Partnership working supports vulnerable people in Gedling

Elected Members have raised just over £10,000 to provide food for vulnerable families and children in the Borough.

Gedling Borough Council’s Humanitarian Team have been leading the Council’s response and recovery work during the pandemic with a specific focus on assisting vulnerable or isolated residents. A number of projects are currently underway with partner organisations to provide support and address inequality including:

Partnering with Rushcliffe CVS to offer a South Nottinghamshire Volunteer Befriending Service where volunteers make regular friendly telephone calls to people in the borough who’re lonely or isolated.
Work with Jigsaw Homes to deliver ‘One Step at a Time’, a project to help local residents who are lonely or isolated and who may be feeling apprehensive about getting out and about. Volunteers are supporting Jigsaw Homes tenants to improve their mobility by walking short distances with them in their local area and improving their confidence by chatting to them. Pilots of One Step at a Time are also being delivered in other areas of the County.
Coordination of meetings every three weeks with representatives from Jigsaw Homes, the CCG, South Notts Integrated Care Partnership, Rushcliffe CVS and Age UK to ensure mutual collaboration and strong operational coordination between commissioned social prescribing services and public sector partners during the winter months.
A project to enhance and promote the role of local NHS Volunteers Responders in partnership with Notts County Council and Nottingham CVS. Funding has been awarded to enable us to assess the impact of the scheme locally and to use the learning to inform future collaborative VCS work.
Virtual engagement with stakeholder groups to inform response and recovery initiatives including Gedling Seniors Council and Youth Council, Faith Leaders and Food Bank contacts. Some of the outcomes of this work include a consultation with Young People to shape services and activities in the borough, and the promotion and signup of schools and Youth Clubs to the charity Kids Against Plastic, run by two pupils at Redhill Academy.

In addition to the Council’s work to support health and well-being, Elected Members had raised just over £10,000 to provide food for vulnerable families and children in the Borough.

The Humanitarian Team lead worked with the County Council’s Children’s Services, ABL Health, Gedling Play Forum, GBC Customer Services, the Richard Herrod Centre Hub and Church and Food Bank Leaders Group to identify and provide healthy, festive food parcels to the 600 most vulnerable families in the Borough in the week leading up to Christmas.

A directory of services and organisations offering support in Gedling is available on the Council’s website and you can also email volunteer@gedling.gov.uk for more information about any of the projects listed. The team regularly produce a Community and Health and Wellbeing newsletter. Please email the team if you would like to be added to the mailing list.

Leading Integrated Care System Appoints New Independent Chair

Nottingham and Nottingham Integrated Care System (ICS) has today confirmed the appointment of Dr Kathy McLean as Independent Chair of the ICS. Dr McLean will take up the post two days a week from 1st February 2021 for an initial term of three years. This appointment follows a rigorous locally-led recruitment process and has been endorsed by the national leadership of the NHS.

Dr McLean’s appointment follows the announcement by Sir David Pearson that he would not be seeking to extend his term as Chair beyond its planned end in March 2021. Sir David is currently leading the Government’s Social Care Taskforce and will continue in that role.

Dr McLean said, “I am delighted to be appointed as Independent Chair of Nottingham and Nottinghamshire ICS. The ICS has been at the forefront of delivering integrated care, particularly in its response to the Covid-19 pandemic and so now is an exciting time to be joining the team. I’m looking forward to bringing my clinical background, my experience of the national NHS and my leadership of a local provider to bear on this leading system. Never has joined-up working across health and care been more important and I can’t wait to be part of the team”.

Paul Devlin, Chair of Nottinghamshire Healthcare NHS Foundation Trust who led the recruitment process on behalf of the ICS said, “We were delighted by the quantity and quality of applications for our Independent Chair role and even more so that someone of Dr McLean’s calibre wants to help lead our system. We ran a comprehensive open recruitment process with input from all parts of the NHS and from local authority and third sector colleagues and I’m really looking forward to working closely with Dr McLean”.

Dr Andy Haynes, Executive Lead of the ICS added, “I am really proud of the work that the ICS has delivered throughout the pandemic, including our pioneering joint approach to data that has enabled us to forecast demand during the peaks of the virus and also support our roll-out of the vaccine. Dr McLean will join at an exciting time for the system and we are really pleased to have secured her services”.

Sir David Pearson also added, “The Nottingham and Nottinghamshire Integrated Care System has delivered many ground breaking changes in recent years. In particular the pioneering work of ‘Call for Care’ supporting people in crisis; our ground-breaking work supporting housing solutions for people with health and care needs; multiagency working in primary care; the adoption of health and care personal budgets for those who need them and joining up citizens records to help provide the right response at the right time. Nottingham and Nottinghamshire is a national leader in the work to deliver integrated care for our residents and I am very pleased that a national leader of Dr McLean’s calibre is taking up the role of Chair. I wish her every success in supporting further improvements in delivery of health, care and wider public services in the City and County”.

