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016c507b-e112-4be0-a796-8f4c4a8cdbe0 DIALOR: DIgitAL cOaching for fRailty (DIALOR) Principle Investigator: Professor Jane Murphy Team members : Dr Euan Sadler , Dr Michele Board , Dr Kat Bradbury , Professor Mike Vassallo , Dr Simone Yule , Dr Dawn-Marie Walker , Crystal Dennis, Matt Sait, Jim McMahon (Patient and Public Involvement Lead) Partners: Bournemouth University, University of Southampton, University Hospitals Dorset NHS Foundation Trust, The Adam Practice, Dorset CCG, Wessex AHSN, Southern Health NHS Foundation Trust Start: 1/4/2022 Ends: 30/9/2024 Bournemouth University web page Lay Summary Frailty is a condition that affects one in ten people over the age of 65. It means people are at higher risk of falls, disability and poorer quality of life. Some may struggle with decreased energy levels, poor appetite, lower strength and having difficulty with household tasks such as shopping and cooking. As the population ages, frailty also impacts on health and social care services because of more GP appointments and increased hospital and care homes admissions. More people own a smartphone with applications (apps) and have access to the internet. This technology can help people to live well by enabling access to person-centred advice and care. It can help share in decision making to meet well-being and health needs and reduce the burden on health and social care systems. However little research has been done, particularly for people with frailty, living at home. Aims This study aims to explore whether a digital approach could be used alongside support from health coaches to help the lifestyle management of frailty (in its early stages). The approach has been used across the NHS in people with long term conditions which we think will transfer to people with frailty. We will work together with people living with frailty, their carers, health coaches and health care professionals (key stakeholders). Design and methods We will do this through two work-packages (WPs) with people from 2 areas in Wessex (Dorset and Hampshire). WP1 will develop and test a new digital approach. It will include interviews with 10 people with frailty and family carers, 20 health care professionals and health coaches. In WP2, we will train health coaches to use the digital approach and measure how well it works in people with frailty. We will collect data including physical activity, eating and drinking, social engagement, quality of life, frailty status, costs of the approach. We will also ask people about their experiences of using it. We aim to recruit 20 people with frailty and their carers, 20 health coaches, 20 health care professionals and commissioners of care services from both areas to do this. This information will help us plan for carrying out a larger study to implement the approach wider across Wessex. We will regularly seek advice from doctors, nurses, commissioners of services during the project. Patient and public involvement (PPI) A group of family carers and health coaches will support the project by membership of a group to support project design, delivery, analysis and reporting and advise on how we share the findings. NOTE: DIALOR was previously known as DONOR and the name changed in consultation with Public contributors Dissemination We aim to share the findings in academic and professional publications, social media, a website, conferences as well as deliver an end of project stakeholder event. Publications DIALOR (DIgitAL cOaching for fRailty): protocol for a single-arm mixed-methods feasibility study of a digital health coaching intervention for older people with frailty in primary care https://doi.org/10.1136/bmjopen-2023-080480 Digital empowerment in long-term condition management: A systematic review and narrative synthesis of the experiences and perceptions of home-based digital health coaching interventions https://doi.org/10.1177/20552076241302230

6b068013-6ee6-484b-88bf-12a053cec877 Wessex SNSDE Study (SETT Centre) Project lead: Professor Chris Kipps, University Hospital Southampton NHS Foundation Trust Building analytic capacity to address compound pressure across health and care systems: testing an approach A pilot project scheme will be undertaken to build on workshop output. SETT:Data and AI, will manage and support a small number of operational modelling projects providing appropriate data governance and clinical data extraction to address proposed service improvement and research questions. Each project will be defined as: · A pilot project expected to lead to future research/grant applications · Requiring clinical data extraction to solve an operational issue · Having clinical and academic team members to identify practical and implementable operational solutions to improve patient care Under the leadership of Prof. Chris Kipps, Clinical Director UHS R&D and SETT Centre, a programme of work will be launched to bring together the interested communities and work through a process to test a cooperative way of working to address real world and current problem(s) relevant to UHS and the broader community.

d94081d4-7fee-46f1-acf1-61bd1a5364fc Understanding barriers and enablers of using the Living with Long Term Conditions scale as part of routine care for people from under-served groups living with type 2 diabetes Chief investigator: Dr Leire Ambrosio, Lecturer, School of Health Sciences, University of Southampton. Team: Professor Mari Carmen Portillo, School of Health Sciences, University of Southampton Dr Lindsey Cherry, School of Health Sciences, University of Southampton Dr Kinda lbrahim, Associate Professor, Faculty of Medicine. University of Southampton Dr Michelle Myall, Principle Researcher, School of Health Sciences, University of Southampton Ms Rashmi Kumar, PPI representative Partners: Ha mpshire and Isle of Wight Integrated Care Board, Hampshire and Isle of Wight NHS Foundation Trust, University of Southampton, Diabetes UK, SO:Linked (Southampton Voluntary Services). Start: 1 October 2024 End: 31 March 2026 Why is this research important? In the England over 15 million people are living with at least one long-term conditions (LTC). People from under-served groups, are at greater risk of having one or more than one LTCs. This not only affects a person’s physical health, but other aspects of their lives, such as emotional, cultural, and socio-economic wellbeing. It is key for healthcare professionals, to understand and assess how a person is living with an LTC to provide person-centred care. We recently developed the Living with Long Term Conditions (LwLTCs) scale for English-speaking populations. This is a person-centred questionnaire to evaluate how well a person lives with a long-term condition, to inform care for people based on their individual needs. What is our aim? To better understand the barriers, enablers as well as contextual factors to successfully use the LwLTCs scale within primary care for underserved groups living with LTCs and liaise with healthcare professionals to support and deliver the future implementation study. What do we plan to do? We will explore potential barriers and enablers to using of the LwLTCs scale in routine primary care. We will interview (n=20) people with LTCs from under-served groups and (n=15) healthcare professionals including General Practitioners (GPs), Specialist Nurses, or Podiatrists who support LTCs patients, across Hampshire. We will also identify and engage with key healthcare professionals to guarantee their support through the later implementation process. All this will help us on developing an implementation strategy to test how feasible it is to use the scale in primary care. How have we involved patients and the public? This study has been developed with public and patient involvement (PPI). Our PPI co-applicant is from a Mixed Asian background from Africa with a family history of type 2 diabetes and living in an area of high socio-economic and health care diversity where high numbers of the population have diverse LTCs. He has been living with an LTC, particularly type 2 diabetes for 20 years. He will chair the PPI group (n=4), help to develop patient information, review data collection materials, and validate and disseminate findings. The PPI group will also assist with reaching out to communities engaged less frequently in research. Three meetings will be scheduled with the PPI group. How will we share our findings? We will publish in academic journals, with public contributor involvement and co-authorship. A lay summary of findings will be provided to participants who wish to receive them. Findings will be shared with clinical teams at primary care practices and healthcare decision makers. How long will it take? 18-months, starting the 1st of October 2024. How will we share our findings? We will publish in academic journals, with public contributor involvement and co-authorship. A lay summary of findings will be provided to participants who wish to receive them. Findings will be shared with clinical teams at primary care practices and healthcare decision makers.

