Issue thirty three 1.1 MB PDF (new window)
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Issue thirty three 1.1 MB PDF (new window)
Winter 2013/14 Issue: 33 Speaking up for others INSIDE THIS ISSUE: • Nina meets Prince Charles • Taking play seriously • Annual Members’ Meeting • Advanced dementia care • Our plans for Queen Mary’s Hospital • Speaking up for others with learning disabilities Welcome Welcome to Exchange Andrew Mayor – Editor The transfer of Queen Mary’s Hospital, Sidcup to Oxleas is an exciting development that will give us many new opportunities to develop our services and provide more joined up care for local people. We are working in partnership with several other NHS organisations and believe that this marks a real turning point in the fortunes of a much loved local hospital. Following years of uncertainty about the future of Queen Mary’s, we have already put plans in place to spend up to £30 million in improvements to the site over the next three years. Of particular interest to many will be our plans for brand new state-ofthe-art kidney treatment and cancer units on the site. Queen Mary’s Hospital transfers to Oxleas On 1 October, Queen Mary’s Hospital, Sidcup, transferred to Oxleas. talking to volunteers in the Friends’ Shop in B Block reception area. Stephen Firn, our Chief Excecutive, visited the hospital on the day. He is pictured above left You can find out more about our plans for the future of the site on pages 20 and 21. Welcome | Oxleas Exchange | Winter 2013/14 Issue: 33 Outpatient services are also being reorganised so that people can access all the services they need from one convenient, central location. We look forward to seeing services at Queen Mary’s flourish over the coming years and will be be bringing you more stories about developments at the hospital in future editions of Exchange. If you would like to send us your stories or comments about Exchange, please get in touch by emailing us: [email protected] or you can tweet us: @OxleasNHS Andrew Mayor Editor 03 New cardiac service is a hit with patients From the cheerful mood, the upbeat music and the energetic activity on all sides, it was hard to believe that this was a class for people recovering from serious heart conditions. P art of the reason may have been that the Friday afternoon session, at Woolwich’s Waterfront Leisure Centre, is part of an expanded community cardiac rehabilitation service that we now provide in Greenwich. It may also be down to the expertise, enthusiasm and commitment of the team, who deliver an individualised recovery programme to patients following a recent acute coronary event or cardiac surgery. A successful bid was made to the British Heart Foundation (BHF) to fund a specialist nurse post in addition to one exercise and two nursing professional posts funded by Greenwich Clinical Commissioning Group. The BHF post means that the class, which has been running for around seven years, is now supported by two cardiac nurses. The team works closely with the Royal Borough of Greenwich’s Healthy Living Service and Greenwich Leisure Limited. When Exchange visited the class recently we met Sue Duggan, our BHF Cardiac Rehabilitation Specialist Nurse, who told us: “The class is part of an eight week structured exercise programme which consists of individualised and progressive exercise training. As well as an initial assessment we conduct mini health checks before, during and after the session to ensure everyone stays safe. This is important when you consider that someone may spend only two days in hospital following a heart attack and be here in the class four weeks later. The increased funding has enabled us to provide an enhanced service to patients. “The programme includes education about the benefits of regular physical activity, and support to assist clients to maintain a physically active lifestyle in the long-term. The education component includes relaxation sessions and talks from other agencies such as the smoking cessation team, the Greenwich Expert Patient FEATURE | Oxleas Exchange | Winter 2013/14 Issue: 33 Programme and Time To Talk psychological therapy service. An important part of my role is helping difficult to reach groups such as the elderly, housebound and some ethnic minority groups to access the service and we offer greater support for patients through more home visits and telephone consultations for example.” Louise Barnett works for the Royal Borough of Greenwich’s Healthy Living Service and led the class through the various exercises. She said: “It’s really great that Oxleas has enabled us to deliver a comprehensive cardiac rehabilitation service. The team has expanded and we now have resources we didn’t have before. In addition to exercise, we’re now able to offer people access to psychological support and an education programme encompassing advice and support on how to make lifestyle changes to improve cardiac health.” Barely seven months after his heart attack and five after bi-pass surgery, 54 year old John McAteer is back at work. Remarkable enough, but John lays asphalt for a living. Originally from Glasgow, John has lived in Greenwich for 30 years. He said: “This is my final session and I can’t believe how well I am. The staff have performed miracles on me. Before I came to the class, health professionals told me what I couldn’t do, how careful I had to be. I thought I wouldn’t work again. But here they answered my questions and told me all the things I could do. Thanks to them I was able to speak to a dietician, a psychologist and a senior cardiologist. Now I eat more healthily, I’ve bought a mountain bike, know how to exercise safely and how to recognise signs of tiredness in my body. My goal was to get back to work and I’ve achieved this.” With six grandchildren and one great grandchild, 62 year old Charlton resident Bella Parish said she has everything to live for but was shocked by a heart attack which came out of the blue in April: “It was very scary – I felt isolated and