1 InequalitiesLeadership:TacklingHealth
03Contents Forewords 06 Introduction to the Purpose Goals 08 Role of NHS organisations in spreading opportunity 10 Next steps 11 Best practice from NHS organisations 13 North East England and Cumbria North Cumbria Integrated Care NHS Foundation Trust 14 North West England Countess of Chester Hospital NHS Foundation Trust Greater Manchester Mental Health NHS Foundation Trust 17 Yorkshire and the Humber Airedale NHS Foundation Trust Calderdale and Huddersfield NHS Foundation Trust Humber & North Yorkshire Health & Care Partnership 21 The Midlands Shropshire Community Health NHS SouthTrustWarwickshire NHS Foundation Trust University Hospitals of North Midlands NHS Trust 28 East of England East Suffolk and North Essex NHS Foundation Trust 29 London Barts Health NHS Trust North East London NHS Foundation Trust The Royal Marsden NHS Foundation Trust 32 South East England Sussex Community NHS Foundation Trust 34 South West England Devon Partnership NHS Trust 2 Contents
3 01Foreword
Recent research found that thousands of babies in England are born prematurely, smaller than expected or stillborn because of socioeconomic and racial inequalities. In terms of maternal outcomes, women from the most deprived areas are twice as likely to die as those who live in the most affluent areas, with women from Black ethnic groups four times as likely to die as women from White groups and those from an Asian background almost twice as likely. There are stark inequalities due to ethnicity evident among both men and women over the last two decades which only increase with age. Nothing illustrates health inequality more clearly than the huge differences in life expectancy, and the number of years people live in good health across the country. Despite most communities seeing their life expectancy increase in the years between 2002 and 2010, between 2014 and 2019, life expectancy went down in almost one in five communities for women and one in nine for men. A man from Blackpool could expect to live 27 years less than a man in Kensington and Chelsea in London. More people are also spending more of their lives in poor health, with huge implications not only for their individual wellbeing and prosperity but also for our health and social care system, and our economy.
Foreword
Following the pandemic, the disparities in people’s health have become ever more stark. We know that significant inequalities exist between different communities. Their health is affected by their ability to access healthcare, and receive the care and treatment they need. All of this affects the outcomes they experience. From the cradle to the grave, some find that they are in a circle of accumulated disadvantage which not only impacts their health but their life chances more widely.
Good health is dependent on a number of wideranging factors. Access to opportunity which enables people to live a productive and rewarding life, the ability to get a good job and a rewarding career, having sufficient income, and the ability to access healthcare close to where they live are just some of the factors that can impact people’s physical and mental health and well-being.
Health inequality itself is part of a much broader picture. A range of factors are responsible for driving it, including poverty, unemployment, poor housing, low education rates and social isolation.
NHS organisations understand the challenges their local communities face and can develop tailored responses that address their specific problems, often in collaboration with other local partners. As anchor institutions in their areas, they can also offer significant employment opportunities in a wide variety of roles, offering advice and information about the range of jobs available with an open and fair recruitment process where anyone with potential can apply. This report also includes further areas where the Purpose Coalition can work with NHS organisations to increase their positive social impact: through knowledge exchange with other NHS organisations; social mobility tracking to measure and report the diversity of their own employees; advocacy for apprenticeships; and by raising awareness of the range of work undertaken in the NHS and so highlighting the role they can play in their communities.
By leveraging their unique position, NHS organisations can be agents for positive change to ensure that everyone has the same access to the health and care services they need, and can benefit from the improved opportunities and life chances that will result.
There are also less well-defined elements which are harder to assess. These include conscious and unconscious racism and discrimination which can all be key drivers, with clear impacts on physical and mental health and well-being outcomes. It is these fundamental issues which need to be resolved if we are to reverse health inequality and deliver improved outcomes for everyone.
Rt Hon Anne Milton, Chair, Purpose Health Coalition
The Purpose Health Coalition, as part of the wider Purpose Coalition, is working with NHS organisations across the country to break down those barriers to opportunity and provide equality of provision and care to everyone who needs it, wherever they live.
It is these fundamental issues which need to be resolved if we are to reverse health inequality and deliver improved outcomes for everyone. "
This report features some examples of the very best practice from a range of NHS Trusts which other organisations can use. They range from a campaign by the University Hospitals of North Midlands NHS Trust to combat tooth decay in the young, to the establishment of a community diagnostic centre by the Countess of Chester Hospital NHS Foundation Trust that enables patients to receive scans and tests closer to home; a scheme by Barts Health NHS Trust which supports local people into low banded roles; and a pre-employment programme by North Cumbria Integrated Care NHS Foundation Trust to help nurse cadets and social care students gain the experience and training they need to work as healthcare assistants.
4 Foreword
The NHS is an integral part of the solution.
Foreword
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Rt Hon Jacqui Smith, Chair at Barts Health NHS Trust and Barking, Havering and Redbridge University NHS Trust
For example, as the largest single employer in the UK, the NHS has huge potential to provide good jobs, not just in health care provision but also in the wide variety of sectors that are part of the NHS, ranging from information technology to administrative and managerial services. With a national budget of over £130 billion, our spending power gives us real potential to ensure our supply chains and procurement processes promote environmental sustainability and yield high social value. This report showcases case studies and examples from NHS organisations up and down the country who are demonstrating innovative and proactive approaches to addressing the inequalities that exist within their communities. They illustrate the potential we have as health systems to positively impact on people’s lives and spread opportunity – ranging from East Suffolk and North Essex Foundation Trust’s Talent for Care Team’s work to promote career opportunities in the NHS to local education institutions, to Sussex Community NHS Foundation Trust’s Care Without Carbon sustainability strategy to reduce carbon emissions and protect the local environment. It is important that we as NHS organisations recognise our role in supporting the levelling up agenda. I hope the examples set out in this report will inspire all of us to go further and faster – our scale and reach means we have the potential to make a real difference.
As Chair in Common of Barts Health NHS Trust and Barking, Havering and Redbridge University Hospitals NHS Trust, I see first-hand some of the health inequalities that exist in this country. The Trusts I chair serve some of the most deprived parts of London – for example, Hackney and Tower Hamlets have more than double the England rate of children claiming free school meals. We also serve some of the most ethnically diverse parts of England, with six in 10 people in our catchment population identifying as Black, Asian and minority ethnic (BAME). And our local areas have large numbers of people experiencing social exclusion, including those experiencing homelessness and vulnerable migrants. Sadly, the data shows that in terms of access, experience and outcomes, these groups tend to fare worse. These types of inequalities are replicated across the UK and are unacceptable: they are avoidable, unfair and systematic, resulting in earlier deaths, lost years of healthy life and significant economic Foreword costs to society. The good news is that, despite so many of the drivers of health inequalities lying far beyond the walls of healthcare institutions we have the power to impact positively on them. We employ large numbers of people; we procure and transport many products; we occupy space and we use resources. We can be good neighbours – using our role as anchor institutions to tackle the inequalities that can create the ill health which shows up in our clinics and wards.
Introduction to the Purpose Goals
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These 17 interlinked, global goals were created to be ‘a blueprint to achieve a better and more sustainable future for all’.
In 2015, as Secretary of State for International Development, Justine Greening MP led the UK delegation to the United Nations (UN) and was at the heart of the efforts to successfully design the UN’s Sustainable Development Goals (SDGs).
