IHSCM Regional HUB Magazine Issue 2

IHSCM Regional HUB Magazine May 2022

Bringing our Regional HUB Network closer, sharing your stories and achievements.

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Contents 3. Message from CEO Jon Wilks 4. London HUB Intro 5. London HUB - Success And Innovation In Response To An Unforgiving Pandemic 10. London HUB Event Replay 11. West Midlands Intro 12. West Midlands - Greening Theatres: The New Cross Experience 15. West Midlands - The Self-Service Reporting Revolution 19. West Midlands - Going the Extra Mile 21. West Midlands - Leadership for Allied Health Professionals 28. West Midlands - A Growth Mindset: Imposter Syndrome’s Nemesis 35. West Midlands - Health inequalities – and our role in public health 40. West Midlands - Excellence In Care 44. West Midlands - The Chronic Pain Management Service 46. GMTS Intro 47. GMTS Blog - Lived Experience - Kofi Madden 52. GMTS Blog - Lived Experience - Lucy Matthews 55. GMTS Blog - Lived Experience - Adam Beattie 59. East Midlands Intro 60. North West Intro 61. South West & Primary Care Hub Intro 62. Wales Country HUB HEIW Intro 63. South East Care HUB Intro 64. West Midlands Care HUB Intro 65. West Midlands Education HUB Arden University Intro 66. London Education HUB University Trinity Saint David London Intro 67. IHSCM 'The Loop' Quarterly Magazine

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CEO Jon Wilks Message

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IHSCM London Hub is compromised of Guys and St.Thomas NHS Foundation Trust.

Royal Brompton and Harefield hospitals became part of Guy's and St Thomas' in February 2021, bringing together world-leading expertise and research in heart and lung disease.

We have over 500 IHSCM members from our London HUB.

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Success And Innovation In Response To An Unforgiving Pandemic Elsie Mensah, Consultant Urologist1 Anna Goodman, Senior Specialist Lead for CMDU1 Daghni Rajasingam, Deputy Medical Director1 1 Guy’s and St. Thomas’ NHS Foundation Trust The onslaught of the COVID 19 pandemic has had a pervasive effect on lives and organisations across the country and particularly on the National Health Service.

Guy’s and St. Thomas’s has been at the heart of the NHS Covid -19 response from the onset. From the utilisation of systems and expertise through the trust’s High Consequence Infectious Disease Centre, and the rapid expansion of our critical care capacity, the trust rose to the challenge of meeting the evolving needs of patients. There was rapid redeployment and retraining of staff, implementation of new pathways and processes, all requiring careful leadership to ensure that service needs were met, whilst ensuring staff who were themselves going through the effects of the pandemic continued to be supported. There was also the successful roll-out of the Covid-19 vaccination program which spectacularly served employees, patients and indeed our prime minister!

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The Covid Medicines delivery Unit (CMDU) is an example of how innovative problem solving, collaboration, teamwork and leadership can translate into real world benefits for patients.

With increasing knowledge about the Covid-19 infection and development of novel treatments, the need to be able to provide treatment to reduce symptoms and hospitalisation was recognised and CMDUs were set up nationally to support clinically vulnerable patients who contract COVID-19 infection.

There was a short time period between the requirement for CMDUs and the need for these units to be able to deliver the service. The centre for innovation, transformation and improvement (CITI) at GSTT was tasked to provide support to CMDU at GSTT. They embedded improvement methodology into the workflow of setting up CMDU, which enabled the team to be very responsive to central policy changes and to continually improve quality of care.

The system initially utilised volunteers as well as staff working from home or self-isolating as well as redeployed staff, but currently also includes substantive staff. The team includes pharmacy, medical and nursing staff, administrative and the CITI team, all with the support and overarching leadership of their clinical leads and trust management.

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High risk patients with covid-19 are automatically referred via a web portal, or through clinicians and GP’s. Patients undergo a two tier triage system, firstly an administrative triage to ensure they meet relevant criteria and secondly a clinical triage to ensure patients would be clinically eligible for treatment. Medication is provided to patients via courier delivery if oral, or by arranging an intravenous infusion as appropriate. The figure below shows the numbers triaged and treated by the team from mid December 2021 – 13th of April 2022.

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There is a race against time and this can be challenging particularly when demand is high and staffing levels are low but the team remain committed to ensuring as many patients as possible are able to benefit from this service. They hold multiple daily huddles for ongoing improvement and problem solving to ensure they remain responsive to changes.

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Unsurprisingly, there has been very positive feedback from patients and families.

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Have a look at some of our brilliant events, that we have facilitated with our London Hub. We have worked on some brilliant conferences that you can catch up on below, click on each image to watch the event.

Event 1

Event 2

Event 3

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IHSCM West Midlands HUB is the Royal Wolverhampton NHS Trust and Walsall Healthcare NHS Trust. In this edition we have lots of input from this HUB and we thank you for sharing all of your great work. We currently have around 500 members and growing accross our West Midlands HUB

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Greening Theatres: The New Cross Experience

Authors: Ranvir Cheema, Janet Smith and Bhagyashree Netke Trust: RWT

The world is facing a climate emergency, with the concentration of greenhouse gases and global temperatures rising. The climate emergency also creates a health emergency, posing direct threats to health.

