Patient and public involvement across CLAHRCs – collaborating and sharing knowledge with PenCLAHRC

As we reflect on five years of CLAHRC research, and look forward to the transition to their successor – Applied Research Collaborations (or ARCs) – we welcomed staff and patient and public contributors from CLAHRC South West Peninsula (PenCLAHRC) – for a learning exchange visit on July 4th.

The meeting was a follow up to our trip to PenCLAHRC last September where we established relationships between the respective involvement teams and patient/public partners on the start of a journey where we will collaborate and share good practice wherever we can.

CLAHRC North Thames Deputy Director Professor Mike Roberts (below) opened the meeting by welcoming our guests and highlighting their vital role in shaping the ARCs. Mike outlined the part they could play in implementation and adoption of research – a new area for ARCs compared to CLAHRCs and a part of the research cycle where patient and public involvement does not traditionally happen.

CLAHRC North Thames researchers Dr Darren Sharpe (University of East London, below) and Chloe Edridge (Anna Freud National Centre for Children and Families) joined the meeting to bring some researcher’s perspective to discussions, and both spoke of the impact involving people has made on their work.

We then welcomed Dr Helen MacDonald (below, left) a Public health registrar working across UCL and the London Borough of Islington on research funded by the Health Foundation. Helen is investigating Linking health and local government data at household level to understand social determinants of health. Linking local government information with health data offers an opportunity to better understand the local population’s combined health and social needs and to improve health and wellbeing in the widest sense across the Borough.

Specialist innovation and technology firm Snap Out are working with the Council on this programme – they facilitated a co-design session to shape the approach to seeking advice from the local Islington public and patient population about the linked dataset and the acceptable use of data as a result of the linked dataset.

This led to some in-depth discussions on how Islington might do this.

To close the meeting we then worked on what involvement in ARCs could look like, how we can collect and demonstrate the impact of involvement and how we can collaborate to improve research and make the most of the skills and experience across both CLAHRCS.

Our thanks to everyone who attended, to Steph Hume from the CLAHRC North Thames team, to Dr Kristin Liabo from PenCLAHRC for helping plan and facilitate the day, to Darren and Chloe for taking the time from their busy schedules to join us, and to UCL Estates and Security for helping make the meeting accessible.

Helping inspire the next generation of scientists

What triggers asthma symptoms?

Can you identify celebrities who live with the condition?

How much lung capacity do you have?

These were just some of the questions we asked visitors to our stall at the 2018 Barts and Queen Mary Science Festival held at Queen Mary University of London’s Mile End campus on 20 June.

The CLAHRC was represented by the My Asthma in School project team at the event aimed at secondary schools and young people interested in a career in science and medicine.

We took the chance to give visitors information on symptoms and managing the condition in schools, and raising awareness among young people they can better understand and support fellow pupils with asthma.

They could also test their lung capacity and put their results on a peak flow rate chart to see how they rated against other young people (below). The team is looking for schools to take part in their work. Signing up your school is quick and easy and will help your school support & empower young people with asthma.

The Exhibitors at the festival provided hands on activities to encourage students to learn more about careers in science.

Now in its eighth year, the 2018 festival was supported by the NIHR Biomedical Research Centre (BRC) at Barts Health NHS Trust and Queen Mary University of London, and Trials Connect.

Thank you to the team and for the invite from Barts and QMUL.

Celebrating research at UCLH

The CLAHRC was represented at the annual University College London Hospitals NHS Foundation Trust (UCLH) research open day held on July 5th at the hospital. The 2018 edition of the event had special significance in the year we celebrate the NHS’ 70th birthday.


We were one of over 30 stalls at the event, which celebrates research going on across UCLH, one of the CLAHRC’s key NHS partners.

Joining our public and patient involvement officer Steven (below left) at the stall were two CLAHRC researchers Emma Dunphy and Dr Rachel Muir.

