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Background: The United Kingdom is facing an acute healthcare workforce shortage in every discipline, hindering National Health Service (NHS) recovery from the residual impacts of the COVID-19 pandemic and increasing ongoing endemic pressures. Objectives: To investigate the effectiveness of interventions relevant to the Welsh NHS context to support both recruitment and retention of clinical staff. Methods: The Wales COVID-19 Evidence Centre (WCEC) conducted a two-stage rapid umbrella review (RUR) in two and a half months. Following an introductory stakeholder meeting with The Royal College of Surgeons of Edinburgh, who requested the research question, and Welsh Government and patient representatives, a rapid evidence map (REM) was conducted to explore interventions that can help recruit and retain clinical staff including return-to-work schemes. The REM identified 58 reviews, including systematic, scoping and narrative reviews, and the findings were presented at an intermediary stakeholder meeting where the focus for the RUR was decided—assessing the effectiveness of interventions for recruitment and retention in healthcare settings that are similar to Wales, including rural areas. Results: The RUR included eight systematic reviews and one scoping review (with an evaluation component), mainly focusing on interventions within rural, remote or underserved areas from across the world. In the synthesis, interventions were mapped across five World Health Organization (2010) categories: educational, regulatory, financial incentives, personal and professional support and bundled (activities that cover two or more different categories). Final findings were presented at an evidence briefing for stakeholders and other interested parties to maximise impact. Furthermore, stakeholders’ feedback was that the RUR enabled them to share accurate data with policymakers in Westminster, other Royal Colleges, and Heads of Medical Schools in the United Kingdom. Conclusions: Although RURs

Background: The National Health Service (NHS) is experiencing an acute workforce shortage in every discipline, at a time when waiting times are at a record high and there is a growing backlog resulting from the COVID-19 pandemic. This Rapid Review aimed to explore the effectiveness of interventions or innovations relevant to the Welsh NHS context to support health professionals’ (HPs) recruitment and retention. The review used the findings of existing reviews supplemented by a more in-depth evaluation of included primary studies conducted in the UK or Europe. Methods: Searches were conducted across seven databases for English language publications from 2015 to February 2022 including: Medline, EMBASE, Ovid Emcare, HMIC, CINAHL, Epistemonikos and Cochrane Library. Organisational websites were also searched for grey literature. Two reviewers title/abstract screened all citations in CovidenceTM, resolving any conflicts. Full-text screening was conducted by two reviewers. All demographic and outcome data were extracted by one reviewer and checked by a second. Eligible systematic reviews were critically appraised by one reviewer and checked by a second using the JBI critical appraisal checklist for systematic reviews. The data were reported narratively as a series of thematic summaries structured around the type of intervention. Results: Systematic (n=8) and scoping reviews (n=1) were included and focused on dentists; general practitioners; physicians; the medical workforce and undergraduates; medical undergraduates; and a variety of different HPs including those in training. Most reviews looked for interventions within rural, remote or underserved areas. The interventions were mapped across five WHO (2010) categories: educational, regulatory, financial incentives, personal and professional support and bundled interventions (activities that cover two or more different categories). Regarding educational interventions, moderate-quality evidence indicated positive associati

Background: While women’s life expectancy is on average longer than men’s in the UK, evidence suggests that women experience more ill health and disability throughout the life course. The reasons for this include women’s underrepresentation in research, healthcare professionals’ (HCPs) education, communication problems between care providers and women, and issues with accessing appropriate services. The purpose of this rapid evidence map (REM) was to identify the nature and extent of the literature, research gaps and priorities in the following topic areas: a) HCPs’ communication with women about women’s health issues and broader health problems during clinical encounters; b) access to specialist healthcare; c) endometriosis; d) menopause; e) women’s health and mental health issues; f) mental health issues associated with specific conditions related to menopause or menstrual health (adenomyosis; endometriosis; fibroids; heavy menstrual bleeding, polycystic ovary syndrome (PCOS), premenstrual dysphoric disorder (PMDD)). Methods: This REM uses abbreviated systematic mapping or scoping review methods to provide a description of the nature, characteristics and volume of the available evidence. Separate searches were conducted for different topics (such as communication, access, endometriosis, menopause, and mental health) and combination of topics. The searches were conducted across four databases (MEDLINE, Embase, PsycINFO, CINAHL) with different date limits applied up to September 2022 for English language citations. Relevant organisational websites and funding bodies were also searched for grey literature and new or ongoing funding calls. Title/abstract and full-text screening and data extraction was conducted by one reviewer. Data was extracted from the abstracts about population characteristics, research focus, and study design. The evidence was presented both narratively and in the form of tables and graphical evidence maps. Results: Regarding communication during

