The main study is testing the Time-to-Transition Caesarean Birth method, which has been developed by Obstetricians and Neonatologists at Southmead Maternity Unit.

Rather than being born rapidly after opening the womb, the doctor will deliver the baby’s head and keep the body inside the womb until the baby starts to breathe or to cry, up to a maximum of 2 minutes, before delivering the baby fully. The birth will be filmed using two Hospital cameras. We will ask for your consent to be filmed. If you say no, we can film the birth in such a way that you will not be visible. You can still be involved in this Birth Partner study if you say no to being filmed.

As you are the birth partner of someone who has agreed to take part in the Time-to-Transition Caesarean Birth study, we would like to invite you to take part too, by sharing your thoughts about your experiences of the birth. If you decide not to take part, the person who you are birth partner to can still be involved in the study.

There will not be any direct benefit to you in taking part, but you may be helping families in the future once the results of this study are known.

This is a questionnaire study and there will be no risk to you.

To find out more about the possible benefits or risks to the caesarean birth itself, please refer to the “Time-to-Transition Caesarean Birth Study” information leaflet. (where can this be found)??

If you agree to take part, we will ask you some questions about yourself (such as age and ethnicity).

We will also ask you to complete a short questionnaire about your experience as a birth partner to a participant of the main study

• once just after the baby’s birth and
• once when the baby is about a month old.

Each questionnaire will take about 5-10 minutes to complete, and can be done over the phone, or on a smartphone or computer if you have one.

This study is being carried out by staff at North Bristol NHS Trust and the University of the West of England.

This study is funded by donations made to the Southmead Hospital Charity.

The Health Research Authority and South Central Berkshire Research Ethics Committee (B) REC: 23/SC/0228 IRAS project ID: 325202 have reviewed and agreed to this study.

If you are eligible and interested in learning more, a Research Midwife will talk to you and help you decide if you'd like to take part in this study. If you would still like to take part, they will ask you to complete a consent form.

You can change your mind and withdraw from this study at any time and without giving a reason, but we will keep information about you that we already have. If you do not want this to happen, tell us and we will stop. It will not affect the care that you receive, nor that of the person you are birth partner for.

We will ask you to let us know your preference by completing a study withdrawal form.

We need to manage your records in specific ways for the research to be reliable. This means that we won’t be able to let you see or change the research data we hold about you. If you agree to take part in this study, you will have the option to take part in future research using your data saved from this study.

All research in the UK, which uses patient information must follow UK law (the Data Protection Act) and GDPR* rules.

North Bristol NHS Trust (UK) is the Sponsor for this study. This means we are responsible for looking after your information and using it properly, according to the rules and law.

In this questionnaire study we will need to use some information about you. This information will include your name, contact details and some basic information such as your age and ethnicity. We will use your contact details to get in touch with you by phone, email, or text.

We will keep all information about you safe and secure. People who do not need to know who you are will not need to see your name or contact details. Your data will be given a code number instead. We will write our reports in such a way that no one can work out who took part in the study.

Once we have finished the research study, we will keep some of the data so that we can check the results. We will store study data for up to 5 years after the end of the project, as per standard protocol at North Bristol NHS Trust. We will write our reports in such a way that no one can work out who took part in the study.

(*GDPR stands for General Data Protection Regulation)

North Bristol NHS Trust is the sponsor for this study. You can find out more about how we use your information at:

Patient Data & Research Privacy Policy | North Bristol NHS Trust (nbt.nhs.uk)

www.hra.nhs.uk/information-about-patients.

You can also:

• Ask one of the research team
• Contact Helen Williamson (Head of Information Governance) at helen.e.williamson@nbt.nhs.uk or by calling 0117 4144767

NHS-sponsored research such as this study is covered by NHS indemnity (the same indemnity that applies to any patient in the NHS). In the unlikely event that you feel you have been adversely affected by taking part in this study, you should contact the research team as soon as possible. 

Should you wish to complain about any aspect of the way you have been approached or treated during the study, the normal NHS complaints mechanisms are available to you.

Please visit www.nbt.nhs.uk/patients-carers/feedback for further information about how to make a complaint or contact the North Bristol NHS Trust Hospital Patient Advice and Liaison Service (PALS): Telephone 0117 414 4569. PALS can also provide confidential advice and support to patients, families, and their carers.

