Foreword from Professor Adrian Edwards, Director, PRIME Centre Wales

I very much welcome you to the 2021 first newsletter. There is a huge amount of important research, innovation and impact work going on. There are now a number of major Covid-related research studies in progress on our portfolio, and of course a range of others too. Many are detailed or highlighted below.

There is also a major development for myself, and PRIME Centre generally in terms of the new Wales Covid-19 Evidence Centre which will start on 1st March 2021. Again more information about this is below.

But the main focus of this Foreword is to wish Happy Retirement to our friend and long time co-researcher Professor Joyce Kenkre. Joyce retired from University of South Wales at the end of January and will be much missed by the colleagues there and of course all of us in PRIME in which she has been Associate Director, leading for USW, since our inception in 2015.

In fact Joyce’s collaborations with us go back before that, in the previous Wales School of Primary Care Research. Her style, knowledge and wisdom will be a gap that we will find hard to fill. Joyce’s networking was also unsurpassed, giving us numerous opportunities to collaborate, work with stakeholders and deliver the research and impact that we all strive for. 

We look forward to hearing how you get on in your new chapter Joyce, and wish you the very best indeed for the future. We will miss you being part of our team.

Replacing the irreplaceable is not an undertaking to make without much consideration. We have been considering and discussing the immediate role of Associate Director for University of South Wales (we have one for each of our 4 participating universities). I am very pleased to share that Professor Carolyn Wallace will take on this role in our leadership group, and that also Prof Ruth Northway from USW will join our Operational Management group. Ruth’s interests are particularly in research for people with learning disabilities, so it will be great to integrate Ruth and her colleagues even more closely into the PRIME team. Thank you and welcome to you both in these new roles, and we are very encouraged by the opportunities.
 

Professor Helen Snooks, Associate Director, PRIME Centre Wales

The race for COVID-19 research: applying for funding in a pandemic

Getting your research funding application right is always a challenge. You’ve got to make sure the study strengthens the existing evidence base and uses a robust methodology appropriate to your research question. You’ve got to build your study team, find the right partners and involve the public. 

It’s already a long to do list, so how do you do it when time is short? How about doing it all in a pandemic? 

Helen Snooks, Professor of Health Services Research at Swansea University, PRIME Centre Wales Associate Director and Health and Care Research Wales Senior Research Leader, shares her experience applying for COVID-19 research funding.

Read the full blog post on the Health and Care Research Wales website.

Supporting the response to Covid-19
 

Director appointed to new Wales COVID-19 Evidence Centre 

Health and Care Research Wales has appointed Professor Adrian Edwards as the Director of the new Wales COVID-19 Evidence Centre.

The £3 million centre, announced in December, is being created on behalf of Welsh Government to make use of UK-wide and international research findings to answer key questions and support decision making in Wales.

This could include addressing the long-term effects of the pandemic and investigating challenges such as infection control and social distancing, the consequences of isolation and the health effects of the economic disruption.

The new Evidence Centre will be hosted in PRIME Centre on behalf of Health & Care Research Wales. It is due to open on the 1st March and will have a dedicated ‘Core Team’ of key researchers and staff. These include PRIME’s Dr Natalie Joseph-Williams (Cardiff), Dr Ruth Lewis (Bangor), Dr Alison Cooper (Cardiff) and a Knowledge Mobilisation specialist to be appointed in Cardiff. Mrs Angela Watkins will also provide management and communications expertise to establish and maintain the new Centre. All posts will be ‘backfilled’ to the host universities. Dr Andy Carson-Stevens will also have a major role chairing the Knowledge Mobilisation Board that will be established, incorporating key stakeholders from patients & public, NHS and social care, policy-leads, Royal Colleges etc.

The new Evidence Centre, based at Cardiff University, is due to open in the next few weeks with a dedicated team of key researchers. The Centre will enable rapid access to key international research findings and evidence, so decisions can be made by Welsh Government and NHS Wales. It will also allow fast and focused research studies to be undertaken on a Welsh level, including into long COVID.

This is clearly a major development and opportunity for the PRIME team, representing acknowledgement and support for the excellent research, methodology, innovation and impact accomplished by all of PRIME over the first 6 years. We certainly thank everyone who has contributed and helped us to this point, and will be seeking your ongoing contributions as well, as we seek to provide the evidence base to inform policy and practice in tackling the diverse and far-reaching impacts of Covid-19.

The Centre will enable rapid access to key international research findings and evidence, so decisions can be made by Welsh Government and NHS Wales. It will also allow fast and focused research studies to be undertaken on a Welsh level, including into long COVID.

Professor Adrian Edwards said: “We need to use research and evidence in managing the pandemic. We also need to understand the impact of the pandemic on the health and care delivery systems across the country and how we ensure we meet the health and wider needs of communities and people in Wales.
 

RCBC fellowship success

Ed Harry, a paramedic with the Welsh Ambulance Service, has been awarded an RCBC fellowship to carry out a PhD on the impact of COVID-19 in the ambulance service.

His research on “What is the impact of a global pandemic on the health and wellbeing of ambulance service staff? A mixed method study in response to COVID-19” will be supervised by Dr Alison Porter, at PRIME Centre Wales, Swansea University, alongside Professor Jaynie Rance of Swansea University’s College of Human and Health Science.
 

Shielding for vulnerable people during COVID-19 

New study

Professor Helen Snooks and PRIME researchers based at Swansea University have been awarded funding for the study: 'Effects of shielding for vulnerable people during COVID-19 pandemic on health outcomes, costs and immunity including those with cancer: quasi-experimental evaluation (EVITE Immunity)'.

