Access to Data Infrastructure

The M-RIC access to data work package has delivered a secure data environment (SDE). An SDE provides a safe place for storing data and information and provides the “engine” for data analytics so we can access, link and understand the data while ensuring only legitimate researchers can use it.

We collect and organise data from different sources within Mersey Care NHS Foundation Trust, such as shared care records, mental health clinical notes and prescribing data. This anonymised data provides us with new ways of understanding mental health difficulties, including patterns of behaviour and symptoms that traditional diagnoses might miss.

Our next step will be to link into other NHS secure data environments to create richer datasets. For example, linking M-RIC data to GP records will allow researchers to assess the best ways to help GPs to support Mersey Care patients in the community. As we do this it is important that we continue to develop appropriate processes for managing and auditing how the data are used to ensure that it is safe, appropriate and lawful. To support this we have established a data access committee, with public representation, to help oversee how the Access to Data system is used.

Facilitating data research using mental health data

Mental health data can be complex, so we have focused on creating a research ready dataset.  This work has included using mathematical algorithms to remove personal identifiable data and funding innovative ways to standardise text-based patient notes.

We are investigating the potential technology such as Generative artificial intelligence (AI) and large Language Models to support mental health clinicians when treating with patients with complex medical histories.

M-RIC has worked with several industry partners. Microsoft supported the deployment of the SDE infrastructure, Holmusk are helping to develop a clinical trial ready dataset and Quantexa are working on tool to assist M-RIC data researchers.

Clinical trials

M-RIC aims to provide more people with the opportunity to take part in mental health based clinical trials. M-RIC is supporting Count Me in in Mersey Care NHS Foundation Trust. This is a new system which will enable more service users and carers to be contacted about getting involved in potential research activities. The Access to Data platform and tools will be used to identify all individuals who meet the criteria for any new clinical trial.

With your permission, it will combine relevant parts of your health records with data about your lifestyle such as daily sleep and activity patterns alongside information about physical and mental symptoms that affect you. Your mental health avatar helps collect information that is not normally captured in our current ways of working that could be the key to identifying the most appropriate or new treatments and help improve your care by personalising these treatments specifically to your difficulties

Your mental health avatar can then be used by you as well as your healthcare teams to better understand your mental health and wellbeing and help direct your treatment in the ways that most help you.

Over time, we aim to use and analyse data from groups of mental health avatars to help the NHS identify the common patterns of mental health difficulties. This will enable us to have better descriptions of people’s difficulties and then ultimately re-design services and offer better treatments.

Improving NHS staff health and wellbeing

Working with design and engineering firm Concentrix Catalyst, we launched an innovative new pilot study aimed at improving the health and wellbeing of NHS staff.

The study involved more than a hundred people working in both clinical and non-clinical roles at Mersey Care NHS Foundation Trust testing a new app, using an Apple Watch and iPhone, for 90 days.

Professor Dan Joyce is the work package lead for Mental Health Avatar and was the Chief Investigator for the trial. He is also a Professor of Connected Mental Health at the University of Liverpool and a Consultant Psychiatrist at Mersey Care NHS Foundation Trust.  He explained:

“The NHS 2023 national staff survey results show 41.71% of staff have felt unwell because of work-related stress in the last 12 months and 42.7% of staff often or always feel worn out at the end of their shift.

“At Mersey Care, we’re proud to be investigating new ways to support staff health and wellbeing which could serve as a model for supporting NHS staff nationwide.”

The iPhone app was developed in partnership with the Trust’s Staff Wellbeing team and Occupational Health and Wellbeing Service. The aim was to provide each individual user with an overall picture of their mental and physical health using powerful health sensors in the Apple Watch to measure sleep, heart rate, heart rate variability, cardio fitness, and physical activity levels.

The study app also gathers feedback from the user about their diet, mood changes and more information is shared through questionnaires. Using metrics from Apple Watch and study questionnaires, users are presented with personalised insights and wellness tips, empowering them to make changes to their lifestyle and behaviour to improve their health and wellbeing.

Dr Jade Thai is Mersey Care’s Senior Research Lead and her team implemented and delivered the trial. She said: “Thanks to the dedication of the Mersey Care Research and Innovation team and Informatics Merseyside, over a hundred participants received the necessary technology, support, and guidance to take part in this study.”

The study, which has now been completed and in the data analysis phase, prioritised user data security with data encryption, anonymisation, and compliance with privacy laws.

We will test if AI (artificial intelligence) and data science can be help identify people with difficult-to-treat depression and link them to the most appropriate treatments and trials of new interventions. We will link with the mental health avatar projects in M-RIC to help us analyse an individual’s symptoms, their ‘rhythms of life’ and biology. This will enable us to gain a better understanding of how people experience mood problems, what works for them and how we can best provide services and treatments in a timely and helpful way.

We are trialling this pioneering research in the NHS through a new regional Mood Clinic delivered by Mersey Care NHS Foundation Trust supported by the Mental Health Mission Mood Theme. This year, we have been working with the work package’s service users and carers to develop and setup the clinic. In particular, they have co-produced the complex assessment forms and processes and are creating videos explaining mood and how it affects us for the clinic’s information webpages.

In addition, we are working alongside the population mental health work package team to collect information on the social determinants of mental health and will start examining how neurodiversity and mood problems interact. These are described by the World Health Organization as the conditions that we are born, grow, live, work and age. They can include everything income, education, social inclusion, early childhood development, housing, access to health services plus much more.

