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Nottinghamshire Healthcare
NHS
NHS Trust
DECEMBER 2010
about mental health and learning disability
Celebrating Nurses and Allied Health Professionals Commemorative event held See page 18
l-r Steve Williamson, Senior Nurse Professional Projects, Professor Rachel Munton, Professor Mike Cooke, Chief Executive Nottinghamshire Healthcare, Janet Sheard, Nigel Risner
RUNNING FOR FUNDS PSYCHIATRIST OF THE YEAR TERRY WAITE AT RAMPTON SPOOKY EVENTS TAI CHI INVOLVEMENT IMH EXHIBITION
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MESSAGE
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FROM THE BOARD
As 2010 draws to a close it is not only the end of another great year for Nottinghamshire Healthcare, but also the end of an era for me as I step down from my position as Trust Chair. The last four years have been amongst the most fulfilling of my working life and I will miss the Trust, and everyone with whom I have had the pleasure of working, very much indeed. However, I am leaving behind an organisation which is going from strength to strength and one which I know will continue to build on all that it does so well. My successor will join the Trust at a really exciting time. As you know, Nottinghamshire Healthcare has been successful in its assessment against Foundation Trust standards; a huge achievement. Health Minister Simon Burns recently offered his congratulations which I am pleased to share
with you. He said: “I am delighted that Nottinghamshire Healthcare has been successful in their assessment against NHS Foundation Trust-comparable standards. We want all trusts to be free to innovate and improve care for patients. Achieving these standards will give the organisation greater autonomy and influence to shape its future and continue providing excellent care to their patients and service users.” Trust membership continues to grow and the Members’ Council is now up and running and having a real influence.
recovery work which is at the heart of all that we do here, but mostly the way in which patients and service users are always our main priority. Thank you to you all for making my time here so special and memorable. Thank you for all your hard work and I wish you a restful and enjoyable festive season.
2011 will see Nottinghamshire Healthcare’s services and staff grow as it begins the provision of community services throughout Nottinghamshire. You can read more about this exciting development on page 13.
With every best wish for the future and Merry Christmas and a Happy New Year.
I am deeply proud of the anti-stigma and
Clair Chilvers, Chair
Race equality: past, present and future Over a hundred delegates attended the launch of the East Midlands Regional Black and Minority Ethnic (BME) Network on 3 November. People from health and social care, third sector organisations, BME communities and the Trust celebrated and discussed the role of the new network. The East Midlands Network is led by Eric Adjaidoo, who is also National Officer and supports the National Network. It was founded through the inspirational work and leadership of Dr Vivienne Lyfar-Cisse. Eric gave a motivational opening address and asked that joined-up working be part of the journey. He emphasised that the Network needed to work bottom up; an inclusive organisation not restricted to
health workers but including the third sector, service users and carers – all of whom have a vital role to play. Ray Warburton from the Equality Development Council talked about the massive change agenda facing the health service. He stressed that it was important that equality does not become a paper exercise but a performance issue which needs to be acted on and managed. He said the NHS was being recast and: “It would be a folly not to ensure that equality is on the agenda”. He added that the National BME Network needs to be an independent partner to the health service to ensure a future equality delivery system. Bruno Daniel, the West Midlands Network Lead, agreed: “We need to take
l-r Robert Mooken, Angela Simpson, Mustafa Syed, Javid Khalique and Sharon Esprit, who all contributed to ensuring the day was a success.
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the bull by the horns and contribute to the equality delivery system.” Joel O Loughlin, Chief Executive, Gravitas Group, led a lively debate between a panel of speakers and the audience. After a busy, successful and positive day Bruno Daniel summarised the conference views, saying for the Network the main emphasis was race. The Network needed to work, develop, recruit and build from the bottom up. People needed to be clear about the improved health outcomes, both needed and deserved, by BME staff, service users and carers. The East Midlands Regional BME Network was now a reality and all the hard work was worthwhile.
l-r Dr Vijay Kumar, Eric Adjaidoo, Bruno Daniel, Ray Warburton, Aneela Asim, Joel O Loughlin and John Fredericks.
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Running for funds The Highbury Harlots raised an impressive £1,020 for Cancer Research in this
year’s Race for Life at Clumber Park. The day was emotional but fun for
those who took part, and the ladies rewarded themselves with a Sunday
roast afterwards. Congratulations to all the runners and walkers.
Local psychiatrist awarded top national accolade Dr Michele Hampson, the Trust’s Clinical Director for Adult Mental Health Services, has been named Psychiatrist of the Year 2010 by the Royal College of Psychiatrists. The annual RCPsych Awards mark the highest level of achievement within psychiatry, and are designed to recognise and reward excellent practice in the field of mental health. Dr Hampson was recognised for her work in improving facilities for vulnerable adults detained by the police under Section 136 of the Mental Health Act. She was instrumental in the creation of the Cassidy Suite at the Queen’s Medical Centre in Nottingham, the Section 136 suite which opened in September last year. The judging panel commented that Dr Hampson’s work was “a national achievement that involved many agencies and overcame many obstacles.”
Delighted to receive the accolade, Dr Hampson said: “When I won the award I commented that I accepted it on behalf of all those who have made me the psychiatrist I am. I am grateful to all those locally and nationally, from all professional walks of life, service users and carers who have guided, encouraged and supported me. I am delighted that there is now evidence that the care of those initially detained by the police under Section 136 has improved markedly, both locally and nationally, and I plan to continue to work on this until national guidance becomes a clinical reality in England and Wales.”
Dr Michele Hampson (right) receiving her award from Professor Dinesh Bhugra, President of the Royal College of Psychiatrists.
Dr Hampson was presented with her award by Professor Dinesh Bhugra, President of the Royal College of Psychiatrists, at a prestigious ceremony held at the Royal Society of Medicine on 16 November. Mike Cooke, Trust Chief Executive, said: “We are absolutely delighted for Michele. This is a very well deserved recognition for all her hard work and dedication. We wish her many congratulations.”
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Mike Harris and Terry Waite CBE outside The David Wilson Unit
Have I recovered? Members of an alcohol support group facilitated by the Trust have been considering recovery, discussing how they will know they have recovered, what might be different in their lives and whether a full recovery is possible or whether it is always a work in progress. As a response one of the members wrote the following poem: Have I recovered?