Shielding was introduced during the COVID-19 pandemic across the UK. It was intended to protect those thought to be at highest risk of serious harm should they catch COVID-19 because of preconditions such as cancer or medications that they were taking. Currently, we do not know whether shielding works – whether it reduces COVID-19 infections, serious illness, deaths; effects on immunity or harms such as isolation, anxiety, depression or delayed care for serious health problems. 

EVITE Immunity will involve work with NHS partners to evaluate shielding in Wales, where records for people who were shielded have already been anonymously linked into other integrated data systems. We will report how shielding affected deaths, hospital and intensive care admissions, COVID-19 infections, immunity status, safety, NHS costs, quality-of-life and how people complied with instructions.

By March 2021 we aim to describe the shielded population, recorded COVID-19 infections and existing immunity data. With further funding we will carry out a full evaluation, and compare NHS records, questionnaire responses and blood test results at 12 months after shielding, for shielded people with similar people not selected for shielding, and subgroups such as those with cancer, BAME or living in deprived communities. We will also interview shielded people and NHS staff about their experiences.

As the shielding policy in Wales broadly replicated the policy in the rest of the UK, evidence from this evaluation will inform policy development and delivery in England as well as the devolved nations. The study is being led by Professor Helen Snooks and has been funded through the National Core Studies Immunity Programme. 

https://emj.bmj.com/content/37/12/752
 

What TRIage model is safest and most effective for the Management of 999 callers with suspected COVID-19? A linked outcome study (TRIM)
Study update

NHS services are experiencing highly volatile demands for care as a result of the COVID-19 pandemic, with initial contact often being a 999 call to the emergency ambulance service reporting coronavirus symptoms. Triage, determining each callers' treatment, is key to appropriate care provision and resource allocation. Undertriage of 999 calls may result in avoidable serious or critical illness or death; overtriage adds unnecessary increased pressure on secondary care services, diverts resources away from the most seriously ill and may expose patients to unnecessary risk of further infection at the hospital. Little is known about what model of triage works most safely and effectively in the context of a pandemic.
 
The aim of the TRIM study is to evaluate the models used to triage and manage emergency ambulance service care for patients with suspected COVID-19 who called 999 in England, Wales and Scotland between March and August 2020. So far, we have surveyed all ambulance services in England, Wales and Scotland to categorise triage models used in call centres and on scene during the 2020 pandemic. The results of this survey were presented at the PRIME Centre Wales Annual Meeting and are being written up for publication. 
 
We are now in the second phase of the study, and are working with selected ambulance services from each triage model type to retrieve anonymised linked outcomes for callers logged by services with COVID-19 symptoms. We will use this data to compare outcomes including death, hospital and ITU admissions, Emergency Department attendances, and COVID-19 diagnosis. We are also collecting data from hospitals in case study areas for patients admitted to hospital and who have a diagnosis of COVID-19. We will link this to the 999 data to identify any missed or undertriaged cases.  We will carry out qualitative interviews with ambulance service and ED staff to better understand their experiences and concerns related to the implementation, effectiveness and safety of these triage protocols.
 
We will deliver our report in July 2021. Our findings will provide evidence about the types of triage models that work best for patients and for the NHS in the COVID-19. The TRIM study is funded by the UKRI-DHSC COVID-19 Rapid Response Rolling Call and is led by Professors Alan Watkins and Helen Snooks.

Supporting Covid-19 awareness animation

Covid-19 is a public health concern, and has resulted in the creation of awareness campaigns with the help of scientists to educate, protect and offer guidance to the public. A few months ago, a nursing student (Mrs Farhaana Peel) informed us that children visiting the ward were alarmed by clinicians wearing PPE. Therefore, we decided to create a bespoke campaign aimed at children, to raise awareness about the importance of wearing PPE and to encourage them to wear masks, wash their hands and be a hero.

Please find the link to the Covid-19 Awareness Animation (created by recent graduates of Cardiff Metropolitan University, Cardiff School of Art and Design; Carys Matthews and Kieran Traas) for the children of Wales below. The team has also discussed adding a socially distanced element to the animation and have planned to create a Welsh version. 

We welcome your feedback and comments, and would appreciate it if you could disseminate it widely on any and all social media platforms or within your organisations.

The animation can be viewed below and also via the link: https://drive.google.com/file/d/1pVrhC1ay4iDvyXh3vl2CumjZ2PVPgqj5/view?usp=sharing
 

Welsh members of the public help launch new report showing importance of involving patients in COVID-19 research

15 January 2021

Adele Battaglia from Newport and Mari James from Pembrokeshire, are two members of Health and Care Research Wales Involvement Community who helped launch a new report from the Health Research Authority (HRA) which shows the importance of involving patients in the design of COVID-19 research.

Read more on the report on the Health and Care Research Wales website.
 

Volunteers needed - Do you have suspected or confirmed COVID-19?

Are you: Aged 65+? or 50-64 with a health condition and have COVID-19 symptoms?

You can help fight COVID-19 by joining the PRINCIPLE Trial.Volunteer online: http://principletrial.org

Other PRIME news of interest

PRIME Centre Wales Annual Meeting 

3rd November 2020, Online

We were delighted to welcome guests to the sixth PRIME Centre Wales Annual Meeting, held 3rd November virtually hosted by Bangor University and held completely online.

To mark the beginning of a renewed funding period for PRIME Centre Wales for 2020-25, this year's meeting focussed on celebrating some of the centre's key impact achievements to date, and looking to the future with new research areas, as well as welcoming the Wales School for Social Prescribing Research.

Due to Covid-19 travel restrictions, this year's meeting was held completely online and we were delighted to welcome over 100 delegates from Wales and beyond including the USA, Canada, Italy, and France.

Read more about the day and view the presentations here.
 

SUPER Group update

PRIME’s SUPER group of public and patient contributors continues to make an active contribution to research activity in PRIME.

