Making it Happen – CaHRU attend 999 EMS Research Forum conference in Newcastle

Members of the CaHRU team together with colleagues from East Midlands Ambulance Service NHS Trust attended the 999 EMS Research Forum conference, ‘Making it happen: delivering research in pre-hospital care’ at the Assembly Rooms in Newcastle on 1 March 2016. The event was organised by the 999 EMS Forum in collaboration with North East Ambulance Service NHS Trust and Newcastle University.

IqbalEMS9991.3.16The conference was opened by Yvonne Ormston, Chief Executive of North East Ambulance Service and introduced by Prof Helen Snooks, Professor of Health Services Research at Swansea University and chair of the EMS 999 Research Forum. The opening keynote was given by Dr Simon Woods of Newcastle University on ‘Ethics and consent in pre-hospital research’. This was followed by a number of oral presentations from the highest scoring abstracts submitted to the conference. This included a presentation by Dr Mohammad Iqbal, research associate at East Midlands Ambulance Service NHS Trust and research fellow at CaHRU, who presented his doctoral study, ‘Non randomised control study of the effectiveness of a novel pain assessment tool for use by paramedics’. After the oral presentations there was a further keynote from Dr Chris Price of Newcastle University on ‘Delivering safe pre-hospital research: a stroke perspective’.

FionaEMS9991.3.16Poster sessions included a presentation from Fiona Togher, graduate research assistant at CaHRU on her doctoral research, ‘Refining questionnaire items in a Patient Reported Experience Measure (PREM) designed for users of NHS ambulance services: Question Appraisal Study’. The afternoon session included a workshop given by Prof Niro Siriwardena and Dr Adele Langlois supported by Dr Stephanie Armstrong, on ‘Ethics and consent in pre-hospital research’, which form part of the Network exploring Ethics of Ambulance Trials funded by the Wellcome Trust. The workshop was well attended and generated ideas on consent, confidentiality, and privacy in relation to ambulance trials as well as ideas on future research.

NEAT_team1.3.16The final keynote was given by Dutch researcher, and acute physician, Dr Prabath Nanayakkara on his ‘Research in the pre-hospital management of sepsis: opportunities and challenges’. The conference was closed by Prof Siriwardena, with prizes presented to the best research, best poster, research most likely to affect practice and best use of data, and thanks given to the organisers for an excellent and memorable event.

East Midlands Academic Health Science Network (EMAHSN) Patient and Public Involvement event

Viet-Hai Phung from CaHRU recently attended the East Midlands Academic Health Science Network Patient and Public Involvement (PPI) event at Nottingham’s Trent Vineyard on 24 February 2016. This provided an opportunity to share learning and best practice in PPI across the health and social care sectors. Viet-Hai, iscurrently undertaking a PhD focusing on the seldom-heard group of people recently arrived in England from EU accession countries, found the event thought-provoking.

Yvonne Coghill, who is Director of Workforce Race Equality Standard Implementation for NHS England, introduced the event. She used the Thomas Jefferson statement that: “There is nothing more unequal than the equal treatment vhp2of unequal people“, suggesting that it is equity, rather than equality, that the NHS should focus on. There then followed a keynote speech by Anu Singh, the Director of PPI and Insight at NHS England. She gave practical suggestions about how the NHS can use PPI meaningfully.

After the opening speeches, representatives from projects targeting seldom-heard groups (Roma, people with learning disabilities, young carers, minority ethnic groups with long-term conditions) talked about how they engaged with them. All four emphasised the importance of actively seeking out their target groups, as well as helping them to help themselves.

A masterclass on involving minority ethnic groups, run by Haseeb Ahmad and Jo Ryder from Leicester City Clinical Commissioning Group (CCG), provided suggestions on how to effectively involve minority ethnic groups, including taking time to establish and build relationships and making links with professionals on the ground, who may act as gatekeepers to other key community figures. After lunch, a session on running engagement events stressed the importance of clarity about the desired outcomes and that interactive methods, such as voting technology, can be effective at engaging participants.

At the close, EMAHSN announced that they have opened up funding of up to £1,500 each for up to 10 PPI groups to support their work in the East Midlands. There were plenty of practical ideas to consider when engaging, and building relationships, with these groups.

By Viet-Hai Phung

Presentation at GP educator conference and bursary award for doctoral study on early cancer diagnosis

BJoseph Akanuwe, doctoral student at CaHRU, was recently invited to present a workshop with Dr Sharon Black (both pictured below) at a regional primary educator’s conference organised by Health Education East Midlands at the Eastgate Hotel on 14 January 2016. Joseph who is a full time PhD student with CaHRU, continues to work as a nurse to support his studies which are supervised by Prof Niro Siriwardena, Dr Black and Prof Sara Owen.

joseph and sharon 1The workshop entitled ‘Estimating and Communicating Cancer risk in the GP Consultation’ was based on his work reviewing the literature around use of cancer risk assessment tools and a series of interviews of primary care practitioners and service users on their perceptions of risk assessment using a novel risk tool (Qcancer) and how this might be used in the primary care consultation. Participants discussed the implications for GPs of using Qcancer to quantify cancer risk; the potential uses of QCancer in the consultation; what communication issues might arise when using Qcancer; and the potential challenges to using QCancer in routine general practice. The workshop raised issues about communicating risk in general practice participants found the discussion of potential advantages and disadvantages of using Qcancer.