“At the suggestion of one of the patients in the Peaks Unit, I asked Terry if he would come back and give a talk for the patients on his experiences, to which he readily agreed. I think this would be of great benefit because all of the patients he spoke to, most of whom have had very difficult lives themselves, acknowledged that none of them had an experience that in any way approached his more than four years spent in solitary confinement.”
The problem I've discovered With the question "have I recovered?" Is that with no bones to mend or scars to heal It all comes down to how you feel There are some days I'm happy And some days I'm sad And some days the cravings just drive me mad I know that the medicine to make me stop Is stacked up neatly in rows in a shop Just a couple of bottles that's for sure Of my screw top fizzing miracle cure But what was making me happy having my fill Was really destroying me, making me ill I knew that really should have stopped When the test results came back I was shocked My liver was showing signs of disease but I carried on drinking I'll do as I please Then came the days when there was no more drinking No half remembered nights No more what was I thinking Eventually days turned to weeks to a year Gradually I began to feel freer But the one thing that wouldn't go and filled me with dread Was the little voice that was stuck in my head I don't want to listen just go away I'm tired of you tempting me every day Some days I'd happily raise a glass full of sorrow But one drink today would mean twenty tomorrow So if you were to ask me am I free from this blight I would say no it's an everyday fight At the moment I'm winning but I could lose Such is the problem I still have with booze.
A truly memorable visit.
From the gutter but looking up.
Terry Waite CBE visits Rampton Hospital On 15 November, Rampton Hospital was visited by Terry Waite CBE. Terry has visited the Trust before, opening the Trauma Centre ten years ago and returning this summer to present at the anniversary conference. Terry is very involved in a number of charities working with offenders, and hostages and had expressed an interest in visiting the Hospital. Following a briefing about the Hospital, Terry visited five wards, one from each clinical service. He was also shown one of the workshops in which men and women were working in adjacent rooms and finally, given an insight into the Hospital’s control room. Following his visit Terry said: “It is quite clear that during the past years a great deal of thought has gone into making Rampton secure bearing in mind that although this has to be a secure establishment those who stay there are patients. I have to say that I felt a sense of pride in the fact that the NHS which comes in for so much unfair criticism takes the trouble to care for some of the most dangerous and troubled members of our society. “As I met patients and staff I could not help but feel a deep appreciation for the staff who, week in week out spend time with individuals who are seriously ill and in some cases dangerous. The staff do this work with little public recognition and the vast majority of the general public have no idea what life in Rampton or the other secure hospitals is like. The rewards of working with the mentally ill are often slow in coming and in some cases are not seen at all and yet the fact
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that individuals will give their time to caring and supporting some of the most troubled people in the country ought to be more widely known. “A good hospital does not just happen. It has to be worked for and much depends upon the leadership that is given. I very much appreciated the fact that the leadership team were able to spend time chatting with me about their work in a free and open manner and the Director gave the major part of his day to taking me around. Thank you all for what you do for us all.” Mike Harris, Executive Director Forensic Services said: “I think it is true to say that of all the many visitors I have taken round the Hospital over the last ten years, Terry is the one who produced the greatest impact amongst staff and patients. Throughout each area he made time to talk to patients and staff and to tell and retell his story. I have never seen the men and women in the hospital so entranced by a visitor and on one ward all of the patients not only sat and talked to him without interruption but all wanted his autograph.
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Malc Cooper: Dementia Carer Campaigner
W
e are sorry to report that Malc Cooper, one of our Trust members and an active campaigner on working age dementia, died on 10 October at the age of 62, after a short battle with pancreatic cancer. Malc’s wife, Judy, was diagnosed with Alzheimer's in 2003. As Judy's condition deteriorated Malc retired from his job to become her full-time carer. Daughter Andrea said: "When Mum was diagnosed, he was angry, but he wanted things to be better for other carers.” Malc spoke at a conference about Alzheimer's in Barcelona in June 2010 and visited many health organisations to raise awareness about dementia. He worked with the National Alzheimer's Society and took part in focus groups and carers' forums as well as helping to create a dementia strategy for Nottingham University Hospitals NHS Trust. Eldest daughter Karen said: "When Dad was ill in hospital, we were overwhelmed by the number of people, be they carers or healthcare workers, who came to pay tribute to him.”
“Malc’s enthusiasm and passion for improving the care of people with dementia was immense. His overriding ability to see humour in the face of adversity and his doggedness in tracking down managers and holding us to account is legendary. Without him the working age dementia service would not be in existence and many people wouldn’t be receiving a service at all. Above all of this he was a devoted and caring husband whose work in his later life was driven by the desire to help others.” Andrea Ward, General Manager, Mental Health Service for Older People “Malcolm was a kind, caring and engaging man. He was great fun to work with and passionate about carers’ issues and tackling the ignorance and fear that surround dementia. He was always willing to help and played a key role in the Involvement Strategy Group and the latest Trust anti-stigma postcard campaign. His face and quote feature on one of the postcards and his kindness, warmth and love shine out. He will be greatly missed.” Paul Sanguinazzi, Head of Involvement “Malc’s support and eye for detail whilst a member of the Communities of Interest Steering Group showed great insight and knowledge. All who worked with him miss him tremendously.” Jane Danforth, Involvement Officer
Health Informatics Service update Update on the Electronic Staff Record Since the initial go-live of the Electronic Staff Record (ESR) within the Trust in February 2007 and in conjunction with the ESR Programme Board and ESR Benefits Team, the Health Informatics Service (HIS) has been developing and implementing modules with the ‘ESR expansion pack’. HIS has already implemented a number of modules such as electronic interfaces with NHS Jobs, HM Revenue & Customs, the NHS Pensions Agency and the General Medical Council. In addition to these they have also introduced the direct recording of all absences by managers, which has enabled them to provide more accurate and up to date information for board reports and provide managers with a reporting tool to help with absence management. Further planned developments include the direct input of termination information and a pilot is due to start across three areas of the Trust within the next month with a view to rolling this out across the Trust early in 2011. Other developments being investigated are the direct input of ‘changes of hours’, ‘changes to personal information’, ‘recording of appraisal dates’, ‘recording of Trust property’ held by employees (such as laptops, mobile phones etc), and the possibility of implementing the ‘employee self service’ module where employees have access to, and the ability to amend, certain pieces of their own information. It is important to understand that ESR is not only able to deliver the basic processes of staff pay, recruitment and absence recording, but that through effective use in the management of staff it can also contribute to improved patient care.
