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ADOPTED PROJECT: Supported remote rehabilitation post Covid-19 Development, deployment, and evaluation of a digitally enabled rehabilitation programme Chief Investigator: Professor Elizabeth Murray – University College London, Dr Henry Goodfellow – University College London Institute of Epidemiology & Health Care Project Team Members: Dr Katherine Bradbury – University Of Southampton, Dr Stuart Linke – Camden & Islington NHS Foundation Trust, Mr Chris Robson – University College London, Professor Fiona Stevenson – University College London Institute of Epidemiology & Health Care, Dr Manuel Gomes – University College London Institute of Epidemiology & Health Care, Dr Fiona Hamilton – University College London Institute of Epidemiology & Health Care, Professor Ann Blandford – University College London, Professor John Hurst – University College London, Professor Delmiro Fernandez- Reyes – University College London, Professor William Henley – University of Exeter Medical School, Dr Melissa Heightman – University College London Hospitals NHS Foundation Trust, Dr Paul Pfeffer – Barts Health NHS Trust, Dr William Ricketts – Barts Health NHS Trust, Ms Hannah Hylton – Barts Health NHS, Trust Dr Richa Singh – Barts Health NHS Trust, Ms Julia Bindman – Patient and Public Involvement contributor based in England. Organisations Involved: Living With, NHS England, various NHS trusts, AHSN Wessex, UCL Partners. Background: Covid-19 had affected nearly 300,000 patients in the UK by 6/7/20. Many remain symptomatic with breathlessness, fatigue, and anxiety for weeks or months. These symptoms can be improved with rehabilitation, but traditional, face-to-face models of service delivery will struggle to cope with these large numbersof patients. A digital approach is likely to be needed, but there are numerous challenges with this approach, including failures of implementation; anxieties around the digital divide/health inequalities; and concerns around low engagement with such programmes. Aim: To refine, deploy and evaluate a digitally- mediated, remote, supported rehabilitation programme for patients affected by Covid-19.Methods: We will combine research methods common to engineering and computer science (focused on developing a product that is safe, stable and meets user requirements) with those familiar to biomedical and health service researchers (focused on effectiveness and population impact). Thus, we will apply the Medical Research Council (MRC) Framework for development and evaluation of complex interventions (Phases 1, 2 and 4)

ADOPTED: Evaluation & Exploration of Multi-Agency Stalking Partnership Interventions Evaluation & Exploration of the Hampshire & Isle of Wight Multi-Agency Stalking Partnership (MASP) Team: Research Team based at University of Southampton Faculty of Medicine and ARC Wessex Partners who will collaborate on the research: Hampshire & Isle of Wight Office of the Police & Crime Commissioner, Hampshire & Isle of Wight Constabulary, Southern Health NHS Foundation Trust, Hampshire & Isle of Wight Probation Service, & STOP Domestic Abuse. Start date: 1 April 2023 End date: 1 April 2025 Hampshire & Isle of Wight (HIOW) was one of the three pilot sites of the Multi-Agency Stalking Intervention Programme (MASIP), commissioned by the Home Office in 2018. The programme identified positive outcomes from the limited number of case consultations and direct interventions delivered. Funding for MASIP ceased in March 2023 and new funding was sought to refresh the initiative and realise its potential. With two years of funding from the Home Office, from April 2023-March 2025, the partnership has been renewed to address stalking in HIOW. Key partners include the Office of the Police & Crime Commissioner for HIOW, HIOW Constabulary, Southern Health NHS Foundation Trust, HIOW Probation, and STOP Domestic Abuse. This service, called the Multi-Agency Stalking Partnership (MASP), aims to deliver a package of interventions to reduce the impact of stalking. The objective of this partnership is to reduce the risk of further stalking behaviour, and improve the psychological wellbeing of the person using stalking behaviours, whilst keeping the safety of the survivor and their dependents at the centre of this work. The service aims to help up to 160 people who have used stalking behaviours, and their victims, per year. The package to be delivered by this partnership will include: The package to be delivered by this partnership will include: - Three novel models of rehabilitation, using Psychologist-Led Stalking Interventions (PLSI), for individuals who are using stalking behaviours - Advocacy and support for individuals who have been victims of stalking, and - Professional development, support resources, and new ways of working for professionals who are working with people who have stalked Our team at the University of Southampton, Faculty of Medicine, has been asked to conduct an independent evaluation of the MASP’s activities. We will also conduct primary research to determine whether and how the interventions that MASP deliver are effective in reducing the risk of further stalking behaviour and improving the psychological wellbeing of the person who has stalked. We hope to be able to create new evidence, that can be shared with other agencies, about what works (and how and why) to reduce stalking behaviours. What are the aims? The objectives of the service evaluation and primary research are: 1. To determine whether the effectiveness of the MASP activities: have they been successful in reducing the risk of further stalking behaviour and improving the psychological wellbeing of the person who has used stalking behaviours? 2. To explore the mechanisms and outcomes of the MASP activities: how and why might they impact on the risk of further stalking behaviour? How will the study be carried out? We will analyse routinely-collected, anonymised, data from the MASP partners to determine the effectiveness of the MASP activities. We will also conduct data directly from MASP professionals, MASP clients, and SASS clients, via survey and interview, to explore further how and why the MASP activities might have any effects. What will happen to the findings? The findings will directly inform the future of stalking-related work in Hampshire & Isle of Wight, and elsewhere. We will share the results widely, through publication in peer-reviewed journals, reports to the funder, and presentations at local, national, and international conferences. Where can I get more information? Please contact MASPinfo@soton.ac.uk for more information. Service links: Southern Health Link to Police commissioner website

