Regional HUB Magazine Issue 3

IHSCM Regional HUB Magazine July 2022

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

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Contents 3. Message from CEO Jon Wilks 4. WMS Intro 5. WMS Connecting Patients Improving Outcomes 11. West Midlands Intro 12. West Midlands - Developing a Research Ready Allied Health Profession Workforce: Where Should the Conversation Start 18. West Midlands - Developing Leaders Within the Allied Health Professions 24. West Midlands - How Does Speech and Language Therapy Contribute to Public Health 30. West Midlands - Integrated Care Systems - Are the Allied Health Professions Fully Informed 36. West Midlands - Staff Satisfaction Surveys - Friend or Foe 44. West Midlands - The Importance of Leadership Training at Undergraduate Level for Allied Health Professionals 53. West Midlands - Using Reflexivity to Optimise Teamwork 62. GMTS Intro 63. East Midlands HUB Intro 64. North West HUB Intro 65. London HUB Intro 66. South West HUB Intro 67. Wales Country HUB HEIW Intro 68. South East Care HUB Intro 69. West Midlands Care HUB Intro 70. West Midlands Education HUB Arden University Intro 71. London Education HUB University Trinity Saint David London Intro 72. IHSCM 'The Loop' Quarterly Magazine

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CEO Jon Wilks Message

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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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CONNECTING PATIENTS, IMPROVING OUTCOMES Editor : Tim Jarrett Organisation : WMS As UK healthcare moves on from the challenges of Covid 19, there are huge opportunities to introduce new ways of working. For more than 30 years, Williams Medical Supplies has partnered with our friends across primary care to ensure that they have access to the latest in diagnostic equipment. To support this even further, we’re now developing a range of Connected Health products.

A driving ethos of our new range is to enable patients to be more in control of their conditions. This is particularly important for those who are able to make appropriate choices by adjusting their lifestyles in ways that suit them.

A great case in point can be found within diabetic patients, particularly those with Type 2 diabetes. The NHS expends a huge amount of energy and spends multiple billions of pounds annually treating what in many cases are wholly preventable complications.

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Williams is delighted to have partnered with Dario Health to introduce their growing range of diagnostic equipment to the UK market.

The first element of the Dario range widely available in the UK is their All-In-One glucose meter. In contrast to traditional glucose monitors (which are often bulky, require batteries or recharging and are often accompanied by a range of paraphernalia such as lancets and strips which all need to be carried), the All-In-One offers a convenient package no larger than a highlighter pen!

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At either end of the device are the strips and built-in lancing device, in the middle is the compact Dario meter – designed to plug in directly to an Android (USB-C) or iPhone (lighting connector). No pairing is required as happens with Bluetooth devices, and training is the matter of seconds. As soon as the meter is plugged in to the phone, the Dario App will launch with clear prompts to insert a strip, apply a small drop of blood after which the reading is given in no more than a few seconds.

The device is extremely popular with younger users and importantly has proven results. Coupled with the healthy lifestyle guidance that the App provides via notifications and email ‘nudges’ and consultation with appropriate healthcare professionals, the results are impressive:

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Improving Patient Outcomes - Notes and References eA1C Ref: Decrease in estimated A1c for people in high-risk over a full year of users monitoring with a digital diabetes management system ADA 2028 Hyperglycaemic events 20% Ref: T2D Users of a Digital Diabetes Management System Experience a Shift from Greater than 180 mg/dL to Normal Glucose Levels with Sustainable Results ADA 2020 10% In-range readings Ref: T2D Users of a Digital Diabetes Management System Experience an Increase of In-Range Glucose Levels Linked to App Engagement ADA 2019 67% drop in severe hyperglycemic events (BG>400mg/dL) Ref: Impact of Digital Management on Clinical Outcome in Patients with Chronic Conditions: Diabetes and Hypertension ADCES 2020.

Whilst allowing individual patients to monitor their own levels, the power of the Dario All-In-One Meter and App can be multiplied by using the Dario Engage platform. Written with care-providers in mind, this online portal allows patients to be monitored as a group, providing insights that are not normally available from patients who choose to record their activities in a traditional diary.

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The dashboard system allows patients who are showing increased levels or who are not measuring regularly to be identified and contacted – saving healthcare professionals time and improving outcomes by focusing on those most needing support with their condition.

We’d love to arrange a demonstration for you. If you’re interested, please contact me directly at tim.jarrett@wms.co.uk and I’ll reach out to you.

Over the next few months, we’ll be focusing on other conditions where our Connected Health range can support you and your colleagues, so watch out for more here soon!

Tim Tim Jarrett is the Head of Medical Services at Williams Medical Supplies.

As well as manging a team that provide annual test and calibration and health & safety services to GP surgeries across the UK, he’s also responsible for identifying areas where technology can help providers deliver care more efficiently.

