The Loop | Issue 8 | January - March 2023

Whether it be nurses, ambulance staff, junior doctors or who knows who in the New Year, any of you reading this on whatever side you favour will know with certainty that:-

Sooner or later, talks will resolve matters.

The question for any side in the disputes is how to make those talks happen. Perhaps what is needed now is some creativity to break what is a clear impasse.

I am something of a fan of John Hegerty, founder of Bartle Bogle & Hegerty (BBH), one of the leading advertising agencies of our age. He was asked what the principal strength was of his BBH organisation – what made it stand out from other advertising agencies and he reasoned that the key was irreverence. There is a good reason why a black sheep is the logo of the company and why it promotes itself with the strap line ‘when others zig, we zag’. You might remember some of his organisation’s most memorable campaigns such as Xbox, Burger King and Audi. All of them approached their brief with a very healthy dose of irreverence (the Xbox advert was actually banned, which did nothing to harm its appeal to gamers!).

Why does irreverence appeal so strongly to us? Well, primarily because in a world so full of choices but where we are guided so powerfully by vested interests towards only limited choice, bucking a trend or siding with the underdog is always attractive. Quite often, it makes us smile too – and that’s OK because humour is a wonderful bed fellow for irreverence.

To illustrate the point, take a look, says Hegerty, at the history of art. The early artworks were designed to revere (whether that be the church, rulers and monarchs) people with power who commissioned artists to create images that

I confess to having watched with despair and frustration the industrial actions of this week take shape over recent months.

JON WILKS Chief Executive

revered them and their lives. People were made to look beautiful, statuesque and commanding. Scenes were made to be awe inspiring and loyalty inducing, in either case irrespective of what the reality of the subject was.

I think that this is a perfect parallel with what we are witnessing in the disputes – all sides presenting the best possible versions of their arguments, irrespective of what a balanced view might provide.

In the history of art, the masses began to lose interest in being directed to think in the manner that the powerful wanted them to think and so was born all kinds of new and attractive art genres, from blues and jazz in music to impressionism in art and the craze of dance halls. Power was effectively liberated to the people who determined what they wanted to believe in and support.

What does this have to do with the current disputes? Well, I think that the traditional means of negotiating have changed, and that change is being provoked by a myriad of forces that simply didn’t exist when, for example, the ambulance workers last went on strike in the 1980s. Social media, YouTube videos, instant news streaming, digital communications media and more have changed the rules and make it easy for people to build (and lose) support very rapidly compared with yesteryear.

And the big change that I detect is that absence of reverence for power. Right now, we have an unpopular government and few people feel reverence towards their ministers. Whilst those ministers gallump around TV studios doing the traditional interviews, the parties with whom they are in dispute nimbly make use of the new powers of instant, mass communication to amplify their grievances and galvanise public support.

In my opinion this is not a government that is tough enough or enjoys enough public support to hold out on talks. My advice to get progress to those talks accelerated is for the unions to make more use still of the new communication media. Create some imaginative, irreverent videos showing the reality of a nurse / ambulance staff day. Find some humour with which the public can empathise. Change the dial to one of garnering further public support. The government will be obliged to talk if the opinion polls don’t support them.

Stay safe, stay strong and thank you for the brilliant work you are all doing. I also wish you and yours the best Christmas you can enjoy and a wonderful 2023. Thank you for all of your support during this year.

Arden University

At Arden University we are very aware of the need for education and training that really supports what employers require and really addresses gaps in workforce knowledge or development.

Arden University

Stephanie West, Head of School, Arden University

We are a fast paced, innovative university and being privately owned we can be flexible and adaptable in ways that other higher education institutions cannot. We are particularly conscious of the needs for social care organisations to be able to enhance the professional perception of colleagues and enable committed and ambitious staff to progress.

It has been an exciting time this summer as we have continued to develop new routes into higher education:

In February 2023 we are launching our Certificate in Higher Education (CertHE) Level 4 in Health and Care Management. This is on campus in the first instance (London, Manchester, Birmingham, Leeds) and offers a completely accessible opportunity to enter higher education, no matter what your previous education or work background.

You can study entry level modules and earn credits to then pursue Level 5 and Level 6/degree level study in future.

We have now launched our first apprenticeship programmes.

