Teamwork Research Articles

Introduction: Provision of safe perioperative care in remote theatre locations has many challenges. NAP 4 identified airway management in remote sites is associated with increased risk of morbidity and mortality [1]. Simulation training can aid preparedness to manage infrequent but highly critical events. Simulation training is often recommended following a critical events [2]. Insitu Simulation (ISS) undertaken in a clinical team’s own workplace provides a safe learning environment, improves team work and performance and identifies latent safety threats [3]. We organised ISS training in our dental DPU for the clinical team after review of learning needs and following recommendations from a critical event. Methods: Protected time for ISS was secured through list cancellation in dental DPU. Scenarios were built around agreed learning outcomes (LOs) and specific critical events. Mannequins and portable simulation patient monitors were used. An eFONA workshop was also delivered. The ISS organised session was run twice, morning and afternoon to facilitate smaller groups and reflective of healthcare team working in theatre and recovery on a standard day. Each group rotated though scenarios in main DPU theatre, dental chair theatre and recovery. Scenarios included CICO, anaphylaxis, choking under sedation, post op bleeding in oral cavity and emergency airway management in recovery. Communications systems were tested to seek assistance from main hospital site. Each scenario was preceded by team brief and followed by structured debrief. Feedback questionnaire was distributed to team members after event. Results: Received an 80% response to the feedback survey. Those who responded 100% agreed or strongly agreed ISS was a psychologically safe learning environment.100% agreed or strongly agreed improved communication, team work, confidence, clinical skills and feeling of preparedness. Team members were able to identify areas for improvement and deficits in resources. 83% suggested ISS should be delivered more frequently, 50% indicated at least twice yearly. Discussion: Feedback indicates ISS was valuable to the clinical team in our dental DPU. Debrief sessions helped identify areas of latent safety threats and areas for improvement. Familiarising with airway drills and eFONA skills with the clinical team may be helpful in difficult airway management or CICO situation for any anaesthetist working alone in a remote setting. Time pressures in clinical environments impede ISS which leads to difficulty in showing improvement in patient outcomes. However, if recommended in a critical event report this is a powerful tool for stakeholders to secure protected time for ISS training. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

Introduction: This teaching simulation aims to improve the team working and leadership skills of different members of the medical team in an acute scenario and allows them to understand the direct roles of each individual team member. Objectives: To assess the effectiveness and value of multi-professional simulation in increasing the awareness of roles within an interprofessional setting. To assess if multi-professional simulation increases confidence levels when managing emergency scenarios in a team-based setting. Methods: The simulation consisted of six varied emergency scenarios common to the Accident and Emergency department, where the scenario would involve care of Addisonian Crises, Euglycaemic Diabetic Ketoacidosis, ACS leading into Heart Block etc. The participants were all at varying levels of training and roles from Advanced Practitioners, Nurses, Senior and Junior Clinical Fellows. Nursing teams would be asked to do an initial assessment of a high-fidelity manikin, refer to their seniors and slowly the full medical team would be involved in handling the patient’s care. Once all scenarios were completed, we collected one minute feedback forms from all participants which investigated how our simulation differed from traditional simulation provided in their training, what they learnt for their own clinical practice and the roles of other professions. Results: Out of the ten candidates, only two of them had previous simulation experience. They reported that the simulation blended acute scenarios well with hospital pathways and therefore felt realistic to their practice. Other comments praised the interactive elements and covering different hospital protocols. Candidates received specific personal learning objectives tied to individual learning, but a highlight was that eight out of ten (80%) candidates felt that this learning improved their teamworking and leadership skills in emergency situations, with emphasis on communication between members of the team, their expertise and limitations. Discussion: High-fidelity multi-professional simulation enhanced awareness of team members’ roles and collaborative dynamics. Participants reported improvements in communication and confidence in emergency care delivery. Broader implementation and further evaluation are needed to assess its impact across different healthcare settings. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

