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Professor Sue Bale Assistant Nurse Director (R


Benefits of HS&DR for the NHS An Update Professor Sue Bale Assistant Nurse Director (R&D) Aneurin Bevan Health Board – PowerPoint PPT presentation

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Title: Professor Sue Bale Assistant Nurse Director (R

Professor Sue BaleAssistant Nurse Director
(RD)Aneurin Bevan Health Board
Benefits of HSDR for the NHSAn Update
  • Putting the NHS in the centre
  • Developed in the context of a transformed
    research system NISCHR
  • Health Services and Delivery Research (HSDR) is
    a strategic priority aim that cuts across the
    other priority aims for SEWAHSP
  • Pace and progress already seeing benefits to
    the NHS
  • Integrating with existing systems for improvement
    in the NHS

New context for NHS research in Wales NISCHR
  • Past 3 years have seen a huge transformation in
    the NHS
  • Changes to funding has enabled the NHS
    organisations to provide their staff and
    departments with a functional infrastructure,
    though these are small in comparison to the size
    of the organisations
  • Through competitive bids have now got funding to
    directly support access to pharmacy, radiology
    and pathology for research
  • Through competitive bids have access to protected
    research sessions for NHS staff
  • Have now got access to research methodologists
  • The Academic Health Science Collaboration has
    been instrumental uniting the Wales research
    communities and has strengthened existing
  • The 3 hubs has enabled a Regional approach
  • SEWAHSP is an important forum to the NHS
    organisations in the SE Wales region

Where did HSDR come from and why?
  • Strong hub lead for the SEWAHSP
  • Considerable support from AHSC lead
  • Quickly engendered a sense of community
  • The NHS an equal partner
  • Health service delivery core business in the NHS
  • HSDR core area of research in Universities
  • HSDR Group first met to scope out interests and
  • HSDR Group first met to explore how we could
    work together

Working in partnership
  • We envisage that the NHS partners
  • Will do different projects
  • Can share projects between any of the NHS
    organisations in SE Wales
  • Can work with 1 HEI or a combination of HEIs
  • Any combination of NHS organisations and HEIs is

  • A flavour of what has been
  • achieved to date

Developing the Infra-structure support for RD
across South East Wales
  • Following discussion and agreement, a needs
    assessment across the SEW Region resulted in a
    funding application submitted to the AHSC
  • Application on behalf of all SEWAHSP and HSDR
    Group members
  • This was successful and funding was secured for 3
    years for
  • 1 wte statistician
  • 1 wte health economist
  • 0.5 wte psychometrician
  • Direct access to research design expertise for
    the NHS
  • Posts specifically to support the NHS, accessed
    through Research Design and Conduct Service
  • Provide clinics and individual advice in the NHS
    of study design, particularly for CRP

Proposed Collaborative HSDR projects and the NHS
in South East Wales
  • Gathered pace already
  • NHS working with Cardiff University (SOCSI)
    Alison Bullock
  • Better understanding Knowledge Transfer in NHS
    managers is of key importance
  • Managers uptake and utilisation of research will
    be essential in developing and delivering the
    best evidence-based services in the NHS
  • NHS working with Cardiff University (Mathematics
    Department, Operational Research) Paul Harper
  • Mathematical modelling is of key importance in
    understanding services, identifying issues and
    then solving them

Knowledge Transfer and the NHS in South East

  • Knowledge Transfer project with Alison Bullock
  • ABHB has identified a researcher for the pilot
  • ABHB has applied for funding to undertake the
  • 2 Health Boards are planning to support the pilot
    through access to staff and funding
  • more from Alison later

  • Mathematical modelling and the
  • NHS in South East Wales
  • Operational Research at the School of
    Mathematics, Cardiff University
  • Sees challenges to the NHS as bringing people
    processes and technology together in an
    integrated way to plan, develop and deliver
    better health services
  • OR Group is recognised as a leading group in the
  • 22 staff and PhD students
  • Research income 3m (Science and Innovation award
    for 2008-2013)

Mathematical modelling contd
  • Recognises that the NHS has to become more
    efficient and patient
  • centred. Focuses on improving
  • Queuing systems (where are they and how to
    eliminate them) by predicting individual patient
    resource needs and outcomes
  • Facility location (have developed scenario
    modelling simulation frameworks) to work out the
    sites for services
  • Behavioural modelling (game theory and theory of
    planned behaviour) helps understand the
    importance of human behaviour in healthcare
  • Important for an evolving NHS in Wales

