The Societal and Indirect Economic Burden of Seasonal Influenza in the United Kingdom.

Seasonal influenza is a significant public-health issue. In the UK, the influenza season is associated with an increased demand for and pressure on the NHS. The direct health and economic impacts of seasonal influenza have received much attention.

Improving care for patients with infection: A clinical practice and healthcare systems perspective.

Introduction: Arriving at a infection (CDI) diagnosis, treating patients and dealing with recurrences is not straightforward, but a comprehensive and well-rounded understanding of what is needed to improve patient care is lacking. This manuscript addresses the paucity of multidisciplinary perspectives that consider clinical practice related and healthcare system-related challenges to optimizing care delivery.

Methods: We draw on narrative review, consultations with clinical experts and patient representatives, and a survey of 95 clinical and microbiology experts from the UK, France, Italy, Australia and Canada, adding novel multi-method evidence to the knowledge base.

Effect of Beetroot Powder Incorporation on Functional Properties and Shelf Life of Biscuits.

The demand for ready-to-use functional foods is high, which encourages manufacturers to develop new, nutritionally valuable products. As an excellent source of biologically active compounds, beetroot ( L.) is considered to have highly beneficial effects on health.

Faecal microbiota transplantation for recurrent C. difficile infections: challenges and improvement opportunities for clinical practice and healthcare systems.

Background: There is growing interest in faecal microbiota transplantation (FMT) as a treatment for recurrent Clostridioides difficile infection (CDI), but evidence on the diverse requirements for safe, effective and accessible services is fragmented and limited.

Aims: To identify key components of FMT provision relating to the patient care pathway, stool donor pathway and wider healthcare system, and to explore variation in practice METHODS: We conducted a narrative review of the literature and consultations with key clinical experts in the field. Evidence is drawn from high-income country contexts, with an emphasis on Australia, Canada, Italy and the United Kingdom as case example countries.

The Burden of Respiratory Syncytial Virus: Understanding Impacts on the NHS, Society and Economy.

Respiratory syncytial virus (RSV) is a common respiratory virus that affects large numbers, mainly of children younger than five. The burden of RSV includes not only ill health for the children with the virus, which in severe cases results in hospitalisation, intensive care and even death; but also the emotional and practical burden on the affected families and carers; and the impact that has on productivity in the economy; alongside the costs of providing healthcare. We reviewed recent literature and published data relevant to the UK and used this information to model the costs to the healthcare system and to the wider UK economy in terms of productivity losses of parents/carers.

COVID-19 Genomics UK (COG-UK) Consortium: Final Report.

The ability to sequence and understand different variants of the SARS-CoV-2 virus and their impact is crucial to inform policy and public health decisions. Soon after the UK went into its first lockdown in March 2020, the CCOVID-19 Genomics UK (COG-UK) Consortium was launched. COG-UK is a collaboration of experts in pathogen genomics including academic institutions, public health agencies, the Wellcome Sanger Institute, NHS Trusts and Lighthouse Labs.

Communicating research evidence to boards in health and care organisations: A scoping study.

Boards in health and care organisations in England play a key role in the governance, strategy, direction and culture of an organisation. It is therefore important to ensure that board decisions are informed by the best available evidence from a range of sources, including service evaluations, organisational performance data, research and evidence-based guidelines. However, there is a scarcity of evidence about how boards use research evidence, defined as evidence stemming from generalisable empirical research, to carry out their roles.

Identifying how GPs spend their time and the obstacles they face: a mixed-methods study.

Background: Although problems that impair task completion - known as operational failures - are an important focus of concern in primary care, they have remained little studied.

Aim: To quantify the time GPs spend on different activities during clinical sessions; to identify the number of operational failures they encounter; and to characterise the nature of operational failures and their impact for GPs.

Design And Setting: Mixed-method triangulation study with 61 GPs in 28 NHS general practices in England from December 2018 to December 2019.

Determination of toxic elements in meat products from Serbia packaged in tinplate cans.

