Dr Aamer Ali joins the South Notts ICP Clinical Leadership team

We’re delighted to announce Dr Aamer Ali has joined the clinical leadership team for the South Nottinghamshire Integrated Care Partnership.

Working alongside ICP Clinical Lead, Dr Nicole Atkinson, Aamer will bring his considerable experience of both working with elderly patients and driving integrated working to this new position.

Aamer is a Consultant Geriatrician at Nottingham’s Queens Medical Centre, with interface and front door frailty as his main area of clinical practice.

He is also the Clinical Director of Integrated Medical Services, and his expertise and experience from more than 12 years working with commissioners and providers will be invaluable in influencing the direction of travel towards improvement for services for older people across South Nottinghamshire.

This role is a perfect fit for Aamer, who has a history of working with teams across the South Nottinghamshire patch. He says: “I have worked closely with South Notts teams, most notably on GPs supporting the Health Care of Older People wards in QMC and development of the community geriatrics project including care home vanguard.”

Aamer runs an outpatient clinic in falls and bone health, along with a virtual clinic for the community falls and bone health team. He also provides mentoring and the educational lead role for the community falls team as well.

He is also a lead in the elective Orthopaedics SCOPES service and is working with the End Of Life Care team in Nottingham.

With his wealth of skills and experience, Aamer will bring strategic oversight to the ICP’s older people’s strategy and hopes his expertise can help shape the development of the ICP’s plans.

Aamer explains: “I have co-authored the NUH Dementia Strategy and sit on both the ICS’s dementia and end-of-life groups, while I also developed the ‘front door’ frailty team that has been working for many years in the emergency department.

“All these projects have given me a broad knowledge, understanding and expertise in older people and older people’s services, particularly working with them when they are in vulnerable states and when they are admitted in crisis.

“I think that it’s really important that I share that expertise and use it to make a difference to community teams. We have talked about transformation for a long time but I have felt that real transformation hasn’t taken place yet.

“I would like to think that, as a hospital doctor bringing this perspective to a community setting, I may be able to influence decisions which result in significant change in elderly people’s services, working with the community services to develop a countywide strategy.”

Born in Lahore, the City of Gardens, Aamer graduated in Pakistan before coming to the UK in 1996, where he trained locally as a geriatrician. A father of three, he has a Level 2 in British Sign Language ( aspiring to level 3) and a love of Indian classical music.

Dr Nicole Atkinson says: “I’m delighted that Aamer has joined the clinical team. His knowledge and expertise will be key to helping us deliver improved integrated care for our older people, and ultimately support them to live happier, healthier lives in South Nottinghamshire.”

Keeping two metres apart is still crucial, writes local GP Thilan Bartholomeuz

This week we are reminding people to keep up with social distancing following the changes announced by government over the weekend.

I am sure this has been welcome news but it is important that we must adhere to social distancing guidance to reduce the risk of infection. Keeping two metres apart reduces the risk of transmission of the virus and this is crucial to overcome this pandemic.

Being able to sit and chat in person with your parents, grandparents or friends in the summer sunshine will feel like a massive step forward. Seeing friends and family will help your overall sense of emotional connection with other people. I’ve written regularly in this column about the effect of the pandemic on mental health – this step will undoubtedly help minimise the sense of isolation some of us have felt and give our minds a welcome boost.

And while this is positive, we must remember that the only reason this step is being taken is because of the hard work and sacrifice so many have made. I know how tempting it will be to go out in the warm weather and meet up with everyone you are desperate to see.

But we must not forget how quickly we could go back to lockdown if the rate of infection increases and how stringent those original lockdown measures were. That’s why I am asking you all, as a local GP, to have your joyful moment and meet up but be considerate – we are still in lockdown and have to observe the below:

limit contact with other people
if meeting in a group there must not be more than 6 people
keep your distance if you go out (2 metres apart where possible)
wash your hands regularly

By following these measures we can all enjoy the new freedoms but still keep the spread of coronavirus down and in doing so protect the most vulnerable members of our community. If we do not follow the advice, we put ourselves at risk of getting infected and increasing infection rate in community.

Please stay safe and if you have any questions check the official advice first at nhs.uk/coronavirus.

Families in Mid Nottinghamshire are receiving Feel Good boxes to help give them extra support during the Coronavirus lockdown.

Lockdown has been tough for us all so Active Notts, whose aim is to enable people to get more active, have been working with key partners to start sending out 200 Feel Good boxes to families living in Mid Notts, to try and make the current situation a bit more bearable and help them stay healthy and active.

