IechydDa
SPRING 2015 EDITION 1
School of Healthcare Sciences
FEATURES Spotlight: Our Children’s Clinic
PLUS
Peer support for breastfeeding women
Healthcare Sciences and the Community Gateway
OT CELEBRATES A GOLDEN JUBILEE
Welcome INSIDE
PAGE 3 Equipping peers to support breastfeeding mums PAGE 4-5 A Golden Jubilee
to the new Cardiff University School of Healthcare Sciences newsletter I am pleased to welcome you to the first edition of Iechyd Da, the School of Healthcare Sciences newsletter. This is an important and exciting time for the School, with several achievements to celebrate and a busy year ahead. Most recently, the Research Excellence Framework (REF) 2014 results, announced in December, ranked ‘Allied Health’ at Cardiff University (in which Healthcare Sciences was included) 4th in the country. The Allied Health Unit of Assessment scored 3.42 out of 4 in this area against a UK average of just over 3.
PAGE 6-7 Spotlight on: The OT Clinic
PAGE 8-9 Developing a sustainable radiotherapy workforce in Malta
90% of our submissions to the REF that exemplified our societal benefit were given the highest four-star rating. We were ranked first in the UK for our research environment, another of the REF rankings. This was assessed to be 100% at the highest four-star rating, indicative of an environment that is “conducive to producing research of world-leading quality”. This same environment supports undergraduate and postgraduate education, supplying many of the UK’s top professionals in these disciplines. We have a new five-year research strategy for the School, which seeks to build on our successes to ensure we grow our reputation as a centre for innovative health research with an international reputation for excellence and impact.
This academic year marks the 50th anniversary of occupational therapy education in Wales. We held a celebratory conference in Cardiff to mark the anniversary. To commemorate our achievements over the years, HRH The Princess Royal spoke at the conference in her role as patron of the College of Occupational Therapists. The conference looked back at 50 years of educating and inspiring occupational therapists in Wales and explored the current and future role of education and research in occupational therapy and its impact on healthcare provision. This edition of Iechyd Da features news about the research and innovative work we are doing here in Wales, the UK and abroad. I hope you enjoy reading about our ground-breaking breastfeeding peer support research and our work in Malta, contributing to the delivery of their five year National Cancer Plan. If you would like to discuss any of the details in this newsletter, please contact the School Marketing Team at HealthSciMarketing@Cardiff.ac.uk. With my best wishes,
Gail Williams Dean and Head of School
School achievements PAGE 10-11 Meet our people PAGE 12 Working with the community 2 Iechyd Da | Spring 2015 | Edition 1
Editors: Heidi Freer-Hay / Kira Hutchinson School of Healthcare Sciences, Cardiff University, Tˆy Dewi Sant, Cardiff CF14 4XN Follow us on Twitter: @CUHealthSci Feedback and items of interest relating to the School are welcome and should be sent to healthscimarketing@cardiff.ac.uk. The editor reserves the right to edit contributions received. Disclaimer: Whilst every effort is made to ensure that information provided is accurate at the time of going to print this cannot be guaranteed. Views expressed in Iechyd Da are those of the authors and do not necessarily reflect those of the School. Cardiff University is a registered charity, no. 1136855
Equipping peers to support breastfeeding mums A new research project aims to help those supporting breastfeeding mothers by developing new skills based on motivational interviewing. Professor Billie Hunter tells us more. Professor Billie Hunter and Dr Julia Saunders are embarking on a study of an innovative approach to providing peer support to breastfeeding mothers in Wales and England, led by Dr Shantini Paranjothy, Director of Research at the Institute of Primary Care and Public Health, Cardiff University School of Medicine. “Motivational interviewing”, a concept developed by Cardiff University Professor Stephen Rollnick, will underpin this new research on providing peer support for breastfeeding. Motivational interviewing is a counselling approach that works by engaging with someone and setting specific goals in order to change behaviour. A key aim of the project is to enable mothers to breastfeed for longer. The research project, which launched in October 2014, will follow three stages. The first stage is establishing how peer support is currently provided and what gaps exist as well as what works well now. The second stage will develop a new peer support intervention with current peer supporters and parents and provide training for peer supporters. This is when the volunteers will be provided with background on motivational interviewing, and how exploring an individual’s concerns and encouraging them to set their own goals can assist a positive outcome. The third stage will try out the new intervention to assess its feasibility.
