Search Results

2bde6957-3a7b-4fc1-81e9-51f920491c2f Developing a core cohort of community researchers in Wessex: towards a sustainable Wessex Community of Practice for public health research co-production Chief Investigator: Professor Nisreen A Alwan, Professor of Public Health, Centre for Population Health Sciences, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust Team: Dr Donna Clutterbuck, Research Fellow, University of Southampton Megan Barlow-Pay, PPIE Lead, NIHR Research Support Service Professor Julie Parkes, Professor of Public Health, University of Southampton, University Hospital Southampton NHS Foundation Trust and Health Education England Wessex Dr Kath Woods-Townsend, Associate Professor (Research) and Lifelab Project Manager, University of Southampton Mirembe Woodrow, Senior Public Health Practitioner, Southampton City Council and PhD student, University of Southampton Partners: Hampshire and Isle of Wight NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Bournemouth University, University of Portsmouth, University of Southampton, Southampton City Council, NIHR Research Support Service Specialist Centre for Public Health, LifeLab, University of Southampton / NIHR Southampton Biomedical Research Centre, Health Determinants Research Collaboration, Southampton, Southampton Centre for Research Engagement & Impact (SCREI), Centre for Seldom Heard Voices, Bournemouth University, HDRC Portsmouth Start: 1 October 2024 End: 31 March 2026 Summary Public health research priorities must stem from the needs of the communities served by such research, particularly those most socially and economically disadvantaged, as well as community groups that are seldom heard. Therefore, community members with lived experience of health conditions and the various factors shaping health and wellbeing have a central role in shaping such research. Co-creating research with the public can lead to research findings that are more relevant to population health and wellbeing, leading to a reduction in heath inequalities. The purpose of this project is to develop a core ‘cohort’ of community public health researchers using an approach that considers the multiple social forces that shape people’s identities to inform research design that is meaningful to Wessex local communities. This cohort will form a Community of Practice (CoP) for research co-design that can help us reach those seldom heard groups in our local communities and understand underrepresented perspectives to inform relevant and meaningful health research priorities, questions and methods. People from such communities are more likely to feel comfortable to inform research that is led or co-led with community researchers. This project will be a Partnership between the NIHR Research Support Service (RSS) National Specialist Centre for Public Health (NSCPH) which aims to support the generation of high-quality research evidence aimed to inform decisions about which interventions have the greatest likelihood to improve population health and reduce health inequalities, and the Healthy Communities Theme of the NIHR ARC Wessex. In the first stage of the project, we will engage with stakeholders, including members of the public, voluntary organisations, Local Councils and health services to shape the project protocol and to co-develop its strategy, key milestones and outcomes. In the second phase of the project, we envisage a group of community researchers being recruited and trained in participatory research (or other research methods of their choice) and be provided with opportunities to link in with health researchers. In the third phase of the project, the community researchers will then choose a pathway (or more) that suits their needs from conducting community-based research, linking with other community members to inform further research projects, co-creating research ideas, or informing research proposals developed by researchers within the ARC or through the RSS. In the fourth phase of the project, we will evaluate the above activities and synthesise and disseminate lessons learnt from the project towards sustainability of our CoP framework. The project’s Research Fellows will also work with public contributors to disseminate findings in ways that are meaningful, alongside preparing publication materials for journals and conferences, and producing infographics. The CoP will help us to co-design health research based on local and regional need; provide stakeholder input into public health research proposals in Wessex; contribute to governance and delivery of NSCPH; and support meaningful and equitable research partnerships with community stakeholders and the public.

