Positive April 2012 by Hargrave Design

April 2012

about integrated healthcare

L-R: Janet Sheard, Paul Sanguinazzi, Sharon Creber, Simon Smith, Mike Harris.

Sharing Our Future Highlighting the importance of involvement in business planning see page 2

check it out partnership working silent kevin preventing falls welcoming new friends breastfeeding

MESSAGE

FROM THE BOARD We recently received notification of this year’s staff survey results from the national NHS staff survey. I am delighted that as a Trust, we have been ranked within the top 20% of Mental Health and Learning Disability Trusts in the Country and scored over and above the national average in a number of areas. One of the top scoring areas showed that staff would recommend Nottinghamshire Healthcare as a place to work or receive treatment. The results within the staff engagement category were also very positive showing an increase on last year’s survey. They indicate that staff feel they are able to contribute to improvements at work and feel motivated and engaged with their work. When compared with the national average, the Trust scored best in the following areas: • Low rate of staff intending to leave jobs • Support from immediate managers • Recommendation of the Trust as a place to work and receive treatment • Quality of job design (clear job content, feedback and staff involvement) • Effectiveness of incident reporting • Percentage of staff using flexible working options Over the past year we have expanded our offender health services and taken on the provision of integrated community health services within Nottinghamshire County and Bassetlaw. With those services, over 2,500 members of staff transferred into the Trust. To receive such positive results after a year of change is fantastic. There are always areas for improvement but overall I am confident that Nottinghamshire Healthcare’s staff are a motivated group of people who feel valued and able to deliver the best possible services they can. We will now be looking at areas we need to target for improvements in the coming year and will keep you updated on developments.

Professor Mike Cooke, CBE Chief Executive 2

Partners get on board to share Trust’s future Service users, carers, members, staff and representatives from partner organisations came to find out more about the Trust’s business plans for 2012/13 at an event in March. The final business plans followed a series of ‘confirm and challenge’ events and an online feedback survey which provided opportunity to give feedback on the plans before they were finalised. The ‘Sharing our Future’ event was organised by the Involvement Team and attended by 115 people. It

included presentations from Mike Harris, Executive Director Forensic Services, Simon Smith, Executive Director Local Services, and Sharon Creber, Associate Director Planning and Performance in Community Services. Each provided a useful overview of the Divisions’ specific objectives and plans for services, as well as the challenges and opportunities that lie ahead.

Get involved in the Centenary Celebrations

L-R: Janet Sheard, Paul Sanguinazzi, Sharon Creber, Simon Smith, Mike Harris.

Eye-catching entertainment from Nikki Larwood of Rosehips Belly Dancers Bottom: The winners of the quiz with their prize

As part of Rampton Hospital’s Centenary celebrations, this month will see 100 trees being planted across the Hospital’s estate. An anti stigma campaign aiming to break down the stigma of discriminatory barriers surrounding mental health and celebrate the positive ways people are discovering their journeys of recovery will also be launched. Patients from the Therapies and Education Department at the Hospital will be taking part in an Arts and Craft competition to create a piece of artwork to represent either the Centenary or a significant event. The winning piece of artwork will be displayed at the Centenary’s Old Fashioned Sports Day and Fete on 14 July.

Paul Sanguinazzi, Head of Involvement, gave an overview of feedback from the online survey, to which 266 people responded before Janet Sheard, Executive Director of Nursing and Allied Health Professionals, chaired a lively question time. The afternoon saw attendees take part in a quiz, before discussing how involvement in business planning can be improved, how information should be communicated, and ways to improve services. The discussion generated a wealth of ideas which will

be used to inform next year’s business planning. “The Sharing our Future event was a fitting climax to a great deal of hard work and engagement that has gone into preparing the Trust’s business plans for 2012/13,” said Paul Sanguinazzi. “I’m delighted that the event was so well received. We want to build on this during the next year. We want service users, carers and members to continue to work in partnership with us to ensure we provide services that make a real difference to people’s health, wellbeing and recovery.” Entertainment throughout the day was provided by Samuel Wheeler, George Wilcockson and the Rosehips Belly Dancers. Feedback from the day was very positive, with 100% of people who completed an evaluation form rating the event as excellent, very good or good. Comments included: “a very valuable day”, “good delivery” and “thank you for a fabulous day”.

Also planned as part of the celebrations is an exhibition on the history of Rampton Hospital. Anyone with old photographs or artefacts that they think would be of interest to staff and the general public are asked to consider loaning them to the Hospital for the duration of the exhibition. The Centenary Steering Group also want to hear from you if you would be able to give your free time to help at the Old Fashioned Sports Day and Fete on Saturday 14 July or if you would like to have a stall to provide a service at the event, ie face painting, hair braiding or craft stall. Please email centenary@nottshc.nhs.uk if you have any old photographs or artefacts that you can loan or if you are interested in providing a stall at the Fete. More information on all of the Centenary events can be found on the Trust or CHP/BHP intranet sites.

1912 - 2012 100 years of improving patient care

Positive April 2012

Enhancing the Healing Environment at HMP Stocken The Offender Health team at HMP Stocken is celebrating the news that an application for a grant from the King’s Fund through the ‘Enhancing the Healing Environment’ initiative has been successful. The funding will be used to adapt a cell for either a dementia patient or a patient with short term memory loss. It will also enable the corridor to be decorated and signage from the centre of the prison to healthcare and the waiting room improved to make it dementia patient friendly. Patients will be able to find their way easily to healthcare and this could reduce non attendance. The adapted cell will make living much easier and could reduce the anxiety of the dementia patient. It is hoped to implement the use of memory boxes, artworks, and items such as a large faced clock. The work will be carried out as a joint partnership project between the Offender Health team and the Disability Officer at HMP Stocken. Expert advice on the decoration and fitments in the cell will be sought from other Directorates in the Trust that specialise in dementia and learning disabilities. The team will also work with the prison to provide meaningful activities and purchase books and games. Alison Hunter, Head of Healthcare said: “We are delighted and excited as this funding will help with our wish to create a positive and therapeutic team and desire to improve the Dementia Pathway for our patients. This will benefit any patient in HMP Stocken with cognitive impairment. For Dementia patients it will reduce agitation and distress, encourage independence and social interaction. It will enhance their daily life and promote safety.” “We want to highlight that Dementia is taken as seriously at HMP Stocken as any other long term condition such as Diabetes or Coronary Heart Disease. If we can keep Dementia patients more settled it will improve patient experience and outcomes, whilst reducing movement around the prison estate and may reduce escorts out to secondary care.”

