The Loop | Issue 5 | April-June 2022

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Deaf Awareness

Reimagining Training

ISSUE

5

APRIL - JUNE 2022

The Loop

IHSCM Quarterly E-magazine

5 'C's of a Digital Journey


Contents

ISSUE

5

4.

Editorial

6.

Poetry Power Hour

8.

A People Plan for Social Care

10.

Living 4 Moments - The Importance of Deaf Awareness

14.

A Practical Solution to one of the Oldest Problems: In Patient Falls

18.

What the NHS can learn from the most productive organisations in the world


22.

Verifyplus - An App created over the pandemic to

26.

Reimagining training using immersive technology

30.

Integrated Care Systems - Whose Perspective?

32.

The Five ‘C’s of a Digital Journey

Support the Social Care Sector in these trying times

CEO: Jon Wilks, Chairman: Roy Lilley, Strategic Advisor: Shane Tickell, Director of Social Care: Adam Purnell, Membership Manager: Emma Caton, Operations Manager: Jade Maloney, Social Media Administrator: Rachel Jury, Operations Administrator: Michaela Shannon, Digital Content Consultant: Luke Farmer


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EDITOR

It is said that we always remem where we were at momentous in our history. When Princess Diana died I was in a gym in Wolverhampton; twin towers atrocity I was at my office desk in South Wales; Hillsborough disaster I was playing cricket. I can recall virtually every detail of the moment when the news broke. On March 23rd two years’ ago I was in Tesco Express in my local town when the news broke and I recall responding by reaching out to join the ranks of those who had lost all reason by seizing a 9-pack of shea butter toilet roll. Covid lockdown would commence from 26th March. These momentous events mark us all indelibly in various ways. But back on 23rd March 2020 as I sauntered down my local high street swinging my toilet roll, truthfully I don’t think any of us really knew what horrors were coming. Boris Johnson’s demeanour was all clenched knuckles and serious expression but we had seen 004

his acts before and, remember, had heard him dismiss Covid as something that we would defeat within 12 weeks, just 4 days earlier. We had no idea. Home working was going to be a novelty, everyone started buying loungewear and ‘you’re muted’ would become a tediously repeated phrase. Those of you working in acute hospitals and care / nursing homes quickly developed the idea. I lead a privileged existence as leader of a professional Institute for you but I am miles away from the everyday rigours, pressures and traumas that every one of you began to contend with, irrespective of your role. Two years later I am left astonished by what you and your patients / service receivers experienced and how you did your best to respond. Many of you were deeply wounded by the events you


were obliged to deal with and some of you still are. Several of you will have lost colleagues or the people that you care about and for. It is impossible for me to understand the appalling wrench that must occur when someone for whom you have been entrusted to care loses their life – and even tougher when it is one of your colleagues. I know that some of you have felt smashed by what occurred. So I wanted to use this editorial to say two things:1. Thank you and well done. We know that it is not over and, for some, never will be. You have done and continue to do your absolute best and that is the most that anyone can ever expect. 2. You are not alone. If you are struggling with the aftermath of what has happened then know that there are

Chief Executive

mber s times

JON WILKS

RIAL

countless others who feel as you do and would love to seek mutual support. If you need some help, please tell someone (including me here at the IHSCM – jwilks@ihm. org.uk). If you can help then asking someone ‘how are you?’ is hugely important. Prime Minister Harold Wilson’s quip that ‘a week is a long time in politics’ may well be true. Two years is certainly a lifetime in health and social care when a global pandemic is thrust upon you. Reflect on what you have done and what you have achieved. It has been extraordinary and, in many respects, miraculous. Stay safe, stay strong and thank you for the brilliant work you are all doing.