Dr McLean is currently Chair of University Hospitals of Derby and Burton (UHDB) NHS Foundation Trust and a Non-Executive Director at Barts Health NHS Trust, prior to which she was Executive Medical Director and Chief Operating Officer at NHS Improvement, the organisation responsible for providing leadership and support to NHS trusts. Before taking up those roles at NHS Improvement she was the

Clinical Transitions Director working with Sir Bruce Keogh to build the NHS Commissioning Board, now NHS England.

Her work has focused on improving quality by building clinical leadership and expertise across the system, supporting the most challenged organisations and the development of clinical networks and senates. In 2018 Dr McLean was awarded an OBE in the Queen’s Birthday Honours for her services to leadership across the NHS.

Dr McLean will continue in her roles as Chair of UHDB and also as a Non-Executive Director at Barts Health NHS Trust.

A look back at 2020: An extraordinary year in NHS and Nottingham’s history

After what has been one of the most extraordinary years in the country’s and the NHS’s history, partners across Nottingham and Nottinghamshire have taken a look back at the year and the challenges faced as well as acknowledging the successes during a tumultuous year.

The NHS has adapted quickly to cope with this year’s changing environment; from dealing with Covid-19 in our hospitals and health care settings, learning how to safely see patients while social distancing, setting up specialist mental health services, developing effective remote consultations, to GPs adapting to see and treat their patients safely.

Despite the challenges, we have collaborated over the last year to support each other throughout the pandemic and now, once again, partners have come together as the Covid-19 vaccine is rolled out to the public.

Each area of healthcare in the county has had its own challenges and while 2020 may have been one of the most extraordinary years in NHS history, it was also a year where we received astounding support from the public, which we are very grateful for. We celebrated the 72^nd anniversary of the NHS and the public showed their support through volunteering as well as the iconic “clap for carers”.

A look back at the year:

At Nottingham University Hospitals this year 6,500 patients were recruited to Covid trials supporting the world-leading work to develop a vaccine and 11,182 staff members had their flu vaccine, protecting them and their patients against flu.
At both Queen’s Medical Centre and Nottingham City Hospital there were 3,337 cancer surgeries from 18 March to 29 December, only slightly down on the same period last year, 18,856 planned operations, 304,066 virtual appointments and 8,332 births.
At Sherwood Forest Hospitals 86.4% of front line workers were vaccinated with the Flu Jab this year – the highest rated year to date. The Trust was also rated as one of the cleanest in the country scoring 100% for cleanliness at King’s Mill Hospital, 99.35% for Newark Hospital and 99.86% for Mansfield Community Hospital against the national average of 98.06%.
In May 2020, England’s Chief Inspector of Hospitals, on behalf of the Care Quality Commission (CQC), improved the rating of King’s Mill Hospital (KMH) to Outstanding.
At Sherwood Forest Hospitals since April 2020: 13,500 patients have had a day case procedure or treatment; 2,200 patients have had an elective inpatient procedure and 210,000 outpatient appointments have taken place. In 2020 around a third of their outpatient appointments were managed remotely through virtual and telephone appointments, helping to keep patients, colleagues and visitors safe.
From January to October 2020 there have been more than 4.5 million GP appointments in Nottingham and Nottinghamshire with 52% being the same day or next. The number of appointments which were booked on the same day or the following day is higher this year than last year by around 6%.
Nottinghamshire Healthcare has set up a new Mental Health Crisis Line for local people in crisis and needing immediate help. Since it was set up in April 2020 it has received 7,000 calls – around 30-40 a day. They also launched a Mental Health Helpline to provide emotional support and more information about help available locally for anyone struggling, and this has received around 250 calls a month.
Nottinghamshire County Council set up a Coronavirus Community Support Hub in March which is accessible by phone, the Council website or the My Notts app.
There are currently 284 voluntary groups, 120 individual volunteers, 87 charity organisations, 20 online community groups and 241 businesses offering support across the county following the pandemic.
Nottinghamshire County Council’s Customer Services Centre has handled 23,219 incoming calls about Covid-19 and made 26,975 outgoing calls relating to emergency food support.
Nottingham City Council mobilised 200 council workers to frontline operations and recruited 400 new workers into social care during the pandemic.
East Midlands Ambulance Service has seen a new rota of doctors join their 999 control room Clinical Assessment Team, working alongside our nurses and paramedics to provide advanced medical advice to help patients get access to the right kind of care at the right time.