9381b390-9efb-4b71-9879-2371689f041c 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 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 Principal Investigator: Dr Zoe Saynor Co Applicants : Dr Nadeem Afzal , Dr Christopher Roberts , Professor Kelly Mackintosh , Dr Danielle Lambrick , Professor James Faulkner , Mr William Freer (PPI Contributor) Partners: University of Portsmouth, University Hospital Southampton NHS Foundation Trust, Swansea University, University of Winchester, For Crohns (charity), Guts UK (Charity) Duration : 12 Months Background: We know that people with inflammatory bowel disease (IBD), of which one of the main forms is Crohns, are at a high-risk of not meeting the physical activity recommendations for health, due to a combination of bowel and general physical symptoms (e.g. abdominal pain, diarrhoea and fatigue). Additionally, there are currently no physical activity and exercise guidelines for young people with IBD – making it difficult to advise what people should be doing. Researchers within our team have been monitoring the effects of COVID-19 and associated lockdowns on physical activity and mental health on a global scale, and saw negative impacts in both people with long-term conditions and in the wider population. However, there is currently no data to tell us how young people with e.g. Crohns have been impacted during this time. in our centre, we are seeing an increasing number of people with Crohns transitioning from paediatric to adult care with metabolic syndrome and we anticipate this will rise in response to the COVID-19 pandemic. Objectives: Assess the barriers to, and facilitators of, physical activity and exercise participation in young people with Crohns disease. Additionally, comparing their views to their parents/guardians and clinicians. Design and Methods: The proposed research will be a qualitative cross-sectional study consisting of individual semi-structured interviews with the three participant groups (in clinic for young people; videoconference for parents/guardians and clinicians). The interview schedule will be co-developed with people living with Crohns. Information from the interview will be digitally recorded, transcribed verbatim and thematically analysed. For the young people with Crohns involved in the study, we are interested in documenting their disease activity and nutritional/growth status at the time of interview so will use the Paediatric Crohns Disease Activity Index (PCDAI) to determine remission, mild activity, or moderate-to-severe activity and growth ‘weight height and BMI’ Z-scores for this. Clinical and Scientific Impact: Physical activity is important for both mental and physical health and is particularly important in people with a long-term condition. This work will provide important understanding of the views and experiences of young people with Crohns, their parents/guardians and clinicians surrounding physical activity and exercise. The findings from this qualitative study will provide insight as to why young people with Crohns may not undertake physical activity and exercise and will help inform the design and delivery of future appropriate physical activity and exercise programmes for this population. This information would complement our ongoing research (The ACTIVE-IBD Study), and will inform future funding applications to develop, evaluate and implement educational and interventional resources to increase the physical activity and exercise undertaken by young people living with Crohns. This funding award will help expedite our journey to the end goal of improving this provision and, ultimately, the quality of lives of people with Crohns

Web-based Implementation Toolkit Home Alignment with Health and Social Care Priorities Fit with Health and Social Care Systems 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. Alignment with Health and Social Care Priorities - Will implementation of your project outputs be a priority for those involved in health and social care? Who is WIT for? WIT recognises the need to provide freely available, accessible and simple to use tools that focus on key considerations at the outset of a project. WIT was 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? implementation 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. co-produced Co-production refers to a way of working together, often with service users, to reach a collective output. When to use WIT Adoption and Spread Adoption and Spread - How will implementation be adopted and spread beyond the original site where implementation takes place. Project Outputs Project Outputs - What is to be produced as a result of your project? For example, this could be a policy contribution, innovation or a tool. Buy-in and Engagement Buy-in and Engagement - Who needs to be engaged in supporting implementation? For example, patients, service users, health and social care professionals. Fit with Health and Social Care Systems Fit with Health and Social Care Systems - How will implementation of your project outputs fit with the changing needs of the health and social care systems. 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. Alignment with Health and Social Care Priorities Alignment with Health and Social Care Priorities - Will implementation of your project outputs be a priority for those involved in health and social care? Outcomes and Impact Outcomes and Impact - Outcome(s) refers to what you wish to achieve as a result of implementation (e.g. increased patient usage of an innovation). Impact refers to the effects of those outcomes for different stakeholder groups (e.g. patients) and the wider health and social care system. 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.