Recent meetings have considered the following topics:

• how to deliver preventative dental care;
• how to improve cancer diagnosis in primary care;
• how to support care for people with dementia.

The group has been recruiting new members and looks forward to welcoming successful applicants to future meetings. SUPER members were actively involved in the PRIME Annual Meeting 2020.

As well as presenting a poster, Mari James (Super Chair) and Bridie Evans (PRIME Lead for Public Involvement) presented ‘Public involvement across PRIME Centre Wales: striving for excellence’ where they described the opportunities for collaboration in PRIME research.
 
Public contributors involved in the TRIM research study have held two meetings of the TRIM Patient Advisory Panel. The TRIM study is evaluating triage models for 999 callers with suspected COVID-19. Eight public contributors provide diverse experience reflecting public and patient experiences through Patient Advisory Panel meetings.

Their input, into decisions about data collection, analysis and dissemination, help ensure patient perspectives are heard and considered by the research team delivering the study. There are also two public contributors among the study co-applicants, and two additional public members who contribute through the independent study steering committee. The TRIM study is funded by the NIHR COVID-19 Rapid Response Rolling Call.
 

Study into antibiotic use wins research paper of the year

A study into antibiotic use led by Centre for Trials Research and PRIME Centre Wales at Cardiff University and in collaboration with the University of Oxford and King’s College London has won research paper of the year 2020.

The PACE study found a simple finger-prick blood test could help to prevent unnecessary prescription of antibiotics in patients with chronic obstructive pulmonary disease (COPD).

C-reactive Protein guided antibiotic prescribing for COPD exacerbations was published in the New England Journal of Medicine last July and has now won the overall prize for clinical research in 2019 from the Royal College of General Practitioners (RCGP).

Professor Nick Francis, formerly of Cardiff University’s School of Medicine and now at Southampton University, said: “Governments, commissioners, clinicians, and patients living with COPD around the world are urgently seeking tools to help them know when it is safe to withhold antibiotics and focus on treating flare-ups with other treatments.

“This is a patient population that are often considered to be at high risk from not receiving antibiotics, but we were able to achieve a reduction in antibiotic use that is about twice the magnitude of that achieved by most other antimicrobial stewardship interventions, and demonstrate that this approach was safe.” Read more.
 

Shared decision making in rare disease in the United Kingdom

A PRIME Centre Wales led White Paper has been published (Jan 2021) to address shared decision making for patients with rare disease. 
 
There are many benefits of shared decision making (SDM) for patients. With greater knowledge of the options available to them and the support to consider these based on their own preferences, patients feel better informed. Their confidence to participate also increases and they are clearer about what matters to them. Patients have more accurate expectations of the benefits and risks of treatments and, by increasing involvement in their care, adherence to treatment could be improved.
 
In the context of rare diseases, SDM is even more important as there is often not a gold-standard treatment or care option available. Clinician experience and patient knowledge may be limited, but patients certainly have invaluable experience of what it means to live with the condition, which should guide decision making. However, while SDM is promoted across all healthcare settings and embedded in healthcare policy, there is currently no specific guidance for clinicians and people living with rare diseases on why, when and how this model should be used and the strategies they could use to implement it.

Dr Natalie Joseph-Williams, Senior Lecturer in Improving Patient Care, PRIME Centre Wales, School of Medicine, Cardiff University, comments:
 
"Over the last few months, I have chaired a Working Group whose aim is to shine a light on the important subject of SDM in rare disease. Our collaboration has led to this white paper, which we hope presents a clear picture of the current barriers and needs within SDM in rare disease in the UK and opportunities for its implementation going forward.

"We hope this paper delivers a call to action for stakeholders in rare disease communities to facilitate the implementation of SDM. Ultimately, we want every patient with a rare disease to be able to say: “this is what matters most to me right now”, and for them to receive care and support that is tailored to their own goals and preferences – care that values patients’ lived experiences."
 

Cross professional collaboration study to investigate the value of monitoring chronic eye care conditions in the community

PRIME researchers at the University of South Wales (USW) are part of team investigating the value of monitoring chronic eye care conditions in the community.

The multidisciplinary group has won a Research for Patient and Public Benefit (RfPPB) grant from Health and Care Research Wales (HCRW) to investigate the benefits of monitoring any long-standing sight-threatening problems.

Professor Carolyn Wallace (pictured above right) and Dr Mark Davies of USW are part of the team, which also includes experts from Cardiff University, Swansea University, Sight Cymru, Aneurin Bevan University Health Board (UHB), and Optometry Wales. Professor Barbara Ryan, who is an optometrist at Aneurin Bevan UHB, is the Project Lead.

Further collaboration also comes from the Macular Society, International Glaucoma Association, and the Wales Council for the Blind.

“Over recent years the workload on the hospital eye service in the UK has continued to expand beyond the capability of the available workforce,” said Prof Wallace).

“Since 2017, ophthalmology has had the highest number of outpatient episodes of any speciality in the NHS.”  Read full story.
 

Landmark patient safety study reveals insights into ‘significant’ avoidable harm in primary care

A national study in England recently published published today in the BMJ Quality and Safety journal has revealed the extent of incidents of significant avoidable harm in primary care.

Thirteen GPs reviewed case notes of more than 90,000 patients in three regions across England over a 12-month period as part of the study. The main causes of avoidable harm were found to be diagnostic error (more than 60%), medication incidents (more than 25%) and delayed referrals (nearly 11%), and that 80% of incidents could have been identified sooner or prevented if action had been taken.

When the results were applied to the English population as a whole, the researchers estimated there would be up to 32,000 cases of significant avoidable harm to patients on average per year.

