The future of occupational therapy and the impact of technology

By Alicia Ridout

Leading occupational therapist, Alicia Ridout, discusses her award-winning work and explores the central role of technology in the future of occupational therapy.

Alicia Ridout, a leading occupational therapist, has recently won the Royal College of Occupational Therapists (RCOT) Tunstall Award for Technology Innovation for her work on the pioneering COG-OT – the Clinical Onboarding Guide for occupational therapists, which she and her team have used to continue their discovery work and to progress the project.

Here, she discusses the importance of technology in occupational therapy and why programmes such as COG-OT are essential for health professional development.

The importance of occupational therapy in wider healthcare

Occupational therapy is essential to the health and care sector and as a sector, we need to ensure that robust systems are put in place to keep up to date with digital competencies and boost confidence to use technology safely, in day-to-day practice. This will help the sector to continue supporting the efforts of the wider health and care landscape to digitise services effectively and improve access for people who need it.

Alicia Ridout, independent occupational therapist and creator of the COG-OT app

Occupational therapy is about working alongside people and their families, helping them achieve their personal goals and essential practical skills, using a holistic approach that respects their strengths and assets. This includes physical, sensory, mental health or communication needs. We see people in a wide range of contexts, people who are experiencing a wide variety of challenges, often for very different reasons.

Occupational therapists’ roles are unique in that we provide services to all age groups, across service boundaries. When it comes to supporting the wider care sector workforce in enabling people to safely access digital tools and services, the sector has always been actively focused on seeking out new technology. COG-OT provides a quick and easy means to access evidence and build competency driven technology skills.

The role of technology in occupational therapy

According to a recent study by RCOT, occupational therapists are facing pressures due to increased demand and vacancies within the industry. This potentially risks leaving people needing assessments, with little or no intervention.

There is a huge opportunity for technology to support people accessing services and occupational therapists, particularly when it comes to prioritising their requirements and influencing technology procurements. Using digital solutions offers the chance to reduce variation in workflows and processes, and also facilitate best clinical practice, streamline access to the right technology, at the right time, and ensure the end user’s experience is high quality.

We launched COG-OT as a web app in 2020, as a proof-of-concept approach to supporting practice development, funded by the Elizabeth Casson Trust. To date, we have won further funding from the Trust to evaluate the tool, as well as funding as part of the RCOT awards twice, in 2021 and 2023, which is crucial for the continued development of this vital resource for occupational therapists.

Why COG-OT has made a difference to the profession

COG-OT supports the profession with guide question sets to stimulate their reasoning about the needs of their service users. It can provide areas of focus and exploration when assessing people who have been referred to their service. This is hugely beneficial to less experienced digital practitioners, as it can help to navigate to the correct technology solution for an individual’s needs and ensure effort invested in the onboarding process is effective. The tool can help therapists by instilling confidence and a consistent but personalised approach to the deployment of technology.

Since the pandemic, digital practice has become increasingly prominent and this is no different in occupational therapy. Digitisation offers its own challenges, but by implementing tools such as COG-OT we are aiming to equip professionals with the digital clinical risk management tools they need for effective practice.

Why investment in technology needs to be prioritised, and how ICSs can support the occupational therapy community

ICSs provide a voice for Allied Health Professions (AHP) via Councils, driving improvement programmes and getting research into practice. The COG-OT team have been working with colleagues in an ICS to surface digital requirements across systems of care and we aim to share this insight widely. Digital confidence is one of many challenges facing AHPs at present, and the wider workforce.

However, as a next step, the sector needs to ensure consistent access to digital solutions, both to support workflows and also speed access to the right technology for users of services and their families. This will ensure that no matter the patient pathway, occupational therapists have easy access to recommended platforms that are of high quality, adhere to regulatory requirements and support clinically driven and collaboratively defined solutions for people in need.

Occupational therapists need to clearly articulate their requirements in this respect. They play a key role in personalised care and ensuring a holistic approach to safe digital deployment at every stage in the care journey – from hospital to community or intermediate care and at home. Digital use at home is different to a hospital environment, and we need to ensure holistic clinical risk assessments are completed.

By integrating safe and high-quality technology into our daily practice, working together with service users and their families and with other health and care professionals, we can pave the way for solutions that really make a difference.

For more information about COG-OT, please contact: cog.ot.project@gmail.com

For more information about Tunstall, please visit: www.tunstall.co.uk/our-solutions

Study highlights prison cancer inequalities

By Gabriel Blaazer

Those diagnosed while in prison face several barriers to treatment and receive worse experiences of care, according to a study led by King’s College London.

Researchers from King’s College London (KCL), University of Surrey and University College London (UCL), funded by the National Institute for Health and Care Research (NIHR), have found that inequalities in cancer outcomes are persistent across English prisons, with those diagnosed while in prison 9 per cent more likely to die from the disease.

The study analysed cancer data from the National Disease Registration Service, which is part of NHS England, and conducted interviews with cancer patients in prison, and prison and healthcare professionals. It finds that cancer patients in prison are 28 per cent less likely to receive curative treatment than the general population, particularly surgery to remove tumours. Only half of the 9 per cent higher mortality rate can be explained by treatment differences.