lost my confidence. Coming to the class has brought my confidence back and I feel fitter. The staff have been wonderful – they help me to be more aware of my body and explain things in a down to earth way that’s easy to understand. Coming to class has been so worthwhile – it’s like a social gathering, a shared supportive experience which I’d recommend to anyone.” Photographer: Tom Latcham, 2013 Photo: Sue Duggan checks Vasif Mustapha’s pulse | 05 News Specialist Bexley children’s services join Oxleas A range of specialist children’s services joined us on 1 October in a move that we think will see more joined up care for children and their families. Nina Turner, second from right, with the Prince of Wales and other Nursing Times nominees High praise indeed for award winner Nina One of our nurses met the Prince of Wales recently and was singled out for praise by him. Later on she won a prestigious Nursing Times Award at a top London hotel. Not a bad day for Senior Nurse, Nina Turner. Nina was invited to a reception at Clarence House on 30 October where she met Prince Charles. She represented an Oxleas team which included Pulmonary Rehabilitation Lead Physiotherapist, Helen Jefford and fitness instructors at Maidstone Prison. They picked up the top prize in the Respiratory Nursing section. Nina said: “I can’t believe we’ve won. It was awarded to me, Helen and all the fitness instruction team at Maidstone. “In the evening one of the judges at the Grosvenor House Hotel said that our work was really inspiring.” Nina and the team’s work believed to be unique in English and Welsh prisons - is aimed at improving the health of prisoners through pulmonary rehabilitation. It aims to bring the treatment of prisoners in this field up to that of patients in the wider community. The project is being run at Her Majesty’s Prison Maidstone in NEWS | Oxleas Exchange | Winter 2013/14 Issue: 33 Kent. It involves patients that suffer from chronic obstructive pulmonary disease. The Prince of Wales said that those nominated for the awards, in 19 categories, are making a “tangible difference’’ to people’s lives, singling out Nina about whom he said: “Nina only qualified three years ago, but she has worked to ensure that the prisoners in her care have access to screening, diagnosis and a pulmonary rehabilitation programme, all steps towards improving the care of prisoners with chronic lung disease.” Head of Bexley Specialist Children’s Services (SCS), Ann Lane, told Exchange how she felt about joining us: “I’m absolutely delighted. Bringing all the children’s services together under one organisation is the most positive thing that could have happened. Children with complex needs have to access lots of services. For patients and families it will mean greater clarity of care pathways. The services that joined us include: • Children’s Community Audiology Service • Community Paediatrics Service • Children’s Community Nursing Team • Children’s Occupational Therapy Service • Children’s Physiotherapy Team “ Bringing children’s services together is the most positive thing that could have happened. ” “We can also plan joint visits or appointments. We will be working closer with CAMHS (child and adolescent mental health services) and the local authority too, further widening the circle of professionals.” Seven year old Zoe from Bexleyheath enjoying an occupational therapy session • Children’s Speech and Language Therapy Service. • Children’s Community Audiology Service. Ann explained how children come to the SCS: “Typically staff are alerted that a baby from the borough has been born with complex needs and the community paediatricians and community nurses will link up with staff at a specialist hospital and start planning for discharge. Other children come to the service when they develop complex conditions.” Caroline Chummin, Manager of the Children’s Community Nursing Team, said: “We felt a bit separated from health visitors and school nurses before and are very happy to be able to work more closely with them and other colleagues now. We are also happy to work within a communityfocused trust.” Ann said: “I look forward to working with our new colleagues to continue to provide the best quality care to local people. Children and families who use our services will not experience any change to the services they receive; they will see the same people they normally see where they normally see them.” 07 “ “ Staff are better It’s really working for now with people with Ryan learning disabilities. ” treat you with They dignity and respect. ” The Bexley therapists who take play seriously It may come as a surprise to learn that play is central to the development of language, but this was the message when Exchange visited a ‘play modelling’ speech and language therapy session at the Upton Children’s Centre in Bexleyheath recently. FEATURE | Oxleas Exchange | Winter 2013/14 Issue: 33 J o Copp is Lead Clinician, Early Years, with Bexley Specialist Children’s Services’ speech and language therapy team. She explained that her team uses play modelling to work with children who have communication difficulties: “The play modelling approach helps parents to learn how to change their own communication to help their child’s language skills develop. ‘Modelling’ basically means demonstrating ways that parents can use play to improve how they interact with their children. Play can be a two way process which helps children to learn and practise language. Rolling a ball to each other, for example, will develop waiting and turn-taking. And imaginary play with teddy, dolly and the teaset enables us to talk as we are playing using rich language with lots of early vocabulary.” skills develop. As adults we can often ask young children lots of questions, telling them to do things and not always giving them time to respond. And often we use complicated sentences rather than making simple comments. Referrals for communication difficulties start from the age of two, most coming from health