Gloucestershire STP – News

Gloucestershire set to benefit further from joined up health and care services

Gloucestershire has been selected to be one of only 14 Integrated Care Systems (ICS) across the country. This means that health and social care services will be working even more closely together to support people to keep healthy and independent, develop care and services in people’s own homes and communities and ensure high quality, safe hospital services are there when needed.

The announcement is in recognition of Gloucestershire’s strong leadership, effective partnership working and ambitious plans to join up support and services as well as improvements in A&E performance, cancer treatment times and access to GP services. We’ve also seen a reduction in cancelled operations and delays for people ready to leave hospital.

Being an ICS will bring benefits to the county, including greater freedom and control over local decisions about how money is spent and how services are developed, as well as a greater ability to attract additional money to the county to develop services for the future.

Going forward, we will continue to draw on the expertise of others, such as councils, charities and the wider voluntary and community sector, to ensure the needs of local people are met.

Annual Review 2017 / 18

Download a copy of our Annual Review Magazine 2017

Getting Gloucestershire Moving

More than £1.2m has been pledged by the CCG and other partners to help get 30,000 inactive people in the county doing daily exercise.

Gloucestershire Moves is an exciting project which aims to create a sustained culture of physical activity through a number of motivating schemes, such as encouraging people to take up healthier ways to travel.

An innovative scheme called ‘Beat the Street’ got underway in Gloucester in June and is proving to be hugely popular. It uses electronic tap boxes on lampposts to encourage people to walk and cycle around the city, with fun challenges and leader boards to add an element of competition.

Within the first three weeks, more than 9,600 people signed up and covered in excess of 43,000 miles between them, meaning that the competition has already met its target of engaging 9,000-12,000 participants. The competition closes on 19 July 2018.

Best foot forward in schools

More than 21,600 pupils from at least 120 schools are now walking, jogging or running their way to better health thanks to the huge take up of the Daily Mile in Gloucestershire.

A partnership between the CCG, Active Gloucestershire, the County Council and local schools, the initiative got underway in March 2017 and its success keeps marching on. An extra 11,121 pupils and 63 schools jumped on board in 2017/18.

Being physically active at a young age not only leads to a range of health benefits, but has also shown to improve academic performance.

Teachers are reporting that children concentrate better in class and come back from their Daily Mile refreshed and ready to learn. Parents comment that their children are eating and sleeping better.

Positive action helps those at risk of diabetes

Nearly 2,000 Gloucestershire people are being given a new lease of life thanks to a free diabetes prevention programme.

The scheme targets individuals who have been identified by their GP surgery as having high blood sugar levels, which puts them at significant risk of developing Type 2 diabetes.

Sessions cover nutrition, exercise and suggested behavioural changes to maintain a healthy weight and become more physically active. Just a few simple lifestyle changes can prevent or delay the onset of the disease.

So far, the programme has been introduced in Gloucester, Cheltenham and the Forest of Dean and plans are in place to extend it across the county later this year. If you receive a letter from your GP surgery, please take action – it could make a big difference to your health.

Learning how to live well with a long-term condition

People in Gloucester and the Forest of Dean who live with a long-term condition can now join the new Live Better to Feel Better programme, where they can learn useful skills to help build confidence and improve their health.

The programme offers participants an opportunity to meet others in a similar situation and talk about some of the common challenges they face and ways to manage their condition.

They can learn how to use simple techniques such as controlled breathing and other relaxation approaches to help them sleep better or manage a low mood. There is also advice about how to get the best from the professional support that is available.

The programme is free, and is provided by Gloucestershire Care Services NHS Trust. It takes place over five sessions run by skilled staff and trained volunteers who really understand the challenges and feelings involved as they have long-term conditions themselves.

It will be available across the county from September this year. It is anticipated around 400 people will join the programme in 2018/19.

How to help yourself when aches and pains affect your daily life

With time, most muscular and joint aches and pains will get better by themselves and there is no need for people to visit their GP.

To help people feel more confident about managing their ailments themselves, we are making it easier to access good quality online information on local NHS websites with useful tips and advice on how to manage common ailments such as back, knee, shoulder or hip pain.

Anyone who needs additional support can refer themselves to physiotherapy services, again without going via a GP. Physiotherapists offer specialist assessment and treatment for a wide range of problems and work with people to help them help themselves.

For advice and information about how to refer yourself to physiotherapy services, visit gloshospitals.nhs.uk/physio or glos-care.nhs.uk/physio.

GP surgeries face challenge of increased demand head-on

GP practices across Gloucestershire have continued to embrace new ways of working to ensure the needs of patients can be met well into the future.

They have grouped themselves into 16 GP ‘clusters’ so they can work more closely together, be more resilient and provide a wider range of services in their communities.

In many areas, other health professionals are working in GP surgeries, providing expert support and freeing up GP time. This includes paramedics, physiotherapists, mental health staff and more than 40 clinical pharmacists.

Signs are that this is making a real difference in surgeries with GP time being freed up to spend with patients who have chronic long term health conditions.

Joining up to offer community support – 65,000 referrals in 12 months

Joined up Health and Social Care Community Teams are working closely with GP practices to support people in their own homes, helping them to return home sooner after operations and treatment or avoid a hospital stay.

The Integrated Community Teams (ICTs), which are run by Gloucestershire Care Services NHS Trust, received more than 65,000 referrals in 12 months and are available seven days a week.

The ICTs look for better ways to help people achieve the best possible outcomes, whilst reducing unnecessary hospital stays.

This year, there have also been over 2,000 monthly patient contacts with the community rapid response service, which provides a response at home or in the community within an hour.

A successful winter thanks to immense team effort

Winter inevitably puts already busy NHS services under even greater pressure. However, this year, unprecedented partnership working and an immense effort from frontline NHS and social care staff led to significant improvements in service performance.

In the seven months from June 2017, the county’s two emergency departments were amongst the strongest in the region for meeting the national maximum four hour waiting time standard whilst performance over the four winter months to the end of February 2018 stood at 91.1% compared to 78.2% for the same period last year.

There were significantly fewer cancelled operations and delays for patients fit to leave hospital and a large reduction in ambulances waiting more than 30 minutes to transfer patients into hospital.

NHS and social care staff helped patients avoid unnecessary visits and stays in hospital and reduced delays through a number of initiatives, including:

  • a greater number of ‘on-the-day’ appointments at GP surgeries
  • the ambulance service providing clinical advice and treating patients at the scene
  • more social care staff working in hospitals to assess patients
  • an increase in home care
  • more patients being seen by community staff close to home
  • better support from mental health and voluntary sector services for people in their homes

Improving specialist mental health support for new and expectant mums

Pregnant women and new mums in Gloucestershire will benefit from over £113k funding which will improve specialist community mental health support for women, their babies and families.

Gloucestershire was one of only 20 areas to be successful in receiving wave one funding last year. This was used to set up a specialist perinatal mental health team which supports pregnant women and new mothers who are experiencing post-natal depression and other emotional difficulties, as well as their babies and families.

The service has been really successful since it started in July 2017, and has already received nearly 150 referrals.

The additional funding will give the service a welcome boost and will be used to expand and develop the team. With one in ten women experiencing a mental health problem during their pregnancy and in the first year after birth, providing high quality support to new mothers, newborns and their families is important, and is a high priority in Gloucestershire.

Working together to talk about mental health

Partnership working in mental health is crucial in preventing people becoming unwell, providing early support and advice and high quality care when needed.

An additional £825k has been spent on the psychological therapy service Let’s Talk to help people experiencing common conditions such as stress, anxiety and depression. This year alone, Let’s Talk helped more than 7,000 people access support.

A further £113k is boosting the £1.5m national funding Gloucestershire received last year to improve specialist community mental health support for pregnant women and new mums, meaning that the service can be expanded to support even more people.

Other developments include the opening of a wellbeing house in partnership with national charity Mind and funding extended hours at The Cavern in Gloucester, where people can benefit from non-clinical support, company and a listening ear.

There have also been new investments in mental health crisis services, criminal justice liaison services and mental health work within local hospitals.

Providing a brighter future for children and young people

Great strides have also been made this year to improve mental health provision for children and young people.

Early advice and help has been a feature of developments this year with the involvement of young people, parents, carers and professionals key to their success.

So far, 19 schools have been accredited as part of the Mental Health champions Award scheme whilst the ‘On your Mind’ website, which is designed to help young people cope with life’s ups and downs, had 10,000 visitors in its first 12 months.

More than 900 people were seen this year by Teens in Crisis which provides online and face to face counselling for young people aged 9 to 21. Of those receiving this support, 88% said they had been helped a lot or totally.

Tackling cancer waiting times and improving support

The NHS in Gloucestershire has been working hard to reduce cancer waiting times and improve support for patients; more people with suspected cancer are now being seen within two weeks and if diagnosed, starting their treatment within 31 days.

Working with partners, we have introduced new GP guidance and patient information to improve arrangements for referral to hospital and we are continuing with an extensive Macmillan GP Masterclass programme to support the early recognition of suspected cancer.

We are also working hard to ensure patients receive faster and more joined-up care through combined clinics; patients can now see a urology specialist and have tests in a single visit whilst people with some skin cancers can be diagnosed and treated on the same day. When a GP suspects bowel or lung cancer, more patients now go straight for a diagnostic test, such as a colonoscopy or CT scan.