Our Trust was responsible for 19034 tonnes of carbon dioxide emissions in 2019 and we have committed to reducing our carbon footprint by 25% by 2025. Our larger initiatives include the creation of a 30-acre solar farm which will aim to provide ¾ of our annual energy requirements, as well as reducing air pollution from fleet vehicles by moving from ultra-low emission vehicles to electric vehicles and reducing care miles through the use of virtual clinic appointments, saving 1,864,673 of patient travel miles and representing a reduction of 343.7 tonnes of CO2 emissions.

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We are also trying to empower colleagues to make more sustainable choices through: ·An Anaesthetics Junior Doctor Sustainability Group and Sustainability Lead, with plans to roll this out across all specialties. ·Setting up a monthly “Sustainability Lunch Hour” for all colleagues across the Trust to dial into and find out about our latest projects. ·A network of climate change champions in each of our theatre departments that is introducing reusable caps amongst other initiatives. ·A waste management project that is evaluating staff awareness of correct waste disposal practices, reducing the amount of clinical waste generated and increasing recycling in clinical and non-clinical areas. ·Reviewing usage of nitrous oxide and ending the purchase of desflurane. ·Changing staff attitudes towards the more environmentally friendly use of total intravenous anaesthesia, in favour of volatile agents. ·Setting up a sterile packs project to reduce unused items in packs that are wasted. ·Using patient warming technologies that generate less waste.

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To quote George Bernard Shaw, “progress is impossible without change, and those who cannot change their minds cannot change anything.” We hope that through re-educating our colleagues, we can change engrained practices and play our part in protecting the environment.

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The Self-Service Reporting Revolution Authors: Sebastian Smith – Cox (Workforce Planning & Intelligence Lead) Trust: WHT Traditionally performance management teams have circulated reports, via email, using static spreadsheets. This provides information at a point in time but often leaves decision-makers with more questions than answers. Typically, the solution to these questions is to circulate yet more spreadsheets, and thus a cycle of decision-maker disempowerment perpetuates.

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We formed a Workforce Intelligence service with the core objective of providing “first-class intelligence to support first-class decision making”. To deliver that ethos, we set out to develop, refine, and then revolutionalise workforce intelligence infrastructure; centring new ways of working around the support of timely and focussed decisionmaking processes.

Autumn 2021 represented the first major milestone in Walsall Healthcare’s strategy to put control of workforce intelligence back into the hands of colleagues. The Business Intelligence platform, within the Electronic Staff Records (ESR) system, was leveraged to roll out selfservice workforce performance dashboards across the organisation.

The dashboards allow users to access live workforce performance intelligence, at division, care group and departmental levels. No longer are managers beholding to a centralised reporting calendar, instead, they now have the means to access dynamic intelligence 24/7.

Some of the greatest benefactors of this innovation were clinical & safeguarding leaders, who during times of high pressure when patient-focussed time should be the priority, need quick access to bespoke dashboards, but also the flexibility to deep dive into areas of concern when capacity allows.

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To ensure a positive user experience, Workforce Intelligence colleagues held a consultation and pilot period before the Trust-wide rollout. This ensured that the concerns and challenges of all colleagues could be taken on board. The result was a diverse suite of dashboards and user support packages built around decision-makers.

There have been 4 major benefits to the rollout of self-service reporting. Firstly, by providing colleagues with the means to own intelligence, they feel empowered to move beyond the question of “what is performance like” and begin partnering with analysts to bottom out “why is performance the way it is, and what can be done to change it”.

Secondly, 24/7 access to live intelligence has helped to improve monitoring. This is best evidenced by the 5% increase in training compliance has increased since roll-out and the 6% hike in annual appraisal compliance during the same period.

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Thirdly, as the first organisation nationally to achieve Trust-wide selfservice reporting via ESR, the reputation of the team has been enhanced; providing credibility to the advice and recommendations offered by analysts.

And fourth, by moving away from a traditional ‘reporting factory’ model, the Workforce Intelligence team has become a decision support unit, rather than a centralised resource.

The team continue working with colleagues to ensure the dashboards remain fit for purpose and encourage leaders to put workforce intelligence at the centre of key decision making. The next phase of our service development will involve providing decision-makers with predictive modelling, so they can even more agile and proactive. It’s a challenge we look forward to and a journey we will take alongside our partners.

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Going the Extra Mile Authors: Janet Smith -MSP® Registered Practitioner (Head of Sustainability) Trust: RWT On Thursday the 17th of March, the team had been asked to clear the children’s ward (A22). Martin Wilkes (Waste Services Supervisor) attended to assist the staff to remove the bulky items for disposal at the waste yard.

During the removal of the waste Martin came across a lot of toys, and rather than disposing of the Martin took it upon himself to ring around local charity shops to see if they would accept the toys and reuse them, unfortunately none of them could collect the toys.

Martin was determined for the toys go for reuse, so he asked for permission to deliver the toys to a local charity shop in Whitmore Reans, which he had previously contacted, called ‘Sue Ryder Care’, who were very grateful for the donation and accepted all the toys.

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Martin Wilkes went above and beyond his duties not only to reduce waste and increase reuse, but to give a helping hand to those young children in need.

