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Health Inequality The aim of this National Priority Consortium in Health and Care Inequalities is to work across all Applied Research Collaborations (ARCs), the Northern Health Science Alliance (NHSA) and with national stakeholders to support the health and care system nationally and across our regions, to reduce health care inequalities. ​ The programme is led by the NIHR ARC North East and North Cumbria and the NIHR ARC Yorkshire and Humber, and involves all 15 ARCs from across the country Who is participating? The cross-sector implementation of NICE-recommended CBT-based interventions for young people in care: Framework development and pilot of trauma-focused CBT. (Involving ARC West, ARC East of England, ARC North East and North Cumbria, ARC Wessex, ARC Yorkshire and Humber, and co-funded with the Child Health and Maternity Consortium

Home > About us Implementation The ARC Wessex implementation strategy focuses on addressing the gap between project that validate an innovation at a signle and/or single group of sites and adoption of that innovation by the wider health and social care system. ​ ​ Sustainable system implementation is not a linear pipeline process, but a dynamic interaction between health and care research, commissioning and delivery at multiple points in the innovation cycle. Looking for the Implementation toolkit? What we do What we do The ARC Wessex Implementation Team has developed a workflow, including an implementation checklist, that is applied to the entire ARC Wessex portfolio. ​ Our workflow includes initial implementation advice to help researchers complete the proposal form, reviewing the ARC proposals, and providing follow-up support to successful projects (advice only or in-depth). ​ For in-depth support, we co-develop detailed implementation plans with the project leads. ​ All projects have access to implementation resources. As well, we actively contribute to the development of materials for the ARC Wessex PhD fellowship programme, including teaching sessions. ​ Collaborating with Wessex AHSN focuses on bringing AHSN criteria or staff into the ARC funding process, making initial contacts in the NHS for ARC portfolio projects (when appropriate), continuing active working on specific projects and contributing to upcoming proposals. ​ The Implementation Team also offers support to each ARC-funded project implementation champion (IC). ICs are not necessarily researchers, are located within, or can readily connect with, the relevant setting(s) where the project findings will have relevance. The IC promotes knowledge of the project, facilitate conversations about its implications and promotes translation. ​ See details of the Wessex NHS Insights Prioritisation Programme Project (NIPP) in conjunction with the Ageing and Dementia theme and AHSN Wessex our team Our team Philippa Darnton Interim Implementation Lead ARC Wessex Profile Dr Michelle Myall Senior Research and Implementation Fellow Profile

COMPLETED: Material Citizenship Framework Project Principal Investigator : Professor Jackie Bridges (Professor of Older People's Care, School of Health Sciences, University of Southampton) Co-investigator : Dr Kellyn Lee (Visiting Fellow, School of Health Sciences, University of Southampton) Researchers: Dr Jane Frankland, Leah Fullegar Collaborator: Zoe McCallum (Chief Operating Officer, Brendoncare) Started : 1 February 2020 Completed: 30 November 2022 Project partners: Brendoncare Foundation. Co-funded by University of Southampton ESRC Impact Acceleration Account, Alzheimer’s Society, The Brendoncare Foundation Concept Material Citizenship, a new approach to dementia care, uses objects used to carry out tasks (such as a mobile phone or curling tongs) as a mechanism for improving the care experience for care home staff and people living with dementia in care homes. It does so by: Encouraging care home staff to include personal possessions in care plans Support use of personal possessions to maintain routines and rituals Enable people living with dementia to carry out everyday tasks, supporting them to the live the life they want to live Impacts Material Citizenship training was delivered to four care homes, part of two care organisations in the UK. Adopting a Material Citizenship approach has had a positive effect on many of the people who live, work and visit these care homes. According to one care home manager, taking a Material Citizenship approach has transformed how they provide care. They have seen an improvement in the wellbeing of residents and increased confidence in staff who attended the training. Care home staff are now supporting people living with dementia to engage in meaningful activities such as delivering newspapers, baking bread and polishing their own rooms – with the polish they like. It has also had a more fundamental impact on the care practices of a care home. In one care home the manager gave an example of how it has changed the culture in the care home. Prior to introducing Material Citizenship catering staff worked certain times of the day and food was restricted to set meal times. This has changed and catering staff are now available to support residents in meal choices and meal times that suit them. It was also reported that prior to Material Citizenship, time restrictions of when people should leave the care home and return to the care home were in place. Residents no longer need to be back at certain times, they have more freedom to come and go as they wish, something noted by an external healthcare professional as being wonderful. Material Citizenship has enabled care home staff to grow in confidence. Prior to attending training care home staff were observed to be frequently deferential when interacting with visiting healthcare professionals. Now care home staff are more willing to engage and assert themselves to get the best possible outcome for residents. By applying a Material Citizenship approach it has been reported staff are less likely to rush to the assumption that medical intervention might be the best way forward to to reduce behaviours they find challenging. Instead, staff are using objects as a way of exploring why a person may be communicating in a negative way and have more confidence when working with people living with dementia. Publication: Material Citizenship: An ethnographic study exploring object–person relations in the context of people with dementia in care homes