Background: The UK social care sector is under increased pressure to combat workforce shortages. With recruitment of professionals impacted by Brexit, the COVID-19 pandemic and the cost-of-living crisis, social care needs innovations to attract, recruit and retain staff. Objectives: To work in partnership with stakeholders to determine the effectiveness of interventions to help attract, recruit and retain social workers and social care workers within the UK context. Methods: This rapid review (RR) was conducted by the Wales COVID-19 Evidence Centre (WCEC). The question was submitted by Social Care Wales, and at an initial stakeholder meeting, they provided a strategic overview of the social care situation in Wales outlining the need for the review. A search of available UK literature (including grey literature) from 2017 to 2022 was conducted within 1 week. At the second stakeholder meeting, the research team presented findings from this, to determine the focus of the RR. Results: This RR and subsequent publication was coproduced with the stakeholders over 2 months. Effective interventions to help with the attraction, recruitment and retention of social workers included practice learning, fast-track graduate programmes and apprenticeships. For the wider social care workforce, effective interventions included preemployment training, national recruitment campaigns, care work ambassadors and valuesbased recruitment. Weaknesses in the primary studies included lack of follow-up and objective evaluations of the interventions. Conclusions: The Social Care Wales team used the RR to inform its programme of work for developing the social care workforce across Wales. On stakeholders’ recommendation, findings were presented to the Directors of Social Services, workforce leads, managers and staff within Wales through the Association of Directors of Social Services. Impact was achieved through the inclusion of the review in the monthly summary of advice to the Technical Advisory

Background: While women’s life expectancy is on average longer than men’s in the UK, evidence suggests that women experience more ill health and disability throughout the life course. The reasons for this include women’s underrepresentation in research, healthcare professionals’ (HCPs) education, communication problems between care providers and women, and issues with accessing appropriate services. The purpose of this rapid evidence map (REM) was to identify the nature and extent of the literature, research gaps and priorities in the following topic areas: a) HCPs’ communication with women about women’s health issues and broader health problems during clinical encounters; b) access to specialist healthcare; c) endometriosis; d) menopause; e) women’s health and mental health issues; f) mental health issues associated with specific conditions related to menopause or menstrual health (adenomyosis; endometriosis; fibroids; heavy menstrual bleeding, polycystic ovary syndrome (PCOS), premenstrual dysphoric disorder (PMDD)). Methods: This REM uses abbreviated systematic mapping or scoping review methods to provide a description of the nature, characteristics and volume of the available evidence. Separate searches were conducted for different topics (such as communication, access, endometriosis, menopause, and mental health) and combination of topics. The searches were conducted across four databases (MEDLINE, Embase, PsycINFO, CINAHL) with different date limits applied up to September 2022 for English language citations. Relevant organisational websites and funding bodies were also searched for grey literature and new or ongoing funding calls. Title/abstract and full-text screening and data extraction was conducted by one reviewer. Data was extracted from the abstracts about population characteristics, research focus, and study design. The evidence was presented both narratively and in the form of tables and graphical evidence maps. Results: Regarding communication during

