One to one specialling and sitters in acute care hospitals; reviewing the evidence

One to one nursing, or specialling is a way of caring for patients by providing continuous observation (by “sitters”) for an individual for a period of time during acute physical or mental illness.

Some patients need more than a general level of observation on a ward, often with the primary aim of reducing risk and protecting the patient.

Our review, published in a BITE, examined published evidence on the topic of specialling and sitters, aiming to identify the challenges and concerns relating to the cost effectiveness and quality of care.

Medication adherence in asthma: can pharmacists help?

Preventer inhalers (inhaled corticosteroids) are a common medication for asthma, and people get the full benefit of the medication by taking their prescribed doses correctly. We know many patients struggle to take enough doses effectvely, which impacts their ability to manage the condition.

Could pharmacists hold the key to helping patients take medicines effectively and in the right doses?

Our latest BITE – a postcard “need to know” summary of our research – presents the findings of our review of the evidence on whether pharmacists involved in asthma care could help people take their preventer inhaler as prescribed, therefore giving them the full benefit of their medication.

CLAHRC evidence influences decisions on front-line services

New knowledge generated by our research impacts commissioning and funding decisions on welfare advice

Our work to investigate the impact of locating welfare advisers in GP surgeries is bearing fruit as the new knowledge and evidence we have generated is influencing commissioning decisions for these services across London and beyond.

We know that a significant amount of General Practitioners workload is generated by patients approaching them with non-clinical issues such as debt, housing and immigration.

While these concerns undoubtedly impact health and wellbeing, doctors are not necessarily the best professionals to assist. Haringey Council trialled a scheme to locate welfare advice, and welfare advisers in GP surgeries to deal with these issues. 

We evaluated the impact of this advice (provided by Citizen’s Advice Bureau staff) on both GP workloads and on the health, wellbeing and use of services by the patients affected.

Our evidence has been used to support the following decisions –

Haringey: our evidence was used to support retention of all except one primary care co-located welfare advice service in and to provide an additional more intensive service at a mental health hospital (St Ann’s Hospital);

Camden: although the CCG decided to cease funding for GP outreach two GP practices have used the study findings to support ongoing funding for services at their practices (including an application for Big Lottery funding)

Deryshire; Citizens Advice services in Derbyshire have requested study findings to support a business case for ongoing funding of GP outreach in the region

Sussex: our study has been used as a basis to develop an evaluation framework in Sussex

Read our evidence 

Read more about the study: 

Does locating welfare advice in GP surgeries improve health and reduce strain on the NHS?

Our work is award winning

CLAHRC researchers enjoyed success at the recent Public Health England Annual Conference in Warwick.

They were among the authors of an award winning poster representing our partnership work with Islington Council.

We are working with the borough as it seeks to link NHS data with its own datasets to build a clearer picture of  local population needs and better target services and interventions.

Linking these sources of data can build a picture of how social determinants of health – the conditions in which people are born, grow, live, work and age – might impact on residents’ wellbeing and use of health services. Examples would include how housing conditions impact on hospital admissions or how serious childhood illnesses could affect school attendance and attainment.

The poster was presented by Laura Scott, Principal Data Specialist at Islington Council and highlights how 90 data sources within the council are being joined up, already proving valuable in understanding local risk factors for ill health and improving access to services.

Islington insights population register: linking council data to understand local population needs for a fairer, healthier society

Laura Scott, Helen McDonald, Mahnaz Shaukat, Lawrence Vandervoort, Logan Robertson, Jessica Sheringham, Sarah Dougan

Over 1500 participants visited the PHE annual conference representing a wide range of organisations working to improve the health of the public. 

The CLAHRC’s Dr Jessica Sheringham (Senior Research Associate) was an author of the poster chosen from over 350 submitted – the award was presented at the conference dinner.

The project is funded by the Health Foundationas part of its Advancing Applied Analytics programme, aimed at improving analytical capability in support of health and care services.

Read more about this work via the link below

Linking health and local government data at household level to understand social determinants of health

Mayor launches school programme developed to improve self-management of asthma in young people

The Mayor of London, Sadiq Khan has launched a programme to improve the self-management of asthma by school children in the Capital. My Asthma in School was developed by CLAHRC researchers based at the Blizard Institute within Queen Mary University of London.

My Asthma in School

The programme uses educational workshops and theatre performance to improve asthma control and peer support for asthma in London secondary school.

Asthma affects approximately one 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 control over their condition.

Dr Gioia Mosler, Outreach and Learning Manager for the ‘My asthma in school project’, 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: “Improving the ability and motivation to self-manage asthma gives many young asthma sufferers the opportunity to improve their asthma control. As a result they would suffer less from common symptoms like coughing at night or breathlessness.”

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 programme has been approved and supported by Sadiq Khan, Mayor of London. Mayor Khan was himself diagnosed with the conditon as an adult –  which he attributes to London’s poor air quality and pollution levels.

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.”

Using behavioural change theories as a framework, researchers have developed a variety of engaging and entertaining media, such as apps, videos, and interactive games.

The intervention includes an interactive theatre performance (below), 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.