ADOPTED PROJECT: How to Support children with cancer, or another serious condition, and their parents during the COVID-19 outbreak How to Support cHildren with cAncer, or another serious condition, and theiR parents during the COVID-19 outbreak?: understanding Experiences, information and support needs, and decision-making – the SHARE study Chief Investigators: Professor Anne-Sophie Darlington Professor of Child and Family Psychological Health, School of Health Sciences, University of Southampton, SO17 1BJ, UK Email: a.darlington@soton.ac.uk Dr Bob PhillipsHonorary Consultant in Paediatric and Teenage and Young Adult Oncology,The Leeds Teaching Hospitals NHS Trust, Leeds Dr Jess Morgan NIHR Clinical Lecturer in Paediatric Oncology, Centre for Reviews and Dissemination, University of York, York Mr Ashley Ball-Gamble Children’s Cancer andLeukaemia Group Project team: Dr Nicole Collaço – University of SouthamptonDr Arvind Nagra – University Hospital Southampton NHS Foundation TrustDr Luise Marino – University Hospital Southampton NHS Foundation Trust Organisations involved: University of York, Children’s Cancer and Leukaemia Group, University of Southampton, University Hospital Southampton NHS Foundation Trust, The Leeds Teaching Hospitals NHS Trust, Kidney Research UK, Kidney Care UK, British Heart Foundation, Children’s Heart Foundation, Cystic Fibrosis Trust, Harry’s Hat, Shine, Together for Short Lives, The Martin House Research Centre. Summary Children and young people with cancer may be particularly vulnerable. Those undergoing treatment have a weakened immune system, meaning they will find it more difficult to fight infections. [1] Comprehensive advice for parents has been compiled by experts and disseminated through the UKs Children’s Cancer and Leukaemia Group (CCLG).[1] However, we urgently need to increase our understanding of evolving experiences, information needs and decision-making of these families under these extraordinarily stressful circumstances. Only through investigating parents’/main carers’ experiences and needs will we be able to tailor and provide the right support, in terms of guidance, information updates, and online interventions to reduce distress and anxiety. Supporting decision-making Children and young people undergoing treatment face ongoing compromises to their immune system, which forces families to manage infection risks regularly. Decision-making under these threatening circumstances needs to be well understood. Furthermore, we know that parents and health professionals differ in terms of what underpins their decision-making. For example, when making decisions related to treatment for febrile neutropenia (with an increased risk of infection) parents value and assess quality of life, fear, and comfort differently to health professionals.[2] During the COVID-19 outbreak, children undergoing cancer treatment are perceived to be more at risk, and thus families will need to assess the information they receive and continue to make decisions in a changing environment. In addition, information provision through established media outlets and social media is constant and everchanging, and not always reliable. This illustrates the importance of investigating children’s and parents perspectives and experiences. Decision-making involves the uptake of information relating to benefits, risks, and uncertainties, but most importantly, this is guided by values and preferences.[3]Families have to construct them in the moment of decision making, based on the available information.[4] When information changes, choices change, producing inconsistencies and difficulties.[5] Again, congruence between families’ preferences, values and changing experiences need to be understood to allow them to make the best decisions in looking after their children. Without this data we will not be able to support them, nor advocate for them on a broader level. Reducing anxiety and stress Families across the country are worried; a rapid systematic review of the experience of families under quarantine for recent severe respiratory viruses (SARS, MERS) shows very high levels of traumatic distress.[6] This has led to the development of support materials and interventions: a book for children ‘Dave the Dog is worried about coronavirus’ developed by clinicians,[7] guidance developed by the Universities of Reading and Oxford to support children and young people.[8], and general guidance to manage anxiety for young people, developed by psychologists.[9]. Children with cancer and their families are particularly worried as their child is particularly vulnerable. A 6-week online intervention, iHOPE, [10,11] providing psychoeducation targeted at the parents of children who have cancer has been piloted, and an evaluation of opening greater access to this programme is planned. Many other support services, generally delivered by face to face meetings and group sessions, are transitioning to an online delivery. These will not be strictly ‘programmatic’ and may be ongoing. During this period of implementation of this resource into the health service, there is a need to simply evaluate its effectiveness, by introducing a short assessment of anxiety and stress before and after the delivery of the intervention. The current study proposes to ask parents to complete a short (to minimise burden) validated questionnaire before and after the intervention. Research Aim and Objectives The study will consist of two work packages (WPs). The aims of WP 1 are 1) to explore experiences, information and support needs and decision-making, and 2) to explore how these change over time as the situation with COVID-19 evolves. The aim of WP 2 is to evaluate whether proposed online interventions to support families reduce anxiety and stress. Research publication: COVID-19: experiences of lockdown and support needs in children and young adults with kidney conditions Yincent Tse, Anne-Sophie E. Darlington, Kay Tyerman, Dean Wallace, Tanya Pankhurst, Sofia Chantziara, David Culliford, Alejandra Recio-Saucedo & Arvind Nagra COVID‐19 and children with cancer: Parents’ experiences, anxieties and support needs Anne‐Sophie E. Darlington, Jessica E. Morgan, Richard Wagland, Samantha C. Sodergren, David Culliford, Ashley Gamble, Bob Phillips

