Monthly shout-out to Rebecca Sandy

This month’s shout-out goes to Rebecca Sandy, Lead Clinical Specialist Occupational Therapist (OT) who is on secondment with Nottinghamshire Fire and Rescue Service from Nottinghamshire Healthcare NHS Foundation Trust. Rebecca has worked with partners across fire services to develop a new and innovative national CPD resource to reduce the risk of accidental fires in the home.

The resource Rebecca has developed is available as a presentation and workbook that can be used by an individual or as part of a team. It highlights key areas where OTs can incorporate fire prevention in their practice, including enhanced assessment of cooking safety, risk enablement with ‘safer’ smoking (where the person does not want to quit smoking), safer access arrangements, and education and advice for families and carers. The resource is designed to increase the confidence of OTs with addressing fire safety and developing closer partnership links with the Fire and Rescue Services.

Rebecca said, “Occupational Therapists have an important opportunity to identify and reduce fire safety risks within our community. We are already working with patients who face a higher likelihood of being affected by accidental home fires, and we can play an important role in helping them and their families and carers to create a safer environment.”

Rebecca’s role with the fire service includes providing specialist assessments and interventions to those at the highest risk of having an accidental fire in their homes, as well as embedding an understanding of health, client-centredness and positive risk-taking within the Prevention team in the fire service.

The new fire safety resource is available to be downloaded from the Royal College of Occupational Therapists website by members of the organisation.

Kathy’s blog: lifting our gaze

‘Every person enjoying their best possible health and wellbeing’ is our shared ambition for people who live in Nottingham and Nottinghamshire.

A year ago we launched our Integrated Care Strategy, which describes what we will do to achieve this ambition over the next few years. We have been reviewing and updating our strategy, which is a timely reminder that our success as partners in an Integrated Care System hinges not only on day-to-day improvement in the delivery of health and care but also on our ability to lift our gaze towards strategic planning and transformation.

We know there are a range of important operational issues that are taking up so much of everyone’s time, such as improving the timeliness of pathways for urgent and emergency care, reducing the number of people waiting for treatments, surgery or cancer or improving access to general practice. These things are critical for our patients but are insufficient by themselves. We need to carve out time to think beyond the daily work, so that we can support changes which will help people to be well physically and mentally. By working together across all our partners, at local neighbourhoods and across the wider system we have the opportunity to be bold and make transformative changes that will not only improve patient outcomes but also bolster the resilience and sustainability of our health and care system as a whole.

We need to keep in mind our joint vision for health and well-being. Our Integrated Care Strategy sets this out with the key principles of prevention, integration and equity.

Our Strategy becomes the guiding light in dark times, meaning we can tackle tactical issues in a strategic manner and focus on the bigger picture rather than only on the immediate issues in front of us.

One of our real strengths as a system is our joint work on data and analytics and we will shortly be able to measure the impact of our Strategy in a granular way to help us track progress.

The responsibility sits with all of us to make a difference and to find the time to make those small, incremental moves towards a more equitable, integrated and preventative health and care system. There are lots of ways that you can be part of this change – whether it was through joining in the conversation at our ICS Partners Assembly, or through making a nomination to our Health and Care Awards or by taking the time to read and digest the Integrated Care Strategy.

But really, the change starts with all of us, every day. What questions can you ask about how our services are arranged and delivered that will make them more efficient and effective? How can you be part of the positive challenge to think about how your part of the health and care system links with the other parts?

Our ultimate goal is not merely to manage illness but to promote health and wellbeing in its fullest sense, supporting our communities to enjoy the best possible health and wellbeing. You can be, and in fact must be, part of delivering that, no matter how hard it seems to find the time.

Dr Kathy McLean

Chair of the Nottingham and Nottinghamshire Integrated Care Partnership

Monthly shout-out: CardMedic Maternity and Neonatal Pilot

Our shout-out this month goes to a new scheme which is helping to overcome communication barriers in maternity and neonatal services.

CardMedic launched within maternity and neonatal services at Nottingham University Hospitals (NUH) and Sherwood Forest Hospitals (SFH) in March. CardMedic is an innovative digital communication tool which improves communications between healthcare staff and patients regardless of language barriers, visual, hearing and cognitive impairments.

Communication barriers can lead to health inequalities and there is a wealth of evidence that associates language barriers with adverse events when accessing healthcare services. Pregnant women who do not speak English are at greater risk of poor birth outcomes compared to their English-speaking counterparts. Poor communication can also have a negative impact on a woman’s experience. The use of CardMedic aims to reduce health inequalities, improve personalised care, enhance quality of care, and improve patient safety.

Nearly 250 people have registered with the service and early feedback has been resoundingly positive. In one example, a registrar was able to communicate effectively with a Vietnamese-speaking service user during a night shift about induction of labour.

