ITEM 7F

Final V. 1 11/29/2013

Originator Dr Amanda Wood Page 1 of 44 Review date June

2014

Research & Development Annual Report

2012 - 2013

Greater knowledge,

Better services …

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Executive Summary The NHS Fife Research and Development Department has seen 9 years of change and positive progress with the department able to deal with all the necessary requirements to support high quality research in Fife. This department has been instrumental in utilising new models of improving research activities in Fife which not only help improve health care to the citizens of Fife but also allow it to be competitive with other bigger and better financed Health Boards in the field of research. One such example is the R&D research nurse model where research nurses are located within the R&D Department, which has had praise and acclaim internationally due to the efficient and effective results obtained in recruiting, establishing and communicating the research activities within their specified fields. The Research and Development Department in Fife has utilised the principles of added value and critical mass to good effect. We are looking forward to the next year where we are keen to work even closer with neighbouring Health Boards, Universities and other agencies either under the auspices of the East of Scotland Academic Health Science Centres or within other similar collaborations. Dr Alex Baldacchino R&D Director NHS Fife

June 2013

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CONTENTS

PAGE

1.0 INTRODUCTION 4

2.0 CURRENT RESEARCH ACTIVITY & INCOME 4

3.0 NHS FIFE RESEARCH STRATEGY & PRIORITIES 5

3.1 PROMOTING A CULTURE THAT SUPPORTS AND ENCOURAGES RESEARCH

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3.2 WORKING WITH PARTNERS 15

3.3 PROMOTING RESEARCH WITHIN AN APPROPRIATE GOVERNANCE FRAMEWORK

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3.4 WORKING IN PARTNERSHIP WITH STAFF 22

3.5 PATIENT AND PUBLIC INVOLVEMENT IN RESEARCH 23

3.6 COMMUNICATING RESEARCH INFORMATION ACROSS NHS FIFE

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4.0 RESEARCH & DEVELOPMENT SUPPORT 24

5.0 RESEARCH PUBLICATIONS 24

6.0 UPDATE ON R&D CHALLENGES IDENTIFIED IN THE 2011/12 RESEARCH & DEVELOPMENT ANNUAL REPORT

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7.0 CHALLENGES FOR RESEARCH & DEVELOPMENT IN 2012-13

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8.0 CONCLUSIONS 26

9.0 RECOMMENDATION 26

APPENDIX 1 – INCREASED RESEARCH ACTIVITY WITHIN NHS FIFE

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APPENDIX 2 – RESEARCH & DEVELOPMENT SUPPORT STRUCTURE 2012 - 13

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APPENDIX 3 – NHS FIFE RESEARCH EDUCATION PROGRAMME FEEDBACK 2012 - 13

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APPENDIX 4 – NHS FIFE RESEARCH PUBLICATIONS – 2012-13

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1.0 INTRODUCTION

This report details the activities within Research & Development (R&D) across NHS Fife from April 2012 to March 2013. It details progress made in R&D over the last 12 months, particularly in relation to challenges identified in the 2011-12 NHS Fife R&D Annual Report and in ongoing work, identifying the key challenges facing R&D. This report documents continued significant developments within R&D over the last 12 months. Our relationship with the Universities of St Andrews and Dundee in relation to research activities has developed significantly. The joint appointments with the University of Dundee, of two Professors (in Public Health and General Practice) have produced benefits in terms of major research grants and contribution to the development of a research culture. Work is well underway with the University of St Andrews, building on the experience of developing the teaching agenda, creating further joint posts. Many thanks are due to the whole R&D team for their consistent hard work and commitment to the implementation of the R&D strategy.

2.0 CURRENT RESEARCH ACTIVITY & INCOME

Two hundred and thirty-four research projects were registered as ongoing within NHS Fife at the end of March 2013. This compared with 265 in 11 - 12 Studies were notably within the fields of Cancer, Haematology, Rheumatology, Cardiology, Obstetrics, Paediatrics, Psychology and Mental Health. Research studies are categorised as either ‘commercial’ (funded by the pharmaceutical industry) or ‘non-commercial’ (funded by charitable organisations, research councils or Government bodies or are unfunded). Of the 234 studies, 24 were commercial and 210 non commercial.

Two hundred and forty-seven NHS Fife staff were registered as being involved in research compared to 172 research active staff reported in 06-07 (see Appendix 1). Research has tended to be clustered around individuals working as part of large national multi-centre trials or in a smaller number of cases, working independently. R&D has worked with the Human Resources Department to ensure consistency around the issuing of Honorary research contracts to researchers, and to improve the process to ensure they are now only issued where appropriate. No Honorary Research Contracts were issued in 12 – 13 to non NHS Fife staff undertaking research in Fife compared with 2 in 11 – 12, 3 in 10 – 11, 0 in 09 - 10 and 8 in 08-09. Eighteen Letters of Access were issued in 2012 - 13. Funding is provided by the Chief Scientist Office (CSO) in respect of research considered ‘eligible’ for funding, in recognition of the unfunded costs incurred by the NHS for undertaking and participating in such projects. Due to the implementation of a new national R&D Management system, there was again no data return to the CSO in respect of research activity during 2012. During 2012 – 13 NHS Fife identified 123 investigators who were involved in 124 eligibly funded research projects, with 6 NHS Fife members of staff being Chief Investigators (compared with 98 investigators, 65 eligibly funded

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projects and 9 CIs in 2009 - 10). The R&D funding allocation for NHS Fife for 2012-13 was £577,000, compared with £225,000 in 2011-12. CSO funding remains the main source of funding available to support all current and proposed future research and development activities across NHS Fife. It is used to support Research and Development within NHS Fife, providing the infrastructure (Appendix 2) necessary to ensure the required management, governance and support of research undertaken within NHS Fife. The total number of CIs across all project types was 36. There were 21 active GP projects (compared with 20 in 2011 – 12, 16 in 2010 – 11 and 12 in 2009-10) NB we didn’t survey GPs this year therefore no research activity was reported directly to us.

3.0 NHS FIFE RESEARCH STRATEGY & PRIORITIES

Approved by the Board in November 2005, and revised and reported against annually, the ambitious NHS Fife R&D strategy supports NHS Fife’s overall strategic aim to provide the highest quality care to, and improve the health of, the population of Fife in partnership with its staff, community planning partner organisations and its citizens. It sets out how the development of R&D will support NHS Fife’s overall strategic aims by:

promoting a culture that supports and encourages research as part of routine practice;

building on opportunities to work closely with partners to increase the volume and quality of research;

promoting research within an appropriate governance framework;

developing the research knowledge and skills of staff;

working in partnership with the citizens of Fife;

ensuring that appropriate financial support and resources are available.

A seventh comprehensive list of annual ‘priorities’ to be addressed was produced from the reviewed and updated strategy document in May 2012. Priorities previously set for 11-12 were also reviewed and progress towards their achievement monitored. Progress this year on each of the strategy’s ‘themes’ is outlined below:

3.1 PROMOTING A CULTURE THAT SUPPORTS AND ENCOURAGES

RESEARCH R&D support funding, from the CSO has ensured the continued great progress in supporting and encouraging research activities, recording research projects, and enabling the establishment / strengthening of existing links with local academic institutions. Within existing finite resources work has continued to be taken forward in a progressive and proactive manner to make research increasingly accessible and meaningful, and to ensure its integration into everyday practice and policy development. The R&D Resource Centre which delivered integrated education, study and support, opened by Professor Sir John Savill, Chief Scientist in July 2009, has provided well-used facilities for the development and education of Fife staff.

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3.1.1 R&D Leads

The NHS Fife Executive Lead for Research and Development, identified in 2005 has continued to represent the Department very effectively, within the context of the Fife Partnership and beyond. The post of NHS Fife Research Director was established in February 2006, with a remit to:

further develop a co-coordinated infrastructure to support and progress R&D in NHS Fife;

establish clear links and working relationships with research partners;

identify new opportunities for collaborative development ventures in order to increase the volume and quality of research activity and funding available to support research;

establish a Research Review group to assess and contribute to local research proposals;

establish research as a core function of NHS activity in Fife;

participate in NHS Scotland Research Directors’ Meetings. The activities of the R&D Director (2 sessions per week) have resulted in continued progress toward achieving R&D’s strategic goals and identified ‘priorities’.

3.1.2 NHS Fife Research Governance Group

Established in 2003, this Group provides advice and support to the R&D Department, overseeing systems established to ensure compliance with Research Governance and to develop the strategic direction for research within NHS Fife in keeping with national and local priorities.

This group is chaired by the Executive Lead for R&D, meets quarterly, and has a membership drawn from researchers and R&D staff, Public Health and Fife Partnership and neighbouring academic institutions. Other representatives include: Finance, Legal Services, Partnership Forum, Ethics service, the Public, Scottish Primary Care Research Network (SPCRN), Tayside Research Consortium and partner organisations.

Following regular review and updating of its role, remit and composition, the group’s activities remain relevant and responsive to the organisation’s developing R&D needs. The current role of the Fife Research Group is to:

co-ordinate and facilitate the implementation of the Research and Development Strategy;

set the strategic objectives for research;

monitor the implementation of the strategy;

provide assurance to the NHS Fife Clinical Governance Committee that all research conducted within NHS Fife is of the highest standard and is fully compliant with all relevant guidance and legislation.

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3.1.3 Researcher Support

Research Director Support The Research Director has met with NHS Fife researchers on several occasions to discuss and advise on study proposals and suggest appropriate methodologies. He has been able to support staff through these complex processes by being able to draw on his own extensive experience of obtaining grant funding, both within the UK and European arena. The R&D Director has represented NHS Fife, with other colleagues, in establishing several work streams with partners currently part of the Tayside Academic Health Science Centre in order to establish the East of Scotland Academic Health Science Node. This node will allow NHS Fife R&D Resource Centre to participate in national and international studies bringing in both commercial and non commercial financial advantages to NHS Fife.

Research & Development Manager

The R&D Manager is responsible for promoting and facilitating delivery of high quality R&D activity across NHS Fife. The R&D Manager works with the NHS Fife R&D Director, to lead and promote ‘research’ and ‘development’ activities and co-ordinate the further development and implementation of NHS Fife’s Research & Development Strategy, managing the R&D Budget, the R&D Office and the R&D team. They have met with various groups, providing tailored presentations and training throughout Fife and the wider NHS community, promoting research, increasing awareness of the responsibilities of researchers, and developing and expanding the support available to those seeking to undertake research. The R&D Manager is also the focal point for progressing the Intellectual Property agenda across NHS Fife, advising on its identification, protection and exploitation.

The R&D Manager carries out generic governance reviews for multi-centre research studies via the NHS Research Scotland Permissions Coordinating Centre, on behalf of other Scottish Health Boards and oversees the R&D approvals process locally.

