Category: News and Events

How can we help Emergency Departments better prepare for the arrival of patients with acute mental health problems?

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New CLAHRC research offers the NHS a great opportunity to better support patients with mental health issues arriving at Emergency Departments.

CLAHRC researcher Dr Helen Barratt and colleagues have used NHS data to describe the population of patients who attend Emergency Departments in England, including their sociodemographic characteristics. As part of the first national study of Emergency Department mental health attendances, the researchers analysed over 6 million adult visits at 97 English NHS Trusts between April 2013 and March 2014.

The data will be invaluable to the NHS in estimating the demand for liaison psychiatry services, and resourcing A & E departments to deal with patients presenting with mental health issues in what is already a stressful environment. This work is timely as recently new NHS Access standards for emergency mental health care have been proposed – obliging Trusts to strengthen the availability of care ‘out of hours’ and the provision of resources for individuals requiring admission.

“Those coming to A&E will receive a response from a 24/7 liaison psychiatry team (or equivalent children’s and young people’s service) within the first hour of their referral, and will receive the appropriate, timely support to meet their needs and an evidence-based package of care.”
Clinically-led Review of NHS Access Standards Interim Report from the NHS National Medical Director

You can see the key figures in the infographic below

 

You can see more of the key figures in a presentation Helen put together below

 

 

What adaptations are needed to deliver psychological therapies in inpatient settings?

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Psychological therapies (sometimes referred to as ‘talking therapies’) offer a chance for patients to explore difficulties in a safe and confidential setting. The therapy is delivered by a qualified professional, working in partnership with a patient to help them better understand feelings that arise from their past experiences, and attitudes towards them. Evidence suggests these therapies can make a big impact on psychiatric patients current and future wellbeing. However, they are a challenge to deliver in inpatient environments due to the short-term nature of many inpatients’ stay, added to the complex needs they often present with.

Dr Lisa Wood is a Care Pathway Lead Psychologist at North East London NHS Foundation Trust (NELFT) as well as a Lecturer in Clinical Psychology at the University of Essex. Dr Wood spent a year with the CLAHRC as part of a Fellowship funded by HEE NCEL to hone her research skills and develop research interests in her specialist area – understanding the lived experience of psychosis from a service user perspective.

In newly published research, Lisa explored the adaptations required to deliver psychological therapies to this population from the perspective of inpatient psychological practitioners. Through interviews with inpatient psychological practitioners, Dr Wood and her research team sought the adaptations required to deliver psychological interventions in this context.

Read the paper

Qual Health Res. 2019 Apr 23:1049732319843499. doi: 10.1177/1049732319843499
Psychologists’ Perspectives on the implementation of Psychological Therapy for Psychosis in the Acute Psychiatric Inpatient Setting.
Wood L Williams C Billings J Johnson S
https://www.ncbi.nlm.nih.gov/pubmed/31014190

 

After the trial: how a programme to improve the health care response to domestic violence and abuse fares in the real-world NHS

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How does an intervention developed and tested by researchers make its way to the front-line of health care?

This is the topic of a new blog by Dr Natalia Lewis, a Research Fellow at Centre for Academic Primary Care in the University of Bristol.

Natalia is part of the research team investigating the impact of IRIS (Identification and Referral to Improve Safety), a general-practice-based Domestic Violence and Abuse (DVA) training, support and referral programme.

After the trial: how a programme to improve the health care response to domestic violence and abuse fares in the real-world NHS

BBC features CLAHRC research into pollution and young lungs

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Professor Chris Griffiths featured on BBC’s the One Show last night talking about the impact of pollution on young lungs. The topical affairs programme ran a feature on the impact of poor air quality on children and young peoples (CYP) development.

Professor Griffiths is leading research into the impact of the Capitals’ upcoming Ultra Low Emission Zone (ULEZ) – introduced on April 1st – on both CYP respiratory health and physical activity levels. The ULEZ is predicted to deliver major improvements in London’s air quality, reducing nitrogen dioxide and particulate exposures in central London.