Dr Andy Haynes, Executive Lead of Nottingham and Nottinghamshire ICS said: “It would be impossible to succinctly capture all of the excellent work that has gone on across our system in the last year. The work to support our acute hospitals in times of pressure has been really strong – with contributions from ambulance colleagues, the community providers, social care teams and with coordination from commissioners, we have come together in times of need to make sure that our patients and citizens are well cared for. The system coming together as one has been a highlight of the year, being able to learn from each other, adapt and continue to care for our patients has been very important. It has not been an easy year; the pandemic has brought with it a number of difficulties and pressures. Despite this, I would like to thank everyone who works in the NHS and social care for their tireless work throughout the last year, it has undoubtedly been a tough year but I think we can take great pride in how we have come together and I hope 2021 sees this positive work continue.”

Lisa Kelly, Chief Operating officer at Nottingham University Hospitals NHS Trust, said: “It has been said by many times that 2020 has been an unprecedented year and has presented a number of significant challenges in what have been very difficult circumstances for us all. I have been delighted and inspired by how Team NUH, alongside our health and social care community partners, has come together to tackle these challenges, support each other and continue to deliver excellent care for our patients and the population we serve. Together we continue to work towards ensuring that no one is in hospital longer than they need to be. Within the Trust we have worked incredibly hard to reduce delays in ambulance handover times so that patients get the care they need and ambulance crews are available to respond to the next emergency. We have put in place new measures and processes to ensure that our Emergency Department is not overcrowded to maintain a Covid-safe environment for our patients and staff.

“Like hospitals up and down the country, as we prepared for the first wave of the pandemic we were forced to postpone some outpatient appointments, procedures and operations. This was a really difficult decision, and we are truly sorry to anyone who was affected. Through extensive planning, hard work and the dedication and flexibility of our staff we managed to restore much of our planned work over the summer and start to reduce some of the backlogs. We continue to work hard to maintain outpatient and diagnostic services, although the second wave of Covid-19 has led to us cancelling some further operations. We have continued to work hand in hand with our partners in the Independent Sector to protect as much capacity as possible for our cancer and urgent patients, transferring over 2,000 patients since March – this has only been possible because of the dedication of our surgical, anaesthetic and nursing staff in working flexibly across multiple sites. We will be working hard through the remaining winter months to maintain those restoration plans whilst meeting the challenges posed by winter and Covid-19.

“In delivering both our planned and emergency services we have had to give significant thought to tackling the new challenges Covid-19 has presented, particularly in maintaining a safe environment for our staff and patients whilst delivering the excellent care we aspire to. I would like to thank all of

the colleagues and teams who form part of Nottingham University Hospitals. It’s a team I am very proud to be a part of”.

Chief Operating Officer for Sherwood Forest Hospitals, Simon Barton said: “It has been a tough year for both our community and our colleagues, but throughout the pandemic we have seen amazing strength, cooperation and determination from our colleagues both within Sherwood and beyond. I am pleased to say that we still remain one of the top hospitals in the Midlands for waiting times for emergency care and for crucially ensuring our Emergency department is not overcrowded which creates risk for patients and distancing. I would like to thank colleagues, as it is testament to their hard work and dedication that we continue to achieve this.

“Although we had to postpone some procedures and operations earlier in the year due to the pressures of the pandemic, I am pleased to say that our cancer care is now back up to our pre-covid levels and we have worked hard to provide elective care alongside the pressures of emergency care and COVID-19. Rebuilding clinics, theatre timetables, staffing rotas and creating safe areas with social distancing, masks and screens has been a real team effort. It has been harder to restore our services than it was to stop them, as we have had to consider how to keep our colleagues and patients safe, but I would like to thank everyone who has been involved in the restoration of our services and our patients for bearing with us whilst we got all the processes in place.

“I’m really proud of what we have achieved over the last year at Sherwood. We have seen colleagues pull together to go above and beyond time and again, which has been really heart-warming to see.”

Dr John Brewin, Chief Executive of Nottinghamshire Healthcare, said: “It’s been a difficult and challenging time throughout the pandemic for everyone. I am so incredibly proud of the way our staff have responded. Their hard work and commitment and innovation in finding new ways of delivering care, has meant that we have been able to continue to provide vital services and the best possible care and treatment to our patients throughout.

“The pandemic has had a huge impact on people’s mental wellbeing. Early on we recognised this and set up a new Mental Health Crisis Line for local people in crisis and needing immediate help. Since it was set up in April 2020 it has received 7,000 calls – around 30-40 calls a day. We also launched a Mental Health Helpline to provide emotional support and more information about help available locally for anyone struggling, and this has received around 250 calls a month. Both the helplines have provided vital support throughout the pandemic and will continue into 2021.”