09039be4-7f54-4e52-b415-7d6e49acfe67 Predicting nurse staffing requirements -validation and scoping extension study (PREDICT-NURSE validation and extension) Chief Investigator: Paul Meredith, Senior Research Fellow, University of Southampton Team: Christina Saville, Senior Research Fellow, University of Southampton Chiara Dall’Ora, Associate Professor in Health Workforce, University of Southampton Zlatko Zlatev, Senior Enterprise Fellow, University of Southampton Peter Griffiths, Chair in Health Sciences Research, University of Southampton Ian Dickerson, PPI Representative Tom Weeks - E Systems Implementation Manager Tom.Weeks@porthosp.nhs.uk Sue Wierzbicki - Lead Nurse - Workforce Sue.Wierzbicki@porthosp.nhs.uk Partners: Hampshire and Isle of Wight Integrated Care Board, Hampshire Hospitals NHS Foundation Trust, Portsmouth Hospitals University NHS Trust, Salisbury NHS Foundation Trust. Start: 1 October 2024 End: 30 September 2025 Our aim We aim to show that a computer algorithm we have developed which uses information that is already collected about patients can provide good estimates of the number of nurses needed on hospital wards to provide safe care for the patients. Background information It is important to have enough nurses to care for patients on hospital wards. If there are too few nurses, patients may take longer to recover, suffer complications, or die, and the capacity of the hospital to cope with new admissions is reduced. Also staff well-being is affected by high workloads and there is more staff sickness. Many hospitals use the Safer Nursing Care Tool (SNCT) to help them manage staffing levels. This involves surveying all the patients in a ward perhaps three times a day. Assessing each patient in this way is an extra nursing task and in itself adds to the workload. We have developed a computer algorithm using data from one hospital which can provide similar estimates of nursing staff requirements to SNCT but we need to check that these estimates would keep patients safe if they were followed. What we will do We shall use data collected for a previous study as input to the algorithm to produce estimates of nurse staffing requirements for each ward shift using information which could be known at the time. We will compare actual staffing with the algorithm’s estimate to see if there is a deficit or surplus of staff. For each admission we will examine how these deficits and surpluses relate to patient outcomes. We will compare using the algorithm to set a threshold for safe staffing with using the SNCT estimates as a threshold. Our comparisons will include looking at how good the methods are for wards with higher numbers of under-served groups such as the over 75s, those with learning disabilities and those with mental health conditions. We will measure the effect of staff shortfalls on the number of staff sickness absences. The performance of the algorithm will be checked using data from a second hospital in the database. We shall work with our partners to find out what tools are used to determine nurse and other staffing requirements on a day-to-day basis in community and mental health settings and what data on care requirements and outcomes is electronically recorded. We will discuss with partners what opportunities, potential benefits and practical considerations there are to implementing a predictive tool of staffing requirements. Communicating results We will write an academic paper, produce an article for the Nursing Times, create a poster for display at conferences, and publicise the results on social media. Involving the public We will involve local PPIE group members in evaluating and commenting on the possible uses of a predictive tool to support decisions in the day-to-day management of nurse staffing levels on wards.