Prisoners with cancer also have fewer hospital admissions than the general population, meaning that the cost of NHS hospital care is lower in the first six months due to fewer outpatient visits and planned inpatient stays. However, once emergency care and security escort costs are factored in, overall hospital care costs are higher.

Accordingly, the study emphasises the need to improve cancer care for people in prisons, to ensure that it is equivalent to that received by the general population.

Commenting on the study’s findings, Dr Elizabeth Davies, Clinical Reader in Cancer and Public Health in the School of Cancer & Pharmaceutical Sciences at KCL, said: “There are a number of structural factors that influence how healthcare is organised within the prison system, including the way in which prisons interact with NHS cancer services.

“Unfortunately, these factors can mean the route to diagnosis for people in prison is different to that of the general population, and they may not always receive the same level of treatment and support. People in prison with cancer have so far been a hidden and under-researched population. They should not be impacted by such health inequalities and should receive the same standard of care as they would in the community.”

To improve cancer care for people in prison, Dr Davies suggested, the NHS, HM Prisons and the Ministry of Justice should make better use of existing data to identify and reduce variations in care, as well as to better co-ordinate care pathways between these organisations.

Barriers to care

While finding that cancer patients in prison follow similar diagnostic pathways to the general population, the study shows that those in prison are disproportionately affected by barriers to care. These include lower levels of health literacy among those in prison, which impacts the ability to obtain and understand the information needed to make informed health or treatment decisions. Alongside this, the process for booking GP appointments in prisons is complex and time-consuming, and persistent communication issues between prison staff and NHS clinicians make co-ordinating care difficult.

Prison healthcare professionals interviewed commented that, prior to diagnosis, it can be difficult to distinguish between those with genuine healthcare concerns and those wishing to leave prison for other reasons.

Cancer patients in prison are also at risk of missing appointments if transport to hospital is not available. Persistent staff shortages in prisons also present another barrier. It was reported last year that many prisons are increasingly running more restrictive regimes, where a lack of staff can lead to prisoners being locked down for extended periods. The most restrictive of these, known as “red regimes”, were put into effect at least 22 times across English prisons in 2023. Prisoners have cited being locked up for 23.5 hours a day with no access to showers when under a “red regime”.

The study also highlights the use of handcuffs as a barrier to accessing care and a reason for prisoners to refuse hospital appointments. Further, prisoners are found to be reluctant to answer certain medical questions or raise concerns during appointments when healthcare professionals are present, and the study is the first to highlight discomfort among healthcare professionals and prison officers due to this practice.

After diagnosis, patients reported feeling unable to follow the advice of oncology professionals for managing and reporting side effects, which is especially challenging as they cannot directly communicate with their consultants from prison.
NHS oncology services often advice patients to bring friends or family members to appointments to offer psychological support and assist them with information gathering and retention, yet most of those diagnosed in prison attend appointments without this support, and their families often have little interaction with oncology teams.

“Prisons are designed to take away elements of control and choice for prisoners, however, this should not apply to their healthcare,” said Professor Jo Arnes, Professor of Cancer Care and Lead for Digital Health in the School of Health Sciences at the University of Surrey. “Our findings show that patients experience a number of barriers during diagnosis and similarly, once treatment started, they struggled to follow the advice of oncology professionals for reporting and managing any side effects.”

“Instead, they were reliant on prison officers and prison health professionals to respond appropriately, which undoubtedly impacts on their overall physical and emotional wellbeing. With a growing and ageing prison population there is an increasing need for patients with cancer within the prison system to access equivalent care to those in the community,” Professor Arnes added.

Professor Rachael Hunter, Professor of Health Economics at UCL, commented: “Although the cost of clinical cancer-related care for people in prison is less than in the general population, this does not reflect cost savings or efficiency, but worse access to care. More evidence is needed on cost-effective ways to improve access to curative cancer care for people in prison that is appropriate for the prison service.”

The study was coproduced by peer researchers with lived experience of the criminal justice system, supported by Revolving Doors – a charity dedicated to improving services for people in contact with the criminal justice system. It was presented in three collaborative papers published by The Lancet Oncology and eClinical Medicine.

The Coloplast Wound Care Partnership Programme

By Joseph Singleton and Tracy Vernon

Joseph Singleton, Tissue Viability Nurse, Coloplast, and Tracy Vernon, Clinical Nurse Manager, Coloplast, reflect on the outcomes of Coloplast’s Wound Care Partnership Programme pilot study, which aimed to improve the outcomes for the local patient population with wounds.

Coloplast’s purpose is to make life easier for people with intimate healthcare needs. Requiring both an understanding of patient’s medical challenges and other concerns impacting their lives, Coloplast listens to both patients and the clinicians who care for them. Coloplast’s business includes Wound and Skin Care, and understands that although wound healing can be complex, choosing the right solution doesn’t have to be. By combining effective products and services designed to release clinical capacity, reduce harm, and optimise services, Coloplast works with clinicians to reduce health inequalities and deliver optimal wound care for patients.

In 2021 Coloplast initiated a Wound Care Partnership Programme (WCPP) with Primary Care Warwickshire with the intention of developing a quality improvement programme, which aimed to improve the outcomes for the local patient population with wounds.¹ This focused upon an educational strategy, evidence-based wound care pathway and robust data collection.

