The Loop | Issue 13 | April - June 2024

The Loop

Keeping Patient

Data Safe

Research training at

Level

Resilience in the Health Sector ISSUE

Editorial

Keeping Your Patient’s Data Safe: Essential

Cybersecurity for Health and Social Care

John Bell & Croyden (Not Just a Pharmacy!)

Resilience in the Health Sector: A Unique Journey

Dementia: Cognition and Communication

We Try

Living with a rare condition in a time of global crisis: communication and support

Care Group

The Looming Peril: Extreme Right-Wing Ideologies and the Vulnerabilities of LGBTQI+ Individuals with Dementia

The importance of research training at undergraduate level for Allied Health Professionals 42. 28. 32. 36. 38.

We need to stop planning and start acting. How the right technologies can address key challenges in primary care today

Why Building International Leadership that Values Cultural Diversity Matters

Enhancing Teaching Excellence through Simulation-Based Education Faculty Development

EDITORIAL

Welcome to our new edition dedicated IHSCM e-magazine, best practice, advice and

Its quite clear from the emails and phone calls that I receive that finance and budget compliance is getting very serious across health and social care. Local authority and NHS local level budgets have been under huge pressure with service delivery coming proportionate strain.

You’ll know that numerous local authorities have already, effectively, declared bankruptcy and you’ll rightly speculate that several others are considering whether to follow suit. Meanwhile across the NHS there are all sorts of pressures and measures being applied by NHS England, presumably at the behest of the DHSC / HMG on local trusts to rectify budget forecast overspends, whatever the implications and effects on service.

Standing up to the demands is career ending and there appears to be a collective senior management feeling of ‘we just have to do it’.

When Aneurin Bevan stood up to announce the birth of the NHS he couldn’t have expected society to be quite as it is today, 75 years on, with the consequent demands applied to his vision for healthcare provision. Nor, I suspect, would he have expected that an overseeing organisation’s approach to demand economics would be to demand budget compliance at any cost to staff, patients and families.

edition of the Loop, your e-magazine, packed with features, and guidance.

It all feels almost other-worldly to me. Reading about Mid and South Essex, for example, being put in financial ‘mandated intensive support’ and ordered to cut 600 full time posts to reduce a projected £100m overspend seems to be a reaction based on ignorance of the service demand dynamics.

Yes, they have added considerable numbers of staff over recent years, and have done so to address service demand. That demand won’t go away, so sacking clinical and non-clinical staff to achieve a balanced budget feels like abandonment of patient need. It must be said that numerous other trusts and local authorities are under very similar pressures.

Where does this take us and, more specifically, you? Unless you are in a very senior role you have little control over the process of budget compliance but hold acute responsibility for delivering safe services.

You’ll know whether your service is safe. You’ll hear the feedback from staff, patients and their families. You’ll see the demand charts or the queue of ambulances or the distraught nurse and you’ll know whether you are delivering a safe service or not.

If it is then praise those delivering it and do all that you can to help them feel fulfilled, recognised, and valued. If it is not then do the right thing –speak up, manage up and stand up. Raise your observations, detail your data and present the truth. It may be painful or even career limiting, but your values and principles need to come to the fore.

Enable yourself to look in the mirror and know that you honoured your profession.

Stay safe, stay strong and thank you for the brilliant work you are all doing.

Keeping Your Patient’s Data Safe: Essential Cybersecurity for Health and Social Care

The NHS is a constant target for cyberattacks, but smaller practices and organisations across the UK are just as vulnerable.

While headlines often focus on large hospital breaches, the patient data you hold in your practice – personal identifiable information, NHS numbers, medical records – is a goldmine for identity theft and fuelling further cybercrime. Here’s what you need to know about essential cybersecurity practices which can help you protect your organisation and keep your patient data secure.

The value of patient data

Patient data is a valuable commodity on the black market. It is a treasure trove of personal information like names, addresses, birthdates, NHS numbers, and most importantly, medical history. This information can be used for a variety of criminal activities:

• The personal information healthcare organisations hold can be used to fraudulently open bank accounts, credit cards, and take out loans in the victim’s name.

• Patient data can be used to submit fake medical claims to insurance providers.

• Criminals can compile patient data with data stolen from other sources to create complete profiles for sale on the dark web.

Why you’re a target

While a large hospital might hold a wider variety of data, small providers still hold valuable patient information. Cybercriminals exploit weaknesses, and smaller practices and providers often

lack the resources to invest in robust defences. The perceived weaknesses in a smaller provider make them more attractive to less skilled hackers too, which makes them vulnerable to a larger number of attackers, who may feel there will be less scrutiny and a reduced risk of being caught.

Criminals might also believe that smaller practices are more likely to pay a ransom quickly to get their systems back online and minimise disruption to patient care, compared to a larger hospital that may be able to afford a longer downtime.

Balancing security and accessibility

Ensuring strong security measures can seem overwhelming, but implementing multiple layers of security can help achieve a balance between safety and convenience. Implement strong password policies, multi-factor authentication (MFA), and user access controls that limit access to sensitive data based on job role.

