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COVID-19 projects We have been responding to the call from the National Institute for Health Research and the Department of Health and Social Care to rapidly respond to the demand for evidence and support for the NHS and care settings during the Covid-19 pandemic. ​ The ARC Wessex Central team has been called in to support the NHS Nightingale Hospital and we are working with other ARCs and specialists. Professor Peter Griffiths is leading a team on Workforce and Staffing. ​ This page lists the ARC Wessex Covid-19 research projects underway, and is updated when new projects come online. #staysafe Our research projects ADOPTED: Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (STIMULATE) Read more ADOPTED PROJECT: Supported remote rehabilitation post Covid-19 Read more COMPLETED: Development of policy recommendations to reduce the impact of COVID-19 on physical activity and mental health in individuals with multimorbidity: a mixed method study. Read more COMPLETED: Predicting Patient Deterioration Risks in COMMunities Read more ADOPTED PROJECT: How to Support children with cancer, or another serious condition, and their parents during the COVID-19 outbreak Read more Developing a web resource to support families bereaved during COVID-19 Read more GOODNIGHT Covid-19 to care-home-based vulnerable individuals Read more COMPLETED: COVID-19 Emergency Department Project Read more

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

Ageing & Dementia Publications Barriers and motivators to undertaking physical activity in adults over 70-a systematic review of the quantitative literature Kilgour AHM, Rutherford M, Higson J, Meredith SJ, McNiff J, Mitchell S, Wijayendran A, Lim SER, Shenkin SD Physical activity (PA) has multiple benefits for older adults (≥70 years old). Despite this many older adults do not undertake the World Health Organisation guideline recommended amount of PA. This systematic review examines barriers and motivators to PA in adults aged ≥70 years. We analysed the quantitative literature, including observational studies and baseline data from randomised controlled trials. Studies examining specific diseases (e.g. cognitive impairment), or care home residents were excluded. Database searches of ASSIA, CINAHL, Embase, Medline, PsycINFO and Web of Science were undertaken on 7 March 2023. Quality assessment was performed using the ROBANS tool. We synthesised the results using the socioecological model. The protocol was registered on PROSPERO (CRD42021160503) https://doi.org/10.1093/ageing/afae080 April 2024 Ageing & Dementia Consequences of Anorexia of Aging in Hospital Settings: An Updated Review Cox NJ The anorexia of aging is a widespread problem amongst older people, particularly in the hospital setting with up to 60% affected. Despite its high prevalence anorexia often goes undiagnosed in hospital, due to a lack of standardized assessment and evidence-based management, but also lack of knowledge regarding consequences. This review summarizes current evidence for anorexia of aging specific to the hospital setting, giving an overview of correlates of appetite in hospital and consequences of anorexia. It highlights an overall scarcity of research on this important clinical problem for hospitalized cohorts. The few studies point to the importance of anorexia of aging in major health burdens for older people, namely malnutrition, sarcopenia and reduced physical performance, as well as higher mortality. Further research is needed to assess temporal sequence in pathways of causality and to develop effective interventions to combat anorexia. https://doi.org/10.2147/cia.s431547 March 2024 Ageing & Dementia Healthcare professionals' experiences and views of providing continence support and advice to people living at home with dementia: "That's a carer's job" Bradbury B, Chester H, Santer M, Morrison L, Fader M, Ward J, Manthorpe J, Murphy C People living with dementia at home and their family carers often feel unsupported by healthcare professionals in managing continence problems. In turn, primary and community-based healthcare professionals have reported lacking specific knowledge on dementia-continence. This study aimed to understand more about healthcare professionals' experiences and views of supporting people living with dementia experiencing continence problems, as part of developing acceptable resources. Having a nuanced understanding of unmet need would facilitate the design of engaging resources that enable healthcare professionals to provide more effective continence support to people living with dementia at home. https://doi.org/10.1186/s12877-024-04830-8 March 2024 Ageing & Dementia Towards an improved dementia care experience in clinical radiography practice: A state-of-the-art review Abowari-Sapeh ME, Ackah JA, Murphy JL, Akudjedu TN The increasing global incidence rate of dementia and associated co/multimorbidity has consequently led to a rise in the number of people with dementia (PwD) requiring clinical radiography care services. This review aims to explore and integrate findings from diverse settings with a focus on the experiences of PwD and stakeholders, towards the development of a holistic approach for dementia care and management within the context of radiography services. https://doi.org/10.1016/j.jmir.2024.01.008 February 2024 Ageing & Dementia The anorexia of ageing and risk of mortality: More than a story of malnutrition? Cox NJ, Lim SE Appetite loss or anorexia due to physiological, psychological and socioenvironmental effects of the aging process is termed the anorexia of aging. The link between anorexia of aging and mortality has subsequently been established by a number of longitudinal studies across multiple settings. Despite the association, clear interpretation of the mechanistic relationship between anorexia of aging and mortality, has been limited. https://doi.org/10.1016/j.jnha.2024.100173 February 2024 Ageing & Dementia