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Poetry Po Hour Gratitude Dr Ivy Glavee, Poet, Artist, Author, NHS Clinical Entrepreneur Fellow, Innovative Dental Surgeon, and Founder of Clinician Burnout

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G R A T I T U D E

stands for Grateful stands for Resilience stands for Appreciation stands for Thanks stands for Incredible stands for Titillating sensation stands for Unique stands for Diverse stands for Excellence and Exuberance


ower Following the success of our previous poetry workshops, we invite you to join us again for another empowering session with our very special guest poet, Charlotte Lunn. Charlotte Lunn is a published poet and bookseller based in Derbyshire. As part of this very special Poetry PowerHour Charlotte will focus on how to use creative writing to empower staff, boost team performance and improve workforce wellbeing; building on the foundation of the skills explored in the first session with Charlotte. Register your attendance here: IHSCM POWER HOUR: Poetry Tickets, Wed 13 Jul 2022 at 12:00 | Eventbrite

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A People Plan for Social Care Launched at the Palace of Westminster by the Institute of Health and Social Care Management On Monday, March 28th, The Institute of Health and Social Care Management (IHSCM), it’s committee of Social Care Innovators, and other voices and talent from the sector attended the House of Lords to launch their People Plan for Social Care. The Baroness Wheeler MBE, Labour’s frontbench spokes person for social care in the House of Lords, was present to support the event. The People Plan is now heading into it’s second consultation period and the IHSCM will be hosting a series of round tables to capture even more voices and opinions to help inform the next version of the plan.

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Read 'A People Plan for Social Care'

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Living 4 Moments The Importan of Deaf Awareness. Our Deaf Awareness training at Living 4 Moments is very different from others because I have included changing technology and techniques that I have learned from my journey from being severely deaf to profoundly deaf.

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Rachel Barber, Managing Director, Living 4 Moments

nce I also understand the complexity and challenges of facing any change of hearing which can lead to isolation, depression, anger, denial etc. Therefore I have included helpful slots during the training where individuals who have lost their hearing can access relevant support at their stage in the change of hearing. All change is hard and as individuals we respond in different ways. I am keen to provide tailored support with quality information for the individual to make choices that are right for them. Employers are losing so much potential talent and commitment when they do not recruit or retain talented individuals. In addition they lose customers when they have a less diverse workforce. This is why our Deaf Awareness training is much needed. Some of our suggestions help recruit and retain employees with other disabilities too.

There are over 12 million people in the UK who have a hearing loss of some level. The risk of hearing loss increases significantly with age. Our deaf awareness training provides support for employers by making them aware of the different challenges faced by people with hearing loss and ways of helping to remove some of those barriers At our deaf awareness training we share simple techniques which are inclusive of deaf employees in meetings. Some of these techniques benefit others including neurodiverse, dyslexic and partially sighted employees. With a more diverse workforce customers benefit too as there is a better understanding of their needs. As well as techniques there are new technologies that make possible considerably improved access.

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But too many individuals with hearing loss and their employers are unaware of the advances that have been made over the last decades. There are small things that can make a big difference. Eg for me a transcribing app has been a huge help in many different situations enabling me to participate more fully than before in meetings, conferences and on the phone. Here are a few practical tips which are helpful in a care home. Our training covers a lot more details and for a wide variety of settings from leisure facilities to work environments. • • • • • •

Set days for changing batteries of hearing aids with the individual Check equipment before putting them in Use smaller rooms for activities where acoustics are better. Have soft furnishing to reduce echo. Smaller groups for activities- this makes it easier for individuals to participate Check the lighting

Do join us at our Deaf Awareness training by emailing rachel.barber@living4moments.com. The training benefits everyone because you may come across friends/family/clients who have a hearing loss. Or you may yourself need the support to make the most in every setting. More diverse workplaces make business sense. Other training we provideEmpowering Choices to understand and apply legislation from MCA, Care Act, Equality Act and Human Rights with risk assessment. Through this training professionals will learn how to empower individuals to make choices that matter to them.

