IMPLEMENTING AN IMPROVEMENT PROJECT DURING A GLOBAL PANDEMIC Our cohort took place in 2020, which meant we felt the impact of the pandemic on our project. Despite the pandemic and over a three-month period interrupted by the COVID-19 surge, we asked coordinators to pair midwives together during a shift and encouraged midwives to trial this new way of working. “[Our] journey was at all times supported by the NIHR ARC Improvement leadership facilitators. [The programme team] were experienced, knowledgeable, supportive, and understanding. Especially as we were challenged by Covid. Many Fellows at different times were pulled away… for operational reasons, redeployment or family illness.” Susan Barry To gain an understanding of the approach, such as offering paper impact of our project, we invited surveys and online survey links staff to participate in surveys and using a QR code. Seventy midwives semi-structured interviews. We participated in our research and just found ways to encourage greater over 80 per cent felt more engagement and increase supported when working in a accessibility of our measurement partnership. LESSONS LEARNED FROM THE FELLOWSHIP Throughout our project, we created a dialogue about PIMS with other midwives, both locally and nationally. Midwives were overwhelmingly positive about working in this way, when possible. Our project also allowed us the opportunity to discuss and identify other challenges midwives are facing in the workplace. We would certainly recommend the NIHR ARC Northwest London team Fellowship to those who are and presentations from external interested in innovation and change speakers in the context of to improve patient care and structured training. There is a professional wellbeing within regular programme of interactive healthcare. As Fellows, you have workshops and support to help you access to the experts within the develop and implement your
project. This is all delivered in a at, slowly, and that has been our supportive and non-judgemental experience. However, just starting way by Drs Rowan Myron, Vimal the dialogue is an Sriram and Fiona Moss. acknowledgement that as health During the Fellowship, we got to professionals we must continuously work with an interesting and diverse challenge the way we do things and group of professionals, with shared work collaboratively with patients goals and enthusiasm. Innovation in and colleagues alike. The most healthcare is not for the faint- powerful lesson has been that hearted and is most definitely not a connecting with people with shared quick fix. As Fiona Moss said during passions and interests will always be one presentation, change is worthwhile, even in this most something you need to chip away difficult and unprecedented era. “Innovation in healthcare is not for the faint-hearted and is most definitely not a quick fix. As Fiona Moss said during one presentation, change is something you need to chip away at, slowly, and that has been our experience… The most powerful lesson has been that connecting with people with shared passions and interests will always be worthwhile, even in this most difficult and unprecedented era.” Tina Prendeville ONWARDS AND UPWARDS: WHAT NEXT? “Being part of the Fellowship gave structure and credibility to our project.” Susan Barry This platform gave us the designing a study that will evaluate confidence to reach out to experts how we implement complex change in our field, start dialogue around and the impact on midwives. This dissatisfaction, burnout and why collaboration with an external midwives are leaving the profession. academic team has been As a result, we are currently instrumental in developing a working with a team of researchers research grant application. You can keep up to date with our journey by following us on Twitter: @TinaPrendeville @SusieCath
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The Health Secretary, Sajid Javid, announced on 26 January that a ‘national vaccination service’ is required to provide mass covid-19 vaccination to the population of England. Speaking at a House of Commons Health and Social Care Committee meeting, Mr Javid suggested the proposed service could cover other vaccines as well as vaccines for covid-19. The rationale is that NHS General Practice is under great strain, and by removing some services that can be provided elsewhere, it will free up time for primary care teams to concentrate on their core work.
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Traditionally, mass vaccine programmes holistically and not just as a transactional in England have relied largely on general activity. This is particularly important for practices, increasingly supported by children where non-attendance for community pharmacies in recent years. vaccination can sometimes be a This was demonstrated to great effect safeguarding issue which requires a during the first wave of covid-19 sensitive approach from primary care vaccinations where the majority of teams, as well as effective inter-agency vaccines were delivered by primary care working. teams. GP teams have secure electronic patient record systems, and are When the Prime Minister, Boris Johnson, experienced in cold storage chains, and announced that he wanted all adults have medical support on site, including England to be offered a covid-19 vaccine resuscitation equipment. Patients often before the end of 2021 he looked to GPs know and trust their family doctors, and to help. As a result, GPs were asked to generally respond better to recalls for drop all non-essential work and focus on vaccination when these come from their vaccination for the remainder of the year. own general practices. A move towards This caused much debate in the national mass vaccine centres and away from and medical press about what the primary care delivery may explain some priorities should be for the NHS and for of the recent slow-down in England’s primary care. Suspending “non-essential covid-19 vaccine programme. work” will have adverse effects on people’s experience of the NHS and risks The public need to be fully informed worsening health outcomes, particularly about what a national vaccination service for poorer groups. It is clearly also a policy will mean for them individually as well as that cannot be sustained for long or the NHS. The majority of all NHS contacts repeated frequently (for example, for occur in general practice, with around one another covid-19 vaccine booster million contacts per day. This means that programme later this year). vaccines can be offered opportunistically when patients are attending for other The current plan to consider a separate reasons as well as in dedicated vaccine national vaccination service for covid-19 clinics. It also allows primary care teams and possibly other vaccinations seems to to have discussions about vaccination be an effort to ensure that GPs are not during these consultations in patients who asked to stop routine medical care again. have concerns or questions about Although investment in the NHS is vaccines, or who are vaccine hesitant. welcome and removing some workload from general practice might have merits, When attending for vaccination, patients there are some caveats that must be also have the opportunity to discuss other considered before a new national issues in their health with their primary vaccination service is established. care team and to benefit from opportunistic health promotion. All this Firstly, any new vaccination service must helps to ensure that vaccination is viewed be more cost-effective than existing models of delivery of vaccines, such as through general practices and
