Partnership case study: Street Health

Sherwood Forest Hospitals NHS Foundation Trust (SFH) has led on bringing partners together to improve mental and physical health for those people living on the streets in Mansfield.

They knew that this is a community who either cannot get to a GP or hospital, or are fearful of going. With partners, they provide fortnightly wound clinics where nurse specialists provide care to people with leg ulcers.   They have organised two health events where homeless people who visit Bridge Street’s soup kitchen were vaccinated against flu, had access to a GP, received an oral check from a dental volunteer and got advice from a sexual health specialist and a dietician.

This work is an example of our commitment to work with partners to reduce health inequalities for those in greatest need.

Hospital, Council and IT Partnership Case Study

Partnership Case Study: Sherwood Forest Hospitals NHS Foundation Trust (SFH), Nottinghamshire Health Informatic Service (NHIS) and Nottinghamshire County Council (NCC)

These organisations are using technology to improve the referral process for patients between Sherwood Forest Hospitals NHS Foundation Trust (SFH) and Nottinghamshire County Council (NCC).

Known internally as the Interoperability project, they introduced automation of Social Care Assessment Notice referrals in 2018 for all SFH sites and SFH now sends on average 300 electronic referrals each month to social care at NCC.

The project gives a number of patient benefits and other advantages including:

  • A reduction in the delay of each Assessment Notice reaching NCC social care by an average of four hours.
  • Social Care Team managers have a real-time view of all new cases.
  • Nearly 600 admin hours saved per year.

This improves the patient experience and reduces the cost of the service. The next phase of the project, which is already in progress, is using software to directly update social care with any patient changes which occur following the initial referral and to digitise the current paperbased ‘Discharge Notice’. All the information will then be presented to Social Care teams in a live case management tracker. This will further improve patient care.

Primary Care Networks explained

Primary Care Networks explained

Nottingham mums can kick the smoking habit in pregnancy with help and advice from the NHS app

If someone tried to give your baby a cigarette, you wouldn’t let them, would you?

Stark words from young mum Danielle Cull who managed to quit a 12-year smoking habit when she became pregnant with both her daughters, one-year-old Darcy-Mae, and and Myla-Rae, who is just four months old.

Danielle, 27, from Bulwell, started smoking when she was just 15 years old and said her habit was costing her  £40 a week, money which she can now spend on her two beautiful daughters.

As soon as I did the test, I stopped smoking straight away. It was an easy choice for me. I could just imagine the smoke going down through me and into the baby. Even when my baby was just the size of a grain of rice, I knew I had to stop smoking,

The unborn baby is human life – it’s your job as a mother to protect your baby, even before it’s been born. Your baby hasn’t made the choice to smoke so why should it have to have all that smoke?

Danielle Cull

My partner doesn’t smoke so he was very supportive, but I was lucky that I didn’t need a huge amount of willpower.

The unborn baby doesn’t have a choice so you have to do what you can to make it safe. The baby was enough for me.

Danielle Cull

Danielle started to smoke again after the birth of her first baby Darcy-Mae, although it was fewer cigarettes than before she was pregnant.

I used to smoke outside the house after she was born and I would try to stay away from her immediately after I’d smoked, but I carried on because I wanted to.

Then I fell pregnant again when Darcy-Mae was seven weeks old, so I stopped again. It was a bit harder the second time, but I knew I had to do it.

I just had to think about the baby – you have to protect that little life inside you. By smoking, you’re putting that baby in danger. You wouldn’t give a newborn baby a cigarette, so why do it to them before they’re born?

Danielle Cull

Danielle has not picked up the habit again after the birth of Myla-Rae.

It’s been harder, but I’m saving money and my asthma has been better too. It means going without, but it’s definitely worth it.

She says she was lucky that stopping smoking wasn’t a massive struggle for her and is also keen to stress that she is not preaching to other women.

I’m not saying I’ve done this so you should, far from it, but I just thought about my baby – it didn’t matter if I was moody or narky, it was for the baby.

