Let’s Talk...

Supported by

NHS R&D NORTH WESTAnnual Conference 2014

Let’s Talk Research24th & 25th September – Bolton Whites Hotel, Bolton

Health Education EnglandDeveloping people for health and healthcare

HEE exists for one reason: to improve the quality of care delivered to patients. We ensure that our workforce has the right skills, values and behaviours, in the right numbers, at the right time and in the right place.

www.hee.nhs.uk

www.facebook.com/nhshee

@NHS_HealthEdEng

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Thank you for sparing the time to attend our conference. ‘Let’s Talk Research’ is the first time we have brought researchers together across the North West since the NIHR held regional events back in 2009. We thought it would be really important to create an opportunity to showcase research and also work with our partners across the region to provide opportunities to learn about tools and techniques for researchers.

I hope you will agree that the programme of events over the two days gives you a unique opportunity to see: Keynote Speakers talking about key research issues; a choice of 20 workshops which feature primary research; and a host of topics which are of relevance to researchers.

We begin the conference with Simon Denegri talking about the important role played by patients and the public in research. We have an exciting opportunity to hear Professor Margaret Whitehead talking about a major new report of the Public Inquiry commissioned by Public Health England. Professor Ged Byrne will be talking to us about the national strategy for research and innovation being developed by Health Education England. The conference closes with a keynote from Clare Matterson who will tell us about the

importance of engagement for the Wellcome Trust, one of the major funders of research in this country and throughout the world.

‘Let’s Talk Research’ is an opportunity for us to come together as a community focused on healthcare research – a space to share ideas and spend time talking about research. Over this couple of days there will be the chance to meet others with similar interests and devote time to research.

We have been really lucky to have the support of a steering group for the conference which included early career researchers. Their hard work under the leadership of Dr Lynne Goodacre is very much appreciated.

Dr Stuart Eglin Director NHS R&D North West

Welcome

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Wednesday 24th September 2pm – Platinum SuiteSimon Denegri

NIHR National Director Public Participation & Engagement in Research

Chair, INVOLVE

‘ Let’s talk patients and the public in research’

Simon Denegri is Chair of INVOLVE – the national advisory group for the promotion and support of public involvement in research funded by the National Institute for Health Research (NIHR) – and NIHR’s National Director for Public Participation and Engagement in Research. He was Chief Executive of the Association of Medical Research Charities (AMRC) from 2006 until 2011 and, prior to this, Director of Corporate Communications at the Royal College of Physicians from 2003. He also worked in corporate communications for Procter & Gamble in the United States from 1997 to 2000. He has a long-standing personal and professional interest in the needs and priorities of people with dementia and their carers and currently chairs the Lay Champions Group for the national portal on dementia research that is to be launched this year. He is a member of the NIHR Advisory and Strategy Boards, is INVOLVE’s representative on the UK Clinical Research Collaboration (UKCRC) Board. He blogs about the public and health research at http://simon.denegri.com and publishes his poetry at http://otherwiseknownasdotcom.wordpress.com.

This talk will look at the key role of patients, carers and the public in making research of public benefit happen. It will look at what we have achieved in public involvement in research over the last two decades, why it is increasingly important, and what the future holds for the public, researchers, health professionals and NHS staff working closer together.

Thursday 25th September 9.15am – Platinum SuiteProfessor Margaret Whitehead

W.H. Duncan Chair of Public Health at the University of Liverpool

Head of WHO Collaboration Centre for Policy Research on the Social Detriments of Health

‘ Heading Due North: promoting health equity from evidence to action’

Professor Margaret Whitehead holds the W.H. Duncan Chair of Public Health at the University of Liverpool, where she is also Head of the Department of Public Health and Policy. Her group is developing ways of assessing the health inequalities impact of complex social interventions and natural policy experiments to address the social determinants of health. She is currently the Chair of the independent Inquiry into Health Equity in the North, set up by PHE, which is due to report in September 2014.

Outline: The talk will cover why and how we need to tackle the ‘inverse evidence law’ and how the results can be used to inform policy to promote health equity. It illustrates the key points by drawing on the “Due North” report of the Independent Inquiry into Health Equity for the North, fresh off the press on 15th September 2014.

Keynote Speakers

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Thursday 25th September 1.30pm – Platinum SuiteProfessor Ged Byrne

Director of Education & Quality, Health Education North West

‘ Creating a research active workforce: a national perspective’

Professor Ged Byrne is a surgeon by profession. Having graduated in Manchester in 1989, he trained in Manchester, Scotland, India and the West Midlands returning to Manchester as a clinical lecturer in 1997. Having been appointed a senior lecturer and consultant in 2000, he was appointed Hospital Dean in South Manchester in 2004. Ged founded the Universities’ Medical Assessment Partnership in 2003 and became the founder director of the Medical Schools’ Council Assessment Alliance. Ged also led the establishment of the University Hospital of South Manchester Academy in 2009. In 2010 he became professor of medical education at the University of Manchester (UoM) and was awarded a National Teaching Fellowship by the Higher Education Academy. In 2012 Ged became Associate Dean for Communications at the Faculty of Medical and Human Sciences at UoM and an honorary Professor of Health Sciences at The University of Salford.

Health Education England (HEE) exists for one purpose only: to deliver a better health and healthcare workforce for England, through the education, training and personal development of every member of staff and recruiting for values. We have a statutory duty to promote research and want to be an evidence-informed organisation. We also firmly believe that innovation is vital to allow health services to meet the challenges of the future. Only by working with our system partners can we ‘develop a more flexible workforce that is able to respond to the changing patterns of service and embraces research and innovation to enable it to adapt to the changing demands of public health, healthcare and care services.’ We have agreed some shared key principles with NHS England and Public Health England (PHE) that support the aims and objectives in our separate Research & Innovation Strategies. Via our Clinical Academic Careers Stakeholder Group, we have also incorporated the views of the Chief Professional Officers, NIHR, the Council of Deans and the Department of Health. HEE’s draft Research and Innovation Strategy has four objectives which we would like to explain in more detail as to how we plan to create a research active workforce.

Thursday 25th September 3.45pm – Platinum SuiteClare Matterson

Director of Culture & Society, Wellcome Trust

‘ Why engagement matters a view from the Wellcome Trust’

Clare Matterson is Director of Culture & Society at the Wellcome Trust. She leads the Trust’s work to weave science into the fabric of society and to explore the place of medicine and health in culture – past, present and future. Clare’s portfolio includes communications, education, grant funding across the humanities, social sciences and public engagement, along with the Wellcome Library and Wellcome Collection, the free destination for the incurably curious. Clare led the Wellcome Trust’s initiative to create the National Science Learning Centre – a major initiative with the UK Government to drive improvement in science education.

Clare joined the Trust in 1999 as Head of Policy, and produced the Trust’s first Strategic Plan. Prior to her time at the Trust, Clare worked as a Management Consultant with Pricewaterhouse Coopers (PwC) advising universities, government departments and funding councils in the UK and overseas. She was a Senior Policy Adviser to the 1999 National Committee of Enquiry into Higher Education and has also worked for the Higher Education Funding Council and the Higher Education Quality Council. She spent two years at the State University of New York, following receipt of a Fulbright Fellowship, and has a degree in Zoology from Oxford University.

The Wellcome Trust spends around £750 million each year to improve human and animal health. As part of this work, the Trust communicates, engages and educates different public audiences on medical research and the public experiences of health and illness. This talk will explore the policy context of these activities, the differing modes of engagement and consider whether any of it makes a difference.

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Quick view programmeWednesday 24th September

1.00pm Registration and coffee

2.00pm Welcome

Dr Stuart Eglin, Director NHS R&D North West

Plenary: ‘Let’s talk patients and the public in research’

Simon Denegri, NIHR National Director Public Participation & Engagement in Research. Chair, INVOLVE

Location Wanderer’s Suite Macron Suite Platinum Suite Chairman’s Suite

2.45pm Creative approaches to communicating research (1)

Developing Cultures of Research & Innovation Paper presentations (2)

Plugging into the Power in our Pockets. Making the most of mobile and social media (3)

NIHR research funding, the Research Design Service and you (4)

3.45pm Refreshments and poster viewing

4.00pm Reaching out to communities – promoting equal access to opportunities for public involvement in research (5)

Primary Research Papers (6) Plugging into the Power in our Pockets. Making the most of mobile and social media (7)

Primary Research Papers (8)

5.00pm Close

Thursday 25th September8.30am Registration and coffee

9.15am Plenary: Heading Due North: promoting health equity from evidence to action

Professor Margaret Whitehead

W.H. Duncan, Chair of Public Health at the University of Liverpool & Head of WHO Collaboration Centre for Policy Research on the Social Determinants of Health


10.00am NIHR Administered Personal Research Training Award (9)


Health Research: promote it, use it, do it (11)

How are AHSNs good for business, academia & the NHS? (12)

11.00am Refreshments and poster viewing

11.30am Putting the ‘net’ in research networks (13)

Primary research papers (14) Engaging with the work of GM & NWC CLAHRCs (15)

How to get out of the way to let research and innovation happen (16)

12.30pm Lunch and poster viewing

1.30pm Plenary: “Creating a research active workforce: a national perspective”

Professor Ged Byrne, Director of Education & Quality, Health Education North West


2.30pm Leading without authority (17)


Introduction to Evidence Synthesis (19)

Primary research papers (20)

3.30pm Refreshments

3.45pm Plenary: “Why engagement matters a view from the Wellcome Trust”

Clare Matterson, Director of Culture & Society, Wellcome Trust

4.30pm Close of Conference

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WorkshopsWednesday 24th September – 2.45pmTitle of workshop 1: Creative approaches to communicating research

Room Allocation / Session Chair: Wanderer’s Suite

Name of workshop Lead: Gillian Southgate

Affiliation: NHS R&D North West

Brief overview of content: This is a short introduction of how to use different creative media such as film, comedy, art, animation, comic strip and poetry to communicate key research messages to a wider audience than currently reached through peer reviewed journals. The first half will introduce different creative ideas and the second half will involve story boarding a short message and thinking about how best to communicate this.

Title of workshop 2: Oral Presentations

Room Allocation / Session Chair: Macron Suite / Lynne Goodacre

Dr Sally Giles & Carolyn Gamble “Doing PPI at scale”: What is the impact of public involvement in the NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre? Interim findings of a formative evaluation.

Jane Rogan Facilitating tissue collection for translational research

Dr Zoe Stamataki Creating a new NHS Landscape: NHS and industry integration

Title of workshop 3: Plugging into the Power in our Pockets

Room Allocation / Session Chair: Platinum Suite

Name of workshop Lead: Kevin Wyke

Affiliation: Director, Leap Further

Brief overview of content: This workshop will give delegates an opportunity to explore the use of mobile devices and social media tools as a support to their work, helping them to connect, collaborate, capture and comment and rapidly get delegates using the mobile devices they have with them to share and learn from their experience at the conference.

The session will be hands on and interactive and will introduce the key tools that are available on our own devices to record, note, capture, connect and comment on what is happening around us. It will include blogging, micro blogging, photography, video and will support delegates to get set up and become familiar with the platforms they want to use

Title of workshop 4: NIHR research funding, the Research Design Service and you

Room Allocation / Session Chair: Chairman’s Suite

Name of workshop Lead: Professor Chris Hatton

Affiliation: NIHR RDS North West and Lancaster University

Brief overview of content: This workshop will briefly go through the major NIHR research funding streams, outline how the NIHR Research Design Service can help, and discuss your ideas.