pharmacists. At a time when NHS budgets risks creating extra work for primary care are under great pressure, NHS funding teams that is not part of their core must be used cost-effectively and services contract and for which they will not be delivered efficiently. A new national paid; and will also be very frustrating for vaccination service would require patients who will have to deal with more substantial funding to establish and run. than one healthcare provider to have any For example, it is difficult to see how a issues they have about their vaccinations national vaccine service could run and how these vaccinations are recorded effectively without full access to patients’ are dealt with. Finally, a newly established electronic medical records. It would also national vaccine service may recruit staff require premises from which to operate, from primary care teams, both clinical and and staff to manage and deliver the non-clinical, thereby further worsening programme. We need the government to the current shortages of staff in NHS show how this investment in a new primary care. service would compare in terms of cost- effectiveness with a similar investment in The government must therefore carefully primary care teams. examine the merits of a separate national vaccination service; and any problems it Secondly, a national vaccination service may cause for existing services; including must achieve a high uptake of vaccination. how it might affect vaccine uptake. We currently have very good uptake of Investing in and strengthening existing most childhood vaccines in England and in NHS primary care infrastructure in general 2021-22, primary care teams also practices and pharmacies may be a more achieved a record uptake of flu vaccines, cost-effective option. Because of the for an extended group of patients importance of vaccination in allowing compared to previous years. Vaccinations England to move to “living with covid-19”, must also be delivered quickly and at scale vaccinations programmes must be when in a pandemic, and there must be a implemented well and achieve a high safe and robust system to target high risk take-up, particularly in the groups most at groups, such as those with frailty, long risk of serious illness, complications and term conditions, the housebound, people death from infectious diseases such as living in care homes, and patients from covid-19. We cannot risk undermining the marginalised groups. current vaccination systems that already work efficiently and cost-effectively in Thirdly, creating a separate vaccination England’s NHS. Any proposals for a new service risks further fragmentation of national vaccination service must primary care. As we have already seen therefore be assessed with the same with the covid-19 NHS 119 service, many rigour we would with any new medical patients will still contact their GPs about treatment with serious consideration of vaccination queries, even if this is no the risks as well as the benefits. longer part of the NHS GP contract. This A version of this article was first published in the British Medical Journal.
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TACKLING RACISM IN UK HEALTH RESEARCH: WHAT PEOPLE CAN LEARN FROM READING THE PAPER The newly published BMJ paper, Tackling racism in UK health research, from our ethnicity and health experts highlights the challenges the sector faces in becoming truly equitable. Drawing on examples of the changes organisations have made to address deep set issues the paper provides a practical insight into areas that need addressing and potential solutions.
AN UNDER RESEARCHED AREA Co-author Mala Rao, Director of the Ethnicity and Health Unit and Medical Adviser to the NHS England Workforce Race Equality Strategy, describes the themes explored in the paper: \"This is the first ever systematic analysis despite the inextricable link between of racism, discrimination and inequality clinical practice and research—will begin in UK health research and I hope it will to be addressed by this paper.\" instigate action to improve ethno-racial equity in this important aspect of health Themes covered in the paper include delivery. It supports NHS England’s racism in research commissioning, patient strategy to address the less favourable and public involvement, academia, the treatment and poorer experience and assessment of research excellence, opportunities of its racialised minority research dissemination and the paper staff. Having contributed to that strategy closes with a ‘call for change’. Each area is from its inception, and seen how it’s described and demonstrated with real driving change across NHS Trusts, I hope world examples with suggested practical that my concern that similar strategies in solutions to address them. health research are woefully lacking— A BROAD LOOK AT THE UK RESEARCH LANDSCAPE Richard A. Powell, Project Evaluation Manager, NIHR ARC NWL, co-authored the paper and states that we need to transform how we view and approach racism in academia. “The critical learning is not the pervasive game itself, creating unequal nature of racism across the health opportunities that actively empower research landscape, but the need to view meaningful participation and thereby that racism through the remedial lens of help remedy past injustices.” equity rather than equality if historical ethno-racial injustices are to be The paper looks to role models to addressed. This means not seeking demonstrate best practice such as the competitive parity on a level playing field themed BMJ issue on racism in medicine, when the game itself is unjust, which contributed to the subsequent discriminating against and denying the decision to launch an NHS Race and effective and active participation of Health Observatory and the work of the players from marginalised communities. NIHR to track, report, and evaluate It’s about committing to an equity diversity throughout research approach that transforms the rules of the organisations. THE IMPACT OF HEALTH INEQUALITIES This paper forms part of the more expansive work being carried out by the Ethnicity and Health Unit. The team are taking action to address longstanding inequalities within the UK health research sector and beyond. The work being carried out focuses on understanding health issues relevant to the Black, Asian and Ethnic Minority communities and on harnessing this new scientific knowledge to bring about real change.