Danielle Cull

The benefits of stopping smoking in pregnancy

Stopping smoking will help both you and your baby immediately. Harmful gases, such as carbon monoxide, and other damaging chemicals will clear from your body. When you stop smoking:

  • You will reduce the risk of complications in pregnancy and birth
  • You are more likely to have a healthier pregnancy and a healthier baby
  • You will reduce the risk of stillbirth
  • Your baby is less likely to be born too early and have to face the additional breathing, feeding and health problems that often go with being premature
  • Your baby is less likely to be born underweight: babies of women who smoke are, on average, 200g (about 8oz) lighter than other babies, which can cause problems during and after labour. For example they are more likely to have a problem keeping warm and are more prone to infection
  • You will reduce the risk of cot death, also known as sudden infant death syndrome
  • Stopping smoking now will also help your baby later in life. Children whose parents smoke are more likely to suffer from asthma and other serious illnesses that may need hospital treatment.

For more information, visit the dedicated website lovebump.org.uk/nottinghamshire/

Nottingham City Council worked with the NHS in Nottingham and Nottinghamshire to launch the LoveBump campaign to help women to cut down on smoking after statistics revealed almost twice as many women in some parts of the city and county smoke during pregnancy compared to the national average.

Smokers see their GP over a third more often than non-smokers and smoking is linked to nearly half a million hospital admissions per year, so the drive to encourage smokers to quit is a key part of the NHS Long Term Plan.

No parent should have to endure the heartbreak of stillbirth, and NHS action, delivered through the skill and professionalism of our midwives, nurses and doctors – means an even greater number of parents and babies experience a healthy birth.

The NHS Long Term Plan sets out a clear and ambitious plan to improve England’s maternity services, which alongside even more expectant mums taking action themselves by stopping smoking, will make having a baby as safe as possible.

The NHS Long Term Plan sets out a clear and ambitious plan to improve England’s maternity services, which alongside even more expectant mums taking action themselves by stopping smoking, will make having a baby as safe as possible.

Simon Stevens – NHS England chief executive

All the help and support smokers need can be found on the new NHS app which has been rolled out across the county over the last couple of months.

What can the National NHS app do?
  • Search ‘smoking in pregnancy’ for help and advice on the app
  • The NHS App will provide the public with a more easily accessible and convenient health service.
  • You’ll be able to order a repeat prescription, get 111 advice, book a GP appointment and even view your GP record.
  • You’ll still be able to see your doctor for face-to-face advice when you need it but there’s no more waiting for the surgery to open at 8am to make a call for an appointment or a prescription.
  • You’ll be in control of your health whenever and wherever you are, even filling in regular health check forms for managed conditions like asthma instead of having to take the time to go to the doctor. Ideal if you haven’t any problems and frees GPs up to spend more time with patients who need the face-to-face consultation.
  • There’s a directory of services to help too, for example giving details of your nearest pharmacy.
  • The app is now available to download free via the  Appstore  for Apple devices and  Playstore  for android.

With the app you can do anything from making an appointment with your GP to ordering repeat prescriptions and getting advice on a huge range of health conditions, including stopping smoking.

The app is a significant step in modernising NHS services and should make life easier for patients and for practices, with the ability to book and manage appointments online, order repeat prescriptions, view your medical history and access 111 Online, among other services.

GP Sonali Kinra is the clinical lead for maternity and said using the app to access information, advice and support on giving up smoking was going to have a big impact on the health of both mums and babies in the city.

We are looking at the impact across the spectrum, through pregnancy and afterwards. Smoking during pregnancy can cause miscarriage, low birth weight, stillbirth and cot death, and second hand smoke is so damaging to babies.

We want to help mums change their lifestyle so they are healthier, and so are their babies.

GP Sonali Kinra – Clinical lead for maternity

Integrated Care in Every Community

Integrated Care in Every Community

Integrating to improve the health of people in Nottingham and Nottinghamshire

By David Pearson

David Pearson, Independent Chair of Nottingham and Nottinghamshire Integrated Care System, talks about the impact working in partnership across health and care is having on the people of Nottingham and Nottinghamshire.

Improving people’s health is at the heart of what integrated care wants to achieve.