These new Purpose Goals identify 14 clear goals, and draw on expertise provided by academia and businesses which has been applied to the unique challenges facing the UK in levelling up. They focus on key life stages and highlight the main issues that need to be resolved in order to create a level playing field for all in this country.
However, Justine has recognised how a common set of ambitious but accessible objectives could also galvanise action to effect real change on equality of opportunity. Working through the Purpose Coalition of businesses, universities, public sector employers like NHS Trusts and local authorities, Justine developed the Purpose Goals which she then launched in February 2021.
7 PostdestinationsPositive16+3 schoolSuccessfulyears2infoundationsStrongEarlyYears1 Right advice and experiences4 Fair progressioncareer6recruitmentOpen5 Good health and well-being8savingsaccessWideningto& credit 7 Closing the digital divide10enterpriseExtending9 Building homes & communitiessustainable12forInfrastructureopportunity11 Achieve equality, through diversity & inclusion 14transitiontheHarnessenergy13 Introduction
The Purpose Goals are intended to guide how the urgent ambition to achieve equality of opportunity in the UK can actually be achieved.
Of course, the impact of the work carried out to do this can, and should, be measurable. To do so, sub-goals within the 14 goals, with quantifiable targets and metrics to measure progress against are being developed by the Purpose Coalition members. This will create a transparent and measurable framework with which we can direct and monitor progress. It can also ensure different actors with different roles can nevertheless work on closing the same, measurable inequality gaps.
Ultimately, the Purpose Goals are a shared framework. Justine and the wider Purpose Coalition believe that with a common understanding and objectives, there can be real action that drives change on the ground, with the shared Goals being a uniting and motivating foundation for progress.
The Purpose Goals provide an ambitious and strategic solution to addressing the challenge, setting out for the first time the gaps that will need to be filled to ensure opportunity and fair outcomes are available to all across the country.
The goals offer a common framework with which organisations can collate best practice and show impact across all of the key life stages and areas of concern. They provide the shared language needed to collectively discuss the current challenges and the solutions to existing inequalities.
The role of NHS organisations in spreading opportunity
NHS organisations can, and do, make a real and sustained difference to create positive change for their workers, patients and society at large. These organisations are central to their local communities and they can be accessible institutions that reach out to everyone.
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COVID-19 exacerbated existing health inequalities and created a huge burden for the NHS, these organisations will need help from elsewhere to recover and strengthen, just like the rest of the country. As one of our most wide-reaching and cherished public institutions, the NHS will be essential in leading the way by leveraging its position in communities and its size and power as an employer and organisational entity. In doing this, it can help level up the UK.
It is therefore in both the NHS’ interests and capabilities to contribute to making this transition fair and accessible.
Achieving equality of opportunity simply cannot be achieved without the participation of the National Health Service. NHS organisations are in a unique position to combat some of the barriers to upward social mobility that exist in the UK, and they have to be part of the solution.
By utilising their voice, reach and reputation, NHS organisations can truly act as anchor institutions to level up the regions in which they operate.
Healthcare digital transformation and NHS trusts now interact with patients and staff more than ever before.
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A Health Foundation report found that of those who received NHS care or communicated with the NHS in 2020, 97 per cent used technology and 82 per cent of NHS staff surveyed said they had used technology more in the past year.
That ambition should apply to one of the country’s most important and impactful institutions, the National Health Service. Of course, the NHS in its day-to-day function makes an enormous contribution to the public and individual good of the UK.
Likewise the transition to a green and net zero economy has also accelerated. As it is such a large institution with large estates, efforts made by NHS organisations to use more renewable energy to run their services more sustainably will have a substantial impact. For example, in October 2020 the NHS adopted a multi-year plan with targets and milestones to become the world’s first carbon net zero national health system by 2040. NHS organisations can have a wider impact on the economy through how it procures goods and services. Overall, the NHS has a budget of £130 billion. This spending power and its significant economic levers gives it real potential to ensure its extensive supply chains and procurement processes aid in the green recovery and social good more generally.
The NHS is held in high regard by the public and communities all across the country. Its presence in every region and community in the UK means that it can influence and speak up for those places and communities that might be at risk of being left behind.
As a commissioner and provider of healthcare, the NHS can target services and outreach to address directly the inequalities that exist in health outcomes and experiences, especially among those who suffer most under other forms of social or economic exclusion. Health and wellbeing are vitally important to the function of a happy, prosperous and equal country. NHS organisations have a much wider reach than just health and many, rightly, now see themselves as important anchor institutions within their communities. Aside from the obvious health impacts, there are other areas that the NHS can influence.
Through initiatives such as Barts Health’s Community Works for Health Programme or North Cumbria’s Step into Work Programme. The NHS can help ensure that it makes the best use of the incredible talent the UK has to offer by providing many people with worthwhile careers that contribute to the social good. In its healthcare provision, organisation and information outreach, the NHS also has a sizeable digital presence. COVID-19 has accelerated the
The NHS is the largest single employer in the UK, as of September 2021 there were 1,355,780 NHS Hospital and Health Service staff, with jobs ranging from healthcare provision, information technology, administration and health policy. Its predominance in the employment market can be used to increase social mobility and spread opportunity throughout society. By providing employment and career progression on such a large scale, the NHS makes a vital contribution to the economy, labour market and the available opportunities for individuals across the country.
The Purpose Health Coalition will continue to enable:
Advocacy around apprenticeships
The NHS workforce challenges are the biggest issues facing the NHS. With acute shortage of workers, it has never been more important to train and grow staff.
The current apprenticeship system and the requirements needed often make it difficult to spend the Apprenticeship Levy and navigate how best to make the system work for the NHS. We know that healthcare organisations recognise the importance of apprenticeships and we will work with them to stress to policy makers the need to make the system more workable.
The leadership of many NHS organisations has been striking. The examples contained in this document will help and encourage other NHS organisations to aim higher. In their own crucial role as anchor institutions NHS Trusts can share what works and help each other to make a difference in the communities they serve. We aim to celebrate and share all that’s good within the NHS and beyond. We want NHS organisations to be able to have access to ideas from other sectors in the economy - whether they be public, third or private sector.
10 Knowledge exchange
Raising awareness of the role of NHS organisations as anchor institutions
Apprenticeships can be an effective way of doing this and in this report we have some great examples of how apprenticeships can be effectively implemented.
04 Next Steps
Social mobility tracking
The role of healthcare organisations is evolving - they now have a wider reach than just health services. NHS organisations, for example, are often the biggest employers within a community and have a huge impact on the local economy. NHS organisations should continue to collaborate more closely with others in the local ecosystem and promote themselves as true engines of social mobility. There is an opportunity for change and strong leadership from those within the NHS is needed.
Next CoalitionHealthPurposeSteps
The Purpose Coalition is running a ground breaking Social Mobility Tracking pilot. This work is a simple means of measuring, tracking and reporting employee socio-economic backgrounds. It is an opportunity to improve diversity in the workplace and be a more representative employer. The Social Mobility Commission has a Government approved set of questions which we encourage all NHS organisations to adopt. As one of the largest employers in this country the NHS can have a powerful impact. This will give a clear idea of fair career progression and at what stage in a person’s career they are facing barriers due to their socio-economic background. This will be a crucial next step for the Purpose Coalition using measurement and metrics to drive change.