Perfusion Imaging and Inflammation Biomarkers Provide Complementary Information in Alzheimer's Disease Michopoulou S, Prosser A, Dickson J, Guy M, Teeling JL, Kipps C Single photon emission tomography (SPECT) can detect early changes in brain perfusion to support the diagnosis of dementia. Inflammation is a driver for dementia progression and measures of inflammation may further support dementia diagnosis. In this study, we assessed whether combining imaging with markers of inflammation improves prediction of the likelihood of Alzheimer's disease (AD). https://doi.org/10.3233/jad-230726 January 2024 Ageing & Dementia How can I improve cancer services for people with dementia? Farrington N, Richardson A, Bridges J Tips and guidance on making cancer services People with dementia have poorer cancer outcomes than those without, and are more likely to experience complications and poorer overall survival (McWilliams et al 2017). Few interventions are designed for older people with cancer and complex needs, such as those with dementia (Farrington et al 2022). doi: 10.7748/cnp.21.5.22.s10 October 2023 Ageing & Dementia Artificial intelligence for diagnostic and prognostic neuroimaging in dementia: A systematic review Borchert RJ, Azevedo T, Badhwar A, Bernal J, Betts M, Bruffaerts R, Burkhart MC, Dewachter I, Gellersen HM, Low A, Lourida I, Machado L, Madan CR, Malpetti M, Mejia J, Michopoulou S, Muñoz-Neira C, Pepys J, Peres M, Phillips V, Ramanan S, Tamburin S, Tantiangco HM, Thakur L, Tomassini A, Vipin A, Tang E, Newby D; Deep Dementia Phenotyping (DEMON) Network; Ranson JM, Llewellyn DJ, Veldsman M, Rittman T Introduction: Artificial intelligence (AI) and neuroimaging offer new opportunities for diagnosis and prognosis of dementia. Methods: We systematically reviewed studies reporting AI for neuroimaging in diagnosis and/or prognosis of cognitive neurodegenerative diseases. https://doi.org/10.1002/alz.13412 August 2023 Ageing & Dementia Case management for integrated care of older people with frailty in community settings Sadler E, Khadjesari Z, Ziemann A, Sheehan KJ, Whitney J, Wilson D, Bakolis I, Sevdalis N, Sandall J, Soukup T, Corbett T, Gonçalves-Bradley DC, Walker DM Ageing populations globally have contributed to increasing numbers of people living with frailty, which has significant implications for use of health and care services and costs. The British Geriatrics Society defines frailty as "a distinctive health state related to the ageing process in which multiple body systems gradually lose their inbuilt reserves". This leads to an increased susceptibility to adverse outcomes, such as reduced physical function, poorer quality of life, hospital admissions, and mortality. Case management interventions delivered in community settings are led by a health or social care professional, supported by a multidisciplinary team, and focus on the planning, provision, and co-ordination of care to meet the needs of the individual. Case management is one model of integrated care that has gained traction with policymakers to improve outcomes for populations at high risk of decline in health and well-being. These populations include older people living with frailty, who commonly have complex healthcare and social care needs but can experience poorly co-ordinated care due to fragmented care systems. Objectives: To assess the effects of case management for integrated care of older people living with frailty compared with usual care. https://doi.org/10.1002/14651858.cd013088.pub2 May 2023 Ageing & Dementia Frequency, duration, and type of physiotherapy in the week after hip fracture surgery - analysis of implications for discharge home, readmission, survival, and recovery of mobility Almilaji O, Ayis S, Goubar A, Beaupre L, Cameron ID, Milton-Cole R, Gregson CL, Johansen A, Kristensen MT, Magaziner J, Martin FC, Sackley C, Sadler E, Smith TO, Sobolev B, Sheehan KJ Purpose: To examine the association between physiotherapy access after hip fracture and discharge home, readmission, survival, and mobility recovery. Methods: A 2017 Physiotherapy Hip Fracture Sprint Audit was linked to hospital records for 5383 patients. Logistic regression was used to estimate the association between physiotherapy access in the first postoperative week and discharge home, 30-day readmission post-discharge, 30-day survival and 120-days mobility recovery post-admission adjusted for age, sex, American Society of Anesthesiology grade, Hospital Frailty Risk Score and prefracture mobility/residence. https://doi.org/10.1016/j.physio.2023.03.002 September 2023 Ageing & Dementia Physiotherapists' perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England Adams J, Jones GD, Sadler E, Guerra S, Sobolev B, Sackley C, Sheehan KJ. Purpose: to investigate physiotherapists' perspectives of effective community provision following hip fracture. Methods: qualitative semi-structured interviews were conducted with 17 community physiotherapists across England. Thematic analysis drawing on the Theoretical Domains Framework identified barriers and facilitators to implementation of effective provision. Interviews were complemented by process mapping community provision in one London borough, to identify points of care where suggested interventions are in place and/or could be implemented. https://doi.org/10.1093/ageing/afad130 September 2023 Ageing & Dementia What makes a multidisciplinary medication review and deprescribing intervention for older people work well in primary care? Howard C, Sheikh C, Rutter P, Latter S, Lown M, Brad L, Fraser SDS, Bradbury K, Roberts HC, Saucedo AR, Ibrahim K A third of older people take five or more regular medications (polypharmacy). Conducting medication reviews in primary care is key to identify and reduce/ stop inappropriate medications (deprescribing). Recent recommendations for effective deprescribing include shared-decision making and a multidisciplinary approach. Our aim was to understand when, why, and how interventions for medication review and deprescribing in primary care involving multidisciplinary teams (MDTs) work (or do not work) for older people. https://doi.org/10.1186/s12877-023-04256-8 September 2023 Ageing & Dementia