We now offer a full route and fast track route Chartered Manager Degree Apprenticeship, 100% remote and accessible, which awards successful graduates with

• BSc (Hons) Health and Care Management degree, that meets (and exceeds) the Level 5 diploma for Skills for Care/CQC Registered Manager requirements

• Chartered Management Institute Level 5 Diploma in Leadership and Management

• NHS Mary Seacole Level 5 Leadership Award

• Chartered Manager status

• Level 6/Degree Apprenticeship success status

For those more experienced and long standing managers, we have also introduced a Senior Leader Level 7 Apprenticeship with MBA in Care, specifically contextualised to integrated care systems and supporting leadership in all areas of health and care management and a Senior Leader Level 7 Apprenticeship with NHS Rosalind Franklin Level 7 Leadership Award, so whether you want to complete a Master’s project to get an MBA or would rather stick to only taught study at postgraduate level, we have an option for you.

These programmes award you with:

• Senior Leader Level 7 apprenticeship

• Chartered Management Institute Level 7 Diploma in Strategic Management and Leadership Practice

•

Chartered Manager status

• an MBA Master’s qualification or NHS Rosalind Franklin Level 7 Leadership Award

To find out more, join our IHSCM lunch time “Opportunities” session on 13th October 2022 at 12pm

For organisations and employers, we continue to welcome any industry collaboration and we are always happy to talk to you about our students supporting your project work, you offering internships/work experience and welcoming you to speak to our students around careers and roles.

Contact me at any time on swest@arden.ac.uk

Health & Social Care Management Qualification.

The Growth of Self Employed Carers

Emma Harding, Founder, Pocket Carer

Care professionals

Providing a highly demanding and skilled service, working long and often unsociable hours, with a level of emotional investment matched by few other professions, there is no doubt that the care sector and those who work in it, play a pivotal role in the UK’s social infrastructure.

provide a vital role to thousands of people and their families across the UK.

It is common knowledge that the care sector is currently suffering a recruitment crisis. In 2021, vacancies in the care sector reached 165,000; a 52% rise which equates to 1 in 10 social care posts in England left unfilled. Salary figures for the same year showed a average hourly rate of just £9.01 for care workers employed within the sector. With this in mind, it is no surprise that many highly experienced and talented care workers, feeling undervalued and overworked, are leaving a sector they love to work in better paid positions in supermarkets, hospitality and warehouses.

However not all those leaving employed services are leaving the sector altogether, more and more care workers are choosing to set up on their own as independent self employed carers.

Support for care workers choosing to take this leap into self-employment continues to grow. The National Association of Care and Support Workers (NACAS) offers advice and support to self employed carers as part of their membership. Organisations such as The Professional Carers Network, Independent Living Group and Community Catalysts all offer support to carers making the jump from being employed to self-employed, whilst other businesses, such as the PocketCarer, make life so much easier for self-employed carers in providing subscribers everything they need to run their own self employed care business in one easy to use app, combining client management software with all in one

business management tools that include invoicing, mileage tracking and income and expenditure recording to help make self assessments as easy as possible amongst many others, as well as a website full of relevant and helpful tips, and weekly up-to-date articles to assist carers with their selfemployed carer business.

So why are many choosing to take the leap to self-employment? With more support networks than ever before available, choosing to become an independent carer is a choice where the benefits of going it alone far outweigh the negatives for most. Being your own boss means you have more control over your work-life and career progression. You can fit your working hours around you and your family commitments, make important business decisions yourself, and have more control over your finances by setting your own rates. Additionally, you are able to focus on the specialist aspects of care you most enjoy and choose your clients yourself.

Branching out in a career you love is a far better alternative to changing careers altogether. Growth of the self-employed within social care is gaining momentum and PocketCarer is extremely excited to be part of it.

clinical, financial

needs and

Use

Managers, clinicians and health authorities around the world benefit from our value-driven, community-wide approach. Discover how we could help you by visiting our population health management page.

Medicine of the Person

In 2005 I retired, for health reasons from a career in health service management.

Working in every sector over three decades and encountering many clinicians of personable natures it was always frustrating when I would have to persuade a colleague of the benefits of a listening and respectful approach to their patient care.

Dr Elizabeth Slinn. DTh, MIHM, Visiting Fellow, University of Winchester

It was an endeavour to try and persuade those on the front line that people have a story to tell which can be both clinically enlightening and also be deserving of respect. I did see some notable converts to a person-centred approach over the years.

On retirement I took on the challenge of the study of theology. After some years of studying the basics with the Jesuits I embarked upon Doctoral studies at the University of Winchester.

During recovery from a personal tragedy I came across the works and writings of Paul Tournier. He was a Swiss physician, a Calvinist who practised medicine at he beginning of the twentieth century. He came to realise that diagnosis and treatment of only the body was reductionist and did not address the problems of the ‘whole person’; their body, mind and spirit.