Dr Jennifer Clegg, Associate Professor and Consultant Clinical Psychologist, presenting at the conference.

Assessment and treatment units: the way forward? More than 100 people took time out in February to focus on the role and value of assessment and treatment units within mental health services. Dr Jennifer Clegg, Associate Professor and Consultant Clinical Psychologist, and Dr Jo Jones, Consultant Psychiatrist, organised a one-day conference on the topic at the East Midlands Conference Centre. “Assessment and treatment units for people who have intellectual disabilities and mental health problems or challenging behaviour have been under scrutiny ever since last summer’s Panorama exposure of poor practice at Winterbourne View,” explained Jennifer. “This conference provided an opportunity to examine evidence about the impact and perceptions of such units and to share good practice. “We wondered whether it might be possible to move towards some harmonisation of practice and perhaps develop a clinical network (and in time a clinical research network), but mostly we were just curious: concerned that anxiety to stop poor practice might be fuelling a leap to impose standards that could shut down exploration when services are still emergent.” Among the speakers was Robert Chaplin, Consultant Psychiatrist and Research Fellow at the Royal College of Psychiatrists, who summarised evidence about admitting people with intellectual disabilities (ID) to adult mental health (AMH) or specialist ID units. The evidence showed that length of stay was shorter and thus cheaper in AMH users, but that users, carers and staff all favoured NHS specialist ID provision. Other speakers included Jennifer Clegg, Tony Holland (Chair in Learning Disabilities at the University of Cambridge), and Debra Moore (past Learning Disabilities Nurse Advisor to the Department of Health). Jennifer spoke about two northern European approaches which are refreshing practice in Nottingham, while Tony and Debra covered integrative approaches to formulation and ID policy. Participants included five psychologists from a specialist challenging behaviour service in Holland and a senior lecturer from Canada currently working in the UK. For further information email jennifer.clegg@nottshc.nhs.uk.

Members of the Panthers with some of the school children

‘Check it Out’: Trust hosts schools event with Nottingham Panthers An event for nearly 200 local school pupils helped wind up the Trust’s ‘Check it Out – Healthy Body, Healthy Mind’ campaign in style last month. The campaign began in November 2011 and ended in March 2012. It aimed to tackle the stigma surrounding mental health and to promote physical health and wellbeing.

performance exploring the effects of smoking on young people, a range of workshops on health topics delivered by Trust staff, and the opportunity to watch a Panthers’ training session.

To celebrate the success of the campaign and raise awareness among young people, a whole day of activities was planned at The Nottingham Ice Arena for pupils from Blue Bell Hill, Edale Rise, Sneinton Church of England and Windmill primary schools. The day was organised in partnership with the Nottingham Panthers ice hockey team and featured a theatre

Nick Daibell, General Manager Adult Mental Health Services County, said: “We are delighted to have been working with the Nottingham Panthers on this important campaign, which encouraged members of the public to check out key health messages and act upon them. This event provided a great opportunity to share these messages, along

with information about the advice and support available, with local pupils in a fun and interesting way.” ‘Check it Out’ followed the success of last year’s ‘It’s OK to talk about it’ campaign. As part of the campaign, the Nottingham Panthers talked about their experiences and gave tips around staying healthy which appeared in match programmes. Free information about key health messages was also available at games throughout the season, with professionals from the Trust on hand to talk about services and provide support.

Trust recognised at Patient Experience Network national awards The Trust has received a Patient Experience Network National award for how it measures, reports and acts on the feedback received from service users and carers. The judges commended the work that the Trust has done to capture feedback from teams through a variety of methods including the Trustwide survey and the online feedback site, Patient Opinion, placing it as runner up in the category of Setting The Stage: Measuring, Reporting and Acting. They were also impressed by how involved service users and carers are in the approach and how the range of feedback was compiled and responded to. The judges comments included: “this project demonstrates a powerful desire to put the patient / service user at the heart of this initiative and shows a strong leadership in putting the whole programme in place” and “Very comprehensive and innovative – trying new things and demonstrating an appetite to push barriers forward.” Last year the Trust was named winner at the awards for its approach to service user and carer involvement.

Positive April 2012

Partnership working at conference core A conference planned for April will encourage service users, carers, families and professionals from health and social care to work more closely together. The Carers’ Council 2012 conference will take place on Friday 27 April at Everyday Champions Conference Centre, Brunel Business Park, Newark NG24 2AG. Entitled “We are all in this together – improving communications and partnership in mental health”, the conference is being run by the Carers’

Council – Allies in Adult Mental Health, and aims to address a number of key challenges: • Major changes in the structure of health and social care driven by government policy, and demands for more creative use of resources.

• Improving communication in the delivery of ‘joined up’ health and social care services.

• Improving the engagement of carers in developing care plans and supporting relatives at points of entry to and exit from health and social care services.

The event will help delegates develop stronger relationships with their ‘partners’ in care, enhance their understanding of how to be more effective in their role, develop their communication skills and create ideas and actions to improve communication and partnership.

• Improving awareness of the value that carers and

Simon Smith, Executive Director of Local Services,

Developing Heart Failure clinics in Rushcliffe Specialist Heart Failure Nurse Louise Hodgson is leading on a project to develop local Heart Failure Clinics in the Rushcliffe area. The CHP Rushcliffe Heart Failure team is committed to working with the local commissioners in developing care pathways to provide effective, quality services for people with established coronary heart disease in an effort to reduce premature mortality. The project ensures that patients who have been investigated are locally managed within the care pathway. They are offered an appointment with the specialist nurse in a clinic local to them to ensure their treatment is optimised and that they have access to the relevant patient education. The specialist nurse reviews the drug management of all Heart Failure patients within her care and advises and supports the relevant GP practice on treatment for those individuals within the practice. A clinic is already established in Keyworth and another is due to open in West Bridgford. Plans are afoot to open a third to cover the north of the directorate in Cotgrave later in the year. Louise said: “This initiative is an ideal way of bringing specialist care out of hospital into the community and allows us to ensure that patients get expert care early on in their illness.”

families bring to care.

will open the conference and interactive theatre will be provided by Indigo Brave to create live situations for delegates. There is no charge to attend the conference but booking is required. For more information contact Peter Robinson at the Carers’ Council on 01623 512607 or email peter.robinson930@ ntlworld.com.