71793130-6407-4a7a-8ebf-2af1daf96dd5 COMPLETED: Understanding the psychosocial needs and trajectories of older adults (>64 years) with alcohol use disorder (AUD) from hospital back into community Lead applicant : Professor Julia Sinclair Co-applicants : Dr Rebecca Band, Professor Jackie Bridges Team Dr Steph Hughes – Research Fellow Zara Linssen – Medical Student Sophie Crouzet – Medical Student Stephen Lim – Implementation Champion Melinda King – PPI advisor Start: 01/01/2023 End: 01/07/2024 Partner organisations: University Hospital Southampton NHS Foundation Trust University of Southampton Background Over 200 physical and mental health conditions are caused by alcohol. In England, more people are being admitted to hospital with, and dying from, alcohol-related disease than ever before. In 2018/19, 44.7% of all alcohol related admissions were for people over the age of 65 compared with 14% in 2010/11. In 2021,1563 patients were assessed by the Alcohol Care Team (ACT) at University Hospital Southampton, 43% of whom were over the age of 60. We know that older adults can often feel more shame and stigma related to their alcohol use compared with younger people. This can create barriers to accessing help with existing community addiction services. Beyond this, very little is known about the reasons why older adults drink alcohol and how this may interact with other social factors like loneliness and social isolation. Further research is needed to understand the ways in which to best support older adults to seek help, and what interventions may best promote positive outcomes. Study Design This study will recruit older people with alcohol use disorder (AUD) admitted to hospital in Wessex. A longitudinal observational design will be used, meaning that people in the study will be asked by the research team to complete questionnaires over time following admission into hospital. This will help to understand the needs of the population. There will be four main research aims: What are the personal characteristics of older adults with AUD? How do participants make sense of themselves in relation to their alcohol use? What happens to participants in the six months following a hospital admission? What factors what might prevent or encourage people from seeking help for their alcohol use? Study Methods The study will identify potential participants through the ACT in Southampton in the first instance. Around 40% of people seen over the age of 65 years. Clinicians working in ACTs have the skills and experience to sensitively identify and assess patients with comorbid alcohol use disorders Discussion about the study and consent processes will be undertaken by the UHS clinical trials officer. Participants who are willing to be part of the study will complete a set of questionnaires in hospital. Well-established measures of alcohol use, quality of life, loneliness, collective efficacy and health service use will be collected. Participants will be asked to complete similar questionnaires again at 3 and 6 months. This will probably take place over the phone. Health service use data will be collected for the 6 months after discharge to explore resource use. Plain English summary of findings Recruitment to the study was difficult. Many patients who were identified as drinking at increasing or possibly dependent levels did not have mental capacity to take part. Of those who were eligible, a large percentage declined to participate. This resulted in a small sample size of 30, 16 of which completed their follow-up questionnaire, and 7 interviews. 20% of the sample died during the study window. Results indicated: Over 50% participants showed some level of cognitive impairment Participants had an average of 4 people in their social network; usually family members Interviews revealed links between social isolation, loneliness and drinking alcohol Those who were housebound reported drinking alcohol all day long Participants stated alcohol is not, and never has been a problem for them 50% participants met the threshold for depression Participants often provided conflicting information for the follow-up questions and in the interviews Participants had poor diets; of 32 nutrients measured 22 were not consumed in-line with the government recommendations 93% participants were taking 5 medications or more What's next? As a small preliminary study the new knowledge has been used to inform future research. Impact on patient care and population health will come from the future research. Recruitment was harder than expected. This learning point has informed recruitment and retention procedures in future research applications. Other findings, for example, the link described qualitatively between social isolation and increased alcohol consumption, has shaped ideas for intervention development. We are preparing an application to undertake the planning and developmental work for an intervention aimed at reducing alcohol consumption in a general population of adults aged 65 and over. We plan to test the feasibility of this intervention in a feasibility study.