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

ADOPTED PROJECT: 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.

ADOPTED: Treatment burden in people below the age of 65 with multimorbidity in primary care: A mixed methods (SPELL) Principal Investigator: Dr Rachel Johnson, University of Bristol Team: Prof Chris Salisbury, University of Bristol Prof Jose Valderas, University of Exteter Dr Simon Fraser, Univeristy of Southampton Dr Maria Panagioti, University of Manchester Dr Tom Blakeman, Univeristy of Manchester Dr Shoba Dawson, University of Bristol Dr Polly Duncan, University of Bristol Dr Michael Lawton, University of Bristol Start Date: 1 February 2022 End Date: 31 July 2024 Background One in two people over the age of 50 have more than one long term health condition (multimorbidity). The number of people living with multimorbidity is growing. Compared with people without multimorbidity, people with multimorbidity have worse quality of life, take more medicines, and are more likely to die or to be admitted to hospital. More people in deprived areas develop multimorbidity at a younger age. As a group, people with multimorbidity have more contacts with healthcare services than people with one or no long-term conditions. Because of this the NHS and policy-makers want to find ways to manage multimorbidity better. People with multimorbidity put a lot of effort to manage their medicines and healthcare appointments (treatment burden). There is some research that younger people experience more treatment burden. Previous research tells us that sometimes it is the simple things like getting appointments with the GP and finding parking that cause the most burden. Although people with multimorbidity are often grouped together, their experience depends on the health conditions they have, their ethnicity, where they live and their level of income. People with multimorbidity who are working age might have different problems such as getting time off work for appointments, managing their health conditions as work, or juggling childcare. This study will focus on people who are under the age of 65, as not much research has focused on them. A recent report by a charity for people with multimorbidity said that not much research has been done on how it feels for people to live with multimorbidity. Also, we do not know the best way to support and treat people with multimorbidity in GP services. If we understand people’s experiences, we might be able to design better services to meet their needs. There are some questionnaires that could be used to find people who be finding it difficult to cope with their multimorbidity burden, but they need more testing in the UK, particularly in younger people. Some questionnaires are too long, and it would be helpful to have a short version (e.g. just one question). This could be used regularly, as a quick way to identify people who might be ‘overburdened’ and need more support. We want to find out how health care services can support people with multimorbidity and reduce their treatment burden. We will do this in three ways: 1) interviewing people with multimorbidity, 2) ask people to complete questionnaires and 3) hold a meeting with people with multimorbidity, GPs and people who organise GP services, to talk about what we have found and work together to make recommendations to improve care. Throughout the study, we will work with the staff and patients at the GP surgeries involved to increase the number of people who take part. We will make efforts to reach and include people from minority ethnic groups and those who have difficulties in accessing health care. We will work with local community groups to raise awareness about this study and translate study materials into different languages. People with multimorbidity who take part in each part of the study will receive a voucher to thank them for taking part. In the first part of the study, we will ask GPs to find people with multimorbidity at their practice. We will invite some of those people to be interviewed, for up to 1 hour, either by phone, video or face to face. During the interview we will find out about their experience of living with multimorbidity, efforts they have to put into managing their health and treatment burden, and ways in which using health care services help or make it more difficult. We will use what we find in this study to help design the questionnaire that we will use in the second part of the study. In the second part of the study, we will ask GPs to invite randomly selected people from their practice. People who agree to take part will fill in questionnaires and give us permission to look at their medical notes. The questionnaires will ask about their experiences of care, how multimorbidity affects them, including the burden because of their health conditions or from managing them. As part of this we will test how well a short measure, based on a very small number of questions or even a single question, works in identifying overburdened people. In the third part of the study, we will hold a meeting with patients, people who organise healthcare services, and commissioners and healthcare professionals. During this meeting we will make sense of the results from interviews and questionnaires to identify how health services can support people with multimorbidity We will work together with people with multimorbidity or those with experience of caring for people with multimorbidity. The idea for this study came from a PPI group focused on multimorbidity research projects, with which both RJ and SC have been involved in for the past two years. We have set up a patient and public involvement (PPI) group including six people (two from minority ethnic groups). This group will be involved throughout the study from developing study materials to developing materials for sharing study findings.

