WESSEX AHSN Case study
3Men2 have had the pleasure of working with the Wessex AHSN since 2014, delivering a wide range of full service marketing and design solutions both digital and print based.
WESSEX AHSN Case study
Who we do work for
Wessex AHSN
The AHSN Network
Patient safety collaboratives
NHS Improvement
Wessex Academic Health Science Network improves people’s health, achieves excellence in healthcare and boosts innovation and growth in the Wessex life sciences and healthcare sector.
The UK Government has identified Life Sciences and Healthcare as important sectors to generate new economic growth as well as increasing the quality of care for patients within the NHS.
They connect academics, the NHS, industry and others to bring fresh energy to old problems, inspire thinking to new ones and spread innovation and best practice.
The Academic Health Science Network (AHSN) was established to present a unique opportunity to align education, clinical research, informatics, innovation, training and education and healthcare delivery. Their goal is to improve patient and population health outcomes by translating research into practice, and developing and implementing integrated health care services. They will support knowledge exchange networks to build alliances across internal and external networks and actively share best practice, and provide for rapid evaluation and early adoption of new innovations.
The national PSC is the largest safety initiative in the history of the NHS, supporting and encouraging a culture of safety, continuous learning and improvement, across the health and care system.
NHS Improvement is responsible for overseeing foundation trusts and NHS trusts, as well as independent providers that provide NHSfunded care. It also offers the support these providers need to give patients consistently safe, high quality, compassionate care within local health systems that are financially sustainable.
VIEW THE WEBSITE HERE
VIEW THE WEBSITE HERE
The PSC is a joint initiative, funded and nationally coordinated by NHS Improvement, with the 15 regional PSCs organised and delivered locally by the Academic Health Science Networks (AHSNs).
VIEW THE WEBSITE HERE
By holding providers to account and, where necessary, intervening, NHS Improvement helps the NHS meet its short-term challenges and secure its future.
VIEW THE WEBSITE HERE
WESSEX AHSN Case study
Offline: Print work has included annual reports, reviews, newsletters, data sheets, flash cards and various pieces of promotional literature. We have also worked on large scale event and conference graphics and display material. Online: Our digital work has included the design and build of websites each supported with bespoke CMS systems, plus email marketing, social media creation and content, presentation platforms and animations. VIEW THE WEBSITE HERE
WESSEX AHSN Case study
“ Working with 3Men2 is nothing short of brilliant. Our organisation is small but looking to make a big impact in healthcare, which means we need a bright, engaging, friendly and noticeable visual identity, which the team at 3Men2 has always implicitly understood. From understanding our web needs through to more traditional printed materials, the team has helped us develop, grow and nurture our brand; and because of this, good quality design has become a cornerstone of our communications and engagement strategy. As a communications team, we receive a great deal of positive feedback, and have been shortlisted for three national awards. Without a doubt, this is partly due to the creativity and professionalism of the team at 3Men2.� Michael Goodeve, Associate Director of Communications
WESSEX AHSN Case study
The first 5 years of Wessex AHSN in numbers
Leveraged
ÂŁ18.3m
Screened over
7,000
worth of grants for our members
people at risk of undernutrition
174
39,000
Wessex GP surgeries using iSPACE, training over
3,000
people directly involved with or treated by our programmes
staff
*may include some double-counting as some people may have been seen by more than one programme **since 2011, when the AHSN was the HIEC Partnership
1 million+
Spread innovations to
254,000
views of our videos**
644 sites
people screened by our programmes*
Awarded
Supported
Adopted
contracts generating
healthcare start-up companies with the Health Innovation Programme
innovations back into the Wessex AHSN
14
ÂŁ8.4m
for the Wessex economy
40
32
WESSEX AHSN CMS system
Because we build websites from the ground up, we were are able to create a bespoke yet easy-to-use content management system that allows multiple users to manage the creation and modification of their digital content. This included publishing programme content, events and news, format management, history editing and version control, indexing, search and retrieval.
WESSEX AHSN Social media
Did you know that there are more than 3.2 billion social media users worldwide? This is why we believe an important part of any marketing strategy is to ensure we integrate social media to engage directly with Wessex AHSN customers and make sharing content easy. We created and continue to manage marketing assets, events collateral, advertising and templates for all Wessex AHSN social media channels including Twitter, Facebook, Youtube and Linkedin.
WESSEX AHSN Annual Review 2016-2017
Foreword
Serenity Integrated Monitoring (SIM): a major breakthrough in the management of high intensity mental health crisis
At Wessex Academic Health Science Network (AHSN) we are clear about our mission
What was delivered in 2016/17?
We connect NHS and academic organisations, local authorities, the third sector and industry. We help create the right conditions to facilitate change across whole health and social care economies, with a clear and consistent focus on citizens, service users and patients. Our twenty-five members work with each other, and with a broad range of stakeholders, to support the creation of wellbeing and wealth in Wessex through making innovation happen at speed and scale.
Supporting health, wealth and transformation across Wessex
53%
reduction in the overall number of people going into crisis requiring police intervention in areas where SIM is working
We are fully aligned with NHS England’s refreshed Five Year Forward View, and are working ever-more closely with the three STPs within Wessex. We are, every day, strengthening our understanding and value in the health and social care system. In health, as in other sectors, innovation and adoption at scale is increasingly driven by interdisciplinary research, synergies between industries, and a step-change in end-user (citizen, consumer, patient) engagement in the process. Seeing the wood from the trees, making connections, spotting opportunities, and understanding how to get traction requires a breadth of perspective and strong roots into, and across, that landscape.
“One of those rare complete ‘no brainers’ as far as the CCG is concerned”
AHSNs connect horizontally across research, industries, commissioners, providers and users; and network vertically between policy formulation, system design, operational coal-face and end-user experience. That role takes us across all parts of the NHS, into industry, local government and other public agencies, into universities, charities, start-ups, and into funders.
Wessex Academic Health Science Network Annual Review
20162017
GP Board Member and Clinical Lead for Immediate Care NHS Mid Essex Clinical Commissioning Group (CCG)
We work up and down the system: from the role of the GP receptionist in improvement and innovation; to dialogue with policy makers and regulators about refining system design to support adoption and spread of innovation. Networks which are open to, and embrace, the diverse perspectives of these stakeholders will, in turn, help the systems and members whom they support, remain open to the adoption and spread of innovation.