Dr Mosler added: “The theatre intervention addresses asthma from a new angle, focusing on peer awareness and support around young people with asthma. The questionnaire data we collected during phase one showed many barriers related to a perceived stigma around asthma. The theatre intervention addresses stigma around asthma in the peer group.”

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 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.

Using Virtual Simulation to Improve Endovascular Aneurysm Repair: Patient Advisor


A common surgical treatment for abdominal aortic aneurysm (AAA) is called Endovascular Aneurysm Repair, or “EVAR”. EVAR uses wires and catheters to insert a stent graft inside the aorta to divert blood away from the aneurysm. EVAR has good short term outcomes, including low complication rates during surgery and shortly after. However, there is a need to improve the long-term success of EVAR, which frequently leads to complications after approximately 5 years. We plan to develop a virtual computer modelling system that can predict the likelihood of success or failure of an EVAR graft, tailored to the individual patient. This tool will be useful for planning EVAR, especially in time-constrained situations like emergency AAA treatment, and for training vascular specialists to improve their skills.

We are preparing a grant application to carry out research on this topic. This research will

  • explore the patient experience of undergoing EVAR and associated follow-up;
  • explore how clinicians who carry out EVAR make decisions around the procedure
  • seek to understand how a computational modelling system can be designed to best meet the needs of key stakeholders (e.g., clinicians and device manufacturers) and improve patient care

We are inviting a patient representative who has previously undergone EVAR to repair an AAA to join our team and shape this work.

Though we recognise the value of individual experience of health and care, we hope you will be able to raise a broader range of viewpoints beyond your own personal experience.

Working alongside our research facilitator, and team of clinicians and researchers, your involvement will ensure that the patient perspective is at the heart of what we do.

Time commitment:                

We ask for a time commitment of approximately 1 hour per week from start until then. Most of this time will involve checking documents or emails from your home, and is flexible. You will be asked to attend three 60-90 minute meetings in September, October and November 2018.


Meetings will be typically held at a Central London location.

Remuneration and Expenses:

Out-of-pocket expenses for travel. A stipend of £30 per meeting. Reimbursement for review of documents subject to the size and scale of the forms (£15 for brief documents; £30 for full grant application).

Supported by:                        

The CLAHRC Research and Implementation Facilitator and Patient and Public Involvement (PPI) officer

Tenure of Office:                     

Through to December 2018 initially with an opportunity to join the research team if the grant bid is successful and/or to become involved in a related research project.

Role description:

The patient advisor will be required to contribute by:

  • Share your ideas, from your own experience, to help prepare a grant application to conduct this research in the UK. If our grant application is successful we will invite you to be part of the research team.
  • Prepare for and attend meetings in central London to discuss plans as a team, or give feedback via a phone call or email
  • Comment on research documents, such as scripts and questionnaires we plan to use to interview patient participants in the research

Role requirements

  • Diagnosis of abdominal aortic aneurysm and previous endovascular aneurysm repair (EVAR)
  • Knowledge and understanding of patient, public and service user perspectives, with an ability to raise a wider range of viewpoints beyond your own personal experience
  • Good communication skills with an ability to listen to others and confidently and constructively express your own views
  • An ability to work effectively and positively as part of a team
  • Assisting the research team in bringing an understanding of the viewpoints of patients to this work
  • Respecting any requests for confidentiality and declaring any conflicts of interest if they arise

Further Opportunities

The patient advisor will have the chance to

  • Get involved in our research grant application
  • Help to steer the research project if the grant application is successful
  • Have input to help direct our wider research plans and ideas in this area
  • Meet and work with world-class researchers in some of the UK’s most prestigious education institutions

Attendance fees and expenses

A stipend for preparation and attendance at meetings of £30 and for review of key documents (£15 or £30 subject to the size of the forms) will be paid to the role-holder. Travel expenses to and from meetings will also be reimbursed.  Those in receipt of state benefits and allowances are advised to contact the Benefits Advice Service for involvement in research. Contact INVOLVE by email: or phone 02380 651088 and quote NIHR CLAHRC North Thames.

Support to Panel members

All members will be supported by an experienced Patient and Public Involvement Officer and the project’s Research & Implementation Facilitator. The role-holder will be expected to identify any personal learning and development needs with the CLAHRC PPI Officer either in advance of formally taking up the role or during their tenure. Advice and help will also be available from the CLAHRC core team.

Recruitment and Selection Process

NIHR CLAHRC is committed to diversity of lay representation and applications are encouraged from individuals based throughout the North Thames region, from all backgrounds, and all age groups (from sixteen upwards). Interested candidates will be asked to complete a short supporting statement.

Contact details

Melissa N Galea Holmes

NIHR CLAHRC North Thames Research & Implementation Facilitator

UCL Department of Applied Health Research

1‐19 Torrington Place, London WC1E 7HB, Rm 112

Postal Address: UCL, Gower Street, London WC1E 6BT

T: +44 (0)20 3108 3269 (Ext. 53237)

E: melissa.galea‐ or

Introduction to Evaluation

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

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

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

This one day, hands-on workshop, run by the NIHR CLAHRC North Thames Academy, addresses these challenges.  It is aimed at staff from NHS Trusts, CCGs and Local Authorities, who have limited experience of conducting service evaluations.