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Hat-trick of c Staff and patients on ward A44 at the QMC have worked together to celebrate Halloween, bonfire night and Diwali.
P O f d o
Spooky events on ward B2 Sightings have been reported of ghostly apparitions, vampires, witches and mummies on the mental health unit at Bassetlaw. On the night of Halloween, ward B2 hosted a Monsters’ Ball for the patients. The ward was decorated to look like a haunted house with most of the decorations being made by the patients over the weeks leading up to the night. Many of the patients and all the staff joined in the fun and dressed up in spooky costumes and face paint.
Spooky sweets, drinks and pizza were on offer and after a few numbers on the karaoke machine the night finished with a DVD. Afterwards the patients declared the night “very enjoyable” and “a welcome distraction”. The decorations were donated to a local Beaver Scout group for their Halloween party. Service users Michael and Susan with Healthcare Support Worker Stuart Havard (centre)
Positive deve
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As part of the long term redevelopment of the Highbury Hospital site in Bulwell, the next stage of work has been completed, with a new clinic, consultation rooms and offices for Adult Mental Health (AMH) services, as well as a conference hall and meeting room suite.
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As a result of this work, the following teams are now all based at Highbury Hospital: • Adult Mental Health City Management Team (formerly at Westminster House), 0115 9555358
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Icing spooky cakes ready for the Halloween party
f celebrations on A44 t
Preparing for a fun Halloween party on 31 October, the ward cookery group prepared food while the ward art group made decorations, iced spooky biscuits and offered face painting. Buffet tea was followed by disco dancing, and the night was rounded off by watching spooky DVDs. The Halloween celebrations were followed on 5 November by bonfire night and Diwali snacks, cultural art work and activities.
Below and left: Celebrating Halloween on A44
The ward is now planning a Christmas Eve extravaganza led by the local Reverend on the accordion with carol singers, a buffet prepared by the cookery group and a visit from Santa. Thanks to all the patients on A44 and staff members Anne Coyle, Gemma Wright, Adam Chillman, Penny Meakin, Gary Holman, Linda Corah, Rebecca Dodman, Lois Adams, Jean Badcock, Vymla Swinscoe, Katie Halloran, Helen Morris and Janet Blanchard for organising the activities.
velopments at Highbury Hospital site • Clinical Psychology Team (formerly at Westminster House), 0115 8760124 • Community Assessment and Treatment Team (CATT) (formerly split between Foster Drive and Highbury Hospital), 0115 8760100 • Crisis Resolution Home Treatment (CRHT) Team (formerly at Queen’s Medical Centre), 0115 9560800 • Single Point of Access for all City referrals (formerly at Moorgreen), 0115 8542270 The following services are based at the Stonebridge Centre: • Recovery Team, 0115 9555446 • Support Time and Recovery (STAR) Team (formerly at Westminster House), 0115 9934560
• Medical Rehabilitation Team (formerly at Westminster House), 0115 9529484 • Assertive Outreach Team (formerly at 600 Wells Road), 0115 9529428 / 0115 9529402 • Deaf Services, 0115 9555446 • Apni Zindagi (Specialist Asian Service), 0115 9414255 The ongoing developments are part of a private finance initiative. The final stage of work will see the existing Lady Middleton and Carlton Wards fully refurbished to replace Lister Ward (Wells Road Centre) and Ward A44 (QMC). This work is due for completion in spring 2011. Work is also continuing on ‘The Woodlands’, a new purpose built facility
which will accommodate Substance Misuse Services currently provided on Porchester Ward at the Wells Road Centre. This development will be completed early next year.
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B2 patients learn tai chi Patients on Bassetlaw’s Ward B2 have been enjoying an opportunity to learn tai chi. The ward gained a grant from the Adult Community Learning Service of Nottinghamshire County Council earlier this year to provide a six week tai chi taster course on the ward. The course began on 1 October and has been well received by the patients who attended. The essence of tai chi is building awareness of natural energy systems and learning to control these for physical and mental health benefits. Tai chi is a Chinese system of physical exercises that is believed to facilitate the flow of Qi (life force) in the body, promoting
good health and vitality. Tai chi uses slow rhythmic movements that are Yin Yang opposites: softness and strength, forward and backwards, action and calm. When combined with deep breathing tai chi improves concentration, conditions the body and clarifies the mind.
the energy tingling in your hands and fingers”. The course tutors, Michelle and Kev Till, are part of the Dukeries Tai Chi Society and have been practising for around ten years.
Patients taking part in the course have said: “It’s difficult to remember the moves, though relaxing to do and watch” and “you can feel
Tai chi instructors Michelle and Kev Till
Institute celebrates partnership at annual event Leaders from the Institute of Mental Health (IMH) and the Centre for Mental Health, based in London, took time out from the Institute’s recent Foundation Anniversary Annual Lunch to mark a new partnership agreement between the two organisations. Earlier this year the two organisations signed a formal agreement to explore and develop new ways of working together and this landmark moment was recognised at the Institute’s showpiece annual event. The IMH will be working with the Centre for Mental Health in the future on joint interest areas, utilising the Institute’s high academic research standards and the Centre’s focus on informing policy and practice with good evidence.
en the Institute of Mental Marking the formal agreement betwe Health are (left to right), Prof l Menta for Centre the and Health shire Healthcare; Prof Ian Hall, Clair Chilvers, Chair of Nottingham ’s Medical School; Prof Nick Dean of the University of Nottingham Cooke, Chief Executive of Manning, IMH Director; Prof Mike Sean Duggan, Joint Chief Nottinghamshire Healthcare; Prof l Health, and Gerry Carton, Executive of the Centre for Menta of Mental Health. Associate Director at the Institute
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This year’s Foundation Anniversary Annual Lunch saw a number of keynote speakers explore the theme of partnership, building upon the partnership work highlighted in the Institute’s new annual report. For a copy of the report, visit the www.institutemh.org.uk website.
