@ResearchWales Issue 5

@ResearchWales Health and Care Research Wales Magazine - Issue 05 - December 2018

The magazine to showcase health and social care research in Wales

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The Welsh ‘code-breaker’ making our visits to the GP safer We speak to an award-winning Welsh researcher and GP who has developed a whole new language of codes to analyse medical errors

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‘Pushing the boundaries’ to deliver early phase research in Wales

The changing face of research training

We’ve been behind the scenes at the Clinical Research Facility in Cardiff, and the new All Wales Early Phase Research Partnership, to find out more.

Discover a whole range of courses designed to meet the needs of researchers in the ever-changing world of health and social care research.

Health and Care Research Wales Magazine - Issue 05 - December 2018

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PAGE 1 28 2 PAGE

Contents

Calendarthe of events ‘Pushing boundaries’

PAG E 1 4

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Setting the standards

Calendar of events Item Style Featured

PAG E 2 0

The changing face of research training

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Foreword Carys Thomas & Michael Bowdery, Joint Interim Directors, Health and Care Research Wales

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PAGE 1 4

News

Setting the Standards

Research news from across Wales

An update from the Public Involvement and Engagement team

PAG E 1 6

PAGE 1 8

The Welsh ‘code-breaker’ making our visits to the GP safer

‘Pushing the boundaries’ to deliver early phase research in Wales

How Dr Carson-Stevens’ work is improving patient safety around the world

Ground-breaking early phase research is now routinely available in Wales

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PAGE 2 2

The changing face of research training

Calendar of events

Find out how research training in Wales is adapting and expanding

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Health and Care Research Wales Magazine - Issue 05 - December 2018

Foreword W

elcome to the fifth edition of

Public involvement and engagement

exercises and dissemination activity as we

@ResearchWales. Much has

continues to be central to all we do and we

work to further raise the profile and uptake

happened since the last issue of the

are pleased to see the National Standards for

of the research we fund. There will be

magazine, including a focused review of

Public Involvement being put into practice

continued access to key National Institute

some of our activities to inform the 2020

across our funded initiatives. We will develop

for Health Research (NIHR) programmes, with

- 2025 Health and Care Research Wales

the use of the Standards to ensure we keep

new opportunities for social care researchers

strategic plan.

improving the way that all fundees involve

to win grants through these schemes.

and engage the public as a core part of their In the meantime, we have pushed forward

work.

with new funding calls for our Health

2018 has been a year of celebrations, marking not only Health and Care Research

Research Grants, Social Care Fellowships,

HealthWise Wales now has 27,500 people

Wales’ third birthday but the 70th

Research for Patient and Public Benefit Wales

registered to help inform new treatments,

anniversary of the NHS. As the year draws

scheme and Clinical Research Time Awards.

health policy and NHS and social care

to a close we can be proud of what we have

We will be appointing our next round of

services long into the future. We strive to

achieved so far and look forward to building

senior research leaders in the spring, who we

ensure that more people have opportunities

on that success in 2019.

expect to play a key role in promoting the

to take part in research studies that can

research endeavour in Wales and supporting

bring real changes to their lives and those of

We’d like to take this opportunity to wish

the next generation of research leaders in

others.

you a Merry Christmas and a Happy New Year

Wales through the Health and Care Research Wales mentoring and training scheme.

and to thank you all for your dedication and Future-proofing research was the theme of

commitment to producing excellent health

our successful annual conference in October

and social care research that makes a real

Our recently published annual report,

and we will continue to ensure that the work

difference to health and wellbeing.

showcasing examples of Health and Care

we fund is fit for the future, allowing us to

Research Wales’ stand-out achievements,

meet the most challenging health and care

demonstrates the strides we’ve taken

questions of the coming decades.

towards achieving our vision for Wales to be

Carys Thomas & Michael Bowdery

internationally recognised for its excellent

We will follow through on our commitment

health and social care research. The breadth

to an open call for new infrastructure awards

Joint Interim Directors, Health and Care

and diversity of the work taking place

early in 2019 and continue work to establish

Research Wales

across our thriving research community is

seamless ‘One Wales’ research services for

also evident in the articles featured in this

sponsors, researchers and the public. You

magazine.

can expect to see new research prioritisation

Health and Care Research Wales Magazine - Issue 05 - December 2018

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D IA B ETES R ES EARCH U NIT CY M R U

The PIONEER series of global studies compared the tablet with established anti-

Tablets replace jabs for a type 2 diabetes drug

diabetes treatments with impressive results.

Data from PIONEER 1-5 have been reported with PIONEER 6, looking at the cardiovascular safety of the tablet, currently in analysis and PIONEER 7 and 8 also underway.

A daily pill could replace injection therapy for people with type 2 diabetes, thanks

Professor Steve Bain, Diabetes Research Unit

to global research studies, involving

Cymru lead, presented the PIONEER journey

participants recruited through the Joint

at a standalone symposium, focused on the

Clinical Research Facility in Swansea. These

results of the studies, at this year’s European

have confirmed the effectiveness and safety

Association for the Study of Diabetes

of a new formulation of a peptide therapy.

meeting in Berlin. He said: “Although widely recognised as being safe and effective

Type 2 diabetes sees the body unable to

treatments, the GLP-1 analogues haven’t had

control blood glucose, causing serious health

a wide uptake in the UK as patients prefer to

issues. Peptide therapy for the disease uses

avoid injection therapies. The availability of

synthetic versions of a small molecule called

an oral treatment option will make this class

Glucagon-like Peptide 1 (GLP-1 analogues).

of medicine much more likely be used.”

This therapy is effective, offering a different treatment option, but these molecules are rapidly destroyed by stomach acid, meaning regular injections are needed – something

News

that limits uptake and continued use. New

Research news from across Wales

technology has allowed for one of these medicines, called Semaglutide, to survive digestion and be given as a once daily tablet.

N ATIO N AL CENT R E FO R P O P U LATIO N H EALT H AND W ELLB EI NG R ES EARCH

based insights for recommendations to inform Welsh policy makers and professionals’ decision-making.

Dr Kelly Morgan and the research team began looking into inactivity in 2016, comparing data provided by nearly 7,400 students from 67 schools about their activity levels, alongside data from schools with levels of sedentary activity amongst 11 – 16 year olds.

Research provides important insight into youth inactivity

“Our findings provide an important insight into the activity levels of this age group, and can be used to align health improvement with the core business of schools and to argue for the implementation of universal, as opposed to targeted, interventions.

Wales’ health policy on children and young people is drawing on findings from the

“Our most recent data shows that inactivity is

National Centre for Population Health and

still rife. There is a need to promote physical

Wellbeing Research’s (NCPHWR) ongoing

activity and reduce sedentary behaviour if

student survey. Their data contributed to

we want to improve health and wellbeing

the Active Healthy Kids Wales (AHK Wales)

outcomes for young people,” Dr Morgan

2018 report, presented at a recent inquiry

commented.

into physical activity of children and young people.

The results of the survey were published at the AHK Global launch in Adelaide in

AHK Wales provides report cards on the

November and a national report will be

health of young people in Wales, and

published in Spring 2019.

NCPHWR research is giving them evidence-

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Health and Care Research Wales Magazine - Issue 05 - December 2018

POWYS T E AC H I NG H EA LT H B OA RD

Improving rehabilitation for young adults affected by stroke A world-first study investigating how a stroke affects the way young adults walk has taken place across six health boards in Wales.