New Executive Director of Nursing Dean Howells has been appointed as Executive Director of Nursing, Quality and Patient Experience. Dean joined Nottinghamshire Healthcare in 2001 and has worked in Leicestershire and Central Notts. His substantive role is Associate Director of Nursing for the Forensic Division. He spent time developing a similar role in Local Services and in the past six months has been Interim Chief Operating Executive for the Bassetlaw Health Partnership. Dean will take up his new role on 1 June, allowing some handover period before Janet Sheard retires on 30 June. Chief Executive Mike Cooke said, “This was a rigorous interview process and we would like to thank colleagues from Involvement, SNAAC and staff side as well as the Board who all agreed that this was the right appointment. It is great that through an authentic approach to staff development and leadership we have been able to appoint such a talented internal applicant to this really important role.”

Meeting the health needs of children in care Children and young people who are in the care of the local authority are amongst some of the most vulnerable in our communities.

Silent ‘Kevin’ in the spotlight The dangers of suppressed profound emotional distress were in the spotlight at a conference held in February at Edwinstowe House. Entitled ‘We don’t need to talk about Kevin’, the event was attended by more than 100 health, education, social work and therapeutic professionals from public, private and voluntary sectors who all work with fostered or adopted children and young people and/ or their families. Speakers attended from Harm-Ed, Rampton Hospital, Child and Adolescent Mental Health Services (CAMHS) and the Portman Clinic. They gave accounts of the self-harming effects of silence in distress, covered the role of therapeutic intervention and showed local data on the correlation between schizophrenic personality disorder diagnosis and early-life separation from parents and experience of child sexual abuse and/or neglect.

pornography were also discussed. Closing questions on what mainstream professionals can do consistently drew advice to get specialist consultation to support their roles in preventative early intervention and therapeutic work. The conference was organised by Chris Parker, Consultant Child Psychotherapist in the City Children Looked-After and Adoption Team. As well as systemicallysupported individual work, members of both City and County Children Looked-After and Adoption CAMHS teams provide consultation to a range of professionals in relation to the emotional and mental health needs of referred children looked-after and adoptive families. One aspect of their work is to encourage reflection on the needs of children and young people whose ways of coping are not a management problem for their networks and whose needs are less easily identified and often overlooked. The value of this work was endorsed by the experience of the speakers at this conference.

Clear evidence suggests that they often have worse health than their peers, which can in turn have long term impacts on their future health outcomes. They are more likely to experience a range of health problems including developmental delay, growth problems, sexual health problems, bedwetting, coordination difficulties, dental decay and vision or hearing difficulties. Children and young people in care also experience significantly worse emotional health and wellbeing issues than other children. Across Nottingham County and City, County Health Partnerships has a team of clinical nurse specialists, paediatricians, designated professionals and administrative support dedicated to promoting the health and wellbeing of these children. The Children in Care and Adoption Health Team is working closely with designated doctors and nurses in safeguarding, social care and CAMHS Children Looked-After teams to ensure that the health needs of children in care are met and that they are kept safe. The Children in Care and Adoption Health Team’s Annual Report is out now. The report highlights the work that the team has undertaken for the year, the impact that it has had on this specific community of young people and their plans and priorities for next year. For further information about the service or to see the report please contact Sharon Thompson on 0115 8831166 or email sharon.thompson@nottshc-chp. nhs.uk. l-r: Louise Gray, Deborah Brooksbank, Kate Beresford and Jo Shipley of the Children in Care and Adoption Health Team

The role of the internet and the negative effects on mental health of cyberbullying, social networking, pro-harm sites and ‘hard’ Positive April 2012

Nottingham West takes a lead in preventing falls A project aimed at preventing falls in care homes is also providing benefits for residential care teams. The Nottingham West primary care team visits clients in their own homes to provide physiotherapy and occupational therapy intervention for clients who are at risk of falling or have fallen. It also provides intervention for a wide variety of clients with other functional or physical problems to enable them to remain at home and prevent unplanned hospital admissions. The team has recently completed a ‘falls reablement’ project which used allocated reablement money to try to reduce incidents of hospital admissions

following falls in care homes. It also looked at ways to take a proactive stance in the assessment of those at risk of falling. The project began in October 2011 and since then the team has identified and shared good practice throughout care homes in Nottingham West, introducing a number of new tools and improvements. A falls incident analysis form and ‘guide to action’ tool are just two of the improvements that have been introduced as part of the project, and both have been well received. Residential care staff have commented that using the falls incident analysis form is helping to identify patterns to residents’ falls and they have also given positive feedback on the guide to action tool for falls prevention. Other examples of good practice that have been shared include the introduction of 24-hour monitoring together with a further six-day ‘watch’ of a resident who has fallen. The project finished at the end of March and a full report of the findings will soon be available. For more information contact Janet Tomlinson or Nicola Adkin on 0115 883 5137 or email janet.tomlinson@ nottshc-chp.nhs.uk or Nicola.adkin@ nottshc-chp.nhs.uk

Students to master cognitive behavioural psychotherapy Registration is now open for a postgraduate diploma/Msc course in cognitive behavioural psychotherapy (CBP). 8

The course will start in late September at the University of Nottingham and will focus mainly on the evidence-based treatment of depression and anxiety disorders. Students will gain a clear understanding of cognitive-behavioural concepts, models, and methods. Those completing the programme will be able to use what they have learned in a safe and effective way to enhance their psychotherapeutic interventions.

AMH City: supporting voluntary services oversees Social Worker Bob Blatchford from Stonebridge Centre and his partner Paula are taking a year off to undertake work for Voluntary Services Oversees (VSO) helping to set up community mental health services in central Sri Lanka. In support, Adult Mental Health (AMH) City staff held a cake bake to raise funds for VSO which is due Paula and Bob with the to lose a third of e raffl the for ated cake don its budget over the next three years. They were delighted to raise over £250 both on the Highbury Hospital site and at Stonebridge Centre. Sue Thornton, General Manager AMH City said: “I would like to thank everyone who took the time to bake cakes for this event with particular thanks to Adkins Bakery who kindly donated the cake for the raffle which was won by Garry Bevis, Service Manager. Special thanks also to HHL who provided free tea and coffee for the event. We all send our best wishes to Bob and Paula for their exciting challenge.”