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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 over 500 members and growing across our West Midlands HUB

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Developing a Research Ready Allied Health Profession Workforce: where should the conversation start?

Authors: Dr Nicky Eddison and Dr Ros Leslie Trust: RWT The publication of Health Education England’s Research and Innovation strategy for Allied Health Professions (AHPs)1 in January 2022 has been seen as a real opportunity for transformational change in AHP research and innovation, reputation, influence and impact on services. At the Royal Wolverhampton NHS Trust, we have considered how best to embed this strategy within our services. As a result, we have developed a “Community of Research Practice (CORP)” which is a multi-disciplinary initiative creating a network open to all staff regardless of grade or experience, to bring people together to discuss the research and innovation happening within the Trust. An integral part of CORP is the quarterly seminars which provide a forum for sharing research experiences, findings, and outcomes, with discussion and enquiry beyond one speciality and across the organisation.

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To give staff an opportunity to be involved in research projects we have launched a dedicated “Research Hub” led by a team of experienced researchers in collaboration with Staffordshire University.

The hub invites AHPs and support workers of all grades and experience to join a research project as a full member of the team and learn new skills.

Alongside these initiatives the Trust has a range of short educational sessions to upskill our staff and give them the confidence to engage with research, including critiquing research papers, referencing, systematic reviews, searching research databases and writing for publication. The Trust also has a dedicated team of experienced researchers who lead “Critically Appraised Topics” which all staff are welcome to get involved in.

All of these help to build an infrastructure to support staff engaging in research, but we still need to explore how we engage them in the first instance. How do we remove a self-imposed fear of research? The “R” word appears to elicit fear and negativity, a belief that “research is for other people”.

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Yet it is not only for everyone, but it is also a core pillar of practice for AHPs. All Health and Care Professions Council (HCPC) registered professionals are required to engage with research as demonstrated by the HCPC’s standards of proficiency for AHPs, which include the following requirements2 ·be aware of the principles and applications of scientific enquiry, including the evaluation of treatment efficacy and the research process. ·be able to use research, reasoning, and problem-solving skills to determine appropriate actions. ·recognise the value of research to the critical evaluation of practice be aware of a range of research methodologies. ·be aware of a range of research methodologies. ·be able to evaluate research and other evidence to inform their own practice.

These standards are different to the Nursing & Midwifery Council (NMC) standards which do not specify research engagement, only stating that a registered nurse will be able to “demonstrate an understanding of research methods, ethics and governance in order to critically analyse, safely use, share and apply research findings to promote and inform best nursing practice”.

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It has been suggested that the difference in the professional registration standards may be a factor in the National Institute for Health Research (NIHR) research funding application rates and successful awards, as, although AHPs are a smaller professional group, they have submitted more high-quality applications than their nursing and midwifery colleagues.

To start to break down the barriers to research and the negative connotation the word elicits it’s important to recognise that clinicians already regularly apply the skills necessary for research in their everyday practice by critically questioning and appraising care, getting involved in audits, quality improvement and service evaluation2. We need to recognise, encourage, and celebrate these skills as they are essential to engaging staff in research and building their confidence to enable them to progress and potentially become research active.

One of the ways to start the conversation around “research readiness” is to adopt the “The Clinicians’ Skills, Capability, and Organisational Research Readiness (SCORR) Tool”2 during annual appraisals. This tool has already been successfully introduced at the Leeds Teaching Hospitals NHS Trust. The tool provides the opportunity to recognise and celebrate the skills staff are already demonstrating,

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acknowledging that these early skills are essential for progressing through their research career.It provides an opportunity for staff to reflect on whether they are meeting the HCPC standards of proficiency and gives an opportunity to offer support where required.

Most importantly, it could be the first step to normalising the conversation around research and reiterating the message that research is for everyone and engaging in research is just as important as being “research active” and producing research.

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References 1.

Health Education England. Allied Health Professions ’ Research and Innovation Strategy for England.; 2022. https://www.hee.nhs.uk/our-work/allied-health-professions/enableworkforce/allied-health-professions’-research-innovation-strategyengland 2.

Iles-Smith H, Burnett C, Ross DH, Siddle HJ. The clinicians’ skills, capability, and organisational research readiness (SCORR) tool. Int J Pract Learn Heal Soc Care. 2019;7(2):57-68. doi:10.18552/ijpblhsc.v7i2.644 3.

Future Nurse : Standards of Proficiency for Registered Nurses.; 2018.

Dr Nicky Eddison is an Associate Professor Dr Ros Leslie is the Non-Medical Research and AHP Research Lead.