Introduction: When opening a new healthcare space, simulation based clinical systems testing allows for potential patient safety threats to be identified [1]. Translational simulation can be used in this context due to the focus on improving patient care and healthcare systems through diagnosing safety and performance issues and delivering simulation-based intervention [2]. The creation of a new paediatric day surgery centre required an interdisciplinary simulation programme designed to familiarise staff with the new environment and equipment, test systems and processes, and enhance team working both within and between departments. Clinical scenarios added focus on human factors and non-technical skills alongside strategies for improvement [3]. Research question: How can a simulation programme help prepare for the safe, functional operation of a new day surgery unit? Methods: The two day in-situ simulation took place at the new Paediatric Day Surgery Unit at Castle Hill Hospital. Participants included anaesthetists, operating department practitioners, scrub, theatre and recovery staff and paediatric nurses, alongside wider hospital teams including outreach, porters, ambulance services, and blood transfusion. The programme involved various clinical and non-clinical scenarios focusing on testing the environment, processes and team-working. All scenarios included debriefing and discussion to raise main learning points and areas for improvement and change. Results: The simulation programme provided valuable insights and over fifty learning points or adjustments were identified. Patient safety threats highlighted included issues with emergency equipment location, familiarity and accessibility, unfamiliarity with novel equipment, availability of protocols for emergencies and transfer and communication between departments or teams. Emergency preparedness was significantly enhanced, with staff demonstrating increased confidence and competence in managing critical situations. Due to the in-situ nature of the simulation, many changes were able to be made on the day by the team directly impacted by them. Actions taken forward included further training sessions, equipment adjustments and process refinements. Discussion: The results indicate that the simulation programme was instrumental in identifying and avoiding potential patient safety risks within a new paediatric day surgery unit. Staff gained familiarity with the new environment, tested medical and non-medical equipment, and validated systems and processes. Hands-on experience and interdepartmental involvement ensured a thorough understanding of the unit’s layout and system functionality. The major conclusion is that simulation-based training is an effective strategy for enhancing patient safety, staff readiness, team working and operational efficiency in a new clinical setting. Future work will focus on implementing the identified actions and conducting follow-up evaluations to assess long-term impact. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

A characteristic feature of the technical and tactical skills of the strongest footballers is the ability to pass the ball accurately and timely when time and space are limited, when facing opposition from opponents, and when physically and emotionally exhausted. The playing activity of football players at the 2024 European Championship is characterized by: various technical and tactical actions of increased coordination complexity, a great variability of technical and tactical means of playing the game, which differ in their structure and nature. Players perform technical actions with the ball while competing with an opponent, which requires the ability to make decisions under limited time and space. Under such conditions, the speed of decision-making is the basis of playing activity. Decision-making speed is a unique systemic property of the player’s psyche, which significantly influences his activity within the playing space and determines the effectiveness of technical and tactical actions in the defensive, attacking, and middle zones of the field. The analysis of playing activity in these zones will help to define the correct direction for improving individual actions of players, as well as group and team interactions in the training process of football players. Purpose: on the basis of pedagogical observations to determine the quantitative team indicators of accurate passes in different zones of the field during the game between the national teams of Ukraine and Romania at the 2024 European Football Championship. Material and methods. Research methods: theoretical analysis and generalization of data from scientific and methodological literature, methods of pedagogical observations, methods of mathematical statistics. During the study, the number of accurate passes in different zones of the field (defensive, middle, and attacking) was recorded. The number of passes was studied in 15-minute segments of the match. A comparative analysis of the indicators of accurate passes was conducted in the game of the 2024 European Football Championship between the national teams of Ukraine and Romania. Research results. The national team of Ukraine in the match of the 2024 European Championship against the national team of Romania had an advantage in the number of passes performed in the middle zone of the field (351) and in the attacking zone (79). The Romanian national team had a smaller number of passes in the same zones (126 and 45, respectively). This match ended with a score of 3:0 in favor of the Romanian team. Conclusions. Pedagogical observations showed the advantage of the Ukrainian national team over the Romanian team in the indicators of accurate passes in the defensive zone by 22.8%, in the middle zone of the field by 64.1%, and in the attacking zone by 43.1%. A high percentage of accurate passes in football indicates long-term ball control and high quality of team play. This means that the players of the Ukrainian national team confidently controlled the ball, accurately delivered it to their partners, which indicates coordinated team work.