7982ebd7-aab7-4e3f-8493-b1caebcd4bea COMPLETED: The Wessex FRIEND Toolbox (Family Risk IdEntificatioN and Decision) Identifying high risk groups early to improve health in young families in Wessex Principal Investigator: Professor Nisreen Alwan and Dr Dianna Smith Team members: Professor Nisreen Alwan (Professor in Public Health, School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Dr Dianna Smith (Lecturer in Geographic Information Science, Geography & Environment, University of Southampton), Professor Paul Roderick (Professor of Public Health, School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Dr Ivaylo Vassilev (Principal Research Fellow, School of Health Sciences, University of Southampton), Dr Grace Grove (Clinical Research Fellow, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton), Dr Nida Ziauddeen (Research Fellow, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton),Dr Lauren Wilson (Research Fellow, Geography & Environment, University of Southampton) Read report: Food Insecurity Risk Indices for Neighbourhoods 2021 Food Insecurity Brief LSOA Level Estimates Sept2021_online[2] .pdf Download PDF • 363KB Start: 21 October 2019 Ended: 30 September 2022 Project Partners: University of Southampton, Solent NHS Trust, Southampton City Council, Portsmouth City Council, Hampshire County Council, Health Education England, Oxford Brookes University Lay summary We know that prioritising health is complex, particularly for families living in social and economic disadvantage. The SLOPE CORE tool estimates the future risk of childhood overweight at the start of primary school. It can be used by health professionals in consultation with the families they are working with to help facilitate various interventions towards the prevention of childhood obesity. We have tested the acceptability and feasibility of this tool in the first phase of the Wessex FRIEND project, as part of a broader programme of work, aiming to improve the health of children and families in Wessex. We have trialled it with health visitors in the first instance, just so that we can get some initial feedback and improve it before combining it with other components of interventions. We have also been refining and tailoring area-based child poverty, food poverty and greenspace access measures to the local and regional context and population, so that our risk tool takes into account the area profile and resources where the family lives. These area-based measures, which represent neighbourhoods, may also be used independently by local governments and civil society/third sector to help in targeting resources to better support people living in areas of higher risk for food and child poverty, or with poorer access to greenspaces. What have we found out? We tested a digital tool called SLOPE CORE which predicts if preschool children are likely to be overweight by the time they start school. Health visitors and parents found the obesity prediction tool quick and easy to use. Using the tool provided the opportunity for health promotion, and may facilitate difficult conversations by giving an objective result and removing the perception of professional judgement. This may encourage conversations on healthy weight and could influence health visitor practice by increasing provision of anticipatory support on feeding. Health visitors felt that, when using the tool, the healthcare professional should have sufficient time to have a sensitive discussion and explain a conceptually difficult concept (risk). Parents felt that the tool provides an opportunity for behaviour change and potential to improve health for the child but can also provide reassurance. They appreciate the provision of additional resources and support with the results. However, before using the tool the healthcare professional should consider whether the tool is appropriate, as it may be unsuitable for some parents. We refined and tailored area-based child poverty, food poverty and greenspace access measures to the regional context and population. These provide improved tools for better planning and targeting of services by the local councils. These area-based measures are combined with the individual childhood obesity estimation provided by the SLOPE CORE Tool on one platform, which can be utilised by frontline professionals dealing with disadvantaged families. We also tested the feasibility of the Generating Engagement in Network Involvement (Genie), a facilitated social network intervention, as a means towards reducing risk of adverse family health outcomes. We tested this with Home-Start in Portsmouth which is a voluntary organisation. Staff found Genie simple to use, really liked the concept and found that familiarity with the system meant the process was much smoother for later entries. Staff felt that being able to fill out Genie on a phone or app would be quite useful. The option of other languages or built-in translation could also make it easier to use. Staff felt that Genie was particularly good for families feeling isolated or new to the area but was unlikely to be relevant for all. However, staff thought it was less realistic for them to use it within the timeframe of visits and other things that need to be done during a visit but they could potentially facilitate the use of Genie by encouraging people to do so themselves. The network mapping was useful as it made people realise what they have and what they need. Staff found it an interesting exercise to start the conversation and find out what was going on in the lives of individuals/families they were supporting. A potential barrier to the use of both tools is lack of wi-fi/internet connectivity. What difference can this make? Using the obesity prediction tool could provide the opportunity for health promotion and facilitate discussions by giving an objective result and removing the perception of professional judgement. This could encourage conversations on healthy weight and potentially influence health visitor practice by increasing provision of anticipatory support on feeding. Using the tool antenatally, or with a younger infant may allow for an easier conversation, allowing the healthcare professional to focus on prevention, as opposed to ‘correcting’ a parent’s current behaviour. Health visitors felt that parents were more likely to be receptive to a preventative approach. The refined area-based measures provide improved tools for better planning and targeting of services by the local councils. Network mapping using Genie made people realise what they have and what they need and help staff start the conversation to find out what was going on in the lives of individuals/families they were supporting. Why in this important? The Childhood Obesity Risk Estimation Tool has the potential to focus targeted intervention for the early prevention of childhood obesity. The updated food insecurity risk index has enabled local government to target available resources to those with greatest need. It has been included in the Joint Strategic Needs Assessment (JSNA) for Hampshire County Council. It has also contributed to food aid planning in Dorset, Hampshire and further resource planning in districts across the country. What’s next? The SLOPE CORE tool combined with the area based measures will require further testing to establish how it can be best used in practice, and any impact it may have on childhood obesity. This could be as part of a new or existing pathway which includes interventions designed to reduce risk of childhood obesity. Healthcare professionals using the tool should be trained in risk commination, be able to advise the parent on next steps, and have time to discuss what can be a sensitive topic. As SLOPE CORE only requires routinely collected data, it may be possible to build the tool into existing systems - such as healthy weight pathways, routine health visiting contacts and relevant GP consultations, which could save time and support existing work rather than further adding to workload for healthcare professionals. If internet access is unreliable, then a paper data collection sheet could be used to capture data required to use the tool at another time. After determining optimum timing and setting for tool use, a longer term evaluation is necessary to explore the impact of the tool on parents and healthcare professionals behaviours in the short term, and childhood obesity in the longer term. Publications: Ziauddeen, N., Roderick, P., Santorelli, G., Wright, J., & Alwan, N.A. (2022). Childhood overweight and obesity at the start of primary school: external validation of pregnancy and early-life prediction models. PLOS Glob Public Health. 2(6): e0000258. Ziauddeen, N., Roderick, P., Santorelli, G., Wright, J., & Alwan, N.A. (2020). OP55 Childhood overweight and obesity at the start of primary school: external validation of pregnancy and early-life prediction models. Journal of Epidemiology & Community Health, 74(Supplement 1), A26. https://doi.org/10.1136/jech-2020-SSMabstracts.54 Smith, D.M., Rixson, L., Grove, G., Ziauddeen, N., Vassilev, I., Taheem, R., Roderick, P., & Alwan, N.A. Household food insecurity risk indices for English neighbourhoods: measures to support local policy decisions. MedRxiv 2022:22273530. https://doi.org/10.1101/2022.04.06.22273530 (preprint and minor revisions requested at PLOS ONE) Smith, D. and Thompson, C. (2022) Food Deserts and Food Insecurity in the UK. Routledge. Further funding because of this research: ARC Wessex - Wessex DIET: Determining the Impact of covid-19 on food sEcurity in young families and Testing interventions MRC Clinical Research Fellowship (Dr Grace Grove) - Investigating the impact of food vouchers on diet composition and the prevention of childhood obesity Other impacts: The food security risk index has been included in the JSNA for Hampshire and has contributed to JSNAs and food aid planning in Dorset, Hampshire and further resource planning in Lancaster, Hull Hertfordshire and Greater Manchester to name a selection of Local Authorities, demonstrating the wider reach beyond Wessex.

