Figure 1 above

How it all began?

I remember attending my first Hospital at Home Society conference in 2024. At this point, I was in the early days of the PhD, eager to learn more about current developments in this research area. During the networking breaks, I remember introducing myself to keynote speakers and little did I know that this would be the start of a wonderful collaboration and supervision for the NIHR SPARC Award.

I was keen to discuss the priority research areas for Hospital at Home (H@H) and later that year, I came across the NIHR SPARC Short Placement Award for Research Collaboration | NIHR. I felt that this was a wonderful opportunity to work with a research team that had the expertise in H@H, who operationally had the research knowledge, the technical and practical expertise in this field, and the existing networks that I could learn from and engage with moving forward. Additionally, my aspirations for professional development to become a clinical academic drove my passion to work with a group of dedicated and trailblazing clinical academics. I felt this would strengthen my experience, especially when considering post-doctoral opportunities.

What is the SPARC award for?

The NIHR SPARC Award allows NIHR academy members to spend time with researchers across other NIHR infrastructure to enhance their personal and professional development and research training experience. From speaking to previous candidates, I learned that this is usually either to develop skills in particular research methods, or to develop collaborations and expertise from researchers in a particular field.

What I did?

The application itself allows you to be quite flexible in how you undertake the placement, which is helpful depending on what you want to achieve. Personally, I had set out 1 day a week over 9 months, whereas other previous applicants undertook it in block placements (e.g. in a 4-week block).

During the placement I managed to conduct clinical visits to H@H services to get the first-hand practical experience. I attended clinical meetings and research meetings linking in with other health tech research centres in the NIHR infrastructure. As part of the award, I also accounted for attending courses and conferences around implementation science and knowledge mobilisation which I felt would be useful for my professional development and demonstrating meaningful impacts with research. The bulk of the collaborative work centred around working on a multi-phase research project. This involved a literature review and arranging an online stakeholder workshop with clinical experts nationally to discuss the findings. This also involved working with a visual minutes artist and presenting the findings at the UK Hospital at Home Society Conference 2026, at the Royal College of Physicians in Edinburgh, which supported input into the survey with H@H practitioners.

Outputs of the placement?

This placement allowed us to develop a Taxonomy of Medicines Safety in Hospital at Home which is aimed for upcoming publication. This enables a better understanding of the concepts of medicines safety in H@H and the links between them. Although the aim of the placement is professional development, I was fortunate to have an abstract accepted for oral presentation at the UK Hospital at Home Society conference in 2026, which is planned for submission to the Journal of Advanced Home Medicine. Additionally, a visual minutes graphic produced from this work is displayed below (See Figure 1).

Blog produced by Faiza Yahya (PhD Candidate), with acknowledgements to the support and supervisory team at the University of Warwick (Professor Daniel Lasserson, Dr Ciara Harris, Sophie McGlen) and the NIHR for funding this award. Appreciation also goes to the Academic Career Development Leads (Newcastle University and NIHR ARC West Midlands) for making this happen.

When “help” might harm: understanding the safety of social prescribing

Social prescribing has become a cornerstone of person-centred care, connecting people to community support, reducing pressure on services, and improving wellbeing. But what happens when these interventions don’t go as planned?

In our recent study, we looked beyond effectiveness to explore an underexamined issue: the potential harms of social prescribing. Using a global umbrella review of existing evidence, we developed a “dark logic” model (a way of mapping how unintended negative consequences might arise).

What did we find?

While social prescribing can offer important benefits, the evidence base highlights several areas of potential risk:

1. Mismatch between needs and services – when referrals don’t align with individual circumstances, leading to frustration or disengagement
2. Equity concerns – where access to community resources is uneven, potentially widening inequalities
3. Burden transfer – shifting responsibility onto individuals or overstretched voluntary sector services
4. Psychological impacts – including feelings of stigma, rejection, or failure if support pathways break down

Importantly, many of these harms are not the result of single decisions, but emerge through complex systems of care, commissioning, and delivery.

Why this matters for patient safety

Patient safety conversations have traditionally focused on clinical interventions. Our findings suggest we need to extend that thinking into community-based and non-medical models of care.

Social prescribing operates across organisational boundaries (primary care, local authorities, and the voluntary sector) which can create gaps in oversight, accountability, and follow-up. Without careful design, implementation, and evaluation, there is a risk that well-intentioned interventions could inadvertently contribute to harm.

What can we do differently?