Overly complicated security controls can reduce productivity and even weaken your security posture. Imagine a GP unable to access a patient’s record due to excessively complex requirements. Employees could become frustrated by overly complicated security measures and resort to workarounds that bypass security protocols all together, such as sharing passwords or using unauthorised devices.

The allure of personal devices

The convenience of personal devices can be a security nightmare. Unsecured laptops and smart phones used to access patient data create entry points for malware. Personal devices might not have the same security measures as work issued devices, making them more vulnerable. Healthcare providers have a legal obligation to protect patient data, and the use of personal devices can make it difficult to comply with data privacy regulations as the practice may not have full control over how the data is stored and accessed.

Beyond the security risks, using personal devices for work purposes can blur the lines between work and personal life for employees. Constant access to work emails and data can have a negative impact on employee well-being and lead to issues like burnout.

The true cost of ransomware

Ransomware is a type of malicious software that encrypts your data and asks for a ransom payment in exchange for the key to unlock it. The financial consequences can be severe, but the real risk lies in the disruption of patient care. If critical medical information is not accessible, it can lead to delays in treatment and potentially impact patient outcomes.

The impact of ransomware can extend beyond the immediate patient base of your practice. Loss of trust in health and social care providers can discourage patients from seeking preventive care, potentially leading to a rise in care costs down the line.

Are you ready for a cyber-attack?

Ensuring your organisation is prepared for a cyber-attack is crucial. It is essential to regularly assess vulnerabilities, implement a backup and recovery plan, educate staff on cyber threats like phishing scams through security awareness training, and have a documented Incident Response Plan. Being proactive by implementing measures such as these can safeguard your business from potential threats and minimise the impact of any security incidents.

Who is responsible for Information Security?

To effectively combat cyber threats, there must be a shared responsibility approach to information security. While leadership sets the tone and IT implements the technical measures, everyone plays a role in preventing breaches and securing patient data. By cultivating a culture of security awareness and vigilance, everyone can contribute to a safer environment.

John Bell & Croyden (Not Just a Pharmacy!)

Andrew Hussey MIHSCM, Healthcare Operations ControlleR, John Bell & Croydon

What’s In a Name?

John Bell & Croyden can trace its roots back to 1798, when John Bell establishes his original pharmacy on Oxford Street. His son Jacob launches The Pharmaceutical Journal (1841) and then founds what is to become The Royal Pharmaceutical Society of Great Britain (1842). In 1903 the business amalgamates with Charles Croyden & Co. to form the John Bell and Croyden we know today. We received our first Royal Warrant in 1909, gaining Queen Elizabeth II’s warrant in 1958 and holding it all the way through to 2022. In 1912 the business moved to Wigmore Street (our location to this day) and in 1928 is acquired by Savory & Moore, themselves subsequently bought by the Lloyds Pharmacy chain.

Protecting Our Valuables

In 1997 John Bell & Croyden became part of Celesio, then, in 2014, US healthcare giant McKesson. Following the sale of McKesson’s UK businesses to Aurelius the group will be known as Hallo Healthcare. However, throughout all this we have always stuck to our ICARE values in our quest for the best customer service –Integrity, Customer First, Accountability, Respect, and Excellence, these are the first things we instil in any new member of staff.

Standing Still

Just like everyone else we struggled during the pandemic, with staff cutbacks and reduced opening hours. I was placed on 3 months furlough due to the hospital I work with being closed whilst they worked out their plan for this unprecedented situation. However, due to some quick thinking and excellent planning skills our teams realised we had the potential to

create the facilities to be one of the first community pharmacies to administer the Covid Vaccine and Covid testing in-store, driving much needed footfall into the store. We have continued these services ever since, just this month starting both the next stage of boosters and the flu vaccine.

Healthcare Services

A big decision was made this year to amalgamate our Pharmacy and Wholesale departments to create Healthcare Services. This allows us more scope to make joint decisions in what will benefit the business, such as the wholesale team working together with pharmacists to support local hospitals, making the best use of the staff we have around us. As a Pharmacy Technician (well almost, 92% through my course is as close as!), I officially work in Wholesale, however there are often things I can help with in Pharmacy and it allows me more freedom to do that, thus benefiting everyone.

The Future

We believe our new collaborative, crossfunctional Healthcare Services team will continue to have success, winning more contracts with hospitals for either stock management, pharmacist support or both, as needed.

We further see the future of John Bell & Croyden, and pharmacy in general, in offering a broad range of innovative services, becoming the first port of call for patients in need of advice or treatment. This will help ease pressure on stretched GP services and ensure the future of pharmacy itself.

Resilience in the Health Sector: A Unique Journey

I have discovered that resilience is crucial, especially when navigating the healthcare sector, as a member of the ethnic minority community. Resilience is the guiding force during challenging times, enabling me to remain mentally, physically, emotionally, and socially strong.

Jeredyne Stanley, Disparity Practitioner

Resilience means having to thrive in a world where addressing equity, diversity, and inequalities often takes a lower position in organisational priorities.

Despite this, being on the outside, allows the opportunity to engage in difficult conversations, drive positive changes, and provide support to those in need. Working towards breaking down barriers

between the communities and access to mainstream services, particularly ethnic minority communities, allows me to reach individuals who may be excluded.