Gloucestershire is also gaining national recognition for its Macmillan Next Steps Cancer Rehabilitation service. This specialist community service for people with breast, colorectal or prostate cancer is provided by Gloucestershire Care Services NHS Trust. It helps people with their recovery, and lifestyle advice to improve and sustain their wellbeing.

Saving lives by early detection of sepsis

More people in Gloucestershire are surviving sepsis thanks to improvements in diagnosing and treating the condition.

Also known as blood poisoning, sepsis is caused by infections such as pneumonia or gut problems. It can be very serious and is often hard to spot, but can be treated easily if it is detected early.

Clinicians in Gloucestershire have been raising awareness of sepsis across a range of non-hospital health settings such as care homes and GP surgeries to help ensure that it gets recognised and diagnosed promptly. To help with this, GPs and other healthcare professionals are now using a calculator called NEWS (National Early Warning Score) which helps with diagnosis.

Meanwhile, our two main hospitals have been highlighted by NHS England as being amongst the most improved and in the top 10% of Trusts in England for identifying and treating sepsis.

Thanks to these initiatives, the county won the Nursing Times Patient Safety Award and was asked to share its approach with NHS England to help other organisations. The West of England region, which includes Gloucestershire, also won the 2018 BMJ Award for Patient Safety.

Over 100 Gloucester people take part in pre-diabetes programme

Residents of Gloucester City are welcoming the opportunity to improve their health by accepting their invitation onto the National Diabetes Prevention Programme (NDPP).

The programme, funded by NHS England, targets individuals who have been identified by their GP surgery as having high blood sugar levels as this puts them at significant risk of developing Type 2 diabetes.

Dr Shabari Hosur, local GP and Clinical Lead for Diabetes at NHS Gloucestershire Clinical Commissioning Group (CCG), said:

“Type 2 diabetes is a chronic medical condition which can have a major impact on people and their families. It affects the entire body and increases the risk of complications, such as an increased susceptibility to heart disease, kidney failure and stroke.

However, the good news is that people at risk who are invited to join the National Diabetes Prevention Programme can learn how to prevent or delay the onset of Type 2 diabetes by making a few simple lifestyle changes.

I really encourage people to accept their NHS health check invitation, as a blood sugar test will highlight their risk of developing Type 2 diabetes and their eligibility for the course.”

The CCG in Gloucestershire is part of the second wave of a national rollout of the scheme. GP surgeries offer the programme to patients with a recent blood result in the range of Non Diabetic Hyperglycaemia, also known as ‘pre-diabetes’.

Since July, eligible patients from five Gloucester practices have been invited to join the local ‘Healthier You’ programme, which is to be available across the county by March 2018.

Katie Tucker, Director at Kingfisher Treasure Seekers, which is delivering the programme said:

“We are delighted that already, over 100 patients have joined the programme; as many as 30% of the patients invited have signed up so far, and this figure is improving all the time.

The ‘Healthier You’ programme is free, and offers participants very specific help to reduce their risk of diabetes.

Initially, patients have a private meeting with a trained facilitator before joining group sessions which provide education about healthy eating and lifestyle choices, advice about reducing weight through exercise and portion control and information about food groups and food labelling.

The changes people make to their lifestyle based on learning about these topics can make huge improvements to their health.”

Debbie Pinnell, Practice Nurse at Brockworth Surgery, said:

“We are thrilled to be actively referring patients onto the NDPP and are experiencing a really positive response from patients so far.

It’s great to have an NHS programme available locally which is tailored specifically to preventing the onset of Type 2 Diabetes and maintaining patient health and well-being.”

 

 

Patients in Gloucestershire set to benefit from expansion of National Diabetes Prevention Programme

NHS England has announced that 13 new areas, including Gloucestershire, are gearing up to offer a leading NHS prevention programme to patients identified at risk of developing Type 2 diabetes.

Wave 2 of the Healthier You: NHS Diabetes Prevention Programme is part of a wider package of measures to support people with diabetes, or on the cusp of getting diabetes, to stay fit, well and prevent further deterioration.

Local people referred on to the programme will get tailored, personalised help to reduce their risk of getting diabetes. This will include education on healthy eating and lifestyle choices and support to lose weight, which have been proven to reduce the risk of developing the disease.

The initiative is being trialled in three Gloucestershire GP practices from the end of June. Patients will be contacted by their surgery if they are identified as being at high risk of developing diabetes and invited to participate in the programme. It is anticipated that the programme will be rolled out across the rest of the county over the next year or so.

Dr Caroline Bennett, Clinical Lead for Diabetes at NHS Gloucestershire Clinical Commissioning Group (CCG) said:

“While a lot of people have a good understanding of diabetes and how to manage it, many others don’t realise just how close they are to developing the condition.

Anyone can get diabetes and the consequences can be serious. It’s therefore really important to take action if your GP practice identifies you as being at high risk of diabetes.

Evidence shows the best way to reduce your risk of Type 2 diabetes is to eat more healthily, take some exercise and, if you are overweight, to lose some weight.”

The programme, which is run collaboratively by NHS England, Public Health England and Diabetes UK, was officially launched last year, with the first wave made up of 27 areas and covering 26 million people – almost half of the country. The latest national figures reveal the programme is making good progress.

Simon Stevens, Chief Executive of NHS England said:

“With more than 18,000 people in England having already started our diabetes prevention programme, the NHS is doing its bit but this is a battle we cannot win alone.”

Alongside this programme, nearly 2.5 million adults and children in England diagnosed with Type 1 and Type 2 diabetes will also benefit from around £42 million of national funding which will be used to advance the care they currently receive.

As part of this scheme, Gloucestershire CCG will receive £230,000 to reduce the number of people who have amputations by improving access to multi-disciplinary foot care teams.

Cllr Tim Harman, cabinet Member for public health at Gloucestershire County Council, said:

“Many people are not aware of the causes of Type 2 diabetes or their risk of developing it.

We know that it is preventable, and the more people we can help the better. This new programme is a great way of supporting people to have a healthier lifestyle.

By taking steps and making simple changes, such as eating healthily, losing weight if you’re overweight, and taking plenty of regular exercise, you can help to reduce the risk of developing type 2 diabetes.”

Dr Alison Evans, Consultant Diabetologist at Gloucestershire Hospitals NHS Foundation Trust, said:

“By working together to support the increasing number of people who are at the highest risk of diabetes to live more healthy lives now through the Diabetes Prevention Programme, we can reduce the number of serious complications associated with the condition such as heart, stroke, kidney, eye and foot problems that we may see at our hospitals in the future.”

Dying Matters … what can you do?

We know that death, dying and bereavement tend to be topics which many people are not comfortable talking about.

However, the NHS in Gloucestershire is encouraging people to talk about these important issues as part of a campaign to promote awareness of the benefits for people becoming more active in planning for a “good” death, whether this is their own death or that of a loved one. Importantly, people are also being encouraged to think about this in advance of ill health.

During this year’s national Dying Matters Awareness Week (8 – 14 May), the NHS Health Information Bus will be out and about around the county, encouraging people to think about what they can do to prepare themselves and others for the inevitable reality of death and dying and to support friends, family or neighbours when they are affected by these issues, such as following a bereavement.

Dr Emma Husbands, Consultant in Palliative Care at Gloucestershire Hospitals NHS Foundation Trust, said:

“Talking about and planning for death and dying is never easy, whether this is about yourself or the people you care for.

However, we all need to have the chance to have these difficult conversations, to help us express our priorities for end of life care and enable the people we love to talk to us about their wishes. This knowledge can help us focus care for each individual.”

The NHS Information Bus will carry lots of information about death and dying, with experts on hand to discuss people’s concerns. The aim is to create a friendly space for people to ask questions about end of life care issues, such as making a will, planning a funeral or coping with bereavement.

Dr Hein Le Roux, clinical lead for end of life care at NHS Gloucestershire Clinical Commissioning Group (CCG), said:

“We took the Information Bus around the county last year, and it was so successful we wanted to do it again.

Lots of people had so many questions, or said they were glad to be able to talk about death. It can be an awkward subject but if we can’t talk about it we only make it more difficult to deal with. Please come along and have a chat with us.”

The theme for this year’s Dying Matters week is “What Can You Do” as it challenges people to do something practical. This might be something for themselves, like making a will, or something for someone else who is bereaved, or caring for a dying relative. This could be something as simple as cooking a meal or walking the dog, but can make a huge difference to someone coping with death or bereavement.

Susan Field, Director of Nursing at Gloucestershire Care Services NHS Trust, said:

“Nurses are extensively involved in supporting people and their families when nearing the end of their life. This ranges from having sensitive conversations with individuals about their end of life choices, recognising any deterioration and providing compassionate care so that any death is dignified.

It’s also important to remember that our nurses continue to support different faiths and beliefs and that they provide care that respects spiritual and religious needs as I believe that if these supportive approaches are present, it helps family members in grieving for  someone they love.”

About 1% of the UK population dies each year, which means about 6,000 people will die in Gloucestershire this year, and each of those deaths will affect many more people in different ways.