He believed, through years of developing his practice and using a unique Christian psycho-therapy approach that many, if not all, conditions could be understood by the balance of these three aspects of the person. He called his approach ‘Medecine de la Personne’ and formed a group of disciples to his thinking. They met every year in Bossey, France and after a morning bible study would listen to Tournier and discuss their own approach and practice. They were all doctors. Tournier always longed for a surgeon to join his following.

Today there is still a legacy organisation of the same name which meets in Europe

every year. 1 This year I was fortunate enough to join them in the Netherlands; as were two surgeons.

My welcome was because I used Tournier’s approach as the basis for my research for a doctorate in theology and practice. After examining his methodology I applied it to the Christian healing ministry, carrying out some empirical research with ministry practitioners. I concluded, unsurprisingly, that Tournier had much to offer all of those involved in the healing of people, both through medicine and through prayer.

Earlier this year I had two hospital stays in cardiology in Southampton. One was a routine procedure and the other was more urgent follow on treatment. I was struck and left smiling by the junior doctors who wanted to know why I was a doctor. Of what? On explanation they would then want to know what my research was about and what it all meant in practice. I was pleased to tell them it was exactly what they were doing. Spending their most valuable time enquiring about my journey, my conclusions and passion for my work, they made me feel interesting and valued. I made a good recovery, not least because I felt ‘whole’ through their ways of caring. Tournier would have been impressed, I am sure, to know that a hundred years on his natural human interest in his patients was alive and well in his colleagues.

1 https://www.medecinedelapersonne.org/en

For further reading: Tournier, Paul (1965).

The Whole Person in a Broken World, Collins, London.

Bringing Knowledge for Healthcare

It isn’t enough to have the right teams in the right place, with the right skills, to deliver high quality, compassionate and efficient patient care. It’s also vital that people use the right knowledge and evidence at the right time.

Sue Lacey Bryant, Chief Knowledge Officer, and National Lead for NHS Knowledge and Library Services in England, Health Education England

Knowledge Healthcare

Applying knowledge into action is the currency of successful healthcare organisations. Yet, “the volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably.” 1 It is simply no longer possible to keep up without proactive knowledge services, without the right decision support tools, and without digital as a driver.

Thankfully, across the UK, NHS staff and learners can use a business-

critical combo of digital collections co-ordinated with knowledge services provided by NHS library teams.

In England, our duty to use evidence from research is embodied in the Health and Care Act 2022 and the national NHS knowledge and library services team is implementing Knowledge for Healthcare, a forward-looking strategy. 2

The right information at the right time

Knowledge comes in lots of different guises – learning and insights gained through experience as well as evidence obtained from research. Health and care staff draw on countless sources of evidence to underpin policy and practice but most are time poor. Many feel deluged by information. Some find it difficult to find evidence, let alone critique it.

Our new NHS Knowledge and Library Hub at www.library.nhs.uk is a treasure trove of knowledge and evidence resources. These are provided for the whole health and care ‘family’ in England. Whether you work in the NHS, social care, prisons, are a community pharmacist or a dentist, an Open Athens password is your key to e-journals, e-books, handbooks, prescribing guidelines and more. 3

We provide BMJ Best Practice as a national clinical decision support tool, helping clinicians to meet the complex needs of patients. 4 We see more trusts integrating BMJBP into the electronic patient record and hear of trainees using this to take small bites of learning in 5 minutes here and there. They call it ‘Time Confetti’.

Patients and carers need the right information at the right time too. However, health and digital literacy levels in England are very low. Connectivity is another issue. The borough-level geodata we provide is useful for those planning initiatives to address health inequalities. 5 Meanwhile, our 30-minute elearning on health literacy shares simple communication techniques like ‘chunk and check’. 6

Staff ‘know-how’, gained through hard-won experience, is an invaluable knowledge asset. The Knowledge Mobilisation Framework7 is a kitbag crammed with quick, practical techniques that any one of us can use to ensure our teams learn from others about “What works - and what doesn’t?”

We don’t always appreciate knowledge as an asset in health and care. Yet our capability to coordinate and mobilise knowledge underpins our success. Our online Knowledge Mobilisation Self-Assessment tool enables Boards, directorates and teams to ‘take stock’ and develop an action plan to make better use of external evidence and organisational knowledge. 9

The right skill mix

By searching, synthesising and summarising evidence, knowledge and library specialists offer the precious ‘Gift of time’ to colleagues, and take the ‘heavy lifting’ out of getting evidence into practice. 8 Get in touch with your local NHS knowledge and library service to discover ways in which they can help you.