< Back This is a Title 01 This is placeholder text. To change this content, double-click on the element and click Change Content. This is placeholder text. To change this content, double-click on the element and click Change Content. Want to view and manage all your collections? Click on the Content Manager button in the Add panel on the left. Here, you can make changes to your content, add new fields, create dynamic pages and more. You can create as many collections as you need. Your collection is already set up for you with fields and content. Add your own, or import content from a CSV file. Add fields for any type of content you want to display, such as rich text, images, videos and more. You can also collect and store information from your site visitors using input elements like custom forms and fields. Be sure to click Sync after making changes in a collection, so visitors can see your newest content on your live site. Preview your site to check that all your elements are displaying content from the right collection fields. Previous Next

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

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 Adoption and Spread Checklist, webinar and resources Quick links: Project Outputs This domain helps you consider aspects that could influence adoption and spread of the use of project outputs both within the organisation or setting where implementation takes places and to other health and social care organisations. Also, what factors may lead to sustainability and the value of such sustainability. NHS Dorset Integrated Care System (ICS) Hampshire and Isle of Wight Integrated Care System (ICS) NHS Trusts Dorset County Hospital NHS Foundation Trust Dorset HealthCare University NHS Foundation Trust Hampshire Hospitals NHS Foundation Trust Isle of Wight NHS Trust Portsmouth Hospitals University NHS Trust University Hospitals Dorset NHS Foundation Trust Salisbury NHS Foundation Trust Solent NHS Trust Southern Health NHS Foundation Trust University Hospital Southampton NHS Foundation Trust Universities Bournemouth University University of Portsmouth University of Southampton University of Winchester Research partners Health Innovation Wessex (formerly Wessex Academic Health Sciences Network) 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 Spread the Learning Project (SLP) "From the beginning we involved our charity partners as stakeholders and part of the co-production team because we were aware that they would have responsibility for implementing the intervention and therefore understood how it would work in practice. We also considered our skill sets and identified areas where we required additional support and reserved funds to pay for a web designer and negotiated some administrative support. We developed a core team of train the trainers to facilitate adoption and spread of the project and ensure consistency but with negotiated flexibility for partner organisations. We had not anticipated all the branding requirements involved which required consistency with our partner organisation. This involved negotiation and sign off from an executive level. Fortunately, because we had engaged with them from the initial stages , they provided a marketing representative to help us comply with their standards." Take away tips Think about what systems and processes will be required to support adoption of your project Consider how your project fits with other systems and how it will provide value and benefits in different systems