The mobile gait lab

The study, ‘Stroke in young adults: What is the metabolic and mechanical cost of

how much oxygen the participant used over

long-term goal is to develop evidence-based

walking and what are the implications for

three minutes of continuous walking, to

rehabilitation which aims to improve how

rehabilitation?’, analysed walking patterns to

determine how efficiently they were walking.

young adults who have had a stroke walk,

understand how an individual’s movement is

enabling them to get back to the things they

affected, allowing grading of their difficulty

The researchers aim to provide a unique

in walking and personalised feedback for

feedback report for every patient, including

planning rehabilitation therapy.

a full gait report, by combining the results

“I would like to thank the Neuro-

from both tests. Comparing their individual

Physiotherapy teams and R&D teams across

50 people affected by stroke and 26

movement pattern with that of the average

Wales for their cooperation, recruitment and

‘controls’ with no stroke history were

stroke-affected person and average

facilitation of this project.”

recruited to take part in a testing session.

unaffected person, could highlight any

State-of-the art equipment allowed exact

significant differences and help improve

The study was led by Dr Jarvis, Professor

assessment of how each person walked,

future treatment plans.

Neil Reeves, Dr Steven Brown and Mr

tracking the movement of individual body

love most.

Samuel Wisdish (Manchester Metropolitan

parts and calculating how much force they

Dr Hannah Jarvis, lead investigator from

University) and funded by the Stroke

were able to put into the ground whilst

Manchester Metropolitan University, based

Research Innovation Fund Wales.

walking. The testing session also monitored

in Powys Teaching Health Board, said: “The

PRIME C E NT RE WA L E S

PRIME & Swansea Centre for Health Economics helping to improve community care services For years, a monthly 86 mile round trip to the eye clinic had put increasing strain on Jim and his wife Mary, both in their late seventies, as Jim tried to preserve the sight in his right eye and his independence, having lost sight in his left eye due to Wet Age Related Macular Degeneration (Wet AMD).

Eye services at hospitals are facing twin pressures of increasing demand and insufficient capacity. To be able to provide effective, accessible treatment and care for people like Jim, changes are needed in the way that services are delivered.

In 2015, the Welsh Government made

Based on the evaluation of the pathfinder

£500,000 available to fund pathfinder

services, the research team made seven

services that brought care for people with

recommendations about the delivery and

Wet AMD into community settings. For

sustainability for the future of services in

Jim and Mary this meant that their regular

Wales. The recommendations, which aim to

appointments were moved to their local

increase capacity by streamlining the patient

community hospital. A service evaluation by

journey, will be published soon.

the Centre for Primary and Emergency Care Research (PRIME), and health economists at

If the recommendations are implemented

Swansea Centre for Health Economics (SCHE)

they should improve the patient experience

at Swansea University, commissioned by the

for people like Jim and Mary, allowing

Welsh Government, assessed four of these

them to spend less time travelling to busy,

pathfinder services, provided by four health

overstretched clinics and more time doing

boards.

the things they choose to do.

Health and Care Research Wales Magazine - Issue 05 - December 2018

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N ATION A L C E NT RE FO R M EN TA L H EA LTH

P UBL IC H EALT H WAL ES

It’s Time to Move at Public Health Wales

Dr Jack Underwood

Investigating the genetics of adults diagnosed with Autism Spectrum Disorder While the last decade has seen developments in services available for adults presenting with symptoms of Autism Spectrum Disorder (ASD), our understanding of their condition and genetic characteristics has lagged behind that of children with the disorder.

Public Health Wales is prioritising the

Over a 12 month period the initiative will

health and wellbeing of its employees by

undergo an evaluation, led by Bangor

providing them with paid time each week

University, measuring physical activity levels,

to undertake a physical activity of their

sedentary behaviour, body mass index and

choice, under the Time to Move scheme.

body fat percentage.

Being less sedentary can help reduce

The initiative aims to raise awareness of

the prevalence of a wide range of health

the benefits of investing in employees,

issues, and the study aims to understand

and could, if successful, lead to other

if allowing staff paid time during the

organisations adopting it.

working week to be physically active will lead to improvements in their health and

There are around 800 Public Health Wales

wellbeing.

staff in the cohort and the results of the evaluation will be published next year.

ASD in adults describes a range of symptoms affecting social, behavioural and communication abilities. Now Wales’ National Centre for Mental Health (NCMH) has played a key role in recruiting participants to be part of a study looking at the genetic characteristics of adults diagnosed with ASD. Dr Jack Underwood and his team collected and analysed data from questionnaires, interviews and DNA. Findings showed there was a significantly higher load of autism common genetic variants in the adult ASD group compared to controls. 90% of those with ASD were found to have at least one other mental health problem, depression and anxiety being the most common. They were also more likely to have migraine headaches, particularly in combination with epilepsy.

The study provides important information about adult ASD which can be used to inform clinical practice and patient counselling.

NCMH are working closely with organisations like the Integrated Autism Service to help adults with their diagnosis.

Dr Underwood’s team hope the findings of this work can contribute to a better understanding of ASD, and help provide specialist treatments for adults with ASD experiencing difficulties in everyday life.

Public Health Wales staff participating in ‘Time to Move’

Protect tomorrow by helping today You have a unique opportunity to be part of shaping the health and wellbeing of future generations in Wales.

Sign up to take part in Wales’ largest health study now!

Register www.healthwisewales.gov.wales healthwisewales@cardiff.ac.uk 0800 9 172 172 @HealthWiseWales

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Health and Care Research Wales Magazine - Issue 05 - December 2018

“By offering specialist smoking cessation advice in line with standard treatment, we can improve quit rates leading to a decrease in treatment complications and improved survival and quality of life. This will also lead to reduced costs to the NHS in terms of pharmaceutical costs, in-patient stays and staff costs.

H WY E L D DA UNI V E RS ITY H EA LT H BOARD

Breaking down barriers - lung cancer research at Hywel Dda University Heath Board

from specialist lung clinics in Wales. People were asked to complete questionnaires about the symptoms they experienced and their journey towards a lung cancer diagnosis. They were also interviewed by researcher Lucy Hill to explore the barriers they may have faced to getting a quick

“This low-cost Welsh initiated service is being extended into other cancer cohorts and evaluation of the service is ongoing. It provides a chance for major service redesign that is immediately applicable and has far reaching implications. The initiative can be replicated in any health care system worldwide, ensuring Wales is firmly placed on the map for practicechanging respiratory treatment and care.”

diagnosis.

The findings indicated that patients’ age, other health conditions, time to get an

Dr Rachel Gemine, grant and innovation manager, Hywel Dda University Health Board

Research at Hywel Dda University Health

appointment, distance to surgery and

Board is helping increase earlier diagnosis

continuity of care were barriers to seeing the

of lung cancer, the leading cause of cancer

doctor that may lead to diagnostic delays. It

death in the UK with over 30,000 deaths per

was also reported that not wanting to burden

lung cancer diagnosis is part of a programme

year.

the GP or ‘show weakness by running to the

of work related to the international trial,

doctor’ were strong reasons for avoiding

LungCAST. Led by Professor Keir Lewis,

seeking help.