Dr Andrew Carson-Stevens, PRIME Centre Wales lead for Patient safety, and a clinical reader at Cardiff University, responsible for defining a case of significant avoidable harm for the purposes of this study, said:

“Most of these cases of significant harm in general practice could be avoided by improving administrative systems that ensure healthcare professionals can reliably make a referral to another service or clinician, review and action test results, monitor and recall patients that do not attend for important investigations, and, communicate clearly with other clinicians involved in the care of their patients."

The research is one of the largest and most comprehensive studies of avoidable harm in primary care to date. An instance of avoidable harm could be a problem with diagnosis, such as a delay or an incorrect diagnosis or issues with medication, such as a prescribing error or monitoring errors.

The researchers identified a number of factors that contributed to the harm, which included organisational, clinician and patient factors, such as multiple health problems, including frailty. Read more.
 

Effectiveness of participant recruitment strategies for critical care trials

Congratulations to Cardiff University medical intercalated student, Timia Raven-Gregg, on the publication of her first author paper following her research placement under the supervision of Fiona Wood, PRIME lead for Person-centre Care and Victoria Shepherd, PRIME collaborator.

The research looks at problems with the recruitment of patients to critical care trials. Despite clinical research improving in the past decades within intensive care, participant recruitment remains a challenge. Not all eligible patients are identified, and opportunities for enrolment into clinical trials are often missed.

Interventions to facilitate recruitment need to be identified to improve trial conduct in the critical care environment. Therefore, we aimed to establish the effectiveness of recruitment strategies in critical care trials in order to inform future research practice.

Tania says: "Following my fourth year at medical school, I decided that I wanted to gain a better understanding of clinical research and have the opportunity to undertake a research project myself. For this reason, I chose to intercalate in a degree in Population Medicine. The idea of better understanding research conducted within critical care instantly appealed to me.

"At the time I was aware of some ideas of the challenges that might be faced, but I had not considered the practicalities surrounding obtaining consent. This project allowed me to have a greater appreciation of research conduct, and how it is impacted by specific clinical environments." 

Timia has also written a blog for the Centre for Trials Research about her project which will be published on the CTR website.

Publication citation: Raven-Gregg T, Wood F, Shepherd V (2021) Effectiveness of participant recruitment strategies for critical care trials: A systematic review and narrative synthesis. Clinical Trials DOI:10.1177/1740774520988678
 

Disseminating research findings from the cancer screening, prevention and early diagnosis work package

The screening, prevention and early diagnosis work package (WP7, leads Prof Kate Brain & Prof Clare Wilkinson) had a prominent presence at virtual conferences and showcases towards the end of 2020 and early 2021. Oral, poster and elevator pitch presentations showcased the range of national and international work undertaken by our team. There was great interest across studies from attendees and engaging discussions and questions were had by all. 
 
Of note it was great to see the final results from trials shared such as @ABACus_3 and students sharing their research project results for the first time from @CardiffMBBChC2. The highlight was winning first prize for the @CABSCovid19 poster and poster pitch at UK Society of Behavioural Medicine Annual Scientific Meeting – well done to Dr Victoria Whitelock! 
 
Many of the posters and presentations are still available to view on the associated websites for the events. Abstracts to look out for:
 
Health and Care Research Wales Conference 2020 – 7^th October 2020 

• The Awareness and Beliefs About Cancer (ABACus) trial of a targeted cancer awareness intervention for adults living in socioeconomically deprived communities in the UK
• Process Evaluation of the Awareness and Beliefs About Cancer (ABACus) trial
• Psychosocial influences on medical help-seeking for cancer symptoms and treatment in Lower and Lower-Middle Income Countries (LMIC) 

• COVID-19 Cancer Attitudes and Behaviour Study: A UK wide prospective mixed-methods cohort study
• The Awareness and Beliefs About Cancer (ABACus) trial of a targeted cancer awareness intervention 
• Process Evaluation of the Awareness and Beliefs About Cancer (ABACus 3) trail of a targeted cancer awareness intervention for adults living in deprived areas of the United Kingdom
• Rurality, deprivation and time to help-seeking for cancer symptoms  

• The association between rurality, deprivation and time to help-seeking for cancer symptoms: a secondary analysis of cross-sectional survey data 
• Awareness and Beliefs About Cancer (ABACus): randomised controlled trial of a targeted cancer awareness intervention for adults living in deprived areas of the United Kingdom

• COVID-19 Cancer Attitudes and Behaviour Study: A UK wide prospective mixed-methods cohort study
   

Call for abstracts for the SAPC ASM 2021

The SAPC ASM 2021 will be a virtual conference over two days: 30th June and 1st July 2021.

We are delighted to announce that abstract submission is now open. Submission deadline: 28th February.

The Scientific Committee is continuing with the same theme Living and Dying Well that was planned for the ASM 2020 last year which will accommodate any work on COVID-19.  The Committee is keen to receive abstracts outlining research, education and policy within primary care which speak to the Conference theme.

Abstracts are invited for short oral presentations, posters, workshops and creative enquiry pieces. 
 

The Evaluation of the Social Services and Well-being (Wales) Act 

The Welsh Government has now published four outputs (9th February – available in both English and Welsh) from the Process Evaluation (PE) phase of the team’s work which captures the workforce experience of implementing the Act to date:

• Report / Adroddiad
• Summary Report / Adroddiad Cryno
• Research Briefing / Briff yr Ymchwil
• Easy Read Report / Ddogfen Hawdd ei Deall

Led by Professor Mark Llewellyn, Director of the Welsh Institute of Health and Social Care (WIHSC), which is based at the University of South Wales (USW), the Process Evaluation report concludes that leaders and workers within the social care sector in Wales are ‘on a journey’ towards the full implementation of the Act.

The report also notes that the key principles underpinning the Act command universal support as the foundation of a values-based framework for action across Wales. The study team spoke with more than 150 respondents across four case study localities in order to assess the difference made to date and found that a different ‘quantum’ of change is required by different parts of the country. The findings are also mentioned in the new Welsh Government white paper ‘Rebalancing Care and Support’.