The exact content in each box will vary from place to place but each will focus of key areas of staying healthy in lockdown:

eating well – this could include recipe cards and food basics.
making time for yourself, relax and getting quality sleep– this could include a book to read and bubble bath.
drinking enough water – this could include a water bottle.
keeping busy – this could include puzzles, playing cards, lego and art activities.
keeping active– this could include a hula hoop, skipping rope, football, yo-yo, juggling balls or a resistant band.

All the resources will have activity cards to go alongside them, acknowledging that not everyone has access to the internet for ideas to help make the most out of resources.

Helen Davis, Strategic Lead at Active Notts said: “We are working with partners across Mansfield, Ashfield, Newark and Sherwood to support families that might need a little bit of help at the moment.

“Our partners in education, health and social care and the voluntary sector are telling us that some people living in the communities where higher health inequalities exist are at times, finding it harder to cope with lockdown. This is because of a number of reasons including; a lack of indoor space, limited outdoor space, often there are more people living in the household, underlying health problems, lower income, lack of IT and limited access to Wi-Fi.

Our partnership approach will ensure resources are not duplicated and people are supported in the right way to get through lockdown.”

Residents will have the chance to take part in challenges and competitions, using the resources, and if they want to can enter an “estate competition” to win prizes. They will also be asked for their feedback on the packs and ideas for what they think would be good in another box.

Hayley Barsby, Chief Executive at Mansfield District Council said: “The Feel Good boxes give us a valuable opportunity to connect positively with residents during the Covid outbreak and encourage them to stay active physically and mentally. The resources provide a platform to build on for future health and wellbeing work in the community and we hope that the community fully enjoys using the contents. We’d like thank resident for engaging with the programme so far to help shape the activities that we are supporting the delivery of with our partners.”

Thilan Bartholomeuz, Blidworth GP and Clinical Lead at Mid Nottinghamshire Integrated Care Partnership said: “The boxes will also provide an opportunity for us as a system to understand how to best support communities through lockdown, and help shape services and provisions in the future so they can have the best possible impact.

“This simple resource is providing an opportunity for services and providers to work closely together, build community relationships and working partnerships that will hopefully grow and develop, as together we work to help everyone get through lockdown.”

Improving your sleep during lockdown is this week’s focus by local GP Thilan Bartholomeuz

It is well known that sleep and mental health are linked but did you know that it is the quality of sleep you get, not necessarily the amount, which is important?

You may have noticed that your sleep patterns have changed since the lockdown began and you may be experiencing difficulty getting to sleep or wake up in the morning still feeling tired. And with the weather getting warmer it is more likely that you may find it more difficult to sleep.

So if getting a good night’s sleep is important for your mental health, what can you do during lockdown to improve your sleep?

If you cannot sleep because you have a physical problem that you are worried about remember you can still contact your GP to discuss, even if it’s not Coronavirus related. The NHS is still here to help you for all illnesses.

If it’s not a physical problem but something else that is keeping you awake at night you can trying practising mindfulness breathing techniques like those here at https://bemindful.co.uk/.

Eating less sugary food and drink, and especially drinks with caffeine, later in the day and getting regular exercise earlier in the day can help too. And while it may be tempting to drink alcohol, it often reduces your quality of sleep meaning you don’t feel as rested as you should.

Another tip is to have a regular routine and go to bed around the same time and make sure the room you sleep in has the features you need to get to sleep. Some people don’t mind a bit of noise, other people need it completely silent.

Try using an eye mask or ear plugs if you need them and when the weather gets warm you may need to open a window, use a cool flannel or a fan to help reduce the temperature so you can sleep. As the days get longer you may also want to consider black out curtains to block out daylight early in the morning.

If you do find yourself feeling tired during the day, try to avoid the temptation for a daytime snooze/ siesta if you can as it can make it more difficult for you to sleep at night.

When you are preparing to go to sleep you should also avoid using back lit mobile phones, ipads and other forms of technology as the light tricks the brain into thinking it’s daylight and the mind is often left in a whirl of information which in turn evoke emotions which are likely to keep you awake.

It is far better to ease gently into a natural sleep. It can also help if you can resist the urge to ‘work’ from bed i.e. by using a laptop, as this can mean you start to associate bed with work instead of rest.

So whether you hit the hay, count sheep or head up the wooden hill to Bedfordshire each night, hopefully these tips can help you have a restful, deep sleep and wake up ready to face a new day.

Kindness is the theme for this week’s column from ICP Clinical Lead Thilan Bartholomeuz

This week is Mental Health Awareness week and this year the theme is kindness.