65894af6-1d61-4f27-8b10-ff3b90451d8b COMPLETED: Safer Nursing Care Tool and nurse staffing requirements What did we learn We found that for some wards using the Safer Nursing Care Tool (SNCT) gives a good estimate of the number of nursing staff needed. However, for other wards, relying on the estimate provided by this tool without further thought could lead to unsafe staffing levels for different reasons. For example, the current guidance recommends setting staffing levels to meet the average requirement, but following this logic, 18 wards in the three Trusts would often have been short-staffed. Also, a quarter of wards needed a sample of over 182 days to estimate the number of staff needed precisely, when the current recommendation is 20 days. Nursing workforce leaders at the three Trusts suggested characteristics of wards where the tool performed least well, for instance, high patient throughput and differences in workload between mornings and evenings. What difference can this new knowledge make? This project and the previous related project (NIHR-funded study https://doi.org/10.3310/hsdr08160 ) led to a direct collaboration with NHS England and NHS Improvement and an invitation to work with them to further develop and update the guidance on using the Safer Nursing Care Tool. The team have spoken about the research findings and implications at a series of NHS Improvement safe staffing fellows training events. They have co-developed a set of resources to help nurses plan staffing. Impact has been achieved through this research shaping revised guidelines published by NHS England and NHS Improvement on using the SNCT in combination with professional judgement to determine nurse staffing requirements. We were invited to help facilitate workshops to co-develop a template for nurses to record their professional judgements. We are also in early-stage discussions with hospital managers in Greece about how the professional judgement framework might be relevant there, as well as discussions about how to achieve wider reach through the World Health Organization website. Why is this important? The professional judgement framework we developed as a result of these projects will benefit nurses, who use this tool nationally, by giving them concrete guidance on issues to consider when deciding staffing levels. It will benefit patients admitted to inpatient wards, through better matching of staffing levels to demand. Having too few nursing staff is related to adverse effects for patients (more deaths, more falls, longer stays in hospital), staff (turnover, sickness) and organisations (higher costs from temporary staff to fill gaps). Diagram 1 We presented the list of wards which were flagged as having overall poor fit to three nursing workforce leaders Some of the common factors they suggested as potential reasons for poor fit are shown here above. They highlighted wards with large morning-evening differences in staffing requirements (based on acuity-dependency ratings) may be among those where the tool fits least well. For wards that are particularly small or large, it is possible that the number generated by the SNCT is less likely to be sufficient to maintain minimum registered nurse levels when rostering staff to shifts. They highlighted some ward characteristics that mean the SNCT multipliers, as they are applied, may underestimate the true workload. These were high patient turnover, older patient population, cancer infusion/device activity. a high proportion of patients requiring one-to-one care AKA enhanced care/specialling. The factors suggested are on the whole congruent with published evidence What next? Our next step is conducting research predicting demand for nursing staff which we plan will also lead to tools and resources to guide decision-making around staffing. Research team: • Professor Peter Griffiths, Chair of Health Services, University of Southampton • Rosemary Chable, Deputy Director of Nursing, Education & Workforce, University Hospital Southampton NHS Foundation Trust • Nicky Sinden, Head of Nursing Workforce, Portsmouth Hospitals NHS Trust • Tracy Moran, Lead Nurse for Nursing Workforce, Education & Practice, Poole Hospital NHS Trust Project partners: • University of Southampton • University Hospital Southampton NHS Foundation Trust • Portsmouth Hospitals NHS Trust • Poole Hospital NHS Trust More information Evi dence Brief Publication 24_11_Professional_Judgement_Staffing_Eprints[16] .pdf Download PDF • 186KB Publications: Saville, Christina and Griffiths, Peter (2021) Ward staffing guided by a patient classification system: A multi-criteria analysis of “fit” in three acute hospitals. Journal of Nursing Management, 29 (7), 2260-2269. ( doi:10.1111/jonm.13341 ). Saville C, Griffiths P, Casey A, Chable R, Chapman H, Radford M, and Watts N (2023) Professional Judgement Framework, doi: 10.5258/SOTON/P1102 University of Southampton ( https://doi.org/10.5258/SOTON/P1102 ) Saville, Christina and Griffiths, Peter , Ejebu, Ourega-Zoé and Fogg, Carole (eds.) (2023) Introducing the Professional Judgement Framework to guide nurse staffing decisions (Evidence Brief, 24) 2pp. http://eprints.soton.ac.uk/id/eprint/484412 Saville, Christina and Griffiths, Peter , Ejebu, Ourega-Zoé and Fogg, Carole (eds.) (2024) Nurse staffing decisions: the Professional Judgement Framework. Nursing Times, 120 (7). https://www.nursingtimes.net/c...4-06-2024/ The Safer Nursing Care Tool as a guide to nurse staffing requirements on hospital wards: observational and modelling study ( nihr.ac.uk ) Video: Computer simulation what and why? https://sho.co/1E34T The importance of professional judgement in nurse staffing decisions https://southampton.cloud.panopto.eu/Panopto/Pages/Viewer.aspx?id=87fcb9bb-e9dc-4b43-8377-acb700e3bec2 Here is the orginal research outline Identifying wards for which the Safer Nursing Care Tool is appropriate for assessing nurse staffing requirements Principal Investigator: Dr Christina Saville Team members: Dr Christina Saville (Research Fellow, University of Southampton) Professor Peter Griffiths (Chair of Health Services Research, School of Health Sciences, University of Southampton), Rosemary Chable RN (Deputy Director of Nursing, Education & Workforce, University Hospital Southampton NHS Foundation Trust) Ms Nicky Sinden (Head of Nursing Workforce at Portsmouth Hospitals NHS Trust), Tracy Moran (Lead Nurse for Nursing Workforce, Education & Practice, Poole Hospital NHS Foundation Trust) Start: 1 December 2019 End: 1 August 2020 Partners: University of Southampton, Portsmouth Hospitals NHS Trust, Poole Hospital NHS Foundation Trust Lay summary It is important to have enough qualified (registered) nurses looking after patients staying on hospital wards, because having too few is associated with worse patient care and more patient deaths. On the other hand, there are extreme shortages of nurses, so having “too many” on a ward could be considered a waste. The Safer Nursing Care Tool is used in many hospital wards in England to work out the number of nursing staff (including nursing assistants) needed. However, a recent