Welcome to the Cambridgeshire and Peterborough CLAHRC. We are a collaboration of academic researchers, clinicians and managers who undertake high quality applied health research focused on the needs of patients and service users, supporting the translation of research evidence into practice in the NHS and social care.
NICE Evidence Updates
The Evidence Update on Autism diagnosis in children and young people was published by NICE in April 2013.
Research done by Professor Simon Baron-Cohen and Dr Carrie Allison (CLAHRC CP) are cited in the evidence update. The report includes commentary from the EUAG on 25 new articles (relevant to NICE clinical guideline 128), covering the following topics:
- Recognising children and young people with autism (including socioeconomic and demographic factors, and differences between girls and boys)
- Referring children and young people to the autism team (use of autism diagnostic tools and possible trajectories of children’s development)
- Autism diagnostic assessment for children and young people (use of diagnostic tools and factors affecting sensitivity and specificity of tools)
- Medical investigations (electroencephalogram coherence and genetic testing)
- Change in diagnosis over time.
CLAHRC CP UPDATE: A programme of diagnostic test accuracy reviews
We are at a pivotal time point where it is possible – and necessary – to foster evidence-based practice surrounding diagnostic tests for dementia: • The National Dementia Strategy (2009) emphasises the importance of early diagnosis of dementia • Tests based on identifying Alzheimer’s disease pathology are being actively developed • No decision rules for the use of biomarker-based tests have yet been evaluated • EU rules on direct-to-patient advertising are being relaxed This is happening in a context of general lack of understanding of the accuracy of existing and emerging diagnostic tests, making it impossible for commissioning and care pathways to be based on robust evidence. [Read More...]
CLAHRC CP UPDATE: A study of the comparative effectiveness of IAPT cognitive therapies
The Improving Access to Psychological Therapies (IAPT) programme aims to provide quick access to cost-effective talking therapies, primarily Cognitive Behaviour Therapy (CBT), to people who have common mental health problems. IAPT targets depression and anxiety disorders which are the commonest mental health problems seen in general practice, causing an enormous health burden at the population level.The introduction of IAPT services takes a significant step towards widening access to mental health services. [Read More...]
CLAHRC CP UPDATE: Developing end of life care provision in the community
Primary Care is central to the provision of End of Life Care (EOLC). Most of the last year of life is spent at home under the care of General Practitioners (GPs) and Community Nurses (CNs). Nationally, 19% of deaths occur at home and 18% in care homes, under the care of GPs and CNs. Local and national strategies emphasise the importance of increasing EOLC provision at home, and the involvement of GPs and CNs in the care of patients approaching the EOL is set to increase over the coming years. Medical and nursing student training in EOLC is limited; this leaves many clinicians feeling unprepared when providing care for people near the end of their lives, feeling that they lack the training and knowledge required to deliver high quality EOLC. Previous studies have investigated the education and knowledge of GPs, while CNs have been little studied in this regard. This study investigated the knowledge and prescribing habits of Peterborough and Cambridgeshire GPs and CNs in order to identify training and educational needs. It also gathered information on their views on the out of hours services in their area and their preferences for further EOLC education. [Read More...]
CLAHRC CP UPDATE: Alternatives to anti-psychotic drugs for patients with dementia
The National Dementia Strategy was launched early in 2009 with a view to enabling people to live well with dementia. Reducing the inappropriate use of antipsychotic drugs is one of the 4 national priorities for the strategy and the focus of a national call to action across health and social care in June 2011. This project aims to support and speed up the implementation of the dementia strategy on antipsychotics, by reviewing the evidence on non-pharmaceutical alternatives and promoting practice change. [Read More...]
CLAHRC CP UPDATE: Development of a referral guide for Autism Spectrum Condition for primary care
Autism Spectrum Conditions (ASC) are characterised by difficulties in social interaction, communication, and adapting to change, alongside unusually narrow interests and strongly repetitive behaviour. Diagnosis of ASC can be a lengthy process because it varies greatly across individuals, and the age at which symptoms first appear differs. Diagnosis is often delayed because it can be difficult to detect in very young children or in later life when ASC can be masked. Parents may raise concerns about their child as early as 18 months, but there is frequently a delay between the point of first concern and an eventual diagnosis. [Read More...]
COLLABORATIVE RESEARCH: Incidence and prevalence of psychotic disorders in England
It has been recognised for some time that care for people with schizophrenia, and similar psychotic illnesses, needs to be designed and commissioned with regard to the needs and wishes of service users and carers. It is therefore important that commissioners planning for new care teams, such as early intervention services (EIS), have all the information they need to understand how much of the illness there is in the population at any one time, and how many new cases there will be in the years to come as the population expands. Without this knowledge, service commissioners will struggle to match population needs in a sustainable way. This aim of this research, commissioned by the Department of Health, is to provide more information on the incidence, prevalence, variability and cost of psychoses than has ever been drawn together before in the UK. [Read More...]