visitors, though the team may also receive referrals direct from parents, carers or staff in under five’s childcare settings. There is no time limit to the therapy which can be delivered in blocks of sessions according to the needs of the child. At the end of sessions, the therapists encourage parents to set aside 10-15 minutes a day of ‘special time’ at home to work on agreed targets using techniques that have been modelled during the session. They also urge them to keep a ‘special time’ diary which allows both therapists and parents to see progress over time. Jo said that the process of building language is a series of small steps, so it is important to manage parents’ expectations: “We encourage them to recognise that progress may be gradual, looking to them to make changes to help their child’s communication Three year old Ryan clearly enjoyed his therapy session with mum Victoria and Assistant Speech and Language Therapist Pat Montgomery. As he dashed from football to puzzle to post box, they joined in the play, encouraging him to use his “The aim at this stage is to simplify our language and get children to use key words and phrases. We encourage parents to follow their child’s lead, comment on what they do, keep the language simple and gradually extend it. So if a child playing with teddy, dolly and the tea-set says ‘teddy’ we encourage parents to model this back adding one word each time such as ‘teddy drink tea’ and ‘teddy drink hot tea’. Some parents run with it but for others just getting down on the floor and playing with a child can be a big change.” growing vocabulary. Victoria said she was delighted with his progress in just three sessions so far: “It’s really working for Ryan. His speech is coming along and he’s a lot calmer in himself. He responds much better one to one and in our special times he’s been learning the difference between big and small bubbles, turn taking and role playing with teddy. If I say less, he talks more, so I wait for him to speak. I’d recommend this therapy to anyone.” Tips that can help language develop •T alking about what has happened that day will help develop memory skills. •W herever possible, use pictures, objects, puppets, acting, gestures and facial expressions. This will keep a child’s interest. •T alk about or play games involving opposites like ‘on and off’ or ‘big and little’. • J oin a child in pretend play. Let them take the lead. This will help their language and creativity. Talk about what they are saying and doing rather than asking lots of questions. •R eversing roles can be great fun for a child. Let them be the ‘mummy’ or the ‘teacher’. •P lay with and talk about sequences of coloured bricks or shapes, numbers and days of the week. Photo: Ryan with Pat Montgomery, left and mum Victoria, right| 09 b News Tilt is a beacon of hope for ex-offenders reach team are present. We work with the STAR worker to organise daily in-house and community activities for our residents. The service is run 24 hours and at least two members of staff are present at all times.” A service with an enviable track record in promoting recovery and independent living moved to our Goldie Leigh site in Abbey Wood in September. T he Tilt project provides high support residential care for men with histories of complex and challenging mental illness who have often spent long periods in hospital following contact with the criminal justice system. This includes careful control and monitoring of the transition from hospital to the community as individuals gain greater independence. in developing a specialist community hostel. With the opening of the recently refurbished building on Lodge Hill, the project has increased its bed numbers from 11 to 18 for people mainly from Greenwich, Bexley and Bromley boroughs. This increase in capacity has been accompanied by greater financial efficiencies. Formerly known as Project 106 because of its previous address in Plumstead, the Tilt project takes its name from Sir Richard Tilt, a former Director General of the Prison Service. His report in 2001 led to the setting up of services to support patients to leave high secure hospitals around the country. Most of the investment nationally went into developing long term medium secure beds. However, in partnership with Bridge Mental Health, we decided to invest Manager of the Tilt project, Ben Spargo, outlined the service: “In addition to the permanent hostel staff, there is an in-reach team from the Bracton Centre (our medium secure unit) consisting of consultants, social workers, community psychiatric nurses, occupational therapists and support time and recovery (STAR) workers. We have meetings every Friday which are similar to ward rounds at which our residents, project support workers and the in- Ben Spargo FEATURE | Oxleas Exchange | Winter 2013/14 Issue: 33 Ben emphasised that the culture of the project is aimed at rehabilitation and recovery: “When residents first arrive we assess them and draw up a support plan with their agreement. They must be committed to their own recovery so every client is given a personal key worker who supports them during their stay and after they move on. We encourage them to think about where they are in their recovery, for example in their relationships, their confidence; the building blocks of their lives. Progress is reviewed at the Friday meetings and our success rate is very high – around 95% do not re-offend. Residents stay with us for an average of 16 months after which many make the transition to living in independent flats while others move to less supported accommodation.” Ahmed, 33, is testament to the effectiveness of the Tilt model. Now living independently, he said that staff helped his recovery: “They gave me support for what I felt I would be good at – like talking about my recovery. I now do volunteering work, talking to other patients and seeing what can be done to help them. I used to find being around people hard, but now I enjoy my caring role and meeting different