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A Practical Solu of the Oldest Pr In Patient Falls The use of assistive technology in the form of fall prevention alarms offers a way of monitoring patients who have moved unobserved from bed or chair. 0014

Cuttler et al., (2017) reported a significant reduction in falls using these alarms, this success was the result of nurses using appropriate risk stratification to select patients who were both at high risk of falls and unable /unwilling to reliably use the call bell. Giving nurses a practical/useful tool to prevent falls, once high risk patients have been identified, helps nurses make the right decision at a critical time by helping them to prioritise responses. AML Falls Management System not only delivers a reduction in falls but also helps nurses prioritise those most vulnerable, therefore allowing them to respond faster when needed. Concerns that the nurse won’t respond in time or that the alarm will fail to sound soon enough prevent people using these systems. Therefore they miss out on an opportunity to have real time data that can help them identify and make


ution to one roblems: Jan Christian, Director of Clinical Services, Approach Medical Limited (AML)

changes in their practice to keep patients safe. Data is collected at a central tablet and provides a remote monitoring capability for the nurse in charge. Unanswered alarms trigger an alert at the nurse in charge’s hub and they can provide reinforcements if someone is at risk and remains unattended. This helps where patients are located in areas of poor visibility, low staffing levels and in managing new admissions where it is harder to carry out a multifactorial risk assessment when both time and information are limited.

The data gathered does not contain any patient information but acts almost like the ‘Black Box’ in aeroplanes providing location specific detail about alarms triggered and responses; allowing detailed proactive falls prevention measures to be activated. AML’s Clinical Safety Officer works with the clinical teams to analyse the data produced from each area and deviations from the expected course are detected and a supportive response offered.

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Table 1 shows the trajectory of improvement in falls/1000 bed days an Acute Assessment Unit has seen since using the falls Management System; however Table 2 spotlights a significant deviation from this trajectory.

in England (Royal College of Physicians, 2020). Stephenson et al., (2016) reported that despite instigating a full education programme for the nurses in a multicentre study, the reported falls rates remained unchanged.

The company investigated with the customer and worked together on a corrective plan. The company were able to visit, plan and resolve the issues within 3 days of it having been identified, ensuring further falls were prevented and the unit remained on track to reduce it’s falls/1000 bed day rate consistently. This targeted practical help for clinical teams, when required, makes falls prevention sustainable in extremely challenging environments.

Teams in the NHS welcome help and Approach Medical Limited are successfully delivering additional support through the use of assistive technology.

Falls have consistently been the biggest single category of reported safety incidents since the 1940’s (Morgan et al., 1985). Very little has changed; falls are still the most frequently reported incident affecting hospital inpatients, with 247,000 falls occurring in inpatient settings each year

References Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons and alarms. BMJ Open Quality, 6(2), e000119. https://doi. org/10.1136/bmjoq-2017-000119 Morgan, V. R., Mathison, J. H., Rice, J. C., & Clemmer, D. I. (1985). Hospital falls: A persistent problem. American Journal of Public Health, 75(7), 775–777. https://doi.org/10.2105/AJPH.75.7.775 Royal College of Physicians. (2020). National Audit of Inpatient Falls (NAIF) (Darft 2_0). RCP. Stephenson, M., Mcarthur, A., Giles, K., Lockwood, C., Aromataris, E., & Pearson, A. (2016). Prevention of falls in acute hospital settings: A multi-site audit and best practice implementation project. International Journal for Quality in Health Care, 28(1), 92–98. https://doi.org/10.1093/intqhc/ mzv113