Motivational interviewing is a counselling approach that works by engaging with someone and setting specific goals in order to change behaviour. “This approach to understanding what influences someone to make a lifestyle decision has proven useful in areas such as smoking cessation. We look at what the incentives, blockers and goals are for someone to do something. We hope this guidance equips breastfeeding peer supporters with additional listening and adapting skills to engage with new mothers, and that it proves effective with supporting women to make positive health decisions,” explains Professor Billie Hunter, School of Healthcare Sciences RCM Professor of Midwifery. This is the first time motivational interviewing will be used in a peer support breastfeeding study, which will focus on socio-economically deprived areas with traditionally low breastfeeding uptake. Health
professionals, parents and the peer supporters will all contribute to the study. The study aims to enable mothers to breastfeed for longer, by placing women at the centre of the intervention. Dr Hunter explains the benefits; “another advantage of this study is that this is a project with beneficial outcomes for all those involved. It’s like focused counselling, where a person can explore the reasons they have for making a decision about something like breastfeeding. They can then set their own agenda, their own targets. We hope to find out how effective this is by the last stage of the research. If it shows promise, we will then apply for further funding to carry out a larger scale study.”
TO LEARN MORE about this
and other projects underway in the Maternal, Child and Family Health and Wellbeing research theme, go to www. cardiff.ac.uk/healthcaresciences/research. 3
A Golden Jubilee
This academic year we celebrate a very special milestone – 50 years of occupational therapy education in Wales.
Modern OT education includes the use of simulated scenarios.
The Welsh School of Occupational Therapy opened in 1964, with an intake an intake of just of just 19 19 students that, unusually students that, unusually for the time, for theincluded time, included two male students. two male students. The first cohort graduated in 1967 with an The first cohort Associationinof1967 graduated Occupational Therapists’ with an Association Diploma.of Occupational Therapists’ Diploma. 4 Iechyd Da | Spring 2015 | Edition 1
Occupational therapy education, and indeed the profession, has come a long way over the last 50 years, and the School, in its various incarnations, has seen many changes along the way. There are now two occupational therapy pre-registration programmes, an undergraduate degree and a graduate diploma, with an annual intake of 78 students. Teaching on both programmes is closely linked with the School’s excellent research profile. However, one thing that hasn’t changed is the desire to utilise occupational therapy to enable people to lead full and satisfying lives as independently as possible. Occupational therapists work in a range of settings with people of all ages. They
recognise that an impaired ability to perform everyday activities, whether due to accident, illness or ageing, can undermine health and wellbeing. By working with people to overcome the effects of disability and enabling individuals to undertake the daily tasks and occupations most people take for granted, occupational therapists are making a real difference to people’s lives. The facts are compelling. Focusing on rehabilitation and reablement by engaging with occupational therapy reduces the risk of developing depression and dementia among the elderly and disabled, and is known to prevent the development of chronic conditions. OTs are increasingly
When the Welsh School of Occupational Therapy opened in 1964 it was the first time occupational therapy had been taught in Wales. employed in A&E; this reduces admissions and re-admissions to hospital. Likewise, by increasing the uptake of community-delivered interventions, reviewing care packages, recommending adaptations to home environments and encouraging rehabilitation, occupational therapists can reduce the need for costly and complex care packages. As well as contributing to an improved quality of life, increasing uptake of therapy services can significantly reduce health and social care costs by enabling individuals to be more independent at home rather than entering care systems. When the Welsh School of Occupational Therapy opened in 1964 it was the first time occupational therapy had been taught in Wales. The diploma focused on improving and understanding physical and practical skills. The School moved to its current site at University Hospital of Wales in 1973, and the diploma became a degree validated by the University of Wales in 1991. Alumni of the school, in its various incarnations, have made a significant contribution to the development of the profession across practice, education and research. The modern incarnation of the Occupational Therapy degree is based on the thorough redesign of the programme that took place in 2007. The programme was restructured to reflect a modular approach to education and the curriculum brought up to date to integrate an ethos of problembased learning and new concepts of appreciative inquiry. Maeve Harnett is a current third year student on the occupational therapy degree. “We’re encouraged to think independently, an