Health and Care Research Wales respiratory

Despite major developments in treatments, there has been very little improvement in

specialty lead, this is the largest cohort in the

lung cancer survival over the last 20 years,

From these findings, the team are continuing

world looking at the immediate and longer

with over 85% of people dying within one

to work on several studies to help encourage

term impact of continued smoking or quitting

year of diagnosis. Earlier detection of the

early diagnosis of lung cancer. For example,

on survival, quality of life and treatment

disease catches the cancer at a potentially

encouraging pharmacists to identify those

complications.

more treatable stage and gives patients

with possible symptoms of the disease and

access to more treatment options.

helping them to get support earlier.

The Factors Associated with lung Cancer Trial

The team are also tackling smoking habits

as reasons that they were unable to stop

(FACT) aimed to understand the reasons why

in lung cancer patients; although one in

smoking. With support from the Wales

some people go to see their doctor with

three people diagnosed with lung cancer

Cancer Network the research team have

symptoms earlier than others.

are smokers, only 16% quit in the three

developed a specialist smoking cessation

months following diagnosis. Their study

service for patients with cancer to maximise

The research team, led by chief investigator

looking at patients’ views on the barriers and

quit rates and improve patient outcomes.

Dr Rachel Gemine, recruited 257 patients

facilitators to smoking cessation following a

Patients reported lack of support, pressure of hospital appointments and fear of failure

Hywel Dda R&D win at Innovation awards Hywel Dda University Health Board’s Respiratory Medicine and Research and Development department won the Research Excellence in the NHS award for LungCAST at the MediWales Innovation awards on 4 December. Dr Keir Lewis, Health and Care Research Wales respiratory specialty lead, and Dr Rachel Gemine, grant and innovation manager at the Health Board, accepted the award presented by Health and Care Research Wales and the GX Group at the National Museum of Wales, Cardiff.

Rachel said: “We are honoured to win the Research Excellence Award...We would like to express our gratitude to all the patients and staff across the UK who have been involved in these studies and thank you to MediWales for the recognition of their hard work and dedication.”

Health and Care Research Wales Magazine - Issue 05 - December 2018

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AN EUR I N BE VA N UN IV ER S IT Y HEA LTH BOA RD

Return of rheumatology research Rheumatology research has been revitalised at Nevill Hall Hospital, under Aneurin Bevan University Health Board, through the efforts of a research nurse.

Over recent years, clinical pressures and priorities for the consultants and clinical nurse specialists leading rheumatology research at Nevill Hall Hospital saw research fall by the wayside.

This created a backlog of research participant follow-ups, and a lack of recruitment into the rheumatology registry, a research study where the long term effects of treatments on patients’ health is monitored.

All of this changed in 2016 when Anna Roynon-Reed, a bank nurse with no

experience of research or the disease area, was brought in to clear the backlog. Anna received bespoke bank research nurse training from the Health and Care Research Wales training team, which included Good Clinical Practice, Informed Consent, Essential Documents and a mini induction to the research delivery team.

Over time she has cleared a ten year backlog of follow-ups. Anna was supported by research nurses, from the Health and Care Research Wales Support and Delivery service, and also importantly members of the rheumatology team. “Without their support, it would be very difficult for me to carry out my job,” Anna explained.

Anna also quickly developed her knowledge of the service and how research could be integrated within it. She said: “Before I could even begin to address the follow-ups I felt it was important to have a better understanding of the service. I arranged to follow the clinical nurse specialists and consultants at their outpatient clinics, worked a shadow shift at the rheumatology day unit and built relationships with staff.”

Anna is now the nurse principal investigator for the study at Nevill Hall Hospital and the team are regularly the highest recruiters for the registry, winning the award for recruitment of the most participants in October 2018.

By understanding how the service worked Anna was able to identify the best way to invite patients to take part in the registry. It also helped with follow-ups as it gave her an idea of the pathway patients took as their disease progressed.

Anna Roynon-Reed

N ATION A L C E NT RE F O R M EN TA L H EA LTH Stress Studies (ISTSS), the guidelines could see NHS PTSD waiting times cut and more people accessing the right support.

“There is now enough evidence to recommend therapist-guided internet-based interventions using trauma focused cognitive behavioural therapy approaches as treatment for adults with PTSD,” explained Professor Jon Bisson, principal investigator at the Traumatic Stress Research Group at Cardiff University and chair of the expert committee that developed the guidance.

Professor Jon Bisson at the launch of the new guidelines in Washington

New international guidelines on treating PTSD

dreams or nightmares, loss of motivation and jumpiness. Unfortunately, the limited numbers of PTSD trained therapists mean waiting times of 18 months or more are common.

Research led by the National Centre for Mental Health (NCMH) has informed new guidelines set to give more people effective traumatic stress therapy, faster.

Estimates indicate 4.6 million people UK-wide are affected by post-traumatic stress disorder (PTSD) caused by traumatic incidents, like accidents or assaults. Effects can be severe, including repeated flashbacks,

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Evidence from the NCMH-led RAPID (Randomised controlled trial of a traumafocused guided self-help Programme versus InDividual trauma-focused cognitive Behavioural therapy for post-traumatic stress disorder) study so far suggests that an online self-help tool can be as effective as face-to-face therapy and has now informed new international guidelines. Developed by the International Society for Traumatic

Professor Julian Ford, ISTSS president, added that: “The excellent work…will make a real difference to people affected by traumatic events. It is great to see so many promising new interventions to prevent and treat PTSD. While, sadly, we are unable to prevent all traumatic events, we now have more tools to help people deal with the psychological impact of traumatic events effectively.”

The new guidelines are available on the ISTSS website.

The RAPID study featured in Issue 3 of @ResearchWales magazine. You can read more about the study here.

Health and Care Research Wales Magazine - Issue 05 - December 2018

C E N TR E F O R AGE I NG A N D D E ME N T I A RE SE A RC H / WA LES SCHOOL F O R S O C I A L CA R E RE SEA RC H

ENRICHing research in care homes

A new social care research network has launched in North Wales with the aim of providing more opportunities for new and innovative research to take place in care homes.

Currently support for research development and delivery in social care settings, in particular care homes, is less well-developed compared to other healthcare settings, meaning that this group is at risk of being isolated from research opportunities.

Co-hosted by the Centre for Ageing and Dementia Research and the Wales School for Social Care Research, in Swansea University, Enabling Research in Care Homes (ENRICH) Cymru is creating a network of researchready care homes, with a number of studies taking place under the scheme across Wales.

This includes a recently opened study into the learning preferences of people with dementia and intellectual disabilities.

Participants are trialling two methods of teaching to determine which is more valuable when supporting people with a diagnosis of dementia. This Bangor University study is currently recruiting, and is already benefiting from the work of the ENRICH Cymru network.

“Care home staff are considered as the

experts in research. Staff often identify areas for improvement, try out a different way of working and change practice. Essentially this is the foundation of research,” Stephanie Watts, ENRICH Cymru coordinator, explained.

ENRICH Cymru also launched in South Wales earlier this year, with 18 care homes registered since the network began.

Delegates at the launch took a virtual tour around a care home, its environment and community to prompt discussion on areas to investigate and develop

Nominations are now open for the Research Impact Awards 2019!

Let’s showcase the hard-working, highachieving staff from the Health and Care Research Wales Support and Delivery service that have made a difference to research and development in Wales. We’re appealing to you to nominate an individual or team who deserve recognition for a 2019 Research Impact Award.

Three awards will be presented at the event under the categories of ‘public’, ‘research community’, and ‘staff’.