Long Term Conditions Theme leads Professor Mari-Carmen Portillo Theme lead Long Term Conditions Theme To promote better living with and management of long-term conditions we need care plans that make sense to people and respond to individual needs. We aim to listen to and learn from people's experiences, explore resources in the community and work in teams that represent different lay people, sectors and professionals. Research projects Change in treatment burden among people with multimorbidity: Protocol of a follow up survey and development of efficient measurement tools for primary care Read more ADOPTED: Treatment burden in people below the age of 65 with multimorbidity in primary care: A mixed methods (SPELL) Read more ADOPTED: (SIFT) Sensors in Fatigue Tracking in Parkinson’s. Exploring the relationship between perception of Fatigue and the performance of physical activities in people with Parkinson's with fatigue using wearable sensors Read more Reframing responsibility through public empowerment: proposing the ‘FoodEnviroScan’ app to unmask unfair environmental cues influencing poor diets Read more Non-digital support for maintaining physical activity in people with long-term conditions – within Maintenance Of physical acTivity beHaviour (MOTH) programme Read more COMPLETED: Digital support for maintaining physical activity in people with long-term conditions Read more COMPLETED: Development of policy recommendations to reduce the impact of COVID-19 on physical activity and mental health in individuals with multimorbidity: a mixed method study. Read more ADOPTED PROJECT: Understanding risk stratification of patients with chronic kidney disease (CKD) in primary care Read more ADOPTED PROJECT: Development of a decision aid for offloading device selection for people with diabetic foot ulceration Read more ADOPTED PROJECT: Breast Cancer Choices: Evaluation and implementation of a digital patient-centred decision aid to support genetic testing in mainstream care. Read more ADOPTED PROJECT: Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) Read more ADOPTED PROJECT: MELD Read more POST DOCTORAL PROJECT: Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study Read more COMPLETED: Testing the living with chronic illness scale Read more Medicines optimisation Read more Interventions to support physical activity for adults (MOTH) Read more MODIFY: The development and iMplementation Of a multidisciplinary medication review and Deprescribing Intervention among Frail older people in primarY care Read more PARTNERS Project: Development and implementation of a digital tool for multisectoralsupport and management of long-term condition Read more ADOPTED PROJECT: EnablExercise in Crohns: A qualitativE study to uNderstAnd the Barriers and faciLitators to physical activity and Exercise IN children and adolescents with CROHN’S disease Read more ADOPTED PROJECT: ExACT-CF: Exercise as an Airway Clearance Technique in people with Cystic Fibrosis – A randomised pilot trial Read more ADOPTED PROJECT: Happier Feet Read more ADOPTED PROJECT (COMPLETE) OPTIM Park Read more Improving support for self-management (WASP) Read more Mental health hub projects Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study Read more Role of patient-assessed functioning as a predictor of health service use in patients with long term mental health conditions Read more Read our publications here Read more Publications Collaborative project: Improving review appointments for people with long-term conditions

Neurological long term conditions: Online integrated care platform study (NeuroOnline) Principal Investigator: Dr Chris Kipps Team members : Dr Chris Kipps, Neurologist and Hon Senior Lecturer, University of Southampton Dr Sarah Fearn, Senior Research Fellow, University of Southampton Dr John Spreadbury, Senior Research Fellow, University of Southampton Dr Alex Young, Senior Research Assistant, University of Southampton Dr Rachel Chappell, Project Manager Start : 1 June 2020 Ends : 31 May 2027 Project Partners : University of Southampton, University Hospital Southampton NHS Foundation Trust, The Health Foundation Lay summary: Digital health platforms can improve care and support self-management, but only if they actually work and if people make use of them. The Neuro Online study aims to better understand how the online platform My Medical Record can be used to support and improve care for people with long-term neurological conditions. Aims: We want to better understand the factors that influence the uptake, use, and effectiveness of an online care and self-management platform for patients with long-term neurological conditions, their carers and the healthcare professionals who care for them. Design and Methods: The Neuro Online study will use surveys and My Medical Record system data to better understand how and why people use the Neuro section of My Medical Record. We will recruit 2000 patients, carers and healthcare professionals to participate for up to 7 years. During this time we will track how they use the online platform and their thoughts on it. We will also ask patients and carers about their well-being and their patient activation measure so that we can compare their experiences with the platform to this information. Participants will have the opportunity to participate in a number of additional sub-studies, which focus on particular issues such as quality of life, what individual characteristics are associated with use (or not) of the platform, and whether certain functions of the platform such as care planning are useful. A small number of patients will be asked to participate in face-to-face interviews to assess their use of the platform. NHS staff will be surveyed to see if platform use changes how they deliver care. As online platforms are increasingly being developed for the NHS, we hope the study will help understand how to make them relevant, useful and appealing to use. The findings should help to optimise the design and usefulness of these online tools, with the aim of supporting and improving the delivery of care. Related publication: A Comprehensive Literature Search of Digital Health Technology Use in Neurological Conditions: Review of Digital Tools to Promote Self-management and Support

