Completed Projects

Completed in 2008

Understanding how the Public Chooses to Use Unscheduled Care Services (UPCUUCS)
There are many services offering unscheduled and emergency care to the public, without medical referral, ranging from Accident and Emergency units to NHS Direct. Many patients call or attend services which they do not clinically need, although there is considerable disagreement between clinicians, managers and researchers about the definition of appropriate contacts. This mixed-method study aims to provide an understanding of the factors which influence members of the public when they make emergency or unscheduled contact with health care services. The project is part of AWARD's Year 4 work for WORD. For more information on the project, please contact Alison Porter and to view of copy of the Final Report please click here. A lay summary is also available.

Completed in 2007

Identification of Determinants of Health Indicators for Cancer, Child Health and Older People's Health
This study is a systematic review of the literature on social determinants of health with specific reference to three population groups: children, older people and people diagnosed with cancer. The research is a collaboration between the Support Unit for Research Evidence and South East Wales AWARD/Cardiff Institute of Society, Health & Ethics (CISHE), with the important pooling of expertise in systematic reviews (from SURE) and social determinants of health (from SE Wales AWARD/CISHE).
For more information, please contact Michael Shepherd

Older People’s Strategy Interim Review
AWARD was commissioned by WORD on behalf of the Welsh Assembly Government (WAG) to carry out an independent review of how the Strategy for Older People in Wales, produced in 2003 by WAG, has been implemented. A joint team from Mid and West Wales and North Wales worked on the project. The first phase of the project, an overview of how local authorities and support organisations have gone about putting the Strategy into practice, was completed at the end of September 2006. Phases 2 & 3 explored processes of consultation and decision making in four case study areas, and consider how performance measures might be used to assess the impact of the Strategy. A final stage, in early 2007, involved working with OPAN (the thematic research network concerned with older people) to prepare a protocol and seek external funding to carry out a longitudinal evaluation of the implementation of the Strategy.
For a copy of the final report please click here.
Further information: Alison Porter, Mid and West Wales AWARD
email a.m.porter@swansea.ac.uk

Unified Assessment: Policy, Implementation and Practice
The Welsh Assembly Government published ‘Creating a Unified and Fair System for Assessing and Managing Care’ in April 2002. The Guidance is commonly referred to as the ‘Unified Assessment Process’ or UAP. It applies to all adult service-user groups, providing a co-ordinated, overarching system of care management in Wales, particularly for people with complex needs. The aim of unified assessment is to ensure more effective joint working and to prevent people being serially assessed and asked for the same information by different agencies.
As part of the core WORD contract, AWARD is carrying out a study of the effect that UAP has had on direct practice and care management. The work will be conducted over a period of 6 months (January 2007-June2007), by members of the AWARD North Wales team, and will involve semi-structured telephone interviews, focus groups and in-depth face to face interviews with staff involved in implementing UAP. There will be opportunities for individuals to reflect on current practice and share their views on the future development and implementation of the UAP. A representative from each Local Health Board area will also be invited to take part.
If you would like any further information about this work, please contact Diane Seddon

Completed in 2006

Developmental norms in speech and language for Welsh and bilingual children
A multidisciplinary working group, led by Seren Roberts, completed and submitted a strategic document to inform the work of Denise Puckett, who had been seconded to the Welsh Assembly Government to lead the working group considering the needs of Speech and Language Therapy in Wales.

Evaluating a pharmaceutical care planning service for older people attending outpatient clinics: a feasibility study
Staff from AWARD North Wales collaborated on this project, led by Janet Thomas and funded by OPOPPS (Older People’s Outpatient Pharmacy Service). A literature review and focus group with outpatient Consultants within the North East Wales NHS Trust were used to inform the development a pharmaceutical care planning service (PCPS) for older people attending hospital outpatient appointments. The PCPS involved the hospital pharmacist arranging an appointment with the patient 2 weeks before their outpatient appointment to discuss the patient’s medication with them. From this, the pharmacist prepared a medication report, to be sent to the Consultant prior to the outpatient appointment. The PCPS was trialled using a Randomised Multiple Interrupted Time Series with three clusters as a feasibility study. On completion of the feasibility trial, interviews were conducted with those Consultants introduced to the PCPS to gauge acceptability, appropriateness and practicality of the service. Measures were made of patient outcomes (e.g., self-report health status), and organisational outcomes (e.g., efficiency of outpatient services) and an economic evaluation was conducted. It is our intention that this feasibility study will inform the development of a more substantive research proposal for submission to a major funding body.

Evaluation of Book Prescription Wales
Book Prescription Wales was introduced in primary care across Wales in June 2005 as a method for delivering bibliotherapy – the use of books as a form of treatment, in this case for people with mild to moderate mental health problems. GPs or other professionals give patients a written prescription for one or more books, which they then take to their local public library. The Welsh Assembly
Government commissioned an evaluation to discover whether the current programme was effectively delivering bibliotherapy, with a view to ensuring effectiveness and value for money of the present remit and possible expansion to other areas. The study evaluated the processes of delivering bibliotherapy through Book Prescription Wales. The study used a mix of quantitative and qualitative methods.
Start date: November 2005 Completion date: August 2006
For a copy of the final report please click here. If you would like more information about this project please contact Angela Evans

A Literature Review of the Health and Social Care needs of Lesbian, Gay, Bi-sexual and Transgender older people
Commissioned under the AWARD contract to support the Welsh Assembly Government’s strategy for older people, a new report from researchers at CISHE highlights the health and social care needs of lesbian, gay, bisexual and transgender (LGBT) older people.
Institutional discrimination can directly impact on the quality care provided and may result in excluding LGBT people from access to care, result in delays or poorer quality of care and may exclude carers from proper access to patients. Supportive networks appear important in maintaining self-esteem in the face of discrimination. Lesbian and gay people in particular have been found to rely on durable friendship networks.
Start date: September 2005 Completion date: August 2006
For a copy of the report please click here