Martin has demonstrated that anyone can make their contribution in looking after our environment and helping the Trust achieve its net zero goals.

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Leadership for Allied Health Professionals Authors: Dr Ros Leslie, Dr Nicky Eddison and Edward Lee Trust: RWT Allied health professionals (AHPs) are the NHS’ third largest workforce, practising in most clinical pathways across all stages of the patient’s pathway, working across organisational boundaries and contributing to the transformation of healthcare1. Strong and effective leadership is therefore crucial. The introduction of senior leadership positions in Trusts is more likely to lead to the sharing of AHP innovations that had a positive impact on patients’ and system outcomes. Moreover, the more senior an AHP leader, the more engaged AHPs are in improvement work2. Strategic Chief AHP leadership therefore benefits improvement activity, as well as influencing the AHP workforce on the Trust’s priorities3. Thus, the need for professionally diverse leadership, including senior clinicians at board level, increases the likelihood of meeting the complex challenges facing the NHS4.

Successful leaders will build on profession-specific, clinical foundations to take on multi-professional, system-wide and strategic activities3.

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A typical AHP leadership career pathway will comprise of knowledge, skills, experiences, personal qualities and attributes developed throughout their AHP career3. In 2017, Health Education England (HEE), NHS England (NHSE) and NHS Improvement (NHSI) worked in partnership to develop a national, multi-professional framework for advanced level practice5, to ensure a standardised approach.

Advanced level practice is a level of practice characterised by a high level of autonomy and complex decision-making, underpinned by Masters’ level education or equivalent, that encompasses four domains: management and leadership, education, research, and area specific clinical competence5. These domains are expressed as pillars of advanced practice (Figure 1).

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My experience – Nicky Eddison I was lucky enough to win a place on the fully funded AHP cohort for the ‘Rosalind Franklin NHS Leadership course’. The course started in January 2020 and involved three back-to-back full day workshops (face to face) which were intense and at times a little strange. There didn’t seem to be a structured learning outcome, which for a traditional learner like me, was very strange and initially, I found myself questioning whether this was the right course for me.

By the end of day three, we had been split into small “impact groups” and we spent the afternoon discussing our “life journey” which was intense and slightly strange and certainly encouraged us to step outside of our comfort zone, be vulnerable and share information.

However, the experience had a hugely positive impact on how the group bonded and started working together. I began to realise that the learning methods were going to be a whole new experience for me and a real learning curve.

Our impact group was due to meet again in April 2021 but due to COVID everything switched to a virtual learning platform, but this didn’t weaken the bond that the group had already formed. During our group impact days, we discussed the learning outcomes we had been working on between group meetings, which included:

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Emotional intelligence - Unconscious bias - The ladder of inference The triangle of drama - Valuing differences and fostering inclusion Learning to learn - 360 feedback - Understanding system types System thinking - Mapping systems - Effective leadership in complex systems The impact of teams - The difference between teams and groups of people - Theories of change - Managing change - Planning for change - Leadership styles and their impact - When things go wrong The above is not an exhaustive list of the course content but will give you an idea of the breadth of information covered. Throughout the course you are reminded to use all the information you have learnt and the skills you have developed, to plan your final assignment which is a 5000-word “integration project”. The criteria are simply that it is rooted in your workplace and focused on an improvement of some kind.

Verdict I would wholeheartedly recommend this course, the content is detailed, and the method of teaching is varied, engaging and practical.

Most importantly, the skills you learn are immediately useful in a workplace setting. I certainly changed how I lead my team as a direct consequence of the skills I learned on this course. If you get the opportunity to get a place on the Rosalind Franklin Leadership course, take it, you won’t regret it.

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My experience – Edward Lee Upon noticing an advert within the training section of the Trust Brief in 2019, with the support of my manager, I applied for the MBA Senior Leader Master’s Degree Apprenticeship (SLMDA) qualification through the University of Wolverhampton. After securing an interview, I was very fortunate to be offered a place and embarked upon my leadership development journey in September of the same year. This opportunity enabled me to advance my leadership and management skills through academic study whilst enabling me to apply theory into practice within my day-to-day role which was evidenced through compiling a comprehensive portfolio.

The programme of study included many different aspects of leadership and management including human resources and leadership, general business operations, entrepreneurialism in business, managing financial performance, strategic management and leadership and completion of a business research project. The course topics were varied and enabled me to explore my leadership style and how I could develop this through practical application.

The overall programme of study concluded with an end point assessment (EPA) conducted by the Chartered Management Institute (CMI).

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This gave me an opportunity to showcase the work that I had undertaken throughout the programme and evidence how I had advanced my skills and knowledge in the field of leadership and management. Despite the challenges that COVID-19 presented within my day job, I was very fortunate to achieve a distinction and be granted Chartered Manager status following my EPA.

Verdict I thoroughly enjoyed the programme because this challenged me both personally and professionally through enhancing my leadership and management skills and enabling me to apply these skills to my role as Clinical Lead for Physiotherapy and Occupational Therapy. I would highly recommend a work-based leadership and management apprenticeship programme as this enables you to undertake academic study alongside applying your learning to a real-life situation, which I found to be invaluable.