Amanda Sullivan, Accountable Officer at Nottingham and Nottinghamshire Clinical Commissioning Group, said: “This year has seen many challenges within primary care and across the health care system. I am proud of the way we have responded to these challenges so that we can continue to provide the best care to our patients.

“Primary care responded to the pandemic immediately by changing the way they saw patients and, where they could, providing virtual appointments. The work of primary care to continue to see their patients during the last year has been incredible and the figures show that from January to October 2020 there have been more than 4.5 million GP appointments in Nottingham and Nottinghamshire, which shows that the NHS has still been here for the public and I am grateful for this on-going commitment, especially throughout winter and with the roll out of a Covid-19 vaccine.

“Despite all of the challenges this year, I feel proud that we have come together to continue to provide for the people of Nottingham and Nottinghamshire and I hope that we continue to build on this into 2021.”

Alison Challenger, Director of Public Health in Nottingham, said: “We’ve been living with Covid-19 in our city and our communities for over nine months. I know this has not been easy for any of us. Our lives have been restricted, we feel inconvenienced, and we all have worry and anxiety over our health and wellbeing. Some of us, sadly, may have lost loved ones to the virus.

“I’m proud of the way people have responded to the challenge of staying safe and slowing the spread of the virus. I’m particularly impressed with the way we supported the most vulnerable people in our society – one of Nottingham City Council’s main strategic objectives was ensuring it had the right workforce in place to care for its citizens during Covid-19. This included mobilising 200 council workers to frontline operations and recruiting 400 new workers into social care.

“Winter will not be easy for us and we will have to continue to follow restrictions to make sure we can ease the burden on the NHS – but I believe we now have a route out of this pandemic, with vaccinations, testing and observance of guidance around ‘hands, face, space’. The end is in sight, but for now we must all continue to play our part to keep people safe.”

Councillor John Knight, Chairman of the County Council’s Resilience, Recovery and Renewal Committee said: “Nottinghamshire County Council has been working to respond to the Covid-19 pandemic and support those most affected by the crisis. Our Coronavirus Community Support Hub was established in March and is accessible by phone, the Council website or the My Notts app. The Hub provides a real-time online database, which allows residents who need support to submit their postcode and requirements and be shown a list of local groups and organisations who can meet those needs. At its peak during the summer, the Hub website received 1,000 hits a day.

“We have developed local guidance for care home providers to support safe visiting, enabling home care providers, professionals and residents’ families to work together to balance the benefits of visiting with the risk of transmission of Covid-19. We have contacted around 12,000 clinically extremely vulnerable people to offer help with putting support arrangements in place, to access food or other services.

“I want to congratulate all of our staff at Nottinghamshire County Council and all of the local volunteers for coming together to help residents through this difficult time.

“Our work to support people through the pandemic is continuing, and we are committed to ensuring that local people continue to have access to the help, advice and support they need.

“If we can take a positive from 2020, it must be the way people have united to overcome the challenges presented by Coronavirus. I hope that with the rollout of new vaccines we can look forward to 2021 being a progressively brighter and more enjoyable year.”

EMAS Chief Executive Richard Henderson said: “Without a doubt, this winter is going to be one of the most challenging yet for the whole health service – but we are prepared and ready.

“We’ve been working hard with our health colleagues around the region to get a robust winter plan in place and while it’s unlikely to be a ‘normal’ festive period for many, our residents can be assured that their ambulance service will be there for them if they need it. As well as the usual spikes we expect in winter-related illnesses, COVID-19 brings us a new set of challenges, but our staff are well trained, equipped and experienced in caring for patients with the virus safely.

“We have recruited even more staff and volunteers this year to ensure we have enough skilled people in place to manage our demand and their dedication is second to none. The doctors supporting our

teams from our 999 control rooms and our specialist practitioners are also making a huge difference, taking the pressure off hospital colleagues by providing advanced emergency care advice and care in people’s homes or our ambulances.

“This is such a busy time for all our amazing staff and I cannot tell you how thankful I am for all that they continue to do every single day. They’ve had to work in new ways to work safely, and I commend them for how they’ve risen to the challenge and responded to what has been a monumental year for us all.”

Lyn Bacon, Chief Executive of Nottingham City Care Partnership, said: “Over the last year we have faced wave after wave of challenge that has pushed us to levels never experienced before. Through the sheer determination and courage of our people and our ability to work as one system, we have faced this head on whilst protecting our most vulnerable patients and staff.”

Nottingham and Nottinghamshire partnership secures £500,000 investment to connect more people with nature to improve their mental health in wake of Coronavirus pandemic

Nottingham and Nottinghamshire Integrated Care System (ICS) has been announced as one of just seven ICS’s in the country to secure £500,000 as part of a two-year national scheme aimed at helping the mental wellbeing of communities hardest hit by coronavirus.

