CLAHRC for South Yorkshire

Summary of Achievements October 2010 - March 2012

Doncaster

Barnsley

Sheffield

Rotherham

Collaboration for Leadership in Applied Health Research and Care for South Yorkshire www.clahrc-sy.nihr.ac.uk

About Us

Impacts on patients

The Collaboration for Leadership in Applied Health Research and Care for South Yorkshire (CLAHRC SY) is a five year programme running from October 2008 until September 2013. Our main funder is the National Institute for Health Research (NIHR). The programme is based on three central pillars of applied research, knowledge implementation and capacity development.

We have eleven themes and several additional cross-cutting themes that carry out most of the visible research and implementation activities within this collaboration.

Our principles are:

The process of bringing together our thematic parts has led to the agreement of four principles that we endeavour to adhere to as a CLAHRC.

• Capacity building

• Building collaborations and co-production • Addressing inequalities in health

• The joint engagement in and ownership of CLAHRC by our partners.

Projects

108 35 32

projects were active this reporting period (57 research projects and 51 service improvement projects).

projects were completed during the reporting period (19 implementation projects and 16 research projects).

Enhancing the Effectiveness of Interprofessional Stroke Rehabilitation Teams was a Stroke theme project undertaken at Barnsley. This intermediate care team worked with CLAHRC over a 15 month period to develop an action plan for change. Patient pathway and outcomes data were collected from 124 patients during this time. Patient scores improved by between 0.59 and 0.78 on all domains of Therapy Outcome Measure (an improvement of 0.5 is considered clinically significant).

BreathingSpace BreathingSpace is a unique facility which offers specialist medical treatment for people in Rotherham who are suffering from a condition known as Chronic Obstructive Pulmonary Disease (COPD). The COPD theme within CLAHRC SY developed an intervention for nutritional rehabilitation for patients with COPD. This intervention promotes ‘food first’ approach with some supplementation. Participants increased their calorific intake by an average of 773 calories per day using the intervention.

WICKED

The Diabetes theme have developed the WICKEDTM (Working with Insulin, Carbs, Ketones and Exercise to manage Diabetes) structured education programme for young people with Type 1 diabetes to support selfmanagement in their transition to adulthood. A series of courses are currently running during the fourth year of CLAHRC, and will include 48 young people in Sheffield, to evaluate its effectiveness.

projects have been initiated this year, 16 of which are externally funded.

16,000

We have recruited nearly over this reporting period.



patients/members of the public to research projects

£12.74M

The total grant capture for our active projects during this year is nearly , with £2.35M income for this financial year. A further £9M other grant income linked to CLAHRC will be initiated during April 2012 - March 2013.

13%

Approximately of our projects are cross theme projects, attracting grants of just over £1M, illustrating the added value and collaborative capacity development being developed and exploited.

36

We have published

peer reviewed publications linked to CLAHRC activity.

We have worked with Medipex on

Three

four

CACTUS The CACTUS study (Stroke and Telehealth and Care Technologies themes) found that patients with post-stroke dysphasia (difficulty speaking) increased their word use by 20% after using a selfmanaged word finding therapy with the StepbyStep© computer programme.

Remarkably, improvement was seen in individuals who were up to 19 years post-stroke. The National Stroke Improvement Programme (NSIP) have promoted the findings of this study, and as a result over 20 speech and language therapy departments have contacted the project team.

projects to identify intellectual property.

CLAHRC SY projects have been cited in national NOCRI publications.

We have delivered training days and learning events to over

2

Enhancing the Effectiveness of Interprofessional Stroke Rehabilitation Teams

1,800

people.

Collaboration for Leadership in Applied Health Research and Care for South Yorkshire

www.clahrc-sy.nihr.ac.uk

3

Impact on Care Pathways ADHD Health Tracker The ADHD Health Tracker project (Telehealth and Care Technologies theme, TaCT) has introduced the use of online technology for collecting and organising assessment and treatment interventions for children with Attention Deficit Hyperactivity Disorder (ADHD) and their families. This includes a multi-media animated suite of questionnaires and neuropsychological test games to enable children as young as

five to contribute to assessment and review of their condition. The technology collects information from clinicians, teachers, children and their families. The technology is currently being used by 18 clinicians in Paediatric Neurodisability, Sheffield Child Adolescent Mental Health Service (CAMHS) and the Youth Offending Teams in Sheffield.

Organisational Impact Diabetes in adolescents

Translating Knowledge into Action (TK2A) theme

The adolescent project in the Diabetes theme has instigated an enhanced approach to multi-disciplinary team (MDT) meetings in Sheffield at the young person’s transition clinic (between children’s and adult services), facilitated by the University of Sheffield’s Psychology Department to support the management of this change. All young people in transition will receive this care in CLAHRC years 4 and 5.

The Translating Knowledge into Action (TK2A) theme has made changes to care in two areas that have contributed to trusts’ Commissioning for Quality and Innovation (CQINS) targets. This includes Enhancing the Quality of Oral Nutrition Support (EQONS) to in-patients at risk of

malnutrition at Sheffield Teaching Hospitals NHS Foundation Trust. EQONS contributed to the data collection process and action planning required for the nutrition CQUIN for 2010/11 and the introduction of National Institute for Health and Clinical Excellence (NICE) quality standards on

venous thromboembolism (VTE) management in Rotherham NHS Foundation Trust. The integration of the VTE steering group and the TK2A project team has produced policies and procedures that have helped achieve the CQUINS target of 90% hospital in-patients risk assessed on admission.