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Leadership courses available to AHPs There is a plethora of leadership programs available, including those on offer via the NHS Leadership academy; starting with the Edward Jenner programme, aimed at those moving into their first leadership post right through to the Nye Bevan course aimed at those planning to move into a board level position and leadership courses aimed specifically at our BAME communities. The AHP Federation has also recently advertised a leadership programme aimed at future leaders of professional associations. Your NHS Trust will also have a range of learning opportunities, which might include strategic leadership bootcamps, management and leadership development seminars, high performance leadership workshops and applied emotional intelligence seminars.

Dr Ros Leslie is the Non-Medical Research Lead and Chief AHP

Edward Lee – Clinical Lead for Inpatient Physiotherapy and Occupational Therapy

Dr Nicky Eddison is an Associate Professor and AHP Research Lead.

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A Growth Mindset: Imposter Syndrome’s Nemesis Authors: Dr Nicky Eddison and Dr Ros Leslie Trust: RWT

Ever felt as though at any moment you are going to be found out as a fraud, like you don't belong where you are, and you only got there through luck? Believing that others have so much more knowledge than you. You’re not alone, many people experience these feelings.

Imposter syndrome was first described in 1978 as “an internal experience of intellectual phoniness”1. People with impostor syndrome struggle with a debilitating feeling of self-doubt, intellectual inadequacy and anticipated failure, often refusing to acknowledge that their performance is due to their ability. Instead, they believe luck or other people are the cause of their success, yet conversely put setbacks down to their incompetence2. The literature shows that imposter syndrome is prevalent amongst all genders, ethnicities and age groups2.

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Figure 1: Adapted from https://www.verywellhealth.com Research indicates a harmful association between impostor syndrome and job performance, job satisfaction, and burnout amongst healthcare professionals2.

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Stanford psychologist Carol Dweck is an expert on how belief systems about our own abilities fuel our behaviour, known as “Mindset Theory”3.

Dweck describes two mindsets (see figure 2), describing how we view and inhabit our personality.

EA “fixed mindset” assumes that our character, intelligence, and ability are innate and cannot be changed and that success is the affirmation of that inherent intelligence, creating an urgency to prove yourself . over and over. In this mindset, “you’re always trying to convince yourself and others that you have a royal flush when you're secretly worried it’s a pair of tens”3.

“Change the way you look at things and the things you look at change” Dr Wayne Dyer.

A “growth mindset,” on the other hand, thrives on challenge and sees failure not as evidence of a lack of intelligence but as an opportunity for growth and improving our abilities. This growth mindset is based on the belief that effort and perseverance can nurture and develop our abilities. Dweck found, that the growth mindset creates a passion for learning rather than a quest for approval.

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People with this mindset are not discouraged by setbacks and don’t see them as failures; on the contrary, they view it as an opportunity to learn. With a fixed mindset, effort is a bad thing. It, like failure, means you’re not smart or talented. If you were, you wouldn’t need effort. For the growth mindset, effort is what makes you smart or talented.

The well-known quote “if you’re the smartest person in the room, you’re in the wrong room” is indicative of a growth mindset, stepping out of your comfort zone, embracing the challenge, and seizing the opportunity to learn.

So, how might this link in with imposter syndrome? Dweck found that often people greatly misestimated their performance and their ability. But it was those with the fixed mindset who accounted for almost all the inaccuracy. The people with the growth mindset were amazingly accurate3.

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Figure 2: Two mindsets adapted from Mindset: The New Psychology of Success3

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So, if you recognise the uncomfortable presence of imposter syndrome, perhaps reflect on the type of mindset you currently have and challenge the views you hold. Other practical tips include: Practice setting realistic goals.

Recognise your expertise.

Define what success means to you without including the approval of others.

Stay away from toxic competitions.

Don't rely exclusively on external validation.

Set limits and boundaries to avoid overworking.

Practice responding to failure in a healthy way.

Praise yourself for successes and efforts.

Remember nobody is perfect.

Determine your support system and lean on them when needed.

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References 1.

Clance P R and Imes S. The impostor phenomenon in high achieving women: dynamics and therapeutic intervention. Psychother Theory, Res Pr. 1978;15.

2.

Bravata DM, Watts SA, Keefer AL, et al. Prevalence, Predictors, and Treatment of Impostor Syndrome: a Systematic Review. doi:10.1007/s11606-019-05364-1 3.

Carol Dweck. Mindset: The New Psychology of Success. Reprint ed. Ballantine Books; 2007.

Dr Nicky Eddison is an Associate Professor and AHP Research Lead.

Dr Ros Leslie is the Non-Medical Research Lead and Chief AHP

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Health inequalities – and our role in public health Authors: Dr Nicky Eddison and Dr Ros Leslie Trust: RWT Health inequalities are ‘unfair and avoidable differences in health across populations and between different groups within society.

Inequalities in health have been further exacerbated by the Covid-19 pandemic which has taken a disproportionate toll on our most vulnerable groups, including some ethnic minority communities and people living in the most deprived areas. The concept of equity in health has been examined and wider determinants of health identified, including concepts such as 1) general socioeconomic, cultural, and environmental conditions; 2) living and working conditions; 3) social and community networks; 4) lifestyle factors; and 5) individual factors such as age, sex, and constitution.