Working with system partners and Nottingham City Integrated Care Partnership, the ICS will be delivering the project from April 2021 to encourage people to connect more with nature for the benefit of their mental health.

Known as the ‘green social prescribing’ project, the scheme has been established by the Department for Environment, Food & Rural Affairs, NHS England and NHS Improvement, and partner organisations. The aim is to examine how health and care services, working with communities and local organisations, can connect more people with nature and nature-based activities to improve their mental health and wellbeing.

The Covid-19 pandemic has highlighted the importance of being outdoors to people’s mental and physical health, as well as the inequality of access to green space. Social prescribing can provide much-needed support by connecting people to community groups and local initiatives for practical and emotional support and to improve their health and wellbeing.

Green social prescribing is about connecting people with nature and their local environments. This could include a wide range of activities, such as walking or cycling groups, gardening or community allotments, conservation tasks, such as tree planting, and creative activities.

Connecting with nature has a huge range of physical and mental health benefits. Evidence, including from Natural England, shows that the NHS could save more than £2billion in treatment costs if everyone in England had equal access to good quality green space.

Across the Nottingham and Nottinghamshire region hundreds of local nature-based organisations, community activities and eco-therapy projects are already working to improve lives and provide support by connecting people with nature and local green spaces. These projects help to support those who are least able to connect with nature, because of where they live, their income or other barriers they may face.

Securing the investment and a place on the national programme will enable partners to expand the offer to our communities and help more people to improve their mental health and wellbeing by getting out and exploring the amazing green spaces that the region has to offer in both urban and suburban areas. Particular focus within the first year will be on communities in Nottingham City, with the pilot growing into the County in the second year. Andy Haynes, Executive Lead of the ICS, says: “The Covid-19 pandemic has had a real impact of people’s lives and has had a significant impact on many peoples’ mental health and wellbeing. This project acknowledges the close links between our own health and the environment around us and the benefits that getting outside and connecting with nature can have.

“The funding and resources for our area are really important, and we can make a real difference for those who need it most. Our aim is to support more people and ensure the NHS and other health and care services are better connected and aware of the fantastic work that voluntary and community sector organisations are already doing across our region.”

Hugh Porter, Interim lead & Clinical Director Nottingham City Integrated Care Partnership, says: “This additional investment that will help improve the lives of people across our region, enabling access to the wonderful green spaces in Nottingham and Nottinghamshire. I am certain that this project will make a huge difference to the community’s wellbeing.”

To find out more visit https://www.england.nhs.uk/personalisedcare/social-prescribing/green-social-prescribing

Developing our workforce together across South Notts ICP

Three senior nurses from Nottinghamshire Healthcare talk about how they joined with Practice Nurses across the Nottingham West PCN to undertake the CARE Programme together and how it’s shaped their way of working…

This Autumn, Clinical Lead Deborah Towers, Community Matron Kath Nussey and District Nursing team leader Denise McCoid from Nottinghamshire Healthcare joined Practice Nurses from across Nottingham West PCN to attend virtual sessions of the CARE programme.

The aim of the programme, which was supported by NHSEI and developed by NAPC, was to develop leadership and potential in relation to population health management within the PCN and the wider health and care system.

The first four sessions were designed to help learners think differently and explore themselves to develop a deeper level of self-awareness, enabling the release of the inner leader.

Deborah says: “The aim is to enable us to develop self-confidence, belief, authenticity and courage to have an impact and influence across our organisation and the wider system. Each week we looked at different areas, including authenticity and mindset, responsibility, relationships and empowerment.

“For all of us, the concept of ‘The Drama Triangle’ was most powerful and we have found ourselves using this concept not only in our work environments but in all aspects of our lives. Reflecting on the model, we have all realised how behaviours – including our own – can have an influence and impact on situations.”

One of the highlights of the course was the opportunity to network with staff from across the Primary Care Network, as Kath explains: “The opportunity to network and have the time to ‘meet’ other nurses was brilliant and has without doubt enabled us to be linked together and utilise and share skills and resources.

“We learned from each other the importance of resilience and how crucial this is in the current climate. Linked to this is developing self-worth and value and encouraging kindness, especially to yourself – something that as nurses we all realised we are not always good at.”

The second part of the programme focussed on the thinking environment, influencing models and skills, which encouraged participants to consider how they listen and how to enable all team members to have time to speak.

Deb explains: “In relation to population health, this has encouraged and enabled us to network and participate in the PCNs and wider system. One of the best things for me was the networking opportunity, so we’ve already reached out to Anna, the PCN Practice Nurse Link, to talk about further opportunities for working together.”

