Message from Centre Director, Professor Adrian Edwards
There is good news and there is less good news.
The good news is that I’m delighted to be welcoming you all to read the first Newsletter in our new 5 years funding period! This new funding is the product of a huge amount of hard work across the PRIME team in all four universities, with success achieved in high quality research and outputs, demonstrating Impact that makes a difference outside academic circles, prominent and effective Patient & Public Involvement, and building capacity for future research in primary and emergency care research in Wales.
We are particularly delighted that the new funding period also includes extra funding for the new Wales School for Social Prescribing Research, led by Prof Carolyn Wallace at University of South Wales – fuller details of this are below. Congratulations to Carolyn on setting up this valuable new part of PRIME.
The less good news? As for all of us, the COVID-19 pandemic presents significant personal and team challenges. First and foremost, we extend our sympathy to those who have been personally affected, and condolences to those who have lost loved ones. Research is secondary to those effects, but we are all striving to continue with important research, working around the challenges of home working (see Screenshot of our Operational Group meeting last week). I want to thank all colleagues and collaborators for their efforts at this difficult time.
More importantly, we are adapting the focus of research to tackle this unprecedented population and health services challenge.
Particular areas of work include the national survey of public experiences of the pandemic, led by our former PRIME colleague Dr Rhiannon Phillips, now at Cardiff Met, working with colleagues in the PRIME and CTR teams at Cardiff. Prof Kate Brain is examining the impact of delayed diagnoses of Cancer, and advising Welsh Government and UK groups about the scale and interventions to ameliorate the impact. Prof Helen Snooks and the Swansea PRIME team are working closely with SAIL colleagues to assess the effect of the “Shielding letters” as a public health intervention. In addition, the team are working on a proposal to investigate what model of call centre and on-scene TRIage of 999 calls is the safest and most effective for the Management of callers with suspected COVID 19 symptoms, a linked outcome study (TRIM). Prof Clare Wilkinson and Dr Marlise Poolman at Bangor University are working with Welsh Government to fast track the implementation of the CARIAD intervention for home-based palliative care. These and others are described below and show that collectively PRIME is rising to several challenges from COVID in the primary and emergency care sector. The benefits of the infrastructure funding to be able to do this quickly and effectively are clear.
Once again we thank our funders for extending the support, and our public, patient, NHS and social care and other academic contributors for this wonderful collaboration tackling the highest priority research challenges that are fundamental to an effective and high value health service for the people of Wales.
Supporting the response to Coronavirus
Public attitudes on coronavirus pandemic
One of the first research projects aimed at gauging the UK public’s attitude and responses to the coronavirus pandemic is being conducted.
Although now closed to new responders, 11,417 people took part in the survey to assess how people feel about - and how they are responding to - one of the biggest health crises facing the country in recent history.
The wide-ranging questionnaire asked how much impact people feel the pandemic is having on their lives, and what they think about the way the government and health services are responding with help from researchers at PRIME Centre Wales, Centre for Trials Research, Cardiff University, Health Wise Wales and Cardiff Metropolitan University.
The research is being led by Rhiannon Phillips at Cardiff Metropolitan University, in partnership with a number of teams in Cardiff University including Centre for Trials Research, PRIME Centre Wales and HealthWise Wales.
The researchers are a large inter-disciplinary team with a wide range of expertise in infections, public health, general practice well-being, communication of risk and mixed methods and qualitative research, and include Emma Thomas-Jones, Kathryn Hughes, Natalie Joseph-Williams, Anna Torrens-Burton and Fiona Wood from PRIME work packages infections and antibiotic resistance, person-centred-care and methodological innovation,
Project leader and former PRIME Research Fellow, Dr Rhiannon Phillips, now a Lecturer in Health and Wellbeing Psychology from Cardiff Metropolitan University, said: “We’ve set this project up very quickly because we want to capture what’s happening right now. This is one of the first projects of its kind in the UK.
“These are uncertain times for many people - the situation is changing rapidly - and we want to make sure we document the here and now and the challenges we’re all facing.”
Dr Emma Thomas-Jones, Senior Research Fellow and PRIME lead for trials, who also leads on infection, inflammation and immunity research at Cardiff University, said: “We want to know what people are thinking, feeling and doing to help the response to this crisis now - but also as a matter of historical record.”