The study is being led by Dr Joanna Crofts at Southmead Hospital (North Bristol NHS Trust). If you have any questions about the study please contact Dr Joanna Crofts, Consultant Obstetrician, Southmead Hospital either by:

The Study Email address: TTT@nbt.nhs.uk

Telephone: 01174146764  - between 9 am to 4pm.

Bacteria live in the intestine to help digest food. If the intestine is damaged by an operation, injury or a disease such as cancer, bacteria can leak into the space surrounding the intestine (called the abdominal cavity) and cause a serious “intra-abdominal infection.” The usual treatment for this is a course of antibiotics (usually for 7 – 18days) and sometimes surgery too. But unfortunately, these infections are complicated and the treatment doesn’t always work. In 50% of patients the infection will return, or they will develop a new one further down the line. This is called “treatment failure” and requires another course of antibiotics, and possibly more surgery.

However, current research suggests that a longer course of antibiotics may benefit these patients by preventing treatment failure and further hospital admissions. So, the EXTEND trial will be comparing an extended course of antibiotics (28 days) against the normal duration of antibiotics (7 – 18 days). Each participant will be allocated by chance into one of these two groups and will be closely monitored for the next 6 months to see if the extended course of antibiotics offers a benefit to patients by reducing the rate of treatment failure.

Principal Investigator: Anne Pullybank

Planned End Date: 30/06/2025

Local Ref (R&D no): 5187

The study aims to further medical knowledge and may improve future treatment of melanoma. The study will investigate how much skin should be removed from around the melanoma during wider excision surgery. Currently, doctors do not know how much skin to remove from around a melanoma to reduce the chances of it coming back. Guidelines in different countries vary in their recommendations on this. This study will investigate if reducing the excision margin to 1cm is as good at reducing the risk of melanoma returning as a 2cm excision margin.

Principal Investigator: Mr Ewan Wilson

Planned End Date: 01/07/2029

Recruitment to end 01/07/2025

Local Ref (R&D no): 4755

The NHS Cancer Vaccine Launch Pad (CVLP) is looking to find people who may be able to take part in research trials for personalised vaccines to treat cancer. By supporting these trials, NHS England (NHSE) aims to speed up the development of personalised treatments for cancer patients. 

We are offering patients having their cancer removed or biopsied the opportunity to have their cancer DNA analysed for changes that could be targeted for personalised treatment. The CVLP is looking for people who may be suitable for cancer vaccine research trials. Vaccines are usually used to stop people from getting a disease, such as polio or measles. Researchers are now looking at using vaccines to stop cancer coming back after it has already been treated. Cancer vaccines stimulate the body’s immune system to recognise and attack cancer cells.  

Cancer vaccines are designed using genetic (DNA) changes found in a person’s cancer. They are individually made for each person. Cancer vaccines are being tested in research trials to understand how well they work. 

Project Details

PI: Ann Lyons

Planned End date: 31/12/2030

Local Ref: 5497

Hospital acquired thrombosis describes blood clots that form in the legs and lungs after someone is treated in hospital. A clot in the leg can cause swelling, pain and other problems. If a clot in the leg breaks off and travels to the lungs, it may be life threatening. Having surgery increases the risk of developing blood clots. Blood clots in the legs and/or lungs are collectively known as venous thromboembolism (VTE).  

Doctors have known about the risks of patients developing blood clots after operations for many years and use two main ways to prevent this: 

• Thinning the blood with injections / tablets, and 

• Wearing elastic stockings to help stop blood sitting in the leg veins where it can clot. 

All participants who undergo surgery that puts them at higher risk of developing VTE require the blood thinners to be taken post discharge from hospital. Currently, some hospitals provide elastic stockings in addition to blood thinners but other hospital do not. There are no good quality research studies to show if the addition of elastic stockings reduces the risk of VTEs in patients taking blood thinners after discharge from hospital. This study is being done to find out if this is true.  