Fiona Driscoll Chair, Wessex AHSN
Bill Gillespie Chief Executive, Wessex AHSN
@WessexAHSN
wessexahsn.org.uk
5
What was delivered in 2016/17?
Led by the Research and Innovation division at Portsmouth Hospitals NHS Trust, we worked closely with the MISSION quality improvement programme and the Wessex Asthma Network to enhance care for patients with respiratory disease.
Wessex GMC has now recruited over 1,800 patients into the national 100,000 Genomes Project; a major drive to try and tackle rare disease and cancer through studying people’s genes.
What was delivered in 2016/17?
The majority of these are through University Hospital Southampton NHS Foundation Trust (UHS); the following trusts have also joined the project, as Local Delivery Partners, to help reach more patients:
•
•
Portsmouth Hospitals NHS Trust
•
•
Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust
•
Creating champions for the model and maximising opportunities for future spread
•
Hampshire Hospitals NHS Foundation Trust
•
Securing additional investment and support from technology partners and pharma
•
Solent NHS Trust
•
Southern Health NHS Foundation Trust
Recruitment rates will increase as our partner trusts ramp up to their full capacity. We have supported UHS to produce engagement materials such as posters, banners, and ‘How To’ guides for clinicians. These have been used at exhibitions and events regionally and nationally.
Successfully planning and beginning to deliver an ambitious new way of treating patients with respiratory problems
•
Achieving national recognition for improving care - e.g. HSJ award Securing additional support for spread from The Health Foundation
•
Shortlisted in four categories at the HSJ Value Awards 2017, and two categories at the Patient Safety Awards 2017
•
Chosen by NHS England as one of eight innovations ready for national scaling - NHS Innovation Accelerator – with Sergeant Paul Jennings as one of 2016/17’s national fellows
•
SIM is currently being set up in four other NHS trusts in England
•
Development of a High Intensity Portal to link all high intensity teams with standardised training and case management
•
Two teams being set up in the USA and Holland
•
SIM model meets all key strategic objectives of the NHS England Five Year Forward View for Mental Health 2016, and the Mental Health Crisis Care Concordat 2014
•
Further expand the network of NHS mental health trusts professionalising and using high intensity mentoring
•
Launch and roll out www.highintensitynetwork.org
•
Further develop the number of international teams
28
How has the AHSN helped you in 2016/17? The AHSN has helped me enormously with all types of support: academic networking, business planning, project management, finding funding, communications and marketing, speaking at conferences and with applying for fellowships and awards. They have been remarkable.
What are the greatest challenges for your work? The greatest challenge has been the sheer amount of work there is to scale a project across the NHS. There are only two people in my team, and we are both part-time!
What are you most proud of? Winning the Nursing Times Award in 2016, and for being the only Mental Health innovation on this year’s NHS Innovation Accelerator programme.
What’s in store for 2017/18? Hopefully even more interest from even more NHS Trusts as we develop the High Intensity Network nationally.
You can follow Paul on twitter too: @MHinnovator
Winner!
of the HRH Prince of Wales Award for Integrated Care (Nursing Times Awards 2016)
@WessexAHSN
wessexahsn.org.uk
Since 2013:
The AHSN identified, planned, and delivered an opportunity for in-depth public education on the project through the Café Scientifique network: Improved early diagnosis of respiratory disease for over
1,000 patients across 90-minute dedicated events
reaching 330 people
Search wessexahsn.org.uk/videos for 100000 genomes
24
@WessexAHSN
in six of our towns and cities
To find out more about the Wessex NHS Genomics Medicine Centre, or to take part in the 100,000 Genomes Project then please use the contact details below: Rare disease participant genomicsrd@uhs.nhs.uk Cancer patient genomicsc@uhs.nhs.uk National Information Line 0800 3898221 @WessexGMC #Genomes100K
1,000 patients identified and reviewed by specialist team
Improved patient quality of life as measured by QALYs for over
VIEW THE BROCHURE HERE
3,000 patients
What’s planned for 2017/18? •
Around 1,000 patients identified and reviewed by specialist team
•
Measurable savings in healthcare utilisation identified
•
Measurable improvements in quality and experience of care
•
Uptake of the model by at least two localities in Wessex
Spotlight on: Sgt. Paul Jennings, National Innovation Accelerator (NIA) Fellow 16/17, and project lead for SIM.
29
The Annual Review demonstrates how they are fully aligned with NHS England’s refreshed Five Year Forward View, and are working ever-more closely with the three STPs within Wessex.
Achieving support from local primary care participants and vanguard partners
•
Winner of the HRH Prince of Wales Award for Integrated Care (Nursing Times Awards 2016)
The Annual Review is designed to indicate where Wessex AHSN have connected NHS and academic organisations, local authorities, the third sector and industry. It highlights where they have helped create the right conditions to facilitate change across whole health and social care economies, with a clear and consistent focus on citizens, service users and patients.
Respiratory: improving lung health across Wessex
genomes project across Wessex
1,800 patients into the 100,000 genomes project
Twice as effective as Street Triage teams in reducing Section 136 (mental health) detentions
•
Find out more about SIM, and watch videos about the project on the Wessex AHSN website by searching ‘SIM’ at wessexahsn.org.uk Follow the team on: @SIMIntensive
@WessexAHSN wessexahsn.org.uk
Wessex Genomic Medicines Centre (GMC): Delivering the 100,000
53% reduction in the overall number of people going into crisis requiring police intervention in areas where SIM is working
•
What’s planned for 2017/18?
That is what we, Wessex AHSN, aspire to. We hope you find this spirit reflected in our review of 2016/17; and in our reinvigorated business plan, which takes us to March 2018.
4
•
Winner!
of the Primary Care Innovation category at the HSJ Awards 2016 and of the Improving safety in Medicines Management category at the Patient Safety Awards 2016
Visit: wessexahsn.org.uk/videos where you can view our new MISSION video
wessexahsn.org.uk
25
WESSEX AHSN Annual Review presentation
A short animation was created for Wessex AHSN to use across their social media platforms as a way of both promoting the Annual Review and their successes over the last 12 months. This included key statements from several of their board members.