11 Next Steps Workforce issues are one of the biggest challenges that the NHS currently faces. With a shortage of workers, it has never been more important to train and grow your own staff. "
Best
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Best practice from NHS organisations05
Through our work with NHS organisations we have come across some incredible examples of best practice. In this section we have picked out some of the best practice from our Purpose Health Coalition partners. While we know that there is so much more going on, these organisations are setting the standard for others to follow in terms of the social impact that they are having on communities they operate within, and widening opportunity to those who need it the most. Practice
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The Step into Work programme at North Cumbria Integrate Care NHS Foundation Trust (NCIC) is aimed at those looking for a supported entry point into the NHS, and is made up of classroom based activities, Core Skills Framework eLearning and a clinical placement. The trust works closely with JCP to recruit candidates, but individuals can also self-refer.
Bridge to the Bank
After three weeks training and a week’s worth of shadowing placement, the students are guaranteed an interview to join the Bank as Health Care Assistants. The trust now has a number of staff on apprenticeships who started via this route. The Bridge to the Bank programme was shortlisted for the Healthcare Recruitment Award at the Health Business Awards 2021.
Best Practice North East and Cumbria
North Cumbria Integrated Care NHS Foundation Trust
The six week programme, includes three weeks of training, such as team building and interview preparation, and three weeks of placements in the hospital.
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The six week programme, includes three weeks of training, such as team building and interview preparation, and three weeks of placements in the hospital. The recruits are all supported to prepare for the workplace and work towards their care certificatean agreed set of standards that sets out the knowledge, skills and behaviours expected of specific job roles in health and social care.
The Bridge to the Bank programme is a three week pre-employment programme that was created by NCIC to help nurse cadets and health and social care students gain the required experience and training to work for the NHS as health care assistants. The Bridge to the Bank programme is available for those aged 18 and over who are currently studying BTEC Level 3 Extended Diploma in HSC or CACHE Level 2 Diploma in Health and Social care. Placements are allocated at hospitals and community settings across the trust.
Step into Work is designed to assist the unemployed into a career in health care.
Step into Work
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The hospital will become a rural hub for: A rapid response team enabling people to receive care and rehabilitation in their own REACThomes.Hospital at Home Team enabling improved access to patients in crisis who might otherwise need to go to hospital to receive treatment in their home. Several outpatient clinics to include some consultant, diagnostic and therapy clinics normally run at Countess of Chester Hospital.
Staff health and wellbeing CoCH is now placing more emphasis on the health and wellbeing of its own staff, through the implementation of a five-year People Strategy. Improving the support which is available for staff is a key aim over the next five years, in response to the impact of the pandemic.
The Trust has two designated wellness areas where staff can access support when needed. Wellbeing and stress management, mindfulness courses, resilience sessions and counselling services are available to everyone working at The Countess of Chester Hospital, in addition to online Throughtools.apartnership with a neighbouring Trust, CoCH has also been trialling outreach psychological support for staff directly affected by Covid-19. Pilot initiatives included a peer support group and a one-to-one consultant psychotherapy assessment service for doctors, with plans to expand further to critical care staff.
Countess of Chester Hospital
Free virtual psychological wellbeing webinars covering resilience, mindfulness, sleep and understanding trauma were also made available.
Best Practice North West England
NHS Foundation Trust Bringing healthcare closer to the home Allowing people to access healthcare closer to home is an important part of reducing inequalities. Countess of Chester Hospital NHS Foundation Trust (CoCH) recognises this and is putting infrastructure in place to ensure this happens. A community diagnostic centre is being created at Ellesmere Port Hospital to enable patients to receive life-saving checks, scans and tests closer to their homes. It is one of 100 community diagnostic centres backed by government investment launching across England, to make services more accessible and convenient for Thepatients.Trustisalso working in partnership with Tarporley War Memorial Hospital to renovate and develop the facility which specialises in inpatient, intermediate care of the elderly.
15 Wellbeing and stress management, mindfulness courses, resilience sessions and counselling services are available to everyone working at The Countess of Chester Hospital, in addition to online tools. " Best Practice
Greater Manchester Mental Health NHS Foundation Trust Peer Support Workers
Additionally, activities have been introduced to help staff develop self-awareness about leadership behaviours. Overall, the trust has a culture that empowers, enables and promotes learning and sharing. To develop the leaders that are crucial to its performance, and future, it has a number of measures in place to support fair progression of staff. They include: Holding regular forums for senior leaders to collaborate on areas of business across the Encouragingtrust. senior leaders to engage with other health and social care leaders. Supporting new leaders through the allocation of a ‘buddy’ from a different area of the organisation to support the creation of lifelong networks. Promoting and engaging in the work of the NHS Leadership Academy and other organisations which support leadership skills and knowledge building.
It is also recognised by Health Education England as a training provider in this field. The trust currently has 34 peer support workers in post and 40 volunteer peer mentors. It is also a member of the National Peer Support Worker Apprenticeship Trailblazer Group and is currently developing a new career pathway for peer support.
GMMH has bespoke, targeted leadership development opportunities for BAME, disabled and LGBT workers. A future leaders programme, for talented staff to access, has also been developed, alongside a framework of support for future career mapping, linked to succession planning and appraisals.
GMMH has these roles, and a dedicated training programme for them, mapped to the National Peer Support Competency Framework.
At GMMH the peer support worker role provides opportunities for people with lived experience of mental health challenges. In the position, they use these experiences and empathy to support other people and their families receiving mental health services.
Activities to ensure fair career progression
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GMMH has these roles, and a dedicated training programme for them, mapped to the National Peer Support Competency Framework. It is also recognised by Health Education England as a training provider in this field.
" Best Practice North West England
Internships for those with a learning disability Airedale NHS Foundation Trust runs a successful internship programme for students with learning disabilities.
Siddeqa Din from Keighley, is a graduate of the internship programme at Keighley College and now has a permanent job at the hospital, working 12 hours a week in the Therapies administration team.
Yorkshire and the Humber
“When I first started I was a bit nervous but excited to learn new skills and get experience of what it’s like to work in a working environment. I love learning new skills and meeting new people. I love my Airedale family.”
AGH Solutions lead on sustainable procurement for Airedale as well as other care organisations across West Yorkshire. The group works together to share good practice and lobby suppliers and the NHS Supply Chain to provide sustainable products and services.
27-year-old Siddeqa from Keighley started on the programme in 2019 and now works in the therapy administration team and has also helped with the Pride of Airedale awards event. She was herself nominated trainee of the year at the Siddeqaawards.says:
A supported internship is a type of study programme for young people aged 16–24 that have an Education, Health and Care Plan. The internship lasts for between six months and a year and is flexible to suit the young person and the employer. The students spend two days at work and have a job coach who liaises with staff, students and their parents and college and carries out regular reviews on their progress. The internship increases the students’ confidence and helps them gain fantastic people skills and experience.
Best
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Airedale NHS Foundation Trust
Using procurement as a force for good The NHS is responsible for 5% of the UK’s carbon emissions and 3.5% of all road travel, so buying sustainably has never been more important.