Crucial to the ‘full’ implementation of the Act’s ambitious vision, is sufficient time and resource in order to continue to bring about and sustain change – hence the principal conclusion that the workforce is still on the implementation ‘journey’. This link will take you to a web page that has a short video clip giving the main highlights from the findings. The team will now go on to research the service user and carer experience of support under the Act during 2021.
 

Simple monitoring could reduce medicine misuse in care homes

New research from Swansea University suggests that a simple nurse- or carer-led medicines’ monitoring system can help reduce medication-related illness for people living in residential care homes – and the process takes just a few minutes per patient.

The research paper published in the PLOS ONE journal looked how the monitoring system, known as the Adverse Drug Reaction Profile (ADRe-p), can help nurses or carers identify medicines’ mismanagement or adverse drug reactions in patients prescribed multiple medicines, and can help avoid medication-related harm and improve prescribing.

Professor Sue Jordan, who led the study said: “The problem presented by the scale and complexity of inadvertent harm from both use and misuse of medicines is very real, which is reflected in the World Health Organisation’s (WHO) Third Global Patient Safety Challenge aiming to reduce avoidable medication-related harm by 50% by next year. Read more.
 

The World Book of Family Medicine - WONCA Europe Edition 2020

Since WONCA is all about collaboration and inspiration, the main focus of this edition lies on working together, with our partners, the networks. But also talented individuals. They wrote 25 contributions, 1000 words (more or less), 5 Take Home Messages (more or less) and 8 references. Most of the contributors stayed within those limits, but every rule has an exception – as we as family doctors are well aware of.

PRIME's research is featured on pages 43-45: Can Social Prescribing Benefit Health and Well-being in the Community? Workshop led by Joyce Kenkre.

Read and download the book here
 

Rural connectivity - the types of issues and impacts that rural consumers, citizens and micro-businesses face

In September/October 2020, the Communications Consumer's Panel’s National Hubs focussed on rural connectivity and the types of issues and impacts that communications consumers living, studying or working in rural areas face.

As part of the Panel’s strategic plan 2020/21, they are committed to working towards all consumers having access to affordable, reliable communications services as a baseline, and no consumer being left behind, regardless of circumstances.

We have long seen communications services as essential services for all citizens, consumers and micro-businesses and the Covid-19 pandemic has highlighted how a lack of reliable connectivity can leave consumers in extremely vulnerable circumstances. Read more.

Fellowship awards
 

PhD Fellowship award success - Leigh Sanyaolu

Leigh joined the Academic Fellows scheme at Cardiff University School of Medicine in December 2019, and worked in the Division of Population Medicine as an Academic GP registrar before that from 2017. His current research interests are common infections in primary care, antibiotic stewardship and antimicrobial resistance. 

“I feel immensely proud to have been awarded this prestigious NIHR and HCRW Doctoral Fellowship. I cannot wait to get started on this much needed research and improve clinical practice in this field.

I am looking forward to working with my supervisors Dr Harry Ahmed, Dr Rebecca Cannings-John, Professor Fiona Wood and Professor Adrian Edwards as well as my collaborators Dr Donna Lecky  (Head of the Primary Care and Interventions Unit of Public Health England), Dr Ashley Akbari (Senior Research Manager and Data Scientist in SAIL) and PRIME Centre Wales.

I would also like to take this opportunity to thank my supervisors, collaborators, the Division of Population Medicine and the PRIME SUPER group for their support during the challenging but incredibly rewarding application process"

New studies
 

Trauma call study

Dr Alison Porter and PRIME colleagues at Swansea University have been awarded funding by the South Wales Trauma Network to carry out a qualitative study to understand the views of ambulance service clinicians and trauma desk clinical staff on the role and functioning of the Network, which has been set up to try to ensure that people experiencing trauma get the most appropriate level of care, including going to the specialist centre in Cardiff if they require it.

Serving the population of South Wales, West Wales and South Powys, the South Wales Trauma Network is made up of hospitals, emergency services and rehabilitation services across the region, working together to ensure patients with life-threatening or life-changing injuries receive the best possible treatment and care.

The Welsh Government has provided £3.7 million capital and over £13 million recurrent revenue funding to support the pre-hospital, major trauma centre, specialist services and network elements of the programme business case.

RAPID 2 study funding awarded

PRIME’s team at Swansea University has been awarded funding to evaluate use, by paramedics, of a local anaesthetic to manage hip fracture pain. The RAPID 2 trial is assessing safety, effectiveness and cost-effectiveness of Fascia Iliaca Compartment Block (FICB), administered by paramedics to patients with suspected hip fracture who call 999. Hip fracture is extremely painful and poorly managed pain, or use of morphine, can affect length of hospital stay and patient recovery.

The team has already shown it is feasible for paramedics to be trained and to safely administer the local anaesthetic, which is injected into the groin (Jones et al. https://doi.org/10.1186/s40814-019-0454-1; Evans et al. doi: 10.1136/bmjopen-2018-026073). It also appears to be acceptable to patients (Evans et al. doi.org/10.1136/bmjopen-2019-033398).

RAPID 2 (Randomised trial of clinical and cost effectiveness of Administration of Prehospital fascia Iliaca compartment block for emergency Pre-Hospital hip fracture care Delivery) is funded by the National Institute for Health Research Health Technology Assessment Programme (NIHR HTA). The team includes clinical and ambulance service members and public contributors. We are seeking additional public contributors and welcome interest from people who have experienced emergency care for a hip fracture, or supported a family member through this.
 

IMPact study new funding 

Improving child welfare in southern Morocco: engaging with local families and stakeholders to develop safeguarding and fostering policies (IMPact)

Swansea University and Prime Centre Wales have been successful in securing funding from The Global Challenges Research Fund (GCRF) which is a £1.5 billion fund from the UK Government to support cutting-edge research that addresses the challenges faced by developing countries. 