Research & Development Coordinator

This post provides a source of expert advice, guidance and support to new and existing researchers and staff on all aspects of the conduct of research in the NHS, and coordinating the NHS Fife Research Education Programme with the offer of ad hoc sessions to individual departments, upon request. In addition, one-to one support has been provided to staff via ad hoc requests and via the monthly Research & Statistics Advice Clinics which operate in five hospitals across Fife. Support includes practical help with data analysis and preparation of papers and dissertations. Monthly 1: 1 advice clinics, tailored to provide specialised advice and support and covering all aspects of research, ethics and intellectual property continue to be delivered complementing existing R&D support services. The research and statistics advice clinics serviced by the R&D Coordinator, were operated across 5 hospital sites (and University of St Andrews), providing assistance to

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68 staff involved in 66 projects (compared with 49 and 43 in 11 – 12, 39 and 36 in 10 – 11 and 53 and 39 in 09-10). Additionally, 43 researchers were assisted by the R&D Coordinator out with the clinics on 30 projects (total of 111 researchers working on 96 projects). 12 staff were given assistance by the local NHS Research Ethics Service Scientific Officer and 4 were advised in the IP advice clinics (compared with 17 and 3 in 11 – 12, 31 and 2 in 10-11). Advice clinics and Education Programme session bookings were organised by the R&D Support Officer. R&D Research Nurses With a limited research history and culture, NHS Fife has very few dedicated research nurses. The policy of offering the R&D Department to ‘home’ the R&D generic research nurses and other externally funded research nurses has provided a base for their development, education and support, enabling them in turn to provide support and advice to NHS Fife staff. Due to the enormous success demonstrated by the generic R&D Research nurse model, in 2008 we secured a second full-time R&D research nurse who is centrally funded via infrastructure funding from the CSO. The 2 generic R&D research nurses have helped prepare ethics and management approval documentation, provided clinical/clerical time to facilitate recruitment, consented participants into studies, maintained case report forms, and communicated between the main trial co-ordinators and busy clinicians who would otherwise be unable to participate. The generic research nurses have facilitated an increase in the number of ‘eligibly funded’ research studies undertaken within NHS Fife, working on 38 multi-centre trials this year in Fife. (this figure is for all trials, not just eligibly funded) The original R&D Research Nurse, now in post for over seven years continues to keep a busy portfolio of eligible studies to 15 in 2012-2013 (from 14 in 10-11, 15 in 2011 – 12). These cover specialties such as Gastroenterology, Obstetrics & Gynecology, and Rheumatology & Diabetes. He has joined the National Advisory Board, after speaking at one of their meetings last year regarding recruitment and retention of patients in research studies. Using the R&D Nurse model from 2009 when Rheumatology were approached with a feasible multicentre study (he is now working on 8 studies with the Rheumatology team) the Generic research nurse has successfully assisted the diabetes team in starting two new eligibly funded studies In preparation for a Diabetes Research Network Nurse to take over when appointed and full training in place. This highlights the continuing success of the Generic research nurse model. To provide high quality research studies with very good recruitment and retention levels to departments who lack such resources, and how given increased resources this could be replicated in other specialties across the organisation.

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Both generic R&D Nurses continue to assist with monitoring of NHS Fife studies and follow up monitoring of studies programmed for early 2012 has been completed. The second generic R&D research nurse continues to work on 4 eligibly funded trials, with 2 eligibly funded and 1 commercial trial in set up, and is working with colleagues on a proposal for a large multi national European study. She continues to provide input into training courses for GCP for non-drug trials and consent as part of the R&D education programme in conjunction with the R&D coordinator and is in the final year of her MSc in health research which has been partly supported by the R&D dept.

Research Governance Officer Thorough ethical and management approval processes prior to the initiation of NHS based research activity frequently proves a taxing and time consuming ordeal for many researchers. The Research Governance Officer (RGO) has been instrumental in reviewing and revising the approval process within Fife to maximise the efficiency and effectiveness of the service provided. They deal with enquiries for approval from individual researchers, pharmaceutical companies and for multi-site studies, via NRSPCC. The Research Governance Officer coordinates the approval process and its associated documentation, entering study / investigator details onto the Scottish Research database (SReDa), maintaining and updating data for quality assurance purposes and regularly generating reports of research activity as required. The RGO is also the key contact for any amendments proposed to ongoing research, assists with costing studies, co-ordinates Site Specific Assessment Reviews and acts as a liaison between other NHS organisations/HR Depts/Universities for the issue of Honorary Research Contracts and Letters of Access via the Research Passport scheme. They also assist in the co-ordination and implementation of the Annual Research Survey, and providing the relevant data in response to Freedom of Information requests relating to research. Some 57 projects have been approved (compared with 82 in 11 – 12, 82 in 10 – 11, 102 in 09-10 and 76 in 08-09) along with 149 amendments to existing studies, (compared with 145 in 11 – 12, 110 in 10 - 11, 60 in 09 – 10 and 31 in 08-09). Average local approval time for amendments is 14 days. Approval times and the increased efficiency of the approval process have resulted in another extremely impressive average local approval time for NHS Fife over the year of 14 days, (10 days for 2011 – 12, 12 days for 2010 – 11) significantly less than the national target of 30 days. 89% of the local reviews were undertaken within the 30 day timeline. This compares well with the other nodes. Of the 57 studies approved since the start of the calendar year, 40 of these have been multi-centre projects co-coordinated through NHS Research Scotland Permissions Co-coordinating Centre (NRSPCC).

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TASC R&D Approvals group undertook 16 generic reviews or 40% of the generic reviews for studies involving Tayside. 100% of generic reviews were approved within the 30 day deadline and the mean review time for generic approval was well within the 30 day target review time set by NRSPCC. 100% of local reviews were undertaken within the 30 day timeline. This compares well with other nodes. R&D Support Officer The R&D Support Officer provides a central point of contact for researchers seeking advice and support, directing them to the most appropriate source of assistance for their query. They have promoted and coordinated bookings for the extensive NHS Fife Research Education Programme and assisted the Research Governance Officer in the administration of the Fife-wide annual research survey and monitoring exercises in early 2012. A bi weekly electronic Research Bulletin / update is compiled and circulated by the Support Officer to all NHS Fife staff who have been identified as research active. The R&D Support Officer provides administrative support for the R&D Manager and other members of the R&D team, and administers room bookings for the R&D Department. They also coordinate arrangements for the biennial Know Fife Research Day; any other R&D events planned and regularly inputs recruitment data into the UKCRN portfolio database.

3.1.4 Clinical Academic Positions

There are currently 6 clinical academic positions supported by NHS Fife:

Clinical Senior Lecturer in Addiction Psychiatry (Dundee)

Professor of Primary Care (Dundee)

Professor of Public Health (Dundee)

Professor of Primary Care (St Andrews)

Professor of Public Health (St Andrews)

Professor of Medicine & Director of Research (St Andrews) Examples of some of their activities ongoing during 12-13 whilst employed by NHS Fife are provided below:

Clinical Senior Lecturer in Addiction Psychiatry (Dundee) - appointed September 2001 Works as a lead clinician and consultant psychiatrist with NHS Fife Addictions Service and Director for the Centre of Addictions Research and Education (Scotland), at the University of Dundee. He works as a Senior Clinical lecturer with the Medical Research Institute, Division of Neuroscience, University of Dundee. For the last 10 years he has been successful in obtaining MRC, ESRC, European Union and Chief Scientist Office research grants. Published 100 peer reviewed publications over the last 10 years and established clinically relevant networks in the field of addictions research such as the Homelessness and Addictions Research Group (HOMAR), Pain and

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Dependence Research Group (PANDORA), and Drug Death Analysis Group with Fife Police Constabulary, Fife Council, NHS Tayside and Forth Valley, and the Universities of Dundee, St Andrews and Stirling. Has established Fife as a centre of excellence in addictions research within the European Commission. Last year NHS Fife was a leading research centre, in collaboration with the Universities of St Andrews and/or Dundee, to three EU funded projects. TRIP (Testing In Recreational Settings Prevention), ORION (Development & Evaluation of an e-Health Overdose Risk Assessment) and CAMILLE (Empowerment of Children and Adolescents of Mentally Ill Parents through training of professionals). Professor of Primary Care Medicine (Dundee) - appointed September 2007

Chief Investigator of two large studies with an NHS Fife consultant as co-applicant: a CSO programme grant to design and test a prescribing safety improvement intervention in practices across NHS Fife and NHS Tayside, and an NIHR funded trial of a complex intervention to improve prescribing in older people with multiple conditions. Has significantly increased the number of eligibly funded studies suitable for inclusion in future NHS Fife Support for Science funding returns. Other current studies include a CSO funded trial of prescribing safety feedback in collaboration with NHS Scotland Information Services Division, two NIHR Health Services Research Programme funded studies examining variation in prescribing safety (started Oct 2011), and developing new methods for creating guidelines for people with multi-morbidity (started Oct 2012, in collaboration with NICE). I additionally supervise two CSO clinical academic PhD fellows, one studying the safety of beta-blockers and non-steroidal anti-inflammatory drugs in people with asthma (Dan Morales, started Sep 2011) and another examining community antibiotic use and resistance (Virginia Hernandez Santiago, started April 2013), and two non-clinical PhD students. Our work on the prevalence of multimorbidity (in collaboration with University of Glasgow) was published in the Lancet in 2012, has been highly cited, and has prompted much policy interest across the UK and internationally. I also supported the successful application for a NRS Career Researcher post by Dr Emma Reynish, consultant geriatrician NHS Fife, am supporting her in grant applications in the field of improving dementia care, and am collaborating with her on two papers currently. Professor of Public Health (St Andrews) - appointed September 2008

The Public Health Group at the University of St Andrews is part of the People and Populations research strand in the Medical School, which includes Public Health, Health Psychology, Adolescent Health and Primary Care.

He coordinates the People and Populations research strand and heads the Public Health Group. Since taking up his appointment in September 2008 he has built research collaborations with international colleagues across disciplines and secured around £850,000 of external funding.

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The Public Health Group has two main threads of research. The first is in violence reduction; in which he leads an international project for the WHO and Scottish Government. This involves partners in South Africa, Lithuania and Jamaica. He also leads the evaluation of a major gang member rehabilitation project in Glasgow and works closely with the Scottish Violence Reduction Unit. This part of the group is actively exploring the link between alcohol and violence in close collaboration with the Scottish Prison service.

His second major area of work is in working with politicians and policy makers on practical measures to reduce health inequalities improve access to health care and make health services more responsive and accountable. Activity in this area involves work in the United States with the Milbank Memorial Fund and with the WHO EURO regional office in Copenhagen.

In Scotland the group is studying a number of equally well pilot projects including one based in Kirkcaldy and also evaluating the introduction of elected members to NHS boards in partnership with the University of Michigan. The group also supervises work on cerebral palsy services and works with the WHO HQ in Geneva on the impact of adverse childhood experiences on adult ill health and on Violence reduction under the auspices of the Violence Prevention Alliance.

The group includes five doctoral students and works closely with University and NHS Fife colleagues in teaching and supervising medical undergraduate, MSc and MRes students. NHS Fife and the University are also cooperating in an exciting 2-year initiative in environmental health and the two organisations jointly host American Public Health interns each summer, this year once again from both Michigan and Yale.

He is controller for 2 of the MRes modules, sits on the school management team and is responsible for developing special projects within the school. Recent examples include a substantial and externally funded development in global health and an innovative program for Canadian medical undergraduates.

Professor of Primary Care (St Andrews) - appointed September 2008

Director of Clinical Studies and deputy Director of Teaching at the Medical School, University of St Andrews. Responsible for a large increase in clinical teaching in St Andrews medical course over the last five years resulting in many NHS Fife employees becoming involved in medical education across all sectors (medical, nursing and AHP, Primary and secondary care). As a result of increased activity, over 20 NHS Fife GP practices are now involved in medical education . 2 GPs have registered for higher degrees in medical education and one nurse, having successfully completed a masters has now registered for a PhD. One further ACT funded member of administrative staff having recently completed a master’s degree in business administration on the subject of quality assurance of clinical placements, is now undertaking further research in the area with a view to registering for a PhD.