Against the backdrop of the expansion of microservice architectures and Platform Engineering practices, monorepositories serve as a key mechanism for standardizing the software development lifecycle. At the same time, their growth exacerbates the phenomenon whereby version incompatibilities block the work of multiple teams. This study aims to systematize and analyze approaches to dependency management in scalable monorepositories in order to develop a holistic methodology for preventing and resolving version conflicts. The methodological basis includes a systematic review of academic publications, content analysis of technical documentation, and a comparative examination of industry reports. The results demonstrate the limited preventive effectiveness of semantic versioning (SemVer) with respect to compatibility errors and establish a taxonomy of management strategies: proactive (centralized version control), reactive (dependency harmonization), and automated (use of intelligent build systems). Case studies confirm that tool selection should correlate with the scale of development, implying an evolutionary transition from basic orchestrators to industrial-grade build tools such as Bazel. It is concluded that high effectiveness in dependency management is achieved through the synergy of organizational regulation, conflict resolution procedures, and the use of intelligent build systems with fine, granular analysis of the dependency graph. The practical significance of the work lies in providing architects and platform teams with a scientifically verified foundation for decision-making in the design and operation of large-scale software systems.

This study examines the effectiveness of the National Service Training Program (PLKN) 3.0 as a strategic platform for empowering Malaysian youth through leadership and technical skill development. PLKN 3.0 is a comprehensive initiative that combines basic military training with technical training. The first phase of the program involves 45 days of military training focusing on discipline, resilience, and leadership. Activities such as critical situation simulations, group training, and physical challenges are aimed at building mental strength and the ability to work in teams. Participants then proceed to the second phase, which involves technical training at colleges or universities. During this phase, they are exposed to specialised skills in strategic sectors such as digital technology, renewable energy, and advanced manufacturing, making them more competitive in the global job market. The study also highlights the role of the Servant Leadership model applied in PLKN 3.0, with values such as social responsibility, teamwork, and integrity, forming the foundation of the program. This approach not only equips participants with technical skills but also fosters a sense of unity through social projects and community service. PLKN 3.0 is supported by a long-term monitoring strategy and the establishment of a monitoring committee to assess the program’s effectiveness regularly. This allows for adjustments to be made to ensure the program remains relevant to the needs of youth and national development aspirations. The study further highlights PLKN 3.0’s role in fostering national unity and a sense of national identity. Overall, this study finds that PLKN 3.0 plays a significant role not only as a platform for individual development but also as a catalyst for social and economic innovation. The implementation of PLKN 3.0 is a testament to the government’s commitment to ensuring youth development aligns with Malaysia’s vision of becoming a prosperous, advanced, and inclusive nation by 2030.

The establishment of our Museum and its subsequent 41 years as “the hub of historic Port Alfred” would never have happened without the perseverance, the vision, and the hard work of teams of dedicated people over the years – our Chairmen and Committee members, The Friends of the Museum, our Curators, our desk volunteers, our visitors, the supporters of our fundraising efforts, the donors of our collections, Our all-too-few but much appreciated sponsors, our local press, our security firm, even Lungisile Sinqe at Tourism who kept the keys for us and always had a smile when we collected them from him for our duties or meetings.

