Additional Authors: Tim Piggott, University of Salford – Dr Roma Forbes, University of Queensland

Background: 
Patient education is a core component of musculoskeletal care, yet broad definitions exist and effective delivery methods are unclear. Musculoskeletal physiotherapists’ use of patient education has been described as individualised and collaborative, reflecting a person-centered model of care. However, discrepancies between perceived and actual practice, and persistently therapist-centered approaches to education have been observed. Adult learning theory (ALT) frames how adults interact with education and echoes the principles of person-centered care. Little is known about the theoretical basis of musculoskeletal physiotherapists’ patient education practice.

Aim
This study aimed to describe the knowledge and use of ALT to inform the patient education practice of United Kingdom (UK) musculoskeletal physiotherapists.

Method
This self-report study used a novel, online questionnaire to collect quantitative and qualitative data from a self-selecting sample of UK musculoskeletal physiotherapists using a multi-modal recruitment strategy. Complete responses were provided by sixty-six participants. Categorical and narrative data were collected and descriptive and thematic analyses undertaken. 

Results
Participants generally self-rated their educational competencies highly, with the exception of evaluating patient education. Participants were more familiar with reflective and self-directed learning than with other ALT. Two high-level themes were described: i) implicit ALT knowledge and ii) challenges in applying ALT.

Conclusion
The results suggest that musculoskeletal physiotherapists may have implicit knowledge of ALT, yet challenges exist in application of the theory. This work supports ongoing training in educational skills for physiotherapists and could be used as a catalyst for musculoskeletal physiotherapists to reflect on their knowledge and use of ALT.

Additional Authors: Joanna Thomas, Warrington and Halton Teaching Hospitals NHS Foundation Trust
Name of presenting author: Joanna Thomas 

Introduction 
Warrington and Halton Hospitals (WHH) Trust is embarking on a transformative journey to enhance its research capabilities, specifically focusing on nurturing the leadership potential of Nurses, Midwives, and Allied Health Professionals (NMAHPs). With strategic funding from the Clinical Research Network North West Coast (CRN NWC), the Trust aims to bolster the capacity and diversity of Principal Investigators (PIs) and encourage broader NMAHP involvement in research.

Approach 
Led by an early career research physiotherapist in partnership with the RD&I team, the strategy includes securing executive support, identifying relevant training programs, implementing a research champion scheme, embedding research in appraisals, and building collaborative networks. The overarching goal is to establish a research-ready NMAHP workforce, ensuring a diverse portfolio of National Institute for Health and Social Care Research (NIHR) studies.

Outcomes 
Anticipated outcomes, now materialising, include an increased number of PIs, expanded NIHR portfolio studies, and enhanced capacity for developing research projects addressing community health challenges. The initiative seeks enduring partnerships with the Clinical Research Network, Higher Educational Institutions, and key stakeholders, positioning WHH Trust as a hub for impactful research.

The sustainability plan involves securing funding sources and pursuing studies aligned with WHH population health needs, ensuring a continuous flow of projects and income to the trust. Through this initiative, WHH Trust taps into the research potential of the NMAHP workforce, providing opportunities for job satisfaction, personal growth, and contributing significantly to healthcare improvement and research excellence.

Affiliation: Lesley Dunleavy, Affiliation International Observatory on End of Life Care, Lancaster University.

Affiliation: Lancaster University, University of Liverpool, University of Chester, University of Huddersfield, Edge Hill University, University of Central Lancashire, Liverpool University Hospitals NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust, The Clatterbridge Cancer Centre NHS Foundation Trust, NIHR Clinical Research Network North West Coast.

Introduction: High-quality research evidence should underpin palliative care provision, but there are barriers to conducting research. Most evidence focuses on potential patient barriers, with staff and organisational issues affecting research involvement underexplored. Our aim is to understand professional and organisational facilitators and barriers to conducting palliative care research.

Methods: A descriptive observational study using an open cross-sectional online survey, and working groups using nominal group techniques. Participants were professionals interested in palliative care research, working as generalist/specialist care providers, or research staff across the North West Coast. Recruitment was via health organisations, personal networks, and social media in 2022. Descriptive statistics and content analysis were used to examine data. East of England – Cambridge South REC (22/EE/0049) approved the study (24/02/2022).

Results: Survey participants (n=293) were mainly from clinical settings (71%), with 45% being nurses. Three-quarters of participants were not research active, but most wanted to increase their involvement. Key barriers identified from the survey (and working groups, n=20) included: lack of organisational research culture and capacity (including prioritisation and available time); research knowledge (including skills/expertise and funding opportunities); research infrastructure (including collaborative opportunities across multiple organisations and governance challenges); and patient and public perceptions of research (including vulnerabilities and burdens).Conclusion & practice implications: Professionals working in palliative care are keen to be research active, but lack time, skills, and support to build research capabilities and collaborations. A shift in organisational culture is needed to enhance palliative care research capacity and collaborative opportunities across clinical and research settings.