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What the NHS can l from the most prod organisations in the The UK National Health Service (NHS) is one of the largest employers in the world. It is the biggest employer in the United Kingdom with an estimate of over 1.3million employees as of January 2021. [1] [Despite being one of the largest employers, the NHS ranks nowhere near the top when ranking the top-performing or most productive organisations in the world. This is because it is riddled with significant issues like high levels of waste, employee turnover and absenteeism, demand-supply mismatch, and last but not least, poor financial performance. Historically, the response from healthcare providers in an attempt to solve this productivity crisis has always been to throw more money in the system and hire more workers, but this has proven time and time again to be ineffective. I recently came across an article written in 2020 by John Hall titled “What makes companies like Apple and Google so productive”, and the points he listed in his article got me thinking (from the viewpoint of a healthcare worker currently working 0018

in the NHS) about how some of these could make a massive difference if taken seriously in healthcare organisations. Just before I proceed, I know many people will be quick to say tech firms are different from healthcare organisations – that healthcare organisations deal with patients and not computer chips or software applications, but I think this is where we begin to miss the wood for the trees. Although productivity is measured based on outputs, it is not the output that drives productivity. It is rather the input - the people who work in the organisations that make the outcomes possible. In one of his viral videos talking about “Broken cultures in Health Care” Simon Sinek argues that healthcare organisations should focus on taking care of their employees and this will


learn ductive e world in turn dramatically improve the way employees focus on taking care of the patients.[2] Back to two of the most productive organisations in the world, Apple and Google. In his article Hall highlights that what makes these organisations more productive than most other organisations, even their tech counterparts can be attributed to 3 factors – Employee happiness, Employee investment, and Teamwork. [3] Let’s start with Employee happiness. Some of the drivers of employee happiness are job flexibility and pay. NHS organisations have been known to have historically inflexible work patterns - Doctors, Nurses, and other allied healthcare professionals usually have to work set rota patterns that do not always fit in with their lives. Also, the pay for healthcare workers in the NHS is grossly inadequate compared to most of the other developed countries in the world, despite being one of the busiest

Tunde Kukoyi, Cardiology Specialty Registrar, NHS

healthcare systems in the world. It is also appalling that loyalty is not rewarded as people get considerably higher pay for being temporary or agency staff, compared to substantive staff which expectedly drives the never-ending artificial scarcity of healthcare workers. The result of this is a high level of employee turnover and absenteeism from work. This has a double cost implication to NHS organisations – firstly having to recruit expensive agency staff to fill gaps, and secondly the cost of recruiting new staff which is expensive and lowers productivity as it takes new staff time to get up to speed.[4] How about employee investment? Although this varies across most NHS trusts, it can be broadly said that NHS organisations do not invest much in their employees. Access to paid professional development courses, mentoring and coaching services, adequate break rest, and recreation facilities are a few of the many important things that are lacking in NHS organisations.

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Very recently, I was having a chat with some of my doctor colleagues, and we all lamented on how difficult it could be to get good food whilst working through several days of long-hour shifts, while massive amounts of food are being wasted daily on most hospital wards. I have also come across heart-breaking sights of hospital staff, having to sleep on hard tables for their all-important sleep breaks on night shifts – yes, even in the NHS. Here’s a funny but true story, on one of my long day shifts, I asked one of the attendants in the hospital if I could get some squash to add to my water as I felt really dehydrated and the response I got was “we don’t have any squash for staff, we only have for patients”. If you don’t take care of the wellbeing and development of the staff who look after the patients, you are ultimately impacting the care of the patients. Finally, let’s talk about teamwork. The “Us versus Them” culture is endemic in most NHS organisations. There is a never-ending battle between Management versus Clinical Teams, Emergency Department Versus Wards, Surgical Team Versus Medical Team, Doctors versus Nurses and the list goes on and on. Even within individual departments, people work mostly for individual achievement or recognition rather than for the good of the whole team or organisation. This not only affects the smooth functioning of hospital systems but also impacts a patient’s journey and can lead to unnecessary delays. Team building activities should be encouraged to staff across different departments find common interests and foster cooperation. Leaders of NHS organisations should also be wary of merely being names with titles on inaccessible office doors or imaginary people that are 0020

only seen when emails are circulated. Instead, they should always make time to walk through the crowd and listen to the concerns and suggestions of their staff. I recently read a post about a Chief Executive of one NHS organisation serving food behind the counter at the canteen and checking on the staff that they were ok. This warmed my heart, and we need to see more of this. One of the leading voices on Leadership, John C. Maxwell, commonly says that there are 3 questions that all employees want their leaders or organisations to answer before they commit fully to these organisations. The first question is “Do you care for me?” The next question is “Can you help me?” The final question is “Can I trust you?” [5] Until NHS organisations start putting themselves in the position to answer these questions in the affirmative, it is very likely that the productivity potential of most NHS organisations would remain largely untapped.