The ULEZ comes into force on April 1st

 

 

The feature runs from 6 minutes 30 seconds into last nights show

https://www.bbc.co.uk/iplayer/episode/m0003mmj/the-one-show-27032019 

You can read about this recently launched CLAHRC study here;

https://clahrc-norththames.nihr.ac.uk/systems_and_models_theme/impcact-of-ulez-on-childrens-physical-activity-and-weight/

 

Becoming Research Active: 26th June 2019; 9am-5pm

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Are you a nurse, allied health professional, public health or local government member of staff who is interested in research or who has had some exposure to research?  Our workshop is suitable for staff from NHS Trusts, CCGs, and Local Authorities who are keen to become involved in research.

Engaging in research is a great way to address the questions that often arise in health care.  It can also play a vital role in producting new evidence and new knowledge for decision-making to improve health care.

This one day, practical workshop provides an introduction to the research process to enable NHS and local government staff to engage in research activity.  The course is run by the CLAHRC North Thames Academy, together with the Research Design Service London (east London arm) and Clinical Research Network North Thames.

This introductory level course is a first step on the journey towards becoming “research active”, either by developing your own small project or getting involved in other ways e.g. collaborating on research studies, assisting clients / patients in your care to take part in research, being a (critical) research ‘consumer’ or helping to shape research priorities, design and delivery.  We ask that participants attend the workshop with a research idea, innovation, or change that they would like to plan for, or collaborate on with researchers.

By the end of the course participants will:

  • Understand the research process, including the principles behind good research design and planning for dissemination and impact
  • Understand the different roles within a research team and identify the points at which you can become involved
  • Be able to apply criteria to judge the potential value and feasibility of a research project idea
  • Have a basic understanding of research governance and ethics requirements, and know where to find out more
  • Know how to involve patients and the public in every stage of research, and understand how it could benefit the research
  • Know how to access relevant resources or the help available across North Thames to design, plan and fund research

This workshop is not aimed at academics and/or researchers.

*e.g. you might have done a Masters level module in collecting and analysing data, or critical appraisal of research, or have helped to support research in your organisation or attended another one of our Academy courses.

All participants will receive a certificate of attendance.

Cost – This course is free for staff working in NIHR CLAHRC North Thames partner organisations (a list of our partners is available on our website). There is a delegate fee of £250 for other attendees.

Venue – Central London

Registration – Please complete the registration form and email to clahrc.academy@ucl.ac.uk by 5pm, Friday 26th April 2019.

Please note,a cancellation fee of £100 will be charged to both partner and non-partner delegates in the event of non-attendance without notic after 5pm on 19th June 2019.

For more information please contact clahrc.academy@ucl.ac.uk

NIHR CLAHRC North Thames funded PhD studentships launched

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NIHR CLAHRC North Thames is now recruiting to its 2019 PhD studentships. NIHR CLAHRC North Thames is funded to conduct high quality applied health research, focused on the needs of patients and the public to produce a direct impact on health and the way health care and public health is organised and delivered.

Led by Professor Rosalind Raine (UCL), we are a collaboration of 50+ partners, including leading universities, NHS trusts, local authorities, clinical commissioning groups, UCLPartners, industry and organisations representing patients and the public.

We invite applications for these 3-year PhD studentships starting October 2019 (exact date dependent on the individual university). Studentships will be based at one of the following Universities: London School of Hygiene and Tropical Medicine, Queen Mary University of London, University College London. Details of the individual projects and supervisors are given below. The studentships include a stipend and full UK/EU fees.