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Wednesday 24th September – 4.00pmTitle of workshop 5: Reaching out to communities – promoting equal access to opportunities for public

involvement in research


Name of workshop Lead: Sue Wood / Philip Bell

Affiliation: North West People in Research Forum

Brief overview of content: Whilst the extent of public involvement in research has grown, there is concern that the people getting involved with research do not always reflect the diversity of the population. The challenge for researchers and organisations is that involving a diverse range of people in a meaningful way means doing things differently.

The workshop facilitated by the North West People in Research Forum will provide an opportunity to discuss some key questions around how we promote equal opportunities for public involvement:

• Why do we need to involve a more diverse population?

• What are the barriers which reduce or prevent access to opportunities for involvement?

• How do we overcome these barriers?

• How do we involve those that find it more difficult to have their voice heard?


Room Allocation / Session Chair: Macron Suite / Jane Martindale

Ian Hepworth Preventing avoidable mental health hospital inpatient admissions: a qualitative study using the think-aloud method.

Paula Bennett Does a Computerised Clinical Decision Support System (eTriage) Improve Quality & Safety in the Emergency Department. A Quantitative Research Study

Martin Troedel Negotiated Work Based Learning: pedagogy to up-skill Advanced Practice Physiotherapists to enhance patient journey and experience in the Emergency Department

Title of workshop 7: Plugging into the Power in our Pockets


Name of workshop Lead: Kevin Wyke

Affiliation: Director, Leap Further

Brief overview of content: This workshop will give delegates an opportunity to explore the use of mobile devices and social media tools as a support to their work, helping them to connect, collaborate, capture and comment and rapidly get delegates using the mobile devices they have with them to share and learn from their experience at the conference.

The session will be hands on and interactive and will introduce the key tools that are available on our own devices to record, note, capture, connect and comment on what is happening around us. It will include blogging, micro blogging, photography, video and will support delegates to get set up and become familiar with the platforms they want to use.


Room Allocation / Session Chair: Chairman’s Suite / Gillian Southgate

Dr Heather Iles-Smith The experiences of ST-elevation myocardial infarction (STEMI) patients who are readmitted within 6 months of primary percutaneous coronary intervention (PPCI)

Christine Mars SACRED: A nurse-led evaluation of allergic reactions following radial access

Sophie Faulkner Let’s bring sleep out of dark: A focus group study exploring the role of the occupational therapist in relation to sleep problems

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Thursday 25th September – 10.00amTitle of workshop 9: NIHR Administered Personal Research Training Award


Name of workshop Lead: Dr Mal Palin

Affiliation: NIHR Trainees Coordinating Centre

Brief overview of content: The NIHR Trainees Coordinating Centre manages a wide range of personal funding opportunities which, together, afford complete career pathways for the aspiring and developing research leaders of the future. This session will review these opportunities, provide hints and tips on how to make the most of them, and present the experiences of an existing award holder.


Room Allocation / Session Chair: Macron Suite / Gillian Southgate

Jo Gibson Creating a Culture of Research: The Role of the Physiotherapy Fellow

Tina Robinson Encouraging a culture of enquiry and research within a radiotherapy team

Dr Julie Nightingale & Rita Borgen The role of a clinical-academic collaboration in inspiring a research culture within a breast screening unit

Title of workshop 11: Health Research: promote it, use it, do it


Name of workshop Lead: Lynne Goodacre

Affiliation: NHS R&D North West

Brief overview of content: Have you ever experienced a glazed look coming over the eyes of colleagues when you start talking about research? What does this tell us about the ways in which research is perceived and talked about currently within practice? This interactive workshop will explore how we can create a more positive, holistic narrative about the role of research in practice which engages people in promoting, using and doing research.

Title of workshop 12: How are AHSNs good for business, academia and the NHS? Case Studies and developing engagement with research and development


Name of workshop Lead: Dr Julia Reynolds

Affiliation: Programme Manager, North West Coast Academic Health Science Network

Brief overview of content: The workshop will cover an introduction to the scope and priorities of the AHSN including some key ongoing and emerging areas. The North West Coast AHSN leads on Digital Health, Infectious Diseases, Personalised Medicine and Neurological Health.

The aim of the workshop is to explore how key stakeholders (University, NHS and business) are beginning to work with the AHSN and to look at how the approach to working is good for the core business of partner organisations.

Case Studies will be presented:

• Red Ninja will highlight a SME perspective.

• University perspective

• NHS Trust perspective

We will open up the discussion to consider how the AHSNs can work with our region to amplify our core business and respond to unmet need in the NHS to improve outcomes for patients in a cost effective way, harnessing new and existing technologies. We would like to debate how we develop our approach and continue to respond to the needs of health and social care. We would welcome attendees to join in this debate.

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Thursday 25th September – 11.30amTitle of workshop 13: Putting the ‘net’ in research networks: using web resources to stay informed


Name of workshop Lead: Michelle Maden

Affiliation: Clinical Information Specialist

Brief overview of content: This workshop will introduce the research network ‘webscape’ and explore the challenges in knowing ‘what is out there’ in terms of research networks and support. The workshop will benefit early career researchers, anyone in the planning stages of research (e.g. looking for funding or research projects) and above all researchers who want to connect with research networks in their field in order to stay ahead of the game.


Room Allocation / Session Chair: Macron Suite / Alison Cooke

Clare Mercer A 6 year study of mammographic compression force: practitioner variability within and between screening sites

Thabiso Nyati Health-seeking among community based male offenders

Jane Martindale Experiences of older people living with AS

Title of workshop 15: Engaging with the work of North West Coast and Greater Manchester Collaborations for Leadership in Applied Health Research and Care


Name of workshop Lead: Professor Mark Gabbay1 and Sue Wood2

Affiliation: Director of NIHR CLAHRC NWC1 and Operations & Project Manager CLAHRC GM2

Brief overview of content: This workshop will provide an overview of the work of the two CLAHRCs within the NW and provide an opportunity for delegates to explore how they can engage with their work.

Title of workshop 16: How to get out of the way to let research and innovation happen


Name of workshop Lead: Dr Will Medd

Affiliation: Certified Coach and NHS R&D North West Associate

Brief overview of content: One barrier to research & innovation is people themselves – including self-doubt, lack of confidence, loss of motivation and a challenging work-life balance. And that’s just the supervisors! Add those barriers to the researchers themselves and it’s no wonder they can experience a world of anxiety. So, how can we unleash the potential of researchers? This workshop will introduce the role of coaching, describe the experience of working with researchers through a coaching framework, and invite you to explore your role in enabling researchers, and their supervisors, to be at their best.

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Thursday 25th September – 2.30pmTitle of workshop 17: Leading without authority – essential ingredients for today’s NHS leader


Name of workshop Lead: Deborah Arnot

Affiliation: NHS North West Leadership Academy

Brief overview of content: What are the essential ingredients required for leaders to operate in the current and evolving health and social care landscape, leading cross sector without authority; how do these enable research leaders to create a culture of innovation and research.


Room Allocation / Session Chair: Macron Suite / Gillian Southgate

Gail Woodburn Maximising the potential of the clinical research nurse workforce in order to promote research and innovation

Carol Doyle Enhancing musculoskeletal research in primary care: engaging a community musculoskeletal physiotherapy service in research studies

Dr Janet Suckley Developing Nursing, Midwifery and allied healthcare professional research capacity in an NHS Trust: The experience of a post-doctoral group

Title of workshop 19: Introduction to Evidence Synthesis


Name of workshop Lead: Professor Rumona Dickson

Affiliation: Liverpool Reviews and Implementation Group (LRiG) and the CLAHRC NWC

Brief overview of content: The use of evidence in practice is considered to be mandatory for all health care professionals. However, the question then becomes what evidence? Linked to this, is what situation are we in and what evidence do we need to find to help us decide how to deliver care in our clinical practice? This is a working workshop. We will begin with an overview of evidence synthesis but the majority of the time will be spent refining questions that participants want to answer, questions that are related to their own clinical practice. We will then explore different ways to identify and assess the evidence that we need. The workshop will also include information detailing how teams of health care professionals might access support for addressing their clinical review questions through the CPD programme of the CLAHRC NWC.


Room Allocation / Session Chair: Chairman’s Suite / Angela Hancock

Joy Gana-Inatimi The Impact of Self-Management Education on Outcomes for Patients with COPD Attending Pulmonary Rehabilitation

Michaela Thompson & Paula Johnson The Experiences of Women with Learning Disabilities Undergoing the Introduction of Dialectical Behaviour Therapy (DBT)

Abstract Withdrawn

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AbstractsORAL PRESENTATIONS

Wednesday 24th September – 2.45pmWorkshop 2 – Developing Cultures of Research & Innovation

Room: Macron Suite

Title: “Doing PPI at scale”: What is the impact of public involvement in the NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre? Interim findings of a formative evaluation

Name of presenting author: Sally Giles and Carolyn Gamble

Affiliation: NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care, University of Manchester

Names of additional authors and their affiliations:

Dr Jonathan Boote and Dr Jill Thompson – University of Sheffield

Jill Stocks, Carolyn Gamble and Joanne Beresford – NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care, University of Manchester

The Greater Manchester Primary Care Patient Safety Translational Research Centre is funded by the National Institute for Health Research for five years, to undertake research to improve patient safety in primary care. Approximately 8% of its £6.5million budget is devoted to public involvement and engagement. A key element of the Centre’s approach to public involvement is its Research User Group (RUG), made up of 12 patients, carers and service users with an interest in patient safety. The RUG works in partnership with the Centre’s research themes, advising and assisting with research developments. The Centre is keen to evaluate the impact that the RUG is having, to ensure that RUG members are involved appropriately and meaningfully, and to ensure that the PPI budget is being spent wisely. As such, an evaluation of the impact of the RUG is currently underway.

In this presentation, we will present:

• The partnership between the RUG and researchers of the Centre

• The methods used in the evaluation of the partnership working

• How RUG members are actively involved in the evaluation, through their membership of the evaluation advisory group

• Some interim findings, based on interviews with key stakeholders, as well as impact feedback forms completed by both RUG members and Centre researchers.

We will provide a number of examples of the impact that RUG members are having in the specific themes and projects in the Centre, as well as discussing the challenges of undertaking meaningful public involvement within such a complex organisation.

Title: Facilitating tissue collection for translational research

Name of presenting author: Jane Rogan

Affiliation: The Christie NHS Foundation Trust


Mr Garry Ashton – Cancer Research UK Manchester Institute

Professor Noel Clarke – The Christie NHS Foundation Trust

Introduction

The key element of obtaining high quality biological specimens for translational research is having a robust infrastructure which underpins sample collection. The Manchester Cancer Research Centre Biobank was established in 2008 and has successfully grown to ensure human tissue research is facilitated within the MCRC.

Approach

Dedicated Biobank Technicians consent patients and collect samples across Greater Manchester and a flexible ethical and consent framework means that collection of samples is not limited by sample type or processing method. A Research Tissue Bank ethics approval with the ability to confer ethics to users of banked samples ensures simple and quick access for high quality research projects. The pan-Manchester model also ensures that researchers have the widest access to samples within the Manchester area and are not limited to samples from just one hospital.

