What is PHIRST @ LiLaC?

LiLaC houses one of the National Institute for Health and Care Research (NIHR), Public Health Intervention Responsive Studies Teams (PHIRST). The PHIRST remit is to work with local government organisations to co-produce timely, robust and accessible evaluations of public health schemes.

Across the UK, local government organisations are running a variety of initiatives to improve health and reduce health inequalities amongst their residents. However, due to many factors, they are often unable to fully evaluate the impact of these initiatives. This means opportunities to share learning and build a knowledge base in public health interventions is lost.

PHIRST aims to address this need and invites local governments in England, Scotland, Wales and Northern Ireland to submit Expressions of Interest (EOIs). Essentially nominating their scheme to be evaluated by PHIRST. All costs associated with the evaluation are funded by NIHR though the scheme itself must have it’s own funding.

Below you can find the details of PHIRST LiLaC evaluations. For more information on the PHIRST scheme and full range of evaluations visit the PHIRST website.

Follow @NIHR_PHIRST on Twitter / X and You Tube.

Bristol City Council Substance Use Support Team (SUST) Trauma Informed Recovery Pathway (TIRP)

Why this study is needed

Drug use causes early deaths and a high number of admissions to hospital. Treatments such as detoxification (detox) and rehabilitation (rehab) programmes aim to reduce or end people’s reliance on drugs and alcohol. Some people (clients) might not be able to complete detox and rehab because they have experienced trauma. Bristol Substance Use Support Team (SUST) are using a Trauma Informed approach to work with clients who have been unable to complete detox.

The Bristol SUST trauma informed approach includes:

Clients watch 6 videos explaining what trauma is and discuss with staff about how it might affect their thinking and behaviour
SUST support workers offer more intensive support and work closely with other agencies that clients are involved with
Clients receive one to one support from volunteers with experience of addiction and recovery
Clients are in settled accommodation

What we already know

We know from existing research that:

the organisation’s approach
staff attitudes
the quality of the staff and client relationships
providing a safe environment

are important in making sure that a trauma informed approach works. Trauma informed approaches have also been found to reduce people’s substance use, to make their mental health and trauma symptoms better and to reduce the number of times that clients leave treatment too soon.

What we aim to find out

We have worked with SUST and people who have experienced addiction and recovery to design the evaluation. TIRP is at the early stages of being carried out and it is likely that there will be small numbers of clients going through it to start with. The three main things we want to find out about are:

Delivering a trauma informed approach
- how it is delivered
- how it works
- what factors affect its delivery
How clients experience the trauma informed approach and any changes to how they cope and how they engage with wider services
To explore costs involved in delivering TIRP and potential savings

How we aim to answer the questions

We will mainly find out the information we need by talking to people. We will interview people involved in delivering the trauma informed approach and clients who are experiencing the trauma informed approach. People with lived experience of addiction and recovery who contribute to TIRP will take part in a focus group. We will analyse the data using thematic analysis which means looking for important patterns in what people are saying that are relevant to the questions we want to answer. We also hope to use numerical data to understand the costs involved in delivering TIRP.

Building and facilitating system capability to create healthy environments in East Sussex and Southampton: a qualitative process evaluation

Background

Our built and natural surroundings are key determinants of health; the places where we live, work and play can support or hinder our physical and mental well-being. Two local authorities have joined together to request an evaluation of their approach to accelerate the creation of health promoting environments. Each authority has employed ‘healthy places’ officers in an attempt to encourage a greater focus on local planning decisions that are beneficial for health as well as a focus on wider considerations of health in policy and practice such as transport and housing.

Aim

The study aims are to identify any changes in knowledge, skills and ways of working that support efforts to promote healthy environments in local authority settings that can be linked in whole or in part to the investment in specialist dedicated posts. It also aims to understand the ways in which these changes come about and to assess any early impact these changes have on policy and practice.

Methods

Through interviews with key stakeholders, local workshops and diaries completed by the ‘healthy places’ officers, the research team will identify the processes and activities initiated by the new roles and assess the extent to which these lead to changes in local knowledge, working practices and policies.

Liverpool Funded Local Welfare Schemes evaluation.

Background

Welfare schemes provide financial or in-kind support (e.g. furniture, domestic appliances, and shopping vouchers) to those most in need. This includes those who are unemployed or looking for work, those with low earnings, raising children, retried, caring for someone, or who have a long-term illness or disability. They also support those who are vulnerable due to circumstance, for example due to recently leaving prison, those experiencing domestic abuse, or those who have endured a crisis such as a fire or flood. The aim of welfare schemes is to reduce financial hardship and therefore improve health and wellbeing. Their wider objective is to reduce expenditure on public services such as the NHS, homelessness services, or social care organisations.

Aims

This study aims to understand: 1) how people make use of the welfare system, 2) whether access to welfare schemes is fair for everyone and, if not, what impact this could have on differences in people’s health, and 3) the impact that welfare schemes have on the health and wellbeing of those who receive support.

Methods

In this study we are working with Liverpool City Council. We will use data they collect on people who make use of welfare schemes, along with undertaking workshops with staff at the council and local community organisations (such as Liverpool Citizens Advice), to understand how people make use of the welfare system and whether access is fair for everyone and what impact this could have on differences in people’s health. We will also undertake interviews with people who have received welfare support to understand the impact of this on their health and wellbeing.

Evaluation of a Money & Mental Health Service delivered by Kent Citizens Advice

Background

Growing numbers of people in the UK are finding it hard to make ends meet because of the Covid-19 pandemic and the cost of living crisis. Having to deal with financial difficulties can be very stressful and lead to poor health and wellbeing. People with low incomes are also most likely to be affected. Citizens Advice is delivering a Money and Mental Health advice service to support people who are experiencing both mental health and money problems living in Kent and Medway. This includes support to reduce debts and to claim benefits, as well as budgeting advice.

Aims

The aims are (i) to understand the impact that the service has on the health and wellbeing of those who receive support (ii) to understand who accesses the service (iii) to understand what works well about the service and what could be improved in future (iv) to understand what costs are involved in delivering the service.

Methods

We will collect information to find out what impact this service has on differences in people’s health and wellbeing and to understand if the service is reaching different groups who might benefit from support. We will interview people using the service to understand their experience of receiving support and how the service may have influenced their health and wellbeing. We will also interview staff involved in delivering the service and from other organisations (e.g. mental health services) who refer clients to the service.

PHIRST @ LiLaC Blog

PHIRST Blog. Tim Wilson, Public Advisor for PHIRST @ LiLaC.

Aug 18, 2023 | PHIRST

In the first of a series of blogs, Tim Wilson a Public Advisor for PHIRST LiLaC talks about his experiences of being involved in the development of the funding application for PHIRST LiLaC and about his involvement in two evaluations currently being carried out by the team.