training programme which can be used nationwide. Using an approach to talking to people in care homes called Normalisation Process Theory (NPT) we will consider the work that people do in managing falls to assess whether GtACH becomes routine practice. NPT will help us to think about those things which help and those which hinder the adoption of GtACH. We have three work packages: WP1. Quality Improvement Collaboratives (QIC) will bring care home and healthcare staff together to develop and research ways to implement the GtACH. WP2. The QIC site teams will implement GtACH in 25 care homes per region (60 in total). Data from all homes and residents (about 2000 residents) will tell us the extent to which GtACH has been taken up in the homes. WP3. We will develop ‘toolkits’ of materials for care homes; containing the GtACH, a ‘return on investment’ calculator, the implementation package, and a ‘how to’ guide for establishing Communities of Practice to deliver and sustain the GtACH across regions. This study has been developed in collaboration with care home managers, care home staff, NHS clinicians and our active Patient, Public, Involvement (PPI) group who are co applicants. Going forward we have identified new PPI partners from Ashington and Bromley. We will talk by videoconferencing if needed. The study will be completed by July 2023 and we will disseminate our findings on the ARC-EM website, producing a short trailer video for YouTube, and through articles in journals and MyHomeLife Magazine. We will link our website on the national forums of the National Care Forum, Skills for Care, and Care England, Age UK, and the Alzheimer’s Society, and hold webinars for funders and managers Method Using monthly stakeholder meetings, consensus groups, interviews and literature searching we re-designed the GtACH into a suite of resources that care homes were happy to use and renamed it, on their request, to the Action Falls programme. Using an implementation theory called Normalisation Programme Theory we designed a research study to test how the Action Falls programme worked in 60 real world care homes. Care homes are being recruited across four ARC locations. All care home staff included in the 60 homes are being invited to complete the Action Falls training and complete a questionnaire (called the NoMAD) to assess how ready they are to use the programme. Interviews with care home staff and the trainers are being completed to get a first-hand view of how well the Action Falls is getting embedded into routine care. Care home staff are coming together in supportive collaborations, called Action falls Collaborations (AFC) to share knowledge, with researchers collecting data at these events. Results Ethical approval for the study has been granted by HRA East Midlands and Derby Research Ethics Committee Ref: 22\EM\0035. The study is adopted by the NIHR portfolio and the NIHR Clinical Research Network are helping to deliver the study in all locations, which are listed below in brackets. 36 care homes (60%) have been recruited, 13 in ARC North East (NE), 9 ARC London South (SE), 14 ARC East Midlands (EM). ARC West Midlands (WM) will start recruitment soon. In the ARC EM location we have four separate NHS Trusts/ Local authority areas involved. 7 NHS/ Local Authority/HEI Falls Leads have been trained in ARC’s NE, LS and EM and have begun training of the care home staff across the locations. One AFC has taken place in NE with the East Midlands AFC and South London due to take place later this month. The NoMAD questionnaires have been delivered to care homes. No interviews have yet been completed as these are due to start in November. In addition to the four locations the team have interacted with 83 individual care homes and 47 stakeholder groups sending them the Action Falls resources and talking over how they might be used, but no training has been offered. The images below show the spread of these enquiries Conclusion The study is progressing well, and care homes are very keen to take part and recruitment for the study is currently at 60%. The sites are set up and staff are in posts. We are approximately three months behind target on the activities due to care homes being reluctant to engage early in 2022 due to COVID. We consider that we may need a no cost 6-month extension to complete all the activities and to also get the Action Falls programme ready for wider spread. All our study meetings are well attended, and we have good participation from our PPI members with information being communicated from out Study Steering Group to the Stakeholders and vice versa sharing knowledge and experience. The study has gathered a lot of interest from outside of the study areas, from care homes and a range of other stakeholders. The research team have been sending out study materials and meeting with these groups over MS Teams meetings sharing resources and information about the study.A PhD student will be working with the care homes outside of our study locations from October 2022.