PARIEDA - Prediction of Acute Respiratory Infection outcomes prior to Emergency Department Attendance Principal Investigator: Dr Daniel Burns, Senior Research Engineer, University of Southampton, d.burns@soton.ac.uk Team: Professor Michael Boniface, Professorial Fellow of Information Systems, University of Southampton, m.j.boniface@soton.ac.uk Professor Matthew Inada-Kim, National Clinical Director-Infection, AMR & Deterioration-NHS England & Improvement, National Clinical Lead COVID NHS@home Visiting Professor, University of Southampton Chair COVID pathways group, matthew.inada-kim@nhs.net Dr Stephen Kidd, Lead Healthcare Scientist, Hampshire Hospitals Foundation Trust, stephen.kidd@hhft.nhs.uk Starts: 1/4/2023 Ends: 30/9/2024 Aim: We will help community doctors and nurses decide how best to care for patients with serious respiratory illness. The right care depends on how ill a patient is and if they will get worse. Care may include home monitoring or hospital visits. We aim to use computer algorithms to help doctors and nurses make these decisions. We expect patients to avoid unnecessary trips to hospital and to feel more supported. Background: Hospitals have had record number of emergency departments visits. Respiratory infections are almost half of the visits. Many of these patients were not admitted to hospital. This means that some patients could be cared outside of the hospital in the community. COVID-19 is a serious respiratory illness. During the COVID-19 pandemic a new way to care for patients was created. Instead of patients going straight to hospital, they were assessed in the community. Only the most serious cases were then sent to hospital. Community care and assessment is now being considered for other respiratory illnesses. Approach: We will use computer algorithms to help community doctors and nurses decide which patients are at most risk of serious respiratory illness. Risk assessment will be done using machine learning. Machine learning is a way to train a computer to categorise patients into groups using data about patients and services they use. We will use historical hospital data to identify patients in high-risk groups. The patient categories will then be used to inform community decisions before attendance at hospital. Patient and Public Involvement: Patients and public have helped develop the research through evaluation pilots for community assessment hubs. PPI will influence data usage and the use of risk groupings within care pathways. Two public members will participant in a Steering Committee. A PPI Committee will organise three workshops involving ten patients and public in the research. Dissemination: Communication will engage the public and decision makers. We will work with patients and the public to design engaging communication and seek acceptance. Our results will be published and will inform national policy.