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

Who are we? Professor Alison Richardson Director Professor Catherine Bowen Deputy Director Our theme leads Dr Stephen Lim Ageing and Dementia Theme Lead Professor Julie Parkes Healthy Communities Theme Lead Professor Mari-Carmen Portillo Long Term Conditions Theme Lead Professor Michael Boniface Workforce & Health Systems Theme Lead Our central teams Philippa Darnton Interim Implementation Lead Jamie Stevenson Communications and Partnership Manager Vacancy Lead for Patient and Public Involvement Richard Trowbridge Chief Operating Officer Dr Michelle Myall Principal research and implementation fellow Dr David Culliford Principal Medical Statistician Rachael Hartup Senior Programme Manager Professor Catherine Bowen Academic Career Development Lead Dr Corine Driessens Senior Research Fellow (Statistics) Nick Sandison Programme Manager Dr Kinda Ibrahim Academic Career Development Associate Lead Our partnership board members Christine McGrath Managing Director Wessex Health Partners Dr Karen Underwood Operational and Finance Lead University Hospital Southampton NHS Foundation Trust Sally Dace PPI representative Dr Peter Wilson Chief Medical Officer, University Hospital Dorset NHS Foundation Trust Professor Anand D Pandyan Bournemouth University Dr Paul Johnson Dorset ICS Nicola Bent Deputy Chief Executive and Director of Innovation Adoption - Health Innovation Wessex Phillipa Darnton Implementation Lead Alex Whitfield Chief Executive, Hampshire Hospitals NHS Foundation Trust Professor Richard Thelwell University of Portsmouth Dr Vicki Osman-Hicks Hampshire and Isle of Wight ICS Professor Saul Faust MBE Director of NIHR Southampton CRF Clinical Director of Wessex CRN Alastair Hutchison Medical Director, Dorset County Hospital NHS Foundation Trust Andrew Strevens Chief Executive, Solent NHS Trust Professor Anne-Sophie Darlington University of Southampton Professor Alison Richardson ARC Director Richard Trowbridge ARC Operations Director Richard Mandunya PPI Representative University of Winchester TBC University of Winchester Dr Mohammed Jawad Hampshire County Council

Development of a core outcome set for nurse wellbeing: a Delphi study Lead applicant: Dr Gemma Simons Co-applicants: Prof Jane Ball , Prof David Baldwin , Dr Emma Wadey, Dr Catherine Smith Participant Information Sheet : Download here Project Summary: Read project summary document (short summary) Read project summary document (long summary) Background : Little attention has been paid to the work lives and wellbeing of the nursing workforce, despite it being a priority area. Currently, there is no consensus on what wellbeing is or how it should be measured. An evidence-based, positive way of measuring wellbeing is through a Core Outcome Set. What is a Core Outcome Set? Outcomes are used to measure whether a strategy, intervention or action has had the required result. There are often multiple outcomes and ways of measuring them, which makes comparison difficult. A Core Outcome Set is an agreed, or consensus, set of outcomes and measurement tools that, when used, provide consistent and comprehensive focus as everyone is measuring and reporting the same outcomes in the same way. Aim: This project aims to develop a Core Outcome Set for Nurse Wellbeing. Objectives: Produce a list of potential wellbeing outcomes and help text to describe them in that are clear and meaningful for nurses [PPI panel] Develop a consensus between nurses and nurse wellbeing experts on a core outcome set for nurse wellbeing [Delphi Study] Identify and assess for quality measurement instruments for the core outcome set for nurse wellbeing identified by the Delphi study [Critical Literature Review] Select measurement tools for the identified core outcome set and agree on a final Core Outcome Set for Nurse Wellbeing [PPI panel and Study Advisory Group]. Implications and Impact: A Core Outcome Set for Nurse Wellbeing developed by nursing and nurse wellbeing experts will provide researchers and those undertaking governance with evidence-based and meaningful tools with which to evaluate wellbeing interventions. This study is registered on the Core Outcome Measures in Effectiveness Trials (COMET Initiative) database https://www.comet-initiative.org/Studies/Details/2433

ADOPTED PROJECT: Comparing pharmacological and non-pharmacological interventions for adults with Attention-Deficit/Hyperactivity Disorder (ADHD): systematic review and network meta-analysis Chief Investigator: Professor Samuele Cortese – University of Southampton Project Team Members: Professor Andrea Cipriani – University of Oxford, Associate Professor Corentin Gosling – University of Paris Nanterre, France, Dr Luis Faraht – University of São Paulo, Brazil / Yale University Child Study Center, USA, Dr Cinzia Del Giovane – University of Modena and Reggio, Italy Background: It is currently unclear how different treatment options for preschool children with ADHD compare with each other in terms of efficacy and safety. We will use data from available randomised controlled trials (RCTs) and apply an advanced and innovative statistical approach (network meta-analysis) to answer this question. The project started in 2022. Expected outcomes: We will understand how pharmacological and non-pharmacological interventions (including behaviour intervention, family-based systematic approaches and dietetic interventions) compare with each other in terms of their beneficial effects on ADHD symptoms and safety. Project Status: Ongoing.