Lead and Chief AHP

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Developing leaders within the Allied Health Professions Authors: Dr Nicky Eddison and Vicki Gardner Trust: RWT There are approximately 170,000 allied health professionals (AHPs) working within the NHS, accumulating over four million patient contacts per week1.The prime position of AHPs within healthcare, working across organisational boundaries, makes them integral to most clinical pathways. There has been a realisation that there is an abundance of underutilised talent within this group. Which needs to be utilised if the NHS is to meet its long term plan. The Chief Allied Health Professions Officer in England and the wider team have had a significant impact in raising the profile of AHPs over recent years. Giving them a sense of collective identity and position within the workforce. Inspiring AHPs to re-think how they deliver their services, whilst shining a light on the importance and scale of the work they do. With the launch of the first strategy in 2017, which identified the transformative potential of AHPs3.A plethora of AHP centric guidance and strategies followed, focusing on public health, research, and leadership culminating with the recently published AHP strategy for 2022-2027, which states it is crucial that AHPs build the diversity of their leadership and step into these roles.

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Leadership Great leaders are pivotal to delivering high-quality care. Hospital performance and the quality of care service users receive are all influenced by the quality of its leadership. Recently we have seen the emergence of advanced clinical roles for AHPs, including, advanced clinical practitioners, first contact practitioners and consultant posts.

From a strategic viewpoint, we have seen the introduction of the Chief AHP role which has further engaged the AHP workforce, highlighting its value and contribution. However, successful outcomes will not be solely reliant on these senior roles, it will depend on effective leadership across all levels and across the entire AHP workforce.

Leadership is not the dominion of the most senior staff, there is an increasing recognition that all employees need to show some level of leadership.

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This is where AHPs can learn from the nursing profession, which has benefited from a more vigorous approach to striving toward leadership progression. Historically nurses have been encouraged and incentivised to develop their leadership skills, and move into non-traditional leadership positions, unlike AHPs. Consequently, the nursing profession continued to expand its leadership, resulting in recruitment to NHS board level positions. It is now a requirement for Foundation Trusts to have a director of nursing role. This is a fantastic achievement by our nursing colleagues considering it wasn’t too long ago that nursing leadership in the UK was described as a ‘crisis’.

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Similar to what nurses experienced when they began transitioning into senior leadership roles, it has been suggested that AHPs may experience reluctance to let go of their prior identity and credibility as clinical practitioners, which may be a barrier to their leadership progression. This is where leadership training is essential, to develop our AHP workforce and equip them with the confidence and skills required. Owing to the fact that we need more of our AHPs to step forward as leaders, helping us create professionally diverse leadership teams, which are best equipped to meet the challenges and ambitions of the NHS7.

The Royal Wolverhampton NHS Trust (RWT) has a suite of leadership training available for staff. This article is going to focus on the innovative and popular ‘Action Centred leadership’ programme.

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

Vicki Gardner is the Practice Education Facilitator for post registration staff.

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Action Centred Leadership training.

RWT has been running the Action Centred Leadership (ACL) programme since 2014 and it is open to all staff, regardless of position or grade, reiterating the value that leadership is for everyone.

ACL is a leadership model developed by Professor John Adair; it has been used continuously since its development in 1962. The model is practical, easy to remember, apply, and adapt to your own situation.

The model focuses on three circles (1) The Task (2) The Team (3) The individual, and how these interact and affect one another.

The Team Leader level forms the basis of ACL training programmes and deals with the fundamental leadership functions which any leader, regardless of position, needs to apply.

The training program is a mix of participative and practical learning, using a variety of methods, small group discussion, plenary discussion, exercises, and case studies. The programme is delivered by both nursing and AHP staff.

At the end of the 2-day programme the participants will: Explore leadership theory and ACL Be able to describe the three-circles model and its application in the work environment Describe the functions of leadership and the role of the leader Examine other satellite theories of leadership and ACL Review their role as a leader and their leadership behaviours Develop an action plan to take back to their work situation

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To quote Professor Adair “I must hold the record for expounding the three circles, but I still love doing it. Why? Because of the simplicity, power, truth and beauty of the model, and its eternal relevance in every situation and at every level” The success of the programme Over 700 staff have completed the 2-day program at RWT since its inception. 98% of whom rated the training as excellent!

If you would like to book on to the ACL course or find out more, please contact Vicki Gardner at vicki.gardner1@nhs.net

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How does Speech and Language Therapy contribute to public health?

Editor: Joanna Williams and Dr Nicky Eddison Trust: RWT We should all have the same opportunities to lead a healthy life, no matter who we are or where we live. However, wider determinants such as housing, the environment, access to fresh food, education and income all influence our health. As such, health inequalities exist and have a significant impact on the health of large groups of people.

“If you’re born poor you will die on average nine years earlier than others” .

To help tackle these large scale inequalities we must ensure that public health is everyone’s business and that includes our Allied Health services which are in a prime position to influence public health.

Speech and language barriers for young children can create difficulties as they move through the education system and into adulthood.

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At the age of five years, children from low-income families have half the vocabulary of high-income families and this continues to grow at each stage of education. In Wolverhampton, 27.1% of children live in income deprived households.

