From social prescribing to integrating mental health care: our research priorities to improve health and care in the West

NIHR ARC West has identified and agreed research priorities for the next four years to help improve health and care in the West, a region which serves around two and half million people.

Our research focuses on four themes: integrated and optimal care, mental health, public health and prevention, and healthier childhoods. Each theme has a research oversight group (ROG), whose members work with ARC West researchers to identify topics that are priorities for the health and care systems and communities in the West.

The four ROGs include representatives from the three health and care systems within the ARC West footprint: Bristol, North Somerset and South Gloucestershire Sustainability and Transformation Partnership (STP); Bath, North East Somerset, Swindon and Wiltshire STP; and Gloucestershire Integrated Care System. They work alongside public contributors – including those with lived experience and young people – and researchers from the universities of Bath, Bristol, Gloucestershire, and University of the West of England.

The theme ROGs have now identified and agreed top line priority topics. These will now be developed further with input from methodological experts, members of the public and local healthcare system leaders.

Professor John MacLeod, ARC West Director and a member of the Healthier Childhoods theme research oversight group, said:

“My fellow members – including medical student David, who blogged about his experience taking part – brought both experience and fresh perspectives to the discussion. The process really showed the value of bringing people together.

“As we move from defining to refining our research questions, I’m confident that continued input from all our ROGs will keep us on track, ensuring that we use our expertise to best effect and draw on the skills of others as much as possible. We hope that the answers we come up with together will make a big difference to people’s lives in the West”

Louise Ting, an ARC West public contributor and member of the Mental Health ROG, added:

“It was good having public contributors involved in each of the themes so that those with personal experience of the health topic could offer their insights and opinions. This helped ensure that appropriate research questions were being developed and prioritised with the public in mind.

“We were also able to draw on our links with different communities to highlight relevant groups and help increase diversity.

“Being part of the process from the outset allowed us to have a better understanding of the context and to influence key decisions. I felt like a valued member of the group throughout.”

Integrated and optimal care

Led by Professor Chris Salisbury, supported by Dr Hugh McLeod.

Research priorities

• Social prescribing: The NHS has identified social prescribing as a national priority in its long-term plan. We will examine the effectiveness of enabling GPs, nurses and other primary care professionals to refer patients to local, non-clinical services that could benefit their overall health, including physical activity, arts and self-help, as well as signposting to advice on housing, welfare or debt.
• Frailty and end of life services: Delivering frailty services is a national and international priority. Provision is complex, with potential for people to fall between services. Evidence suggests that service interventions tend to be assessed in isolation, rather than from a holistic perspective. We will look at how to better organise systems to provide integrated and co-ordinated care that more effectively meets the needs of older people living with frailty, their families and carers.

Mental health

Co-led by Professor Paul Moran and Dr Lucy Biddle, supported by Dr Theresa Redaniel and Dr Jelena Savovic.

Research priorities

• Fragmentation of care: We will explore existing mental health services and care pathways provided to people with complex needs who do not cross the threshold for secondary care. Some of the groups that are at higher risk of ‘falling between services’ include people with personality disorders, co-morbid addiction, people with complex post-traumatic stress disorder, as well as people who repeatedly self-harm, but who may not meet criteria for a diagnosable mental disorder. We will also explore services offering psychological therapies (e.g. the Improving Access to Psychological Therapies programme) to these groups of people and whether the types of therapies offered are appropriate and accessible.
• Self-harm and suicide: We will look at interventions that have been implemented in the local area aimed to support people who self-harm or are at risk of self-harming or suicide and how effective these interventions are. We will examine the pathways to care for people who self-harm, such as where they go to for help if they are self-harming.

Public health and prevention

Co-led by Professor Russ Jago and Dr Sara Blackmore, supported by Dr Jeremy Horwood and Professor Frank de Vocht.

Research priorities

• Population health management (PHM): This uses insights from routinely collected data to improve the health of an entire population by data driven planning and delivery of proactive care. This work will focus on how PHM can be best utilised to identify health inequities so services can target those most in need.
• Air pollution and active travel: In response to COVID-19, Local Authorities are making rapid changes in the built environment to reduce pollution and increase cycling and walking routes. We aim to conduct research into what changes have been made and the impacts of these changes, including levels of physical activity and air pollution.

Healthier childhoods

Led by Professor Esther Crawley, supported by Dr Sabi Redwood.

Research priorities

• Adverse childhood experiences (ACEs): ARC Healthier Childhoods stakeholders want to understand the economic case for interventions on ACEs to determine strategy and commissioning decisions. They are particularly interested in interventions in which health and social care work together to break the cycle of ACEs and support recovery from trauma.
• Children and young people’s mental health: The ARC West Young People’s Advisory Group identified mental health, and mental health in school, as a priority area for further research, with particular emphasis on the impact of school disciplinary policies (including the use of pupil isolation) on mental health. The Healthier Childhoods stakeholders identified a research need in understanding what mental health interventions should be used in the context of a global pandemic.

Find out more about our priority topics: register for the ARC West Showcase event on 15 March