Health inequalities are complex and challenging. In 2008 a commissioned review recommended that reducing health inequalities would require action and specific policy objectives, since then health and health inequality has generally worsened5. This lack of equality matters, as some of the people most at risk of experiencing health inequalities are also often those who find it the hardest to access high-quality support . T  ackling these inequalities is of paramount importance for public health.

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How will the digitalisation of healthcare affect health inequalities?

Digital transformation is cited as a key priority of the NHS Long Term Plan to reduce face-to-face outpatient appointments by up to a third by 2024 and most patients are expected to receive a “digital first” option by 20298.

As a result of the planned telehealth expansion, there have been concerns that the digital transformation will widen the digital divide for certain populations when telehealth becomes ubiquitous.

We must be mindful to embrace new and innovative ways of delivering healthcare, noting that telehealth has the potential to reduce health inequalities e.g., reduction in financial cost to patients of attending hospital appointments, the reduction in the burden of treatment for patients with chronic and complex health conditions.

Telehealth can also make access to healthcare easier for vulnerable communities including homeless people and people with mental health problems or debilitating illnesses.However, we must also be conscious of the risk of increasing health inequalities due to digital exclusion within certain groups.

Public health Public Health was defined byAcheson, 1988 as “the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society. Health professionals must go beyond health and medical care and acquire skills to reach out to the whole of society where the significant determinants of health are located, including working conditions, education, the environment, helping people improve their health and wellbeing, or preventing the deterioration of their health.

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Public health focuses on the entire spectrum of health and wellbeing, not only the eradication of particular diseases, in other words, we do not only have a responsibility to treat the sick we must also aim to keep the well, well.

The four domains of public health: Population healthcare – aims to maximise value, equity, and good outcomes by focusing on the needs of the population and delivering person centred services across the entire health and care system (Groups of people where treatment is standardised for the group not individualised, not a clinical intervention).

Health protection – aims to protect the population’s health from communicable diseases and other threats, while reducing health inequalities (Communicable/infectious diseases or environmental impact, population wide, screening and immunisation).

Health improvement – describes the work to improve the health and mental wellbeing of individuals, communities, or populations through enabling and encouraging healthy lifestyle choices and developing resilience. (Non-communicable, lifestyle modifications, diet, exercise, MECC must not be something which is already part of your clinical role i.e., outside of what the patient was referred for).

Wider determinants –also known as social determinants, are a diverse range of social, economic and environmental factors which impact people’s health and wellbeing. Addressing the wider determinants of health and wellbeing has a key role to play in reducing health inequalities (Effects context in which people live).

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How can Allied Health Professionals at RWT contribute to public health?

The Allied health Professional (AHP) workforce, led by Dr Ros Leslie, is planning a programme of public health initiatives, one of which will involve a series of videos educating RWT staff on the importance of foot health, foot posture and overuse injuries.

Resulting in a repository of health education information for our staff and wider communities to access. Our skilled workforce will be visiting local schools and care homes to educate our communities on lower back pain and foot biomechanics, cardiovascular health, and reducing the risk of contractures and falls in Care Homes. We will also be launching a campaign on the importance of pelvic floor health, targeting our workforce and linking in with the local Women’s Institute, to ensure we reach the wider community.

In addition, our AHP researchers are actively exploring the impact of COVID-19 on our service users12,13 and wider communities, the impact of telehealth on health inequalities, service user experience, the burden of treatment and AHP telehealth guidance.

RWT AHPs are also leading on an Office of Health Improvements and Disparities funded project exploring how each Allied Health Profession contributes to public health.

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Dr Nicky Eddison is an Associate Professor and AHP Research Lead.

Dr Ros Leslie is the NonMedical Research Lead and Chief AHP

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Quality is defined as ‘the standard of something as measured against other things of a similar kind; the degree of excellence of something.’

The main focus of the Trust’s Quality team over the next 18 months is to continue working with colleagues as we strive for excellence in care. The Clinical Systems Framework (CSF) is our overarching strategy and our workstreams are aligned to the ‘Excellence in Care’ section of the CSF. We are currently working on: Nursing documentation We introduced a revised: • Patient risk assessment • Admission details • Initial assessment. We also piloted an intervention chart devised by our Tissue Viability colleagues at the end of March 2021.

We are also developing and revising other documents as we aim to streamline documentation whilst ensuring it is individualised for our patients.

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‘The Wolves Way’ accreditation This accreditation is our patient-first approach. Organisations that have introduced accreditation schemes have been shown to improve the quality of patient care, along with increasing pride within teams in terms of how they feel about their service. We have been scoping accreditation models within other NHS Trusts and have identified a pilot ward. The next phase will be an options appraisal to be presented to staff and explored through focus groups. This will inform what the ‘The Wolves Way’ model here at RWT will look like. This will be implemented over the next 18 months.

Deteriorating Patient and Sepsis We have been reviewing the data from Vitals observations to generate a new report for observations on time and sepsis screening. Pilot wards within the Trust are trialling new interventions which include reviewing vitals clinical for when observations are due and reviewing the frequency of observations carried out.