The awards ceremony will take place at the Support and Delivery event on 14 March 2019 at Jury’s Inn, Cardiff. To nominate an individual or team, fill in this online form now. Deadline for entries is 17:00 on 15 February 2019.

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WA LES GE NE PA RK

Developing the next step for genomic diagnostics in Wales Wales’ participation in a ground-breaking project could transform the lives of the 75,000 people in Wales living with a rare disease for which there is no diagnosis, which means little or no progress in tackling symptoms and uncertainty about what life holds for them.

One such family who hopes to benefit is that of a two year old who has undergone continual genetic testing in an unsuccessful bid to identify a cause for their intellectual disability, to understand the potential impact on their life and perhaps open the door to a treatment.

The parents have previously sent genetic samples to Europe in the hope of achieving a diagnosis and gaining some understanding and control of their child’s symptoms.

Now, thanks to Wales’ participation in the 100,000 Genomes Project, they and others in Wales affected by rare disease have the opportunity to have their entire genome sequenced. Analysing the whole genome for changes in the genetic code may pinpoint the cause of their condition, offering the

B ETSI CA DWA L A D R U N IV ER S ITY HE A LTH BOA RD

World-leading clinical research centre opens in North Wales The people of North Wales are set to access the latest trial treatments and contribute to new therapies and diagnostics that could change the face of conditions like diabetes, cancer and cardiovascular disease thanks to a new state-of-the-art facility.

The North Wales Clinical Research Centre (NWCRC) has opened its doors in Wrexham, allowing researchers to carry out cuttingedge studies. Part of Betsi Cadwaladr University Health Board’s Research and Development department, the NWCRC aims to become an internationally recognised centre of excellence, working with universities, life sciences and pharmaceutical companies.

“With this facility we now have a clinical

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prospect of diagnosis and possibly treatment options.

Government to join the project to develop a UK-wide initiative.

“When you have a diagnosis, you can gauge how they could be affected in later life and prepare for this,” said Mum, “for now, we are just taking things as they come.”

With funding from Welsh Government and the Medical Research Council, patient recruitment for the Welsh arm of the project started in February 2018 and the target of 440 participants was reached on 28 August 2018. The initial results for 19 families have been returned and are awaiting validation.

The child’s father sees the potential for the future of genomics-focused healthcare as, “patients will definitely benefit from conditions being identified at an early stage, which could help prevent them from becoming more problematic later on.”

The 100,000 Genomes Project was launched in England in late 2012. In September 2016, Genomics England invited the Welsh

research centre with fantastic equipment that allows the opportunity for our staff to be able to conduct cutting-edge clinical research,” said Professor Stephen Hughes, academic and scientific director of the NWCRC. “Crucially, undertaking clinical research will benefit the people of North Wales at a national level and beyond. The aim of the research centre is to primarily provide a world-class facility for our patients and members of the public, ensuring that North Wales is actively involved in undertaking cutting-edge clinical research.”

While the 100,000 Genomes Project in Wales has now closed to recruitment, the project is expected to inform and accelerate integration of genome sequencing into clinical care pathways in Wales, helping to improve diagnosis and treatment of many conditions, and the collection of genomic data for future research studies.

Professor Iqbal Shergill, consultant urological surgeon, is undertaking several basic science and clinical trials at the NWCRC involving patients with kidney stones, bladder and prostate cancer.

Professor Shergill said: “The newly established NWCRC provides an exciting opportunity for undertaking clinical research in North Wales. We will be able to collaborate with local and national academics and work with life sciences and pharmaceutical companies to provide better care and diagnostic services for our patients.”

Professor Stephen Hughes & Professor Iqbal Shergill working in the lab

Health and Care Research Wales Magazine - Issue 05 - December 2018

WELSH HE A LT H E CO N O M ICS SUPPORT SE RVI C E The team have presented their work at national and international conferences and are now working with York University and Université Catholique de Louvain, Belgium, seeking interest from International Health Economic Association (iHEA) members to develop an iHEA Special Interest Group on the Economics of Nature and the Outdoors.

They are also in discussion with the North Wales Wildlife Trust, Coed Lleol (Small Woods Wales), and Gwynedd Transport about getting people out into the countryside to improve their health and wellbeing.

The value of nature There is growing research evidence for the significant positive impact of time spent outdoors on our physical and mental health. Access to nature is associated with better health outcomes and where people have access to outside spaces there is less income-related health inequality.

Researchers in the Centre for Health Economics and Medicines Evaluation (CHEME) at Bangor University are interested in exploring the economic value of these spaces and their impact on population health and wellbeing.

Professor Rhiannon Tudor Edwards, WHESS lead and Health and Care Research Wales senior research leader said: “Social prescribing [where primary care professionals refer people to local, nonclinical services] is increasingly being used to enable people with physical or mental health problems to benefit from time outside; walking, gardening or enjoying nature. This provides both physical exercise and social contact and is increasingly showing economic benefits in terms of reduced reliance on formal health and social care services.”

The team conducted two systematic reviews, funded through the Welsh Health Economics Support Service (WHESS), to estimate the value members of the public put on accessing and using green and blue spaces, such as parks and beaches.

Their findings indicate that accessing green and blue spaces can have a positive impact on health and wellbeing among the population, and that the public are willing to pay to gain the health benefits of engaging in physical activity outdoors.

SE N IOR RE SE A RC H L EA D ER

among the most common causes of death in the UK, with an estimated cost of £1bn a year.

Pharmacogenetic test evaluation at Bangor University Researchers led by Health and Care Research Wales senior research leader Professor Dyfrig Hughes have made significant contributions to developing and evaluating a genetic test that aims to prevent patients having adverse reactions to medicines.

The ‘pharmacogenetic panel test’ examines many different genes at the same time giving more information than a single gene test - and is an essential step forward in delivering personalised, targeted treatments for patients.

Our genes can play a role in how our bodies respond to medicines so carrying out genetic testing prior to a medicine being prescribed can help identify whether a patient is at risk of an adverse drug reaction (ADR). ADRs are

The team at the Centre for Health Economics and Medicines Evaluation (CHEME) at Bangor University, has conducted extensive work to assess the cost-effectiveness of pharmacogenetic panel testing.

services across different healthcare systems internationally, which would have a significant and far-reaching impact on the safe and effective use of medicines.”

“As many as one in five ADRs are due to genetic factors; other reasons can be due to reduced kidney function, increasing age and interactions with other medicines being taken by a patient,” said Professor Hughes.

“However, the translation of confirmed genetic associations to clinically useful tests has been somewhat underwhelming. With funding from the NIHR i4i programme, and in partnership with MC Diagnostics, a company based in North Wales, and the University of Liverpool, a genetic panel test is now in commercial development.

“Our research methods could be used to support the introduction of pharmacogenetics

Health and Care Research Wales Magazine - Issue 05 - December 2018

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HEA LTH W I S E WA L E S

recruiting at more and more public events over 2018, from the Mold Food Festival to the Cardiff Half, as well as in our health boards and NHS services. Social media has supported interactive engagement at these events, including games, competitions and lively discussions, to reach a large and diverse spread of the population.

HealthWise Wales – in it for the long run

On the ground, it is the regional HealthWise Wales research assistants, based at health boards across Wales, that have taken this forward, recruiting the bulk of over 12,500 new participants this year.