The WCPP initiative consisted of three stages:¹

Stage 1: A baseline audit (data-driven approach) which identified three themes:

Post-operative wounds were most common.
More than half of the wounds audited were non-healing (over two weeks with limited progress).
Numerous patients were having frequent dressing changes.

Stage 2: Triage and referral criteria were established with the support of the Coloplast Tissue Viability Support Service:

Two clinics per week were set up with 30-minute appointment times to facilitate holistic assessment.
Patients’ eligibility for supported shared care was established following the National Wound Care Strategy Programme guidelines.
Twelve clinically focused education models were delivered to primary care staff by Coloplast.

Stage 3: An extended 11-month clinical evaluation, where patient satisfaction and staff feedback were attained.

107 patients participated in the extended 11-month clinical evaluation:¹

213.5 hours of clinical time were undertaken by Coloplast. This time allocation had the added benefit of freeing up 427 practice nurse appointments, accounting for 142 hours of clinical time over the 11 months.
31 per cent of patients were eligible for supported shared care resulting in the freeing of an additional 42 hours of clinical time.
48 wounds healed.
46 patients were referred to local leg ulcer services in accordance with the local pathway.
Uplift in healthcare practitioner wound care knowledge evidencing improvements in education assessment scores (35 per cent uplift in learning seen). The education offered within the WCPP has been found to reduce variations of care, as well as support the development of pathways to streamline care and support clinicians in practice.²

The pilot has led to further partnerships in other areas driving quality improvements in wound care.

References

¹ Singleton J, Vernon T, Shaw S (2023) Coloplast Wound Care Partnership Programme: a pilot study. Wounds UK, Vol 19, No 3

² Letchford J, Buckley E, Singleton J, Vernon T (2022) How to deliver essential wound management education in the primary care setting. Poster presentation Wounds UK

People powered healthcare – delivering the NHS blueprint

By Dr Allison Smith and Duncan Macleod

Partnership working can deliver great results. In this example, a volunteer supported service with Royal Voluntary Service contributes to vastly reduced readmission rates – at two per cent compared to a national average of 15.5 per cent.

The pandemic drove us to think differently about the delivery of healthcare, and in many ways, it proved that ‘necessity is the mother of innovation’. In our article of 25th March, we discussed how the NHS and Care Volunteer Responders programme, established at the height of the pandemic in March 2020, exemplified truly integrated partnership working between NHS England, local NHS systems, a charity (RVS) with a social enterprise (GoodSam digital App), and most importantly, the public.

But this is not the only effective partnership of this type we can showcase that yields system efficiencies and improved patient outcomes.

Royal Voluntary Service works closely with the Leicestershire and Rutland ICS, a team of 86 local volunteers, and 11 RVS staff, to deliver several critical hospital discharge and admission avoidance services to more than 2,500 at-risk older adults (aged 55+) per year.

A core objective of these support services is to reduce (re)admissions associated with ambulatory care sensitive (ACS) conditions, focusing on non-clinical interventions which ultimately have clinical consequences. This includes ensuring our clients understand the importance of staying hydrated to avoid admissions associated with UTIs, encouraging clients to mobilise and reduce sedentary behaviour to improve muscle strength and mass, and provide opportunities for socialisation which stimulate both the mind and the body.

The services set out below are integrated in the discharge pathways ‘zero’ and ‘one’ at Leicester’s Glenfield Hospital and Royal Infirmary, as well as at the Leicester General Infirmary. Across the service, volunteers and staff are involved in morning discharge meetings; our staff and volunteers work alongside NHS staff to identify patients who would benefit from a portfolio of services on offer:

Assisted Discharge (three-day day support): The client will be taken home and supported to settle in; this involves checking that the clients’ home is safe, warm, and they have food; if not, a small food shop is undertaken. The next day the client will receive a call to check on their welfare and assess any additional needs. The Trust uses this service to improve discharge (e.g. before 3 pm) and patient flow from ED. It typically runs at full capacity.
Supporting Your Recovery (6-12 weeks): This service is offered to clients that might need a bit more support following discharge and have been identified by the Trust as at-risk, either because of previous admissions with 30 days, lack of family support, and frailty and/or wider wellbeing. Each patient will have an assessment of needs and a tailored ‘Personal Support Plan’; this will focus on social and physical rehabilitation with the aim of building confidence, reducing isolation, and ensuring they are able to manage their ‘activities of daily living’. The service assists clients to go out shopping, attend medical and social appointments, and can provide companionship, either face-to-face or over the phone. This service helps to reduce (re)admissions by improving hydration/nutrition, physical activity, and wellbeing. On average clients are supported with 6.2 visits per month, and readmission rates for these clients are around two per cent versus the national average of 15.5 per cent.
Leicester Patient Transport (Treatment – Oncology): We also work with the Trust/ICS to ensure oncology patients attend their appointments on time and reduce DNAs to outpatients. The service is more than just transport to appointments; it provides invaluable emotional support, respite for carers, and companionship for patients who are often undergoing stressful periods of medical treatment.

