North West London Awards 2016: Excellence in Education and Training Shortlisted Nominees

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1 North West London Awards 2016: Excellence in Education and Training Shortlisted Nominees Recovery and Well Being in Practice Project Team The Recovery and Wellbeing College in Practice Project (PIE) is a partnership between Central and North West London NHS Foundation Trust's Integrated Education Team, Recovery and Wellbeing College and the Kilburn Park Medical Centre. Underpinned by the principles of coproduction, a programme of educationally framed courses and workshops for healthy living has been delivered in the GP practice and at venues in and around the local community. Individuals within primary care are being supported to recognise and develop their talents and resources in order to become experts in their own self-care, to self-right ; and do the things they want to do in life. The nature of the clinical encounter is being transformed, changing the nature of conversations and facilitating shared decision making. The project has created learning opportunities which span physical, mental health and wellbeing for both patients and staff. Through collaborative learning, the project offers professional and personal learning and development activities for staff, with regards to how recovery principles are integrated into their clinical practice, and the recognition that staff experience their own recovery journey too. Although aimed at those who frequently visit their GP, the project outcomes will be used to inform whether this model if successful could be extended geographically and expanded to include other pathways, patient groups and conditions. Dr Barbara Cleaver Imperial College Healthcare NHS Trust Dr Cleaver took on the challenge of delivering a short modular course for GPs and Emergency Nurse Practitioners in skills for urgent care. Her objective was to ensure, that as all EDs start to focus on the acute and major presentations, patients with urgent health needs seen in an urgent care centre were given appropriate diagnosis and treatment. The course was closely mapped to the common presentations in urgent care, focusing particularly on those areas where a GP or nurse practitioner may have less experience or confidence, including mental health and paediatrics. These were grouped into relevant clusters of experience and the teaching style varied from lecture, case-based discussion and small practical workshops. Video recording and workbooks for GPs means that the course is both transferable across locations and sustainable. The course has been extremely well received with many requests for repeat courses and future dates. It has also attracted attention from the Pan-London Emergency Care Board who would like to use it as an example when setting a common knowledge and skills based curriculum for practitioners working in the urgent care setting. Harrow CCG Education Forum This project aims to help clinicians and people living with diabetes learn together about the challenges of diabetes to help make changes to their approach, both one to one in the consulting room and in groups through workshops. Specific objectives include making the person perspective central, consulting differently, utilising patient education better and tailoring packages to the needs of different groups but also learning together to create a common approach. Participants were given the opportunity to learn a person-centred, empowering consultation model, suitable for diabetes and other long term conditions, and create their own action plan for how to put their learning into practice in their next clinical encounter. Connecting Care for Children (CC4C) Child Oral Health Project Child oral health in England is a serious public health issue. One third of five-year-olds are suffering from tooth decay, and it is the most common reason for elective childhood hospital

2 admissions. Through the established Connecting Care for Children (CC4C) model hospital paediatricians and general practitioners currently participate in joint clinics and multidisciplinary team meetings in community practices across north west London. In collaboration with the postgraduate dental training team in these CC4C Hubs a new initiative was piloted for 26 foundation dental trainees that aimed to provide consistent and accurate dental health messages to local families. The initiative allowed dental trainees to learn about the wider healthcare system, healthcare inequalities and perceived barriers to better oral health. The initiative successfully created an integrated multi-disciplinary and collaborative educational network between foundation dental and medical trainees and allied health professionals. Maternity Practice Development Team Chelsea & Westminster Hospital NHS Foundation Trust The Multidisciplinary Obstetric and Midwifery Simulation (MOMS) course has been running at Chelsea and Westminster Hospital for the past six years. The mandatory two day course is attended by all midwives, nurses, obstetricians, anaesthetists and trainees in obstetrics and anaesthetics and more recently the maternity support workers and doulas. Annually the course is re-designed and adapted based on evaluation from local risks in the maternity unit as well as risks outlined by national confidential enquiries. The course integrates presentations, interactive workshops, skills and drills stations and simulation based training, designed to focus on both technical and non-technical skills of working