study showed that it is more suitable on some wards than on others. For example, we found that factors not accounted for in the tool, e.g. whether a ward is surgical or medical, and the proportion of single rooms, also affected professional judgement of whether staffing was adequate. Aim This study aims to understand which ward characteristics mean that the Safer Nursing Care Tool gives a good estimate of the nursing staff required, and which ward characteristics mean that the number might need to be adjusted or further considered by taking into account the expertise of ward leaders. It also aims, if possible, to provide some general rules or an add-on tool to help nursing managers with setting staffing levels. Methods We will analyse the data that were collected for a previous study in a different way. This time we will focus on differences between wards rather than hospitals. We will use analytical techniques for finding patterns in data to identify similar wards. In our team we have experienced leaders in nursing who will provide expert professional insights into ward characteristics. Patient, public and community involvement and sharing results We will involve nursing managers in the study because they are the potential users of any rules or tools we develop. We plan to develop a resource (rules or a tool) for nursing ward managers and to run a workshop to test use of this resource. We plan to write one academic paper about what we find out. We also can share the plans for this with lay members from the PPI group as appropriate. We are developing a smaller user group across Workforce and Frailty and Older People teams.

663cd08e-9825-45c9-8e1b-c94d485206ee COMPLETED SOCIAL CARE: Building capacity in social care through co-produced research and a research learning partnership between University of Portsmouth and Portsmouth City Council Background Social care is facing many challenges and, in a time where staff are stretched and resources are low, research can feel like a luxury rather than part of daily activities. Yet research is crucial for improving practice and finding innovative ways to overcome challenges. To increase capacity in social care research, academia and social care need to work together to understand each other and co-produce a programme that will fit with the workplace demands of social care and focuses on issues that hold meaning and value to those we are seeking to engage. The work that we co-produce will therefore lead to tangible practice change and/or a strengthening of the evidence for existing practice. The University of Portsmouth (UoP) and Portsmouth City Council (PCC) do not currently have a research learning partnership established, however our civic partnership agreement provides a strong impetus to build a learning partnership that will inspire, engage, and provide professional development for social care professionals in research, whilst providing academics with direct experience of co-producing research in complex public service contexts. Through this project we aim to develop such a research learning partnership. Contributors: Amy Drahota, Reader in Health & Social Care Evidence & Evaluation, University of Portsmouth Carole Fogg, Senior Research Fellow, University of Southampton Patricia Gilbert, Lecturer (Sociology), University of Portsmouth Patryk Jadzinski, Senior Lecturer (Paramedics), University of Portsmouth Gail Mann, Research Development Lead, Portsmouth City Council Nils Niederstrasser, Senior Lecturer (Psychology), University of Portsmouth Lucy Porteous, Senior Lecturer (Social Work), University of Portsmouth Clare Rachwal, Deputy Head of Service, Adult Social Care, Portsmouth City Council Jenny Roddis, Associate Head (Research & Innovation), University of Portsmouth Sharon Smith, Principal Social Worker, Adult Social Care, Portsmouth City Council Annabel Tremlett, Senior Lecturer (Social Work), University of Portsmouth Aims and Objectives Our overall aim is to build research capacity in social care through establishing a research learning partnership between the University of Portsmouth (UoP) and Portsmouth City Council (PCC) adult social care team, the public and other key partners, and develop co-produced research relevant to PCC social care practice and national issues. We will achieve this via the following four objectives: A. To establish a research learning partnership for social care between UoP and PCC which will provide learning opportunities for both partners and their associated stakeholders around the development, design, and delivery of research. B. To identify and prioritise research topics for development for further grant funding opportunities, within social care and also in collaboration with other health and care delivery partners. C. To undertake preliminary research activities (e.g. a systematic review, public involvement activities, and potential data gathering) on a prioritised topic in adult social care, which will underpin a funding application for further primary research. D. To develop guidance on increasing capacity in social care research via co-production in collaboration with wider ARC Wessex social care research partnerships. Research Plan / Methods We will begin this project with a three-month exploratory process with social care teams, that will be about relationship-building and working together to devise a programme of activities that will meet the needs of social care, establish what a learning partnership would look like, and how this will fit with the expertise of academics. We envisage that we will co-develop some activities that centre around relevant topic(s) of importance to social care, and that the academics can support based on their expertise. Our focus will be adult social care, to tie in with the School of Health & Care Professions’ thematic strength in older adults, PCC’s adult social care team, and the ‘ageing and dementia’ research area of ARC Wessex. The project will involve a researcher-in-residence, employed by UoP but embedded within PCC, to work alongside adult social workers and build a culture of joint research across the organisations. We will be seeking to integrate research into current processes, for example through senior social worker team meetings and practice support forums that would be happening anyway. Throughout the project we will be seeking to establish a legacy of ongoing work and practice, through the development of funding applications for future projects and the development of a community of practice that will outlive the duration of the funding, nurture an affinity for research, and help demonstrate the value of research to social care. Summary of findings This project had four strands: 1: Growing a research culture and working together We helped six people at Portsmouth City Council (PCC) to become research active or develop their research skills; four were awarded ‘Visiting Researcher’ status at the university, and two were social workers employed on the joint social work project as research assistants. Of the four visiting researchers: One social worker received mentorship to undertake their own small research project; One Mental Health Practitioner developed their research ideas, and applied for research funding; Two individuals independently completed a research project and were supported to develop their analysis and findings through collaboration with University researchers. All individuals are pursuing further research and supporting each other. 