important skill for us to implement whilst on practice placement. Problem-based learning teaches us to think critically and base our practice on the evidence, which in turn increases our professional competence and confidence.” Dr Steve Whitcombe, the School’s Professional Head for Occupational Therapy, says: “students are required to take responsibility for their own development. By developing their problem solving skills, our students will be better prepared to meet the needs of an increasingly complex health and social care agenda. Opportunities for occupational therapists to work in non-traditional settings are increasing - working in services for the homeless, for example, for charitable organisations or in commercial organisations. These opportunities require our graduates to be able to use their knowledge and expertise in new and innovative ways.” In addition to this, the recent creation of the new School of Healthcare Sciences, which brought together the former schools of Nursing, Midwifery and Healthcare Studies, provides new opportunities for shared learning. Health professionals who are taught together in a multi-professional educational setting learn early on to collaborate with other health professionals, with studies demonstrating that they are far more likely to work effectively together in clinical settings. The breadth of environments in which occupational therapy is an instrumental part is demonstrated by the range of research currently underway in the School. Dr Carly Reagon’s Tenovus funded study is investigating the effects
of choral singing on quality of life, self-esteem and empowerment for cancer sufferers and their carers. On quite a different note, Dr Gail Boniface is leading a NISCHR funded project looking at the processes by which families of disabled children apply for home adaptations in Wales: “Grants are available to adapt housing for disabled children in Wales. However, the administration of such grants is complex. They are funded according to housing tenure, and are facilitated by different local authority departments and different professionals, so can be difficult for service users to navigate.” The outcome of this research will inform the delivery of these processes and hopefully influence the development of future services across the board - not just for families with disabled children. The scope and impact of occupational therapy across the UK is growing, and it is timely, on the occasion of the 50th anniversary of occupational therapy education in Wales, to celebrate our contribution to this very important profession. As Steve points out: “we are developing the leaders of the profession; ensuring that we produce professionals who can support service users to live as independently as possible and to help them do the things they need, want or are expected to do. This is, as it always has been, at the heart of what we do.”
Read our ‘Meet our People’ feature on Dr Carly Reagon on page 10.
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Spotlight on:
The OT Clinic On the anniversary of 50 years of OT education in Wales, Sue Delport and Wendy Cumines reflect on the first year of our OT Children’s Clinic.
6 Iechyd Da | Spring 2015 | Edition 1
The OT Clinic at Cardiff University was launched in early 2014. The aim of the clinic was to provide specialist services for children with developmental disorders experiencing difficulties with their performance and function in daily tasks (occupations). Consistent with the guiding principles of Cardiff University’s strategy ‘The Way Forward’, the clinic offers enhanced educational opportunities for undergraduate OT students studying at Cardiff University and provides a foundation to develop future research capacity. The OT Clinic, located in Tˆy Dewi Sant at the University Hospital of Wales, has state-of-the-art assessment and treatment facilities, including a fullyequipped sensory integration room. We offer specialist assessment and intervention mainly for children with developmental disorders such as developmental coordination disorder, autistic spectrum disorder, and sensory processing disorder. Some children have a formal diagnosis made by a health or educational professional - others may not have a formal diagnosis but parents or teachers may be concerned about the child’s performance or behaviour. As an independent practice, we accept referrals from families, carers, health and educational professionals who are concerned about helping children achieve their full potential. All referrals are screened and if accepted, assessment and intervention is tailored to meet the needs of the individual. During our first year we’ve worked directly with 14 children and two adults, resulting in over 60 treatment sessions. We’ve also been able to provide advice and guidance by email or telephone to many of the parents who have contacted the clinic seeking reassurance. All our clients, regardless of age, are encouraged to become equal partners in their own treatment. Where filming takes place in the clinic, for example, to allow us to reflect on how