ENDS

For more information about Dying Matters Awareness Week, and the events on across the country, visit: dyingmatters.org/page/map-awareness-week-events-2017

The Information Bus will be visiting the following venues between 9.30am and 3.30pm:

  • Monday 8 May – Clock Tower Roundabout, Coleford
  • Tuesday 9 May – Market Place, Stow-on-the-Wold
  • Wednesday 10 May – King Street, Stroud
  • Thursday 11 May – The Cross, Gloucester
  • Friday 12 May – M&S, Cheltenham

A series of short films have been produced for Dying Matters Awareness Week:

One Gloucestershire STP Bulletin – March 2017

This bulletin brings you up to date with features that have been making the news and reflect key themes within Gloucestershire’s Sustainability and Transformation Plan (STP).

The NHS and Care organisations in the county are working together with local partners as ‘One Gloucestershire’ to ensure joined up care, support and communities.

Whether it’s placing greater emphasis on self-care and prevention, developing community based alternatives to hospital care, enhancing mental health provision or developing the local workforce, we have much to report on.

We understand that our community partners lead busy lives, receiving information from a range of sources every day. Our aim is provide you with a brief summary of local developments and an option to read more.

Thank you to all those individuals and groups who took the opportunity to share their views with us during the recent period of staff and public engagement over our STP priorities.

You can find out more and read a short guide summary of the key themes and priorities in the Gloucestershire STP here.

I hope you enjoy the read.

Mary Hutton
Gloucestershire STP lead

‘People and place’ model highlights changing healthcare and community support

A key feature of 2016/17 has been local GP practices working in closer partnership and grouping themselves into 16 GP ‘clusters’ across the county. This approach has been agreed by the system and community and mental health staff are working with the practices to support the ‘place based approach’ to care.

And in many areas of Gloucestershire, other health professionals, such as clinical pharmacists, paramedics, physiotherapists and mental health staff, are working more closely with GP practices to support local people.

This approach aims to support greater resilience and sustainability of GP services. The joint working with health and care partners allows for a wider range of services to be provided to meet the specific needs of local communities.

For example, one pilot scheme under development across two inner city clusters will see GP practices identifying patients who would benefit from seeing full time mental health workers, rather than GPs.

In some rural clusters, GP practices are working together to support the health and wider social needs of more elderly, frail patients, meaning that they can stay at home and be cared for in the community. The practices can deliver better care for patients, co-ordinated by local nurses and GPs who understand their needs.

The ‘people and place’ model, which is now starting to take shape, involves joined up health and social care teams working alongside the GP clusters – providing care in peoples’ own homes and in the community, supported by specialist staff if needed. Closer partnerships are also being forged with the community and voluntary sector.

Better support for patients with respiratory conditions

Steps are being taken in Gloucestershire to offer better advice and support to patients with lung disease.

During this year, the NHS Trusts, CCG and partners have been actively seeking feedback from patients and carers on how services could be improved and how to better help people to manage their condition.

Patients have fed back that they can find it hard to understand their disease, how to manage living with it and how to help themselves feel better.

To address this, more people with Chronic Obstructive Pulmonary Disease (COPD), a condition that causes breathlessness, are being offered a structured programme of exercise and education.

This involves attending a group with other COPD patients and their carers where all attendees are supported together to understand their disease better.

The courses give attendees an opportunity to do exercises that will help improve their condition and show them how to use their medications to have better control of their symptoms.

This year, patients with COPD and other health conditions were offered an additional review from their GP practice to ensure they had all the information they needed to manage their condition throughout the colder winter period.

Work is now underway to develop integrated specialist teams that focus on prevention and early diagnosis and provide seamless, joined up care and support to patients at all stages of the care journey – at home, in the community and in hospital.

Better support for patients at risk of falling – 6,000 home visits this year

Health and social care leaders in Gloucestershire are placing a greater focus on preventing illness and injury in older age and on developing community support across the county to help people stay independent for longer.

Services have been working together to offer better advice and support to older people in particular, who are at the greatest risk of falling. In Gloucestershire, the number of older people is increasing, and about 35,000 people fall each year, often resulting in distress and loss of confidence, independence and mobility.

One great example of partnership working to reduce harm from falls is between the local NHS, County Council social care and Gloucestershire Fire and Rescue Service (GFRS), who are advising people on how to make their homes safer on their regular visits.

Gloucestershire Fire and Rescue Service carried out over 6,000 home visits to people last year.

This partnership has enabled the Fire Service to expand their Safe and Well visits.  Along with the usual fire safety checks, they now make sure older people are safe at home from other risks.

Better care for people nearing the end of life

NHS and social care partners in Gloucestershire have made a commitment to transform experiences of palliative and end of life care by signing up to a countywide End of Life Care Strategy.

The strategy outlines the county’s promise to offer the highest possible quality of care and support to people who are dying. It also sets out an ambition to respond better to the wishes and needs of patients and their families in relation to where they would like to be cared for and where they would like to die.

NHS Gloucestershire Clinical Commissioning Group (CCG) was recently one of two CCGs to be appointed to the NHS England End of Life Care Programme Board to represent commissioning.

Dr Hein Le Roux, Clinical Lead for End of Life Care at the CCG, said:

“Our aim is that everyone should experience a ‘good end to their life’.

We want to ensure that people are given the opportunity to express their preferences about where and how they are cared for, supported and die, and to make it possible for health and social care services to work together to enable their wishes to be met.

It is important for all of us providing end of life care to encourage people to talk about their choices, and to ensure that every individual is able, to the best of our ability and circumstances, to have the best death possible, and that their wishes are respected.

We also want to support families and carers during the difficult times both before and after their loved one’s death.”

The CCG and its partners, including the county’s hospices, care homes, community services and hospitals, have developed 12 key aims to ensure that people receive care that meets their individual needs.

These include ensuring that the many services people need are well coordinated, so that patients receive seamless care that meets their individual priorities, needs and preferences and that end of life care is appropriate, timely and communicated sensitively.

Another important area of work that will be taken forward is around Advanced Care Planning. This is a voluntary process of discussion and review which enables someone who has capacity to indicate their preferences and wishes for the future, meaning that their wishes can be identified, respected and adhered to.

Emma Husbands, Consultant Palliative Medicine at Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) and Chair of the End of Life Care Quality Group, said:

“GHNHSFT are committed to working collaboratively with our countywide colleagues to address such a crucial aspect of all of our lives.

We have now distilled the twelve principles into a strategy to ensure that we embed all aspects of delivery of end of life care.

Death is a part of life and as organisations, staff and patients, we are working together to ensure that we enable personalised care to be as good as it can be right up to and including the end of life.”

Cllr Dorcas Binns, cabinet member for older people at Gloucestershire County Council and Vice Chair of the End of Life Strategy board said:

“Death is a subject we don’t talk about much, but everyone has to face at some point.

I want to make sure all professionals who look after people in their last days have the specialist training and skills they need to give the best quality care.”

Susan Field, Director of Nursing at Gloucestershire Care Services (GCS) NHS Trust said:

“GCS is committed to supporting people to live through life limiting conditions and illness and helping them and their families prepare for their death, helping people to die with dignity.

End of life care touches all parts of ours services, with our nurses being at the heart of care in the last days of life.  They work closely with the patient’s family, GP and specialist services to ensure that people are able to pass away with dignity, receiving compassionate bespoke care in the place of their choosing, surrounded by those who matter to them.  End of life care is multi-dimensional, providing holistic care including physical, emotional, psychological and spiritual support.

End of life care is provided in a range of settings which includes care in the community, such as community hospitals, within patient’s homes, care homes and hospices. Our Trust is committed to working collaboratively with countywide colleagues, to make sure that regardless of the care setting, the quality of care should be of the highest standard and compassionate care must be at the forefront, after all we only have one chance to get it right.”

End of Life Care is a priority within the Gloucestershire Sustainability and Transformation Plan (STP) and the publication of the strategy represents an important step in making improvements happen.

To read more about the STP and find out about how you can get involved, visit the STP website at: www.gloucestershireSTP.net

 

Care professionals recognised at special awards evening

Care professionals and community champions from across Gloucestershire were recognised for their outstanding and dedicated service at the first ever Gloucestershire Health and Social Care Awards at Gloucester Cathedral this winter.

The event, which also included appearances from the Caring Chorus, GDance and Gloucestershire Young Carers, celebrated all that’s great about health and social care in the county.

Information on the categories and finalists can be found at www.gloucestershirelive.co.uk/hscawards

The Daily Mile – keeping Gloucestershire’s children active

Thanks to funding from the NHS in Gloucestershire, primary schools across the county are being encouraged to improve the fitness, health and wellbeing of their pupils through The Daily Mile™ initiative, a simple programme that gets children walking, jogging or running for 15 minutes each day.

The Daily Mile is easy to implement and is great fun for both pupils and teachers.  Eighteen schools and over 4,000 pupils have already signed up to the scheme which will run from 24 April throughout the summer school term.

In addition to the obvious health and fitness benefits that result from daily physical activity, recent research has further revealed that doing a Daily Mile improves behaviour in class, and attainment. Teachers report that children concentrate better in class, and come back from their Daily Mile refreshed and ready to learn, whilst parents comment that their children are eating and sleeping better.

