Northumbria Healthcare Research Repository
The Northumbria Healthcare Research Repository contains published research by staff working for Northumbria Healthcare NHS Foundation Trust. The repository is managed by the Library and Knowledge Services team and jointly owned with the Innovation, Research and Development Department.
For further information or to submit an article, please contact repository@northumbria-healthcare.nhs.uk
Recent Submissions
Item type:Item, Protocol for a factorial randomised controlled trial, embedded within WHiTE 8 COPAL, of an Enhanced Trainee Principal Investigator Package and Additional Digital Nudge to increase recruitment rates.(2019)Recruitment remains an issue when conducting randomised controlled trials (RCTs) with a significant proportion of studies failing to reach their target sample size. Studies evaluating interventions to improve recruitment aimed specifically at recruiters to the trial are limited in number. This factorial RCT will evaluate the effectiveness of an educational intervention to trainee principal investigators and a positive reinforcement intervention via an email nudge on increasing recruitment. The targeted recruiters will be in 20 centres nationally recruiting to one large orthopaedic randomised controlled trial, WHiTE 8 COPAL. Centres will be randomised via minimisation to one of four groups. The primary outcome is recruitment rate in the first six months that a centre is actively recruiting, with data being analysed via a Poisson regression model. Results will be presented as adjusted incidence rate ratios with 95% confidence intervals. Secondary outcomes relate to the feasibility and logistics of running the interventions. We will also collect feedback regarding the educational programme set out for the trainee principal investigators. The study started in August 2018 with the anticipation of the primary objective endpoint by October 2019. The results of this study will be used to inform the design of future RCTs, particularly in orthopaedics in the UK, where the role of Trainee Principal Investigators is now a consistent one across different trials. Trial registration: 11600053, ISRCTN, 20/08/2018; SWAT 67, Northern Ireland Hub for Trials Methodology Research SWAT repository, 01/10/2017.Item type:Item, P04-4 Holistic support for women with complex social needs: using a CORE20PLUS5 approach – the best start in life pathway(2026)Background: The Best Start in Life pathway (Enhanced Continuity of Care) provides holistic, person-centred care for women in line with CORE20PLUS5 principles. The pathway complements existing midwifery and obstetric services and focuses on reducing health inequalities by supporting women with complex social needs, including those seeking asylum, recent migrants, refugees, women from ethnically marginalised groups, and those living in poverty. Methods: Women were identified at booking through demographic data and offered targeted, continuous support throughout pregnancy, focusing on optimising physical and emotional wellbeing. Interventions addressed a range of needs, including physical activity, healthy eating, emotional health, infant feeding, safe sleeping, vaccinations, finances, benefits, housing, and navigating wider systems. Results: Since November 2023, 284 women have been supported on the pathway: 181 from ethnically marginalised groups and 103 living in areas of deprivation. Outcomes achieved included registration with Family Hubs (38.3%), improved Outcome Star scores (100% of women made progress in at least one outcome area), access to financial support (39.2%), mental health support (20.9%), provision of baby equipment or additional education to promote safe sleep and safety (43.7%). Qualitative data from case studies further demonstrated positive impacts on women’s experiences, confidence, and engagement with services. Conclusion: The Best Start in Life pathway demonstrates the effectiveness of a holistic, equity-focused approach to maternity care aligned with CORE20PLUS5 principles. By addressing wider determinants of health and providing tailored, person-centred support, the pathway has improved access to services, enhanced wellbeing, and promoted safer, more positive pregnancy experiences. These outcomes highlight the importance of integrated, person-centred models in reducing inequalities and ensuring every woman and baby has the best possible start in life.Item type:Item, P16-7 Reducing health inequalities in endoscopy attendance rates through non-attendance prediction and healthcare navigation: a mixed methods study(2026)Background: Targeting 20% most deprived communities with clinical early-stage cancer diagnosis focus can reduce patient harm (Core20PLUS5 Framework). DNA (Did Not Attend) appointments impact patient health outcomes in cancer diagnostic tests; treatment delays, additional re-arranging resources and potentially more severe diagnosis/prognosis. A multi-disciplinary team developed a predictive risk model, identifying DNA high-risk patients due to health inequalities and piloted patient healthcare navigation. Methods: Machine learning model trained on 2-years of 39,447 endoscopy appointments data identified endoscopy high-risk DNA patients based on risk factors including health inequalities. Probability factors contributing, positively or negatively, include; attendance behaviours, demographic factors; deprivation, age, gender, and procedure type. Variables such as prior DNAs, rurality, and socio-economic deprivation were among the most predictive. Over 12-weeks patients with 10% or greater probability of DNA received pre-appointment healthcare navigation calls; understanding and helping mitigate attendance barriers. Results: Pre-appointment calls were made between 7 October 2024 and 17 January 2025. 