Background: The National Health Service (NHS) is experiencing an acute workforce shortage in every discipline, at a time when waiting times are at a record high and there is a growing backlog resulting from the COVID-19 pandemic. This Rapid Review aimed to explore the effectiveness of interventions or innovations relevant to the Welsh NHS context to support health professionals’ (HPs) recruitment and retention. The review used the findings of existing reviews supplemented by a more in-depth evaluation of included primary studies conducted in the UK or Europe. Methods: Searches were conducted across seven databases for English language publications from 2015 to February 2022 including: Medline, EMBASE, Ovid Emcare, HMIC, CINAHL, Epistemonikos and Cochrane Library. Organisational websites were also searched for grey literature. Two reviewers title/abstract screened all citations in CovidenceTM, resolving any conflicts. Full-text screening was conducted by two reviewers. All demographic and outcome data were extracted by one reviewer and checked by a second. Eligible systematic reviews were critically appraised by one reviewer and checked by a second using the JBI critical appraisal checklist for systematic reviews. The data were reported narratively as a series of thematic summaries structured around the type of intervention. Results: Systematic (n=8) and scoping reviews (n=1) were included and focused on dentists; general practitioners; physicians; the medical workforce and undergraduates; medical undergraduates; and a variety of different HPs including those in training. Most reviews looked for interventions within rural, remote or underserved areas. The interventions were mapped across five WHO (2010) categories: educational, regulatory, financial incentives, personal and professional support and bundled interventions (activities that cover two or more different categories). Regarding educational interventions, moderate-quality evidence indicated positive associati

Background: Two cancer rehabilitation (CR) services provide in- and outpatient support, such as a 12-week exercise programme, fatigue management groups etc., in two oncology centres in South Wales, UK. However, some cancer patients still report unmet rehabilitation needs. The aim of this study was to investigate how the two CR services work, for whom, and in what circumstances. Methods: A realist informed mixed-methods study was conducted. Quantitative secondary analysis of a CR database containing pre and post rehabilitation outcome measure data (e.g.: FACIT-F, etc.) was performed using paired t-test or Wilcoxon signed rank test. Qualitative, semi-structured interviews with rehabilitation professionals (n=20) and cancer patients (n=15) were conducted and reflexive thematic analysis was used to develop themes. Results: The quantitative data showed that the 12-week exercise programme potentially led to improved fatigue and mobility (p<0.05), which was supported by some qualitative accounts. However, several factors hindered adequate CR provision. Insufficient needs assessment and care coordination could have led to unmet needs, whilst unmanaged therapeutic relationships might have resulted in cancer patients’ dependency on CR services and a lack of self-management behaviour. Conclusion: Improved coordination of patient support and boundary setting for CR services is needed. However, some of these issues cannot be resolved until CR is fully embedded in the cancer pathway.

Background: Two cancer rehabilitation (CR) services provide in- and outpatient support, such as a 12-week exercise programme, fatigue management groups etc., in two oncology centres in South Wales, UK. However, some cancer patients still report unmet rehabilitation needs. The aim of this study was to investigate how the two CR services work, for whom, and in what circumstances. Methods: A realist informed mixed-methods study was conducted. Quantitative secondary analysis of a CR database containing pre and post rehabilitation outcome measure data (e.g.: FACIT-F, etc.) was performed using paired t-test or Wilcoxon signed rank test. Qualitative, semi-structured interviews with rehabilitation professionals (n=20) and cancer patients (n=15) were conducted and reflexive thematic analysis was used to develop themes. Results: The quantitative data showed that the 12-week exercise programme potentially led to improved fatigue and mobility (p<0.05), which was supported by some qualitative accounts. However, several factors hindered adequate CR provision. Insufficient needs assessment and care coordination could have led to unmet needs, whilst unmanaged therapeutic relationships might have resulted in cancer patients’ dependency on CR services and a lack of self-management behaviour. Conclusion: Improved coordination of patient support and boundary setting for CR services is needed. However, some of these issues cannot be resolved until CR is fully embedded in the cancer pathway.