The original blueprint of the NHS was rooted in the idea that healthcare provision should be a collective and collaborative responsibility between state and citizen. Our charitable mission, and the services we provide, speaks to these fundamental roots.

There now exists a growing body of medical evidence supporting the health and wellbeing gains associated with well-run, purposeful volunteering.3 In a recent survey, RVS volunteers reported higher rates of happiness (+seven per cent) and lower rates of anxiety (eight per cent) compared to a national sample of UK adults (ONS 2003). In addition, volunteers report that volunteering makes them more physically active; on average volunteers do an extra 147 minutes more of physical activity each week.

Given these health gains, RVS has increasingly reached out to those in the most deprived neighbourhoods (IMD areas 1 and 2) to get them more involved and active in their community as a tool for addressing health inequalities. Our survey suggests that 12 per cent (England), 8 per cent (Wales), and 6 per cent (Scotland) of volunteers come from the most deprived areas (IMD 1 and 2).

There are exemplars of this type of partnership working in many parts of the healthcare system; however rather than be an exemplar, this should be norm. Integration should not just include that of health and social care systems’ the public and civil society organisations both want and should have a stake in its delivery. Greater ‘people powered healthcare’ delivers both improved efficiency and population health gains.

Royal Voluntary Service will be attending the Integrated Care Delivery Forum event in Birmingham on the 9th May.

Switching to decaf could prevent thousands of falls per year, care home trial suggests

By Integrated Care Journal

In a first-of-its-kind trial, care home residents were offered decaffeinated hot drinks in a bid to reduce falls experienced rushing to the toilet.

Switching care home residents to decaffeinated coffee could lead to a substantial reduction in toileting-related falls, data from a trial has indicated. The trial was conducted across eight Stow Healthcare residential care homes over six months and saw roughly 300 residents given the chance to blind taste-test caffeinated and decaffeinated drinks.

The trial was instigated after staff noticed several residents falling on their way to the toilet. They suggested switching residents’ drinks to reduce bladder and bowel urgency for those with an overactive bladder or incontinence. the trial resulted in a 35 per cent reduction in toileting-related falls over three months, between June – November 2023 and follows a similar initiative by University Hospitals of Leicester NHS Trust (UHL) in 2021.

According to a joint report published by Care England, Stow Healthcare and UHL, if scaled across the care sector, the switch to decaffeinated drinks would mean thousands of falls prevented and could save the NHS as much as £85m per year.

Falls are the most common cause of injury-related deaths in people over the age of 75. People living in care homes are three times more likely to fall than those living at home; they are generally more frail, less mobile and have a higher prevalence of incontinence than the general population.

More than 90 per cent of residents chose to take part in the trial after being told about the potential health benefits of making the switch, with the choice of caffeine always available on request.

Residents, staff and families at Stow Healthcare’s facilities have described the “huge difference” made by switching to decaf and pride in being a part of the trailblazing trial.

The report authors describe the simple switch as “ground breaking” and are now encouraging other care providers to “give decaf a go!”

The full report can be accessed here.

Professor Martin Green OBE, Chief Executive at Care England, said: “Falls have a detrimental impact on thousands of older people every year, not to mention the knock-on cost to the NHS. When we first heard about the results of UHL’s decaf trial in a hospital setting, the potential benefits for social care were immediately clear. For such a simple, cost-neutral solution to have such a profound impact is extraordinary. With a huge national focus on reducing pressure on the NHS, this pioneering trial demonstrates that simple solutions can help address enormous challenges. Care England is delighted to have been involved in this project and would encourage care providers across the country to give decaf a go!”

Ruth French, Director at Stow Healthcare, said: “The decaf project has been eye-opening for all of us at Stow Healthcare. Our residents and staff have been fully engaged in this project from the moment we launched. To achieve a falls reduction of 35 per cent connected to going to the loo is a significant finding for us all in social care. The impact of a serious fall can have devastating consequences, and finding simple ways such as decaf drinks that might reduce this risk is ground-breaking. We hope it will inspire everyone in social care to take up the challenge!”

Sarah Coombes, Continence Nurse Specialist at University Hospitals of Leicester NHS Trust, said: “Ever since implementing the original ‘Taste the Difference Challenge’ at UHL, my dream has been to see it rolled out nationally and into the community setting. I hope that this will inspire other care providers to follow suit and to promote this simple change to improve patients’ continence and reduce the risk of falls.”

Andrew Selous MP, Chair of the APPG on Bladder and Bowel Continence Care, said: “The findings from Care England, Stow Healthcare and UHL’s decaffeination trial are extremely encouraging. At a time when our NHS and social care system are facing real pressure, decaffeination appears to have emerged as a solution hidden in plain sight. The APPG on Bladder and Bowel Continence Care is committed to finding wholistic solutions to support people with continence issues to live well and this initiative represents exactly that. We now need to look at how these findings can be expanded to deliver positive outcomes for people nationwide.”

New report finds UK medicines shortages are ‘exacerbated’ by Brexit

By Samantha Semmeling

Nuffield Trust report finds that while medicines shortages are now commonplace globally, they have become the ‘new normal’ in the UK, as organisations call on the government to conduct an urgent review into medicines supply chains.