VIEW THE ANIMATION HERE
WESSEX AHSN Annual Review 2017-2018
Foreword Wessex Academic Health Science Network Annual Review
Our first five years in numbers:
Academic Health Science Networks (AHSNs) are at an exciting time in their history.
2017-2018
Awarded 14 contracts generating
£8.4m
We have now finished the first five years of our licence, and in May 2018 AHSNs were licensed for a further five years by NHS England.
for the Wessex economy
39,000
Here is a compilation of our impact – counting from April 2013 to March 2018.
people directly involved with or treated by our programmes
In health, as in other sectors, innovation and adoption at scale is increasingly driven by interdisciplinary research, synergies between industries, and a step-change in end-user (citizen, consumer, patient) engagement in the process. Seeing the wood from the trees, making connections, spotting opportunities, and understanding how to get traction requires a breadth of perspective and strong roots into, and across, that landscape.
Spreading healthcare innovation across Wessex
174
Wessex GP surgeries using iSPACE, training over 3,000 staff
Academic Health Science Networks (AHSNs) connect horizontally across research, industries, commissioners, providers and users; and network vertically between policy formulation, system design, operational coal-face and end-user experience. That role takes us across all parts of the NHS, into industry, local government and other public agencies, into universities, charities, start-ups, and into funders. And up and down the system; from the role of the GP receptionist in improvement and innovation; to dialogue with policy makers and regulators about refining system design to support adoption and spread of innovation.
Supported
Networks which are open to, and embrace, the diverse perspectives of these stakeholders will, in turn, help the systems and members which they support be open to the adoption and spread of innovation.
40
Spread
healthcare start-up companies with the Health Innovation Programme
43
We believe these ambitions are reflected in our new business plan, new direction, and are indicative of a small organisation making a big impact.
Leveraged
innovations to other AHSNs in England
£18.3m
1 million+
worth of grants for our members
Fiona Driscoll Chair, Wessex AHSN
views of our videos**
Spread innovations to
644 sites Screened over
Bill Gillespie Chief Executive, Wessex AHSN
7,000
Adopted
people at risk of undernutrition
32
254,000
@WessexAHSN wessexahsn.org.uk
innovations back into the Wessex AHSN
people screened by our programmes*
*may include some double-counting as some people may have been seen by more than one programme **since 2011, when the AHSN was the HIEC Partnership
4
@WessexAHSN
wessexahsn.org.uk
The Healthy Ageing programme: supporting Wessex to age well, and stay independent
5
An ageing population is one of the biggest challenges for our future in Wessex:
@WessexAHSN
wessexahsn.org.uk
Dr Elaine Maxwell, clinical adviser, NIHR Dissemination Centre
Projects planned for 2018-19 within three streams of work:
24%
of the population in 2012 over 65 years old
30%
of the population in 2030 over 65 years old amounting to 600,000 people in Wessex
2037
the population of the over 80s expected to have doubled
1
(estimated ONS data)
‘Frailty’ is a distinctive health state related to the ageing process, where multiple body systems gradually lose their built-in reserve. Progression of frailty means an individual has increasingly complex health and social care needs, with increased risk of falls, disability, and need for long term care.
In 2014, it was estimated that...
6.5%
of over 60 year olds
30%
of over 80 year olds
...were living with frailty
65%
of over 95 year olds
2
3
Nutrition and Hydration •
Produce and publish the nutrition wheel
•
Implement Hydrate for Care Homes: phase 1 in 16 Hampshire County Council care homes; Phase 2 HIOW-wide. Phase one launched in April 2018
•
Develop / evaluate Hydrate for Domiciliary Care (3 – 5 agencies for pilot). Modify Hydrate in Care Home approach
Weymouth and Portland Community Hub: quantitative evaluation based on Dorset CCG collated Dashboard Data
•
Inpatient Carers Hub, UHS
•
Ongoing identification and prioritisation of innovations for evaluation
•
Evaluation of Red Bag in Care Home rollout across north and mid Hampshire
Spread •
ESCAPE Pain (national AHSN programme and NIA Fellowship)
•
Joint working with NIHR Dissemination Centre to use themed review ‘Comprehensive Care: people with frailty in hospitals’ to develop an audit looking at care of people with frailty in hospital. Development of audit with Healthy Ageing Programme acute care expert group with plan to pilot across Wessex
•
Ongoing identification and prioritisation of best practice for spread
•
Development of Healthy Ageing Timeline to showcase and share Wessex-wide and national Healthy Ageing and frailty initiatives
(Age and Ageing 2014)
“The healthy Ageing programme will help by engaging with health and social care services across the region, ensuring widespread dissemination of good practice and developing a clear local focus on the planning of frailty services within our region. By the end of our ambitious programme, I hope we will have developed a region-wide approach to the management of chronic health problems in our older population with particular focus on prevention and planning for the future.”
VIEW THE BROCHURE HERE
Evaluation •
Dr John Duffy, stroke and frailty consultant at Hampshire Hospitals NHS Foundation Trust and a member of the Healthy Ageing steering group 22
@WessexAHSN
wessexahsn.org.uk
15
Following on from the success of the previous years Annual Review, we expanded the infographic styling to include an overview of the achievements accomplished by Wessex AHSN over last 5 years. This was later adapted into posters and a pop-up display system for Wessex AHSN to use at events and presentations.
“Frailty is important both because of the challenges it presents for health services, but also, and more importantly, the need to ensure people live well with frailty, and avoid the risk of deterioration and poor quality of life. Wessex AHSN is taking the lead by ensuring innovative changes in services designed to improve the experience of frailty are well-grounded in research evidence. I hope the Wessex programme of work gains the commitment of local health service providers to develop reliable quality improvement tools that can be used nationally.”
Aiming to add value to the frailty agenda and activities in Wessex through focus on innovation and spread
14
23
WESSEX AHSN Alcohol report
Background
300,000
Reducing Harm from Alcohol Programme
Project Overview
Project Overview
g)
Local analysis at trust level will be necessary to identify what further developments of infrastructure or training may be required to support local improvements. Age and gender may impact adversely on how alcohol use is documented, with those over the age of 50 and women being less likely to be screened for alcohol use. Patients were more likely to be prescribed treatment for alcohol detoxification if they had been seen by a hospital alcohol team.