For more information contact your local NHS knowledge and library Service: https://www.hlisd.org/

Sue Lacey Bryant: knowledgeforhealthcare.england@hee.nhs.uk

Links 1. Gawande, Atul. The Checklist Manifesto: How to get things right. Metropolitan Books, 2009 2. https://www.hee.nhs.uk/our-work/knowledge-for-healthcare 3. https://library.nhs.uk/knowledgehub/nhs-openathens-the-key-that-unlocksso-much/ 4. https://www.bmj.com/company/hee/ 5. http://healthliteracy.geodata.uk/ 6. https://www.e-lfh.org.uk/programmes/healthliteracy/ 7. https://www.e-lfh.org.uk/programmes/knowledge-mobilisation-framework/ 8. https://www.hee.nhs.uk/our-work/library-knowledge-services/valueproposition-gift-time 9. https://library.nhs.uk/staff-learners-and-employers/knowledge-as-an-asset/

The NHS has been significantly impacted during the pandemic and must prioritise workforce investment, COVID-19 recovery and reduce the backlog of care.

To support patients, key objectives have been outlined in the NHS Long Term Plan and the NHS Operational Planning and Contracting Guidance. These objectives support the Integrated Care Systems (ICSs) priorities to:

• Enhance experience of care

• Improve the health and wellbeing of the population

• Reduce per capita cost of healthcare and improve productivity

• Address healthcare inequalities

• Increase the wellbeing and engagement of the workforce

IQVIA, a human data science company, have been working with ICSs to achieve these priorities as well as the overarching aims of the NHS. Through their Interface pharmacist team, their dedicated team of clinical pharmacists and nurses who support primary care and community health services IQVIA can support with patient identification and treatment actions, therapy reviews, patient and clinical education and flexible capacity support.

Case Study: Leicester, Leicestershire & Rutland (LLR) ICS

IQVIA were commissioned by LLR, to deliver a Respiratory Optimisation Programme over a seven-week period.

This clinical support would ease some of the pressure caused by the backlog of care and allow vulnerable patients to receive timely support due to the additional clinical capacity. IQVIA were able to:

• identify opportunities for improvement, support efficient allocation of resources and deliver patient-centric services which improve access to medicines and optimise care.

• identify gaps in care, recognise patients at risk of adverse events and improve patient outcomes.

• provide skilled capacity to deliver best care at scale and address healthcare inequalities

• provide mentorship opportunities to the multi-disciplinary team and support and sustain enhanced care

Interface pharmacists delivered 3,000 COPD clinic appointments across the ICS, working with 71 practices.

This equates to working with 54% of the ICS. Across these practices,

• 11, 348 patients had a recorded diagnosis of COPD

• 8,692 (77%) were identified as patients who may benefit from treatment optimisation

• With 7,420 (85%) of these patients invited to clinic

Of those patients seen in clinic:

• 635 patients received an escalation to their current level of management

• 100 patients received a deescalation of their current level of management

• 2132 patients maintained their current level of management

• 1,119 non-pharmacological interventions were made, including referrals for smoking cessation or pulmonary rehabilitation

Due to the pandemic and subsequent backlog in care, many of these patients had no recorded care process in the last 12 months.

After the pharmacist clinics there were significant increases to these key markers, including:

• 96% increase in patients who had a COPD review

• 171% increase in patients who had their inhaler technique checked

• 212% increase in patients with a CAT assessment

The seven-week support programme provided LLR with the additional clinical resource needed to assess and proactively manage patients with COPD.

The increased capacity benefited the health and well-being of patients whilst the multidisciplinary team were engaged with the review to provide ongoing, continued care.

For more information, visit: Twitter: @IQVIA_UK LinkedIn: IQVIA UK & Ireland www.iqvia.co.uk

Professionalisation of Healthcare Management

Professional has a broad meaning; for a lot of people is simply means getting paid for something you do regularly or making a living from a regular activity.

Ukonu Obasi, Healthcare management Lecturer, Arden University)

Professionalisation Healthcare Management

Professionalism on the other hand has to do with the expected behaviour, skill and knowledge of some who is trained for a profession. Professionals like doctors, nurses and pharmacists, have training and then are licenced to practice by a professional body.

This professional body sets out codes of conduct, which practitioners of the profession must abide by, and failure to do so, can mean being sanctioned or

prevented from practice. In this way, the there is professionalism for those professions.