References 1. NHS Workforce Statistics - January 2021 (Including selected provisional statistics for February 2021) - NHS Digital. [online] NHS Digital. Available at: <https://digital.nhs.uk/ data-and-information/publications/statistical/nhs-workforcestatistics/january-2021> [Accessed 14 February 2022]. 2. Hall, J., 2020. What Makes Companies Like Apple and Google so Productive?. [online] Calendar. Available at: <https:// www.calendar.com/blog/what-makes-companies-like-appleand-google-so-productive/> [Accessed 14 February 2022]. 3. Sinek, S., 2019. Broken Cultures in Health Care. [online] Youtube.com. Available at: <https://www.youtube.com/ watch?v=d0PuJ-_19Rw> [Accessed 14 February 2022]. 4. Evans, M., 2016. NHS Crisis: The Cost Of Employee Turnover & Absenteeism - Questback. [online] Questback. Available at: <https://www.questback.com/uk/blog/the-nhsin-crisis-the-cost-imposed-by-absenteeism-and-high-staffturnover/> [Accessed 14 February 2022]. 5. Maxwell, J., 2014. Should I Stay or Should I Go?. [online] John Maxwell. Available at: <https://www.johnmaxwell.com/ blog/should-i-stay-or-should-i-go/> [Accessed 14 February 2022].


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Verifyplus An App created over the pandemic to Support the Social Care Sector in these trying times 0022


Harj Nanuwa, CEO, VerifyPlus

The sector has faced different challenges and experiences during the pandemic, whilst still playing an important role delivering crucial services for people in the local communities of which they serve. There have been increased workloads with many changes/updates to government guidance regarding vaccinations/visitors/ testing. It has been recognised that staff and managers have experienced frustrations, tiredness, exhaustion and burn out. Despite this, the sector has been doing an amazing job throughout the pandemic whilst being impacted heavily.

EMCARE (local care home association across Leicester, Leicestershire, Rutland) decided to investigate on the frontline. The general message we constantly heard was that too much time was being spent on admin and all homes wanted to do was simply spend that time on delivering services which would directly support, residents/staff/visitors.

With the announcement of the VCOD1 legislation, there was a realisation of how this was going to be a logistical nightmare and would add further pressures to Care Homes, including ongoing issues with doorstep challenges.

We therefore decided to look for solutions to reduce pressure. On researching we soon realised that there was no simple/ easy solution. So, with the support of the local councils, we worked with Care Homes to create Verifyplus to help the sector.

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Care Quality Commission Regulation

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Legal Issues Facing Care Operators

“A highly professional team. Excellent communication. In-depth knowledge of Adult Social Care Sector. Flexible, well connected, very responsive.”

Gordons Partnership Solicitors have a naaonal reputaaon in the health and social care arena. We only act for care providers, never commissioners or regulators, ensuring our advice is truly independent. We offer specialist advice on: Regulatory Maaers Involving CQC and Care Inspectorate Wales Safeguarding and Police Invessgaaons Embargoes by Commissioners Contract Disputes and Fee Recovery Inquests and Safeguarding Adult Reviews Employment Issues Empl The Sale and Acquisiion of Care Businesses For a free, iniial chat about the issues you are facing, please contact Neil Grant on 01483 366069 or at