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The Black Country Early Outcomes Project The ‘Early Outcomes’ project was a year-long project beginning in August 2019, funded by the Department for Education. The Royal Wolverhampton NHS Trust (RWT) was one of four Trusts who were successful in their bid to be part of this initiative. Joanna Williams, a highly specialist speech and language therapist at RWT was a member of the project team.

The project had three main aims: ·To eradicate silo working: to create networks of teams, enabling shared learning and cross-professional multi-disciplinary teams (MDT).

To establish best practices and link up with health visitors. ·To upskill the early years' workforce:the aim was to improve practitioners’ knowledge of speech, language, and communication development. The training focused on how to identify speech, language, and communication needs and how and when to make an appropriate referral to specialist speech and language services. It also provided strategies and interventions to support children and empower parents to support their child in the home environment.

Since the project ended, work has continued establishing the use of a robust and consistent screening tool across Wolverhampton. The screening tool is currently in place in Walsall and Sandwell.

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·To improve school readiness and good level of development (GLD) for children across the Black Country: GLD is a performance measure used at the end of the reception year, it is a measure of attainment, not progress. Children are defined as having reached a Good Level of Development at the end of the ‘early years foundation stage’ if they have achieved at least the expected level of development for the Early Learning Goals in the prime and specific areas of learning. This helps professionals and parents to understand broadly what a child can do in relation to national expectations and identify any delays where additional support may be required.

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Project outcomes The project delivered serval important outcomes including a range of resources for children, families, and practitioners, including: ·The development of a series of activity packs: these packs have been designed for parents and carers and are available via the Black Country Early Outcomes Website and have been shared amongst members of the MDT at universal, targeted and specialist levels, with distribution widely encouraged. Feedback from parents and caregivers has continued to be positive ·An Early Outcomes Pack: this pack is intended to be a reference document for practitioners with ideas to share with parents and caregivers, and includes information on attachment and bonding, social and emotional development, and ideas for activities for children 0-5 years. This pack has been distributed to every Early Years Setting across the Black Country and is referenced by speech and language therapists, early years and childcare development officers at setting visits. ·An information pack for parent volunteers: this pack includes information on the ages and stages of language development and tips for supporting language development in the home. Parent volunteers are offered training which enables them to cascade the information to identified families as part of their role.

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Where can these resources be accessed?

All the resources from this project are readily available via a dedicated website at http://www.blackcountryearlyoutcomes.co.uk/. The website has continued to be updated since the launch and new resources are added as they are developed.

The “Early outcomes project” is a fantastic example of how speech and language therapy can contribute to public health via population-level initiatives with the aim of reducing avoidable health inequalities amongst children living in the Black Country. Improving standards and outcomes and addressing weaknesses around speech, language, and communication.

Joanna Williams is a highly specialist Speech and Language Therapist

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

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Integrated Care Systems – Are Allied Health Professionals fully informed?

Author:Dr Nicky Eddison and Dr Ros Leslie Trust : RWT Providing episodic treatment for acute illness, dictated by a medical model, is not a sustainable healthcare model. The NHS must provide collaborative and proactive support for a growing and ageing population and people living with complex needs who receive care and support from a variety of health and social care professionals.

Reducing barriers between services and focusing on population health and wellbeing. Thus, instead of working independently every part of the NHS, public health and social care system will need to seek ways to connect, communicate and collaborate so that health and care needs are met.

NHS England’s plan to implement integrated care through partnerships between the NHS and local authorities (Sustainability and Transformation Partnerships (STPs)) has already seen the development of the first “Integrated Care System” (ICS).

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The Health and Care Bill will put ICSs on a statutory footing from July 2022, with the ultimate aim of every part of England being covered by an ICS by 2029. Working together is the organising principle of these systems, to ensure integrated care between hospitals and communitybased settings, mental health, and social care. Thereby reducing competition, creating shared leadership and action, and encouraging collaboration to meet the health and care needs across an area. With the ultimate aim to impact population health, prevent ill health, tackle wider determinants of health and reduce inequalities between different groups.

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The success of the ICS model relies on collaboration between and across groups throughout the healthcare spectrum.

How informed are Allied Health Professionals on the impending Integrated Care Systems?

With more than four million patient contacts every week4, working across organisational boundaries and providing patient-centred high-quality care means the work Allied Health Professionals (AHPs) do is integral to most clinical pathways, and are key to providing integrated care. Thus, it is essential that AHPs understand ICSs, the impact they have on services and what AHPs can do locally and nationally to help shape them. AHPs would, therefore, welcome guidance and information from the professional bodies. Discussions with the AHP leads at the Royal Wolverhampton NHS Trust (RWT) indicate that either the engagement of AHP professional bodies with their members has been lacking, or members are not aware that advice and guidance exists.

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Physiotherapists appear to be well informed by their professional body, the Chartered Society of Physiotherapy (CSP), has used its media platforms to inform members. CSP regional groups have also provided a wealth of information to members through a series of webinars.