With 60% of NHS carbon emissions coming from the supply chain, the NHS are looking at ways to reduce purchasing in the first instance. The group’s achievements include implementing sustainable systems such as Warp, which creates a convenient marketplace allowing teams to find used and surplus equipment from other trusts, free of charge. They also work together on behalf of all Trusts and organisations to reduce duplication, allowing the group to request suppliers sign up to a clean air commitment and only have to be asked once by all care organisations in West Yorkshire.
The internship increases the students’ confidence " Practice
Siddeqa also has advice for any new interns: “Take your job slow and don’t rush too much. If you’re stuck, you need to ask someone and learn. When I first started I asked people for help; they are all very nice people.”
The group meet regularly to share ideas and agree a Green action plan and also have inspirational guest speakers to promote sustainable services and ideas, such as NHS Ocean, who are a group of motivated individuals from healthcare, environmental health and marine science who work to ensure ocean health is considered and where appropriate included within healthcare strategy.
How long have you been a mentor? I have been informally coaching and mentoring for years. In 2021 I undertook the level 5 training in coaching and mentoring. That was brilliant and gave me a whole new skill set. Importance of being a mentor? I feel coaching is more important than mentoring. Coaching is where we sit and listen, believe in the power of the coachees to find their way to achieve their own goals. Through prompts, active listening, reflective questioning and use of simple tools we can help people to find their way through and find solutions that work for them. Also being a coach is a short term relationship aimed at creating independence, not dependence. We give people the tools to find their own solutions. We can move into mentoring (imagine they are 2 ends of a scale, rather than 2 separate disciplines). But it’s important to allow the coachee to make the choice, for example ‘I have some past experiences in this area you may find useful. Would you like me to share them now’
18 Best Practice Yorkshire and the Humber
The first clinic had an 83% success rate and all those who had the first vaccine came to the second clinic, which had a 100% success rate.
The importance of mentoring CHFT runs a mentoring scheme to enable staff to progress in their careers. Below is an interview with one of their mentors.
Calderdale and Huddersfield NHS Foundation Trust
CHFT worked in partnership with both Kirklees and Calderdale community learning disability health teams (South West Yorkshire Partnership NHS Foundation Trust) to identify who would benefit from such a bespoke service. As part of the process the Trust: Adopted paperwork developed by another Trust for capacity and best interest documentation.Createdasocial story to help people prepare with photos of the building, car park, rooms and the staff who would be at the clinic on the day to help reduce anxiety and fear. Held it on a Saturday when the hospital is much quieter and car parking was available. Made a bespoke plan for every individual to meet their needs, which included distraction techniques, including listening to Abba and Cliff Richard on YouTube. Set up the lecture theatre so it was like going to the movies with the Greatest Showman playing and snacks which included popcorn and chocolates.
Calderdale and Huddersfield NHS Foundation Trust (CHFT) hosted two special vaccination clinics at Calderdale Royal Hospital during the pandemic for people with a learning disability.
What makes a good mentor? A good coach –listens, believes in the power of the coachee (and absolutely believes in the individual in front of them), uses silence to give the coachee time to consider, engages in coaching themselves (ie is committed to the practice and believes it works for them aswell as everyone else). Holds the coachee to account to make progress on their goals. Has regular supervision for themsleves to ensure they keep learning. Also enjoys meeting people, is curious about others. Remembers the tough times in their own career and now wants to be the person they would have wanted alongside them in that moment.
Equal access to services
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...help people to see what energises them and where their skills are.
Best Practice Yorkshire and the Humber
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Most significant impact on mentoring? Well, the lightbulb moments of course stay with you. I remember quite a conversation that went like this: Coachee – everyone will think I’m rubbish at my job Me – Everyone? Coachee – Yes Pause – silence Me – who’s everyone? Coachee – you want me to name them? Me – Yes Pause – silence, coachee starts to talk, another silence Coachee – well I can’t think of anyone Me – No one Coachee – no one. I’ve gone through all my colleagues and none of them think I’m rubbish at my job
The coachee went on to describe this as a lightbulb moment that lifted things off their shoulders. I was incredible what they achieved. How do you encourage innovative ideas? It often involves the use of tools. Perhaps a questionnaire on a topic (for example a skill they want like handling conflict, or knowledge they want like where to go in their career). This gives a stepping off point for a conversation. A really simple question give me an example of when something went really well, what did you learn. When something didn’t go so well, what did you learn. What did others do around you? It’s often enough to unlock thoughts, help people to see what energises them and where their skills are. Who are you currently mentoring and the work you are doing? (Please feel free not to use names!) a colleague who came into the trust as a trainee, achieved a supervisory post and is now on a development programme and thinking about ‘what next at work’. Another colleague, more experienced, who took on different and additional responsibilities during covid and really found her voice at work. Trying to work out how to hold that and be resiliant going forward. Such a privilege to work with them both. I am learning all the time as you see how differently we all think. There isn’t ever a ‘right’ way. There are always choices. What's the best advice you can give to help plan a career rather than simply work to keep a job? Stay curious and open to new opportunities. Learn new skills. Focus on what people can do, not what they can’t do (including yourself).
Humber
Since opening in July 2018, the facility has contributed to a three per cent reduction in emergency hospital admissions for patients aged over 80, while saving an average of £100 per patient per year on medication costs.
The service is also piloting a new school readiness project - Big Hopes, Big Future - an evidencebased intensive support programme targeted at vulnerable pre-school children to improve their readiness for school.
The Every Mum Matters campaign in Hull, East Riding of Yorkshire, North Lincolnshire and North East Lincolnshire supports new and expectant mums and their families to be able to recognise symptoms of perinatal mental health problems early and encourage them to seek help quickly. Specialist services and support are available in these areas.
Hull Maternity Voices Partnership
Best Practice Yorkshire and the
Patients identified at risk of severe frailty are invited to a half-day appointment at the centre, where they receive several multi-disciplinary reviews of their care. Prior to their visit, a member of the clinical team visits the patient at home to identify any issues about their health, social interaction or day-to-day living they wish to discuss with the team.
A standout case study which underlines Humber & North Yorkshire Health and Care Partnership's ‘live well, age well’ vision is The Jean Bishop Integrated Care Centre. It represents a new approach, developed by ICS partners, in providing anticipatory, integrated out-ofhospital care for Hull’s frail, elderly population.
The MVP is made up of over 40 members, including local mothers, CCG commissioners, healthcare professionals, Local Authority leads and representatives from the community and voluntary sector. The programme includes perinatal mental health, health promotion and prevention and safer maternity care. This work interfaces with the Local Authority-led First 1001 Critical Days partnership strategy that ensures the best start in life for the next Home-Startgeneration.Hull is a voluntary organisation offering both practical and emotional support to families with at least one child under five living in Hull. The family support service promotes parental confidence and improved outcomes for children.
The Hull Maternity Voices Partnership (MVP), working as an integrated system, ensures women and their families receive safe, high quality maternity care from pre-conceptual planning to care in the postnatal period.
The Jean Bishop Integrated Care Centre
Humber & North Yorkshire Health & Care Partnership
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The ICC team includes GPs, community geriatricians, pharmacists, advanced practitioners, social workers, carers and therapists who link up with other community speciality teams. The team also provides an outreach service to care home residents. After their assessment, a care plan is shared electronically and coordinated by an identified care coordinator. If the patient’s condition changes, a model is in place within primary care to ensure patients and their carers receive the care and support they need.
