Much of our research is based on solving practical health problems affecting patients, clinical practice and policy makers. The influence of our research is wide-ranging.
At an individual level, it is directly impacting on patients using the services and treatments informed by our research, along with nurses and doctors who use our research to improve and inform their clinical practice. And at a wider level, it is used by health organisations in the UK and overseas to inform policies, guidelines and practices.
We have strong relationships with health and social care services, patients and carers, clinical practitioners and policy decision makers and this enables us to conduct research that we know is answering some of the key questions facing the health service today.
We work with all of these groups to ensure our research is timely, relevant and that, importantly, that it will effect beneficial change and our strong relationships with patient groups and health organisations provide us with real world input into our research projects.
As well as working alongside these external groups, we provide significant support to our researchers to help them work with external parties. Through training, access to expert advice and encouragement to disseminate research findings widely we aim to provide the healthcare sector with answers to the research questions that really matter to patients and healthcare providers.
Take a look at how some of our projects are affecting healthcare in the UK and beyond.
We are informing national guidance for clinicians
Our research examining the ways in which doctors and nurses communicate with patients over the telephone will contribute to an evidence-base which is informing national guidelines on the use of telephone triage.
Our research has examined how GPs and nurses communicate when they are conducting telephone triage using decision support software. Understanding these interactions with patients is central to evaluating the safety and effectiveness of telephone triage in managing demand for face to face appointments. We found that whilst the average length of call is often similar, the type, number and content of questions asked of patients by clinicians was often very different. These different styles of triage have implications in terms of how patients feel about the triage experience and also the type of information being collected by clinicians.
Our work will help patients who are required to self-medicate
Ensuring patients with chronic or long term conditions take their medication properly is a key challenge to healthcare providers. Our study examining issues around not taking medication properly showed that therapy can be extremely effective in helping patients and improving their health.
During the research project, we worked with 136 people who had high blood pressure and were expected to regularly self-medicate. During the study, some of the patients were selected to attend an adherence therapy group which met regularly over a seven week period. Others were asked to continue with their medication as usual, without attending the therapy. The study found that those attending therapy had a much higher adherence rate than previously, and their blood pressure was almost at a normal level. Whilst these were initial results, it has shown that adherence therapy can be useful for helping patients manage long term conditions.
We're improving support for older women in violent relationships
Through and EU-funded research project, we have been gaining knowledge and raising awareness about the issue of intimate partner violence against older women. Comparatively little has been known about this subject until now, but through studying case files held by the police and other UK criminal justice agencies, running workshops with criminal justice and social support experts and seeking the views of older women who had experienced intimate partner violence, we have gathered a body of new knowledge. We have used this knowledge to develop guidance for support organisations and many of our materials are freely available. We were also asked by the NPIA (now the College of Policing) to help in the production of training materials and our guidance is also being used, where appropriate, by the Crown Prosecution Service.
Our dementia research is helping healthcare policy and planning
Through our involvement in major studies into dementia, we have been helping to provide accurate information to the public, decision makers and healthcare planners.
We undertook two large studies in collaboration with the University of Cambridge and the Medical Research Council and found that the number of people in the UK is substantially lower than anticipated in the over 65 age group. However, the study also showed differences in the proportion of people with dementia in different areas, which suggests that health inequalities may have a bearing on a person's likelihood of developing dementia in later life.
Our findings were publicised widely through the media and disseminated to practitioners, providing valuable evidence that has an influence on the planning of healthcare services for dementia patients in the future.
Raising standards of care for older people
Increased concerns about levels of care of older people in institutional settings has led to a drive to understand how mistreatment and loss of dignity can be prevented. Our research is focusing on identifying the patterns of practices supporting good and bad care on an institutional level, examining the factors that might persistently underpin mistreatment in residential care homes in the UK. This is being used to inform new national guidelines to support staff training, commissioning and inspection of organisations providing institutional care for older people.
Informing approaches to disability in Africa
More than one billion people in the world live with some form of disability and the UN considers this population as the world's largest and most disadvantaged minority. Our research in community based rehabilitation (CBR) has informed the development of participatory approaches to promote equal access to health care, education, skills training, employment, social mobility and political empowerment. Through this work we have made a significant contribution to the practitioner guidelines, educational resources and events of the Pan-African Community-Based Rehabilitation Network (CAN) (www.afri-can.org). This has included regular pan-African conferences, with 2013's conference including 387 participants from 67 countries, including health ministers from most African nations.
A new approach to post-surgery care: saving time, money and inconvenience
Dupuytren's disease is a common hand disorder which causes the fingers to contract, in many cases causing considerable disability. It's particularly prevalent in Northern Europe but whilst surgery can restore full hand function, recovery from the surgery has traditionally included patients' being required to wear a night splint for up to 6 months. Through our research (SCoRD trial), we identified that routine night-time splinting is no more effective than providing splints only when a contracture recurs (in a minority of patients). The impact of our research has resulted in saving therapists time, fewer hospital visits and lessening inconvenience to patients from wearing a splint. It has informed treatment and policy guidelines here in the UK, in the USA and in New Zealand.
Growing the evidence for exercise therapy
The burden of managing chronic diseases presents one of the major healthcare challenges of the 21st century. And whilst the positive role of exercise in managing many long-term conditions is increasingly recognised, there are still a large number of research questions to be answered. These include developing knowledge about how exercise therapy can be optimised to maximise health benefits and understanding both the role of exercise in disease modification and why some patients respond differently to others to exercise therapy. Through our research we have helped to build a robust evidence base for the use of exercise in the management of many long-term conditions, such as in the UK National Cancer Survivorship Self-Management Initiative.
Improving standards for care home residents
The quality of life of care home residents and those at the end of life has become a focus of interest following recent scandals. We have delivered a programme of research over the last 15 years which has examined resident's health status and evaluated interventions targeted towards improving care and their quality of life. In the last few months we have finalised a training DVD for care homes which has been awarded the UK Stroke Forum Quality Mark. The group's work is also included in the 2013 National Institute for Health and Care Excellence (NICE) guidelines for stroke.
Collaborative Learning in Practice (CLiP)©
The School of Health Sciences in partnership with Health Education East of England and our practice partners including Norfolk and Norwich University Hospital, James Paget University Hospital, East Coast Community Healthcare, Norfolk Community Health and Care NHS Trust, Queen Elizabeth Hospital and the Norfolk and Suffolk Foundation Trust have been piloting an exciting project to deliver a different way of practice learning called Collaborative Learning in Practice (CLiP)©.