The role of the healthcare manager should be professionalised. The healthcare manager has significant responsibility for the health and well being of vulnerable people. Their actions and inactions impact on the health of those individuals and their loved ones.

It is therefore important that healthcare managers have a code of conduct, and they can be regulated with the possibility of sanction and withdrawal of licence to practice.

The professionalisation of the healthcare manager role, is one way to improve quality standard, and ensure greater accountability for practice. Right now, anyone with a basic knowledge of healthcare can apply and receive a Care Quality Commission (CQC) approval to run a care centre.

With this approval, the person can set up an organisation and become a provider of care, subject to the approval of a local authority. This means that there is no standard qualification for healthcare managers, and there is no regulation of healthcare managers in the United Kingdom (UK).

What should happen is that there should be an accepted qualification for healthcare managers. Universities like Arden University provide Bachelor of Science (B.Sc) degree in Healthcare management.

Just as the accepted standard for nursing is now a B.Sc in nursing, this would also make the role of healthcare management recognised and considered a professional role in healthcare.

Nurses are granted their licence to practice by the Nursing and Midwifery Council (NMC). This role can be played by the Institute of Health and Social Care Management (IHSCM).

The professional body will ensure the professionalisation of the healthcare management role, the regulation of the qualification to ensure high standard, to enforcement of code of conduct that will help to ensure quality of practice and care provision, and this will improve the standard, prestige and image of the profession.

It will allow it to attract and keep the best practitioners, develop research and ensure that service users are safe.

We have all seen and heard about what could happen when care goes wrong.

We all know that sometimes, no one is held to account when that happens.

This measure will go a long way to ensure that we have a way of identifying poor quality in care management, before service users are harmed.

Integrated solutions for your workforce

mii Rota and mii Roster are integrated solutions designed by the NHS for the NHS ensuring workforce optimisation, compliance with current rules, and flexibility for policy changes in the future.

Available for all staff groups, these market changing solutions deliver an exceptional mobile app-enabled user experience, true interoperability, and intelligent reporting.

mii Rota enables the creation of rotas based on demand, while mii Roster replaces existing manually intensive medical rostering processes with an NHS designed cloud-based solution, helping you to optimise your medical workforce.

Part of the mii platform, facilitating a shared vision for procurement, data, intelligence and best practice to drive improvements across the NHS.

To find out more, visit liaisongroup.com/liaison-workforce or get in touch at info@liaisongroup.com or telephone 0845 603 9000

Ensuring Sustainability Health and Care

Sustainability in Health and Social Care is a paramount issue. The NHS has been facing unprecedented pressures since at least 2010, exacerbated by the pandemic, although, the health and social care challenges in the U.K. are rooted in the workforce agenda.

Sustainability in Social

This is exacerbated by waiting lists for consultant-led elective care 1 and staff shortages2 . Navigating through growing obstacles without interrupting the delivery of safe care across the U.K. must be prioritised.

Leading the MedTech Sustainability action plan

For 125 years, BD has been advancing the world of healthTM. During that time, our experience in developing solutions for an array of healthcare

complexities and their associated manufacturing and supply chain challenges affords us insights into operating sustainably. We are proud of our sustainability commitments and goals, which will evolve to continue meeting the needs of our business and stakeholders.

At our Plymouth manufacturing facility, we continue to build and implement a pipeline of projects to lower our environmental impact 3 ,

Greg Quinn, Director Of Public Policy & Advocacy, BD

ensure a responsible supply chain and maintain a healthy and thriving workforce. These efforts are aligned with national targets and stakeholder expectations.

Creating agile supply chains

With ongoing economic and geographic instability, we must create supply chains that are adaptable to disruption, sensitive to the environment, and robust to ensure continuity in the delivery of healthcare.

By developing effective frameworks by which the best medicines, devices and technologies can be provided without compromising quality, contributes towards more affordable, and accessible care in a more sustainable fashion. This must include evolving sustainable manufacturing innovation allied to best practice logistics support.

Ensuring patient and worker safety

The link between staff shortages and impact on mental health and wellbeing are known – but shortages also put patient safety at risk 4 . Training is integral in ensuring patient and worker safety. Industry support, patient coalitions, and strong health policy can help establish a sustainable workforce, alleviate staff pressure and optimise patient care.

These gains optimise efficiencies and safety when allied to increased uptake in automation.

Ongoing provision of personalised and timely support

An effective personalised approach to health and social services connects people to their communities and environment.

This requires an integrated resolution which takes into consideration the needs of the patient as well as those of the services that patients will need to access ensuring they receive the right care, at the right place, at the right time.