It is run by the Mental Health Foundation and this year it is asking us all to do three things:

Reflect on an act of kindness.
Practise acts of kindness to yourself and others during the week
Share your ideas on how you think we could build a kinder society that would support mental health using #KindnessMatters and #MentalHealthAwarenessWeek

They have picked kindness because being kind to others not only helps them but helps us by reducing our sense of isolation and stress. They say that people do not remember what you say to them, but they remember how you make you feel and for me kindness is key to this. There are times as a GP when I have had to give people news which is upsetting. Practicing kindness allows me to put myself in their place, take my time and make sure they understand what I’ve told them and make sure they have enough time to ask any questions that they want. Kindness is not about making issues that make us sad and upset go away, but it is about looking about how we act as individuals and a community to those around us.

They are plenty of examples during the pandemic of people being kind and generous from volunteering to take food and medication to others, raising money in new ways or taking part in trials which may uncover new drugs to treat Coronavirus.

But you should also take the time to be kind to yourself. I wrote a number of weeks ago to remind you that we are still here in the NHS to help you for all your health concerns, not just coronavirus and I am pleased that the number of people coming to A&E for strokes has returned to normal levels.

However the number of people coming for other health concerns are still lower so please if you are feeling unwell please be kind to yourself and make sure you are contacting your GP, pharmacist or 111.

Please stay safe and if you have any questions check the official advice first at nhs.uk/coronavirus.

First Mid Nottinghamshire ICP digital Board meeting to take place

The Mid Nottinghamshire ICP is to hold its first digital Board meeting later this month.

To ensure social distancing measures are kept to, the May meeting of the Mid Nottinghamshire ICP Board will take place via MS Teams on Thursday, May 28 from 1pm – 3pm.

Members of the public are still welcome to attend virtually. If you would like to do this please email rebecca.tryner@nhs.net who will be able to send you the log in details.

Blog 4: My reflections of working in isolation and lockdown

My name is James Waldron and I’m a GP in Nottingham. I came here from Southampton for University and have loved it so much I’ve never left! Improving the experience for First 5s in the region is at the core of the things I do each week.

Dear all,

Well we find our-selves in rather strange times! Welcome to the 4th Blog!

I must first apologise for the apparent radio silence! There is in fact a 3rd blog but on the expected day for publishing this we also had the lock down announcement! (So I shall save that for future weeks.) **

I’d like instead to share with you my reflections of working in isolation and lockdown and what this has meant for me, and what it might mean for the future of general practice.

The First 5 community has been really tested in this time. As a group we are newer into the workplace which is challenging at the best of times, but, we are nothing if not adaptable and the electronic and online social spaces that we find ourselves plugged into (such as the Facebook group here or signing up to the free Shiny Mind App here– teamnet) have helped us stay strong and resilient and rapidly adaptable.

In the first 2 weeks of this I was in quarantine as there was a cough in the house. Fortunately, apart from an odd loss of smell there were no other symptoms for me. However, this meant being confined to the house, learning to work primarily from home, and forgoing the 5 or 6 events, extra-curricular activities and socialising I cram into my week. It was a bit of a change to say the least!

Whilst this time stuck inside could have been rather frustrating for someone as extraverted as me, it did give me some time for reflection and exploration and I put my mind towards learning a new skill, something that had never quite risen to the top of my priorities. (For some of my inspiration here, I’d recommend giving this Ted Talk a Go – “Now is the time to start working on your bucket List” – Dr Richard Armitage – a local GP!)

So I decided to stop procrastinating and start learning how to edit video and produce educational resources (and allowing the use of some creative flare, and small starring role in replacement for my AmDram group, currently on hold). I finally had some time and focus to start to learn what I had been putting off for months. You can see my first video on working from home: The “Light Hearted Guide to Getting Started” here as well as some other videos produced recently. Since then there has been a flurry of activity in the virtual space with resources for returning to work such as the “IT Tips for Returners” document, as well as the “eGP Learning” channel of podcasts and videos going into overdrive with lots of great resources!

Not only this, there has been time for reflection. The reduction in some of the busyness of my usual week has allowed me to focus on perhaps some neglected aspects of my life. My self-care has improved and I’m taking more time to spend with family and to exercise, finding some beautiful spots whilst walking or jogging (jogging – something I never thought I would do) just a short distance from the house. Taking time to enjoy sunshine, greenery, wildlife and serenity which is has maybe been missed as I rush through life at my usual breakneck pace.

So this is the first of my reflections in this odd situation in which we find ourselves. There have been some surprising personal benefits arising from adversity. This is reflected in many of my friends and fellow First 5s who have found time and focus to learn new skills, found different ways of channelling our strengths and energies, both in work life and at home.