Kath adds: “It was the wider networking that was really useful to me, so since the course I’ve been in contact with our project Diabetes Specialist Nurse, as well as the Trust lead for tele-health. It’s given me the confidence to make these contacts and develop them, and to know that I can make a difference as a nurse.

Deb adds: “We’ve been around a long time in the area and this supports and strengthens that. While the networks were already there, this has given us a new perspective on how to get the best out of these relationships for the patient. We have a stronger voice together!”

As part of the programme, participants were asked to think of a project that would ultimately have a positive impact on patients.

Locally Deb, Denise and Kath are planning to work on a service improvement project in conjunction with a local Practice Nurse to look at improving the health of a particular client group in residential care. They will be engaging with staff across the PCN to increase their knowledge and plan to educate and enable them to manage and deliver insulin.

Deb adds: “We all feel lucky to have had this opportunity and are already sharing the knowledge. If anyone has the opportunity to do this course, I’d definitely recommend it.”

If you would like to get more information on any of the above or chat about the course please get in touch. Email: deborah.towers@nottshc.nhs.uk

Nottingham West social prescribing highlights of 2020

Louise Redhead, Social Prescribing Manager

Earlier this year, South Notts ICP News visited the Nottingham West and Rushcliffe Social Prescribing Teams to see how they were developing. This December, we revisit the Nottingham West team to see how things have progressed, especially during what has been a difficult year.

One year into the Social Prescribing team contract at PICS and the Nottingham West team has grown from the original two link workers to five, covering the three neighbourhoods, Stapleford, Beeston and Eastwood.

Louise Redhead, Social Prescribing Manager at PICS (Primary Integrated Community Services), offers an insight into how the team have explored solutions around non-medical issues that impact on the health and wellbeing of members of our communities.

“As well as mapping out and delivering additional covid-support for hundreds of the most vulnerable residents in Nottingham West, the team have maintained their case load work, while also supporting the development and set up of new community initiatives. Read on to find out more about their work with a friendship group in Beeston, a project to address the barriers to South Asian women accessing health care, the Broxtowe Health Partnership and the Eastwood Community Project. Louise also shares her excitement for their plans for 2021, including the set-up of a new local telephone befriending service, a community garden and a local community hub, and the roll out support from the PCN’s new Health and Wellbeing Coach.

“The teams have worked very hard in what has been a challenging year for everyone. They have established their roles, established themselves as part of the PCN workforce, made vital links with the community and voluntary sector and helped to get the message out there as to what social prescribing actually is and its benefits. They have also met the challenges of working through a pandemic, the first in our lifetimes, and the difficulties and uncertainty that brings, not only for the team, but their patients and communities too.

“Link Workers left the surgeries in March and adapted their way of working under Covid, as their roles became more important than ever. Working from home office, the sofa or dining room tables, they worked in partnership with the CCG and Nottinghamshire County Council Covid Hub to identify the most clinically vulnerable patients and they set about making contact with them. These included patients with dementia, those who were frail or housebound and those with learning difficulties. The Link Workers got to work identifying if they had any support networks, whether they were shielding and if they needed urgent food parcels and deliveries. Were they able to get their medication? Did they need support around loneliness and isolation? Were there any other identifiable needs for support? The team did a phenomenal job – between them they made contact with 351 patients between March and September on top of their caseload work.

“During this period, Link Workers communicated with GP practices and community and voluntary groups, and worked with local mutual aid groups. They mapped the local services prior to the Nottingham County Council Hub being available and ensured that all who needed this information had it to hand. They collated information for groups that provide mental health support and worked with local surgeries and pharmacies around medication delivery. This was all done while maintaining an active caseload and ensuring that the patients they were working with received any direct support that they needed, and they were busy delivering food parcels, connecting with befrienders, referring on for care and support needs, and communicating with families and carers to ensure everyone was supported.

“As shielding has eased, the Link Workers have been able to get back to something that reassembles their ‘normal’ role, and can start to look at the future – being able to focus more on community development and addressing health in equalities within the communities. This has included delivering walking groups, being successful in applying for funding to start a Friendship Group in Beeston, and working alongside GP’s to address the barriers to South Asian women accessing health care.

“The team have also created a quarterly newsletter to share positive stories and information with their surgeries. We’ve presented a re-launch campaign to forge new links with GPs who may not have been aware of the service and to share feedback on the types of referrals the team have supported so far. We have also been involved with Broxtowe Borough Council on a number of projects including the Broxtowe Health Partnership, looking at mental health gaps as well as facilitating conversations in the recent PCN ‘Community Voices’ event.