The latest report in the Nuffield Trust’s Health and International Relations Monitor project, The future for health after Brexit, concludes that while Brexit has not caused UK medicine shortages, it has made it significantly more challenging to address them.

The report finds that over the last two years, shortages of medicines including life-saving antibiotics, epilepsy, and chemotherapy drugs, have become a ‘new normal’. As well as reducing patient access to medicines, the shortages are placing significant burdens on pharmacists and GPs.

The shortages have also resulted in the need for the government to reimburse pharmacies for buying drugs above their standard costs more often. Since 2022, the NHS has spent an estimated £220 million on price concessions, absorbing an increasing sum of NHS England’s prescribing budget.

The research is supported by the Health Foundation and explains that UK shortages are reflective of problems in the global medicines market, and not caused directly by Brexit. The UK, however, is experiencing these shortages more acutely that comparable countries.

Global shortages have occurred due to a combination of factors, including a thinner market caused by manufacturing dominance in India and China, post-pandemic inflation and the war in Ukraine.

The Nuffield Trust’s Brexit programme lead, Mark Dayan, said: “We know many of the problems are global and relate to fragile chains of imports from Asia, squeezed by Covid-19 shutdowns, inflation, and global instability.
“But exiting the EU has left the UK with several additional problems – products no longer flow as smoothly across the borders with the EU, and in the long-term our struggles to approve as many medicines might mean we have fewer alternatives available.”

“The medicines supply chain is broken at every level”

The report explains there are unique factors affecting the UK’s shortage issue. A change to prescription patterns causing a squeeze in supply of certain medicines; HRT prescriptions increased by 40 per cent in 2021/22, while policy decisions around medicines pricing and financing, and Brexit, have all contributed.

Brexit has lowered the value of the sterling and removed the UK from EU supply chains. It has also meant the UK is left out of EU efforts to mitigate the shortages, such as initiatives like the Critical Medicines Alliance, as well as efforts to bring medicines manufacturing back to Europe.

Additional customs checks at the border and greater regulation faced by manufacturers have also led some companies to remove the UK from their supply chains.

Professor Tamara Hervey, of the City Law School, said: “There is nothing inevitable about this ‘new normal’ where Great Britain is isolated in efforts to manage fragilities in global supply of the products and people we need to run the NHS. It is the consequence of policy choices and those could be different.”

Although the report warns that rebuilding the EU-UK health relationship more formally is not a current a priority for EU institutions and representative bodies, it outlines steps the UK government could take to address the issue without requiring renegotiation with the EU. These include anticipating shortages in advance, transparency around them, and taking care to ensure sudden squeezes on cost do not drive instability.

A spokesperson for the Department of Health and Social Care said: “Our priority is to ensure patients continue to get the treatments they need. There are around 14,000 licensed medicines and the overwhelming majority are in good supply.”

The report additionally found the UK’s medicines regulator has been slower to approve new medicines compared to the EU. Between 2022 and 2023, four drugs authorised by the European Commission had been approved faster in UK than in the EU. However, 56 had been approved later and eight had not been approved at all as of March 2024.

Several organisations and individuals are calling on the government to carry out a review of the medicines supply chain.

Dr Leyla Hannbeck, Chief Executive of the Association of Independent Multiple Pharmacies (AIMp), said: “The medicines supply chain is broken at every level and unless the Department of Health and Social Care reviews its processes and procedures, we will never achieve the stability that will guarantee patients their prescription when they need it.”

Louise Ansari, Chief Executive at Healthwatch England, has also urged the government to carry out such a review to “ensure medicine safety and resilience.”

The Royal Pharmaceutical Society has launched a project to investigate the shortages by convening stakeholders from across the supply chain, with recommendations expected later this year.

The recently concluded pharmacy inquiry, conducted by the Health and Social Care Select Committee, also extensively discussed the shortage issue and is therefore likely to make recommendations to government in the near future.

Medicines shortages have placed a significant burden upon many healthcare professionals, but particularly the pharmacy profession. Public Policy Projects (PPP) is contributing to the debate by convening pharmacy professionals as part of a programme to document the challenges and their impact on the wider sector. If you would like further information about PPP’s Pharmacy and Medicines Programme, please contact Samantha Semmeling, samantha.semmeling@publicpolicyprojects.com.

2024 Our Health Heroes Awards winners revealed

By Integrated Care Journal

The winners of the eighth annual Our Health Heroes Awards were announced this week at a glittering awards ceremony held at the Queen Elizabeth II Centre in London.

Supported by NHS England, NHS Employers, NHS Shared Business Services, NHS Race & Health Observatory, SFJ Awards and Integrated Care Journal, Our Health Heroes Awards celebrates the wider healthcare workforce that supports our NHS doctors and nurses on the frontline.

From porters and cleaners to receptionists, gardeners and security guards, these often unsung heroes make up roughly 40 per cent of the NHS’s million-plus workforce; Our Health Heroes Awards is a national celebration of their achievements and an opportunity to give thanks for the important role that they play in keeping our health service functioning.