2: Joint social work project A research question was developed through discussions and shadowing within adult social work teams at PCC. This led to a review of the evidence on how and why different features of collaborative working may impact the outcomes of older adults receiving services. We found 28 relevant studies that helped develop three theories on collaborative working. The theories relate to: how multidisciplinary team meetings are managed; how staff can learn from each other and feel safe to speak out; how new solutions for older adults can arise when staff feel safe to speak out. These theories can be used to develop recommendations and new interventions to improve how social workers can work with other professionals to provide the best care for older adults. 3: Research learning programme A 6-part seminar series, Research Skills in Social Care , was delivered in-person for colleagues at PCC and online for wider audiences. The series gave an overview of the six stages of conducting a literature review to grow research knowledge and encourage discussions. Team members also gave seminars on their research projects through the Applied Research Collaboration Wessex online seminar series. 4: Reflecting on what we have learnt about growing research The process of growing research has been rewarding and challenging. Success has come from mentorship and individual relationships where trust and rapport are developed, and confidence is built at a steady pace. Arranging rooms and technology in a different organisation for the seminar series was difficult, however the in-person nature of the seminars was beneficial for sparking informal conversations and removing barriers between research and practice, presenting an “accessible” face. What we did with this Knowledge The knowledge from the joint research project is being shared with the wider adult social work team to inform team development. Additionally, we are working the Health Determinants Research Collaboration (HDRC) at Portsmouth City Council to establish how the activities to grow research can be expanded to other areas of the city council and local authorities wider afield. We are working together to develop a report for publication and continue to work with the adult social work team to grow research. Where next? • A funding application has been submitted by an Approved Mental Health Professional to conduct a literature review around racial disparities in coercive mental health treatment •A social worker is planning small research project evidencing the need for a larger autism/neurodivergence support service for adults •Further collaboration with Health Determinants Research Collaboration initiative •Discussing development of interventions based on the findings of the joint research project. This will form the basis of a future funding proposal. Koren Luddington – Visiting Researcher & Social Worker “I was matched with a mentor from the University, who was empathic and reassuring of my self-doubts. She made me feel as though all questions were valid and she was able to provide explanations that felt personalised and relevant to my field of work” Taken from Koren’s blog post on NIHR ARC Wessex Supporting capacity building in this project has been really eye opening - throughout this project I have met incredible, passionate people that are doing everything they can to provide support. There is such a wealth of knowledge and innovation happening in Adult Social Care, and it’s up to us in research to support and encourage that. Dr Leah Fullegar Leah.Fullegar@port.ac.uk

894e3c82-d20e-4fbc-a56a-7d96277ba61e COMPLETED: PARTNERS Project: Development and implementation of a digital tool for multisectoral support and management of long-term condition PARTNERS Project: Development and implementation of a digital tool for multisectoralsupport and management of long-term condition Principal Investigator: Professor Mari-Carmen Portillo Co Applicants : Line Bragstad, Dr Dorit Kunkel, Dr Kat Bradbury, Dr Lindsay Welch, Hayden Kirk, Dr Caroline Barker, Sandra Bartolomeu Pires, Christopher Edwards, Lindsay Cherry, Francesca White, Caroline Aylott, Cathal Doyle. Partners: University of Southampton, University of Oslo, Solent NHS Trust, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight ICS, Versus Arthritis, and Parkinson’s UK. Lay Summary Background to the research : Self-management is an approach to help people with long term conditions manage their health daily. Existing NHS self-management tools focus on healthcare (medication management, appointments) and fail to capture aspects of how people live with and adjust to long-term conditions. This includes social support (family/friends) and other resources and networks available like the voluntary sector, industry and community groups.We have created an intervention (an action to improve a situation or prevent it getting worse) to support self-management for people with Parkinson’s Disease and their family/carers. This intervention recognises the role of social support, voluntary sector, industry, and community groups in adjusting to living with a condition. Our next step is toadapt this intervention to the needs of people living with other conditions like Arthritis and for those living with more than one condition and create a digital tool. Aim of the research : To develop, implement and evaluate a digital tool that supports the management of people with Parkinson’s Disease and/or Arthritis. The tool will support professionals and other organisations to connect, share resources and optimise communication and referrals, leading to more personalised and cost-effective use of resources (beyond healthcare) in the community. Design and methods: The research will take place in community settings in Wessex. We will prioritise disadvantaged groups (those less comfortable using technology and less able toaccess available resources and support). We will : 1. Work with our patient and public involvement (PPI) representatives, relevant voluntary organisations, health and social care providers, and key people involved in policy making and NHS strategy. They will have a voice ineach decision to ensure our tool is relevant and acceptable to those using it. 2. Host discussion groups with people with Parkinson’s Disease and/or Arthritis and theirfamily/carers to understand the positive and negative aspects of existing digital tools, from a patient perspective. 