Workforce & Health Systems Theme lead Professor Michael Boniface Theme lead Deputy theme leads Dr Dan Burns Health Systems Dr Chiara Dall'ora Workforce Workforce & Health Systems Theme We know that the health workforce are an asset and in short supply. As part of our ARC research we are planning a series of studies. We will look at the best ways for staff to work - for example where and when. We also want to improve conditions - in part by ensuring they have time to do the jobs we are asking them to do. Cultivating a flow of pioneering ideas that offer the potential to transform people's lives and the economy using information technology is a motivating force that drives us. Our capacity to rapidly turn these ideas into benefits for partners through collaborative, applied research and innovation makes Southampton a truly exciting place to be. Research projects PUNDIT – Predicting hospital Usage Numbers via a DIgital Twin Read more ADOPTED: A Study to Evaluate the Introduction of new Staffing Models in Intensive Care: a Realist evaluation (SEISMIC-R) Read more PREDICT-NURSE – feasibility: Predicting Patient Acuity/Dependency-Based Workload from Routinely Collected Data to Assist with Nursing Staff Planning – feasibility study Read more ADOPTED: Nurture-U (Southampton): A longitudinal survey for student metal health and wellbeing Read more ADOPTED: FLOWS Planning for Frailty: Optimal Health and Social Care Workforce Organisation Using Demand-led Simulation Modelling Read more ADOPTED: SORT-IT (Salisbury Operational Research Track – Improving Together) Read more Workforce Evaluation Toolkit project (WET) Read more ADOPTED: Social Prescribers In Deprescribing Role (SPiDeR) Read more ADOPTED: Improving patient safety, workforce wellbeing and NHS efficiency through improved shift patterns for nursing staff: study protocol Read more PARIEDA - Prediction of Acute Respiratory Infection outcomes prior to Emergency Department Attendance Read more ADOPTED: Geospatial mapping of emergency calls from older adults to ambulance services in the South Central region, with a focus on people living with dementia: a feasibility study. Read more COMPLETED: Predicting Patient Deterioration Risks in COMMunities Read more ADOPTED PROJECT: Developing and testing a Patient Report Experience Measure for patients accessing Acute OnCology services: The PREMAC study Read more ADOPTED: Consequences, costs and cost-effectiveness of different workforce configurations in English acute hospitals: a longitudinal retrospective study using routinely collected data Read more POST DOCTORAL PROJECT: The career aspirations of nurses working in the research delivery workforce: a cross-sectional survey Read more ADOPTED PROJECT: Magnet4Europe: Improving mental health and wellbeing in the health care workplace Read more PROCED: PROactive, Collaborative and Efficient complex Discharge Read more Mental Health, Workforce and Well-being Research Framework - ARC Collaboration Read more COMPLETED: Safer Nursing Care Tool and nurse staffing requirements Read more COMPLETED: Shift Pattern Feasibility Read more COMPLETED: Improving community health care planning Read more CLECC Toolkit and background: Creating Learning Environments for Compassionate Care (CLECC) Read more COMPLETED: COVID-19 Emergency Department Project Read more Mental health hub projects Work lives and Wellbeing of Mental Health Nursing Workforce Read more Development of a core outcome set for mental health nurse wellbeing: a Delphi study Read more Read our publications here Read more Publications Access our evidence brief here Read more Evidence briefs Reports, toolkits and support Find the information and tools to improve your work here Read more

PPI/E Strategy 2021-2024 full report Below you will find the full report of the Patient and Public Involvement and Engagement (PPI/E) Strategy 2021-2024. ​ NIHR Applied Research Collaboration Wessex Authored by Caroline Barker (Lead for PPI/E). Supported by our Public Champions and Katherine Baker (PPI Officer). ​ Document overview: Background information Our vision Our aims Programme of activities Resources, partners and collaborators Reporting and monitoring The purpose of this strategy Patients and the public are at the heart of our vision to improve the health and well-being of people across Wessex . We need and value the voices of the communities our research serves. The knowledge, experiences and support of patients and the public are essential to ensure that our research goals and solutions are relevant, prevent waste, and bring the greatest possible benefits to society. This document outlines our strategy for Patient and Public Involvement and Engagement (termed PPI/E) in the work of ARC Wessex . Definitions We recognise there are different definitions to describe involvement and engagement activities within health and social care. For the purposes of this document we will adopt the following definitions: Patient and public involvement: research being carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them. (NIHR INVOLVE 2017). Engagement: where information and knowledge about research is provided and shared. PPI/E: an abbreviation/acronym. Used to describe patient and public involvement or engagement work and projects, or activities that connect or encompass both. Public: in this strategy we use the term ‘public’ to describe people affected by our research who do not have a professional role in health and social care services. This may include patients, service users, survivors, carers, family members or members of the general population. We also use the acronym WISeRD, which stands for Wessex Inclusion in Service Research and Design Group. This is our strategic PPI/E group. It is composed of PPI Champions (public), the PPI/E team and staff links for each research theme. As you read this document, you may come across other terms, abbreviations and acronyms that are unfamiliar to you. We have provided brief descriptions in the footnotes. There is also a glossary of terms at the end of the document. Context and opportunities ARC Wessex launched in October 2019. As part of our application to become an ARC, we had to develop an outline PPI/E strategy. CLAHRC Wessex (preceded ARC Wessex) shared our commitment to PPI/E and the work done by the CLAHRC laid good foundations for ARC Wessex to build on and progress. We are proud of the work we have done to embed PPI/E in our projects and programmes over the first 18 months. ​ This strategy, developed in wide consultation with our partners and public communities, builds on the outline PPI/E strategy from our application. It covers activities from April 2021-Oct 2024. ​ Our locality, Wessex, has strengths in involvement and engagement. We have the Wessex Public Involvement