Improving the health of people in our area is at the heart of the way we work across health and care in Nottingham and Nottinghamshire. We know that statutory services only affect 20 per cent of people’s health and wellbeing with 80 per cent coming from wider factors, such as housing, employment and the environment.We want to make things better for people in Nottingham and Nottinghamshire, improving not only the length of people’s lives but also the quality of their lives. We’ve focused previously on getting the structures and systems right, wanting to provide the best quality services, but not focusing enough on the outcomes we want to achieve. That is changing.

Through the NHS, local government and other partners working together we’ve been able to show how integration can improve the health of our population, genuinely making a difference to individuals accessing health and care services and to the staff working within our system.

We’ve been sharing information across our system, with 100 per cent of GPs signed up to the GP Repository for Clinical Care, which provides data from health providers and the council, enabling us to understand if we’re putting our resources in the right place. It’s also helping our referral processes: at Sherwood Forest Hospital NHS Trust the health and social care referral process has reduced from 3 days to 32 seconds, benefiting patients and staff.

Less people are dying from strokes in Greater Nottingham. Through the sharing of data to identify people at risk we’ve been able to prevent an estimated 75 strokes and 25 deaths. What better way to demonstrate that integration works.

We want to promote behaviours that maximise the health of our population, giving people greater control over their health through the provision of the services we provide. We’ve increased the number of personalised budgets, with 2,300 people now having personalised budgets letting them live the life they choose and empowering people to take control of their care.

We’ve only been able to achieve this by working together as equal partners. The NHS can’t do population health management without local government. There are significant differences in the way we work but we both want to achieve the same outcomes. In Nottinghamshire we have a shared vision and are committed to achieving the outcomes we’ve jointly agreed. If you start with the outcomes you want to achieve and the contribution you can make it will give you a clear case for working together.

We’ve benefitted from having a history of working together in Nottinghamshire. There was a lot of trust within the system already but there has still been challenges, and there should be. We should be challenging each other but we should also be working to create the conditions in which local systems can succeed.

There are 35,000 people working in health and care in Nottinghamshire. There is a huge job to be done to tell the story of integration. If we want to provide an authentic narrative and change the way we work, we need to show how it can make a difference to our population. How are we making people’s lives better? If we can answer that question, then we can see that integration is working.

Notts GP practices amongst first in country to be connected to NHS App

All GP practices in Nottingham and Nottinghamshire are fully linked up with the NHS App…

Giving patients the ability to book and manage GP appointments, order repeat prescriptions, view their medical records and access a range of other services.

Notts is one of the first places in England to have the app switched on. The app is being rolled out across the country gradually and is expected to be completed by summer.

Patients can download the app from the Apple or Android apps stores and follow the simple on-screen instructions to set it up, link it to their GP practice and enjoy its full functionality.

Unlike previous online GP services, most patients will not need to visit their GP practice to set up a login for the NHS App, but can prove their identity in the app and create their NHS login.

The NHS App enables patients to:

  • check their symptoms and find out what to do when they need help urgently
  • book and manage appointments at their GP practice
  • order repeat prescriptions
  • securely view their GP medical record
  • register to be an organ donor
  • choose how the NHS uses their data.

I’m delighted that our patients can now enjoy the full range of services that the NHS App has to offer.

This is a significant step in modernising NHS services, and should make life easier for patients and for practices, with the ability to book and manage appointments online, order repeat prescriptions, view your medical history and access 111 Online, among other services.

This should help ease some of the pressures on practice reception desks and phone lines, giving people who use the app an alternative they can use from their sofa, and freeing up more time for those patients who wish to continue to use more traditional methods to interact with their practice

Alexis Farrow – Head of Strategy and Transformation at Connected Nottinghamshire

We have made significant progress over recent years in making GP services more accessible online. The NHS App is another major step forward as it provides all patients in England with the same service that is NHS owned and run.

It’s great that patients in Nottingham and Nottinghamshire can now use the full range of services in the NHS App. But this is just the first step in an exciting journey as we will continue to develop and add new features to the app to help improve the patient experience of dealing with the NHS and ease the pressure on the frontline.

Tara Donnelly – Chief Digital Officer for NHS England

Click here  to read a blog from Hucknall Road Medical Centre who introduced the NHS App to their patients in March 2019.