Audit of screening and referral pathways within individual acute trusts
This study used retrospective audit data collected from patients with a liver disease diagnosis and a hospital admission of >24 hours during 1st January to 31st March 2015 at seven acute trusts in Wessex. Data was collected from 643 individuals (ARLD code n=247, other alcohol codes n= 116 and other liver disease codes n= 280). The audit questions asked were:
potential years of life lost due to alcohol in 2016
• • •
What was the documented evidence for alcohol screening and brief intervention in this population? How closely did the care for these patients follow a best practice pathway? Were there differences in management which had an impact on outcomes for patients?
https://www.slideshare.net/WessexAHSN/baseline-audit-of-alcohol-related-assessment-and-management-acrosswessex-acute-trusts It is hoped that Trusts will repeat this audit in early 2019 using data for January – March 2019. The repeat audit will highlight the impact that the increased training and specialist alcohol liaison services has had on the identification of harmful drinkers, and their treatment.
The audit demonstrated that each trust has a varied uptake across the patient pathway.
Acute Trust
Pathway filtered (%) documented (yes) B’mouth
Dorchester
HHFT
IOW
PHT
UHS
Salisbury
All Trusts
Documented alcohol use
78.8 (n=82/104)
84.2 (n=32/38)
87.6 (n=92/105)
78.7 (n=48/61)
56.4 (n=106/188)
88.5 (n=85/96)
77.8 (n=35/45)
75.4 (n=480/637) 2 missing
70.7 (n=58/82)
75.0 (n=24/32)
77.2 (n=71/92)
54.2 (n=26/48)
77.1 (n=81/105)
83.5 (n=71/85)
60.0 (n=21/35)
73.5 (n=352/479) 1 missing
Programme Report May 2018
Filter applied (alcohol use documented (yes) and Harmful alcohol (yes))
Alcohol is a major health problem in the UK with over 300,000 potential years of life lost due to alcohol in 2016. (1) Alcohol-related harm places a significant and growing burden on NHS services and is the leading cause of death among 15 to 49 year olds. (2)UK society has a complex relationship with alcohol, which has a major impact on policy, including within the NHS. Public Health England data from 2014/5 shows that the rate of alcohol related hospital admissions continues to rise steadily to 2138.7 per 100,000 (139,251 individuals). Since 2008/9 the rate has risen by 29%.
Outputs Further details and links to outputs can be found at http://wessexahsn.org.uk/projects/140/integrated-treatment-for-arld-making-it-happen-2017 Work has also been presented at the Wessex Public Health conference, March 2018.
Filter applied (alcohol use documented (yes)) Adequate alcohol history taken?
This data has been analysed and presented at the Wessex AHSN Reducing Harm from Alcohol conference (Feb 2018).
Documented brief advice given by non-HAT
89.7 (n=26/29)
33.3 (n=4/12)
13.8 (n=4/29)
55.6 (n=10/18)
46.5 (n=33/71)
43.5 (n=20/46)
23.5 (n=4/17)
45.5 (n=101/222)
Referral to HAT
44.8 (n=13/29)
0.0 (n=0/12)
28.1 (n=9/32)
0.0 (n=0/18)
76.1 (n=54/71)
50.0 (n=23/46)
70.6 (n=12/17)
49.3 (n=111/225)
1.
Phillips H, Sinclair J, Grellier L, Gordon H. (2017) Audit of screening for hazardous alcohol intake of patients admitted with liver disease, and the implementation of an alcohol pathway. Gut 2017; 66:A79-A80
2.
Taylor C Gordon H, Sinclair JMA (2017). Audit of management of patients with possible Alcohol Related Liver Disease (ARLD) at University Hospital Southampton. Poster Royal College of Psychiatrist Addiction Faculty annual meeting, London.
Filter applied (alcohol use documented (yes) and Harmful alcohol (yes) and reviewed at HAT (yes)) Treatment prescribed
100 (n=10/10)
0 (n=0/0)
87 (n=20/23)
N=0/0
85.2 (n=46/54)
95.7 (n=22/23)
100 (n=11/11)
90.1 (n=109/121)
CIWA used?
10 (n=1/10)
N=0/0
65.2 (n=15/23)
N=0/0
29.6 (n=16/54)
8.7 (n=2/23)
0 (n=0/11)
28.1 (n=34/121)
Evidence of alcohol related discharge support offered
90 (n=9/10)
N=0/0
60.9 (n=14/23)
N=0/0
61.1 (n=33/54)
73.9 (n=17/23)
90.9 (n=10/11)
68.6 (n=83/121) (2.5% N/A)
Wessex AHSN included as one of its priorities a quality improvement programme, ‘Reducing Harm from Alcohol’, to highlight and address the deficits in awareness, research and policy in this important and under championed area of healthcare. Concentrating on approaches to reduce the morbidity and mortality caused by increased-risk drinking, a specific focus on Alcohol Related Liver Disease (ARLD) has been used (as an example disease state caused by increased-risk drinking) to highlight current services and processes, and pilot innovations to improve outcomes for patients. The programme ran from October 2013 – March 2018. It has made significant advances in the development of approaches and materials to improve knowledge about, and identification of, patients drinking at increased-risk levels. This includes: support of local champions to engage with commissioners with the aim of developing local services; production of high quality benchmarking data of ARLD (Alcohol Related Liver Disease); and piloting innovative alcohol treatment pathways to achieve improved health outcomes.
@WessexAHSN wessexahsn.org.uk
4
@WessexAHSN
wessexahsn.org.uk
Alcohol consumption is responsible for
3-5% of absences from work
5
wessexahsn.org.uk
21
Alcohol is a major health problem in the UK with over 300,000 potential years of life lost due to alcohol in 2016.
Theme 1: Development of approaches and materials to improve awareness and training about increased-risk drinking in health professionals, to promote early identification and treatment of patients drinking at increased-risk and dependent levels
Wessex AHSN launched a quality improvement programme, ‘Reducing Harm from Alcohol’, to highlight and address the deficits in awareness, research and policy in this important and under championed area of healthcare.
The first quality standard in the NICE clinical guideline for alcohol-use disorders (CG115) is ‘Health and social care staff receive alcohol awareness training that promotes respectful, non-judgemental care for people who misuse alcohol’.
