Health and Care Awards 2023

Kashmeera Gorecha: Improving uptake and understanding of talking therapies in South Asian communities

The project aims to increase awareness, knowledge and understanding of Talking Therapies and wider mental health with South Asian communities.

Discussions were held with local communities and system partners aiming to understand barriers and co-design solutions. A Community Engagement Lead was recruited from and for this community to co-produce solutions to this inequality.

Over 1000 people from the South Asian Community have now been engaged with through a series of workshops, lectures, community group talks and 1:1 discussions.

The evidence shows an improvement in knowledge and understanding of Talking Therapies, improvement in confidence to talk about mental health, including to a professional, family and friend when identifying a mental health issue from the workshops delivered.

Targeted Lung Health Check project team

The Targeted Lung Health check service invites people aged 55 to 74 who have ever smoked to a lung health check and CT scan.  The aim is to identify lung cancers and other respiratory diseases at an earlier stage when there is more chance of curative treatment.

The Programme has achieved an uptake rate of 74% – the highest in the country. 120 cancers have been diagnosed in total – 60% of these have been diagnosed at an earlier stage and 70% have a curative treatment plan.

The service is delivered on mobile units in the community to improve accessibility and all communication materials are translated into the nine most spoken languages. The team also links with GP practices, councils, charities, and faith centres to gain valuable local insight to shape the communication and engagement strategy and reduce barriers to participating.

Improving the uptake of health checks for people with learning disabilities from ethnic minority communities

A full-time learning disability nurse was employed to engage with communities to better understand the barriers to accessing health checks, improve knowledge and understanding, and increase the uptake of the health check by providing personalised outreach support.

Following feedback from communities, additional written information to promote and support the health checks was produced in the top five spoken languages, interpretation services were used and appointments were undertaken at a location convenient to the individual including their home and day centres, with longer appointments and over multiple appointments if required. 

The uptake of health checks within Nottingham City has increased on average by 36% across our ethnic minority communities.

Smokefree team

The Smokefree Team set up a bespoke stop smoking service within the community for patients with serious mental illness. The service helps to address the health inequalities and subsequent reduction in life expectancy.

The service includes the offer of support within inpatient mental health units, educational resources in a range of formats and training sessions for patients. Focus groups with patients were used to ensure a collaborative, person centred approach is at the heart of the service.

The team is now a national example of best practice and supports several other Mental Health Trusts with the implementation and facilitation of smokefree services, including the writing of their Smokefree and vaping policies and procedures.  

Andrew Dobb

Andrew Dobb, a Family Support Worker in the Community CAMHS South Team, has successfully engaged young people with a neurodiversity by using their specialist interests to build rapport, creating resources to meet their individual needs and offering flexibility around meetings and ways of communicating. His approach has resulted in service users being discharged from CAMHS and not returning.

Andrew has worked collaboratively with partnership agencies such as schools, educational psychologists, EOTAS agencies, social care, Development and Attachment Team and has acted as an advocate for this cohort of young people to allow their thoughts to be heard.

Andrew has also been proactive in supporting neurodiversity specialist practitioners and the wider network of CAMHS.

BAME wig project

Feedback from patients at Nottingham University Hospitals NHS Trust showed that that no black hairdressers were on the list of eligible suppliers of wigs for patients suffering from alopecia due to cancer treatment.

The Black Asian Minority Ethnic Shared Governance Council worked closely with Sistas Against Cancer, a Nottingham based community support group that offers peer support to anyone affected by cancer or anyone supporting someone with cancer. They approached Nottingham Hospitals Charity for funding to purchase appropriate wigs and scarves for trial.

The project initially started off for BAME patients experiencing hair loss following chemotherapy, however the service now carters for all patients experiencing hair loss regardless of ethnicity. As of September 2023, 70 patients have accessed the trichologist services (providing scalp care).

Oasis Community Centre

Oasis Community Centre staff and volunteers do an outstanding job delivering 35 projects which offer help and support for all ages, needs and interests. They offer holistic and therapeutic care to people with health and wellbeing needs, focusing on people who are disadvantaged.

Supporting people from disadvantage, staff consider the whole person, providing practical food aid, clothing, essentials items, social prescribing, drop-in Cafe projects, specific mental/physical health support, befriending and counselling.

Oasis Lifeline Projects offer educational, therapeutic and social care programmes to people with needs of many kinds through gardening, floristry, woodcraft, cactus growing, fruit and vegetables. food production, arts/crafts, digital skills and other aspects. This has been a great success taking referrals from GP’s, Social Prescribers, Citizens Advice, Job Centre, Council and all organisations in Bassetlaw.

Promoting Independence Service

The Promoting Independence Service, delivered by Bassetlaw Action Centre, works with health and voluntary sector colleagues to provide practical interventions to help people regain their independence following a hospital stay.

