The West Midlands Evidence Repository (WMER) represents a project which has connected a group of NHS libraries in a consortium. Prior to its establishment, four members of the consortium, from four Black Country Trusts, were part of the British Library national repository project aimed at NHS Trusts, which unfortunately was unsuccessful. Another Trust, from Birmingham, already had its own institutional repository, but this had come up for renewal. The WMER project was therefore established in 2022 to replace these repositories and create a new joint resource. This project represents a new endeavour for the now nine consortium libraries who have come together, requiring new learning and new ways of working. This presentation initially outlines how the consortium was formed, through to the establishment of managing WMER as business as usual and looking to take on new members. But what is WMER? Firstly, WMER is an institutional repository. It stores metadata and, depending on the individual Trust, full text of research outputs in electronic format. This can include formal journal articles, books, and book chapters, as well as grey literature which otherwise is often lost, such as reports, innovation projects, and conference proceedings. As an institutional repository, therefore, WMER allows for the collation of each organisation’s research in one place and archiving of full text of that research where applicable. However, WMER also allows access to that metadata and full text by sharing it publicly online. As a tool to connect people to research, the repository acts within the individual Trusts and the consortium as a knowledge mobilisation and staff awareness tool. Notably, it helps staff to connect to research both internally within their own Trust and externally to research from other organisations. In addition, WMER also enables staff to connect with fellow researchers. This has the potential to foster local and regional research cultures, and lead to collaborative research both within and across organisations. Furthermore, WMER allows the general public to connect with the research conducted within the consortium organisations. This means there is accountability for how public money is spent, but also means the consortium Trusts’ research can be seen and used easily throughout the world, increasing its overall impact, and the reputation of the Trusts as research organisations. In this regard, WMER as an institutional repository is also essential for the organisations to engage with modern research practices embodied by open scholarship or open science and specifically the open access agenda. WMER and the consortium are continuing to grow. More research is being added each day, an additional Trust has recently joined, and six more Trusts have expressed an interest in joining.

Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals and interventions to be added to the individualized care plans. We also report the results of usability studies carried out in four pilot sites by patients and clinicians. Keywords: Chronic disease management; Clinical decision support systems; Evidence based clinical guidelines; Integrated care.

COVID-19 has impacted on the experience of those who are grieving and on the work of those who support them. As a newly appointed bereavement chaplain for a community children’s team, I have reflected on the experiences of those I am working with, and on how my role has been impacted by COVID-19. This article looks at several areas where COVID-19 has affected grieving people, both parents and others. I also reflect on my own experience of working with them at this time, the distress this has caused me, and the values and creativity that are leading me forward.

Objectives: Just Culture aims to improve patient safety by examining the organisational and individual factors that contribute to adverse events, enabling corrective action so that errors are not repeated. This qualitative study aims to: (1) analyse whether the attitudes and behaviours of clinicians and managers are aligned with a Just Culture; (2) identify barriers and enablers to an organisation adopting a Just Culture. Methodology: This qualitative study used interviews and observation of Trust meetings to elicit the attitudes and behaviours of staff. Semistructured interviews were conducted with 13 doctors of all grades, 5 medical students and 2 managers. Five meetings that reviewed clinical incidents and mortality were observed. This was done in a single Hospital Trust in the Midlands, England. Data were thematically analysed using directed and inductive approaches. Results: There is evidence of a fair incident management process within the Trust; however, there was no agreed vision of a Just Culture and the majority of the staff were unfamiliar with the term. Negative perspectives relating to clinical incidents and their management persist among staff with many having insecurities regarding being the subject of an investigation and doubts about whether they drive improvement. Conclusion: This paper examines the significance of these findings and provides recommendations which may have application within other healthcare organisations. Major recommendations include (1) Just Culture: define an agreed vision of what Just Culture means to the Trust; (2) investigations: introduce incident management familiarisation training; (3) Learning Culture: increase face-to-face communication of outcomes of investigations and incident review; (4) investigators: establish an incident investigation team to improve the timeliness and consistency of investigations and the communication and implementation of outcomes.