Introduction
In November 2022, I successfully secured the role of Clinical Research Lead for NMAHP within Wrightington, Wigan and Leigh NHSFT (WWL). This will contribute to policy developments, future practice and provide strategies to enhance impact and evaluate change. 

Approach
In April 2023, started the NIHR Senior Research Leader (SRL) Programme, which provides access to a new national platform to influence change as it follows the plan to discover, build and sustain a future where research is led by Nurses and Midwives. 

My top three priorities for developing and enhancing the research culture in my organisation are: 

1. To develop our future research leaders by promoting research career pathways and research training available for all staff through existing schemes and supporting individuals.
2. Embedding a research culture at Ward level by developing research quality standards within the Trust’s Aspire Ward accreditation programme and celebrating research and its impact on our patients.
3. Aligning research with the needs of our patients and by articulating clear research priorities which are focused on, and informed by our patients, their carers and our profession, linking to the wider organisational and national priorities. 

Outcomes
We have already seen an improvement in the interest and understanding of research across the trust and have developed a research incubator to nurture and grow interest by NMAHP staff. We plan to undertake formal evaluation early 2024 in line with the Senior Research Leader programme. 

The Aspiring Cancer Nurse Specialists Pilot maps a blueprint of cancer training, transforming 5 nurses into clinicians now armed with the capability to become skilled CNS. This transformative pilot programme, designed to equip nurses with the knowledge and expertise needed to excel in the CNS role (NCAT, 2010), has set a new benchmark for cancer nursing career development.

The intensive 12-month programme, participants were provided 1-day per-week to undertake comprehensive learning. A holistic approach ensured that participants gained a deep understanding of cancer diagnoses, pathways, treatments, and toxicities, whilst developing skills to deliver personalised, compassionate care.

All candidates enrolled received a set of competencies that were to be achieved by the end of the programme based on the Royal College of Nursing (RCN) CNS competency framework. 

The framework consisted of 13 domains and each participant was assessed according to two levels depending on their current banding. The standards for successful completion were as follows:

Band 5 professionals should achieve level-1 assessment on all competencies, Band 6 professionals should achieve level-2 on at least 75% of all competencies. 

Summary of key findings: 

• 60% of participants are now in a CNS role and feel confident in their duties 
• 100% of participants achieved level-2 competency, demonstrating excellent knowledge and ability to undertake required competencies, with and without supervision 
• All participants knowledge of cancer pathways from diagnostics through to treatment and follow-up improved from “basic” or “average” baseline to “good” or “very good” post-programme.

Additional Authors: Professor Michelle Heys, University College London – Kirsten Prest, City, University of London

Introduction
Over 500 million children, around 1 in 4 children globally, are thought to live in a humanitarian setting, where undernutrition, violence and lack of access to healthcare and early learning opportunities pose serious threats to early childhood development (ECD). 

Aim
This systematic review aims to evaluate the evidence for interventions, which support caregiver parenting skills and abilities to interact with their child, to improve ECD outcomes within humanitarian settings. 

Methods
A search across 3 databases and grey literature was conducted to investigate the effect of caregiver interventions on outcomes relating to health, nutrition, responsive caregiving, safety, and opportunities for early learning for typically developing children and children with developmental delay or disability living in humanitarian settings. Eligible studies  were reviewed using the Critical Analysis Skills Programme framework and recommendations for future implementation of caregiver interventions were formulated against SIGN 50 Guidelines.

Results
Eight studies met the eligibility criteria. Conditional recommendations were made for interventions to improve responsive caregiving and reduce harsh parenting practices for typically developing children living in refugee settings. Further research is required for outcomes relating to socioemotional development and well-being, nutrition and early learning skills and across all areas of ECD in post-disaster areas. No studies investigating interventions for children with development delay or disability were found.

Conclusions
Caregiver interventions may improve ECD outcomes in typically developing children living in humanitarian settings. Urgent action is required if we are to enable all children living in humanitarian settings to reach their full developmental potential.

Background
Mental Health is paramount to personal wellbeing. With the population of the United Kingdom changing over decades, the National Health Service (NHS) has experienced significant challenges in adapting services to meet a wide range of needs, with inappropriate interventions consequently impacting negatively on racialized communities.

Study Aim
The focus of this study was to explore South Asian Indians’ experiences of psychological therapies received in primary care when presenting with depression. 

Methods
A Qualitative and Grounded theory analysis study was used, with a total of 7 SAI’s patients participating. Qualitative semi-structured interviews were conducted with participants in West Midlands who had experienced depression and received CBT. Data was gathered and analysed using a Grounded theory (GT) approach. 

Findings 
Four unique findings emerged, indicating that first encounters are crucial as they determine service uptake and successful completion of treatment and dropout rates. SAI’s, dropping out of services was a result of patients feeling considerable progression in their condition that they no longer required services. Accessing services can be a personal choice based on individual evaluations and perception whether the service would be beneficial, meaning SAI’s would engage in psychological therapy presuming they were “listened” to and “understood” from individual contexts.