We worked with Wessex AHSN to present a report that reviewed the programme, it’s ongoing development and outputs produced by the project.
Whilst the reduction of harms from smoking is now well integrated into healthcare, NHS professionals remain less comfortable asking patients about their alcohol consumption, with the consequence that opportunities for interventions are missed (‘Making Every Contact Count’), and patient outcomes are not optimised. One major contributing factor is that there are low levels of ‘alcohol- specific health literacy’ in those working within the NHS. Consequently, the opportunities for staff to optimise their own health are also missed. As alcohol consumption is responsible for 3 – 5% per cent of absences from work (HSE data), and as the NHS is Europe’s largest employer, this represents a significant problem.
a)
Know Your Numbers: Improving the alcohol specific health literacy of NHS staff
The Know Your Numbers project has developed, piloted and spread a suite of awareness and training tools and approaches primarily aimed at healthcare professionals to improve the early identification and treatment of patients drinking at increased-risk levels.
VIEW THE REPORT HERE
These materials include: • •
•
a range of leaflets, posters and presentations for individual NHS trusts to adapt to their local needs; a web-based alcohol application to assist health professionals in accurately estimating the amount of alcohol a patient drinks, to enable effectively tailored treatment to prevent complications of acute alcohol withdrawal or provide appropriate interventions; a Know Your Numbers bar, which has been exhibited at the New Forest Show in 2014 and 2015, annually at University Hospital Southampton open day and at the University of Southampton Science and Engineering Fair (SOTSEF).
The Know Your Numbers materials are being widely used across Wessex by health teams and commissioned alcohol services. Since the beginning of 2016, approximately 58,600 people have been screened in these trusts. Training has been provided by the programme through Train the Trainer events and support for training of trust staff by local specialist nurses. Further spread of the materials has been made to: • •
• •
@WessexAHSN
@WessexAHSN
Project Overview
Over the five years of the Reducing Harm from Alcohol programme, the initiative has developed and piloted a number of innovative ways of improving staff awareness of the need to take an accurate alcohol history and improve their competencies to do so.
8
20
National groups: Public Health England; Her Majesty’s Prisons; British Liver Trust; Medical Council for Alcohol; Liver for Life NHS Trusts: Hillingdon Hospital; Aberdeen Royal Infirmary; Gartnaval Royal Hospital Glasgow; Royal Surrey County Hospital; Primary Health Care UCL; Bracknell and Ascot CCG; University Hospital Bristol; East Kent Hospital University NHS FT; Hertfordshire CCG; Chertsey Hospital AHSNs: Oxford; South West; Kent Surrey Sussex; West of England; Eastern Pharmaceutical Companies: Kyowa Kirin; Norgine.
wessexahsn.org.uk
9
WESSEX AHSN OPEN planning guide
Tasty drinks recipes
BMI:
trition is:
ks
Avoid ‘diet’ or ‘low fat’ products
Super Soup Packet of cup a soup 200ml warmed whole milk 4 tablespoons milk powder 2 tablespoons double cream / grated cheese Mix together and serve warm
Milky drinks See GP for a medical review
Eating well, feeling good Guidance if you have unplanned weight loss or are underweight
Tips for eating more
Fruit Blast 100ml fresh fruit juice 100ml lemonade 1 scoop ice cream 1 tablespoon sugar Mix together and serve chilled
Shop bought supplements e.g. Complan and Meritene (made with whole milk)
Include nourishing drinks, e.g. whole milk, milky coffee, milkshakes, hot chocolate, malted drinks e.g. Ovaltine, Horlicks
If you’re concerned about someone... • Encourage them to make an appointment with their Practice Nurse (or community nursing team if applicable) • Share your concerns with health or social care workers involved in the person’s care • Check for signs of anxiety, depression or lack of interest in things they previously enjoyed
Fortify food – add extra calories without increasing the food portion. Examples include adding cream to soups and casseroles, or adding butter and cheese to mashed potato
Fortify your milk and use this in place of usual milk
Your plan Your weight & BMI
You can:
• Talk to them about eating and ask questions to open up the conversation, e.g. “Tell me what you had to eat yesterday?”
Date:
Weight:
BMI:
The likely cause of your undernutrition is:
Your key goals
(tick all that apply)
Gain weight
Fortify your food
Milky drinks
Maintain weight
High energy snacks
See GP for a medical review
Other advice
• If you are in the kitchen or making a drink, you could check the fridge and kitchen cupboards – this can give an idea of whether foods are fresh and within date, and whether there’s a good variety of food
Name:
• Encourage snacks and milky drinks
Team:
Eating well, feeling good Guidance if you have unplanned weight loss or are underweight
Please contact
Telephone:
• Support them to attend social events which include meals, such as lunch clubs
Consider joining a local lunch club Detach these 2 cards and keep them somewhere handy
Why is ‘eating well’ important? Eating well is important for everyone. It enables the body to get the right balance of nutrition to work at its best. Malnutrition means ‘poor nutrition’. A person is ‘malnourished’ when they have not eaten enough (undernourished), or too much (overweight) of the right foods to stay healthy. It can lead to illness because the body isn’t getting the right nutrition to work properly. This booklet focuses on identifying and treating undernutrition.
Who is at risk? Anyone can be at risk. This risk increases with age, but it should not be accepted as just being part of old age. There are many factors which can cause someone to lose weight or to be underweight: Social factors • Isolation, loneliness • Work and financial pressure • Lack of cooking skills • Difficulty shopping or preparing food • Lack of knowledge about food and nutrition
Psychological factors
Physical factors
• Confusion • Anxiety and depression • Dementia • Bereavement
• Poor appetite • Illness, recent hospital stay • Swallowing problems • Memory loss • Poorly fitting dentures • Sickness, nausea and diarrhoea • Loss of taste and smell • Dementia
The Wessex AHSN have put together Older People’s Essential Nutrition (OPEN) tool-kit with the aim to develop and evaluate an approach for the provision of good nutritional care for older people, by providing undernutrition awareness training and follow up support to a range of sectors to provide a collaborative and joined-up approach to tackling undernutrition in older people.