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

Social care An effective health service is reliant on an effective social care system, and it is therefore vital that we develop a robust research base for social care, to ensure that local authorities (LAs) and third sector organisations provide the most effective services within a wider integrated system of health and social care. Our research projects Exploring collaborative research within local authority adult social care Read more ADOPTED: FLOWS Planning for Frailty: Optimal Health and Social Care Workforce Organisation Using Demand-led Simulation Modelling Read more SOCIAL CARE: Evaluation of Southampton City Council’s Male Engagement Worker (MEW) Project Read more SOCIAL CARE: Building capacity in social care through co-produced research and a research learning partnership between University of Portsmouth and Portsmouth City Council Read more SOCIAL CARE: Local Authority Adult Social Care Recruitment and Retention research project Read more Professor Lee-Ann Fenge Social Care lead Growing social care research capacity ARC Wessex and CRN Wessex have pulled together to expand research into social care. Four researchers have been funded to work with local councils inDorset, Portsmouth, Southampton and Hampshire. ​ Senior Research Fellow Doctor Michelle Myall has just been named researcher-in-residence at Southampton City Council. Amy Drahota will work with Portsmouth City Council, Andy Pulman with Bournemouth, Poole and Christchurch Council and Dorset Council and David Raper with Hampshire County Council. The researchers come from the Universities in Southampton, Bournemouth, Winchester and Portsmouth. ​ Research projects are at an early stage but will include issues like domestic abuse and social care workforce capacity. Funding is also available to support development of Research Champions within councils to work with the four research leads. ​ The social care research champions will be existing employees from the councils concerned. The specific focus of the role will differ by individual council and its needs. This will be an opportunity for learning for all involved, to understand more about what support is needed to enable growth in social care research. Our Post-Doctoral Fellows Dr Andy Pullman Bournemouth University Dr Amy Drahota University of Portsmouth Dr Michelle Myall University of Southampton Dr David Raper University of Winchester As part of the ongoing Social Care projects established throughout Wessex, a lunch-time seminar series will be taking place each month. Please take a look at our events page for details. The next webinars are: ​ Feb 15, 2024 12:00 Evidence for the role of social care in reducing ambulance conveyance for older people with and without dementia in the South Central region by Carole Fogg and Patryk Jadzinski Mar 21, 2024 12:00 Participatory action research by Professor Lee-Ann Fenge Apr 18, 2024 12:00 My journey from dementia care assistant to PhD and beyond by Leah Fullegar ​ If you missed an online seminar see below for the recordings Social Care Lunchtime Seminars Social Care Lunchtime Seminars Play Video Share Whole Channel This Video Facebook Twitter Pinterest Tumblr Copy Link Link Copied Search video... Now Playing Social Care lunchtime seminar #10 28:29 Play Video Now Playing Social Care lunchtime seminar #9 Participatory action research by Professor Lee-Ann Fenge 52:08 Play Video Now Playing CRED Talk_ Working with care homes to help residents eat and drink well - March 13 2024 52:05 Play Video Now Playing Research Skills in Social Care - Seminar 1, Formulating a research question 42:21 Play Video Seminar presentation Presenters Seminar Zoom links Seminar 2 - Andy Pullman Download PowerPoints ​ Set one - Practitioner data Set two - HEI data summar Set three - Methodology

ADOPTED PROJECT: Happier Feet ADOPTED PROJECT: Happier Feet Disrupting the vicious cycle of healthcare decline in Diabetic Foot Ulceration through active prevention: The future of self-managed care Chief Investigator: Dr Andrew Weightman – University of Manchester Project Team Members: Dr Katherine Bradbury – University of Southampton, Professor Helen Dawes – University of Exeter, Mr Andrew Eccles – University of Strathclyde, Dr Safak Dogan – Loughborough University, Dr Glen Cooper – University of Manchester, Professor Frank Bowling – University of Manchester, Dr Xiyu Shi, Loughborough University, Professor Ahmeet Kondoz– Loughborough University Organisations Involved: Diabetes UK Background: There is a significant unmet clinical need for an adaptable, acceptable and adoptable technology to identify and prevent diabetic foot ulcer (DFU) formation, to enable self-management and timely clinical intervention to improve outcomes and reduce the economic burden of healthcare provision. Our primary purpose is to develop and implement an adaptable, acceptable, and cost- effective smart sensing insole technology which can detect when a DFU is likely to occur and can adapt plantar tissue loading to prevent formation, thus enabling self-management. This project proposes to build and expand on current smart insole technologies for the detection of DFUs, utilising a sensor fusion approach for their identification. A smart insole with integrated pressure (normal, shear), temperature, gait (IMU) and mechanomyography (acoustic) sensors will identify early indicators of ulceration and when movement is appropriate/inappropriate. The smart insole will respond to these inputs and adjust the foot (and gait), through an array of artificial muscles, to support better (safe/ comfortable) movement. This project aims to co-develop this new smart sensing insole with people living with diabetic foot ulcers. We hope to establish: What patients think of the idea of a smart sensing insole for early detection of DFUs which includes the provision to adjust the foot to reduce pressure on areas of likely ulceration. A prototype insole and optimised this with patient feedback. Early safety testing of this device. Security protocols to enable secure storage and sharing of data from this insole (e.g., between patient and clinicians).