Speakers at the event, held at the Sir Colin Campbell Building, home of the Institute, included several professors from the Institute, CLAHRC and the University as well as Nick Benefield, Department of Health, Nick Joseph, Ministry of Justice, Karen Lynas, East Midlands NHS Leadership Academy, and Prof Sean Duggan, Joint Chief Executive of the Centre for Mental Health. Sean outlined areas in which his organisation could work more closely with the Institute and some of the challenges for the new collaboration. Prof Nick Manning said: “There was a great buzz around the room and the event was so popular that it was standing room only at the back. These occasions are extremely useful in being able to clarify to attendees our future direction and hear from invited guests as to the external forces which will shape our progress. “I would like to thank all speakers and delegates for their contributions, and all the artists featured within the new Voices exhibition, which opened on the same day, showcasing work of an extremely high standard.”
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Nottinghamshire Healthcare
NHS
NHS Trust
about involvement Membership and Involvement Update
T
he Trust now has more than 7,800 public members. Public members continue to be involved in activities throughout the Trust. Here is a brief update on a number of these activities and how they have been making a positive difference. Volunteering Volunteering within the Trust provides a service which complements the specialist professional care for patients and client
The Rosewood garden
groups served by Nottinghamshire Healthcare. There are currently more than 150 people volunteering in a clinical/ therapeutic setting and approximately 40% are current or past service users. Participating in the third Invest to Lead Programme Following the success of the 2009/10 Invest to Lead 2 Programme, the Trust is now running Invest to Lead 3. The programme is designed to develop leaders within the Trust. Volunteers from both involvement centres have taken up the opportunity to participate on the five-month
programme and are due to graduate in February 2011. Roseforce Gardening Group Rosewood is very proud of the achievement it has made in the garden. With a lot of hard work and effort from members and service users from Wathwood Hospital, the garden now has raised flower beds, rockeries, paved paths and even a vegetable patch. Produce includes onions, runner beans, broad beans, tomatoes, carrots, curly kale, lettuce, radish, beetroot and parsnips and the Roseforce Group meets weekly to keep the garden in order and harvest the vegetables.
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Rosehips belly dancers
Service user and carer experience survey The service user and carer experience group makes sure that the Trust collects feedback and views from service users and carers about their experiences of the Trust’s services. It also ensures that service users and carers receive feedback on the views and issues they raise and what action the Trust’s services have taken. Surveys continue to be sent to every service in the Trust and responses are increasing. We have had over 3,000 surveys returned between June 2009 and September 2010. The survey report for July – September 2010 is now available on the Involvement section of the Trust intranet. Speaking at the induction programme for new staff More members are getting involved in the Trust induction programme by giving their own accounts of personal experience of mental health, learning disability or substance misuse. As well as speaking from personal experience, volunteers explain about the work of Involvement, what it means to them and how new staff can be more aware of the good work taking place in our two involvement centres and across the Trust. Involvement volunteers from the Involvement Centre, Nottingham and Rosewood, Ollerton take part every month. Training and development Involvement is developing more learning and development opportunities for our service users and carers. This is to enable them to move forward with their
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recoveries and lives whilst improving their skills and abilities. Some of our service users and carers have recently completed a City and Guilds level 2 NVQ course in mentoring. Staff interviews Service user and carer members of the Trust continue to be involved in the interview process for appointing new staff to the Trust. They are involved both in shortlisting and as part of the interview panels via the Employment Resourcing and Interview Forums held at Duncan Macmillan House and Rosewood. Rosehips belly dancers Rosehips are part of our social inclusion development. They are a group of approximately 14 ladies including services users, carers and staff members, who meet weekly to belly dance. The group is now well established and is regularly booked to perform at events throughout the Trust including Wathwood Hospital, Enright Close event, Mansfield Market for World Mental Health Week, Stepping Stones and at the Involvement Centre at Duncan Macmillan House. The group is very friendly, it’s a good confidence booster and is excellent for physical and mental well being. Positive Writing Group The Positive Writing Group launched a Compendium of writing during Mental Health Awareness Weeks. This collection of stories, poems and artwork has been produced by service users and carers themselves. Domestic Fire Safety Project This group works in partnership with Nottinghamshire Fire and Rescue Service in an effort to reduce the number of deaths attributable to domestic fire accidents by raising awareness amongst staff and service
users of the dangers of fire through education and targeted events. The aim of the group is to raise awareness of mental health issues through all levels of staff within Nottinghamshire Fire and Rescue Service so that they are better equipped to understand the needs of a person with a mental health problem when attending an incident. Involvement in Forensic Services Some of our involvement volunteers have regular links to the Patients’ Council at Rampton Hospital and the forums at Wathwood and Arnold Lodge. We are also working with Community Forensic via the Involvement Centre on patient information about the use of seclusion and helping to develop a Patient Information Group. Governor Members and the Members’ Council The first Members’ Council meeting was held on 28 September 2010 and was a great success. Training sessions including mental health awareness and equality and diversity for Governor Members have been well received and another is planned about the broader NHS and finance. Some of our Governor Members are getting involved in communities of interest and visiting Trust services. The second meeting of the Members’ Council will be held on 10 January 2011. Members can represent their views via the Members’ Council and the Governor Member for the constituency in which they live. If you would like to get in touch with a Governor Member please contact the Membership Office on 0800 012 1623. More information about the Members’ Council can be found on the Trust website at www.nottinghamshirehealthcare.nhs.uk/ get-involved/the-members-council.
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Positive Writing Group launches Compendium entertaining an intimate The Positive Writing Group’s first ever publication, entitled Compendium, was launched at the Involvement audience with readings, songs, and a storytelling Centre during Mental Health Awareness weeks. workshop. The booklet is a collection “There’s a really high of stories, poetry, artwork standard to all the work, and photography, and and the finish of the booklet represents 12 months of has a really professional work by the group of feel,” said contributor David writers, musicians, artists Hewerdine, who also led the and photographers. launch event. “The launch was absolutely brilliant, too. The creators all had their There was a really positive moment in the limelight at energy in the room, very the launch event, supportive. There were plenty of people and they seemed to enjoy it. It could have continued for hours, I think.” Musician and contributor Will Juckes entertained with two songs, and read his wryly comedic poem ‘Elvis at the Shrink’ to gales of appreciative laughter. “I really enjoyed that performance,” he said. “Every time you perform
Meet a Public Governor… Gladys Bombek It is a great honour to have been elected on to the Members’ Council as a public governor member for the Nottinghamshire County constituency. I am a service user volunteer, now based at the Involvement Centre, Duncan Macmillan House. I have been a volunteer since 1991 and joined as a public member of the Trust three years ago. I have always had a passion about improving services for people with mental health problems and learning disabilities and I am looking forward to representing the views of local people and service users and carers in shaping Trust services.
and it goes well, it’s a boost to your confidence.” To get your copy of Compendium, or for more information about the Positive Writing Group, please contact the Involvement Team on 0115 993 4567.
