Details of the PhD students within the PCCC Theme, and their projects, are given below. As well as their academic team, the students involve ARC NWC Public Advisors who help to co-produce the research and inform the work through their lived experience.

Andy Davies
Name of project: Embedding clinical exercise physiologists into Complications from Excess Weight (CEW) services for children and young people with severe obesity
Summary: To address the increasing prevalence of severe obesity in children and young people in the UK, NHS England has established Complications of Excess Weight (CEW) services. CEW services adopt a multidisciplinary team approach to care; however, these services don’t currently have a designated exercise specialist employed within the team.

The overarching aim of the project is to understand how a physical activity (PA) and exercise intervention, supported by an exercise specialist and mHealth technologies, could be integrated into the care delivered by CEW services.

To achieve this there are three main objectives:
1: Evaluate the exercise and PA support currently available in CEW services throughout England.
2: Use coproduction methods to refine and optimise the use of exercise specialists and mHealth technologies to deliver PA within CEW services.
3. Conduct a feasibility study of the developed intervention to determine the feasibility of a full trial.

Supervisors: Dr Matthew Cocks, Prof Helen Jones, Dr Florence Kinnafick, Dr Senthil Senniappan
Host Organisation: Liverpool John Moores University

Anna Hunt
Name of project: Suicide crisis and self harm attendance at A&E in autistic young people: a mixed method study
Summary: Autistic children and young people (CYP) are at a higher risk of suicide and more than four times as likely as their typical peers to be admitted to the hospital after harming themselves. It is currently unknown why self-harm rates are higher in autistic CYP and how services and support should be best placed to accommodate their needs.

This study will collect data across A&E departments to review how many autistic CYP attend in suicidal crisis. We will look at rates of admission for self-harm and suicidal crisis in A&E departments to assess the prevalence of the issue and review the services accessed to determine whether the most effective pathways for CYP are accessed.

This study aims to provide a comprehensive evaluation of: (i) the prevalence of attendance of autistic CYP to A&E departments in suicidal crisis and / or self-harm (ii) explore the experiences of autistic CYP and (iii) the experiences of A&E staff.

Supervisors: Dr Pooja Saini, Dr Emma Ashworth, Dr David Moore
Host Organisation: Liverpool John Moores University

Sam Meredith
Name of project: Multimorbidity clustering to inform more equitable health and social care
Summary: Multimorbidity is one of the biggest challenges facing healthcare systems. The Academy of Medical Sciences outlined these challenges in its 2018 report on multimorbidity within the UK. The Academy indicated that individuals from deprived backgrounds experience multimorbidity at an earlier age, suffer worse health outcomes and use more health service resources than any other demographic. Additionally, research has indicated that multimorbid individuals have higher emergency department attendance and hospital admission rates than non-multimorbid individuals.

Our study has:
• Outlined the social determinants of multimorbidity associated within emergency hospital admission.
• Defined multimorbidity within emergency hospital admission research to improved comparability within the field.
• Created the UK’s first small area multimorbidity indicator aimed at identifying areas within the UK with high multimorbid admission burden.

Supervisors: Dr Jennifer Downing, Prof. Sarah Rodgers, Prof. Tony Marson, Dr Keith Bodger
Host Organisation: University of Liverpool

Donna Shrestha
Name of project: Exploring socioeconomic inequalities in the patient’s journey in those undergoing abdominal wall reconstruction surgery
Summary: The reality for patients from the most deprived areas in the UK is that they not only wait longer for their elective surgery, compared to patients from more affluent areas, but also face a higher risk of complications post-surgery.

We aim to further explore the inequalities in the surgical patient’s journey, supporting the strategic goals set out in the NHS long Term Plan’s to reduce health inequalities. This research has, so far, shown a difference in length of hospital stay and greater complication rates in patients from lower socio-economic backgrounds in patients undergoing abdominal wall reconstruction surgery.

Future and ongoing research will:
1) Understand the association between patients’ fitness before surgery and deprivation. The results may impact the planning of prehabilitation programmes (improving fitness before surgery) to make them more equitable.
2) Consider the barriers to engaging with a prehabilitation programme through interviews with patients undergoing abdominal wall reconstruction surgery.

Supervisors: Dr Chris Gaffney, Mr Draen Subar, Dr Theo Bampouras, Dr Cliff Shelton
Host Organisation: Lancaster University

Lizzie Wrench
Project: Mapping the health inequalities of pancreatic cancer and evaluating interventions to improve quality of life
Summary: By 2030 pancreatic cancer is predicted to become the second leading cause of cancer-related deaths and, therefore, improving the outcomes of individuals with pancreatic cancer has become increasingly important. Only 25% of people survive 1 year or more – this means research into ways in which the outcomes and quality of life can be improved is pivotal.

This research has three arms – to determine the inequalities in incidence and outcomes of pancreatic cancer across the country to highlight hotspots where interventions need to be focussed on. The second is to determine whether glucose regulation is an area that could be targeted to improve symptoms and quality of life by utilising continuous glucose monitors. The third arm is to determine the facilitators and barriers to patients participating in and health care staff implementing prehabilitation as this forms part of Pancreatic Cancer UK’s recommended optimal care pathway.

A review of the theory and procedure, validity and reliability and any special considerations of a range common methods used to measure glycaemic control, co-authored by Lizzie can be found here.

Supervisors: Dr Christopher Gaffney, Dr Theodoros Bampouras, Mr Daren Subar & Dr Robert Lauder
Host Organisation: Lancaster University