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Medication safety Working closely with our pharmacy colleagues and Continuous Quality Improvement (CQI) team, we have developed a project brief for critical medications. Critical medications are drugs that should never be omitted or delayed. Our project has led to the development of a pocket guide to increase awareness of which medications are grouped as critical. To monitor progress, our pharmacy colleagues have developed a missed medications report which will be available for staff shortly with the aim of having the data available on In Phase

Nutrition and hydration on inpatient wards The food and drink consumed is so important for our patients and should be viewed as a fuel to aid recovery whilst in hospital. Poor nutrition and hydration can increase the risk of falls, pressure ulcers, urinary tract infections and impair cognitive function. We have added the dietary requirement and nutrition care plan to our nursing documentation along with an oral health assessment.

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We have developed a nutrition strategy and are working closely with our dietetics team and our colleagues at Walsall Healthcare NHS Trust for the development of a Nutrition and Hydration Ambition. We have piloted a hydration assessment, revised fluid balance and a hydration chart on three wards at RWT and we are starting the evaluation phase. The food chart has been redesigned and is ready to pilot, with the aim of highlighting when patients are not eating adequate amounts.

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The Chronic Pain Management Service has set up a pain management programme aimed at helping patients who have chronic pain to have a better quality of life. The programme takes place over eight weeks and has up to ten patients participating in each session. Lasting for two hours, sessions include educational slots about subjects such as pain medication, relaxation and the benefits of exercise.

These may potentially help someone overcome the symptoms of chronic pain. Each attendee also receives a booklet with relevant information from each of the sessions, this can then be utilised after the programme has concluded and used for reference. Chronic pain patients often feel isolated because of their pain so to have a programme that builds a community is beneficial for them. Due to COVID-19 restrictions the programme was recently moved online.

The first virtual programme, we are pleased to say, has been successful.

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IHSCM and GMTS joined forces last year and the partnership continues to grow. We now have around 300 active members from GMTS and have our joint event planning is underway for 2022.

Join the NHS Graduate Management Training Scheme and make a difference to the lives of millions of people. We are the biggest employer in Europe and have placements available across England.

Our scheme offers you the opportunity to develop into a future leader in one of our specialisms including management, human resources, finance, policy and data analytics. Our trainees work in a range of organisations and types of services. You could be improving patient care in a busy hospital department or developing better ways of using data to improve key services as part of an office-based team. You will face challenges and enjoy success on a scheme where no two days are the same. This could be the start of an amazing journey.

The NHS Graduate Management Training Scheme has moved up the prestigious Times Top 100 Graduate Employers ranking, from 4th place in 2020 to 3rd in 2021. Earlier this year, the Scheme won ‘Graduate Employer of Choice’ in the General Management category, at The Times Graduate Recruitment Awards 2021.

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Finance trainee Kofi Madden joined GMTS in 2019 and has gained some remarkable experiences while on placement.

Kofi's first placement at St Helens & Knowsley NHS Trust was severely disrupted due to Covid-19, but Kofi was quickly given responsibility at the start of the pandemic.

During the first wave, Kofi managed Whiston Hospital's PPE store, including rationing and distributing millions of items of PPE stock throughout the hospital, external sites and office locations.

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This job moved very quickly, starting with no reporting to lots of reporting, managing over a million items of stock, a full warehouse stacked from floor to ceiling. At one time Kofi was working six or seven days a week, driving to the hospital with no-one on the roads, but the hospital was very busy tackling Covid.

Kofi said: "We were able to provide a delivery service not only to the wards but external sites and support services in offices. I made sure I met at least one person from every ward in the hospital and let them know about the service.

"I went from first six months of being a trainee, to the next six months taking responsibility of a job no-one has done before, working with the Head of Procurement and reporting to executives. I remember one time I got a phone call saying the British Army are downstairs, reporting into me to deliver PPE! We whittled it down from seven days a week to five days a week once the national situation had calmed down by managing the stock carefully.

"It was a massive change, but it was down to the Head of Procurement giving me the responsibility, they were a great support, showed me great leadership, he wouldn't delegate anything he wouldn't be willing to do himself."

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In addition to the finance placement and Covid challenges, Kofi completed a two-month flexi placement with Mersey Care. During this two-month placement, Kofi developed capacity and demand management tools for the eating disorder, psychology and autism services.

Kofi utilised and modified tools originally introduced by an external developer and implemented these into services teams processes, whilst building relationships across different departments.

The data output found that some departments were relying on trainees and others were losing hours unaccounted for. This resulted in departments identifying practical changes via reporting from the tools.

"I learned how intricate the model could get with the service, you could get down to the level of detail of how much time people spent for example writing letters or travelling, or how many clinics people could do in a week - a lot more detailed than I first realised.

"I really enjoyed learning the new skill, and my manager held my hand at the start, by the second meeting let me take the lead, and by the third round of meetings he let me loose, I ran with it and took responsibility."

Kofi has learned a lot from placements and education elements of GMTS.

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Finance trainees complete a CIPFA qualification but also modules from the Elizabeth Garret Anderson (EGA) programme.

"I now know the importance of leadership styles and how teams can be effective from the EGA - I didn't realise it at the time, but now I do.

Sometimes it can be difficult to make that connection especially in the finance specialism. It was also difficult because I was returning to education after full-time work but got there in the end."