CLAHRC CP UPDATE: Designing and Implementing a Youth Mental Health Service
Mental health problems in young people are thought to account for approximately 50% of the disease burden among 12-25 year olds. It is widely recognised that most chronic and severe mental health problems begin in adolescence, with about 75% of all mental illnesses emerging between the ages of 15 and 25. In about 3-5% of these young people, mental illness persists, becoming a chronic problem. Why is this? There is evidence that young people with mental health issues are not accessing mental health services, possibly due to the fragmentation of mental health services, and overall poor provision of mental health services for young people. This has resulted in a lack of quality care for adolescents and young adults with mental health disorders. This briefing describes a CLAHRC Fellowship project that aimed to improve youth mental health services in one area of the East of England. [Read more...]
CLAHRC CP UPDATE: Systematic review of screening for dementia
Dementia is one of the most severe and devastating disorders we face. There are approximately 700,000 people with dementia in the UK. In just 30 years, the number of people with dementia is expected to double to 1.4 million. Currently the level of diagnosis of people with dementia is generally low, with a 24-fold variation between highest and lowest activity by PCT. For over a decade, researchers have sought ways to improve the early detection of dementia, yet many patients who meet the criteria for dementia do not receive a formal diagnosis, or receive a diagnosis in later stages of the disorder. The pressure for earlier diagnosis, and for population screening as a possible approach to improving detection of dementia, will increase as the burden of dementia increases, and as new therapies emerge. [Read More...]
CLAHRC CP UPDATE: The TC 17 project: Transfer of Care at age 17
The TC17 project focuses on the transition period from adolescence to adulthood in two vulnerable groups of young people: those in the care of the local authority and those receiving psychological help from the Child & Adolescent Mental Health (CAMH) service. About one third of young people who are referred to adult mental health services from CAMH stop attending within 6 months. Around 50% of adolescents in care suffer from mental illness. Their relatively poor social, economic and health outcomes in early adult life may be due in part to the absence of collaborative psychiatric management in the teenage years. [Read More...]
CLAHRC CP UPDATE: Health service user transitions in mental health services
Mental health services struggle to perform well in cases of young patients transitioning away from a Child and Adolescent Mental Health Service (CAMHS). In the past few years there have been several calls from policy-makers, academics, services and service users’ communities to improve the process of healthcare service transitions (HST) for young people. Service users criticise the lack of arrangements and poor information sharing, often report feelings of being ‘dumped, cut off and abandoned’ and may leave medical supervision altogether. The aim of this CLAHRC research project is to understand the process of moving from one mental health service to another; the study focused particularly on young mental health service users “transitioning away” from the Child/Adolescent Mental Health Services of Cambridgeshire and Peterborough. [Read More...]
CLAHRC CP UPDATE: A service design approach to frequent attendance in the emergency department
Frequent attenders have been associated with a number of characteristics including: male, out-of-hours attendance, vulnerability, high rates of addiction, mental health problems, somatoform disorder and chronic medical problems. This variation makes it difficult to study this population and in this case, to design appropriate services. The main driver for this project was the set-up of a multi-agency working group to tackle the issue of frequent attenders to emergency departments locally, in particular, to address unmet mental health needs that may be contributing to frequent attendance. This project aimed to contribute to the working group by using specialist clinical knowledge, local data and design concepts to develop ‘personas’ (precise representations of particular people that the design will address). These ‘personas’ remain throughout the design process and all decisions can be assessed by the design team against these representations to inform service design. [Read More...]
CLAHRC CP Information for patients and the public: Applied research in autism
The Autism Research Centre has a database of 30,000 individuals with a diagnosis of ASC or a relative with ASC who have registered as volunteers. As well as participating in studies, volunteers have the opportunity to feed back about their experiences of taking part in research and often put forward ideas for new research. We involve people with autism and parents in every stage of our research projects to make sure the research is relevant to them. For example, we hold focus groups to discuss possible research ideas, and we involve them in the advisory groups that oversee the research projects. [Read more...]
Is part of a research project by the adolescent theme of the CLAHRC CP and involved 11 children in care in collaboration with the Cambridgeshire Film Consortium. The film will be used as part of a mental health training course for foster carers that is being developed by CLAHRC CP and its research partners, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire County Council Children’s Services and NHS Cambridgeshire.
You can see My Name is Joe on You Tube. You can also see My Name is Joe: Behind the Scenes. A short documentary which gives insight into the background and making of My Name is Joe.
Read more here
LATEST CLAHRC BITE
The Red Flags tools were developed as short versions of four existing screening instruments for autism spectrum condition.
The Red Flags are brief checklists of screening instruments for Autism Spectrum Condition. There is one for each of four age groups: toddlers, children, adolescents and adults.
This CLAHRC research study led by Professor Simon Baron-Cohen and Dr Carrie Allison addresses the need for a tool to help primary care professionals make decisions about referral to specialist services for a full diagnostic assessment for ASC.