people.” Members’ focus groups help plan the way ahead “ I would like to warmly invite you to attend any or all of the focus groups. Another Tilt success story is Steve, who moved into his flat in early December 2012. At 42 years old, this was the first time he had lived independently. Physically and sexually abused as a child, from the age of 17 Steve spent seven years in an adult prison and 11 in Broadmoor psychiatric hospital. Around eight years ago Steve was deemed well enough to be transferred to the Bracton Centre where he was supported until “ They gave me the support I needed ... I was treated as a human being, with respect ” ready to move on to Project 106: “They gave me the support I needed. I don’t think I would have done as well in any other hostel. I was treated as a human being, with respect. Their perseverance helped me to be a stronger person than I thought I was.” ” Focus groups are your opportunity to let us know what we should focus on over the coming year. Our Chair, Dave Mellish, attends each event so that he can meet our members and hear your views. You will also have the opportunity to meet senior staff and our commissioners, governors and non-executive directors. We hold focus groups annually in Bexley, Greenwich and Bromley boroughs. Dave Mellish is in no doubt as to the importance of the groups: “Our members’ focus groups are amongst the most significant meetings of the year as they are a wonderful opportunity for our members, service users and carers to have their views heard on what should be our priorities over the next 12 months. “I would like to warmly invite you to attend any or all of the focus groups. The feedback we gather from members helps us to develop our Annual Plan which sets our priorities for the year ahead. Progress made against these priorities is discussed at our Board and Council of Governors’ meetings throughout the year. This is a tangible way in which you hold us to account.” Members focus groups 2014: • Bexley Tuesday 4 February The Marriott Bexleyheath 3pm - 5pm • Greenwich Wednesday 12 February Woolwich Town Hall 6pm - 8pm • Bromley Thursday 20 February Community House 3pm - 5pm. To date, over 7,000 people have become members - service users, carers, local people and staff. Photo: Dave Mellish | 11 “ Members They helped me stay at home which is what I wanted ” Norman Lamb MP, seated right, in conversation with patients Tom Ducey and Maureen Luxford, while Cllr John Fahy (standing) looks on Pioneers push boundaries in health and social care Two of our patients recently met Minister of State for Care and Support, Norman Lamb, to talk about the care they have received under an exciting new initiative to deliver better joined up health and social care. T he nationwide ‘pioneers’ programme invited local areas to demonstrate the use of ambitious and innovative approaches to deliver person centred, coordinated care and support. Our successful work with partners was recognised in October as Greenwich was named one of 14 integration pioneer sites – chosen from over 100 applicants. The aim is to make health and social care services work together to provide better support at FEATURE | Oxleas Exchange | Winter 2013/14 Issue: 33 home and earlier treatment in the community to prevent people needing emergency care in hospital or care homes. On his visit to Memorial Hospital, Norman Lamb heard from 46 year old Plumstead builder Tom Ducey, who described how he was incapacitated with weight problems for two years, unable to work and suffering from leg ulcers and depression: “I needed a Zimmer frame to walk and couldn’t manage at home, but it all started to change following a single phone call from my sister. The health and social care people stepped in. They changed my life completely, giving me exercises to do, with physio and occupational therapy, and a diet plan to follow. They kept with me to make sure I would be able to look after myself. Nothing is too much trouble for them – they have given me so much confidence.” “Before they helped me I was more than 40 stone and hadn’t worked for two years. I’ve now lost 21 stone, feel completely different and I’m determined to go back to my job. The whole system worked for me, after just one phone call. It’s an incredible service.” After the visit, Mr Lamb said: “This week I visited the Memorial Hospital in Greenwich, one of our 14 integrated care pioneers, where over 2,000 patient admissions have already been avoided thanks to interventions by the Joint Emergency Team. This amazing team responds to alerts within care homes, A&E departments and GP surgeries. For example, working together with carers and nurses, they have ensured those with severe mobility problems have access to equipment and therapies keeping them out of hospital.” Maureen Luxford, 75, from Eltham, faced the prospect of going into residential care after heart surgery meant she had difficulties living at home. But the pioneering service changed all that, with four daily visits. Former waitress Maureen told Mr Lamb: “As soon as I left hospital the team came in to help me get up in the morning and get dressed, brought me lunch, and came again in the evening. They gave me exercises to do and were always there to help at the end of the phone. They helped me stay at home which is what I wanted. It’s a wonderful service which should be spread across the country. We are a key member of the Greenwich Pioneer partnership along with a number of other agencies including Royal Borough of Greenwich. Building on a strong foundation of integrated work between health and social care - and the impact of the award winning Joint Emergency Team (JET) - the pioneer initiative will build new bridges between integrated care teams and general practice. The Greenwich Pioneer partners are: the Royal Borough of Greenwich; NHS Greenwich Clinical Commissioning Group; Oxleas; Greenwich Action for Voluntary Services; Greenwich Healthwatch; Lewisham and Greenwich NHS Trust and primary care. Interest groups