A Study of the Carers Strategy in England
This three-year study was funded by the Department of Health. The research team looked at current activity undertaken to support carers in England and identified areas of good practice in relation to the provision of information to carers, the assessment of carer need and service provision. A parallel study (funded by the Wales Office of Research and Development) was also carried out to assess of the effects of the Carers Strategy in Wales. For further information about this project please contact Diane Seddon
Start date: September 2003 Completion date: September 2006

A study to determine the level of occupational health (OH) activity in Wales
This study was commissioned by the Welsh Assembly Government (WAG) to provide a clear picture of OH training opportunities and service provision in Wales. Once the current situation has been mapped, measures can be put in place to improve both access to OH training and OH services across Wales.
A review of the background literature was undertaken. Desk-based research was carried out to identify which courses lead to professional qualifications in OH and which of these are accessible to people living in Wales. A postal survey was carried out to identify what OH services are made available by a range of employers in Wales and from private occupational health providers. Links were forged with with key OH stakeholders (as recommended to us by WAG) who had ongoing input into this project’s development, including advice on protocol development and feedback on draft outputs. For a copy of the study report please click here
If you would like to find out more about this study please contact Bridget Wells on 01792 513409 or email Bridget Wells

A survey of exercise referral schemes in Wales (SURFERS)
A number of exercise referral schemes have been developed in different parts of Wales. They have a range of referral criteria, serve a variety of different client groups and operate in an number of different ways. To assist the Assembly in developing a new All-Wales exercise referral scheme, a survey was designed to provide information on current schemes, who they serve and how they work. The survey was sent to health promoters across Wales, while other approaches were used to ensure that ifnormation was gathered on as many of the existing schemes as possible.
For further details please contact Maggie Hendry

A survey of local health promotion initiatives for older people in Wales
In line with the Welsh Assembly Government ‘Healthy Ageing Action Plan for Wales’ (2005), this survey was conducted to provide a baseline measure of provision of health promotion initiatives for older people. The study also examined the regional variation in these initiatives and identified training needs amongst the providers. A postal questionnaire survey was sent to health promotion specialists. The study concluded that improvements in the coverage and effectiveness of interventions known to be useful are needed as well as more research to ascertain the most appropriate interventions, especially in the fields of sexual health, smoking and alcohol use. For further details please contact Maggie Hendry

A systematic review of leisure centre exercise referral schemes (STROLERS)
Most adults in Wales do not take sufficient exercise. A national exercise referral scheme for Wales is planned to improve this. The aim of this project was to carry out a systematic review of exercise referral schemes (ERSs) to inform the new scheme. All randomised controlled trials (RCTs), observational studies and qualitative studies were identified that evaluated ERSs. Results were combined in a meta-analysis where sufficiently homogeneous. Exercise referral schemes resulted in a statistically significant increase in the numbers of sedentary people becoming moderately active at 8-12 months. However, the absolute risk reduction was small, and it is not certain that even this level of activity is sustained for longer periods. For further information about this project please contact Maggie Hendry

Completed in 2005

Workforce Redesign
As part of the Welsh Assembly Government’s Health and Social Care Review programme, the Workforce Redesign subgroup commissioned AWARD to undertake an overview of the literature on workforce redesign issues between health and social care providers. The project was divided into two stages. Phase 1 consisted of a scoping study identifying and summarising the quantity, type and focus of references. Following feedback from WAG on these results, Phase 2 consisted of an overview of the published literature; the aim of which was to describe and appraise the evidence concerning effectiveness of services delivered jointly by health and social providers in the UK, in order to identify specific workforce issues, highlight areas of good practice and identify questions for further research. For a full copy of the Workforce Redesign report please click here and for further information please contact Julie Peconi

Completed in 2004

NHS Direct Wales
NHS Direct Wales (NHSDW) was introduced across Wales between June and October 2000. The nurse-led 24-hour service was set up to provide advice, information and reassurance so that callers could look after themselves, or to direct those that needed further professional help to appropriate care.
In 2001, Swansea University was commissioned by Swansea NHS Trust on behalf of the Welsh Assembly Government to undertake a 3 year evaluation study of NHSDW. The study was a collaborative project, involving Swansea, Bangor, and Sheffield Universities. In response to the commissioner’s brief, the study was designed to answer wide ranging evaluation questions, with the following objectives:
1. To describe the actions of callers following their call to NHSDW, the appropriateness of advice given and the cost implications of NHSDW
2. To measure the impact of NHSDW on demand for other immediate care services
3. To describe the views of nurses within and outside NHSDW concerning the impact of the introduction of NHSDW
4. To evaluate the provision of the service in Welsh
For a copy of the final Evaluation report please click here and for further details contact Julie Peconi

Sustainable Health Action Research Project (SHARP)
Communities have the motivation and skills to identify and participate in addressing issues affecting their health and wellbeing. But effective community involvement is a long term process requiring time and resources within the mainstream of statutory sector strategies, budgets and activities. These findings were published by the Pembrokeshire SHARP Project, one of seven Welsh Assembly Government funded projects exploring participative ways of tackling health in deprived parts of Wales through the Sustainable Health Action Research Programme. SHARP projects were supported by AWARD members. More information is available from AWARD member Angela Evans or here. If you wish to obtain a free copy of the SHARP DVD please e-mail