Our current challenges are not insurmountable. Through strategic partnerships, industrial collaboration, technology and innovation, we are building a sustainable integrated Health and Social Care model that benefits all stakeholders.

1 British Medical Association (BMA). NHS backlog data analysis. September 2022. Available at: https://www.bma.org.uk/advice-andsupport/nhs-delivery-and-workforce/pressures/nhs-backlog-dataanalysis. Last accessed: September 2022

2 House of Commons Health and Social Care Committee. 2022. Workforce: recruitment, training and retention in health and social care. Available at: https://committees.parliament.uk/publications/23246/ documents/169640/default/. Last accessed: September 2022

3 Environmental, Social and Governance, BD, accessed 02 December 2022,  https://www.bd.com/en-us/about-bd/esg

4 NHS medical staffing data analysis (bma.org.uk) Mental health impacts of COVID-19 on NHS healthcare staff - POST (parliament. uk) NHS workforce shortage has "serious and detrimental" impact on services - NHS Providers

It’s Time to Deliver Fair Pay for Nursing

Nursing is in my view one of the best jobs in the world and should be rewarded appropriately so that patients continue to have experienced nursing staff there when they need them delivering the best and safest care, they have the right to receive.

Maria Trewern, Director, Clinical Workforce and Quality, Jigsaw Management Partnership

Fair Nursing

Nursing is in my view one of the best jobs in the world and should be rewarded appropriately so that patients continue to have experienced nursing staff there when they need them delivering the best and safest care, they have the right to receive.

However, the current situation with the cost of living totally out of control, a Govt having been in limbo for months, over 47,000 NHS nursing posts vacant and rising. Alongside this there is the issue of the decade old Agenda for Change job descriptors which do not reflect the highly skilled nursing roles of today which should attract a pay level commensurate with the responsibility of that role. Whereas, in fact, nursing pay has fallen behind by a significant margin over the last decade.

Nursing staff always want to deliver their best for those in their care. However, staffing shortages mean they are stretched to breaking point which impacts the care they can deliver. They can clearly see that the demands, complexity and responsibility of their role continues to grow but pay doesn’t reflect this. Many leave each shift feeling worried, burnt out, stressed and exhausted. This is not sustainable nor is it acceptable that staff should feel this way.

The Government and successive Ministers for Health continued refusal to recognise the skill and responsibility of the job is pushing people out of the profession. This reflects their failure to address the concerns about patient safety due to escalating staff shortages, low morale, lack of a workforce

planning, but still expect staff goodwill to keep services running and patients safe. It is Government’s failure to award a meaningful pay award that clearly indicates to nursing staff just how undervalued they are by politicians.

Now the Government needs to sit up and take notice, the Royal College of Nursing is simultaneously balloting across all the UK for members to state their willingness to take strike action. The RCN and other unions feel there is now no alternative but to take this major step.

NHS Pay is a political choice. Governments across the UK can decide on nursing pay at any time – it’s not true that they don’t have a choice - they do. In not doing so, refusing to cover potential pay awards, it significantly hinders employers, increases the risk of ever increasing vacancies with resulting risk to patients being without the level of nursing staff needed for their care.

Be under no illusion, nursing staff, the largest part of the NHS workforce, are angry, organised, campaigning for a significant pay increase which if not forthcoming may push them into taking industrial action and with public support.

Nursing staff deserve better, they deserve respect and an acknowledgement of their skills, dedication and the highly valued care they deliver each and every day. When they have this from the Government employers, then, and only then, will recruitment soar, retention prove a reality and patients and their families will benefit accordingly.

It’s time to deliver fair pay for nursing.

New Postgraduate Healthcare Management degrees

Available from October 2021

Developed to meet the increasing demand for managing and leading preventive health services in communicable and non-communicable diseases.

Arden University offers you the opportunity to study online around your current job

MASTER OF PUBLIC HEALTH

Aligned to APHEA European Public Health competencies, this programme will prepare you for a career in the public health sector with particular focus on the latest digital and analytical skills sought by employers.

MSc GLOBAL HEALTH MANAGEMENT

Designed in collaboration with leading employers , this course focuses on issues that impact health but transcend national boundaries.

More full and short qualifications coming in early 2022, including leader and senior leader apprenticeship routes

For more information or to apply please visit arden.ac.uk

Sue Jones, Independent facilitator

It is unfortunately the norm when someone needs care, a social worker, or health care professional will prescribe the care they think the person needs. This is often done without real understanding of the person’s needs and the support they have around them.