This has been a time of great flux for all of us, but in the fire of this pandemic I think we will all emerge stronger, more experienced and better able to take on the challenges we invariably face in this fast-changing world.

Until next time! (and hopefully it won’t be as long). Stay well

James

@jammiestdodgers – feel free to contact me if you would like to be put in touch with any aspects of support, whatsapp groups for First5s, First 5 support etc. Or just a general chat!

** Incidentally, this entry ended up as a 3 page epic, so to avoid overwhelming you I shall release it in shorter instalments.

Blog 8: Everyone you meet is fighting their own battle….Be Kind

Dr Sonali Kinra is our ICS lead for GP Retention. This is her monthly blog series where she gives an insight into her role and more.

We all continue to wade through information overload and changing guidelines attributed to Covid-19. Not wishing to compete with demands on your time I am sending you a short update on workforce-related activities and engagement. Hope you all continue to receive your daily national updates through NHSE Primary care bulletin and locally throughTeamnet.

In the last month, I had the opportunity to discuss further with NHSE and NAPC regarding GPN leadership in Primary care networks and I hope to send out further information on this in the coming months. Along with Nottinghamshire Alliance of training hub (NATH) we launched Shiny Mind App- free wellbeing and resilience app for all primary care in Nottinghamshire ICS. You can opt in here– please remember to use you nhs.net email, you will receive your username and password within 2 working days- do not download the app before receiving that information. Dr Gandhi has done a very useful walk through video for this app.

Dr Gemma Wilkinson and I also worked through challenges of getting medical student volunteers into primary care which was met with some success and Gemma continues in her role providing support to trainees and new to practice fellows.

As we all adopt and adapt to hot hubs, remote working, video consultations, our locum colleagues have been facing additional challenges given the current landscape. Michael Wright(CEO of Notts LMC) and I wrote this joint letter to locums .To follow this through we have organised a zoom meeting for our locum workforce(doctors and nurses) on Wednesday 27th May 2000hrs-2100hrs. This is a part of my commitment to you for ongoing engagement and find common ground and solutions. If you wish to join the session to email info@phoenixprogramme.co.uk and we will send you the joining instructions by email.

We also had our 3rd group meeting for Rise and Shine Nottingham- an inclusive group I set up 5 months ago promoting flexible working and leadership opportunities for all. If you wish to join this group then DM me. We have also linked in with FlexNHS and will be having our 1st meeting with national colleagues working on the agenda of flexible working within NHS. There isn’t a better time to push ahead with this agenda as it improves our wellbeing, efficiency and impact upon climate change.

This was followed up by another Zoom meeting with GPs due to go on maternity leave and those returning to work- Phoenix programme has collated tip and IT resources which will be useful for those returning to work. Dr Kerri Sallis also shared this quick 7 minute Banana pudding recipe.

Our NHS people in association with RCGP has launched Looking after You too campaign- individualised coaching session for all primary care staff – I had my first session and would highly recommend it- it’s an opportunity to pause and reflect on the last few weeks and provide you with practical tools to deal with the emotional rollercoaster we all continue to go through.

Look after yourself and your loved ones.

As Ever

Sonali

@SonaliKinra

Ease of restrictions to allow unlimited exercise is positive step forward says local GP Thilan Bartholomeuz

It has now been seven weeks since we went into lockdown and I know that many of us have struggled with it, even if we are now used to some of the restrictions.

That was why it was good to hear more details about how we could gradually move out of lockdown over the coming months from the Prime Minister Boris Johnson.

You may have seen that the he announced that there would be a new Coronavirus alert system launched with five levels: level one meaning the disease is not present and level five being the most serious.

He said that we are at level four and he is hoping to move us to level three with some small measures that would ease some restrictions but still allow us to keep the infection rate low.

I was particularly pleased to hear him remove the restriction on exercise so that people could go out more than once a day to be active. He also said that you could go the park with members of your household to exercise which I’m hoping will help improve everyone’s mental wellbeing.

However it is important to remember that when you are outside you must maintain social distancing with people who are not in your household. This means if you do go to the park, you must still stay away from others.

If you choose not to take up the new rules on exercise, the best advice is still to stay at home, especially if you are one of the vulnerable patients that we are particularly keen to shield from Coronavirus. If you are not sure about how the new measures effect you, the best thing to do is to stay at home.

It is only by maintaining this social distancing that we can stop the spread of coronavirus and keep the infection rate down. If we continue to do this then hopefully in June and July we will see other restrictions lifted with some more public spaces reopened.

Please stay safe, stay home and if you have any questions check the official advice first at nhs.uk/coronavirus.