Dr Muir (below left) gave visitors an opportunity to take part in a LEGO Serious Play demonstration. LEGO Serious Play is an innovative and engaging way to construct and share knowledge and stories in research, and was initially designed to be used in the corporate world to map complex problems through shared models and landscapes. Visitors got the chance to construct mini-models in 3 minute Lego Serious Play exercises. To find out more about Rachel’s work email r.muir@ucl.ac.uk

Emma (below left) is a Senior Physiotherapist based at Homerton University Hospital NHS Foundation Trust, and supports patients in their journey back to health after injury. Emma has developed TRAK, a web based resource to help with rehabilitation from Anterior Cruciate Ligament injuries – particularly common among active sportspeople.

TRAK includes diagrams and short films demonstrating exercises included in a patients rehab programme, and can complement face to face therapy for those in recovery from ACL injuries. For more info on TRAK contact Emma at emma.dunphy@ucl.ac.uk

Our thanks to Emma and Rachel for their time and for UCLH for inviting us to take part and for running an excellent event as ever.

Introduction to Demand, Capacity and Flow – 25th September 2018

Does your organisation encounter problems with patient flow?

Are you interested in forecasting demand or capacity planning but don’t know where to start?

Do you want to learn some common pitfalls, principles and rules of thumb that might help you?

 

This one day, hands-on workshop is an introduction to demand, capacity and flow aimed at staff from NHS Trusts, CCGs and Local Authorities, and is run by the NIHR CLAHRC North Thames Academy.

After attending this workshop, you will have the skills and knowledge to apply simple principles and rules of thumb for managing demand and capacity in your local organisation or service.

The course covers:

  • Exploring what we mean by demand, capacity and flow
  • The role of variability in demand forecasting and capacity planning
  • How these concepts relate to flow within and between organisations
  • Common pitfalls including the role and limitations of using historical data
  • Some useful rules of thumb from ‘queueing theory’
  • Practical skills and tips for applying these concepts within your own organisations

This workshop is suitable for staff from NHS Trusts, Local Authorities and CCGs. It is not aimed at academics and/or researchers. No previous knowledge of demand, capacity or flow is required but basic Excel skills are essential.

Participants should attend the course with a service in mind in which they need to manage demand and capacity. You will need to bring a laptop/device with you to the course, on which you can access Microsoft Excel.

All participants will receive a certificate of attendance.

Cost – This course if free for staff working in NIHR CLAHRC North Thames partner organisations (please click here to see a list of our partners).  There is a delegate fee of £250 for other attendees.

Registration Please complete the registration form and email it to clahrc.academy@ucl.ac.uk by 5pm, Friday 3rd August 2018.

Please note, a cancellation fee of £100 will be charged to both partner and non-partner delegates in the event of non-attendance without notice after 5pm, Tuesday 18th September 2018.

For more information, and to be added to our mailing list, please contact clahrc.academy@ucl.ac.uk

Welfare advice in GP surgeries – what is the impact on GP’s workload and patients’ health and wellbeing

GPs are often faced with patients seeking help and advice on non-clinical issues such as debt, unemployment and housing. Though these issues undoubtedly impact patients’ health and wellbeing, health professionals are not always the best qualified people to tackle them.

We investigated the impact of putting welfare advice, and welfare advisers in GP surgeries on

  • the ability of low income groups to secure financial support they are entitled to
  • patients’ anxiety and stress associated with financial related social worries;
  • and, to GP time spent managing non-clinical issues

New CLAHRC BITEs offer a summary of two papers investigating the impact –

  1. A qualitative study to identify the processes by which co-located services can improve outcomes for GP practices

Key Findings

Co-location of welfare services has many benefits to patients including:

  1. Offering a signposting option for staff in contact with patients with ‘non-clinical’ social needs.
  2. Helping to address underlying patient social issues.
  3. Providing an alternative option for patients seeking help for such issues.
  4. Reducing bureaucratic pressures and time demands on practice staff.

Read the BITE

Co-located welfare advice in GP surgeries: part I

  2. A quantitative study, using a controlled comparison, assessing the impact on mental health and service use of co-located welfare advice.