Community Outreach Team in areas of lower uptake and most vulnerable communities including minority populations, Best Practice
Working in close collaboration with a range of partners including both Local Authorities and the military, the Vaccination Team utilised three vaccination buses to help them to respond to the fast- spreading omicron variant during the Booster Sprint in December 2021.
Residents were targeted in Telford and Wrekingby: Sending texts to residents in target areas to make them aware of when the vaccine bus was Outboundcoming.calling to residents in the lowest uptake Targetedareas.social media messages to residents in low uptake areas. Requests to Town and Parish Councils, ward members etc. in low uptake areas to promote via their channels
The Midlands
The vehicles were sourced and repurposed into mobile vaccination units with changes such as privacy screens, power connections and heating added to allow NHS teams to set up the clinics wherever they parked. The buses, affectionately named Bob, Betty and Basil, have been run by a variety of staff including the Council, the military, NHS staff and volunteers.
All staff members have gone above and beyond, working weekends and holiday periods to ensure its efficient running and as part of the effort to get the vaccine to as many people as possible by the New Year.
How it worked
Shropshire Community Healthcare NHS Trust is the Lead Provider for the Shropshire, Telford and Wrekin Vaccination service and works in partnership across all health partners and with Local Authorities to deliver a highly successful Covid Vaccination Programme across its conurbation, which is both Rural and Urban. Below are two examples of how the Trust is tackling health inequalities.
programmeHowHealthCommunityShropshireNHSTrustShropshire,TelfordandWrekinvaccinationistacklinghealthinequalities
This intelligence-led approach allowed locations to be selected where Covid vaccine uptake was lowest, through community engagement either via direct contact, community-focused communications or both. Areas targeted were amongst the most deprived and ethnically diverse communities in the county.
Using a combination of data and insight –backed up by a comprehensive and imaginative communications campaign that included tailored text messages to unvaccinated patients, and calls to residents encouraging them to get their jab – the Vaccination Buses have improved access to vaccination. This was particularly effective in the county’s most disadvantaged, diverse and rural communities, significantly increasing the number of vaccinations delivered to these groups of people.
Residents were targeted in Shropshire by: Outbound calling to vulnerable residents flagging vaccinations and other available support. Targeted social media messages to residents in low uptake areas.
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Case study 1: Project/initiative Shropshire, Telford and Wrekin Vaccination Team has come up with a novel and highly effective solution to help address low vaccination uptake in some of its most vulnerable communities, tackling health inequalities with three Vaccination Buses – Bob, Betty and Basil and targeted community engagement.
This initiative has clearly narrowed the vaccinerelated inequalities in Shropshire, Telford and Wrekin, particularly with respect to an increase in first doses, as well as reduced the number of unvaccinated people in the most disadvantaged areas and among ethnic groups where uptake wasAnlowest.impressive
22 farming communities, and targeting working places, alongside specialist Gypsy and Traveller Team and Business support teams. Targeting large employers of our Eastern European populations by taking the bus to them and translating materials.
The challenge
Also of note is uptake of vaccine amongst people who are immunosuppressed (3rd in the country), pregnant women (best in region) and people with learning disabilities and autism, with bespoke clinics being provided for these groups.
Personal case study
A requirement for vaccination clinics in
Best Practice The Midlands
Quieter clinics with no queuing (families, carers and health professionals) or busy Dedicatedrooms.waitingtime slots or personalised appointment times, with plenty of advanced notice to allow for forward planning.
85% (+49.5%) of over 18-year-olds had come forward for their booster vaccination. There was also an increased uptake of first (+1.8%) and second doses (+5.2%) of COVID-19 vaccination since the booster sprint, with 81.6% of the eligible population receiving both doses.
People with learning disabilities and autism have been disproportionately affected by the Covid-19 pandemic. To help ensure that this gap was reduced in Shropshire, Telford and Wrekin the vaccination programme have co-produced a Covid-19 accessible vaccination pathway, making reasonable adjustments that aim to help increase vaccine uptake to this cohort.
The ethnicity gap narrowed by 0.4% for 1st dose, 1.5% for 2nd dose and 2.9% for boosters (white v all BAME groups) 1st dose deprivation gap narrowed by +0.14% (most deprived v most affluent) 1st dose uptake of people with COPD (97.1%)
Impact
A point of contact to ask for any reasonable adjustments (email or phone number) i.e. long appointments, help addressing needle phobia concerns, personalised support etc.
Recognising that busy, noisy and fast-paced vaccination clinics are not always the ideal environment for people with learning disabilities, the trust conducted stakeholder engagement. The engagement helped identify barriers to attending clinics or having a vaccination, gaining a better understanding of any reasonable adjustments or improvements that could be made to the service delivery model with the ultimate aim of increasing vaccine uptake amongst this group.
Through stakeholder engagement and research undertaken, the Trust identified there was a need for:
Establishing accessible clinics – two clinics in familiar settings were made available, one in Shropshire and one in Telford and Wrekin. Each setting had a dedicated room for an accessible vaccination clinic with its own entry/exit, dimmer switches, good acoustics, temperature control, sensory equipment etc.
> Short video to talk people with Autism through what will happen during their Covid- 19 vaccination
> Mary, Elliot and John share their experience of the impact of vaccination at Oak Tree Farm and the benefits of the COVID vaccine
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Accessible information throughout with short clear instructions, using threeword sentences.
THE IMPACT
Examples include bespoke clinics for people with learning disability and autism which were designed from engagement and feedback from service users. This adaptation and constant evolvement of the programme has ensured the trust is always improving patient experience and maximising uptake. "
The Aftersolutionlistening to patients with learning disability and autism, their carers and experts, Shropshire, Telford and Wrekin Covid-19 vaccination service made the following changes: An email helpline was made available for patients/carers for initial discussions with the Covid-19 vaccination service.
communication with tailored information through a range of media including films:
Promotion of clinics was done via local authorities, local voluntary and community organisations, local family and carer networks by sharing a communication toolkit and flyers etc. Clinics also promoted on social media, media and the ICS/CCG Targetingwebsite.
Clinics are appointment only, with plenty of time per appointment to allow time for reassurance/discussion and ensure no queues/social distancing etc.
Social stories to explain what will happen.
Knowledge and feedback from service users, carers and/or specialist groups has been key to shaping the vaccination delivery model. Examples include bespoke clinics for people with learning disability and autism which were designed from engagement and feedback from service users. This adaption and constant evolvement of the programme has ensured Shropshire Community Health NHS Trust are always improving patient experience and maximising uptake.
> Josh shares his experience of having the COVID vaccine
Best Practice The Midlands settings that are familiar to people with learning disabilities and autism. Alternatively, if possible, taking the vaccine to people rather than asking them to come to vaccine centres.
Data showed that only 10% of those discharged from hospital with a diagnosis of COPD accessed pulmonary rehab, this triggered a review by the Physiotherapy department to better understand the reasons for this. Using the QOF data which looked at rates of COPD per 1000 population, derived from the Trust strategy unit review of respiratory care and equity of healthcare provision undertaken in March 2021, it was noted there was a significant difference in prevalence within the Stratford district with higher rates in the population residing in more rural areas. This led the team to consider that historically pulmonary rehab had been delivered in population hubs which may have been difficult to access from a rural area, thus increasing health inequalities when accessing services.