Ganesh Sathyamoorthy, co-author and using health services, delivering health Trustee Sickle Cell Society and Assistant services and undertaking health services Director Ethnicity and Health Unit is a research. Initially, the unit has focussed leading voice on health inequalities, its work on vaccine equity amongst black recently, in particular, relating to vaccine and minority ethnic communities. We are uptake, and has been using his platform to also working to support the delivery of speak to healthcare professionals the new NHS induction for overseas nationwide on this important topic. doctors. The aim of the unit is to improve health services for black and ethnic “The COVID-19 pandemic has bought into minority people by working with the staff sharp relief the health inequalities delivering health services and impacting on minority communities, in researchers delivering health research.” particular their experience in terms of Image by freepik.com
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I don’t support the BMA's view that NHS GPs in England should consider taking industrial action. I think this will alienate the public and lose GPs support at a critical time. NHS England is not going to invest adequately in the current independent contractor model of general practice. Why does the BMA not ballot GPs about the NHS salaried option instead whereby GPs and their staff would become NHS employees? The BMA’s GP Committee has always opposed the option of GPs becoming salaried employees of the NHS. For many years, NHS England has been unwilling to fully support the independent contractor model of NHS general practice. Instead, we are going to find the independent model gradually fading and GPs increasingly being employed by commercial companies contracted to deliver NHS services. This will be a much worse outcome for GPs and patients than other alternatives. And in anticipation of all the responses from GPs about why the current independent model is better than salaried NHS employment, I know these arguments well and list them in a blog I published in 2013. I have been a GP partner for over 20 years and know how this model of NHS primary care works, including its strengths and weaknesses. I make the counter argument about why we should pursue the option of GPs becoming salaried employees of the NHS (like the > 1m current NHS employees in the UK) in an article I published in the BMJ in 2016. The BMA needs to consider this employment model seriously if it is to make working as a primary care doctor viable. All the BMA's attempts to prop up the independent contractor model of general practice in their negotiations and discussions with NHS England over the last 10 years have failed. Their latest attempt will also fail. FURTHER READING Should GPs in England be employed by the NHS?
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The newly published paper Strategies and interventions for healthy adolescent growth, nutrition, and development featured in a new series in The Lancet draws on insights from neuroscience, economics, psychology, medicine, and public health to review the most effective ways of working with young people to improve their nutrition. The comprehensive series paper addresses the fact that adolescent growth and nutrition has been largely overlooked in intervention and policy research and takes a broad look at the many interventions and policies extending across education, health, food systems, social protection, and digital media that that impact adolescent diets.
'EXCITING AREA FOR RESEARCHERS' Co-author of the paper Dougal groups, make this an exciting Hargreaves, Houston Reader in area for researchers and Paediatrics & Population Health, policymakers at global, national Children and Young People and local levels.” workstream NIHR ARC Northwest The three new papers form an London highlights the importance important series that builds on nutrition has on adolescents: the growing interest in designing “The openness of adolescents to and implementing effective change, and the knock-on effects strategies and interventions for of their actions on other age adolescent nutrition. CHANGES IN DIET AND PHYSICAL ACTIVITY Adolescence is described as a most sensitive to social norms. It ‘pivotal point’ is a person’s is not surprising though, that the development offers opportunities most effective health actions for to adopt changes in diet and adolescents take into account physical activity that can persist their rapid emotional into later life in the face of a development and identity growing obesity epidemic. As Co- formation and the social forces, author Geva Greenfield and such as peer context. It is hence Research Fellow, NIHR ARC unlikely that a single, ‘one size Northwest London, explains: fits all’ intervention will generate “Adolescence is a pivotal point desired outcomes. We hence of change, characterised by both argue in this paper for a cognitive, and emotional growth. multifaceted approach Among all age groups, considering various adolescents are probably the interventions.” The papers were officially launched at an event hosted by Murdoch Children’s Research Institute (MCRI), Global Alliance for Improved Nutrition (GAIN) and The Lancet. Follow #NourishOurFuture on Twitter for more.
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Face masks are no longer mandatory in England. Why is this a retrograde step in controlling the spread of Covid-19? Covid-19 is an infection that is largely spread indoors – particularly in crowded, poorly ventilated areas – through inhaling droplets and aerosols produced by infected people when they cough, sneeze, sing, talk, or breathe. Face masks are a simple method of reducing the risk of infection – but masks work much better if they are worn by large numbers of people. The main function of a mask is to reduce the emission of droplets from infected people into the air. The droplets are captured by the mask and hence less virus enters the air. Much of the benefit of wearing face masks goes to other people but they can also benefit the wearer, particularly if a high-specification FFP2 mask is worn that filters out more particles and droplets when the wearer breathes in air. Wearing face masks will reduce the spread of the coronavirus and help protect others. This is very important in settings where we are in contact with older and more vulnerable people – such as in supermarkets and on public transport. Wearing a mask has no major side effects and does not change a person’s oxygen or carbon dioxide levels. Widespread wearing of face masks has been an important part of the pandemic control strategies of countries that have been more successful in containing the spread of Covid-19. Vaccines are essential and can protect us from developing a more serious illness, as well as reducing the risk of death. But we must maintain the use of other control measures, such as the use of face masks, until we are past the worst of the Covid-19 pandemic.