Outcomes

The Biobank is used by a large number of research groups within the MCRC to facilitate their sample collection which wouldn’t be possible without the MCRC Biobank infrastructure. The successful Biobank model has been used to facilitate the CRUK Stratified Medicine Programme and sample collection for clinical trials. The Biobank ensures that the researchers drive the sample collection rather than the other way round.

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Title: Creating a New NHS Landscape: NHS and Industry Integration

Name of presenting author: Zoe Stamataki

Affiliation: The Christie NHS Foundation Trust


Gillian Heap – The Christie NHS Foundation Trust

Professor John Radford – The Christie NHS Foundation Trust/The University of Manchester

Introduction

In 2011, The Department of Health launched a 10 year strategy for UK Life Sciences to deliver an integrated healthcare economy through partnerships to accelerate healthcare innovation and better patients’ outcomes. The Christie NHS Foundation Trust presents the results of building strategic partnerships between the NHS and Pharma Industry. The paper is looking to establish new thinking on working together with industry by describing a framework that ensures common understanding, responsibility, transparency and probity in the joint working process.

Approach

The Trust appointed an Alliance Manager who acted as a single point of contact for industry, investigators and the research team. The Alliance Manager employed several strategies of successful working including: (1) Facilitating operational and strategic meetings to enable close communication and problem resolution, (2) Setting up agreements to speed up feasibility timelines and sharing of information, (3) Setting up and recording study delivery timelines and set up metrics.

Outcomes

The paper illustrates that working in collaboration with industry affects positively all organisations involved and creates a clinical research environment that benefits patients by improving national health, wealth and world-wide reputation. The data demonstrate that The Trust increased commercial partner activity as a result of the transparent and systematic way of working with industry.

Wednesday 24th September – 4.00pmWorkshop 6 – Primary Research Papers

Room: Macron Suite

Title: Does a Computerised Clinical Decision Support System (eTriage) Improve Quality and Safety in the Emergency Department. A Quantitative Research Study

Name of presenting author: Paula Bennett

Affiliation: Stockport NHS Foundation Trust. University of Salford

The aim of this paper is to describe the results of a quantitative research study which evaluates the effects of a computerised clinical decision support system (CCDSS) on Emergency Department Triage. The research explored the impact of eTriage a CCDSS on the quality and safety of the triage assessment and the subsequent effect on the whole ED patient episode.

Increasing ED attendances are currently creating extreme pressure in the unscheduled care system (Kings Fund 2013). Recruiting more staff to deal with increased demand is often not an option. A recent systematic review identified the positive impact that CDSSS can have on the process of acute care (Sahota et al 2011). To date there is little published research in the UK that evaluates the effects of CCDSSs on ED care.

This study used quasi-experimental evaluation research to assess the “before and after” impact of eTriage by adopting a time series design. 400 ED records were analysed over the course of 1 year for quality and safety markers before the introduction of eTriage. 400 records were analysed for the same markers 1 year post implementation. Data was analysed using descriptive and inferential statistics. Results demonstrate the highly statistically significant impact that eTriage had on the quality and safety of Triage decisions.

This study demonstrates the positive impact of a CCDSS on clinical decisions in ED and it increases our understanding of the contribution that CCDSS can have on providing a clinical safety net.

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Title: Preventing avoidable mental health hospital inpatient admissions: a qualitative study using the think-aloud method

Name of presenting author: Iain Hepworth

Affiliation: Greater Manchester West Mental Health NHS Foundation Trust


Linda McGowan, Professor of Applied Health Research, School of Healthcare – University of Leeds

The aim of this study was to explore how mental health liaison nurses, working in A&E departments in the North of England, manage people who seek inpatient admission but do not meet the criteria for inpatient care.

Liaison nurses assess the suitability of people presenting at A&E who request inpatient admission. However, not all presentations meet the criteria for admission (Parsonage & Fossey 2011). Little is known about how liaison nurses manage this client group.

A qualitative design was used to collect and analyse the data. A purposive sample was sought, and sampling continued until data saturation occurred (n=18). Data were collected using the ‘think aloud’ technique (Ericsson & Simon 1993) with subsequent semi-structured interviews. Participants were asked to ‘think aloud’ their response to four vignettes designed specifically for the study. Data were analysed using framework analysis (Ritchie & Spencer 1994).

This study found that liaison nurses use a range of therapeutic interventions to manage this client group. These include:

• Managing unrealistic expectations about hospital

• Promoting community treatment, particularly crisis resolution and home treatment, as superior options to inpatient treatment.

Other findings include

• Liaison nurses receive limited training in this area.

• Reduced bed availability does not affect the decision to admit, but may impede the effectiveness of the liaison service.

• Liaison nurses believe that avoidable admissions that are admitted have poor outcomes.

Conclusions

The liaison nurses promote home treatment as superior to inpatient admission. However, existing evidence base relating to the efficacy of home treatment does not support this. Specific training may increase the effectiveness of the mental health liaison service.

Title: Negotiated Work Based Learning: pedagogy to up skill Advanced Practice Physiotherapists to enhance patient journey and experience in the Emergency Department

Name of presenting author: Martin Troedel

Affiliation: The Royal Liverpool and Broadgreen University NHS Trust


Julie Walton, Senior Lecturer, Head of Directorate of Postgraduate Studies, School of Health Sciences – The University of Liverpool

Dr Lawrence Jaffey, Consultant Emergency Physician, Emergency Department; Badri Narayan, Orthopaedic Consultant, Trauma and Orthopaedics; Fiona Cowell, Extended Scope Practitioner, Trauma Clinics – The Royal Liverpool and Broadgreen University NHS Trust

Introduction

Negotiated Work Based Learning (NWBL) (Boud, 2001) allows the development of bespoke Masters Level modules for the Advanced Practitioner Physiotherapist (APP). A partnership arrangement between the APP, the hospital and the university provides an effective environment for NWBL. This pedagogy merges and translates educational theory into clinical practice. The APP developed modules to interpret radiographs and overall management of low energy foot and ankle trauma (LEFAT) in the Emergency Department (ED). Evaluation of the NWBL pedagogic model and its success in up skilling an APP to enhance the patient journey in the ED is described.

Methods

A mixed methods research approach consisting of prospective clinical audit, prospective structured patient experience questionnaire (PEQ) and retrospective data were undertaken over a 4 week period in an inner city ED. Local ethical approval was granted and data was collected and analysed by an APP and the Audit Department.

Results

PEQ respondents reported 100% satisfaction with the level of privacy and dignity maintained by the APP; during consultation, examination and treatment, and that all their care needs were met. Prospective data indicated the average time patients spent in the ED was 109 minutes, well below the four hour target for ED attendances (Taylor, 2011).

Conclusions

A very high level of service delivery and patient satisfaction with the APP role in the ED is evident (Francis, 2013). NWBL is an effective pedagogy to up skill APPs and satisfies organisational needs in developing new roles, and has a positive impact on the patient journey and experience in the ED.

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Wednesday 24th September – 4.00pmWorkshop 8 – Primary Research Papers

Room: Chairman’s Suite

Title: The experiences of ST-elevation myocardial infarction (STEMI) patients who are readmitted within 6 months of primary percutaneous coronary intervention (PPCI) treatment

Name of presenting author: Heather Iles-Smith

Affiliation: Lancashire Care NHS Foundation Trust


Professor C. Deaton – University of Cambridge

Dr Malcolm Campbell – University of Manchester

Professor L. McGowan – University of Leeds

Purpose

The purpose of the study was to explore, in detail, the experiences of PPCI patients readmitted due to potential Ischaemic Heart Disease (p-IHD) symptoms within 6 months of STEMI.

Methods

Participants were purposefully selected in a qualitative study. Semi-structured, in-depth interviews were conducted on one occasion 6 to 12 months following PPCI, with sampling, data collection and data analysis being conducted concurrently. Data were organised using Framework analysis (Ritchie et al., 2003) and constant comparative analysis (Corbin and Strauss, 2008) based on initially deduction and subsequently induction was used to identify cogent themes.

Results

25 participants (14 men, 27-79 years) were interviewed. Participants experienced between one and four readmissions during the 6 month time period. Final discharge diagnoses included, cardiac, psychological problem, indeterminate, pulmonary and gastric. Four main themes (and subthemes) emerged from the data 1) Fear of experiencing a further STEMI, 2) Uncertainty and inability to determine cause of symptoms, 3) Insufficient opportunity to validate self-construction of illness, 4) Difficulty adapting to life after an STEMI.

Conclusion

Factors such as shock at experiencing a STEMI, hypervigilance of symptoms and difficulty with symptom attribution all appear to play a role in that patients decision to seek help when they experienced p-IHD symptoms. Participants also reported adopting self diagnosis and self treatment prior to calling for medical assistance. Findings suggest that changes are needed to cardiac rehabilitation, additional education and post STEMI follow-up to address gaps in information needs and to identify and manage psychological distress.

Title: SACRED: A nurse-led evaluation of allergic reactions following radial access

Name of presenting author: Christine Mars

Affiliation: Liverpool Heart and Chest Hospital NHS Foundation Trust


Carla Livesey, Ian Kemp and Rod Stables – Liverpool Heart and Chest Hospital NHS Foundation Trust

Background

Radial artery access for cardiac catheterisation is associated with reduced procedural costs, reduced access-site related bleeding and patient preference (Rao, 2010). Radial artery spasm and occlusion are common complications. Radial artery spasm can be uncomfortable and negatively impact upon procedural success and completion. Introducer sheaths with hydrophilic coating can reduce the incidence of spasm (Rathore, 2010). Delayed cutaneous inflammatory reactions have been associated with coated sheaths (Kozak, 2003).

Aim

SACRED is a single-centre registry study aiming to examine the safety and efficacy of the Cook Flexor® Radial Introducer Sheath Set. The primary outcome measure is the incidence of cutaneous granuloma at 28 days. Secondary outcome measures are procedural success rate, radial-related intra-arterial vasodilator use and access site complications during admission.

Methodology

Consecutive patients were screened. Patients unable or unwilling for follow up or with previous ipsilateral procedures were excluded. Over 54 days, 432 patients were recruited. Follow-up was at 28 days.

Results

Failure to access the intended radial artery occurred in 19 / 446 attempts (4.3%). This was against the predominant non-use of intra-arterial vasodilators (83.8%). Access site complications were observed in 33 / 446 (7.4%) with local haematoma being the most frequent (25 / 33 :75.8%). No patients required surgical review or blood transfusion for vascular complications. Radial artery occlusion was detected in 15 / 412 sites (3.6%, 95% CI 1.83-5.44%). Successful follow-up was achieved for 429 sites with the study sheath. A single incidence of delayed inflammatory reaction was observed (0.23%, 95% confidence interval (CI) 0 – 0.68%).

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Title: Let’s bring sleep out of the dark: A focus group study exploring the role of the occupational therapist in relation to sleep problems

Name of presenting author: Sophie Faulkner

Affiliation: Manchester Mental Health and Social Care Trust, University of Manchester


Dr Hilary Mairs – University of Manchester

Introduction

Adequate sleep is necessary for optimal occupational performance, and sleep problems affect a person’s health, functioning and quality of life (Strine & Chapman 2005). As some sleep problems are relatively common (Morin & Benca 2012) they are encountered by occupational therapists in various practice settings. However the contribution occupational therapists can make has not yet been fully defined, and the evidence base is also somewhat limited for other frontline healthcare workers (Hellstrom et al 2011).