within the multidisciplinary team in emergency situations. Since the MOMS course was created, further branches of the course have been formulated including internationally, facilitating courses in Uganda, Ethiopia and central and rural South Africa. So far 31 international training courses have run, reaching over 351 midwives, doctors and health care assistants and an estimated 10,000 maternity patients. Connecting Care for Children Imperial College Healthcare NHS Trust Connecting Care for Children (CC4C) is a Paediatric Integrated care model that has been operating whole systems change across north west London for two years. It is an intervention that enables primary, secondary and community care to work cohesively, alongside the local population. GP practices work together in groups, Hubs of three of four practices, offering monthly specialist children s clinics along with an MDT. They offer a unique opportunity for general practitioners and paediatricians to work in collaboration and deliver the best possible care. This environment generates rich discussions and learning for all professionals. It has seen a substantial (60-80%) reduction in the number of children attending outpatient appointments in secondary care. Trainee doctors work with CC4C as part of their paediatric rotation, which promotes the concept that healthcare happens outside of a hospital and that doctors should consider a patient s journey. ICU Airway Group Chelsea & Westminster Hospital NHS Foundation Trust The multi-professional Chelsea and Westminster Intensive Care Unit (ICU) Airway Group was formed as an innovative response to a critical incident involving a young ICU patient with a difficult airway. The group included ICU nurses, physiotherapists, physicians, critical care outreach, burns team and anaesthetists. Four issues were highlighted as contributing to the incident: lack of airway alerts, need for improved staff education regarding difficult airway management, inadequate handover of patients with difficult airways and pre-operative assessment lacked detail. The result of the initiative is an improvement in safety and quality; airway signs are displayed prominently, staff knowledge of airway emergencies is enhanced and the simulation has allowed staff to learn about human factors and develop teamwork and leadership skills. The quality of care of patients with a difficult airway (including patients with a tracheostomy) has also improved. 2

3 Ridgeway Surgery and the Harrow Local Pharmacists This project came about following concerns raised regarding poor communication between clinicians and local pharmacists. Challenges associated with use of the electronic prescribing system and difficulties in communication between parties led to patient, pharmacist and clinician dissatisfaction. An evening event for local pharmacists and practice members was held for the discussion of these problems and to find solutions with the ultimate goal of increasing patient satisfaction and effectiveness of delivery of patient care. This initiative led to improved communication channels for pharmacists to reach doctors e.g. a bypass phone number and surgery mobile for texts. Pharmacies were asked to warn surgery of medication shortages/unavailability so avoiding patients being prescribed unavailable medications. This innovative joint learning and communication between GPs and the local pharmacists has led to regular joint learning, cost efficiencies, improved two way communication and ultimately improved patient care. Challenges in End of Life Care Project The Challenges in End of Life Care Project was the vision of two GPs who have a passion for education. They had recognised that within their own faculty of GP trainers responsible for educating future GPs, there was a lack of confidence in having discussions about decisions related to resuscitation. This highlighted a need for training amongst Harrow GPs. Now in its second year, it has successfully educated 548 multi-professional attendees across 28 educational events. Attendees have included GPs (including GP trainees), nurses, health care assistants, pharmacists, paramedics and CNWL staff including, consultant psychiatrists, psychiatry trainees and mental health nurses. Attendees have not just come from Harrow but across north west London. The teaching faculty has also been multidisciplinary which has enriched the learning experience of participants by allowing perspectives of different professions to be better understood. The Hillingdon Education & Training Team Hillingdon CCG Over the last 12 months Hillingdon Education and Training team has completely re-vamped their primary care education, making it fun, relevant, contemporary, multidisciplinary, responsive and timely. The result has been positive feedback and significantly improved attendance. This has been achieved by an improved guide for speakers, working jointly with service providers, timing events to align with relevant activities and providing more emphasis on clinical pathways. London North West Health Visiting Clinical Academic Hub London North West Healthcare NHS Trust In 2013, London North West Healthcare NHS Trust developed a health visiting strategy entitled Embracing the Best. This strategy was a local response to the national Health Visitor Implementation Plan a Call to Action (DH, 2011), which identified an urgent need for transformational change in the area of education and development of staff to ensure on-going assurance around the quality of the workforce, while strengthening and building capacity to support student health visitors. In recognition of these difficulties, an innovative clinical academic hub, the first in the country, was set up to support this transformational change in the areas of recruitment and education and development. The hub is still in its infancy but to date has had a positive impact on the health visiting workforce, contributing positively to the majority of staff involved in the audit and improving professional development and training, collaborate working across the three boroughs and improving quality through up-to-date polices, standards and guidelines. It has also contributed to recruitment and retention of health visiting staff, as well as increased staff satisfaction. 3

