NIHRDataInsights/HRCSData huggingface dataset:
Title: Towards a framework for enhancing procurement and supply chain management practice in the NHS: lessons for managers and clinicians from a synthesis of the theoretical and empirical literature
Funder: Department of Health (England)

Abstract: The aims of this proposed literature synthesis are to provide intelligence for enhanced procurement and supply chainmanagement practice in the NHS to understand the strengths weaknesses and gaps in existing theories about procurementand supply management in terms of its application to health care and to offer a practical guide to NHS managers andclinicians with responsibility for commissioning and procurement of non-pay goods and services. The four objectives andresearch questions in more detail are:Objective 1: To explore the main strands of the literature (for example in institutional and production economicsoperations management organisation theory the resource-based view of strategy business-to-business marketing publicmanagement) and to identify the main theoretical and conceptual frameworks which relate to decisions about the effectivemanagement of third party providers of goods and services.Research question 1: What are the main disciplinary sources of ideas about procurement and supply chain management(SCM) and what are the principal theories conceptual frameworks and main paradigms?Objective 2: To understand to what extent existing evidence on the experiences of NHS managers and clinicians involvedin procurement and SCM matches these theories and to provide an explanatory framework for understanding thecharacteristics of effective procurement policy and practice in the NHS.Research question 2: How can theories about procurement and SCM in general help NHS managers and clinicians in theirprocurement activities in particular in light of recent and planned changes to commissioning structures incentives andprocesses in the NHS?Objective 3: To assess the empirical evidence about how different procurement and SCM practices and techniques cancontribute to better procurement processes and outcomes.Research question 3: What is the empirical evidence about the impact of different procurement and SCM practices andtechniques on outcomes at different stages of the procurement process and in different settings and organisational contexts?Objective 4: To map and evaluate different approaches to improving procurement and SCM practice including modellingdiagnostic and facilitation tools and identify how these approaches relate to theories about effective procurement andSCM.Research question 4: What are the different approaches to improving procurement and SCM practice and which are likelyto work best in the different contexts and types of NHS organisations?


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Characterising the nature of primary care patient safety incident reports in England and Wales: mixed methods study
Funder: Division for Social Care and Health Research (Wales)

Abstract: Primary care poses unique challenges for the design of better quality systems of care delivery. Transferring lessons from advances made from over a decade of patient safety research in specialist care settings may therefore not be without problems A WHO-commissioned systematic review and Delphi expert consensus study (February 2012) highlighted the paucity of empirical work that explores the relationship between cause (the error) and effect (harm) and the underlying system failures that facilitate this relationship (Panesar et al. in review). In 2003 a major national investment was made to better understand patient safety incidents occurring in England and Wales called the National Reporting and Learning System (NRLS). The NRLS contains a free-text description of the event perceived causative factors and any planned actions made locally following the incident. Over 47000 incident reports exist from primary care in England and Wales and these have never previously been systematically analysed. Such reports permit a retrospective ‘window’ on the healthcare system providing a means of looking to the future by identifying weaknesses of the system that are still present and could lead to further incidents involving patients (Vincent 2004). This study aims to understand the nature and range of patient safety incidents in primary care reported to the NRLS. A team comprising primary care doctors nurses and health services researchers will undertake thematic content analysis of free-text data in reports to describe the incident identify potential contributory factors type and severity of harm. A codebook will comprise iterations of existing coding frameworks for primary care patient safety incident description e.g. the LINNEAUS taxonomy (LINNEAUS EURO-PC http://www.linneaus-pc.eu) type of harm (Vincent et al. 2013) and severity of harm (NRLS 2004) as well as empirical de novo creation of a potential contributory factors coding framework. Assigning codes requires ‘sense making’ of the reported story and eliciting human factors and organisational issues discussed within it (Reason 1990; Vincent et al. 1998; Henriksen and Kaplan 2003). Incident characteristics will be summarised using descriptive statistics. Modelling will determine the strength of association between types and severity of harm. A map will be generated to demonstrate the relationships between themes and their potential contributory influences.We anticipate the research will benefit patients and the NHS by characterising patient safety incidents that lead to harm in primary care. This is an unexploited area within primary care patient safety and should serve to demonstrate the value of safety monitoring and frame the benefits of a reporting culture for healthcare professional managers leaders and patients in the NHS.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Mindfulness, attentional control and healthy eating
Funder: Division for Social Care and Health Research (Wales)