Photo by Danie Franco on Unsplash FACTORS ASSOCIATED WITH ACCESSING LONG-TERM SOCIAL CARE IN OLDER PEOPLE
The rise in demand for healthcare by an ageing population together with budgetary constraints has put great pressure on the availability of adult social care (ASC). In response, healthcare organisations and researchers have developed practices of care and support, focusing on prolonging functional independence. This is done through exploring possible risk factors associated with unplanned outcomes, typically readmissions to hospital or using predictive models to forecast outcomes. Predictive models are widely used by The cohort comprised 13,394 health care providers in the UK and residents, aged ≥75 years with no US due to their potential to inform prior history of ASC at baseline. Of early interventions. However, these, 1.7% became ASC clients over equivalent models for predicting 12 months. Residents were more new onset of long-term ASC, defined likely to access ASC if they were as need for help with tasks of daily older or living in areas with high living in the community or in care socioeconomic deprivation. Those homes, are rare, particularly those with pre-existing mental health or using administrative data. neurological conditions, or more intense prior health service use In this study published in Age and during the baseline period, were also Ageing, we describe risk factors for more likely to access ASC. A long-term ASC in two inner London prognostic model derived from risk boroughs and develop a risk factors had limited predictive power. prediction model for long-term ASC. Pseudonymised person-level data Our findings reinforce evidence on from an integrated care dataset known risk factors for residents aged were analysed. We used 75 or over, yet even with linked multivariable logistic regression to routinely collected health and social model associations of demographic care data, it was not possible to factors, and baseline aspects of make accurate predictions of long- health status and health service use, term ASC use for individuals. We with accessing long-term ASC over propose that a paradigm shift 12 months. towards more relational, personalised approaches, is needed.
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In an article published in The Guardian, Prof Azeem Majeed discusses… RATIONAL USE OF LATERAL FLOW TESTS FOR COVID-19 In recent days, it has become very clear that there are nowhere nearly enough lateral flow tests for Covid-19 in England to allow the government’s policy of their indiscriminate use. Even if funding could be found to buy more tests, it is unlikely to government could source enough tests to meet current and future demand because of the many other countries that are also trying to obtain the tests as they struggle to control the wave of infections from the Omicron variant of SARS-CoV-2. The government is in part to blame for asymptomatic and the two tests are the current problems with the both negative. increased demand in tests. It has encouraged members of the public to What can we do to improve how well test regularly; for example, before lateral flow tests are used? The first social events such as parties; and step is for the government to publish before meeting friends and family data on the daily supply of tests. We from outside their immediate then need clear guidance from the household. The very high level of government on what groups should be Covid-19 cases in the UK (with around prioritised for testing and how 183,00 cases reported on 29 frequently they should test. Carrying December) also means that many out several tests in one day is not a more people will have been advised to good use of these tests. And nor is test regularly in line with guidance carrying out daily lateral flow tests from Test and Trace. This will include after a positive PCR test (other than on guidance for close contacts of cases day 6 & 7 as discussed above). Even who are asked to carry out daily tests daily tests are inappropriate in for 10 days if they are fully vaccinated asymptomatic people when there is to avoid isolating. People with a Covid- currently such a large gap between the 19 infection can also test themselves supply and demand for tests. NHS on day 6 and day 7 of their illness and guidance is for staff to test twice per end their period of isolation if they are week with a lateral flow test but many asymptomatic people are testing more frequently than this. NHS Trusts and
general practices need to review their kind of prioritisation is quite normal in testing polices and give clear guidance healthcare and was done, for example, to staff to protect the supply of tests. with Covid-19 vaccination to ensure access was given based on clinical and Once we have information on the daily occupational priority. Groups for supply of tests, we can then prioritise priority access to tests should include: who will have access to the tests. This – NHS STAFF IN PATIENT-FACING ROLES – PEOPLE WORKING IN SOCIAL CARE – TEACHERS AND OTHER PEOPLE WORKING IN SCHOOLS – WORKERS IN ESSENTIAL PARTS OF THE ECONOMY SUCH AS PUBLIC TRANSPORT – GROUPS SUCH AS HGV DRIVERS TO ENSURE DELIVERY OF ESSENTIAL ITEMS – PATIENTS WHO ARE CLINICALLY VULNERABLE – PEOPLE FOLLOWING GUIDANCE FROM TEST & TRACE There is also now a lack of PCR tests to We also need to look at the costs of diagnose Covid-19. An important supplying these tests and determine question for the government is should what we can afford to spend. Although we use lateral flow tests to give better the tests are supplied at no cost to the access to testing for people with public, they are not free and will come symptoms and reduce testing for at a considerable cost to the taxpayer. people who are asymptomatic? If this Access to diagnostic services and other does happen, we will still need to health services always has to be decide which groups would have limited; and based on factors such as access to lateral flow tests in place of clinical need, health outcomes, and PCR tests. Successful implementation cost-effectiveness. of this policy could allow many more people to receive a test. Although With the UK facing record numbers of lateral flow tests are not as sensitive as people with Covid-19, we need the PCR tests, they will still identify many government to act quickly, decisively people with Covid-19. and rationally to ensure we maximise the benefits of England’s Covid-19 testing capacity. A version of this article was first published in The Guardian newspaper. Further Reading: It’s time for more targeted use of lateral flow tests for Covid-19