Engaging in discussions about equity, diversity, and inequalities can be complex and challenging. Therefore, more rewarding while outside of the organisational setting, as there is no organisational backlash.

I raise awareness about disparities, through Rivers Enterprise, a social initiative. Through this initiative, I have successfully promoted positive changes by combining my professional expertise with a genuine dedication to nurturing change. Rivers Enterprise was rooted in the powerful belief that every individual, regardless of their background, possesses the potential to achieve greatness and deserves an opportunity.

It also makes working with the NHS, charities, local and national government departments easier and my impact and contributions more meaningful.

Despite the obstacles, I do persevere with resilience to continue promoting awareness about disparities.

For example, it is commonly asserted that ethnic minority communities do not actively engage in initiatives, which lead to equity gaps, which result in short-term projects being implemented to address this disparity. Using resilience, knowledge and experience, as key assets I usually communicate, pointing out areas such as business strategy, personal development plans, and professional training within these organisations, which contribute to the disparity. A further great deal of strength is needed to tactfully inform on how diversity, equity, and inequalities can be addressed during the early planning stage in organisational structures.

It is also imperative to point out that in addressing bias and systemic challenges effectively, it is crucial to offer personalised support and guidance tailored to the specific needs of individuals. Therefore, a variety of voices are needed to be actively engaged in leadership discussions, with a focus on prioritising equity from the very beginning.

The integration of leadership and equity is essential, as decision-making processes often lack diverse perspectives.

From experience, I can state that reducing disparities requires acknowledging and respecting the unique qualities of each individual, while also upholding their privacy.

Further, to empower women, I founded Rivers LPC, an independent charity for women, dedicated to providing support to those facing barriers in accessing essential and formal services; or those choosing to not engage with formal authorities. Rivers LPC offers a variety of opportunities, mentoring and sessions designed to empower vulnerable women and assist them in overcoming the challenges of life.

Collaborating with ethnic minority communities and supporting vulnerable women comes with its own set of obstacles. However, I have developed personal coping strategies to navigate through these hurdles and biases.

As a result, my focus has shifted towards fostering community collaborations, promoting awareness of diversity and equality, and working to dismantle systematic barriers. I am dedicated to advocating for the protection and empowerment of women, while striving to create equal opportunities for all. These efforts have highlighted the importance of resilience in overcoming challenges along the way.

Women’s charity - https://riverslpc.org

Social enterprise - https://www.riversenterprise.org

Linked in profile - https://www.linkedin.com/in/jeredyne-stanley-0aabb737/

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Dementia: Cognition and Communication

Selfhood and Agency in Dementia Care: the role for social interaction

Linda Robinson Training | Consultancy

and Communication

The dementia disease affects the human brain and is progressive and incapacitating. It is caused by a range of concomitant illnesses: the psychological, emotional and physical symptoms and complications people living with dementia (PLWD) may experience are determined by the area of the brain affected. PLWD present with complex neurological difficulties due to the nature of the dementia disease, including pragmatic and semantic complications occurring in the interactions between paid carers and PLWD.

It is pertinent to understand the interactive, communicative transactions between paid carers and PLWD to gain an insight into communication and social interaction within an institutional care home setting.

Some of the most complex of these support needs are located within the identification and delivery of appropriate care and support with PLWD. This is further contingent on whether PLWD consent to receiving personalised care and

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support as part of person-centred practice embedded within their care and support plans from paid carers and other professionals.

Integral to providing this care and support for PLWD is communication: interpersonal communication is a primary human need and core care component because it is everyday conversation that supports social interaction. This furthers the capacity to support PLWD in articulating their individual needs and emotions, making decisions, and contributing to shared ideas. Everyday talk should thus be an essential and integral component of their care and support provision.

Research into communication skills is abundant and there is a wealth of communication skills and techniques.

For example, there is a need for caregivers to build a reciprocal connection with people living with Alzheimer’s Disease, by taking time to communicate exchanges effectively and by understanding how communication is vital for people living with Alzheimer’s from their perspective.

Such knowledge can help provide paid carers and health care professionals with the aptitude to apply communication skills to their work practice to promote agency. However, addressing the difficulties in communicating with PLWD and facilitating interaction is still troublesome.

Furthermore, a lack of communication with others creates social isolation. A sense of feeling alone and unacknowledged can provoke anxiety, depression, and other mental health difficulties in most PLWD, which is exacerbated by monotony, poor self-occupation skills and a lack of sensory stimulation.

The consequent ‘world-weariness’ created decreases mental wellbeing alongside the effects of the dementia disease itself, culminating in further social detachment. It can further engender a sense of unfamiliarity at having to develop new relationships within the health and social care environment with people they do not know including other residents and professional people: for example, district nurses.

Without effective communication and an understanding of PLWD communicative needs, this can also lead to behavioural challenges, withdrawal and distress.

Yet, despite this ever-growing body of knowledge reinforced by reports into how we should communicate with PLWD, care providers still find it extremely difficult to accommodate communication time for PLWD, exacerbated by the fiscal constraints and in a post pandemic and unprecedented time of growing austerity and recession, how will communicative time be provided to PLWD?