It is estimated that there are 115,000 children in institutional care in Morocco, therefore it is critical to develop a dialogue with policy makers and the community on the importance of foster care to reduce abuse and neglect into adulthood resulting in lifelong trauma for children who spend any period in institutional care. Our 6 month project co-led by Professor Helen Snooks and Dr Fadi Baghdadi will be led by PRIME researchers from Swansea University, in partnership with The Moroccan Children’s Trust (MCT), Foundation Amane Pour La Protection De L’enfance (FAPE) in Morocco and University of Pittsburgh (USA). 

The research team will work closely with families, children and stakeholders to produce empirical evidence to provide better understanding of the perceptions of foster care in the general population; explore ways family resilience can be enhanced to prevent children being abandoned or taken into care; and explore ways of supporting and building a well-resourced, effective and sustainable foster care system in Morocco that will provide safety and security to vulnerable children.  

For further information contact Dr Ashra Khanom on a.khanom@swansea.ac.uk
 

Disseminating research findings from the cancer screening, prevention and early diagnosis work package

The screening, prevention and early diagnosis work package (WP7, leads Prof Kate Brain & Prof Clare Wilkinson) had a prominent presence at virtual conferences and showcases towards the end of 2020 and early 2021. Oral, poster and elevator pitch presentations showcased the range of national and international work undertaken by our team. There was great interest across studies from attendees and engaging discussions and questions were had by all. 
 
Of note it was great to see the final results from trials shared such as @ABACus_3 and students sharing their research project results for the first time from @CardiffMBBChC2. The highlight was winning first prize for the @CABSCovid19 poster and poster pitch at UK Society of Behavioural Medicine Annual Scientific Meeting – well done to Dr Victoria Whitelock! 
 
Many of the posters and presentations are still available to view on the associated websites for the events. Abstracts to look out for:
 
Health and Care Research Wales Conference 2020 – 7^th October 2020 

• The Awareness and Beliefs About Cancer (ABACus) trial of a targeted cancer awareness intervention for adults living in socioeconomically deprived communities in the UK
• Process Evaluation of the Awareness and Beliefs About Cancer (ABACus) trial
• Psychosocial influences on medical help-seeking for cancer symptoms and treatment in Lower and Lower-Middle Income Countries (LMIC) 

• COVID-19 Cancer Attitudes and Behaviour Study: A UK wide prospective mixed-methods cohort study
• The Awareness and Beliefs About Cancer (ABACus) trial of a targeted cancer awareness intervention 
• Process Evaluation of the Awareness and Beliefs About Cancer (ABACus 3) trail of a targeted cancer awareness intervention for adults living in deprived areas of the United Kingdom
• Rurality, deprivation and time to help-seeking for cancer symptoms  

• The association between rurality, deprivation and time to help-seeking for cancer symptoms: a secondary analysis of cross-sectional survey data 
• Awareness and Beliefs About Cancer (ABACus): randomised controlled trial of a targeted cancer awareness intervention for adults living in deprived areas of the United Kingdom

• COVID-19 Cancer Attitudes and Behaviour Study: A UK wide prospective mixed-methods cohort study

Supporting Covid-19 Awareness Animation

Covid-19 is a public health concern, and has resulted in the creation of awareness campaigns with the help of scientists to educate, protect and offer guidance to the public. A few months ago, a nursing student (Mrs Farhaana Peel) informed us that children visiting the ward were alarmed by clinicians wearing PPE. Therefore, we decided to create a bespoke campaign aimed at children, to raise awareness about the importance of wearing PPE and to encourage them to wear masks, wash their hands and be a hero.

Please find the link to the Covid-19 Awareness Animation (created by recent graduates of Cardiff Metropolitan University, Cardiff School of Art and Design; Carys Matthews and Kieran Traas) for the children of Wales below. The team has also discussed adding a socially distanced element to the animation and have planned to create a Welsh version. 

We welcome your feedback and comments, and would appreciate it if you could disseminate it widely on any and all social media platforms or within your organisations.

The animation can be viewed below and also via the link: https://drive.google.com/file/d/1pVrhC1ay4iDvyXh3vl2CumjZ2PVPgqj5/view?usp=sharing
 

Call for abstracts for the SAPC ASM 2021

The SAPC ASM 2021 will be a virtual conference over two days: 30th June and 1st July 2021.

We are delighted to announce that abstract submission is now open. Submission deadline: 28th February.

The Scientific Committee is continuing with the same theme Living and Dying Well that was planned for the ASM 2020 last year which will accommodate any work on COVID-19.  The Committee is keen to receive abstracts outlining research, education and policy within primary care which speak to the Conference theme.

Abstracts are invited for short oral presentations, posters, workshops and creative enquiry pieces. 
 

Welsh members of the public help launch new report showing importance of involving patients in COVID-19 research

15 January 2021

Adele Battaglia from Newport and Mari James from Pembrokeshire, are two members of Health and Care Research Wales Involvement Community who helped launch a new report from the Health Research Authority (HRA) which shows the importance of involving patients in the design of COVID-19 research.

Read more on the report on the Health and Care Research Wales website.
 

Simple monitoring could reduce medicine misuse in care homes

11 January 2021

New research from Swansea University suggests that a simple nurse- or carer-led medicines’ monitoring system can help reduce medication-related illness for people living in residential care homes – and the process takes just a few minutes per patient.

The research paper published in the PLOS ONE journal looked how the monitoring system, known as the Adverse Drug Reaction Profile (ADRe-p), can help nurses or carers identify medicines’ mismanagement or adverse drug reactions in patients prescribed multiple medicines, and can help avoid medication-related harm and improve prescribing.