There was evidence of a new pedigree of patients wishing to be equal stakeholders within Talking Therapies decision making policies and suggesting co-production approaches to healthcare.

Conclusion
Research on this topic is limited. Key findings may contribute to necessary debates about healthcare inequities and inequalities, thereby informing policy changes and development.

Additional Authors: Hannah Gaffney, Cheshire and Wirral Partnership NHS Trust

Despite older people with a ‘personality disorder’ making up 44% of completed suicides of older people (Mattar & Khan,2017) complex emotional and relational needs (CERN) in older adults are not fully understood and often go unrecognised and/or untreated (Dykes, Lord & Kaiser,2022). Locally there was poor understanding of prevalence and needs of older people with CERN. Hence, we could not be sure whether services were recognising or meeting the needs of this group. A scoping project was conducted to understand prevalence, presentation and needs of older adults accessing an Older Adult Community Mental Health Team.

Out of 305 service users with functional mental health diagnoses, 233 met project criteria. Data was obtained via staff consultation for 90 service users, remaining data was collected via clinical note review. Using guidelines from the British Psychological Society, 17 individuals (7.3%) were identified as potentially having CERN. People with potential CERN were most likely to be given a diagnosis of a mood or psychotic disorder.

Findings suggest that CERN in older adults remain under recognised and misunderstood. Older adults appear to exhibit CERN through behaviours like self-neglect and social isolation, differing from younger populations. These findings are in line with similar scoping studies. 

Research suggests that psychological therapies for CERN can be equally effective for older adults as for younger people. However, if challenges are not identified, it might inadvertently lead to discrimination in accessing treatments. Addressing recognition and treatment of CERN in older adults is crucial to ensure equitable access to care.

Additional Authors: Dr Martin McCabe, The University of Manchester, Division of Cancer Sciences/ The Christie Hospital – Dr Sabine van der Veer, The University of Manchester, Division of Informatics, imaging and data science – Prof Janelle Yorke, The University of Manchester, Division of Nursing, Midwifery and Social Work

Introduction
Adolescent and young adult (AYA) survivors of a central nervous system (CNS) tumour represent a vulnerable group whose post-treatment symptoms impact overall health-related quality of life. Identifying unmet needs is essential for providing personalised support but no validated needs assessment tools (NATs) are available to support this. The aim was to develop and validate a NAT for AYA (16-39 years) survivors of a CNS tumour.

Method
Items were generated from qualitative data and cognitive interviews produced the draft NAT in consultation with clinical experts. 128 of 313 eligible participants from four NHS clinics completed the draft NAT at time 1 and 2, one week later. Comparator instruments were completed and used to evaluate validity. Piloting YOU-CAN in routine follow-up concluded the study. Ethical approval was granted for all phases (21/NW/0344) and a patient experience group contributed throughout.

Results
A systematic review of 29 qualitative studies generated 207 potential items, these were grouped by similarity and reduced to 41, thematic analysis of cognitive interview data (n=8) resulted in the draft NAT (49-items). Hierarchical analysis and Rasch analysis identified 33 items for removal. Pilot data (n=6) suggested YOU-CAN (16-items) helped participants to discuss needs that would have otherwise been overlooked.

Conclusion & implications for practice
YOU-CAN is a reliable questionnaire designed to assess unmet needs, offering the opportunity to improve provision of personalised support if used routinely. Additionally, it aims to improve the collection of routine data which can be used to benchmark and direct services to those most in need. 

Additional Authors: Dr Ruth Carlyle, NHS England

Introduction: NHS knowledge and library specialists both support researchers and undertake research. The aim of this programme, delivered as part of the Knowledge for Healthcare Learning Academy (Health Education England, 2021), was to equip participants with the knowledge, skills and confidence to undertake research which either adds to the evidence base for the knowledge and library profession or equips them to contribute as a member of a healthcare research team. 

Approach
Content comprised workshops, work-based learning, action learning sets, online discussions, masterclasses, and personal reflection. The programme took place over 10 months via MS Teams. Additional support was provided by personal coaches, participation in action learning sets and 1-2-1s with the trainer. 

The programme will conclude in January 2024 with a face-to-face celebration event for the 7 people who completed the course.

Evaluation of the pilot is planned for February 2024. It will consist of 2 retrospectives (Health Education England, 2019). One of these will focus on the experience of the participants, the other on those of the organisers, facilitators, and trainers.

Outcomes
Participants undertook 2 small-scale research projects. One as an individual and the other as part of a project group. Participants are encouraged to make the output of their research publicly available. Topics included health literacy, the link between knowledge and library services and NHS staff wellbeing, and e-books.A community of practice has been set up on FutureNHS to enable participants to continue to support each other as they develop their research careers.