Avoiding Hospital Admissions (ITHAcA) HIT review for 2019-20

Professor Sarah Purdy and Dr Peter Goyder, Directors of the Integration to Avoid Hospital Admissions Health Integration Team (ITHAcA HIT), give an update on the HIT’s activities in 2019-20.

Over the year we have continued to focus on developing our urgent care projects, and to increase the involvement of public contributors and other stakeholders in our work. Our four key projects looking at different areas of the urgent care system are described below:

The General Practitioners in Emergency Departments study is led by Professor Jonathan Benger at the University West of England and supported by several members of the ITHAcA team. This study is exploring the different models of care used across the country of general practitioners working in or alongside emergency departments. This study is now moving into a final dissemination phase, with virtual workshops for public contributors and local commissioners being held to discuss the studies key findings. A large-scale dissemination meeting is planned for autumn 2020.

We are continuing with our work with Dr Massimo Antognozzi in the Physics Department at the University of Bristol, and Vitamica, the spin off company formed from this partnership. We have been joined by Gail Hayward who is the Deputy Director of the NIHR Community Healthcare MedTech and IVD Cooperative. Gail’s team specialise in supporting device design and testing in the community and we will be working with them and our design colleagues in Sheffield Hallam University to apply for further funding to support this work.

A scoping project, to explore the employment of paramedics within primary care teams (funded by Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group) has led to an application for further funding to conduct an evaluation of this initiative. This work is led by Drs Sarah Voss and Matthew Booker, with support from other members of the ITHAcA team, and will use a realist methodology to investigate how paramedics can be used most effectively within primary care teams.

The TICKLISH study led by Helen Baxter and supported by a Knowledge Mobilisation NIHR fellowship is well underway with results available in 2022. This project is exploring the interactions between researchers and stakeholders in urgent care with an aim to understand how knowledge is shared and where and how this can lead to new knowledge being created. Although, due to the COVID-19 crisis, meetings with urgent care clinicians and health service managers have had to be suspended, work with public contributors has provided some valuable insights and enabled the study to continue.

As a HIT we have had some incredible successes in our research, and from this the informal collaboration between the Universities of Bristol and the West of England has grown to become a formal collaboration to grow research in urgent and emergency care. Unfortunately, we have found it increasingly hard to continue to meet as a HIT over the past year and with the current COVID-19 crisis many of our team, as urgent care clinicians, have made the decision to step forward to the front line. For these reasons we have collectively agreed that it is time to bring the formal organisation of the ITHAcA HIT to a close, but to continue to continue to work with each other on research and to collaborate with colleagues in the NHS, social care and other sectors on this really important area of work. We would like to thank all the people who have supported our work since we formed in 2012.