4 Carers Art Therapy Group Project Central & North West London NHS Foundation Trust This project was established in response to a request from Kensington and Chelsea Mental Health Services to support carers of people with mental health difficulties accessing the services within Central and North West London NHS Foundation Trust. The Trust recognises the challenge that carers face and also the vital contribution that they make in their caring role. A healthy and supported carer can prevent or limit the need for patients to access services, and good support will acknowledge carers needs in their own right. The Art Therapy Group was formed and the number of referrals required a second group to be set up. The carers described the groups as enabling them to feel more positive in themselves and in their role as carers. This seemingly small investment of time paid dividends and the carers feedback and responses showed how the service enabled them to develop and to feel more confident in themselves by allowing their voices to become stronger and better heard. Full of Life Team Full of Life Full of Life is a parent managed charity supporting and providing services to disabled children/adults with learning disabilities and their parent carers. Their roots are grounded in parents sharing experience and expertise to shape and develop local preventative services that keep families together. To ensure parent carers stay healthy physically and emotionally Full of Life provides aromatherapy and massage sessions, organises trips out for parents and encourages parents to take up a local discounted gym membership. They have found that parents often lose their confidence so to address this they provide assertiveness training as well as health, education, social care and legal training. Full of Life also provides day, afterschool/college, Saturday and holiday provision for young people with complex needs who need one to one or two to one support. This service ensures that parents have a break from what will be a lifelong role of caring, the service enables young people to stay in their local communities, learning new skills and building friendships. Full of Life s regular parent forums offer parents the opportunity to meet with other parents, which has led to a very strong community who support each other through sometimes very difficult situations. Bucks New University and Independent Voices Independent Voices is made up of service users and carers who engage with Buckinghamshire New University. The experiences views and engagement of this group are essential to the curriculum development process. The group has known each other and worked together for several years and are a mutual support group, as many of them have similar health and care experiences. The group members are used in simulation sessions, acting in the role of patient which enriches the student learning experience and provides students with a deeper understanding of what will be required of them in practice situations. Group members also participate in classroom sessions, discussing their experiences and healthcare journeys so students can appreciate some of the wider issues involved in delivering care. Kerry Howard, Old Oak Surgery From the moment Brook Green Medical Centre became involved with Old Oak Surgery in 2015, it was evident that one individual had been integral to maintaining the practice list during very challenging times. Kerry Howard, a Healthcare Assistant, has been a member of the practice for almost 27 years. Originally based in East Acton, the practice moved to Shepherd s Bush in Despite many of the patients having surgeries closer to their home they have remained loyal to the surgery. When asked why they have done this, they almost always reference Kerry. 4

5 Nurse Education and Bands 1-4 Development The Hillingdon Hospitals NHS Foundation Trust The Hillingdon Hospitals NHS Foundation Trust has supported the development of Health Care Support workers by embracing and supporting the development from board level down. Signing HEE s Talent for Care Partnership Pledge, demonstrated the Chief Executive's commitment to this initiative. The Trust is implementing a pathway which includes the opportunity for support workers to undergo Level 2 intermediate apprenticeship or (Essential Care Certificate) or a Level 3 advance apprenticeship (Advance Care Certificate). The pinnacle of the pathway is the newly developed (pilot) Progressive Care Certificate which is being delivered in conjunction with Bucks New University to enable Health Care Assistants to be better prepared for university and the requirements for study at undergraduate level. The Trust also works in partnership with Uxbridge Further Education College as part of a workplace shadowing experience and is exploring other avenues to