This study analyzes the role of cultural values in shaping employee behavior at Seria Clinic. Organizational cultural values serve as a foundation for character development, work ethic, and social interactions among employees. In healthcare services, these values not only guide internal behavior but also reflect the clinic's identity to patients and the community. Understanding how employees internalize and apply these values is crucial for maintaining service quality and institutional image. The research used a descriptive qualitative approach, collecting data through in-depth interviews and participatory observation. Interviews were conducted with staff from various levels, including medical personnel, administrative staff, and management. Participatory observation was used to observe work behavior, employee interactions, and challenges in the workplace. The results show that integrity, care, discipline, and cooperation are key values at Seria Clinic. These values improve team cohesion, work motivation, and employee loyalty, contributing to a harmonious and productive work environment. The study concludes that consistent internalization of cultural values is vital for building an ethical, service-oriented, and sustainable work culture, which is crucial for enhancing healthcare service quality.

Understanding the expectations of new generations of students entering higher education can be challenging. Generation Z have been brought up in a digital world, keeping them focused and entertained. Education must respond to the changing student profiles. Consideration should be given to integrating a hyper-cognitive approach to meet the expectations of students and fuel a positive learning experience for all evolving generations. To determine student nurses' satisfaction of escape rooms to facilitate learning of professional values; teamwork, decision making and sharing information. Quantitative cross-sectional questionnaire to capture participants' satisfaction following their participation in the escape room activity. The pedagogical benefits of escape rooms were explored as a teaching strategy for the evolving generation of students entering nurse education. The premise being,offering influential 'games' which nurture and encourage active collaboration among students would help to form peer connections and create relationships among new students entering nurse education. Escape rooms are coactive and can drive interdependence among participants sharing a goal by creating an environment for team working in nursing education. Of the 45 student nurses 100% (n=45) felt part of a team, 98% (n=44) had a positive experience, and only 2% (n=1) thought that the experience was stressful. Using escape rooms as a teaching and learning tool is an innovative pedagogical approach, offering a dynamic, hands-on experience that engages students through problem-solving and teamwork. Student nurses gave positive responses to teamwork, decision making, sharing information and enjoyment of the activity. This research will inform the development and uptake of core competencies for future nurses, creating teamwork and professionalism within a collaborative live educational environment. Not applicable TRIAL REGISTRATION: Pilot not a controlled trial. No registration.

To test the hypothesis that Practical Obstetric Multi-Professional Training (PROMPT) is effective training. Multi-professional training in the labour ward has, in most cases, shown to be effective, in some cases not to be effective, and in some instances, it has worsened the outcome following the introduction of training. If training is to be performed, it should be adequate training. Thus, monitoring the outcomes is mandatory to determine if training is effective. Adjustments become possible to achieve improved outcomes. PROMPT Training has 14 modules: Team working, Basic life support and maternal collapse, maternal cardiac arrest and advanced life support, maternal anaesthetic emergencies, foetal monitoring in labour, pre-eclampsia and eclampsia, maternal sepsis, major obstetric haemorrhage, shoulder dystocia, cord prolapse, vaginal breech birth, twin birth, acute uterine inversion, basic newborn resuscitation. The concept involves scientifically written modules based on clinical studies, multi-professional training, central integration of teamwork and communication training and multi-professional training in the labour ward for obstetricians, midwives, neonatologists, anaesthetists and further professions involved. Systematic literature review. A systematic literature search of PubMed, Embase, Medline, Scopus, and the Cochrane Library was conducted for studies published between January 2000 and November 2024. Eligible studies evaluated PROMPT training and reported clinical outcomes, training effects, or cost-effectiveness. Forty-two studies met inclusion criteria, comprising randomised controlled trials, observational cohorts, and quasi-experimental designs. Methodological quality was assessed using the Cochrane Risk of Bias tool, and sensitivity analyses explored consistency across study types. A total of 62 studies were identified, of which 42 met the inclusion criteria and were analysed across 14 PROMPT training modules; 20 publications were excluded. Of the eligible studies, 37/42 reported improvements in 8/14 modules, most notably in teamwork and communication, management of shoulder dystocia with reductions in brachial plexus injury, decreased rates of hypoxic-ischaemic encephalopathy and low 5-min Apgar scores, improved management of pre-eclampsia with increased magnesium sulfate use, reduced decision-to-delivery intervals for umbilical cord prolapse, and better outcomes in postpartum haemorrhage, breech and instrumental deliveries, maternal cardiac arrest, and neonatal resuscitation. Additional findings included reduced litigation costs and evidence of cost-effectiveness. Three studies demonstrated no significant improvement, one trial reported worsened 5-min Apgar scores after implementation in 12 Scottish maternity units, and one study showed mixed outcomes. At Hannover Medical School, our own data demonstrated substantially reduced adverse outcomes after 2½ years of PROMPT training. PROMPT Training effectively reduces adverse outcomes of rare but severe obstetric complications, if training is implemented using authentic PROMPT materials, team and communication training will be implemented, and training will be repeated annually in a multi-professional way.