The team are in regular discussions with Public Health Wales and Welsh Government and have already provided their first policy briefing to Welsh Government in April. The research team is keen that the findings should be put to good use as soon as possible, with early access to the find and those organising the frontline response will get early access to the reports to help inform the measures they are taking.
The questionnaire was distributed via the HealthWise Wales project, which is collecting data to build up an in-depth picture of the nation’s health to help plan future needs.
Don’t ignore vague symptoms of cancer during pandemic
Impact of the COVID-19 global pandemic on symptomatic diagnosis of cancer – the view from primary care
Warning of impact of Covid-19 pandemic on cancer diagnosis issued in leading medical journal Lancet Oncology.
People need to be alert to the more vague symptoms of cancer and not be afraid to seek advice from their GPs during the global coronavirus pandemic, medical researchers say.
They also warn new ways of remote working could make it harder for GPs to pick up on worrying symptoms, in a comment article published today in Lancet Oncology.
The experts, including Kate Brain (pictured above), Professor of Health Psychology at Cardiff University and PRIME lead for screening, prevention and early diagnosis research, comment: “It is likely that patients with well recognised ‘red flag’ symptoms such as a new lump or rectal bleeding will continue to present to primary care.
“However, with Covid-19 at the forefront, vague cancer symptoms such as fatigue, change in bowel habit and weight loss may be dismissed by the patient as trivial. Respiratory symptoms including persistent cough may be attributed to Covid-19 and not acted on.”
The researchers say cancer in primary care - from diagnosis to management of those living with the disease - is “evolving rapidly” in the face of the global pandemic.
“In a climate of fear and mandated avoidance of all but essential clinical services, delays in patient, population and healthcare system responses to cancer symptoms seem inevitable,” they say.
Kate Brain, who is looking at the impact of delayed diagnoses of cancer, says: “UK national cancer screening programmes - which account for 5% of all cancer diagnoses each year - have been suspended. As such, early diagnosis through spotting - and acting upon - the early signs of cancer becomes extremely important.
“Cancer cannot wait - even in the midst of a pandemic. We would urge anyone with symptoms that are causing concern to contact their GP.” Read more.
CARiAD for COVID-19
CARiAD, an NIHR funded pilot trial led by Professor Clare Wilkinson and Dr Marlise Poolman from PRIME Centre Wales, Bangor University, had just completed before the pandemic began.
The research tested an intervention teaching lay carers to give as-needed subcutaneous injections at home to a dying loved one. Sadly, it seems that many could die at home during a time when the work force is depleted.
Those writing policy for palliative care during the pandemic asked to implement this new practice rapidly.
The NIHR fast tracked publication, and Wales Government fast tracked a new all-Wales policy on 20th March. England plan to adopt the CARiAD intervention urgently as well; this is a rapidly evolving situation led by Prof Bee Wee of Oxford University.
Implementation of CARiAD is by no means simple – this intervention is cascaded down from the Palliative Care teams to the District nursing teams and then to the family members. Training the trainers is a huge piece of work, and safety and governance are key. Bangor University are supporting the research team to do this emergency implementation with the rigour it deserves.
We plan to both urgently implement, and to study the implementation at the same time, in order to ensure patients and their families are best served. Thankfully, expedited research funding and processes are available through the NIHR, and we submitted an application for these funds in early April. Meanwhile, Dr Marlise Poolman and Professor Clare Wilkinson are supporting clinical teams in the use of the new practice across both Wales and England.
The CARiAD research team at work, Bangor University.
COVID-19 symptom tracker
PRIME researchers working in screening and early diagnosis have been advising Welsh Government on the communications strategy for the COVID-19 Symptom Tracker study led by King's College London and ZOE Global Ltd.
Professor Kate Brain who leads the screening and early diagnosis work package in PRIME comments:
"I was pleased to be able to advise Welsh Government on strategies for involving under-represented populations in the COVID-19 Symptom Tracker app, drawing on the combined knowledge and expertise of our WP4 SPED research team to hopefully enhance the reach and coverage of this important study."
Further information about the study and how to download the app, visit: https://covid.joinzoe.com/
Researchers launch project to investigate how COVID-19 affects pregnancy
Cardiff University is collaborating with Imperial College London to establish a global registry of those affected by COVID-19 in pregnancy.