Network (PIN) that ARC Wessex plays a leading role in. This is a network of staff and public working with NIHR and committed to improving public involvement in research. We do this by sharing our knowledge, supporting and developing each other. We also work together on projects that would not be possible if we did not share the workload between us. These include developing PPI/E training and trialling approaches to improve diversity and inclusion in PPI/E. ​ Our partners in NHS providers , charities and higher education institutions (e.g. Universities) have their own expertise and strengths. We are willing and committed to working together on areas of shared priority. Our Vision We aim to deliver high quality public involvement and engagement for health and social care. Our activities will meet the values and principles of good public involvement as outlined in the UK Standards for Public Involvement . Our activities will occur across, and add value to, each aspect of Wessex ARC: At project-specific level (e.g. an ARC-funded or ARC-supported research project). Across each of our four research themes and the wider ARC programme. With our partners and collaborators organisations. Our overarching aims Aligned to the UK Standards for Public Involvement, are aims are to: Listen to voices relevant to our research priorities that reflect the diversity of our local population – ensuring the underserved have a voice (UK Standard Inclusive Opportunities). Build a culture that respects different perspectives, values contributions and supports mutually respectful and productive relationships (UK Standard Working Together). Provide health research communities of Wessex (including public) adequate PPI/E training, support and learning opportunities at the right time for their project/programme and/or their own development needs (UK Standard Support and Learning). Involve the public at strategic and operational levels, ensuring best practice and supporting research transparency (UK Standard Governance). Use innovative approaches and good communication to expand the reach of our activities, maximising impact by stimulating knowledge-of, and interest-in, our research (UK Standard Communications). Capture, monitor and share learnings to feedback to those involved, avoid duplication, contribute to the evidence base and build our academic PPI/E (UK Standard Impact). We will build on our local strengths and focus on areas where we believe we can have the greatest impact. [1] [2] [3] [4] [5] [6] [7] [8] [9] Aim 1: Listen to voices relevant to our research priorities that reflect the diversity of our local population – ensuring the underserved have a voice (UK Standard Inclusive Opportunities ). Aim 2: Build a culture that respects different perspectives, values contributions and supports mutually respectful and productive relationships (UK Standard Working Together ) Aim 3: Provide health research communities of Wessex (including public) adequate PPI/E training, support and learning opportunities at the right time for their project/programme and/or their own development needs (UK Standard Support and Learning ). Aim 4: Involve the public at strategic and operational levels, ensuring best practice and supporting research transparency (UK Standard Governance ). Aim 5: Use innovative approaches and good communication to expand the reach of our activities, maximising impact by stimulating knowledge-of, and interest-in, our research (UK Standard Communications ). Aim 6: Capture, monitor and share learnings to feedback to those involved, avoid duplication, contribute to the evidence base and build our academic PPI/E (UK Standard Impact ). Resources Our PPI/E team, in partnership with our research community (including public and researchers), will deliver the programme. A Lead for PPI/E will oversee delivery. A Communications & Partnerships Manager, Administrative Officer and a PPI Officer support them. A dedicated PPI/E budget will support: expense and time reimbursement for public contributing to our work; training costs required to support public in their role; consumable and facilities costs relating to PPI/E events, including training events; development and testing of new initiatives. This is in addition to PPI/E budgets set out within each research project, and academic career development awards. ​ Partners and collaborators We will work closely with involvement, engagement and communications teams in our partner charities, health and care providers and higher education institutions. This will enable us to maximise opportunities, minimise duplication and create economies-of-scale. Our public engagement activities wil l benefit from University of Southampton’s experienced Public Engagement in Research Unit, Public Policy Unit (connects with policy advisors and central government) and LifeLab (working with young people to engage them with research). Consolidated funding for our Lead for PPI/E facilitates strong cross-organisational working. This Lead person manages a PPI/E team working across University Hospital Southampton, including the Wessex PIN and other NIHR infrastructure (Southampton BRC and CRF ). ​ Reporting and monitoring An annual plan is written each year that covers progress to date and plans for the next year (see footnote for full detail ). The plan is developed by the Lead, with input from WISeRD, and approved by the ARC Director. Progress against our milestones are reported to: WISeRD at our meetings (every two months). The Executive Leadership Group (every two months). Rolling theme updates (including PPI/E) are a standing item. The Lead for PPI/E provides a formal update annually and given additional time on the agenda to discuss items as required. The ARC Director at meetings with the PPI/E team (twice a year). The ARC Partnership Board (twice a year) as part of the progress reports submitted to board members. CCF vi a the formal annual reporting structures (once a year). [17] [18] [19] [20] [1] Wessex includes Dorset, Hampshire, the Isle of Wight and South Wiltshire. [2] ARC stands for Applied Research Collaboration. They support applied health and care research that responds to, and meets, the needs of local populations and local health and care systems. [3] INVOLVE was a national coordinating centre for public involvement in health and care (until March 2020). A new Centre for Engagement and Dissemination aims to build on the work of INVOLVE. [4] Collaborations for Leadership in Applied Health Research and Care [5] National Institute for Health Research [6] Any organisation that provides NHS services [7] The standards are a framework for what good public involvement in research looks like. [8] ARC Wessex has four research themes: Ageing & Dementia; Long Term Conditions; Healthy