Extract from The Magic Green Box: “When, finally, the box was untrammelled, its neglectful custodians were astonished at what they saw. As if precogitated, the disparate artworks upon which it had spent a year gorging itself seemed organised, shuffled together into a comprehensible form. This photograph and that poem. These two pieces of prose. That painting. A drawing, a cartoon, a song.”
One of my passions is to challenge the stigma that affects people who suffer from mental health difficulties, substance misuse and learning disabilities. The first Members’ Council was excellent and all the governor members were made to feel welcome and valued. Governor Members were able to ask any questions we had to Mike Cooke, Clair Chilvers and Ruth Hawkins. Now that the Trust has achieved Foundation Trust standard, the role of the Members’ Council becomes even more exciting. I really look forward to working with the Trust and the Members’ Council in making a positive difference for the future.
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Profiling our public membership We want our membership to represent the people and communities we serve as a Trust. As part of our equality and diversity monitoring we ask new members for certain information about themselves to help us ensure we have a representative and balanced membership, although members can choose not to disclose this information if they wish.
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Public Membership by Age
Public Membership by Area Nottingham City Nottingham County
49%
7% 29% 16%
14% 9%
29% 12-22 23-40
41-65 65+
48%
Membership Breakdown by Ethnicity
Public Membership by Gender
30%
628 unknown
0% 1%
4456 female
5% 60%
These charts show the make-up of our membership in terms of age, geography, ethnicity and gender as of November 2010.
S. York & Rest of E. Midlands Other (England and Wales)
White Black or Black British Asian or Asian British
4% Mixed Chinese Other or Not Stated
2576 male
0
1000 2000 3000 4000 5000
Using my own experiences of self-harm to help others Self-harm is frightening to many because of the simple fact that it is visible, unlike many other forms of mental health which are more concealed. Perhaps the most damaging aspect of self-harm is in how other people react; after all it is not something that is particularly subtle. It is because of this that many people choose to hide their self-harm and they carry on going about their business as usual. Because people may not be dealing with the issues that need to be addressed and because they are often still living their lives in a way that does not indicate that there may be underlying problems of any sort, the chances of them actually seeking help or even being identified as needing help do not usually happen. Self-harm is slowly being taken seriously with various charity organisations, many of which are actually formed and run by people who have experienced self-harm issues themselves. More research and training is also now being carried out. However there is still a lot of work to be done to get the services truly needed to provide the adequate
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help, support and treatment needed. This is why through Involvement and Communities of Interest, I am aiming to get self-harm greater recognition within the services provided by the Trust. The aim will be that in the future, people can access treatment and support and hopefully, in time, care for people who self-harm will be on a level with that of other mental health treatments offered by the NHS. Written by David Hewerdine, Involvement Service User/Volunteer Image shows anti-stigma postcard featuring Jenny’s experience of self harm. For more information about Involvement and Communities of Interest please call the Involvement Team on 0115 993 4567
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Transforming Community Services The Trust is a member of a new consortium of providers which is delighted to have been successful in gaining preferred provider status for a number of community services from NHS Nottinghamshire County. The consortium, County Health Partnerships, also includes Central Nottinghamshire Clinical Services (CNCS), who currently provide out of hours and primary care services through a social enterprise and Principia Providers in Health, a primary care clinician led consortium.
The services that will be provided by County Health Partnerships include: Mental Health, Learning Disabilities and Specialist Services such as special needs dentistry and New Leaf, Health Care at HMP Whatton, Inpatient and Outpatient services in the south of the county, Walk-in Centre Stapleford (currently subject to formal review and consultation) Staying Healthy, Long Term Conditions and Older People including dietetics, cardiac rehabilitation and oral health promotion and Children and Young People including school nursing and health visiting. The formal transfer of services valued at £70 million, will begin in April 2011. The 2000 staff transferring with the services will be employed by Nottinghamshire Healthcare.
Challenging the smoking culture A pilot project being run in the Trust is investigating the best ways to help service users cut down or even stop smoking. It is commonly acknowledged that the relationship between smoking and mental illness is strong, and that smokers with a mental illness smoke much more frequently and also much more heavily than other smokers. Now, thanks to funding from the Department of Health, a pilot project has been launched in Nottingham City to
County Health Partnerships will form a third, primary care led Division with locality based Directorates for Nottinghamshire Healthcare in addition to our Local Services and Forensic Divisions. A Transitional Board across NHS Nottinghamshire County and Nottinghamshire Community Health has been set up to oversee the transfer of services to the new providers to ensure minimum impact on staff and service users. A Partnership Board will also be established with the other primary care providers to oversee our integration and the establishment of the Division. We look forward to working together with our partners to continue to improve healthcare for the people of Nottinghamshire.
explore options around implementing a comprehensive tobacco dependence treatment for patients and staff in mental health trusts. The project team is Dr. Elena Ratschen, project lead; Camilla Parker, research assistant; Julie Parkin, Registered Mental Nurse seconded from Broomhill House, and Helen Turner, Occupational Therapist. Helen and Julie, trained smoking cessation advisors, will work on two acute wards, two rehabilitation areas and in the community recovery team. People with a mental illness often suffer from poor physical health and smoking related illness is one of the major reasons for premature deaths. Smoking is a major contributor to health inequalities between individuals with mental illness and those without and it is often wrongly assumed that
Multi-agency health and wellbeing programme success A multi-agency pilot project focusing on health and wellbeing has received positive feedback in a recent evaluation. The programme was developed earlier this year for people attending Springwood day centre. Tony Price, Steve Pritchett and Rebecca Holmes, all Nottingham City Community Learning Disability Nurses, facilitated a number of health promotion workshops, working alongside health facilitation nurses, a community heart nurse and representatives from New Leaf. The workshops covered areas including physical wellbeing, health action plans, personal hygiene and relationships. The project also supports individualised health needs with the provision of one to one sessions facilitated by the community nurse. During an audit meeting to evaluate the pilot attendees gave positive feedback and asked for the project to be delivered to all Nottingham city day centres. Comments included: “The nurse explained everything. I enjoyed finding out about blood pressure and weight.” “I learnt about good relationships.” Further programmes are now planned to be delivered throughout 2011.
people with mental illness cannot, will not or should not stop smoking, and support is usually minimal. The aim of this project is to find out what the current problems and procedures related to smoking and the smoke-free policy are; to offer tailored individual and group support in addressing smoking to those mental health patients who are interested, and to suggest and lead the design pathways and procedures that should result in more comprehensive support and clearer structures for everyone. If the project is successful the main outcome will be guidelines for rollout in all trusts across the country. Work on the wards and in the community started in October and is due to be completed next summer. For any further information please contact Camilla at camilla.parker@nottingham.ac.uk.