Method

This paper reports upon a focus group study designed to elicit the views of occupational therapists working in mental health settings (where sleep disturbances are particularly prevalent) regarding their role in relation to sleep problems. Thematic analysis using a constant comparative approach was used to capture key themes.

Findings

Occupational therapists identified sleep as a significant and persistent occupational problem for many of their clients, and acknowledged that sleep was often overlooked, by clients, their relatives, and the multi-disciplinary team; including occupational therapists. Although they identified and evaluated some approaches to addressing sleep needs, they were uncertain regarding optimal practice. They identified some barriers to addressing sleep, but also some possible strategies for development.

Conclusion

Sleep is a valid and relevant area of concern for occupational therapists and other healthcare workers. Given the findings of this study and the paucity of literature there is an urgent need to design and evaluate assessments and interventions to address sleep problems in mental health and in other settings.

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Thursday 25th September – 10.00amWorkshop 10 – Developing Cultures of Research & Innovation

Room: Macron Suite

Title: Encouraging a culture of enquiry and research within a radiotherapy team

Name of presenting author: Christina Robinson

Affiliation: Rosemere Cancer Centre, Lancashire Teaching Hospitals NHS Foundation Trust

The NHS aspires to the highest standards of excellence and professionalism and commits to using innovation and research as vehicles to improve care. The Society and College of Radiographers have put the spotlight on fostering research culture within radiographers to ensure that research is embedded into radiotherapy practice. Recruitment into NIHR portfolio trials continues to increase3 but the challenge is the timely translation into routine NHS practice and care to benefit service users nationwide and inspire innovation amongst clinical teams.

In June 2013, the Rosemere Cancer Centre (RCC) Radiotherapy department set out to evaluate their research capability and capacity.

The ‘research champions’ initiative was conceived by the RCC Research radiographer, and developed in partnership with the Radiotherapy Service Manager and Practice Educator. Continuous improvement principles were employed.

Clinical research tasks and research enrichment opportunities were assigned via a central platform (MOSAIQ Oncology Management System, IMPAC Medical Systems). Research champions selected opportunities relevant to their current practice or area of interest. Mentorship from an experienced researcher supported the development of key research skills.

This initiative was open to staff of all levels of experience. Early indicators prove that a wider range of clinical staff are undertaking research, becoming involved in trial set up and attending research networking events.

We will present reflections from the ‘research champions’ and raise questions including how do we truly measure if research is embedded in clinical practice and how do we evidence the impact of this on service users and the service itself?

Title: Creating a Culture of Research: The Role of the Physiotherapy Fellow

Name of presenting author: Jo Gibson

Affiliation: Royal Liverpool and Broadgreen University Hospitals NHS Trust


Jo Winton and Mat Smith – Royal Liverpool and Broadgreen University Hospitals NHS Trust

Introduction

NHS reforms consistently stipulate the centrality of Evidence Based Practice to modern Healthcare. However, embedding research activity into an already pressurised clinical setting can be perceived as prohibitive by clinicians.

An Orthopaedic Unit, with recognised expertise, felt they were not utilising their patient-rich resources or the expertise of clinicians to their full potential. Research continued to be regarded as the domain of a select few.

Approach

The working partnership and shared vision of Orthopaedic Surgeons, Specialist Physiotherapists and Industry sponsors resulted in the creation of the inaugural Physiotherapy Fellowship Post, a three year appointment. Central to the purpose of the new role was engendering a culture of research; establishing routine collection of Patient Reported Outcome Measures (PROMs) alongside clinical practice; and to coordinate research activity within the Unit. Furthermore, this unique opportunity aimed to emphasise the essential symbiosis between clinical practice and research whilst supporting the development of the Fellow as an Advanced Practitioner.

This was a challenging role and was underpinned by the acquisition of relevant research skills as part of Masters study. The emergent nature of this innovative post demanded flexibility and creative thinking from the post-holder and mentors. Similarly the barriers and difficulties commensurate with effecting cultural change demanded multiple strategies. Clear vision and leadership were paramount.

Outcome

The Physiotherapy Fellowship has been successful in creating a culture of research and establishing the infrastructure to make it possible. There has been a commensurate increase in research activity and ultimately the vision of clinician led research has become a reality.

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Title: The role of clinical-academic collaboration in inspiring a research culture within a breast screening unit

Name of presenting author: Rita Borgen

Affiliation: Breast Screening Unit, East Lancashire Foundation Trust


Lisa Porter-Bennett – Breast Screening Unit, East Lancashire Foundation Trust

Julie Nightingale, Dr Fred Murphy and Carena Eaton – University of Salford

Catherine Gedling – NW Research Design Service

Introduction

Breast screening radiographers (mammographers) regularly participate in service evaluation and clinical audit, yet rarely undertake empirical research, a phenomenon also noted within the wider radiography profession. A research partnership was established between a breast unit and a university to explore the nature of staff-client interactions in the breast assessment clinic and to foster and promote an ethos of research and evidence-based practice (DOH, 2012).

Approach

The three phase project was investigated through a mainly qualitative multi-methods approach, including audit, practice observation, interviews and focus groups. A steering group including university, hospital and patient representatives was set up to oversee governance arrangements and support novice researchers throughout their research journey. All clinical colleagues within the breast screening unit were consented to be participants in the research, and two mammographers also participated in data collection and analysis.

Outcomes

Staff-client interaction was found to be effective and empathetic, but additional merits of engaging in collaborative research include enhancements in: research governance awareness; research expertise; internal and external recognition and networking; formal research training; CV and PDR development; peer benchmarking; individual accreditation; service improvement and dissemination skills. Outputs include articles, posters and presentations at national conferences and a book chapter.

A clinical-academic partnership is beneficial in developing a research culture in a relatively small clinical department. Individual academic and clinical colleagues benefitted from increased confidence and enhanced professional recognition. The clinical department gained a greater awareness of the importance of research, and pride in the service they delivered.

Thursday 25th September – 11.30amWorkshop 14 – Primary Research Papers

Room: Macron Suite

Title: A 6 year study of mammographic compression force: practitioner variability within and between screening sites

Name of presenting author: Claire Mercer

Affiliation: University Hospital of South Manchester, University of Salford


Peter Hogg and Katy Szczepura – University of Salford

Judith Kelly and Sara Millington – Countess of Chester Hospital

Rita Borgen and Beverley Hilton – Burnley District General Hospital

Erika Denton – University of East Anglia and Norfolk & Norwich University Hospital

Introduction

The application of breast compression force in mammography is more heavily influenced by the practitioner rather than the client. This will affect client experience. This study builds on previous research 1-3 to establish practitioner variability of compression force application within and between three screening sites.

Methods

This longitudinal study assessed three consecutive analogue screens of clients within three breast screening centers in the UK. Recorded data included: practitioner code, applied compression force(N), breast thickness(mm), BI-RADS® density category. Exclusion criteria included: previous breast surgery, previous/ongoing assessment, breast implants. 975 clients (2925 client visits, 11,700 mammogram images) met inclusion criteria across three sites. Data analysis: assessed practitioner variation of compression force (N) over 3 sequential screens. Breast thickness(mm) was also assessed.

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Results

Site one had three practitioner compressor groups, each being significantly different to the others. Sites one and two demonstrated no significant difference in mean, first and third quartile compression force and breast thickness values CC(p>0.5), MLO(p>0.1); ’site one and three’ and ‘site two and three’ did (p<0.001).

Conclusion

This research demonstrates that the amount of breast compression force applied by practitioners is not consistent across three screening sites. Greater consistency between practitioners in the application of compression force for clients is exhibited when guidance dictates a minimum compression force (site three). This may have a positive impact on image quality comparisons over time, radiation dose and potentially cancer detection. The large variation in compression forces could negatively impact on patient experience between the units and within a unit.

Title: Experiences of older people living with AS

Name of presenting author: Jane Martindale

Affiliation: Wrightington, Wigan and Leigh NHS Foundation Trust


E. Kashefi – University of Lancaster

Lynn Goodacre – Research Northwest R&D

Introduction

The increasing demographic of ageing means people are living longer with long-term health conditions with an implication that people with AS may need to develop additional skills to manage their symptoms as they age. Our aim was to develop a greater understanding of the experience of ageing with AS.

Method

Ethical approval was obtained (MREC ref. 11/NW/0456) to explore the needs of people over 60 with AS. Six focus groups were recorded and transcribed. Transcripts were coded and a thematic analysis was conducted using NVIVO 10.

Results

Analysis identified 5 key themes: 1. ‘It doesn’t go away” describes how AS remains active as people age with continuing functional and symptomatic challenges. 2. ‘Wheels fall off after 60’ describes participants’ perceptions of their disease progression within the context of ‘normal ageing’. 3. ‘Keep on pushing, keep on going’ describes the challenges of maintaining motivation to remain active and the importance of a positive mental attitude. 4. ‘Living a fulfilling life’ describes how participants developed ‘learnt expertise’ and made active choices about how they managed their AS with its imposed restrictions. 5. ‘Paying a price’ describes the significant psychological, physical and financial consequences associated with living with AS.

Conclusions and implications for practice

People aspire to remain as active as possible whilst facing new challenges in relation to their lifestyles and priorities as they age. This highlights a continuing clinical need to appreciate that the ‘older person’ faces additional challenges within the context of an active and often debilitating condition.

Title: Health-seeking among community based male offenders

Name of presenting author: Thabiso Nyathi

Affiliation: Greater Manchester West NHS Mental Health Foundation Trust

Introduction

There are no UK studies examining health-seeking among community based males offenders. The objective of the research was to identify factors affecting health-seeking among community based male offenders with mental health problems.

Methods

A qualitative design study using unstructured in-depth interviews of 8 community based male offender mental health service users about their experience of seeking mental health treatment. Interviews were recorded, transcribed verbatim and analysed using grounded theory methods. Permission to undertake the study was granted by Greater Manchester Probation Trust and North West REC – GM North Study no: 11/H1011/7

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Results

The experience of making the choice to seek mental health help among participants was influenced by 5 factors:

1. Motivation

2. Family and/or practitioner (mental health or criminal justice)

3. Social Capital/Stigma

4. Empowerment

5. Helpfulness of services.

Conclusion

Motivation of service users and support of family (or practitioner) can positively affect health-seeking whilst stigma and unhelpfulness of services/practitioners can negatively affect health seeking (Howerton et al 2007) among male offender population.

Implication for practice

When engaging male offenders with mental health problems, health practitioners need to:

• take account of previous experience of mental health services and practitioners and

• adopt a recovery focused approach as opposed to a problem managing approach to providing mental health help.

Thursday 25th September – 2.30pmWorkshop 18 – Developing Cultures of Research & Innovation

Room: Macron Suite

Title: Maximising the potential of the clinical research nurse workforce in order to promote research and innovation

Name of presenting author: Gail Woodburn

Affiliation: Central Manchester NHS Foundation Trust (CMFT)


Janette Dunkerley – (CMFT)

The presentation will include:

• An overview of Clinical Research nursing (CRN) – the art and science, linked to values and behaviours (very topical)

• CMFT’s leadership model and key workstreams relating to innovation

• Impact of our work regionally and nationally.

Given the importance of the CRN role in relation to maximising recruitment into clinical trials (Offenhartz 2008) it is important to identify who CRNs are, where they work, who they are employed by, what they do and how they do it (Ledger et al 2008). The identification of CRNs enables accurate workforce numbers to be noted and enable targeted, systematic support to help CRNs to perform their role and maintain the highest standards of clinical research.

