It’s Not Just Hospitals – the variety of settings where clinical research can take place (Part 2 – Care Homes)

By Sandra Prew, Network ENRICH Lead

In this blog, I am going to build on a previous blog from Andrea Shilton Research Delivery Manager for the Network, which highlighted the increasing demand on healthcare, and the resulting opportunities to conduct research in a variety of settings. Last time, Andrea talked about research in Hospices.  This time I am going to look at Care Homes.

Increasing demand on healthcare

There are now 11.8 million people aged 65 or over in the UK; this is projected to rise by over 40 percent (40.77%) in the next 17 years to over 16 million (Reference 1).  To support this demand, there is a growth of independent healthcare providers, care villages, care homes, and nursing homes.  They provide for a variety of care needs for those unable to live at home due to increased frailty or incapacity or multiple health conditions.

The Care Home setting

There are an estimated 4,699 nursing homes and 6,023 residential homes without nursing in the UK, and according to the latest Laing & Buisson survey (Reference 2), there are 421,100 people aged 65+ in residential care (including with nursing).

Care homes have a diverse population with health conditions which include stroke, dementia, Parkinson’s disease, diabetes to name but a few. End of life care is also provided by many.  Clinical research, like health care, can take place outside hospital settings, and care homes are a good example of this. The importance of care home research is recognised, especially in the field of Dementia.  The Government’s  Challenge on Dementia 2020 states ‘By 2020 we would wish to see, more research being conducted in, and disseminated through, care homes, and a majority of care homes signed up to the NIHR ENRICH Research Ready Care Home Network’.

Overcoming the challenges of conducting research in Care Homes

Conducting research in a care home setting presents its own set of challenges, but they are not impossible to overcome and need to be addressed if we are to improve care for those who live in them, especially those with dementia. Care homes are often relatively small organisations and can be inexperienced in overcoming research barriers. Learning to talk the same language when talking about research is essential, as is a shared vision of improving residents’ lives. Across the West Midlands, these challenges have been addressed through the work of the Network’s ENabling Research In Care Homes (ENRICH) Team.  Collaboration, partnership working and a commitment to equality of access for all, contribute to our goal of implementing research.

For example, an ENRICH Steering group was established, bringing together voices from NHS Trusts and Universities, care home managers, carer representatives, researchers and other professionals who work across homes and research.  Having a Team for ENRICH means we can lead and coordinate their efforts to become research ready and active. We can act as a support, a point of reference and advisers to those either conducting research, preparing to, or those who want to take part in research. ENRICH supports over 100 Care Homes in the West Midlands.

This research culture continues to develop and the Network is facilitating opportunities for sharing of issues and expertise to overcome the problems encountered in homes, by supporting local events and arranging events to showcase what research is being done.

If we are to understand the growing aging population we need to extend research beyond the traditional NHS setting and work closely with partners in non-NHS care organisations.  I am hopeful that, as healthcare changes in the future, we will see more collaborative working, and clinical research will be continued to be delivered beyond the NHS, regardless of age, mental capacity or residence.

Reference 1:

Reference 2: Care of Older People UK Market Report, Laing & Buisson, 2017





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