sols@gordonsols.co.uk 0024

www.gordonsols.co.uk London 020 7421 9421 | Guildford 01483 451 900


The initial aim was to make life easier for owners, managers, staff & visitors with the additional admin due to VCOD1. However, this soon evolved into a vision to support Social Care by using a digital solution to reduce admin burdens - Less for Staff/Management to worry about… Giving more time to CARE. The key criteria for Verifyplus was : It needed to do what it needed to, nothing more nothing less • Make life easier, saving management/ staff time • Quick set up to get operational/ implemented • Simple/easy to use • Cost effective • Flexiblity/Adaptable to changes to legislation/guidance • Accessible 24hrs • Management oversight • Recording of just the right amount of info, nothing more, nothing less • Help provide a robust system for compliance with CQC/GDPR In order to save time/resources for the homes, we provided various direct support, via : • Explainer video • Short demonstrations (30mins) • Training videos (3mins) • Detailed instructions • Support line Some feedback received 1. "VerifyPlus is one of the easiest systems that I have seen to be able to provide this evidence… really small amount of time to setup”. Katie Wade, Registered Manager, Amberwood Care Home 2. “Verifyplus gives me the confidence

of knowing exactly who comes in & my staff are doing the job, & above all everybody is safe”. Mohammed Anwar, Owner, Allag Care Ltd 3. “Verifyplus app is a user friendly software to tick all the boxes for compliance of accurate recording and GDPR data protection”. Manisha Zala, Associate Director, Midlands Care Eventhough VCOD1 is being revoked the App still continues to support Social Care further with other features 1. Resident Feature – Enabling staff to see Nominated individual/Essential Care Giver information at a glance 2. Staff Testing Feature – Staff able to input their own information… Managers having time sensitive information to hand…At a click of a button, data transferred to the bulk upload spreadsheet 3. Resident/Visitor Testing Feature – Simple inputting…Easy access…Quick transferring of data We have also been asked by Care Homes to incorporate signing in/out book, fire list and quality assurance in future updates. We created what we set out to do, with Verifyplus being a cost & time effective, innovative, user-friendly digital tool to support managers/staff to ensure the smooth running of their care setting.

For more information, please see www.verifyplus.co.uk Contact - support@verifyplus.co.uk or 0116 482 6669

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Reimagining using imme technology Laura Sheerman , Gerontologist, HE/FE educator and digital learning specialist

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g training ersive Upskilling through continuous learning and development is important to ensure best and safe practices. The health and social care sector have predominantly utilised multimodal training methods for years, combining in person, on the job training with e-learning. But with new emerging education and training technologies, or Technology Enhanced Learning (TEL) perhaps it’s time for a training review. 0027


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Generally, the purpose of any training is to support workers to improve their practice, benefiting the individuals they support. For this to happen, a transfer of knowledge is required. Transfer of learning is, broadly speaking, a process in which knowledge constructed in a particular context (source task) is used in a different context (target task) after being mobilised, recombined and/ or adapted. Understanding how successfully current training approaches are in transferring knowledge to practice, is enigmatic with little data to draw on. However, studies exploring VR compared with traditional training, note improved rates of knowledge transfer, confidence and motivation1,2,3&4 . Indicating traditional methods are not as effective as they could be, positioning e-learning little more than a compliance tick box exercise. Virtual reality produced using a 360o camera offers an affordable, agile and on demand immersive form of training. Capturing live footage, a spherical field of view is produced, enabling the user to explore and engage with the environment using a smartphone5 . Users can access 360o VR content by downloading an app for iPhone or Android on to their smartphone. Slotting the smartphone into a virtual reality smartphone-based head mounted display (VR SHMD) e.g. Google Cardboard, the user is able to interact with content on demand e.g. LifeSaver VR 6, Autism Virtual Reality 7.