Key Findings – service users receiving welfare advice versus control group

  • Had the advice service not been at the practice, nearly half of the advice group would not have sought help or consulted their GP instead.
  • The majority of advice recipients reported improved circumstances after advice (e.g., stress, income, housing etc.)

Compared to those who did not get advice, after 3 months:

  • Those in the advice group whose circumstances improved experienced a bigger improvement in their well-being.
  • Those in the advice group experienced a bigger reduction in financial strain, reduced credit card and overdraft use.
  • Those in the advice group experienced a bigger reduction in symptoms of common mental disorder, especially among recipients who were female, those who identified as Black and those who reported that their circumstances improved as a result of advice.
  • There was, however no evidence for a reduced frequency of GP consultations.
  • For every £1 of investment by funders, those receiving co-located advice gained £15 in entitlements on average

Read the BITE

Co-located welfare advice in GP surgeries: part II

 

Beyond searching- supporting NHS colleagues to contribute to systematic reviews

We recently collaborated with colleagues at Peninsula CLAHRC to deliver a successful ‘Beyond Searching’ course.

Members of the PenCLAHRC Evidence Synthesis Team (EST) travelled to London to work with CLAHRC North Thames’ Dr Antonio Rojas–Garcia in delivering the workshop to 19 librarians from the NHS and various universities.

Beyond Searching was devised 5 years ago by members of the EST who have been running annual workshops ever since. The course is designed to show health information professionals that they already have the skills to effectively contribute to systematic reviews –  reviews aiming to find as much as possible of the research relevant to the particular research question, and to identify what can reliably be said on the basis of these studies. The training gives them the confidence to get involved in the process and to advise others.

Librarians and other information professionals are highly skilled and motivated individuals with a drive to learn about new technologies and ways of working. They already have the skills needed to contribute to systematic reviews so our course is more about how they apply those skills. ‘It is always a joy to teach this workshop – often we learn a lot ourselves in the process – and it was particularly good this time to get the chance to collaborate with colleagues from CLAHRC North Thames.’

Morwenna Rogers (EST member)

This was the second year that the course followed a flipped classroom model, which EST members learned about during their visit to the University of Michigan two years ago. The model frees up classroom time for discussions and active learning, by making some of the foundation lectures and reading material available to participants in advance.

Attendees were asked to complete a series of online tasks prior to the course, which introduced them to key concepts of systematic reviewing and comprehensive searching. This enabled attendees to focus on more detailed aspects of search techniques during the workshop.

Guest speaker Claire Stansfield from the EPPI-Centre was also invited to discuss the use of automation (employing machines, computers, or robots to help researchers identify relevant papers), and its implication for reviews in the future.

The beyond searching team were delighted with the positive feedback they received. One attendee said that it was:

The best training [they] have ever attended

Another attendee planned to use the knowledge she had gained to change practice in her own place of work, and another thought that the flipped classroom model was excellent preparation for the face to face teaching day.

Dr Rojas – Garcia (below) praised the cross CLAHRC co-operation behind the delivery of this workshop, remarking:

It was great to spend the day collaborating with colleagues from PenCLAHRC. I considered it a very positive experience, it has been really encouraging to see how other colleagues teach about systematic reviews.’

To read more about the Beyond Searching workshop  collaboration, visit the EST blog.

Engaging school programme to reduce high levels of poorly managed asthma in young people

CLAHRC researchers based at Queen Mary University of London launched the My Asthma in School programme this week – an initiative that aims to improve the self-management of the respiratory condition by school children.

Developed by researchers at the University’s Blizard Institute, the programme will use films and apps in educational workshops and theatre performance to improve asthma control and peer support for asthma in London secondary schools.

The programme has been approved and supported by Sadiq Khan, Mayor of London, who himself lives with the condition.

He said: “The Greater London Authority and I believe that the ‘My Asthma in School’ programme is likely to promote the necessary education young people require to effectively self-manage their asthma.”

He added: “I encourage all London secondary schools to take part in this programme.”

Asthma affects approximately 1 in 11 children and young people in the UK; and young people with asthma have higher rates of school absences and visits to their doctor or the hospital. According to the data collected for the study, nearly half of young people (aged 11-18 years) with asthma did not have good control over their condition [Harris K et al,J Asthma 2017,54(10):1033-1040].