Objectives We aimed to learn about public health human resource development in the United Kingdom (UK), where recent reforms have been made in public health nursing education. Our objective was to obtain transferable lessons that could inform the education of public health professionals in Japan.Methods The Committee on Public Health Nursing organized an online lecture cosponsored by the Internationalization Promotion Committee and the Japan Academy of Public Health Nursing. The lecture, titled "Supporting the development of the public health nursing workforce in the UK: the example of health visiting," was given in June 2024 by Dr. Karen Whittaker, Senior Education and Workforce Lead at the Institute of Health Visiting (iHV). It was available live and on-demand for one month. Members of each committee were present on the day of the lecture to deepen their understanding through dialogue.Results The lecturer introduced the position of public health in the UK, the challenge of health inequalities, and an overview of the relevant service systems. Specific attention was given to the Universal Healthy Child Program for England, public health nursing with a focus on health visiting, and iHV activities. The Q&A session expanded the discussion to cover topics such as service design, workforce education on diversity to address health inequalities, and multi-disciplinary team working. It also explored the potential career pathways for health visitors and requirements for education, which now include a post-graduate Specialist Community Public Health Nurse (SCPHN) - Health Visiting qualification. Additionally, the importance of professional proficiency and continuing professional development (CPD) was emphasized, as these are required to renew registration every three years with the independent regulator, the Nursing and Midwifery Council. The role and purpose of iHV in supporting health visitors and the issues addressed by iHV were also covered. Including both live and on-demand participation, the session received a total of 636 views.Conclusion The UK approach to health inequalities is based on proportionate universalism. In the UK, a multi-ethnic country, education on ethnic diversity is provided to personnel involved in public health, which is helpful when considering education in Japan. In the UK, basic education and CPD based on uniform standards for SCPHN are systematically provided and are considered necessary to support quality assurance as a profession. Since basic education and CPD for public health nurses are not standardized in Japan, there is a need to systematically provide education based on common standards.

Primary malignant tumors of the chest wall account for less than 1 % of all neoplasms, with chondrosarcoma constituting 20 % of these. Secondary chondrosarcomas developing against the background of pre-existing enchondromas or osteochondromas (both solitary and multiple, as seen in Ollier’s disease or Maffucci syndrome) are even rarer. The slow growth of such neoplasms often leads to late diagnosis, and the complex anatomy of the localization poses challenges for specialists, requiring thorough preparation and coordinated work of a multidisciplinary team. The available literature contains limited reports on the surgical treatment of chondrosarcoma of the sternoclavicular joint, the I–II ribs, and/or the sternum, with few observations documented. This article presents a literature review dedicated to this issue, as well as two rare clinical cases of patients with chondrosarcoma of the upper thoracic aperture, which are of interest to oncologic orthopedists, thoracic and vascular surgeons, as well as diagnosticians.

