Category: News and Events

Introduction to Economic Evaluation – 31st October 2018

Posted on by CLAHRC

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

Do you want to assess the outcomes and sustainability of a new service?

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

 

This one day, hands-on workshop aims to provide an introduction to addressing these challenges.  It is run buy the NIHR CLAHRC North Thames Academy.  The course is aimed at staff in frontline services in the NHS and local governement, who have limited experience of conducting economic evaluations and decision making analysis.

After attending this course, you will have the skills and knowledge to undertake your own simple economic evaluation of a local intervention or service, and be able to appraise other evaluations.

The course will cover:

  • introduce the basic principles of economic evaluation methods

  • explain how to assess the costs of an intervention/service

  • explain how to measure and value outcomes of an intervention/service

  • give practical examples of economic evaluation analysis

  • help to understand how to use economic evaluation in decision making

  • offer the opportunity to discuss in small groups the economic evaluation you are doing or thinking of doing.  A facilitator will help scope  your economic evaluation, draft its core elements, identify the data you will need to use, think how you could overcome information or data gaps

This worksop is suitable for staff from NHS Trusts, Local Authorities and CCGs who need to evaluate local programmes or service from an economic perspective as part of their work.  It is not aimed at academics and/or researchers.

In order to be most beneficial for the participants, we invite applications from individuals who are carrying out or soon will need to carry out an economic evaluation of a service/intervention.  In the selection process, we will give priority to applications providing a detailed description of such projects.  Groups of people working on the same project are encouraged to apply.

No previous knowledge of economics is required (or experience of study design and statistics), however an interest in economics and being comfortable with numbers is desirable.

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 to clahrc.academy@ucl.ac.uk by 5pm, Friday 31st 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, Wednesday 24th October 2018.

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

 

Pulse checks in over 65s sees major improvements in the detection of atrial fibrillation

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New CLAHRC research highlights a simple intervention that could improve detection of atrial fibrillation (AF) – a potentially dangerous heart condition affecting a million people in the UK and associated with 1 in 8 strokes (1 in 3 strokes among those aged over 80 years).

East London GP and CLAHRC researcher Dr John Robson led an investigation into the impact of regular pulse checks in general practice on AF detection among patients aged 65 and over. This work, published in the British Journal of General Practice, offers evidence that these checks – a cheap and straightforward intervention – rapidly improved the detection and prevalence of AF, meaning quicker access to treatment and reduced risk of stoke for those diagnosed.

The condition causes an irregular and often abnormally fast heart rate and is a leading cause of stroke – with strokes caused by underlying AF twice as likely to be fatal. AF is common in older people, but often shows no symptoms – meaning earlier detection and access to treatment means reduced risk of stroke and the health problems stroke victims have to live with afterwards.

Dr Robson and his team checked historical GP records to investigate the impact of a programme promoting pulse regularity checks across three groups of East London GP practices (or Clinical Commissioning Groups) –  City and Hackney, Newham, and Tower Hamlets.

An analysis of electronic primary care patient records before (2007–2012) and after (2012–2017) checks were introduced showed significant increases in AF detection.

Br J Gen Pract. 2018 Jun;68(671):e388-e393. doi: 10.3399/bjgp18X696605
Opportunistic pulse checks in primary care to improve recognition of atrial fibrillation: a retrospective analysis of electronic patient records.
Cole J, Torabi P, Dostal I, Homer K, Robson J

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

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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

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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

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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

Posted on by CLAHRC

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 is 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

Posted on by CLAHRC

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

Posted on by CLAHRC

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.

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

Posted on by CLAHRC

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

Improving how professionals can identify and support children experiencing domestic violence

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New CLAHRC research has highlighted a lack of guidance for health and social professionals who encounter children exposed to domestic violence.

Around one in five children in the UK have been exposed to domestic violence or abuse between their parents or caregivers. Children can be directly impacted – leading to emotional and behavioural problems and risks of physical injury and death when children are caught up in the violence between adults.  Even when not directly involved, children’s exposure continues through witnessing and being aware of the violence – and through its health, social and financial consequences. Health and social care workers are often the first professionals to have contact with a child experiencing these situations.


In a collaboration with CLAHRC East of England and international colleagues from the McMaster and Western Universities in Canada we examined the evidence on child, parent and professional views on acceptable approaches to identifying and responding to children exposed to domestic violence.

The resulting research paper, published in BMJ Open, highlighted conflicting views of children and mothers on the one hand and professionals on the other when it came an ideal response. Children and mothers wanted professionals to talk to children directly and engage them in safety planning. Professionals preferred to engage with children via the parent and they often did not perceive children exposed to domestic violence as patients or clients in their own right.

Guidelines for health professionals who encounter women who have experienced domestic violence provide various questions and prompts they can use in discussions, and a set of principles to follow. There are no equivalent recommendations on how to identify and respond to children exposed to domestic violence and limited evidence on which to base future guidance. Our analysis also revealed that professionals were not happy with the existing safety guidelines for children and mothers exposed to domestic violence and wanted changes.

The research was funded by the Public Health Agency of Canada through funding to the VEGA (Violence, Evidence, Guidance and Action) project. The VEGA Project is part of the Canadian Government’s Public Health Response to Family Violence. This research will inform the development of public health guidance, protocols, curricula and tools for health and social service providers. The research was supported by the NIHR CLAHRC North Thames and NIHR CLAHRC East of England.

Resources supporting this new research include a blog in The Conversation by lead researcher Dr Natalia Lewis, and we have worked with CLAHRC East of England on a joint BITE – a summary of the research with key learning for busy professionals interested in this work.

Read the paper

Natalia V. Lewis, Gene S. Feder, Emma Howarth, Eszter Szilassy, Jill R. McTavish, Harriet L. MacMillan, Nadine Wathen.

Identification and initial response to children’s exposure to intimate partner violence: a qualitative synthesis of the perspectives of children, mothers and professionals.

BMJ Open 2018. Published in BMJ Open. April 2018. Doi:. http://bmjopen.bmj.com/content/8/4/e019761

Read a BITE sized summary

How should health and social care professionals identify and respond to children experiencing domestic violence?