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june 2013

about integrated healthcare

Collaborating with Ecominds

Improving health and wellbeing with the Idle Valley Project see page 6 championing CPA growing a future fit for work Taking Steps cooking up a storm


MESSAGE

FROM THE BOARD

Welcome to another busy edition of our Positive newsletter – each month there seems to be more to report on and more achievements to celebrate. This month we look at feedback from the Members’ Council, loads to celebrate with the signing of our Children’s Centres contract and a roundup of news and views from around the Trust. Health Partnerships has recently had its contract for community services extended for a period of one year by the Nottinghamshire Clinical Commissioning Groups (CCGs).This means the contract will now run until 31 March 2015. Congratulations to all those involved in the partnership who have worked so hard to secure this extension. Each month I feel privileged to read about what you are all getting up to –

working together to develop our services and improve our patient and service user experience. The Trust Board is aware how difficult things are in the NHS at the moment – with the constant barrage of negative media coverage. We’re proud that at Nottinghamshire Healthcare we continue to work hard to deliver for the people that matter, so thanks to your teams for that and the support you give to each other. 1 May saw us make our submission to the National Trust Development Authority (NTDA) in our journey to Foundation Trust. May has also seen the start of our robust Accountability Reviews where the performance of the Divisions and the Corporate function is challenged and validated. These are always an interesting experience – from both sides of the table and thanks to colleagues who have been so well prepared!

I look forward to hearing more from you all next month.

Professor Mike Cooke CBE Chief Executive

Ben Nevis – conquered! In April’s Positive magazine, Andy White from the Capital Planning Unit told readers all about his plans to climb Ben Nevis, in support of New Life Children’s Centres in the Gambia. “I’m pleased to announce that the trip was successful, although the last 1000ft were very testing being climbed in snow and ice!” said Andy. “We were hoping to raise £10,000 between 20 climbers

Andy conquers the summit

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and although only 11 did take part, by the following morning we had raised £8,000 and our total is still rising. “I’d like to thank all those who sponsored me, including the Trust’s Principal Supply Chain Partner Balfour Beatty, who contributed £500.” To give a donation, either contact Andy on 0115 9691300 x 16283 or 07767 641477 or email andy.white@nottshc.nhs.uk. For further information go to www.newlifegambia.co.uk.


Care Pathways Launch Event: Local Services Wednesday 10 April was a significant and exciting date for Local Services – over 60 service users/carers and staff attended The Park Inn Nottingham to launch the development of mental health care pathways. The event was opened by Amanda Kemp (Deputy Executive Director of Local Services) who provided an overview of the afternoon and spoke about the importance of the work to be done with the support of our service users/carers and staff, the impact this work will have on the quality of service delivery, the future funding of our services and patient outcomes and benefits. The care pathways event provided an opportunity for delegates to hear presentations from Commissioners, lead clinicians and a Trust governor about the expectations, development and implementation of care pathways for Nottinghamshire Healthcare. During the event two chosen pathways (Cluster 10 and 20) were presented which provided delegates time to carry out a table exercise to collate their opinions, views and suggestions from a set of four questions. The development of pathways will be ongoing. An event providing an opportunity to view pathways specifically relating to dementia was held last month at Highbury Hospital. For further information contact Claire.Holmes@nottshc.nhs.uk, Andrea.Cain@nottshc.nhs.uk or Rachel.Redford@nottshc.nhs.uk.

Trust Annual General Meeting This year the Trust’s Annual General Meeting and Annual Members’ Meeting will be held on Friday 26 July at the East Midlands Conference Centre, University Park, Nottingham NG7 2RJ. Lunch will be provided. The theme is ‘Integration Working for patients’ and will focus on integrated services and how this has improved patient care. The event will run from 11.00am featuring over 80 interactive stands showcasing stories of excellence and good practice across the Trust. This will be followed by the Annual General Meeting and Annual Members’ Meeting at 1.00pm. For more information and to register online from 14 June please visit: www.nottshealthcareagm2013.co.uk

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Championing CPA across the Trust Care Programme Approach conference The Care Programme Approach (CPA) Improving Quality of Care and Service Users’ Experience Conference was held in March. Attendees heard from Deanna Westwood, Care Quality Commission (CQC)’s Compliance Manager for the Central Region, on the CQC’s view about driving quality and the importance of CPA in evidencing the work the Trust is doing in patient care. Local Services/CPA/MHA Manager Jaswinder Basi said: “Generally the CQC don’t come to present, so we’re thankful to Deanna for providing an excellent presentation on their perspective.” The conference was chaired by Medical Director Dr Peter Miller, who gave an excellent overview of the importance of the delivery of the Care Programme Approach. The conference was well received by the 115 attendees from all clinical areas in Local Services. Feedback included: ‘Thanks for an interesting, enjoyable & thoughtprovoking day’, ‘I feel motivated to review my care plans’ and ‘It has refreshed my perception hearing direct stories of service users’ experience.’ Throughout the day workshops focused on core areas of assessment, care planning and service user involvement.

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Professor Patrick Callaghan delivered a workshop on assessment focusing on core assessment skills and identifying needs through effective engagement with service users. Research Fellow Elizabeth Khalil and Research Assistant, Andrew Grundy ran a Care Planning workshop looking at how to deliver clear care plans as well as identifying how therapeutic interventions would deliver on the needs identified during assessments. A service user involvement workshop was delivered by service users recently trained through the CPA Champions project (see article opposite). They promoted effective engagement with service users. Clinicians all went away with their own action plans to implement over the next few months in their everyday practice. The CPA Team will be organising a further conference to take place in October and views this as a positive step towards driving for the highest standards in Assessment, Care Planning, Service User Involvement and Care Co-ordination.

Dr Peter Miller and Senior Managers Zoe Rowe, Sandra Crawford, Jane Danforth, Jonathan Wright, Paul Carruthers and Angie Jackson came together to present certificates and congratulate Service Users John Chambers, Julie Ford, Fedora Freestone and Eileen Burnside for successfully completing the CPA Champions Training Course 2012-2013. The course, led by Local Services/ CPA/MHA Manager Jaswinder Basi, supported them in gaining a detailed understanding of the Care Programme Approach and the important role it plays in the care of patients and service users, through promoting effective assessment and delivery of therapeutic care plans. The Champions were taught presentation skills, including the use of PowerPoint, and learnt how to effectively deliver their message using a multitude of visual and auditory techniques in teaching.


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Each of the service users developed individual presentations which they delivered on the Presentation Day. The topics covered were the importance of including carers; service user involvement; care plans; and overuse of medication. The Champions have committed themselves to promoting the CPA across the Trust, working with the CPA team in developing information for service users. From August they will also be involved in delivering parts of the Care Co-ordinator training. One key element of the Local Services Governance department’s CPA/ MHA teams’ CPA strategic plan is to improve the overall experience of patients, carers and services users – also one of the Trust’s top three priorities. Jaswinder said: “A new CPA Champions course will be run from August to give more service users the chance to learn presentation skills, effective communication and confidence building. “If you know of any service users who would benefit from this course and would be interested, please put them in contact with either Emma Mosby or Bethany Mobbs-White at the CPA Office on 0115 9934580.” From left, Jaswinder Basi, Zoe Rowe, Angie Jackson, Paul Carruthers, Sandra Crawford, Jane Danforth, Julie Ford, John Chambers, Eileen Burnside, Fedora Freestone, Jonathan Wright, Dr Pete Miller and Alan Coomes

Regaining confidence after a stroke

The Trust offers a 10-week course for stroke survivors of any age who, within the first two years after their stroke, need support in adjusting to how stroke has changed their lives. This course is supported by County Health Partnerships, Sherwood Forest Hospitals and Nottinghamshire County Council. Below is Joan Tinsley’s story. Since this interview Joan has sadly passed away and this article has been published in her memory with the kind permission of her husband Len.

“I had a very full life before my stroke. I used to exercise three times a week, I really miss that. I was in the house when my stroke happened. I was in the conservatory folding the clean washing, I leaned over to place the folded washing on a pile and I sat down. I don’t remember much but my husband found me slumped over the chair. Len called the paramedics and they came really quickly, apparently they were only

in the village and came straight away. They said that I had had a ‘slight stroke’. At first they thought it was a hypo as I am diabetic. Len said: “I knew from my experience as a medic that it was not a hypo and that it was more serious than they were making out.” They called for the ambulance eventually and took me to City Hospital. They did all the usual tests, took bloods and put me on a drip with a tube up my nose. I had had a severe stroke and could hardly talk. I was very miserable. After ten weeks in hospital and they had got me on my feet they told me I could go home, that felt great. The START team came in for six weeks but we struggled with adaptations and ramps and conversion of the bathroom to start with. It would have been much better if all that had been done prior to me coming out of hospital. I got a social care package which was four times a day, that’s now down to two visits. They help to get me get into the shower and help me shower, then they get me dressed. They come again later in the day to get me ready for bed. Since going on the Regaining Confidence After Stroke course I started going to the gym and I tried chair-based exercises but didn’t like them. I try to do more at home with my husband, who encourages me. Meeting other people helped me and it was also helpful seeing what experiences they had. And yes the course did make me feel better about myself. My husband has learnt from the course so he sets goals for me and helps me to achieve them – he nags. I worked with the Health Service for 38 years; we had planned for our retirement with lots of hopes and dreams, I now feel quite positive and I look forward to going on the next cruise.” For more information on the Regaining Confidence After Stroke course, email dawn.anderson@nottshc-chp.nhs.uk or call 01623 673302.