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Domestic Violence & Abuse (DVA) can affect anyone, regardless of age, ethnicity, gender, sexuality, class, lifestyle or geographic location. It’s a common problem & continues to be an issue among families, impacting on both the mental & physical health & wellbeing of all who are exposed - perpetrators, victims, and the children who witness the violence. Crime Survey for England & Wales for the year ending March 2020 estimated that 5.5% of adults aged 16 to 74 years (2.3 million) experienced DVA in the last year. Children exposed to DVA are more likely to either experience or perpetrate DVA as adults. Following the advent of the COVID-19 pandemic, visits to the UK National Domestic Abuse Helpline website increased by 700% in the second quarter of 2020 compared with the first quarter. Stay-at-home mandates have also amplified pre-existing mental health conditions & psychosomatic distress reactions. Usual channels of support were jeopardised by lockdown & social distancing, and those suffering abuse needed to find alternative means of support & safety. There are major concerns that DVA cases in general are vastly unreported. Raising awareness of the negative consequences of DVA in the society, would not only help survivors of DVA to openly discuss & encourage receiving support but will also support victims who may be suffering in silence to recognise & acknowledge the abuse they are experiencing. The World Health Organization (WHO) encourages the health sector to play a crucial role in prevention. Raising awareness about DVA in the community setting can also translate to more victims & perpetrators becoming aware of the help & support they can rely on to tackle this rising problem in society. To this end, & working in collaboration with Dr Vasu Siva, Imperial SCARU launched the RAPID study, which is a community & patient-facing survey & interview-based study to understand the public’s awareness, attitudes & perceptions of contributing factors to tackling DVA, and to explore recommendations for interventions to tackle DVA in the contemporary setting. Please consider raising awareness about DVA & this study by sharing this link: https://imperial.eu.qualtrics.com/jfe/form/SV_0qDVaA5YVl0Gej4
By Dr Angelica Sharma Academic Foundation Trainee, FY2, Imperial College London
The Society of Primary Care (SAPC) Madingley Conference was held virtually between 20-21st January 2022 attracting over 200 attendees. The theme was centred around ‘Primary Care - Building Back Better’. The sessions provided key knowledge updates, lessons learnt during the pandemic and ideas for change to help shape the future of primary care. The 2-day event focussed on areas such as health inequality and change including digital methods and innovative tools to address disparities in health care. Panel discussions on ‘Digital Health: What’s Next?’ brainstormed ideas on how to integrate digital health tools within General Practice. Use of digital technologies in healthcare has progressed rapidly, especially in the face of COVID. In the next 20 years, approximately 90% of NHS jobs will require digital skills (Topol, 2019). However, there is a lack of formal integration of digital health within the medical curriculum and it is often an element that is not assessed within medical school.
DIGITAL HEALTH INITIATIVES INCLUDED: 1. ‘Live Well with Parkinson’s’ - a mobile application where patients living with Parkinson’s disease are able to track their symptoms on a day-to-day basis with clinicians receiving this data in live time. 2. ‘Living with COVID Recovery Programme’ - formulating a clinical pathway to support individuals with long COVID with use of a patient-facing application delivering advice and offering a messaging service to contact health professionals. I showcased our initiative to develop a primary care longitudinal digital health curriculum (DHC) for undergraduate medical students at Imperial College London. We compiled and reviewed learning objectives across all year groups and the learning objectives which had scope to integrate a digital health component were selected. As medical students are taught in a diverse range of settings, we explored appropriate formats of delivery of these learning objectives, including tutorial/lecture- based settings, and within written or clinical examinations. Finally, to align these curriculum changes with medical student assessments, we also carried out digital health exam question writing workshops. In these workshops, primary care clinicians were supported in implementing a digital health theme to proposed learning objectives. Key themes included patient generated data (i.e., wearables, mobile phone applications), remote consultations and electronic medical records. We were awarded the ‘Early Career Research’ Prize - with special thanks to Dr Renee Ewe, Dr Viral Thakerar and Dr Ravi Parekh. WE ALSO PRESENTED MEDICAL EDUCATION INITIATIVES FROM THE PRIMARY CARE DEPARTMENT AT IMPERIAL COLLEGE INCLUDING: 1. Sense of belonging, authenticity, and wellbeing: A mixed- methods study - Dr Zoe Moula. Medical students experience poorer wellbeing as compared to other students. Subject to the outcome of a funding application, this mixed-methods study will aim to understand how the sense of authenticity and belonging impacts medical students' wellbeing. It will also aim to examine differences when adjusting for previous experiences of discrimination; pre-
existing mental health conditions; protected characteristics; and year of study. The main objective of this study will be to identify and implement strategies that promote medical students' sense of authenticity, belonging and wellbeing. 2. Coaching skills for pupils from widening participation backgrounds considering healthcare careers - Hamza Ikhlaq (Medical Student). A coaching skills workshop was developed and evaluated for sixth form pupils from widening participation backgrounds to support access to healthcare careers. Coaching offered students a greater sense of awareness and improved communication skills. 3. Exploring the impact of a series of novel medical education masterclasses - Dr Nick Sylvan. The masterclass series delivered in summer 2021 to UK medical students, included guest speakers, interactive workshops, and discussion panels on topic including diversity and inclusion, digital health, professional identity, preparation for practice and coaching skills. The masterclasses broadened students’ perspectives, agency, personal development, and inclusivity. 4. Evaluation of the remote delivery of a community careers widening participation programme - Nida Hafiz (Medical Student). Widening Access to Careers in Community Healthcare (WATCCH) programme for Year 12 students who were from widening participation backgrounds. Due to the pandemic, the WATCCH programme was delivered online. Feedback from students suggested that although online sessions increased accessibility, face-to-face interaction would have helped build better relationships with peers and mentors. Bethany Golding (Community Collaborations Lead) competed in a ‘Dragon’s Den’ style session on ‘What would you do with £1 million worth of funding?’. The talk focused on the importance of community engagement, especially in reaching out to communities and people with physical or mental health related disabilities. Examples of previous projects included tackling food poverty in local communities. She highlighted the importance of community small grants programmes to bring communities together around health and wellbeing in a way that is led by them. THE NEXT SAPC ANNUAL MEETING WILL BE HELD IN PRESTON IN JULY 2022, LATER THIS YEAR.