Continues as primary care lead for Tayside and Fife Asthma and Allergy Research Group (TFAARG) a joint venture with Dundee University which has

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now recruited well over 100 patients into complex clinical studies from Fife. Also involved in multi disciplinary research in several areas of chronic disease management. In collaboration with a photonics engineer currently has successfully achieved funding this year of almost £500K to look at the use of light as a diagnostic management tool for cardiovascular disease in community settings. She continues to work with the Generation Scotland team as part of the access management committee for the resource and is currently involved in several projects making use of this resource

As Director of the East Node of the Scottish Primary Care Research Network has organised successful meetings with Fife GPs on the subject of becoming involved in research at various levels. Several Fife GPs continue to become involved in the facilitation of student research projects. Deputy Chair of the NIHR HTA Primary Care, Community and Preventive Interventions panel and completed 10 year tenure as a member of the NICE Appraisal team in May 2013. Also sits as a member of the NHS Medical Advisory Group, NHS Education Scotland Faculty Development Group and the Scottish Deans Medical Education Group. A founding member of the Scottish GP Tutors Group (SGPTG) she has been successful in achieving financial support from NES for this group.

Professor of Public Health (Dundee) - appointed September 2007 An internationally acknowledged expert in the field of diabetes and its complications. Uses large scale epidemiological approaches to i) understand the determinants and pathogenesis of diabetic complications ii) study the response to treatments and safety of treatments in diabetes and iii) contribute to the development of new treatments in diabetes. Since September 2007 Has been the tenured Professor of Public Health at the University of Dundee, Scotland UK and Honorary Consultant in Public Health NHS Fife UK. Previously held full tenure professorial posts at the University College London, UK and University College Dublin Ireland. She makes major contributions to the key goals of Health Science Scotland; to promote excellence in the field of clinical and translational medicine in health boards including Fife. Current research programme includes

Go SHARE.

SDRN type 1 bioresource.

Studies that utilise large scale national datasets to explore diabetes epidemiology including the detection of unexpected adverse and beneficial drug effects.

Professor of Medicine (St Andrews) – appointed August 2010

Appointed at the Foundation Sir James Black Chair of Medicine at the University of St Andrews (August 2010). He is currently the Chief Investigator of the REMoxTB project that is investigating two treatment-shortening regimens in a regulatory pivotal study. This study has recruited more than 1900 patients throughout in Africa, India, Thailand, Malaysia, Mexico and the Peoples’ Republic of China. This is the first regulatory study of a novel treatment regimen for more than forty years and, if successful will be an

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important development. This study will close in the summer 2013 and report early in the New Year 2014.

Our group has now commences a new clinical trial using a novel methodology to speed up the evaluation of a range of new regimens known as the Multi-arm- multi stage MAMS-TB study. It started to recruit patients in May 201s and will complete in the autumn of 2014.

One of three Chief Investigators for the PanACEA consortium that has been give 27 m Euro funding from the European Developing Country Clinical Trials Partnership and is the main European-African clinical trials network. In addition to the REMoxTB project they have been responsible for determining the optimal dose of rifampicin, trialling a novel agent, SQ109.

He is also the Chair of TB-Drug development UK which brings together researchers from throughout the UK from medicinal chemists to clinicians.

Was part of the team that has been awarded 15m Euro from the Innovative Medicines Initiative the PreDiCT-TB consortium. With more than twenty partners throughout Europe the consortium aim to develop methods that will shorten the time taken to perform clinical trials in tuberculosis. This group will develop new and more comprehensive mathematical models of tuberculosis treatment and physic based methods to identify persistent tb bacilli responsible for poor treatment response.

He will work with NHS Fife Consultant Microbiologist on studies of catheter associated urinary infection, and, using the newly established sequencing facility at the University investigate the epidemiology of Staphylococcus aureus and the flow of organisms between hospital and community.

Work continues on antibiotic resistance through the Predicting Antibiotic Resistance (PAR) consortium funded by the EU FP7 programme. In this programme they have developed novel methods to determine the fitness of resistant organism, the mechanism of adaptation to resistance and to determine how organisms change as a result of transmission within patients.

Recent molecular diagnostic assays developed by the laboratory have enabled the respiratory pathogen S. pneumoniae to be serotyped with a single PCR reaction. Similarly he has developed methods to identify “atypical” pneumococci. All of these methods are currently under trial for implementation into Scottish laboratories. Further studies are underway into the potential new human pathogen M. amphoriforme. The whole genome sequence for all of the available isolates has been completed and prepared for publication. Additionally, proteomic studies of pathogenicity are nearing completion.

He provides teaching in all aspects of infectious diseases and antibiotic therapy in the undergraduate programme. He contributes to the Masters courses in trials methodology and research methodology. He is one of the three convenors of the Welcome Trust genomics and Clinical Bacteriology Course now in its ninth year that provides consultants, clinical scientists and post graduate medical trainees with an introduction to molecular microbiology.

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3.2 WORKING WITH PARTNERS

Key to increasing both the quality and quantity of the research we undertake is establishing and consolidating NHS Fife’s links with research active partner organisations. Such activities will also promote/increase opportunities for Fife-based clinicians and other staff to become Chief / Principal Investigators. Key partners with whom NHS Fife has been working to develop research across the region are detailed below:

3.2.1 Research Networks

The R&D Director and Manager have continued to work with the Scottish disease specific research networks, and links with the networks have gone from strength to strength again this year. These have been ably assisted by the national and international recruitment successes of Fife R&D research nurses, supporting clinicians to undertake large clinical trials. These successes, in terms of numbers of trials opened and patient recruitment into trials, which have resulted in the Cancer, Stroke, Diabetes, Dementia and Mental Health research networks funding increased hours and extending contracts for their R&D based nurses in the past, continue to result in excellent feedback from the networks. Scottish Cancer Research Network (SCRN) The SCRN oncology research nurse covers 4 oncology specialties - Haematology, Breast, Lung and Colorectal cancers. This continues to provide access for Fife patients into clinical trials locally which previously would have required travel into Edinburgh Cancer Centre. The current trials portfolio consists of a total of 7 trials open to patent recruitment in April 2013. 9 trials have closed to recruitment in the preceding year however there are a large number of trials which have patients attending for long-term follow up requiring ongoing research nurse support and data collation. Data management and trial administration continues to be challenging to complete with lack of resources to support the research nurse. This issue is being addressed locally and at network level 2012-2013 has been a successful year and trial recruitment has been achieved at a steady rate, although slightly less than 11/12, with 43 patients recruited this year. This decrease in trial recruitment is mirrored across the network due to the closure of several trials. The challenge for the next year is to maintain consistent trial recruitment across all 4 cancer specialties and manage the trial portfolio which will integrate research into clinical practice. It is predicted that activity will expand in colorectal cancer trials in Fife as there are a number of research studies which would integrate into the trial portfolio. There are gaps within the research portfolio in breast cancer and lung cancer which need to be addressed to maintain research activity in these areas.

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South East Scotland Stroke Research Network (SESSRN)

Stroke research ongoing from SSRN adopted trials undertaken in NHS Fife continues to go well. Recruitment into ENOS and TARDIS trials continues. We are also open to recruitment for PATCH study but as yet have not recruited to this trial.

CLOTS 3 trials closed to recruitment towards the end of 2012. 25 patients were recruited to this trial. A collaborators meeting is due to take place at the end of this month in Edinburgh to present the results of the study to participating sites. The results will then be published in peer reviewed journal (lancet or similar).

A local NHS Fife CI Music therapy study ran in 2012. 28 participants were recruited. Results from this study are also being presented later this month to local collaborative group before being presented at a MDT conference in London June 2013.

DARS continues to be a very successful trial to run locally. Recruitment remains buoyant and we are continually in the top 3 recruiting sites for all participating centres. Aim going forward or 2013-2014 is to open up 2 new stroke studies which are under review at present. Scottish Primary Care Research Network

The East Node of SPCRN facilitates high quality studies of relevance to primary care in Fife, Forth Valley and Tayside. During 2012-2013, 21 practices in Fife were involved in 13 network studies (compared to 26 practices / 14 studies in 2011-2012). This included 4 dental practices.

Five of the practices hosted 1 study during the year with 1 involved in 2 studies, 2 involved in 3 studies, 6 involved in 4 studies, 4 in 5 studies, 1 in 6 studies and 1 in 7 studies. None of the 13 studies were commercially funded. The East Node contributed to 22 of the 31 national studies recruiting through SPCRN in 2012-2013, and Fife practices were invited to join 11 of these. Of 6 local studies, 1 requested recruitment in Fife.

Diabetes Research Network SDRN is currently funding a 0.2 WTE research nurse in Fife, with NHS Fife contributing another 0.2 WTE. There is also some nurse resource for the SDRN Type 1 bioresource. This year, we have concentrated on academic studies within Fife with the Type 1 bioresource, DIRECT- GLP1 and DIRECT -METFORMIN studies recruiting well. We hope to introduce some commercial research studies within the next few months. Scottish Dementia Clinical Research Network

The network was set up in August 2008 and funded by the CSO. The initial objectives set by the CSO have been achieved within the proposed time scale. These objectives included the research register to be set up and the employment of key personnel across Scotland.

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The network currently has over 2200 patients & carers on the research interest register with an approximate 50 / 50 split of patients to carers. The network is now working with 12 Health Board regions across Scotland, supporting studies ranging from questionnaires and qualitative research studies to double blind placebo controlled trials. The SDCRN has continued to host a yearly conference with a day devoted entirely too public patient involvement. This was extremely well received and evaluated from both the public and professional community with over 300 attendees over the 2 days.

The SDCRN now has an active website and Twitter and Facebook pages as well as PPI (Patient & Public Involvement) and writing groups that are conducted bi monthly. In order to convey NHS Fife’s willingness and commitment to active participation in all Research Networks, the R&D Manager and Research Director have continued to meet with the Leads and Managers of all Scottish research networks. Due to the notable successes of our R&D based research nurses to date, we were able to achieve additional funding for research nurse posts from:

Dementia Research Network

Mental Health Research Network

Stroke Research Network

Diabetes Research Network

Cancer Research Network

Stroke Research Network

It is anticipated that further research nurse posts or extension to existing posts will result from these alliances, and will be accommodated and supported by the R&D Department, providing a huge resource for NHS Fife and greater equity of access to trials for Fife patients.

3.2.2 Thematic Research Groups

Research ‘thematic’ groups, based on current areas of research strength within NHS Fife, have previously been identified as priority areas towards which R&D support should be targeted. Such identification of thematic priorities in this way enables traditional ‘boundaries’ (Operational/Primary Care/Public Health) to be overcome, enabling and encouraging the expertise and involvement of academic partners and of Fife Partnership organisations. The following thematic priority areas were identified in November 2005: Mental Health (neurodegenerative, developmental, addictions, psychological therapies); Diabetes; Cardiovascular & Stroke; Cancer & Palliative Care; Maternal & Child Health; Epidemiology, Informatics & Health Protection; and Respiratory Research. Five research thematic groups (Neurodegenerative Research Group (MH), Clinical Addiction Research Group (MH), Palliative Care Research Group, the Children & Young People's Wellbeing Research Group, and the Women and Children’s Health Research Group) were established between 2006 and 2008 and have continued to be supported by the R&D Department. Several of the groups have representatives from local Universities. Activity over the past

18

year has been variable with some groups being very active in planning new studies and providing a forum for researchers to present their findings prior to wider dissemination. A Respiratory Interest Group was set up in August 2010 to stimulate research into respiratory health. Unfortunately the group foundered in 2011 due to work pressures in attending meetings. However, the Research Coordinator has continued his involvement with the Respiratory MCN which ensures a continuation of research support into respiratory conditions. In addition, the Research Coordinator has represented NHS Fife at national meetings of the CSO-funded Scottish Respiratory Research Network. One large scale project is planned pooling data from lung function assessments in various centres across Scotland. A Pain Research Group was been set up in 2012 with input from Fife clinicians and the University of Dundee.