PIVOT: Promoting Increased physical actiVity in hospitalised Older adults with Trained volunteers NIHR Advanced Fellowship Award: Dr Stephen Lim, Consultant Geriatrician University Hospital Southampton NHS Foundation Trust and NIHR Clinical Lecturer in Geriatric Medicine University of Southampton Team : Dr Samantha Meredith Research Fellow, University of Southampton, Dr Beth Stuart Clinical Trials Unit statistician, University of Southampton 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.

ADOPTED: Geospatial mapping of emergency calls from older adults to ambulance services in the South Central region, with a focus on people living with dementia: a feasibility study. Lead : Dr Carole Fogg, Senior Research Fellow, University of Southampton Team: Dr Dianna Smith, University of Southampton, Professor Bronagh Walsh, University of Southampton. Collaborators: Phil King – Senior Business Analyst, South Central Ambulance Service (SCAS) Vivienne Parsons – Specialist Business Analyst, SCAS Simon Mortimore – Assistant Director of Business Intelligence, SCAS Martina Brown – Research Manager, SCAS (and additional members of the research team – Helen Pocock – Senior Research Paramedic, Chloe Lofthouse-Jones – Education Lead, Patryk Jadzinski – Paramedic/Senior Lecturer) Nic Dunbar – Head of Community First Responder Operations, SCAS (and Operational Leads David Hamer and Jack Ansell) Starts: 13th March 2023 Ends: 31st July 2023 Summary What is the project about? This is a new project that will explore the feasibility of using geospatial techniques to map emergency 999 calls from older adults, including those living with dementia. What is the rationale for this proposal? NHS ambulance services are under intense pressure to deliver timely and safe care. Immediately life-threatening conditions have to be prioritised. Older people with falls and symptoms related to long-term chronic conditions with lower category calls may experience long delays before an ambulance arrives. Such patients often have recurring needs for emergency care due to lack of alternative care pathways or long waits for social care assessments. These patients may also have dementia, putting them at greater risk of clinical deterioration whilst waiting for their needs to be met. Geospatial projects are of particular interest to emergency services, as a single service covers a wide geographical area and a dispersed population. Currently SCAS uses mapping to identify clusters of self-harm, suicide attempts and other trauma incidents. Impacts of geospatial projects in other ambulance services include improving cardiac arrest response times and identifying vulnerable communities during Covid-19. Adults aged ≥65 represent a large proportion of SCAS demand (2022: 17% of 111 calls, 48% (21,200 per month) of 999 calls), with around 14% living with dementia [3]. Better information on the location and outcomes of these calls through applying geospatial techniques can shape service provision to meet population needs, improve patient experience and outcomes, and enable existing resources to be used to best effect. What are we currently doing? Applicant CF is leading a project collaborating with South Central Ambulance Service (SCAS) to systematise recording of dementia on the ambulance electronic patient record. Ambulance staff are now able to record data about dementia in a specific place, and initial analyses show around 70 entries daily across the South Central region (November 2022). Improved recording of dementia in ambulance data provides an opportunity to explore factors associated with service demand related to dementia, such as deprivation, and to inform configuration of emergency and associated services to meet older people’s care needs more generally. These may include attendance by Community First Responders (CFRs) with additional training regarding dementia, or referral to a social care line to organise care for older people. What are the next steps? We propose to explore the feasibility of using geospatial data to map low category calls to older adults (aged ≥65), including a subgroup of those with dementia. Data on older adults in patients with emergency 999 calls will enable understanding of understand areas of greatest need and identify areas of inequality. Geospatial mapping will also highlight areas in which there are high frequencies of calls so that multi-sector appropriately-trained resources may be focussed in particular geographical areas. Initial results can be used to design prospective studies of care models which are informed by, and evaluated using, geospatial data. How will we achieve this? Project Objectives: 1. Test feasibility and methods of data specification, extraction and aggregation from the SCAS data warehouse. 2. Produce geospatial maps representing the extracted data to identify areas of highest demand, or where Community First Responders and specialist frailty cars may be most needed, and with which equipment. 