CO-RESEARCHERS DRIVE CO-PRODUCTION WORKSHOP INVOLVING PEOPLE WITHOUT PRIOR RESEARCH EXPERIENCE THROUGHOUT THE RESEARCH CYCLE. Dorota Chapko and Kabelo Murray from the NIHR ARC NWL Patient, Public, Community Engagement and Involvement Theme, with their Imperial College colleagues at the Patient Experience Research Centre (Jane Bruton, Vas Papageorgiou) and the Institute of Global Health Innovation (Dr Lindsay Dewa) ran a 3-hour workshop on research co-production, as part of the Research Methods eFestival organised by the National Centre for Research Methods.
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A SPECIAL WORKSHOP What was special about this workshop was the fact that it was co- designed and co-delivered by co-researchers, which means individuals with lived experiences of different health conditions (or different identities) who were involved in a research project throughout the entire research cycle without prior research experience. The co-researchers represented two different organisations: Heart n Soul, which is an arts organisation for people with learning disabilities and autistic people, and Positively UK for people living with HIV, as well as a team of young people with experience of mental health difficulties. Together, co-researchers came up with 5 ‘Key Messages’ for what research co-production is and how it should be done. These are: 1. Share power 2. Co-production can help you to connect with people 3. Remain connected 4. Use clear language and make things simple 5. Be kind, have fun, and learn from each other! By meeting teams representing different ‘lived experiences’, all academics and non-academics across the three projects had a chance to evaluate their ‘co-research’ from a different perspective, including the relational skills that they built throughout ‘co-research’, and challenge their own assumptions about their co-research practices. This way, collectively, we have produced exemplar evidence for how to involve people of different
‘lived experiences’ in health and social care research and identified essential behaviours and practice. A POWERFUL EXPERIENCE \"Working with co-researchers from Heart and Soul and PositivelyUK was a truly powerful experience for me. I often contend with the distance between academics and those that we research with. However, this eFestival, and working with the coresearchers reminded me both of the importance and impact that working in a co-produced manner can have. It has helped me reorientate how I want to research and the type of work I want to do as I develop myself as an academic and a researcher.\" Kabelo Murray, Public and Patient Involvement Manager, NIHR ARC NWL This overall, made it a truly inclusive event, challenging the current PPIE practices within academic and health care settings. Those involved received great feedback for our workshop that served as an eye-opener for what would look like a good research co-production practice and why. Robyn, a co-researcher from Heart n Soul who is autistic, commented on social media about participation in the project: “If you are not learning, you are not engaging in the right way”. The Heart n Soul co-research story is summarised in this fantastic video: Heart n Soul at the Hub on Vimeo
THE IMPROVE STUDY HAS BEGUN! AFTER A DELAY DUE TO THE COVID PANDEMIC, WE WERE DELIGHTED TO FINALLY LAUNCH THE IMPROVE STUDY IN OCTOBER 2021
iMprOVE is quasi-experimental cohort study examining the impact of The Daily Mile, a popular physical activity intervention, on primary school children’s physical activity, mental wellbeing, and educational performance. We are recruiting Year 1 children (aged 5 school to assess sustainability of The Daily and 6 years) from state-funded primary Mile, and whether physical activity and schools throughout Greater London that mental health change during the primary implement The Daily Mile (intervention school years. Our protocol with more group) and those that do not (control detail has been published and can be group). We are measuring children’s found here. physical activity using a wrist-worn physical activity monitor, and assessing To identify how many schools are doing mental health and educational The Daily Mile, we distributed a survey to performance through questionnaires. We 1,717 state-funded primary schools in are also measuring children’s bio- London during September 2020. A total of impedance and collecting data on 369 (21%) schools completed our survey, parental health. We will follow-up the this included at least two schools from same children in each year of primary every London borough. The schools that