HealthWise Wales was at this year’s Cardiff Half Marathon, recruiting another 1,200 people into the national cohort to share their data and take part in research studies from across the Health and Care Research Wales infrastructure.

clinics, leisure centres and blood donor clinics right through to the Swansea Air Show, people want to contribute, to help their children and grandchildren,” Sarah explained.

Meanwhile, the South East region has built up a strong approach via GP practices and other community care settings.

That strong recruitment has put HealthWise Wales on a sound footing heading into 2019, allowing the study team, and researchers wanting to perform studies with the cohort, to begin answering important questions about the nation’s wellbeing and NHS services.

In North Wales, research assistants Marie Latham-Jones and Lisa Hother have recruited 2,245 HealthWise Wales participants in just six months, a 420% increase for the North.

“We see what the project could do for the people of North Wales and we’re proud to be part of it, and of the recruitment we’ve achieved,” commented Marie.

The nation’s flagship project for understanding what shapes our health and wellbeing, HealthWise Wales’ cohort of public participants now stands at over 27,000. That’s a rare achievement for any cohort study, giving the scale that will allow the study to give a more comprehensive understanding of factors affecting Wales’ health and social wellbeing.

In the South West, Sarah Davies and colleagues have worked in a wide range of settings, including an innovative pilot partnership with the Welsh Blood Service to recruit at their donor clinics. “The response from people has been great, from hospital

And that’s why the project has been seen

To discuss the study further, get your research questionnaires on the site or recruit cohort members to your study please contact the HealthWise Wales study team or visit the ‘For Researchers’ section of the HealthWise Wales website.

HEA LTH A ND C A RE R ES EA RCH WA LES S U P P O RT AND DEL IVERY CENT R E U P DAT ES

Research Route Map Health and Care Research Wales’ Research Route Map is designed to help guide health and social care researchers through the research process. It aims to give researchers and research teams easy, user friendly guidance on every aspect of the research process, whichever stage you may be at. It makes clear the support available from Health and Care Research Wales and others, providing guidance, best practice examples and key documents and templates.

The Research Route Map has been developed through consultation with the research community in Wales and is available on the Health and Care Research Wales website.

Health and Care Research Wales’ annual report Our 2017-18 annual report highlights some of the stand-out examples of research from across our infrastructure and its impact on people and services.

It also showcases our support for researchers and the central role of public involvement and engagement in health and social care research across Wales.

Read the Heath and Care Research Wales Annual Report 2017-18, or see the Annual Report snapshot infographic for a quick overview of the report highlights.

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Health and Care Research Wales Magazine - Issue 05 - December 2018

“The event had a fresh and engaging feel, really the best I have been to.”

Delegate feedback

The Health and Care Research Wales conference 2018: Future-proofing research in Wales

only by doing that can we future-proof our

exhibitors from across the infrastructure with

NHS, can we develop a sustainable NHS and

the chance to promote their work.

The Health and Care Research Wales annual conference brought over 330 delegates

can we deliver effective services which work across the whole of the life course.”

Reflecting on the event Carys Thomas, joint interim director of Health and Care Research

Thought-provoking, interactive workshops

Wales, said: “Thank you to everyone who

and presentations followed, highlighting

joined us at the Health and Care Research

the role of Welsh research in shaping the

Wales conference 2018 and to those who

treatment and care of the future.

made it a great success. It was great to see the research community coming together

There were a number of firsts for the

and to hear of the work underway to address

conference this year including TED-style

the challenges ahead of us and the positive

research in Wales.

presentations - short, inspiring talks - by

impact of research on the lives of the people

Health and Care Research Wales senior

of Wales.”

Opening the conference, and setting the

research leaders and a poster zone. Over 100

to the SSE SWALEC Stadium in Cardiff for a packed day focused on future-proofing

scene for the day ahead, Dr Frank Atherton, Chief Medical Officer for Wales said: “We need to make sure that research and good evidence are at the heart of everything we do and of our decision-making because

abstracts for posters and presentations were

If you missed the Health and Care Research

submitted, with 35 being selected for display

Wales conference 2018 you can listen to all

at the conference.

speaker presentations and catch up on the event highlights on our website.

The exhibition area gave delegates an opportunity to network and provided 27

Award winners Public Involvement Achievement The National Centre for Mental Health for ‘Partnership in Research’ (PÂR), its pioneering work on public involvement in mental health research.

Best poster ‘Research inequalities in health and social care: how can we address the exclusion of adults who lack capacity to consent?’ - Victoria Shepherd, National Institute for Health Research (NIHR) doctoral research fellow at the Centre for Trials Research Second place: ‘Make a quack about your research’ - Cheryl Lee, Health and Care Research Wales Joint third place: ‘A changing identity: a focus group study of the experiences of women diagnosed with secondary breast cancer and their psychosocial support needs’ - Ceri Phelps, University of Wales Trinity Saint David & ‘The unmet health and social care needs of older caregivers: a systematic review’ - Alisha Newman, Wales Cancer Research Centre Best interactive stand (voted for by delegates) Brain Repair and Intracranial Neurotherapeutics (BRAIN) Unit.

Second place: Research Capacity Building Collaboration (RCBC) Wales.

Third place: The Secure Anonymised Information Linkage (SAIL) databank.

Health and Care Research Wales Magazine - Issue 05 - December 2018

13

P UBL I C INVOLV EME N T AN D E N GAGEMEN T

Setting the standards

Launched this year, the UKwide National Standards for Public Involvement provide for the first time a common framework for organisations to develop their involvement of the public in research. They provide indicators allowing identification of areas of strength and areas that need improvement, in order to achieve good, fully rounded public involvement.

H

ealth and Care Research Wales view the Standards as vital to progressing

public involvement and there are already excellent examples of the Standards being used across our research community.

Using the UK Standards to audit current Health and Care Research Wales public involvement training provision was a key recommendation from the 2017 Health and Care Research Wales Involving People Network review.

“We’re really excited to be using the National Standards for Public Involvement in our work.

It’s so important that our training meets the needs of the public involvement community and helps to prepare members of the public for their involvement in research,” explained Barbara Moore, senior public involvement and engagement manager at Health and Care Research Wales’ Support & Delivery Centre.

“We brought together public members and representatives from the Health and Care Research Wales infrastructure, in a workshop to review our training modules, website information and online training tools.

Delegates at the BRAIN Involve Community Day

“Using the audit tool we had developed to support us with the review, we were able to

Please share your public involvement stories!

document whether the training programme adhered to the Standards and were also able to suggest improvements and agree next

Have you made good use of the National Standards for Public Involvement? Tell us by contacting the Public Involvement and Engagement Team.

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steps.”

This work identified a number of ways practice could be improved including:

Health and Care Research Wales Magazine - Issue 05 - December 2018

• involving members of the public in a training needs analysis in 2019 • reviewing the training programme and considering whether additional content should be co-produced with the public • looking at access to courses via alternative methods, rather than the internet.

“Feedback on the workshop and the audit tool was positive and Health and Care Research Wales are now encouraging more workshops to audit other aspects of public involvement work,” added Barbara.

The audit tool is available for anybody to use to audit public involvement in their service or research project.

Feedback “It was very useful participating in this audit. Although I had seen the National Standards previously, this was the first time I had used them in a formal meeting.”