If your primary school would like to participate, please contact tomhall@activegloucestershire.org

University of Gloucestershire to offer new nurse training programme

The University of Gloucestershire has been approved by the government to deliver training for an important new NHS nursing role which will sit alongside existing nursing care support workers and fully-qualified registered nurses to deliver hands-on care for patients.

Health Education England, the body responsible for planning and developing the healthcare and public health workforce, announced that Gloucestershire was one of 24 test sites that will deliver training for the new Nursing Associate role.

Working in close partnership with the CCG, Gloucestershire Hospitals NHS Foundation Trust, 2gether Mental Health NHS Trust and Gloucestershire Care Services NHS Trust, the University of Gloucestershire will design and deliver training in the new role.

Gloucestershire has been allocated 32 Nursing Associate training places, out of 1,000 places allocated nationally in this wave. Training will start in 2017.

As part of their training programme, Nursing Associates will undertake placements in a variety of health service settings to get hands-on experience of working in the health service and become well-prepared to provide a high standard of care to NHS patients in the future.

There was further good news in the announcement that the University will offer a new nursing degree from September 2017. The course will help tackle nursing shortages both locally and nationally through a three-year undergraduate degree with hands-on experience at every stage.

Development of a sustainable health and care workforce is a key theme within Gloucestershire’s Sustainability and Transformation Plan (STP).

Gloucestershire announced as Diabetes Prevention Programme site

Gloucestershire has received a boost in the fight against diabetes being one of 13 areas in the country to be announced in the next phase of the rollout of a National Prevention Programme.

The CCG will work with Gloucestershire County Council to implement the new programme, which will identify people at high risk of developing Type 2 diabetes.

People referred by their GP will get tailored, personalised help to reduce their risk of Type 2 diabetes, including education on healthy eating and lifestyle, help to lose weight, and bespoke physical exercise programmes. Together, this has been proven to reduce the risk of developing the disease.

The programme is supported by Gloucestershire’s Sustainability and Transformation Plan (STP), which sets out the county’s ambitions to support people in Gloucestershire to live healthier lives through a greater emphasis on prevention, self-care and community support.

Eye appointments for children now available closer to home

Children across Gloucestershire who are found to have problems with their eye sight at school vision screening could now be referred to their local community optometrist instead of hospital.

Primary Eyecare Gloucestershire (PEG), which has been providing community eye health services since last year, has already introduced new glaucoma and cataract services as well as treatments for specific minor eye conditions.

The new service will give children who have failed their school vision screening within a defined criteria access to a full assessment through a community optician. This will reduce the need for many children to wait for a hospital appointment.

Formed by Gloucestershire Local Optical Committee (LOC), PEG manages a network of established and experienced optometrists which includes both independent practices and chains such as Specsavers and Vision Express.

Community optometrists have high levels of expertise and are well-equipped to provide excellent treatment and service, enabling children to have appointments close to home at convenient times.

Mental health services for pregnant women and new mums to benefit from £1.5m funding

Gloucestershire is one of only 20 areas across the country to be successful in being awarded national funding which will be used to improve specialist community mental health support for women, their babies and families around the time of birth.

The funding will be released over the next three years and will be used to set up a new community mental health team which specialises in supporting pregnant women, new mothers, their babies and families experiencing complex mental health issues and other emotional difficulties.

The team will help ensure that women have access to expert advice and information on the impact pregnancy and childbirth can have on their mental health during their current or future pregnancy.

The CCG is working with pregnant women and new mothers, and partners including 2gether NHS Foundation Trust, Gloucestershire County Council, Gloucestershire Care Services NHS Trust and Gloucestershire Hospitals NHS Foundation Trust to take plans forward.

This development supports a number of key themes within Gloucestershire’s Sustainability and Transformation Plan (STP), including improving mental health support, placing greater emphasis on preventing ill health, helping people to be healthy and well at home and enhancing community based services and support.

Gloucestershire primary school pupils challenged to “trot” around Europe

Primary schools across Gloucestershire are being asked to encourage children to walk, jog or run a mile every day at school under The Daily Mile initiative.

The Daily Mile has a very simple aim, which is to improve children’s health and wellbeing by being active with their friends outside in the fresh air each day at school.

The initiative was introduced in Stirling in 2012, and despite rising obesity rates across the UK, the school reported that it transformed the health of its pupils.

Thanks to funding from the Clinical Commissioning Group (CCG) in Gloucestershire, the scheme is being offered to the county’s primary schools.

Active Gloucestershire is leading the roll out of the initiative, whereby schools are challenged to collectively “trot” around Europe by the end of the summer term. Children can do this by going on an educational journey with School Games mascot ‘Old Spot’ on his ‘European trot’.

With childhood obesity rates rising, encouraging physical activity at an early age is important, and research has shown that children who are overweight in primary school are less likely to revert to a healthy weight in later life.

Dr Andy Seymour, Clinical Chair at the CCG, said:

“The Daily Mile is a great initiative, and I wholeheartedly encourage primary schools to participate.

Running or walking a mile each day not only offers physical and mental health benefits, but is also great fun for both children and teachers.

Children’s lifestyles have become increasingly sedentary in recent years, and this takes its toll on their physical and mental wellbeing.

The Daily Mile is a simple, accessible and enjoyable initiative which provides massive public health benefits and protects the future health of the county’s young people.

We are pleased to be working with health partners to introduce this initiative across Gloucestershire.”

The scheme is easy to implement and is fun for both pupils and teachers.

Over 2,000 pupils in Gloucestershire are already taking part, with teachers reporting that children concentrate better in class and come back from their Daily Mile refreshed and ready to learn. Parents comment that their children are eating and sleeping better.

Cottia Howard, Head Teacher at Upton St Leonards Church of England Primary School said:

“The Daily Mile has very quickly become an important part of our school day.

After just a couple of months, we are seeing a positive impact on physical wellbeing and attitudes to learning.

There are a lot of smiles around the track and a great sense of achievement for children and staff, so we are confident it will benefit emotional health as well”.

Tom Hall, Head of Education at Active Gloucestershire, is leading on the roll out of the initiative across Gloucestershire:

“The Daily Mile is non-competitive, fully inclusive and fun!

It has so many benefits for children, from building team work and social skills to helping children become more confident and better engaged with the outdoors.

We have written to every primary school in Gloucestershire inviting them to take part. Our discussions with teachers have looked at the real benefits of a short break from curriculum, introducing exercise that helps make children more productive and alert, in addition to having wider health benefits.

Active Gloucestershire will support your school all the way.”

Cllr Andrew Gravells, cabinet member for public health at Gloucestershire County Council, said:

“It’s great to see so many schools joining up to the Daily Mile.

We know that there are plenty of health benefits from being more active and this is a really fun way to help improve health.”

To encourage more schools to get involved in The Daily Mile, Active Gloucestershire has launched “Old Spot’s European Trot” to all 246 primary schools in Gloucestershire.

This is a fun, free, easy-to-use and sustainable challenge involving the whole school during the summer term. Schools are challenged to collectively complete a virtual running or walking tour of Europe. Winning schools will be given the opportunity to complete their mile with a local celebrity, or even Old Spot himself!

For further information or to sign up please click on Daily Mile at www.activegloucestershire.org or contact tomhall@activegloucestershire.org

Improving local dementia care through partnership working

The number of people living with dementia in Gloucestershire is thought to be approximately 9,000.
GPs and other professionals are taking positive steps to improve dementia care and support, with over 68% of people now being diagnosed compared to 32% just six years ago.

The care and support provided locally is set to improve still further, with developments including:
• A pilot project for Community Dementia Nurses (CDNs) to coordinate annual reviews and provide support to all people living with dementia in a cluster of GP surgeries in Stroud and Berkeley Vale. This will ensure the most suitable professional undertakes the annual review and should reduce duplication between healthcare staff in the area. It will have the added benefit of making things less complex for patients and carers. Streamlining the process should also free up more time for professionals to focus on increasing the care and support to people living with dementia in their own homes, helping them to avoid hospital admission.
• Improved processes for discharging people with dementia from hospitals so that they return home more quickly and that the person and their carers are supported to reduce the likelihood of future admissions.
• The development of a range of easily understandable information for patients and carers, to help them understand the full range of support available and where and when to seek help.
• Increased training to care homes, enabling them to care for people living with dementia for longer and avoid unnecessary admission to hospital.
• Better diagnosis and support for people from minority groups.

Consultant Psychiatrist Dr Martin Ansell, of 2gether NHS Foundation Trust, said:

“Our Gloucestershire Dementia Strategy is well established and, as a group of agencies, we are making great strides towards improving the care, support and treatment we provide for those people with dementia in the county.

As part of the Sustainability and Transformation Plan, we are now able to build on our strategy still further to look at what we do as individual agencies and what we do together, and how we can reduce duplication and improve coordination.

Almost all of us are now impacted on by dementia in some way – as a patient, carer, family member, professional or friend. Now is a great time to look at the processes and systems we have in place and make things even better for those affected by the condition.”

Dr Hein Le Roux, Clinical Lead for Dementia at NHS Gloucestershire Clinical Commissioning Group, said:

“Dementia can be difficult to diagnose, especially when symptoms are mild. However, reaching a timely diagnosis can make a huge difference in helping someone stay independent and in their own home for as long as possible. It gives people, and their families, the best chance to prepare and plan for the future and receive any treatment that may be possible.
Raising awareness, improving understanding of dementia and working with partners to ensure seamless support is provided to people with dementia are key priorities for the CCG and its member practices.”