3. Design our self-management tool. 4. Test the tool through two primary care surgeries (GP) and voluntary organisations (Parkinson’s UK and Versus Arthritis).Testing will help understand how the tool is used and what helps or hinders its success. Deliverables : The research will generate: a digital tool to support more effective self-management of Parkinson’s Disease and/or Arthritis, recommendations for policy development, evidence for how to improve NHS services. Public Patient Involvement: We willwork with people with Parkinson’s Disease and/or Arthritis and their families/carers. We will work together as equal partners to define their level of involvement, roles, methods to input and training needs. We will also explore what works best or what we should do differently intheir involvement. Dissemination : We will share our learning across the different groups involved. This will include presentations, policy briefings, newsletters, and public events. What did we find out? We found that people with Parkinson’s and/or arthritis, their carers and professionals involved in their care wanted a digital app that was: • Simple • Easy to navigate • Hybrid – in person contact also signposted Included: • Community resources from voluntary/charity sector • Free or inexpensive resources • Links to peers/buddy for support What next? PARTNERS 2 has evolved, as a continuation project. This allowed time for: • A suitable digital company to be found with previous experience of working with people with health condition • Full briefing of the digital company about what was required of the digital web app. • Development of a prototype app The PARTNERS 2 project will now: Develop the prototype app with User involvement through a series of online workshops, feedback sessions and interviews. Aim to gain full exposure of the app by having it adopted onto the My Medical Record platform at the University Hospital Southampton NHS Foundation Trust.

ff477b29-43df-41e3-8562-aeeb2cfcbef7 COMPLETED ADOPTED: Investigating Quality of Care for People with Dementia Undergoing Cancer Treatment in Ambulatory Care (ImPaCT) Principal Investigator: Dr Naomi Farrington Team members: Dr Naomi Farrington (Advanced Nurse Practitioner and NIHR Clinical Lecturer, University Hospital Southampton and University of Southampton), Professor Jackie Bridges (Professor of Older People’s Care, School of Health Sciences, University of Southampton), Professor Alison Richardson (Clinical Professor of Cancer Nursing and End of Life Care, University of Southampton and University Hospital Southampton). Start: 01 January 2019 End: 31 May 2022 Project partners: University Hospital Southampton NHS Foundation Trust, University of Southampton. S tudy is funded as part of a HEE/NIHR Clinical Lectureship Lay summary: There is not much information about people with dementia having cancer treatment. This study aims to understand how high quality care can be provided for people with dementia undergoing outpatient cancer treatment (radiotherapy, chemotherapy or other anti-cancer treatment). The study uses a research method called ethnography, which is where a researcher conducts ‘fieldwork’ to study a group of people to better understand that group. It will look at: The environment (surroundings and conditions) of the outpatient clinics and treatment areas; How people in the outpatient clinics and treatment areas behave and interact with each other; How treatment and support is organized in the outpatient clinic and treatment areas. Fieldwork will take place in the outpatient departments of University Hospital Southampton NHS Foundation Trust. It will include observations, interviews and review of patient notes. The people who will be invited to take part in the study are: People with dementia having cancer treatment; Friends or family supporting people with dementia having cancer treatment; Staff involved in the care of people with dementia having cancer treatment (doctors, nurses, support workers, administrative staff, and others). All those who take part in the study will be asked to give consent. The study includes: Observation . this will be carried out in cancer outpatient clinics and treatment areas. This will look at the environment (surroundings and conditions); the everyday interactions that happen between patients, carers and staff; and way in which care and support take place. Observation will take place in the general clinic areas as well as during doctor appointments and when treatment is being given. The researcher will take detailed notes. Interviews . these will be carried out with patients, carers and staff. These will focus on how people in the study speak and act to understand more about how they think and feel. Interviews will be digitally recorded, and a written transcript will be made. Patient notes . Researchers will look at patient notes to add to the information from observation and interviews. They will look at the notes to find out about diagnosis, treatment and support offered to patients. These 3 methods of data collection will help the researchers put together a detailed picture of the outpatient setting including how people act ( behaviour ), the surroundings and conditions ( environment ), and the way treatment and support is organised ( processes ). This will reveal ways in which healthcare organisations might best provide cancer treatment for people with dementia that is person-centred (focused on the needs of the person themselves) and of a high quality. What did we learn? The cultural environment of the outpatient care setting reflects and supports the standardized processing of people for cancer treatment. Dementia introduces a wider set of care requirements not catered for by a standardized treatment model. The needs of patients with dementia could be addressed most effectively when individualized care, was offered. This was possible when services were responsive to patient need. What difference did this new knowledge make? Outpatient cancer services can ensure responsiveness by: having an established way of eliciting needs, preferences and expectations a belief that a person's needs and expectations are legitimate, and that effort should be made to address them ability to accommodate these needs and expectations. Why is this important for patients, health and care providers, and policy makers? Managers of outpatient cancer care services have a better understanding of how to design and organize settings so that the needs of people with dementia can be addressed. Patients with dementia and their families will be more likely to receive personalized care that meets their needs. Policy makers will be more aware of the need to incorporate principles of personalized care into policies guiding the care and treatment of people with multiple health conditions. What have we done? This work has been part of building momentum to increase the profile of how people with cancer and dementia receive care and treatment. A national symposium was carried out with clinicians and academics in 2022 showcasing work addressing cancer and dementia. Dr Naomi Farrington is presenting this work as part of a session on ‘Person-Centred Care’ at the European Oncology Nursing Society in Madrid, October 2023. 3 papers have been published on this study: Understanding the cultural environment of the outpatient care setting for patients with dementia receiving cancer treatment: a qualitative study. https://pubmed.ncbi.nlm.nih.gov/36382351/ How can I improve cancer services for people with dementia? https://journals.rcni.com/cancer-nursing-practice/evidence-and-practice/how-can-i-improve-cancer-services-for-people-with-dementia-cnp.21.5.22.s10/full 'A rea l fine balancing act’: A secondary qualitative analysis of power imbalance in comorbid cancer and dementia in an outpatient treatment setting. https://pubmed.ncbi.nlm.nih.gov/36929372/ C LEAR steps for a responsive outpatient cancer service • C larify needs, expectations, preferences and goals • L egitimise these as valid • E nable these to be met by implementing strategies • A udit to ensure this is working for patients caregivers and health service • R ecord for the future https://vimeo.com/688041079