Jeff Horton, public member

The application of the National Standards

“The results of the exercise formed the basis

for Public Involvement was also the feature

of an application to the Wellcome Trust

of a recent Brain Repair and Intercranial

Institutional Strategic Support Fund. The

Neurotherapeutics (BRAIN) Involve Community

grant is aimed at developing better digital

Day.

resources including animations, a forum and better access to information for members

“The clarity of auditing the Standards with regard to training provision became much easier than I’d imagined - all due to the mix of insight and experience present during the audit meeting.”

Lynette Lane, senior training and development manager “I found working as a group a really useful exercise as it allowed us to ‘brainstorm’ thoughts, leading to discussion and consensus, making the whole exercise much easier than I anticipated. The main output for me was that I plan to repeat the format of the exercise within my own organisation.”

Julia Townson, research fellow/ senior trial manager, Centre for Trials Research

“BRAIN Involve is the public and patient

of the public. If approved this grant would

involvement group that helps to inform our

have a measurable impact on patient and

research activities,” said Dr Emma Lane, BRAIN

public involvement for our unit but would

Involve principal investigator. ”It is made up

also be of wider benefit for research in Wales,

of people who are, or have been, affected

giving digital access to patient and public

by neurological diseases such as epilepsy,

involvement opportunities in neuroscience

Huntington’s disease, Multiple Sclerosis or

related research, something which is not

Parkinson’s disease.

currently available.”

“Our BRAIN Involve Community Day brought

Astrid Burrell, a member of BRAIN Involve,

together members of the public and

said: “I felt very privileged to be asked to give

researchers to address the new National

a short talk as part of the morning lectures

Standards for Public Involvement and refresh

about my experience as a member of BRAIN

the group’s Terms of Reference to make sure

Involve.

that we are meeting those standards.

“I was able to share the importance and “We wanted to highlight issues such as how

relevance of public/patient involvement,

to create better opportunities for existing

describe the sort of work I do and to praise

members as well as making researchers more

the researchers in BRAIN for welcoming and

aware of the resources available for their work.

valuing our input and the special insight we have into actually living with various

“This scoping exercise allowed us to find out

neurological conditions.

how current and interested members feel about available resources and opportunities

“I hope that others I met at the interesting

and how we can improve our patient and

afternoon workshops will feel encouraged to

public involvement and our engagement with

become more involved in this important work.

researchers.

A very useful day with many ideas for the future.”

Health and Care Research Wales Magazine - Issue 05 - December 2018

15

“I’ve done all sorts of studies in the last eight years where time and time again we’re seeing the same problems in different guises, but more often than not it’s the systems that the humans have to work with that are problematic rather than the people themselves.”

Dr Andy Carson-Stevens FE AT U RED

The Welsh ‘code-breaker’ making our visits to the GP safer It’s 08:25 and you’re sitting on a row of seats in a busy room, waiting for your 10 minute slot to see your GP.

B

ehind the doors, just off the waiting area, are doctors who can help diagnose your symptoms, maybe prescribe you medication or even refer you to a specialist, if you need further tests.

You’re there to get better and you have hope that you’ll come away with a solution to your problem. However, for many people it doesn’t work out that way.

In fact you could be the one person out of the 33 in that waiting room who will experience what’s called a ‘patient safety incident’ today; a medical error that could, or does, lead to a harmful outcome.

Here we speak to Dr Andy Carson-Stevens, an award-winning Welsh researcher and GP

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who aims to spot and eliminate those errors through a whole new language of codes.

Dr Carson-Stevens’ work is not only helping to improve patient safety here in Wales but also around the world.

The scale of the problem “You talk to any professional working in the primary care setting, whether as a GP or a practice nurse, and patient safety is their ultimate priority,” said Andy, lead for patient safety research at the Wales Centre for Primary and Emergency Care Research (PRIME Centre Wales), one of Health and Care Research Wales’ funded centres. “No-one goes to work to cause harm.”

While patient safety incidents can include errors like being prescribed the wrong type or dose of drug, or mis-diagnosis of symptoms, the most common issues arise because of the very systems designed to manage our care.

“More often than not it’s not about the doctor getting it wrong,” explained Andy. “It’s more likely to be the complex systems that allow patients to be harmed.

“So, it’s about the doctor realising that a patient needs a referral to a cancer specialist and because there are three or four ways a referral can be dictated, then written up and eventually sent from his or her practice, there are many opportunities for delay.

“I think we just need to disentangle the chaos so that we have confidence in our own internal processes, so that everyone knows and feels confident, not least patients, that there’s a reliable process.”

In 2008, the ‘1000 Lives Campaign’ launched in Wales, aiming to save lives and prevent patients coming to avoidable harm in hospitals.

“In some ways it’s staggering that we’ve had a decade of research into hospital safety, focusing on a smaller volume of patients, and all of a sudden it’s like we’ve woken up and realised, ‘hold on a minute, we’re delivering masses of care over here in primary care settings and it could very well be having the same kind of burden on health and wellbeing’.”

The PISA care model One of the first steps to improving safety

Health and Care Research Wales Magazine - Issue 05 - December 2018

is to make sure all errors, or patient safety incidents, are recorded so they can be analysed for any patterns and lessons learnt, to hopefully stop them happening again in the future.

However, views on what is and isn’t a reportable error varies between GPs and practices. To tackle this and get a common understanding of how to identify, record and learn from an incident, Andy and his team have created the Primary Care Patient Safety (PISA) Learning for Care Improvement Model.

“Evidence is hard to ignore,” added Andy.

“You can say to someone look this particular error has happened 37 times, do you really think it’s a coincidence? Then they realise.”

“We developed a library of words so doctors and nurses can pick a code to describe what happened, why it happened and also what the outcomes were for patients. And those three things were more than enough for us to be able to identify patterns and to start looking for priorities.”

“Creating that vocabulary for primary care has been a really important step forward for the entire field. We’ve had years of research in

The ‘real’ people behind the numbers

hospital settings but if we were just using the same vocabulary to describe safety

While Andy is focused on the numbers and the patterns emerging from the data, his research partner Antony Chuter provides a lay perspective on the research.

in primary care it wouldn’t work.”

Dr Andy Carson-Stevens

“From the harrowing stories we read through, we have to create aggregates of data,” said Andy.

“When we’re aggregating stories to numbers Antony will never let us forget that there are real people behind those numbers every time.”

“The work I’ve been doing with Andy in Wales around safety is just so important to patients, the public and carers, to know the health system is safe,” said Antony.

“There are some very challenging topics and it’s important that we do this research to prevent these things happening again in the future.”

Dr Andy Carson-Stevens

Example incidents

Making sense of the data Thousands of patient safety incident records are logged in the National Reporting and Learning System; a huge database made up of files sent in from every NHS organisation in England and Wales.

“About six years ago, I and a group of colleagues were challenged to make sense of those reports and data,” recalled Andy.

Andy accepted the challenge and cracked the case.

“It turns out that if you give each incident a code, essentially codes mean something and when you have a series of codes you can take a really complicated long story and represent it with four or five buzz words.

GP requested patient was monitored for Atrial Fibrillation (AF). Notes not communicated.

Patient not monitored for three weeks. Patient admitted to hospital. Patient died.

Urgent cancer referral fax to hospital. Received receipt with message saying, ‘Consultant has own fax machine and number in his room – please use it in the future.’ Possible delay due to wrong number.

16-year-old patient took wrong medicine for three days and suffered serious side effects including catatonic seizures. Similarity of packaging led to error in tablet selection. Contacted manufacturer to request reassessment of packaging.