We Try

As a Registered Manager, it often feels like you have the weight of the world on your shoulders, balancing a gigantic house of cards about to collapse at any point.

In domiciliary care, due to the nature of working in the community, you haven’t got constant oversight like you may have in one setting, which can easily lead to feelings of not being in control.

Like most if not all managers, if we are short-staffed, I'm on the front lines with everyone else. One day I attended to a

client who during general conversation said: “love, you're one person and you don’t always get it right, but you keep trying”. I responded with an off-the-cuff remark “yes, my husband also says I'm trying” and made a joke about it. That client didn't realise in that moment how much weight they had lifted from my shoulders.

We are driven by love, dedication, a want to improve, a need for outstanding care and a desire to look after everyone (staff and clients) that we forget to breathe and celebrate the small successes.

I call myself a 'jack of all trades' and 'master of none' as every day is genuinely different. One minute I am checking policies, the next training and suddenly a staff member has a breakdown and I am a shoulder to cry on.

I am a passionate advocate for professional recognition of social care and all that work under this umbrella as despite feeling like a 'jack' we are actually masters at what we do. Is everything perfect and do we always get it right? The short answer – no. If inspectors or reviewing officers go through everything with a fine-tooth comb would everything be perfect? Again no, but I have a plan and I am striving for the best.

When I sat down with that client at a later date and said, “out of interest as a user of the service what do you want from me as a manager?” The answer they gave was “honesty”. Honesty to admit when things

Lynsey Powell, Registered Manager

fall short, when things have been forgotten and when things are behind.

We are well aware of our duty of candour but also, we are acutely aware of the saying ‘where there's blame there's a claim’ so we can sometimes give a politician's answer to a straightforward question.

We are professionals but we are also people who make mistakes and have very human failings, sometimes sorry is a powerful word and mends a lot of bridges.

Some say when you come to work you leave your problems at the front door, but as a manager, you can't leave work at your own front door as we are needed 24/7.

So, we balance a gigantic house of cards and reinforce it with a good team, a strong network of peers, a supportive family and a shed load of caffeine.

We take a deep breath and remember we are one person and don’t always get it right, but we try.

Living with a rare condition in a time of global crisis: communication and support

This article considers the challenges faced by children living with the rare condition of hemophilia and their families during the COVID-19 pandemic due to enforced restrictions.

It draws insight from literature, supported by reflections on lived experience of a parent, on the impact of the COVID19 crisis on communication, social welfare for children with hemophilia and their families which may go unnoticed, however, could have adverse effects on the quality of life, and wellbeing of these children if not managed appropriately and highlight the need for a more sustainable approach to care for this group for better health outcomes.

Hemophilia is a rare genetic bleeding disorder where sufferers do not have enough clotting factor (a protein known as the factor VIII OR IX) to control bleeding episodes when they happen (WFH, 2012).

Having to live with such rare condition brings about a feeling of pain and

confusion. As the COVID-19 pandemic hit, information for people with hemophilia was limited although the Hemophilia Society, UK (2020) mentioned no increased susceptibility to the infection.

Even with this information, most of the patients were unclear whether to categorise themselves in the vulnerable group or not whereas in some low- and middle-income countries, people with hemophilia were categorised among the vulnerable group who needed shielding. This lack of clear and unified communication and information across board created panic and confusion for families (Dickinson & Yates, 2020). Some of the confusions were also around necessary hospital appointments which were suspended with no clear plan, and failure to recognise how this could have an impact on the wellbeing of the child and family.

condition crisis: support

Ogechi Ohadomere, BSc, MSc, PGCE, PGCAPHE, MIHM, FHEA

Assistant

Professor,

Leadership and Management in Health School of Nursing, Midwifery and Health | Faculty of Health & Life Sciences

Coventry University

The expectation at this point would have been visits by community nurses or conference calls to families to communicate exact details of what to do, but most families received generic letters. This is based on reflections from a parent’s lived experiences, hence, there is need for research to explore the extent to which this is evident across families.

According to the World Health Organisation (WHO) 2012, such situation could be managed through meeting and developing a community of families with similar challenges, support from dedicated team of specialist health and care providers and other support networks to minimise the feeling of isolation that a rare condition can present with as families have found comfort in physical contact through support from other parents while attending clinics or by their healthcare providers (Thomas

& Gaslin, 2001). These forms of support were hindered by the COVID-19 restrictions which according to Cassis (2007) & Saxena (2013), the level and quality of communication, social support and welfare has a great influence on the physical and mental wellbeing of the individual.

Considering managing the communication and social gap as a result of the COVID-19 pandemic or any other future crisis, setting up routine online interactions and social networks with an assigned individual healthcare provider, and a network of peers and other families in similar situations especially within a crisis period could provide more support and unified communication.

References

Cassis, F. R. M. Y. (2007). Psychosocial care for people with hemophilia. Treatment of hemophilia, 44, 1-12.

Dickinson, H., & Yates, S. (2020). More than isolated: The experience of children and young people with disability and their families during the COVID-19 pandemic. Melbourne, Australia: Children and Young People with Disability Australia (CYDA).