Project Details

PI: Anne Pullyblank

Planned End date: 31/07/2027

Local Ref: 5522

Perianal fistulising Crohn’s disease affects around one third of patients with Crohn’s disease during their course.  It is one of the most debilitating complications in Crohn’s disease.  Treatment methods are still evolving and approaches involving a combination of medical treatments and a number of surgical techniques are proposed.  However, the efficacy of these approaches to achieve clinically relevant outcomes is uncertain.  The majority of the recommendations are based upon expert opinion and there is relatively little scientific evidence to guide Crohn’s Disease perianal fistula (CD-pAF) management.

Our research is vital to understand the causes and consequences of problems in Crohn’s disease and improve the lives of those affected.  We aim to convert our research findings into clear improvements in health and services for people with Crohn’s disease with perianal fistula.  You could help by taking part in research that is relevant to you.  This might be to do with symptoms that you have now, or that you’ve had in the past, or even symptoms that you have never had (for comparison to other people who have).

Project Details

PI: Caroline Burt

Planned End date: 31/12/2030

Local Ref: 5495

This is a good painkiller for the type of surgery you have had.

We recommend you take 2 x 500mg tablets regularly 4 times a day for 1 or 2 days. Please check the label of the paracetamol you’ve bought and follow the instructions. If you have been given paracetamol prescribed by your anaesthetist before your operation, please remember it is perfectly safe to take 2 x 500mg tablets every 6 hours.

Remember not to take any other tablets containing paracetamol, such as co-dydramol or co-codamol.

You should take these tablets even if you have no pain, as they will keep the pain away. Paracetamol works in a unique way and will work with other painkillers.

We will write down when your next dose is due. 

This is an anti-inflammatory painkiller.

The dose is normally 1 x 400mg tablet 3 times a day, but check the label of the preparation you have. If you can take ibuprofen, it should be taken regularly with paracetamol. Do not take ibuprofen at the same time as other anti-inflammatories such as aspirin, Nurofen, Brufen, or naproxen.

Ibuprofen has few side effects:

• It can sometimes cause indigestion, so they should be taken with food. If you develop indigestion or abdominal pain, stop taking them.
• If they make you wheezy or breathless stop taking them.

If you are not sure if you can have them please read the label or ask your Mediroom nurse or practitioner.

Anti-inflammatory tablets can be taken at the same time as codeine phosphate and will improve your pain relief.

We will write down when your next dose is due. 

Some patients will be given codeine to have on top of their paracetamol and/or ibuprofen. If you should already be taking these regularly you should continue to do so, otherwise you do not have to take codeine.

You do not have to take codeine regularly. It is a stronger painkiller which can be helpful if regular paracetamol and/or ibuprofen are not enough on their own to help with your pain.

Codeine may have side effects such as nausea, drowsiness, dizziness or constipation (having plenty of fluids and some fruit helps avoid constipation). If, however, the side effects are unpleasant, stop taking them and consult your GP or pharmacist.

1 or 2 codeine tablets can be taken up to 4 times a day for added pain relief. Do not exceed the prescribed dose.

We will write down when your next dose is due. 

With the following options, please be aware that you can’t access your notes until you receive a ‘security phrase’ from your Midwife.

a. Using a mobile phone

iPhone - Please search for the Badger Notes app in iTunes and download. Once done, tap the icon on your home screen to open.

Android - please search for the Badger Notes app in the Google Play store and download. Once done, tap the icon on your home screen to open.

b. Using a PC or tablet
You can log in to the Badger Notes website by clicking this link: badgernotes.net

For more information, please see Badger Notes help.

If you're registered with a GP in England, you can also create an account using NHS login.

The video below shows you how to log in, and explains the various Badger Notes features.

All information is held securely and cannot be accessed without the correct login details (similar to when you use internet banking).

No – the only person who can access your information is you. For care purposes, healthcare professionals such as GPs will also have 24-hour access to information - but only once they've been granted access to Badger Notes by you.

It is configured to the 11 most common languages as held on/used by the Badger Notes app, as follows: English, Welsh, Polish, Punjabi, Bengali, Spanish, Portuguese, Romanian, Lithuanian, Somali, and Maori. There is also a translate function on the desktop version.

You can access Badger Notes on a home device (e.g. desktop or laptop computer, tablet) via the internet. If you do not have internet access, please speak to your Midwife.