Read more about how to apply on this page;

https://clahrc-norththames.nihr.ac.uk/nihr-clahrc_north-thames-academy/phds/ 

The PHDs on offer are below:

Cancer and comorbidity: impact of comorbid conditions on equity of access and safety and outcomes of cancer treatments

CLAHRC Research area: Health Economics and Data

Developing and evaluating an online community of practice for public health decision-makers

CLAHRC Research area: Health Economics and Data

Addressing the polypharmacy challenge in working-age adults

CLAHRC Research Area: Multimorbidity

Optimising resources from the internet in primary care consultations

CLAHRC Research area: Innovation and Implementation Science

Somatic and psychotropic polypharmacy: Understanding sociodemographic factors and the effects of polypharmacy in people with mental health problems

CLAHRC Research Area: Multimorbidity

Mapping Complex CAre Pathways for Personality Disorder (MACCA-PD)

CLAHRC Research area: Mental health

Understanding and facilitating self-management in child and youth mental health for socially excluded populations

CLAHRC Research area: Mental health

Evaluating services for older adults with multimorbidity across health and social care

CLAHRC Research area: Multimorbidity

Patient experiences on inpatient psychiatric wards: does this information get used to improve outcomes?

CLAHRC Research area: Mental health

Equity in service provision for people newly diagnosed with dementia and their family

CLAHRC Research area: Mental health

Implications of digital health innovations on the demand, use, cost and experiences of health and social care services

CLAHRC Research area: Innovation and Implementation Science

 

Mechanical thrombectomy is cost-effective up to 24 hours from stroke

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CLAHRC researchers demonstrate the value of intervention beyond the current recommended 6 hours

Ischaemic stroke is the most common type of stroke, occurring when a blood clot blocks an artery cutting blood flow to part of the brain. Stroke can lead to coma, severe disability and eventually death if not treated promptly. 

Mechanical clot retrieval (thrombectomy) is an intervention to remove clots when the current medical treatment (thrombolysis) is not sufficient to dissolve them.

Thrombectomy to remove a clot

Current guidance from NHS England and the National Institute for Health and Care Excellence (NICE) (see below) only supports this intervention within 6 hours from stroke onset.

NHS England – Clinical Commissioning Policy on Mechanical Thrombectomy for Acute Ischaemic Stroke.

NICE – Mechanical thrombectomy devices for acute ischemic stroke. Guidance MIB153. 30 July 2018 

Our researchers compared the cost-utility of mechanical thrombectomy (MT) in addition to medical treatment versus medical treatment alone performed beyond 6 hours from stroke onset in the NHS.

Our research, published in the International Journal of Stroke, shows that MT is still cost-effective if performed up to 24 hours. The publication is now cited as health economics evidence in the latest NICE evidence review (Stroke (Update). Evidence review D: thrombectomy- Draft for consultation). and has been used to recommend the offer of MT up to 24 hours. 

The work demonstrates mechanical thrombectomy is cost-effective up to 24 hours from acute ischemic stroke symptom onset – we propose the NHS implements this intervention on the basis of improvement in the quality of life of patients as well as economic grounds.

Pizzo, E., Dumba, M., & Lobotesis, K. (2019).
Cost-utility analysis of mechanical thrombectomy between 6 and 24 hours in acute ischemic stroke.
International Journal of Stroke
https://doi.org/10.1177/1747493019830587

Registration Open

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Rethinking Cancer UCL Cancer Domain Symposium

Monday 13 May 2019

UCL Institute of Education

Registration for the inaugural UCL Cancer Domain Symposium is open

Cancer remains one of the major causes of morbidity and premature death worldwide; one in two people in the UK born after 1960 will be diagnosed with some form of cancer during their lifetime. UCL has a proud track record in addressing the societal, technical, and health challenges of cancer and in exploring its underling biology.

This symposium, organised by the UCL Cancer Domain, invites our broad community to assemble for the first time at scale to consider challenges and opportunities in cancer research, prevention and treatment, from biological, clinical, technical, economic and societal perspectives. The event showcases our distinctive multidisciplinary expertise and features interactive discussion sessions with our speakers and panels. Talks are scheduled on the following themes:

  • Cancer evolution: can we beat Nature?
  • Cancer detection: the earlier the better?
  • The cancer treatment revolution and how we afford it

We are delighted to announce that Professor Charles Swanton (UCL Cancer Institute and Francis Crick Institute) and Professor Mariana Mazzucato (UCL Institute for Innovation and Public Purpose) will deliver the keynote lectures at this event.