This year’s gold, silver and bronze winners (listed below in that order for each category) are as follows:

Outstanding Lifetime Contribution to Healthcare, sponsored by NHS Employers:

Philip Helliwell, Rheumatology Consultant, Bradford Teaching Hospitals NHS Foundation Trust
Elaine Allison, Matron, St. Bartholomew’s Court Nursing Home
Anthony Westacott, Learning and Development Manager, Avon & Wiltshire Mental Health Partnership NHS Trust

Apprentice of the Year:

Phoebe Edwards, Podiatry Apprentice, East London NHS Foundation Trust
Ben Martin, Data Quality Support Analyst, Bradford Teaching Hospitals NHS Foundation Trust
Debbie Harris, Healthcare Assistant, Essex Partnership University NHS Foundation Trust

Operational Support Worker of the Year:

Paula Di Palma, Housekeeping Manager, St Raphael’s Hospice
Cat Carman, Social Prescriber, Fenland Group Practice
Tina Jackson, Family Liaison Officer, Portsmouth Hospitals University NHS Trust

Clinical Support Worker of the Year:

Chido Munyanyi, Therapy Support Worker, University Hospitals of Leicester NHS Trust
Kerry Clark, Macmillan Cancer Support Worker, Nottingham University Hospitals NHS Trust
Swati Gor, Healthcare Assistant, Havergal Surgery

Healthcare Volunteer of the Year:

Tracy Spencer, Volunteer, WithYou in North Lincolnshire
Paul Fox, Yoga4Health & Yoga4NHS Co-ordinator, The Yoga in Healthcare Alliance
Rezmin Islam, Volunteer, Liverpool Women’s NHS Foundation Trust

Team award category winners:

St Clare Hospice (Dedication to a Lifelong Learning Culture – sponsored by SFJ Awards)
Dentaid (Best Health and Care Initiative by a UK Charity)
Southern Health (NHS Improvement through Digital Innovation – sponsored by NHS Shared Business Services)
RECONNECT (Best Healthcare Workforce Collaboration – supported by Integrated Care Journal)
Spectrum CIC (Best Healthcare Initiative in a Community or Criminal Justice Setting)
West London Perinatal Service (Equality, Diversity and Inclusion Champion – supported by NHS Race & Health Observatory)

The Our Health Heroes Awards 2024 is delivered by Skills for Health and supported by NHS England, NHS Employers, NHS Shared Business Services, NHS Race & Health Observatory, SFJ Awards and Integrated Care Journal. To find out more visit: www.skillsforhealth.org.uk/awards.

News, Workforce April 16, 2024

New data reveals mental health toll on NHS staff

By Integrated Care Journal

Despite challenges facing the service, the NHS remains one of the UK’s most loved institutions, says survey data, as NHS Charities Together launches new campaign urging public to continue supporting NHS and its staff.

More than three quarters (76 per cent) of NHS staff surveyed said they have experienced a mental health condition in the last year, according to new data collected by NHS Charities Together. Conducted by YouGov on behalf of the charity, the survey of more than 1000* NHS professionals also found that 52 per cent reported experiencing anxiety and 51 per cent reported struggling with low mood.

More than two-fifths of respondents (42 per cent) said they had experienced exhaustion in the last year, while three in five (60 per cent) reported feeling concerned for the mental health of colleagues.

Despite these challenges, however, 79 per cent of respondents said they feel proud to work for the NHS and 68 per cent said that they are unlikely to leave within the next 12 months.

The survey reveals the impact of increasing pressure on NHS staff, who are now subject to ‘winter pressures’ throughout the year, and are increasingly facing high workloads, long and unsociable hours and exposure to traumatic, stressful events. 96 per cent of those surveyed said they believe that overall pressure on NHS services is growing, and 69 per cent said that morale is the lowest they have ever experienced. A similar number (70 per cent) said that work-related stress has negatively impacted their mental health in the last year.

The release of these findings comes alongside the launch of a new campaign from NHS Charities Together called Support Goes Both Ways, which aims to raise awareness of need to continue to support NHS staff, so that they can best support the public.

Commenting on the findings, Ellie Orton OBE, CEO of NHS Charities Together, said: “Staff working within the NHS do a hugely challenging job every day, often dealing with traumatic events most of us would never encounter. The majority of NHS staff love doing the job they do, and both NHS staff and the general public feel proud of our NHS. But the nature of the work can have a detrimental impact on their mental health, and stigma can prevent them talking about it.

“Many NHS Trusts are already doing what they can to prioritise the mental health and wellbeing of our NHS staff, but it doesn’t go far enough. We will continue to work closely with NHS England and across the UK to ensure the additional support we provide for NHS staff has the most impact.”

In a separate survey, also carried out by YouGov on behalf of NHS Charities Together, more than 2,000 members of the public were invited to give their opinion on the NHS. Despite the challenges facing the NHS, the 2024 survey revealed that almost four in five (78 per cent) agreed that the NHS is one of the UK’s most loved institutions, compared to three in five (60 per cent) of the 2,000 respondents surveyed in 2022 who stated that the NHS is the best thing about the UK.

The proportion of respondents saying that they would consider a role working for the NHS if they were starting their career again, has risen slightly, from just over one in four (28 per cent) in 2021 to three in 10 (30 per cent) in 2024**.