3.2.3 Academic links

The R&D Executive Lead and the R&D Director have continued to make contacts at a senior level with both the St Andrews and Dundee Medical Schools around the development of clinical academic posts. They have also been developing productive partnership arrangements with the University of Dundee in order to facilitate the establishment of the East of Scotland Academic Health Science Collaboration. It is anticipated that these will result in significant permanent clinical academic posts with both immediate and long term benefits for NHS Fife. The current number of clinical academic positions in Fife is 6 (see section 3.1.5 above). The formal agreement established between the New Medical School in St Andrews University and NHS Fife to create a joint research strategy will be consolidated with a memorandum of understanding which will further strengthen the organisations' commitment to deliver research excellence in Fife.

3.2.4 Targets identified in the NHS Fife R&D Strategy (12-13)

WORKING WITH PARTNERS

Outcomes

Increase the number of staff actively involved in Research and Development activity by 10% per year

132 (06-07) 139 (07-08) 179 (08-09) 250 (09-10) 275 (10 – 11) 309 (11 – 12) to 247 in 2012 - 13 = -20.1%

Increase the number of projects, including eligibly funded projects as defined by the CSO, within NHS Fife by 10% per year

Increased from: 192 (06-07) 202 (07-08) 202 (08-09) 249 (09-10) 253 (10 –11)

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265 (11 – 12) to 234 in 2012 - 13 = -11.7%

Increase the number of publications by NHS Fife Staff in peer reviewed journals by 10% per year

45 publications (06-07) 46 publications (07-08) 41 publications (08-09) 78 publications (09-10) 85 publications (10 –11) 145 publications (11 – 12) to 80 in 2012 - 13 = - 40%

3.3 PROMOTING RESEARCH WITHIN AN APPROPRIATE GOVERNANCE

FRAMEWORK

To ensure the quality of research is maintained and continuously improved and that high standards of patient care are achieved, any research carried out within NHS Fife must be carried out according to the standards set out in the Research Governance Framework for Health and Community Care (2nd Edn published March 2006).

Already robust Research Governance procedures continue to be reviewed and developed to ensure that the R&D governance systems and processes remain fit for purpose.

3.3.1 New Research Projects Approvals The Research Governance Officer coordinates a robust single point entry system to ensure the appropriate receipt and consistency of requests for management approvals to ensure that all required documentation is in place prior to Medical Director approval. All research must have a favourable ethical opinion (where appropriate) and NHS Fife Management Approval before commencing. Once approved, studies are recorded on the national R&D database (SReDA). Research lacking appropriate approval and not on the Research Register is not subject to the legal cover afforded by the NHS Fife Indemnity scheme.

3.3.2 Relocation of R&D Department

The Research & Development Department relocated to the Education Centre within Queen Margaret Hospital, Dunfermline in February 2013. The move has been beneficial in providing facilities to ‘house‘ the increasing number of research nurses, adequate office space and access to meeting rooms available for staff attending education program sessions. It can also accommodate visiting advisors from the East of Scotland Research Ethics Committee and Scottish Health Innovations Limited.

3.3.3 Communication

As an interim measure to a fully functioning R&D webpage, a biweekly electronic Research Bulletin update has been issued to all present and past research active NHS Fife staff since April 07. The update contains details of in-house and external education, dates and locations for the various advice clinics, events & seminars, recently issued commissioned bids / grants.

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Further development of these communication systems into an R&D Webpage and an R&D newsletter are underway.

3.3.4 Monitoring

Active projects are subject to annual monitoring of both the study and research team in order to identify any ‘issues’ with their ongoing research. The main issue highlighted once again was lack of knowledge/training around ‘Good Clinical Practice (GCP)’, the international ethical and scientific quality standard for designing, recording and reporting trials that involve the participation of human subjects. Compliance with this standard provides public assurance that the rights, safety and well being of trial subjects are protected, and that the clinical trial data are credible. Since there is now a duty for all staff participating in clinical trials to be educated on the requirements of GCP, this has been provided via in-house training and an on-line accredited GCP training package which investigators can access and undertake at their own pace. Follow up monitoring of NHS Fife Sponsored trials was carried out in early 2012 by the trained generic Research Nurse

3.3.5 Financial Probity

Regular support has been provided from the Operational Division Medical Director’s Directorate Accountant, providing appropriate financial management and guidance on the costs of research and their recovery. Regular reports are received and figures for completion of the Annual report and quarterly reports on expenditure to the CSO are provided as part of the ongoing support. Regular meetings have been established with Financial Services to oversee, invoice, monitor and disseminate funds received into research trial accounts in payment for researcher participation in pharmaceutical sponsored trials.

3.3.7 Intellectual Property (IP) Policy

An Intellectual Property policy, Invention Record and Non disclosure agreement facilitates identification and protection of inventions and innovations in NHS Fife. This allows for the exploitation of activities generating IP by all staff (not just researchers) across the whole organisation. Increased commercialisation activity resulting from the exploitation of IP increases the financial and healthcare benefits for NHS Fife. A comprehensive education and awareness raising programme is being carried out to ensure staff are aware of the support available and the importance of protecting IP for the organisation. 2 new IP disclosures were made this year (compared with 5 in 2011 – 12, 7 in 10 – 11, 9 in 09 -10 and 4 in 08-09).

3.3.8 Review of R&D policies/documents

The R&D Research Strategy was reviewed and updated in August 2010 to include annual ‘priorities’ designed to ensure achievement of Strategy targets. These are annually reviewed, and outcomes against them reported to the Fife

21

Research Governance Group. Revised priorities for 2012-13 were included in the updated 2012-13 strategy.

3.3.9 Research Governance

Research involves an element of risk in both financial and human terms and as such proper governance arrangements must be in place to ensure that the public can have confidence in, and benefit from, quality research. The public has a right to expect high scientific, ethical, and financial standards, transparent decision-making processes, clear allocation of responsibilities and robust monitoring arrangements. The SGHD Research Governance Framework sets out the underlying principles applicable to all research concerned with the protection and promotion of public health. Internal Audit - B42/12 - Research Governance (May 2012) An Internal Audit review of research Governance was completed in May 2012, to follow-up and report on the controls reviewed within the last full audit review (B25/09). The tone of the report was very positive, reflected in the overall A grading with no recommendations for auction.

3.3.10 Ethical Review - Site Specific Assessments

Site Specific Assessment (SSA), the process by which the suitability of local researchers and facilities is determined, was transferred to all R&D offices from their local Research Ethics Committees in April 09. This has continued to be undertaken and coordinated within R&D with 6 Site Specific Information forms (SSIs) requiring SSAs to be carried out during 12-13.

3.3.11 Targets identified in the NHS Fife R&D Strategy (12-13)

PROMOTING RESEARCH WITHIN AN APPROPRIATE GOVERNANCE FRAMEWORK

Outcomes

Provide R&D support for every research project registered in NHS Fife

Continues to be achieved

Provide assurance to NHS Fife Board that all research activity meets the requirements of the Research Governance Framework

Continues to be achieved

Increase commercialisation activity resulting from the identification and protection of intellectual property thereby increasing the financial and healthcare benefits for NHS Fife

Projects with potential IP identified: 5 in 05-06 1 in 06-07 3 in 07-08 4 in 08-09 9 in 09-10 7 in 10 -11 5 in 11 – 12 2 in 12 - 13

Ensure that 10% of all ‘high risk’ projects are audited

Continues to be achieved

Provide accurate quarterly/6monthly updates and Annual Reports on financial expenditure to the CSO

Continues to be achieved

Provide financial information for the R&D Activity & Continues to be

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Expenditure report achieved

Identify the actual cost of research undertaken in NHS Fife and maximise our returns from commercial research

Continues to be achieved

3.4 WORKING IN PARTNERSHIP WITH STAFF

Within Fife, research is undertaken by and with staff for the benefit of patients and members of the public. It is essential that we work with staff and the Public Partnership Forum to promote the benefits of research activity for individual staff members as part of their commitment to personal and professional development. A member of the Public Partnership Forum is involved in the work of the Fife Research Governance Group. Research activity depends on staff having appropriate skills and local access to regular research education and workshops open to all NHS Fife staff. In recognition of the benefits of working in partnership, NHS Fife and its community planning partners host an annual research day attended by staff from all the contributing organisations.

3.4.1 Research Education Programme

After a thorough review of all feedback received from participants of the 2012 Education programme the comprehensive 2013 programme was developed aimed at increasing the capability of NHS Fife staff to undertake research. A high quality multidisciplinary programme, addressing identified research education requirements was provided by specialist trainers and local R&D staff. Education was provided in 43 day or ½ day sessions (47 in 11 – 12, 36 in 10 - 11 18 in 09-10 and 15 in 08-09) including 18 workshops offered as part of the scheduled Education programme and 10 additional workshops presented and tailored to specific departments on request. Subjects taught include: Statistics for the Terrified , Research for the Terrified, Developing your Research Question and Proposal , Critical Appraisal – Making Sense of Other People’s Research, Good Clinical Practice, Good Clinical Practice Update, Basic Research Design & Terminology , Interpreting Statistical Data, Preparing a Scientific Poster, Systematic Reviews ,Getting Started in SPSS, How to Interview Research Participants and Run Focus Groups, Questionnaire Design & Avoiding Pitfalls, Selecting a Sample and Calculating Statistical Power, Using Excel for Data Analysis and for Presentation, GCP for non-Drug Trials, Planning your Data Collection and Analysis, Introduction to Qualitative Research, Writing Up and Getting your Work Published, Achieving Success with your Dissertation, and Involving the Public in Research. R&D related education was delivered to 153 members of staff (compared with 254 in 11 – 12, 171 in 10 – 11, 109 in 09-10, 169 in 08-09, 148 in 07-08, 98 in 06-07, and 82 in 05-06). The Research & Development Department offered ad hoc sessions organised for departments at their request often to tie in with pre-existing study days. This meant disruption to clinical commitments was kept to a minimum for staff that would otherwise have had to request time off to attend the education sessions.

Evaluations of the training provided are available in Appendix 3.

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3.4.3 Targets identified within NHS Fife R&D Strategy (12-13)

WORKING IN PARTNERSHIP WITH STAFF Outcomes

Increasing the number of staff actively involved in research and development activity

Achieved (see 3.2.5 above)

Deliver a research education and development programme aimed at increasing the capability of staff to undertake research

Continues to be achieved

Increase the number of staff participating in the research training programme

Places booked: 82 (05-06) 98 (06-07) +19.5% 148 (07-08) + 51% 169 (08-09) + 14% 109 (09-10) – 35% 171 (10 -11) + 56% 254 (11 – 12) + 48% 153 (12 – 13) - 40%

Support staff registered for higher degrees Continues to be achieved

3.5 PATIENT AND PUBLIC INVOLVEMENT IN RESEARCH

Ensuring the involvement of consumers in the research process in the development and execution of research projects where appropriate should be important to every NHS organisation. Findings over the past 10 years have shown a marked increase in the success of research which has involved service users in its design and implementation. A member of the Patients Forum who has a special interest in research is an active member of the NHS Fife Research Governance Group and has also participated in the Fife Research Day Planning Group. The Fife and Forth Valley Research Ethics Committee also has strong lay representation.