Abstract: Mindfulness-based therapies are becoming increasingly popular in clinical and non-clinical practice. However, at present our understanding of how they work is limited. One possibility is that they increase attentional control. If so, mindfulness may prove useful for reducing attentional bias. This is important since attentional bias has been implicated in overeating as well as a range of addictive behaviours such as smoking and alcohol abuse. Studies 1 and 2 of this project will examine links between mindfulness, attentional control and attentional bias by (a) examining differences in attentional control and attentional bias between those who regularly practice mindfulness strategies and those who do not, and (b) examining whether mindfulness training can increase attentional control and reduce attentional bias. Study 3 of this project will involve the development of a mindfulness-based intervention to aid healthy eating. This will focus on reducing consumption of ‘unhealthy’ snacks and desserts using strategies aimed at reducing attentional bias. Randomised controlled trial methodology will be used to conduct an exploratory evaluation of this intervention and to explore the extent to which any changes in eating behaviour are brought about by increases in attentional control and reductions in attentional bias.


Research activity codes: 6.8 COMPLEMENTARY
Health categories: GENERIC HEALTH RELEVANCE
Title: A realist evaluation of patient involvement in a safer surgery initiative
Funder: Division for Social Care and Health Research (Wales)

Abstract: The degree of avoidable harm resulting from adverse events related to surgery have resulted in over 5000 individual incidents of severe injury or death in hospitals in England and Wales over the past 5 years. Consequently, the National Health Service has issued guidelines for staff aimed at reducing adverse events related to surgery in hospitals. The guidelines focus on, amongst other things, attempts to improve patients’ safety in hospitals through promoting the involvement of patients in the planning and delivering surgical care. However, prior research has rarely addressed questions relating to the involvement of patients in attempts to improve safety in hospitals. In contrast this project seeks to evaluate interventions currently encouraged by NHS Wales which see patients taking an active role in promoting their own safety when using surgical services. The studentship will therefore extend what is presently known about this under-researched area by asking questions relating to a range of contextual issues such as the conditions and circumstances that are required for patients to adopt safety roles, including their willingness and ability to do so. The findings from this study will inform the safer practice of all healthcare professionals, managers, policymakers and patients in Wales and beyond.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE
Title: Care of older people who fall: evaluation of the clinical and cost effectiveness of new protocols for emergency ambulance personnel to assess and refer to appropriate community based care
Funder: Division for Social Care and Health Research (Wales)

Abstract: The proposed trial will measure the costs and benefits of a new health technology - a protocol for use by emergency ambulance paramedics in the care of older people who have fallen allowing the paramedic to assess and refer appropriate patients to a community based falls service. We will carry out a randomised controlled trial in which ambulance stations in three participating services (London Wales East Midlands) are randomly allocated to 1) implement the new health technology (intervention group) or 2) to continue to provide care according to their standard practice (control group). Paramedics based at the stations selected for the intervention group will receive additional training protocols and clinical support to enable them to assess older people and decide whether they need to be taken to the Emergency Department (ED) straight away or whether they could benefit from being left at home with a referral to a falls service. We will compare costs processes and outcomes of care for patients aged 65 or over who have fallen and are attended by paramedics with the new protocols with those attended by paramedics delivering usual care at 1 and 6 months. The most important outcomes are those related to further falls - subsequent 999 calls and ED attendances for falls. We will also compare between groups: all falls; fall related injuries; hospital admissions; quality of life; fear of falling; satisfaction; deaths; operational measures for the services e.g. time spent on jobs; and the costs of care (and any knock on effects) to the NHS and other services and to patients and carers. We will also gather in-depth information from patients carers and health care providers (paramedics ambulance service managers and falls service staff) about how the new service works and about any factors which encourage or hinder its use


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: GENERIC HEALTH RELEVANCE
Title: Randomised controlled trial of a pedometer-based walking intervention with and without practice nurse support in primary care patients aged 45-74 years
Funder: Department of Health (England)