Our model of employment of research nurses and ongoing professional development support ensures CRNs are supported and that patients participating in trials were protected. This has then enabled us to create a culture or research and innovation within a growing professional group and champion leading edge practice. Examples to be showcased include:

• First Research Nurse Advanced Practitioners in the country

• CLRN research nurse of the year award for impact on recruitment

• Highest recruiting Trust in Greater Manchester and second nationally

• ‘we do clinical research’ campaign – raising awareness of research

• Research nurses care pledge – our values and behaviours work

• Regional and national leads.

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Title: Developing Nursing, Midwifery and Allied Healthcare Professional research capacity in an NHS Trust: The experience of a post-doctoral group

Name of presenting author: Janet Suckley

Affiliation: Central Manchester University Hospitals NHS Foundation Trust


Dr Nicola Booth – Central Manchester University Hospitals NHS Foundation Trust

Dr Penelope Stanford – University of Manchester

Mr Timothy Twelvetree – Central Manchester University Hospitals NHS Foundation Trust and University of Manchester

Introduction

The National Institute for Health Research (NIHR) has a Clinical Academic Training (CAT) scheme for Nurses, Midwives and AHPs (NMAHP) (NIHR 2014), which in reality is an academic clinical career model. This presentation illustrates an alternative for developing clinical academic careers, where the emphasis is more on the in-service, than academic development of research capacity. This can have far reaching benefits for increasing research capacity within the NHS whilst retaining experienced clinical staff and contributing to evidence based patient experiences.

The presentation will explain the process of setting up a NMAHP group and its first Trust initiated research study at Central Manchester University Hospitals NHS Trust (CMFT).

Approach

• Develop clinical academic careers and support NMAHP research in CMFT;

• Develop a clinically relevant research project in response to the launch of the Major Trauma service at CMFT;

• Support individual professional development using existing and developing research skills, mentoring and leadership in NMAHP research.

Outcomes

A study addressing a Trust and NHS clinical priority has been developed, time from clinical practise to conduct the study agreed, training needs identified and funding secured from Manchester Academic Health and Science Centre (MAHSC) and CMFT. The research team have developed expertise in applying for ethics and research governance approval, writing and negotiation skills and have contributed to the development of research capability in others to initiate a model of sustainable research capacity building for the NHS.

Title: Enhancing musculoskeletal research in primary care: engaging a community musculoskeletal physiotherapy service in research studies

Name of presenting author: Carol Doyle

Affiliation: Community Business Unit, East Cheshire NHS Trust


Ruth Heaton, Chris Smith, Paula Salmon – Community Business Unit, East Cheshire NHS Trust

Introduction

Improving access and care for patients with musculoskeletal problems is a key NHS priority, with recognition that more research studies are needed in the primary care setting.

Musculoskeletal patients account for 25% of GP consultations with many receiving physiotherapy treatment as part of their management. An estimated 53 patients out of every 1000 GP consultations will be referred on for musculoskeletal physiotherapy (Holdsworth et al 2006).

One challenge to the uptake of research findings into clinical practice is the lack of engagement of physiotherapists in research activity.

We aimed to use physiotherapy engagement in research studies to enhance evidence based practice within primary care to ensure primary care services deliver high quality, cost effective and innovative care to patients.

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Approach

Strong links and networks have been forged with the Arthritis Research UK Primary Care Centre, Keele University where high quality studies investigating musculoskeletal problems in primary care are carried out.

This approach has been supported by committed physiotherapy managers and senior clinicians plus two new physiotherapy research facilitation posts which link the research and clinical communities.

Outcomes

Over the past 6 years this community musculoskeletal physiotherapy service has been involved in three randomised controlled trials, one implementation study, one evaluation study and one national survey.

The total number of patients recruited to these studies has been 2599 with 138 physiotherapists involved.

One major impact from involvement in the implementation study has been the introduction of a stratified care approach to the management of low back pain (Foster et al 2014).

Thursday 25th September – 2.30pmWorkshop 20 – Primary Research Papers

Room: Chairman’s Suite

Title: The Impact of Self-Management Education on Outcomes for Patients with COPD Attending Pulmonary Rehabilitation

Name of presenting author: Joy Gana-Inatimi

Affiliation: Liverpool Heart and Chest Hospital NHS Foundation Trust (LHCH) University of Central Lancashire (UCLan Postgraduate School of Medicine and Dentistry


Professor Paola Dey, Dr Chris Sutton and Heather Stewart– University of Central Lancashire

The role of self-management education for Chronic Obstructive Pulmonary Disease (COPD) patients in pulmonary rehabilitation (PR) is poorly researched (Effing et al 2009). We report the findings of a retrospective study exploring the relationship between self-management education and COPD.

Method

Anonymised patient demographic and clinical information was extracted from an administrative database of patients attending PR from 01/01/2009 to 31/08/2011. Data included the MRC dyspnea scale (respiratory disability measure), Bristol COPD Knowledge Questionnaire (self-management knowledge) and the Shuttle Walk Test (functional outcome measure).

Ethics approval was gained from the UCLan Ethics Committee and LHCH Research Committee.

Preliminary Results

Of 825 patients, 56.9% were female, 49.3% were ex-smokers and 45.9% had mild COPD. The mean age was 67 years. Those referred to the service but who did not attend were more likely to be younger, more socioeconomically deprived, have mild COPD and smoke. In those who completed PR, there was significant improvement in self-management knowledge (p<0.001), distance walked during the Shuttle Walk Test (p<0.001) and MRC dyspnea scale (p<0.001). However, there was weak but statistically significant correlation between change in self-management knowledge score and change in the distance walked (r=0.11; p=0.033).

Conclusions

Poor self-management knowledge may impact on compliance with PR. The lack of a relationship between self-management knowledge and functional outcome might be due to a true lack of association, the quality of the educational component of the programme or poor validity of the Bristol COPD questionnaire to measure self-management outcomes. Further work is underway to help understand these findings.

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POSTER COMPETITION

In your conference pack you will find a voting slip for the poster competition and we are asking all delegates, as you go around the posters, to select the poster which you feel:

“Engages you the most and communicates its message most effectively”

A voting box will be located on the registration desk and voting closes at 2.30pm on Thursday 25th September.

The poster prize will be presented during the closing session of the conference.

Title: The Experiences of Women with Learning Disabilities Undergoing the Introduction of Dialectical Behaviour Therapy (DBT)

Name of presenting author: Michaela Thomson

Affiliation: Calderstones Partnership NHS Foundation Trust


Paula Johnson – Calderstones Partnership NHS Foundation Trust

Introduction

Calderstones Partnership NHS Foundation Trust provides specialist forensic services for people with a learning disability. In 2010 Dialectical Behaviour Therapy (DBT) (Linehan, 1993) was introduced to the Women’s care pathway (Lew, M, 2006).

The research to be presented looks at the experiences of the first group of women to take part in DBT.

Methods

Favorable ethical opinion was obtained (NRES Committee North West-Preston (13/NW/0051) and permission given from the Trust Research and Development Committee. Participants were recruited from a cohort of 7 women identified by the DBT team to be included in the first wave of DBT. All 7 consented and undertook a semi-structured 1:1 interview which was audio recorded and transcribed verbatim. Data was analyzed using Interpretative Phenomenological Analysis (IPA) (Smith et al., 2009) which is a flexible approach to best meet the aims / objectives and highlight the lived experiences of the women.

Results

Preliminary themes to emerge from the data include:

• Understanding the DBT model

• Two therapies at once

• Supporting us to practice homework

• Our feelings about DBT

• Using DBT skills

• Our suggestions for the future/other services

Conclusion & implications for practice

There was a clear message coming from the data regarding the women’s experiences of DBT as initially challenging and difficult to understand but more importantly, useful, worthwhile and transferrable. The value in shaping the therapy in a person centred way to use materials meaningful and relevant to each individual was acknowledged by the women as particularly beneficial.

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POSTER ABSTRACTSTitle: Exploration of the impact of Routine Outcome Monitoring (ROM) feedback to

physiotherapy patients

Name of presenting author: Alison Dewhurst Poster Number 1

Affiliation: The University of Central Lancashire (UCLan) Lancashire Care NHS Foundation Trust

A literature review on feedback intervention identified a research gap concerning feedback of ROM within physiotherapy.

A mixed methods study was designed to explore impact of ROM feedback to physiotherapy patients. Ethical approval was gained from: Lancaster research ethics committee; NHS R&D; UCLan.

Patients with a diagnosed shoulder problem were recruited and consent gained at one north west NHS trust. Participants attended a shoulder exercise class. Participants filled in a shoulder specific ROM (The QuickDASH) at every treatment session. Scores were plotted onto a graph and discussed with each participant at every session. On completion of treatment a semi-structured interview was conducted discussing accuracy, relevancy, utility, goals, feedback of ROM and other types of feedback used.

Interview data and ROM scores were analysed to identify response patterns.

Results:

• Respondents were aware of some of their goals

• Goals were identified that were hidden within the data

• Respondents used multiple types of feedback to gauge recovery in addition to ROM scores

• Patients in one physiotherapy setting may respond differently to another

• It is unknown if the physiotherapists concur with respondents’ data

• Differing strengths of responses to ROM feedback were identified with respondents who began treatment with similar severity

Conclusions / Implications for practice:

Further exploration of how ROM feedback is required to determine how it relates to:

• Patient age, gender, condition severity

• Feedback perceptions (patient and staff)

• Expressed goals, goal commitment, hidden goals

• Patient behaviour changes related to goals

• Other sources of feedback data

• Treatment setting (group versus individual, NHS versus private)

Title: The formation of an integrated occupational therapy and social work team planning discharges from an acute hospital setting: a systematic literature review

Name of presenting author: Rachel England Poster Number 2


This systematic review examined the evidence behind an integrated team of occupational therapists and social workers planning discharges from an acute hospital setting. There were three objectives; to identify how this type of team is described within the literature; to determine the evidence on integrated teams in relation to discharge planning; and to explore the professional issues this type of team might raise for the occupational therapy profession. Relevant databases were thoroughly searched but only four qualitative studies met the inclusion criteria. These articles were critically analysed and compared in detail and then their findings synthesised. Thus, the literature mainly described this type of team as “interprofessional” and “integrated”, and identified that integrated teams were patient focussed (Jones and Jones 2011) and team members should be co-located in order to share knowledge and information (Duner 2013).

Improvements in discharge planning included comprehensive patient assessment, with better care planning from relevant professionals. Integrated working enables a faster discharge from hospital and is aligned to occupational therapy professional values because it is holistic and client centred. It benefits occupational therapists who can gain deeper professional knowledge by being co-located with other professionals. However, although integrated team working can clarify and maintain professional roles, the occupational therapy role appeared to be the most blurred. Recommendations include higher quality research into the relationship between integrated care and discharge planning, which must include evaluation of outcomes. Occupational therapists must consider how to communicate their role in a hospital setting

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Title: Dexamethasone and haemorrhage risk in paediatric tonsillectomy – a systematic review and meta-analysis

Name of presenting author: Jennifer Bellis Poster Number 3

Affiliation: Alder Hey Children’s NHS Foundation Trust & University of Liverpool


Professor M. Pirmohamed, Professor A.J. Nunn and Dr J.J. Kirkham – University of Liverpool

Dr Y.K. Loke – University of East Anglia

Dr S. Golder – University of York

Introduction

In children undergoing tonsillectomy, dexamethasone is recommended to reduce the risk of post-operative nausea and vomiting (Steward et al. 2011) with non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief (Lewis et al. 2013). This systematic review aimed to determine whether children who receive dexamethasone with/without NSAID, are more likely to experience post-tonsillectomy haemorrhage (PTH). A methodology appropriate to the evaluation of a rare adverse event was adopted (Loke, Golder & Vandenbroucke 2011).