a particular intervention is progressing over subsequent visits, children are encouraged to sign their own consent forms which have been especially designed for them. Reflecting on the benefits to our clients by the interventions of our experienced occupational therapists, we can clearly see the progress they’ve made towards meeting the goals developed as a result of their initial assessments. One of our parents described the difference in her son since he started visiting the clinic: “Before he was like a bull, bombing off at a hundred miles an hour, which made his ability to listen and hear difficult so you had to shout or be loud to get his attention or get eye contact. His gross motor skills were big, large, rough and speedy. “Now he’s running, his gross motor skills appear softer and his ability to listen and hear has improved so we no longer have to shout to gain his attention.” While clients are always seen by one of the experienced therapists, the opportunity is there, if consent is given, for our current students to assist in the clinic. So far four OT students have had direct involvement with clients and their families with many other students benefitting indirectly from access to the assessment and treatment facilities and evidence based resources available within the clinic. Feedback from students showed that they found the experience beneficial in developing their confidence, knowledge and skills in working with children.
Moving forward,
we are developing processes to allow greater opportunities for student participation in the clinic along with a formal system for evaluating their learning experience while working with us. We’ve received a constant stream of referrals throughout the year, which points to a definite need in South Wales for a clinic of this nature and the potential to expand our services. Links are being made with statutory agencies and colleagues in the community as well as research networks within the University to develop future research opportunities for staff, undergrad and postgrad students. And of course, we will continue to work with our existing clients; ensuring that they find their time in the clinic as enjoyable as they do beneficial.
TO MAKE A REFERRAL
to the clinic or submit an informal enquiry, email otclinic@cardiff.ac.uk or call 029 2068 7689.
Feedback from students showed that they found the experience beneficial in developing their confidence, knowledge and skills in working with children.
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We celebrate the graduation of the very first cohort to embark on the University of Malta’s BSc in Radiography, run in collaboration with the School of Healthcare Sciences, and look at the way in which the collaboration is transforming cancer care in Malta.
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The new €48 million Mater Dei Hospital Oncology Centre will host three linear accelerators for radiotherapy treatment.
Developing a sustainable radiotherapy workforce in Malta
In 2010 the Maltese Department of Health began a significant expansion of cancer services designed to bring them in line with other European countries and increase cancer survival rates. European regional development funding was made available for the building of a €48 million oncology centre, which will house state-of-the-art equipment for the delivery of radiation therapy and enable the use of modern radiographic techniques. Recognising that diagnostic radiography education in Malta would need to develop to incorporate therapeutic radiography in order to provide a skilled and experienced workforce for the new centre, the collaboration between the Maltese Department of Health, the University of Malta, and Cardiff University was born. Erica Chivers, one of the programme co-ordinators, explains the partnership: 8 Iechyd Da | Spring 2015 | Edition 1
“The Department of Health in Malta had an ambitious 5-year plan to modernise cancer services, but faced a lack of expertise. So while they deliver the radiography elements of the degree, lecturers from Cardiff go out to deliver the radiotherapy and oncology education. “The collaboration provides an ideal opportunity not only for Cardiff to share best practice in the education of healthcare practitioners, but also to influence the way in which healthcare is practiced by the radiography workforce.” Delivering the programme overseas is a big commitment, with staff from the School of Healthcare Sciences
delivering up to 25 weeks of teaching in Malta between them. The course also involves a 22 week practice placement for students in two Welsh oncology departments. “The challenges we’ve faced have often been unforeseen – we were in Malta in 2010 for a planning meeting, scheduled to last two days, when the Icelandic volcano erupted! We couldn’t get back for over a week!” says Lynn Mundy, a programme co-ordinator. “But the benefits are undeniable. The Maltese students are taught current techniques, and are exposed to evidence-based practice, which they will continue to practice when qualified.