Cllr Dorcas Binns, Lead Cabinet Member for older people at Gloucestershire County Council said:

“We know that people who have dementia are often admitted to hospital unnecessarily and their health declines in unfamiliar surroundings; we want to avoid that wherever possible.

The county council has dedicated funding to make sure people with dementia are only admitted to hospital when they really need it, to avoid causing unnecessary distress.

When people with dementia are in hospital, it’s harder to assess their ongoing care needs due to the upset caused by an unknown environment. As a result, they may not get the most appropriate help. The council is committed to improving the help we give to people with dementia and their carers.”

To read more about the STP and find out about how you can get involved, visit the STP website at: www.gloucestershireSTP.net

Gloucestershire ‘leading the way to ensure sustainability of GP services’

The Clinical Chair of NHS Gloucestershire Clinical Commissioning Group, Dr Andy Seymour has said that the CCG, its localities and member GP practices are leading the way in developments to support a sustainable future for GP services and the local workforce.

The statement comes as the CCG publishes Joining up your GP care’ the public summary to its five year Primary Care Strategy.

Dr Seymour said:

“The national issues around recruitment and retention are well documented and are reflected locally. That said, we are doing a tremendous amount here in Gloucestershire to prepare for the future.

In terms of workforce, we are pleased to see full GP training places in the county and have established a working group with Health Education England and GP representatives to ensure everything is done to offer newly qualified GPs, who are coming to the end of their training, the right package of support and opportunities to stay in the county.

We have embarked on a high profile GP recruitment campaign, in partnership with the British Medical Journal, which is already showing some signs of success in attracting GPs to live and work in the county.

Whilst recognising the importance of the partnership model within practices, we are actively supporting qualified GPs who are unable to commit themselves to a full time post, or who wish to pursue a portfolio career, to work in general practice in the county.

We are also leading the way in Gloucestershire in supporting, and investing in, other healthcare professionals working within GP practices, including clinical pharmacists who are experts in medicines. We have already received reports from some GP practices that this is helping to free up GP time for the benefit of patients.”

Director of Primary Care, Helen Goodey described the wider work being done to ensure GP services are more resilient and sustainable going forward. She said:

“Local GP practices in the county are working in closer partnership and are now grouped into 16 GP ‘clusters’ across the county. This approach supports greater resilience and sustainability of GP services and also allows for a wider range of services to be provided to meet the specific needs of local communities.

For example, one pilot scheme under development across two inner city clusters will see GP practices identifying patients who would benefit from seeing full time mental health workers, rather than GPs.

In some rural clusters, GP practices are working together to support the health and wider social needs of more elderly, frail patients, meaning that they can stay at home and be cared for in the community. The practices can deliver better care for patients, co-ordinated by local nurses and GPs who understand their needs.”

In addition, the Choice+ initiative in the county, supported by local GPs, has meant the availability of additional urgent GP appointments, 7 days a week. Between April 2016 and early 2017, over 35,000 additional urgent GP appointments had been made available across Gloucestershire.

Dr Seymour added:

“Whilst recognising the very real pressures that exist, we are very much working together as ‘One Gloucestershire’ here in the county to lead the way in finding local solutions to the challenges we face. We are doing some really innovative work with our partners and whilst there is a long way to go, we are determined to approach this positively.

It is also important to highlight the overall high levels of patient satisfaction with the quality of care in Gloucestershire, borne out in the findings of the national GP patients’ survey. The vast majority of practices are also rated as good by the Care Quality Commission and this is testament to the commitment and resolve of local doctors and practice teams.”

New ways of working in primary (GP) care and development of community based services are key themes within Gloucestershire’s 5 year Sustainability and Transformation Plan (STP).

Last chance for public to give their views on five year health and care plans

This week offers the last chance for people living in Gloucestershire to share their views on the principles and priorities set out in the county’s five year Sustainability and Transformation Plan (STP).

The STP sets out the very significant challenges that exist and the opportunities to ensure local people can access high quality, sustainable and safe physical and mental health care into the future.

The challenges include a growing population with more complex needs, increasing demand for services, escalating drug costs, recruiting enough staff with the right skills and expertise and pressure on finances.

Whilst the engagement period comes to a close this week, one final drop-in session has been scheduled on Saturday 25 February 10am-4.30pm, when Chatterbox will be visiting Eastgate Shopping Centre in Gloucester. Via touchscreen and by recording short video clips, the “photobooth” style Chatterbox offers an innovative opportunity for local people to share their views on the STP and how people can be supported to lead a healthy life.

People in Gloucestershire are also invited to provide their feedback by completing the online survey at www.gloucestershirestp.net or emailing yourview.glosstp@nhs.net by Friday 24 February.

Making a difference in mental health care and support

The mental health of Gloucestershire’s communities is being made a priority by local health and community partners.

In line with national policies to both prevent mental illness and improve the care available, a number of initiatives are underway.

These include:

  • Investing in Let’s Talk, the county’s Improving Access to Psychological Therapy service, to help those experiencing common conditions such as stress, anxiety and depression
  • Enhancing the support provided to those in mental health crisis, including better links with the emergency services
  • The opening of a wellbeing house in partnership with national charity Mind and funding extended hours at the Crisis Café in Gloucester so people can benefit from non-clinical support and feel less isolated
  • Improved support for children and young people, so that mental health issues can be addressed and treated at a young age
  • Closer working between GPs and mental health professionals
  • Offering more opportunities and advice on ‘self-care’, so that people are able to take steps to avoid mental health conditions or take action at the early signs
  • Introduction of a new perinatal mental health service for expectant and new mothers

Chris Fear, Medical Director for 2gether NHS Foundation Trust, which provides mental health services in Gloucestershire, said much was being done to improve access to services and enhance support.

He said: “Earlier this year, the Five Year Forward View for Mental Health was published nationally, and it emphasised the importance of treating mental health in the same way that we treat physical health.

“Mental health has long been the ‘poor relation’ in the health service nationally, but locally we, NHS Gloucestershire Clinical Commissioning Group and other partners have been working together proactively for many years. It’s now recognised nationally that mental health needs to be more openly discussed and we will be building on this in Gloucestershire to ensure the support available is enhanced and better promoted.

“One in four adults experiences at least one diagnosable mental health problem in any given year and many of these problems start in childhood. In fact, one in 10 children has a diagnosable condition, including, for example, depression, anxiety, or conduct disorder.

“When we realise the huge impact mental health has on quality of life, the link between mental health issues and physical health, the huge cost to the economy of people being unable to work due to mental illness and our suicide rate to mention just a few examples, the need to address mental health is paramount.”

Dr Tristan Lench, Clinical Lead for Mental Health Services at NHS Gloucestershire Clinical Commissioning Group, said:

“There is significant momentum locally to build on recent developments and make a real difference in mental health care and support.

Through partnership working, we are aiming to ensure that people with mental health problems can access the right advice, information and support when they need it most.

Investing in mental health services and support is a key theme throughout Gloucestershire’s Sustainability and Transformation Plan from ill health prevention through to joined up, timely crisis care.”

Cllr Kathy Williams, cabinet member for long term care at Gloucestershire County Council, said:

“Improving services for people with mental health problems is a key priority for both the county Council and the NHS in Gloucestershire.  This plan will put in place a new partnership approach that will make a huge difference to the help and support people can get when they’ve got a problem.  It will make a real change for the better and really help to ensure people have the confidence to seek help when they need it.

“During the coming year I will be continuing to work with my colleagues to ensure we’re doing all we can to signpost people to sources of support.”

Delivering the Five Year Forward View for Mental Health is one of the priorities contained within Gloucestershire’s Sustainability and Transformation Plan, alongside other key mental health priorities.

To read more about the STP and find out about how you can get involved, visit the STP website at: www.gloucestershireSTP.net

Gloucestershire announced as Diabetes Prevention Programme site

Gloucestershire has received a boost in the fight against diabetes this week, as one of 13 areas in the country to be announced in the next phase of the rollout of a National Prevention Programme.

NHS Gloucestershire CCG and Gloucestershire County Council will work together to implement the new programme, which will identify people at high risk of developing diabetes.

Those referred by their GP will get tailored, personalised help to reduce their risk of Type 2 diabetes, including education on healthy eating and lifestyle, help to lose weight and bespoke physical exercise programmes, which together have been proven to reduce the risk of developing the disease.

Dr Caroline Bennett, lead for Diabetes at NHS Gloucestershire Clinical Commissioning Group said:

“By identifying those at greatest risk of developing diabetes and encouraging them to join the programme, we can also support them to reduce their risk of a range of conditions that can be associated with being overweight, having a poor diet and a sedentary lifestyle.

This is really positive news for Gloucestershire and we look forward to working together with our partners across the NHS, county council and district councils in what will be real example of partnership working to support our local population.”

Cllr Dorcas Binns, Gloucestershire’s Health & Wellbeing Board Chair, said:

“Diabetes is a very serious long term condition, but the good news is that type 2 of the condition is largely preventable through lifestyle changes. This programme is a brilliant opportunity to make a real difference to people’s lives by helping them to take more control over their own health.”