Holywell Care Group

Holywell Care Group is a special place, offering care services across Preston and Morecambe.

Sabe Connor Director, Holywell Care Group

But like all of us in care, we’ve faced challenges with getting the right staff, which led us to understand the importance of doing things differently. We realised that Holywell is where kindness makes everyone feel at home – and that’s all down to our people who are fully committed to providing the highest level of service, support, and care.

We get to know everyone inside and out, so we can make sure our clients are in the safest hands, they feel at home, and love life. This is what makes Holywell different. In our sector, our experience, best practice, and care should be a given, otherwise we would not be here. But in a competitive marketplace, we wanted to add a layer of personality to the services we offer – to help attract likeminded people.

We listen, learn, and work together to get to know each client – so we can tailor their care packages. The warmth, energy, and dedication of our teams allow us to do this, because we genuinely care about the people we support.

We are protective, compassionate, supportive, and connected. Each one of us is human, and we are dedicated to building trust so we can provide the care our clients deserve. Our kindness exceeds expectations, enriching their lives and supporting their families. We built this feeling into the foundation

of everything we do. It’s what helps us stand out to the audiences we want to appeal to, in terms of joining our team, or using our services – whether that’s our clients, their family, or social care and service providers.

It's our mission to make sure that we do everything with kindness – building friendships, or creating a sense of belonging, we do the right thing for every client and member of our team. Our people encapsulate our culture, values, and everything we stand for. But that’s how we’ve employed the very best in the business, by hiring people who help us stay true to our purpose. Recruitment is tough in social care. So, by demonstrating how much we care about our team, and by clearly defining our purpose and our values, we were able to inject some excitement into our recruitment and training.

We invest time to develop and train our team on an ongoing basis, to maintain our high standards. This is recognised by CQC and our Investors in People Accreditation. We are always expanding our multi-cultural team and we believe that people join us because our attitude, training, development, and support set us apart. People join Holywell and want to stay because there is a real sense of family. Our residents are part of a community too, where they can relax in the company of friends and carers, take part in activities, and enjoy life!

The Looming Peril: Extreme Right-Wing Ideologies and the Vulnerabilities of LGBTQI+ Individuals with Dementia

In today's complex societal landscape, the intersections of identity and health vulnerabilities magnify the risks faced by marginalized communities. Among them, the LGBTQI+ individuals with dementia stand at a precarious crossroad, threatened by the resurgence of extreme rightwing ideologies. This essay delves into the multifaceted dangers posed by these ideologies, spotlighting the unique vulnerabilities of LGBTQI+ individuals grappling with dementia.

Daithi Cee

The Threat of Marginalization

Extreme right-wing ideologies thrive on exclusionary rhetoric, perpetuating narratives that undermine the humanity and rights of LGBTQI+ individuals. As dementia progresses, individuals become increasingly susceptible to societal attitudes and systemic biases. The convergence of dementia and discrimination amplifies the risk of marginalization, eroding the support networks vital for LGBTQI+ individuals.

Erosion of Healthcare Rights

Access to inclusive healthcare services is fundamental for LGBTQI+ individuals, particularly those facing cognitive decline. Extreme rightwing policies often seek to dismantle healthcare provisions and roll back protections for marginalized groups. In the context of dementia, this translates to barriers in accessing affirming care and a heightened vulnerability to neglect and mistreatment.

Loss of Autonomy and Identity

Dementia fractures the fabric of identity, challenging individuals' autonomy and sense of self. For LGBTQI+ individuals, whose identities may already be contested within societal norms, the loss of agency exacerbates feelings of alienation and invalidation. Extreme right-wing ideologies compound this loss by perpetuating heteronormative frameworks that dismiss the lived experiences of LGBTQI+ individuals with dementia.

Exposure to Conversion Therapy

The resurgence of extreme right-wing ideologies emboldens proponents of conversion therapy, a harmful practice aimed at erasing LGBTQI+ identities. Individuals with dementia are often rendered more susceptible to coercion and manipulation, making them prime targets for such unethical interventions. The collusion of dementia and extremist agendas jeopardizes the mental and emotional well-being of LGBTQI+ individuals, subjecting them to traumatic experiences and erasing their authentic selves.

Threats of Institutionalization

In the absence of robust legal protections and support structures, LGBTQI+ individuals with dementia face the looming specter of institutionalization. Facilities may lack cultural competency and fail to provide affirming environments, subjecting residents to discrimination and abuse. Extreme right-wing ideologies perpetuate stigmatization, further isolating LGBTQI+ individuals within institutional settings and compromising their dignity and rights.

