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Co-Director of Raparu Consult Community Interest Company
Visiting Professor at the University of Staffordshire and Honorary Professor of Keele University
Projects
Recent projects
Celebrating the success of Raparu’s Work-Able programme!
Raparu was among 8 Stoke-on-Trent organisations awarded a grant through the UK shared prosperity fund (UKSPF) to delivery projects aiming to support local residents in developing employability skills and supporting local businesses.
Raparu aimed to achieve this by the DigitALL scheme, an overarching project aiming to equip individuals and businesses with digital skills to enhance employability skills, as well as improve skills of people already in employment. Enhancing staff health and wellbeing was central to Raparu’s objective to inspire local people in using digital aids to better their lives in and out of work.
Through hosting over 25 healthy working/upskilling events with the focus on the importance of maintaining a healthy workplace, and minimising physical and mental stress, the programme managed to engage with over 1,290 local participants who have successfully reported improvements in access to basic digital skills, enhanced levels of digital inclusion and an overall supportive approach to engaging in digital health skills to improve their health and wellbeing!
Recent projects focused on detecting undiagnosed atrial fibrillation that I have led on (2021-2025)
Our innovative delivery of the AF detect, protect and prevent programme over the last three years utilised the AF detection AliveCor KardiaMobile device, under Professor Chambers’ leadership in various areas of Staffordshire. The innovative aspects included:
· combining with the ‘flu vaccination service in 16 practices in East Staffordshire to target patients most at risk with undiagnosed AF (49 new cases of AF were confirmed by 12-lead ECGs);
(Mathew S and Chambers R a. Correspondence. Evaluating the use of a mobile device for detection of atrial fibrillation in primary care. Br J Cardiol 2021;28:101doi:10.5837/bjc.2021.036 https://bjcardio.co.uk/2021/07/correspondence-10/
Mathew S and Chambers R b. Improving the utility and sustainability of novel health technology to improve clinical outcomes for patients: an East Staffordshire experience of screening for atrial fibrillation with the AliveCor KardiaMobile. BJGP Open February 2021. DOI: 10.3399/BJGPO.2020.0169 https://doi.org/10.3399/BJGPO.2020.0169 )
· talking directly to patients in Stoke-on-Trent, invited by Accurx texts matched to their risk factors by their practice teams in community settings such as local libraries, where they were updated about AF and checked; training social prescribers and other unregistered staff with frontline engagement with patients to use the AliveCor device and do opportunistic checks. The latest capture of the numbers of patients newly diagnosed through this community reach over a 5 months period was 30 newly confirmed cases of AF of which 20% were identified by social prescribers; these results were relayed by an infographic to national leaders (eg Gareth Lord, CVD Prevention Programme, NHS England 2023; Dr Matt Kearney UCL 2024) who congratulated us for our successful innovative delivery.
(Sundaram S and Chambers R. Identifying undiagnosed AF; Don’t risk it programme. Meir PCN eposter and oral presentation. Royal College of General Practitioners’ Annual Conference, 2024.)
The national AF Association recognised our trial of two types of cardiac holter monitors for detecting cardiac arrhythmias as one of the AFA showcase leaders in 2022. This project was initiated by our concern that many cases of AF may be missed if it is paroxysmal or episodic. Of the 85 patients in five general practices in Staffordshire who wore the Zio or ePatch holter for 7-14 days, 94% were found to have an arrhythmia, of which 15 had AF, confirming the need for ongoing detection when an arrhythmia is suspected but not confirmed, rather than a one-off clinical examination. The usual service in Staffordshire in 2022/23 that still persists now and is replicated across England is for a patient to be referred to secondary care first to then be fitted with a holter for 24 -48 hours, that involves an 8-12 week wait and two trips to the hospital site for the fitting and removal of the holter.
(AF Association: Feasibility of cardiac Holter monitors for detecting cardiac arrhythmias in general practice - published in the AF Association Healthcare Pioneers’ Report 2022 – Showcasing best practice: https://www.heartrhythmalliance.org/afa/uk/healthcare-pioneers-report/case-studies/52 )
The current programme that I’m leading, building on what we have learnt from these earlier projects, is to empower mental health frontline staff caring for people with serious mental illnesses in hospital, to identify those with undiagnosed AF, or other arrhythmias to detect, protect and protect patients with undiagnosed or poorly treated AF - as advocated in the NHS Long-Term Plan. As we conclude the project we will share this learning and
recommended focus on people with mental ill-health, at scale across the UK through publication of an article, webinars, social media routes and the Hospital Trust communications’ team.
Digital inclusion is part of the message of self-care in the technological age. Many people could use technology better, if there was a purpose to it, but without a clear need, many see it as a gimmick, or a cost-saving measure.
But people can understand their medical conditions better if they are participants in the recording of their blood pressure, blood oxygen readings, or blood sugar levels, and can stay at home, and treat themselves as agreed with their health professional, which saves them leaving their house when feeling ill, and can start treatment early.
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Remote monitoring via text messages, and the use of video consultations enables accurate care to be given when and where it is needed.
Without some engagement of the public in understanding the use of technology, just providing equipment will not achieve the desired results, so providing help, from organisations who can provide formal training, community groups, or buddies can help to increase confidence in using technology.
Sometimes people have difficulty travelling to centres, and technology can help with video consultation, or providing equipment to enable self-treatment to be carried out at home. Apart from using blood pressure monitors, peak flow meters, or pulse oximeters, more technologically advanced equipment is becoming available to use at home. An automatic blood sugar monitor linked to an app on the patient's phone can help people with diabetes to understand how their blood glucose varies according to their daily activities.
A wearable wrist heart rate monitor is being used during exercise following heart attacks or cardiac surgery to give patients confidence to increase their activity, knowing that the effect on their heart is within agreed limits.
Other patients, who often fail to attend for pulmonary rehabilitation, are undergoing this training remotely, using Virtual Reality headsets. So far, the response has been very good.
There is more information in our website www.Raparu.co.uk