completed our survey provide the - the target is to recruit 3000 children in sampling frame for the study. total. Although we are recruiting schools throughout London, we are very grateful In October 2021, we started inviting for support from the NIHR Clinical schools to participate in iMprOVE. To Research Network North West London, date, we have recruited around 27 schools who are encouraging schools from their and have collected data from just over Schools Research Network to participate 250 children and 250 parents. in the study. Recruitment and assessments are ongoing PATIENT AND PUBLIC INVOLVEMENT & ENGAGEMENT (PPI&E) In June 2021 prior to iMprOVE commencing, we led two PPI&E workshops with Year 1 primary school children. This was to pilot the wrist-worn physical activity monitor that we ask the children to wear 24/7 for a 7-day wear period. In the first workshop, we engaged the children in physical activities and a discussion about physical activity and why it may be important. At the end of the session, the children were given the monitor to wear for one week. In the second workshop (a week later) the children returned the monitors and answered questions about how they got on with wearing it. The children’s feedback has been published as a blog by Imperial’s Patient Experience Research Centre (PERC), but here is a snippet of what the children said when we asked them how comfortable they found wearing the monitor during the day, whilst in the bath, and when sleeping…. Involving Year One students to help shape research into physical activity and child health
Overall, the feedback was positive! As a thank you, we awarded the children with a certificate naming them as a ‘Junior Public Health Scientist’ for providing excellent feedback after wearing the physical activity monitors, which they were delighted with (they screamed with excitement - we were in the school library and I had to request that they scream quietly!!) WE ARE STILL RECRUITING PRIMARY SCHOOLS INTO IMPROVE… We would welcome interest from state-funded primary schools in Greater London to participate in our study. More information can be found on our study website. Email us to find out more Twitter: @DrBinaRam Lead Researcher: Dr Bina Ram Research Assistant: Mrs Rahat Afzal Principal Investigator: Professor Sonia Saxena
CONGRATULATIONS!
Paquita De Zulueta was awarded the 2021 Schwartz Shining Star Award from the Point of Care Foundation. WATCH VIDEO
Photo by Markus Spiske on Unsplash
15TH EUROPEAN PUBLIC HEALTH CONFERENCE 9 – 12 NOVEMBER 2022 STRENGTHENING HEALTH SYSTEMS: IMPROVING POPULATION HEALTH AND BEING PREPARED FOR THE UNEXPECTED WELCOME TO BERLIN 2022 The first EPH Conference since Marseille 2019 to take place live and in person. The spectacular Hub27 venue, which is part of Messe Berlin, provides us with ample opportunities for informal chatting, personal exchange and live networking. We hope you will join us and look forward to welcoming you in Berlin. ABSTRACT SUBMISSION OPENS 1 FEBRUARY Abstract submissions for the in-person 15th EPH Conference 2022 - 1 February until 1 May 2022, 18:00 CET. Abstracts are invited for workshops, oral presentations, pitch presentations and E-posters. All sessions will be 60 minutes. Do not miss the opportunity to be recognised for your hard work. More information. ABSTRACT MENTORING PROGRAMME EPH Conference offers an Abstract Mentoring Programme providing an opportunity for young and/or less experienced abstract submitters to receive feedback from experienced reviewers. The programme opened is targeted at researchers who have limited access to colleagues to ask for guidance and comments on their proposed abstracts. More information on our website. REGISTRATION Registration for the virtual 15th EPH Conference opens 1 April 2022. Registration fees will be announced on our website. THEME AND PROGRAMME The theme will be ‘Strengthening health systems: improving population health and being prepared for the unexpected’. In the past years, we have learned from the Covid-19 pandemic that infectious diseases know no boundaries. Although we have seen the successful development of vaccines, we have also seen with the spread of the Delta and Omicron variants around the globe that these vaccines have not yet been available to everyone. At the conference, we want to explore how the public health community can bring about better population health. How can Europe take a more active role in global health?