Conclusion

The perilous convergence of extreme right-wing ideologies and dementia poses a grave threat to the well-being and rights of LGBTQI+ individuals. As advocates and allies, it is imperative to challenge discriminatory narratives, fortify support systems, and advocate for policies that uphold the dignity and humanity of all individuals, regardless of identity or cognitive status. Only through collective action can we dismantle the barriers that perpetuate marginalization and safeguard the rights of LGBTQI+ individuals with dementia

References

1. Herek, G. M. (2009). Hate Crimes and Stigma-Related Experiences Among Sexual Minority Adults in the United States: Prevalence Estimates from a National Probability Sample. Journal of Interpersonal Violence, 24(1), 54–74. https://doi.org/10.1177/0886260508316477

2. Fredriksen-Goldsen, K. I., Kim, H.-J., Bryan, A. E. B., Shiu, C., & Emlet, C. A. (2017). The Cascading Effects of Marginalization and Pathways of Resilience in Attaining Good Health Among LGBT Older Adults. The Gerontologist, 57(suppl_1), S72–S83. https://doi.org/10.1093/geront/ gnw162

3. Stein, G. L., Beckerman, N. L., & Sherman, P. A. (2010). Lesbian and Gay Elders and Long-Term Care: Identifying the Unique Psychosocial Perspectives and Challenges. Journal of Gerontological Social Work, 53(5), 421–435. https://doi.org/10.1080/01634372.2010.484645

4. Wallace, S. P., Cochran, S. D., Durazo, E. M., & Ford, C. L. (2011). The Health of Aging Lesbian, Gay and Bisexual Adults in California. Policy Brief UCLA Cent Health Policy Res PB2011–3, 1–8. https:// escholarship.org/uc/item/9h05d7bh

5. Alzheimer’s Association. (2020). Alzheimer’s Disease Facts and Figures. https://www.alz.org/media/Documents/alzheimers-factsand-figures.pdf

6. Human Rights Campaign. (n.d.). Conversion Therapy. https://www. hrc.org/resources/conversion-therapy-the-dangerous-practice-oftrying-to-change-someones-sexuality

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We need to stop planning and start

How the right technologies can address key

in primary care

Carmelo Insalaco, CEO and Co-Founder, Rapid Health

stop start acting. technologies key challenges today

Carmelo Insalaco, CEO and CoFounder of Rapid Health, highlights the importance of using existing innovations to address primary care challenges.

The Times Health Commission report aptly highlights the main challenges the NHS is currently facing, and where we need to focus our attention to future-proof it and mitigate potential risks to quality of patient care. Now, we need to look towards the right digital solutions which can implement real change and resolve problems for good, such as patient access and the workforce crisis.

The report’s 10-point plan for health, acknowledges problem areas to prioritise. However, there remains a clear need for a larger healthcare workforce and smarter technologies to implement the plan effectively. Unproven technologies can potentially cause additional challenges and delays.

That’s why it’s crucial to use existing, proven technology within the infrastructure to pinpoint and efficiently address specific challenges.

Automated clinical triage tools can help

The report proposes creating digital health accounts and patient passports for everyone, enabling people to access test results and schedule appointments online. While this is promising, we need to make sure they need to book the right appointments which

don’t require an additional workforce to navigate the patient, introducing new bottlenecks. Automated clinical triage tools read patient records to assess them at first contact. Patients are then informed of the necessary appointment/s and offered various suitable booking times, providing a personalised care pathway and choice for the patient.

The plan’s third point focuses on guaranteeing timely appointments and reinstating continuity of care while promoting ‘super practices’. The key to this is managing demand. Automated clinical triage is essential for this as it can standardise decision-making and automate navigation and administrative tasks. Automation of tasks ensures appointments are spread throughout the day, based on urgency, allowing clinical staff to meet the needs of every patient.

On average, 44% of primary care appointments are booked for urgent same day review, but evidence shows this can be halved with current automated clinical triage innovations, and could be 10-15% once there are better systems to manage pre-existing conditions.

Smart digital front doors can assess patient needs and practice capacity to distribute demand accordingly in real time. This is encouraging patients to adopt new ways of booking appointments without having the anxieties associated with the “8am rush”.

At Manor Court Surgery, 77% of patients preferred choosing their own appointment times and 69% preferred using automated clinical triage, proving that if the digital capability is there and works effectively, patients are willing to adopt new ways of accessing care.

We need scalable, problem-solving solutions

The report recognises ‘technology has the power to transform healthcare,’ but if the solutions aren't scalable and targeted towards solving problems across the whole patient pathway, what’s the benefit?

The technology to address these concerns does exist and real-world evidence shows that benefits can be realised in just days and weeks, not years.

We need a layer of coordination, intelligence and interoperability to ensure pre-existing digital tools are integrated effectively into the NHS to solve problems long term.

Why Building International Leadership that Values Cultural Diversity Matters

There are challenges for leaders to consider as globalisation increases for multinational organisations, it is important to be responsive to change and in building an effective team that truly supports cultural diversity.

Melissa Mclaughlin, Deputy Head of School in Health & Care Management, Arden University

It is imperative that leaders are using the most effective approaches to engage with and motivate their teams. Leadership and management styles have a significant impact on organisational success and outcomes. Kotter (1990) states that the focus of leadership tends to be on future vision and embracing change, whereas aspects such as control and planning tend to be central to management. Both aspects are required for organisations to not only function but to thrive, leaders need to focus upon cultural awareness and practices as differences in culture across teams impacts performance and outcomes.

