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28 February 2017, Updated 22 March

Find out more about SPCR Collaborative Funding Round 16

Ageing and the health and care of older people

Life expectancy is increasing by two years per decade. Older people represent the fastest growing sector of our population, with the over 60 year olds representing one fifth of the population. The largest population increase will be seen in the oldest old age group (over 85s). Between 1991 and 2031, the population of England and Wales will increase by 8%; in comparison, older people in the over 80s age group will increase by 138%.  In the United Kingdom (UK), improving the health and social care of our ageing population is one of the government’s priority areas; these demographic changes will present enormous challenges for health and social care providers in the UK. They will have particular implications for general practitioners and primary care teams as one of the key priorities for future healthcare delivery to older people will be to ensure that it is delivered as close to their homes as possible. The introduction of the Quality and Outcomes Frameworks (QOFs) has led to a considerable improvement in chronic disease management. However the focus of QOF on single disease management may be detrimental to the care received by older people who often have multiple-morbidities, poly-pharmacy, mental health problems and cognitive impairment and frailty. In addition, the needs of carers are too often overlooked.


General practitioners will require the knowledge and skills to care for older people with complex needs and their carers yet this is not a compulsory part of GP training; in addition they will require support from their specialist colleagues to manage an increasing workload. A recent British Geriatrics Society survey found little change in the % of geriatricians with sessions allocated to Community geriatrics yet the bulk of clinical need is in community settings.  Many local and national initiatives are looking at innovative ways of providing more efficient, integrated and person-centred care for older people e.g. Vanguard Schemes and local devolution (Manchester); several SCPR members are involved in such schemes and in their evaluation.   There would be considerable added value in bringing together this group of people within an already established NIHR framework such as the SPCR especially with future funding calls from NIHR focused on topics such as multi-morbidity.   


Key clinical challenges for possible future research studies include:

  • management of complex multi-morbidity and polypharmacy
  • clinical assessment and care of older people who are frail/pre-frail
  • mental health of older people
  • health promotion in later life
  • safeguarding, vulnerability and risk assessment
  • health and wellbeing of older people from ethnic communities
  • ethical and legal issues in elderly care
  • quality of healthcare for older people in nursing and residential care
  • service provision for integrated health and social care and intermediate care services


Brief Behavioural and Psychological Interventions - Working Group


Primary care encounters are typically brief, particularly in the current resource stretched NHS. While behavioural and psychological interventions are frequently shown to have significant benefits for health outcomes, they are often lengthy and resource intensive, which are significant barriers to widespread adoption within primary care. At Nottingham, we have an explicit interest in developing brief and feasible behavioural and/or psychological interventions to improve health and the effectiveness of existing medical interventions (e.g., vaccinations). However, we know many other colleagues across SPCR schools do work in similar areas. This working group would seek to identify areas for new collaborations and crossover – that could form the basis of future SPCR funding bids.

Conversation Analysis

The Conversation Analysis Group will primarily seek to explore and explain the value of CA for primary care research.  It will provide a vehicle for discussion and knowledge exchange between people already using CA or wishing to use CA. A key focus will be to develop new lines of collaborative research across SPCR. This will be through developing projects that primarily employ CA as the main methodological approach as well as contributing to other projects by developing and leading on work packages.  The CA Group will be convened by people already leading key projects using this methodology, and will link to the wider CA community.

Digital health working group

Meeting to be held on 22 June 17

Digital health interventions are expected to be one way of helping the NHS rise to the challenges of delivering more and better care with reduced resource, and there are numerous examples of efficacious interventions, but to date, relatively few examples of successful implementation of digital health interventions into routine care within the NHS.  Specific areas where research is urgently needed include: improving user uptake of and engagement with digital health interventions, and achieving integration and implementation within routine care.


Involving patients and families in improving the quality & safety of healthcare

Involving patients and families as partners in their care is seen to be a key way of helping the NHS to improve the quality and safety of healthcare.  Research on how best to do this has largely focussed on the inpatient setting but there has been a recent shift to exploring the patient role within the primary care setting.   We are interested in connecting with anyone across the school with a broad interest in person centred care, and the patient role within that context, but particularly with those interested in or currently researching shared decision making (SDM) and/or patient/family/carer involvement in improving patient safety.

Mental health




Research into mindfulness based approaches, including Mindfulness based stress reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT), as well as their adaptations for digital health is already underway within SPCR. The purpose of the working group would be to bring colleagues together already working in this area to explore the added value in pulling together a programme of work in this area-bringing methodological expertise and innovation alongside expertise and variation in the ways mindfulness is being adapted and applied for different patient groups and conditions. At Bristol we have experience in delivering MBCT to COPD and asthma patients with co-morbid anxiety, developing MBCT for survivors of domestic violence and abuse as well as carrying out systematic reviews using meta-ethnography in this area. if colleagues from 3 schools, in addition to Bristol, are interested in collaborating, we will hold an initial meeting in Bristol to i. share existing areas of expertise and patient focus ii. identify areas for collaboration and crossover iii. identify a programme of work that maximises working groups expertise





We are also setting up PPI workshops, with a variety of themes, to support the use of Patient and Public Involvement in identifying and prioritising research questions for FR16. If you would like to take advantage of this opportunity, please get in touch with Emma Palmer-Cooper with information on your research and clinical theme (along with the names and numbers of other interested parties where appropriate) before 31.3.17.  Workshops will be arranged for themes with sufficient expressions of interest.