Methods

Data sources: Bibliographic databases and selected tertiary sources.

Study selection: Randomised and non-randomised studies in which children undergoing tonsillectomy received dexamethasone with/without NSAID.

Participants: Children undergoing tonsillectomy.

Interventions: Administration of peri-operative dexamethasone ± NSAID.

Study appraisal: Risk of bias assessment and evaluation of haemorrhage rate data collection and reporting using the Cochrane Risk of Bias and McHarm Tools.

Synthesis methods: Pooled estimate of the effect of dexamethasone on the risk of haemorrhage rate using the Peto odds ratio method.

Results

The pooled estimate for haemorrhage rate in children who received dexamethasone was 6.2%, odds ratio 1.41 (95% CI 0.89-2.25, p=0.15). There was risk of bias and inconsistent PTH data collection and reporting rates in many of the included studies. Clinical heterogeneity was observed between studies.

Conclusions

The pooled analysis did not demonstrate a statistically significant increase in the risk of PTH with dexamethasone with/without NSAID use in children. However, the majority of the included studies were not designed to investigate this endpoint. Therefore large studies which are specifically designed to collect data on haemorrhage rate are needed.

Title: A thematic synthesis of adolescent stammering experiences

Name of presenting author: Jennifer Roche Poster Number 4

Affiliation: Stockport NHS Foundation Trust

Title Dr Maria Flynn – University of Liverpool

Introduction

Stammering is characterized by an interruption to speech such as repetitions and blocks and is often accompanied by an emotion reaction which reinforces the stammer (Howell, 2011) often leading to increased levels of anxiety during adolescence (Smith, Iverarch, O’Brian, Kefalianos & Reilly, 2014). The present study aimed to review published qualitative experiences of stammering during adolescence.

Methods

A thematic synthesis

Results

Nine original studies were included. Major emergent themes were; awareness of stammering, speech, education, personal and social development, family, the future, and things that helped and did not help during adolescence. Only one paper included participants who was an adolescent at the time of the study; the average age of participants was 33 years old. Results suggest that speech fluency was overwhelmingly the focus of speech therapy. Conversely, there was a consensus of receiving therapy which lacked emotional support for stammering across studies, which was perceived as unhelpful. Not talking about stammering in general was overwhelmingly perceived as negative and was unanimously considered an important factor in successful therapy experiences.

Conclusions and implications for practice

Lack of emotional support for stammering appears at odds with the view of stammering being a multifactorial disorder comprised of much more than speech hesitancies. This appears to have rendered the adolescents in this study without support for understanding their own emotions, which lead to a feeling of isolation and guilt for some. Therapies offered to adolescents should include support to deal with emotional issues around stammering.

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Title: A service evaluation to explore the re-referral rate and possible reasons for re-referral in patients with low back pain, in one NHS trust

Name of presenting author: Charlotte Williams Poster Number 5

Affiliation: Manchester Metropolitan University

Background and Purpose

High care seeking behaviors are costing the National Health Service money (Morris et al, 2012). Patients with low back pain (LBP) frequently attend General Practice and Emergency Departments (Reid et al, 2001). Their attendance patterns have not been determined in physiotherapy. This service evaluation aimed to conduct an exploratory survey to investigate the re-referral rate to physiotherapy of patients with LBP and explore possible factors that may contribute to this.

Method

A retrospective survey of 938 clinical notes for patients with LBP attending one NHS physiotherapy service was conducted. Data were collected on multiple characteristics, including the number of patients re-referred. Multivariate analysis determined if any characteristics were strongly associated with re-referral rate.

Results

16% of the sample was re-referred. Patients with the following characteristics were more likely to be re-referred: high pain scores, high functional disability scores, high levels of psychosocial distress, retired, long history of LBP, other co-morbidities, received individual physiotherapy treatment and > 61 years of age. These findings can be generalised to the population of patients with LBP referred to the Physiotherapy Services with 95% confidence (+/- 3.5%).

Conclusions

Re-referral rate of patients with LBP was small yet potentially significant. Complex patients with a combination of characteristics were considered to have the most important influence on this re-referral rate. Current local service provision may not be targeting this patient group effectively resulting in poor implementation of long term self management strategies and consequently re-referral to physiotherapy services for further support

Title: Proficiency in Radial Arterial Line Insertion for the Advanced Practitioner. Using a Negotiated Work Based Learning Approach

Name of presenting author: Justine Monks Poster Number 6

Affiliation: Liverpool Heart and Chest Hospital NHS Foundation Trust University of Liverpool


Julie Bridson-Walton – University of Liverpool

The Advanced Practitioner (AP) currently works within a 30 bedded regional cardiothoracic critical care area. The requirement for haemodynamic monitoring and blood sampling, via arterial line access, is a pre requisite to comprehensive assessment and management of the critically ill patient. Proficiency in radial arterial line (RAL) insertion is an intrinsic requirement of the AP role. The need to fill a skills gap was the driver for acquisition of this complex skill.

NWBL was the most appropriate pedagogy for the development and assessment of this advanced clinical skill (Boud and Solomon 2011)

NWBL offers a unique opportunity to create a bespoke approach for acquisition of a specialised skill, whilst ensuring competence, which traditional didactic pedagogy alone could not provide. A NWBL approach acknowledged the importance of learning from real work in a real environment. Proficiency of advanced skills were achieved via self-guided and self-regulated learning in the work place (Raelin 2008). Learning outcomes were defined at Master’s level and assessments included Objective Structured Examination (OSE), Direct Observation of Practice (DOPS) and a portfolio of practice, which included thirty three RAL insertions. All of which aided both a reflective and analytical approach to practice.

A NWBL approach, enabled development of a bespoke skill, by assimilating in depth knowledge and experience through critical reflection, self-guided and self-regulated learning, ensuring continuous professional development, together with lifelong learning, which are pre requisites to successful, safe and competent practice, a requirement of the statutory regulatory body (NMC 2008).

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Title: Exploring General Practitioners’ (GPs) experiences of identifying and managing childhood obesity

Name of presenting author: Donna Sager Poster Number 7

Affiliation: Public Health Department, Stockport MBC

Introduction

Department of Health policy (2011) has proposed a clear role for GPs in responding to the increase in childhood obesity, despite a limited evidence base which would secure such an emphasis. The aim of this study was to explore GPs’ experience of identifying and managing obese children, and to identify the GPs’ responses to the physical, psychological and familial needs of the obese child.

The study was completed as part of a Professional Doctorate. Ethical approval was secured (10/155) from Salford University Ethics Panel.

Method

Retrospective, semi structured interviews were completed with 10 GPs and the rich ideographic data was analysed using Interpretive Phenomenological Analysis (Smith et al. 2009).

Results

The GPs’ responses were determined by their understanding and knowledge of a wide range of family behaviours, attitudes and health beliefs. This knowledge was critical in providing a flexible response which enabled them to address the sensitivity of the subject and negotiate the different and often dissonant views of the parents. However the GPs’ highlighted individual and professional dilemmas including role competence, legitimacy, and professional uncertainty. Organisational challenges such as time pressures, competing priorities, and limited access to specialist services were identified. The findings are explored in relation to relevant literature (Turner et al., 2009).

Conclusion

A unique insight into the identified professional behaviours is provided by exploring the GPs’ dominant epistemological framework which resulted in the identification of 4 dominant role types. The diversity of responses is addressed through practical recommendations to improve areas of professional practice.

Title: ‘Get Moving to Keep Moving’ – Exploring the Effectiveness of Exercise in Parkinson’s Disease

Name of presenting author: Hannah Rooney Poster Number 8

Affiliation: East Cheshire NHS Trust

A masters level 7 module ‘Evidence Based Approach to Neurological Rehabilitation’ undertaken November 2013 - January 2014 by a specialist neuro-physiotherapist working in neuro-outpatients at East Cheshire NHS Trust. The aim of the study was to explore the effectiveness of exercise for people with Parkinson’s disease in order to inform clinical practice. A literature review was completed, exploring the evidence base behind various types of exercise and the effects on those with Parkinson’s Disease.

The available literature describes varied interventions, methodological designs and limitations, therefore it was decided to supplement the evidence base by looking at smaller studies for evidence of improvements – studies with quasi-experimental / pilot / feasibility designs assessing specific interventions in this patient group.

From the evidence, it is recommended that a structured, regular exercise programme should be completed, preferably from diagnosis, in order to maintain function and influence neuroplastic changes. The programme needs to consist of a combination of aerobic, flexibility and strength elements and the most positive results will likely be gained if exercise is completed in group situations with regular monitoring to maintain motivation/progression.

This piece of work highlighted the importance of critiquing the available evidence in order to gain informed clinical practice as the term ‘exercise’ can be ambiguous in the treatment of Parkinson’s Disease. In the clinical setting, physiotherapy intervention for patients locally has been examined to ensure the different aspects of exercise are included in exercise programmes and the delivery of exercise in group situations has been developed with great success.

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Title: Supporting the care of children with diabetes in school: a qualitative study of nurses in the UK

Name of presenting author: Marie Marshall Poster Number 9

Affiliation: Central Manchester Foundation Trust, Royal Manchester Children’s Hospital


W. Gidman and P. Callery – The University of Manchester, Manchester Academic Health Science Centre

Introduction

Intensification of diabetes management in children has legal and practical implications for schools (Gosden et al 2010, NHS Diabetes 2013).

Aim

To describe a study which identified problems experienced by diabetes nurses when providing support to schools.

Methods

Eight focus groups and eight telephone interviews were held nationally with a purposive sample of 47 nurses who provide support to schools in acute or community settings. Data were analysed through a process of constant comparison.

Results

Nurses identified an ambiguous and inadequate legal and policy framework. The responses of schools to the nurses were variable and unpredictable because the views of head teachers determined the level of cooperation with the children. School staff lacked knowledge about diabetes. Relationships between school staff and parents could also affect their willingness to provide support for diabetes care. The skills of negotiating appropriate support for children were learnt by experience rather than through formal training or evidence based guidance. Nurses’ accounts demonstrated uncertainties about what could be required of schools, how schools would respond, individual responsibilities, and what constituted best practice.

Conclusions

Future research on school based support and the importance of school context is required; what are perceived to be facilitators and barriers in providing the level of support a child with diabetes requires in school.

Implications for practice

Inadequate, ambiguous policies, no legal duty on schools to support intensive diabetes management results in nurses having to negotiate diabetes care on a case-by-case basis with individual schools

Ethical approval: Manchester Research Ethics Committee.

