1. Collaboration for Leadership in Applied Health Research and Care: Nottinghamshire, Derbyshire and Lincolnshire Health and Social Care Forum Community Action Derby: 12 th January 2010 Research making a difference to practice

2. Overview Overview of CLAHRC NDL Themes: clinical and implementation research themes Studies taking place in Derby Return to work in Stroke study

3. From what we know to what we do CLAHRC’s pull together researchers/clinicians/commissioners/ users/carers to work together to get what we know into standard practice. 9 CLAHRCs across the country – all working slightly different ways

4. Partnership Working Building partnerships Multiple perspectives Learning together Diffusion Fellows and CLAHRC associates are vital to partnership working

5. How does CLAHRC work? Applies an Organisational Learning model: Researchers work alongside (not decoupled from) healthcare staff (Diffusion Fellows) to do the research & support its implementation in a situated way in real time as evidence-based innovation is translated into practice CLAHRC Associates (from any sector or background) form networks around Diffusion Fellows to help the research to practice process

6. CLAHRC NDL: Structure

7. CLINICAL THEME MENTAL HEALTH Lead: Richard Morriss 4 Projects Programme Manager Research Fellows/Associates Diffusion Fellows CLINICAL THEME STROKE REHABILITATIO N Lead: Marion Walker 4 Projects Programme Manager Research Fellows/Associates Diffusion Fellows CLINICAL THEME CHILDREN AND YOUNG PEOPLE Lead: Chris Hollis 4 Projects Programme Manager Research Fellows/Associates Diffusion Fellows CLINICAL THEME PRIMARY CARE Lead: Joe Kai 4 Projects Programme Manager Research Fellows/Associates Diffusion Fellows IMPLEMENTATION THEME (to facilitate the transfer of research into practice and to research implementation) Lead: Graeme Currie Programme Manager Implementation Research Fellow Implementation Educator Diffusion Fellows ENGAGEMENT, SYNTHESIS AND DISSEMINATION THEME (building bridges to add value and increase impact) Lead: Justine Schneider Programme Manager Engagement Research Fellow Patient/ Service users Engagement Fellow (commissioning and service users and carers) Diffusion Fellows Director of Research: Richard Morriss The NIHR CLAHRC NDL is funded by the National Institute for Health Research

8. Stroke RehabilitationMental HealthPrimary CareChildren and Young People Return to work after stroke Readiness for psychological treatment in people with Personality Disorders Reducing diabetes risk in people with South Asian origin Developing consensus on treatment outcome measures in CAMHS Home visiting prior to discharge from hospital Dental and physical health in people with mental health problems Pre-conception screeningTranslating evidence based medication management for ADHD into routine NHS practice Early supported discharge after stroke Chronic mood disorder: the effectiveness of specialist experts Morbidity post injuryGroup parenting and other early interventions for children at risk of ADHD Home based computer rehabilitation after stroke Supported employment and CBT (Individual Placement and Support) Stepped care for medically unexplained symptoms Exercise to prevent obesity on children with asthma CLAHRC NDL Projects

9. Return to Work After Stroke

10. Evidence from Stroke Less that one third of stroke survivors of working age return to work Although severe disability accounts for a proportion of this figure there remains significant unmet need For many the primary goal is to return to work

11. Return to Work: Aims To design a vocational rehabilitation service specific to the local needs of people with stroke in Derby, involving key stakeholders and test its feasibility and cost effectiveness, usefulness and acceptability in a pilot randomized controlled trial (RCT). To determine what people with stroke, their employers and other stakeholders (NHS, Job Centre Plus and the Third Sector) want from a vocational rehabilitation services, so that appropriate services can be designed.

12. Return to Work: The Projects 1 1.Interview and observational study of current provision: 1.What vocational rehabilitation services people in Southern Derbyshire currently receive following a stroke and how and where are work issues are currently addressed? 2.What do people with stroke, their employers and other stakeholders (NHS, social services Job Centre Plus and the Third Sector) want from a vocational rehabilitation service? 2.Pre-trial intervention phase (case study design) 1.Can we deliver this locally? 2.Is it seen as acceptable and useful by recipients.

13. Return to Work: The Projects 2 3.Pilot Randomised Controlled Trial 1.Can we design and test the feasibility and cost effectiveness of delivering a vocational rehabilitation service for people with stroke? 4.Qualitative study to identify changes experienced and valued as a result of participating in the service. 1.What service interventions are most valued in practice by an employee with stroke? 2.What service interventions are most valued in practice by an employer?

14. Contact Details Nicola Wright: nicola.wright@nottingham.ac.uk nicola.wright@nottingham.ac.uk Return to Work after Stroke – Kate Radford: kradford@uclan.ac.uk