Author, comedian and former doctor, Adam Kay, whose number-one bestselling book and multi-BAFTA-winning TV show, This is Going to Hurt, provided an insight into the often funny but harrowing daily life of a junior doctor, said: “These figures sadly come as no surprise at all. I know from my own experience just how hard NHS staff work, day-in, day-out, and the mental toll that routinely takes. We are uniquely privileged to have the NHS and should be proud of the wonderful people who sacrifice so much and go so far beyond the call of duty to look after us when we need it. But they desperately need support too, which is why I’m very proud to get behind NHS Charities Together’s Support Goes Both Ways campaign.”

Pat Chambers, Charity Development Manager, County Durham and Darlington NHS Trust Charity, said: “During the pandemic, many staff were affected mentally and emotionally. The extra support from NHS Charities Together enabled us to fund wellbeing spaces, equipment and food and drink for staff, who were working exhausting shifts in the constraints of PPE.

“We also received funding for the Trauma Risk Management (TRiM) project. TRiM is a trauma-focused peer support system helping to prevent extreme trauma and PTSD – similar to interventions delivered for service personnel returning from conflict zones. Funding enabled us to recruit 53 staff volunteers to be trained in providing peer support and interventions. We also funded a staff choir, which was a great outlet for staff and even saw us recording a single during lockdown, which hugely boosted morale.

“The unique challenges of the job means many NHS staff still face mental health challenges today, and the extra support is still needed, allowing us to promote wellbeing across our workforce and therefore ultimately continue to support the delivery of safe, compassionate and quality patient care.”

Hannah Canning is the Health and Wellbeing Coordinator at North West Anglia NHS Foundation Trust. Her role is fully funded by NHS Charities Together, through the North West Anglia Hospitals’ Charity, and was created to support frontline workers in the hospital. She said: “Thanks to the funding from NHS Charities Together, I’m able to support the wellbeing and mental health of staff in the hospital. I’m focusing on individual and team wellbeing and encouraging breaks and rest – considering all things that affect staff while they are on shift. Using this funding, we are able to go ‘over and above’ to support our staff.”

Ellie Orton OBE, CEO of NHS Charities Together, added: “NHS Charities Together already funds extra support such as counselling, green spaces, helplines and wellbeing zones and we’re launching Our Support Goes Both Ways campaign to raise awareness that while those who work for the NHS have a duty to care and protect us all, we all have a responsibility to make sure those who work for the NHS are looked after too.”

Steph Gorman is an intensive care nurse at Guys and St Thomas’s Hospital in London. She said: “I’m passionate about my work as a nurse. It’s hard, and I’ve had my struggles, but despite everything, it’s still one of the best jobs in the world. In the past, I’ve needed to seek help and started one-to-one counselling sessions at the hospital, which was really beneficial.

“Working as a nurse is still incredibly challenging. It’s so vital that we continue to invest in NHS staff mental health. NHS Charities Together have funded wellbeing zones at the hospital, just one example of the types of measures that really help make a difference.”

*Healthcare Professional sample: Total sample size was 1078 NHS staff. Fieldwork was undertaken between 13th – 19th February 2024. The survey was carried out online. The figures have been weighted and are representative of all NHS staff by occupational group.

**GB/UK Omnibus: Total sample size was 2068 adults. Fieldwork was undertaken between 16th – 18th February 2024. In 2022, total sample size was 2132 adults. Fieldwork was undertaken between 13th – 14th January 2022. For the 2021 survey, total sample size was 2120 adults and fieldwork was undertaken between 11th – 12th March 2021. The surveys were carried out online. The figures have been weighted and are representative of all UK adults (aged 18+) while for the 2022 survey, the figures are representative of all GB adults (aged 18+).

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Supporting care companies in the digital switchover

By Kristian Torode

As many industries embrace the changes the Public Switched Telephone Network (PSTN) switch-off will bring, there are others that have cause for concern. Vital care devices such as telecare systems will be impacted by the switch off — so how can care companies ensure a smooth transition for their customers? Here, Kristian Torode, Director and Co-Founder of PSTN switch-off specialist, Crystaline, investigates.

Around 1.8 million UK residents use telecare devices, which enable vulnerable people to live independently by providing assistance in the case of accidents. These wearable devices alert family, carers or emergency services when pressed and can also connect to other safety equipment such as fall detectors, smoke alarms and door sensors.

However, the PSTN switch-off in December 2025 means that the copper wire phonelines that have historically connected these systems will be turned off, threatening their functionality.

In recent months, a number of stories of serious incidents that occurred when telecare devices no longer worked after users were switched from analogue to digital phonelines have hit the headlines. In February 2024, it was reported that Ofcom is investigating Virgin Media over its compliance with rules to protect vulnerable customers during the digital switchover. Consequently, Technology Secretary Michele Donelan met with telecoms providers to determine how best to safeguard vulnerable users during the switchover, which resulted in a commitment not to migrate customers if the functionality of a telecare system is at risk.

However, this poses challenges for vulnerable telecare users, telecoms operators and care providers alike.

Digital divide

Telecare systems are most beneficial to people who have communication, mobility or visual impairments, meaning many users are elderly or disabled.