Title: Community integration following brain injury: Comparing outcomes for individuals with cognitive communication disorder and those without

Name of presenting author: Naomi Saul Poster Number 10

Affiliation: Blackpool Teaching Hospitals NHS Foundation Trust, Community Brain Injury Rehabilitation Service, University of Birmingham


Dr Andrew Worthington – Headwise

The aim of this study was to explore the impact that Cognitive Communication Disorder (CCD) has on community integration following brain injury. It explored relationship, vocational and living skills outcomes across two groups. The first group of individuals had sustained acquired brain injury but did not have any communication changes, whilst the second group had acquired brain injury with a diagnosis of CCD from a speech and language therapist. It was hypothesized that those participants with CCD would achieve less favourable outcomes than those without communication changes, particularly for relationship and vocational measures.

Ethical approval for the study was gained through National Research Ethics Service North West (approval number RG_13-051). Individuals were invited to take part in the study by letter and data was collected through face to face interviews using the Syndey Psychosocial Reintegration Scale. Quantitative data was collected in the form of three sub-scores for each area and a total score out of 48.

The results of the study found no significant statistical differences between the two groups, most likely due to the small number of participants. However, for the CCD group there was found to be a significant statistical difference between return to work and living skills, and also between relationships and living skills.

This study highlights the challenges that individuals with CCD face in maintaining and forming relationships, and returning to productivity. The study promotes discussion regarding the role of the speech and language therapist in vocational rehabilitation affirming the need for interdisciplinary working.

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Title: Development of an effective 360 degree feedback tool for Allied Health Professional Clinical Team Leaders

Name of presenting author: Lisa Edwards Poster Number 11


High quality leadership is essential for the NHS, and whilst there is access to evidence based clinical training, very little evidence based management development exists.

360 degree feedback correlates highly with other scores of leadership, and is particularly effective in obtaining accurate feedback on performance from peers and superiors (Harris & Kuhnert, 2008).

The literature suggests that 360 degree feedback is only effective if the tool has been designed properly and consideration given as to how the process will occur (Goodge, 2005).

The aim of the study was to design and produce a 360 degree feedback tool that would give meaningful feedback from a range of staff to Allied Health Professional Clinical Team Leaders.

The study used purposive sampling to establish focus groups to design the tool. The groups consisted of a range of AHPs in different bands. A tool was produced based on the work in the focus groups and this tool was then piloted on two Team Leaders using questionnaires. The results were analyzed and intra-rater reliability was tested.

The findings showed that the tool (which was based on job descriptions and competencies) was easy to use, allowed feedback to be presented to the Team Leaders in a constructive way, and was popular with staff. Intra-rater reliability showed moderate-substantial agreement.

It is proposed that the 360 degree feedback tool is used on all Clinical Team Leaders as part of their development plan.

Title: HPV and p16 Positivity in Squamous Cell Carcinomas of the Head and Neck in East Lancashire

Name of presenting author: Adam G. Ogden Poster Number 12

Affiliation: East Lancs Hospitals NHS Trust


D. Muskett and M.B. Aslam – East Lancs Hospitals NHS Trust

Introduction

Over one million new cases of upper aerodigestive tract (UADT) cancer arise worldwide each year, with more than 700,000 resulting deaths (Ferlay et al, 2010). Human papilloma virus (HPV) has been implicated as a risk factor and is integrated in a subset of UADT cancers; particularly head and neck squamous cell carcinoma (HNSCC) affecting the tonsils and oropharynx. Current prevalence data varies according to source, where one meta-analysis has estimated 22% HPV positivity in HNSCC tumour biopsies using predominantly PCR (Dayyani et al, 2010). A separate study found that 30.2% of patients with oropharyngeal cancers tested seropositive for HPV16 E6 protein, as compared to 0.8% in controls (Anantharaman et al, 2013). We aim to determine the proportion of HPV-positive HNSCC cases diagnosed at East Lancashire Hospitals Trust (ELHT) and incorporate HPV testing into routine histopathological workup in this on-going study.

Methods

Archived specimens from known HNSCC cases diagnosed at ELHT undergo testing for p16INKa (p16) immunohistochemistry (IHC) and HPV INFORM in situ hybridisation (ISH). Cases are determined as positive as per a predefined scoring protocol. Data analysis considers potentially confounding variables and commentary is made with reference to local cancer data.


Amalgamation of HPV ISH and p16 IHC into existing diagnostic algorithms allows better management of patients with HPV-positive tumours. HPV-positive tumours have improved prognoses compared to non-HPV types; partly due to their increased sensitivity to chemoradiotherapy. These markers might also be used to identify distant metastases of oropharyngeal primary origin.

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Title: The influence of pharmacist validation of discharge prescriptions on hospital readmissions

Name of presenting author: Sarah Upton Poster Number 13

Affiliation: Calderdale & Huddersfield NHS Foundation Trust and University of Huddersfield

Title Dr Margaret Culshaw – University of Huddersfield

Introduction

In 2009, the Care Quality Commission reported that discrepancies in discharge medication information were recorded by 81% GP practices “all” or “most of the time”. The EQUIP study (Dornan et al., 2009) identified a hospital prescribing error-rate of 9%, and highlighted that pharmacists had identified most of the errors in their routine practice. The aim of this study was to quantify the effect of enforcing pharmacist validation of discharge prescriptions (TTOs) in normal working hours, and determine the influence on 30-day readmission rate.

Methods

Data was collected for all discharges from Calderdale Royal Hospital’s Short Stay Unit between 23rd September 2013 and 26th January 2014. Pharmacist validation of TTOs became mandatory during normal working hours from the mid-point. Data collected included admission/discharge dates, demographic details, and whether the TTO had been validated by a pharmacist.

Results

Three-hundred-and-fourteen patients were discharged during the baseline evaluation. The proportion of TTOs validated by a pharmacist was 39% (122/314), and the readmission rate was 16% (50/314). During the intervention evaluation 296 patients were discharged. The proportion of TTOs validated by a pharmacist increased to 75% (223/296), and the readmission rate decreased to 12% (36/296).


Mandating pharmacist validation of TTOs during normal working hours resulted in a substantial improvement in validation rate, and was also associated with an improvement in readmission rate. It is acknowledged that the activity of the Trust’s Readmissions Virtual Ward varied during the study, further work will be undertaken to evaluate the influence of this.

Title: Negotiated work based learning (NWBL) to up-skill an advanced nurse practitioner (ANP) to interpret plain film chest radiographs in patients in a nurse led chest drain clinic

Name of presenting author: Amanda Walthew Poster Number 14

Affiliation: Liverpool Heart and Chest Hospital and The University of Liverpool NHS Foundation Trust


Julie Walton and Denise Prescott – The University of Liverpool

Steve Woolley, Asante-Siaw and Dot Homan – Liverpool Heart and Chest Hospital NHS Foundation Trust

Introduction

Prolonged air leaks from chest drains are a recognised complication occurring in around 15% of patients following thoracic surgery (Wilkinson et al, 2011). This leads to prolonged hospitalisation and patient frustration. As a thoracic ANP, interpretation of chest radiographs was deemed essential to enable autonomous management of patients discharged with chest drains. Achievement of this advanced clinical skill would improve the inefficiencies of patient delays for assessment within the current service; therefore, improving patient care and experience and reducing the need for medical staff intervention. However, ANPs who undertake image interpretation must be trained to a level comparable with that of a radiologist at first post competence. This could not be achieved by traditional methods of learning due to its bespoke nature. Hence, NWBL was the appropriate pedagogy (Boud, 2011).

Approach

This NWBL approach enabled expert guidance from the University and work based mentorship from the consultants and radiologists. Assessment strategy involved direct observation of clinical skill (DOPS) whereby an assessment tool- MINI IPX (adapted from the RCR, 2013) was utilised to address the skills needed to gain competence. Formative and summative assessments involved interpretation of a series of ten chest radiographs on two separate occasions by the ANP. This test-retest method ensures reliability and consistency. Importantly 100% accuracy in correct diagnosis was required to ensure patient safety.

Outcomes

Increasing competence and capability in this advanced clinical skill has enabled autonomous management of patients attending the nurse led chest drain clinic; expediting treatment, improving patient outcomes and service efficiency.

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Title: Are we meeting the needs of women attending for breast screening assessment?

Name of presenting author: Carena Eaton Poster Number 15

Affiliation: Directorate of Radiography, University of Salford


R. Borgen – Breast Screening Unit, East Lancashire Hospitals NHS Trust

J. Nightingale and F. Murphy – Directorate of Radiography, University of Salford

Introduction

The referral for further assessment after routine breast screening can cause anxiety and distress (Rehnberg, Absetz,Aro, 2001.). Previous research (Mather, McKenzie, Robertson, 2013.) has shown that the skill and attitude of the staff can contribute to the quality of the experience and that a poor experience can influence whether a women returns for further breast screening.

The aim of this study was to:

• Document the nature, frequency and health professionals involved in the communication episodes experienced by clients (women) in the assessment clinic

• Identify the client perceptions of the interactions within the assessment clinic.

Methods

An ethnographic approach was applied to explore the nature of staff-client interactions in a breast screening assessment clinic. Data was collected from participant observation of the client journey and semi-structured interviews with the clients (women). The data collected was analysed using thematic analysis.

Ethical Approval was granted for the study from NWREC (11/NW/0741), East Lancashire Foundation Trust and the University of Salford Ethics Committees.

Result

Overall women were satisfied with the information they were given about the reason for their referral for assessment and the outcomes of the test. The observational data highlighted a variance in the way information about abnormal findings was communicated.


Overall the women’s experience of the assessment process was positive. Further analysis of the how information is communicated to women about an abnormal findings may identify exemplars which can be used to inform future training.

Title: Obesity and dental caries: is there a common risk? A study protocol

Name of presenting author: Hilary Whitehead Poster Number 16

Affiliation: Lancashire Care Dental Service, Lancashire Care NHS Foundation Trust


Emma Hall-Scullin, Martin Tickle and Tanya Walsh – School of Dentistry, University of Manchester

Catherine Morley – Lancashire Care Dental Service, Lancashire Care NHS Foundation Trust

Keith Milsom – Dental Public Health, NHS Merseyside

Introduction

The causes of obesity are complex. Psychosocial and environmental factors are key determinants. These causes have also been linked to the development of dental caries, leading to the suggestion that a “Common Risk Factor” approach could be used to prevent both diseases (Watt et al 2012).

Aim

This poster presents the results of a study exploring the longitudinal relationship between caries and obesity in a cohort of older children/adolescents.

Objectives-To describe

1. The development of caries in children between the ages of 7-15 years.

2. The changes in BMI between the ages of 12-15 years.

3. To evaluate the longitudinal relationship between caries and BMI between the ages of 12-15 years.

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Method

A whole population study in East Lancashire of children who were aged 12-years at baseline in 2011.Ethics approval granted 11/NE/0006. Data was collected in schools. Positive consent was obtained. Caries status (Pitts et al 1997)) was reported at 2 data points over the duration of the study. Height and weight measurements (based on Child National Health Measurement Programme) were recorded for participants at ages 11-13 and 14-15 years.

Results

Data analysis is on-going. Currently there are no results available. These will be available for the conference in September 2014.

Conclusion

A literature review showed limited evidence of the association between caries and body weight. Identification of a link could impact on policy development by supporting the Common Risk Factor approach. Conversely no link or a negative link could support specific Oral Health improvement programmes.