a95fe10a-8d2a-464a-8d99-2e3067bb89e8 ADOPTED PROJECT: ExACT-CF: Exercise as an Airway Clearance Technique in people with Cystic Fibrosis – A randomised pilot trial ADOPTED PROJECT: ExACT-CF: Exercise as an Airway Clearance Technique in people with Cystic Fibrosis – A randomised pilot trial Principal Investigators: Dr Don Urquhart , Dr Zoe Saynor Co Applicants : Mrs Lorna Allen (Cystic Fibrosis Trust), Professor Steve Cunningham, Professor Ioannis Vogiatzis , Professor Steff Lewis, Ms Aileen Neilson Partners: University of Portsmouth, University Hospital Southampton NHS Foundation Trust, University of Edinburgh, University of Northumbria at Newcastle, Cystic Fibrosis Trust, CF Warriors (Charity) Starts: May 2022 Ends: 31 October 2023 Background: Cystic fibrosis (CF) is the UK’s most common inherited genetic condition and affects more than 10,500 people. The disease causes problems with the movement of salt and water in the body, resulting in sticky mucus building up, mostly in the lungs and gut. Thick mucus in the airways leads to repeated infections which, over time, damage the lungs. Chest physiotherapy is prescribed to loosen and clear sticky thick mucus from the airways and so to help to reduce lung infection. Chest physiotherapy is a routine treatment to keep people with CF healthy. However, many say it is time consuming and a burden. People with CF have asked if doing exercise could have the same effect as chest physiotherapy sessions for helping clear mucus. Exercise could be more enjoyable and less burdensome. Through a recognised priority setting partnership, the CF community recently ranked research to ‘reduce the burden of their care’ and answer ‘whether exercise can replace chest physiotherapy’, as their number 1 and 7 priorities. Surveys show that many people with CF have occasionally chosen to replace chest physiotherapy with exercise for airway clearance, and we recently confirmed this through a UK-wide survey. We now need to know if they would be willing to take part in research that asks some to stop chest physiotherapy and to exercise (with coughs and huffs) instead. New medicine (modulators) have recently become available for many people with CF, bringing dramatic improvements in their health. Some people who have started modulators are considering whether they can reduce or stop treatments – including chest physiotherapy. So, we need to know the effects of stopping chest physiotherapy and determine if exercise can be used instead - our study aims to understand this. Our recent survey in people with CF, their families, physiotherapists and doctors, showed us that many consider hard exercise with coughs and huffs to be able to clear mucus from the airways. We will study 50 people with CF (>12 years old) for 28-days. We will ask half of them to continue their usual care, and half to stop chest physiotherapy and do exercise that gets them breathing deeply (with coughs and huffs) instead. We will see if people are willing to start and continue with such a study and what they think of the study processes. We will also see how stopping chest physiotherapy and replacing it with exercise affects measurements of their lung function. Within the study we will talk with people with CF and members of their CF team to understand their experiences. This information will tell us whether a larger study can answer Publications Safety, feasibility and efficacy of exercise as an airway clearance technique in cystic fibrosis: a randomised pilot feasibility trial | Thorax

bd39e9d4-a228-4123-b44c-d499a7f27a45 Prevention schemes for female vicitms and offenders in Hampshire and Dorset Principal Investigators: Dr Sara Morgan Team members: Dr Sara Morgan ( Lecturer in Public Health School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Fiona Maxwell (Public Health Registrar School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Sergeant Ali Attwood (Hampshire Constabulary, Restorative Justice Lead) , Debbie Willis ( Hampton Trust charity, Domestic Abuse Service Manager), Vicky Atkinson (Hart District Council, Domestic Abuse Project Coordinator), Patricia Durr ( One Small Thing ), Mona Samiy ( Stop Domestic Abuse charity , Project Manager) Start: 11 November 2019 Ends: 11 November 2021 Project Partners : University of Southampton, University Hospital Southampton NHS Foundation Trust, Hampshire Constabulary, Hampton Trust, Hart District Council, One Small Thing, Stop Domestic Abuse. Lay summary: Background and study aims Compared to the previous year, in 2018 there was an overall 8% increase in theft in England and Wales and a 6% increase in crimes involving sharp instruments or knives. In order to tackle this increase in crime, many believe that more needs to be done to address the reasons why people commit crime in the first place, as well as the damage it causes to peoples’ lives. This means working together in the community to offer solutions to those affected by crime, including victims and offenders. When we discussed possible solutions with local service providers, it was felt that a tailored approach is needed for women, as their needs are unique. Women in prison are very likely to be both victims and offenders whilst, in the general population, one in four women are also victims of abuse within the home and more than half the women in prison have experienced domestic abuse themselves. In response, three projects are being piloted in Hampshire and Dorset to address the needs of women affected by crime. What does the study involve? To understand how these projects are working, we plan to carry out group interviews with those delivering the pilot intervention projects in the community. This will primarily be to understand how the projects are working. We will also use information gathered from the project staff about the women using the service to understand whether women go on to seek further assistance in the community, what sort of women engage with the project, and what changes for them as a result of using the service. This study proposal was developed in collaboration with public representatives; including offenders, victims, social care workers, domestic abuse service manager, and police officers. They have all shaped the design of the study; by informing us what types of research questions we should be asking. Going forward, we will continue to involve similar representatives throughout the research study; for example, to co-produce the materials used in the study, such as information sheets, and to gain feedback on the write up of the study. What will we do with the study findings? It is important that the information gained from the study reaches the widest number of people. We will therefore consider who to engage, and how to reach them, from the very start of the study. The main findings will be developed into a short summary report, which will be accessible to the general public through our public representatives and collaborators. They might include charitable organisations in the community (e.g. Stop Domestic Abuse, Hampton Trust) or services that work directly with women affected by crime (e.g. NHS, probation services).

