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Collaboration for Leadership in Applied Health Research and Care: Nottinghamshire,
Derbyshire and LincolnshireHealth and Social Care Forum
Community Action Derby: 12th January 2010
Research making a difference to practice
Overview
•Overview of CLAHRC NDL•Themes: clinical and implementation research themes•Studies taking place in Derby•Return to work in Stroke study
From what we know to what we do
• CLAHRC’s pull together researchers/clinicians/commissioners/ users/carers to work together to get what we know into standard practice.
• 9 CLAHRCs across the country – all working slightly different ways
Partnership Working
• Building partnerships• Multiple perspectives• Learning together
Diffusion Fellows and CLAHRC associates are vital to partnership working
How does CLAHRC work?
Applies an Organisational Learning model: Researchers work alongside (not decoupled from) healthcare staff (Diffusion Fellows) to do the research & support its implementation in a situated way in real time as evidence-based innovation is translated into practice
CLAHRC Associates (from any sector or background) form networks around Diffusion Fellows to help the research to practice process
CLAHRC NDL: Structure
IMPLEMENTATION THEME (to facilitate the transfer of research into practice and to research implementation)Lead: Graeme Currie
Programme Manager
Implementation Research Fellow
Implementation Educator
Diffusion Fellows
ENGAGEMENT, SYNTHESIS AND DISSEMINATION THEME (building bridges to add value and increase impact) Lead: Justine Schneider
Programme Manager
Engagement Research Fellow
Patient/Service users
Engagement Fellow (commissioning and service users and carers)
Diffusion Fellows
Director of Research: Richard Morriss
The NIHR CLAHRC NDL is funded by the National Institute for Health Research
Stroke Rehabilitation Mental Health Primary Care Children and Young People
Return to work after stroke
Readiness for psychological treatment in people with Personality Disorders
Reducing diabetes risk in people with South Asian origin
Developing consensus on treatment outcome measures in CAMHS
Home visiting prior to discharge from hospital
Dental and physical health in people with mental health problems
Pre-conception screening Translating evidence based medication management for ADHD into routine NHS practice
Early supported discharge after stroke
Chronic mood disorder: the effectiveness of specialist experts
Morbidity post injury Group parenting and other early interventions for children at risk of ADHD
Home based computer rehabilitation after stroke
Supported employment and CBT (Individual Placement and Support)
Stepped care for medically unexplained symptoms
Exercise to prevent obesity on children with asthma
CLAHRC NDL Projects
Return to Work After Stroke
Evidence from Stroke
• Less that one third of stroke survivors of working age return to work
• Although severe disability accounts for a proportion of this figure there remains significant unmet need
• For many the primary goal is to return to work
Return to Work: Aims
• To design a vocational rehabilitation service specific to the local needs of people with stroke in Derby, involving key stakeholders and test its feasibility and cost effectiveness, usefulness and acceptability in a pilot randomized controlled trial (RCT).
• To determine what people with stroke, their employers and other stakeholders (NHS, Job Centre Plus and the Third Sector) want from a vocational rehabilitation services, so that appropriate services can be designed.
Return to Work: The Projects 1
1. Interview and observational study of current provision:
1. What vocational rehabilitation services people in Southern Derbyshire currently receive following a stroke and how and where are work issues are currently addressed?
2. What do people with stroke, their employers and other stakeholders (NHS, social services Job Centre Plus and the Third Sector) want from a vocational rehabilitation service?
2. Pre-trial intervention phase (case study design)1. Can we deliver this locally?
2. Is it seen as acceptable and useful by recipients.
Return to Work: The Projects 2
3. Pilot Randomised Controlled Trial
1. Can we design and test the feasibility and cost effectiveness of delivering a vocational rehabilitation service for people with stroke?
4. Qualitative study to identify changes experienced and valued as a result of participating in the service.
1. What service interventions are most valued in practice by an employee with stroke?
2. What service interventions are most valued in practice by an employer?