Clinical learning is a challenging aspect of nursing education which affords the nursing student an opportunity to practice the theory that is learned in classroom. The aim of this paper is to explore the lived experiences on clinical exposure of B.Sc. Nursing first year students. Qualitative phenomenological research design was used. The total sample size was 10 students based on the saturation of the information that was determined by the samples. Purposive sampling method was used for the selection of the samples. Face-face in-depth interview was taken with a help of semi-structured interview guide. Analysis of data was carried out by using the thematic analysis. The findings revel that the nursing students experience the inefficient communication, lack of team work, difficulty in socialization that increased their stress and anxiety in their workplace. In addition, language barrier, empty feeling towards patient care and discrimination in care. The study concluded with the nursing students experience insufficient knowledge, skill towards patient’s care which creates stress and anxiety among students. However, to provide support in the clinical learning may enhance knowledge and skill among students.

Patients with neoplasms have a higher risk of developing cardiovascular diseases. In 90% of patients, acute coronary catastrophe occurs with the progression of cancer. The complexity of managing such patients is associated with an increased risk of bleeding, thrombotic complications and the need for surgical treatment of cancer in the near future. We analyze a case of simultaneous stenting of the trunk of the left coronary artery and resection of the bladder for decaying adenocarcinoma in a patient with acute coronary syndrome without high-risk ST segment elevation. The main principle of managing such patients today remains the joint work of a multidisciplinary team and an individual approach.

Abstract Introduction The impact of 24/7 operations on cognitive performance at the individual level has been well established. However, very few studies have explored the effect of fatigued individuals on team performance outcomes. Furthermore, no studies have examined the impact of team member proximity under fatigued conditions. Methods Participants in this study underwent two nights of restricted sleep (six hours in bed) before commencing a 31.5-hour wakefulness protocol, during which they completed one of three team tasks every two hours: Captain Sonar (co-located, cooperative), Monster Game (co-located, collaborative), and COHESION (distributed, collaborative). Before and after each task, participants completed the Karolinska Sleepiness Scale and Psychomotor Vigilance Task (PVT). Results Results showed, increased time awake led to increased sleepiness (p<.001), slower response times (p<.001), and more frequent lapses (p<.001). Post hoc tests indicated that sleepiness and response times increased significantly following the distributed task (COHESION, p<.001). In contrast, participants were less sleepy and had faster response times after completing the co-located, cooperative task (Captain Sonar, p=.012), compared to immediately prior, suggesting an alerting effect of this co-located task. Furthermore, co-located teams maintained their performance within the team tasks, unlike distributed teams, whose performance declined with increasing time awake. Discussion This study highlights the benefits of face-to-face, co-located teams. Additionally, these findings suggest that working in teams may serve as a fatigue risk management countermeasure. These findings also have implications for teams in disaggregated and distributed operational environments, particularly in 24/7 workplaces. Novel countermeasures are needed to optimize human capability in non-co-located settings.

ObjectiveIn low resource settings, there are several barriers to achieving a multidisciplinary approach covering all aspects of cleft including psychosocial services. The study aim was to gain insight into current psychosocial practices in these settings.DesignCross-sectional study.SettingComprehensive Cleft Care Workshop in October 2024.ParticipantsWorkshop Attendees.InterventionsA 20-item survey including quantitative and qualitative questions about psychosocial practices in participants' workplaces was distributed.Main Outcome MeasuresThe main outcomes were to assess cleft psychosocial practices, and the challenges faced when integrating psychosocial care in low resource settings.ResultsSeventy-six respondents were working in low-resource settings in Africa or Asia, with 67.2% working in plastic or oral/maxillofacial surgery department and 68.4% working in an academic hospital. Almost 90% of respondents work in a multidisciplinary team. Of those who responded that psychosocial care was available in their setting (n = 44), 47.7% reported that either psychologists or psychiatrists were responsible for providing this care. Twenty-five (56.8%) of these respondents reported that although psychosocial support is available, this service is not provided by a cleft specialist. Most respondents reported a lack of resources/tools (68.4%) as a challenge to referring patients to psychosocial care and mentioned a need for: (1) more cleft-specialized psychosocial personnel; (2) dedicated financial budgets; (3) increased awareness; and (4) protocols to integrate multidisciplinary discussions.ConclusionsAvailability, accessibility and knowledge of the importance and recommended delivery of psychosocial services in cleft remains limited in low resource settings. Further research into psychosocial needs and ways of improving delivery is required.