Students will need to be released from their work on Thursdays each week during the course in order to attend teaching sessions and small group supervision. For more information including entry requirements visit http://bit.ly/CBTMSc or call 0115 9515559.

Art Exhibition launched An exhibition of art work created by Trust service users and patients was launched by Mike Harris, Executive Director, Forensic Services in Nottingham last month. The exhibits, Living Narratives and From Negatives to Positive, were lead by the Arts in Health Team and were on show at the Nottingham Society of Artists throughout March. Living Narratives showcased innovative ways of describing the life stories of men with personality disorders, while From Negatives to Positive featured photographs by people who have survived mental health difficulties. The launch was a success and members of the public that attended the exhibition were ‘moved’ by the work of the patients and service users. For more information contact Penny Coulson, Art Co-ordinator, on 0115 9691300 ext 11853 or email penelope.coulson@nottshc.nhs.uk.

Welcoming new Friends

The Friends of Nottingham Mental Health recently welcomed its new Chair, Dr Michael Elliott. Dr Elliott, who is also a Governor Member and a Mental Health Act Associate Hospital Manager for the Trust was appointed in February. The ‘Friends’ was established in 1999 to help people with mental health problems, those in recovery, carers, support agencies and services in Nottingham. The charity also aims to promote public awareness and understanding of mental health issues. The charity is currently seeking ways in which it can energise and expand its focus to make a meaningful impact to more of its stakeholders. To help do this the Friends is wishing to recruit volunteers and members who feel they can provide time, expertise or ideas in helping the charity move forward. If you are interested in getting involved, please contact: Vicky Lee on 0115 9934513 or by email: vicky.lee@nottshc.nhs.uk For further information, visit the website: www.friendsofnottinghammentalhealth.org.uk Members of the Friends with Dr Michael Elliott holding a cheque for £400 donated by Gedling Borough Council to the charity

Positive April 2012

Gypsy, Roma and Traveller (GRT) Communities Training Jane Danforth, Involvement Officer and Gladys Bombek, Trust Governor, recently attended a training course organised by the Trust Equality and Diversity Department and delivered by Helen Blow of Astren (www.astren.co.uk) and Stuart Mounsey, English Roma Consultant, on meeting the needs of Gypsy, Roma and Traveller (GRT) communities. Here Jane recounts her experience of the day: We heard about GRT communities and their cultures and lifestyles. This gave us an opportunity to challenge myths and stereotypes, enabling us to understand the impact of inequalities on the lives of GRT communities, particularly around health inequalities and mental health. It was useful to challenge our own feelings and discover that we all held some of these prejudices due to lack of knowledge and awareness. The stigma experienced by GRT communities was highlighted by Stuart, an

English Roma businessman. He was incredibly open and revealing about how society misjudges and excludes these communities based on stereotypes, racism, persecution, exclusion and prejudice. Highlighting the negative impact of Channel 4’s ‘My Big Fat Gypsy Wedding’, he gave an opinion that many of the GRT communities are not at all like the people portrayed in the programme. Furthermore, he believed that the programme focused on Travellers of Irish Heritage and

A gypsy trailer ‘Westmorland Star’ (© Melanie Davies)

A traditional gypsy trailer

was not representative. What struck us about the training was the opportunity given to raise awareness within our Trust and to involve these communities by going out to meet with the communities themselves. Building positive relationships is a problem in itself as people, both GRT communities and staff, are often so wary of each other that we have to work at building trust first. Having been so impressed with the content and quality of the training we want to raise awareness with other staff

about the issues faced by GRT communities to try to reduce the stigma. And a final pause for thought… • In a small local GRT study carried out in Nottingham, 80% indicated that they face mental health issues – although they used other terms to describe them. • GRT communities are five times more likely to have health problems than other groups • Gypsy and Irish Traveller mothers are 20 times more likely than mothers in the rest of the population to have experienced the death of a child. Catherine Conchar, Head of Equality and Diversity commented: “Very little positive information is heard in the media about people from GRT communities and having such informed knowledge enables us to challenge the stereotypes and prejudices we often see and hear, helping create a society which is more understanding and supportive of one another.”

Breastfeeding support proves a hit

Theresa Drozdowska, Health Improvement Practitioner at County Health Partnerships, said: “I can’t praise the volunteers enough. They give up their time so that they can make a difference to the new mums they see; it really is fabulous. I am so grateful to the health visitors and midwives who have embraced the peer support volunteers. The volunteers complement the support given by the health professionals and new mums really appreciate their help and advice.”

A breastfeeding peer support programme is proving popular with new mums and families.

Many mothers give up breastfeeding within the first 10 days but 90% of them wish that they had been able to continue for much longer. The peer support volunteer programme aims to enable new mums to continue breastfeeding for longer whilst providing extra support for them along the way.

County Health Partnerships developed the breastfeeding peer support volunteer programme in partnership with Sure Start, and earlier this year Mansfield 103.2 radio station also added their support. The scheme encourages individuals who have good breastfeeding experience to step forward to help new mums. The volunteers receive free training and then attend local baby and breastfeeding encouragement and support groups.

Any mum who has breastfed can enrol to become a breastfeeding volunteer. If you are interested in becoming a peer supporter, want to find out more, or want to know where your nearest support group is, speak to your health visitor or midwife or email theresa.drozdowska@nottshc-chp.nhs.uk.

A reporter from the Mansfield radio station attended local Sure Start sessions in February to interview new mums and peer supporters and as a result became interested in signing up as a peer supporter herself. The peer supporters provide new mums with much needed extra support, and tips about how to make breastfeeding work for them. They also telephone new mums within a few days of coming home from hospital to offer support and build confidence.