Best Practice The Midlands
South Warwickshire NHS Foundation Trust is passionate about addressing health inequalities in their service provision and have recently been allocated national funding from the Respiratory Network to support this.
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The model subsequently developed by the physiotherapy team seeks to address this issue, using a two pronged approach. Firstly, the team will go into GP practices offering 1:1 consultations with those identified as requiring pulmonary rehab – baseline tests such as lung function tests could be performed and this approach would also give the patient the opportunity to ask any questions and address any concerns to improve uptake of pulmonary rehabilitation. Secondly, the pulmonary rehab classes would be located within the PCNs either in GP surgeries or local community premises, bringing care directly to the individuals. This multi-faceted, person centred approach is an excellent example of how the Trust are seeking to address health inequalities in South Warwickshire by using data to identify a need for its population and develop a strategy and plan to address it.
Given the current cost of living crisis and rise in fuel rates, this has the potential to impact further on access.
South Warwickshire NHS Foundation Trust Addressing Health Inequalities in Pulmonary Rehab
The team now take up to 10,000 calls a month, have implemented a text messaging facility which saved between 2-3,000 outbound calls a month, and in 2019 were joined by the Integrated Care Coordination team (ICC) who clinically triage all of the community services who require an urgent or same day response. Both teams promote a change culture which has seen them be instrumental in supporting the out of hospital programme team with rolling out telehealth monitoring initiatives including MySense and DOCOBO, which have given us the opportunity to reach service users in a different way during challenging periods. The iSPA and ICC teams have supported the enrolment of more than 2,000 patients in care homes onto the DOCOBO app, giving care homes both more options in terms of how they connect with us and a way for them to quickly alert our services, their GP or the ambulance service if they are concerned about a resident.
The iSPA team are keen to continue to bring in more interactive services and systems to provide a smart and efficient service and ultimately offer an improved and differentiated way of accessing our services for our population.
" Best Practice The Midlands
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The iSPA is also supporting the roll out of DOCOBO at home with an initial cohort of 200 patients, enabling them to enter their own sats which are then monitored daily by the ICC team so the correct level of interaction can be actioned by offering trusted clinical advice or allocating directly to a clinician to complete a visit if required.
Warwickshire’s Integrated Single Point of Access (iSPA) South Warwickshire NHS Foundation Trust operates an iSPA, a telephone and email service where patients, carers and all health professionals can ring in and refer to Theservices.iSPAhas been on an incredible journey over the last 3 years and is a shining example when an organisation thinks differently and is willing to try new things, it can overcome challenges and deliver innovative solutions.
Pivotal to the success of the service has been contact centre manager Riyaz Kathawala; Riyaz joined the Trust in 2018 from a banking background and set about revolutionising the service by introducing quality measures similar to those seen in the banking sector’s contact centres and helping to build an environment promoting a sense of belonging for the team.
The iSPA team are keen to continue to bring in more interactive services and systems to provide a smart and efficient service and ultimately offer an improved and differentiated way of accessing services for the trust's population.
Teaching resources were left in every school and all classrooms had a QR code poster for easy access for teachers to be able to explore further information or download resources.
Toothpaste was also delivered to several charity groups, including The Macari Centre, House of Bread in Stafford and Foodbank Stoke who all support the most vulnerable members of the community.
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“We have really enjoyed delivering the pilot KSS project and the Trust would welcome a further discussion on how we can continue to provide key health education messages in the future.”
Each child completed post workshop surveys which proved they understood all the oral healthmessages with common comments being:
In just 10 weeks 33 oral health workshops were delivered in 25 partner schools, distributing bags to over 2,000 young local people. These figures would have been significantly higher without covid restrictions.
Adrian Hurst, Head of Community at Stoke City Football Club said: “We use a variety of the Football Club's assets and interventions to help transform the lives of (young) people both on and off the pitch.
The campaign has been so successful that it is now being replicated more widely across the country with Keep Britain Smiling. The campaign uses social media platforms - Instagram, Facebook, Twitter, Youtube and Tiktok - and celebrities such as Peter Crouch to get its message across.
‘I am always going to “spit and not rinse” ‘I am never going to take coke or lemonade, or milk to bed.’
The Keep Stoke Smiling campaign has been running since 2018 to combat the levels of tooth decay seen in young people across the region.
University Hospitals of North Midlands NHS Trust Keep Stoke Smiling
The UHNM Charity and Stoke City Community Trust partnered together to distribute thousands of tubes of toothpaste kindly donated by Colgate. Through education, over a 10-week period both charities set out to provide young people and the wider community within Staffordshire key information they need to make their own decision on what food and drink they consumed, and how it can have a positive impact on their dental health for life.
The first part of the project was focused on educating Key Stage 2 pupils in North Staffordshire schools about the importance of dental health. This was achieved through workshops in local schools led by UHNM Consultant Orthodontist Karen Juggins.
‘I am 100% never, not ever “going to drink red can coke”.
In 2021 a pilot campaign was run as part of Keep Stoke Smiling to create a fizz free culture within schools in the region.
Best Practice The Midlands
Case study - Project SEARCH
We have seen his confidence grow and develop over the last few months, along with his general ability and his interpersonal skills.
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Best Practice The Midlands
Interns complete three different work placements over the academic year (one per term), and are greatly supported by their teams and supervisors onsite. Since the start of the programme in 2018, UHNM has supported 26 young people with special educational needs and disabilities on-site, including through the difficulties of the pandemic and subsequent educational lockdowns. So far, 17 students have graduated, with a further 7 on the current programme.
Project SEARCH
Whilst the majority of students have successfully secured paid employment, UHNM has also supported others into further education or voluntary roles, according to their personal circumstances.
William Nock, one of the youngest porters in the trust, took part in Project SEARCH with his twin brother Conrad. Louise Durose, Portering Manager, said: “As a result of the Covid-19 pandemic, William saw his internship interrupted back in March, but he returned to site in June as a fully-fledged member of staff. He has worked throughout this difficult time and has had such a positive impact on all who have come to know him. We have seen his confidence grow and develop over the last few months, along with his general ability and his interpersonal skills. He is a bubbly, caring and compassionate member of staff and a pleasure to work with.”
UHNM is open to any young person aged 18-24 with an Education, Health and Care Plan (E.H.C.P). Prospective students are identified by local education providers, or can apply independently. Students work in non-clinical support roles, such as portering, retail, catering, domestics and UHNMtransport.provide a classroom base and staff facilities, where students are based Monday to Friday, with their teacher and job coach. Students spend 45 minutes every morning studying functional English and preparation for adulthood. After completing their initial UHNM and departmental inductions, students spend from 10am – 3pm in their supported internship placements, with their ‘buddies’ from UHNM and Sodexo; these are staff who have been specially selected to help students learn the job roles, and model expected work behavior. Interns and buddies are supported by Newfriars staff throughout the week. Interns return to the classroom base each day from 3pm-3.30pm, for a de-brief, where they can reflect on their day and discuss their progress, or any concerns they may have.
The Talent for Care Team supports staff across ESNEFT and promotes career opportunities within ESNEFT and the NHS. The team participates in outreach work with local education institutions. The team introduces the idea of careers in healthcare to children as they approach choosing GCSE or leaving school and going into employment.
The CDC includes X-rays and ultrasound scans, blood tests, physiological measurements, pathology, and endoscopy services. This Community Diagnostic Hub improves health inequalities by providing a better experience for patients, reducing waiting times and providing greater availability of, and access to, care.