The COVID-19 pandemic has caused a significant disruption to all levels of education, especially pupils from disadvantaged and vulnerable groups. Students aged 16-19 years are at a crucial time in their lives as they transition into further study or employment. The pandemic has brought together a unique set of conditions, not only involving disruption to education, but also to environmental, economic, social and emotional areas of young people’s and their families’ lives. This rapid review investigated strategies to support learning and wellbeing among 16-19 years old learners engaged in full time education within a college or school setting who have experienced significant gaps in their education as a result of the COVID-19 pandemic. This review is an update from a previous review conducted in August 2021. Reviews were published 2016-2022, with only one addressing post COVID evidence. 14 systematic reviews, four rapid reviews, one protocol and five UK organisational reports were identified from the initial searches in August 2021. Two systematic reviews one rapid evidence assessment, and two organisational reports were identified through an update in June 2022. There was no direct systematic review evidence that evaluated strategies to support learning for 16–19-year-old learners following the COVID-19 pandemic. Evidence for strategies to support learning and wellbeing for 16-19 years old learners who have experienced significant disruption in their education is from studies conducted before the COVID-19 pandemic. Research is required to evaluate whether interventions that were successful in relatively “normal” circumstances will be as successful during / post-pandemic. Although supported by a limited volume of evidence, targeting support activity at learners from the most deprived socio-economic backgrounds has a significant positive impact on their progress.

Introduction: An estimated 11% of patients have dementia prior to a cancer diagnosis (Ornstein et al. 2020). These patients have poorer cancer treatment outcomes compared to those without dementia (Hopkinson et al. 2016). Cancer Memory Mate developed from our previous research (Hopkinson et al. 2020) is a specially trained oncology professional who offers advice and resources to support safe cancer treatment in someone with a memory problem, a common symptom of dementia. Aims: To report obstacles and enablers influencing implementation of Cancer Memory Mate in a cancer centre in South Wales, UK. Methodology: The Cancer Memory Mate project was launched on 30/9/2020. Clinical observations (n=3), and semi-structured interviews with staff (n=9) were conducted prior to training of 24 Memory Mates and launch. Further observations (n=7) and staff interviews (n=28) were conducted post-launch to explore the obstacles and enablers to implementation. Data were analysed using the Normalisation Process Theory framework of Duke et al. (2020). Results: The concept of Memory Mate had some level of coherence for staff who described how it can improve the patient pathway and experience. Moreover, staff invested time in becoming Memory Mates, demonstrating cognitive participation. Staff strived to take collective action to provide the best possible care for cancer patients, although certain professionals might only champion particular elements of being a Memory Mate. Reflecting on implementation, Memory Mates expressed the need for further service promotion, as some staff members had limited awareness of the project. This obstacle could be attributed to service organisation issues and the COVID-19 pandemic. Conclusion: Cancer Memory Mates were enthusiastic about the project and gave examples of Memory Mate improving the supportive care of patients and carers. Obstacles to implementation were wider staff awareness and service organisation issues that need to be addressed for Memory Mat

Background: Cancer rehabilitation, which can comprise exercise and dietary advice among other interventions depending on people’s needs, has been found to improve quality of life worldwide. However, in Wales, 41.3% of Welsh Cancer Survey respondents reported receiving no or limited support with their rehabilitation needs. The reasons for this insufficient support are uncertain. The broad aim of this study was to investigate what works in two cancer rehabilitation services, for whom, in what circumstances and how. Methods: Realist evaluation (RE) informed the study design, as RE seeks to answer the question of what works, for whom, in what circumstances and how with the development of context-mechanism-outcome (CMO) configurations. Based on RE principles, first four initial cancer rehabilitation theories were developed through literature review and consultation with experts. The initial theories were tested with mixed methods: quantitative secondary analysis of routine cancer rehabilitation data; and qualitative, one-on-one, semi-structured interviews (n=35) with healthcare professionals and people with cancer. Findings: Testing the four initial theories which focused on information provision, healthcare professionals’ training, individualised care, and cancer rehabilitation interventions showed that services did not always work as hypothesised. Numerous contexts inhibited information provision, healthcare professionals’ training and cancer rehabilitation, for example, the medical model, healthcare professionals’ lack of time, accessibility concerns, and insufficient needs assessment, leading to fluctuations in service uptake, staff capacity issues and people’s unmet health needs. Moreover, professional boundaries were identified as mechanisms influencing cancer rehabilitation provision. However, well managed therapeutic relationships, family and “spontaneous” peer support aided the provision of individualised, tailored cancer rehabilitation interventions resulting i