What are the symptoms to look out for? If you or someone you know is experiencing any of the following, they could be at risk of losing weight or becoming underweight: • Underweight (Body mass index (BMI) less than 20) • Unplanned weight loss • Poor appetite or trouble finishing meals • Eating less food or drink than usual • Finding it hard to keep warm • Poor concentration or irritability • Loss of interest in food • Withdrawal or loss of interest in clubs and activities • Pressure ulcers or poor wound healing
Spotting the signs of weight loss • Shirt collars looser • Looser dentures • Thin arms • Thinner legs • Belts and waistbands looser • Clothes look too big • Shoes and slippers looser • Jewellery looser or slipping off Detach these 2 cards and keep them somewhere handy
Tips for eating more Losing weight is not a natural part of the ageing process. If you are older and losing weight, the following eating guidelines may apply to you:
Tasty drinks recipes Fortified milk 4 tablespoons milk powder 1 pint of whole milk Mix together
Eat small, frequent meals and snacks, instead of 3 large meals
Banana milkshake
Introduce snacks around your favourite TV programmes
High calorie snack ideas include thick and creamy yoghurts, cake, cheese and crackers and buffet foods
Eat foods high in calories and protein, e.g. full fat dairy products, meat and fish
Yoghurt & Berry Smoothie 150ml whole milk Small pot of Greek yoghurt Handful of frozen berries Small banana Blend together
Small, ripe banana Scoop of vanilla ice cream 1 cup of fortified milk Teaspoon of honey Blend together
WESSEX AHSN Wessex Health Innovation Forum
Wessex Health Innovation Forum: Dorset
Co-hosted by the AHSN and local NHS organisations, the Wessex Health Innovation Forum events are designed to support the development of innovative technologies and models of care by bringing together staff from health, academia and industry with an interest in using innovation to transform services.
Wessex Health Innovation Forum: Isle of Wight
The meetings showcase innovations from within the local health system and further afield that have the potential to improve the quality and efficiency of patient care.
Harnessing bright ideas for patient benefit Monday, 17 July 2017 at 17:30 – 21:00 Share Lecture Theatre, Fusion Building, Talbot Campus, Bournemouth University, Fern Barrow, Poole BH12 5BB Please note that refreshments also will be provided For more information and to register your place, visit bit.do/dorsetinnovation2017
Wednesday, 4 July 2018 at 6:45 – 9:30pm St Mary’s Hospital, Newport, Isle of Wight The health system on the Isle of Wight is unique; and faces challenges both familiar to the wider NHS, and challenges particular to the island. Co-hosted by the Isle of Wight NHS Trust and Wessex Academic Health Science Network, the main aim of this Innovation Forum is to bring together the island’s primary and secondary care professionals; to network, share ideas, connect and explore ways to help improve services for the island’s population. Transforming services takes more than one evening, but we aim to start many conversations. On the night, we will hear from an international speaker – Keith Dewar – who has spent his working life transforming healthcare services on an island with strikingly similar challenges to the Isle of Wight (Prince Edward Island, Canada). Keith will share his hindsight of what worked and what didn’t over the past 15 years.
Co-hosted by Wessex Academic Health Science Network and Dorset Clinical Commissioning Group.
We will also hear from healthcare innovators (often clinicians) who have developed new ways to tackle current (and future) problems. The Innovation Forum will showcase some exciting innovations which are already impacting other areas of the NHS, as examples of how technology might help some of the island’s challenges.
This forum will showcase national innovations available through the Innovation & Technology Tariff and from within the local health system that have the potential to improve the quality and efficiency of patient care. By providing a platform for innovators and clinicians to openly discuss the problems and required solutions we aim to accelerate the development of innovations to enable wider engagement and adoption across the system.
If you register, but are later unable to attend on the night, please tell us so we can reallocate your space, as our events are often fully booked with waiting lists.
@DorsetCCG @WessexAHSN wessexahsn.org.uk
Wessex Health Innovation Forum: Portsmouth
Refreshments, buffet, and networking time will be provided, and a full agenda will follow. Spaces are limited, so please book as soon as you are able.
#NHS70Innovations
@IOWNHSTrust @WessexAHSN wessexahsn.org.uk
Speaker biographies
Wessex Health Innovation Forum: Portsmouth
Bill Gillespie CEO, Wessex AHSN
Rebecca McKay Chief Operating Officer, CRN Wessex
Bill is an experienced health manager who has worked at board level in health organisations in the UK and overseas for the last 15 years. Since returning to the UK in 2014, Bill has fulfilled a number of consultancy roles including support to the London Health Commission, South West London and St George’s Mental Health Trust, Katie Piper Foundation (health charity) and as Interim Regional Director of Specialised Commissioning for NHS England South, before starting with Wessex AHSN in January 2016.
Rebecca trained as a nurse at the John Radcliffe Hospital in Oxford and went on to work in the coronary care unit. Before embarking on a BA in Social Sciences and later a MSc in Social Research Methodology at London University.
Sue Harriman CEO, Solent NHS Trust
Harnessing bright ideas for patient benefit
Trained as a nurse in the Royal Navy. Sue was a trained critical care nurse for a number of years and after completing a BSc in Infection Prevention at the University of Hertfordshire, joined the NHS in 2002 to become a Nurse Consultant in Infection Prevention.
Wednesday, 29 November 2017 at 17:30 – 21:00 Richmond Building, University of Portsmouth, Portland Street, Portsmouth, PO1 3DE
Sue has been an Executive Board Director for nine years. Her executive roles have included Director of Nursing and Allied Health Professions, Chief Operating Officer and Managing Director. Sue was appointed to lead Solent NHS Trust as Chief Executive in September 2014.
For more information and to register your place, visit bit.do/portsmouthinnovation The NHS is changing. Health organisations, local authorities and universities are increasingly working together to help meet the challenges the NHS faces.
Sue has lived and worked, locally, in Hampshire since her military career brought her here nearly thirty years ago. She is committed to bringing health and care services together so they work in partnership with the community, and those who use and work with them.