ENRICHER – involvEment iN the cRiminal justice system & the ImpaCt on women’s Health dorsEt & hampshiRe Chief Investigator Professor Julie Parkes Professor in Public Health Head of School of Primary Care, Population Sciences and Medical Education Faculty of Medicine University of Southampton, South Academic Block, Southampton General Hospital, Tremona Road, Dr Emma Plugge Associate Professor in Public Health School of Primary Care, Population Sciences and Medical Education Faculty of Medicine University of Southampton, Co-Investigators Dr Donna Arrondelle , Research Fellow, University of Southampton Dr Naomi Gadian, Public Health Specialist Registrar, University of Southampton Donna Gipson, Director EP:IC Consultants Ltd, West Malling, Kent Dr James Hall , Associate Professor of Educational Psychology, University of Southampton Paula Harriott , Head of Prison Engagement, Prison Reform Trust Professor Kathleen Kendall , Professorial Fellow of Sociology as Applied to Medicine, University of Southampton Dr Sara Morgan , Associate Professor in Public Health, Faculty of Medicine, University of Southampton Professor James Raftery , Faculty of Medicine, University of Southampton, Dr Lucy Wainwright , Director of Research, EP:IC Consultants Ltd, West Malling, Kent Starts: 1st April 2023 Ends: 30th September 2024 Summary This study will look at what happens to women’s health and wellbeing when they are imprisoned. The imprisoned women will be women from Dorset and we will compare any changes to changes in women from Hampshire who go to Hope Street instead of going to prison. Hope Street is a charity-funded alternative to prison, available only to women from Hampshire; women live in special accommodation in the community where they are secure and where they are able to access a range of health and social care services. Women who go to prison are often from the poorest communities and they often have many different health problems, particularly relating to their mental health. These health problems are often related to their crimes and so by making sure they get the services they need, this will help their health improve and benefit wider society by helping tackle crime. This study will ensure that this new and unique information is available to those who plan and deliver health services locally. The Southampton research team on this project are carrying out a 5-year evaluation of Hope Street. This means they can use the data that they are collecting as part of this evaluation on the health of women at Hope Street to compare to women from Dorset who are imprisoned. Researchers will collect information on the health and social care needs of the two groups of women at the same time intervals over a one-year period and in the same way. We will then compare this information to look for differences. We will interview the women so that we understand what their experiences are like in prison or Hope Street, and why there might be differences. We will also look at the cost of their care. The information from our study will help the professionals who plan health and social care services and also those who work in criminal justice settings such as prison or probation. Women with experience of imprisonment are part of the eight-person study team. They have helped design the project and will be working with Hope Street women to train them in research. They will also be important in spreading the word about the study. This will enable us to reach not just academic audiences and policy makers through publishing in journals or presenting at research conferences, but also people with lived experience of imprisonment and charities that work in this area. Informing a wide range of people will be important in ensuring that the findings from this study are acted on.

Case studies: Anna Badley It doesn't matter where you start. Find your research journey - there’s more than one path I love research and I always have done, but my journey to being awarded an ARC Wessex PhD Scholarship has been far from traditional. ​ I have always been passionate about the nursing profession and in particular nurses and others who provide care in a person’s home. As a very busy District Nurse and Community Matron I had always assumed that research would be something I did later in my career. An incident at work left me severely unwell. This incident not only changed my life, it made me want to help others and learn about work pressure and how this impacts well-being and mental health. ​ I moved into a Research Nurse position which was invaluable, it opened my eyes in seeing how research works in the NHS from research design to recruitment and data collection. It also gave me a great understanding of research governance and ethics. At the same time, I began work on my Master’s dissertation. I was fortunate enough to work with Professor Jane Ball, a globally renowned nursing researcher who became my supervisor. The MSc Dissertation allowed me to experience conducting my own research whilst developing skills in academic research. ​ For anyone thinking of getting into research I would say go for it! Research is rich, rewarding and exciting. It doesn’t matter where you are starting from, there are so many opportunities available. ​ It is easy to think that research or doing a PhD is an individual activity, I have learnt from my journey that it is only possible as a team - without the generosity of time, knowledge and leadership from Professor Jane Bal l, University of Southampton and Dr Sarah Williams , Solent NHS Trust this research would not be possible and I hope that together we can learn how to prevent nurses and others from getting harmed by doing a job that they love. ​ Top tips Get in touch with your Research and Development team - they are a great source of knowledge about opportunities and how to start your research journey If you can, I would really encourage people to get experience in NHS Research Delivery, Internships are a good way of getting this experience Connect with people - research is only achieved in a team Find your research journey - there’s more than one path