This work aimed to examine the influence of the storage period on the content of toxic elements (As, Cd, Hg, and Pb) in five types of canned meat products regularly used in the Serbian Armed Forces. Cans of beef goulash (BG), pork ragout (PR), spam (SP), liver pate (LP), and meatballs in tomato sauce (MB), produced according to military standards and stored under regular conditions, were analyzed. Meat products were packed in tin cans made according to special requirements in terms of tin and varnish application and stored for up to 6 years.

Characterising and describing postpartum haemorrhage emergency kits in context: a protocol for a mixed-methods study.

Introduction: Postpartum haemorrhage (PPH) is an obstetric emergency requiring prompt and accurate response. PPH emergency kits containing equipment and medications can facilitate this kind of intervention, but their design and contents vary, potentially introducing risk of confusion or delay. Designs may be suboptimal, and relying on localised kit contents may result in supply chain costs, increased waste and missed opportunities for economies of scale.

Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation.

Background: Reducing avoidable harm in maternity services is a priority globally. As well as learning from mistakes, it is important to produce rigorous descriptions of 'what good looks like'.

Objective: We aimed to characterise features of safety in maternity units and to generate a plain language framework that could be used to guide learning and improvement.

Enabling NHS Staff to Contribute to Research: Reflecting on Current Practice and Informing Future Opportunities.

RAND Europe was commissioned by The Healthcare Improvement Studies (THIS) Institute to conduct a rapid review of the evidence base on engaging NHS staff in healthcare research. The review aims to help inform THIS Institute's efforts to establish and implement an effective strategy for engaging staff across the NHS with its research activities. The study will also be useful for other organisations and initiatives seeking to engage NHS staff in research.

Transforming Urgent and Emergency Care and the Vanguard Initiative: Learning from Evaluation of the Southern Cluster.

Urgent and Emergency Care (UEC) vanguards aim to improve the quality, efficiency and effectiveness of UEC services so that patients receive the most appropriate care at the right time and in the right place, and so that unnecessary admissions to accident and emergency (A&E) and hospitals are reduced. The Southern Cluster comprises three such UEC vanguards. RAND Europe's evaluation examined the impacts of the vanguards, the processes underpinning delivery (and associated enablers and challenges), and implications for future policy and practice.

Innovation as a Driver of Quality and Productivity in UK Healthcare: Creating and Connecting Receptive Places-Emerging Insights.

The demand for health services in England is both growing and changing in nature, yet resources are limited in their ability to respond to the scale and scope of need. As a result, the NHS is under increasing pressures to realise productivity gains, while continuing to deliver high quality care. RAND Europe and the University of Manchester have been commissioned to conduct a study to examine the potential of innovation to respond to the challenges the NHS faces, and to help deliver value for money, efficient and effective services.

Understanding value in health data ecosystems: A review of current evidence and ways forward.

The potential of health data to improve the efficiency and effectiveness of health research and development, healthcare delivery, and health systems more widely is substantial. There are many initiatives across the EU that are experimenting with ways to capture value and address the nexus of technical, legal, ethics-related, governance and data protection-related, and cultural challenges to delivering potential benefits for society and the economy. The field of health data research and policy is highly dynamic and there is a need for further reflection, thematic learning and evaluation to better understand how to create and connect receptive places, to inform future interventions and to identify transferable lessons.

Hepatitis C: Understanding Factors That Influence the Physicians' Treatment Decisions.

This study aimed to inform Hepatitis C (HCV) treatment by (1) better understanding the nexus of factors physicians consider when making HCV treatment decisions; (2) investigating the comparative influence and importance of specific factors and the trade-offs implicated in the decisionmaking process; and (3) examining how much thrombocytopenia impacts treatment decisions and how it impacts treatment. To meet this goal, we conducted five analyses, focusing on four European countries characterised by different approaches to healthcare organisation and financing, which alongside cultural differences may have potential implications for treatment pathways for patients with HCV infection. These were: France, Italy, Spain, and the United Kingdom.

Galvanising the NHS to Adopt Innovation: The Feasibility and Practicality of Recommendations from the Interim Report of the Accelerated Access Review.