Dr Gioia Mosler, Outreach and Learning Manager for the ‘My asthma in school project’ (below, left) was at the launch event and said:

The number of deaths from asthma in the UK rank among the highest in the EU. Many of these deaths could be prevented with better self-management.

She added: “We want to improve the ability and motivation of young people to self-manage their asthma so they can take control of their condition.”

The research team’s results showed that young people with asthma often faced many barriers to addressing their condition, including lack of knowledge, or embarrassment to use their asthma inhaler in front of others. Based on these findings, as well as behavioural change theories, the researchers involved young people to develop a series of engaging teaching elements for an intervention, including several games, apps and videos: www.myhealthinschool.org.

The intervention will also deliver an interactive theatre performance, lasting approximately two hours, to help raise awareness of asthma among peers. The performance has been developed with partners at Greenwich and Lewisham Young People’s Theatre [Mosler G et al,Lancet 2017,391(10118):303–304].

 

Dr Mosler added: “The theatre intervention addresses asthma from a new angle, focusing on peer awareness and support around young people with asthma. The theatre addresses barriers related to a perceived stigma around asthma in peers, young people with asthma reported during our initial data collection.”

My asthma in School is one of the first school-based interventions for asthma self-management in the UK. Similar trials have been undertaken outside the UK, however, given that the health and education systems differ, results from these interventions may not be transferable to a UK setting.

The intervention will be trialled in London during the next few months. Given a positive result of this intervention it could be adopted as a wider programme to improve asthma in young people.

The programme is run as part of the My Health in School initiative based at the Blizard Institute within Queen Mary University of London which aims to improve life and health of young people at school. The team works with Professor Jonathan Grigg, who leads several studies about asthma and lung health in children and young people.

Schools are encouraged to get in touch to join our research –  email: info@myhealthinschool.org.

Website: www.myhealthinschool.org

Twitter: @SchoolsAsthma

References

Harris, K.; Mosler, G.; Williams S. A.; et al. (2017): Asthma control in London secondary school children. Journal of Asthma; 23: 1–8.

Harris KM, Kneale D, Lasserson TJ, McDonald VM, Grigg J, Thomas J. School-based self-management interventions for asthma in children and adolescents: a mixed methods systematic review. Cochrane Database Syst Rev. 2015;(4)

Mosler G. & Euba T.  (2017): Taking control through drama. Lancet; 391: 10118, p303–304.

Does the NHS have a future? Join the debate at a London School of Hygiene & Tropical Medicine event on July 3rd

After 70 years, does the NHS have a future?

 

 

 

Never a week goes by without claims of another ‘crisis’ engulfing the NHS: insufficient resources, dispirited staff, poor safety, waiting times, inadequate social care and more.

To mark the 70th birthday of the NHS, our colleagues at the London School of Hygiene & Tropical Medicine (LSHTM) are hosting a Question Time event with an expert panel from nursing, medicine, health policy and research to focus on the challenges and prospects for the future.

If you register to attend this free debate you can submit questions for the panel and contribute to the discussion on the day if you wish to.

Panellists for this event are –

  • Dame Donna Kinnair, Director of Nursing Policy & Practice, Royal College of Nursing
  • Nigel Edwards, Chief Executive, Nuffield Trust
  • Jane Dacre, President, Royal College of Physicians, London
  • Martin McKee, Professor of European Public Health, LSHTM

It will be chaired by Sir Nick Black, Professor of Health Services Research, LSHTM

It is free to attend but registration is required, please follow the link below.
https://www.eventbrite.co.uk/e/does-the-nhs-have-a-future-registration-45200336423

Venue

London School of Hygiene & Tropical Medicine
John Snow Lecture Theatre
Keppel Street
London
WC1E 7HT

Date and time

Tuesday 3 July 2018
17:30 – 18:30

Find out more:
https://www.lshtm.ac.uk/newsevents/events/does-nhs-have-future