There is a widely held assumption that this type of prescribing of care is the most effective and efficient to do so. There are alternatives though that can improve outcomes and save money. A case study below provides an example of what is happening currently and what that could turn into using a different approach.

A lady aged 79 was diagnosed with an advanced terminal illness and was classed as end of life. As such she was entitled to Continuing Health Care. Her family included her husband and four daughters who were able to support Mum, but needed some extra help. The social worker assessed what they felt she needed which was two carers for an hour four times a day, seven days a week. There was little communication with the social worker and the home care company. The care plan was around tasks for the carers to complete within the time frame allocated.

This was at a cost of £23 per hour per carer which totalled £1,288 per week. When the care began there was frequently little for the carers to do because the daughters or husband were there to support. This resulted in the carers only doing part of the hour or the family trying to find tasks for them to do.

What the family really wanted and needed was the following:

• A conversation around what the whole family actually needed and what would benefit them most.

• This would have included moving and handling training because the family were afraid of hurting their Mum and

wanted to do this safely.

• Practical guidance on delivering personal care

The solution

In an ideal world a social worker, healthcare professional and family should meet initially to discuss what a good outcome would be for Mum.

Also discuss the various option that are open to families such as direct payments that give people the control as to what and how they pay.

An ideal outcome would have looked like this:

• Organise moving and handling training for the family

• Provide practical advice on delivering personal care

• With the agreement of all involved one care assistant would help the family to support Mum, three times a day for one hour, seven days a week. (The family could choose their provider). This involved care tasks or help around the home.

• The cost of which was £483. A saving of £805 based on the hourly rate above. Even if the hourly rate went up to £30 per hour it would still be a saving of £658.

There are many other examples where a multi-disciplinary approach provides better outcomes, saves money, and saves the NHS. This happens in home care every day and Buurtzorg are also champions of this approach. It works.

Be a Learning Disability Cheerleader

The introduction of Tier 1 of the Oliver McGowan Mandatory Training in Learning Disability and Autism in November coincided with the ITV News investigation into the current lack of appropriate community-based support for children and young adults with a learning disability.

Nicola Simpson, The Learning Disability Cheerleader

When we think social care, it is often dementia or mental health which immediately springs to mind. But, how can we as people with a learning disability, carers, families and professionals improve understanding and public perception of learning disability? Well, we could become the biggest cheerleaders of the learning disability sector!

Empathy:

Being able to put ourselves in the place of someone with a learning disability is imperative to cheerleading their interests, hopes and aspirations. If we as professionals consistently plan services from the perspective of those individuals who use them, these services are theoretically more likely to be meaningful, person-centred and achieve personal and service outcomes. Likewise, a public who understands individuals will likely feel compelled to push general policy conversations forward.

Experience:

We can only cheerlead the sector if we honestly acknowledge the diverse experiences of people with a learning disability and accept that historically these have not always been positive. By doing this, we can work collaboratively with individuals and their families to listen to their stories and prevent those from the past being retold. We

need to celebrate the diversity of experiences, talents and skills shared by people with a learning disability.

Engagement:

To cheerlead the learning disability sector and develop the public’s relationship with individuals with a learning disability, effective communication is key. Talking to people with a learning disability, their families and friends; listening to their views, experiences and concerns, I would suggest, is the most effective way to secure meaningful involvement, quality support and lasting empowerment.

Empowerment:

Truly empowering adults with a learning disability involves flipping the narrative of the past and handing the power over to them. Individuals with a learning disability need to see themselves and be seen, within their communities, as active agents of decision making and change. Key to this is working in partnership with professionals, policymakers and communities. Collaborative decisions will inevitably further the opportunities available to individuals with a learning disability and ensure that these opportunities are fully taken up

Putting People at the Heart of Integrated Outpatient Pathway Optimisation

Integrated care is imperative for improved population health. Through proper collaboration we can tackle inequalities, enhance productivity, reduce costs while bringing down the post covid backlog.

Integrated care calls for an integration of purpose, process, and data with people at the heart.

In other industries when change is needed, separate teams (people) are brought together into the same place.

The aim is to agree on the same purpose, share the same data, collaborate on implementation of best practice, work out their differences and challenge the status quo. It’s not so easy, but done correctly, it speeds the process towards successful change and improvement.

So how can people in healthcare, working in the same health system, treating the same patients do so effectively if they:

• Never meet or communicate effectively

• Look at different data

• Use incompatible PAS/EPR systems

• Have different goals and different drivers?

What if we looked at this in a different way,  changed the way we collaborate with other organisations and involved our patients as well?