Considered subjective in nature, it is difficult to capture exactly how to define culture as it is a dynamic concept and ever evolving. However, it is thought to include one’s values, learnt beliefs as well as any specific rules, norms or symbols of importance. It further includes traditions that are typical for a collective group of people. Organisations need to understand these collective differences as Winkelman (2005) notes that how we think, feel, function and approach life will differ significantly dependant on the cultural background someone hails from. To be truly multicultural as an organisation it instils an assumption that the leadership approach will take more than one culture into account to be truly reflective of the people within a team. It can further include sub-sectors such as race, gender, ethnicity, religion, sexual orientation, spirituality and age. Diversity refers specifically to the existence of different cultures or ethnicities within any group or organisation. There are

many differences in how the world is perceived especially within work as research has shown in multiple studies ranging from individual communication styles (Sanchez-Burks et al., 2003), the work-related values that are considered important (Tran, Admiraal, & Saab, 2017) and experiences of employee wellbeing are all uniquely interpreted across cultures.

Organisational diversity is an asset which should never be underestimated, it is noted that if diversity is both valued and represented by the leadership team it brings a range of benefits that in turn support organisational growth and development. Shown by Downey, et al, (2015) organisations that focus on inclusive practice creates more thriving environments, in which, people feel safe and confident which shows increases in engagement, productivity and overall performance. Further to this Østergaard, Timmermans & Kristinsson (2011), indicate it increases innovation as the skills, knowledge and experience available is more varied. There can be challenges with language and cultural differences which can be perceived as a barrier. However, being aware of these factors and ensuring this is considered throughout organisational approaches allows for this knowledge to be utilised as a resource that can be used to increase performative outcomes. Research by Mullins (2019) found various benefits of diversity in an organisation, these included improvements in customer relationships, increased employee satisfaction, strengthening of skill variety, improved recruitment and retention.

The importance of research training at undergraduate level for Allied Health Professionals

Authors

Dr Ali Aries: Allied Health Professions Research Lead, The Royal Wolverhampton NHS Trust

Louise Wallace: Clinical Team Leader, Community MSK Assessment and Physiotherapy Service, The Dudley Group NHS Foundation Trust

Jake Hughes, MSci Physiotherapy student, Keele University

Christine Wan, MSci Physiotherapy student, Keele University

Dr Ros Leslie: Black Country ICS Chief Allied Health Professional and RWT Chief AHP

Background

In 2024 a unique opportunity arose for two students to undertake placements within a bespoke research capacity building project called ‘Research ABC’.

ABC stands for Allied Health Professions Building (research) Capacity Across the Black Country. The project, led by Dr Ali Aries, Allied Health Professionals (AHP) Research Lead at The Royal Wolverhampton NHS Trust (RWT), was completed over eight months (August 2023-March 2024) targeting six NHS trusts across the Black Country (Black Country Healthcare Partnership NHS Foundation Trust, Dudley Integrated Health and Care NHS Trust, Sandwell and West Birmingham NHS Trust, The Dudley Group NHS Foundation Trust, RWT and Walsall Healthcare NHS Trust).

AHPs employed or hosted by one of these provider organisations were invited to take part in this service evaluation. The project bid was submitted by Dr Ros Leslie (Chief AHP at RWT), to receive funding from the Clinical Research Network West Midlands (CRN WM) Improvement and Innovation grant.

The grant aimed to enable the Black Country Integrated Care System (ICS) to address the four domains of Health Education England’s Allied Health Professions’ Research and Innovation Strategy for England: capacity, capability, context, and culture. The strategy comprises three vision statements, each having a distinct intention to accelerate transformative change.

The Research ABC Team made a survey available in October 2023 to AHPs across the Black Country (n=2396), to ascertain current levels of engagement in research, both at an individual and an organisational level. Research skills, training needs and barriers to engagement in research activities were also surveyed.

Following this benchmarking exercise, AHPs have been offered training, resources, and support to develop skills to build capacity for setting up and running research studies throughout the region. Developing networking opportunities is also a key aim of the project and the team has created a networking and training space on Microsoft Teams for all the 250 survey respondents who indicated interest in accessing this space.

Student learning objectives

The Research ABC placement highlighted the importance of research in healthcare and the skills required to be a good research team member, including effective communication, initiative, and leadership skills. Students also had the opportunity to contribute to the development of training resources to be used as part of the project.

The aim of the placement was not only to appreciate the importance of evidence-based practice in clinical practice, but also to break down barriers to participation in research; for example, many people think a PhD degree is required for taking part in research. However, graduate AHPs should be

engaged in clinical research at the very beginning of their careers –helping to raise awareness of the importance of evidence-based practice, and the positive impact it can have on the quality of patient care delivered.

What opportunities arose from the placement?

• Training opportunities:

• Excel training with RWT’s Digital Innovation Unit

• Good clinical practice

• Literature searching with RWT’s Knowledge and Evidence Specialist

• ‘Writing for publication’ workshop

• Musculoskeletal and neurological critically appraisal topic (CAT) groups

Meetings/shadowing opportunities:

• Research and Development (R&D) Lead at RWT

• R&D Directorate Manager at RWT

• Group Director of Research and Development for RWT and Walsall Healthcare NHS Trust

• AHP Leads meetings

• Research champion meetings

• Black Country AHP and Nursing Faculty meetings

The students’ perspectives (Christine Wan and Jake Hughes) The placement offered us an opportunity to experience what it is like to be a part of a multidisciplinary team (MDT), while attending training and meetings which consolidated our knowledge in the field of research.