Bassetlaw moves closer to BabyFriendly award Bassetlaw Health Partnership (BHP) has been celebrating after successfully achieving Stage One of the UNICEF UK Baby-Friendly Initiative award scheme in February. The Baby-Friendly Initiative works with healthcare systems to ensure a high standard of care in relation to infant feeding for pregnant women, mothers and babies. By providing a framework for implementing best practice, it ensures that all parents make informed decisions about feeding their babies and are supported in their chosen feeding method. Alison Jee, Infant Feeding Lead for BHP, said: “It’s a real boost to receive this award, which reflects the hard work

and sound principles that have been put into place in Bassetlaw to improve the care and support that women receive in relation to feeding their baby. There is now a breastfeeding policy in place, which provides the foundation for best practice standards and a robust training schedule for all staff. “We also have a Bassetlaw-wide network of volunteer ‘breastfeeding buddies’ peer supporters who are helping to support mums in the community. It’s an exciting time, with lots of challenges ahead. “The next stage now is to complete the staff education programme and then ensure that the principles are firmly embedded into practice. This will then

Alison and members of the health visiting team during a recent breastfeeding management course.

allow us to be assessed for Stage Two of the award scheme, where staff knowledge and skills are reviewed by a UNICEF Baby Friendly officer.” Full accreditation is achieved when all the required standards are embedded into practice and implemented routinely with all pregnant and breastfeeding mothers. Implementing Baby Friendly standards is a proven way of increasing breastfeeding rates and also means health professionals can give mothers the support, information and encouragement they need to ensure a positive breastfeeding experience. For more information about the scheme visit www.unicef.org.uk/babyfriendly.

Positive April 2012

Some of the attendees with the Trust’s Recovery Packs

CLAHRC supports new research project The Collaboration for Leadership in Applied Health Research and Care (CLAHRC) is setting up a series of funded ‘research into practice’ placements.

Recovery conference attracts international visitors More than 60 people, including visitors from New Zealand, Canada, Australia and Denmark, came to Highbury Hospital last month for a conference about Recovery.

The special event, which attracted international and national interest, was held as part of a unique series of ‘Recovery Demonstration Days’. The days have been organised to discuss and share the range of successful initiatives across the Trust that support people with mental health challenges on their journey to recovery. The day highlighted the Trust’s innovative peer support workers initiative and the thriving Recovery Education College, both of which are providing vital support and opportunities to people accessing services. Attendees also learned more about the Trust’s Recovery Strategy and how this has been successfully embedded in services, as well as how the Trust makes sure that people are kept involved in all that it does. The Trust’s commitment to Recovery and provision of Recovery-focused services have received national recognition. It is one of only four trusts selected as national demonstration sites for Recovery. Dr Julie Repper, Trust Recovery Lead, said: “We are delighted by the overwhelming response to the conference. The Trust is committed to supporting people on their journey towards recovery and has implemented a range of initiatives which provide invaluable support to achieve this. These exciting events provide an opportunity to share knowledge, experiences and best practice with others to ensure that Recovery-focused services are not only achieved, but also maintained.” For more information visit http://bit.ly/SupportingRecovery. Chief Executive Mike Cooke speaking at the conference

The placements are designed to be short term, small, manageable and immediately relevant research projects to be carried out by nurses and allied health professionals in their workplace and to the benefit of their service and patients. An outline proposal was sent to directors of nursing in partner NHS trusts in December 2011 and 36 applications were received. The CLAHRC has been able to support 11 placements of one day a week for 13 weeks. Four applications from speech and language therapists have not been funded individually, but the CLAHRC hopes to establish a group project. The research for this will be carried out in the workplace and supported by CLAHRC employees, including academics and senior managers from the NHS and local government. The first tranche of seven successful applicants attended an orientation session at the university in early March with a second tranche of four to follow. CLAHRC Director Professor Rachel Munton

Trust digs into collaborative working

Back l-r: Mike Parsons, Mike Cooke. Front l-r: Mel Knight, Chief Executive, Castleoak, Simon Smith, Executive Director Local Services, Nottinghamshire Healthcare, Andrea Ward, General Manager, Mental Health Services for Older People, Nottinghamshire Healthcare, Richard Hardman, Director of Service Development, Barchester Healthcare

A ‘ground-breaking’ ceremony held in February has marked the beginning of an innovative new healthcare partnership. The venture between the Trust and Barchester Healthcare will provide pioneering services for people and their families affected by working age dementia, Huntingdon’s disease and alcohol-related brain injury. Mike Parsons, Founder and Chief Executive of Barchester Healthcare, and Professor Mike Cooke CBE, Chief Executive of Nottinghamshire Healthcare, were joined by representatives from the two organisations to mark the start of this initiative on the former site of The Forest on Southwell Road, Mansfield. Barchester Healthcare provides nursing care for older people and personalised support for adults of all ages with a range of disabilities. The new development will create 50 places for people requiring intensive person-centred care and support and the building will also form a base for the Trust’s community team. A joint venture agreement was developed in 2008 that

initiated the collaborative working between the two organisations. Recognising the complementary roles they could each play in the development and delivery of care, they have not looked back since. “Developing a service that draws on good practice from the public and independent sector is something that we are keen to explore,” said Mike Parsons. “Our new services will reflect local needs and continue to promote Barchester’s reputation for delivering high quality services and person-centred care in the best possible care environments.” Professor Mike Cooke CBE added: “We are delighted to be working in partnership with Barchester Healthcare to provide access to high quality, responsive and individualised care. This excellent new facility will enable more people to be treated closer to home and will ensure that they receive that care in the most appropriate environment to meet their needs.” The new partnership venture is expected to be completed towards the end of the year. For more information about Barchester Healthcare visit www.barchester.com.

Positive April 2012

B50 votes for new ward name Patients, staff, families and carers cast over 50 votes in a bid to select a new name for B50 ward’s planned home at Highbury Hospital. B50 is scheduled to move out of the Queen’s Medical Centre and into its new home, currently Hastings ward, by December. The B50 team was asked to decide on a new name for Hastings before they move in as all the wards/ suites at Highbury are named after trees, bushes or similar.

Patients and staff take part in a ballot to choose a new name for Hastings ward.

Health Informatics Update: I.T. Service Desk achieves national recognition An exciting 18 months of hard work for the Trust’s IT Service Desk has culminated in the award of Connecting for Health accreditation. The accreditation means that the IT Service Desk operates to a set of standards that are nationally recognised throughout the NHS and based on a set of international guidelines. For colleagues it means that when they contact the IT Service Desk they can be sure that their call will be dealt with in a professional manner and that the Service Desk staff are working to processes which are recorded and meet the Trust’s business needs. The IT Service Desk can now also deal directly with national service providers for products such as SystmOne and Choose and Book, cutting out the NHS national service desk.

In a keenly contested ballot three names came out on top with 10 votes each – Mulberry, Cherry and Sycamore.

