School of Dementia Studies receives million pound funding to help lower hospital admissions

The study, funded by the National Institute for Health Research (NIHR), is led by Professor Murna Downs, Head of the School of Dementia Studies with the University’s Faculty of Health Studies, and will begin in March 2015 to be completed by June 2018.

Professor Murna Downs, said: “Reducing rates of hospitalisation for Ambulatory Care Sensitive (ACS) conditions is a government priority. ACS conditions, if not actively managed, can lead to unplanned hospital admissions, which are costly to the NHS and distressing to the person, their family and nursing home staff.

“Nursing home residents are amongst the frailest and most vulnerable members of society. Most have complex health care needs and more than two thirds have dementia. Spotting early changes in residents’ health is essential to ensure active management of ACS conditions in nursing homes.”

Research carried out in 2012 from a Programme Development Grant (PDG) identified multi-component interventions which, when tested in US nursing homes, showed promise in reducing avoidable admissions. They involved a combination of skills enhancement of nurses and care assistants, clinical guidance and decision-support tools, family involvement and implementation support.

Professor Downs and her team will build on these findings and test the outcomes in a UK setting. She will use the NIHR funding to carry out a two-stage research programme with the aim of reducing avoidable hospital admissions.

Professor Downs added: “With this funding we hope to develop and test guidance for care homes, which has the potential to reduce avoidable hospital admissions. Here at Bradford, we are committed to carrying out cutting-edge research that improves lives and addresses some of the biggest issues in society today, including an aging population.”

The funding will enable the researchers to work in collaboration with primary and secondary care clinicians, nursing home staff and family members to develop clinical guidance and decision support systems for UK nursing homes. They will also determine the best methods to enhance the skills of nursing home staff and clarify the role of family members. Finally the grant will enable the researchers to design the implementation support and guidance for the intervention.

In stage two of the programme, they will test the new guidance in two nursing homes in Bradford. They will then conduct a pilot evaluation in 16 nursing homes in Bradford and London to determine the impact of the guidance on avoidable hospital admissions and on a range of resident, staff, family and system-related secondary outcomes.

In this second stage they will also receive stakeholder feedback. If the results suggest that the intervention reduces avoidable admissions from nursing homes, they will seek further funding to evaluate the intervention in a larger number of nursing homes around the country.

Professor Downs will work with a range of researchers from across the country on the project (listed below). This includes working with research network volunteers from the Alzheimer's Society

Dr Doug Brown, Director of Research and Development at the Alzheimer’s Society, said: “Alzheimer’s Society is thrilled to see our Research Network volunteers playing an integral role in shaping this important research.

“Through sharing their real-life experiences of caring for someone with dementia, our volunteers are adding tremendous value to the research by ensuring that it is well designed and stands the best chance of maximising benefits for people with the condition. In this case, their involvement will ensure that the research findings will result in practical ways to reduce unnecessary hospital admissions.”

Notes

This study is funded by the National Institute for Health Research Programme Grants for Applied Research (NIHR PGfAR) Programme (ref: RP-PG-0612-20010).

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).

Research team: M Downs (University of Bradford), E Sampson (University College London), K Froggatt (Lancaster University), B McCormack (Queen Margaret University), B Woodward-Carlton (PPI representative, Alzheimer’s Society Research Network), S Nurock (PPI representative, Alzheimer’s Society Research Network), L Robinson (University of Newcastle), C Ballard (Kings College London), H Gage (University of Surrey), G Rait (University College London), R Hunter (University College London), N Freemantle (University College London), J Young (Bradford Institute for Health Research) and J Wright (Bradford Institute for Health Research).