ADOPTED: Development, evaluation and provision of an intervention for primary and community NHS staff to help carers and homecare workers supporting people living at home with dementia with their continence. Principal Investigator: Dr Catherine Murphy, Senior Research Fellow, School of Health Sciences, University of Southampton. Team: Jane Ward: former carer, Alzheimer’s Society Research Network Member, co-founder of Dementia Friendly Hampshire, Patient Research Ambassador: Prof Miriam Santer: Professor of Primary Care Research, Faculty of Medicine, University of Southampton: Prof Jill Manthorpe: Professor of Social Work, Director of NIHR Policy Research Unit in Health & Social Care Workforce, King’s College London – Associate Director of NIHR School for Social Care Research: Prof Mandy Fader: Professor of Continence Technology, School of Health Sciences, University of Southampton: Dr Leanne Morrison: Lecturer in Health Psychology, School of Psychology & Primary Care Research Centre, University of Southampton. Partners: Health Innovation Wessex, Alzheimer’s Society, Homecare Association, Carers UK, Queen’s Nursing Institute, Dementia UK. Start: 1/06/2022 End: 1/4/2024 Summary Most of the 850,000 people living with dementia in the UK live in their own homes with support from family or friend carers. Dementia puts people at much greater risk of developing continence problems (with urine/wee or faeces/poo) than people without dementia of the same age. Continence and toilet-use difficulties cause many problems for both people living with dementia and carers, for example, sore skin, infections, embarrassment, anxiety, fear of going out, relationship breakdown, and expenses such as cleaning carpets or laundry. Dementia can mean that using pads or reminders do not work well for people as time goes by. Many carers find dealing with incontinence hugely distressing. They describe feeling poorly prepared and alone. Many find it difficult to talk about and want better support from health and care professionals. Recently we asked people living with dementia, carers and nurses to tell us what information and support they would find useful. From that, we developed a detailed, practical handbook specifically for carers, covering: · understanding why someone with dementia might become incontinent · helping people keep ‘dry’ · managing incontinence · talking about incontinence · continuing with daily activities and socialising. The handbook contains many ‘real-world’ quotes from carers and will be made freely available on www.continenceproductadvisor.org (an NHS endorsed website). This is a good start but requires carers to find and use the handbook by themselves. Most carers want proactive support from the professionals they see (either healthcare or homecare workers), but healthcare professionals often feel ill-equipped to help carers or advise homecare workers. Therefore, in this study, we will develop a new resource that will build on the handbook and equip healthcare professionals to: · start conversations with carers and homecare workers · discuss continence problems and help people choose goals · deliver practical advice to carers and homecare workers. To do this, first we will review research on similar resources and speak to up to 45 primary and community healthcare professionals and homecare workers to fully understand their needs and how a new resource could be used and useful. We know that many people living with dementia and carers have regular contact with homecare workers who often help with washing and going to the toilet. Then, we will work with carers, people living with dementia, healthcare professionals, homecare workers, care commissioners or funders, voluntary groups and professional bodies to develop the resource. We will ask up to 60 people living with dementia, carers, homecare workers and healthcare professionals to use the resource and tell us what they think. We will then make changes to improve the resource. We want this resource to be used by as many primary and community healthcare professionals as possible so that they can support homecare workers and family carers. So, throughout this project, we will ask people about the best way to make it both useful and accessible. It will be freely available via www.continenceproductadvisor.org and we expect adopted and recommended by a range of organisations such as the Alzheimer’s Society, Skills for Care, Homecare Association and professional groups.

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.

