Effective, clear and compassionate verbal and non-verbal communication has been shown to be essential to good patient care, as well as part of an efficient and cost-effective healthcare system (McDonald, 2016). Since the Covid-19 outbreak, communication between patients and healthcare professionals has altered, with healthcare professionals facing new challenges: adapting to the introduction of widespread use of Personal Protective Equipment (PPE), video-call consultations, social distancing and limited physical touch. Healthcare professionals have described the impact of wearing PPE as isolating, exhausting and impeding communication, articulating the urgent need for research in this area which has been reiterated by proactive requests for support from institutions such as University College of London Hospitals (UCLH). Through Clod Ensemble's Performing Medicine programme WILLSON (Principal Investigator) provides sector-leading interventions in healthcare education using performative techniques from non-verbal artistic disciplines, such as dance and physical theatre, to enable healthcare professionals to gain a deeper understanding of how they communicate non-verbally. These techniques have been proven to enhance self-care and communication with patients and colleagues (Osman et al., 2018). This proposed research programme of interviews and workshops will investigate the impact of arts-based interventions on the training and support of healthcare professionals and medical students with regard to the non-verbal communication challenges presented by Covid-19. Undertaken by a unique, multidisciplinary partnership between arts organisations, NHS trusts and academics who have been collaborating for decades, this project will create, test, scale and disseminate online and in-person resources to support healthcare professionals and medical students.

A growing proportion of the population living with and beyond cancer are working-age cancer survivors, and 300,000 are estimated to be teenagers and young adults (TYAs) aged 16 to 39. With advances in medical treatments, up to 90% of TYAs now live beyond their treatment, a growing population. A cancer diagnosis will disrupt anybody's life, their personal biography, resulting in a significant impact on their physical, emotional, social, and economic well-being. This will be even more challenging for young people, diagnosed at a vulnerable time of multiple transitions and emerging adulthood (e.g. completing education, leaving home, becoming financially independent, forging relationships/marrying, having children). Our project aims to understand how the social integration of TYAs is impacted by a cancer diagnosis. We will describe their social reintegration (SR) through outcomes relating to: employment (income, type of employment); educational attainment (level of education and satisfaction); social development (quantity and quality of social support, connections, and participation); and subjective well-being (how people feel about their life, including satisfaction with key life domains such as health, family, income, social relationships, leisure time, work, and sex life). We want to understand which factors contribute (together or independently) to enable or disable TYAs' SR trajectories following treatment. This will be facilitated by linking knowledge and methods from multiple fields such as medical and psychosocial oncology, sociology, and developmental psychology. We will explore how social science perspectives and methodologies can inform the development of health and social care support that minimises the impact of cancer on TYAs' lives. Through 3 interconnected strands including a qualitative sub-study we will explore, in turn, several sets of factors that may influence TYAs' SR trajectories: socio-demographic factors (e.g. age, gender, geographical area); clinical factors (e.g. cancer type, time since diagnosis); psychosocial factors (e.g. extraversion, self-efficacy); patient-reported outcomes ('PROs', e.g. ongoing symptoms, health-related quality of life). Other factors, potentially unaccounted in existing literature, may emerge from our qualitative patient interviews. This will enable the development of stratified, evidence-based knowledge to improve the educational, employment, and social development opportunities of TYA cancer patients. To evaluate the influence of socio-demographic and clinical factors we will analyse and compare 2 existing databases. These databases include information on our planned outcomes in the general population and a nation-wide cancer group. To evaluate the influence of psychosocial factors and patient-reported outcomes we will run a longitudinal study with 2 patient groups (one during and one after treatment) across 2 centres. To explore wider potential factors we will run interviews with TYAs in the socio-demographic and clinical strata defined by the secondary data analyses. Our ambition is that TYAs should have the same or better opportunities and socio-economic outcomes as their peers or as they would have expected if they were not diagnosed with cancer. To develop the support to achieve this, we require the evidence this project will deliver. Within 3 years, the 3 strands of our project will come together to offer a comprehensive description of the 'biographical disruption' and inequality of opportunity and outcomes brought about by a cancer diagnosis in the lives of TYAs. This will be summarised in the Multidimensional Stratification Model of Social Reintegration Outcomes, which will be relevant to many health and social care policies addressing patients' future socio-economic outcomes.

A key component of the NHS (and global) response to the COVID-19 pandemic has been to reinforce acute and critical care capacity, through an unprecedented re-deployment of personnel from different care pathways into fluid teams consisting of volunteers, student doctors and nurses, and in some cases military personnel [1-4]. These COVID-teams provide a unique opportunity to examine the interaction of many of the established factors for successful delivery of medical teamwork and care. Current evidence suggests that without common teamwork, shared communication patterns and clear leadership structures, the ad-hoc and fluid nature of these COVID-teams increases risk to patient outcomes, delivery of care [5-9] and team member resilience, mental-health and retention [10,11]. This project will examine how non-technical factors for healthcare delivery (leadership, social support & cohesion, communication, shared mental models, co-ordination) and expected moderating factors (occupational background, preparedness, work-life balance, home situation, proximity, workforce allocation models) impact on perceived COVID-teamworking and performance, individual team member well-being and team member employment retention intentions. It will be a mixed methods cross-sectional exploratory study of COVID-team members, clinical directors and senior hospital managers across a wide range of partnered NHS Trusts. Qualitative interviews will identify key themes and will be followed up by a more widely recruited confirmatory survey examining longer term individual well-being and retention intentions. Throughout, there will be a high emphasis on rapid dissemination of results to NHS partners and wider medical and other stakeholders to inform evidence-based workforce guidance and accelerate team-working theory, practice and policy.