Earlier this year our Chair Dave Mellish wrote to our members about the introduction of ‘sub classes’ for our Service User/ Carer constituency based around how we structure our services. Members’ feedback told us that some of you were unhappy with this term so we have changed it to ‘interest groups’. The idea of interest groups is that members can belong to the group that is of most interest to them, get involved and help us plan for the future. The interest groups are listed below. • Working age adult mental health services (including forensic and prison) • Older people’s mental health services • Adult community health services • Children and young people’s services (community and mental health) • Learning disability services • Carers. To become a member, please call 0300 1231541 or email [email protected] 13 News Using technology to improve patient care More awards than anyone else In a world where just keeping abreast of new technology can be a challenge, our staff are finding innovative ways to bring benefits to the people we serve. to help patients to better prepare for appointments and improve outcomes by making them feel more supported. Services taking part in the pilot include: adult speech and language therapy; Bexley and Greenwich recovery teams; and Greenwich early intervention in psychosis. Artists at the Bracton Centre, our medium secure mental health unit, have built up an impressive record of picking up Koestler awards in recent years, but this year they have excelled themselves by winning more awards than any other secure mental health setting in the UK. achievement at a ceremony at the Royal Festival Hall, South Bank Centre, on 24 September. Louise Sheridan, Bracton Centre Koestler Arts Coordinator, received the certificate from artist Jeremy Deller, pictured centre above. Supporting patients is also a key aim of our early intervention in psychosis teams who recently launched a new social networking website called Safe Zone. The team were presented with a special award to recognise their The Bracton held its very own Koestler Arts Awards presentation In Greenwich and Bexley, our health visitors are using a new tool that helps parents better understand their children’s health and gives great advice and tips. The ProParent Health Visitor App can be downloaded onto a smart phone or tablet and has a wealth of information about children’s health and development including antenatal, feeding, immunisation, behaviour and minor ailments. It also lists local services available to parents in Greenwich and Bexley including clinics and children’s centres. A page from ProParent with information on the benefits of healthy eating The app explains the role of health visitors, the type of support that parents can expect from them and links to other Oxleas’ services. For expecting parents or those with newborns, FAQs (frequently asked questions) give reassuring advice around pregnancy, delivery, baby development and speech and language. We developed the app because parents told us they wanted it. Mums usually have to take children to appointments and the app helps dads to be more involved. Delivered by Infomax, a company that provides IT solutions to healthcare needs, the app will be adapted for use by other health visitor and school nurse services. While it will be formally launched in the New Year, you can download it now. Safe Zone was developed entirely for people who have used our early intervention services. The first of its kind in the UK, it offers information on psychosis and a place where people can share their experiences, read stories about recovery, make friends and get involved in social events. Another app is being piloted in our services which uses innovative yet simple technology. ‘Buddy APP’ automatically texts patients with messages like: ‘how are you feeling today?’ and ‘how would you rate your mood?’ An online ‘mood diary’ is created for each patient which allows both them and their therapists to see how they are doing over a period of time. It aims Consultant Psychiatrist Kemi Mateola was involved in helping to set up the website. She said: “Safe Zone promotes social inclusion so that clients feel a better sense of belonging and feel less isolated. Only early intervention clients, and clinicians involved in their care like nurses and occupational therapists can use the site.” NEWS | Oxleas Exchange | Winter 2013/14 Issue: 33 on Tuesday 26 November. The Koestler Trust is the UK’s best-known prison arts charity. It has been awarding, exhibiting and selling artworks by offenders, detainees and secure patients for over 50 years. Chelsea FC score highly with MOVE kids programme, the coaches were on hand to help support children as part of the Greenwich MOVE (Mobility Opportunities Via Education) programme. This is an initiative for all children within the borough who have movement difficulties. Chelsea coaches made some Greenwich children very happy when they visited the London Soccerdome near the O2 in October. Representing Chelsea FC Foundation, the club’s community outreach Vicky Lambert, our Children’s Physiotherapy and Occupational Therapy Manager, said there are more events like this one planned in the next twelve months: “The Children’s Physiotherapy Service in Oxleas has successfully implemented the MOVE programme across the borough. Part of the initiative is to lead on the organisation of fun, innovative experiences to provide opportunities for disabled children and their families that they would otherwise be unable to access. These opportunities foster an interest in sports as well as giving the children a chance to practise their independent movement that the MOVE programme encourages.” The children enjoyed more sport in the afternoon provided by Art2Movement, including specialist sports such as fencing and archery. Photo: Pet 15 Annual Members’ Meeting had lots to offer There was something for everyone at our Annual Members’ Meeting (AMM) at IndigO2 at The O2 Arena in September. A n estimated 550 