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

f06fb2ad-c8c9-436f-982c-c278b7185585 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.

Understanding the psychosocial needs and trajectories of older adults (>64 years) with alcohol use disorder (AUD) from hospital back into community Team: Kinda Ibrahim is a lecturer and a pharmacist at the Faculty of Medicine and the Deputy Lead for the Ageing and Dementia Theme within the NIHR ARC Wessex Jay Amin is Associate Professor in Psychiatry of Older Age at the University of Southampton and an honorary consultant in Old Age Psychiatry at Southern Health NHS Foundation Trust. Sue Latter is a Professor of Health Services Research and a nurse by background and an expert in medicines optimisation research. Simon Fraser is an Associate Professor in Public Health at the University of Southampton. Ruth Bartlett is a Professor at the University of Southampton and Director of the University of Southampton's Doctoral Training Centre in Dementia Care, and a lead coordinator for the ARC Wessex Faculty. Rosemary Lim is an Associate Professor at school of pharmacy, University of Reading. Michelle Board is an Associate Professor in Nursing Older People at the Faculty of Health and Social Science at Bournemouth University. Starts: October 2022 Ends: September 2024 Lay Summary Most people with dementia or mild cognitive impairment (MCI) have multiple chronic conditions and take five or more regular medications (polypharmacy). Polypharmacy in people with dementia/MCI can lead to increased risk of drug interactions, side effects such as falls and cognitive decline, and sometimes hospitalisation and death. Some types of medications (such as strong anticholinergic drugs) can increase risk of developing dementia and cognitive impairment. It is estimated that over £400 million is spent annually in the UK in hospital admissions related to harm from medications. Identifying harmful medications and stopping or switching to safer alternative (deprescribing) has the potential to reduce the risk of developing dementia and improve outcomes for people already living with dementia. However, to date, deprescribing interventions for people with dementia/MCI have focused on specific drug classes (e.g., anti-psychotics) or have been limited to inpatient or nursing home setting. In the UK, it is estimated that 61% of people with dementia live at home where medication is a part of daily living. Most studies also focused on medication-related outcomes (e.g. discontinuation of high-risk medications) rather than patient-centred outcomes, and did not involve the person with dementia and their carer. Therefor it is essential to understand how primary care staff could involve people with dementia/MCI and their caregivers in shared-decision making about stopping medications safely. The aim of this study is to develop a primary care–based deprescribing intervention focusing on increasing shared-decision making targeting people with dementia/MCI and their caregivers. The proposed research will include two phases: First, a search of published literature to understand how effective deprescribing interventions among people with dementia/MCI, with a focus on what works or does not work for this population. Secondly, we will conduct interviews with people with dementia/MCI and their caregivers as well as healthcare professional. We want to understand how deprescribing can be initiated and monitored among people with dementia or MCI in primary care setting and how patients and their caregivers could be involved in decisions about medication taking. Then we will use the information we gather to identify the key elements/factors that make deprescribing and shared-decision making possible in primary care. We will develop an intervention which will then be refined in a future study, subject to funding, through a series of workshops and rapid iterations with key stakeholders to discuss its content, format, style and delivery. Read all Mental Health Hub projects