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Best Practice
The Talent for Care team explores which apprenticeship is most suitable for staff and will help to develop a career.
East of England
The team introduces the idea of careers in healthcare to children as they approach choosing GCSE or leaving school and going into employment.
Trust Talent for care team
Community Diagnostic Centre ESNEFT opened an early adopter Community Diagnostic Centre (CDC) at Clacton Hospital in Tendring. Clacton was chosen as a location because it combines high deprivation with high population density (it is home to the most deprived neighbourhood, Jaywick, within Suffolk and North East Essex). CDCs provide a broad range of elective diagnostic services away from acute facilities, providing easier and quicker access to tests and greater convenience to patients.
East Suffolk and North Essex NHS Foundation
The Talent for Care Team enrol staff members onto a huge variety of apprenticeships. These include an annual Nurse Degree 'top up', ODP, Healthcare Assistant Practitioner and ACP cohorts, as well as new apprenticeship opportunities being explored.
ESNEFT are in the process of becoming an apprenticeship training provider, enabling the trust to develop its own bespoke programmes for a range of different apprenticeships.
A total of 1,500 local people have accessed work at the trust and nearly 10% of staff have come through the Community Works For Health programme. This has allowed them to get jobs they probably would not have been able to access without the programme.
The programme has continued its effort to capture quality candidates from the east London catchment areas by working closely with key referral and training partners from core areas: Newham, Tower Hamlets and Waltham Forest.
“My first placement was in the medical records department. I have unique skills with numbers, and I wanted to work here with the records. Project SEARCH eventually helped me get that job.
The Community Works For Health Programme at Barts Health supports local people into lower banded roles. The programme works through: A talent pool approach for local job-ready candidates who are primed to apply for Band 2-3 positions. Providing an apprenticeship route for younger candidates who can apply for a minimum of a 12 month position whilst working towards a learning framework.
Tyeres Sule started his Barts Health NHS Trust journey as an intern at Newham Hospital via DFN Project SEARCH. Before starting the project, Tyeres held a qualification in electrical engineering, a field he was keen to explore further. He needed support, however, and his advisor at Newham’s workplace team suggested joining DFN Project SEARCH.
Project Search As part of the Community Works For Health Programme, the trust supports initiatives such as Project SEARCH - an employment scheme for young people with severe learning disabilities.
COVID-19 delayed the start of the role, yet he stayed positive and engaged by creating a routine for himself. He continued revising theory as well as developing mock circuits to practice with electricity flow at home. Tyeres is now an electrical craftsman apprentice; working while studying one day a week on a level 4 electrical course.
All candidates pass functional skills assessments at NHS Information Days and then receive additional pre-employment training if necessary.
Aqib, another DFN Project SEARCH participant, began working at Whipps Cross Hospital in 2015 as a health records clerk. He describes the project as “life changing”; helping to build his confidence and overcome barriers. “I learnt about the hospital and departments through my placements” he says.
“Project SEARCH was life changing for me. Before the programme I didn’t speak with anyone unless I had to. I wasn’t confident enough.” Best
Barts Health NHS Trust Community Works For Health Programme
Tyeres then started rotational working within the estates department, initially assisting with small tasks around the hospital. Tyeres stood out as a motivated, hard-working individual with a positive outlook. His role saw him start earlier than other interns to check the alarms, air conditioning and boilers serving the entire hospital. His team, and particularly the manager of estates, were so impressed with his dedication and commitment that they decided to create a position for him where he could be a permanent member of the team, with the opportunity to progress into a managerial role.
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A workforce reflective of the local community is one that has a higher retention rate and one that has a greater understanding of local dynamics and needs.
LondonPractice
NELFT offers a number of volunteer and work experience programmes, as well as a full range of apprenticeships and Final Student Placement Programmes, through collaboration with the National Apprenticeship Service, further and higher education Institutions and professional bodies.
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BestLondonPractice
Through partnerships with local colleges, the trust aims to engage with and recruit young people and identify ‘hard to reach’ demographics.
North East London NHS Foundation Trust
The staff working at the hospital came from a range of backgrounds, with 41 percent living in areas within the lowest three Indices of Multiple Deprivation. Fifty percent of staff were black, asian or minority ethnic and 57.4 percent were female. Fourteen percent were not in employment or training before they joined the NHS Nightingale Hospital London.
Half of these staff reported that they were more likely to remain in healthcare following their experiences of working at the hospital. Three quarters of the workforce reported that they were interested in further training, development or career opportunities in health and social care after their Nightingale experience and a significant number registered to complete the Care Certificate with NELFT.
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Pandemic response North East London NHS Foundation Trust (NELFT) significantly increased the size of its bank of temporary staff during the pandemic to meet the requirements of the NHS Nightingale Hospital London and the mass vaccination sites. Several of these individuals have been able to take up substantive posts or clinical apprenticeships within NELFT.
Through partnerships with local colleges, the trust aims to engage with and recruit young people and identify ‘hard to reach’ Itdemographics.hasnowtrained over 100 Health Ambassadors, as part of its schools and colleges outreach work and is beginning to work with Care City. This project has delivered 21 virtual and face to face careers events, including a virtual careers week, supporting 1,600 participants to consider future careers in health and social care. To date it has recruited seven young people to the Young Persons Panel and held three employer engagement workshops.
Varied paths into job opportunities
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Enabling values-based Leadership and Management development at all levels is one of the core priorities set out in the trust’s Education and Training Strategy. In line with this, The Royal Marsden offers a wide range of management and leadership programmes to support the development of those in more senior roles. The offer includes short courses, individual modules and accredited programmes, with different initiatives aimed at aspiring managers, future leaders, first line managers, middle managers, senior managers and senior leadership teams. These leadership and management development pathways help staff explore development opportunities available to them at The Royal Marsden.
The Royal Marsden NHS Foundation Trust has invested in a career development platform, which is open to all staff members and includes comprehensive career pathways for each professional group, as well as hundreds of training resources focused on enhancing soft skills.
The trust has created new posts such as Nurse Assistants, that bridge gaps and allow for career progression for entry level healthcare professionals, as well as supporting a small number of healthcare assistants to achieve their nursing degrees whilst still in employment. Coaching and mentoring Coaching or mentoring for all staff at the Royal Marsden is offered through a network of internal coaches and mentors and it also supports staff in finding mentors outside the organisation. In 2021/22 14 staff took part in mentoring and 26 undertook coaching.
The Royal Marsden NHS Foundation Trust Ensuring fair career progression
Alongside this, a number of professional career pathways enable staff in a range of professions to view the future options for career progression that are available to them.
While establishing internal coaching, mentoring and shadowing programmes, the Trust sought expressions of interest directly from staff in underrepresented groups via its various staff networks. Refreshing its coaching and mentoring offer enabled several staff to access opportunities, with 45 per cent of the applications received coming from black, Asian and ethnic minority staff. It also regularly promotes opportunities, both within the trust or externally via regional networks, such as the NWL BAME Nurse development programme.
It provides funding to create new jobs for people aged 16 to 24 on Universal Credit trying to find work. Job seekers meet up with staff managing the programme from the trust who place them into roles in any service that matches their career goal or just something they show interest in.