3. Present the data to stakeholders and identify priorities for follow-on research grant(s). Project Methods: We will meet the objectives by: 1. Working with the SCAS Business Intelligence (BI) team to understand and define data items for specification for a combination of geospatial, administrative (interval between call time and attendance, time on scene), sociodemographic and clinical (main reason for call, record of dementia in patient record following attendance) data for low acuity calls (category 3 and 4) for people aged ≥65 over a one year period. 2. Using ArcGIS software to produce new choropleth maps (Lower Super Output Area [LSOA] scale in the SCAS region (Berkshire, Buckinghamshire, Hampshire, and Oxfordshire) of the frequency of 999 calls and ambulance attendances overall and categorised by sub-groups, e.g. patients presenting with falls / with dementia / experiencing a ‘long wait’. Using Office of National Statistics (ONS) and Census data to estimate the proportion of the population of highest risk for frailty and falls (age, ill health, living alone). Holding at least one stakeholder meeting, involving SCAS staff, CFRs, the public, representatives from services providing urgent care to older people in the community (e.g. specialist frailty cars, social care, general practitioners, fire and police services) to share results, identify immediate impacts and agree areas for further research.

Developing a web resource to support families bereaved during COVID-19 Principal Investigators : Dr Natasha Campling and Dr Michelle Myall Team Members : Dr Natasha Campling (Lecturer & Senior Research Fellow, School of Health Sciences, University of Southampton; Dr Michelle Myall (Senior Research & Implementation Fellow, School of Health Sciences, University of Southampton); Dr Susi Lund (Visiting Research Fellow, School of Health Sciences, University of Southampton); Dr Alison Allam (Patient and Public Representative) Start: 1 January 2021 Project Partners: Winchester Bereavement Support; The Bereavement Centre (Southern CO-OP) Plain English Summary Why is the study needed? The current coronavirus (COVID-19) pandemic has led to increasing numbers of people who have experienced, or are facing, bereavement both in the UK and worldwide. We know that bereavement can seriously affect people’s health. Bereaved people are more likely to experience serious physical and psychological health consequences, such as heart disease and anxiety and depression, particularly in the first year of losing someone close to them. There are some things that can help prevent the health effects caused by grief. For example, being able to see a person receive good end of life care, being prepared for the death of a person, attending the funeral and having the support of family members and friends. During COVID-19 many families and others important to a dying person have not been present during end of life care and death has occurred suddenly. Social distancing restrictions have prevented the support often provided through families and friends coming together. Restrictions applied to funerals have prevented some families being able to attend the funeral of a relative. All of this can make it difficult for people to make sense of what has happened and to look for support to help them with their loss and grief. However, traditional ways of providing bereavement support (face-to-face or by telephone or video) may not be possible because of an increase in demand for support. A family focused online support resource, which considers grief in the context of the family, offers a way of helping people to deal with their bereavement in these unusual times. What are the study aims? We will design an online resource, to provide bereavement support by helping users make sense of the loss of the person close to them. We will work with patients and public representatives, bereavement experts, such as bereavement organisations and palliative care social workers, and a web designer to develop the resource. This will be carried out through a survey and online workshops. We will ask people who have been bereaved during the COVID-19 pandemic to test the resource and provide feedback on it by leaving comments in a space provided within the resource itself. This will help us make changes needed to improve it. What will happen to study findings? From the start we will work with our patient and public representatives, bereavement organisations, health and social care professionals to ensure our findings reach the widest possible audience. We will share progress, findings and the outcomes of the study on social media channels (e.g. Facebook/Twitter), on the websites of our partner organisations, and the website of the funder of the study, National Institute for Health Research Applied Research Collaboration Wessex (NIHR ARC Wessex). At the end of the study we will report our findings in an academic journal and at relevant conferences.