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Collaborating with Ecominds for mental wellbeing Let’s Talk Wellbeing Bassetlaw IAPT service aims to improve the health and wellbeing of people with depression and anxiety, and part of its remit is to link closely with community groups and projects that improve wellbeing in diverse and innovative ways.

tasks within a supportive group. The emphasis is on developing social skills and networks, confidence building and learning new skills to promote progression into training, mainstream volunteering or employment.

One such voluntary sector project is the Idle Valley Ecominds Project, a conservation project run by Nottinghamshire Wildlife Trust on the Idle Valley Nature Reserve near Retford. This project now needs the support of GPs in the area if it is to continue to offer its award winning service, and Let’s Talk Wellbeing is adding its voice to the call for it to be recognised as a complementary treatment option.

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Over the past two years, 32 participants have indicated very positive outcomes as a result of attending the project: “As a service we are very fortunate to have the Idle Valley Ecominds Project on our doorstep and have begun to work more closely with the project,” said Clinical Lead Dr Mick Collins. “We are able to refer patients to the service and have been particularly impressed with the work that is done and feedback that we have had.”

• 88% report improved mental wellbeing • 69% report a major improvement in mental wellbeing • 75% report improved confidence • 55% report improved physical health • 100% report a positive and supportive atmosphere.

The project gives people experiencing mental health issues the opportunity to get out in the fresh air and take part in practical conservation and horticulture

There is a growing amount of research into the therapeutic benefits of outdoor activity for mental health service users, showing that these activities can be


Doverbeck have the recipe for success A dash of imagination, a sprinkling of inspiration and a bit of bakery brilliance proved a winning recipe for the residential intermediate care team and their clients at the Doverbeck Unit, Maun View. Runwood Homes, which runs Maun View, held an Easter cake competition across its 62 residential homes. On the Doverbeck Unit, the patients and team of a Physiotherapist, Occupational Therapist and two technical instructors decided to take part as one of their groupbased activities which encourage and promote activities of daily living. Technical instructor Lisa Clibbery said: “We chose a rehabilitation-themed cake, with rabbits as the patients and an Easter chick as a therapy team member. The rabbits were completing bed transfers supervised by a therapist, and doing walking practice within the parallel bars. “The patients decided to make it a colourful spring explosion with a meadow and flowers. Each stage was photographed and the recipe and ethos behind it sent to Runwood’s head office. “We waited and waited then out of the blue came the phone call to say we had won first place and £200 in home improvement vouchers to spend on the unit. The staff and patients are already finding ways of using them to improve our service!”

as effective as antidepressants in treating mild to moderate anxiety and depression. Mind’s 2007 research into the benefits of outdoor activity in green spaces concluded that it can have a dramatic effect on boosting self-esteem and lowering stress levels. It can also be available without the waiting times, costs or negative side effects associated with many other treatment options.

The fantastic finished cake

Let’s Talk Wellbeing Bassetlaw has pledged its support to further the collaboration of the Trust with Ecominds, and assist in raising awareness within the local primary healthcare community. For more information and referral forms go to www.nottinghamshirewildlife.org/ ecominds or contact Beccy Lees, Ecominds Project Officer on 01777 713940 or email rlees@nottswt.co.uk

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Adolescent Unit wins funding to further its vision for care Inspired and motivated by the exceptional Dialectical Behavioural Therapy (DBT) training facilitated by Allison Tennant and her team last year, the Thorneywood Adolescent Unit team has designed and implemented its own programme. The team has also now secured NICE funding to develop the vision further. “The underpinning principles of DBT of mindful awareness, balancing acceptance with change and the unrelenting faith in human beings and their capacity for change, resonated with us as a team,” explained Staff Nurse Eleanor Dean. “We left the training determined to weave these principles into our philosophy of care. Although DBT was originally designed to treat adults with personality disorder, we recognised its applicability to our client group as an early intervention, given the very nature of adolescence with many of our young people regardless of ‘diagnosis’, who struggle to adapt to change and manage their overwhelming emotions and emerging personality.” DBT skills are taught on both a group and individual basis, with young people completing homework following sessions to practice and build confidence in applying the skills learnt.

Self-harm has significantly reduced since DBT was implemented on the unit, and young people report feeling more self-aware, hopeful about the future, confident and in control. Eleanor added: “We wrote a bid incorporating our positive outcome measures and experiences which we delivered with a service user and family member to the NICE panel in March and were delighted to be awarded over £11,000 to develop our DBT vision. “We are using this money to train our team and develop and implement a parental skills group, in order to provide a DBT based model of care that will guide the way we work with all young people and their parents and carers on the unit. “A huge thank you to the Peaks Unit at Rampton Hospital for sharing with us their valuable knowledge and expertise and for giving us the skills to bring hope to others.”

New artwork on the unit

What the young people have to say about DBT: “DBT is wicked and awesome. As patients at Thorneywood Adolescent Unit, we all use DBT in different ways with diagnosis ranging from anorexia to emotional dysregulation to depression or schizophrenia. “It can be a very useful coping strategy as it aids recovery by reminding us of different ways to cope during difficult situations in everyday life that are not detrimental to our health. “From mindfulness to distraction techniques each person can benefit from incorporating DBT skills into their daily routine to enable a healthier, happier lifestyle. It gives us that time we need to focus away from our diagnosis and to experience some time out which stays beneficial for a prolonged period of time after each DBT session.”

Foster Care Fortnight Foster carers in Nottinghamshire have gone online to share their experiences of fostering during Foster Care Fortnight (13 to 26 May). In a series of video clips which appear on Nottinghamshire County Council’s website, seven carers talk about what inspired them to start fostering and the huge rewards it brings them. They also offer advice to those thinking about fostering and talk about the approval process and the ongoing support they receive from the Council.

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From left, Charge Nurse Amanda Forster, Nurse Consultant Allison Tennant, Staff Nurse Eleanor Dean, Ward Manager Adeline Hunt and Clinical Psychologist Kathy Huke


Executive Mentoring Scheme – the legacy continues This year’s participants on the Executive Mentoring Scheme chose ‘Healthy Body, Healthy Mind’ as their message for reaching out to local people.

Positive feedback from visitors included requests to reproduce the events in other arenas such as schools. Babita Chady, Health Care Assistant, CAMHS said: “Our thanks go to all who attended and the people who provided their expertise to make the events an exceptionally rewarding experience.” Other members of the team were: Debbie Barnes, Rampton Hospital Visit Host Coordinator; Michelle Brooks, New Leaf Advisor; Sujata Das, Consultant; Carolyn Desforges, SLT co-ordinator; Jean Gregory, District Lead; Jayesh Jani, Performance

Analyst; Anne Spooner, Integrated Adult Community Team Professional Lead; and Jane Swan, Senior Medicines Management Advisor. About the Executive Mentoring Scheme The Trust’s Executive Mentoring Scheme started in 2007, launched by Chief Executive Mike Cooke. The legacy continued in 2010 when the Trust re-launched the scheme for a second cohort which successfully delivered three projects – the Strategy for Success, Mental Health Issues in BME communities and the Antibullying and Harassment Staff Helpline.

The 2012-2013 cohort engaged with the diverse community of Nottingham, delivering two one-day health events. Healthy Body Healthy Mind raised awareness of the impact of diet on mental and physical health, promoting positive wellbeing. The friendly atmosphere at ASDA in Hyson Green and Smithy Row in the City centre enabled the public to engage with specialist Asian and African mental health services, on serious health issues in a relaxed and interactive format. The free prize draw and Smoothie Bike were a highlight at both events.

Nottinghamshire’s Director for Children’s Social Care, Steve Edwards, said: “We currently have nearly 400 foster households across the county, but we need to grow this number to replace foster carers who retire or have a change of circumstances. In addition to this, we need to respond to the growing demand for foster carers due to the increasing number of children in care.” The Council’s greatest need is for carers willing to foster older children and teenagers, boys, sibling groups and children with learning disabilities.

has given them a new lease of life and completely changed their outlook. • Sue and Trev. They have managed to fit fostering into their busy lives by both working part-time. Their own daughter, now 11, has formed a close bond with the children her parents foster, treating them as if they were her own siblings. • Patricia Richards, a retired single mum from Newark. She praised the practical and emotional support she receives from her supervising social worker, meaning she never feels on own.

Examples of foster carers featured are: • Loraine and Sandy Sanderson, based in North Nottinghamshire. In their video, they talk about how fostering

Fostering team manager Tracey Coull explained: “We’re hoping that by listening to the personal stories of some of our foster carers, people who’ve been

considering fostering will feel inspired to pick up the phone and make that first call to us. The video clips are a powerful way of getting our message across. “The carers talk poignantly about the immense rewards they get from watching the children they foster grow, both physically and emotionally, becoming more confident and developing behaviour that’s more appropriate for their age.” The Council offers packages of support to its foster carers including supervised social worker support during the assessment process and afterwards; a link with an experienced carer for new foster carers; financial allowances; a programme of activities for children and young people; and ongoing training and development.

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A Sure Start to successful e Sure Start Ashfield District, which provides services across 11 Children’s Centres, recently took part in the Trust’s Patient Feedback Challenge, to fully embed their approach to collecting and responding to client feedback.