staff, service users, carers, colleagues from partner organisations and trust members enjoyed the day. In addition to the formal meeting and staff recognition awards ceremony, this included a film and seminar programme and stalls representing our directorates, staff networks and some of our partners. There was a moving performance by singers from the Orpheus Centre, a performing arts charity for young adults with disabilities. And spoken word artist and second year student nurse Molly Case delivered her YouTube sensation poem ‘Nursing the Nation’. Chair Dave Mellish addressed the IndigO2 by describing how much Oxleas has changed in recent years. He said that, only three years ago, we were a mental health and learning disability trust with a caseload of about 11,000 patients. Now, he said, we have a caseload of 110,000. He added that from 75 Service users and staff ran the Adult Learning Disability Services stall Forensic and Prison Services staff took a well earned cuppa sites we now work across 125 and that we need to work more with our partner organisations. Medical Director Dr Ify Okocha said that we will continue to produce high quality care, which means we measure clinical effectiveness, patient safety and patient experience. He also said that in a new development the Board of Directors are visiting frontline teams on a monthly basis, to talk to them and see how they work. Director of Finance, Ben Travis, said that we are well placed to respond to the considerable uncertainties that the future holds. He said that our finances are in good shape and that Monitor, the health services regulator, has rated us with a financial risk factor of five – the best an NHS organisation can achieve. Lead Governor, Raymond Sheehy, assured the audience that Oxleas Governors work to: “put the needs of the patient at the heart of everything Oxleas does.” FEATURE | Oxleas Exchange | Winter 2013/14 Issue: 33 Staff were kept on their feet as people visited the stalls to find out more about our services Chair Dave Mellish addressed the meeting Molly Case gave a moving rendition of her poem ‘Nursing the Nation’ Help was on hand for the foot sore Members of Orpheus performed to great acclaim As usual, the photo booth proved ever popular Norman Ward, Green Parks House, won the Recognitions Award for Excellence 17 Groundbreaking dementia care praised by King’s Fund Our advanced dementia care service was highlighted recently in a report and video produced by the prestigious health charity, The King’s Fund and won an NHS award for innovation. T he King’s Fund report, called ‘Oxleas Advanced Dementia Service - Supporting carers and building resilience’, showcases work led by Dr Adrian Treloar and Dr Monica Crugel. They developed a model to help patients with advanced dementia live at home for as long as possible with support from family and/or carers. In England, 670,000 people have a diagnosis of dementia, and this is estimated to double in the next 30 years. The cost to the UK economy will double from £17 billion currently to over £50 billion. With growing numbers of dementia patients being admitted to hospitals and care homes, the Oxleas service both supports the wishes of many families and carers and achieves significant savings by providing palliative (end of life) care at home. The Advanced Dementia Service was formed in November 2012. It brought together two services - Greenwich Advanced Dementia Service (GADS) and Bexley Advanced Dementia Care At Home project. The service consists of a consultant in old-age psychiatry, several specialist nurses and a dementia social worker. highlighted the importance of care coordinators in providing seamless care to families and of regarding the carer as an essential element of the team: “Without the presence of an engaged, willing carer, none of the patients would be able to stay at home.” Staff working within the service liaise with community health services and GPs to provide care in patients’ homes, with a key focus on supporting the carer or family to provide palliative care for the patient. You can read the report and watch a video about the service at kingsfund.org.uk/publications/ oxleas-advanced-dementiaservice An audit of the service has shown that 70% of patients die at home, compared to figures for England and Wales of 6% for people receiving standard care. In November, GADS picked up the Partnership Award plus £35,000 in the NHS Innovation Challenge Prize for Dementia. The King’s Fund report particularly Feature | Oxleas Exchange | Winter 2013/14 Issue: 33 supporting somebody at home you are avoiding significant costs. We think we have saved a good £2.5m by doing better quality care.” Director, Older People’s Mental Health Services, Estelle Frost, said: “The comments are overwhelmingly very positive, people have really valued having access to a service that gives them the opportunity to keep the person with dementia at home.” Dawn Larkin has cared full time for her 81 year old father Walter Bennett for over four years. For Dawn and husband Roy, putting her father into a care home was not an option: “He’d lived in the same house in London for 50 years, never went abroad and didn’t like change. He wouldn’t have survived two weeks in a home. So Roy and I sold our house in Maidstone which we loved and bought this house in Welling with its ground floor extension. I cared for dad alone for a year and it was a real battle to get any help. Then we contacted the Alzheimer’s society who put us in touch with Monica Crugel and thank God they took Dad. Elaine Hughes, an Alzheimer’s nurse and Linda Wilson, a nurse practitioner, coordinate Dad’s care, whether it be an air pressure mattress for bed sores or specialist care from the hospice. They are always at hand to give advice and Elaine pops round regularly to see how Dad is doing. His care is quite complicated, so it’s most important that we see the same people to ensure continuity. He can’t talk now, but with people he knows Dad will put up his hand and