Published: 10 December 2020
The NIHR has funded nine new research projects to help us to better manage current and future waves of the COVID-19 pandemic and investigate its long-term impact on society and the health and care system.
The projects, which total £5.5 million in funding, span a wide range of specialties and scientific disciplines and were funded at a rapid pace due to the urgency of the pandemic. Research ranges from digital devices to help improve tracking and tracing in care homes, to remote rehabilitation regimes for patients affected by Long-COVID and tools and support systems to help staff boost their wellbeing and performance during further stages of the pandemic.
Emerging evidence shows that the virus has had long-term impacts on both the physical and mental health of patients and the NHS workforce caring for them and rapid deep-rooted impacts on the services and organisation of the health and social care sector.
Professor Chris Whitty, NIHR co-Lead and Chief Medical Officer, said:
“Building on research NIHR led in the early stages of the pandemic, we want to generate high quality evidence to improve this pandemic response and future responses - drawing on the experiences of patients and those working on the frontline in health and social care.”
Lord Bethell, Minister for Innovation, said:
“COVID-19 is an awful disease and we are determined to beat it. That’s why I am so excited that NIHR is investing a further £5.5m to unlock the mysteries of this dreadful contagion.”
The projects were funded as part of the NIHR's Recovery and Learning call. They include funding from the Health Technology Assessment (HTA) Programme, the Health Services and Delivery Research (HS&DR) Programme and the Evidence Synthesis Programme (ESP).
The newly-funded projects are summarised below.
Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN)
University Hospitals Coventry & Warwickshire NHS Trust
NIHR132046 - £1,191,977
Some COVID-19 patients continue to experience long-term symptoms, even after months of recovery including; shortness of breath, tiredness and anxiety. While ongoing symptoms may be improved upon through a combination of regular exercise and group support; because the NHS is struggling to meet growing demand, an alternative method of support is much needed. Researchers will assess the effectiveness of an eight-week programme which will offer online, home-based physical and mental health support to see if this can help patients while taking additional pressure off the NHS.
Work-related stress: the Impact of COVID-19 on Critical Care and Redeployed Nurses (CANDID)
University of Aberdeen
NIHR132068 - £184,567
COVID-19 placed great pressure on nurses who were working under very difficult conditions and experienced significant challenges. Researchers will use a model of occupational stress called Job Demand Resources to better understand stress in nurses working in critical care during the pandemic. They will examine how it has impacted staff and compare their results to a similar study, completed just before the onset of COVID-19. The results could help further our understanding of how the impact of stress can be mitigated by personal, job and support resources, so that the NHS can be better prepared to support and retain critical care staff if a second or third wave of the pandemic occurs.
Nurses working in 23 adult critical care units in Scotland (20) and England (three) will be asked to complete a questionnaire and take part in an in-depth interview. Critical care nurses and nurses redeployed to those units on at least two occasions will be invited to take part.
Protecting older people living in care homes from COVID-19: challenges and solutions to implementing social distancing and isolation
King's College London
NIHR132541 - £237,058
Older people living in care homes often have complex needs and are at higher risk of poor health outcomes and mortality especially if they contract COVID-19. To protect older people, care homes use measures such as social distancing and isolating of residents, which they describe as challenging. We do not yet have a good understanding of this challenge and how best to address it, as the procuring of real-life experiences and perspectives of residents, their families/friends, and staff working in and with care homes, has not been conducted.
Over a period of 12 months, this mixed methods tripartite study will address this gap by conducting a rapid evidence review in phase 1. This is followed by in-depth case studies with six care homes across England in phase 2 to help understand the complex phenomenon of social distancing and isolation for older people living in care homes to protect them from COVID-19. These findings will be used in phase 3 to co-produce a toolkit of evidence-informed guidance and resources for health and care delivery now, and to support further outbreaks of the coronavirus.
Lessons from the frontline: The impact of redeployment during Covid-19 on nurse well-being, performance and retention
Bradford Institute for Health Research
NIHR132041 - £281,359
This study aims to better understand how to plan for and manage redeployment of nurses and support staff during a pandemic and the long-term impact of different kinds of redeployment on staff wellbeing, performance and retention.
Researchers will work at three NHS trusts to complete two projects. Firstly they’ll examine how redeployment decisions were made based on an ethical framework and the barriers and enablers to doing this, by interviewing 30 senior staff and asking how staff were supported in their role and return to their previous teams.
Secondly, they will interview 50-60 nurses at three time points during 10 months on how redeployment affected their longer-term job performance and wellbeing.