3.5.1 Targets identified in the NHS Fife R&D Strategy (12-13)

PATIENT AND PUBLIC INVOLVEMENT IN RESEARCH Outcomes

Ensure that there is patient and public representation on relevant R&D groups

Continues to be achieved

Involve patients and the public in the development of patient information relating to research projects

Continues to be achieved

3.6 COMMUNICATING RESEARCH INFORMATION ACROSS NHS FIFE

Two-way communication of Research information across NHS Fife has presented a significant challenge due to the dispersed nature of the organisation. Although key research information is currently held within public folders within Outlook, these will be transferred to an NHS Fife R&D webpage during the coming year.

3.6.1 Internal Communications

Email updates on the research training programme, R&D support and details of the annual Research Day are circulated regularly. Biweekly electronic research ‘bulletins’ are sent to all research active staff (past and present),

24

providing up to date information about advice clinics, conferences, seminars, workshops and funding opportunities within and out with NHS Fife. To reach staff that do not have access to the organisation-wide emails, details of the R&D Department, its staff and the support on offer have been placed on notice boards across the organisation. A quarterly R&D Newsletter has been drafted and will be produced in 2013, accessible via the intranet.

3.6.3 Target identified in the NHS Fife R&D Strategy (12-13)

COMMUNICATING RESEARCH INFORMATION ACROSS NHS FIFE

Outcomes

In advance of a fully operational NHS Fife intranet, research information will be provided as a 2 weekly electronic bulletin

Continues to be achieved

4.0 RESEARCH & DEVELOPMENT SUPPORT

The facilitation and support of research, driving the delivery of effective systems of research management and governance are the key aims of the R&D Department. The NHS Fife Executive Lead for Research and Development and the Research Director have enabled the organisation and the R&D team to continue to support the development and implementation of the R&D strategy and significantly raise the profile of R&D within and out with NHS Fife.

The R&D Department accommodates the: NHS Fife R&D Director, NHS Fife R&D Manager, R&D Coordinator, Research Governance Officer, R&D Support Officer, 2 Generic R&D Research Nurses (1 funded by CSO infrastructure funding), Scottish Cancer Research Network Research Nurse & the R&D Stroke Research Nurse, and part funded posts in Diabetes, Mental Health and Dementia. R&D staff support and manage research to ensure its quality, compliance with legislation and guidance, and good governance, with the ultimate aim of improving patient care. They advise on and manage the R&D process registering, administering and monitoring all research; providing help and support to researchers; coordinating and facilitating all research; identifying & addressing research training and education needs; negotiating optimal terms with sponsors and funders to ensure full cost recovery; identifying, protecting and exploiting intellectual property.

The R&D Department also coordinates the preparation and submission of the NHS Fife Research Strategy, NHS Fife’s Annual R&D reports on expenditure and activity to the Scottish Government, Support for Science data collection exercise which determine support received and the Research Governance Compliance reports.

5.0 RESEARCH PUBLICATIONS

A number of NHS Fife researchers had research papers published in peer reviewed and professional health-related journals in 2012-13 (Appendix 4). Research presentations and papers presented at conferences are also detailed. In total there were 80 peer reviewed publications in 2012 – 13.

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6.0 UPDATE ON CHALLENGES IDENTIFIED IN THE 2011-12 RESEARCH & DEVELOPMENT ANNUAL REPORT FOR 12-13

In order to ensure the successful implementation of the NHS Fife Research Strategy a series of annual ‘priorities’ have been selected from it, to be progressed. Identified priorities and challenges established to be taken forward within Research & Development in 2012 -13 were as follows:

a. We have continued with the long process of encouraging discussion of research as part of Personal Development Plans within the operational division and CHPs during appraisals of health care staff.

b. R&D participation in the development of the medical and nursing

clinical academic career development in Fife has been continued.

c. Details of research-related academic degree programmes and bursaries have been circulated, resulting in increased numbers of applications and to encourage staff to apply

d. Formal links and mutual joint strategic priorities with the School of

Medical and Biological Sciences, University of St Andrews have been achieved as a consequence of the signed memorandum of understanding between St Andrews University and NHS Fife.

e. We will continue to seek the establishment of PhD programmes/short

term senior research fellows from possible endowment funds within NHS Fife in close liaison with neighbouring universities and other academic institutions.

f. We have continued to support and participate as an active member of

the NHS Research Scotland (NRS) East of Scotland research node by establishing for example joint standard operating procedures, with a view to future co-sponsorship agreements.

g. We have continued to support and consolidate the joint Tayside and

Fife Health Informatics Centre Prescribing Database to enable service based evaluations.

h. The grant writing /mentoring scheme jointly run by R&D Team and the

Nursing Midwifery and Allied Health Professions Research Unit (NMAHP RU) is currently on hold.

i. We have identified a location for and secured agreement for

development of a local Clinical Research Facility within NHS Fife. 7.0 CHALLENGES FOR RESEARCH & DEVELOPMENT IN 2013-14

Selected from the Strategic Plan of Activities and Priorities set for 2013-14:

i. Formal links and mutual joint strategic priorities will be established with the

School of Medical and Biological Sciences, University of St Andrews as a

26

consequence of the signed memorandum of understanding between St Andrews

University and NHS Fife.

ii. Development of the joint Tayside and Fife Health Informatics Centre Prescribing

Database will be consolidated to enable service based evaluations.

iii. The business case for local clinical research facilities within Fife using existing

opportunities and resources will be reviewed with the ambition of delivering a

CRF within the financial year 2013-14.

iv. NHS Fife involvement with the TAyside medical Science Centre (TASC) between

the Universities of Dundee, St Andrews and NHS Tayside will continue to

formalised.

v. We will seek to maximise commercial research opportunities locally and with East

of Scotland Node partners

vi. A dedicated research website will be established

vii. We will continue to engage public involvement on all research committees

/groups

8.0 CONCLUSIONS

Progress has been made implementing many aspects of the Research & Development Strategy, promoting the research agenda, developing a research culture and raising the profile of R&D, whilst continuing to build strong alliances with colleagues with the wider research communities. The NHS Fife Executive Lead for Research and Development, Research & Development Director and Research & Development Manager have ensured a significant raising of the profile of NHS Fife R&D and promotion of Fife as an important, emerging player in the current, and future Scottish research agenda.

DR AMANDA WOOD NHS Fife R&D Manager

DR STELLA CLARK NHS Fife Executive Lead for Research and Development

DR ALEX BALDACCHINO NHS Fife Research Director

With special thanks to AMY SCOBIE, R&D Support Officer for input into this report.

9.0 RECOMMENDATION

The Clinical Governance Committee is asked to:

Note the contents of this paper.

June 2013

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APPENDIX 1

RESEARCH ACTIVITY WITHIN NHS FIFE 2012 - 2013

NUMBER OF REGISTERED PROJECTS

0

50

100

150

200

250

300

2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13

YEAR

NO

. O

F R

EG

IST

ER

ED

PR

OJ

EC

TS

NUMBER OF NHS FIFE RESEARCHERS

0

50

100

150

200

250

300

350

2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13

YEAR

NO

. O

F N

HS

FIF

E R

ES

EA

RC

HE

RS

28

APPENDIX 2 NHS FIFE RESEARCH & DEVELOPMENT SUPPORT STRUCTURE 2012 - 2013

Research Governance

Officer

R&D Support Officer

R&D Mental Health

Research Nurse (P/T)

R&D SCRN Research

Nurse

R&D Stroke Research

Nurse

R&D Research

Nurse

R&D Research

Nurse

R&D Dementia Research

Nurse (P/T)

R&D Coordinator

R&D Manager Finance Support

R&D Director

Legal Services

Support and Advice

Professional Accountability

Director of Clinical Delivery

NHS Fife Executive Lead for R&D

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Figure 1. Relevance of Workshop

YES NO RESPONSE

Figure 2. Will use knowledge from workshop

YES NO RESPONSE

APPENDIX 3

EVALUATIONS OF R&D EDUCATION PROGRAMME TRAINING 2012 - 2013

30

Figure 3. Organisation of Workshop

EXCELLENT GOOD

Figure 4. Overall Rating of Workshop

EXCELLENT GOOD

31

APPENDIX 4

NHS FIFE RESEARCH PUBLICATIONS 2012-13

Publications

Baldacchino A., Balfour D., Passetti F., Humphris G., Matthews K. (2012). The neuropsychological consequences of chronic opioid use: a quantitative review and meta-analysis. Neuroscience and Biobehavioral Reviews 36, 2056-2068.

Frisher M., Baldacchino A., Crome I, Bloor R (2012). Non-fatal opioid overdoses: extent of the problem in Europe and critical assessment of known risk factors and circumstances, including factors that may lead to a fatal outcome. EMCDDA, European Commission, Lisbon.

Baldacchino A., Blair H., Scherbaum N., Grosse-Vehne E., Riglietta M., Tidone L., Sommer B., Tan L, Little H., Galea S, Crome I. (2012). Clinical outcomes for psychotic and co-morbid patients admitted to acute psychiatric wards in four European centres - Follow up to 6 months. Journal of Mental Health and Substance Use: Dual Diagnosis 5(3), 240-253.

Baldacchino A., Hughes Z, Kehoe M., Blair H., The Y., Windeatt S., Crome I. (2012). Cannabis psychosis: Examining the evidence for a distinctive psychopathology: a systematic and narrative review. American Journal of Addictions (in press).

Charzynska K, Hyldager E, Baldacchino A., Greacen T., Henderson Z., Laijarvi H, Hodges C.K, Sier oslavska J, Baeck-Moller K. (2012). Comorbidity patterns in dual diagnosis across seven European sites. European Journal of Psychiatry 25(4), 179-191.

Bedford L. & Townend E. (2012) ‘Reflections on being employed in the NHS while an MSc in Health Psychology student’, Health Psychology Update, Vol. 21, Issue 2, Autumn 2012, pp 25-28.

HE Harris, S Brannan, G Venters, A McQuillian, F Lovegrove, J Gibson, DJ Chinn, JS McLaren. Have you been to CAPRI? www.capri.scot.nhs.uk: early results of a clinic for arthritis patients in remission on the internet. Rheumatology, 2012; 51 (Suppl 3): 45.

Chinn DJ, Davis A, Sharma S. (2013) Prediction of post-operative pain following arthroscopic subacromial decompression surgery: an observational study. F1000Research 2013, 2:31 (doi: 10.12688/f1000research.2-31.v1)

Chisholm, C; Love, J (2012) Talking Mats Communication Framework. NHS Fife AHP News 2(2):3

Chung, J (2011) Development of an occupational therapy neuropsychological assessment forum in Fife. Dementia AHPproaches 1(3):2 Chung, J (2012) South of Scotland Cognitive Behavioural Course 2012/13 NHS Fife Allied Health Professions News 2(3) 2

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Clark, N. (2012) Big Lottery Award for Employ Your Mind Project in Fife NHS Fife AHP News 2(2):2 Clark, N. (2013) OT clinical supervision: a journey of service development. OT News March 2013 42:43

Colhoun H. (2012) Association of LDL cholesterol, non-HDL cholesterol, and apolipoprotein B levels with risk of cardiovascular events among patients treated with statins: a meta-analysis. JAMA. 2012 Mar 28;307(12):1302-9. Erratum in: JAMA. 2012 Apr 25;307(16):1694. JAMA. 2012 May 9;307(18):1915.

Colhoun H. (2012) Genome-wide association study of genetic determinants of LDL-c response to atorvastatin therapy: importance of Lp(a). J Lipid Res. 2012 May;53(5):1000-11. Epub 2012 Feb 24.

Alkayyali S, Lajer M, Deshmukh H, Ahlqvist E, Colhoun H, Isomaa B, Rossing P, Groop L, Lyssenko V. Common variant in the HMGA2 gene increases susceptibility to nephropathy in patients with type 2 diabetes Diabetologia in press.