Cllr Andrew Gravells, cabinet member for public health at Gloucestershire County Council, said:

“This announcement is great news for the county and another example of what can be achieved when organisations work together. I’d like to thank everyone involved in our successful bid. We know that type 2 diabetes is preventable, and the more people we can help the better.”

Dr Alison Evans, Consultant Diabetologist at Gloucestershire Hospitals NHS Foundation Trust, said:

“The increasing number of people being diagnosed with diabetes puts a huge pressure on the NHS. By supporting those at highest risk to live more healthy lives through the Diabetes Prevention Programme, we can ultimately also reduce the number of serious complications associated with the condition such as heart, stroke, kidney, eye and foot problems.”

The programme is supported by Gloucestershire’s Sustainability and Transformation Plan (STP), which sets out the county’s ambitions to support people in Gloucestershire to live healthier lives through a greater emphasis on prevention, self-care and community support.

As well, as the national prevention programme, a range of other initiatives have been launched in Gloucestershire to support self-management of the condition, including the on-line education tool for adults with Type 2 diabetes, MapmyDiabetes, and the video awareness project led by young people with Type 1 diabetes, ‘I’m controlling it’.

Helping people and communities to stay healthy

  • Social prescribing supporting a growing number of people
  • University academic hails ‘good practice’ in Gloucestershire

Over 2,500 people across Gloucestershire have benefitted from an innovative social prescribing scheme as a result of joint working between the NHS, local councils and a range of voluntary organisations and community groups.

Social prescribing is an approach which links people who attend their GP surgery with non-medical needs to sources of support in communities, often provided by voluntary and charitable organisations and local groups and activities.

Dr Simon Opher MBE, Clinical Lead for Social Prescribing at NHS Gloucestershire CCG said:

“Social prescribing helps people who don’t necessarily need medical care, with GPs referring to sources of community support and community activities to help improve the individual’s wellbeing.

It supports people with issues such as coping with caring responsibilities, loneliness and low level mental health issues through community-based activities such as exercise on prescription, art groups or volunteering to help other people. This can have an immensely positive impact on people’s lives.”

Markus White, who lives in The Forest of Dean, said that social prescribing really helped turn his life around:

“My experience of social prescribing has been completely positive. My life was quite difficult due to a break-up which left me homeless. Social prescribing helped me get somewhere to live. I really felt supported, like someone was on my side. Now I feel able to look forward, and have a more positive outlook.”

Councillor Kathy Williams, lead cabinet member for long-term care at Gloucestershire County Council  said:

“The scheme has had a really positive impact on individuals, while at the same time it gives a boost to our communities. It’s a great example of what can be achieved when local organisations work together and something that we’re very proud of in Gloucestershire.”

Dr Richard Kimberlee, a Public Health Economist at the University of the West of England (UWE Bristol), has been evaluating Gloucestershire’s social prescribing pilot, and found the county’s approach successful in helping to reduce GP appointments and emergency admissions via A&E as well as improving people’s wellbeing and getting people back into work or volunteering.

About the work in Gloucestershire, Dr Kimberlee, founding member of the Social Prescribing Network of UK and Ireland, said:

“I’m very much convinced of the great benefits social prescribing brings to GP practices, particularly among those patients taking up a lot of resources. These are patients who make a lot of GP visits for many reasons, some of which will be non-medical while others will be for problems that can be effectively self-managed with support.

The pressure on health service providers and their partners is exponentially growing and they need to think quickly to stem the tide. The social prescribing approach can be part of the solution by triggering cultural change within primary care.”

A range of new technologies are also being used more widely to help patients manage their long-term condition.

One example of this is Mapmydiabetes, a new online education and support resource for people with Type 2 diabetes, currently available in Gloucester and the Forest of Dean.

Dr Caroline Bennett, Clinical Lead for Diabetes at NHS Gloucestershire CCG said:

“Mapmydiabetes contains lots of useful information about diabetes that helps patients to understand and manage their condition better. This is really important as it reduces the likelihood of suffering from complications such as heart problems and sight loss.

It enables patients to learn about diabetes, record and track their progress and share information with their GP or Practice Nurse, without needing to make an appointment. The system is very easy to use, and patients can access it at home or out and about on laptops tablets and mobile devices.”

Paul Noble, a patient with type 2 diabetes from Gloucester who uses Mapmydiabetes, said:

“Mapmydiabetes helps me look at how I manage my whole day-to-day lifestyle to actually control my diabetes. It has been the turning point for me. I now understand all the activities I need to take care of, such as salt in my diet, the type of food I eat, my activities and my blood pressure. Doing this means that my diabetes takes care of itself.

We were measuring appointments in weeks; now we’re looking at months, and the amount of time I spend with my nurse is far less.”

Amongst the range of initiatives launched in Gloucestershire to support self-management of Diabetes is the video awareness project led by young people with Type 1 diabetes, ‘I’m controlling it’. 

Preventing ill health, helping people to be healthy and well at home and enhancing community-based support are key themes within Gloucestershire’s Sustainability and Transformation Plan (STP).

To read more about the STP and find out about how you can get involved, visit the STP website at: www.gloucestershireSTP.net

University of Gloucestershire gets green light for nursing degree in 2017

The University of Gloucestershire has been given the green light to offer a new nursing degree from September 2017, after the course was approved, subject to conditions, by the Nursing and Midwifery Council.

This new course aims to tackle nursing shortages both locally and nationally by offering a three-year undergraduate degree with hands-on experience at every stage of a student’s development. It is led by the University in partnership with Gloucestershire Hospitals NHS Foundation Trust, 2gether NHS Foundation Trust, Gloucestershire Care Services NHS Trust and the NHS Gloucestershire Clinical Commissioning Group.

Teaching will primarily take place at the University’s Oxstalls campus in Gloucester.  During the course of their degree, students will also gain first-hand experience at acute and mental health facilities in partnership with the local Trusts across the county.

Dr Joy Darch, Academic Subject Lead for Nursing at the University, said:

“Our programme will empower graduate nurses of the future to lead a culture of care that puts patients at the heart of everything they do. This is an important time for nursing, and we have had a fabulous opportunity in Gloucestershire to create the curriculum in partnership with patients and providers to prepare nurses with the skills and knowledge needed for a modern day health and care service in a wide range of settings.”

Health Education England (HEE), the body that coordinates the country’s medical training, announced last month that the University of Gloucestershire has been approved as a test site for the new ‘Nursing Associate’ role. That is a new healthcare position sitting alongside existing nursing care support workers and fully-qualified registered nurses to deliver hands-on care for patients.

Executive Nurse at NHS Gloucestershire Clinical Commissioning Group, Marion Andrews-Evans said:

“It’s vital for the county’s future that together we develop a sustainable nursing workforce. This is really good news for those people keen on pursuing a career in nursing with the right training, education and learning support.  It’s also really good news for patients. There is a real sense that community partners are all pulling together in the same direction to ensure that Gloucestershire develops its reputation as a centre of excellence for nursing.  We would like to congratulate the University for helping to make this a reality.”

Gloucester MP Richard Graham said:

“Health is the biggest employer in Gloucestershire, so the increasing focus by our University on providing the skills for my constituents and others in the county to have lifetime careers in health is absolutely right.

“I hope both parents and students will see the huge practical advantage of being able to study for nursing degrees and higher apprenticeships so close to home, and without any limits on numbers now.”

Development of a sustainable health and care workforce is a key theme within Gloucestershire’s Sustainability and Transformation Plan (STP) published last month.

University of Gloucestershire to offer new nurse training programme

The University of Gloucestershire has been named as one of the Universities approved by the Government to deliver training for an important new NHS nursing role.

Health Education England (HEE), the body responsible for planning and developing the healthcare and public health workforce, announced that Gloucestershire was one of 24 test sites that will deliver training for the new Nursing Associate role. This new role will sit alongside existing nursing care support workers and fully-qualified registered nurses to deliver hands-on care for patients.

Working in close partnership with Gloucestershire Clinical Commissioning Group and the NHS Trusts serving the county – Gloucestershire Hospitals NHS Foundation Trust, 2gether Mental Health NHS Trust, and Gloucestershire Care Services NHS Trust – the University of Gloucestershire will design and deliver training in the new role.

Gloucestershire has been allocated 32 Nursing Associate training places, out of 1,000 places allocated nationally in this wave. Training will start in 2017.

As part of their training programme, Nursing Associates will undertake placements in a variety of health service settings – not just the NHS Trusts, but also partners including Millbrook Lodge – the Order of St John Care Trust, Sue Ryder, Leckhampton Court Hospice and the South West Ambulance Service Trust. These placements will give students hands-on experience of working in the health service, so that they are well prepared to provide a high standard of care to NHS patients in the future.

Stephen Marston, Vice-Chancellor at the University of Gloucestershire said:

“The University is delighted to have been given the green light to play our part in providing training for the important new role of Nursing Associates.

“The health service plays a vital role in the wellbeing of the people of Gloucestershire. We all depend on it. Yet there is a real shortage of people with the skills and qualifications to meet the needs of health service employers, both in the county and nationally. This new role of Nursing Associates should help tackle that shortage. We have built a strong partnership with the NHS organisations in Gloucestershire to develop joint plans for introducing this new training programme, and we are very pleased that we can now move forward to deliver this exciting initiative next year.”