After attending this workshop, you will have the skills and knowledge to undertake your own evaluation of a local programme or service.

The course covers:

  • Different types of evaluation, including their pro 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

This workshop is suitable for staff from NHS Trusts, Local Authorities and CCGs.  It is not aimed at academics and/or researchers.  Participants should attend the course with an evaluation in mind that they may need to carry out.  No previous experience of study design, statistics or evaluation is needed.

All participants will receive a certificate of attendance.

Cost – This course is free for staff working in NIHR CLAHRC North Thames partner or 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 to by 5pm, Friday 5th October 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 4th December 2018.

Free award-winning workshops for clinical academic researchers on patient and public involvement in research

Our partners at the NIHR University College London Hospitals Biomedical Research Centre (BRC) are offering a series of free workshops for researchers who want to develop skills in patient and public involvement (PPI) in research.

The workshops, supported by the Wellcome Trust and open to researchers working in UCLPartners partnership organisations, are practical and the aim is to build up researchers’ skills in effectively involving lay people in the research process, from setting research priorities to designing protocols.


Beginners only

  • Introduction to PPI – Get started with the theory of PPI and lots of practical ideas. Read more
  • How to fill in the PPI section of a grant form – What do funders expect when they ask you about PPI? How can you use this to make your research better? Read more

Beginners and experienced

  • Finders keepers? – How to access and sustain patients and the public for involvement in research. Read more.
  • Facilitation skills for PPI – For researchers who want to run one-off discussions with groups of patients and the public. Read more

Experienced only

  • Meaningful PPI? How was it for you? – Your opportunity to reflect on what you’ve done so far, celebrate what has gone well and plan to address some of the challenges. Read more


Tuesday 25 September

14.00–16.00: Intro to PPI: what can PPI do for you

This session is for anyone new to PPI. Learn what patient and public involvement is all about, and how it can help your research. Pick up some of the basics of incorporating patient involvement into your work.

Friday 28 September

9.30–11.30: Getting stuck into PPI: focus groups and more

This session is for anyone who understand the role of PPI, and wants to put their learning into practice. The session examines PPI methods in more depth, with looking particularly at how to run a PPI focus group.

Tuesday 9 October

13.00: How to fill in the PPI section of grant form

This session is for anyone struggling to work PPI into their funding applications. Learn what funders are looking for, and at what stage of applying for funding you should be seeking patient input.

14.00–16.00: Facilitation: how to get the most our of your PPI activities

This session is for anyone looking to run workshops of focus groups. Learn how to get the most out of your meetings.

Monday 12 November

11.00–13.00: How to find patient partners, and keep them involved

This session is for anyone looking to involve patients in their research. Learn where to go to find people who will get involved, and how to help them remain engaged.

Thursday 13 November

12.00–14.00: Building relationships: how to work with patients and the public

This session is for people who are ready to run PPI activities. Learn how to work sensitively with patients and the wider public, including language barriers and making PPI accessible

14.30–16.30: Intro to PPI: what can PPI do for you?

This session is for anyone new to PPI. Learn what patient and public involvement is all about, and how it can help your research. Pick up some of the basics of incorporating patient involvement into your work.


 To book a place please see the schedule below and contact the PPI Helpdesk stating:

  • name of workshop
  • date of workshop
  • your name
  • job title and organisation

A maximum of two courses can be booked per person. There is no charge for attending a course, however ULCH BRC  reserve the right to charge a £50 non-attendance fee if you fail to inform them 24 hours before the workshop that you won’t be attending.

Due to the limited spaces available for our PPI workshops, there will be an attendance fee for staff not based at UCL or one of our UCLPartners organisations.

NIHR CLAHRC Career Development Conference

Developing your career in applied health and care research – challenges and opportunities

Thursday 4 October 2018 from 09.00 to 17.00
Senate House, University of London, Malet Street, Bloomsbury, London WC1E 7HU

Early career researchers (ECRs) face many challenges as they set out on their journey into health and social care research, and must prepare to face an increasingly competitive academic environment in which to pursue their interests and passions.

As part of their programme of support the three London CLAHRCs (Northwest London, North Thames and South London) have come together to deliver a career development conference for early career researchers across the whole CLAHRC community on 4th October at Senate House London.

The one-day conference, delivered in conjunction with the NIHR Trainees Coordinating Centre, will be a mix of plenary sessions, skills workshops, delegate presentations and careers clinics. It’s a great opportunity for ECRs to connect and learn about further career development.

As well as senior researchers from across the capital we’re delighted to welcome key note speakers Dr Louise Wood, Director of Science, Research & Evidence at the Department of Health and Social Care (below left) and Professor Dave Jones, NIHR Dean of Faculty Trainees. Both will share knowledge and guidance arising from their roles in creating the next generation of health researchers

It’s a timely gathering, with the launch of the NIHR Academy set for late October 2018 (following a strategic review of training within NIHR) and the arrival of the successor to CLAHRCs, Applied Research Collaborations, or ARCs in 2019.

Places will be allocated on a first come first served basis so early registration is advised.

Registration for the event is now open at