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Keep well this winter
Tony Bernard and Janet Sheard work out in the Fitness Centre
Discounted Fitness Centre membership Already wondering how you’ll get rid of the extra pounds that Christmas will inevitably add to your waistline this year? The University of Nottingham Fitness Centre could be the answer. The Fitness Centre at the back of the University Park Sports Centre on the main University campus is offering 30% off its membership fee for Trust service users, carers and staff.
“I think it’s great that the gym has got behind mental health in this way,” said Tony. “It’s reducing stigma and encouraging people to become more socially included as well as promoting a healthy lifestyle by improving physical fitness levels and psychological coping responses linked to internal/external stressors.” Janet Sheard, Executive Director of Nursing and AHPs, said: “This is a great opportunity and it’s fantastic that the Fitness Centre can work with us to make their facilities more accessible.”
To claim the 30% discount members of staff will need to show proof of employment with the Trust (e.g. ID badge or payslip) at the Fitness Centre. Tony Bernard, CPN, Early Intervention Service users and carers will need to in Psychosis, already attends the gym. show a letter from their care He secured the discount with the help coordinator or other relevant worker of Tom Sherratt, Fitness Centre which states that they are under the Manager, who agreed that society Trust’s care or care for someone who is. continues to have a negative misconception of people who For further information on joining the experience mental illness. Fitness Centre call 0115 846 7533.
Invest to Lead 3 was launched at the Trent Vineyard on 26 October. This year over 300 delegates are taking part in this five session learning experience, which is developing enhanced and distributed leadership skills across the Trust.
and organisational activity and instil a culture of improvement at all levels of an organisation. This programme is as much about behavioural change, as it is about looking at the processes in place to do day-to-day work. By adopting and embedding best practice in how workload is managed, meetings are run and emails are dealt with, the Trust can get the best out of each of us and our teams.
The theme for some of the sessions is the Productive Leader programme, a systematic, evidence-based programme which can help look at personal, team
We are also exploring the leadership journey of our own Executive Team and during the October event Dr Mike Harris was interviewed about why and how he
Invest to Lead 3
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The winter months can place significant pressures on our health and on NHS services. Staying as healthy as possible by proactively managing our own health and wellbeing and following key advice can help prevent complications and avoid unnecessary illness and admission to hospital. Keep warm; keep your house warm; there are grants available to help you do this and make sure you eat properly and have hot drinks. Get the flu jab if you are over 65 or have a serious medical condition and make sure you have the right support in place to manage your long term condition to prevent the need for emergency care. If you do become unwell there are a range of NHS services on your doorstep which could help; you don't always need to see a GP or go to A&E: • Self Care - A range of common illnesses and complaints can be treated with a well stocked medicine cabinet and plenty of rest. • NHS Direct provides a confidential telephone service, 24 hours a day, to give advice and guidance on health issues. Call 0845 46 47. • Pharmacy can provide confidential, expert advice and treatment for a range of common illnesses and complaints. • NHS Walk-In Centre offer convenient access to a range of treatments for minor illnesses and injuries that don't need a trip to hospital. If you have an illness or injury that won’t go away, make an appointment with your GP. A&E departments and the 999 ambulance service should only be used in a critical or life-threatening situation.
had started in his career and how he had got to where he is now. This made for interesting and inspiring listening. Further Executives will feature later in the programme. The day also featured action learning sets where delegates tackle real life issues and problems. Early next year a Year Book will be produced featuring the outputs of this work – to enable innovation and good practice to be shared. Future sessions will also enhance the group’s knowledge about the Quality, Innovation, Productivity and Prevention (QIPP) agenda.
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Dr Victoria Tischler and Professor Nick Manning, IMH Director, presenting the judges’ winning certificate to Nottingham-based artist Anthony Gariff (centre).
Voices exhibition opens at Institute of Mental Health An art exhibition that challenges the convention of hearing voices as a negative symptom of mental illness has been launched at the Institute of Mental Health. Voices, a visual arts exhibition at the Institute’s premises on the University of Nottingham’s Jubilee Campus, brings together works by 21 local, regional, national and international artists that intrigue, stimulate and question the notion of voices. The exhibition is curated by Dr Victoria Tischler, arts co-ordinator at the
Better Payment Practice Code
Institute in partnership with City Arts Nottingham. Dr Tischler said: “Within psychiatry, those who hear voices are said to experience auditory hallucinations, a symptom associated with psychosis. It is estimated that four per cent of the British population hears voices. Yet we all experience voices in different ways; voices that may be tormenting and critical or guiding and inspiring. Many highly creative individuals report hearing voices and in some cultures such hallucinogenic experiences are seen as healthy and are revered.
The Better Payment Practice Code requires the Trust to aim to pay all undisputed invoices by the due date or within 30 days of receipt of goods or a valid invoice, whichever is later. The Trust's performance against the code is measured as invoices paid
“Aside from the aesthetic function that this - the third Institute exhibition - fulfils, it gives voices to those marginalised and stigmatised by mental health difficulties. The exhibition showcases a diverse range of work related to voices by individuals including patients, health professionals, artists and students.” The free exhibition runs until May 2011, Monday to Friday, 9am to 5pm. It was launched on the day of the Institute’s Foundation Anniversary Annual Lunch (Wednesday 3 November).
within 30 days of the date of the invoice, plus a buffer of four days to allow time for the invoice to arrive at the Trust. Where invoices have been sent directly to off-site locations, this is the date the invoice is received within the Accounts Payable function at Mansfield.
Performance continues to improve and the Trust is currently meeting the target for 2010/11. To ensure this continues, please book goods in promptly and check, certify and return invoices to the Payments Office for payment. If there is a problem with the invoice, please let the Payments Office know.