Our “dark logic” model is not about discouraging social prescribing, but about making it safer and more equitable. Key implications include:

• Building safety considerations into service design from the outset
• Strengthening monitoring of outcomes beyond uptake and satisfaction
• Supporting the voluntary and community sector to deliver sustainable services
• Ensuring equity is a central focus in referral pathways and access
• Recognising and addressing the emotional and psychological experiences of participants

Looking ahead

As social prescribing continues to grow, there is an important opportunity to embed patient safety principles into its development. This means moving beyond asking “does it work?” to also asking “for whom, in what contexts, and at what cost?”

By bringing a safety lens to this evolving area of practice, we can better ensure that social prescribing delivers on its promise, without leaving unintended harms unseen.

Call to action

We encourage researchers, practitioners, commissioners, and community partners to actively incorporate safety thinking into social prescribing policy and practice. This includes:

• Designing services with potential harms in mind, not just intended benefits
• Sharing learning on unintended consequences across organisations and sectors
• Embedding routine monitoring of safety outcomes in evaluation frameworks
• Involving patients and communities in identifying what “safe” support looks like in practice

By working collaboratively and proactively, we can ensure that social prescribing not only supports wellbeing, but does so safely, equitably, and sustainably.

Paper link – https://bmjopen.bmj.com/content/16/5/e108998.abstract

Experience of participation and poster presentation.

By PhD Student Rajeev Shrestha

On 18^th July 2025, I got the opportunity to attend the Great North Pharmacy Research Collaborative (GNPRC) Conference, held at the Hilton Hotel, Gateshead. This event brought together pharmacy professionals, researchers, and pharmacy trainees to explore innovations in medicines optimisation, collaboration, and workforce development.

 

A key highlight for me was presenting my poster titled “Outcome of Deprescribing in People with Life-Limiting Conditions: A Systematic Review”. This study aimed to synthesise evidence on the clinical-, medicine and system-related outcomes of deprescribing practices among palliative patients. I had an opportunity to interact with fellow attendees during the poster viewing sessions that really sparked meaningful conversations around the safer use of medication. Personally, it was encouraging to see the ongoing works on reducing inappropriate use of medication by practising pharmacists.

 

The conference agenda was rich with insightful sessions. I particularly appreciated the breakout session on “Shared Decision Making and its Role in Reducing Overprescribing,” which also resonate with the area of my research. The growing emphasis on collaboration across sectors, from community pharmacies to NHS manufacturing, highlighted the evolving role of pharmacists in shaping safer, more effective care pathways.

 

Overall, GNPRC 2025 was a valuable experience to me. The event inspired new ideas, informed ongoing initiatives and deepened our commitment to contributing to quality use of medications.

Natalia Ochodzka, MSci Biomedical Sciences Graduate

Natalia held a summer internship between May and June of 2024 with Dr Matt Cooper. Natalia worked on a systematic review looking to identify digital toolkits used in the self-management of long-term conditions within the home and reflects on her internship here:  

Hi! I am Natalia, a recent graduate of MSci Biomedical Sciences with a Professional Placement Year programme at Newcastle University. I was also a research assistant at the School of Pharmacy for six weeks in May and June this year. My project was a scoping review focused on home-based interventions that support mental and physical health self-management in patients with multiple long-term conditions. I was based at the Newcastle Patient Safety Research Collaboration office and spent 60 hours surrounded by a wide range of researchers – from undergraduate interns, through research assistants and doctoral candidates to associates.

The nature of a literature review is very methodological; you need to follow certain steps to diligently get through thousands of publications to narrow your search to the most relevant reports, which then combined will (hopefully) suggest an answer to your research question, or at least provide you with the most relevant information on the search topic. Although it seems like an individual job, the part of the internship I enjoyed the most was interacting with my team! Daily discussions on topics related (and not so much) to our research questions made me realise that there is no one right way to do things right and that I should never limit myself to thinking in the regular, three-dimensional way. I learned distinctive styles of working, studying, and teaching, and all of it combined made me a better researcher. I saw the value and consequences of diligent work ethics, networking, and collaborating with people from outside of your study/ work circle. I am certain that this experience alongside the support received at PSRC will empower my future in clinical research, focused on physical activity and experimental medicine.