Sussex Community NHS Foundation Trust
Key to the Trust’s progress has been the development of its new Care Without Carbon Sustainability Strategy (Green Plan), approved by the Board in Sept 2021. It sets out how it will continue to meet the Trust vision to provide excellent care at the heart of the community, in the context of climate change.
Sussex Community NHS Foundation Trust is part of the Kickstart Scheme run by the Department of Work and Pensions and the Job Centre to get young people into jobs.
It has recruited six people substantively: a nursery nurse, three in our People team, one as a Care Support Worker and one in Facilities, and there are plans to increase the scheme significantly.
South East England
The vision of Care Without Carbon is: ‘together we lead the way in Net Zero Carbon healthcare; protecting the environment on which our health depends’.
So far in 2022, the Trust has offered fixed-term contracts to 19 members of staff through this scheme, which has included roles in estates, finance, the nurseries and e-rostering.
As a leader in the sustainable health and care sector, Sussex Community NHS Foundation Trust is committed to meeting the ambitious NHS England Improvement (NHSEI) targets, and where possible, exceeding them.
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Kickstart Scheme
Care Without Carbon ‘Care Without Carbon’ is Sussex Community NHS Foundation Trust’s sustainability strategy to reduce carbon emissions.
An interim target of 57% CO2e reduction by 2025/26 has been set. Delivering on this strategy will drastically reduce the environmental impact of the Trust and also deliver real health benefits to our patients and the wider community.
The Trust will bring its direct emissions (NHS Carbon Footprint) down to Net Zero Carbon by 2040 and its indirect emissions (NHS Carbon Footprint Plus) to Net Zero Carbon by 2045.
Participants are given a 25-hour per week, six-month fixed-term contract. They can move teams while on placement to learn a variety of skills and experience different jobs. At the end of the placement, while they are not guaranteed any sort of employment, they are guaranteed an interview if they apply to a vacancy in the trust.
At the heart of the Care Without Carbon framework are its Sustainable Healthcare Principles – Healthier lives; streamlined processes and pathways; and respecting resources.
The Trust is delivering this through its eight workstreams in areas such as energy use, transport and waste, and also in the clinical decisions made within the organisation.
The Trust is now working up a new heat pump project for the site to replace the existing gas Continuedboilers.to purchase 100% renewable backed power, using only ‘clean’ renewable power – i.e. electricity from hydro, solar and wind Betweenonly.2010-11 and 2021-22 the Trust has reduced its absolute carbon footprint by 3,993 tonnes CO2e. This is a 41% reduction against the 2010-11 baseline and puts it on a trajectory to meet its 25/26 target.
The vision of Care Without Carbon is: ‘together we lead the way in Net Zero Carbon healthcare; protecting the environment on which our health depends’. " 1. Between 2010-11 and 2021-22 the Trust has reduced its absolute carbon footprint by 3,993 tonnes CO2e. This is a 41% reduction against the 2010-11 baseline and puts us on a trajectory to meet our 25/26 target.
In relation to the element that focuses on energy use and buildings, the TrustInstalledhas: a 55kWp solar array on the roof of the Chailey Westfield building to support the net zero ambition for this building.
South East England
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Proposed Outcomes
The aim of the Community Chaplain role is to provide advice, guidance and leadership in the Local Implementation Groups; signpost staff and clients to spiritual, pastoral and community support close to home; and support clients directly within the local community. Chaplains are uniquely placed to be able to deliver for CMHF – built upon their years of experience developing relationships with community leaders, charities, different faith groups and community special interest groups.
Devon Partnership NHS Trust
Best Practice South West England
If our Pilot is successful we would anticipate being able to provide evidence that: Where Chaplains have engaged with clients referred to them, the number of readmissions into our services might have been Colleaguesreduced.inLITs, PCNs, and other frontline professionals are personally seeking the chaplains’ advice and expertise in supporting their clients and outreach initiatives. We receive increasing numbers of referrals of community clients to us for pastoral and spiritual support. We can evidence ways in which we have helped to embed clients into community support groups – be it of faith or other nonreligious, special interest groups. We have shared our findings with peer Chaplaincy Departments across the Country for critical inspection.
Chaplaincy within the new Community Mental Health Framework Devon Partnership NHS Trust’s Chaplaincy department was created in December 2019.
We spent the first two years building capacity to provide a chaplaincy presence on all of our inpatient wards – a mixture of staff and badged chaplaincy volunteers.
We are developing a pilot to engage within community services, as part of the new Community Mental Health Framework (CMHF). The project, which we believe will be of national significance, aims to place chaplains in the frontline of pastoral support for our community clients. The service will develop to work with the core leadership of the Voluntary Alliance across Devon, the Locality Implementation Groups and the PCNs to help create a seamless tapestry of support across professional and voluntary services.
It is vital that everybody, without exception, has access to services that support our holistic care of a person’s physical, mental and spiritual wellbeing. "
It is vital that everybody, without exception, has access to services that support our holistic care of a person’s physical, mental and spiritual wellbeing.
The success of the internship catalysed the Trust’s ambition to swiftly develop the Supported Intern to ‘Supported’ Apprenticeship pathway, as it was quickly recognised that internships
By ‘thinking outside the box’ the Trust’s Corporate Affairs team developed a supported internship for an excellent candidate, enabling the placement to happen fully remotely. Working ‘online’ met the needs of both the intern who suffers from significant anxiety, particularly around travelling, and of the Trust who could not readily support an intern on a Trust clinical site.
" do not have a seamless transition to further development and ultimately substantive employment. We felt uncomfortable to benefit from the skills and contributions of an intern, only to see their journey end after the unpaid Althoughplacement.seemingly a simple and obvious transition, the barriers that have been encountered to make this pathway a reality have been numerous and challenging; both internally and externally to the Trust. This leads us to be significantly concerned about how widespread the disadvantage for young people with additional needs is, preventing them from accessing further education and employment in a fair, equitable and accessible way.
Best Practice Supported Internship At Devon Partnership Trust Supported Internships have become a clear priority for the NHS in recent years. They are study programmes specifically aimed at young people aged 16 to 24, who have a statement of special educational needs, or an Education, Health and Care Plan (EHCP), and who want to move into employment, but need extra support to do so.
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The interns receive support from a job coach. As the interns develop their confidence, skills and knowledge, the job coach steps back gradually, as and when is appropriate to each individual.
South West England Supported Internships have become a clear priority for the NHS in recent years.
Working through each barrier logically, making contact with countless education providers and unpicking a number of Trust procedures and practices, we are hopeful we are about to secure our very first supported intern, into a paid apprenticeship role with us. We want to celebrate the amazing asset she is to our Trust. We are extremely proud of our intern, the skills and capabilities she has demonstrated to us, the patience she has exhibited and most significantly, her courage. But most of all we want to thank her for just how much she has taught all the members of her team – about care, compassion, inclusivity, tenacity and breaking down barriers. We owe so much to her for opening our eyes, individually and collectively, to a wider world of Wepossibilities.arenowambassadors to deliver change and to see our workforce evolve in the coming years with confident, valued and developed staff working throughout our services that have come through a supported internship journey.
Devon Partnership NHS Trust has had a Supported Internship programme in for three years. However, the impact of the pandemic prevented the Trust from placing interns, who were no longer actively engaged with their educational providers and weren’t able to come safely to sites easily.
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