Wales and the world Earlier this year, Andy won the Yvonne Carter Award for Outstanding New Researcher.

Through this prestigious award Andy is now working with researchers in Turkey, helping them to apply his patient safety ‘codes’ to their own medical errors.

“You don’t necessarily have to speak the same language, you can communicate in codes about what happened and why. It sounds a bit geeky but actually I see that as an opportunity to maximise the insight on human error. We’ll be able to have conversations about safety in the same way they do in the airline industry, when an accident investigation occurs.

“They may come up with solutions in Turkey that we really need to learn from in Wales or elsewhere. So, the sooner we can coordinate that, build the infrastructure to compare, contrast and look for the guiding lights that emerge from structured data, the better.”

Health and Care Research Wales Magazine - Issue 05 - December 2018

17

F EATURED

‘Pushing the boundaries’ to deliver early phase research in Wales Imagine being the first person in the world to be given the opportunity to test a new drug; it’s a drug that might not help you now but it could give hope to thousands of people in the future, living with the same chronic condition as you.

to greet us when we arrive and she’s eager to show us around.

“We’re very lucky to have a facility like this because we’re able to offer new treatment options in Wales,” said Jessie. “There are numerous facilities like this in England and if patients in Wales wanted to access phase 1 trials previously they would have to go across the border to get the treatment. So I think it’s great for patients.”

T

There are many doors along the corridor; behind them are offices for the dedicated research nurses as well as consulting rooms where patients can be taken through the consent process.

We’ve been behind the scenes at the Clinical Research Facility (CRF) in Cardiff, and the new All Wales Early Phase Research Partnership (AWaRe), to find out more.

Towards the end of the corridor is a door to the left that opens on to a ward with space for eight beds and off to the right is a laboratory, packed with freezers, fridges, incubators and centrifuges (blood spinning machines).

his type of ground-breaking early phase research – when new treatments are tried for the first time in patients – is now routinely available here in Wales.

Great for patients The CRF is based within the University Hospital of Wales on the upper ground floor.

Jessie Powell, senior nurse manager, is there

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“We wouldn’t be able to conduct the number of early phase trials that we have, or to the complexity, if we didn’t have a laboratory,” explained Jessie. “A lot of the phase 1

studies have numerous blood testing. For example, a patient might need to have a blood sample taken pre-dose, they would then be dosed with the new drug, and might then need to have further samples taken every 15 minutes.

“If you’ve just got one nurse looking after a patient, taking the bloods and also processing them, if they had to go off the unit to do that, we wouldn’t be able to observe the patient to make sure they were safe and happy as well as processing the blood.”

World-first research Early phase research activity at the CRF has increased in the last year and it’s hoped this trend will continue. The CRF now houses both early phase and late phase study teams, with Health and Care Research Wales funded nurses in both areas to deliver clinical trials.

In August, the first patient in the world was dosed at the CRF with a new drug that aims to prevent and manage type 1 diabetes.

Health and Care Research Wales Magazine - Issue 05 - December 2018

“I’m really grateful that I was given the opportunity to take part in this study. I hope that my participation will help with the management of type 1 diabetes for future generations.”

First patient to receive dose of diabetes drug

But all of that is changing.

The Wales Cancer Research Centre, funded

by Health and Care Research Wales, has helped to develop a partnership – known as AWaRe – between Velindre Cancer Centre and the South West Wales Cancer Centre.

Jessie Powell, senior nurse manager

“I think it’s great for patients that we were first in the world to dose,” said Jessie.

“Without a facility like this we wouldn’t be able to offer that to patients.

“We really had to push the boundaries with that trial as we’d never actually managed to staff three overnight stays here before. We did it so we know that we can do that but it’s all about what we do next; it’s about pushing the next boundaries.”

“Our patients in West Wales can now be seen at an information clinic in Swansea to talk about the possibility of entering an early phase trial without travelling to Cardiff for that initial consultation,” explained Siân Whelan, Cancer Research UK senior research nurse at Singleton Hospital in Swansea.

“Before we set up the clinic some patients would make the trip to Cardiff to be told that there wasn’t a trial available to them. We are updated by Velindre on a weekly basis so we know if there will be a trial available and we can go through a check list with the patient to look at their trial eligibility here in

Kay Wilson, early phase team lead at Velindre Cancer Centre, described the collaboration as having “huge benefits” to patients and their families. “This joint working is a fantastic opportunity for Welsh patients and our research community in Wales. Together we can achieve great things to impact patients’ experience and outcomes.”

24/7 research Both the CRF in Cardiff and the AWaRe partnership have plans to further improve access to cutting-edge treatments in a way that benefits, and is convenient for, patients.

“This is just the beginning,” said Siân. “We hope the service may be extended in time to provide the treatment locally too.”

Jessie believes the success of dosing the first patient in the global diabetes trial will open doors to bring more studies to the CRF and Wales.

“What we would like to see in the future is if we conduct the phase 1 study here in Cardiff, that the study team then comes back to us for phase 2 and phase 3 so we can see the drug from first-in-man right through to licensing really. That would be fantastic.

“I think we become very attractive globally as a facility if we can offer that kind of commitment and that kind of staffing for trials, because I know there are a lot of facilities that wouldn’t be able to do it,” concluded Jessie.

“We’re not yet 24/7 but I think in the future that’s where we would like to be.”

Swansea.”

Convenient care

Click the image to watch the video

Patients taking part in early phase trials may have tried the standard care, for example chemotherapies or immunotherapies to treat cancer, and that hasn’t worked for them.

It’s at that point that they may be eligible for an early phase research drug. In the case of cancer patients in Wales that can mean travelling.

Currently all early phase cancer trials that open in Wales are managed from Velindre Cancer Centre in Cardiff. When a patient wants to explore an early phase trial as an option, they need to visit that centre.

Health and Care Research Wales Magazine - Issue 05 - December 2018

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F EATURED

The changing face of research training The past decade has seen a huge increase in the number and type of research studies being delivered across Wales and more and more people are taking part in them to improve future care.

T

he need for training to keep up and

deliver high quality research. As the research

“Ahead of the session we ask them to provide

landscape changes, so do the training needs

us with a protocol they are working on so

of those carrying out the research. Over

that the training can include real examples

the past ten years we have developed the

that directly relate to their practice.”

training programme to not only include off-the-shelf courses but bespoke training

Cardiff and Vale Trauma and Orthopaedic

to support emerging or specialist areas of

Research Department recently requested

interest such as primary care and deferred

a bespoke GCP session. Within their

consent in critical care.”

directorate they have 36 consultant surgeons and over 50 junior medical staff. Research in

Meeting demand

the department also relies on other health

Wales’ training programme, from what it

Demand for our Good Clinical Practice

occupational therapists, nurses and

covers and who it is aimed at, to how and

(GCP) training has increased dramatically as

podiatrists. Previously, surgical staff have

where it is delivered.

funding for health and social care research

found it difficult to take the time to attend

adapt to this expansion has led to a

transformation of Health and Care Research

professionals including physiotherapists,

in Wales has expanded. But it’s not just the

GCP training off-site. Having the training

In 2008 the research training programme in

number of courses that have increased, GCP

delivered on-site also gave the other allied

Wales was made up of 32 courses delivered

training is being delivered in more settings

health professionals the opportunity to

to researchers working in health and social

than ever, for a wider range of delegates and

attend.

care research. Core training included Good

across a greater number of specialties.