d7cea2fb-fab3-4e8d-86f6-e2d2952f0404 ADOPTED: Nurture-U (Southampton): A longitudinal survey for student metal health and wellbeing Principal Investigator: Lucy Dorey Start Date: 1 July 2021 End Date: 1 July 2025 Background: Promoting good mental health within university students is a priority. Anxiety, depression and self-harm are rapidly increasing. University mental health services report demand beyond their capacity. Effective ways to prevent student mental difficulties are urgently needed. Further, university should be a positive life experience and promote students' emotional fitness and ability to thrive. Research and student feedback recommend changing university culture, environment and teaching to promote wellbeing. Stepped care in which students move through different steps based on need is also suggested to improve student wellbeing and service capacity. This starts with wellbeing promotion and prevention for all students, steps up to self-help for those with mild symptoms and to professional support for those with elevated symptoms. However, these approaches have not been rigorously tested in universities. We don't know which elements best promote good student mental health. We don't know what approaches work best for the diverse student body across gender, ethnicity, sexuality, sociodemographic background. We will test initiatives within the university environment and at each of the steps, see which initiatives students use, how well they work, and identify which work best for which students across diverse groups. Students will be active partners in shaping, delivering and evaluating all research. We will use repeated twice-yearly online surveys across 6 universities (110k undergraduates) to assess student wellbeing and mental health and understand what helps or hinders students seeking and getting help. A digital self-monitoring tool allows students to track their wellbeing, stress, and what support they use over time so we can map how they move through stepped care and how different steps interact with each other. To test whether changing university environment promotes wellbeing, first we will evaluate embedding compassion into education: teaching about diversity and mental health, practising kindness and understanding for self and others, and making assessment more flexible and responsive to students. Focus groups will explore how students experience this approach. Second, we will introduce a voluntary online mental health literacy course for first year undergraduates that teaches what influences mental health, how to promote wellbeing and how to seek help. Surveys before and after the course will test if it increases students' knowledge, healthy behaviours, helps-seeking and wellbeing. To better understand how to make self-help work for students, randomised trials will test book-based guided self-help to build personal strengths, unguided digital self-help to prevent depression in high-worrying students and digital self-help for depression and anxiety. We will compare supported versus unsupported digital cognitive-behavioural therapy, meditation and peer support apps to find out which app(s) students find most acceptable and explore which students most benefit from. We will test self-help with and without support because unsupported self-help can reach vastly more people and there is uncertainty about whether and for whom supported self-help is more effective. To improve the efficiency of student mental health services, we will test if adding a digital self-monitoring tool shared between student and clinician improves student experience and time to recovery by enabling care to be more proactive and responsive (e.g., more frequent meetings if symptoms rise). From this research, we will develop an evidence-based integrated model of inclusive and acceptable student wellbeing and mental health support. In partnership with students and university leaders, this model will inform policy recommendations. We will develop guidance, courses and tools to promote student wellbeing that are easily added to existing systems or that use tried-and-tested low-cost technology to ease their adoption and ongoing use.

Research Fellow < Back Skaiste Linceviciute Research Fellow Long Term Conditions Skaiste Linceviciute is a Research Fellow at the ARC Wessex Mental Health Hub at the University of Southampton appointed to work on projects related to the Long-Term Conditions and Ageing and Dementia themes. Skaiste brings expertise as a qualitative researcher in areas on uncovering the challenges and unmet needs of people living with long-term physical and mental conditions as well as pursuing research on person-centered support systems. Skaiste is also the Mental Health Hub's Researcher Representative for the ARC Public Involvement Forum Wessex, working together with other contributors ensuring research meaningfully addresses community priorities and is guided by people with lived experience. Previous Next

a0531f94-b063-4041-908b-5830a10b5f66 ADOPTED: Community pharmacy alcohol-related liver disease risk identification and linkage to care through development of a complex intervention (CIP-LINC) Prinicpal Investigator: Dr Alexander Smith Start Date: 16 February 2023 End Date: 31 March 2025 Background Liver scarring (known as cirrhosis) is a frequent and ever more common reason for dying in the United Kingdom (UK). The most common cause of liver scarring in the UK is alcohol. Death from liver scarring can be prevented if liver disease is found at an early stage. This can be hard because many people with liver scarring do not look or feel unwell until they develop liver failure. At this stage it is too late to prevent complications. Alcohol-related liver disease can be found earlier by assessing for it in people who drink too much alcohol. This is advised in national guidelines. Local pharmacists are one of the most accessible health professionals. There are over 12000 local pharmacies in England. Lots of these pharmacies are in areas where more people have alcohol problems. Local pharmacists are able to identify people who drink too much alcohol and provide them support to drink less. However, it is not known if local pharmacists can get these people assessed for alcohol-related liver disease. This study looks at how this could be done with the aim of creating a Toolkit to make it happen.