SCHOOL ACHIEVEMENTS Lecturer and PhD student Amie Hodges has been successful in her bid of RCN funding for her PhD exploring the experiences of siblings of children with Cystic Fibrosis.
The team were quite emotional when the first cohort from the programme graduated in December, and are hugely proud of their achievement. All have been employed by the Department of Health, and began practising in November. Our own Cardiff students benefit from learning alongside their Maltese colleagues, and we’ve found that more want to go on overseas placements themselves as a result.” In December, the first cohort to enrol on the new programme reached the end of their four year programme, and graduated. Keren Williamson, a Cardiff lecturer in radiotherapy, was able to attend and participated in the academic procession. She describes the ceremony: “the students were delighted that someone from the University was able to attend. It was very moving, with a speech from one of the students, and each graduate was applauded individually as they were presented with their parchment and had their photograph taken.” The team speak highly of all the students. Hard-working and dedicated, they are determined to make their health service the best it can be. “They are always looking for the best way of doing something, rather than just a good way,’ says Erica. “We get nothing but positive feedback from their clinical educators and their patients when on placement in Wales, and they set an excellent example for our own Cardiff students. Their attitude and achievements make all our hard work worth it.”
In the future, in order to provide a high end service, these students will need to undertake advanced qualifications, and they all seem keen to exploit postgraduate opportunities. This interest in CPD will ensure the lasting legacy of Cardiff’s involvement with the undergraduate programme. The team were quite emotional when the first cohort from the programme graduated in December, and are hugely proud of their achievement. All have been employed by the Department of Health, and began practising in November. As Lynn describes them, these students are the “bright future of radiotherapy”, determined to pioneer modern radiotherapy practice and make the most of the opportunity to effect change. Ultimately, those who will benefit most from this collaboration will be patients. Cancer sufferers treated at the new oncology centre will have access to modern facilities and practices which will in turn save people’s lives. The service has been transformed into a patient-led environment, with practitioners demonstrating empathy, compassion and dignity in delivering a high quality patient led service. These outcomes demonstrate the ways in which education can transform and save lives.
Professor Lesley Lowes was awarded the Research in Nursing Award at November’s RCN in Wales Nurse of the Year awards in November. Professor Lowes was also nominated for a Quality in Care Diabetes for ‘Best Initiative’ award, with her DECIDE study Highly Commended by judges at the awards ceremony in October. Congratulations to Amy Lake, who won the Norman K. Harrison Medal at the Institute of Medical Illustration awards in October. In September the School was ranked first in the UK for physiotherapy in The Sunday Times University Guide 2015. Staff members awarded their PhDs recently include Dr Judith Carrier, Dr Nicola Evans and Dr David Clarke.
ALSO IN 2014... Dr Valerie Sparkes was appointed to Reader in Arthritis Research and Dr Monica Busse-Morris was appointed to one of the shortest Readerships on record before being appointed Professor of Healthcare Sciences. Staff who were successfully promoted to senior lecturer include Sue Annetts, Rhian Barnes, Dr Judith Carrier, Judy Cousins, Una Jones and Dawn Pickering.
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Meet our people... Dr Carly Reagon, Lecturer Carly qualified as an occupational therapist in 2000 at the Essex School of Occupational Therapy, before going on to work as a clinician in orthopaedic rehabilitation. She has been working for the School of Healthcare Sciences since completing her PhD at Cardiff, a grounded theory case study of evidence-based practice in occupational therapy. Her current research is a Tenovus funded investigation into the effects of choral singing on quality of life, self-esteem and empowerment and the factors which underlie these effects in both patients previously diagnosed with cancer and their carers. Describe yourself in three words‌ Messy. Messy. Messy. Why occupational therapy? Originally I was studying archaeology, but realised that there wasn’t much I could do to help old bones. Who or what inspires you the most? Vera Britten. She wrote about her experiences as a nurse in the First World War in Testament of Youth. She was strong, intelligent and feminist. What are you most proud of? My two year old son Wilfred. Also finishing the first draft of my novel.