GMTS has a strong reputation throughout the NHS and Kofi was given an important piece of advice early on in his first placement.

"One CEO said to me 'the scheme can give you the keys to the NHS and it's up to you to use them'. This gives you the realisation that once you speak with the right people, they will let you see as much as possible.

"It's not until you get into the organisations that you get to realise you do actually get the chance to have the keys, have a look at everything that's going on and get such a well-rounded view of the NHS." Having the 'keys to the NHS' doesn't cover absolutely everything - one evening Kofi got his car locked in the hospital car park at the end of the first week, the car was stuck for the whole weekend - keys to the car park may have been more useful on that day!

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"At least I was able to get to know security staff at the hospital! And getting to know people in the hospital and departments really helps, for example the housekeepers in the wards became friends as they got to know me while distributing PPE." And a final piece of advice Kofi would give to new graduates joining the scheme: "It's hard to prepare someone for what the scheme is, treat as a good experience, get involved, grasp opportunities and enjoy yourself!"

Find out more about hosting a trainee, providing a flexiplacement for trainees or joining the scheme as a graduate.

NHS Graduate Management Training Scheme | NHS North West Leadership Academy (nwacademy.nhs.uk)

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Finance trainee Lucy Matthews graduated from GMTS in 2021 and found the experience extremely rewarding.

At the start of the scheme Lucy was excited, although a little nervous.

Lucy completed a physics degree before starting the scheme, so many of the finance elements were brand new.

One of Lucy's highlights looking back at GMTS is how she has grown as a person, developing leadership skills and learning how finance departments play a vital role in patient outcomes.

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GMTS trainees complete an orientation period before starting their first placement which often includes exposure to senior meetings, shadowing staff in different departments and meeting teams across the host organisation.

"The orientation gave me a really good grounding and almost a newfound appreciation for the NHS. I’ve always felt that the NHS is an amazing organisation, that’s why I wanted to work for it, however the orientation gave me an even greater appreciation for all that goes on behind the scenes.

"My first placement was with in an acute trust in financial services, this gave me a really good grounding into NHS finance, I was able to gain an understanding how hospitals work. I was given a clinical buddy, she would take me on walk rounds every few months, so I could see different areas of the hospital and explain things to me.

"I completed my two-month flexi-placement at a large consulting organisation in Healthcare Consulting which allowed me to develop skills different to what I had done in my first placement, such as programme management and business case writing. It allowed me to view the NHS from a different perspective and felt it was a unique experience, one I really valued.

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"My second placement was at a community and mental health trust in management accounts, so a completely different type of placement, but I really found my feet in this placement."

The scheme can be very demanding, especially in the finance specialism and this provided Lucy with lots of challenges.

"I think studying to become a a chartered accountant, completing competencies, working full-time - juggling all that is hard work, but it does pay off in the end.

"The support is great - programme and placement managers and the trainee support manager Kelly helped me throughout. I could talk through things, they were really good at giving advice and helped me find my own answers, so I became more independent. The support you get on the scheme is brilliant."

Lucy also recommended support communities across the NHS, including Future-Focused Finance, a national programme to support staff and engage everyone in improving NHS finance. The programme facilitates networking, sharing ideas and learning, bringing finance and clinical or other non-finance colleagues together.

Find out more about hosting a trainee, providing a flexi-placement for trainees or joining the scheme as a graduate.

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Adam Beattie began his GMTS experience with a whirlwind orientation at Liverpool Heart & Chest Hospital.

GMTS trainees complete a 20-day orientation plan before starting their first placement to provide a broad overview of the NHS and wider healthcare system through the lens of their host organisation.

Activities can include meeting senior leaders, working with carers and partner organisations, learning how services are delivered and organisations operate.

Adam said: "I really enjoyed having interactions with patients. For example, I spent time with rapid response nurses, they were really friendly and nice to get to know them at the end of my first week.

"The cardiac rehabilitation class was also really interesting. Once a patient has had surgery, the community team takes them on and gets their health level back on track. It was really good to see the whole spectrum and talk to patients about their experience."

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In addition to meeting clinical and patient facing teams, Adam met with senior staff at Liverpool Heart & Chest Hospital Foundation Trust.

"I got to meet the chief executive who was brilliant, we chatted about all sorts of things, including personal management philosophy and thinking about what type of manager I want to be, but it was quite informal.

"I had meetings with other executives too and each had their own perspectives and personalities, it was nice to speak to different types of people and hear their insights."

Other activities included shadowing outpatients, patient flow, therapies services and learning about physiotherapy.

"I spent a full day with the physios, I didn't realise how much that encompassed. Before I thought the role of a physio was one thing, but actually was completely different than what I expected and so much more.

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A"I met various people, from those managing referrals and scheduling outpatients, to spending time with PA's and co-ordinators, through to following the patients, it was really interesting."

Starting the GMTS scheme can be daunting, but Adam gave advice to other trainees starting the scheme and orientation activities to help overcome any nerves.

"Before orientation, I had questions ready beforehand and tried to be as inquisitive as possible. The biggest challenge was having the confidence to meet so many people I've never met before and make the most out of each situation. It was intense, at the end of each day I was happy but ready to relax - I slept well each night!"

It may sound daunting, but Adam advises future graduates to enjoy all experiences, even during the application and recruitment process.