Likewise, the Royal College of Speech and Language Therapy has provided its members with a summary document that describes the implications of ICSs and the opportunities for Speech and Language Therapists. Finally, the Association of Ambulance Chief Executives (AACE) have consulted all the ambulances services regarding ICS, producing a document that describes an organisational response to the NHSEI consultation on Integrated Care Systems. This document does not, however, encompass all Paramedics working outside of the Ambulance Service and the Paramedics at RWT are not aware of any information coming forth from The College of Paramedics.

Interestingly, in January 2019, The Chief Allied Health Professions Officer looked at the NHS Long Term Plan and what it means for AHPs, in a blog8 and advised that, by working with colleagues across health and care, AHP leaders would identify how best to support Integrated Care Systems. Since then, we have seen the rapid growth and development of AHP Councils to support the new ICSs by providing a hub of AHP expertise and advice and raising the profile of the AHP workforce to maximise their contribution to transformed health and care service.

Perhaps AHP Councils should do more to facilitate communication within partner organisations and with AHPs at their place and local level.

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AHP Councils and the professional bodies must do more to empower a strong AHP voice within the ICS structures as system-wide integrated care must involve AHPs working collaboratively across multiple sites and as part of multidisciplinary teams. It is essential, therefore, that the AHP professional bodies and councils effectively engage with their members and advise them of the opportunities that ICSs present. A lack of oversight or guidance to date has meant that, for many AHPs, there has been no clear sense of what their contribution or responsibilities should be.

The time for engaging with everyone who will play a role in ICSs is now.

In order to ensure our health service is sustainable over the coming years, we must unleash the insight and brilliance of our AHP workforce4, with their wealth of knowledge and expertise they must be part of the conversation, but they can only do this if they are fully informed and know their value

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

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

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Staff satisfaction surveys – friend or foe?

Author: Dr Ros Leslie, Dr Nicky Eddison, Gail Parry Trust: RWT Surveys are generally considered an effective tool to understand the concerns of employees1, especially during the recent challenging times.

Conducting employee surveys gives staff an opportunity to share their feelings and highlight problems that might otherwise remain hidden.

When done correctly, surveys can provide critical data that can be used to influence organisational culture, by making positive changes based on survey feedback. Staff, in turn, feel valued and respected2. Positive staff engagement has been linked to reduced staff turnover, lower sickness absence and improved patient experience.

The National Health Service (NHS) is the United Kingdom’s largest employer and is dependent on an engaged, properly resourced workforce to cope with ever rising demand. The NHS staff survey provides a national and local picture of how our NHS people experience their working lives, gives staff a voice, and provides the data organisations need to improve employee engagement and experience, and ultimately improve patient care2. It is one of the largest workforce surveys in the world and has been running every year since 2003.

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Approximately 600,000 of our 1,370,991 NHS people take part in the NHS staff survey. And, being an official national statistic, the survey data is considered to meet the highest standards of trustworthiness, quality, and value.

NHS England (now NHS England and NHS Improvement) took ownership of the NHS staff survey from the Department of Health in April 2013. The survey has undergone a significant refresh, and now the 2021 results are reported against the seven ‘People Promise’ elements and two themes (Staff engagement and Morale)4. The People Promise sets out what is important in the working lives of our NHS people, such as health and wellbeing, flexible working, and feeling we all belong, whatever our background or job role. The survey results are used by individual organisations and at a system, regional and national level and will be used to see what progress has been made on the People Promise.

Although the highest response rate since 2018, only 38 per cent of staff at the Royal Wolverhampton NHS Trust (RWT) completed the 2021 NHS staff survey.

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The reasons staff choose not to complete surveys are multi-factorial and include not having a strong opinion either positive or negative, believing they don’t have anything that needs to be heard, and concerns about confidentiality.

We need to change the narrative around completing staff surveys and communicating opinions, concerns, and compliments in general.

Surveys are not the enemy. For the organisation to grow, learn and improve we must enable staff and service users to communicate their feelings. The NHS staff survey is an important medium to collect data on how staff feel.

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The results of the 2021 NHS survey undertaken by staff at RWT demonstrate improvements in many areas, however, they also highlighted concerns around bullying and harassment being higher than the national average. This is something the Trust is taking extremely seriously and addressing through various workstreams including the Equality, Diversity and Inclusion delivery plan (incorporating the Race Code action plan), the ‘Zero Tolerance’ to racism campaign, the Civility and Respect programme and ‘Freedom to Speak up Guardian’ processes. The Civility and Respect programme will provide an opportunity to hear from staff about ways in which they are being civil and respectful and how they can start to build this into their cultures and practice within their teams.

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The Trust will share several tools including a bite-sized introductory workshop, alongside several videos and materials focusing on civility and respect. It is hoped the campaign will help to reduce the number of staff experiencing bullying and harassment and instances of discrimination and improve overall morale and motivation.