BJoseph also presented findings of a qualitative study involving semi-structured interviews and focus groups of 19 service users and 17 practitioners on cancer risk estimation and communication. The results of the workshop will contribute to validation of the research findings. Joseph has also been invited to present his most recent study, ‘Patient and practitioner perspectives of QCancer use in primary care consultations’ at the Trent Regional SAPC conference in Leicester in March 2016. His work was recently recognised through a bursary awarded by a member of the University Court to support his studies.

CaHRU research on measuring quality presented at the Larrey Society’s Future of EMS Conference

niro2Professor Niro Siriwardena recently presented on ‘Developing new ways of measuring the quality of emergency medical services’ on 21 January 2016 at the Larrey Society’s inaugural conference on the Future of EMS in London. The Larrey Society, the brainchild of its founder David Davis, is an international organisation of paramedics and NHS, independent and voluntary ambulance services with leaders from health and academic communities, formed a year ago. The society is named after Dominque Jean Larrey, an army surgeon in Napoloen’s army who developed field medicine and ambulances.

NThe meeting was chaired by Sue Noyes, chief executive of East Midlands Ambulance Services NHS Trust and included keynote lectures from Prof Andy Newton, president of the society, Prof Jonathan Benger, professor of emergency medicine at the University of West of England, Prof Siriwardena, director of CAHRU, and Prof Kevin Mackway-Jones, professor of emergency medicine. Prof Newton talked about the current state of ambulance services and the urgent need to innovate to improve care quality. Prof Benger described an innovative method of ambulance dispatch currently being introduced and evaluated in the South West. Prof Mackway-Jones discussed the causes of and potential solutions to emergency department blocking.

photo2italiccolourWORDSProf Siriwardena described work done by ambulance services in England over the past eight years developing new quality measures of ambulance service care and improving care for conditions such as heart attack, stroke, diabetes and asthma using methods such as largescale quality improvement collaboratives. He went onto describe the new indicators being developed through research programmes such as Prehospital Outcomes for Evidence Based Evaluation using method such systematic literature reviews, interviews of ambulance staff and patients, consensus methods and data linkage to derive risk adjustment measures, which provide potential for better measurement and improvement of ambulance service care.



CaHRU hosts second East Midlands Research into Ageing Network regional seminar at University of Lincoln

Emran-png-250The Community and Health Research Unit, as part of the work of the centre’s Healthier Aging programme of research, recently hosted the second East Midlands Research into Ageing Network (EMRAN) seminar that took place at the University of Lincoln on 25 November 2015 and which focused on the care of older people in the community. The seminar started with a brief presentation by Professor John Gladman and Chris Craig on EMRAN’s purpose to facilitate collaborative applied research into ageing and older people research across the East Midlands and a brief update on EMRAN’s progress, including recent publications and projects which are being developed thanks to EMRAN’s intervention.

jo1The first part of the seminar included four ‘Elevator Pitches’. Dr Carlos Rodriguez Pascual (University of Lincoln; Lincoln County Hospital) presented his project on frailty and cardiovascular disease, exploring how a combination of a comprehensive geriatric assessment (CGA) score and frailty is a predictor of cardiovascular disease in an older person. The second pitch, presented by Dr Jo Middlemass (CaHRU, University of Lincoln), outlined findings from the ‘CArers of people with Dementia: Empowerment and Efficacy via Education’ (CAD: E3) project that aims to improve carer and patient well-being by offering carers of people with dementia a multicomponent intervention (focusing on education and skill-building). The third pitch, presented by Dr Fiona Marshall (University of Nottingham), looked at a project aimed at creating more dementia friendly areas, by gathering local information (through geo-spatial mapping) of what health, social, religious groups, community and voluntary services (amongst others) there are for older people living in the Peak District of Derbyshire. Finally, Dr Gill Garden (United Lincolnshire Hospitals NHS Trust) presented the very successful Bromhead Care Home service, which involved training care home staff so they can more confidently and effectively deliver care in care homes and reduce admissions to hospitals.

EMAS - PTS 7Professor Niro Siriwardena (Director of CaHRU, University of Lincoln) delivered the second part of the seminar, presenting the work of CaHRU and ideas for developing new projects involving ambulance services: ‘Pathways for Older People from Ambulance Services to Safe Community Care’. The aim of the presentation was to show that paramedics, apart from safely transporting patients, can also offer important treatment and refer patients who don’t require hospitalisation to community services that are often more adequately equipped to care or support them. After the successful SAFER-2 trial (Support and Assessment for Fall and Emergency Referrals), exploring how ambulance staff could assess and divert older people who had suffered a fall to appropriate community-based services, Prof Siriwardena and his colleagues at the East Midlands Ambulance Service (EMAS) are currently interested in exploring other conditions, such as hypoglycaemia, epilepsy and COPD (chronic obstructive pulmonary disease) which may also be amenable to community pathways.

After a quick recess for some much needed tea and coffee, the attendees split into small groups to discuss the projects presented earlier, focusing on possible challenges and solutions to the design and conduct of each study, and consider ideas for further research and exciting collaborations. The seminar came to a close with Chris Craig and Prof John Gladman thanking everyone for their participation and with a promise for more similar events and innovative seminars.

Despina Laparidou