  • Mathematical modelling and the
  • NHS in South East Wales
  • CV, WAST and now ABHB previously working with
    HEI in isolation from each other
  • The HSDR Group has enabled the value and
    possibilities of such mathematical research to be
    discussed and explored together
  • The HSDR Group has enabled mathematical research
    to be further spread across SE Wales
  • HSDR will be the forum for sharing, learning and
    collating these projects
  • CV funds from corporate funds (65k and 55k)
  • ABHB funds from corporate funds (150k)
  • WAST funds from external EPSRC through CU

  • OR work in ABHB
  • MSc student project operational research project
    in dermatology
  • Joint appointments of 4 post doctoral OR
    mathematicians (2 in January 2013 and 2 in April
  • Will be part of the ABCi more later
  • Will work on the Clinical Futures programmes
  • Especially for centralising Specialist Critical
    Care services and community based services
  • Provide a cohort of expertise
  • Spend 1 day a week at the Maths Department
  • Will be integral to developing future services

  • OR work in Cardiff Vale
  • Continuous funding of PhD students
  • Modelling in Emergency Unit led to identifying
    bottlenecks, reconfiguring services, improving
    patient flow
  • More than half way through a 3-year plan of
    implementation and has already saved 1m
  • Automated scheduling of physiotherapy at the
    neurological rehabilitation centre (Rookwood)
  • Implemented since January 2011 it has transformed
    bookings and released clinician time
  • Physiotherapy treatments are tailored to patient
  • Lengths of stay have been optimised
  • Improved quality of life for patients

  • Cardiff Vale University Health Board
  • In partnership with CU we have developed funding
    mechanisms to that
  • focus on optimising healthcare delivery
  • Co-Principle Investigators for MAGIC (Making Good
    decisions In Collaboration) a Health Foundation
    Grant evaluating mechanisms that support the
    implementation of Shared Decision Making in the
    NHS setting
  • SHINE Award 2011 Hysteroscopy move from GA to LA
    outpatient procedure. Evaluation performed in
    partnership with CEDAR
  • - 90 procedural success well tolerated by
  • - Saving of 651 per procedure and 100 hours of
    theatre time
  • Collaborative study with School of Mathematics,
    reached final adjudication stage of a SHINE
    application for study employing operational
    research modelling to determine the value
    components associated with service transfer
    (secondary to community care setting)

CV Faculty for Quality Improvement
  • In partnership with CU we have developed a
    Faculty for QI.
  • The purpose is to bridge the gap between bench
    and bedside
  • and foster an improvement and innovation

Cwm Taf Health Board
  • Investment and Successful funding applications
    has lead to
  • increased RD Infra structure to support HSDR
  • x2 AHSC Clinical Research fellowships
  • a) Anaesthetics and Critical Care Medicine
  • b) Endocrinology (Thyroid Disease)
  • Undertaking Collaborative Research with Cardiff
    University in
  • respective fields and supporting projects on the
  • x1 Clinical Trials Pharmacist Support
  • x1 Clinical Research Scientist Support
  • Health Board currently reviewing potential HSDR
    /pathway to portfolio projects in Therapies,
    Medicines Management, Public Health Medicine,
    Knowledge Transfer (with CU) and Medicine (NISCHR
    RSPD Allocation)

Aneurin Bevan Centre for improvement (ABCi)
integrating RD into existing systems
  • Functions of ABCi
  • Developing leaders and supporting leadership
  • Train staff in a range of improvement
  • Support projects for improvement
  • Innovation, resources and knowledge management
  • Will continue strong links with 1000 Lives Plus,
    NLIAH, Delivery Support, IHI and Patient Groups
  • Collaboration with Paul Harper (Mathematical
    modelling) and Alison Bullock (Knowledge
    Transfer) are very important

In Summary
  • HSDR collaborative projects are being developed
    and gathering momentum
  • Benefits of sharing resources are coming to
  • Boundaries between NHS service delivery and
    academic research being removed
  • Partnerships are clearly symbiotic
  • Opportunity to facilitate evidence based changes
    in NHS service delivery through better
    understanding Knowledge Transfer now available
  • Now over to Alison