RWT has a Staff Survey Oversight Group (SSOG), which meets monthly and has been established to support discussion around staff survey results. It provides an opportunity to share experience and good practice across divisions and directorates and ultimately to ensure that relevant actions are being taken.

It is unlikely, however, that once-a-year engagement surveys are sufficient to explore the morale in the workplace year-round and therefore, continual assessment is needed6. RWT recognises the importance of providing other channels of communication, to enable staff to share their views and concerns. The organisation has recently introduced ‘meet the execs’ sessions which enable all staff to have access to the Trust’s executive board, providing an opportunity to ask questions and learn more about the executive team. The Chief Nurse has recently started ‘Tea with Ann-Marie’, informal drop-in-sessions giving staff the opportunity to raise concerns directly to the Chief Nurse. The Chief AHP is also planning to launch a similar initiative in the near future.

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RWT has made a commitment to improving staff experience as a key element of improving care, therefore staff engagement will be a continuing focus rather than a short-term goal. This forms part of a wider culture change which will need to be embedded within the organisation.

Key factors to ensure success include7: ·High-profile and sustained support from the board and senior leaders ·Support for line managers to foster engagement ·Visible senior leadership support for staff engagement ·Two-way communication ·Working with equality networks to get views from a range of staff ·Use of surveys, online forums, and face-to-face staff engagement sessions ·Recognition of staff achievements ·Using data from a range of sources to inform action ·Working in partnership with staff side councils and trade unions

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It is essential for staff engagement to start with the individual; therefore, staff need to feel engaged within their team. Approaches from the most improved organisations included team development programmes to support individuals to work more effectively and line managers to lead in an engaging way. At RWT staff engagement sits within the scope of the Organisation Development Lead, including overseeing the national and quarterly surveys.

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The surveys are seen as an ongoing continuous plan, and rather than trying to do new action plans every year, managers are being asked to review goals and objectives from previous action plans and assess if improvement has been made, with the aim of making the improvements that count. They are being advised to CONTINUE to do the things that are making a real difference and seeing positive changes and to STOP doing the things that are not working.Also, START something that they have not done before, that way, managers will be making plans with their team. Hopefully, staff will then begin to see the outcomes from the survey and will feel involved in making local plans and sharing team goals.

Dr Ros Leslie is the NonMedical Research Lead and Chief AHP Dr Nicky Eddison is an Associate Professor and AHP Research Lead.

Gail Parry is the Organisation Development Lead

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The importance of leadership training at undergraduate level for Allied Health Professionals Author : Dr Nicky Eddison, Dr Ros Leslie, Alice Banner and James Smith Trust : RWT The NHS needs great leaders at every level to ensure it delivers high quality care. The performance of hospitals and the quality of care service users receive are all influenced by the quality of its leadership. The NHS long term plan sets out to strengthen and support good, compassionate and diverse leadership at all levels.

Leadership is not the dominion of the most senior staff, there is an increasing recognition that all employees need to be leaders. Thus, leaders come in many different forms and can operate at any level.

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Given the importance of leadership to enable the health service to thrive, the NHS has developed several models of leadership including the Clinical Leadership Competency Framework model5 and The NHS Leadership Academy’s Healthcare Leadership Model. The aim is to build leadership awareness and capability in undergraduate training programmes5. Too often the NHS focuses solely on the clinical development of employees, once they excel clinically, they are naturally promoted to a management/leadership role in the unsubstantiated belief that someone who excels clinically will excel as a leader, in reality, management and leadership require a completely different skill set. Often, the change from a clinical position to a management position occurs without any leadership training. Therefore, it is essential that leadership is incorporated within the mainstream curriculum of healthcare undergraduate courses and staff are offered continued leadership development throughout their career.

Covid-19 meant that innovative placement offers were required. As part of its 2020-21 Clinical Placement Expansion Programme (CPEP) project the Royal Wolverhampton NHS Trust’s Physiotherapy service, in collaboration with Keele and Wolverhampton universities, developed a leadership placement for undergraduate physiotherapy students.

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The leadership placement introduces the students to the concepts of leadership, the various theories of leadership styles, exploring topics such as unconscious bias, self-awareness, conflict, the ladder of inference, change management, conflict, compassion and empathy, personality types and communication styles, to name a few. The students also have the opportunity to observe a variety of leaders in their everyday roles, observing leadership in action under a variety of conditions. The aim of the placement is not only to introduce concepts of leadership but to break down the misconception that only certain personalities can excel at leadership. We need our graduate Allied Health Professionals to be emersed in leadership at the very beginning of their careers, to embrace it, to know they have a pivotal role and a wider influence within the organisation. We need to develop their leadership skills as a core requisite of their role, at all levels, not as a luxury add-on for the select few.

