The National Health Service (NHS) faces mounting pressure from an ageing population and the backlog of care following the COVID-19 pandemic. The NHS Long Term Workforce Plan sets out a strategic framework to address these pressures through three priorities: train, retain and reform. The plan outlines a range of measures, including the doubling of medical school places over the next decade. Realisation of these ambitions is constrained by limited training capacity, as existing educators face significant pressures due to clinical demands. Clinical Teaching Fellow (CTF) programmes provide resident doctors with protected time for education and may help expand capacity and alleviate workforce pressures on established educators. Despite their rapid growth, CTF programmes remain under-described, and their contribution to NHS workforce priorities has not been systematically examined. To address this gap, this scoping review will map published and unpublished evidence on UK-based CTF programmes, engaging knowledge users to ensure findings are relevant to practice and workforce priorities.

The review will follow the Joanna Briggs Institute methodology for scoping reviews and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews. Evidence will be identified from academic databases (British Education Index, EMBASE, ERIC, MEDLINE, Scopus, Web of Science) and grey literature sources (Google Scholar, NHS and medical school websites, deanery pages and job-advertising platforms). Two reviewers will independently screen and extract data using a piloted form, with discrepancies resolved by discussion or a third reviewer. Extracted data will undergo descriptive analysis and narrative synthesis, guided by a Theory of Change framework to identify how CTF programme inputs, activities and outcomes relate to NHS workforce priorities. Knowledge users will be engaged throughout the review to refine research questions, inform source selection, interpret findings, and shape dissemination.

Ethical approval has been granted. All participants will provide informed consent. Participant contributions will be pseudonymised, and data will be managed in accordance with UK data protection legislation. Dissemination will be informed by knowledge users to ensure that findings on CTF programmes, including reported outcomes and identified gaps, are shared with those involved in delivering or supporting CTF programmes and with NHS stakeholders responsible for workforce priorities in training, retention and reform.

Prehospital notification by emergency medical services (EMS) can activate hospital resources before the patient arrives, which has been shown to improve in-hospital care for stroke patients. Optimising prehospital and handover processes in stroke care requires considering end-user perspectives to enhance acceptance and effectiveness of the developed solutions. The aim of this study was to identify current barriers in the preclinical-clinical phase of stroke care.

Within the investigator-initiated CAEHR project (CArdiovascular diseases—Enhancing Healthcare through cross-sectoral Routine data integration), an interface for transferring data from the electronic prenotification system to the hospital information system is implemented. A mixed-methods approach with semi-structured interviews as well as a cross-sectional online survey was used to gather feedback from healthcare professionals at a single stroke centre in Germany as well as from the participating EMS personnel. Data collection for the interviews was conducted between January and August 2023 and for the online survey between May and September 2023.

Interviews were conducted with 10 healthcare professionals, including seven from the neurological clinic and three from EMS. Additionally, 39 EMS employees took part in a cross-sectional online survey.

Challenges identified were educational and training aspects affecting preclinical processes and patient handover procedures, along with the opportunity for establishing more uniform protocols. Participants emphasised the importance of detailed patient information. Electronic prenotification was seen as an important step regarding structured information transmission, reducing the risk of information loss in stroke care.

The study highlights the importance of addressing organisational processes in addition to technical interfaces for implementing effective stroke care processes.

German Clinical Trials Register, DRKS00029103.

Despite the known haemostatic action of emicizumab (Hemlibra) in haemophilia A patients, its role in the prevention and control of bleeding in high-demand haemostatic situations, such as major surgery, remains to be determined. Patients receiving regular emicizumab prophylaxis often require concomitant factor VIII (FVIII) therapy during major surgery to prevent uncontrolled bleeding and to promote postoperative healing. However, there are limited prospective surgical data relating to concomitant FVIII and emicizumab use. Simoctocog alfa (Nuwiq) is a B-domain deleted recombinant FVIII produced in a human cell line without chemical modification or protein fusion with proven efficacy as surgical prophylaxis in adult and paediatric patients. The Nuwiq for Perioperative management Of patients With haemophilia A on Emicizumab Regular prophylaxis (NuPOWER) study aims to examine perioperative efficacy and safety of simoctocog alfa in haemophilia A patients on emicizumab prophylaxis undergoing major surgery.

NuPOWER is a prospective, open-label, single-arm, multicentre study that will be conducted at approximately 15 centres worldwide. Up to 28 male patients ≥12 years with severe haemophilia A and no FVIII inhibitors will be recruited. All patients must be receiving regular emicizumab prophylaxis and scheduled to undergo a major surgical procedure during which concomitant simoctocog alfa will be administered. The primary endpoint is the overall haemostatic efficacy of simoctocog alfa, adjudicated by an independent data monitoring committee using a pre-defined algorithm, and will consider intraoperative and postoperative efficacy assessments by the surgeon and investigator, respectively. Secondary endpoints include intraoperative haemostatic efficacy, postoperative haemostatic efficacy, number of allogeneic blood products transfused, perioperative FVIII plasma levels (as measured by FVIII activity) and thrombin generation, and safety parameters. In the era of non-factor therapy, NuPOWER will generate valuable prospective data on concomitant use of simoctocog alfa and emicizumab prophylaxis in patients with severe haemophilia A undergoing major surgery.

Ethical approval has been received from institutional review boards/independent ethics committees, and the study will be conducted in compliance with the Declaration of Helsinki. This work will be disseminated by publication of peer-reviewed manuscripts and presentations at scientific meetings.

CT EU 2022-502060-21-00; NCT05935358.