The research will inform future planning of redeployment strategies for nurses, as creating a more flexible NHS workforce is currently a national priority and so redeployment may become more common in routine service delivery and as well as for planning more specifically in a pandemic or other crisis situation.
CONtact TrAcing in Care homes using digital Technology (CONTACT) - A pragmatic cluster randomised controlled trial, cost-effectiveness evaluation and theory-informed process evaluation
University of Leeds
NIHR132197 - £1,552, 387
This study aims to evaluate whether wearable ‘fit-bit-style devices can effectively record contacts between care home staff, residents and visitors and prevent the spread of COVID-19 compared to traditional NHS Test and Trace.
Deaths and infection rates were high during the first wave of the pandemic and contact tracing can be difficult in these environments due to residents' memory and communication difficulties and care home staff having many contacts with residents and other staff each day.
The digital devices will be used in 32 care homes in Yorkshire and the Midlands over the course of a year and compared to 32 others using the NHS Test and Trace system. The devices will allow homes and the researchers to identify a month’s contacts almost immediately and help analyse patterns and trends of contacts to better monitor infection control.
It is hoped the technology can limit the infection, reduce deaths and lead to safer visiting conditions – boosting the quality of life and mental wellbeing of residents.
Procalcitonin: Evaluation of Antibiotic use in COVID-19 Hospitalised patients. (PEACH)
University of Leeds
NIHR132254 - £731,858
During the pandemic there has been an increase in use of antibiotics in patients with severe COVID-19.
This is because doctors worry that there might be a bacterial infection on top of the viral infection, despite a lack of evidence to guide the use of antibiotics in these patients.
This study will investigate if a procalcitonin blood test (PCT) - used in many hospitals to help diagnose bacterial infections and guide antibiotic treatment – is effective in COVID-19 patients.
Researchers analyse retrospective data from 7,000 COVID-19 patients across 11 NHS acute hospitals – half who will have used PCT testing during first wave of the COVID-19 pandemic - to determine whether and how PCT testing should be deployed to protect patients from antibiotic overuse if the NHS experience a second wave of COVID-19 infection.
They aim to find out if use of the procalcitonin test in COVID-19 patients reduced antibiotics and/or improved patient outcomes, such as time in hospital or on intensive care, death rates, and infections with superbugs and will also assess its cost effectiveness.
They will produce guidelines for doctors on how best to use the procalcitonin test in patients with COVID-19, so that antibiotics are started early if needed and stopped promptly if unnecessary, thus reducing side effects, antibiotic resistance and infections with superbugs.
The Resilience Hubs: An NHS Outreach, Screening and Support Navigation service model to support the mental health needs of key workers affected by the COVID-19 pandemic
Greater Manchester Mental Health NHS Foundation Trust
NIHR132269 - £474,380
NHS key workers experienced acute mental health problems during the COVID-19 pandemic. To prevent long-lasting mental health issues, researchers will assess the effectiveness of new NHS mental health and wellbeing services called 'Resilience Hubs’ that are being set up in three UK sites for key workers to get the right mental health support as quickly as possible. There is also an emphasis on how best to reach these key workers. The Resilience Hub approach was originally developed in response to major incidents like terrorist attacks in the past and the model is being replicated to support mental health needs of key workers in other UK regions. As it is not known how effective they will be to the NHS workforce in response to the COVID-19 pandemic, the results could help further understanding of how the Hubs can be useful in supporting the mental health needs of varying key workers and how the Hubs’ support can be improved to suit the needs of different UK regions who might require a service of this kind in the future.
Supported remote rehabilitation post Covid-19: development, deployment and evaluation of a digitally enabled rehabilitation programme
University College London
NIHR132243 - £781,964
Covid-19 had affected many who remained symptomatic with breathlessness, fatigue and anxiety for weeks or months. These symptoms can be improved with rehabilitation, but traditional face-to-face models of service delivery will struggle to cope with these large numbers of patients.As a digital approach is likely to be needed, researchers aim to organise and evaluate a digitally remote, supported rehabilitation programme for patients affected by Covid-19.
Prevention and treatment of persisting olfactory dysfunction after COVID-19 infection
University of Oxford
NIHR132103 - £34,011
Loss of sense of smell frequently follows COVID-19 infection. For many patients, the loss is temporary and their sense of smell recovers quickly, for others, the problem may persist and can have a detrimental impact on their quality of life. Researchers will identify treatments that are used to prevent and treat the loss of sense of smell. They will examine any existing trials to help them assess the effectiveness of these treatments and any associated adverse effects.