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Primary research with people with multiple sclerosis and their carers, led by Brunel, has had positive impacts on service user and government organisations internationally; research has improved practice in relation to the nature and effect of self-management strategies of people with Multiple Sclerosis, as well as enhancing therapy for the condition and raising awareness of the needs of carers. The research has shaped evidence-based guidelines, consensus papers, reports and policies, which have in turn enhanced the effectiveness of professional practice and service delivery. Through developing the evidence base and sharing best practice the research has resulted in improved health and welfare benefits for people with multiple sclerosis and their carers.
UCL research into end-of-life care has informed policy on palliative care for dementia patients and influenced NICE quality standards for end-of-life care in three areas: spirituality, psychological assessment, and advance care planning. The research has also been used by the charity St Mungo's to develop educational resources for services working with homeless people with advanced liver disease. Evidence collated by UCL on the importance of palliative care in heart failure has formed the basis of Caring Together, a £5m investment by Marie Curie Cancer Care and the British Heart Foundation to improve end-of-life care in heart failure. A review of the effectiveness of hospice care is being used to support commissioning bids for end-of-life care services.
Research by Professor Les Mayhew and Professor Ben Rickayzen at City University London on the question of how the public sector and the private market might jointly establish a better way of funding long-term care for the elderly has influenced policy thinking and development within the Treasury, the Department of Health, the Dilnot Commission, the actuarial profession and among ministers and parliamentarians. Evidence is provided here that shows that their research on population ageing has had an impact at the highest levels in Whitehall. In addition, Mayhew's work on integrated health and social care for Brent Council has helped to transform services at local level and provides a model that could be replicated more widely.
Acute stroke services in the Belfast Health and Social Care Trust have been reorganised using research on modelling stroke patient pathways through hospital, social and community services carried out in CSRI at Ulster. By suitably administering thrombolysis (clot-busting drugs), a stroke patient's time in hospital, community rehabilitation and nursing homes can be reduced, so that although the treatment costs money up front, it saves in the long-term and also improves quality-of- life. The work has contributed to changing stroke patient policy in the Belfast Trust as well as enhancing patient quality-of-life. It is applicable throughout the UK and beyond.
The findings of an innovative ethnographic study of Health Care Assistants (HCAs) who care for dementia patients were used to create a stage play, Inside out of Mind,which was performed to audiences of HCAs, NHS managers and the general public.
The performances raised awareness with NHS managers and healthcare policy makers, of the role and importance of HCAs; their working environment, the skills they need and the difficulties they encounter. It enabled HCAs to reflect upon their practice and to identify specific areas upon which they would focus to improve care.
The research has led to the design of a new clinical pharmacy service model, centred on community pharmacies, to improve the care of patients with palliative care needs living in the community. This resulted in better provision of information for patients (and their carers) and new training resources and staff development opportunities for the multi-disciplinary palliative care team. Funding has been secured to rollout the new service across NHS Greater Glasgow and Clyde Health Board (NHS GGC - 1.2M population) in 2013. The research has also supported a successful bid to explore the service model in a remote and rural Health Board (NHS Highland) and has informed specific programmes of Macmillan Cancer Support UK, pharmacy workforce planning, and the Boots Macmillan Information Pharmacists initiative.
There are an increasing numbers of people living into very old age. At the same time there is a drive to enable people to live within their own homes for as long as possible. Consequently, health and social care services that previously would have experienced very few people with dementia now have this as part of their core function. Yet there is no tradition in these services of supporting people with dementia and there are many reports of inadequate care. For example, Valleley reports that over half of people living in extra-care housing with dementia were admitted to other care settings during the first two years due to challenging behaviour, conflicts with staff and other residents, and distress on the part of the person with dementia.i Similarly, hospital patients with acute and chronic medical conditions concomitant with dementia are consistently reported to experience poorer quality outcomes than patients with similar conditions without dementia.ii The research described below has had significant benefits for those living with dementia both in extra-care housing and in hospital settings, primarily at the national level but also internationally. It has enhanced quality of life for individuals living with dementia, improved the practice of professionals working with people with dementia and had economic benefits.
Quality of care for the increasing numbers of frail older people is an issue of international concern. Led by Professor Meyer at City University London, in partnership with Age UK and Dementia UK, My Home Life (MHL) is a collaborative movement of people involved with care homes for older people. It was established to improve the quality of life of everyone connected with care homes for older people and has become the recognised voice for the sector. The original underpinning research and ensuing projects all focused on knowledge translation, in particular the factors that enhance quality improvement in care homes. MHL actively works with care homes to progress quality improvement and share the lessons learned throughout the system. The programme has had a significant impact on both policy and practice in health and social care, influencing Government policy and supporting practice improvement across national and international borders.
This case study demonstrates how programmes of research led by the University of Sheffield since 1995 have generated theoretical models and implementation tools that have had considerable significance and reach in a diverse number of areas.
There have been impacts on:
IOE research, led by Professor Sonia Jackson, has resulted in improved educational opportunities for a particularly disadvantaged and under-recognised group of young people — those from the public care system. The study, By Degrees, triggered new legislation and support systems to help these young people get to university and complete their studies. It led directly to a mandatory £2,000 bursary for care-leavers who go on to HE in England and Wales and the introduction of a prestigious quality mark now held by more than half of the UK's universities to highlight the extra support they offer care-leavers. The research is also beginning to influence policy thinking in EU countries.