Communities and Workforce and Health Systems. Found out more on our website. [9] Underserved is the term we have chosen to use to describe people who are less well included in research. It is important to recognise that underserved groups are context-specific. There is no single, simple definition to describe all underserved groups. [10] The Microsoft Accessibility Checker is a free tool available in Office 365. It finds most accessibility issues and explains why each might be a potential problem for someone with a disability. It also offers suggestions on how to resolve each issue. [11] The equality impact assessment is a systematic and evidence-based tool, which enables us to consider the likely impact of work on different groups of people. [12] Operational leadership group. [13] This project aims to test how feasible and acceptable a childhood obesity prediction tool is. [14] The Academic Career Development Group in ARC Wessex is focused on building capacity and capability within the health and care system. [15] The ARC Partnership Board is a decision-making body for ARC Wessex. [16] A theory of change is a description of why a particular way of working will be effective, showing how change happens in the short, medium and long term to achieve its intended impact. Logic models are a way to graphically represent this theory. [17] Biomedical Research Centre [18] Clinical Research Facility [19] PPI/E annual plan covers: progress against last year’s objectives and the wider strategy; objectives, plans and milestones (with timescales) for the next year; plans for engaging our stakeholders; plans for dissemination and monitoring impact; cross ARC collaborations; plans for research and capacity building; leadership and management; finances [20] CCF = NIHR Clinical Commissioning Facility. They manage and administer the ARC funding scheme [ii] Public involvement activities describe activities where research is carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them. [iii] Engagement activities describe activities where information and knowledge about research is provided to and shared with the public. [iv] Underserved is the term we have chosen to use to describe people who are less well included in research. It is important to recognise that underserved groups are context-specific. There is no single, simple definition to describe all underserved groups. Want to know more? You can read our full strategy Have questions or comments? Email PublicInvolvement@uhs.nhs.uk

Long Term Conditions publications Beyond individual responsibility: Exploring lay understandings of the contribution of environments on personal trajectories of obesity Serrano-Fuentes N, Rogers A, Portillo MC Reversing the upward trajectory of obesity requires responding by including the multiple influences on weight control. Research has focused on individual behaviours, overlooking the environments where individuals spend their lives and shape lifestyles. Thus, there is a need for lay understandings of the impact of environments as a cause and solution to obesity. This research aimed to understand the influence of environments on the adoption of health practices in adults with obesity and to identify lay strategies with which to address environmental barriers to behaviour change. https://doi.org/10.1371/journal.pone.0302927 May 2024 Long Term Conditions Interventions to Foster Resilience in Family Caregivers of People with Alzheimer's Disease: A Scoping Review. Santonja-Ayuso L, Corchón-Arreche S, Portillo MC The family caregiver of a person with Alzheimer's disease still experiences, in most cases, negative consequences in their biopsychosocial environment, which are related to the acquisition of this role. However, it has been observed that this fact is not universal in this type of population since benefits can be obtained in the act of caring through the development of resilience. Given this possibility and given that nurses are the health professionals who support people in this illness process, there is an urgent need to identify which non-pharmacological interventions could improve or promote resilience in family caregivers of people with Alzheimer's disease. https://doi.org/10.3390/ijerph21040485 April 2024 Long Term Conditions Methodological Proposal for the Adaptation of the Living with Long-Term Conditions Scale to the Family Caregiver Marín-Maicas P, Portillo MC, Corchón S, Ambrosio L Caring for people living with LTCs has a negative impact on the quality of life of caregivers, affecting their psychological, emotional, social, physical, and financial well-being. Evaluating how the family caregivers live with LTC can provide social health professionals with important information when planning interventions that favor better living . Therefore, it would be useful to have a tool available that allows for objectifying the degree to which people live with LTCs, for both the individuals affected by LTCs and the family caregiver. Presently, many scales exist that allow for measuring different concepts in family caregivers.However, although an instrument exists that measures the degree of living with LTC, according to the people with LTCs the “Living with Chronic Illness Scale” , no instrument was found that measures the degree of living with LTCs of family caregivers that includes all the dimensions that shape said process. This gap in the literature, in relation to measurement instruments that evaluate how the family caregiver experiences living with LTCs, is the common thread in this work. Based on an instrument created for people living with LTCs, an adaptation of this scale was planned to extend the reach of the instrument to family caregivers. Numerous recommendations exist on the process of adaptation of a scale to a context different from which it was created, but the available guides only refer to the methodological process for their transcultural adaptation, and especially to the guidelines established that allow the use of the scale in a language that is different from the one used for its creation. However, no specific system with the necessary methodological steps to be taken for the adaptation of the EC-PC to the family caregiver was found. Therefore, the aim of this study is to present a detailed description of the methodological process of adapting the EC-PC to the family caregiver (EC-PC-Family), providing transparency to the process followed to construct a robust instrument, to contribute towards filling the gap found in the scientific literature. https://doi.org/10.3390/nursrep14010041 March 2024 Long Term Conditions Change in treatment burden among people with multimorbidity: a follow-up survey Hounkpatin HO, Roderick P, Harris S, Morris JE, Smith D, Walsh B, Roberts HC, Dambha-Miller H, Tan QY, Watson