The Centre for Trials Research (CTR) will host the PAN-COVID online database of women with suspected and confirmed coronavirus from early pregnancy to after delivery of the baby.
The UK government has said limited evidence suggests there are no coronavirus-related complications in pregnancy but pregnant women are being advised to limit social contact.
It is hoped this research will help scientists gain a better understanding of how coronavirus affects early pregnancy, fetal growth, prematurity and virus transmission to the baby.
The 18-month study is part of 21 new projects into novel coronavirus announced today by the UK government.
Julia Townson, the research fellow leading the CTR team in Cardiff, is in charge of building the online database where healthcare professionals from the UK and around the world will be able to enter data directly.
“We hope this project will provide researchers with a huge amount of information to help guide prevention and treatment of coronavirus for pregnant women during this pandemic,” she said.
“At the moment we know very little about how COVID-19 affects pregnancy and babies after delivery so this is obviously an area of big concern for many people right now.
“We hope this research will provide a greater understanding of how it affects every aspect of pregnancy, on a global scale.”
The CTR will support the study, providing academic expertise in web and database development, data and study management and statistical analyses. Read more.
Supporting Dental Services in COVID-19
Following the issue of a “red alert” status from the office of the Chief Dental Officer, all routine dental care has been suspended as this cannot be conducted without generating aerosols. Dentists in primary care have been advised to provide only an assessment and advice service.
An Urgent Dental Centre has been established and is operating seven days per week from the University Dental Hospital. Patients experiencing intractable pain, swelling, bleeding or trauma can access the service via the triage system on 029 2044 4500.
Clinical staff from the Dental and Oral Health Work Package are contributing to the organisation and staffing of the Urgent Dental Centre as well as liaising with colleagues in primary dental care over the clinical management of their patients at this time.
International links and shared learning
PRIME Centre Wales international links with the World Organisation of Family Doctors (WONCA) have facilitated the sharing of latest learning and practice from primary care colleagues around the world for the management of COVID-19.
Joyce Kenkre, PRIME Associated Director and Professor of General Practice at the University of South Wales, sits on the WONCA Working Party on Research and the EURIPA Internal Advisory Board, and has been linking in with Welsh Government to share guidelines and information developed in other countries.
Particular areas of interest and potential shared learning which Professor Kenkre has been collating information on include the impact on screening, and one year and five year morbidity and mortality of people with conditions other than COVID-19 due to the cessation of service provision.
New expressions of humanity help dispel fear and protect the mental health of bereaved families
April's issue of the BMJ features an editorial on death and dying during the pandemic co-authored by Sarah Yardley and Martin Rolph.
Sarah is a Consultant in Palliative Medicine and an Honorary Clinical Senior Lecturer, Marie Curie Palliative Care Research Department, University College London, and is supported by Andrew Carson-Stevens and PRIME Centre Wales in her THIS Institute Post-doctoral Fellowship. The study is entitled 'Use of ‘close-to-practice’ methodologies to explain and change impact of interpersonal relationships in quality improvement' and will examine how improvement tools in palliative care and psychiatry are used in practice to consider what might work better.
Martin is a member of the PRIME Centre Wales SUPER group, which was actively involved in supporting Sarah's application. Some of the SUPER members have subsequently become part of the patient advisory group which provides public and patient contributions during her study.
Read the editorial at:
Yardley Sarah, Rolph Martin. Death and dying during the pandemic BMJ 2020; 369 :m1472
Other news of interest
Welcome to WSSPR: Wales School for Social Prescribing Research
We are pleased to officially launch the Wales School for Social Prescribing Research, funded by Health and Care Research Wales and nested within PRIME Centre Wales.
WSSPR is a virtual all-Wales school which aims to develop a social prescribing evaluation methodology, building on the work previously completed by the Wales Social Prescribing Research Network (WSPRN).
The rapidly growing enthusiasm for social prescribing and its potential to influence delivery of services in primary care have exceeded expectation but the development of its evidence base and robust quality standards for evaluation have trailed (Lovell et al, 2017; Bickerdike et al, 2017).
WSSPR will sit within PRIME Centre Wales under the theme 'Seamless care closer to home', within the work package 'Care closer to communities'.
Please head over to our new website to learn more about us, our current projects and our research network - www.wsspr.wales.
You can also follow us on Twitter @WSSPRCymru or get in touch with us via. e-mail - firstname.lastname@example.org.