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Christmas is fast approaching. Why not make somebody’s Christmas extra special by making them a special gift out of salt dough? Here’s the basic recipe: Ingredients: 200ml (1/3 pint) water; 300g (10oz) plain flour; 300g (10oz) salt; 1 tablespoon of vegetable oil.
Thorneywood news Thorneywood editor Chloe Britton reports on activities at the unit: This last month has been really busy at Thorneywood. First of all we decorated the unit for Halloween with balloons, cobwebs, spiders, pumpkins and other decorations, some of which we made ourselves. Then it was Bonfire Night and some of us went to the Forest Recreation Ground in Nottingham to see the fireworks. It was like being at Glastonbury with all the mud but the fireworks were worth it. Every Thursday morning on the unit we have a group called ‘Breakfast Club’ where we do something different for breakfast that we get
involved with making. To add to the Halloween atmosphere we made pumpkin muffins, which went down a bit like Marmite (some lovers, some haters). We also had the half term holidays so we had a week off from the Education Base and kept ourselves entertained by getting creative in the art room. We have some expert artists down here at Thorneywood, some of whom made some fantastic origami. At the end of the week we had a unit trip out to the cinema to see ‘The Social Network’, which finished off the holiday break nicely. When we went back to school a group called ‘Samanya’ came in to do an interactive drama workshop educating the older pupils about sex and relationships. At first we were a bit apprehensive and didn’t really know what to expect but after about 10 minutes we were all much more relaxed and were contributing and asking questions. There were three actors from the drama company, who were all very friendly and made a potentially awkward topic for teenagers easy to talk about. Back at the Education Base we have been preparing the wildlife for winter by making fat balls for the birds and refurbishing our insect hotel, The Ritz Thorneywood. We added another layer by placing a palette on top of the others and securing it with string. This creates a perfect place for insects to hibernate and wrap up warm for winter.
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Method: Mix all the ingredients together, put the mixture in the fridge for half an hour to cool, then get creative using shape cutters or let your imagination run wild. Put your shapes in the oven for at least four hours on a low heat (100ºC) until they set hard. Cooking time will vary depending on size. Allow to cool and then decorate.
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What is your job title and what does your role entail? a Acute Learning Disability Liaison Nurse. My role working as a Learning Disability Nurse within a team in Nottingham entails supporting people who have a learning disability and their carers when accessing acute hospital services. Also supporting hospital staff by raising awareness of the needs of people with a learning disability, and reasonable adjustments that may need to be made for equity of access to healthcare. Our team also provides training to hospital staff on learning disability related health issues.
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How long have you been with Nottinghamshire Healthcare NHS Trust? a Since January 2010, although I did previously work for the Trust between 1998 and 2007.
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What do you see as your priorities for Nottinghamshire Healthcare? a To continue to be one of the leading trusts providing mental health and learning disability services.
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What is your employment background? a I worked as a Healthcare Assistant, and then was seconded to do my nurse training through the Trust. I worked in a residential home for six years, and then when this job was advertised, I thought I would apply.
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A recipe for success! Just over a year ago Helen Ashwell, a Lecturer in the Therapies and Education Department at Rampton Hospital, launched a healthy eating recipe book to encourage patients to try and cook healthier meals. Now Robert Wilson, 16-year-old son of Debbie Wilson, Technical Instructor and one of Helen’s colleagues, is proud of the weight loss he achieved after using the book: “Three months ago I was unhappy, overweight and constantly teased about my weight. My whole outlook on life was bad. I knew I had to change, but how? I didn’t even know where to start. I had tried lots of diets before but none of them worked. A few days later, my mum brought a book home from work called ‘Positive About Healthy Eating’ by Helen Ashwell. I started to cook the meals in the book in an attempt to lose weight. Most people think that healthy food doesn’t taste as good as food they can get from a take-away but after using this book I definitely think differently.
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“I found that the recipes had a lot of different flavours, each of them delicious. One of my personal favourite recipes was the recipe for chicken and spinach curry, which I found to be just as tasty as a regular curry, but at only 375 calories per serving it’s a much healthier alternative. “Through using Positive About Healthy Eating and doing regular exercise I managed to go from 12 stone 10lbs to 10 stone 2lbs in just three months. Due to the journey I have been on in losing the weight, I now want to be a fitness instructor to help people achieve their goals and pass on my knowledge.” “I’m delighted that my book is really helping people like Robert,” said Helen. “The recipes have been designed to help with portion control, without denying people the creativity that cooking requires.”
q&a
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q What is the best piece of advice you have ever been given? a Never put off till tomorrow what you can do today. q What was the last CD you bought? a 100 Greatest Driving Anthems… I drive a lot!
q What is your greatest achievement? a Getting this job, and also setting up a record company.
q What makes you angry? a Ignorance and narrow mindedness. q What are you most passionate about? a I have always been passionate about supporting people with a learning disability.
Robert Wilson before and after losing 2½ stone with the help of Helen Ashwell’s recipe book.
q What is your idea of bliss? a A relaxing evening in with my fella, watching a movie with a few glasses of wine and a tub of Ben and Jerry’s.
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What three words would you use to describe yourself? a Busy, unique, loud!
This month we talk to Acute Learning Disability Liaison Nurse Shelly Hancock
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What single thing would improve your working life at Nottinghamshire Healthcare? a Nothing I can think of… It is a good organisation to work for!
q What is your favourite hobby? a Listening to music, going to gigs. I am also a part time band manager. www.newgenrocks.com
q What keeps you awake at night? a I can never sleep after watching Horror films!
q What is your favourite film? a I like lots of films, but mostly anything by Kevin Smith or that has Leonardo Di Caprio in it.
What is your favourite holiday destination? a New York.
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Who would you take to a desert island? a Jordan, my partner. Where do you see yourself in 10 years’ time? a Maybe in a different job role within Nottinghamshire Healthcare, unless my band sells millions of records haha! Then I will be living in New York!
q Do you have a ‘claim to fame’? a I have been fortunate enough to have had quite a few! Maybe the best one for me was Terry Wogan reading out my congratulations to Lordi (Finnish Rock band) for winning the Eurovision song contest!
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How would you like to be remembered? a That I actually made some kind of difference in someone’s life.