POST DOCTORAL PROJECT: The career aspirations of nurses working in the research delivery workforce: a cross-sectional survey Chief Investigator: Dr Miriam Avery – University of Southampton and University Hospital Southampton NHS Foundation Trust Organisations Involved: University of Southampton, University Hospital Southampton NHS Foundation Trust. Background: We know that nurse-led research in health and social care is crucial to enable nurses to deliver high quality care based on the best available evidence. Nurse-led research is being generated within higher education institutions and a small number of NHS roles, but nurses remain an under-represented group in health services research. There is a clear capacity problem for nurse-led research. Within the NHS, the largest group of nurses working in research are in research delivery roles. This section of the nursing workforce has experience, skills, and competencies in delivering research within a health and social care environment from start to finish. All these skills are of prime importance when designing and leading a research study. However, as there is little published data on the career aspirations of this group of nurses, the extent to which they have the desire to progress an independent researcher career and build capacity for nurse- led research is unknown. The aim of the study is to undertake an online survey of nurses working in research delivery roles in local acute NHS Trusts to determine the career aspirations of this group of nurses. The study is at a very early stage, with the research proposal and protocol in the process of being developed. We expect the set-up and recruitment phase to be completed by the autumn of 2022. This study is in the early stages of development. The planned online survey includes questions around the current activities of nurses in research delivery roles, as well as training, skills, competencies, and career aspirations. The findings from the survey will provide much needed data about the aspirations of this group of nurses, which will determine the next phase of this research project. If there is aspiration for independent research amongst a section of this workforce, then there is an urgent need to facilitate progression along this career path.

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.

CLECC Toolkit and background: Creating Learning Environments for Compassionate Care (CLECC) CLECC is a training and development programme that has been tested and measured over several years in different care environments. It is designed to help improve the wellbeing of health and care staff and make a difference to patient care. It’s easier for you to care for patients when you feel well cared for yourself An important part of feeling well cared for is working in a team that supports you, where members care about how you are and want to help you It’s hard to provide good care to patients when you feel stressed, isolated and unsupported CLECC aims to provide the conditions in which every team member feels able to be compassionate with each other and with patients We have developed and tested CLECC in real-life health and care settings to see how practical it is to use and to understand its impact in different settings. Our results to date indicate its promise for supporting staff learning and wellbeing, and the delivery of compassionate care. Professor Jackie Bridges Professor Jackie Bridges, a nurse by background and now Professor of Older People’s Care at University of Southampton in the UK, has led this work for over a decade. She has worked closely with experts from different fields, particularly in nursing practice, to develop the CLECC programme and the accompanying research. This page contains a facilitator guide and accompanying resources to help health and care teams learn about CLECC and use it in a practical real-world setting. CLECC is constantly being improved and revised with feedback from nursing, care staff and managers so please get in contact with any feedback. You can fill out the form below or contact us direct. Contact us Email arcwessex@soton.ac.uk Or via our Twitter page Let’s start with the basics What is CLECC and what evidence do we have that it works? Our two videos below can answer those questions Guides – How do we do that? I want to use CLECC A guide for facilitators – 101834 A4 Brochure - CLECC Facilitator Manual AMENDS - Jackie Bridges - FINAL .pdf Download PDF • 1.14MB I want to show CLECC to a team and get them thinking about how to use it Slideshow to accompany facilitator guide – download PDF here (32 pages) CLECC Whole Team Introductory Learning Activities slideset .pdf Download PDF • 13.63MB I want to tailor how I use CLECC based on understanding people’s experiences at work Download the questionnaires below: Workplace Learning Questionnaire – for use by teams to identify team learning climate strengths and issues Team CLECC Workplace Learning questionnaire for care settings .pdf Download PDF • 108KB Climate for Care Questionnaire – for teams to evaluate team working climate CLECC Team Climate for Care questionnaire .pdf Download PDF • 107KB Please take time to tell us why you are using CLECC