F, Fraser SD Background: Treatment burden is the effort required of patients to look after their health and the impact this has on their functioning and wellbeing. Little is known about change in treatment burden over time for people with multimorbidity. Aim: To quantify change in treatment burden, determine factors associated with this change, and evaluate a revised single-item measure for high treatment burden in older adults with multimorbidity. https://doi.org/10.3399/bjgp.2022.0103 October 2022 Long Term Conditions Person-centred integrated care for people living with Parkinson's, Huntington's and Multiple Sclerosis: A systematic review Bartolomeu Pires S, Kunke Dl, Kipps C, Goodwin N, Portillo MC People living with long-term neurological conditions (LTNCs) have complex needs that demand intensive care coordination between sectors. This review aimed to establish if integrated care improves outcomes for people, and what characterises successful interventions. https://doi.org/10.1111/hex.13948 January 2024 Long Term Conditions Psychometric properties of the living with long term conditions scale in an English-speaking population living with long term conditions in the UK Ambrosio L, Hislop-Lennie K, Serrano-Fuentes N, Driessens C, Portillo MC Objective: To present the psychometric properties of the living with long-term condition (LwLTCs) scale in an English-speaking population of people with different LTCs. Design: An observational and cross-sectional study, with retest was conducted. Psychometric properties including feasibility, internal consistency, confirmatory factor analysis, reproducibility and content validity were tested. https://doi.org/10.1136/bmjopen-2023-077978 January 2024 Long Term Conditions Exploring Adherence to Pelvic Floor Muscle Training in Women Using Mobile Apps: Scoping Review Harper RC, Sheppard S, Stewart C, Clark CJ Pelvic floor dysfunction is a public health issue, with 1 in 3 women experiencing symptoms at some point in their lifetime. The gold standard of treatment for pelvic floor dysfunction is supervised pelvic floor muscle training (PFMT); however, adherence to PFMT in women is poor. Mobile apps are increasingly being used in the National Health Service to enable equity in the distribution of health care and increase accessibility to services. However, it is unclear how PFMT mobile apps influence PFMT adherence in women. We aimed to identify which behavior change techniques (BCTs) have been used in PFMT mobile apps, to distinguish the core "capability, opportunity, and motivation" (COM) behaviors targeted by the BCTs used in PFMT mobile apps, and to compare the levels of PFMT adherence in women between those using PFMT mobile apps and those receiving usual care. https://doi.org/10.2196/45947 December 2023 Long Term Conditions English Validation of the Living with Long Term conditions scale Ambrosio L, Hislop-Lennie K, Serrano-Fuentes N, Driessens C, Portillo MC Background: The English version of the living with long term conditions (LwLTCs) scale is a comprehensive person-centred measure that evaluates the complex process of living with long term conditions. Objectives: To present the psychometric properties of the LwLTCs scale in an English-speaking population in people with different long term conditions. https://doi.org/10.1093/eurpub/ckad160.811 October 2023 Long Term Conditions Reducing the impact of COVID-19 on physical activity and mental health Ambrosio L, Faulkner J, Lambrick D, Morris J, Compton E, Portillo MC Background: During the COVID-19 pandemic the United Kingdom government released regular guidance on limiting the spread of COVID-19. People, including those with long term conditions, were told to use physical distancing, self-isolation and/or shielding during COVID-19 to protect themselves and others. A consequence of these interventions was to exacerbate poor lifestyle behaviours, namely less physical activity. Objectives: To propose recommendations to support and sustain their physical activity of people with long term conditions during and after COVID-19 or other pandemics. https://doi.org/10.1093/eurpub/ckad160.1570 October 2023 Long Term Conditions A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity Stannard S, Berrington A, Paranjothy S, Owen R, Fraser S, Hoyle R et al Social, biological and environmental factors in early-life, defined as the period from preconception until age 18, play a role in shaping the risk of multiple long-term condition multimorbidity. However, there is a need to conceptualise these early-life factors, how they relate to each other, and provide conceptual framing for future research on aetiology and modelling prevention scenarios of multimorbidity. We develop a conceptual framework to characterise the population-level domains of early-life determinants of future multimorbidity. https://doi.org/10.1177/26335565231193951 September 2023 Long Term Conditions Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaboration Fraser SD, Stannard S, Holland S, Boniface M, Hoyle RB, Wilkinson R et al Most people living with multiple long-term condition multimorbidity (MLTC-M) are under 65 (defined as ‘early onset’). Earlier and greater accrual of long-term conditions (LTCs) may be influenced by the timing and nature of exposure to key risk factors, wider determinants or other LTCs at different life stages. We have established a research collaboration titled ‘MELD-B’ to understand how wider determinants, sentinel conditions (the first LTC in the lifecourse) and LTC accrual sequence affect risk of early-onset, burdensome MLTC-M, and to inform prevention interventions. https://doi.org/10.1177/26335565231204544 September 2023 Long Term Conditions Improving personalised care, through the development of a service evaluation tool to assess, understand and monitor delivery Johnson L, Kirk H, Clark B, Heath S, Royse C, Adams C, Portillo MC Systematically implementing personalised care has far reaching benefits to individuals, communities and health and social care systems. If done well, personalised care can result in better health outcomes and experiences, more efficient use of health services and reduced health inequalities. Despite these known benefits, implementation of personalised care has been slow. Evaluation is an important step towards achieving the ambition of universally delivered personalised care. There are currently few comprehensive assessments or tools that are designed to understand the implementation of personalised care at a service or system level, or the cultural, practical and behavioural factors influencing this. The aim of this paper is to describe the development and testing of a system-wide evaluation tool. https://doi.org/10.1136/bmjoq-2023-002324 September 2023 Long Term Conditions