A special thank you goes to Siobhan Buxton in the ICB Maternity Commissioning Team, Gemma Boyd (Consultant Midwife and Professional Midwifery Advocate at SFH), and Debrah Neale (Matron for Community Engagement and Innovation at NUH) who have been an integral part in the launch of the service.

On Day Service pilot for Nottingham City East

Nottingham City East Primary Care Network (PCN) have been showcasing a pilot project which is helping patients get urgent same day GP appointments.

The On Day Service, based at St Ann’s Valley Centre, has created extra urgent same day appointments based in a central hub that practices can utilise if they are at full capacity. The service operates 5 days a week, 10am – 3pm.

The pilot has been running since May 2023 as a partnership between the PCN and Nottingham City GP Alliance.

Data showed that residents within the PCN were the biggest utilisers of the Urgent Treatment Centre (UTC) on London Road, with approximately 11% of the population attending between April 2022 and March 2023. Evaluation of the pilot service is underway but it is expected to have reduced attendances at the UTC and supported practices to be more resilient and responsive to their patients.

Dr Kathy McLean, Chair of NHS Nottingham and Nottinghamshire Integrated Care Board, said: “I was delighted to visit the On Day service recently and spend a morning with the team. This is a great example of practices in one area working together to benefit their patients. It also fits with our principle of ‘equity for all’, as the pilot is making healthcare as accessible as possible for those communities who may otherwise struggle to get support, due to language barriers.”

62% of the residents who live in the Nottingham City East PCN area are defined as the most deprived 20% in England. It is also an incredibly diverse area with 23 different languages spoken. The area also has higher than national average prevalence of severe mental illness, depression and learning disability.

Monthly shout out: Allied Health Professionals leadership work

Our monthly shout out goes to Leanne Horsley from Sherwood Forest Hospitals Trust and Sally Knapp from Nottinghamshire Healthcare Trust for their system leadership work with Allied Health Professionals (AHPs). AHPs include physiotherapists, occupational therapists (OT), therapeutic radiographers, podiatrists, paramedics and other professions in health and care.

Leanne and Sally have worked strategically and collaboratively with a range of AHP leads to:

attract over £765,000 of investment through short term funding for specific projects
lead staff development opportunities across seven different AHP groups
grow practice placement capacity
support four different professional apprenticeships helping unregistered staff take up new roles as AHPs
lead the Nottinghamshire senior leadership team and OT system-wide integrated rotations with a suite of resources and blueprint for this to be replicated
develop a toolkit for OT services that will be used nationally to establish innovative and robust rotations for newly qualified occupational therapists that encompass health and social care organisations, across physical and mental health settings
produce and implement an AHP support worker development toolkit to help provide a full and accurate picture of the unregistered workforce, which is crucial for workforce deployment, planning and future staff development
create an AHP educators’ community of practice to increase clinical placements in the private, independent and voluntary organisation sector
the possibility of an AHP legacy mentor programme where experienced AHPs, usually in latter stages of their careers, provide coaching, mentoring and pastoral support to staff newly appointed into Health or social care

Suzanne Avington, Associate Director for AHPs at Nottinghamshire Healthcare Trust, said: “Leanne and Sally are forward thinking, proactive innovators. Their pursuits build on national AHP and health policy and direction which they continue to shape to the needs of the ICS. Their work and their approaches inherently reflect the three principles of the Integrated Care Strategy. They epitomise working across organisations, identifying, and acknowledging the diversity and unique offer of AHP workforce across health and social care to grow and develop a future generation of staff that are multiskilled and adaptable. With understanding and curiosity, they look to test how inclusive our offers are to educate and train staff in order to develop the capacity and capability of a diverse workforce that is reflective of the communities we serve.”

Monthly shout out to – the Smokefree Team at Nottinghamshire Healthcare NHS Foundation Trust

Congratulations to the Smokefree Team at Nottinghamshire Healthcare NHS Foundation Trust, who have been awarded the ICS monthly shout-out for their work to support patients with mental illness to stop smoking.

The work of the team includes:

Setting up a smokefree service within inpatient mental health units, utilising a holistic, person centred approach to smoking cessation and harm reduction.

Designing and facilitating the use of bespoke, educational resources and materials to aid distraction techniques to manage nicotine withdrawal. These have been produced in an easy-read format and other languages and also flash cards for non-verbal patients. The packs have been shared with other mental health trusts nationally.
Delivering bespoke training sessions to patients, directly on the ward, educating on different types of Nicotine Replacement Therapy, alongside the benefits of a harm reduction approach for patients who are not ready to quit smoking.
Designing and delivering speciality training modules to 2500 staff working in patient facing areas such as coffee bars and receptionists in GP surgeries.

Delivering a suite of support and training within the Specialist Services directorate, including Child And Adolescent Mental Health, Mother and Baby and also within the prison service.