We look forward to working with you in the future.
Professor Carolyn Wallace
Director of WSSPR
PRIME paper no.2 in top BMJ Quality & Safety articles of 2019
Congratulations to Helen Snooks and colleagues in PRIME's emergency and unscheduled care research team on the announcement that their paper looking at the effects and costs of implementing predictive risk stratification in primary care, has been awarded second place in the top ten BMJ Quality and Safety articles of 2019.
Across the National Health Service (NHS), predictive risk tools are being implemented in general practice to identify patients for case management, in part in hope that these tools might reduce emergency admissions.
Here, Snooks et al. performed a stepped wedge trial across 32 practices in one Welsh health board to evaluate the costs and effects of the introduction of an emergency admission risk prediction tool (PRISM). Read more
Blog post from Megan Elliott: What influences men to take part in weight loss programs?
Men tend not to take part in weight loss programs but few studies explore why this may be. In this blog post, the lead author of a new qualitative study published today in BMC Public Health discusses her team's research which seeks to answer this question.
However, engagement of men in these weight loss programs is low. Men make up 11-25% of people who go to Counterweight, Weight Watchers, Slimming World and Rosemary Conley Diet and Fitness Clubs. With a greater prevalence overweight men compared to women in the UK, and rising obesity rates globally, this lack of engagement is concerning.
Our study, published in BMC Public Health, sought to understand what influences the engagement of men in weight loss services. Read more
Congratulations to Dr Harry Ahmed on NIHR Advanced Fellowship award
Congratulations to Dr Harry Ahmed, co-lead for the infections and antimicrobial resistance work package in PRIME Centre Wales on being awarded an NIHR Advanced Fellowship funded by Health and Care Wales Research Wales.
The Fellowship funding will enable Harry to investigate the impact of infection and antibiotic treatment on people who use oral anticoaguant medication. He is planning a large scale epidemiological research programme using the Clinical Practice Research Datalink with linkage to ONS and hospital data.
The research will address the key questions:
Harry comments: "I'm delighted to have secured my second NIHR Fellowship and be able to lead clinically relevant research with colleagues from Cardiff, Oxford, and Public Health England."
- Does infection affect the risk of serious bleeding in people who use oral anticoagulants?
- Which antibiotics might affect the risk of serious bleeding in people who use oral anticoagulants?
- How can we manage and treat infection more safely in this population?
Harry is a Senior Clinical Lecturer in Epidemiology and Director of the Academic Fellows Scheme at the Division of Population Medicine, Cardiff University School of Medicine, and a practicing GP at Penygraig Surgery, Rhondda Cynon Taf.
He is happy to hear from anyone who wishes to collaborate on any aspects of the project. Get in touch by emailing Harry on: email@example.com
Farewell and thanks to PRIME Research Fellow, Matthew Jones
Matthew Jones, Research Officer in the PRIME team at Swansea is leaving us for pastures new. Matthew has been with us since June 2016 and is now moving onto a new role where he will be using cognitive behavioural therapy to treat patients with common mental health conditions via video call, telephone and instant messenger system on behalf of private health insurers and the NHS.
He will also be staying research active as part of his PhD studies so hopes to cross paths with the team in the future. We held a virtual leaving party for him (see photos below) with some added hats for a bit of fun and we wish him the best of luck in his new role.
PRIME becomes official member of HSR UK
PRIME Centre Wales is delighted to now become an organisational member of HSR UK (Health Services Research UK).
HSR UK is a self-supporting membership organisation dedicated to the promotion of health services research in policy and practice. The collective voice of UK health services research, HSR UK connect researchers with health service leaders, managers and clinicians to drive improvement and innovation in the NHS.