Livingstone SJ, Looker HC, Hothersall E, Wild SH, Lindsay RS, Chalmers J, Cleland S, Leese GP, McKnight J, Morris AD, Pearson DW, Peden NR, Petrie JR, Philip S, Sattar N, Sullivan F, Colhoun H. Risk of Cardiovascular Disease and Total Mortality in Adults with Type 1 Diabetes: Scottish Registry Linkage Study PLos Med. 2012 Oct;0(10):e1001321. Doi: 10.1371/journal.pmed.1001321. Epub 2012 Oct 2. PMID: 23055834 {PubMed – in process}

Colhoun H, Livingstone SJ, Looker HC, Morris AD, Wild SH, Lindsay R, Reed C, Donnan PT, Guthrie B, Leese GP, McKnight J, Pearson DW, Pearson E, Petrie JR, Philip S, Sattar N, Sullivan FM, McKeigue P. Hospitalised Hip Fracture Risk with Rosiglitazone and Pioglitazone Use Compared with other Anti-diabetic Drugs. Diabetologia. 2012 Nov;55(11):2929-2937

Sandholm N, Salem RM, McKnight AJ, Brennan EP, Forsblom C, Isakova T, McKay GJ, Williams WW, Sadlier DM, Mäkinen VP, Swan EJ, Palmer C, Boright AP, Ahlqvist E, Deshmukh HA, Keller BJ, Huang H, Ahola AJ, Fagerholm E, Gordin D, Harjutsalo V, He B, Heikkilä O, Hietala K, Kytö J, Lahermo P, Lehto M, Lithovius R, Osterholm AM, Parkkonen M, Pitkäniemi J, Rosengård-Bärlund M, Saraheimo M, Sarti C, Söderlund, Soro-Paavonen A, Syreeni A, Thorn LM, Tikkanen H, Tolonen N, Tryggvason J K, Tuomilehto J, Wadén J, Gill GV, Prior S, Guiducci C, Mirel DB, Taylor A, Hosseini SM; DCCT/EDIC Research Group, Parving HH, Rossing P, Tarnow L, Ladenvall C, Alhenc-Gelas F, Lefebvre P, Rigalleau V, Roussel R, Tregouet DA, Maestroni A, Maestroni S, Falhammar H, Gu T, Möllsten A, Cimponeriu D, Ioana M, Mota M, Mota E, Serafinceanu C, Stavarachi M, Hanson RL, Nelson RG, Kretzler M, Colhoun H, Panduru NM, Gu HF, Brismar K, Zerbini G, Hadjadj S, Marre M, Groop L, Lajer M, Bull SB, Waggott D, Paterson AD, Savage DA, Bain SC, Martin F, Hirschhorn JN, Godson C, Florez JC, Groop PH, Maxwell AP. New susceptibility Loci associated with kidney disease in type 1 diabetes. PLoS Genet 2012 Sep;8(9):e10002921. Doi: 10.1371/journal.pgen.1002921

Kennon B, Leese GP, Cochrane L, Colhoun H, Wild S, Strang D, Sattar N, Pearson D, Lindsay RS, Morris AD, Livingstone S, Young M, McKnight J, Cunningham S Reduced Incidence of Lower-Extremity Amputations in People with Diabetes in Scotland: A nationwide study Diabetes Care. 2012 Sep 25.

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Chasman DI, Fuchsberger C, Pattaro C, Teumer A, Böger CA, Endlich K, Olden M, Chen MH, Tin A, Taliun D, Li M, Gao X, Gorski M, Yang Q, Hundertmark C, Foster MC, O'Seaghdha CM, Glazer N, Isaacs A, Liu CT, Smith AV, O'Connell JR, Struchalin M, Tanaka T, Li G, Johnson AD, Gierman HJ, Feitosa MF, Hwang SJ, Atkinson EJ, Lohman K, Cornelis MC, Johansson A, Tönjes A, Dehghan A, Lambert JC, Holliday EG, Sorice R, Kutalik Z, Lehtimäki T, Esko T, Deshmukh , H, Ulivi S, Chu AY, Murgia F, Trompet S, Imboden M, Coassin S, Pistis G; CARDIoGRAM Consortium; ICBP Consortium; the CARe Consortium; WTCCC2

Harris TB, Launer LJ, Aspelund T, Eiriksdottir G, Mitchell BD, Boerwinkle E, Schmidt H, Cavalieri M, Rao M, Hu F, Demirkan A, Oostra BA, de Andrade M, Turner ST, Ding J, Andrews JS, Freedman BI , Giulianini F, Koenig W, Illig T, Meisinger C, Gieger C, Zgaga L, Zemunik T , Boban M, Minelli C, Wheeler HE, Igl W, Zaboli G, Wild SH, Wright AF, Campbell H, Ellinghaus D, Nöthlings U, Jacobs G, Biffar R, Ernst F, Homuth G, Kroemer HK, Nauck M, Stracke S, Völker U, Völzke H, Kovacs P, Stumvoll M, Mägi R, Hofman A, Uitterlinden AG, Rivadeneira F, Aulchenko YS, Polasek O, Hastie N, Vitart V, Helmer C, Wang JJ, Stengel B, Ruggiero D, Bergmann S, Kähönen M, Viikari J, Nikopensius T, Province M, Ketkar S, Colhoun H, Doney A, Robino A, Krämer BK, Portas L, Ford I, Buckley BM, Adam M, Thun GA, Paulweber B, Haun M, Sala C, Mitchell P, Ciullo M, Kim SK, Vollenweider P , Raitakari O, Metspalu A, Palmer C, Gasparini P, Pirastu M, Jukema JW, Probst-Hensch NM, Kronenberg F, Toniolo D, Gudnason V, Shuldiner AR, Coresh J, Schmidt R, Ferrucci L, Siscovick DS, van Duijn CM, Borecki IB, Kardia SL, Liu Y, Curhan GC, Rudan I, Gyllensten U, Wilson JF, Franke A, Pramstaller PP, Rettig R, Prokopenko I, Witteman J, Hayward C, Ridker PM, Parsa A, Bochud M, Heid IM, Kao WL, Fox CS, Köttgen A. Integration of Genome-Wide Association Studies with Biological Knowledge Identifies Six Novel Genes Related to Kidney Function.Hum Mol Genet. 2012 Sep 25 2012

Govan L, Maietti E, Torsney B, Wu O, Briggs A, Colhoun H, Fischbacher CM, Leese GP, McKnight JA, Morris AD, Sattar N, Wild SH, Lindsay RS on behalf of the Scottish Diabetes Research Network (SDRN) Epidemiology Group The effect of deprivation and HbA1c on admission to hospital for diabetic ketoacidosis in type 1 diabetes. Diabetologia. 2012 Sep;55(9):2356-60

Looker H.C., Nyangoma S.O., Cromie D., Olson J.A., Leese G.P., Black M., Doig J., , Lee N. Lindsay R.S., McKnight J.A., Morris A.D., Philip S., Sattar N., Wild S.H., Colhoun H on behalf of The Scottish Diabetic Retinopathy Screening Collaborative and the Scottish Diabetes Research Network Epidemiology Group. Diabetologia. 2012 Sep;55(9):2335-42. Diabetic Retinopathy at Diagnosis of Type 2 Diabetes in Scotland

Preiss D, Tikkanen MJ, Welsh P, Ford I , Lovato LC, Elam MB, LaRosa JC, DeMicco DA, Colhoun H , Goldenberg I, Murphy MJ, MacDonald TM, Pedersen TR, Keech AC, Ridker PM, Kjekshus J, Sattar N, McMurray JJ. Lipid-modifying therapies and risk of pancreatitis: a meta-analysis. JAMA. 2012 Aug 22;308(8):804-11.

van Leeuwen N, Nijpels G, Becker ML, Deshmukh H, Zhou K, Stricker BH, Uitterlinden AG, Hofman A, van 't Riet E, Palmer CN, Guigas B, Slagboom PE, Durrington P, Calle RA, Neil A, Hitman G, Livingstone SJ, Colhoun H, Holman RR, McCarthy MI, Dekker JM, 't Hart LM, Pearson ER. A gene variant near ATM is

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significantly associated with metformin treatment response in type 2 diabetes: a replication and meta-analysis of five cohorts. Diabetologia. 2012 Jul;55(7):1971-7. doi: 10.1007/s00125-012-2537-x.

Colhoun H, Livingstone SJ, Looker HC, Morris AD, Wild SH, Lindsay RS, Reed C,

Donnan PT, Guthrie B, Leese GP, McKnight J, Pearson DWM, Pearson E, Petrie

JR, Philip S, Sattar N, Sullivan FM, McKeigue P for the Scottish Diabetes Research

Network Epidemiology Group. Hospitalised Hip Fracture Risk with Rosiglitazone and

Pioglitazone Use Compared with other Anti-diabetic Drugs Diabetologia 2012;

55(11): 2929-2937

Boekholdt SM, Arsenault BJ, Mora S, Pedersen TR, LaRosa JC, Nestel PJ, Simes RJ, Durrington P, Hitman GA, Welch KM, DeMicco DA, Zwinderman AH, Clearfield MB, Downs JR, Tonkin AM, Colhoun H, Gotto Jr AM, Ridker PM, Kastelein JJ. Association of LDL cholesterol, non-HDL cholesterol, and apolipoprotein B levels with risk of cardiovascular events among patients treated with statins: a meta-analysis. JAMA. 2012 Mar 28;307(12):1302-9. Erratum in: JAMA. 2012 Apr 25;307(16):1694. JAMA. 2012 May 9;307(18):1915.

Colhoun H. Meta-analysis participation: Cholesterol Treatment Trialists' (CTT) Collaboration, Emberson JR, Kearney PM, Blackwell L et al. Lack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy. PLoS One. 2012;7(1):e29849. Epub 2012 Jan 19.

Curnow, E (2012) Tailored Activity Program (TAP) NHS Fife Allied Health Professions News 2(5) 4 Sept. Curnow, E (2012) Fife Mental Health Occupational Therapy Service wins ROMPA competition for Poster about Social Group for People with mental health problems including dementia. Dementia AHPproaches 2(2) 6 Davidovic, E. (2012) OT Healthcare Support worker’s experience of a formal practice placement with Alzheimer’s Scotland NHS Fife Allied Health Professions News 2(3) 7:8 Dorman, L. (2012) Long Term Conditions Alliance Scotland NHS Fife Allied Health Professions News 2(5) 7 Sept. Gawander, J. (2012) Establishment of An Occupational Therapy Assessment Clinic Dementia AHPproaches 2(1)12 June 2012

Leslie W S, Gibson A, and Hankey C R (2013) Prevention and Management of excessive gestational weight gain: a survey of overweight and obese pregnant women. BMC Pregnancy & Childbirth 2013. www.biomedcentral.com/1471-2393/13/10.

Duffy MA, Hernandez Santiago V, Orange G, Davey PG, Guthrie B. Prior

trimethoprim prescription and trimethoprim resistance in childhood urinary tract

infections: multilevel modelling of population data 2004-2009. British Journal of

General Practice 2013; 623: e238-e243

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Payne RA, Abel GA, Guthrie B, Mercer SW. The impact of physical multimorbidity,

mental health conditions and socioeconomic deprivation on unplanned hospital

admissions: a retrospective cohort study. CMAJ 185:E221-E228: online publication

ahead of print Feb 2013

Saunders C, Byrne CD, Guthrie B, Lindsay R, McKnight J, Philip S, Sattar N,

Walker JJ, Wild SH on behalf of the Scottish Diabetes Research Network

Epidemiology Group. External validity of randomised controlled trials in glycaemic

control and the influence on vascular disease: how representative are participants?