Five ambitions for the NHS in the Midlands and East Senior executives across the Midlands and East strategic health authority region have agreed five ambitions which aim to make a difference to patients during 2012/13. Through these ambitions, the NHS will be working with local organisations, including local authorities and the voluntary sector, to deliver improvements over the next twelve months and beyond, particularly in the area of safeguarding patient safety and enhancing quality.

Completing the work needed to achieve the award was very much a team effort. Led by Ian Stevens, Technical Services Manager, and with Raymond Paxton managing the project, the team worked extremely hard to document processes and to implement systems and practices that not only meet the requirements of the accreditation but also allow them to better serve the operations of the Trust. The outcomes clearly show a high standard of service, but one that the team is still looking to improve on.

The ambitions are:

“I would like to thank everyone who has had input to us gaining this accreditation,” said Ian. “From the Service Desk staff who have adopted our changes to policies and processes with enthusiasm, through to the Network and Telecoms staff who helped us to deploy our new telephony system so smoothly. Everyone in IT has played some part in this success and should share in it.”

• Significantly improve quality and safety in primary care: Working with GPs to create a definitive set of measures to improve the standard of primary care and prescribing practice.

The team will now collect a certificate which will be proudly displayed in the Service Desk office. They are not resting on their laurels though and are already looking towards further improvements in service.

• Create a revolution in patient and customer experience: Encouraging participation and shared decision-making

• Eliminate avoidable grade 2, 3 and 4 pressure ulcers: Avoidable pressure ulcers are a key indicator of the quality of nursing care. Preventing them happening will improve all care for vulnerable patients.

The patients decided that the time-honoured method of pulling a winning name out of the ballot box should be used to decide the new name for Hastings ward, and the final winner – ‘Cherry’ – was read out to a round of applause and cheers. Guests at the ballot event then enjoyed tea and cake provided by the patients’ ‘cook up’ session and Helen Forrester, Ward Manager, led a toast to the success of the new ward. The patients are keen to make sure that B50 is not forgotten and are already discussing plans for a collage or mosaic to hang on the wall of Cherry ward. Hastings ward is currently empty and design planning is now being carried out before building work/ decoration takes place to upgrade it and make it fit for purpose.

with patients and the public to deliver the healthcare services that people want and need. • Make every contact count using every opportunity to deliver brief advice to improve health and wellbeing: Encouraging all NHS staff to inform and help people make positive lifestyle changes.

IAPT to be delivered in British Sign Language A Trust colleague is set to be one of the first in the country to train others to deliver improving access to psychological therapy (IAPT) services in British Sign Language (BSL) to deaf people. Dr Kevin Baker, Clinical Psychologist, Learning Disabilities Service, has won a 17-month contract to deliver psychological wellbeing practitioner (PWP) training to deaf professionals with Liverpool John Moores University. The training is part of a new pilot project in the North West and South Central regions of England. Kevin has been around deaf people since a child and is fluent in BSL. This, together with his previous career as a university psychology lecturer and his skills as a clinical psychologist, made him an ideal candidate.

forward for deaf people who use sign language. For example, writing notes while someone is signing is impossible because it means looking away from the patient. Also, concepts such as thoughts, feelings and behaviours have slightly different connotations when translated into BSL, so these have to be adapted for deaf PWPs and then further for deaf patients. “Deaf people also experience huge difficulties in picking up information that we take for granted, such as on radio and television or in ‘corridor conversations’. This means that teaching to a post-graduate level on the PWP course needs to progress alongside careful and respectful checks on the background knowledge of the trainees.”

“The role is challenging,” explained Kevin, “not only because the IAPT PWP national syllabus is delivered in BSL, but also because much of the training has to be heavily adapted, balancing evidencebased practice with values-based practice.

Difficulties in access to information and services, together with repeated experiences of isolation, contribute to a 40% incidence of mental health problems in the deaf population compared with 20% in the hearing population. The new BSL IAPT services aim to go some way toward reducing this disparity.

“Many of the techniques we naturally use for working psychologically with hearing people are not necessarily as straight-

To find out more about the PWP training contact Kevin on 01623 404614 or email kevin.baker@nhs.net.

• Ensure radically strengthened partnerships between the NHS and local government: Supporting clinical commissioning groups to work closely with local authorities to deliver a health and social care system that works for patients. All five ambitions aim to make a difference to patients over the coming months. They will also help local organisations deliver on some of the key priorities for the health service and the pledges in the NHS Constitution. Keep in touch with the progress on the ambitions by following @NHSMidlandsEast on Twitter, or by visiting www.westmidlands.nhs.uk/ WhatWeDo/ClusterAmbitions.aspx Dr Kevin Baker

Positive April 2012

Personality disorder training a success Personality disorder awareness training has been proving popular with attendees throughout the past year. The one-day basic awareness training course is delivered by Nottinghamshire Personality Disorder and Development Network – part of the Specialist Services Directorate of the Trust. It is designed to raise awareness of issues around personality disorder, to challenge stigma and to promote positive ways of working. The course was attended by over 150 people throughout 2011 and has been attended by almost 500 in total since it began. Attendees have included not only Trust colleagues, but also representatives from Mind, Rethink Mental Illness, Framework and local colleges keen to access the training. Feedback has been very positive, with attendees saying that they found the training useful in gaining a new understanding of the diagnosis of personality disorder and that the input from service users was invaluable in framing the experience of living with personality disorder. In response to other feedback, the content of the course has been expanded to include some exploration of staff attitudes and skills and the importance of early attachment and life experience in helping us to understand how personality difficulties might develop. The basic awareness training is running throughout 2012. Dates and further information are available on the intranet via the Learning and Development pages or email sally. jackson@nottshc.nhs.uk.

Personality Disorder Care Pathways Launch Event A special event to provide people with a greater understanding of the principles, process and design of the care pathway for individuals with personality disorder will take place in May. The Personality Disorder Care Pathways Launch Event will present work carried out by a dedicated project team and highlight the achievements made regarding collaborative working relationships and increased communication between services and professional groups. Emma Sly, Care Pathway Facilitator for PD Services and Project Lead said: “This Trust is in a unique position to have Personality Disorder (PD) services represented at all levels of security from community

forensic, low, medium and high secure. Providing integrated care is essential to meet the needs of this population, to transform the way that care is provided to enable people with complex needs to live healthy, fulfilling, independent lives. “Setting clear, ambitious goals to improve the experience of patients and service users has been at the heart of the work undertaken.” The event will offer opportunities to learn about all aspects of the pathway.