"My advice to applicants is to be yourself, enjoy it and do what you would naturally do. For example, in the assessment centre, we were asked to bring what you did during Covid to keep you busy. I did a wine course, so I took a wine book to show how much I'd learned about wine! It got a laugh and helped me feel more comfortable during the assessment centre."

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Being ready to learn, listen and make contacts was a big benefit of Adam's orientation.

"I met people during orientation that I am now working with in my placement, for example I met people in Radiology and Quality Improvement which helped understanding and allowed me to reach out for collaboration when I began my role.”

"I'd also advise trainees to look at their competencies before orientation as it can help give ideas how to achieve them with the people you meet during orientation."

Following the orientation, Adam moved to his first full time placement working on new projects, appreciating the support of new colleagues and enjoying a positive working environment at Liverpool Heart and Chest Hospital.

Find out more about hosting a trainee, providing a flexi-placement for trainees or joining the scheme as a graduate.

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Northamptonshire Healthcare NHS Foundation Trust and the University Hospital of Leicester are the home of our East Midlands HUB. IHSCM Membership is growing for our newest Regional HUB. and we are looking forward to an eventful 2022!

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St Helens and Knowsley Teaching Hospitals make up the IHSCM North West Regional HUB. We currently have hundreds of members across this trust and have started planning some exciting in person events at this HUB for 2022!

We look forward to hearing more about this trust in the next magazine edition.

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Devon Integrated Care System is the home for IHSCM South West Regional HUB. The Integrated Care System for Devon (ICSD) is a partnership of health and social care organisations working together with local communities across Devon, Plymouth and Torbay to improve people’s health, wellbeing and care.

We have many exciting events planned for 2022 and we look forward to hearing more from our newest hub in the next edition.

Williams Medical Supplies in Wales is our Primary Care HUB. We have worked with Williams for the past year and have helped to facilitate some of their great events. Williams Medical Supplies Ltd is a Wales-based manufacturer and retailer of medical products to the primary care and secondary care markets. It is the largest supplier to general practice in the United Kingdom with a portfolio of products ranging from surgical instruments to pharmaceuticals.

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May 2022

Health, Education and Improvement Wales makes up the IHSCM Wales Country HUB. HEIW have a leading role in the education, training, development and shaping of the healthcare workforce in Wales. Ensuring we have the right staff, with the right skills, to deliver world-class healthcare to the people of Wales both now and in the future.

Established in 2018 as a Special Health Authority HEIW sit alongside health boards and trusts as part of NHS Wales.

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At Hampshire Care Association, the goal is to ensure that care provision in Hampshire is of the highest standard and quality and that those requiring care receive it with dignity and compassion.

HCA membership consists of care providers of Residential, Domiciliary, Nursing, Learning Difficulty and Mental Health homes.

HCA work with: Hampshire County Council (HCC) Portsmouth City Council (PCC) Southampton City Council (SCC) HCA also continue to negotiate passionately with all of the above for a Fair Price for Care.

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The West Midlands Care Association has been the voice of the care industry within the region for over twenty years. The Association offers the crucial support care providers require to deliver sustainable excellence within community, nursing, special needs and residential home settings.

The Association offers the crucial support Care providers require to deliver sustainable excellence within community, nursing, special needs and residential home settings.

Most services are delivered by the dedicated team at the Association office with support from our board members (Executive Team and Board Members) A raft of far-ranging services enables members to spend more hours doing what they do best - care - while we carry out essential, timeconsuming tasks necessary for CQC compliance and business

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Arden has a proud heritage in flexible learning. We’ve grown and evolved from our beginnings in 1990 as the chosen online learning partner for universities across Britain, to offer a new kind of learning experience, providing both online and blended learning that meets the changing needs of modern life.

Today, we offer more than 70 degree courses, many of which are accredited by leading professional bodies such as the British Psychological Society, the Chartered Management Institute, the Chartered Institute of Marketing, the Agency for Public Health Education Accreditation, and more.

We strive to do things differently, and believe in doing things better.

With study centres across the UK in Manchester, Birmingham, London, and Leeds, as well as in Berlin, Germany, we offer our students the chance to gain life-changing degree qualifications no matter their background or personal circumstances.

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Operational since March 2012, the London campus has become a key part of the UWTSD Group. Ideally located within the centre of one of the world’s most famous capitals, students are able to widely benefit from all that the city has to offer.

Studying at UWTSD London creates a unique experience combining the University’s nearly 200 years of academic learning with inspiring and innovative teaching and learning environment.

The London campus boasts a wide range of computing, business management, accounting, and health and social care courses.

Featuring undergraduate courses such as BA (Hons) Business Management, BSc (Hons) Applied Computing as well as the Certificate of Higher Education: Skills for the Workplace and Skills for the Workplace (Health and Social Care) programmes.

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The Loop Magazine We hope that you have enjoyed the very first edition of the IHSCM Regional HUB Magazine. We also produce a magazine that is accessible to all members quarterly. To view the latest edition and previous editions please click on the image below or here - Magazine – IHSCM (ihm.org.uk)

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IHSCM Regional HUB Magazine May 2022

Bringing our Regional HUB Network closer, sharing your stories and achievements.