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Main: Janet Sheard Top: Stands and attendees Bottom: Nigel Risner
Commemorating Nurses and Allied Health Professionals More than 200 nurses and allied health professionals (AHP) came together on 5 November to celebrate their contribution to care. The special event was organised by the Nursing and AHP Directorate with SNACC members influencing the programme. The aim was to provide an opportunity to share examples of best practice and celebrate successes. Janet Sheard, Executive Director of Nursing and AHP, opened the day by acknowledging the challenges many services are facing and emphasised the important role nurses and AHPs have to play both now and in the future. Professor Clair Chilvers, Trust Chair, also gave thanks for everyone’s hard work. For many, the highlight of the day was a presentation from motivational speaker Nigel Risner on how to make an impact in everyday work. Other speakers included Helen Marriott, AHP Lead for NHS East Midlands, Catherine Pope, Associate Director AHPs, and Professor Rachel
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Munton, Interim Director of Nursing, NHS East Midlands and Deputy Director East Midlands Leadership Academy. They focused on local and national priorities and proved to be inspiring and motivating. Updates on work within Local and Forensic Services Divisions were presented and the event also offered market stall style exhibitions. Feedback was that the event was refreshing and honest, providing inspiration, motivation and clarity: “I have really enjoyed the day. It has given me a better understanding of how the changes are going to affect me and the NHS.” Other delegates reported that Rachel’s speech “changed my mind, that I do have a part to play and my contribution is worthwhile.” And “was not only engaging, but felt honest, addressing our concerns that quality is being affected by cuts/changes and perhaps persuaded us to give the NHS another chance – thank you.”
Best practice directory coming soon Attendees were invited to share their examples of best practice which will now be collated and published in a forthcoming best practice directory. Janet Sheard said: “We received over 100 great examples of best practice working on the day and really wanted to share the fantastic work that everyone has been doing. By publishing it in a directory we hope it will form a really useful and important tool that we can all benefit from; helping us be more productive and efficient in the way we work and in turn enabling us to provide the very best service and care.”
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Liaison team attends international dementia conference The Acute Care Liaison Team at King’s Mill was delighted to be nominated for ‘NHS Team of the Year’ in the recent International Dementia Excellence Awards, run by the Dementia Services Development Centre (DSDC).
“The daytime conference was really interesting and we also attended some great workshops about future care innovations and enjoyed the evening dinner and some useful networking opportunities,” said Tony Wilde, Clinical Nurse Specialist in the Acute Care Liaison Team.
DSDC is the international leader in the dementia field and the awards are designed to recognise organisations and individuals who have worked to improve the quality of life of people with dementia. They celebrate the important work being undertaken to support people with dementia internationally and are a celebration of innovation and good practice.
Other conference attendees came from around the world
Entries for the 11 award categories came in from across the globe and the winners were announced at a conference held in October at London’s Excel centre in Canary Wharf.
Manor Road is one year old Manor Road Community Mental Health Team (CMHT) celebrated its first birthday on 5 November 2010 with a bonfire night themed buffet lunch. Jacket potatoes and chilli were the order of the day as service users, carers and staff joined in to listen to a Tom Jones CD and reflect on the achievements of the last year. Amanda Peto, CMHT Manager, said: “There have been a lot of changes recently but Manor Road is continuing Manor Road service users, carers and staff at the birthday lunch
Karen Perry, Liaison Nurse, and Tony Wilde, Clinical Nurse Specialist, at the conference.
with keynote speakers jetting in from four countries: Professor Sandrine Andrieu from the Toulouse University School of Medicine; Professor Henry Brodaty, Director of the Dementia Collaborative Research Centre at the University of New South Wales, Australia; Professor Stephen G. Post, from Stony Brook University, New York and Professor Emma Reynish from the University of Stirling. The conference was aimed at all those who work with and support people with dementia. It addressed critical issues in practice across the range of professions and organisations that support people with dementia and the themes addressed key issues prioritised in national dementia strategies both in the UK and internationally.
to make sure that health and social care needs are met and that we provide the best for Gedling.” In its first year Manor Road has set up groups for service users, carers and a recovery group. The ‘Stop and Think Group’, which is the first of its kind in a community setting, has also begun at Manor Road and is running successfully. The ‘Stop and Think’ project is based on learning from the Personality Disorder Network about supporting service users in the community and giving them skills and coping strategies.
Martina Parsonage, Health Service Team Leader, said: “The reason we’ve been able to do so much in the first year is that the CMHT is now based in the community it serves. This makes all the difference to service users. When we were based at the Mandala Centre it was as if we were visiting; now we’re here to stay.” Nick Daibell, General Manager, said: “I am positive about the successful first year at Manor Road. The event today was in response to requests to Mike Cooke at the August ‘Catch Up with Cooke’ event and I think the number of people here today demonstrates how Manor Road does genuinely reach into the community.”
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Breaking the ice about mental health and learning disability Taking a swing at the stigma of mental health and learning disability the Nottingham Panthers are the most recent recruits to the Trust’s anti stigma campaign. Launching the campaign on 29 December, messages about one in four people being affected by mental health problems will begin ringing through the stadium. Programmes will feature personal stories by service users and players about their experiences of stigma and social exclusion, and even Paws the Panthers mascot will be sporting a Trust T-shirt supporting the campaign! Sharon Eaton, Business/ Development Manager, County AMH, who is part of the project team co-ordinating the Trust’s
involvement said: “This is a unique opportunity to promote our anti stigma message as well as incorporating a lot of the work we do around social inclusion and community engagement. “We have a number of tickets available to six match games and we are making sure that these go to service users and their carers who use the services of the Trust wherever they might live. The project team is currently working with community mental health teams and residential inpatient services to ensure as many service users as possible can participate. We are also involving staff who will assist with attendance at the games with transportation and support as required.”
The first game the Trust is involved in will be on 29 December with tickets available for the six games from 30 January 2011.
Photography by Unique Images
For more information contact Sharon Eaton on 01623 784770 or email sharon.eaton@ nottshc.nhs.uk.
WHO WE ARE... WE NEED YOU! You may have picked up this copy of the newsletter not knowing what Nottinghamshire Healthcare NHS Trust is. We provide mental health and learning disability services for the whole of Nottinghamshire. We also manage medium-secure units in Leicester and Rotherham, and the high-secure Rampton Hospital near Retford.
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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. 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. 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 March issue of Positive, please contact us by 4 February 2011. 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