Lings Bar measures up a simple solution

Measurement charts are given out to relatives and carers for them to measure the heights of various items around the home, such as toilets, armchairs, the bed and any steps or stairs. These measurements are used to order the correct equipment for discharge. By using the measurement charts staff save time and avoid the need to visit the property to take the measurements themselves.

When inpatient therapy staff at Lings Bar Hospital were asked to identify something that prevented them from completing their jobs effectively, their answers led to an easy solution to improve services for patients.

However, a tape measure is needed to take the measurements and complete the form and many relatives or carers reported that they either did not have one, could not find one at the property, or did not know where one was. So, the forms often came

Feedback from the County Health Partnerships’ staff showed that they felt regular delay in receiving measurement charts back from relatives and carers prevented them from planning a timely discharge and caused a delay in the pathway to discharge.

Information on the achievements of the project team and the different working groups established to meet targets set on a variety of aspects within the pathway including assessment and treatment interventions, the formulation process and offence paralleling behaviour will be presented. The Personality Disorder Forum process will also be outlined along with the work on the actual transitions for service users. Market stalls on the day will exhibit different aspects of the PD Care Pathway developments which include the individual service Integrated Care Pathways. There will also be the opportunity to talk to the clinicians who have made these developments happen. The launch will take place in the Mike Harris Learning and Development Centre at Rampton Hospital on Monday 28 May. Places are limited and preference will be given to individuals working within the Personality Disorder Services. For more information contact Emma Sly, on 01777 880131 or email emma.sly@ nottshc.nhs.uk. To book a place contact mikeharrisconference@nottshc.nhs.uk

back with estimated measurements or even lengths of string representing the height of different items. In these cases it was necessary for the inpatient team to visit the property to take correct measurements. Once the feedback had been identified through a ‘better for you’ hub event, Sara Jane Ashmore, Head of Inpatient Nursing Services, began investigating ways to solve the problem. She contacted tape measure manufacturers and providers to explain the situation and ask for donations so that the team can provide patients with tape measures and help plan safe patient discharges. As a result, 400 tape measures have now been received from one company and another has agreed in principle to discussing further supplies.

Rubbish funds for local charity Colleagues throughout the Trust have raised almost £3,000 for charity by recycling used printer materials. The Health Informatics Service arranges for old printer toners and cartridges to be collected and recycled wherever possible, instead of sending them for landfill and Nottinghamshire Hospice receives a payment for each item. The Hospice cares for people across the county who have been diagnosed with any life limiting illness. It offers a free

service to patients and their loved ones and aims to take care of their physical, emotional, spiritual and social needs. The recycling company has now awarded the Hospice an impressive £2,912.86 in payments generated by the Trust’s recycling. Let’s keep up the good work! Dr Mike Ward and Rachel Walters with the Nottinghamshire COPD Guideline

Forum focuses on respiratory matters One year on from its inception, February saw the first 2012 meeting of the Mansfield & Ashfield Respiratory Forum. The forum was formed in February 2011 and is organised by Rachel Walters, Respiratory Nurse Educator for Mansfield and Ashfield. It has an educational element and is an opportunity for staff with a respiratory interest to network, share best practice and promote integration of the teams. Despite a snowy evening and near cancellation, the February meeting proved a great success with 35 healthcare professionals in attendance including GPs, practice nurses, community matrons, respiratory nurse specialists, respiratory physiotherapists, heart failure nurse specialists and community staff nurses. The first guest speaker for the event was Dr Mike Ward, Consultant Physician and DH Respiratory Clinical Lead,

East Midlands at King’s Mill Hospital, who spoke about Chronic Obstructive Pulmonary Disease (COPD) management in primary care. Dr Andrew Molyneux, Consultant Physician at King’s Mill Hospital, then spoke about the diagnosis and management of sleep apnoea. Both presentations led to interesting question and answer sessions. The forum meets three times each year and previous meetings have included clinical topics such as managing COPD exacerbations and bronchiectasis management as well as a guest speaker from the Biomedical Research Unit in Nottingham. One meeting took on an ‘ask the panel’ format with a panel of respiratory experts taking part in discussions throughout the evening. The next meeting will be held in May. For more information about the forum or if you are interested in attending, please email rachel.walters@nottshc-chp.nhs.uk.

Forum members

This simple solution to an ongoing challenge has resulted in no further reports of delays with measurement forms being returned.

Positive April 2012

Changing our environment through recovery in CAMHS Thorneywood inpatient adolescent unit has been fortunate enough to be in the process of refurbishment. It has been during this time that the young people on the ward have had opportunity to reflect on how the ward environment impacts on their recovery and initial feelings on arrival to the unit. Through group discussion the young people came up with the idea of creating a piece of artwork to place in the main entrance area to welcome new people.

It was agreed that five canvases with recovery themed words would create a professional and welcoming environment for new people. The group brainstormed together and decided on, ‘strength, recovery, love, hope and support’. During groups and with support of nursing staff and the Occupational Therapist, the young people carefully created these beautiful panels with gold embossing to add texture and fun. These panels have radically transformed the living

environment of the young people, who later commented on their participation: “With help and support I am recovering. The teamwork during this project helped me become less anxious.” Katie “This project was very personal and inspiration for me and everyone else as the words have very different and important meanings to us all. I particularly enjoyed embossing the papier mache to give the canvas a professional look.” Chloe “I enjoyed decorating and creating the canvases. I found the words, ‘hope, support and

strength’ especially positive as once they are displayed it will encourage young people to stay optimistic.” Alexandra Each young person is on a journey of recovery and has been empowered through their own skills and abilities to change the environment. We all look forward together to many more future inspiring projects. Thanks to our environmental co-ordinator Richard Murden, the canvases were put up on the walls speedily so current young people can really enjoy the fruits of their work. Mel Homan, Occupational Therapist

The specially created canvasses

Turning over a new leaf New Leaf Nottinghamshire held a successful health and wellbeing event last month in Beeston offering smokers the chance to sign up to receive support to help them quit.