stroke their face or hair. “Just being able to pick up a phone and get help has taken such a weight off. If the support we have had could be spread across the country you wouldn’t need to put people in homes.” Clinical Director and Consultant Psychiatrist Dr Adrian Treloar was instrumental in setting up the service. He said: “Our referral criteria is based on a simple hypothesis: anyone cared for at home with advanced dementia should have someone to support them, someone to coordinate that care.” Adrian went on to comment that savings can be made while services are being improved: “If you avoid a care home by Photo: Dawn Larkin | 19 News An exciting future for Queen Mary’s Joining forces to help young people Keith Soper When South London Healthcare NHS Trust was dissolved in October, rumours circulated that Queen Mary’s Hospital in Sidcup had closed, or was about to do so. In fact, the hospital remains open and has an exciting future. Q ueen Mary’s was transferred to Oxleas on 1 October. We provide some of the services and run the site for four other NHS organisations now working at the hospital. Over the next three years we plan to spend up to £30 million to bring services and buildings up-to-date, and ensure that people receive good quality, efficient services in welcoming surroundings. Exchange spoke to Keith Soper, Head of Transformation and Operations at Queen Mary’s, who is excited about our vision for the future of the site. He told us that plans are already well underway and explained that we first looked at how the 50 acre site was being used and if efficiencies could be found. It was soon apparent that not all space was being well used so part of our plan is to remove surplus buildings and reduce the overall footprint by some 14,000 square metres. The plans also seek to rationalise where services are delivered with the aim of grouping outpatient and associated diagnostic services in one area in the main building (B Block). Keith said: “At the moment there are no clinical services on the ground floor. Our plan is to move admin staff away from the main entrance and co-locate services here that will enable outpatients to access everything they need in one convenient place. We’re looking to create flexible spaces which will be more efficient and convenient. For example, people requiring different outpatient services can come to one reception area and be called into whichever consultation room is available.” Thus outpatient services (currently located around the site) and the Urgent Care Centre (now in A NEWS | Oxleas Exchange | Winter 2013/14 Issue: 33 Block) will be moved close to the main entrance in B Block. They will be joined there by pharmacy, imaging (x-ray, ultrasound, CT and MRI Scanning), phlebotomy (blood tests) and the café. Work begins before Christmas. A brand new kidney treatment unit will be created in C Block where the restaurant and café are now. This will be a major improvement, relocating the existing temporary facility to a central position and increasing dialysis chairs from eight to 24. There will also be the opportunity to run renal clinics from the unit. Work is due to start in spring 2014 and be completed early in 2015. A cancer centre will also be developed to provide radiotherapy locally to people in Bexley. At present they have to travel to central London or Maidstone. Chemotherapy, currently available just one day a week at Queen Mary’s, will also be provided at the new unit and there will be a cancer information centre. You can find more about Queen Mary’s Hospital at qmh.oxleas.nhs.uk What we have done Since 1 October our Estates and Facilities team have been getting to grips with a £5 million backlog in maintenance works. These include an overhaul of the external drainage system, and fixing over 60 external lights. All rubbish bins on the site are being replaced. A car park has been re-opened and a new one built providing additional spaces. External signage has been replaced, some clinical areas have had their décor refreshed and works have begun to the grounds and gardens. In addition, a mountain of paper clinical records is being moved off-site to a secure location. According to Keith: “We have already moved 120,000 sets in six weeks and have another 500,000 to move; 250,000 of them by next March. This will free up a significant amount of space; records can be recalled within two hours if needed and the medical records service will continue to run as normal in the meantime.” An exciting new project which aims to deliver a comprehensive activity project to young people within our early intervention services was launched at Charlton Athletic Football Club on 5 October. The project, which we are funding, is a collaboration between our early intervention service and Charlton Athletic Community Trust (CACT). The launch coincided with Charlton Athletic’s first ever Mental Health Awareness Day and their match against Blackpool. Joining Oxleas and CACT on the day to raise awareness of mental health were Kent and Medway NHS Trust, Bridge Mental Health and Greenwich Mind. Around 250 staff and volunteers including the Oxleas contingent were on hand to dispense information on mental health, local services and support. Our staff also handed out information on membership and encouraged visitors to join us. Before the match both Addicks and Blackpool players showed their support by wearing antistigma t-shirts. And in the interval, Charlton became only the second football club to sign the Time To Change Pledge to end stigma and discrimination against people with experience of mental health problems. Though the result of the match was a 0-0 draw, Charlton scored a big hit with service users who were given free match tickets. Consultant Psychiatrist Kemi Mateola works in our Bexley Early Intervention Team and is full of enthusiasm for the project which focuses on weekly activities to engage young people in sport and outdoor activities along with art and cultural based days: “We are very excited about