It is assumed plantar fascia has important role to support the arched structure of the foot (Gefen, 2002). Plantar fascia changes along its extension. It divides into splits either in horizontal or in sagittal plane. It attaches to the bones and soft tissues (Wearing et al., 2006). The objective of this research is to design a plan of investigation according to the non weight bearing landmarks and measurements of the foot which can be effective in lower limb rehabilitation/treatment/ prevention schedule. Method To identify non weight bearing landmarks. To identify the mid line of the plantar aspect of the foot. To calculate the measurements of the foot. To identify the location of the plantar fascia along its length in unloading and before modification in both feet. To register identified location of the plantar fascia in ultrasound image. The out come of this research can be resulted in more effective treatment in a short time, increasing successful team work in rehabilitation and increasing the percentage of prevention.

Perinatal mental health disorders affect one in five mothers during pregnancy or within 2 years post childbirth. These disorders can lead to poor pregnancy and childbirth outcomes and maternal deaths. Additionally, they negatively affect a child's cognitive, social and emotional development. Stigma and a lack of specialised services have limited access to mental health care. National Health Service England invested £365M in community perinatal mental health teams, but their impact on women and infants' outcomes are not known. Develop a taxonomy of community perinatal mental health teams (work package 1). Compare and validate two assessments of quality of mother-infant interaction for use by community perinatal mental health teams (work package 2). Evaluate the effectiveness and cost-effectiveness of community perinatal mental health teams (work packages 3 and 4). Mixed-methods study. Community perinatal mental health teams in England. Women who were pregnant or within 2 years postnatal. Work package 1: Typology of community perinatal mental health teams in England. Work package 2: Reliability and validity of two observational assessments of parent-infant interaction. Work package 3: Realist evaluation interviews with women, partners/close others, and staff to determine effective community perinatal mental health team components. Work package 4: Analysis of linked data: Association of community perinatal mental health teams with access to secondary care mental health services. Risk of acute relapse and improved obstetric and neonate outcomes for women with pre-existing severe disorders in areas with community perinatal mental health teams compared to generic services. Economic analysis of cost of community perinatal mental health teams. Objective 1: Community perinatal mental health team typologies revealed in 2020, 84% had basic staffing levels and 63% had more multi-professionals. Objective 2: The 'Parent Infant Interaction Observation Scale' and 'National Institute of Child Health and Human Development' assessments of mother-infant interaction were reliable and valid; the National Institute of Child Health and Human Development is more suitable for community perinatal mental health teams. Objective 3: Work package 3: Interviews with 139 women, 55 partners/close others and 80 health workers highlighted the importance of specialist perinatal knowledge, responding in a warm and non-judgemental way, working closely with other healthcare providers, optimising medication, supporting mothers to reduce conflict and improve social support, helping mother-infant bonding, and teaching emotional management. Work package 4: Analysis of linked health data revealed higher risks for obstetric and neonate problems in women with severe mental health disorders, particularly recent or very serious episodes. Work package 4: Areas with community perinatal mental health teams saw increased mental health access among perinatal women and reduced need for acute care, albeit at a higher cost and with greater neonatal risks. High levels of missing data on diagnosis and mental health outcomes in existing health and service data. Lack of data on child outcomes. Evaluation occurred during community perinatal mental health team changes and the coronavirus disease discovered in 2019 pandemic limiting a full assessment of the impact of community perinatal mental health teams on maternal and child outcomes. Community perinatal mental health teams can support perinatal women with complex, moderate/severe mental health disorders, but further attention to women's physical needs is essential. The use of observational assessments of parent-infant relationships will enhance the evaluation of community perinatal mental health teams' impact on infant outcomes. Research should focus on prospective studies that gather mental health and child outcomes from community perinatal mental health teams and primary care mental health, to assess broader impacts of perinatal-specific treatment across care pathways. This study is registered on Research Registry as researchregistry5463. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/49/38) and is published in full in Health and Social Care Delivery Research; Vol. 13, No. 38. See the NIHR Funding and Awards website for further award information.