If this is the case, a copy of your notes will be sent on to the new hospital.

Have you tried these things?

• If you registered using your NHS login details you must use the blue NHS login button to access your account:
• If your current details do not match your NHS login details you will need to change them via the NHS app
• It may be helpful to try to log into the website via a web browser and not the app.
• If your password is not recognised click on the ‘forgotten password’ button to reset it. 
• Further help can be found at Badger Notes - Help & FAQ

If you are still having problems, then please call our dedicated Badger Notes helpline on 0117 3429301 or email badgernotessupport@uhbw.nhs.uk. You will be asked to quote your NHS number so please ensure you have this to hand. This is a non-urgent telephone line and is monitored 10-4 Monday to Friday and 11-3 at weekends by administrative staff. If you need to speak to a midwife, you should call your local hospital as normal.  

What we will do: 

• Enable more people to engage in public and patient involvement (PPI) and co-production of research
• Provide research opportunities that reflect our patients’ experiences
• Improve patient safety and experience by demonstrating and implementing research results

How we will do it:

• We will seek to understand the logistical, cultural and language barriers which inhibit equitable and inclusive PPI with all the communities we serve. This knowledge will allow us to develop guidance to support, engage and empower underserved communities. Disseminating our learning with our healthcare partners will support best practice that is implemented system-wide.
• We will maximise opportunities in research, that reflect the needs of our patients and communities, by raising awareness and demystifying research through the effective use of different media platforms. Research campaigns and engagement events will maximise the use of environmentally sensitive approaches. Through cross-organisational collaborations we will ensure opportunities to participate in research across the region.
• We will work with our research and PPI partners to ensure research outcomes are disseminated to study participants in appropriate and timely ways. We will work with our colleagues across NBT and the region to implement the outcomes of research to improve health outcomes, whilst avoiding and reducing the environmental costs of repeating unnecessary research studies.
• We will actively use our experience from previous studies to improve the design, deliverability, and efficiency of studies to ensure effective implementation, whilst reducing the negative environmental cost of research and healthcare.

What success will look like

• The demographic profile of staff, patients and public involved in research will better reflect our local community.
• The results of our research will be implemented into clinical care efficiently and within pre-defined timelines.

What we will do:

• Build upon the skills of our workforce and volunteers
• Develop the future workforce
• Develop improved career pathways for all our research staff

How we will do it:

• We will promote research as a dynamic career option, co-designing a suite of training programmes, supporting new starters, optimising delivery expertise, developing new and more effective ways of working and supporting courageous and compassionate leadership through training which is both inclusive and environmentally sensitive.
• We will develop comprehensive career pathways to empower and support emerging talent to help individuals to pursue and access funding, mentorship, and coaching (academic or NHS) to realise their career and research ambitions.
• We will promote opportunities to develop as leaders and lead researchers investing in the researchers of the future to address current issues with innovative solutions and strategies.
• We will seek opportunities to enhance our quality improvement cycles and embed the lessons learned which includes adapting study design and delivery, providing state-of-the art research facilities and using technology proactively.

What success will look like

• Improve our current internationally recognised “Investors in People” accreditation.
• An increased number of non-medical researchers acting as lead researchers.

What we will do:

• Increase awareness of research and its impact on clinical care
• Deliver research that improves healthcare and patient experience
• Embed research in the care pathway of all NBT services

How we will do it:

• We will promote the rights of patients to engage in research, and for staff to understand their opportunities and responsibilities to offer and support appropriate research, irrespective of profession, background, or characteristics. We will ensure patients and staff are supported to engage with research and the research information is easily accessible. All internal funding opportunities will be widely available, and access will be equitable, inclusive, and promoted through multiple media channels
• We will actively engage with clinical divisions and healthcare education programmes to demystify research and promote research as everyone’s right and responsibility. This will enable current and future clinicians to address clinical questions that improve the health and experience of our patients and communities.
• We will work with clinical and leadership teams to focus and embed research within clinical pathways and staff job plans, ensuring results are disseminated through departments and divisions in a timely manner. We will ensure the time our staff invest in our research is recognised and appreciated, helping to raise awareness of the value and contribution research makes in clinical practice.
• We will co-design an adoption process with the Trust Transformation team to facilitate the implementation of research findings at NBT, agreeing targets for implementing research findings and demonstrate the value of evidence-informed and value-based practice across all clinical areas.