BreathingSpace (COPD) Training provided by BreathingSpace to 894 professionals in Rotherham has improved the accuracy of a diagnosis of COPD in primary care to 80%. This compares well to the national norms for accurate diagnosis which varies from 50-70% in primary care.

COPD Development of the nutrition rehabilitation intervention for patients with COPD has had an impact on the care pathway, increasing awareness and referral rates of nutrition and pulmonary rehabilitation (PR) in this patient group.

4

Collaboration for Leadership in Applied Health Research and Care for South Yorkshire

www.clahrc-sy.nihr.ac.uk

5

Policy Impact

Joint theme activity

Keeping Warm in Later Life (KWILLT)

Cross theme activity highlights the added value of our collaboration. Some examples include:

The Keeping Warm in Later Life (KWILLT) project in the Reducing Health Inequalities theme explored the factors that influence knowledge, beliefs and attitudes in keeping warm at home. Six ‘pen portraits’ were developed that were able to inform local policy through the Joint Strategic Needs Assessment (JSNA), and the Rotherham’s Affordable Warmth and Fuel Poverty strategy. The project also has an impact at a national level through a workshop held with the Department of Health to inform the drafting of the Cold Weather Plan, and the National Energy Action have used these in strategic planning at governmental level.

ITS PEN PORTRA

Expanded Newborn Screening project The Expanded Newborn Screening project has now been approved by the National Screening Committee. Detailed screening protocols, diagnostic protocols and medical and dietetic protocols for the five new disorders to be screened have been developed. All of these have been agreed by national working groups from the clinical, laboratory and dietetic services of the sites who are participating, and so will effect change during the implementation of this programme.

The South Yorkshire Cohort (SYC) The SYC is a longitudinal study of people’s health, lifestyle and use of healthcare services, and that will eventually involve 20,000 people. This project is beginning to realise its potential both as a research facility and service planning resource. It has recruited 14,618 participants from 29 GP practices across Sheffield, Barnsley and Rotherham (13,298 this reporting period). Of these respondents, 12,183 consented to be contacted again for research purposes, also allowing access to their health data for research and service development projects. Seven portfolio and four nonportfolio projects have used the cohort this year. The SYC is also a named link on three new, externally funded projects receiving £6.1M. Additionally the SYC is showing promise in influencing health and social care planning in Rotherham through the Joint Strategic Needs Assessment. The Health Inequalities theme is planning to replicate this approach in the other areas in our region. A business case is beginning to be developed for long term sustainability for this facility. Recruitment to the South Yorkshire Cohort contributes to South Yorkshire Comprehensive Local Research Network (CLRN) accruals from 1st June 2012.

6

Collaboration for Leadership inwww.clahrc-sy.nihr.ac.uk Applied Health Research and Care for South Yorkshire

Health Inequalities and Genetics

COPD and Intelligent Commissioning

Consanguineous marriage and rare recessive disorders: Marriage between cousins is more common in some communities leading to higher risk of genetic conditions. This Health Inequalities /Genetics project is informing the development of culturally appropriate service responses at community and health service level. This project has attracted further funding from Jeans for Genes in partnership with the Pakistan Advice and Community Association (£23K).

Home Oxygen Assessment pathway: Home Oxygen Assessment pathway was the result of a collaborative project with NHS Rotherham and Rotherham FT involving the COPD and Intelligent Commissioning themes. The arising changes in the care produced an estimated cost savings for NHSR of £99K over 2011. The Yorkshire and Humber Home Oxygen Network have requested that the pathway document be used as a template for other home oxygen services in the region.

Obesity, UCHD and TaCT

PPI and TK2A

MOMTech: This is a joint project between the Obesity theme, User-Centred Healthcare Design (UCHD) theme and the Telehealth and Care Technologies (TaCT) theme, and is developing a mobile phone technology to assist pregnant women manage an appropriate weight gain during pregnancy. This project is working with women and practitioners in Doncaster.

Venous Thromboembolism (VTE): VTE information for patients with aphasia was developed between a Patient and Public Involvement (PPI) group and members of the Translating Knowledge into Action (TK2A) and Stroke themes as a result of a gap in services identified by the TK2A theme during the introduction of National Institute for Health and Clinical Excellence (NICE) guidelines on VTE.

www.clahrc-sy.nihr.ac.uk

7

Contact details Programme Manager: Jo Cooke Email: [email protected] Administrator: Jenny Powell Email: [email protected]

CLAHRC for South Yorkshire acknowledges funding from the National Institute for Health Research. The views and opinions expressed in this publication are those of the authors, and not necessarily those of the NHS, the NIHR or the Department of Health. CLAHRC SY would also like to acknowledge the participation and resources of our partner organisations. Partner details can be found on our website. © Sheffield Teaching Hospitals NHS Foundation Trust 2012

www.clahrc-sy.nihr.ac.uk