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Providing users with access to responsive, interactive simulated environments, virtual reality makes it possible to create short impactful simulation-based learning experiences (SBLE). This means, workers can train in shorter periods of time and improve performance quickly, without the need to engage in longer e-learning episodes, or expensive in person training. Although off the shelf training examples are few and far between, the NHS have taken the lead in showcasing and developing 360 simulations. Health Education England incepted a National Strategic Vision 8 for simulation and immersive technologies, putting the wheels in motion for new training approaches. Examples include NHS Leicester Stroke VR simulation, Torbay and Devon NHS Foundation Trust and Somerset NHS Foundation Trust. With some imagination and creative thinking, 360 content can be created in-house by purchasing a 360 camera e.g. Insta 360 One X2, Richo Theta and investing in a 360-content creator tool – There are multiple options on the market. These authoring tools allow the insertion of knowledge assessments, as well as a central dashboard to track employee engagement and scoring – ideal for evidencing CPD.


Technology Enabled Learning, using immersive technology is likely to form a significant part of future training, sitting alongside in person training and e-learning. With the potential to offer improved knowledge transfer and knowledge retention, could 360 virtual reality become an e-learning replacement?

Further Reading 1 Lovreglio, R., Duan, X., Rahouti, A., Phipps, R. and Nilsson, D. (2021) Comparing the effectiveness of fire extinguisher virtual reality and video training. Virtual Reality, 25(1), pp.133-145. 2 Chittaro, L., Corbett, C.L., McLean, G.A. and Zangrando, N. (2018) Safety knowledge transfer through mobile virtual reality: A study of aviation life preserver donning. Safety science, 102, pp.159-168. 3 Allcoat, D., Hatchard, T., Azmat, F., Stansfield, K., Watson, D. and von Mühlenen, A. (2021) Education in the digital age: Learning experience in virtual and mixed realities. Journal of Educational Computing Research, 59(5), pp.795-816. 4 Maddry, J.K., Varney, S.M., Sessions, D., Heard, K., Thaxton, R.E., Ganem, V.J., Zarzabal, L.A. and Bebarta, V.S. (2014) A comparison of simulation-based education versus lecturebased instruction for toxicology training in emergency medicine residents. Journal of Medical Toxicology, 10(4), pp.364-368. 5 Frisby, B. N., Kaufmann, R., Vallade, J. I., Frey, T. K., & Martin, J. C. (2020). Using virtual reality for speech rehearsals: An innovative instructor approach to enhance student public speaking efficacy. Basic Communication Course Annual [online], 32,59–78. 6 Resuscitation Council UK (2020) Lifesaver VR (Version 2.19) [mobile app]. Available from iOS App Store. 7 National Autistic Society (2020) Autism Virtual Reality (Version 1.3) [mobile app]. Available from iOS App Store. 8 Health Education England (2020) Enhancing education, clinical practice and staff wellbeing. A national vision for the role of simulation and immersive learning technologies in health and care.

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Integrated Care Systems Whose Perspective 0030


ve?

Sue Jones, Home Care Business Consultant, Thoughts Become Things

Integrated care systems are coming to a local authority near you soon!

The main aim of the ‘system’ is to “integrate care across different organisations and settings, joining up hospital and community-based services, physical and mental health, and health and social care”. An admiral intention and one that is needed. As a family, who have been through our own tragic situation, have experienced the non-existent link between primary care and social care. That has been our experience, although, I know some local authorities have great examples of work that has already been achieved, which should be commended.

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Who exactly are these systems for and whose perspective is being sought? For an ICS to be successfully implemented, and achieve what it is meant to, relies on the willingness of every part of the ‘system’ to see other’s perspectives. The main perspective, first and foremost, should always be that of the individual that is seeking support, in whatever capacity. Additionally, if that person cannot communicate their needs for themselves, then the capacity for an appointed person to have their perspective heard on behalf of the individual must be in place, without bureaucracy. In addition to the above, many organisations could be involved in an ICS e.g., GP’s, local authorities, community groups, home care businesses, care homes, technology providers etc. They all need to be prepared to understand other perspectives. What may work for a GP may not work for a home care business and so on. Additionally, unpaid carers and the people who are at the periphery of support also need to be included. From experience there is little evidence of this being sought. We must also remember regulators should be part of the process, as they need to have a good understanding to perform their role.