We were offered the opportunity to organise and conduct a focus group and

a semi-structured interview. The aim was to understand the perspectives of the Research ABC Team members. With the help of our educators, we learned how to complete the consent form and participant information sheet. We then shared the roles of moderator and facilitator, both taking field notes and recording the discussions. Despite doubting our own abilities at first, we ultimately felt proud of our performance and what we had achieved.

We were encouraged to create a poster on our findings and will present at the Physiotherapy Research Society conference, due to take place in Bournemouth on 12 April 2024.

Another important part of our placement was to search for literature using databases and critical appraisal skills (CASP) tools. This ensured we were able to select the most relevant literature for our needs. We also learned of the benefits of being a research-active Trust, and how evidence-based practice leads to better patient outcomes.

With a limited availability for research placements, we feel privileged to have been a part of this placement. With exposure to new areas and experiences, we have developed our leadership skills and confidence. Further to this, the placement highlighted that there are more career paths outside of traditional clinical work.

Enhancing Teaching Excellence through Simulation-Based Education Faculty Development

Simulation-based education (SBE) is emerging as a powerful tool for enhancing teaching across a broadening spectrum of undergraduate and post-graduate courses at Staffordshire University, a CAE Centre of Excellence for simulation and the first Higher Education Institution in Europe to achieve International Nursing Association of Clinical and Simulation Nursing (INACSL) IV endorsement.

Joseph Natalello Lecturer – Patient Safety and Simulation, Staffordshire University

Teaching through Simulation-Based Faculty

In recent years, SBE has gradually been adopted across courses within Sports and Exercise, Psychology, Policing, sciences, and more and not solely reserved for more traditionally simulation-focussed courses based in healthcare.

However, with this expansion of SBE, it is vital to ensure faculty members become adept simulation facilitators and importantly, remain so. It is also notable that the role of the simulation facilitator is well established in the literature, and the scope of the role encompasses all facets of SBE, from planning, to implementing, to evaluating, and bringing relevant specialists together to create an effective learning experience.

Additionally, there can be a hefty reliance on myriad simulation technologies to enhance the experience and with this comes a need for training and upskilling staff to ensure the most appropriate technologies and strategies are utilised in the most effective way.

A two-day development course titled Foundations of Simulation was devised to provide an in-depth overview of SBE and to provide faculty with the opportunity to train and practice their simulation facilitation skills, it is aimed at those new to simulation or those who are considering implementing it within their area of practice.

During the course, participants have the opportunity to design a simulation–based experience within their own setting by being guided through the process by dedicated and experienced simulation facilitators working within the university.

The trainers, from academia, practice, and technical, created an E-book and shared site to host supplementary and reference materials and this is available to all staff that have attended the training to assist them with continuing their simulation facilitation journey.

The course is designed based on evidence-based teaching and learning and is informed by guidelines from organisations including Health Education England’s (HEE) 2018 National Strategic Vision for Simulation and Immersive Technologies.

Additionally, reference to multiple simulation society’s standards are made including the Association for Simulated Practice in Healthcare (ASPiH), the Society for Simulation in Healthcare (SSIH) and the INACSL 2021 Guidelines for Best Practice.

Simulation-based Education faculty development involves equipping educators with the knowledge, skills, and confidence to effectively integrate simulation techniques into their teaching practices. It encompasses training sessions, workshops, and ongoing support aimed at enhancing pedagogical strategies specific to simulation-based learning environments. Foundations of Simulation is one of several faculty development courses offered at Staffordshire University to both internal and external participants.

To find out more about our work on faculty development, visit our CPD page here: https://www.staffs.ac.uk/courses/ short/health-science-and-wellbeing

MS c SIMULATION –BASED EDUCATION (SBE)

The MSc in Simulation-Based Education (SBE) by distance learning is structured for those in the workplace with a part-time approach with two modules per year for the first two years with a MSc research dissertation or project-based change in year three.

The MSc in Simulation-Based Education (SBE) will offer a post-graduate qualification that is innovative and contemporary offering a programme for professionals who are currently utilising or considering the pedagogy of simulation for teaching, learning, assessment, modelling of concepts or devising new ways and changing systems of working.

Professions that utilise simulation include practitioners and academics/ educators from health and social care, emergency services, aviation, defence, security, business, and law. The programme may aid teachers particularly those from STEM subjects at primary and secondary level. Lecturers

offering Apprenticeships for 16 – 19-yearolds particularly those in health, social and business care are increasingly adopting simulation as a tool for skill rehearsal prior to work – based placements.

The unique aspect is this MSc is focussed on all types of simulation -based education and is open to anyone in the world who meets the entry criteria irrespective of role or background.

Modules Years 1 - 2

• Contemporary Issues in Simulation

• Simulation for teaching, learning and assessment in your sphere of practice

• Simulation for change and innovation

• Research in Simulation

Modules Year 3

• Master’s Dissertation

• Master’s Project

• Cost £8,865

• Students will be able to step off at PgCert and PgDip