What will success look like?

• An increase in research awareness and engagement amongst patients and staff.
• An increase in the number of research findings being implemented at NBT.

What we will do:

• Build on our reputation for cross-system research and innovation to make us the collaborator and centre of choice
• Identify our strengths, clinical priorities, and opportunities to develop and deliver world-leading research
• Ensure efficient resource utilisation for the delivery of NBT and cross-system research

How we will do it:

• We will develop and maintain with our regional partners, a suite of best practice guidance, policies, and agreements to enhance efficient and seamless processes. These will maximise research productivity and income in regionally strategic areas which will also promote inclusivity and be environmentally sensitive.
• We will continue to explore and deploy new research methodologies suitable to pragmatic health and social care research, including working with NBT Information Governance, and Digital Services and Technology to implement and deliver big data projects efficiently and effectively. New approaches will allow us to broaden and diversify our research portfolio focusing on under-represented professions, specialities, and communities.
• We will embed quality improvement in everyday practice to enhance the design and delivery of the research led and delivered by NBT. We will work with regional partners to develop and share best practice, facilities, training, and infrastructure. This will, in turn, improve our efficiency in the way we deliver research thus enabling further investment in our teams and facilities.

What will success look like?

• A comprehensive suite of guidance which supports cross regional research.
• We will lead and implement adaptive pragmatic solutions to delivery challenges.

Helen Lewis-White, Deputy Director Research & Development

We are delighted at how much we have achieved as a research community over the last five years. NBT has offered increasing opportunities for our communities to become involved in research, doubling recruitment into clinical research between 2017-2022.

NBT’s grant success over the last 5 years has been firmly based on high quality Patient & Public Involvement (PPI), ensuring we are seeking the answers to questions most relevant to our patients and the clinical services we deliver. During that time nearly 250 PPI meetings supporting 20+ research groups have worked together to define and refine research ideas, approaches and interventions, and to monitor the progress of studies as members of trial management groups.

During the same five year period, the number of departments offering research grew from 45 to 55 resulting in research taking place across every division of the Trust. In addition 8000 participants were directly recruited at North Bristol NHS Trust. We currently lead over 30 multi-centre studies across 100 Trusts throughout England and the devolved nations, offering new opportunities for patients and participants to engage in research.

The primary role of everyone within the Trust’s research infrastructure is to enable patients and the public to engage in relevant research opportunities, helping to shape healthcare for the future. For some, research may offer a new or additional treatment option, but for many people who participate in research the benefit for them is knowing they are contributing to improving care and outcomes for others.

“It’s clear that the medical community are continually trying to answer new questions, but they can only do this with the help of patients. As a lay member of the public, we don’t understand fancy medical vocabulary, so we have to dream up new ways of describing medical terms. We also have to think of ways to make our research programme interesting and to encourage as many people as possible to sign up.” Public & Patient Involvement Member.

“I know my Alzheimer’s is not going to get better. I decided to take part in research because it might just help people with this disease in the future” Research Participant

The NBT Research & Development team supports all aspects of research activities supporting the different developmental stages of research. From exploration of ideas, through qualitative ‘question finding’, through to the dissemination and implementation of findings from these clinical trials into real world practice for population health benefit.

Research at NBT is a multi-disciplinary and multi-specialist activity incorporating patient and members of the public, whose specialist lived experience provides our teams with essential and unique perspectives. This allows the research teams to work closely with Patient and Public Involvement (PPI) representatives, to co-develop and shape the important research questions, design the most appropriate study format, and to then monitor the progress of studies through to completion. Finally, the teams will then support the wider public dissemination of study findings and appropriate implementation, leading to an improvement in, or a change to, the delivery of clinical services.

NBT currently manages £28 million in research grants with an annual grant income of approximately £2.5 million. During the last five years the breadth and scope of the grants supported and awarded has grown significantly and we are currently leading 60 research grants and partnering on a further 59 externally led grants.