Diabetic Medicine 2013;30(3);300-308

Morales DR, Jackson C, Fielding S, Guthrie B. Long acting β-agonist prescribing in

people with asthma in primary care. Thorax 2013; 68:192-194

McCowan C, Magin P, Clark S, Guthrie B. An observational study of psychotropic

drug use in older patients resident in their own home or in care. Age and Ageing

2013; 42(1):51-56

Hughes L, McMurdo M, Guthrie B. Guidelines for people not for diseases: the

challenges of applying UK clinical guidelines to people with multimorbidity. Age and

Ageing 2013; 42(1): 62-69

Grant A, Treweek S, Dreischulte T, Foy R, Guthrie B. Process evaluations for

cluster-randomised trials of complex interventions: a proposed framework for design

and reporting. Trials 2013;14:15

Guthrie B, Treweek S, Petrie D, Barnett K, Ritchie LD, Robertson C, Bennie M.

Protocol for the Effective Feedback to Improve Primary Care Prescribing Safety

(EFIPPS) study: a cluster randomised controlled trial using ePrescribing data

(clinicaltrials.gov registration NCT01602705). BMJ Open 2012; 2(6)

Guthrie B, Payne K, Alderson P, McMurdo MET, Mercer SW. Adapting clinical

guidelines to take account of multimorbidity. BMJ 2012;345:e6341

Mercer SW, Gunn J, Bower P, Wyke S, Guthrie B. Managing patients with mental

and physical health comorbidity. BMJ 2012;345:e5559

Grant A, Dreischulte T, Treweek S, Guthrie B. Protocol of a mixed methods

evaluation of a cluster randomised trial to improve the safety of NSAID and

antiplatelet prescribing: Data-driven quality improvement in primary care (DQIP).

Trials 2012; 13:154

Smith BH, Guthrie B, Sullivan FM, Morris AD. A thesis that still warrants defence

and promotion: Commentary on Mackenzie J. A defence of the thesis that “The

opportunities of the general practitioner are essential for the investigation of disease

and the progress of medicine”. Br Med J 1921 1 (3153) 797-804. International

Journal of Epidemiology 2012; 41(6): 1518-1522

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Mercer S., Guthrie B., Furler J., Watt G., Hart J.T. Multimorbidity and the inverse

care law in primary care. BMJ 2012;344:e4152

Barnett K., Mercer S., Norbury M., Watt G., Wyke S., Guthrie B. The epidemiology

of multimorbidity in a large cross-sectional dataset: implications for health care,

research and medical education. The Lancet 2012: 380; 37-43

Dreischulte T., Guthrie B.. High-risk prescribing and monitoring in primary care: how

common is it, and how can it be improved? Therapeutic Advances in Drug Safety

2012; 3(12): 175-184

Murphy D., Guthrie B., Sullivan S., Mercer S., Russell A., Bruce D.. Insightful

Practice: a useful measure for professional revalidation. BMJ Quality and Safety

2012;21(8);649-656

Dreischulte T., Grant A., McCowan C., McAnaw J., Guthrie B.. Quality and safety of

medication use in primary care: consensus validation of a new set of explicit

medication assessment criteria and prioritisation of topics for improvement. BMC

Clinical Pharmacology 2012:12;5 doi:10.1186/1472-6904-12-5

Dreischulte T., Grant A., Donnan P., McCowan C., Davey P., Petrie D., Treweek S., Guthrie B. A cluster randomised stepped wedge trial to evaluate the effectiveness of a multifaceted IT-based intervention in reducing high-risk prescribing of non-steroidal anti-inflammatory drugs and antiplatelets in primary medical care: The DQIP study protocol. Implementation Science 2012; 7:24

Hodgkinson, K & Newman, M (2012) Gaining Confidence through Creativity Dementia AHPproaches 2(1)10 June 2012 Lindsay, G (2012) Gardening as a Therapeutic Activity. Carousel presentation at European Year for Active Ageing and Solidarity between Generations 2012 Long Term Conditions Alliance Scotland, Scottish Parliament Friday 27th April 2012 Lindsay, G (2012) The Occupational therapy Service Therapeutic Garden Dementia AHPproaches 2(1)5 June 2012

McElhinney, R, Morton, L. and Reid, H. A Controlled Trial of a CBT Group for Women with Low Self-Esteem submitted to 'The Cognitive Behaviour Therapist' (under review 2013).

Mitchell G. (2013) Depression and Anxiety Following Psychosis: Associations with Mindfulness and Psychological Flexibility. Behavioural and Cognitive Psychotherapy 41(1) 34-51.

Mitchell, G. & McArthur, A. (2013) ‘Developing acceptance and commitment therapy for psychosis as a group-based intervention’, in E. M. J., Johns, L. C. & Oliver, J. E. (Eds) ‘Acceptance and Commitment Therapy and Mindfulness for Psychosis’, Wiley-Blackwell (Ch 15, pp 219-239)

Mitchell, G. & McArthur, A. (2013) ‘Acceptance and commitment therapy for psychosis in acute psychiatric admission settings Morris’, in E. M. J., Johns, L. C. &

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Oliver, J. E. (Eds) ‘Acceptance and Commitment Therapy and Mindfulness for Psychosis’, Wiley-Blackwell (Ch 14, pp 206-218)

Morton, L. From The Heart: What can Psychology offer the Congenital Heart Population? New Voices Article in The Psychologist (accepted for publication 2013)

Morton L. (2012) Part 1: ‘Some Emotional Challenges of Growing Up with a Heart Condition’, GUCH News, Issue 68, Spring.

Morton L. (2012) Part 2: ‘What can Psychology offer Congenital Heart Disease Survivors?’ GUCH News, Issue 69, summer.

Morton L. (2012) Part 3: ‘Some more Psychological Therapies’. GUCH News, Issue 70, autumn.

Morton L. (2012) Part 4: ‘The Good News’. GUCH News, Issue 71, winter.

Morton L., Roach L., Reid H., Hallam-Stewart S. (2012) ‘An Evaluation of a CBT Group for Women with Low Self-Esteem, Behavioural and Cognitive Psychotherapy’, Vol. 40, 221-225.

Nesbit K., Dale H., King K. (2012) ‘the impact of healthy lifestyle interventions on psychological health: a systematic review’. Submitted to British Journal of Health Psychology, awaiting allocation.

Pickles C. ‘Language, meaning and the inner Cartesian computational world’ Journal of Theory and Psychology (Sage publications) - submission date- May 2012

Pickles, C. (2013) Valuing the Flourishing Life, accepted for publication Jan 2013, European Journal of Person Centred Medicine; to be published 2013

Pickles, C. (2013) on being a Therapist and a Person: Self-reflection, Science and Impartiality, accepted for publication, April 2013, Journal of Integrative Psychotherapy; to be published 2013

Porter E. (2012) ‘Developing the Pregnancy Support Pack for People who have a Learning Disability’, British Journal of Learning Disabilities (currently published on ‘early view’ awaiting publication in journal).

Porter E., Kidd G., Murray N., Utyman C., Spink A., Anderson A. (2012) ‘Developing the pregnancy support pack for people who have a learning disability’. British Journal of Learning Disabilities.

Porter E., Kidd G., Murray N., Utyman C., Spink A., Anderson A. (2012) ‘Developing the pregnancy support pack for people who have a learning disability’. British Journal of Learning Disabilities.

Prattis, C; Love, J (2012) Dementia: A six party study course for Health Care Assistants - reflections from Fife Dementia AHPproaches 1(4):4

Quinn K. (2012) ‘Reshaping Care for Older People: The Role of Psychology in ICASS’, (poster) presented at the Reshaping Care for Older People Event, 1/6/12

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Campbell M., Robertson A. & Jahoda A. (accepted Sep 2012) ‘Psychological Therapies for People with Intellectual Disabilities: Comments on a Matrix of evidence for interventions in challenging behavior’, Journal of Intellectual Disability Research.

Roach L. (2013). Guilt, dysfunctional thought processes and depression in caregivers of people with dementia. Unpublished doctoral thesis, University of Edinburgh.

Roach L., Laidlaw K., Gillanders D., Quinn K., (2013). Validation of the Caregiver Guilt Questionnaire (CGQ) in a sample of British dementia caregivers. Manuscript submitted for publication.

Campbell M., Robertson A., Jahoda A. (accepted Sep 2012) ‘Psychological Therapies for People with Intellectual Disabilities: Comments on a Matrix of evidence for interventions in challenging behavior’, Journal of Intellectual Disability Research.

Robinson C., Lanza P.. (2012) ‘Application of Psychology in an NHS Setting: Development of a multicomponent lifestyle behaviour change intervention for a pilot diabetes metabolic surgery service in Fife’, Health Psychology Update, Vol. 21, Issue 2, Autumn 2012, pp 7-11.

Samuels, T (2012) Employ Your Mind Interview with Norma Clark, AHP Lead, NHS Fife. OT News July 2012 p35

Presentations

Dale H., Peden C. (2012). Risky Driving in Young People: The effect of the Safe Drive Stay Alive initiative on driving behaviour and determinants of behaviour. NHS Fife Department of Psychology Biannual Conference; Dunfermline; December 2012. Oral Presentation.

Dale H., Watson L., Adair P., & Humphris G. Evaluation of an innovative behaviour change intervention for looked after young people through a partnership between Health Psychology and Public Health. Faculty of Public Health Conference; Crieff; November 2012. Oral presentation.

Dale H., Watson L. The devlopment and evaluation of a health behaviour change service for looked after young people. European Scientific Association on Residential & Foster Care for Children and Adolescent; Glasgow; September 2012. Oral presentation.

Dale H., Watson L. The devlopment and evaluation of a health behaviour change service for looked after young people. European Scientific Association on Residential & Foster Care for Children and Adolescent; Glasgow; September 2012. Oral presentation.

Neville F., Williams D J, Goodall C, & Donnelly P. D (2012). Transdermal alcohol monitoring: Analysis of a pilot study. Modernising Justice Conference, London 14th June.

Neville F., Williams D J, Goodall C, & Donnelly P. D (2012). Transdermal alcohol monitoring as a tool to change behaviour. CPD to Fife Public Health Department, Leven, 4th July.

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Neville F., Williams D J, Goodall C, Murer J S, & Donnelly P. D. (2012). An exploration of transdermal alcohol monitoring among university students in Scotland. British Psychological Society Social Psychology Section Annual Conference 2012, St Andrews, 21st-23rd August.

Williams D J, Murer J S, & Donnelly P. D (2012). What can public health learn from social psychology? Viewing gangs as collectives and the implications for violence prevention. British Psychological Society Social Psychology Section Annual Conference 2012, St Andrews, 21-23 August

Gavine A J, Donnelly P. D, Goodall C & Williams D J. (2012). Establishing an evidence base for the prevention of youth violence: Evaluation of the Medics Against Violence programme. International Society for Social Paediatrics and Child Health Annual Conference, St Andrews, Scotland, 6-8 September.

Neville F, Williams D J, Goodall C, & Donnelly P. D (2012). An exploration of transdermal alcohol monitoring among university students in Scotland. Glasgow Family Law and Social Services Seminar, Glasgow, 1st October.

Harvey M J, Williams D J, Neville F, & Donnelly P. D (2012). Utilizing systems thinking to conceptualize and inform economic evaluation of an assets-based approach to addressing health inequalities: A case study from Scotland. American Public Health Association 140th Annual Conference, San Francisco, CA, 27th-31st October, 2012.