df3a87da-ba5f-40cd-8109-9f23cf0662d9 COMPLETED: Promoting person-centred care using the CHAT&PLAN conversation guide Promoting person-centred care using the CHAT&PLANTMconversation guide Project leads: Professor Jackie Bridges (Professor of Older People's Care, School of Health Sciences, University of Southampton), Dr Teresa Corbett (Lecturer, Solent University) Team members: Professor Jackie Bridges (Professor of Older People's Care, School of Health Sciences, University of Southampton), Dr Teresa Corbett (Lecturer, Solent University), Professor Alison Richardson (School of Health Sciences, University of Southampton), Dr Jane Winter (Macmillan Consultant Colorectal Nurse, University Hospital Southampton NHS Foundation Trust), Start: 1 October 2019 Ends: 30 April 2022 Project Partners: University Hospital Southampton NHS Foundation Trust, Southern Health NHS Foundation Trust, Bournemouth University, Macmillan Cancer Support Lay summary The aim of this Wessex ARC project is to share a conversation guide we have developed through our research. The guide helps health and social care staff talk to older adults who have lots of different conditions. The guide has 8 steps that should be followed in a meeting with people about their needs and personal goals. We call the guide “CHAT&PLAN” and we’d like to make sure that people working in health and social care know about it and use it in their work. This website leads to resources to support people to use CHAT&PLAN in their work. We have a new project underway with the Wessex Cancer Alliance that tests out some new ways of supporting people with cancer, including the CHAT&PLAN. Corbett, T., Cummings, A., Lee, K., Calman, L., Fenerty, V., Farrington, N., Lewis, L., Young, A., Boddington, H., Wiseman, T., Richardson, A., Foster, C., Bridges, J. (2020). Planning and optimising CHAT&PLAN: a conversation-based intervention to promote person-centred care for older people living with multimorbidity. PLOS One . https://doi.org/10.1371/journal.pone.0240516 The following people were involved in the research behind the CHAT&PLAN: Dr Hilary Boddington, Professor Jackie Bridges, Dr Lynn Calman, Dr Teresa Corbett, Dr Amanda Cummings, Dr Naomi Farrington, Vicky Fenerty, Professor Claire Foster, Dr Kellyn Lee, Lucy Lewis, Professor Alison Richardson, Dr Jane Winter, Professor Theresa Wiseman, Alexandra Young

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

e3705a45-1f6d-4b9b-9466-a536d5b062ff COMPLETED: Shift Pattern Feasibility Feasibility of collecting and using nursing shift patterns data in acute, community and mental health wards Principal Investigator: Dr Chiara Dall’Ora Team members: Dr Chiara Dall'Ora (Senior Research Fellow in Nursing Workforce, School of Health Sciences, University Of Southampton), Professor Peter Griffiths (Chair of Health Services Research, School of Health Sciences, University of Southampton), Ms Nicky Sinden (Head of Nursing Workforce at Portsmouth Hospitals NHS Trust), Dr Sarah Williams (Associate Director of Research & Improvement, and Academy Lead at Solent NHS Trust), Ms Catherine Smith (Associate Director Workforce Research and Innovation, Southern Health NHS Foundation Trust), Professor Jane Ball (Deputy Head of School (Research & Enterprise), School of Health Sciences, University of Southampton), Dr David Culliford (Senior Medical Statistician, School of Health Sciences, University of Southampton), Mr Anthony Austin, PPI contributor Start: 1 October 2020 Ended: 31 December 2022 Partners: University of Southampton, Portsmouth Hospitals NHS Trust, Solent NHS Trust, Southern Health NHS Foundation Trust. UNISON, Royal College of Nursing Lay summary Nurses and care assistants form the largest group of NHS staff. Most work in services that provide care across 24 hours of the day. Research indicates that the organisation of nursing shift patterns might affect the productivity of health services. The introduction of long shifts in nursing was offered as a strategy to maintain service levels while eliminating overlaps. However, research has found that long shifts are associated with higher rates of sickness and poorer patient care. So far, there has been little research exploring individual factors influencing shift work experiences among nurses, and research has been largely confined to acute hospitals. What did we learn/find out? Working long shifts (12-h or longer) leads to more burnout for nursing staff Having little choice around shift patterns leads to more nursing burnout Nurses working 12-h shifts reported lower choice around shift patterns than nurses working 8-h shifts When wards in Mental Health and community hospitals operated with high proportions of long shifts, there were higher rates of patient incidents This was particularly the case for self-harm incidents and incidents of patient disruptive behaviour What difference can this new knowledge make? It will help nurse managers and those in charge of creating nursing rotas It will help nurses working in inpatient settings choose their shift patterns It will keep patients safer because they will be cared for by nurses who are less tired Why is this important for patients, health and care providers and policy makers ? Nursing burnout is at an all time high, and we provided evidence that can help alleviate burnout Improving patient safety is of paramount importance for any health organisation, and our findings support changes to work organisation to improve patient safety What we are going to be doing next? We will keep disseminating our findings by publishing further papers We are now co-developing feasible changes to shift patterns with nursing staff and their managers as part of our new project We have applied for further funding to maximise analysis of datasets we have created as part of this study Publications https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-022-00731-2 Shift work characteristics and burnout among nurses: cross-sectional survey | Occupational Medicine | Oxford Academic https://onlinelibrary.wiley.com/doi/10.1155/2023/6626585 https://onlinelibrary.wiley.com/doi/10.1111/jocn.16974