While vulnerable users are likely to be more heavily impacted by changes to their phone service, it is difficult for them to access information relating to the switchover and how it affects them. According to Good Things Foundation data, non-internet users are twice as likely to have a disability or health condition than extensive users, and six times more likely to be over 65 years of age. As a result, many of those who rely on telecare lack the digital skills to find online information relating to switchover dates and to set up routers for digital phoneline services.

Although telecoms providers have put protections in place for those with disabilities and additional needs, many customers are unaware that they should give these details to providers, meaning existing lists are likely inaccurate.

Tackling telecare issues

So, what can telecare providers do to safeguard elderly and disabled residents? Firstly, telecare companies and local authorities offering these services should share data on who has a device with telecoms providers, allowing them to support vulnerable customers during the switch off.

The next step is to ensure that the right technology is in place before the switch off date. On the care provider’s end, upgrading to a PSTN alternative such as Voice over Internet Protocol (VoIP) now will make sure that there is time to perform checks on existing telecare devices before December 2025. As a result, non-compatible analogue systems can be replaced in advance of the switch off.

Finally, care companies and local authorities must make sure that customers are aware of how the PSTN being turned off will affect their telecare systems. This allows clients to test their personal alarm after their phoneline has been upgraded to ensure it is still fully functional.

As the PSTN switch off draws closer, elderly and disabled telecare customers stand to be one of the groups most heavily impacted but least informed about the effects of the digital switchover. Getting the systems in place in advance and performing thorough testing means telecare companies can guarantee a smooth switchover that safeguards vulnerable people.

To learn more about Crystaline’s PSTN switch off support services for SMEs, including those in the care sector, and to explore digital telephony alternatives, visit the website.

“Overwhelmingly positive” results for early years tool pilot

By Integrated Care Journal

Health visitors trialling the Alarm Distress Baby Scale tool reported enhanced understanding of babies’ behaviour and greater confidence in supporting parents to bond with their children.

A new trial testing the feasibility of a novel baby observation tool has taken place at Humber Teaching NHS Foundation Trust, funded by The Royal Foundation Centre for Early Childhood. The tool is intended to support parent-child interactions and increase the ability of a health visitor to interpret baby behaviour.

The four-month trial ran from July to November 2023 and saw participating health visitors receive training to use the tool, known as the Alarm Distress Baby Scale (ADBB). The ADBB looks for social behaviours in babies, including eye contact, facial expressions, vocalisation and levels of activity and seeks to help parents and practitioners understand the ways in which babies express themselves and their feelings.

Health Visitors conduct a number of regular checks on babies during their first years and the ADBB tool is typically drawn upon within the 6-8 week check. Health visitors who undertook the training reported it had helped enhance their understanding and that they had continued to draw upon those skills throughout all their contact with families.

The pilot ran in two areas initially, Humber and South Warwickshire, but the outcome of this trial is the recommendation that training be expanded to further areas. The findings of the trial have been set out in an evaluation report published by The Institute of Health Visiting and The University of Oxford.

Quantitative and qualitative data were collected over the trial period, and health visitors described their experiences of using the ADBB as “hugely beneficial” and “of great importance” to their work. They reported that the tool allowed them to:

Have more meaningful conversations with parents and carers about the emotional wellbeing of their baby;
Promote positive parent-infant interactions, attachment, and bonding; and
Identify those babies and families in need of greater support during this critical period of development.

Karen Hardy, Specialist Health Visitor at Humber Teaching NHS Foundation Trust said: “We were delighted to have been asked by The Royal Foundation for Early Childhood to take part in this trial. Our Health Visitors have found the training extremely useful and an additional element for them to draw upon throughout all their interactions with babies and parents. Having received the training myself, I can speak to its effectiveness at identifying needs of the baby and parent during those early weeks.

We know that babies are born ready to relate and can communicate how they are feeling from a very young age. The ADDB really adds to the health visitor’s skills repertoire aiding observation and interpretation of babies’ social cues and communication. This not only highlights when things are going well but enables early identification of babies that may be experiencing distress associated with adverse or challenging family circumstances, so that we can put appropriate support in place as early on as possible. It is great to hear that the report is recommending the extension of this training to more Health Visitors”.

Executive Director of The Centre for Early Childhood, Christian Guy, said: “The results of the initial phase of testing are so encouraging. We now want to move quickly to ensure we build on this work, bringing the benefits of this model to more health visitors across the country so that, ultimately, more babies and their families get the support they need to thrive.”

It has been noted that during the trial, the health visitors involved identified behavioural concerns in 10 per cent of the babies they met while using the tool. All identified families were subsequently offered additional support, which ranged from follow-up visits, emotional wellbeing visits and video interaction guidance, as well as connections to Child and Family Centres and referrals to Specialist Perinatal Mental Health and other support services.

Dr Jane Barlow, Professor of Evidence Based Intervention and Policy Evaluation at The University of Oxford, who oversaw the evaluation of the trial said: “Babies are born with amazing social abilities. They are ready to relate and engage with the world around them, communicating how they feel through their behaviours.

Whereas previous approaches have focused on the parents’ perspective, this training has really helped health visitors to ‘read’ the baby during interactions and develop greater sensitivity in terms of the observation of potential attachment and bonding issues that would not have been identified without the training.”