Professor Sue Jordan, who led the study said: “The problem presented by the scale and complexity of inadvertent harm from both use and misuse of medicines is very real, which is reflected in the World Health Organisation’s (WHO) Third Global Patient Safety Challenge aiming to reduce avoidable medication-related harm by 50% by next year. Read more.
 

The World Book of Family Medicine - WONCA Europe Edition 2020

Since WONCA is all about collaboration and inspiration, the main focus of this edition lies on working together, with our partners, the networks. But also talented individuals. They wrote 25 contributions, 1000 words (more or less), 5 Take Home Messages (more or less) and 8 references. Most of the contributors stayed within those limits, but every rule has an exception – as we as family doctors are well aware of.

PRIME's research is featured on pages 43-45: Can Social Prescribing Benefit Health and Well-being in the Community? Workshop led by Joyce Kenkre.

Read and download the book here
 

Rural connectivity - the types of issues and impacts that rural consumers, citizens and micro-businesses face

In September/October 2020, the Communications Consumer's Panel’s National Hubs focussed on rural connectivity and the types of issues and impacts that communications consumers living, studying or working in rural areas face.

As part of the Panel’s strategic plan 2020/21, they are committed to working towards all consumers having access to affordable, reliable communications services as a baseline, and no consumer being left behind, regardless of circumstances.

We have long seen communications services as essential services for all citizens, consumers and micro-businesses and the Covid-19 pandemic has highlighted how a lack of reliable connectivity can leave consumers in extremely vulnerable circumstances. Read more.

Recent publications

Zayed M, Williams V, Glendenning AC, Bulger JK, Hewes T, Porter A, Snooks H, John A. Care-pathways for patients presenting to emergency ambulance services with self-harm: national survey. Emergency Medicine Journal 2020;37:752-755. 

Avery AJ, Sheehan C, Bell B, Armstrong S, Ashcroft DM, Boyd MJ, Chuter A, Cooper A, Donnelly A, Edwards A, Evans HP, Hellard S, Lymn J, Mehta R, Rodgers S, Sheikh A, Smith P, Williams H, Campbell SM, Carson-Stevens A. Incidence, nature and causes of avoidable significant harm in primary care in England: retrospective case note review. BMJ Quality & Safety Published Online First: 10 November 2020. doi: 10.1136/bmjqs-2020-011405
 

Elliott M, Watson H, Lewis A, Wallace C. A participatory mixed-methods evaluation of a Falls Awareness Programme (2020), "A participatory mixed-methods evaluation of a falls awareness programme", Working with Older People, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/WWOP-09-2020-0046
 

Joseph-Williams N, Abhyankar P, Boland L, Bravo P, Brenner AT, Brodney S, Coulter A, Giguere A, Hoffman A, Körner M, Langford A, Légaré F, Matlock D, Moumjid N, Munro S, Dahl Steffensen K, Stirling C, van der Weijden T. What Works in Implementing Patient Decision Aids in Routine Clinical Settings? A Rapid Realist Review and Update from the International Patient Decision Aid Standards Collaboration. Medical Decision Making. December 2020. doi:10.1177/0272989X20978208
 

Harrop E, Morgan F, Longo M, Semedo L, Fitzgibbon J, Pickett S, Scott H, Seddon K, Sivell S, Nelson A, Byrne A. The impacts and effectiveness of support for people bereaved through advanced illness: A systematic review and thematic synthesis. Palliative Medicine 2020, Vol. 34(7) 871–888
 

Murray RL, Brain K, Britton J, Quinn-Scoggings H, Lewis S, McCutchan G, Quaife S, Wu Q, Ashurst A, Baldwin D, Crosbie P, Neal R, Parrott S, Rogerson S, Thorley R, Callister M. Yorkshire Enhanced Stop Smoking (YESS) study: a protocol for a randomised controlled trial to evaluate the effect of adding a personalised smoking cessation intervention to a lung cancer screening programme. BMJ Open 2020;10:e037086. doi: 10.1136/bmjopen-2020-037086
 

Howells E, Davies R, Jones V, Morgan MZ. Gwên am Byth: a programme introduced to improve the oral health of older people living in care homes in Wales - from anecdote, through policy into action. Br Dent J 229, 793–799 (2020).

Events

Social Prescribing Evaluation Forum Session 2 - Developing a monitoring framework for social prescribing
 

At the Wales School for Social Prescribing Research we will be running three social prescribing evaluation forums per year. The aim of the forums is to provide a place for discussion and resources to support social prescribers and community groups in conducting evaluation and monitoring.

We are inviting members of the Wales Social Prescribing Research Network and the three Welsh Communities of Practice to participate, initially spaces will be limited to 25 people per session and will be allocated on a first come first served basis. We would suggest that 1-2 people per organisation sign up to each session. There will be a waiting list in the event that the forum is oversubscribed.

We will host these forums on Microsoft Teams and joining instructions will be sent to attendees nearer the time.

In addition to the session above we will also be holding three pre-bookable clinic sessions to provide support on specific evaluations. These can be taken up by an individual, or by members from a service/organisation as a group.  If you would be interested in booking one of these slots, please complete and return the attached application form to wsspr@southwales.ac.uk.  

We hope you are able to join us.  If you have any queries please don’t hesitate to get in touch by emailing wsspr@southwales.ac.uk
 

3rd International Social Prescribing Network Conference 'Social prescribing & community - beyond the pandemic'

4-5 March, Online

Thank you to our sponsors & supporters, The College of Medicine, Share and Care Homeshare, The University of Salford, NHS England and The National Academy for Social Prescribing.​

You can find details about our upcoming conference below.  For all further queries please email spnc@salford.ac.uk.  