Eleanor Allen MSc Forensic Psychology Graduate

Eleanor held a summer internship between May and June of 2024 with Dr Matt Cooper. Eleanor worked on a project evaluating a hospital to home discharge service with a local charity. Eleanor reflects on her internship:

My research internship spanned six weeks and primarily involved the design and delivery of a service evaluation. This project was commissioned by a local charity and focused on hospital-to-home transitions in care. Coming from a forensic psychology background, the project area was relatively unfamiliar to me. Nevertheless, the skills required were transferable, allowing me to utilise my previous experiences as a volunteer researcher, in court, and from my research methods training. While I had some prior experience with qualitative data collection, this was the most immersed and involved I had been with a project. I was responsible for coordinating participants, data management and conducting one-to-one qualitative interviews with the charity staff members. Throughout the data collection process, we reflexively updated the interview schedule, meaning that every interview influenced future iterations of the questions. This led to effective and meaningful data collection and allowed me to incorporate my insights from the interviews. I presented my initial reflections and findings at the School of Pharmacy conference. The event gave me the opportunity to discuss the project with others from a broad range of academic disciplines, and gain insight into the research community at the school. I was particularly interested in the language used by charity staff members, especially relating this to self-identification as a barrier for carers seeking help. Often, staff held dual roles as carers and employees, and their language reflected how normalised their caring roles were. The conference was an excellent opportunity to meet other researchers and learn about ongoing projects within the school.

Overall, this internship was extremely valuable. Conducting research in an applied context was highly rewarding, and despite my background in forensics, I was able to apply my existing skills to the role. My experience and insights were valued by the research team, and I felt able to contribute meaningfully to the project. I also developed novel skills, such as communicating with a wide range of people, including participants, external partners, and academics. My qualitative interviewing and data management skills were also strengthened through the project. I am happy to say that I have now started as an assistant psychologist in an NHS Trust conducting research! I spoke about my experience with qualitative interviewing and recruitment in my application. Above anything else they seemed to like how I spoke about rapport building and connecting with people. I’m super grateful for the experience because it really built my confidence with that. Thank you Matt!

Arisha Ahmed MSc Pharmacy Graduate

Arisha held a summer internship between June and August 2024, supervised by Dr Matt Cooper. Arisha worked on a systematic review looking to identify digital toolkits used in the self-management of long-term conditions within the home and reflects on her internship here:

This summer I undertook a research internship with the School of Pharmacy at Newcastle University with Dr. Matthew Cooper as my supervisor. This project has allowed me to develop skills valuable in both research and my own professional development. My role within the team included, developing a systematic search strategy, navigating research databases (e.g. Medline, Embase, PsychINFO and CINAHL), study selection, evaluation of research quality in addition to completing a data extraction. Whilst the project was rewarding, we faced a few setbacks that taught us important lessons about the research process. For example, the screening process and data extraction took longer than initially anticipated which impacted the long-term plan of the project. These challenges taught us the importance of setting realistic deadlines and maintaining flexibility within project planning. The setbacks allowed me to truly understand the complexity of the research process as well as the importance of delegating tasks to each team member effectively to ensure a robust and timely piece of research was produced.

The findings from this research will continue to contribute to ongoing research activities within the School of Pharmacy at Newcastle University. Outcomes from this project aim to advise healthcare providers with invaluable knowledge as well as inform advancements in digital medicine. The project team are particularly interested in how to inform and guide Artificial intelligence (AI) systems to create AI driven health solutions. These innovations have the potential to significantly improve patient care and enhance clinical decision-making in the future.

As a healthcare professional, this internship has allowed me to critically analyse studies, assessing their rigor, relevance and impact to provide evidence-based care to my patients. It has also enhanced my appreciation for the vast array of research available to us in medicine. I am excited to further explore how medical policy, and advancements can be shaped by research, and I hope to pursue a career in research alongside my role in the NHS, focusing on integrating innovative digital solutions to patient care.

Co-theme Lead Professor Adam Todd of “Safer management of polypharmacy in multiple long-term conditions” and Professor Clare Bambra of “Safer Management of Multiple Long-Term Conditions in Disadvantaged Communities” co-authored a recent article in the BMJ Open “Ecological study of the association between the English national vaccination programme and area deprivation inequalities in COVID-19 mortality“

The paper concludes that inequalties in COVID-19 mortality rates could be significantly reduced by the National COVID-19 vaccination strategies. However barries to vaccination uptake in the most deprived areas need to be overcome if more is to be acheived.

Kayleigh Davison Lead Advanced Pharmacist Practioner and NIHR In-Practice Fellow, Newcastle University,

Supervised by Professor Andy Husband (Director of NIHR Newcastle PSRC) and Dr Anna Robinson-Barella (EDI Theme Lead for NIHR Newcastle PSRC).