To enable the increase in patient opportunities to participate across the research landscape the NBT research infrastructure has grown from 115 staff members to over 140 individuals. We have also continued our commitment to invest in and develop our team members. In 2019 R&I was awarded an Investors in People Silver accreditation in recognition of the programme of work the R&I infrastructure has undertaken supporting, and improving how we work as individuals, teams and as a department, and developing our leaders now and for the future.

NBT prides itself on the strength of its research collaborations across a wide range of academic affiliations, healthcare settings, and industry partners.

Academic Health Science Centre (AHSC) which focuses on close collaborative system-working across the Bristol, North Somerset, and South Gloucestershire (BNSSG) Integrated Care System (ICS). The partnership enables the best use of the regional academic research infrastructure, combined with the implementation and evaluation expertise and activities led by the West of England Academic Health Science Network, directly informing the work of the BNSSG ICS.

We now aspire to build upon the previous NBT research strategies and our experiences throughout the COVID-19 pandemic, which has driven and shaped how research is now conceived, developed, and delivered.

Our academic links with globally recognised academic research institutions including the University of Bristol, University of Bath, and University of the West of England (UWE) have contributed significantly to our success. Through these collaborations NBT ensures the research we lead is patient centred, clinically important, and pragmatically delivered.

Throughout the last five years, and particularly the last two years during the COVID-19 pandemic, our collaborations have driven our continued strength and growth. Through these collaborations and mutual support NBT helped lead the regional COVID-19 vaccine research response, supporting other Trusts to recruit to COVID-19 pandemic vaccine trials across the West of England region. NBT continues to support and lead the NIHR Comprehensive Research Network: West of England (CRN:WE) and to work with partner Trusts across the region to develop novel quality improvement programmes, innovation in research delivery, and to share best practice.

NBT also benefits from being a leading and founder member of the vibrant and ambitious strategic health research and innovation partnership, Bristol Health Partners

“Generating a research culture requires innovation, creativity, engagement and skill. Here at NBT we are instilling a collaborative research culture across all areas of the Trust to ensure research stays at the heart of what we do.”

Dr Tim Whittlestone, Chief Medical Officer

Below are a few examples of the research achievements at NBT from across the lifespan of our patient population, realised through close collaborative working with our patients and partners.

STAR Programme

The STAR Programme developed and tested a care pathway for the one in five patients who will experience chronic pain three months after knee replacement surgery. STAR identified underlying causes of chronic pain and enabled onward referral for targeted treatment through screening, assessment with an extended scope practitioner, and telephone follow-up over 12 months. STAR demonstrated clinically important improvements in pain and recovery, and is good value for money, reducing hospital admissions and length of stay.

The STAR care pathway was implemented at NBT within six months of the final report to the NIHR, and is now being rolled out nationally, with the potential to improve pain and recovery for over 20,000 patients each year alongside annual NHS cost savings of over £14 million.

ASSIST

The ASSIST trial has tested a new device for assisted vaginal births and is the first potential device for assisted birth since the introduction of the ventouse suction cup, in the 1960s. For this trial a major success has been the use of alternative patient information methods. The study team developed videos to explain the study, demonstrating how the device works on a mannequin doll and including answers to common questions. Women and partners were able to watch the video at their leisure and given another opportunity to ask questions. The use of a freely accessible video combined with both a brief and detailed patient information leaflet was commended by the Research Ethics Committee (REC) for facilitating parents understanding of the study during emotive and challenging times.

CERA: COVID-19 Emergency Response Assessment

In collaboration with the University of Bath the CERA study explored the emotional impact of the COVID-19 pandemic on frontline Emergency Room and Intensive Care Unit medics. It demonstrated the significant psychological toll the COVID-19 pandemic was exerting and helped highlight the need for greater focus on mental health and wellbeing. It was particularly useful in highlighting the challenges medics feel in seeking assistance, and the fear and shame they experience when they admitted their emotional wellbeing is being affected by their role.

AERATOR

Aerator, a collaboration with the University of Bristol, tested the aerolisation of procedures during COVID-19 pandemic in multiple clinical settings. The study design enabled rapid assessment and dissemination. The results of the Aerator study were used extensively to inform the levels of personal protective equipment policy nationally and internationally. This both protected staff and patients but also enabled an evidence base for reducing unnecessary infection control procedures and enabling clinics to increase their capacity and begin to address patient backlogs.