New innovations and technology will be part of the solution, and will transform healthcare, as they have all other aspects of society. But developing technology that meets healthcare needs, and works sustainably in a real world environment, takes multidisciplinary teams working across sectors. This is your opportunity to find out more from local healthcare innovators, academics and clinicians who are looking at new ways to tackle current (and future) problems. Co-hosted by the University of Portsmouth and Wessex Academic Health Science Network, the Portsmouth Health Innovation Forum will showcase local exciting health innovations from healthcare and academia, and some of the expertise and facilities available in Portsmouth to support this work.
Rebecca started working at Charing Cross Hospital in London as regional nurse co-ordinator on the UK Small Aneurysm Study for 2 years in 1991 before embarking on a 6 year career as a HIV senior research nurse at King’s College Hospital, London. Rebecca joined the Barts and The Royal London Hospital in 1999 to set-up and manage the Clinical Research Facility. In 2002 Rebecca moved to Miami in Florida for 5 years. During that time she worked for a private research company, Elite Research, as their Business Development Manager. On returning to the UK Rebecca started working for the Hampshire and Isle of Wight Clinical Research Network and was appointed the Senior Manager in April 2012. In January 2014 Rebecca was appointed the Chief Operating Officer for CRN Wessex.
Michael Fergusson, CEO and Founder, Ayogo Health Inc. Michael is immensely proud to be part of a company acknowledged as one of the 100 most innovative mHealth companies in the world, and that is widely recognised for helping patients take control of their treatments. Over past few years, Michael won many kudos: he was Ernst & Young’s Social Entrepreneur of the Year, and named to the PharmaVOICE 100, a peer-nominated list of the 100 most inspiring people in Life Sciences. What he is most proud of, though, is his work creating an environment where he and his colleagues can live the Ayogo motto: to do our best work, to change the world, and to laugh every day.
If you’d like further information, please email: EnquiriesAHSN@wessexahsn.net
@uopresearch @WessexAHSN wessexahsn.org.uk
@uopresearch @WessexAHSN wessexahsn.org.uk
4
@uopresearch
@WessexAHSN
wessexahsn.org.uk
5
WESSEX AHSN Conference materials
Wessex Academic Health Science Network
Conference 2016
Predict
Prevent
Adapt
Wednesday, 19 October 2016 11:00 – 16:00 St Mary’s Stadium, Southampton
Agenda: The day will feature a marketplace of NHS, university and small business innovators, interactive sessions on genomics, disruptive innovation, digital health and technology, and much more. 11am – 1pm Marketplace and networking The event opens with a large marketplace of NHS, universities, research bodies, commercial innovators and national organisations showcasing their fantastic work. This is a great opportunity to learn about innovation taking place across Wessex and from further afield. We will also be running a Randomised Coffee Trial during the networking time, as part of the national Fab NHS Change Day, which is also taking place on 19 October. Lunch, tea and coffee will be served during this time.
1pm – 4pm The afternoon is jam-packed with Q&A, breakout and fantastic sessions
@WessexAHSN #WessexPPA wessexahsn.org.uk
The Wessex AHSN stakeholder conference involved keynote speakers, Q&A sessions and interactive workshops, discussing genomics, disruptive innovation, digital health and technology. It also featured a marketplace of NHS, university and small business innovators. We provided printed materials and digital assets for the conference, including display systems, tabletop agendas, full PowerPoint presentation and introduction animation.
WESSEX AHSN Pharmacy Show collateral
Medicines optimisation and the AHSNs: Helping people get the most from their medicines Each AHSN works with CCGs, trusts, patients, pharmacists and the pharmaceutical industry to help patients get more from their medicines, and improve medication safety.
Medicines optimisation and the AHSN Network: Helping people get the most from their medicines Making sure patients get the most from their medicines is central to medicines optimisation (MO) programmes across each of England’s 15 Academic Health Science Networks (AHSNs). Prescribing a medicine or medicines remains the most frequent intervention made by the NHS. Getting the most from medicines for both patients and the NHS is becoming increasingly important. Evidence shows us that between 30 and 50% of medicines prescribed for long-term conditions are not taken as intended. Many people take medicines, and the number of medicines that each person takes is increasing. Between 2003 and 2013 the average number of prescription items per year for any one person increased from 13 to 19, so it’s vital that patients get the right medicines, they understand how to use them safely and effectively, and that they know where to go for support. Each AHSN has programmes which improve medicines use and work with CCGs, trusts, patients, pharmacists and the pharmaceutical industry to achieve two key objectives: increasing use of services known to help patients get more from their medicines, and improving medication safety by addressing avoidable errors.
Going further and faster to reduce AF related strokes by working together AHSNs across the country have been implementing innovations and improvements in the management of atrial fibrillation (AF). The work of AHSNs, with their partners in the NHS and industry, has prevented hundreds of strokes already. The AHSN Network’s AF Community of Practice brings together and utilises the knowledge and experience of people working for or on behalf of AHSNs to enable individual AHSNs to go further and faster in their endeavours to reduce the number of avoidable AF related stroke. The community is advancing the spread and adoption of innovations in the detection of AF and the use of therapies to avoid strokes by forming share, adapt and adopt groups.
ahsnnetwork.com atlas.ahsnnetwork.com
The annual Pharmacy Show is the largest gathering of pharmacy professionals in the UK and offers over 100 education sessions across eight conference streams, as well as the opportunity to meet over 400 suppliers, network with over 8,000 colleagues and hear presentations from industry leaders about key issues affecting the profession.
The Newcastle upon Tyne Hospitals NHS Foundation Trust has worked closely with North of Tyne PLC to develop an electronic referral process (clinical handover) that allows hospital pharmacy staff to refer patients to their community pharmacy for post discharge follow-up. Community pharmacists contact patients within three days of referral. The service has been running since July 2014, with more than 100 referrals a month being made. The Academic Health Science Network for the North East and North Cumbria (AHSN NENC) supported the development and implementation of this framework across the region. Once fully operational, 10 acute and mental health trusts will be able to refer patients to 742 community pharmacies. A number of trusts plan to have nurses and doctors as well as pharmacy staff make referrals to ensure best outcomes for patients. The project is now gaining traction nationally, with a number of AHSNs with their acute trusts and community pharmacy colleagues implementing electronic clinical handover.
Targeted medicines support reduces readmissions: Oxford AHSN Patients are being offered targeted support from community pharmacies after leaving hospital to help them make the most of their medicines and avoid readmission to hospital.