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A student perspective (James Smith and Alice Banner) We believe that the leadership placement had a positive impact on our physiotherapy training. The placement gave us an opportunity to experience what it is like to be an Allied Health Professional (AHP) leader, and the range of different non-clinical job roles available. We also received several leadership sessions, in which we learned about self-awareness, passive-aggressive behaviour, personality, and other relevant theories to leadership. Although these were taught sessions, they incorporated lots of discussions. This was a great learning experience, as it meant that we were able to hear about Nicky’s experiences and relate them to our own past, and potentially future, experiences.

As a result of these sessions, we both feel that our self-awareness has increased, and we are now more reflective of our behaviours and biases. It was also emphasised that leadership can take place in many roles, and not just management. The skills we have learned can be applied to different areas of our life, such as within our families, sports teams, studies and in the workplace.

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During our time on placement, we had many opportunities to work with and interview different members of staff. It was interesting to discover the wide range of career paths that lead to management positions and how many had never planned to take a non-clinical role.

It was also clear to see there was a variety of personalities and leadership styles within the team, showing there isn’t a ‘one size fits all’ approach to leadership.

As a result of the placement, we also have the opportunity to continue working with the Trust beyond our placement. We are both student representatives for the Black Country Preceptorship Programme. This involves attending meetings and contributing to discussions, to provide a student’s perspective.

We both feel it was a privilege to have this placement, as most of the students in our cohort will not have this exposure, and thus will not gain the skills we have acquired. It also gave us perspective on the range of career opportunities for AHPs within the NHS, and the structure of an NHS Trust. Because of this placement, we both feel that we have a ‘head start’ over other students if we want to pursue a management role, as we have a better understanding of the NHS structure, experience of working in management, and knowledge of what skills are required to be an effective leader.

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Higher Education Institute Perspective – School of Allied Health Professions, Keele University Helen Edwards - Lecturer in Placement Support & Development Caroline Nichol – Lecturer in Placement Support & Development Kelly Green - Director of AHP (Allied Health Professions) Placements We are excited and fully support leadership placements being a normal attribute and diversification to student placement profiles, as leadership is identified by the Chartered Society of Physiotherapy (CSP) as a crucial element of the 4-Pillars of Physiotherapy practice.

Leadership requires essential skills, including communication, and confidence in taking the lead and influencing change, which is transferrable to diverse environments for future practice and job opportunities, encompassing both clinical and non-clinical roles.

Early exposure to leadership can only have a positive influence on student AHP training programs.

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Covid-19 has encouraged HEIs, placement providers, and students to diversify placement experiences with challenges of placement capacity, resulting in an increase in leadership placements. Historically leadership teaching and placement experiences were considered for students nearing the end of their degree programs. However, with the success of leadership placements, undertaken at the Royal Wolverhampton NHS Trust, and in response to placement evaluation, we strongly feel they should be offered to students earlier in their training, from the first year onwards. This would facilitate the early development of transferable leadership skills, enabling the application of theory to practice at any stage of training, thereby contributing to the desired Keele graduate attributes: independent thinking, synthesizing information, creative problem solving, communicating clearly, and appreciating the social and environmental implications of studies and activities.

Our vision is in line with the CSP drive and agenda where students graduate with a diverse placement profile including both clinical and non-clinical opportunities, identified as an important addition to traditional core specialisms.

‘No service is too specialist or caseload too complex for quality student learning - the key is identifying and unlocking the learning opportunities’ .

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This is reflected in the new national Common Placement Assessment Form (CPAF), where language and criteria identify and encourage assessment in diverse settings such as leadership placements The success of leadership placements relies on effective planning from the provider and collaboration with HEIs and students. HEIs are a key support to the provider and students pre, during, and postplacement to evaluate and evolve

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The Royal Wolverhampton NHS Trust has had successful leadership placements, demonstrating exceptional planning, effective collaboration, and robust evaluation processes, striving to expand and develop the leadership placement model further. They are exemplary role models to students and need to be commended for their commitment, effort, and innovative vision in embracing and welcoming students into the multidisciplinary leadership opportunities within the Trust. Students have been at the forefront of facilitating change and the student's voice has been viewed as crucial in breaking down barriers and providing an alternative perspective to service delivery.

The use and variety of tools and digital technology on these leadership placements have enriched the learning environment, enhanced the learner's experience, and showcased their achievements.

Feedback from leadership placements has been implemented into curriculum development at Keele University to help shape the needs of student training for the future and we look forward to developing this with continued collaboration.

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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Using reflexivity to optimise teamwork Author : Dr Nicky Eddison, Catherine McKeown, and Dr Ros Leslie Trust : RWT Sub-optimal functioning within a team can have serious consequences on task outcomes, in healthcare this can impact service users. It can also impact individual health and wellbeing, staff progression, job satisfaction and attrition rates. The ability to examine one’s feelings, reactions, and motives and how these influence what one does and thinks is known as reflexivity1. When applied to the context of a team, it is the extent to which teams take the time to stop and reflect together on what they are trying to achieve and the mechanisms of how they achieve their aims. This is typically an area that teams neglect. They do so at their peril.