Each Sure Start Children’s Centre adapts to meet the needs of its local community, and this includes the way they engage with people. As part of the challenge, the team embraced new methods of collecting feedback including use of an iPad, feedback tree and Patient Opinion, enabling more families to not only have a say, but also to see exactly who has read the feedback and what change is being made in response. Community Development Worker Daniel Fisher said: “We have also empowered our volunteers to collect feedback, giving a voice to more families and helping shape our services to the needs of the community. “We now want to help other areas of the organisation shape their own service through increased consultation and feedback methods. “We are now using new methods to capture children’s experiences directly, through a child’s picture posted on Patient Opinion, to be responded to in pictures. We have also started a Sure Start Facebook page including links to Patient Opinion and open to all Trust staff.”

What Sure Start is doing on my street By Hannah Smith, Sure Start Volunteer I live in Kirkby-inAshfield and when I started going to Sure Start I often wondered why other parents from my street didn’t access Sure Start centres. Then I became a volunteer for Sure Start and wanted to try and see why parents wouldn’t come to the group. When Sure Start did an event on the park on my street and it was successful, I came up with a list of ideas that we could do on the park.

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I gave the list to one of the Family Health and Support Workers who was going to set up a group on Mayfield Street. The group has now been running since September and I have been gathering some feedback from parents off the street. I asked four parents who live on the street and access the Mayfield group: 1. Why didn’t you attend any Sure Start groups until Mayfield group started? Answers: I couldn’t go to groups because I am a carer for my disabled husband as well as looking after my kids. It’s too far to walk, I feel uncomfortable going to groups on my own, my working

hours change from one week to the next, groups start too early in a morning and when my little girl is at nursery in afternoon and group is in a morning it’s hard to get home after a group and walk up to nursery in time. 2. Are you enjoying the group and if so what do you like about it? Answers: I enjoy it because it’s only over the road, my kids love it, the older kids have got a good relationship with staff, I like it because I don’t have to walk far and everyone is really friendly. 3. What would you like sure start to do in the future on Mayfield Street? Answers: I would like to see a group for 12+, the 5-12 group to be on for


l engagement Other changes made in response to feedback include: • Evening volunteer training and courses • Youth club in Kirkby (see article below) • Plans to incorporate Pizza Massage at different Children’s Centres • Sessions to link into baby clinic • Working with Patient Opinion to include ‘parents/guardians’ in their list of client groups, also to promote more family/child friendly pictures promoting Patient Opinion • The need for paid peer supporters has been highlighted to Clinical Commissioning Groups (see article on page 12)

Gathering children’s feedback

• Domestic Violence drop in now delivered at alternate Children’s Centres to accommodate families with transport issues.

The Trust, in partnership with Family Action and North Nottinghamshire College recently won a contract to deliver 58 Children’s Centre Services on behalf of Nottinghamshire County Council. Pictured here are members of the collaboration known as Nottinghamshire Children and Families Partnership, at the official contract signing last month.

Daniel added: “We have been lucky to have the backing of our senior manager Karon Foulkes to enable the team to participate fully. It is seeing this bigger picture about using the challenge as a method of sharing our best practice which has been vital in our team’s success.” For more information on Sure Start, email daniel.fisher@nottshcchp.nhs.uk or call 01623 444670 or 01623 510946.

Dads get involved with local Children’s Centre group A Dads’ Group at Newstead Sure Start Children’s Centre, run by County Health Partnerships, is proving to be a great way for dads to get involved.

t bit longer than an hour and more events on the park. 4. If there were any courses to run down on the street what would you like? Answers: I would like a childcare course to do if it’s only across the park, craft course and any courses that you can get to do down here. For me, to do what the staff have done is amazing and is benefiting the children on the street. It is slowly making the street into a fantastic little community. For more information on Sure Start, email daniel.fisher@nottshc-chp.nhs.uk or call 01623 444670 or 01623 510946.

The group was developed following feedback from the dads that they would like to attend a Sure Start group, but struggled to attend during the week because of work commitments. The new group was set up for every third Saturday of the month. “On my first visit to the dads’ group I felt quite nervous and I didn’t know what to expect. This was soon eased by the welcoming staff there, they made me and my daughter feel very welcome,” said Chris Neijs. “My daughter enjoys all the events put together by the Sure Start team.

“At the beginning of this year I was asked whether I’d like to volunteer for the group, and I was delighted to take up the opportunity. I get involved in setting up for the session and helping out the staff with lunch and tidying up. While volunteering for Sure Start I have had the opportunity to take part in training courses to improve my volunteering skills. I would definitely recommend the group to other dads.” Health Improvement Practitioner Andy White added: “We have different activities each month, mostly utilising the outdoors. We welcome all male carers, dads, uncles and grandads.” For more information about the group, contact Andy on 01623 673859.

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One small step at a time… By Georgina, Health Peer Mentor volunteer “I have in my time seen the devastating effects on families whose children are removed because of their mental health issues. Parents who have to state that their child is at risk, despite the fact the children are not, so that they can access appropriate support; mothers whose children are removed and adopted when the mother wants to be the child’s parent. Equally I have seen and experienced the devastating consequences on children who have had abusive, neglectful parenting. It’s all about striking the correct balance. I hope by volunteering with County Health Partnerships that my lived experiences can improve through education, training, openly discussing and sharing what was unhelpful and what was helpful with others. That other Mums with disabilities, whether that be learning, mental or physical, can get a better service and hopefully get the correct support put into place so that they too can have an opportunity to be a parent and so that hopefully children can remain with their parents. By volunteering as a Health Peer Mentor I want to be able to offer peer support for groups of single and disabled parents, and to inform and raise awareness of Mums with disabilities to professionals. I know this is a lot to hope to achieve and there is no short quick answer but I hope my passion and drive to see change for the better for parents and children will encourage others to look at how together we can start to address the issues. My first hope is to address old beliefs about what makes a good parent. One small step at a time, with the support of County Health Partnerships and Sure Start.” For more information on the Health Peer Mentor Programme, email dawn.anderson@nottshc-chp.nhs.uk or call 01623 673302.

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Newly refurbished Family Centre Back in August 2012 the Visitors’ Centre team at Rampton Hospital started a piece of consultation work about the Family Centre. All patients who have children accredited to visit them at the Hospital were sent a questionnaire about their experiences and ideas to improve the Family Centre. As part of that questionnaire they were also asked if they wanted to be a part of an active working party. This received a great response with 17 patients becoming actively involved in the process of improving child visits. Staff from the Visitors’ Centre visited the wards and met with the working party members to gather ideas and make choices about what improvements were to be made.

The refurbishment has included: • Creating one large visiting room • New carpets, blinds and repainting • More defined age related areas for teenagers and babies/toddlers • Murals and patient artwork • New equipment and toys. It is a legal requirement for children visiting any high secure hospital to have a designated area to see their relative. There has been little change to the Family Centre since opening in 1997. The new and improved room looks great and we would like to thank the patients, visiting children and their families for their input and ideas, without which these changes would not be happening.


Dementia Friends in Action

The Trust Board was challenged recently by Andrea Ward, General Manager, Mental Health Services for Older People (MHSOP) to become Dementia Friends. Never shy to rise to a challenge, a session was developed, using the skills of the Alzheimers’ Society and the Board has now completed its awareness training.

Update from the Members’ Council The Members’ Council met on 9 April at Rampton Hospital. The main focus of the meeting was the Francis Report and the lessons learnt for our organisation. Director of Nursing, Quality and Patient Experience Dean Howells delivered the session around the Francis Report, and all the attendees were encouraged to discuss and debate the issues raised. Other updates included: • An informative environmental scan and progress report on our Foundation Trust application process from Chief Executive Mike Cooke CBE

A Dementia Friend learns a little bit more about what it’s like to live with dementia and then turns that understanding into action – anyone of any age can be a Dementia Friend. From helping someone to find the right bus to spreading the word about dementia on social media, every action counts. Friends’ information sessions are run by Dementia Friends’ Champions, who are volunteers who have taken the Dementia Friends Champions’ training. After the Dementia Friends’ information session the Alzheimer’s Society wants you to tell them about how you are going to turn your understanding of dementia into a practical action. You will get lots of ideas about the actions you can take at your Friends’ information session, and there will be lots of other ideas on the Dementia Friends’ website. You don’t have to commit to doing something timeconsuming. Every action counts. Dementia actions could include: • behaving patiently with someone showing the signs of dementia • spending more time with, helping or supporting a friend or relative affected by dementia

• signposting people affected by dementia to more information and support • volunteering with an organisation to support people with dementia. • fundraising for a dementia-related cause. • helping your workplace to be more dementia friendly. • telling other people about Dementia Friends or spreading the word through social media. “We go and do the things together that we enjoy and we work on Sue’s garden together.” Wendy, friend of Sue who is living with dementia The website will capture the ways that Dementia Friends are helping to make life better for people living with dementia in their communities. Every action registered on the website will help understand what our target of one million Dementia Friends by 2015 are doing to make life better for people with dementia. To begin please log on to www.dementiafriends.org.uk

• A presentation on the purpose of the Quality and Risk Committee from Non Executive Director Nick Plant • A presentation on the purpose of the Finance and Performance Committee from Non Executive Director Peter Parsons. Our Foundation Trust application is moving forward, and there will soon be an election process for a new Council of Governors, expected to start within the coming few months. If you are interested in standing for Governor and would like more information, contact Becky Cassidy on 0115 9691300. Members can represent their views via the Members’ Council and the Governor Member for the constituency in which they live. If you would like to get in touch with a Governor Member please contact the Membership Office on 0800 012 1623. More information about the Members’ Council can be found on the Trust website at www. nottinghamshirehealthcare.nhs.uk/ get-involved/the-members-council The next meeting of the Members’ Council will be held on Tuesday 18 June at Duncan Macmillan House.