Title: Promoting A Culture Of Research And Innovation From The Most Junior To The Most Senior In Our Therapies Service

Name of presenting author: Jo Haworth Poster Number 17

Affiliation: The Walton Centre NHS Foundation Trust


Jenny Thain – The Walton Centre NHS Foundation Trust

Introduction

Research and Innovation is a clear priority within the 5 year strategy for the Walton Centre NHS Foundation Trust. The Trust’s Therapy Service have matched this priority with objectives directed to raising the profile of research and innovation, increasing staff motivation for involvement and ensuring that both are easily accessible by all grades.

Approach

A Therapies’ Research Committee was set up with membership across disciplines, grades and levels of research / innovation experience. Questionnaires were designed to assess therapist’s attitudes towards research / innovation, analyse themes and facilitate an action plan to be drawn up to match therapy objectives.

Actions

• Therapy Study Day – Delivered in-house and directed towards introducing concepts and discussing previous and current research active staff’s experiences.

• Development of a web-based, information support system accessible through a shared drive.

• Therapies representation on the Trust’s Research and Innovation Committee to ensure dissemination of information and raise the profile of therapists within these areas.

• Research Forward Planning Meetings supported via staff-wide S.W.O.T. analyses and discussion surrounding therapy service priorities. Annual midway and final reviews.

• Mentor Scheme allowing research experienced therapists to support staff new to research / innovation.

Outcomes

• Increased research activity within the therapies service including involvement in multi-centre and multi-disciplinary trials, and involvement as primary researchers and research assistants.

• Increased research profile for therapy service.

• Increased therapy service applications for research funding awards.

• Dissemination of research findings to local and national audiences via presentations, posters and publications.

Title: First Steps – Developing tomorrow’s Clinical Research Nurses

Name of presenting author: Janette Dunkerly Poster Number 18

Affiliation: Central Manchester University Hospitals NHS Foundation Trust (CMFT)


Kirstine Bowden – NIHR/Wellcome Manchester Clinical Research Facility

Aim

To stimulate interest in developing the research nurse workforce of the future through the provision of structured research placements.

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Method

The MCRF has provided research focused student placements for a number of years. The experience and knowledge gained through offering these placements has developed and matured into a competency based student nurse programme across the Trust.

Over the last 18 months, with joint collaboration across the Research and Innovation (R&I) Division, a hub and spoke model of student placements has evolved with the MCRF providing the ‘hub’ placement for students and the 18 research teams based in the research areas, based in CMFT, offering the ‘spoke’ placements.

To promote research as a placement opportunity, the R&I division has engaged in several activities, including regular meetings with the Practice Educator Facilitator and quarterly inter-professional seminars to students.

Results

The introduction of this model has allowed the R&I division to increase their capacity to take nursing students, enabling a higher number of students to experience research in practice and gain an understanding into the world of clinical research nursing. The clinical research nurses mentoring these students ensure their practice is questioned and maintain their mentorship qualification, which would otherwise elapse.

Conclusion

It is anticipated; the current CMFT student placement model can be shared across other CRF’s and Trusts. Therefore, the number of students being exposed to clinical research nursing will increase. This will be of benefit to the nursing students today and equip the clinical research nurses of tomorrow.

Title: Pharmacy Services and Supporting Mental Health Research (Main Focus on Clinical Trials)

Name of presenting author: Maxine Syme Poster Number 19

Affiliation: Manchester Mental Health and Social Care Trust


P. Brown – Manchester Mental Health and Social Care Trust

Introduction

There has been a national drive to make it quicker and easier to get clinical trials up and running in the UK (National Institute for Health Research, 2013: 1). Pharmacy services are sometimes seen as ‘blocks’ or barriers to the smooth running of trials (Norton, 2011: 59). This project builds on previous work commissioned by the Mental Health Research Network to streamline the set up of mental health trials.

Aims

1. To outline the current situation in some Mental Health NHS Trusts in England in terms of supporting trials.

2. To make recommendations to improve the efficiency of setting up and running mental health trials.

Methods / Design

• Qualitative.

• A survey (using Survey Monkey©) was emailed to the Chief Pharmacist and R&D Manager of each Mental Health NHS Trust in England.

• Relevant results from The National Institute for Health Research Pharmacy Survey 2012 were analysed.

Results

• The majority of participating Mental Health Trusts were running between 0-10 trials as at 31 March 2012.

• Some Mental Health Trusts:

– Have minimal or no dedicated trials pharmacy staff;

– Are reliant on Acute Trust pharmacies to dispense trial medication.

Discussion

• Local research networks should each have a pharmacy advisory group.

• Clinical trial responsibilities should be incorporated into pharmacy service level agreements between Mental Health and Acute Trusts.

Conclusion

Overcoming some of the pharmacy-related barriers to the conduct of trials should help streamline the set-up and delivery of both commercial and non-commercial trials.

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Title: Supporting engagement in research – the Salford Royal way

Name of presenting author: Philip Hammond Poster Number 20

Affiliation: Salford Royal NHS Foundation Trust


Jess Zadik and Francine Jury – Salford Royal NHS Foundation Trust

Salford R+D is an integrated service overseeing research and development on behalf of the NHS in Salford. We have established an Engagement Team to complement the range of support services offered to the research community in Salford and to fulfill the requirements of involvement as laid out in the NHS constitution 1.

The Engagement Team support researchers and academics to include PPI at every stage of the research cycle; from choosing the best methods for engagement to helping recruit participants. The team provides ongoing support to public members to ensure they are able to effectively contribute and have their say.

In this poster we will highlight how the team provide:

• Advice on developing and using appropriate methodologies (eg surveys, focus groups, semi-structured interviews etc)

• Support to use innovative and emerging technologies/ methods (eg social media/networking, crowdsourcing, bluecasting etc)

• A database of local communities and groups of interest to facilitate engagement with a diverse range of people

• Practical support to develop PPI groups

• Training, support and advice to public members

• Citizen Scientist project: a unique initiative making it easier for members of the public to find out about health research and to seek opportunities to get involved and take part.

• Links into local networks and promotion of research across the Trust and within Salford.

The poster will provide examples of some of the key events and successes from its first year of existence along with discussion of some of the challenges faced and steps we have taken to overcome them.

Title: Supporting public involvement and engagement in research: The North West People in Research Forum

Name of presenting author: Melanie Chapman Poster Number 21

Affiliation: North West People in Research Forum


Committee and Working Group members – North West People in Research Forum Executive

Aim

The North West People in Research Forum was launched in 2011 to champion public involvement and engagement (PIE) in health and social care research in the North West region of England. The Forum exists to:

• Support members of the public who are, or wish to become, actively involved in research

• Support researchers to involve and engage the public

• Form links between researchers and the public

• Share learning about PIE in research

• Develop a network of expertise in PIE in research.

Methods

The Forum includes an Executive Committee, Training Working Group and Events Working Group, each of which has equal representation of public and professional members. A Forum Facilitator and administrator support the Forum.

Results

The Forum has over 400 members and 50 organisational members. The Forum’s work has included:

• Providing information and advice

• Developing links with local researchers, research networks and patient and service user groups across the North West

• Providing a means of linking members of the public who are interested in research and researchers who wish to involve members of the public but may find it difficult to identify people

• Running and supporting events to share learning and provide networking opportunities

• Developing and delivering training

• Developing a resource to share information about training opportunities at different research stages research for a range of audiences

• Utilising the Forum website, social media and newsletter to provide information about PIE in research, events, examples from the North West, and opportunities for the public to play an active part in research.

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Title: Establishing a Research User Group

Name of presenting author: Philip Hammond Poster Number 22

Affiliation: NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre (Salford Royal NHS Foundation Trust/University of Manchester


Sally Giles and Ailsa Donnelly – NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre (University of Manchester)

The Greater Manchester Primary Care Patient Safety Translational Research Centre is funded by the National Institute for health Research for five years, to undertake research to improve patient safety in primary care. Approximately 8% of the £6.5million budget is devoted to public involvement and engagement.

A key element of the Centre’s approach to public involvement has been to establish a core Research User Group (RUG) made up of 12 patients, cares and service users with an interest in research.

RUG members work in partnership with the Centre’s research teams, advising and assisting with research developments.

In this poster we will map the journey taken to establish the RUG including:

• Recruitment of a diverse range of members

• Launching and establishing the RUG

• Development of key documents including role descriptions, terms of reference etc

• Elections for Chair and Vice Chair

• Alignment of members to the Centre’s research themes

• Establishing partnership working between members and researchers at theme level

• Coordinating involvement and engagement activity

• Evaluation of the impact of RUG

The poster will provide examples of key findings and examples of impact from the first year of activity along a discussion of some of the challenges faced.

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NHS R&D NORTH WEST Annual Conference

Let’s Talk Research

16th & 17th September 2015 Venue T B C

Call for abstracts & workshop proposals opens Monday 12th January 2015

Closing deadline for submission Friday 27th March 2015

New for 2015

Alongside opportunities to present your work via oral and poster presentations in 2015 we will be seeking proposals from individuals or groups who would like to run workshops of relevance

to the NHS research community.

Full details will be available on the NHS R&D NW website www.research.northwest.nhs.uk

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The North West People in Research Forum supports public involvement and engagement in health and social care research in the North West of England by:

• Supporting members of the public who are, or wish to become, involved as partners in research.

• Supporting researchers to involve and engage the public in all stages of research

• Raising awareness about opportunities to get actively involved in research in the region and further afield

• Sharing learning and information about public involvement and engagement in research through:

1. The NWPiR Forum’s website, newletters and social media

2. Hosting and co-hosting events

3. Providing information about training and events

4. Publicising examples of good practise

Individual and organisational membership is free. You can become a member via the website or by contacting us directly.

North West People in Research Forum 11th Floor, 3 Piccadilly Place, Manchester

www.northwestpeopleinresearchforum.org

Email: [email protected]

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NOTES

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AutumnPeer 2 Peer Coaching 15th/16th October & 28th January

Introduction to Innovation workshop (In Association with NWC AHSN) 22nd October 2014

Post Doc network meeting 23rd October 2014

Getting Started in Research 29th October 2014

Dementia Evidence synthesis event 2nd October 2014

WinterFrom Innovation to Idea to Project Plan (In Association with NWC AHSN) 4th November 2014

Introduction to Innovation workshop (In Association with NWC AHSN) 25th November 2014

PPI Catalyst Event 3rd December 2014

Introduction to Innovation workshop (In Association with NWC AHSN) 8th December 2014

Creative Workshop 22nd January 2015

From Innovation to Idea to Project Plan (In Association with NWC AHSN) 26th January 2015

Post Doc network meeting 12th February 2015

Post Doc network meeting 7th May 2015

Leading Cultures of R&I Leadership, Development Programme November 2014

December 2014

January 2015

February 2015

For further information on these and forthcoming events please see the events section on our website; www.research.northwest.nhs.uk/our-events

Thank youWe would like to thank the following people who for their involvement in the conference steering group, abstract review process and running the conference.

Angela Hancock

Alison Astles

Alison Cooke

Claire Mercer

Sam Pywell

Amanda Bennett

Sian Carlton

Jane Martindale

Jen Roche

Catherine Ricklesford

If you are an early career researcher and are interested in working with us to develop next year’s conference please get in touch with [email protected]

Forthcoming Programme of Work 2014/15

NHS R&D North West 11th Floor, 3 Piccadilly Place Manchester M1 3BN

Tel: 0161 242 1337

www.research.northwest.nhs.uk

Become part of the NW research community – join the NHS R&D NW Early Career LinkedIn group: http://goo.gl/mkZ15c

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