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Depression is a major public health problem, producing substantial deterioration in health and well- being and costing the UK £billions annually. A programme of research at Exeter, led by Professor Richards, (trials and Phase IV implementation studies) has changed national policy on the treatment of depression (NICE guidelines). It has also underpinned the UK's Improving Access to Psychological Therapies (IAPT) programme which has been widely implemented, leading to new treatment for over 1 million people, with a recovery rate in excess of 45%, and over 45,000 people coming off sick pay and benefits. The research has also achieved International impact.
Southampton's research into the management of depression highlighted deficits in the way GPs were assessing and treating depression, and demonstrated failure to improve their performance through education alone. The findings were included in guidelines drawn up by the National Institute for Health and Care Excellence (NICE) and led to incentives for questionnaire assessments of depression being introduced into the GP contract Quality Outcomes Framework (QOF). UK-wide QOF data from 2008-2013 demonstrated questionnaire assessments in 2.2 million cases of depression. Subsequent Southampton-led research showed that improved targeting of treatment resulted from questionnaire assessments, and trial evidence shows such assessments improve patient outcomes.
The ability of healthcare professionals to empathise with patients has been shown to enhance patient satisfaction, improve symptoms and promote well-being. Research at University of Glasgow has developed the Consultation and Relational Empathy (CARE) Measure — the first validated, patient-rated questionnaire developed in a primary care setting that measures patient perceptions of healthcare professionals' empathy and quality of care. The CARE Measure is formally embedded into healthcare professional training standards through its inclusion in Scottish General Practitioner (GP) appraisals and the Royal College of General Practitioners Membership (MRCGP) and Interim Membership by Assessment of Performance (iMAP) processes; through these means more than 8,000 GPs are using the CARE Measure. It has also been incorporated into the Scottish Government's policy on Healthcare Quality and adopted by the General Medical Council and the Chartered Society of Physiotherapy.
We have developed the first ever physiotherapy guidelines (2008-) for contracted (frozen) shoulder (CFS). CFS is painful and disabling, affects c.9% of the UK working-age population,1 and costs the NHS > £13.5 million annually.2 Appropriate physiotherapy could improve outcomes and reduce costs by up to £2,000 per case.b
Endorsed by the Chartered Society of Physiotherapy (CSP), the guidelines have generated great interest and already influenced practice and will improve the quality and cost-effectiveness of clinical management, as well as patients' experiences. They will also provide a better framework for research into the condition and, as a `live', electronic document, will evolve with future research.
Atrial fibrillation (AF) is the commonest heart rhythm abnormality, affecting around 8.8 million people in the European Union, and conferring a substantial risk of stroke and death. Up to 2% of the UK population, some 1.2 million individuals, take oral anticoagulation medication.
The University of Birmingham is an internationally-respected centre of excellence for research in AF, and has made crucial impacts in international clinical practice guidelines and improvements in patient care. Primary care research at the University of Birmingham has led to the transfer of oral anticoagulation services from secondary to primary care, and latterly patient self-management, resulting in improved clinical outcomes. In addition, the BAFTA trial has provided evidence to support the use of anticoagulation therapy (warfarin) for people aged over 75 who have atrial fibrillation, resulting in changes in clinical management of these patients.
A decade of research at the University of Southampton has given thousands of people around the world suffering from dizziness and balance disorders access to a self-management resource that can alleviate their symptoms. Professor Lucy Yardley has pioneered the use of a Balance Retraining (BR) booklet to transform the means of delivering cost-effective, life-changing treatment previously offered to less than one in ten UK patients. The booklet, translated into several languages, has been distributed to patients and practitioners as far afield as China and Japan. Yardley's findings have contributed the bulk of good quality evidence to the Cochrane Review on vestibular rehabilitation.
The University of Nottingham's Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care has enhanced the understanding, implementation and uptake of advance care planning for end of life care. Its work has shaped public policy and influenced national initiatives that have improved quality of life and reduced the number of deaths in hospitals. The research has been cited as an exemplar by the World Health Organisation and has helped inform policymaking at European level. It has guided professional practice, educated care staff and contributed to a more positive public attitude towards talking about end of life issues.
This systematic evidence, evaluating the effectiveness of midwife-led care, has helped to shape policy improvements in promoting access to midwifery care and reducing health inequalities nationally (e.g. NHS, Department of Health [DH]) and internationally (e.g. Australia, Brazil & US). The review was recognised by the DH and updated rapidly to inform NICE intrapartum guidelines. As part of the Commissioning, Service Delivery and Organisation theme, the Maternal and Early Childhood Health Research Group (MACHRIG) led by Professor Hora Soltani, in collaboration with the Sheffield Teaching Hospital-Jessop Wing (STH-JW) and maternity user representatives, has initiated an awareness campaign to encourage information sharing on types of maternity care and to enhance the implications of findings for women and staff via the hospital website and targeted seminars. It is envisaged that its impact will continue to grow through an extensive dissemination strategy and media coverage.
Although essential for coping with escalating health and social care demands, adoption of `remote care' — telecare and telehealth — has been slow. Professor Barlow's research group provided evidence to establish how remote care can be sustainably and efficiently embedded into healthcare. They then helped design and evaluate the Department of Health's Whole System Demonstrators, the world's largest trial of remote care. As a consequence, the government launched the 3 Million Lives programme in January 2012, with an estimated potential net benefit to the NHS of £450m over the next 5 years. Research taken up by the Audit Commission and TSB/DTI has further influenced UK remote care policy by developing the evidence base and evaluating gaps in basic research.
Adult Social Care (ASC) is a growing sector which currently employs 1.6 million care workers and benefits 1.8 million care recipients. Research carried out by Manchester Metropolitan University (MMU) into the recruitment, development and retention of ASC workers has had a direct impact on ASC policy, management practice and human resource (HR) practice.
In the area of health, welfare and public policy, the primary research impact was on the Adult Social Care Recruitment and Retention Strategy 2011. Among ASC managers and HR practitioners, the research findings informed and stimulated debate over the conduct of ASC work and the benefits of good HR practice.