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King’s Fund Presentations at HMP Whatton and Stocken Colleagues at HMP Whatton and HMP Stocken have been celebrating the completion of projects carried out in partnership with the prisons and the King’s Fund. Over 50% of the men at HMP Whatton are 50 years of age and over and there is an increasingly high incidence of long term conditions, palliative/terminal care and complex presentations. The Healthcare Team has worked closely with discipline colleagues and the King’s Fund ‘Enhancing the Healing Environment’ (EHE) team to complete the second project within the Prison, this time focusing on the needs of men with disabilities and dementia. The project involved the refurbishment of a small dormitory into a two-bedded room with an adapted en-suite toilet and wet room area, ensuring their dignity and safety needs are met This will allow men to remain in their normal location as long as possible, before having to move to specialist facilities or hospital. It will also facilitate the earlier discharge of men from secondary care.

Sarah Waller, CBE, Programme Director with the King’s Fund said, “I am always delighted to work with the Prison and Healthcare Team at HMP Whatton, as there is a truly integrated partnership. The emphasis on dignity is superb. The previous project is a beacon and exemplar site for palliative care. I know the Disability Suite will benefit the men that use it, as well as providing a great resource to support the work Prison and Healthcare colleagues undertake.”

The new facility was opened last month by Dr. Laurence Howard, Lord Lieutenant of Rutland and the High Sheriff of Rutland, Mrs Trish Ruddle was also present at the event. Sarah Waller CBE, together with Jeanne Hignett, Project Lead, paid tribute to Alison Hunter, Head of Healthcare and a core member of the project team who sadly passed away during the project. A plaque in her memory will be placed in the Healthcare waiting area.

Over the past eight months the Healthcare Team at HMP Stocken has worked closely with prison colleagues and the King’s Fund EHE team on a project focusing on the needs of men with dementia. Work included the refurbishment of a cell into a one bedded room with an adapted en-suite toilet and wet room area.

Kate Davies, National Head of Offender Health Commissioning with NHS England, said, “I am really impressed with the look and feel of the space that has been created. We know that environments have an impact on the way our service users behave and I am sure this project will benefit everyone that uses them. Well done everyone involved!”

The project also involved prisoners presenting their ideas of the layout and decoration of the healthcare department and they had an active role in the design and creation of bricks for a sculpture. Feedback from prisoners has been extremely positive and they have appreciated the effort of all involved.

Adrian Perks, Associate Director Offender Health added, “I would like to thank all members of the teams at Whatton and Stocken for their expertise and support in these projects. It is great to see effective service user involvement in innovative schemes and I am really pleased the facilities mirror the best of contemporary community facilities.”

l-r Sarah Waller and Jeanne Hignett at HMP Stocken

Above: the Dementia Suite at HMP Whatton Left: Healthcare and Prison colleagues present on the project at HMP Whatton

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A tiring trip for cyclist in aid of Hospice Allan Spurr, a nursing assistant at Rampton Hospital, will be cycling the length of mainland Britain on 1 August 2013 in aid of Bassetlaw Hospice, Retford. The trip, that will cover almost 1000 miles from Land’s End to John O’Groats, was originally planned for May 2011 but due to an unfortunate accident that left Allan with a dislocated shoulder, the trip was postponed.

The DVD will include Allan’s journey from 2011 through to completion of the cycling trip next month.

In recognition of the challenges Allan has faced, a DVD is being created for the recovery model that is used within Rampton Hospital where Allan is the recovery champion on Erskine Ward.

Bassetlaw Hospice provides specialist palliative care and support for the Bassetlaw community. It exists to enable patients with progressive life limiting diseases and their carers achieve the

Allan said: “I now feel ready to give it another go and I am working hard to prepare myself physically and mentally! I am undertaking this personal challenge to raise funds for the Hospice as a thank you for the tender care they provided for two of my very close friends.”

best quality of life. Each year the Charity needs to raise a minimum of £250,000. All the donations they receive help to continue this provision provided for patients and their families at what is always a very difficult time in their lives. We all know someone who has suffered the loss of someone close. Bassetlaw Hospice helps at times when things get difficult and Allan feels strongly that this is a very worthwhile cause. If you would like to sponsor Allan to raise funds for the Hospice please go to: www.virginmoneygiving.com/ AllanSpurr-end2end

Steps to safe recovery conference The Mental Health and National Learning Disability Directorate held a conference at Rampton Hospital in February, focusing on the specialist clinical practice and broad range of expertise within the three services that make up the Directorate. It was created in November 2009 following the merger of the former Mental Health Service Directorate (incorporating the Deaf Service) and the National High Secure Learning Disability Directorate. Questions were posed at the time about how such diverse clinical services could be effectively managed with their individual identities maintained under a single structure without some detrimental effect to their clinical effectiveness. Over three years later, the services that make up the Directorate are successfully integrated whilst retaining their unique clinical identity. The Steps to Safe Recovery conference showcased their innovative clinical work, and provided an opportunity to network and share good practice with colleagues from other services. Delegates including Trust staff, prison service representatives and private healthcare providers were welcomed by Clinical Director Ilona Kruppa, and Chief Executive Mike Cooke, who highlighted the importance of patient experience of quality care, and the development

of individual care pathways working towards meaningful recovery. He emphasised how important it is to always remember the patient voice. Presentations described the services’ care pathways, progress on the development of an electronic version of the care pathway, recovery initiatives and the therapeutic community approach within the high secure learning disability service.

Delegates also had the opportunity to attend up to four from a choice of twelve taster sessions designed to provide a flavour of the therapeutic interventions delivered within the three services. Feedback on the whole day was very positive, with delegates particularly enjoying the interactive taster sessions which gave an understanding of what patients experience.

Positive June 2013

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Growing a future:

Horticulture + Workskills at Rampton Hospital

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The Therapies and Education Department’s Horticulture and Workskills area at Rampton Hospital is continuing to prove popular with patients. Referrals have doubled in the past year and feedback is reflecting the positive results. Horticulture Horticulture is a garden centre and small animal unit providing both male and female patients the opportunity to work in a safe, relaxed, learning environment. Patients can take part in indoor work in polytunnels, including seeding, propagating, and planting. Outdoor garden work includes learning how to undertake various activities in a garden environment, including the welfare and feeding of poultry and fish, garden maintenance and use of machinery. Horticulture aims to offer an environment in which male and female patients can achieve individual goals and meet

personal needs identified in their care plans. The unit aims to promote physical fitness, team work, concentration, motivation, creativity, self-confidence and self awareness in patients. Through practical involvement in a range of activities, individuals can develop self esteem, enthusiasm and a sense of achievement. The staff encourage the development of skills, technical competencies and the gaining of qualifications to enhance opportunities for employment after discharge from the high secure setting. Patients are currently able to work towards a Level One City & Guilds Certificate, gaining a nationally recognised qualification.

Feedback from attendees

I attend work skills and I enjoy going a lot. I enjoy the varied activities and it feels like they are preparing me for moving on.

Seasonal produce for sale There is an abundance of fresh produce available from the Hospital’s Horticulture and Workskills Department. This is the result of a lot of hard work and dedication by patients who have engaged with the service over the winter months.  If you wish to show your support for the project you can do so by placing your orders or popping down to see the team to find out what’s on offer. Items for sale include bedding plants, herb and vegetable plants, fruit, pot plants and freshly laid free range eggs. NB – orders can only currently be taken from employees of Nottinghamshire Healthcare. When placing an order, individuals will need to provide their employee payroll number for payment purposes. To find out what is currently available visit the horticulture area of the intranet. To place an order call 01777 247 925 or email horticultureworkskills@ nottshc.nhs.uk  

I attend two sessions of workskills and two sessions of horticulture each week. If I could pack everything else in and just go there that is what I would do. I feel proud when I have completed things like concreting, plumbing; I wish it had started earlier. I feel it is benefiting me. It makes me feel better. When you see what you have achieved you feel proud. Going to these sessions is better than any anti-depressant you could have. I would like to see more animals at horticulture. The animals got me in touch with my empathy.

I am learning new skills and practising my therapeutic skills without even realising. I am also building my confidence. I benefit from it all. I am learning new skills at the workskills, looking after the animals and growing vegetables. I feel happy there. It’s the only place I feel happy. It brings out so much joy in me being there. I can go down there feeling bad and within a short time I am so happy. The staff are spot on – they are really helpful. They treat me so well and respectfully. They give me lots of praise.

I feel I am learning new skills. A lot of patients here have committed crimes using weapons and now I am trusted enough to be working with tools. It makes me feel good that I am trusted.