540 predicted high-risk DNA patients were contacted (78% engagement rate). Themes identified: forgetting, anxiety and feeling un-informed. Baseline DNA rate, (same time period, previous year) estimated 17% for ‘high-risk’ patients. Pilot results: ‘high-risk’ patient DNA rate fell to 5% for patients contacted (11% including patients unable to contact). Endoscopy patient text reminders paused March 2024 resuming November 2024, 3.5 weeks into pilot. Pilot observed 52 DNAs from 650 appointments. Scaling data up over a year, assuming 10.8% DNA rate consistent, estimated preventing 150 DNAs; calls alone generate 10% DNA reduction for ‘high-risk’ patients and 20% reduction with reminder text. Conclusion: Targeted pre-appointment patient calls for those predicted DNA high-risk are associated with statistically significant reduction in the proportion of DNAs. The work has scaled up; further 5 service areas developing predictor models. This small-scale study’s findings are limited to NHS trust endoscopy service in the Northeast of England; further formalised research is necessary.Item type:Item, P02-7 The NHS healthy weight declaration: adoption and implementation within an NHS trust: a mixed method approach(2026)Background: The NHS Healthy Weight Declaration (HWD), developed by Food Active in 2015, provides a preventative, whole-systems framework to promote healthy weight across communities. Northumbria Healthcare NHS Foundation Trust (NHCT) became the first NHS Trust to adopt the HWD following its pilot phase. The Trust’s HWD includes 15 commitments aimed at supporting a sustainable approach to healthy weight among patients, staff, and the wider community. This research, conducted by Northumbria University, evaluated HWD-related activities implemented from its launch in November 2022 through December 2024. Methods: A mixed-methods approach was used, including document reviews and observation of two HWD steering group meetings. Thematic analysis, guided by theoretical frameworks, identified 31 implementation strategies aligned with the commitments and overall HWD goals. Results: Findings indicate the HWD was successfully launched in collaboration with North Tyneside and Northumberland local authorities. A comprehensive local needs assessments tailored implementation plan was developed, a steering group established. Progress was evident across all 15 commitments, 7 commitments showed evidence for the most progress throughout the first year of implementation. Specific actions involved development of an active office checklist and a weight stigma checklist, review of food and drink provision, introduction of a healthy meeting guide, delivery of Making Every Contact Count (MECC) and helpful conversation about weight training, review of active travel infrastructure, new resources to support staff and activities to target healthy weight in pregnancy. Conclusion: The Trust has made significant progress and developed a 2025–2027 action plan to sustain momentum. NHCT’s systematic, coordinated approach has informed a replicable framework for other Trusts, now used by Food Active to support further adoption. Food Active commended NHCT for its multi-stakeholder engagement, strategic alignment, and ongoing reflective practice, which have driven measurable change within the Trust and its communities. We recommend building on existing partnerships to facilitate progress for the remaining actions.Item type:Item, P10-1 Understanding high admission rates for alcohol use and self-harm in children and young people and pathway of care quality assurance: case report(2026)Background: Concern was raised that two routine data indicators show the catchment local authorities (LA) of Northumbria Healthcare NHS Foundation Trust (NHCT) to be national outliers for admissions for alcohol-specific conditions in under 18s and self-harm inchildren and young people (CYP). A working group investigated this which included experts from public health, child health, mental health and data and intelligence. Methods: The working group approached this public health question by: appraising the indicators using public health data interpretation skills; and contemporaneously examining and quality assuring pathways of care for CYP attending the NHCT emergency department (ED) for these reasons. Results: Appraisal of both indicators highlighted an upward trend after a new specialist emergency care hospital opened, suggesting underlying processes, including recording, could be artificially increasing admission rates. Further interrogation of the data showed that around one third of CYP admitted for these reasons are taken to the short stay unit and soon discharged, raising the question as to whether they are a true admission. Examination of the care pathways identified a gap for CYP of transition age (16-17), including in receiving enhanced support. A quality improvement project was undertaken in partnership with ED and each LA commissioned alcohol service to develop a robust referral pathway for under 18s presenting with alcohol intoxication from both LAs, including updating safeguarding referral processes. Conclusion: This public health question brought the importance of public health data interpretation and appraisal skills to the fore. Work is planned to further investigate the indicators including benchmarking with other trusts. NHCT can be assured that pathways of care for CYP are safe, high quality, and robust. Clinical teams involved in caring for CYP have provided feedback that there is now a clear process, increased awareness of external services and support, and available resources in ED.
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