Professor Lisa Bayliss Pratt, Director of Nursing and Deputy Director of Education and Quality, Health Education England, said:

“The high level of interest in delivering training for this important role means that we have been able to select even more sites to take forward the training. It further underlines the real appetite for helping to deliver this new role which we believe can provide a real benefit to the nursing and care workforce across a range of settings and play a key role in the delivery of patient care with safety at its heart.”

Gloucester MP Richard Graham said:

“This is another big step forward on our University’s journey to teaching health skills, whether through degrees or higher apprenticeships. And it opens the door for my constituents to become among the first Nursing Associates in the country”.

Executive Nurse at NHS Gloucestershire Clinical Commissioning Group, Marion Andrews-Evans said:

“We are delighted to hear this news and it’s a really positive development for Gloucestershire. A lot of hard work has gone in to this and we believe it’s vital for the county’s future that together we develop a sustainable nursing workforce. Not only is this good news for patients, it is also good news for those people keen on pursuing a career as a Nursing Associate with the right training, education and learning support.”

Susan Field, Director of Nursing at Gloucestershire Care Services NHS Trust said:

This is a great opportunity for Gloucestershire’s health community. Nurses have a hugely important role in community services. A skilled associate nurse workforce will offer greater support to our registered nurses, and help the Trust continue to provide high-quality person-centred care. The new role will provide a clearly defined practice and education pathway, which will help the healthcare community create the conditions for sustainable workforce development, and innovative practice for the people of Gloucestershire. This is an exciting time; I look forward to meeting these Nurse Associates in the near future.

Maggie Arnold, Director of Nursing at Gloucestershire Hospitals NHS Foundation Trust, said:

“The Nursing Associate will create a new type of care worker with a higher skill-set to assist, support and complement the care given by registered nurses. It is about creating a workforce that fits around the changing needs of the people that we care for with prevention and wellbeing at the heart of the role.”

Development of a sustainable health and care workforce is a key theme within Gloucestershire’s Sustainability and Transformation Plan (STP) published last month.

Gloucestershire secures nearly £1.5M to improve mental health support for pregnant women and new mums

Pregnant women and new mums in Gloucestershire are to benefit from nearly £1.5M funding that will improve specialist community mental health support for women, their babies and families.

NHS Gloucestershire Clinical Commissioning Group (CCG) worked with partners including 2gether NHS Foundation Trust (2gt), Gloucestershire County Council (GCC), Gloucestershire Care Services NHS Trust (GCS) and Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) to submit the county’s case to government in a bid to secure funding which will be released over the next three years.

Gloucestershire is one of only 20 areas across the country to be successful in being awarded this national funding.

The funding will be used to set up a new community mental health team which specialises in supporting pregnant women, new mothers, their babies and families experiencing post-natal depression and other emotional difficulties.

Dr Jeremy Welch, GP in Tewkesbury and Clinical Lead for Maternity Services at NHS Gloucestershire CCG said:

“Improving support for pregnant women and new mums is one of our key priorities in Gloucestershire.

Over the past few years, we have been working with and listening to women, and their partners, who have themselves experienced mental health problems around the time their baby is born. This has given us invaluable insight, and has helped us to develop our plans and guide steady improvements in care and support for women and families.

Establishing this Specialist Perinatal Mental Health Team is an important part of our future plans, and will enable us to ensure that women have access to expert advice and information on the risks of pregnancy and childbirth on their mental health.”

Dr Sally Morgan, Consultant Psychiatrist at 2gether NHS Foundation Trust said:

“The team will provide specialist care for women who have experienced severe mental illness such as schizophrenia or psychosis while pregnant or after birth, responding quickly if they become ill and helping to minimise risks to both the mother and baby. They might do this, for example, by giving medication advice, offering psychological support and providing lifestyle advice. They will also be able to offer expert advice on the risks and benefits of treatment options.”

Dawn Morrall, Assistant Director of Midwifery at Gloucestershire Hospitals NHS Foundation Trust, said:

“We are recruiting a perinatal mental health specialist midwife to be part of this team to work to ensure that women have a comprehensive plan to support their mental health during pregnancy and after the birth of the baby.

The team will work closely with Improving Access to Psychological Therapy services (IAPT), maternity services, health visitors, GPs and community organisations which can provide advice and care for women.”

Kathy Williams, cabinet member for long-term care at Gloucestershire County Council said:

“Pregnant women and new mums need their mental health to be as well cared for as their physical health. This is an important part of making sure that, right across health and social care, mental health issues are treated as seriously as physical health ones. This funding will help ensure mothers get the support they need at this critical time.”

Janet Mills, General Manager for Children and Young People’s Services at Gloucestershire Care Services NHS Trust, said:

“We recognise that one in six women is affected by mental health issues and stress during pregnancy or after birth. These women need specialist care and support and this new team will help us to provide that, making sure that people get the care they need when they need it.”

This development supports a number of key themes within Gloucestershire’s Sustainability and Transformation Plan (STP), including improving mental health support, placing greater emphasis on preventing ill health, helping people to be healthy and well at home and enhancing community based services and support.

To read more about the STP and find out about how you can get involved, visit the STP website at: www.gloucestershireSTP.net

Better support for patients at risk of falling highlights greater focus on prevention

Health and social care leaders in Gloucestershire have highlighted a greater focus on preventing illness and injury in older age and on developing community support across the county to help people stay independent for longer.

Services have been working together to offer better advice and support to older people in particular, who are at the greatest risk of falling. In Gloucestershire, the number of older people is increasing, and about 35,000 people fall each year, often resulting in distress and loss of confidence, independence and mobility.

A number of initiatives to support people in their own homes are now in place. One great example of partnership working to reduce harm from falls is between the local NHS, county council social care and Gloucestershire Fire and Rescue Service (GFRS), who are advising people on how to make their homes safer on their regular visits.

Gloucestershire Fire and Rescue Service carried out over 6,000 home visits to people last year and all three partners have been keen to work together to ensure these home visits cover key messages.

Councillor Dorcas Binns, Cabinet Member for Older People at Gloucestershire County Council said:

“We know, across the country, that older people are at more risk of both falls and accidental fires at home. That’s why we brought together the council’s social care teams with our fire and rescue service, and with the NHS Clinical Commissioning Group, so we could all work together to fight both problems.

This partnership has enabled the Fire Service to expand what they cover during their Safe and Well visits.  Along with the usual fire safety checks, they now make sure older people are safe at home from other risks. They identify potential trip and slip hazards and carry out basic falls risk assessments and refer to specialist teams when needed. They can also give advice on staying active and hydrated and help people link up with other sources of support in the community.  Firefighters are brilliant at this – they’re both really well trusted and very experienced in spotting and explaining risks.”

Gloucestershire Fire and Rescue Service also now act as Telecare responders for people who don’t have anyone else that can respond for them. This service has enabled people to stay in their homes longer and reduced the need for care home placements.

Other initiatives across the county include activity and active balance classes, which can help people to maintain their mobility, as well as more intensive help, such as health assessments and medication reviews.

More emphasis is also being given to community-based services to support people when they do have care needs. Most patients prefer to stay independent and in their own homes, rather than be admitted to hospital, and the county’s Integrated Community Teams (ICTs) are helping people to do this.

These teams combine the skills of community nurses, occupational therapists, physiotherapists, social workers and reablement workers who work alongside GPs, mental health staff and voluntary and community organisations to provide care for people with a variety of issues, such as arthritis, diabetes and frailty. They can also give health advice, support and reassurance to patients and carers, actively supporting patients or their families to manage their own care.

Community Manager at Gloucestershire Care Services NHS Trust, Melanie Richmond, said:

“Our focus is on supporting and enabling patients to remain in their own home instead of going into hospital. In my community area, Tewkesbury, the team has over 1,200 face-to-face patient contacts per week, and across the county we have in excess of 10,000 patient contacts per week.”

The Rapid Response Service, known as a ‘hospital at home service’, also helps patients to remain in their own home. It provides urgent and specialist care, sometimes within one hour, in times of crisis, and is available 24 hours a day, seven days a week across the county.

Gloucestershire Care Services NHS Trust’s Clinical Lead for the Rapid Response Service, Kathy Cambell said:

“On average, the team is now caring for 60 patients per week, and over 80% of these people will avoid an admission to hospital whilst they recover. The team have advanced clinical skills to assess and treat people with conditions such as an acute kidney injury, COPD, bladder infections, blood poisoning (sepsis), and other infections which require oral or intravenous therapy.

The Rapid Response team also provides care for frail adults, terminally ill patients, and people who have had a fall that is likely due to an underlying medical condition.”

New hospital services have also been introduced to provide same day assessment and treatment and reduce the need for hospital stays.

The Older People’s Advice and Liaison Service (OPAL), led by Consultant Geriatricians, provides intensive medical support to older patients in Gloucestershire’s two large hospitals to improve quality of care and avoid hospital stays where appropriate.