Further information: https://hsruk.org/join-hsr-uk/join-hsr-uk
Francis NA, Gillespie D, White P, Bates J, Lowe R, Sewell B, Phillips R, Stanton H, Kirby N, Wootton M, Thomas-Jones E, Hood K, Llor C, Cals J, Melbye H, Naik G, Gal M, Fitzsimmons D, Alam M F, Riga E, Cochrane A & Butler CC. C-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT. Health Technol Assess 2020;24(15)
Price CI, Shaw L, Islam S, Javanbakht M, Watkins A, McMeekin P, Snooks H, Flynn D, Francis R, Lakey R, Sutcliffe L, McClelland G, Lally J, Exley C, Ridgers H, Russell I, Vale L, Ford GA. Effect of an Enhanced Paramedic Acute Stroke Treatment Assessment on Thrombolysis Delivery During Emergency Stroke Care: A Cluster Randomized Clinical Trial. JAMA Neurol. Published online April 13, 2020. doi:10.1001/jamaneurol.2020.0611
Gibson R, MacLeod N, Donaldson LJ, Williams H, Hibbert P, Parry G, Bhatt J, Sheikh A, and Carson‐Stevens A. (2020) A mixed‐methods analysis of patient safety incidents involving opioid substitution treatment with methadone or buprenorphine in community‐based care in England and Wales. Addiction, https://doi.org/10.1111/add.15039
Cornell S, Gould A, Ellis G, Kenkre J & Williams EM. Clinical perception of a novel cardiovascular lifestyle prescription form in the primary and secondary care settings of Wales, UK.Health Promot J Austr. 2020 Apr;31(2):232-239. doi: 10.1002/hpja.284.
Cooper A, Carson-Stevens A, Hughes T, Edwards A (2020) Is streaming patients in emergency departments to primary care services effective and safe? BMJ 2020;368:m462
Shepherd, V. and Davies, J. (2020) Conducting a randomised controlled trial in care homes: the challenges of recruiting residents who lack capacity to consent. SAGE Research Methods Cases. doi:10.4135/9781529726626
Singh Curry R, Evans E, Raftery A, Hiscosk J, Poolman M (2019) Percutaneous venting gastrostomy/ gastrojejunostomy for malignant bowel obstruction: a qualitative study. BMJ Supportive & Palliative Care. 9:4
McCutchan G, Smits S, Ironmonger L, Slyne C, Boughey A, Moffat J, Thomas R, Huws DW, Brain K (2019) Evaluation of a national lung cancer symptom awareness campaign in Wales. Br J Cancer 122, 491–497 (2020). https://doi.org/10.1038/s41416-019-0676-2
Barnes E, Bullock A, Chestnutt IG, Cowpe J, Moons K, Warren W. 2020. Dental Therapists in General Dental Practice. A literature review and case study analysis to determine what works, why, how and in what circumstances. European Journal of Dental Education 24 (1) , pp. 109-120. 10.1111/eje.12474
NWCR & Tenovus PhD Studentship Award
We invite applications from principal investigators, with a track record of successful PhD supervision, to submit proposals for this jointly funded research award. NWCR and Tenovus Cancer Care (Tenovus) seek to fund a health services PhD research award which will aim to impact cancer policy or practice through the targeted area of psycho-social oncology.
Research proposals should address the interactions between the physical, psychological, social and behavioural aspects of the cancer experience for the cancer patient and care-givers.
This is an open call, but projects must seek to provide evidence to impact the cancers that are significant to the combined population of the two Charities – the North West of England and Wales.
PhD studentship grants are awarded for up to three years with a maximum funding budget of up to £75,000
All applications will undergo rigorous external peer and scientific review.
Closing time and date 5pm, Monday 22nd June 2020.
Further information: https://nwcr.org/funding-researchers/nwcr-tenovus-phd-studentship/
Prioritising funding and support for COVID-19 research across the UK
Working with partners across UK, Health and Care Research Wales is leading, enabling and delivering world-class COVID-19 research, a key element of the Government’s overall response to the pandemic.
COVID-19: guidance on health and social care research projects for educational purposes
Please see new guidance which relates to health and social care research projects conducted by undergraduate and master’s students.
Funding available for the development and testing of therapeutics to treat COVID-19
LifeArc has made available an initial £10 million for the identification of therapeutics that can be rapidly deployed to treat COVID-19. The aim is to run trials in patients during the current epidemic. It is anticipated that applications will be for funding to repurpose one or more drugs that are generic, already licensed, or are in late stage development for another indication.
The Dunhill Medical Trust
These support research projects that are important to understanding the mechanisms of ageing, treating disease and frailty and identifying and developing new and effective ways to improve the lives of older people. The grants also support research into treating diseases and conditions that disproportionately affect older people but are less well-funded.