Positive June 2013

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Workskills Since August 2012, the team has also been running the Workskills Programme. Currently in its two-year pilot phase, it aims to teach patients techniques in various construction-based vocations, including building and plumbing, with the overall goal of preparing and equipping them for work in the future. All skills taught in the building skills area are graded for function and risk. The area gives patients the opportunity to develop team working skills by working collaboratively on major tasks such as wall building, painting and decorating, block paving, fence construction, tiling and push fit plumbing. Health and Safety in the work environment is an integral part of the teaching across all activities within horticulture and workskills. All patients at the Hospital (currently with the exception of those in the Peaks Unit), are able to access the 54 horticulture sessions and 36 workskills sessions run each week. There are also 12 sessions per week specifically for women. Pauline Munro, Vocational Services Manager, said: “Patients and staff are equally enthusiastic about this project. It really is making a difference; patients are gaining so much from it, not

only workskills, but also in self confidence and esteem. To see their work translated into results is great and provides a sense of achievement. “There is much trust involved with patients working on the unit; using tools and machinery and they really feel like they are developing and moving on when they are afforded such trust. We have recently planted 500 Christmas trees on the site where the villas were. As you can imagine this took a lot of time and effort from the patients and we are all looking forward to seeing the field filled with fir trees which staff will be able to purchase for their festive celebrations. “Feedback from patients is extremely positive and many have requested new skills to learn such as electrical, mechanics and landscaping and areas for expansion including growing more vegetables and bringing in larger animals so it becomes more of a working farm. “The next stage of the project is to evaluate the pilot phase of the building skills, expand the working group to cover all services within the Forensic Division and explore new work areas and related educational qualifications. With continued support and positive results we really hope this service will grow and grow.” New Horticulture and Workskills intranet site There is now a dedicated Horticulture and Workskills area of the intranet where staff can find out more about the projects running within the department, news and developments and future plans. The site will be regularly updated with details of the seasonal stock for sale. Contact the team To find out more about the horticulture and workskills project call 01777 247 925 or email horticultureworkskills@nottshc.nhs.uk

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Success in Quality Standard accreditation Following a two-day inspection by assessors, the Wathwood Estates and Facilities areas have been approved for the ISO Quality Standard 9001:2008. “As a Directorate we have worked extremely hard to extend the accreditation we have at Rampton Hospital to other service areas,” said Kay Mulcahy, Head of Estates and Facilities (Forensic).   “Wathwood was the first additional site put forward, and credit goes to all the team who supported the assessment and preparation work.”  The plan now is to incorporate Arnold Lodge Estates and Facilities into the standard in September this year and The Wells Road Centre teams by the end of this financial year.   

Adam (centre) pictured with catering colleagues

All the best, Adam It was a sad but also very special day for DMH Catering in April as they said farewell to Adam Radford. Adam left as a different and more confident person from when he first began working

in Café Art each Tuesday. He will be greatly missed by the staff and customers. Fellow staff member Claire Teft said: “He developed so much and has been a great addition to the team. We wish him all the very best.”

Adam added: “Kath Barks and Claire have been lovely to work with, I will miss them. I feel good and happy that all these people have been there for me. I have more confidence in myself and do more things.”

New young person visiting DVD In March 2013 the Visitors’ Centre at Rampton Hospital had an initial screening event of the newly filmed ‘Young Visitors’ Guide to Rampton Hospital’ DVD. The DVD, which was produced by the Visitors’ Centre and Social Work Department at Rampton Hospital, will be sent out to children under the age of 18 who are in the process of being accredited to visit their relative at the Hospital. The DVD shows what it is like to visit the Hospital, the Visitors’ Centre, main Hospital Reception, the security processes, and the Family Centre where all child visits take place. This short film

is a valuable tool as it helps prepare children visiting relatives at Rampton Hospital to have a better idea of what to expect, helping to make the security process less of a daunting experience. The screening of the DVD showcased the acting skills of some of the Hospital staff and the children who starred in the DVD are all volunteers from a local amateur dramatics group. The Visitors’ Centre team would like to thank these actors (young and old) without which the DVD would not have been possible. If you are aware of a young person or a child relative to a current patient at Rampton Hospital who is wishing to visit, please contact the patient’s Social Worker to discuss further.

Positive June 2013

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Directions and Developments for SAS Doctors Some of the Trust’s more than 40 Staff and Associate Specialist (SAS) doctors came together in March for their second annual combined away day with their clinical supervisors. This group includes staff grades, specialty doctors and associate specialists, and 25 of them

attended the highly interactive ‘Directions and Developments for SAS Doctors’ day. It focused particularly on getting ready for revalidation and how to meet professional development needs to maintain standards and quality. The important contribution of the SAS doctors in the Trust was highlighted at the event through the display of poster presentations of audit, and three presentations on varied subjects including mental capacity law, sexual health and improving appraisal for SAS doctors. “Like some good midfielders on a football pitch, they may not be immediately

noticeable, but their work is fundamental for the team to succeed, and they are deeply missed when absent,” said Dr Carone. Medical Governor Dr Stuart Leask opened the day and talked about his role, and Dr Sandy Taylor, Associate Dean for SAS Matters in the East Midlands Workforce Deanery, rounded off the proceedings by offering an update on the foreseeable changes in medical education. The away day was organised by SAS Tutor Dr Ramakrishnan, and Paula Burke and Gaynor Batty from the Post Graduate medical education department.

Dr Ramakrishnan presents Dr Walker (left) and Dr Kamavarapu (right) with awards for their poster presentations

Recognising the importance of being Fit fo The importance of the Nottinghamshire Fit for Work service has been recognised locally by the Clinical Commissioning Groups, who have commissioned an extended service. The service is delivered by the Support in Work team employed by Nottinghamshire Healthcare and Enable, a Nottinghambased third sector organisation. Nottinghamshire was one of a series of pilot projects launched in 2010 to explore options for early intervention to stop people falling out of work due to ill health.

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Recently the service has been commissioned by Nottingham City and Mansfield and Ashfield Clinical Commissioning Groups and Nottingham City Public Health to build on the expertise developed through the pilot. The service has been extended to include not only those individuals off work sick, but also those struggling to manage in work with a health condition, as well as individuals who are struggling to get back into employment with a health condition in the City and Mansfield and Ashfield areas.

The service provides a mix of case management and group interventions by case managers with mental and physical health backgrounds. Referrals come from the clients themselves, their GP or other health professionals, or from employers. Once a return to work plan is established with a client, the case manager offers support, helping with both health-related and other factors such as mediating with their employer, until the plan comes to a successful conclusion. In many instances, personal interventions such as debt counselling,


A Blast from the Past Dr Wilson Walker concluded: “This was an excellent and informative day. The SAS doctors are keen on continuing along this route to improve both the quality and the recognition of their role and to provide the best possible patient care.”

Earlier this year Colin Gell, a former advocate in the Trust in one of its earlier incarnations, got in touch to say that he had been clearing out his garage and found some old newspaper cuttings featuring the closure of Mapperley Hospital from 1994. This triggered some happy memories of Colin’s time advocating for patients at Saxondale Hospital as well as Mapperley and he thought he would tell us more about it. “I began working as an advocate for patients during 1986 with MIND Nottingham, trying to give patients a voice. One of the issues was that the social club at the Hospital was open from 7-8pm but the patients couldn’t get there till 7.50pm! We were able to sort that out thankfully. We also helped patients have a say when Saxondale closed and they had to be moved to other settings. “We held the first Patients’ Council in September 1986 and 15 to 20 people attended. Mike Harris was Chair of MIND at the time and he put me forward as a volunteer organiser. I was employed by Nottingham Advocacy Group, an independent user-led organisation. The Council represented patients in practical ways – by getting the tea trolley on Carlton Ward mended for instance. The Council eventually morphed into the Citywide Council which dealt with rather more strategic matters, such as service development and the opening of new facilities. It came to a natural close in 2006. I have retired now but have also done work with Leicestershire Partnerships and De Montfort University. Here at Nottinghamshire Healthcare the involvement agenda is so vibrant – it puts other places to shame. “I remember my time in Nottingham fondly and the newspaper cuttings really brought back some memories – it’s amazing that some of the people I worked with then are still here- such as Gladys Bombek and Glenis Brocklebank. To see the older institutions shut and newer services develop has been a privilege and I wish everyone at Nottinghamshire Healthcare well, especially the Involvement Team, who are continuing the journey we started all those years ago – keeping the patient at the centre of what the Trust does.”

it for Work advice on housing or family problems, or help with new or amended employment are the most important. Client feedback makes it abundantly clear that ‘human interventions’ are as important as medical ones and GPs locally have recognised the benefits to their patients of working with the service to get back to and sustain in work. Nottinghamshire Fit for Work can be contacted on 0115 956 0890 or email supportinwork@ nottsfitforwork.org.uk

Colin Gell

Positive June 2013

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Taking Steps through therapy to recovery A group of Rampton Hospital patients and staff have collaborated to make ‘Taking Steps’, a life-size interactive board game. The innovative project was designed to enable those involved to reflect on therapy experiences and the steps towards recovery taken whilst at the Hospital. The group consisted of mental health service patients who had completed individual Cognitive Behavioural Therapy for Psychosis (CBTp), staff practitioners trained to deliver CBTp and a senior occupational therapist. Group members used their CBTp experiences to design and paint game squares which were subsequently grouped according to the therapy stages of assessment, intervention and relapse prevention. For example, one group member called his square ‘Light Bulb Moments’ as “Working through therapy was like having lots of light bulbs go off in my head. I got an understanding of what it was like for therapy to work. I became aware of myself. I became aware of people around me. I started to credit myself for the good characteristics I have rather than always dwelling on the bad and thinking everyone else thought badly of me.” While some members of the group had an established interest in and talent for art, some were convinced that they did not, and never would have, that talent. Despite this, all group members were keen to contribute.