Health inequalities are strongly influenced by social determinants such as income, education, occupation, gender, ethnicity, and place of residence. These factors affect people's exposure to risk factors, access to healthcare, and overall health outcomes. As part of the Joint Action ‘Prevent NCDs’, funded by the EU4Health Programme 2021-2027, a dedicated focus on Social Inequalities aims to reduce avoidable inequalities in cancer and other non-communicable diseases (NCDs). This effort promotes a multidimensional and cross-country approach, based on evidence, policies, practical tools, and training. This workshop presents the early findings and methodological directions of the Social Inequalities component, structured around four key areas:1. Synthesizing evidence on the social determinants of health across Europe: The first presentation will outline how inequalities in cancer and NCDs are distributed across the European region, based on systematic umbrella reviews. These efforts provide the foundation for future recommendations on how to improve equity-oriented NCD prevention policies and strategies across countries.2. Reviewing and comparing existing policies and interventions: The second talk will highlight the policy landscape across Europe, based on a scoping review and country-level reports. Focus will be given to effective practices addressing social determinants, as well as on barriers to their implementation and opportunities for cross-country transferability. A shared digital repository of tools and resources is being developed.3. Evaluating actions with an equity lens: Many interventions fail to reduce health inequalities because equity considerations are not embedded in their design or evaluation. In the framework of the Joint Action ‘Prevent NCDs’, the team working on social inequali-ties has developed capacity-building activities and an Equity Tool to support pilot action teams. The aim is to integrate equity systematically from the planning phase, ensuring that actions are designed to effectively address and reduce health inequalities.4. Enhancing health literacy to counter health inequities: Health literacy (HL) is addressed within the Joint Action ‘Prevent NCDs’ as a comprehensive, system-level enabler of equity. Several national surveys are being launched in collaboration with WHO's M-POHL HLS24 initiative to measure HL in the general population, ethnic minorities, digital access, and mental health. Parallel scoping and umbrella reviews are also underway to identify good practices, and a European Health Literacy Arena is being developed to promote collaboration and innovation. With five presentations followed by interactive discussion, this scientific session will provide a critical overview of how Europe can address social inequalities in health by acting on upstream drivers and embedding equity in practice.Key messages• Reducing health inequalities requires action on the social determinants of health, grounded in data and evidence.• Embedding equity into policies, evaluations, and health literacy initiatives is key to lasting change.

ObjectivesTo understand factors that influence the intention of workers to remain in or leave employment in National Health Service (NHS) mental health crisis services and to use findings to formulate recommendations for NHS trusts to achieve improved worker stability in mental health crisis services.DesignA reflexive thematic analysis was conducted to explore the retention-related experiences of crisis workers. Secondary data was obtained from interviews conducted with crisis workers. This was collected by The University of Sheffield as part of the Retention of Mental Health Staff (RoMHS) study.SettingSix NHS Trusts in England.ParticipantsAll crisis worker interviews from the RoMHS study were included, totalling 10 participants: 70% female, 30% male, exclusively White British, and mostly occupying leadership roles.ResultsFive themes were identified as influencing the retention of crisis workers: resource limitations, organisational culture and leadership, fairness and consistency, personal agency and team working. These themes are comparable to factors known to affect retention of the mental health workforce more widely. However, this study found a greater emphasis on the emotional burden of crisis work, including the challenges of complex risk management, and a perceived vulnerability of crisis service workers to increased workload and fewer development opportunities compared with other specialist mental health services.ConclusionThis study identifies that crisis workers face similar retention-related issues compared with the mental health workforce more widely, but with additional challenges related to the emotional intensity of the work and susceptibility of crisis services to resource constraints compared with other specialist mental health services. Further research should focus on employees who left crisis services, under-represented groups within the crisis workforce and the impact of retention-related policy.