Heart Rhythm Congress Detect and diagnostics
Metrics and infographics AF Community
Pan-London AF
Landscape Data Tool
The project is a joint initiative between Oxford AHSN, six NHS trusts, approximately 400 community pharmacies in Berkshire, Buckinghamshire and Oxfordshire and PharmOutcomes, a web-based pharmacy information service. When fully operational, it could benefit hundreds of patients every month.
AHSN medicines optimisation programmes The West Midlands AHSN is supporting the local Transfer of Medicines programme, which involved the roll out of a region-wide Green Medicine Bags scheme in April 2016. Patients are encouraged to take their medication with them into hospital and the Green Bags keep the medicines together, which then move through the care system with the patient. The programme aims to improve patient safety by giving staff accurate information and reducing inappropriate prescribing and errors.
The AHSN Networks AF community ‘share, adapt and adopt groups’
Stroke Prevention in atrial fibrillation (iSPAF): Pan-London AHSNs The pan-London interdisciplinary group, Stroke Prevention in Atrial Fibrillation (iSPAF), is implementing a local medicines optimisation strategy to ensure patients with AF receive best practice treatment, and that clinicians are supported to deliver this.
The community shares projects and learning on the Innovation Exchange: healthinnovationexchange.org.uk ahsnnetwork.com atlas.ahsnnetwork.com #AHSNs
The AHSN MO programme and Transfers of Care (TOC)
The work includes an AF pathway improvement toolkit to assist CCGs in identifying both local needs and existing best practice.
#AHSNs
WESSEX AHSN Serenity Integrated Mentoring identity
Icon created to be used as a prefix to high intensity programmes using the SIM model.
Specialist support for High Intensity Mental Health Crisis Developing a National Research Network
Identity creation for Serenity Integrated Mentoring (SIM), an innovative mental health workforce model that brings together the police and community mental health services in order to better support people with complex mental health needs.
highintensitynetwork.org
WESSEX AHSN High Intensity Network
With currently 10 live trusts and another 7 underway in England, the network has already established a global reach with 1 team live in Holland, another launching in the USA and interest from New Zealand, Australia and Sweden. WINNER NURSING TIMES AWARDS 2016 HRH Prince of Wales Award for Integrated Care
The High Intensity Network is an award winning model of care to support emergency and healthcare teams struggling with highly intensive patterns of mental illness and behavioural disorders. For the first time, NHS Mental Health Trusts across England and Wales are able to train together, share best practice and develop new national standards of care for some of our most vulnerable and high risk service users.
VIEW THE WEBSITE HERE
WINNER HSJ VALUE AWARDS 2017 Mental Health
WESSEX AHSN Digital strategy infographic (WIP)
1
2
3
When you see a patient at an initial appointment, all the information they have already put into the website will be available to you; saving appointment time and allowing for a richer conversation. If they need to be referred onwards, the system will allow you to book directly with the local hospital or other onward appointment.
Over the next few years, patients will be triaged by online services, which will help them determine where to seek help, when they’re not feeling well. This will help keep phone lines free for urgent cases and send patients directly to GP, nurse and pharmacy services. Patients will also book their appointments while online.
Hospital staff will be able to see all the information about the patient, that their GP, nurse and other professionals have loaded into the care record. This will allow for a richer conversation with the patient and the best possible discussion about their health and care.
Patients’ conversations and histories will be logged and accessible in the shared health care record. This means all professionals will be up to date with the latest information and will be able to have a rich and meaningful conversation at appointments.
GP SURGERY
HOME PHARMACY
Original concept supplied by client
Our interpretation of brief Any test results will be sent directly to patients’ smartphone, tablet and/or email, which health professionals will also be able to see. This will mean fewer appointments; freeing up valuable time.
The systems will also be accessible by staff in care homes, meaning social care staff will be able to update the system and also keep up to date with thoe they care for. This will ensure the best care possible between health and social care services.
HOSPITAL
Patients’ conversations and histories will be logged and accessible in the shared health care record. This means all professionals will be up to date with the latest information and will be able to have a rich and meaningful conversation at appointments.
Anonymised patient information, at a population level for Hampshire and Isle of Wight, will have been shared and analysed to understand the needs of the population, to allow for better and wholistic service planning and resourcing.
NHS PLANNING If you need ongoing care, you’ve told us that you’d rather be supported at home. To do this we have to help our staff to work more flexibly. We are therefore installing Wi-Fi in all our NHS buildings with the majority already completed*.
CARE HOME
The creation of a digital strategy ‘journey’ showing how GP surgeries, hospitals, paramedics and pharmacy services will be able to access patient records and information in realtime via a central database. Our understanding of the process and the end requirement allowed us to interpret an initial sketch at the briefing stage and see it through to complete artwork and implementation, through a process of shared understanding and communication.
EMERGENCY SERVICES
Valuable patient information will also be available to those working in emergency medicine; making care safer and quicker for those who need it.
*at Autumn 2018
Our digital strategy Supporting people to stay well
Joining up care locally
Specialised care when needed
Integrated Health and Care Records
Information Governance
Provider Digitisation and Infrastructure
Intelligence and Analytics
Digital Access and Empowerment
Public and Clinical Engagement
Comprehensive longitudinal care record accessible at the point of care.
Clear and consistent information governance arrangements across the STP
Foundation for information being recorded and viewed digitally at the point of care
Better use of data to to drive substantial improvements in health and care
Enabling patients to interact with their record and collaborate in their care
Ensuring involvement of professionals and citizens in the development of our digital plans
@WessexAHSN wessexahsn.org.uk
WESSEX AHSN WESSEX PSC Safety Practice Framework
The Safer Practice Framework has been developed as a self-assessment tool to support General Practice teams, with a focus on patient safety. Designed as a voluntary tool, the aim is to support practices with their quality improvement work in the 5 priority areas identified by the Care Quality Commission (CQC) – are they safe, are they effective, are they caring, are they responsive and are they well led?
WESSEX AHSN Case study
“ Just wanted to convey my thanks for doing such a great job with the branding and for providing so quickly. Please congratulate yourselves on another job well done� Charlotte Forder, Deputy Head of Communications
WESSEX AHSN Case study
Thank you for your time For more case studies like one why not check out our website VIEW OUR WEBSITE HERE