Abstract: BackgroundPhysical activity (PA) is vital for health yet most adults are inactive and do not achieve the recommended 30 minutes of moderate intensity activity on 5 or more days weekly. Adults most common PA is walking light intensity if strolling moderate if brisker. Pedometers measure step-count and can increase walking but most trials have had short-term outcomes have not separated out pedometer effects from other support and have reported only step-counts not time spent at different PA intensities. Design: Primary care based 3-arm randomized controlled trial with 12 month follow-up and health economic & qualitative evaluations.Participants: 993 inactive patients aged 45-74 years with no contraindications to increasing their moderate intensity PA will be recruited by postal invitation from 6 South West London general practices and randomly allocated into three groups. All participants will have their PA assessed objectively (step-count & time spent at different PA intensities) for 7 days at baseline 3 months and 12 months by wearing an accelerometer which gives no patient feedback. They will also complete questionnaires and have anthropometric assessments.Intervention: One intervention group (pedometer alone) will be posted out a pedometer diary and written instructions for a 12-week pedometer-based walking programme based on their own baseline accelerometer step-count. The second intervention group (pedometer plus support) will receive a pedometer and diary and three individually tailored PA consultations with a practice nurse. They will be supported to follow a 12-week pedometer-based walking programme using strategies such as self-monitoring goal-setting boosting motivation and anticipation of set-backs. The control group will continue usual PA. Main outcome measures in all groups after 12 months:1.Change in average daily step-count (primary outcome)2.Change in sedentary time and time spent in at least moderate intensity PA weekly3.Cost-effectiveness. 4.Acceptability of the interventions.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE
Title: Self-Management of Analgesia and Related Treatments at the End of life (SMARTE)
Funder: Department of Health (England)

Abstract: Despite there being a good understanding of patient and carer concerns regarding opioid analgesia and related side effects much less is known about the optimal means of addressing these concerns which is why they have been highlighted by NICE guidance (1). We aim to develop a support tool to improve the management of medications for pain relief nausea constipation and drowsiness in patients with significant pain approaching the end of life. Our self- management support tool (SMST) will be developed using a patient centred approach and will be delivered in partnership with health care professionals (HCPs) in two UK regions. Ultimately we aim to establish the acceptability and up-take of our prototype SMST and determine the feasibility of evaluating this intervention within a larger trial. We have interpreted the brief so that we will focus on patients who are treated with or due to start treatment with opioids for pain and that experience (or anticipate) adverse effects of these medications.Our objectives are divided into three distinct phases which is in-line with the MRC framework on developing and evaluating complex interventions and NPT(9).[1] Development objectives (Phase I)•Establish a PPI panel •Establish the content of a prototype SMST and a manualisation strategy that includes a protocol to standardise (i) the training of HCP and (ii) the delivery of the intervention by HPCs to patients and carers•Understand self-management needs and capabilities of patients and carers.•Define usual care[2] Modelling objectives (Phase II)•Refine and co-design the prototype SMST and manualisation[3] Feasibility assessment objectives (Phase III)•Assess acceptability and up-take of the SMST in a mixed-methods observational study involving patients informal carers and HCPs from 4 palliative care services•Assess the feasibility of obtaining outcome data for a larger trial


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE
Title: Home-based health promotion for vulnerable older people
Funder: Department of Health (England)

Abstract: Aim: To develop and test feasibility/acceptability of a home-based health promotion intervention for older people with early frailty.Design: Evidence review in-depth interviews and development acceptability feasibility of a complex intervention.Evidence synthesis: We will update systematic reviews of trials and systematically review policy qualitative and other data focussing on defining active components and theories in relevant health promotion interventions. We will use methods developed by NICE/SCIE to synthesise heterogeneous literature.Setting: Community (home) based in London & Hertfordshire.Target population: Older people 65+ years with early frailty in receipt of community health services/visited at home by a health professional in the previous 6 months.Exclusion criteria: Those in care homes on GP palliative care register who lack capacity to consent already case managed (e.g. by community matrons).Qualitative study: We will supplement data from a current qualitative study with 52 older people and stakeholders from NHS local authority and community groups with up to 10 further interviews with older people with early frailty and 4 focus groups with carers home care workers and health professionals. These will explore facilitators and barriers to health promotion and content/delivery of a new intervention. Transcripts will be analysed thematically.Intervention: Using a co-design approach successful in previous work we will convene panels of older people/carers and multi-disciplinary stakeholders/experts to develop the intervention. Using the MRC Complex intervention model we will develop/manualise the intervention and synthesise evidence from the reviews theory and qualitative findings. The intervention will be delivered by health professionals at home for older people with early frailty.Feasibility study: General Practices will identify individuals receiving home visits and invite them to take part. Those eligible will be randomised to receive the intervention or treatment as usual. Intervention visits will be recorded and assessed for content/fidelity.Outcomes: A theory-based intervention tested for acceptability/feasibility in community settings. Data on patient recruitment retention willingness to be randomised and potential outcomes for an RCT: functioning; quality of life; frailty; well-being; mobility; psychological distress; uptake preventative interventions; CVD risk factors (BP BMI smoking alcohol exercise); falls; medication use; service utilisation (NHS/social care); costs; QALYs; mortality. Sample size: To test feasibility we will identify 12-13 eligible older people per GP practice in 4 General practices (50 participants). This was feasible in previous work.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE
Title: Survey and point prevalence study of sedation practice in UK adult general critical care units
Funder: Department of Health (England)