Five minutes with… CAT JACKSON RESEARCH COORDINATOR
What is your role within the department and how long have you been here? I am the Research Coordinator at Imperial College London, for the School for Public Health Research (SPHR) funded by the National Institute for Health Research (NIHR). SPHR is a consortium of eight Universities working with NIHR and government agencies to undertake cutting-edge research to address public health priorities in England. I work part time in the role 2 days per week, and have worked at Imperial for almost a year and a half. I also work at the University of Liverpool 3 days per week as a Network Manager for the STFC Cancer Diagnosis Network, as well as being a busy mum to two girls! I was recruited during the midst of the pandemic. I am based in Liverpool, and have worked completely remotely from home since starting at Imperial, which has worked surprisingly well. I am looking forward to visiting campus in the near future and meeting everyone in person. What does your role involve? My role is predominantly organisation of SPHR Imperial. This includes being the primary point of contact for all administrative-related matters and coordinating responses to both internal and external requests for information. I also actively manage the finances, ensuring projects stay within budget, negotiating extensions where required and providing NIHR with complex quarterly reports. Internally I arrange meetings, circulate all relevant communications, help PI’s, post docs and students with travel arrangements, raise purchase orders, help coordinate and process expenses and supporting with research patient and public involvement processes. Why PCPH? Imperial is internationally renowned for public health. I’m really proud to be part of the PCPH team and feel lucky to be involved in ground-breaking research, collaborating with our funder and universities across the UK, potentially influencing health policies that impact us all. I’m surrounded by a team of amazing colleagues in PCPH who I have a lot of respect for, they are conscientious and hardworking, as well as kind and caring, and I think that makes a big difference in any role. What do you enjoy most about your role? It is a fast paced, varied job! Working two days per week, it took me a while to get to grips with the complexity of the programme, but is a job that I enjoy. My background is in Project Management but also have a Master’s in Public Health, so my role coordinating the SPHR research at Imperial, combines the two perfectly. Public Health is something that I am passionate about, and although I am on the peripheral, I feel that in my capacity as the Coordinator I am still potentially helping to make a difference. What were you doing prior to this? I’ve never been one to sit around, I started working at the age of 16, alongside studying, and would often have multiple part time jobs at the same time. My first job was in the outdoor clothing shop Black’s, people used to come in to buy things like backpacks and mosquito nets for their travels to far away and exotic places, that’s what inspired me to travel. I’ve also worked in call centres, managed off licenses, but my favourite role is waitressing. I’m professionally trained in silver service and have worked at some very fancy weddings and celebrity studded events. I’m very much a people person and so love the social aspect of waitressing! So much so I still work at Aintree Racecourse when the Grand National is on. In terms of my current role, I studied Geography at University. After graduating I secured a graduate project management role within a Local Authority supporting the Building Schools for the Future programme. I was responsible for transition, creating plans and being on the ground to help move and merge 10 schools of staff, pupils and their belongings, across into 7 new 21st Century Centres for
Learning. It was a great role that taught me so much. Once the project finished and the team disbanded, I took a job as a Research and Finance Assistant at The University of Liverpool, which was part time and fitted in with my young family. Over several years, I worked my way up, to now leading on Projects. At the same time, I started studying for a Master’s in Public Health part time, when my youngest child was 18months old. Lots of people thought I was crazy taking on studying, whilst working with two young kids, but it was one of the best decisions I’ve made. Tell us about your outside interests I love to run. I find it exhilarating! If I’m feeling stressed or sad I run, if I’m happy and excited I run. No matter the mood, it always makes me feel even better! I’m also slightly obsessed with food, eating it and cooking it! I love all cuisines, but particularly enjoy cooking Indian food. I’ve travelled around the World quite extensively. We never went abroad when I was little so I made it my mission to visit lots of different places as I got older. My first solo trip was on a skiing holiday to Italy, which I booked with a friend on a last-minute whim at 17. I’d never been skiing before but was quite good by the time we got back! My next trip was a 6 weeks tour of Thailand when I was 18. As a mum I now find it hard to think of my parent’s waving me off at an airport with only details of my first night’s stay! This only made me want to travel more though, and led on to a yearlong round the World Trip with friends after finishing University. And then some years later when I got married 12 years ago, rather than splashing our savings on a fancy wedding, we blew the budget on a 7 week Round the World honeymoon, starting in Singapore, moving on to Malaysia, Bali, Australia, New Zealand, Fiji, LA, finishing in Las Vegas. I absolutely love seeing and experiencing new places, culture and obviously the amazing different foods too, it’s so good for the soul! I’d love to go travelling again one day! What are your goals for the next few years? I’m quite driven, in terms of bettering myself, both professionally and personally. I’ve always been quite envious of people who have a clear career path, that’s not me. I have never really known what I want to be when I grow up, so instead I’ve done things that I enjoy, in areas that I’ve found myself to be good at, such as organising and communicating with people. I always try and take opportunities that arise, which so far has worked out quite well! I think it’s important to take calculated risks, I’d rather have a go and fail trying, than regret not having a go at all! Who knows where the next few years will take me professionally, but my next goal personally is to complete a marathon, watch this space! You’re to be marooned on a desert island – which 3 people (real or fictional, dead or alive) would you choose to be marooned with and what three tunes would you take with you? Someone funny to keep me entertained, so Billy Connelly, the Scottish comedian, as he’s hilarious and has always made me laugh! Someone practical to help us survive, I think Bear Grylls would do a good job doing that! And a strong female role model, to keep us focused, driven and keep moral up. I’ve always admired Michelle Obama (pictured), I’m sure she’d be an asset to the team! And wow what a team that would be! My musical taste is quite varied and ranges from the heavy metal my dad listened to when I was growing up, through to the Indie music I got into as a teenager, and on to the Disney classics my kids have us listening to now. So, my three tracks reflect that and would be: • Jimmy Hendrix - All along the Watch Tower • Oasis - Live Forever • Disney Encanto - Two Oruguitas
We are developing a digital tool to guide people back to physical activity following a period of illness, such as Covid-19 infection. We would like your help in trying out the digital tool (app), and your views on how well it works for you. It will guide you through some strengthening exercises for at least 12 weeks to help you build a strong base for getting fitter, and will check in with you daily to see how you are getting on. We would also like to interview you (lasting around 30-45 mins) to see how it is working for you. You get continued access to the app until August 2022. If you are between 35- 60 years, you can participate. If you are interested in taking part, please contact David Salman.
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