Other digital tools, such as apps and gaming, to assess and support mental health will also be developed in collaboration with children and young people in our local communities as well as industry partners.

We are partnering with the Children Growing Up in Liverpool (C-GULL) study. This major seven-year programme, which launched in 2023, aims to improve the health and wellbeing of children and families in Liverpool. The study is collecting data from 10,000 families to provide valuable insights into how we can improve health outcomes for children. This data will help us to better understand brain development in children and young people in our local communities.

We will take data from the C-GULL project and analyse it in more detail using our own secure data environment. We will use our mental health avatar digital technology to support parents to help them understand their child’s behaviour and support their mental health.

Our overall aim is to improve the outcomes for children and young people in areas such as education, wellbeing, life opportunities, and quality of life.

While studying the immune system in relation to psychosis, we will see if changing the way we use anti-inflammatory medications could lead to new treatments for people with psychosis.

With permission of individual service users, we will collect biological samples. By creating a bank of biological samples, it will assist us to discover new ways of characterising and treating psychotic-spectrum disorders such as schizophrenia.

Our research will combine the biological data we collect with data collected via our secure data environment to identify new pathways, strategies, and public health interventions for preventing psychosis.

Our progress

• In partnership with people with lived experience we have developed a plan for how we are going to carry out drug trials to find new treatments for people living with psychosis disorders. This is quite complex because it involves working across different hospital sites and involving patients at different stages in their mental health journey.
• We  have brought together a team of NHS and academic researchers who all have different expertise, along with people with lived experience, to co-create a clinical drug trial pipeline for future drug development in mental health.
• We have obtained ethics permission to run a trial collecting biomarkers in different groups of people with psychosis treatment outcome to identify what markers are associated with better mental health. Biomarkers are measurable markers or signs that tell us what is taking place inside a patient’s body.

Our plans

• We will have a research nurse based within the Early Intervention for Psychosis Service to be a bridge between researchers and the service.
• We will build and test a trial platform that is capable of speeding up the process of running clinical trials safely so we can get treatments to patients as quickly as possible.

Liverpool City Region (LCR) Adverse Childhood Experiences (ACEs) Alliance

We have set up the Liverpool City Region (LCR) Adverse Childhood Experiences (ACEs) Alliance which is a collaboration between M-RIC and Liverpool John Moores University (LJMU).

It brings together researchers, practitioners and policy makers in the region to share knowledge on how to support people who are affected by adverse childhood experiences (ACEs), identify the needs and opportunities for further research in the area, and conduct relevant research in the future.

The LCR ACEs Alliance first met in April 2024 and work has begun on a vision statement and guiding principles and an ACEs anthology, a collection of personal stories that aims to show how common ACEs are and some of the supporting factors that help people cope with ACEs.

We also have plans for an LCR ACEs video, a dedicated LCR ACEs web section on the M-RIC website and an ACEs conference working with LJMU in July 2025.

The ‘Hope and Mattering’ project

This project aims to produce and pilot evaluation tools to measure the psychological impact of the meaningful involvement of patient and the public advisers in research.

In April we held a consultation workshop with the wider group of public advisers to begin the process of identifying what meaningful involvement looks like, and how meaningful and non-meaningful involvement can make people feel.

We aim to create evaluation tools to measure the psychological impact of involvement in research working with public advisors through a series of workshops between October 2024 and February 2025.  We plan then to pilot the tools within one or more mental health research studies that may be conducted within M-RIC, National Institute for Health and Care (NIHR) Applied Research Collaboration North West Coast or partner organisations.

We are also working with the Mood Disorder Care Innovations work package around the new regional mood clinic to help develop systems to enable them collect, record and respond to information on the social and economic factors that impact the mental health of service users. We will do this working alongside M-RIC public advisors.

Identifying barriers to recruiting participants into research studies

In February 2025 we plan a patient and public involvement and engagement workshop to identify barriers and facilitators to recruiting participants into research studies, with a particular emphasis on clinical trials in primary care.

CHESS: Civic Health Equity: from Silos to Systems project

In July 2024, researchers at the University of Liverpool received a share of £9.7M new UKRI funding for the CHESS: Civic Health Equity: from Silos to Systems project. The project aims to evaluate the health impact of multiple programmes of social and economic support for households across Liverpool City Region.

These services help struggling households with income, employment and training addressing UKRI’s themes of place-based health inequalities and sustainable economic growth.  They include:

• The Ways to Work programme which provides services to enhance employability including information, advice and guidance, transitional employment opportunities and skills development.
• Households into Work which supports people at risk of eviction, homelessness, domestic abuse, social isolation and chronic health issues.
• Liverpool Citizens Support Scheme (LCSS) which provides direct cash and in-kind transfers to households in crisis
• Citizens Advice on Prescription (CAP) which aims to improve mental health and wellbeing by supporting patients with non-medical issues that may impact their health.
• The Life Rooms which provides a wide range of support to improve your physical and mental wellbeing and is delivered by Mersey Care NHS Foundation Trust.

This research will investigate what is working well and what isn’t. It will examine their costs and health benefits, and how to adapt and combine them to maximise impact; redesigning services to benefit disadvantaged communities, in LCR and beyond.

Findings will contribute to the population mental health work package as well as work by the Heseltine Institute for Public Policy, Practice and Place on public service reform.

Work began on the projects in October 2024.