FLEXI: Falls management exercise programme led by NIHR ARC East Midlands working with NIHR ARC Greater Manchester and NIHR ARC South West Peninsula The FLEXI Study (FaLls EXercise Implementation) Principle Investigator: Dr Elizabeth Orton Team members: Professor Denise Kendrick , Professor Stephen Timmons , Professor Carol Coupland , Professor Pip Logan , Professor Tahir Masud , Professor Vicki Goodwin , Professor Claire Hulme , Professor Chris Todd , Dr Helen Hawley-Hague , Dr Paul Wilson, Professor Dawn Skelton , Mrs Margaret Beetham Partners: NIHR ARC Greater Manchester , NIHR ARC South West Peninsula ,South West Academic Health Sciences Network, Royal Society for the Prevention of Accidents, Health Innovation Manchester, Later Life Training, Torbay and South Devon NHS Foundation Trust, Leicester-shire and Rutland Sport. Research sites: Devon Integrated Care System (ICS), Manchester combined authority, Leicester, Leicestershire and Rutland ICS, Derby and Derbyshire ICS Starts: 1/10/2021 Ends: 30/9/2023 Lay Summary Falling can cause injury, pain, loss of confidence and independence. This is undesirable for the individual and their families, and places significant demands on health and social care services. Falls are not inevitable. By improving an individual’s strength and balance, alongside skills to help getting up from a fall (should this happen), the likelihood of a fall occurring or having damaging consequences, such as a long lie on the floor, can be minimised. The Falls Management Exercise (FaME) programme is a group-based, face-to-face, six-month exercise programme specifically aimed at improving the strength and balance of people aged 65 and over. Research has shown that FaME results in fewer falls, improved confidence, and reduced fear-of-falling. Despite this, FaME is still not available everywhere across England. More needs to be understood about how best to increase its availability and ensure high quality delivery. To improve our understanding of this, we previously studied FaME’s set-up, delivery and quality in the East Midlands. We learnt a lot about how to get FaME running and showed that the programmes worked outside of a research setting. Using learning from the East Midlands, we developed a guide for implementing FaME called the implementation toolkit . This evidence-based toolkit contains all the information needed to set up and run a FaME programme, from making the initial business case to promoting it to participants. We now want to use this toolkit to see if FaME can be made more available in two new, and very different, regions: Greater Manchester and Devon, and assess whether FaME works in these populations too, particularly if adaptations are made because of Coronavirus. We aim to: 1) Understand how best to increase availability of FaME in two new areas and assess the role that the toolkit plays in this. Using the toolkit we will work with local experts to promote FaME to organisations that decide what health services should be funded locally. 2) Study the delivery of FaME in the new areas and see if programmes work in these populations by measuring improvements in participating individuals. 3) Test ways of maintaining the quality of FaME programmes over time. Working with Later Life Training, a national not-for-profit organisation with expertise in FaME, we will measure the quality of programmes and test what works to make them better. We will use this information to improve the implementation toolkit and develop plans to support national implementation of FaME.

Read about Clare's suprising journey into research Latest news ARC Wessex update - Spring 2024 Alzheimer's Society give £370,000 to extend dementia research Unique research collaboration highlights innovative approaches for post-pandemic healthcare ARC Wessex welcomes Implementation lead in joint role with Health Innovation Wessex Online tool for Long Covid support Is it cost-effective to deploy more nurses on hospital wards? Read more NIHR ARC Wessex in numbers 200+ Members 80+ Academy members £15M Invested in research 250 Research projects How can we help? For professionals & researchers Read more For public & patients Read more For training & development Read more