10 Iechyd Da | Spring 2015 | Edition 1
If you could have three wishes, what would they be? 1. I would love to go back in time and visit the First World War trenches (preferably in a suit that made me immune to bullets, shells and rats) 2. The whole world turning vegetarian 3. World peace
What would you most like to influence or change about healthcare? Free dentists please.
Where do you see the future of occupational therapy going? More OTs in the community.
How do you relax in your spare time? I am currently editing my first novel. I also love trail running, singing in choirs, and anything to do with history (especially WW1 related).
If you could invite anyone to dinner, who would it be and why? Vera Britten (see above) Winston Churchill (what a character. And he would be sure to provide the champagne) Wilfred Owen (my favourite poet, after whom I named my son)
Who at work would you most like
to thank? Dr Gail Boniface who supervised my PhD and always made me feel worth it!
I would love to go back in time and visit the First World War trenches (preferably in a suit that made me immune to bullets, shells and rats). 11
Working with the community In 2014 the University launched five flagship engagement projects, with ambitious aims to work with communities to tackle poverty, boost the economy, and improve health, education and wellbeing.
families are treated with the dignity that ensures that they feel in control of their own health, wellbeing and treatment, through consultation, information and discussion” says Sally.
Healthcare Sciences’ Richard Day and Dr Sally Anstey were heavily involved with the Community Gateway, one of the first flagship projects to get off the ground. The Community Gateway project brings together a team from a diverse range of subjects, including architecture, planning and geography, psychology, and of course healthcare sciences. Focusing in the first instance on the local Grangetown area, the aim of the project is to establish a relationship with the community that will generate positive, real world outcomes. As Dr Sally Anstey describes: “this is a new and unique model of community engagement. Our aim is to establish a two-way and equal partnership, so that we can understand what issues exist and learn more about what might be done to improve health and well-being. It isn’t about the University imposing solutions upon the community, but about supporting and enabling that community to realise its aspirations, and thus make a practical difference to people’s lives.”
Thus far, the project has focused on understanding the ways in which this partnership could work. Focus groups were held in Grangetown designed to unpick the ways in which the local community currently perceives the University, and how they would like to work with the institution moving forward. Coming from a healthcare background, Sally and Richard are perhaps particularly well placed to understand that the things that are most important to a community are those that have a practical impact on their lives – health and wellbeing in its broadest sense. “There was a definite sense in the focus groups that the community felt ‘done to’ by the University, but that in order for a community to feel truly aspirational they need to engage on their own terms. Providing support and access to the University’s resources is only going to make a real difference if it enables the community to address issues that are important to them, in the way they want. This reflects the ethos running throughout education and research in healthcare sciences – ensuring that patients and their
The consultation resulted in the development of a steering group, consisting of members from both the University and from Grangetown, that will have ultimate oversight of the Community Gateway project. Members of the community will be able to put forward ideas for individual projects aimed at improving local health and wellbeing, and those that are successful will be provided with start-up funding, support and guidance from the University. Sally explains: “one of the initial ideas was put forward by a group of local Bangladeshi women, who are seeking ways to improve the health of their menfolk. The School of Healthcare Sciences, for example, has a wealth of experience, research and resource that could be tapped into for a project like this. In return, the women propose to offer cooking lessons. This is exactly the kind of thing that benefits the University as well as the community – developing the institution’s understanding of the cultures on its doorstep in new – and tasty - ways.” For Sally, the most important aspect of the Community Gateway is the aim to make the projects ultimately self-sustainable. “The University has resources – people and skills – that can benefit the community. And we can provide small pots of start-up funding. But by applying for more research funding, giving people more choice and more opportunities, we ensure that we enable people to take these projects forward themselves. We empower them to achieve their own aspirations. This is what I hope to achieve by collaborating on this project – for the University to give something back – but only in a way that is wanted, and is beneficial in a real and practical way.”
This is a new and unique model of community engagement. 12 Iechyd Da | Spring 2015 | Edition 1