The support offered by the service includes befriending, home support with daily living tasks, housing advice, support to get active and a community car scheme.

It is estimated that the service is saving £686,400 to the healthcare system every year in reduced hospital bed days.

Working to Achieve Value and Excellence (WAVE) Programme

Nottingham University Hospitals’ (NUH) WAVE programme is a multidisciplinary programme which identifies opportunities to improve the quality of care offered to patients through the review of benchmarking, patient level information, variation across pathways and supporting information.

Over six years, there have been significant cost savings to the Trust, with £51m of savings to health and care budgets identified, £29.5m of which has been achieved. Improved options and services have been made available to the community and patients, at lower cost, across different specialties. Community and patient experience has also improved, ensuring equity of service, no matter where they live, through the data and intelligence used across partner organisations.

NEOS Daycase Arthroplasty MDT Team

Nottingham Elective Orthopaedic Services have implemented New Ambulatory Patient Pathways for Hip and Knee Arthroplasty, resulting in remarkable improvements.

By transitioning to this innovative approach, the team has achieved a significant reduction in the length of stay for patients, with many now being discharged after just one day compared to the previous 3.5 days. This transformation has not only saved time and improved the patient experience but has also projected an impressive cost saving of approximately £1,600 per patient.

The team’s approach has been built on a foundation of patient feedback, ensuring that qualitative data is continually collected to shape and refine their strategies. Patients were involved and co-produced patient information/educational video. The team’s consistent focus on data collection, qualitative feedback, and continuous refinement ensures that their improvement model remains adaptable and responsive to changing circumstances.

NUH Prehab Service

NUH Prehab Service, which has been co-designed with patients from the outset, prepares people ahead of their cancer surgery through improvements in physical fitness, psychological wellbeing and healthy eating.

The NUH Prehab Service works collaboratively with health, social care, the independent and 3^rd sector. It enables personalised care to be closer to home, thereby improving likely outcomes.

Patients report improved physical ability and psychological feelings including regaining a sense of control. The project has also made financial savings by reducing the average time spent in hospital.

Mental Health Support Team Steering Group

Mental Health Support Teams (MSTs) in schools help destigmatise mental health through open and compassionate conversations, training, signposting and providing reflective space for school staff. They enable a timely response to children and young people, supporting needs earlier and reach children and young who may not have otherwise accessed services, and whose difficulties might have required more specialist care in the future, if not supported.

The partnership which drives forward MHSTs has co-production at the core and consists of ICB and local authority commissioners, health providers, education leads, co-production group ‘Leaders Unlocked’ and social care.

Approximately 280 schools (112,000 pupils) will be able to access support by January 2025. This represents approximately 60% coverage of schools, far exceeding the national target of 25%.

Veteran care through custody

The Veteran Care through Custody project is a unique partnership between the Offender Health team at Nottinghamshire Healthcare NHS Foundation Trust, and the veteran’s charity Care after Combat. The project offers specialist healthcare and holistic wraparound services to veterans in prison and has so far transformed the lives of almost 500 veterans in Nottinghamshire and wider East Midlands region.

A combination of veteran-specific clinical interventions from Notts Healthcare together with the wrap-around support of staff and volunteers from Care after Combat has seen incredible results in terms of health and wellbeing outcomes for some of our nation’s most vulnerable veterans.

The project is a firmly embedded collaboration with the NHS and the Justice system, delivering support to not only a targeted vulnerable population but also impacting on the wider community with measurable outcomes. The project could potentially be adopted into prisons nationally.

Children’s Bereavement Centre: 2023 bereavement residential

Children who have suffered a loss or bereavement are one and a half times more likely to be diagnosed with a mental health disorder. This preventative project takes groups of children on a two-day bereavement residential, which involves enrichment activities and one to one support.

The annual residential trip helps equip children with coping strategies, improve their resilience and confidence, reduce isolation and provide them with the chance to remember their loved ones in creative ways.

96% of attendees expressed positive feelings at the end of the residential. Four of the people who now volunteer are people who attended the project as service users when they were in their teens.

One version of the truth data – to support hospital discharge

The nominees provided system leadership to empower staff across health and social care to create a one version of the truth discharge dataset that all partners agree is accurate. 

This data supports collaboration and data informed practice across the wards and the multi-disciplinary Transfer of Care Hubs in managing the timely, safe and appropriate discharge of older people once they are well enough to leave hospital and return home.  It has supported better practice and decision making and more people are now going directly home in a shorter time, leading to people spending 20,000 fewer days a year in a hospital bed at one of our acute hospitals.

