AVOIDING ATTENDANCE AND ADMISSION in Long Term Conditions NEWSLETTER Issue 1 December 2014 This is the first newsletter we have produced in order to inform and update colleagues about the National Institute for Health Research, Collaboration for Leadership in Applied Health Research and Care, Yorkshire and Humber (NIHR CLAHRC YH) Avoiding Attendance and Admission theme. We have had a very busy first year developing the 5 year programme of work. Most of this has involved establishing the team, developing collaborations around Yorkshire and Humber with healthcare organisations and applying for Ethical, CAG and R&D approvals in order to begin obtaining data. We have had excellent support from across the region with many services keen to participate through interviews, focus groups and in providing data for us. We have also had great feedback about the importance and timeliness of such a study in tackling one of the major challenges facing healthcare today – that of delivering a safe and efficient service that is sustainable given the changing nature of healthcare and patient needs. I hope you find the newsletter informative and that you will share it with other services, professionals and patients. I also hope you will be able to attend some of the events we will be hosting in the forthcoming year. This is an exciting programme of work for us all to be involved in and is an opportunity for us to develop services in the region and also to provide a national model for emergency and urgent care. Please do not hesitate to contact me or any other member of the team if you would like further information about any of the project work we are undertaking. Can I take this opportunity to wish you all a happy, relaxing and safe Christmas and I look forward to continuing working with everyone in 2015. Best Wishes Sue Mason Professor of Emergency Medicine, NIHR CLAHRC YH Theme Lead

MEET THE TEAM: AAA Management Group Theme Lead: Suzanne Mason Theme Manager: Colin O’Keeffe Theme Researchers: Angela Carter, Sarah Crede, Rachel O’Hara, Suzanne Ablard AHSN Programme Manager: Maxine Kuczawski CLAHRC YH Core Team: Christine Smith Theme Administrator: Tanya Shvab In the photo (right to left): Colin O’Keeffe, Maxine Kuczawski, Sue Mason, Tanya Shvab


AAA CLAHRC YH WORKSTREAMS Core funding from NIHR Matched funding from partners

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RCF Consultancy

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Routine ‘big data’ analysis to identify patients with long term conditions who might have an avoidable hospital attendance or admission Qualitative scoping study involving key stakeholders in Yorkshire & Humber Systematic literature review The Academic Health Science Network (AHSN) Improvement Academy Projects Research Capability Funding Projects

Core studies – NIHR CLAHRC core and Matched funding Analysing Emergency and Urgent Care System Demand in Yorkshire and Humber: A data linkage study of pre-hospital and emergency department data Aims:  Analyse linked NHS data from a number of providers of emergency and urgent care (EUC) in Yorkshire and Humber to analyse patient demand and flow through these parts of the system. Data sources:  Yorkshire Ambulance Service (999/NHS 111)  Acute hospital routine data (ED/Inpatient) Progress:  Ethical approval and approval from the Confidential Advisory Group (CAG) to undertake data-linkage work using identifiable patient data.  Nine of the thirteen Acute Trusts in Yorkshire and Humber have agreed to participate so far and are processing the relevant approvals.  Data collection is scheduled to begin in February 2015.

A qualitative scoping study of emergency and urgent care stakeholders in Yorkshire and Humber Aims:  To understand the key challenges facing the emergency and urgent care system in YH. Methods:  Interviews with key stakeholders to understand: 1) Demands facing organisations; 2) Initiatives established to address demand and reduce avoidable attendance and admissions especially in patients with long term conditions from a range of perspectives across the EUC system. Progress:  Completion of interviews with 24 stakeholders from across Yorkshire and Humber.  Interviewees include consultants in emergency and acute care, ambulance service managers, senior commissioning managers from CCGs, GPs and community care teams.  Analysis of these complex data is underway and will be completed by February 2015. AHSN Improvement Academy Urgent Care Theme: Improving the speed and appropriateness of treatment in EDs using evidence-based methods such as Senior Doctor Triage This is a 2-year improvement project supported by School of Health and Related Research (S.Mason & M Kuczawski) and the AHSN Improvement Academy. The aim of the project is to gain an overview of existing practice in relation to Senior Doctor Triage in the region, identify good practice and then share this as well as lessons learnt with Trusts via the development of guidelines and recommendations for future practice. Meet Maysam Abdulwahid, PhD student PhD research project: The effectiveness of senior doctor triage in relation to other triage models used in emergency departments across the UK. Maysam delivered a talk at the College of Emergency Medicine conference: The impact of senior doctor assessment at triage on emergency department performance measures: Systematic review and metaanalysis of comparative studies. (September 2014) In the photo: Professor S.Mason (left) and M. Abdulwahid (right)

SELECTED RELATED PUBLICATIONS in 2014  Lecky, F. et al. (2014). The international federation for emergency medicine framework for quality and safety in the emergency department. In Emergency Medicine Journal Vol. 31 (pp. 926-929). BMJ Publishing Group.  Mason, S. et al. (2014). Innovations to reduce demand and crowding in emergency care; A review study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 22(1), 1-7.  Croft, S. J. et al. (2014). An evaluation of the referral process in the emergency department. Emergency Medicine Journal, 31(10), 827-832.  Snooks, H. A. et al. (2014). Support and Assessment for Fall Emergency Referrals (SAFER 1): cluster randomised trial of computerised clinical decision support for paramedics. PloS one, 9(9), e106436.  Mason, S. et al. (2014). The AHEAD study: managing anticoagulated patients who suffer head injury. Emergency medicine journal: EMJ, 31(9), 775.

FORTHCOMING EVENTS 6 January 2015 - Advisory Group Meeting Avoiding Attendance and Admission in LTC theme, NIHR CLAHRC YH CONTACT US for more information and collaboration: [email protected] Visit our web page: http://clahrc-yh.nihr.ac.uk/ourthemes/avoiding-attendance-and-admissions-in-long-termconditions

18 March 2015 - Best Practice & Research in the ED: Focus on Senior Doctor Triage AHSN workshop for ED consultants and staff to instigate a round-table discussion about Senior Doctor Triage. It will also cover topics of NIHR CLAHRC YH Avoiding Attendance and Admission in LTC theme. The Yorkshire & Humber Injuries and Emergencies Specialty Group Meeting will follow the workshop. To register please contact T.Shvab, Project Administrator at [email protected] Attendance is free upon registration.

 The University of Sheffield 2014, a partner of the Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (CLAHRC YH) This newsletter is part of independent research by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH). The views and opinions expressed are those of the authors, and not necessarily those of the NHS, the NIHR or the Department of Health.

AAA Newsletter December 2014 (2).pdf

Kuczawski, Sue Mason, Tanya Shvab. AAA THEME FUNDING SOURCES AAA CLAHRC YH WORKSTREAMS. Routine 'big data' analysis to identify patients.

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