“After discussing experiences of the different stages of CBTp and generating themes and imagery, the group used rough paper to experiment and plan out their ideas,” explained CBTp Service Manager and Accredited Therapist Jonathon Slater. “For the less confident artists, we provided alternative forms of media including photographs, which could be adapted and used to create montages. This enabled all members of the group to contribute, sparking an interest in art and revealing previously undiscovered artistic talents!” A means of navigating the squares to mirror a therapy journey was then agreed. Feedback included: “Producing the boards has been good fun. It reinforced my CBTp gains,” and “I hope experiencing ‘Taking Steps’ will encourage others to take a risk in CBTp and share and challenge their experiences, particularly voices.” With support from the group, ‘Taking Steps’ has become an invaluable way

of offering others an insight into therapy and recovery experiences. Comments by carers, peers and wider Trust staff who have journeyed round ‘Taking Steps’ include: “The pictures and stories made me more aware of the obstacles patients and therapists face when doing therapy. The stories linked to each game square were very empowering,” and “I really found ‘Taking Steps’ helpful. Reflecting on the artwork helped me understand the journey as a patient and their therapist might. It felt open and honest about the challenges of the CBTp programme as well as its gains. Very creative!” “The aim now is to organise similar groups in the future and continue to add member experiences to ‘Taking Steps’,” added Jonathon. “We hope that the skills participants gain will contribute towards them developing these interests into meaningful occupations.” For more information or to have a go at ‘Taking Steps’, contact Jonathon on 01777 248321 or Jonathon.slater@nottshc.nhs.uk

Group facilitators, Senior Occupational Therapist Glenn Painter and CBTp Service Manager and Accredited Therapist Jonathon Slater, proudly stand with some of the ‘Taking Steps’ game squares

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Steve Smith, Penny and Bruce from Making Waves, new champion Gary Sharp, Laura Humphreys, and Ahmed Mohammed

Fantastic fun for Macmillan Close April saw clients and staff from Macmillan Close enjoying two fantastic events. A week away in Cornwall Staff and residents spent five nights in three caravans overlooking the beach at Crantock, near Newquay in Cornwall. They visited Healey’s cider farm to see the production of cider and other local products like jams and chutneys, spent an afternoon crab fishing in Padstowe and enjoyed a barbecue on the beach, and visited Penzance and Land’s End. The Blue Reef aquarium was the highlight of the visit, where the group saw a giant turtle being fed. “Throughout the trip residents were able to enjoy doing activities they had never done before, so there were a lot

of firsts for them,” said Support Time and Recovery Worker Steve Smith. “It was a packed few days and they were very disappointed when we had to come home. One resident had such a great time he told everyone he had ‘had the best time of his life’.” Knockout pool competition The final of the memorial Vladislavs community shield knockout pool competition took place on 26 April at Macmillan Close.

In its second year, the competition is open to staff and any service users. There were around thirty entrants this year, and the competition kicked off at the end of January. The final match included two games, with Gary Sharp winning this year’s title. Runners up were Steve Smith in second, Laura Humphreys in third and Ahmed Mohammed in fourth place. Penny Bunn and Bruce Beevers from Making Waves were guests of honour and presented the trophies. After the match, residents, staff, friends and families also enjoyed a buffet and social afternoon.

Staff and residents at Land’s End

Positive June 2013

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Providing the tools to talk about cancer

A new cancer awareness toolkit has been launched by Bassetlaw Health Partnerships, to help promote early diagnosis and treatment. One in three people will be affected by cancer, and the team was commissioned to deliver cancer awareness training and design the

Working to PREVENT exploitation of the vulnerable PREVENT, part of the government’s counter-terrorism strategy, has been the focus of a health workshop attended over the last six months by 80% of Bassetlaw Health Partnerships colleagues. Bassetlaw’s Safeguarding Team has delivered the sessions, embedding PREVENT as another strand of the safeguarding adults agenda. PREVENT focuses on working with individuals and communities who may be vulnerable being drawn into violent extremism and terrorism. Health professionals are well placed to identify and support those who may be susceptible to exploitation, and the workshops have generated lots of discussion around risk factors, roles and responsibilities.

toolkit to remove the barriers associated with cancer, and raise awareness of the disease in communities across Bassetlaw. “Passing on knowledge of the signs and symptoms of cancer could result in early diagnosis and therefore quicker treatment,” said MacMillan Cancer Information Support Worker Heather McMillan. “Early diagnosis of the disease is proven to save lives, so the interactive toolkit aims to improve the early presentation of the disease by equipping people with the skills to raise the subject of cancer in an appropriate manner.” Health Development Manager Donna Ramsden added: “When it comes to the subject of cancer many people are reluctant to discuss their fears, but being able to talk through those fears is crucial. “The toolkit will arm users with adequate knowledge and the relevant skills to talk about cancer issues with ease and confidence in their communities. They will be able to share relevant signs and symptoms and stress the importance of screening programmes, encouraging early diagnosis.” A thousand copies of the toolkit have been produced and will be distributed to all the volunteers at the maintenance events to be held in June. Plans are also in place to launch the CD amongst health professionals, GP practices and relevant service user groups to ensure cancer awareness messages continue to be cascaded throughout Bassetlaw. For further information contact Heather McMillan on 01777 863282 or Donna Ramsden on 01777 863278.

PREVENT workshop attendees

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Cooking up a storm in national chef awards Dawn Stanley, Catering Team Leader at Wathwood Hospital, has been shortlisted alongside five other professionals for the Craft Guild of Chefs’ ‘Peoples’ Choice award. This prestigious award celebrates unsung heroes in the chef world, and recognises those who have made an outstanding contribution to the industry as a whole as well as having a big impact on colleagues. Dawn was nominated by Head of Estates and Facilities (Forensic) Kay Mulcahy. She said: “Dawn is a ‘hands on’ chef at Wathwood. She leads a team of around ten staff, and ensures a quality, cost effective and nutritious catering service is provided for patients, staff and visitors to the hospital. “Dawn leads by example, passing on skills to the catering team, and compliments from patients and staff are commonplace. “In addition to her normal role, over the last nine months Dawn has worked with patients and the occupational therapy team for the first time to open the fine-dining restaurant ‘Section 17’ within the Hospital.” The restaurant opens once every three weeks and is loosely based on ‘The Clink’, a restaurant in HMP High Down, where prisoners train in catering in a bid to prevent reoffending. Working in ‘Section 17’ helps patients with their recovery and provides another arena for them to gain qualifications and increase

confidence, as well as experience working within an exciting, operational business. Kay added: “Dawn has played a major part by guiding and supporting patients in the kitchen, instilling in them a passion and eagerness to serve great food. She has also been responsible for the genuine team spirit in the kitchen which has been calm, friendly and encouraging. “Being a finalist in this award is a fantastic achievement for Dawn, and wonderful recognition of her dedication.” The winner of the People’s Choice Award will be announced at a special dinner at the Grosvenor House Hotel in London on 10 June. Dawn Stanley

Offender Health shows the way with supply chain savings The Offender Health Team has recently completed a six-month project to reduce expenditure across the Directorate. Working with an external consultant, the team focused on improving contract terms and reducing wastage. This approach enabled savings of more than £500,000, without affecting staff numbers or clinical programmes. The majority of savings have been delivered through pharmacy sourcing, supply and prescribing practise. Many areas of the Trust may benefit in the future from the work initiated by Offender Health. “We wanted to demonstrate that with a focused approach, sustainable savings could be delivered in a short period of time,” explained Christian Cusworth, Supply Chain Consultant to Offender Health. “Having listened to frequent and ongoing media criticism of the NHS, it is rewarding to be part of project that has exceeded its objectives and delivered results on time. Although only a small part of the organisation, we have shown that it is possible to make required savings without restructuring or negatively effecting patient experiences.”     Adrian Perks, Associate Director Offender Health added: “Christian was able to provide us with the expertise and capacity we needed to drive forward this project and achieve significant recurrent savings, without adversely impacting on clinical teams.  “All members of the Directorate Management Team have been really impressed with this approach and we will certainly use it again if required.”

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National panels invite expertise from Trust Board Non-Executive Director Professor Saul Tendler, and Chief Executive Professor Mike Cooke have both recently agreed to participate in national advisory groups. Saul has been appointed as a member to the UK Healthcare Education Advisory Committee. The Committee specifically advises the higher education funding bodies in the UK, including the Higher Education Funding Council for England (HEFCE), on medical, dental and health education matters. This includes advising the UK Higher Education Funding Councils on the impact of NHS changes on healthcare

education and research and advising on the interpretation of government health departments’ workforce needs in terms of education provision. Saul said: “I am delighted to have been appointed to this committee. The interface between the Universities and the NHS is pivotal in delivering world-class healthcare education and research; I hope to be able to ensure that this will continue to flourish.” Saul’s appointment is for a term of three years. Mike has accepted an invitation to join the Research Excellence Framework expert

review in 2014. The REF is a new system for assessing the quality of research in UK Higher Education Institutions (HEIs). It will be undertaken by the four UK higher education funding bodies. The HEIs make submissions which feature a number of areas for assessment by expert sub-panels working under the guidance of four main panels. Mike’s role will be that of an impact assessor on the psychology, psychiatry and neuroscience sub-panel. He said: “I am delighted to have been invited to contribute to such a prestigious exercise. I look forward to contributing to research impact and

relevance to mental health and related subjects.” The funding bodies intend to use the assessment outcomes to inform the allocation of their research funding to HEIs, with effect from 2015-16. Later this month Mike will be the keynote speaker at the celebration dinner of the Health Services Research Network Symposium 2013. The Symposium features presentations and discussion at the leading edge of UK and international health service research, bringing together researchers, practitioners, senior managers and policy makers.