Community heart failure pathway and access

A clinical pharmacist with a special interest in heart failure was seconded to support NNE Primary Care Networks to reduce a backlog in heart failure appointments.

The clinical pharmacist offered clinics to increase medication levels where needed, review heart failure patients and identify clinical risks and support the heart failure specialist nurse in her role.

As a result of the clinical pharmacist being in post for a year, the backlog of patients was reduced from 100 patients to around 17 patients waiting and the waiting time to see a heart failure specialist nurse was down from 52 weeks to approximately seven a week wait.

DFN Project SEARCH (Sherwood Forest Hospitals Trust)

DFN Project SEARCH helps students with special educational needs and disabilities access work placements within the hospital departments and services. The scheme has been successful not only for the students who benefit from gaining independence, making friends, budgeting skills and experience of employment, but also strategically improving the relationship between Sherwood Forest Hospitals Trust and its private sector partners and West Notts College.

Within the programme, structured learning has been developed to equip the students with extra circular aspects including budgeting, sexual health and dental as well as travel training for example which aid independence and thus delivers in outcomes of the ICS strategy. 

During the 22/23 intake, 3 placement students graduated, with 2 gaining employment with ICS partners, and the other actively seeking opportunities, with college support.  The scheme has Board backing, who have committed further investment into the 23/24 programme and an increase in the number of placements offered.

Trevor Clower (support for unpaid carers)

Trevor Clower is an unpaid carer who has introduced Carer Roadshows across Nottingham and Nottinghamshire and has also developed online content to support carers with information about local services.

From 2013 – 2019 there have been 22,000 visitors to the Carers Roadshows which take place across Nottingham City and County, over 4,500 visitors to YouTube Virtual Carers Roadshow and 2850 visitors at the 2023 nineteen Carers Roadshows.  Data has been collected from over 29000 visitors to inform improvements to our community care services via the Local Design Teams formed as part of the Community Care Transformation Programme.

Trevor has created a network of partners across social care, health, voluntary services and local community to support the sharing of information about free local services for carers.

Small Steps Big Changes Family Mentor Service

Family Mentors are a highly trained paid peer workforce that deliver the Small Steps at Home evidence-based programme of child development and preventative health support to parents of 0—4-year-olds.

The Family Mentor Service provides social value through commissioning established voluntary and community sector organisations that employ local people based on aptitude not qualifications. It provides accredited training at Level 2 (equivalent to GCSE). The Service is co-produced with and co-delivered by the community it serves and the mentors speak 14 non-English home languages.

Parents reported improvements in wellbeing and confidence in both parents and children, children eating healthy food options, and improved sleeping routines and behaviour (2019). Children who used the service scored significantly higher on communication and gross motor areas of the Ages and Stages Questionnaire in the first year.

Gedling – Falls Prevention Project

A Project Group was set-up with representatives from Gedling Borough Council, the Primary Care Network, Active Notts and a Postural Stability Instructor, who worked in an integrated and collaborative way to use Ageing Well seed funding to set up three Falls Prevention classes in the community, aiming to improve the physical and mental health of Gedling residents in identified areas of health inequality.

70% of people attending reported an increase in their strength and balance and 97% increased knowledge of how to get up from the floor on their own. They have been empowered to lead a more independent life without resource to social care and they have become more socially active.

The classes were well attended and have continued.  Participants pay £5 a week. Their strength, balance and social confidence is improving, helping to reduce health and social care costs.

Children with Diabetes Team and Active Hospitals

Patient assessment data showed that a high proportion of children in the diabetes service were inactive. The Children with Diabetes team worked with the Active Hospitals project to secure £2,463.00 from the Nottingham Hospitals Charity.

Trent Bridge Community Trust delivered a 10 week programme of mixed sports for children in the service. 80% of attendees reported that they would be more active following the sessions, 100% wanted more sessions, and 57% were less anxious following the sessions.

The children themselves were essential to the planning of the groups, and their evaluation. A survey was completed as part of planning, to determine a range of activities which the children were interested in, and to gauge interest in the group. Further evaluation is being carried out to determine the impacts on the children’s weight and blood sugar.

The Bassetlaw Food Insecurity Network

The Bassetlaw Food Insecurity Network was set up to offer joined-up support for local residents with their food needs.

The network has set up food hubs, run slow cooker courses, created community allotment sites, developed a children’s kitchen initiative and held social eating events. During the initial set up of the food hubs, the locations are given six weeks of support to run the hub, and then expected to be sustainable to continue the provision without support.

Organisations within the network have spent considerable time on the ground visiting and meeting residents face-to-face to understand their needs and how to innovatively develop pre-existing ideas or develop new ones.

As a result of the success, the network lead has been requested to attend seminars, University conferences, national training webinars, the NHS, and councils, to share best practice.