That is why Libera and Neon have collaborated to bring together:

• Decades of experience across Primary Care & Secondary Care.

• Change management and OD expertise combined with deep analytical and software expertise.

We share the same purpose driven approach and strong belief in the value of the NHS.

Our solution is practical and achievable. It focuses on people, together with the right balance of process and technology.

Kris Glover, MD & Founder, Neon Health Solutions

Miriam Lemar, Partner, Libera Partners LLP

Our approach will:

• Give patients access to the information they need to navigate their own system of care increasing control, improving understanding and collaboration.

• Provide OD and change management support to drive:

- Collaboration and communication across the whole patient pathway

- Data driven focus on key areas of opportunity.

- Improved Advice and Guidance between Primary and Secondary care.

- Improve the relationship between acute and primary care by understanding each other better and aligning on the shared purpose

• Share access to a single analytics and integrated modelling platform available to clinicians and teams across an ICS

We are writing this at a time of crisis in the NHS, there is ongoing industrial action, waiting lists are larger than ever.

Primary care is creaking, secondary care is struggling to address a backlog that continues to grow and our populace is more and more disillusioned with the service.

We can’t produce more clinicians and nurses in the very short term. We need to work better together across the organisational boundaries, understand each others perspective and cultures, and do things differently.

We need to improve the patient experience and develop better working relationships across providers, only this will increase productivity and efficiency in each organisation. It will result in better trained and happier staff, increased retention and deliver against the ICS objectives –improving patient care: a win win.

If you want to push boundaries, give us a call.

Making a datadriven difference winter resilience

Everyone is struggling with the pressures of winter and even more so this year with the costof-living crisis and the impacts of the war in Ukraine.

Aspects that only add to the already tortuous backlog challenges driven by the pandemic.

datadifference to resilience

To provide some glimmers of hope as you tackle these pressing problems, we highlight a couple of successes we’ve seen, from the introduction of a live A&E sitrep dashboard to the impact of a system-wide demand and capacity model. These are initiatives we’ve developed together with our healthcare customers which have made a difference to their winter resilience.

1) Identifying pressure points in A&E and across a system through live daily sitrep reports

In Somerset, urgent analytical support was needed for their Winter Room programme to help inform ICS

decision making in building their resilience to winter pressures.

To help them, we developed reporting dashboards that provided a combination of time series and other visualisations to clearly show the trends in urgent care demand and the continuing impact on elective care. These could be easily viewed on TV screens in the Winter Room as well as being shared across system partners. The ICS is now looking to enhance this capability by further developing the live A&E data report with a local provider so that they can predict future demands and early warning systems.

2) Creating a system-wide demand and capacity model to identify capacity gaps and risks

To forecast the demand for services and support their winter planning, Bath and North East Somerset, Swindon and Wiltshire ICB urgently needed to understand demand and capacity across their entire system. We worked with them to develop a systemwide demand and capacity model that could model multiple scenarios based on recent demand. The model enabled them to identify capacity gaps and highlight risks across acute and community providers, including by types of bed.

The fully tested model enabled them to forecast bed usage, discharges, and community demand. This was achieved through segmenting the population by patient/admission characteristics and defining projected lengths of stay (LoS) for each patient grouping based on historical data. The ICB was able to highlight risks and explore mitigations using a snapshot of projected demand and capacity from within the Urgent Care system over a 6–9-month period for several scenarios.

A range of bed gaps were identified across different scenarios for each provider. These helped to identify the potential levels of mitigation needed, against which projected winter scheme impacts could be compared.

The use of this single system-wide modelling approach facilitated constructive system-wide discussions

and actions. These benefited from being based on a consistent and comparable picture. Additionally, the model’s underpinning methodology ensured that data could be easily updated enabling ongoing comparison between the latest demand and capacity data and original projections.

“The support from SCW was integral in providing our system with a robust approach to planning and managing through a challenging period. Importantly, the model gave partners within the system a trusted evidence base around which to collaborate and agreeSam Wheeler, Assistant Director Business Intelligence - System Architecture and Transformation, NHS BSW ICS”

These two compelling cases give a flavour of the contribution data and insight can make to effective evidence-based decisions. Appropriately informed collaborative choices are a vital component in addressing winter pressures as well as wider system challenges. Our analytical experts were pleased to contribute the underpinning support to achieve this.

To find out more about how SCW can help with data-driven decision making and your winter pressure challenges, contact Paul Walton, our Associate Director of BI Consulting, paul.walton1@nhs.net