The team is an example of best practice nationally and it supports other mental health trusts with the implementation and facilitation of smokefree services, including the writing of their smokefree and vaping policies and procedures.

System Analytics Intelligence Unit podcast

The System Analytics Intelligence Unit (SAIU) was set up on 4 July 2022. This followed the COVID pandemic, where as a system we identified the huge value and benefit of integrated working with our systems data/intelligence and analytical partners to better identify and support the health and care of our population.

In our latest ICS podcast, Dr Kathy McLean (Chair of the Integrated Care Board) chats to Maria Principe (Director of Clinical Transformation and Effectiveness, ICB), Sergio Pappalettera (Contract and Information Manager, ICB), Stephen Wormall (GP lead for health inequalities mid Notts, ICB) and Chris Packham (Associate Medical Director at Nottinghamshire Healthcare Trust) about how the SAIU is offering a more granular and detailed understanding of what’s happening in and across our system.

The Princess Royal launches new mental health therapy group in Broxtowe

Her Royal Highness, The Princess Royal, visited Plumptre Hall in Eastwood today to learn about ‘invaluable’ new services from mental health occupational therapists who help residents improve their mental health.

Her Royal Highness is the Patron of the Royal College of Occupational Therapists and made a special visit to Nottingham to learn more about the positive impact of the new service during a special event jointly hosted by Nottingham West Primary Care Network and the Royal College of Occupational Therapists.

People living in Nottinghamshire can now access support from mental health professionals without a referral from a GP. Mental health occupational therapists are clinically trained and work with people of all ages to find holistic personalised, practical solutions to everyday challenges.

In Nottinghamshire, mental health occupational therapists work from general practice surgeries and get involved with local community groups to identify and address mental health needs early on. This new service is available across Mid and South Nottinghamshire to residents registered with a GP surgery in Hucknall, Gedling, Broxtowe, Mansfield Town and South Mansfield, and North Ashfield.

Catherine Seals, Mental Health Occupational Therapist for Nottingham West Primary Care Network, invited The Princess Royal to launch a new group-therapy choice for residents that promotes conversations about mental health and offers practical, personalised steps to help keep well.

Residents of Broxtowe met with Her Royal Highness and talked about using the service to manage their daily routines and achieve personal goals. Paul Cooke, 36, a father of three from Giltbrook and engineer at Rolls Royce, described his experience of therapy with a mental health occupational therapist as “a breath of fresh air” and explained how working with Catherine “helped me align more to my old self.”

The Princess Royal heard how mental health occupational therapists focus on how mental health may be affecting a person’s daily life, help people identify their goals and break down barriers to achieving them.

Local health care staff invited Her Royal Highness to explore the different techniques used to empower patients to manage anxiety and mood, regulate emotions, develop motivation and interest levels, and renew their interest in hobbies and important roles within life.

Sir John Peace, Lord Lieutenant of Nottinghamshire was part of a group of local dignitaries, who, together with representatives from the Royal College of Occupational Therapists and NHS Nottingham leaders, saw for themselves how occupational therapists design services that improve care within communities.

Nottingham West supports a collaboration of 12 GP surgeries within Broxtowe, and was one of the first Primary Care Networks in the country to employ mental health occupational therapists. Nottinghamshire leads the way in creating new services within primary care due to an effective partnership between 11 Primary Care Networks, including Nottingham West, and Primary Integrated Community Services (PICS), a local healthcare organisation run by GPs.

Find out more about the different roles in general practice.

Find out how the mental health occupational therapy role works.

Monthly shout-out: Respiratory Nursing Team

Congratulations to the community respiratory nurses from Nottinghamshire Healthcare NHS Foundation Trust for their work to support people with learning disabilities who have COPD.

The team identified that specific patient groups were facing barriers to receiving information for them to self-manage their COPD. Lead nurse Hiedi Swift and Learning Disability Nurse Sarah Atkinson have worked with the respiratory nursing team to develop a COPD action plan for patients with learning disabilities.

The plan was adapted to make it more pictorial to allow patients to interpret it more easily. This will help them to identify problems earlier and reduce the chance of hospital admission and GP contact.

The COPD self-management plan is coloured so patients with Autism can use it more easily and read it with comfort. The inside of the plan retains the traffic light system as most patients can follow this. The biggest change has been the actions, which have been changed from written directions to pictures. The correct inhaler technique is also being added into photographs for the patients to check they are using their inhalers correctly.

Hiedi Swift, lead nurse for the project, said: “We wanted to ensure that all patients from all socio-economic backgrounds had the information they needed to help manage their COPD. Patients in the Mansfield area have varying barriers to communications, which can include poor literacy. By adapting the information for different groups, we can help prevent ill health for everyone who is affected by this long-term condition.”

The COPD learning disability plan is the first one developed in the UK.