Gloucestershire Hospitals NHS Foundation Trust Consultant in Older Person’s Medicine Dr Ian Donald said:

“Patients are assessed immediately so that they can be given the care and treatment that best suits their needs, often avoiding hospital admission. We can do this, for example, by putting arrangements for community support in place. For patients who are admitted, care planning and treatment start immediately. Many patients are seen and discharged either without staying or with just a one-day stay.

A short attendance at the hospital for some rapid investigations for those with frailty helps get an accurate diagnosis which then supports the community services delivering care back at home.”

Moving forward, we believe we will continue to place greater emphasis on prevention of illness, support more self-care, provide more joined up care and support in the community. This is reflected in Gloucestershire’s Sustainability and Transformation Plan (STP).

Public invited to give their views on five year health and care plans

Health and care partners are inviting people living in Gloucestershire to share their views on the county’s five year Sustainability and Transformation Plan (STP), which was published earlier this month.

The Gloucestershire STP sets out the very significant challenges that exist and the opportunities to ensure that local people can access high quality, sustainable and safe physical and mental health care into the future.

Clinical Chair of NHS Gloucestershire Clinical Commissioning Group, Dr Andy Seymour said:

“We face a growing number of challenges, so need to accelerate the pace of change. Together with our staff, partners and the public, we need to be forward thinking in how we organise services and community support and use the money available to us.”

The main challenges facing the county include a growing population with more complex needs, increasing demand for services, escalating drug costs, recruiting enough staff with the right skills and expertise and considerable pressure on NHS and social care finances.

The STP sets out priorities including:

  • Placing greater emphasis on prevention of illness and self-care, with investment to support this
  • Providing more joined up care and support in people’s homes and in the community
  • Exploring options to bring together some district general hospital services into ‘centres of excellence’ to ensure safety and quality
  • Developing a ‘best use of medicines’ programme and priority fund the drugs and treatments that have the greatest health benefit for the population
  • Developing a sustainable workforce
  • Making the most of new technologies

Dr Seymour added:

“We are now in a period of staff and public engagement over the priorities set out in the plan, and we want everyone to be able to have their say and know that their voice will be heard. Their feedback will enable us to develop detailed proposals for change for discussion over the course of next year.”

People in Gloucestershire are invited to provide their feedback by 24 February 2017, and there are a number of ways which this can be done:

Better support for patients with respiratory conditions

The NHS in Gloucestershire is taking steps to offer better advice and support to patients with lung disease.

We have been actively seeking feedback from patients and carers on how we can do things better. We have heard from patients about their experiences of living with sleep apnoea, Chronic Obstructive Pulmonary Disease (COPD) and Bronchiectasis to understand how services could be improved to help them to manage their condition better.

Patients have told us that they can find it hard to understand their disease, how to manage living with it and how to help themselves feel better.

To address this, more people with Chronic Obstructive Pulmonary Disease (COPD), a condition that causes breathlessness, are being offered a structured programme of exercise and education to help them self-manage their condition. This will involve attending a group with other COPD patients and their carers where all attendees are supported together to understand their disease better.

The courses give attendees an opportunity to do exercises that will help improve their condition and show them how to use their medications to have better control of their symptoms.

Steve, a COPD patient who lives in Gloucestershire, found the course really helpful. He now feels that he understands how to manage his condition and visits his GP less often:

“The course teaches you how to take care of yourself to give you the best chance of having a good life. With my knowledge through the course, linked with telehealth, I know if I’m going downhill.  I keep a rescue pack at home, which involves steroids and antibiotics, so now I can get in front and start the medication quickly. I’m a lot more positive with my outlook and my attitude … I’m not afraid of COPD any more. I recommend the course to anyone.”

Patients with respiratory conditions, who are vulnerable to health complications associated with flu, are strongly encouraged to take up the offer of their free flu jab from their GP surgery.  This winter, patients with COPD and other health conditions are also being offered an additional review from their GP practice to ensure they have all the information they need to manage their condition throughout the colder winter period.

Gloucestershire Hospitals NHS Foundation Trust Consultant in Thoracic Medicine, Dr Andrew White said:

“Patients require that our services work as seamlessly as possible and that care along the clinical pathway is joined up.

Our ambition is to develop integrated specialist teams that provide specialist skills to patients from the home to the hospital and to support pathways from prevention, early diagnosis and through to emergency and palliative care.”

Singing groups specifically for people with a lung condition are also available to enhance the medical support people with respiratory conditions already receive. Singing can teach people a better understanding of breath control through their voice, which can in turn improve their self-esteem and reduce social isolation for some.

These are examples of some of the ideas supported by Gloucestershire’s Sustainability and Transformation Plan (STP), which sets out the county’s ambitions to support people in Gloucestershire to live healthier lives.

Providing people with better understanding of how to live well and manage their health conditions will help people with respiratory illnesses to avoid hospital admissions, and stay well at home.

To read more about the STP, leave your views and find out about how you can get involved visit the STP website at: www.gloucestershireSTP.net

Health and Social Care Partners publish the Gloucestershire STP

The NHS and County Council, working with a range of community partners, have published the Gloucestershire five year Sustainability and Transformation Plan (STP).

It sets out the very significant challenges that exist and the opportunities to ensure local people can access high quality, sustainable and safe physical and mental health care into the future.

The challenges include a growing population with more complex needs, increasing demand for services, escalating drug costs, recruiting enough staff with the right skills and expertise and considerable pressure on NHS and social care finances.

Clinical Chair of NHS Gloucestershire Clinical Commissioning Group, Dr Andy Seymour said:

“To meet these growing challenges, we need to accelerate the pace of change, and together with our staff, partners and the public, be forward thinking in how we organise services and community support and use the money available to us.

In primary care for example, GP practices are looking at how they can work more closely together to provide services within local communities and wider partnership working at community level is also a key theme within our STP.”

Accountable Officer of NHS Gloucestershire Clinical Commissioning Group and Gloucestershire STP footprint (area) lead, Mary Hutton said:

“There will be tough choices going forward and therefore it’s important that we have a framework within which to take decisions – the STP provides us with this framework.

We now look forward to beginning a period of staff and public engagement over the priorities set out in the plan. The next step will be to develop detailed proposals for change for discussion over the course of next year.”

The Gloucestershire STP sets out priorities to:

  • Place greater emphasis on prevention of illness and self-care with investment to support it
  • Provide more joined up care and support in people’s homes and in the community
  • Explore options to bring together some hospital services into ‘centres of excellence’ to ensure safety and quality
  • Develop a ‘best use of medicines’ programme and priority fund the drugs and treatments that have the greatest health benefit for the population
  • Develop a sustainable workforce
  • Make the most of new technologies.

Chief Executive of Gloucestershire County Council, Pete Bungard said:

“By working together in a joined up way in Gloucestershire, we can build stronger, healthier communities and reduce over-reliance on health and care services.

As we live longer we frequently experience more complex needs, which increase the demand for a range of services. We will continue to improve the way we work in partnership so that individuals can access help to stay as well as possible, maintain their independence and receive joined up care and community support when it is really needed.”

Chief Executive of 2gether NHS Foundation Trust, Shaun Clee said:

“Mental health and wellbeing is one of our key priorities and all partners recognise that there is no health without mental health. Whether it’s strengthening our approach to prevention or further joining up community and crisis services, there is a commitment in the STP to invest in this area to improve people’s lives and reduce pressure on other areas of the NHS.”

Chief Executive of Gloucestershire Care Services NHS Trust, Paul Jennings said:

“Through the emerging ‘People and Place’ model, we are on course to make further positive strides in Gloucestershire to join up care and support in people’s homes and in the community. The STP describes how GP practices will work closely with health, social care and the voluntary and community sector to support local populations.”

The STP also describes outline plans to develop a supporting network of centres and services to support people’s urgent care needs.

Chief Executive of Gloucestershire Hospitals NHS Foundation Trust, Deborah Lee said:

“Our acute hospital sites have a very important part to play in providing sustainable health services for the future. However, we want patients to access the very best care, delivering the very best outcomes and believe that bringing some of our hospital services together to create ‘centres of excellence’ can provide real benefits. We would like to continue that conversation with staff and local people.”

“Importantly, we want to ensure that our specialist services are always available to patients when they are needed and given the growing demands on our hospitals, this means that increasingly our services will be targeted at those whose care cannot be provided at home or in the community. I’m delighted that our partners are committed to ensuring local access to alternatives to hospital based care to enable us to deliver this vision.”

Chair of Healthwatch Gloucestershire, Claire Feehily said:

“Like other areas of England, the health and care community in Gloucestershire is clearly facing significant challenges. It is imperative therefore that all partners remain committed to working together and devise a shared plan for the future.

We are pleased that Healthwatch Gloucestershire has been asked to contribute to the plan and we welcome the fact that local people will have an opportunity to contribute to these discussions over the coming months to help shape specific proposals for change.”

Claire Mould, Chair of the VCS Alliance said:

“It is promising that the great value, contribution and potential of the voluntary and community sector is being recognised in Gloucestershire and the STP is clear that in order for joined up care and support to succeed, wider partnerships, skills and knowledge are essential going forward.”

Local people can now download a copy of Gloucestershire’s Sustainability and Transformation Plan, read the short guide, complete the on-line survey and find out about engagement opportunities in their area at: www.gloucestershireSTP.net

 

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