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The conscious reflection on team functioning is an important process in the development of effective teams, and an important predictor of team outcomes. The higher the team reflexivity the more innovative the team.

Team reflexivity questionnaire Team reflexivity is a useful and straightforward way to think about how well a team is functioning and how effective it is. It can be measured by a dedicated questionnaire produced by Michael West. The questionnaire is based on two main dimensions. The first dimension is ‘task reflexivity’, which refers to reflexive behaviours with respect to the team’s task. Exploring how well the team reviews, responds, and adapts to processes and objectives.

The second dimension is ‘social reflexivity’, which refers to the extent a team reflects on the social processes within the team. Exploring how well people in the team work on their relationships, identifying and resolving conflict and building a sense of belonging and cohesion. A team demonstrates social reflexivity by being supportive when the team or individual are experiencing a stressful situation. Sharing knowledge and skills, practising civility, and resolving disagreements quickly. Task and social aspects of reflexivity can influence how well a team performs. An effective leader requires an understanding of the dynamics of these two aspects within their team.

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The reflexivity questionnaire should be completed by all team members. Everyone’s score is then calculated for both task and social reflexivity. All the participants’ scores are then plotted on a simple graph. The resultant diagram will indicate the extent to which team members agree about the type of team they work in.

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The four types of teams The outcome of the questionnaire will help identify which of the four team types4 a team is currently functioning as.

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Type A: A fully functioning team represents a team that reflects on and modifies its objectives, processes, tasks, and social support strategies appropriately.

Type B: A cosy team has warmth, support, and unity amongst team members, but may not be efficient or functional.

Type C: The dysfunctional team has poor functionality and team unity.

Type D: The cold efficiency team's task performance tends to be good, but the team unity is poor.

Experience with using the reflexivity questionnaire The orthoptic service at the Royal Wolverhampton NHS Trust has been using the reflexivity questionnaire since 2018 with the aim of exploring and reviewing how the team is functioning. Most recently, the questionnaire was completed by 10 of the 12 members of the team.

The results of the questionnaire were then analysed and plotted on the team type quadrant. The results indicated that the team largely sat within the ‘fully functioning team’ type but there were a small number of results which fell into the ‘cosy team’ type. This suggests an emerging issue where social relationships within the team might be preventing honest and open discussions around task objectives and processes.

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Further analysis of the team’s responses showed that the score for the question “Conflicts are constructively dealt with in this team” was the lowest of all the social reflexivity questions whilst “team members are always friendly” scored the highest. The first dysfunction of a team5 is the absence of trust, essentially the unwillingness to be vulnerable, to be open and honest about mistakes and weaknesses.

The lack of trust sets the tone for the second dysfunction which is the fear of conflict. The inability of the team to participate in unfiltered debate of suggestions and ideas, instead, they choose to guard their feelings and opinions.

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When a team trusts each other, it can thrive in an environment of constructive conflict. Conflict often elicits a negative connotation, when in fact, constructive conflict is essential for a team to thrive.

By utilising the team reflexivity questionnaire, the potential issues have been identified and provided the team with an opportunity to discuss and review the findings.

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The Assistant Head of Orthoptics said it was reassuring to see that the team fell into the category of fully functioning, but acknowledged the results also highlighted the risk of the team becoming too cosy in its approach to operational procedures.

It was felt that conflict was perceived as a negative occurrence and perhaps something that is felt more acutely within this team as it is rare. People within the team value their social aspect of working relationships very highly and if this is compromised for any reason it is perceived to be a significant issue. This provided an opportunity for the team to reflect upon the way in which they communicate with one another, and the need for open, honest, and direct conversations. This led to team members reporting that they would prefer to be informed of issues that arise straight away, as opposed to in a 1:1 scenario or at a later date.

The need and benefit for team members to be more aware of operational issues within the department was also discussed.

Solutions put forward to address this were an improved structure to 1:1 meetings along with more regular whole team meetings with an operational agenda.

It will be interesting to review the results of this questionnaire when repeated in 12 months’ time, to establish whether the changes that have been implemented have been effective.

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If you would like more information on the team reflexivity questionnaire, how to access it and how to use it please contact the authors of this article.

Catherine McKeown is the Assistant Head of Orthoptics.

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

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

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The NHS Leadership Academy sits proudly within the NHS People Directorate, NHS England. We aim to help everyone in the NHS discover their full leadership potential and achieve the highest standards in health and care. All of our leadership programmes, lifelong learning and talent scheme offers are designed to deliver the NHS People Plan and our People Promise.

Our team brings a wealth of experience and passion for leadership, talent and unlocking potential, pushing for the best in world-class learning and development.

Find out more about hosting a trainee, providing a flexi-placement 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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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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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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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.

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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.