Download the current programme: CLICK HERE

Book your ticket: CLICK HERE
 

Funding opportunities

Top tips for winning research funding

PRIME Associate Director, Professor Helen Snooks has produced this helpful reference guide for researchers: 'Top tips for winning research funding' and is available to view in PDF.

Social Care PhD Studentship Awards

Are you passionate about finding a way to improve social care services in Wales?  

The Social Care PhD Studentship Award offers talented individuals the opportunity to undertake research and study leading to a PhD. Applications must come from the proposed PhD supervisor, and are welcome across a broad range of social care research topics.

Closing date: 5th March.  

Read more and apply: https://healthandcareresearchwales.org/social-care-phd-studentship-scheme
 

Wellcome - PhD Programme for Health Professionals

The aim of this scheme is to fund PhD programmes that offer health professionals outstanding research training in supportive and inclusive research environments.  The call is open to applications that address the aims of creating knowledge, building research capability, and training a diverse group of future leaders in clinical academia.  Programmes can apply for up to 5 fellows/year for 5 years, with the first intake in autumn 2022. 

Further information can be found on our website https://wellcome.org/news/why-were-launching-new-round-phd-funding-health-professionals.   

Details of the scheme, with associated FAQs and a sample application form can be found at https://wellcome.org/grant-funding/schemes/phd-programmes-health-professionals. 

We hope to set up a couple of webinars in the New Year, but in the meantime, if you have comments or questions, please do contact us at clinicalphd@wellcome.org.

Deadline: 4 March 2021
 

RCGP support for researchers

The Royal College of General Practitioners (RCGP) is supporting researchers to implement academic primary care findings into practice for GPs.

The Research programme includes:

• Scientific Foundation Board grants
• RCGP Marie Curie Palliative Care Research Fellowship
• RCGP Research Ready®
• RCGP Impact from Research
• Influencing research
• Research awards

The new Impact from Research programme offers to partner on research projects and support impact and dissemination through a range of activities.
Further information: www.rcgp.org.uk/research

NIHR

Health Services and Delivery Research Programme

The commissioned workstream invites applications in response to calls for research on specific questions which have been identified and prioritised for their importance to the NHS and patients. Proposals may include primary research, evidence synthesis, or feasibility and pilot studies. See our current funding opportunities or download a list of potential future research topics currently being developed.

• 20/124 – Adult Community Health and Social Care services to avoid planned and unplanned hospital admissions
  Deadline: 18 April 2021

Health Technology Assessment Programme

• 20/109 Shorter vs longer fixed-course antibiotic treatments
  Deadline: 05 May 2021
   
• 20/110 Prophylactic antibiotics in chronic obstructive pulmonary disease
  Deadline: 31 March 2021
   
• 21/01 Health Technology Assessment Programme Researcher-led (primary research)
  Deadline: 05 May 2021
   
• 21/02 Health Technology Assessment Programme Researcher-led (evidence synthesis)
  Deadline: 05 May 2021

Public Health Research Programme 

The PHR programme invites applications from researchers whose studies will generate new knowledge on the benefits, costs, acceptability and wider impacts of non-NHS interventions intended to improve the health of the public and reduce inequalities in health. 

The researcher-led workstream offers researchers the opportunity to submit proposals on topics or research questions within the programme’s remit.

• 20/119 Public health interventions led by or involving the police
  Deadline: 30 March 2021
   
• 20/120 Food taxes and subsidies
  Deadline: 30 March 2021
   
• 20/121 Indoor air quality
  Deadline: 30 March 2021
   
• 20/122 Multi-agency approaches to tackling illicit tobacco
  Deadline: 30 March 2021
   
• 20/135 Continuing priority research topics of interest to the PHR Programme
  Deadline: 30 March 2021
   
• 20/136 Public Health Research Programme researcher-led
  Deadline: 30 March 2021

Cross Programme

• 20/142 Prehabilitation: Living with and beyond cancer
  Deadline: 30 March 2021
   

Clinical Innovation Hub - Accelerate projects

The Clinical Innovation Hub is a partnership between Cardiff University and Cardiff and Vale University Health Board.  The Clinical Innovation Hub is a partner of the Accelerate project, Clinical Innovation Accelerator (CIA). Accelerate is a consortium £24M programme led by the Life Sciences Hub Wales in collaboration with Cardiff University, Swansea University and the University of Wales Trinity Saint David.  

It is funded by the Wales European Funding Office (WEFO) and will utilise EU Structural Funds to identify innovation projects that meet an unmet clinical need.

The awards are open to academia, industry, students and healthcare professionals. Innovations could take the form of new technologies, products, processes or services to deliver economically viable solutions for adoption into routine health and social care delivery, for patient benefit, health economic benefit and to stimulate economic growth with attendant socio-economic benefits in Wales.

Support that Accelerate can offer:

• Funding for “Pilot” (6-12 months and <£20K) and “Platform” (12-18 months and < £150K) projects
• Access to future funding opportunities/initiatives
• Clinical input - Buy out and attract in kind NHS staff R&D time
• Human resource - Clinical Innovation fellows, project management, business management, cost benefit analytics and  research technologist assistance
• Collaborations  - Industry/Academic/Clinical partner
• Advice & Guidance - A Multidisciplinary Team (MDT) of Clinical Innovation experts, including devices and intellectual property experts
• Access to leading Welsh University, University Health Boards and Trusts - patients, facilities and personnel
• Funding /deadlines: Support and awards operate on an always open basis with funding anticipated until 2021 so you can apply at any time.  If you would like further information on submitting a proposal or have an innovative idea that you think would benefit from the advice or support for Cardiff University applicants, please contact Barbara Coles: colesb2@cf.ac.uk

Further information: 

• http://www.cardiff.ac.uk/innovation/our-partnerships/cardiff-and-vale
• https://lshubwales.com/accelerate