Hi I am Kayleigh Davison, Lead Advanced Pharmacist Practitioner and NIHR In-Practice Fellow, Newcastle University.  I’ve recently become the only pharmacist to be awarded a National Institute for Health and Care Research (NIHR) In-Practice Fellowship, which I’ll be balancing alongside my clinical work in General Practice.  The NIHR In-Practice Fellowship is an incredible opportunity that will allow me to develop as a researcher without stepping away from my clinical work. I started working in general practice as part of the NHS pilot for Clinical pharmacists in general practice and now work as an Advanced Pharmacist Practitioner. I have always worked and wanted to work within primary care providing the first point of contact in the healthcare system for our patients providing holistic care. I have been very fortunate to develop clinically within primary care over the years under the supervision and mentorship of excellent GPs. Through this time I have developed a special interest in polypharmacy (when patients are prescribed multiple medications) and in particular over 15 regular medications. 

My research focuses on polypharmacy (when patients are prescribed multiple medications) and health literacy. Health literacy is basically how well someone can understand and use health information to make decisions. Shockingly, 61% of adults struggle with understanding basic health information. For those on many medications, this can make managing their treatments much harder. But the connection between polypharmacy and health literacy hasn’t been thoroughly explored in the literature yet. My aim is to shed some light on this issue and find ways to better support patients who may find complex medication regimens challenging.

My advice for others that may want to consider a clinical academic career is to start talking to your colleagues in academic institutes about your ideas or opportunities that may be available. There is also a lot of support available via National Institute for Health and Care Research (NIHR) and within our region we are fortunate to have NHIP academy who supported me alongside the academics within the Newcastle Pharmacy school throughout my application process explaining the different fellowship options to giving me feedback on drafts, the academy was there every step of the way.

NIHR Newcastle PSRC, Professor Annette Hand

On a dull and foggy Thursday afternoon I travelled down to the House of Lords in London to represent the Newcastle NIHR PSRC for the launch of the National State of Patient Safety Report (2024). This report, first published two years ago, is produced by the Institute of Global Health Innovation at Imperial College London and is commissioned by the charity Patient Safety Watch. The report assesses the state of patient safety within the NHS, using all available data, and provides a detailed picture of the national state of patient safety in England.

After making my way through security I was ushered up a grand and spiralling staircase to the beautiful River Room to mingle with academics, researchers, politicians and charity staff, all personally invited due to their connection to improving patient safety. The event was hosted by Professor Lord Ara Darzi, Co-Director of the Institute of Global Health Innovation, who informed us that unfortunately there had been a decline in 12 out of the 22 metrics that had been reassessed. Lord Darzi stated that “Our latest report on patient safety in England reveals alarming declines…The NHS is now falling behind leading nations in patient safety. We urgently need to address these issues to repair the health service and provide high quality care for all patients and their families.”

He provided some of the headlines of the report which are:

• In 2023, the number of deaths that could have been avoided if the UK matched the top 10% of OECD countries: 13,495 deaths
• In 2023, the UK ranked 21^st out of 38 OECD countries for patient safety
• The NHS spends £14.7 billion a year treating people who have been harmed by mistakes made during their care.
• Cost of harm for claims resulting from incidents in 2023/24: £5.1 billion
• In June 2024, the number of people waiting for elective care was 7.6 million
• 2 in 3 staff feel unable to carry out their jobs fully due to workforce shortages

Whilst these are all stark statistics Lord Darzi eloquently illustrated the personal impact of this report stating that we must never forget that behind every statistic outlined in this report, is a life.  A life cut short, or seriously impaired. A family in grief, or now consigned to be life-long carers.  He described the only way we can properly commemorate the people affected by patient safety failings is to learn and improve.

The report also highlights that the impacts of unsafe care are not spread evenly across England but are greater in the North than the South, something we are only too aware of. The report also details a complex picture of national patient safety with evidence that the health system cannot keep pace with the number of recommendations already made on it. What was reassuring was rather than adding further recommendations it was advised that a focused set of patient safety priorities must be agreed that we can all work towards, and something I expect we will hear more about this in 2025.

We also briefly heard form Jeremy Hunt, Chair of Patient Safety Watch and Baroness Merron, the Minister for Patient Safety, on their progress and commitment to the patient safety agenda. Finally, we hear from Merope Mills, a senior editor of the Guardian and patient safety campaigner, providing us with an emotional update on the progress of Martha’s Rule NHS England » NHS to roll out ‘Martha’s Rule’, and the fantastic impact this is already having to so many lives within the NHS.  

I had plenty to reflect on during my long journey home, and whilst the report does provide some very sobering statistics, I know that together we can change this trend and make a real difference to patient safety outcomes. 

Read the report: https://www.imperial.ac.uk/stories/National-State-Patient-Safety-2024