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Partner in Focus - The Royal Devon & Exeter NHS Foundation Trust

Posted on May 5th 2017

As a partnership of NHS Trusts across Devon, Cornwall and Somerset, plus the Universities of Exeter and Plymouth, we aim to work with healthcare professionals, policymakers and the public to identify areas of research that reflect the real needs and concerns of the health service in the South West. 

Highlighting how this works in practice, we’ve brought together some of the work carried out with the Royal Devon & Exeter NHS Foundation Trust (RD&E).

The RD&E has been our host organisation since 2014 but since our inception in 2008, we have worked together on projects that have resulted in real change to the way the Trust works and continue to develop new collaborative studies.

An ongoing programme of work is being conducted in partnership with the hospital’s acute stroke service. This began when modellers from our PenCHORD team created a detailed computer simulation of the emergency stroke treatment process. The aim was to identify and test possible improvements to the system to maximise a patients chances of receiving clot-busting medication (thrombolysis) and to reduce post-stroke disability. Based on the findings of this study, the RD&E implemented changes that have seen the number of people receiving thrombolysis after stroke triple and the average time to deliver treatment halved.

This project’s success has led to further partnerships with the South West Cardiovascular Strategic Clinical Network and the South West Academic Health Science Network to roll out the findings to other acute stroke services in the region.

The RD&E’s Clinical Lead for Stroke, Dr Martin James, who also has an NHS liaison role with PenCLAHRC, said:

"The opportunity to collaborate with local academics to solve real problems for the NHS was too good to miss. Building a computer simulation with PenCHORD meant that we could do in a few months what usually takes years of trial and error to sort out, and it was a great learning process for both of us.

 

"We have now been able to take that learning to other hospitals and accelerate the process of quality improvement in delivering this vital acute treatment for stroke. It has given us the potential to triple the benefit from thrombolysis for people with stroke in the South West, and produce big savings for the NHS from reduced long-term disability."

Building on this partnership with PenCHORD, Alaric Moore, Performance Improvement Manager at the Trust, was part of our first cohort of students on the Health Service Modelling Associates Programme. This scheme aims to build capacity within the NHS in the use of operational research and modelling, to support change and the decision-making process.

The Trust identified a specific issue they were facing for Alaric to focus on – “How would the addition of a Clinical Decisions Unit affect patient flow and waiting times at the RD&E Accident and Emergency?”. With ongoing mentoring and support from both PenCLAHRC and the Trust, it is hoped findings from this work can be implemented to support service improvements.

An exciting new initiative for hip fracture surgery is currently being developed as a result of a research question brought to the CLAHRC by Mr John Charity, Associate Specialist in Trauma and Orthopaedics at the RD&E.

Tranexamic Acid (TXA) is a drug used in many operations to reduce bleeding but there are concerns over its use in the frail elderly (those at greatest risk of hip fractures), due to the risk of blood clots. PenCLAHRC researchers are working with Mr Charity and a team of specialists, to develop a national trial looking at the use of TXA in hip fracture surgery and whether it could lead to reduced transfusion rates, improved recovery times and shorter hospital stays.

Commenting on our ongoing relationship, Adrian Harris, Medical Director of the RD&E, said:

"The partnership between PenCLAHRC and the RD&E is of great importance to us.  It allows questions relating to real patient facing care to be answered.  This leads to real change, and benefits our patients immensely. 

 

"We will continue to foster this successful relationship and hope to develop new, exciting and innovative projects that will further improve patient services across the region."

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