It has been a pleasure to be involved in the creation and development of the ‘Eastwood Community Project’. There have been exciting conversations involving community groups and statutory bodies around a number of areas that will benefit the whole of Eastwood and out into the NG16 area. These have included a new local telephone befriending service, a community garden and hopefully a Local Community Hub in the New Year. It is really exciting to see just how much Social Prescribing can do to support patients and connect them with their communities – because connection is the key to improving wellbeing.

“We are pleased to welcome on board our new ‘Health and Wellbeing Coach’ who will soon be working with patients from all over the PCN, looking at the many ways that they can improve their health and wellbeing, especially after a year like the one we have all just had.

Here’s looking to a brighter 2021!”

Case studies

Mrs H, Stapleford

A GP referred Mrs H, 77, who lived alone and had been recently diagnosed with breast cancer. She was struggling to come to terms with her diagnosis and had overwhelming bouts of anxiety. The link worker spent time talking with Mrs H to understand her preferred coping mechanisms, and could then suggest some relaxation techniques. At their next appointment, Mrs H described feeling overwhelmed by all her appointments, by all the phone calls she was getting about her health, and all the information from different professionals. Her pharmacy had also changed so it was also more difficult to collect her prescription. The link worker arranged for her prescriptions to be delivered, and on their next call, Mrs H spoke of the difference not having to worry about her medication had made to her at that point in time.

Mr T, Beeston

A GP referred Mr T, who lived alone and had recently lost his sight. His flat had been damaged, so he was living in a hotel while it was being fixed, but had to move back early when the Covid-19 crisis began. Most of his possessions had been damaged and he only had a microwave to cook with. He usually had help to do his shopping, but hadn’t been able to talk with his local shop to access their assisted shopping service since the pandemic started. He also couldn’t get hold of any shop to ask for deliveries and his food supplies were running very low.

The link worker spent some time on the phone with the patient, speaking about his difficulties and what support he would benefit from. Mr T agreed for his details to be shared, so the link worker approached a local community group who brought round a food parcel that same day, arranged for a hot meal to be delivered to him four times a week for free and they also found a volunteer to do his food shopping for him. His social worker was also brought up to date and agreed to continue their support for him.

Mr W, Eastwood

Mr. W was referred for low mood and isolation; he was having issues in his marriage, he had hardly left his house in years, had reduced mobility and put on weight. He felt unable to get back into any exercise.

The link worker worked with the patient to identify what mattered to him in his life. She arranged activities and trips for him to try that were based on his interests and took into account his anxieties. They set goals together and over the next couple of months, the patient managed to go around town with his wife shopping and worked with his pain team to reduce his pain medication. He attended a slimming club with his daughter and started to take regular exercise, with walks in nature and swimming.

Mr W said: “Thank you so much for your support and confidence. I couldn’t have done it without that”.

Nottingham City and Nottinghamshire County statement on the childhood flu programme: the alternative offer to live attenuated influenza vaccine

During winter, airborne infections such as the influenza virus are common. The influenza virus, commonly known as the flu, is not only distressing for children but can also lead to serious health complications such as pneumonia, bronchitis, febrile convulsions and severe respiratory distress.

To protect children against the flu, the NHS is now providing a vaccine which is administered as a spray through the nose. The vaccine is available for free on the NHS for:

· Children aged 2 to 3 years

· Primary school aged children

· Year 7 children

· Children aged 2 to 17 with long-term health conditions

Since the nasal spray is not licensed for use in children under the age of 2 years, children aged 6 months to 2 years in a high-risk group for flu are offered the vaccine as an injection instead.

Children who attend primary or secondary school are vaccinated at the school. Home-schooled children are vaccinated in a community clinic. All other children are vaccinated in their GP practice.

Gelatine content

The nasal spray vaccine contains gelatine which is made from pork. The gelatine used is a highly purified product and is essential for stabilising the vaccine.

We understand that some parents may have religious or ethical objections to the pork gelatine content of the nasal spray. We hope that the information we are providing here will help you make an informed decision.

The nasal spray protects your child more effectively. Compared to the injectable alternative, the nasal spray has been shown to:

• Reduce the risk of life threatening complications

• Offer longer lasting protection

• Be effective against more strains of the virus.

Leaders of major faiths have expressed the following views about the vaccine:

• The British Fatwa Council has issued a fatwa which concluded that the nasal flu vaccine containing porcine gelatine is permissible for use. This can be accessed online in English and Urdu here.

• Rabbi Abraham Adler, from the Kashrus and Medicines Information Service, said: “It should be noted that according to Jewish laws, there is no problem with porcine or other animal derived ingredients in non-oral products. This includes vaccines, including those administered via the nose, injections, suppositories, creams and ointments.”

If you have previously declined consent for your child to have the nasal spray but have since changed your mind, you can complete an online consent form here.