Aerator also made use of innovative mechanisms for engaging clinicians and the public with the results of the study, using a comic strip to explain the issue and the results, ensuring the results were more accessible. https://artibiotics.com/blog/aerator

This new research strategy outlines our ambitions for the next five years. It complements and supports the Trust’s values and underpins the behaviour and principles of every member of staff.

Our strategy will describe what we plan to achieve, the objectives we will need to meet them, and the additional steps we will be undertaking to further embed research within patient pathways and our community. At the same time, it is essential we remain agile to changing priorities as they arise, through constant monitoring of our research portfolio and how it informs and is shaped by health and care delivery across the BNSSG ICS.

While this strategy is specific to clinical research, we recognise a culture of innovation is a key element of ensuring research is converted to clinical change and patient benefit which forms the bedrock of the research cycle.

With empowerment as a core principle of our strategy, we aim to:

• Empower patients and public as co-producers of research
• Empower clinical staff to address questions they believe will improve patient care
• Empower researchers with the skills and knowledge to best deliver the research they undertake and lead on
• Ensure patients and the public are key contributors and collaborators within our research environment
• Empower all our communities to hold us to account and create equity of access and inclusivity whilst ensuring our research is environmentally responsible.

Since 2016 each review of the strategy has been shaped through stakeholders’ consultation exercises, questionnaires, meetings, and conferences. These include the researchers who generate our research, the teams who deliver the strategy and our regional strategic partners and stakeholders. Each year we monitor our progress and report to the Trust Board. In 2020 our primary focus shifted to helping answer critical questions about the spread, prevention, and treatment of COVID-19, noting that the epidemic disrupted many of our other research activities resulting in some objectives not being completed, whilst other key activities became more urgent.

Whilst the Trust and R&I department has achieved so much against the delivery plans for the 2017-2022 strategy, changes to health and social care priorities, technologies and wider social change means the Trust now requires a new strategy to take it through the next five years. To develop the new strategy, we consulted widely with internal and external stakeholders undertaking the following engagement activities:

• A survey distributed across the research teams, research active clinical staff, managers and all NBT Trust email address recipients to ask whether the Vision, Mission and Aims represented the aspirations and commitments of our teams, partners, and stakeholders.
• A series of meetings were held in early 2022 to better understand the objectives, aspirations, and ambitions which we should endeavour to pursue through our strategy.
• The comments and feedback were collated and contributed to the formulation of the Vision, Mission, Aims and Objectives, which were then disseminated for further and wider consultation with internal and external stakeholders.

The last five years has seen substantial changes in societal attitudes and responsibilities in two significant spheres. COVID-19 and the Black Lives Matter movement have both highlighted the lack of progress healthcare and research has made in ensuring inclusivity and representation from all our communities, and the consequential health and wellbeing inequalities. During the same period the NHS and NBT have declared a climate emergency in recognition of the impact on health and wellbeing that environmental factors are causing.

Founding Principles

Following the above consultation and engagement activities, two overarching principles have been included in the new strategy as we seek to embed these attitudes and behaviours in the research developed, supported, and delivered at NBT:

Principle One

In everything we do we will seek true equality and inclusivity.

Principle Two

In everything we do we will seek to minimise the negative environmental impact of our actions.

Internal Stakeholders

• The research infrastructure
• Research Leads
• Research Innovation Group
• Divisional Clinical Directors
• Divisional Directors
• The Trust Equality and Inclusivity forums
• NBT PPI groups
• Southmead Hospital Charity
• The Staff of NBT

External Stakeholders

• University Hospitals Bristol and Weston NHS
• Foundation Trust
• Avon and Wiltshire Mental Health Partnership
• NHS Trust
• University of Bristol
• University of Bath
• University of the West of England
• NIHR Bristol Biomedical Research Centre
• NIHR West of England Clinical Research Network
• NIHR Applied Research Collaboration West
• Bristol Health Partners Academic Health Science Centre
• West of England Academic Health Science Network
• Healthier Together BNSSG Integrated Care System