Matthew Williams, research manager

Clinical Practice, Valid Informed Consent and Cat Johnston, Health and Care Research

explained the benefits of having a bespoke

Wales GCP training manager said: “GCP

GCP session: “The conversation can be more

Fast forward to 2018 and whilst those same

training is now delivered on-site at GP

focused on the needs of the attendees.

courses still form the basis of the training

practices as well as in hospitals. We are

In our case there is very little medicinal

programme, the number of courses offered

seeing more requests from dental practices

research undertaken in the department and

has tripled, evolving to meet the needs of

and in future we will be delivering GCP

therefore it’s possible for the training to

researchers in the ever-changing world of

training in care homes.

focus more on medical device research.

Managing Essential Documents in Research.

health and social care research.

“We also support varied requests for

“I have had one member of staff contact me

Health and Care Research Wales senior

individual study or team-specific training

and want to start their own research after

training and development manager Lynette

from neurology to public health. Bespoke

attending the session which is really positive

Lane explained more about the evolution

training means we can adapt the course to

for us.”

of the training programme: “Training is

focus on areas that are more relevant to the

essential to support researchers in Wales to

delegates.

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Health and Care Research Wales Magazine - Issue 05 - December 2018

“I feel very privileged to have been part of this pilot course, it will impact on all aspects of my work as it encourages excellent research practice. The variety of topics and expert teaching highlighted what is needed in different areas of clinical research.

Thank you for the opportunity to learn with you, it has been invaluable to me.”

Delegate feedback

exist within your own bubble. Research staff

This course is a unique concept for the

already have access to the basic, essential

training team, there are very few similar

Health and Care Research Wales training

training courses to support them in their

models within the UK and those that are

helped to support the innovative research

own research practice but we wanted to give

available are delivered by private companies

them an insight into the wider picture of

at a cost to delegates - as with all of our

research in Wales to help them to see how

training courses this is delivered free of

their role fits within the Health and Care

charge. The feedback on the pilot session

Research Wales infrastructure.

was very positive and the course will now

Supporting innovation

nurse bank initiative at Aneurin Bevan University Health Board, providing the newly recruited bank nurses with bespoke training sessions including

run twice a year.

GCP, Informed Consent, Essential Documents and a mini induction to the research delivery team. The initiative

“We also wanted to use the opportunity to showcase and share the knowledge and experience we have within Health and Care

won the award for best abstract at

Research Wales by asking staff from across

this year’s NHS R&D Forum and has been rolled out in other health boards.

You can read about the success of the bank research nurse role on page 8.

the infrastructure to deliver training in their own area of expertise.

“This gives delegates a better understanding of other roles and processes but is also a development opportunity for the person

A new model for research training in Wales

Future training needs “We provide a responsive, flexible training service,” said Lynette. “We’re aware of changing research landscapes and processes and will continue to take the initiative to provide appropriate research training for a range of research staff in various roles, throughout Wales.”

planning and delivering the training. We’re investing in talent, in those attending as delegates but also in the staff delivering the

The Foundation in Research Practice course is

sessions.”

the latest addition to the training programme.

Showcasing expertise from across the

The two-day course is made up of short,

Health and Care Research Wales Support &

interactive presentations by Health and

Delivery Service and infrastructure, this new

Care Research Wales staff, providing

course aims to give an insight into research

delegates with a greater understanding of

processes and support to NHS research staff

the processes involved in setting up a study,

who are about six months in post.

how their role fits into the research process, the quality assurance methods used within

Lynette explained why the course was

research and knowledge of the principles

developed and the benefits of the training

to apply when working with research

for both delegates and trainers: “We know

participants. It also builds knowledge of the

how complex the research world can be for

essential functions and services aligned to

those who are new in post and it’s easy to

research support and delivery in Wales.

To find out more about Health and Care Research Wales training, including upcoming training courses, visit the Health and Care Research Wales website.

If you would like to get in touch about bespoke training please contact the training team.

Health and Care Research Wales Magazine - Issue 05 - December 2018

21

Calendar

ExChange Annual Adoption Lecture

Launch of Ageing & Dementia @Bangor

7 January 2019 Glamorgan Building, Cardiff University

North Wales, 17 January 2019 South East Wales, 24 January 2019 South West Wales, 25 January 2019

Birth family contact after adoption: Learning from the Northern Irish experience.

opportunities posed by an ageing society.

Free learning opportunity for social workers wishing to undertake a research project 17 - 25 January 2019 All Wales As part of the final phase of the current CPEL programmes, the Alliance (Bangor, Glyndwr, Swansea and Cardiff Universities) is offering a series of one-day sessions for social workers and social work managers to explore the possibility of carrying out a small-scale, practice-based research project in their team.

Social media training To find out more about any of these events, visit the Health and Care Research Wales events calendar.

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CADR warmly invite you to a formal launch of Ageing & Dementia @Bangor. The aim is to promote high-quality research, teaching and training that addresses the challenges and

Spring 2019

First steps: researchers and the public working together January 2019 This interactive course includes an overview of the research cycle and lay involvement, a discussion of service user roles and responsibilities and practical tips for effective involvement.

Acing your abstracts training Spring 2019

Develop new creative communications

This half day workshop will provide you with

techniques, discuss clever strategies to get

the tips and tricks to produce an abstract which

taken more seriously in your organisation,

will have a greater chance of being accepted

and build the confidence to produce creative

by judges and also provide ideas on how to

content that will delight your audiences.

produce a winning poster, which will appeal to judges and delegates alike.

Health and Care Research Wales Magazine - Issue 05 - December 2018

Public Health Wales Research Showcase

Health and Care Research Wales Support & Delivery Day

BJGP Research Conference 2019

14 March 2019 Jury’s Inn, Cardiff

29 March 2019 RCGP, London

Public health research, policy and practice:

Theme - One Wales: Working together in

It’s an exceptional opportunity for

bringing together health and social care.

research.

researchers at all stages of their careers to

13 March 2019 Hadyn Ellis Building, Cardiff University

acquire new skills and present their work in a constructive, peer-reviewed environment.

Health Economics for Public Health Practice & Research

JBI Comprehensive Systematic Review Training

8 - 10 April 2019 The Management Centre, Bangor

27 April - 1 May Cardiff University

April 2019

The JBI Comprehensive Systematic Review Training Programme is designed to prepare researchers and clinicians to develop, conduct and report comprehensive systematic reviews of qualitative and quantitative evidence.

Research Governance is one of the core

At the end of this short course delegates will have gained an appreciation of the concepts, methods and application of health economics to public health.

Research governance training

standards for health and social care and involves a broad range of regulations, principles and standards of good practice that exist to achieve, and continuously improve, research quality in the UK and worldwide.

International Clinical Trials Day 2019

Foundation in research practice

20 May 2019

May 2019

Health and Care Research Wales are proud to

20 May 2019 marks 272 years since the start

The course aims to give brief reference to

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of the first clinical trial on board the HMS

research activities within comprehensive short,

Salisbury.

sharp training sessions for research staff.

Annual NHS R&D Forum 12 - 14 May Hilton Metropole, Brighton

Health and Care Research Wales Magazine - Issue 05 - December 2018

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Answers to the question posed to delegates at the Health and Care Research Wales Conference 2018

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Health and Care Research Wales Magazine - Issue 05 - December 2018