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Services and Systems

The departments continued research into understanding how services are configured and policy enacted is essential to developing effective future interventions. Without a systemic appreciation, innovation and effective change may not last or be sustainable. 

An understanding of the sophisticated interrelationship of these three research streams is the key to generating evidence to develop effective services and eradicate inequalities. Find out more about our projects below.  

Projects

This study, led by Dr Jason Scott, is funded by The Dunhill Medical Trust and North Tyneside Clinical Commissioning Group. The aims are to develop a better understanding of incident reporting in relation to transitions in care between hospitals and care homes, and to co-design a systems-level response to safety issues for patients transitioning between these.  

The study will be split into two parts that run alongside each other. During the first part, we will review how care homes respond to safety incidents. This will include looking at what policies exist, what technology is used and how reports are captured. From this, we will create categories of the different systems being used to capture safety incidents.  

During the second part, we will work with a small number of care home organisations in North East and South West England, covering different types of care homes. We will begin by speaking with care home staff to find out how they report incidents. Separately, we will also speak with staff from non-care home organisations who are involved in people moving between hospitals and care homes. We will then review the information held by care homes.  

Using what we learn throughout the study, we will jointly design a new system for learning from safety incidents. This new system will be compared with existing systems and recommendations will be made for how it can be put into practice. Throughout the study, we intend to work with policy-makers to ensure that changes inform both policy and practice. Find out more

This project comprises ten research studies that examine Australian perpetrator intervention systems. The studies focus on the most common pathways of identification, assessment and intervention with perpetrators and examined how the engagement and retention of perpetrators within systems can be enhanced. Together, the studies aim to provide a comprehensive analysis of integrated systems and interventions for perpetrators, and a mapping of current domestic and family violence responses to perpetrators. 

Project partners include Curtin University, RMIT University, University of New South Wales, University of Western Sydney, Griffith University, Northumbria University and the University of Oslo.

Making Every Contact Count (MECC) is a national public health strategy which supports public-facing workers to use routine contacts with individuals to enable healthy lifestyle changes. This project responds to literature gaps and research priorities highlighted by regional stakeholders, including the NENC MECC Strategy Group. The project involves all organisations implementing MECC across LA, healthcare and other public, private and voluntary and community sector (VCS) settings within NENC. This includes a diverse range of implementation and delivery approaches, alongside variation in implementation time frame and level of ‘embeddedness’ within organisations. This research aims to improve health and wellbeing of people within NENC by facilitating a joined-up, evidence-based approach to delivery of public-facing MECC interventions. The comparative approach will identify and promote good practice, improving the quality of MECC interventions. Understanding regional application and reach will also help target those in need of support, and identification of potentially under-represented groups/demographics.

Funded by NIHR ARC NENC. Collaborators: Northumbria Healthcare NHS Trust; Newcastle University; Teesside University; OHID

When people reach the end of their lives, it is really important that they can be where they want to be – for many people, this will be in their own home, surrounded by their friends and family. To make this choice possible, it is important that the services delivering end of life care are available at a time and place when the patient and their family need support. We need to understand better what people need at the end of their lives, when they need it and how health and social services can support them.  Patients are particularly vulnerable at the end of life and, when they need help, they need it to be quick and accessible. This research will look at how teams called Rapid Response Services work. These services provide support to people at the end of life in their own homes.  

We will compare two different Rapid Response Services to find out how each service helps patients and their families, how they work with other community teams, what the impacts of the Covid-19 pandemic have been, and the costs of each service for the NHS. We will ask professionals involved in delivering end of life care how the service supports people and, importantly, we will ask carers and patients about their views and experiences of using the service and whether it has made a difference to them and, if so, in what way. Our findings should help us to understand better how to develop Rapid Response Services to support patients and their carers during Covid-19 and beyond. 

Research Team: 

PIs 

  • Joanne Atkinson, Head of Dept of Social Work, Education and Community Wellbeing, Northumbria University 
  • Amanda Clarke, Professor of Nursing, Northumbria University 

Co-Is 

  • Angela Bate, Associate Professor of Health Economics, Northumbria University 
  • Sonia Dalkin, Associate Professor of Applied Health Research, Northumbria University 
  • Caroline Jeffrey, Senior Lecturer and Registered GP, Northumbria University 
  • Peter McMeekin, Professor of Health Economics, Northumbria University 
  • Paul Paes, Consultant and Reader in Palliative Medicine, Newcastle University 

RAs 

  • Kathryn McEwan, Research Fellow and Study Coordinator, Northumbria University 
  • Melissa Girling, Research Fellow, Northumbria University 

On behalf of Fuse, Northumbria university is leading a study on how local authorities made decisions in times of austerity (and COVID-19) in order to maintain their targets to address health inequalities. In collaboration with four other partners from within the School for Public Health Research (The London School for Hygiene and Tropical Medicine; The Universities of Liverpool and Central Lancashire; the University of Sheffield and the University of Cambridge), the study focuses on five local authorities in England.

Using a combination of publicly available quantitative data, a documentary analysis and a series of interviews, and an overall realist logic of analysis, we are drawing on theories of stress, trust, engagement and normalisation process theory to explain how and why certain interventions are more likely to achieve their ambitions than others.

Young people who have been in the care of child welfare systems face myriad challenges as they transition into adulthood, resulting in poor long-term outcomes. The overwhelming international trend shows that compared with their peers who have not been in care, care leavers are more likely to experience unstable living conditions, low engagement in employment, financial instability, low levels of educational attainment, poor physical and mental health, and involvement in criminal justice systems. Child welfare policies to support young people as they transition to independence are implemented differently in different countries, leading to different outcomes.  

To date, there has been no international comparisons at a population level to determine how various policy contexts influence outcomes for care leavers, thus not allowing a granular explanation for why young people continue to experience poor outcomes. This project will develop a nuanced and dynamic understanding of how different policies and practices produce pathways that either promote or constrain positive outcomes in adulthood. We will compare administrative data from Norway and Australian to objectively quantify and compare, at a population level, associations between service use pathways and young people’s outcomes as they transition from out-of-home care within different policy contexts. The mixed-methods study will make cross-country comparisons of the lived experiences of young people, their carers, and service provision practices that act as barriers and facilitators to positive long-term outcomes within Norway and Australia. The combined findings from the population-level data, together with an in-depth understanding of their lived experiences will identify a best practice model to facilitate better outcomes. A policy analysis and synthesis will be conducted alongside these studies to highlight the influence of policy on service provision practices, young people’s pathways, and outcomes. 

Project partners include Norwegian University of Science and Technology, Curtin University, Northumbria University, University of Western Australia and the Telethon Kids Institute. 


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