Register your place here: https://ucl-cancer-domain-symposium-2019.eventbrite.com

Join the conversation by tweeting us @UCL_SLMS using the hashtag #UCLCancerDomain

Introduction to Evaluation Online: 7th May – 4th June 2019

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Do you need to demonstrate the impact of projects in your organisation?

Do you want to improve the design and implementation of your programmes?

Are you tasked with carrying out an evaluation, but don’t know where to start?

Consider enrolling in our four-week online course run by the NIHR CLAHRC North Thames Academy to address these challenges. This course has been recently updated. It is aimed at staff in frontline services at NHS Trusts, CCGs and Local Authorities, who have limited experience conducting service evaluations and would like to learn about evaluations in flexible time.

After participating in this course, you will have the skills and knowledge to undertake your own evaluation of a local programme or service. Inspired by the content of our popular face-to-face evaluation course, the online course will cover:

  • Different types of evaluation, including their pros and cons
  • How to select suitable methods and approaches for evaluating a local programme or service
  • Practical skills and tips in using evaluation methods and approaches
  • Ways of sharing your evaluation findings to make an impact

Teaching will be delivered entirely online. You’ll learn by watching videos and lecture slides; interacting through activities and questions; and learning from others by taking part in the discussions that accompany each step. You’ll also develop a plan for a real life evaluation you may have to conduct. 

Who is this workshop suitable for?

Staff from NHS trusts, local authorities and clinical commissioning groups who need to evaluate local programmes or services as part of their work. The course is not aimed at academics or researchers.

What preparation is needed?

Participants should attend the course with an evaluation in mind that they may have to carry out.  No previous knowledge of evaluation is required, or experience of study design and statistics.

Participants will receive a certificate of completion if they undertake at least 80% of the course activities.

Dates – Tuesday 7th May – Tuesday 4th June 2019.

Learning hours – an estimate of 3 hours per week (12 hours in total)

Cost – £100 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 – Registration will open between 25th February and 3rd May 2019.
To register for this course, please go to the UCL online store.

For more information please contact clahrc.academy@ucl.ac.uk

Bart’s Research Centre for Women’s Health is up and running with the EMmY study

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We’re delighted to announce our latest research partnership – with the the Bart’s Research Centre for Women’s Health (BARC) .

BARC was launched in June 2017 and is led by Professors Shakila Thangaratinam and Khalid Khan.

The Centre is funded by Barts Charity and based within Queen Mary University of London at the Whitechapel campus.

The centre team (pictured above) will focus on improving the health of mothers and babies in East London, addressing healthcare challenges such as diabetes, obesity and heavy blood loss during childbirth.

The first BARC study is set to start in January 2018 –  “EMmY: Effectiveness and acceptability of myo-inositol nutritional supplement in the prevention of gestational diabetes: a pilot placebo controlled double blind randomised trial”.

EmMY will aim to randomise 200 women who are at risk of developing gestational diabetes, across three sites (Barts Health, Guy’s and St Thomas’, and Central Manchester University NHS Trusts).

Participants will be randomised to receive either 4g of Myo-inositol – a naturally occurring substance produced in the human body that belongs to the vitamin B complex group – or placebo study supplement daily, from the end of the first trimester until delivery.

The pilot will examine rates of recruitment and randomisation to the trial, and rates of adherence to the intervention. Researchers will analyse reasons for participation, non-participation, and non-adherence to the trial protocol. Any preliminary estimates and insight into trial procedures from the EMmY study will then inform a future large-scale trial.

The CLAHRC is supporting the study by providing health economic analysis for the pilot and full trial and assisting with patient and public involvement..

Contact Doris Lanz, BARC Senior Trial Manager for more info at d.lanz@qmul.ac.uk