As well as New Leaf, a variety of other services were on hand to give out health information and complementary therapies, including body MOTs, Diabetes testing, Blood pressure checks and carbon monoxide readings. Edit Bodis, New Leaf Cluster Lead said: “The team are really friendly and there are a number of ways we can support people to reach their goal.”

Members of the New Leaf Nottinghamshire team

q What is your job title and what does your role entail? a Clinical Governance Manager (Forensic). My role entails taking a lead role and specific responsibility for providing frameworks and operational management to lead, manage and deliver the Clinical Governance agenda across the Forensic Division which includes high, medium, low secure, community forensic and offender health services.

q&a This issue we chat with Joanne Gleaden, Clinical Governance Manager (Forensic)

q How long have you been with Nottinghamshire Healthcare NHS Trust? a I’ve been with the Trust since it was formed in April 2001 but have worked at Rampton Hospital since July 1989.

passionate about? a My family.

q What do you see as your priorities

q What single things would

for Nottinghamshire Healthcare? a To work with staff to ensure high quality, safe care is provided to patients at all times, ensuring that the CQC Essential Standards of Quality and Safety are met. Ensure systems are in place to bridge any gaps identified.

q What is your employment background? a It is varied, starting off on a Youth Training Scheme at Cottam Power Station. I then worked in an office at a sweet and cigarette wholesalers where technology was a little behind the times! There was a pipe from the main office to the warehouse and when an order was hand written, you were expected to bang on the pipe and shout “order on its way” and drop the order down! I then worked in the Head Office at Budget Rent a Car prior to moving to Rampton Hospital in the Personnel Department where I gained my IPD. I then worked as Office Manager in the then Staff Education Centre where I completed my Degree in Business Studies. I then went to manage the Clinical Audit Team and completed an MSc prior to taking up my current role. q What is the best piece of advice you

have ever been given? a Work hard, play hard, finish what you start and if you get knocked down then get back up again.

q What was the last CD you bought? a 101 Running Songs q What is your greatest achievement? a After leaving school at 15, it was quite

an achievement for me to successfully complete my MSc in Quality Improvements in Healthcare.

q What makes you angry? a Cruelty to animals and children.

q What are you most

improve your working life at Nottinghamshire Healthcare? a More staff and more time in the day.

q What is your favourite hobby? a My hobbies have changed

considerably over the years, I used to run a fair amount and completed a few 10ks, I also got my black belt a few years ago in kickboxing. I have slowed down a little recently as the hip has taken the pressure, so lots of dog walking with my two border collies and cycling now.

q What keeps you awake at night? a Everything! I’m a terrible sleeper. q What is your favourite film? a Love Actually. q What is your idea of bliss? a Bobbing up and down on my

arm chair lilo in the sea with the sun

shining down on me and a glass of wine not far away...

q What three words would you use to describe yourself? a Enthusiastic, determined and dependable. q What is your favourite holiday destination? a Italy. q Who would you take to a desert island? a Bear Grylls – if he can cope with Miranda Hart, he can cope with me. q Where do you see yourself in 10 years’ time? a Depends what opportunities arise. q Do you have a ‘claim to fame’? a I do have a photo which appeared in our

local paper of me with the late Princess Diana when she came to visit Rampton Hospital. I had very dark brown big curly hair!

q How would you like to be remembered? a Fondly.

Graduation success Congratulations to Helen Watkinson, Clinical Nurse Manager, on her graduation. Helen graduated in November with a masters degree in health and social care leadership from Sheffield Hallam University. At the University’s request Helen then returned in February of this year to lead a workshop at the Centre for Professional Development Leadership and management conference. The workshop looked at the process and content of Helen’s degree dissertation – a systematic review of interventions and strategies that prevent ill health and promote resilience in mental health care workers. A big thank you from Helen to all the staff and patients in the Women’s Service at Rampton Hospital for their support and encouragement throughout the course.

Helen Watkinson

Positive April 2012

WHO WE ARE...

l-r: Peter Woodhams, Carer Consultant Meriden, Julia Danks, Meriden Family Programme, Ruth Hannan, Princess Royal Carers Trust, Jacquie Cullen, Family Interventions Service

Trust hosts East Midlands launch of Triangle of Care Health and social care professionals and carers from Nottinghamshire, Leicestershire and Derbyshire came together in February for the East Midlands launch of the Triangle of Care. The Triangle of Care is a guide jointly published by The Princess Royal Trust for Carers and the National Mental Health Development Unit. It is a therapeutic alliance between service user, staff member and carer that promotes safety, supports recovery and sustains wellbeing. The Triangle of Care approach was developed by carers and staff to improve carer engagement in acute inpatient and home treatment services. The guide outlines key elements to achieving this as well as examples of good practice in acute mental health care.

The launch seminar was opened by Simon Smith, Executive Director of Local Services, who emphasised the Trust’s commitment to supporting the families and carers of service users and commended the Triangle of Care as “making a major contribution”. The Triangle of Care model identifies six key elements of best practice, including identifying a carer as early as possible, making sure that staff understand what it means to be a carer, and providing training to support them. These elements offer a framework for adoption, with worked examples of good practice and a self-assessment tool to allow evaluation of the current methods of carer engagement within services. The event enabled delegates to learn more about the key principles of the Triangle of Care, evaluating current practice, and modifying or augmenting current practice to achieve desired standards. The Princess Royal Trust for Carers will now bring together statutory providers, third sector organisations and carers to work together on fully implementing the Triangle of Care in mental health trusts in the East Midlands.

Recognising Excellence Jane Carr, Substance Misuse Worker, based at HMP/ YOI Hatfield has been presented with a Recognising Excellence Award from the prison Governor.

Jane (left) receives her commemorative certificate from Governor Marion Mahoney

Jane’s award was in the category of Key Stakeholder involvement; recognising someone who provides an essential service to, but is not employed by, the prison service. Jane, who is part of the Offender Health team, has been in her role for more than 12 years and has been dedicated to building good relationships with the prison and its staff, working well with multi disciplinary teams.

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 12 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 June issue of Positive, please contact us by 4 May 2012. However, due to space constraints we cannot guarantee the publication of all articles received by the deadline. Nottinghamshire Healthcare NHS Trust, The Resource, Duncan Macmillan House, Porchester Road, Nottingham, NG3 6AA tel 0115 9691300 www.nottinghamshirehealthcare.nhs.uk

Well done and congratulations to Jane. Printed on Cocoon · 100% recycled paper