On 18 November, HM Government released new guidance stating that, “arrangements should be made to ensure that children who previously declined vaccination due to the porcine gelatine content, are recalled and offered the alternative vaccine”. Parents in Nottingham and Nottinghamshire of school-aged children who have declined the vaccination due to porcine reasons will be contacted and offered

the injectable alternative by the local School Aged Immunisation Service. Clinic sessions will be available for those who accept this offer. Parents of children aged 2-3 years who have declined the vaccination due to porcine reasons and would like the injectable alternative should contact their GP.

New specialist dementia service launched for families in the Clifton, The Meadows and Wollaton areas

Dementia specialist Admiral Nurse, Rachael Lowe, will be leading a clinics-based service for families in the local area affected by the condition. The service is a partnership between national charity Dementia UK and nine GP practices across Clifton, The Meadows and Wollaton, with £100,000 provided by Dementia UK’s corporate partner, Central England Co-operative, for Rachael’s post for the next two years. It is one of the first clinics in the country to support families in the community. Rachael will also be advising healthcare professionals around best practice in dementia care, such as the need to provide tailored information and support across families’ experiences of the condition.

Dementia UK is the only charity dedicated to supporting families by providing dementia specialist Admiral Nurses. When things get challenging or difficult for people with dementia and their families, Admiral Nurse’s work alongside them; giving compassionate one-to-one support, expert guidance and practical solutions which can be hard to find elsewhere. They are continually trained, developed and supported by Dementia UK.

Rachael is an advocate of relationship-centred approaches to dementia care, which ensures that the needs, rights and wishes of people living with dementia are always respected. Prior to her starting her role with the charity Dementia UK, Rachael has spent the last five years working in specialist dementia nursing homes in Nottingham, and previously as a continuing care nurse assessor.

Commenting on her role, Rachael said: “There’s still so much uncertainty around dementia; for the families who don’t know where to turn in times of need, to healthcare professionals who need guidance on how to support people living with dementia in their communities. I am so honoured to be opening this new service, which will improve care for the hundreds of families living with dementia in these areas. This service is for anyone struggling with looking after someone with dementia. I will work with the families to identify ways to improve care at home through emotional support, as well as providing information and teaching practical skills.”

Robana Hussain-Mills – Nurse Clinical Director

Many primary care networks (PCNs) have a GP as Clinical or Deputy Clinical Director. But, other professions can bring a different perspective to the role. Robana is a practice nurse and Deputy Clinical Director of Nottingham City East (NCE) PCN.

Nationally there are less than 20, out of 1,300 clinical and deputy clinical directors, who are nurses. There is still an element of elitism within the PCN structure. I remember a GP saying to me ‘Robana, GPs aren’t going to listen to a nurse’. If people don’t know me, they assume I’m a GP. Meetings are often started with “We can begin now, all the clinicians are here.” and all the GPs in the room are listed, even if the chair knows me and what I do. It’s like being invisible. A minority within a minority. Which is hugely frustrating and upsetting. Do I say anything you ask? Yes, I do. There is still much work to be done in getting acceptance as nurse in a leadership role, but speaking out and highlighting the issue is the best way to enact change.

I began my nursing career in secondary care (NUH), and then community (CityCare) but for the past sixteen years I have been in primary care working as a practice nurse within Nottingham City. And, for the last seven years I have worked jointly in commissioning.

The last 12 months as Deputy Clinical Director for the PCN has been an extraordinary journey. I would describe PCNs as a great leveller. Noting specifically that for this reason nurses should be confident to take part. It really is a level playing field.

Nurses are problem solvers and will quite often give a very logical solution to the on-going challenges the patients we are caring for face. We know our patients. Leading the development of services and realising ideas, such as quality improvements and group consultations, to benefit patient care and experience is the way that nurses will raise their profile. Once they achieve that I hope that their confidence will be built enough to take on the bigger roles.

I hope to lead by example and shape the role of Nurse Deputy Clinical Director. I would love to inspire other nurses to consider these types of role at PCN level. I’m keen to demonstrate how my skills and experience as a nurse leader, frontline practitioner and commissioner will help shape the future of general practice and the wider PCNs.

Like any PCN, NCE has its own set of challenges. Covering 66,500 patients across seven practices, NCE has a varied population by comparison to other networks. It has areas of affluence and others of deprivation, that also struggle with organised crime, homelessness, drugs and alcohol – all of which are linked to high unemployment and health inequalities. With PCNs still in their infancy it’s important to recognise that change takes time and that the road to improving health outcomes in the PCN structure will be difficult, but not unachievable. Change can be a strength if you’re able to adapt it to your population. This is the thing that excites me the most about working in a PCN leadership role. I am able to drive the changes for my population, adapting to people’s needs and making a real difference.