Award Title: Responding to people in danger. A development and feasibility study to co-develop a community pharmacy response service for domestic abuse and suicidal ideation.
Funder: Department of Health and Social Care

Abstract: Aim - This project aims to develop and test the feasibility of a service for people in danger from either domestic abuse or suicide, to access help through community pharmacies. _x000D_
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Background - The current COVID-19 situation has increased the number of people feeling suicidal, and has increased domestic abuse. Both of these situations are distressing and can be fatal. However, these deaths are preventable, and harm can be minimised, if people are able to access timely and appropriate help. _x000D_
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Community pharmacies are known to be highly accessible, with long opening hours and no requirement for an appointment. Due to the distressing nature of these issues, we aim to make the service as discreet as possible. Discussions with members of the public has indicated that a name with an analogy may help to make it discreet. There has been a positive response to an initial suggestion of using the analogy of a lifeguard and life-ring. The details of how the service would work, the training and service resources and a promotional strategy will be co-developed in the first stage of the project. _x000D_
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Design and methods used - In phase one, we will hold 8 interviews with local experts, 2 lay focus groups and 3 development workshops with members of the public and pharmacy staff. Through these activities we will develop the name, concept, design and resources for the new service. Resources will include developing a clinical assessment and referral tool, and a training package for the pharmacy staff that will deliver the service. _x000D_
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In phase two, we will launch the service to 8 pharmacies across Lincolnshire. The service will be promoted in local community venues. We will train 3 members of staff from each of the 8 pharmacies in the scheme. We will collect data on the usage of the service and on the number of referrals made. We will also collect data from 4 pharmacies who will not be using the service, as a control. _x000D_
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We will need to know if the proposed service is successful and if there is a favourable opinion of the service from members of the public, the pharmacy staff, and the organsiations that accept referrals. We will assess this by holding interviews with 3 customers  and the staff in each of the pharmacies that took part. We will conduct an e-survey in local communities. We will finish with a summary workshop with the pharmacy staff and members of our public and patient panel. By working together, we aim to develop a user-friendly service to offer safety and support to people in danger. _x000D_
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Public and patient involvement - It is important to us that the views of the public and patients are taken into account in the design of this service. Our proposal is based on consultation with members of the public and relevant organisations. A diverse panel of members of the public has been set up to work with the researchers throughout the project to give their views.  _x000D_
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Dissemination – If the study finds that the proposed service is successful, it may lead to a larger research trial for further testing. This has the potential to become a widespread service through community pharmacies. The concept of the service, and the results from the study will be actively promoted to relevant organisations and the public, plus publications.

Lay Abstract: Research question_x000D_
How feasible and acceptable is a co-produced community pharmacy response intervention for identifying and referring people in danger from suicidal ideation or domestic abuse? _x000D_
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Background_x000D_
The effects of the COVID-19 pandemic have worsened the incidences of suicidal ideation (SI) and domestic abuse (DA). Barriers to care for people experiencing DA and SI include: capacity, psychological burden, timing and level of severity. This intervention addresses these barriers by developing a discreet response service for people in danger through community pharmacy. Pharmacies offer long opening hours and access without an appointment. This will allow more people in need to access appropriate and timely care. _x000D_
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Aim: To co-develop and evaluate the feasibility of a community pharmacy response intervention for people in danger from DA or SI._x000D_
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Objectives: _x000D_
1.To develop a point of contact and triage referral resource in partnership with relevant experts and local referral organisations, for both DA and SI._x000D_
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2.To co-develop with patients / public and professionals the scope and features of a discreet response intervention in community pharmacy, to include the name, logo, promotional strategy and protocol for delivery in a pharmacy._x000D_
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3.To co-develop with patients / public and professionals a training package and mentoring support service for pharmacy staff delivering the intervention._x000D_
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4.To deliver the intervention in a purposive sample of community pharmacies and collect feasibility data on intervention usage and consequent referrals._x000D_
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5.To ascertain and evaluate client, public and professional views on accessibility, acceptability, implementation, feasibility and intervention fidelity in practice._x000D_
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6.To evaluate the potential for the intervention to be scaled up for a future trial, including economic and statistical considerations._x000D_
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7.To engage with the public and professionals to disseminate findings and reporting of the intervention as an output. _x000D_
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Methods_x000D_
This study will co-develop and evaluate the feasibility of an intervention in community pharmacies to respond to people in danger from either SI or DA, with parallel engagement of a steering group and PPI panel. _x000D_
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Development - Qualitative interviews will be held with 8 representatives from referral organisations, followed by 2 lay focus groups and 3 co-production workshops with 8 lay people and 4 pharmacy staff in each workshop. _x000D_
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Feasibility - Purposive sampling will be used to recruit 8 intervention and 4 control pharmacies, based on rural or urban location, sole pharmacy or co-located. The pharmacies will then be randomised to give 8 intervention and 4 control pharmacies. 3 members of staff from each intervention pharmacy will be trained, followed by implementation of the intervention. Service use and referral data will be collected from the intervention pharmacies, and data on requests for assistance from control pharmacies over 6 months. Public acceptability will be measured using an e-survey and interviews with 3 customers per intervention pharmacy. A feasibility workshop will be held with the 24 intervention participants, steering and PPI group. _x000D_
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Timelines for delivery: 6 months development, 9 months implementation, 9 months evaluation. _x000D_
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Anticipated impact and dissemination_x000D_
The findings will be actively disseminated to the public, stakeholders and research community. This study will inform a future cluster randomised trial

Research Activity Codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health Categories: MENTAL HEALTH;DISPUTED AETIOLOGY AND OTHER