Neville, F., Williams, D. J., Goodall, C., & Donnelly, P. D. (2012). Transdermal Alcohol Monitoring: Preliminary Findings from a Project into Alcohol and Violence. The Carter Center, Atlanta, 5th November.

Linden, W., Neville, F., Williams, D. J., Goodall, C., & Donnelly, P. D. (2012). Transdermal Alcohol Monitoring: Preliminary Findings from a Project into Alcohol and Violence. 8th CEP Conference on Electronic Monitoring in Europe, Bålsta, 8th-10th November.

Neville, F., Williams, D. J., Goodall, C., & Donnelly, P. D. (2012). Glass of 2012: Alcohol consumption, attitudes and social norms at a Scottish university. Faculty of Public Health Scotland Annual Conference, Crieff, 8th-9th November. (Presenter)

Neville, F., Williams, D. J., Goodall, C. Murer, J. S., & Donnelly, P. D. (2012). University spirit: An experimental trial exploring the experience and efficacy of transdermal alcohol monitoring at a Scottish university. Faculty of Public Health Scotland Annual Conference, Crieff, 8th-9th November.

Williams, D. J., Neville, F. G., & Donnelly, P. D. (2012). Exploring the association between Old Firm derbies and incidents of community and domestic violence within Glasgow. Faculty of Public Health Scotland Annual Conference, Crieff, 8th-9th November.

Goodall C, Shaw D, Linden W, McCluskey K, Williams D, Neville F and Donnelly P. D (2012) The ethics of sobriety testing in criminal justice. Faculty of Public Health Scotland Annual Conference, Crieff, 8th-9th November.

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Gavine, A. J., Donnelly, P. D., Goodall, C. & Williams, D. J. (2013). The involvement of healthcare workers in delivering school-based violence prevention programmes: Limiting and motivating factors. NADEGS Annual Conference. Dundee, Scotland, 24th-25th January.

Goodall, C., Neville, F., Williams, D. J., & Donnelly, P. D. (2013). The potential of continuous transdermal alcohol monitoring to support changes in drinking behaviour. 6th Australasian Drug and Alcohol Strategy Conference, Sydney, Australia, 19th-22nd March.

Taylor J., Bradbury-Jones C., Duncan F., Kroll T.. British Association for the Study and prevention of Child Neglect 8th Congress Queens University Belfast. Presentation of paper: Health professionals’ Response to Disclosure about Domestic Abuse: Attitudes to Children 2012.

Gallen K. A Randomised Control Trial of CBT Based Self-Help for Fatigue in Multiple Sclerosis Presentation. NHS Fife Psychology Conference. December 2012.

Guthrie B. March 2013. Invited presentation - Multimorbidity and polypharmacy in UK primary care: from epidemiology to interventions. University of Zurich

Guthrie B. March 2013. Multimorbidity and polypharmacy in Scotland: epidemiology, implications and potential interventions for the most complex patient. NHS Fife Grand Round

Guthrie B. February 2013. Invited presentation - Multimorbidity and the Last Phase of Life conference, Edinburgh

Guthrie B. February 2013. Invited presentation - The NIHR Health Services and Delivery Research Programme. National Institute for Health Research Primary Care Themed call, London.

Guthrie B. April 2012. Invited presentation - Teaching critical reading and thinking skills for clinical practice. South East Scotland Trainers’ Workshop

Guthrie B. April 2012. Invited presentation - Time trends in psychoactive prescribing to people with dementia in Scotland 2001-2011. Scottish Government Health Department Dementia Strategy Group

Guthrie B. October 2012. Invited presentation - Multimorbidity in Scotland Scottish Government Health Directorates Quality Strategy Effective Delivery Group, Edinburgh.

Guthrie B. October 2012. The rising tide of polypharmacy and potentially serious drug interactions 1995-2010: repeated cross-sectional analysis of dispensed prescribing in one region. Society for Academic Primary Care Annual Scientific Meeting, Glasgow

Guthrie B. October 2012. The impact of the 2004 and 2009 regulatory warnings on antipsychotic prescribing to older people with dementia: segmented regression time series analysis of general practice clinical data 2001-2011. Society for Academic Primary Care Annual Scientific Meeting, Glasgow

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McElhinney R., Morton L., Reid H.. A controlled trial of a CBT group for women with low self-esteem. Poster to be presented at Conference to Promote Evidence Based Psychological Interventions. DCP-Scotland, Royal College of Surgeons, Edinburgh, Tuesday October 23rd 2012.

McElhinney R., Morton L. - A Controlled Trial of a CBT Group for Women with Low Self Esteem. NHS Fife Psychology Conference. Dec 2012.

McKay E. (2012) "An exploration of implicit and explicit emotion in adult survivors of CSA”, BPS Survivor Scotland Meeting, 17th October 2012.

McKenzie S. (2012) Therapeutic Group Intervention for the psychosocial Problems Subsequent to Brain Injury (published) International Brain Injury Association World Congress March 2012

Posters

Baillie, C & Koziel, J (2012) Patient and Carer Stories. Practice Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ Bremner, L; Hogg, G; Lindsay, G (2012) Motivational Audit Process. Poster presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Brown, G; Payne, A (2012) Experiences of Attending Conference. Poster presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Brown, G & Payne, A. (2012) Social Inclusion: A Comparative Audit of Fife Mental Health Occupational Therapy. Practice Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ

Hall NH, Sinclair A, Chinn DJ, Styles CJ. Blindness due to Diabetic Eye Disease in Fife: 2000 – 2009 versus 1990 – 1999 Presented at the Royal College of Ophthalmologists meeting, Liverpool, May 2012. Awarded a prize.

Clark, N & Aitken, L (2012) Focus Education Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ Clark, N. & Braid, M (2012) RTC- Information Benchmarking Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ Curnow, E (2012) A Years Work for R&D Officer Mental Health Occupational Therapy: Promoting Evidence into Practice. Poster Presentation at College of Occupational Therapists Annual Conference, Glasgow June 2012 Curnow, E (2012) A Years Work for R&D Officer Mental Health Occupational Therapy Poster Presentation at AHP Conference AHP's as Agents of Change in

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Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ

Dale H.. (2012). Behavioural Health Consultant (BHC) role - an overview. NHS Fife Department of Psychology Biannual Conference; Dunfermline; December 2012. Poster Presentation.

Dale H., Watson L., Adair P., & Humphris G. Evaluation of an innovative behaviour change intervention for looked after young people through applying Health Psychology and Public Health. Public health science: A national conference dedicated to new research in public health. Royal Society of Medicine; London; November 2012. Poster presentation.

Dale H., Watson L., Adair P., & Humphris G. (2012) Motivating and supporting looked after young people to change their health behaviours; development and evaluation of a personally tailored behaviour change intervention. NHS Fife Department of Psychology Biannual Conference; Dunfermline; December 2012. Poster Presentation.

Dale H., Watson L., Adair P., & Humphris G. Evaluation of an innovative behaviour change intervention for looked after young people through applying Health Psychology and Public Health. Public health science: A national conference dedicated to new research in public health. Royal Society of Medicine; London; November 2012. Poster presentation.

Davidovic, E; Braid, M (2012) Support Workers Experience of a Formal Practice Placement with Alzheimers Scotland. Poster Presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Davidovic, E & Braid, M (2012) A Support Workers Experience of a Formal Practice Placement with Alzheimers Scotland. Practice Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ

Davis. A, Congress of the European Society for Surgery of the Shoulder and Elbow Dubrovnik September 2012. Poster 24: Prediction of post-operative pain following arthroscopic subacromial decompression surgery: an observational study.

Gavine, A. J., Donnelly, P. D., Goodall, C. & Williams, D. J. (2012). An educational approach to preventing violence in Glasgow's secondary school students: The Medics Against Violence programme. American Public Health Association 140th Annual Conference, San Francisco, CA, 27th-31st October.

House, K., Donnelly, P. D., & Williams, D. J. (2012). Exploring the relationship between family violence and major football matches in Glasgow, Scotland. American Public Health Association Annual Conference, San Francisco, CA, 27th-31st October.

Williams D. J, Neville F, Harvey M. J, Donnelly P. D, (2012). Evaluating the assets-based approach to addressing health inequalities in Scotland: Utilizing a community-based participatory research approach. American Public Health Association Annual Conference, San Francisco, CA, 27th-31st October.

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Neville F, Williams D. J, Harvey M. J, Goodall C, Murer J. S, & Donnelly P, (2012). Tackling Scotland's drinking problem: An examination of transdermal alcohol monitoring as a tool to change drinking behavior. American Public Health Association Annual Conference, San Francisco, CA, 27th-31st October.

Gawander, J (2012) Specialist Skills + Collaborative Working = Person Centred Care Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ Hynie, A; Curnow, E; Smart, K (2012) Group Matrices for Group Planning. Poster presentation at College of Occupational Therapists Annual Conference June 2012 Hynie, A, Curnow,E Smart, K (2012) Group Matrices for Group Planning Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ Koziel, J. (2012) Animation: Fun Creative Therapy. Poster presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Koziel, J; Baillie, C (2012) Patient and Carer Stories. Innovative Technology Poster Presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Koziel, J; Hynie, A; Dorman, L (2012) Group Interviews – Are they the Future? Poster presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Lindsay, G; Finnegan, P; Hamilton, J; Prattis, C (2012) Community Creative Group. Poster presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Lindsay, G. Finnegan, P Hamilton, J, Prattis, C. (2012) Community Creative Group Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ Long, A; Hogg, G. (2012) EMI Cognitive and Functional Assessment Clinic. Facilitated poster presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Love, J; Prattis, C; Czemerys, A (2012) The Use of Life Story in Occupational Therapy. Poster Presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Love, J. ; Prattis, C. (2012) The Use of Life Story Work in Occupational Therapy Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ Mackenzie, S; Hodgkinson, K. (2012) Do People Feel ‘Better’ Following Engagement in the Activity of Walking? Facilitated poster presentation at College Occupational Therapists Annual Conference, Glasgow June 2012.

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Payne, A; Love, J (2012) Get to Blether: Introduction of a social based group for Older Adults. Poster presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Payne, A, Love, J. (2012) “Get to Blether: Introduction of a Social Based Group for Older Adults” Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ

Quinn K. (2012) ‘Reshaping Care for Older People: The Role of Psychology in ICASS’, (poster) presented at the Reshaping Care for Older People Event, 1/6/12.

Rowantree, V. (2012) Engaging Mental Health Clients in Therapeutic Occupation for the Purpose of Cognitive Remediation Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ Sanders, D, Haynes, S, Payne, A; Brown, G; Crawshaw-Zein, K (2012) AMPS Integration into Fife Mental Health Occupational Therapy Services Facilitated poster presentation at College Occupational Therapists Annual Conference, Glasgow June 2012 Sanders, D, Payne, A, Haynes, S, Brown, G, Crawshaw-Zein, K (2012) AMPS – Integration into Fife Mental Health OT Services Poster Presentation at AHP Conference AHP's as Agents of Change in Health and Social Care Conference 5 September 2012 at Murrayfield Stadium, Edinburgh EH12 5PJ

Taylor E, (2012) Poster about Role of Clinical Associates in Applied Psychology (CAAPs) presented at BPS conference (joint poster between all adult CAAP’s and Child CAAP’s)

Turvey T, Taylor O, Rusk A, Nesbitt K, Graham T. Evaluation of Mindfulness Training Courses in an Adult Psychology Service and piloting Compassion Focused Therapy (CFT) within these courses. Poster Presentation. NHS Fife Psychology Conference. December 2012.