the collaboration we have with Charlton Athletic Football Club. Clients have the chance to do all sorts of exciting activities, such as white water rafting.” Addicks players Chris Solly, Simon Church, Lawrie Wilson and Yann Kermorgant wearing their anti-stigma t-shirts 21 “One of the things we are doing is to try to get crisis cards that people can show to the police or ambulance crew so they can get help when they need it. We’ve also gone out onto the streets in Bexleyheath and Bromley and asked people to sign a pledge not to use insulting words like ‘spaz’, ‘mong’ and ‘retard’. Last year I got Advocacy for All’s Self-Advocate of the Year Award for speaking up for myself and others with learning disabilities.” Sunny tries on some shades at a Woolwich market stall Changing attitudes about learning disabilities 29 year old Sunny Sokhal has a simple conviction - that people with learning disabilities should not be discriminated against. To that end he has joined a number of local groups and is not afraid to take his message onto the streets. Sunny, who lives independently in Bexleyheath, was referred to Stuart House around five years ago for help with mental health problems. He made such progress that after two years he joined the Bexley branch of Advocacy for All, a local charity that supports people with a learning disability to have a voice. Sunny told Exchange: “We work with the police and the ambulance service and explain to them about ‘hate and mate’ crime. Hate crime could be where you are called names. This has happened to me on a bus and in Bexleyheath when I was called ‘retard’. Mate crime is when someone pretends to be your friend and then takes advantage of you like stealing your money. These are common things for people with learning disabilities. News | Oxleas Exchange | Winter 2013/14 Issue: 33 Sunny also belongs to Mencap’s Speaking Up and Respect groups and earlier this year joined our ‘Can you understand it?’ group that works to make information produced by Oxleas more accessible. He said: “I want to help others to understand things better. I also want to encourage more people to join the group.” With five current members supported by staff, the aim is for Sunny and others to lead the group themselves in future and produce a bi-annual newsletter. Another string to Sunny’s bow is his role sitting on interview panels that recruit psychiatric staff: “I’ve got lots of experience of being interviewed for jobs. I worked for Asda for 10 years and then at Bluewater. In September I started working at McDonalds. I work there 20 hours a week.” For more information on Can you understand it? please email the group at canyouunderstandit@ oxleas.nhs.uk Transforming Betts Ward by listening to patients In the last two years the experience of patients on a mental health ward has been transformed and complaints reduced by 80% due to a challenging project. people’s experiences? The videos changed my career. I’ve never been the same since I watched them. I’m very pleased that I took the challenge and Betts Ward is a much better place as a result of experience based co-design.” The Experience Based Co-Design (EBCD) project took place on Betts Ward at Green Parks House, our mental health inpatient unit in Bromley. It was led by members of ResearchNet, a network of service users who work with us to help us improve our services. EBCD involves gathering experiences from patients and staff through interviews, observations and group discussions, identifying key ‘touch points’ (emotionally significant points) and learning from these. It has been successfully used in other parts of the NHS but had never before been used in a mental health ward. Neil Springham, Head of Art Therapy, recruited members to take part in the project. He said: “Acute mental health wards can be stressful for staff and frightening for service users. Asking people about the most difficult time in their life, filming it and showing it to staff was a big ask.” Short, edited films were created from the patient interviews and viewed by staff and patients who discussed the findings and identified areas for improvements. Neil again: “The films were a way of bringing together two groups of people that was mutually beneficial. We realised that staff often only see patients when they are acutely unwell and it is great for them to see people again when they are well.” Exchange asked Edward Kanu, Ward Manager, why they had used EBCD: “I thought to myself why am I in this job? I want to make a difference and I thought why wouldn’t I want to hear about The Betts Ward team have changed how they triage new patients and now get feedback from patients in daily patient experience meetings chaired by Edward. These give patients an opportunity to talk about the past 24 hours on the ward, and staff can hear about issues and respond before they escalate. An unexpected benefit was the huge therapeutic impact on the people who took part. Ami Woods (pictured), is an art therapist who spent some time as an inpatient on Betts Ward. She said: “Turning a difficult experience into something productive has been a really important part of my recovery.” She continued: “It’s been a really hard project, but it’s been very empowering for people. Usually you keep this stuff quiet – you don’t tell anybody. This turned all that on its head and said ‘You can make a difference.’” Photo: Ami Woods| 23 For information on our services, health issues and ways to keep healthy, go to oxleas.nhs.uk Useful contact numbers: Patient Advice and Liaison Service If you require information, support or advice, please contact us free on: Tel: 0800 917 7159 Email: [email protected] Trust membership To become a member of Oxleas NHS Foundation Trust contact us on: Tel: 0800 389 6642 Email: [email protected] or join online at oxleas.nhs.uk Careers For the latest information on vacancies at Oxleas, please visit our website at oxleas.nhs.uk oxleas.nhs.uk Follow us on Twitter @OxleasNHS Like us on Facebook facebook.com/OxleasNHS