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Secure data is another issue that could well slow progress down. Blockchain technology (which enables people/ organisations to access only the data they need), is being developed that is central to sharing data safely between people and organisations. It is in its infancy now but will be part of the future of ICS. By investing time and resource now by engaging with everyone who is part of the system, will save more time and resource in the future. Collaboration and compromise between all groups is the only way to achieve this. A fully operational Integrated care system, that has been created by taking all views into consideration, has the capacity to positively change many lives. So, what would a great integrated care system look like? For me this is for anyone, be that individual, family member, care provider, GP, should be able to go to one central hub (online or within communities) and be signposted to the correct place where they can access the information/ support needed. For that information and support to be right and appropriate for the individual/organisation. Additionally, the data on the ICS be secure to protect the people it serves. Is that too much to ask?


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The Five ‘C of a Digital Journey

If a digital health and care service is a mountain to climb, we are probably only in the foothills an base camp seems a long way off. That was the conclusion from the IHSCM’s Roun Table on what it might take to create a digital future. After an hour of discussion, debate and questions from a very well informed audience, five strands emerged.

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The Five ‘C’s of a Digital journey. Confidence… creating the confidence of users, clinicians and the public that the Apps, the systems and the accesses are safe, reliable and properly regulated. At the moment the hinterland has more in common with the wildwest than it has with a reliable regulated sector where suppliers can be relied upon and held accountable and technology is pug-and-use, not plug-and-hope. Conversations… communications, call it what you will but a dialogue between users, developers and system leaders, particularly across the divide between health and social care. A digital future for one without the other is pointless as we come, more and more, to realise, each is the servant of the other and together they are the servant of service users, patients carers, residents and the people working to deliver ‘ joined up care’. Collaboration… if the experience of the pandemic has taught us anything, it is; working together creates innovative care, safer care and better value for money. A digital future is no future if it is not like the stripe that runs through toothpaste. Wherever you squeeze the tube, you get red and white. In health and care, where ever the point of entry, use and access, the the experience is uniform and joined up. Confluence… of technology. Perhaps this is another way of saying interoperability; something that has eluded policy makers, defeated the industry and annoyed the people, in the front-line, using systems that don’t speak to each other. Government has set a target of 80% digitisation of the care sector by 2024 and is set to publish its first Digital Health and Care Plan this Spring. If is only outlines how both health and care can benefit from digital technology it will be an opportunity lost. If it points the direction to joined-up services 0036

and joint access to data, care and health records, research and analytics backed with realistic funding, it will be a long overdue breakthrough. Clarity of Purpose… the last ‘C’ and probably the most important. The key question all managers, setting out on a project, should ask themselves and their teams; ‘What are we trying to achieve’ and the second question… ‘by when’? Computers for the sake of computers, digital because we can do it, technology because it is the fad, the fashion, the ‘thing’ of the moment. What do we want to achieve? A faster, safer, health and care sector, that is super value for money and fabulous to work-in. How difficult is that? We are pleased to acknowledge the discussion was made possible by an educational grant from ORCHA (Organisation for the Review of Care and Health Apps) and our panel of experts; • •

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Liz Ashall Payne, CEO, ORCHA Neil Ralph, Head of the Technology Enhanced Learning team, Health Education England Palvi Dodhia, Director, Serene Care Dean Royles, President, The Healthcare People Management Association (HPMA) June Hall, Chair of the IHSCM Digital Special Interest Group, is also on the panel representing our IHSCM Health and Social Care members.

Chaired by Roy Lilley. Click here to see the full discussion for free. Orcha NHS Learning Hub


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Transitioning home care businesses from a transactional model to a valued service model, to attract private clients. Sue Jones - Founder

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