RCGP Annual Research Grants
The RCGP Scientific Foundation Board have opened their call for Annual Research Grants. The deadline is 31st July 2019. These are relatively small grants of up to £30,000 but we have had some success with these in the past, particularly from our Academic Fellows.
The SFB is our charitable funding body and awards grants for research projects whose findings will be of direct relevance to the care of patients in the general practice setting. Any GP, primary healthcare professional or university-based researcher may apply for a grant for scientific research to be undertaken in the UK.
Applications for PAGs will be reviewed quarterly according to the following calendar:
- Quarter 2: deadline for submissions 31 May 2020, applications reviewed by 30 June 2020
- Quarter 3: deadline for submissions 31 August 2020, applications reviewed by 30 September 2020
- Quarter 4: deadline for submissions 30 November 2020, applications reviewed by 31 December 2020
A maximum of three applications per quarter will be funded.
Further information: https://www.rcgp.org.uk/clinical-and-research/our-programmes/research-facilitation-and-support/research-grants-and-fellowships.aspx
RCGP support for researchers
The Royal College of General Practitioners (RCGP) is supporting researchers to implement academic primary care findings into practice for GPs.
The Research programme includes:
- Scientific Foundation Board grants
- RCGP Marie Curie Palliative Care Research Fellowship
- RCGP Research Ready®
- RCGP Impact from Research
- Influencing research
- Research awards
The new Impact from Research programme offers to partner on research projects and support impact and dissemination through a range of activities.
Further information: www.rcgp.org.uk/research
UKRI Future Leaders Fellowships
UK Research and Innovation also invites applications for Future Leaders Fellowships. The Fellowships will grow the strong supply of talented individuals needed to ensure a vibrant environment for research and innovation in the UK. The scheme is open to researchers and innovators from across business, universities, and other organisations.
Further information: https://www.ukri.org/funding/funding-opportunities/future-leaders-fellowships/
Application deadline: 30 April 2020
Health Services and Delivery Research Programme
Health Technology Assessment Programme
Clinical Innovation Hub - Accelerate projects
The Clinical Innovation Hub is a partnership between Cardiff University and Cardiff and Vale University Health Board. The Clinical Innovation Hub is a partner of the Accelerate project, Clinical Innovation Accelerator (CIA). Accelerate is a consortium £24M programme led by the Life Sciences Hub Wales in collaboration with Cardiff University, Swansea University and the University of Wales Trinity Saint David.
It is funded by the Wales European Funding Office (WEFO) and will utilise EU Structural Funds to identify innovation projects that meet an unmet clinical need.
The awards are open to academia, industry, students and healthcare professionals. Innovations could take the form of new technologies, products, processes or services to deliver economically viable solutions for adoption into routine health and social care delivery, for patient benefit, health economic benefit and to stimulate economic growth with attendant socio-economic benefits in Wales.
Support that Accelerate can offer:
- Funding for “Pilot” (6-12 months and <£20K) and “Platform” (12-18 months and < £150K) projects
- Access to future funding opportunities/initiatives
- Clinical input - Buy out and attract in kind NHS staff R&D time
- Human resource - Clinical Innovation fellows, project management, business management, cost benefit analytics and research technologist assistance
- Collaborations - Industry/Academic/Clinical partner
- Advice & Guidance - A Multidisciplinary Team (MDT) of Clinical Innovation experts, including devices and intellectual property experts
- Access to leading Welsh University, University Health Boards and Trusts - patients, facilities and personnel
- Funding /deadlines: Support and awards operate on an always open basis with funding anticipated until 2021 so you can apply at any time. If you would like further information on submitting a proposal or have an innovative idea that you think would benefit from the advice or support for Cardiff University applicants, please contact Barbara Coles: firstname.lastname@example.org
RCN Foundation Education Grants
Educations available for Nurses, Midwives and Health Care Assistants.
Our education grants fund a wide variety of learning, development and research opportunities, providing the support individuals need to make a difference to quality patient care.
The RCN Foundation believes that patients deserve the best possible experience and care, delivered by well trained and high performing professionals.
For nurses to be able to keep up to date with new developments and use their knowledge and skills to transform the care their patients receive, it is important they engage in development opportunities and shared learning.
There are ten grants available, with various opening and closing dates. Spring grounds round is now open, and closes at 5pm on 29 May.
Further information: https://rcnfoundation.rcn.org.uk/apply-for-funding/educational-grants