Abstract: The study seeks to establish current sedation practice in UK adult general critical care units. The study consists of two phases: a point prevalence study (Phase 1) and a survey of current practice (Phase 2). This combination of study designs will give the most complete picture of current practice in terms of both breadth and depth of information. The Phase 1 point prevalence study has the strength of demonstrating actual practice at a patient level with data linkage to the national clinical audit for adult critical care (the Case Mix Programme) permitting more detailed examination of sedative use for specific patient groups. The survey of current practice (Phase 2) will enable the inclusion of all adult general critical care units across the UK.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: GENERIC HEALTH RELEVANCE
Title: Mobilising knowledge across health and social care boundaries in community settings: understanding and developing the role of knowledge brokering
Funder: Department of Health (England)

Abstract: More people than ever receive support from health and social care services. Organisations providing these services have increasingly been trying to work better together and some of them have set up ‘Integrated Teams’ of health and social care staff. This project will help staff from Integrated Teams in Leeds share what they know so that their working practices become more co-ordinated. The fellow will support the teams to identify a problem which is being experienced by their service users and develop a solution by sharing knowledge. The project will also develop a practical tool to help other teams share knowledge.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Design; a vehicle for moving knowledge in a healthcare context
Funder: Department of Health (England)

Abstract: I aim to understand how User-centred Design theory and practice might help change learning from research projects into something usable in everyday life or practice. Using interviews, workshops, prototyping and case-studies, I will develop a set of principals to support this, working with the National Institute for health research (NIHR) Collaboration for Leadership in Applied Health Research and Care, Yorkshire and Humber (CLAHRC YH), changing traditional academic outputs into actionable tools. I will share the learning through training workshops, exhibitions, articles and digital toolkits. Benefits are improved services and patient experience made possible as understanding of this new approach develops.


Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE
Title: A National Centre for Protein Kinase Profiling
Funder: Medical Research Council

Abstract: Protein kinases have become the most studied class of drug target, with 30% of the R&D effort of the pharmaceutical industry now devoted to this topic. The challenge is to develop drugs that inhibit just one or at most a few of the 500 protein kinases encoded by the human genome. To assist this process, the MRC Protein Phosphorylation Unit (MRC-PPU) introduced the idea of kinase profiling in which the specificities of hits identified by screening compound collections are rapidly profiled against a panel that currently comprises 80 protein kinases. This service has proved to be of critical importance to the pharmaceutical industry, has spawned a spin-out company in Dundee (the Upstate division of Millipore) that employs 70 people and created a new industry worth #200 million per annum worldwide. In recent years, the number of academic researchers operating drug discovery programmes has increased enormously and the kinase profiling service of the MRC-PPU has become vital in providing an affordable service for these organisations. The purpose of the application is therefore to provide the funding needed to set up a National Protein Kinase Profiling Centre for the academic community, MRCT and other organisations. Without such support the service to these users will not continue, because the pharmaceutical companies with whom the MRC-PPU collaborate and who have funded the service so far, now wish the funding for this resource to be used by the MRC-PPU to develop new services that are not yet commercially available.


Research activity codes: 2.6 RESOURCES AND INFRASTRUCTURE (AETIOLOGY);5.9 RESOURCES AND INFRASTRUCTURE (TREATMENT DEVELOPMENT)
Health categories: GENERIC HEALTH RELEVANCE
Title: MRC Clinical Trials Unit as the London Hub for Trials Methodology Research
Funder: Medical Research Council

Abstract: The MRC CTU vision is to integrate methodological research within the development, execution, analysis and reporting of trials. The trials themselves pose methodological problems and in turn, the methodological work results in new and better ways of designing, conducting and analysing trials. Our methodological research will initially be focussed in areas where we already have established expertise and experience. We shall also respond to new methodological questions as they arise, and as time and priorities permit.


Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES);2.5 RESEARCH DESIGN AND METHODOLOGIES (AETIOLOGY)
Health categories: GENERIC HEALTH RELEVANCE