Community Nursing Review To address the national intention of moving more care from hospitals to the community and feedback from the primary care survey, Health Partnerships commissioned a comprehensive review of the Community Adult Nursing Service in Nottinghamshire County. Community adult nursing teams work in localities that mirror Clinical Commissioning Groups and in the main are within District Council boundaries. The review started in January and was completed in April. As part of the review staff engagement workshops were held at locality level and the views of GPs as key stakeholders were also actively sought. Initial key findings were that staff are motivated to deliver high quality services; there are great examples of innovation e.g. virtual ward and mobile working and

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there is a desire to value and revitalise District Nurse training and leadership skills. The full findings of the review have now been compiled and a report recently published. This report will be used to formulate recommendations and will help to develop a clear and shared vision for community adult nursing. Some of the key recommendations highlighted in the report are: • To enhance the current professional leadership structure to allow communication from the Lead Nurse to all community nursing team members, in both directions. This will raise the profile and value of professional nursing issues; create a structure for reflection and the opportunity for inspiration and innovation. The most effective professional nursing structures are locally focused and enable any nurse to be released from clinical work to become a passionate, local professional lead.

• All staff should be clear about the organisational and Primary Care Service team priorities and local action planning to address some of the frustrations faced by teams, with senior leadership, to drive through initiatives that can be quickly implemented. • The review has identified a gap in leadership training for all Community Matrons, District Nurses and band 6 Nurses. There is a need to develop a career pathway for nurses in the community and to invest in the appropriate training, support and coaching. The report will be shared with all adult community nursing staff in a series of workshops across the County. This will give an opportunity for all to hear the key themes and outcomes transparently. For further information please contact Liz Hallam, Deputy Chief Operating Executive for Health Partnerships at liz.hallam@nottshc-chp.nhs.uk.


Domestic Violence and Abuse is a Serious Healthcare Issue Domestic violence and abuse is a serious healthcare issue often with life long and potentially fatal consequences affecting the physical and psychological health of survivors, children and families. However, it is under recognised and under treated within healthcare settings. The Department of Health’s task force on the health aspects of violence against women and children in 2010 highlighted that the NHS spends more time dealing with the impact of violence and abuse than almost any other agency, and needs to do better. Health Partnerships identified that health practitioners are in a unique position to assess and identify domestic violence and abuse and to provide access to appropriate support through routine enquiry but require awareness of the existence of domestic violence and training to support disclosure and improve health outcomes.

In a collaborative partnership, Health Partnerships and Nottinghamshire Women’s Aid have delivered domestic violence and awareness training and routine enquiry to 378 child and family health practitioners successfully achieving a CQUIN (a Commissioning for Quality and Innovation payment framework enabling commissioners to reward excellence). Staff who attended the training identified improved awareness and confidence in their roles, commenting that the training was thought provoking and had changed their practice; that they were informed

about things they had never thought about and that they now felt confident to refer. Debbie King, Specialist Practitioner for Domestic Violence and Abuse said: “The importance of domestic violence and abuse as a serious healthcare issue and improving health outcomes for survivors, children and families within Nottinghamshire Healthcare, will be recognised with the launch of a Trustwide Strategy on the issue of domestic violence and abuse.” Further training dates are now available by contacting the Learning and Development Department.

Community services contract extended Health Partnerships has recently had its contract for community services extended for a period of one year by the Nottinghamshire Clinical Commissioning Groups (CCGs). This means the contract will now run until 31 March 2015. The initial agreement was a three year contract with an option of two individual year extensions, but securing this additional year shows that the community services we provide are worth investing in, which means we can provide better patient care. Paul Smeeton, Chief Operating Executive for Health Partnerships, said “The past two years have seen many changes as the service has moved to a clinical led, locality focused model. The Division will continue to move forward with this new locality approach working with each Clinical Commissioning Group. Our staff have continued to improve patient

care whilst delivering major financial savings, supported by being part of Nottinghamshire Healthcare which is now moving towards Foundation Trust status. “I would also like to thank our local primary care partners (SNICS and CNCS) for their support in helping us work more closely with primary care. Part of our approach has been the opportunity for general practitioners to lead as clinical directors for community services and without the knowledge and expertise of SNICS and CNCS, this wouldn’t haven’t happened.

what happens in the health community due to the changes with local acute trusts.” The Division shall be working closely with the CCGs to continue to improve services for patients by also working more closely with General Practices and to understand the services currently provided. This will enable revised service specifications to be agreed which will be more focused on providing more community care for people in their own homes.

“The organisation has the ability to provide services that are small and focused, across Divisions and influence

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Highbury Hospital welcomes patients onto new ward Highbury Hospital welcomed patients onto a brand new ward on 15 April, ahead of its official opening in July. Cherry Ward, named by patients, is a 20 bed short-term acute assessment ward for women aged over 65 years with functional mental health problems. The ward was previously located at the Queens Medical Centre and patients are

already planning a collage or mosaic for one of the ward’s walls to remember happy times on the previous ward. Sharon Howe, Modern Matron at Highbury for Mental Health Services for Older People (MHSOP), said: “There was a mixture of excitement and apprehension, but staff and patients were eager to be on their new ward and moving onto a new refurbished ward was really exciting for everyone. There will be improved facilities that will support the care of the patient, their families and carers. She added: “The Ward Manager Helen Forrester, her team and patients have been involved with the design and refurbishment of the ward.” The official opening by Mike Cooke will take place on 22 July, with market stalls showcasing mental health awareness for the various areas of Highbury Hospital during the afternoon.

Oral Health Promotion Team

Recognition for the Oral Health Promotions Team

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The Oral Health Promotion Team from County Health Partnerships, has recently been recognised in the Dental Awards 2013 as finalists in the Team of the Year category and Best National Smile Month event.

importance of flossing through informative and practical advice. The successful event involved local dental practices, schools and other community sites to offer presentations and flossing demonstrations.

During National Smile month last year the team delivered a Flossing Fortnight Roadshow which aimed to highlight the

Julia Wilkinson, Oral Health Promotions Coordinator said: “It was a great opportunity to inform local people about the importance

of regular flossing and also how to floss correctly! The majority of people we spoke to were flossing incorrectly – some not at all!” The team works closely with local and professional groups and is passionate about increasing awareness of oral health and the importance of regular dental care for adults and children. Receiving finalist positions against an extraordinary number of

entries for both categories is a great achievement! “It was a huge honor to be nominated for these National Awards and a great opportunity to showcase all the work the local tooth fairies have been implementing. It’s great to know that our work is being recognised nationally as well as locally.”


Better access to oral health for vulnerable people Some of the most vulnerable people in society are not accessing essential health services, and in some areas being wrongly signposted. A new role within the Salaried Dental Team has vastly improved accessibility for those who are vulnerable, to ensure they have the same healthcare support as the rest of the community. Alex Hobson, a Dental Nurse Team Leader in County Health Partnerships has, over the past three years, looked at ways to ensure people are given the correct dental care and appropriate information and support. A Health and Wellbeing Group was formed following the recognition that some adults with learning disabilities did not seem to have access to the same healthcare support as the rest of the community. The group delivers a wide range of health information to day centre clients in an interactive and open forum. Everyone is

Harm Reduction Nurse Specialist Laura Garner recently led a threemonth Health Shop campaign to increase testing levels for HIV and other Blood Borne Viruses (BBV) in Nottingham’s injecting drug-using population.

People who inject drugs are a high risk group for BBVs. A new awareness brand was developed (shown on the stand in the photo below), with campaign materials distributed through relevant services. Three well attended events were held on World AIDS Day in drug services in Nottingham, promoting testing and

encouraged to get involved in activities and contribute to discussions in an environment they are familiar with. All the services have to work together to deliver these messages in an effective way, so the group meets to review the days and looks at how to develop it further. The feedback is very positive and the group has now been rolled out to Mencap. Alex works on this project with Healthy Hearts nurses, Learning Disability Facilitators, Community Nurses, Audiologists, Day Centre staff and the City Council’s Health and Wellbeing policy officer. Alex said “Following my first session a young man at the centre was very self conscious about his teeth and asked if he could talk to me about his concerns. He couldn’t ever remember accessing dental services previously and I suggested he came along to one of our clinics. A member of the day centre staff offered to support him at this visit. He agreed as long as I would be present too. An appointment was arranged when I was in clinic and he was supported for his dental check up and for his subsequent treatment appointments. Even though he was terribly nervous, he felt more at ease with having a familiar face with him. He is working hard now to look after his mouth and attends the clinic regularly with support, and enjoys his visits, as do we at the clinic.”

featuring speakers, lunch and free gifts. Testing was also offered in a variety of locations to improve equity of access, including pharmacies, homeless hostels, shared care clinics and The Health Shop, using methods such as dried blood spot (DBS), venous and point of care testing.