Pharmacological And Non-Pharmacological treatment of ADHD in Pre-schoolers: a systematic review and network meta-analysis: the PANPAP study Lead applicant: Professor Samuele Cortese Co-applicants: Andrea Cipriani, Corentin Gosling, Luis Farhat, Cinzia Del Giovane ​ Background: Children with Attention-Deficit/Hyperactivity Disorder (ADHD) have problems with attention and need to move more than most children. About 5% of school-aged children and 2% of pre-schoolers have ADHD, respectively. This translates into almost 10,000 pre-schoolers with ADHD in the South West England area. Interventions for ADHD include pharmacological and non-pharmacological treatments. When not treated, ADHD entails a significant burden to society, estimated at more than £20,000 per year. Therefore, it is important to detect and treat ADHD in the early years to prevent the negative consequences of ADHD later in life. Experts and ADHD support groups agree that the NHS does not meet the needs of pre-schoolers with ADHD. Currently, there are either long waiting lists or no services for pre-schoolers with ADHD in the NHS. To provide the best care for pre-schoolers with ADHD, we need to make sure that the NHS offers treatments that work well and are safe. In 2018, the National Institute for Health and Care Excellence (NICE) recommended mainly non-pharmacological interventions (behavioral interventions) for the treatment of pre-schoolers with ADHD. Back then, there was a paucity of studies on other non-pharamcological interventions and on medications for ADHD in pre-schoolers. Since 2018, there has been an increasing number of studies on other types of interventions (e.g., family-based interventions and diet) and on medications. There has also been an increasing trend in some countries (e.g., USA) to use medications for pre-schoolers with ADHD. Therefore, we need to understand which is the best intervention for pre-schoolers with ADHD. Aim: To compare the efficacy and safety of pharmacological and non-pharmacological interventions for ADHD in pre-schoolers. ​ Methods: We will not do a new study, which would be very expensive. Rather, we will use a new type of research, called “network meta-analysis”. This approach uses data from available studies to compare different types of treatments even when they have not been compared directly in the individual available studies. Therefore, we will first systematically search for published and unpublished studies of any pharmacological or non-pharmacological treatment for pre-schoolers with ADHD. We will then combine the information from these studies with a state-of-the-art statistical approach. We will finally assess the quality of the studies included in the analysis and the strength of the evidence that we will generate. We are well known experts in this type of research. The study will be conducted at the University of Southampton, in collaboration with international researchers, including a statistician with renowned expertise in this type of analysis. ​ Impact: The findings of our research are expected to inform future regional, national and international guidelines on the treatment of ADHD in pre-schoolers. As such, our results will be disseminated to local commissioners and policy makers, NICE, and international guidelines groups such as the European ADHD Guidelines Group. We will also disseminate our findings to associations of families with children with ADHD in the Wessex area, at the national (for example, National Attention Deficit Disorder Information and Support Service, ADDISS), and international level (ADHD Europe).

ADOPTED PROJECT: MELD Developing a Multidisciplinary Ecosystem to study Lifecourse Determinants of Complex Mid-life Multimorbidity using Artificial Intelligence (MELD) Chief Investigator: Dr Simon Fraser – University of Southampton Project Team Members: Dr Nisreen Alwan – Associate Professor in Public Health, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Professor Michael Boniface – Director of the University of Southampton IT Innovation Centre and Web Science Institute, Professor Ben MacArthur – Mathematical Sciences University of Southampton, Professor Rebecca Hoyle – Mathematical Sciences University of Southampton, Dr Sarah Crozier – Associate Professor of Statistical Epidemiology, MRC Lifecourse Epidemiology Unit, Faculty of Medicine, University of Southampton, Mr William Ware – Patient and Public Involvement Contributor, Mr James McMahon – Patient and Public Involvement Contributor, Dr Emilia Holland – Public Health Specialty Registrar, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Dr Zlatko Zlatev – Senior Enterprise Fellow, Electronics & Computer Science, University of Southampton Background: As with many countries we are facing challenges related to the growing number of people living with multiple long-term health conditions like diabetes, heart disease or dementia. All the way through peoples’ lives many things influence the chances of developing such conditions. This includes some things that are hard to research - broader issues throughout life such as the environment people grew up in, their education, work, and so on. Sadly, people from more socially and economically disadvantaged backgrounds are more likely to develop multiple conditions at an earlier age. There is also evidence that the order of developing conditions varies considerably and influences what then happens to people. This makes understanding these broader issues and how they affect that order vital to inform when and how we should intervene to prevent conditions developing. To achieve this, we need to study large numbers of people over their whole lifetime, but such datasets do not exist. Very large health datasets collected from NHS GPs are helpful but haven’t been running long enough to track from birth to later life. They include lots of information on long term conditions but not much about broader issues. In our Development Award (called ‘MELD’) we had access to one such dataset of about 700,000 people, which we used to identify health conditions. We also accessed data from the ‘1970 British Cohort Study’ – a long-running research study called a ‘birth cohort’ Publication: Early-onset burdensome multimorbidity: an exploratory analysis of sentinel conditions, condition accrual sequence and duration of three long-term conditions using the 1970 British Cohort Study https://bmjopen.bmj.com/content/12/10/e059587.full