The Department of Health and the Wellcome Trust, in co-operation with NHS England, asked RAND Europe to conduct a limited consultation with key stakeholders about the practicality of measures and incentives proposed as part of the NHS Accelerated Access Review (AAR), which aims to assess the pathways for the development, assessment, and adoption of innovative medicines and medical technology. Through a focused engagement exercise with key healthcare stakeholders this project explored the implications of selected interim AAR propositions and feasibility of implementation for key actors, in primary and secondary care as well as commissioners and academia. Specifically, the project investigated the feasibility of implementation of three specific propositions including: a new earmarked fund to encourage AHSNs and other key innovation actors to re-design systems to embrace innovation; mobilising the influence of clinical system leaders to champion change; and encouraging secondary care organisations to take on "innovation champion" roles linked to financial incentives and a new emphasis on accountable care organisations.

Evaluating the Role and Contribution of Innovation to Health and Wealth in the UK: A Review of Innovation, Health and Wealth: Phase 1 Final Report.

The Department of Health's Innovation, Health and Wealth (IHW) strategy aimed to introduce a more strategic approach to the spread of innovation across the NHS. This study represents the first phase of a three-year evaluation and aims to map progress towards the IHW strategy and its component actions. This evaluation used a combination of quantitative and qualitative methods: document review, key informant interviews and stakeholder survey.

Treatment for Dementia: Learning from Breakthroughs for Other Conditions.

The past few decades have seen a number of medical breakthroughs that enabled the effective treatment of a range of conditions, transforming them from fatal into manageable ones. Examples include certain cancers and HIV. Conversely, progress on dementia has been limited.

Leadership as a Health Research Policy Intervention: An Evaluation of the NIHR Leadership Programme (Phase 2).

In early 2012, the National Institute for Health Research (NIHR) leadership programme was re-commissioned for a further three years following an evaluation by RAND Europe. During this new phase of the programme, we conducted a real-time evaluation, the aim of which was to allow for reflection on and adjustment of the programme on an on-going basis as events unfold. This approach also allowed for participants on the programme to contribute to and positively engage in the evaluation.

How policy can help develop and sustain workforce capacity in UK dementia research: insights from a career tracking analysis and stakeholder interviews.

Objectives: To identify research support strategies likely to be effective for strengthening the UK's dementia research landscape and ensuring a sustainable and competitive workforce.

Design: Interviews and qualitative analysis; systematic internet search to track the careers of 1500 holders of UK doctoral degrees in dementia, awarded during 1970-2013, to examine retention in this research field and provide a proxy profile of the research workforce.

Setting And Participants: 40 interviewees based in the UK, whose primary role is or has been in dementia research (34 individuals), health or social care (3) or research funding (3).

The use and impact of quality of life assessment tools in clinical care settings for cancer patients, with a particular emphasis on brain cancer: insights from a systematic review and stakeholder consultations.

Purpose: Patient-reported data are playing an increasing role in health care. In oncology, data from quality of life (QoL) assessment tools may be particularly important for those with limited survival prospects, where treatments aim to prolong survival while maintaining or improving QoL. This paper examines the use and impact of using QoL measures on health care of cancer patients within a clinical setting, particularly those with brain cancer.

The NIHR Invention for Innovation (i4i) Programme: A Review of Progress and Contributions to Innovation in Healthcare Technologies.

The National Institute for Health Research (NIHR) Invention for Innovation (i4i) programme supports the development of innovative medical technologies for patient benefit. The i4i product development stream involves collaborative projects between at least two partners from academia, the NHS and industry. Medical technology innovators apply for funding for one to three years, through a peer review-based process that includes presentation to a selection panel.

Barking, Havering and Redbridge University Hospitals NHS Trust Fellowships in Clinical Leadership Programme: An Evaluation.

Leadership is seen to be central to improving the quality of healthcare and existing research suggests that absence of leadership is related to poor quality and safety performance. Leadership training might therefore provide an important means through which to promote quality improvement and, more widely, performance within the healthcare environment. This article presents an evaluation of the Fellowships in Clinical Leadership Programme, which combines leadership training and quality improvement initiatives with the placement of temporary external clinical champions in Barking, Havering and Redbridge University Hospitals NHS Trust.