One hundred and eighty five injecting drug users tested, many who had never tested or not tested for over a year. The vast majority chose DBS, and feedback showed this method of testing to be the most acceptable. No new HIV infections were detected but 20 active Hepatitis C infections were found.

l-r Sarah Paling and Zoé Belle-Boulé

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Sharing progress on integration project By Vicky Wright, Project Manager Health Partnerships’ Nottingham North and East locality hosted a visit from Dr Helen Lovell from the Joint Integrated Care Unit at the Department of Health recently to share progress on a local transformational change programme to integrate adult community care services. Health Partnerships is working closely with a range of local health, social care and voluntary sector partners to redesign adult community care services. Our local objective is to deliver joined up services that provide person-centred, wrap around accessible care and enable people to take control of their health and independence. This work is in response to the local challenges to reduce hospital and residential care admissions by improving community care for the frail elderly and those with long term conditions. The Division is taking the lead on the first phase of a larger health and social care integration project by

Increased support improves use of outcome measures A significant increase in the use of outcome measures within the Trust’s Child and Adolescent Mental Health Services (CAMHS) has been shown in a new audit. The Collaboration for Leadership in Applied Health Research and Care – Nottinghamshire, Derbyshire, Lincolnshire (CLAHRC-NDL) Children and Young People Theme recently conducted a reaudit of case notes, and compared it with an audit from 2011. The use of outcome measures has been supported by an increase in

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redesigning adult community health teams to develop three multi-skilled multi-disciplinary teams based around GP practice groups, with a single referral point. These new teams will provide affordable effective case management to complex care patients, deliver a range of planned care and support prevention and self-care and are planned to go live early in the summer. Dr Lovell was greeted by the project team responsible for taking this transformational change forward. The team includes clinical leads who are designing services with significant staff involvement, Health Partnerships’ management and partners from social care, mental health, Nottingham North and East Clinical Commissioning Group (CCG) and Mansfield and Ashfield CCG. Dr Helen Lovell started the visit with a presentation about national work on integration and support opportunities available. Vicky Wright, Project Manager then gave a presentation on how this work was being taken forward through strong clinical leadership and significant staff engagement. This was followed by discussion and debate about the challenges of integration including managing culture change and measuring the impact of the change. Following on from the visit, the integrated health and social care project has been put forward to be part of some national work to identify how effective integrated care can be measured.

administration support , training on how to use the measures, and access to core outcome measures on RiO, as well as CLAHRC research supporting the use of outcome measures within the Trust. Additionally, the Trust introduced a Commissioning for Quality and Innovation (CQUIN) target in April 2011 to complete any one of four measures on the electronic record system: • Strengths & Difficulties Questionnaire (SDQ) • Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) • Children’s Global Assessment Scale (C-GAS) • Goals Based Outcome (GBO) at time 1 (initial assessment) and time 2 (6 month follow-up, or discharge if sooner). CLAHRC Research Fellow Dr Charlotte Hall said: “The research team wanted to investigate whether these initiatives may have helped to increase the use of outcome measurement within CAMHS.

“A significant increase was found in both the single and repeated use of outcome measures from the time of the original audit. Repeated use (baseline and followup) of HoNOSCA had increased the most, from 10% to 50% of cases. There was also greater consensus on which measure to use, with most clinicians using a combination of HoNOSCA, C-GAS and SDQ. “Overall, the results might reflect an increased clinician awareness of the need to measure outcomes alongside greater administration support to enable this to occur. These improvements will help in the achievement of CQUIN targets and provide valuable feedback for clinicians and service-users.” The CLAHRC-NDL project forms part of a wider project aimed at achieving consensus on assessment and outcome measures in CAMHS (CATO study). For more information contact Dr Hall on 0115 8232438 or charlotte.hall@ nottingham.ac.uk.


q&a

This month we meet Ward Co-ordinator Kevin Mee

q What is your job title and what does your role entail? a My job title is Ward Co-ordinator for Newark and Sherwood, covering the new virtual ward in Newark and Trent. I support the community clinical team in identifying patients at risk of hospitalisation through the PRISM scheme. I am also a Health Partnerships’ Diversity Champion supporting the Trust’s LGBT Forum. q How long have you been with Nottinghamshire Healthcare NHS Trust? a I have worked for the NHS since 2007, starting as a Healthcare Assistant in mental health. After 14 months I moved to Mansfield Community Hospital working on Chatsworth Ward and in the community. After a further 16 months I moved to Rushcliffe to work within the Virtual Ward Pilot. q What do you see as your priorities

q What was the last CD you bought? a I love the 80s – the last CD I purchased was a compilation CD featuring hits from the 80s. q What is your greatest achievement? a Studying for my diploma in psychotherapy; it was hard work but worth it all when I received the certificate. q What makes you angry? a Rude people who jump the queue

and any form of discrimination such as racism, homophobia, ageism etc.

q What are you most passionate

about? a I am very passionate about my job and working within a positive team with likeminded people.

q What single thing would

for Nottinghamshire Healthcare? a Working with the integrated community team and preventing hospital admissions by using the latest prediction tools available.

improve your working life at Nottinghamshire Healthcare? a Better understanding of the voluntary sector and how we can work together.

q What is your employment background? a Prior to joining the NHS my background was in IT, working for Dixons Store Group on their business technical support line. I have also worked for Center Parcs in the heart of Sherwood Forest, and been a shop manager for a chain of well-known newsagents.

q What is your favourite hobby? a I enjoy web design (nothing heavy)

q What is the best piece of advice

you have ever been given? a Difficult one… Treat others like you wish to be treated.

and am a member of the European Roller Coaster Club; I have been lucky in trying out most UK coasters before they open to the general public.

q What keeps you awake at night? a Coffee! And two dogs should they

find their way to the bedroom.

q What is your favourite film? a Anything by Stephen King – Dead

q What is your idea of bliss? a Lazy summer nights; me and my

partner having family and friends around for a chat and BBQ, helping us plan for our civil partnership ceremony later in the year.

q What three words would you use to describe yourself? a Thoughtful, spontaneous and organised (well, I try to be). q What is your favourite holiday destination? a Has to be Florida; a place I would love to retire to! q Who would you take to a desert island? a Someone like Jimmy Carr who could keep me amused with a few jokes to take the boredom away. q Where do you see yourself in 10 years’ time? a I feel really settled in my life both at home and at work, so I would like to think that if any opportunities come along I would re-assess it then. I would like to start some voluntary work with addiction issues; something which I am pursuing. q Do you have a ‘claim to fame’? a Yes, I was the official Big Brother

correspondent for the BBC in 2003/2004; I did a regular radio slot on the BBC local radio every Friday; eviction predictions, that kind of thing!

q How would you like to be remembered? a A true helper of others with a passion for his family and friends.

Zone is one that comes to mind.

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WHO WE ARE...

Equilibrial members celebrating their anniversary

Equilibrial celebrates fifth anniversary Equilibrial, a self-help support group for those with a diagnosis of bipolar (manic depression), is celebrating its fifth anniversary. Group members come from Bassetlaw and surrounding areas, and have many skills, abilities and talents. Members of the group say: “It is good to be in a group that is so accepting, and understands what life is like without having to explain.” “This group helps me to feel less isolated and more accepting of my condition.” “The group normalises life for me and highlights the fact that I am not alone.”

and celebrated its continuing success with increasing numbers of members. The event was held at The Crossing in Worksop, a venue that provides a therapeutic, holistic haven. The group normally meets fortnightly at The Crossing, as well as having occasional social therapeutic activities and guest speakers. Equilibrial – on my wavelength – recognises that everyone deserves a balanced life. Consultant Psychiatrists at Bassetlaw Hospital and others recommend the group.

“It’s like a second family to me.” In March, the group marked its anniversary with a cake and a buffet,

For more information, contact Dave Bacon at Bassetlaw Action Centre on 01777 709650 weekday mornings.

Peer Support workshops The Institute of Mental Health Training Team is running a series of experiential workshop seminars on applications of Peer Support. The first, held in May in conjunction with Self Help Nottingham, explored best practice in Establishing and Sustaining Peer Support Groups. It will be repeated in Leeds in July. Future workshops in the series will cover Peer Support for Long Term

Conditions including Dementia, Peers as Health Coaches, Quality Assurers, and Advocates, and sessions targeted at specific audiences including psychiatrists, CAMHS workers, and commissioners. The next workshop in Nottingham will be on 12 and 13 September and will focus on Peer Health Coaching. For more information please contact Karen Sugars on karen.sugars@ nottshc.nhs.uk or 0115 823 2416.

You may have picked up this copy of the newsletter not knowing what Nottinghamshire Healthcare NHS Trust is. We provide integrated healthcare services including mental health, learning disability and community health services. We also manage medium secure units in Leicester and Rotherham, and the high secure Rampton Hospital near Retford and provide healthcare in 11 prisons across the East Midlands and Yorkshire.

WE NEED YOU!

If you have any ideas or suggestions for the newsletter, please contact Suzanne Aitken in the Trust Communications Team on 0115 955 5403 or via email at suzanne.aitken@ nottshc.nhs.uk We are always pleased to receive articles for possible publication, but ask that they do not exceed 300 words. Wherever possible when naming individuals, please include details of their job titles/roles and the organisation they are from. If any individuals other than yourself are mentioned in what you write or featured in accompanying photographs, please make sure you check with them that they are happy to be potentially featured. It is your responsibility to ensure this consent is given. Please send photos as separate image files and not in Word documents. Please note that the Communications Team has full editorial control and may have to edit articles appropriately. Therefore, if you want to see the final version please ensure you send your article in with plenty of time before the deadline and state clearly what you require. If you would like copies of any past editions of Positive, or if you are having any ‘distribution issues’ with the newsletter – whether you’re receiving too many copies, too few, or none at all – then please contact us. If you would like your story in the August issue of Positive, please contact us by 5 July 2013. However, due to space constraints we cannot guarantee the publication of all articles received by the deadline. Nottinghamshire Healthcare, The Resource, Duncan Macmillan House, Porchester Road, Nottingham, NG3 6AA tel 0115 969 1300 www.nottinghamshirehealthcare.nhs.uk www.facebook.com/ nottinghamshirehealthcare www.twitter.com/nottshealthcare Printed on Cocoon · 100% recycled paper

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Positive June 2013  

All the latest news from Nottinghamshire Healthcare NHS Trust.

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