encourage work experience. Dr Francesca Cleugh Imperial College Healthcare NHS Trust Francesca has been instrumental in the development of the Quality Improvement (QI) Hub at Imperial College Healthcare Trust. As the London lead of the Royal College of Paediatrics and Child Health National QI Education Programme she has brought her invaluable experience to both the design and delivery of the programme. It is one of the most successful education programmes provided by the College and is delivered nationally. Francesca has been an innovative, progressive educator, focused on keeping the patient at the centre of the learning and education in QI. Francesca s enthusiasm for the philosophy of QI is infectious, which brings those she meets from all professions and all grades on the QI journey which is fantastic to see as a trainee. Mr Nigel Davies Chelsea & Westminster Hospital NHS Foundation Trust Over many years as a clinical and educational supervisor and departmental lead at Chelsea and Westminster, Mr Davies has done his utmost to maximise the quality of training. He takes every question in clinic or theatre seriously and answers comprehensively with reference to basic principles. He is the cornerstone of the weekly journal club, bringing a fresh and original perspective to any paper discussed. While operating, he encourages and instructs sensitively. He has high standards but takes personal responsibility for everything the trainees do. Mr Davies has made a profound and long-lasting impression on a large number of trainees who have been privileged to work with him. Sharin Baldwin London North West Healthcare NHS Trust Sharin is a great clinical leader, academic, innovator and role model. She carries out trust-wide learning needs analysis for health visiting staff and develops bespoke training packages in response to feedback, identified gaps, learning from incidents, serious case reviews and complaints. Working in collaboration with the Institute of Health Visiting, Sharin has ensured that staff has access to high quality training with regular updates. Primary Care and Community Nursing (PCCN) Route Collaborative Collaboration between Buckinghamshire New University, Hillingdon CCG and Central and North West London NHS Foundation Trust developed a new approach for organising pre-registration nursing placements. The Primary Care and Community Nursing (PCCN) Route involves a three year view of a student pathway and subsequently mapping out individualised placement routes. This PCCN route is sustainable through a robust system of a "hub and spoke" approach to placements which is managed by existing educational roles in the Community Trust and new 5

6 developing roles in the CCG. It has provided an opportunity for students to experience another side of healthcare historically shrouded in mystery for them, with many assuming they are unable to work in the community or primary care setting as newly qualified nurses. It has increased placement capacity and impacted on workforce development with around 50% of third year students on a community placement continuing into employment on qualifying (including district nursing, school nursing, health visiting and children's community nursing). LNWH Non-training Grade Professional Development Programme London North West Healthcare NHS Trust This project provides a full programme/portfolio of professional support to the non-training grades (NTGs) at London North West Healthcare (LNWH). This group (of over 320 doctors) has traditionally received suboptimum professional/educational investment/development. The programme has supported improved compliance for appraisal and revalidation of NTGs and is used to improve recruitment and retention of non-training grades. For example in acute/general medicine all clinical fellows are incorporated into the training rotation so that they rotate through a number of medical subspecialties to gain broad experience. The department has invested in simulation equipment to hold core skills training in house. ARCP (Annual Review of Competence Progression) style annual reviews are held and each NTG has an educational supervisor. Professional development and support is included in the job package which has resulted in improved recruitment and retention in a recent recruitment round of 30 fellows which had previously been hard to fill. With the development of good practice guidelines a process for defining levels of competency which ensures NTGs are appointed into rotas at the appropriate level has been implemented. Progression is based on competency rather than seniority in years in employment. Goodall Education Team Central & North West London NHS Foundation Trust The Nurse Development Days initiative is part of a HEE NWL funded project to support recruitment and retention of senior community and practice nurses across north west London. These days are designed to retain staff in north west London and also break down barriers between nurses working in different settings. The initiative supports nurses from different settings to learn together. Equal numbers of practice and community nurses attend the sessions with a growing number of nurses from the acute sector. The initiative has also been a vehicle to build a network across north west London in the hope to work towards closer collaboration in recruitment. My Next Step Transition to General Practice Nursing Programme Team The University of West London This innovative role development programme, funded by HEE NWL and facilitated by the University of West London, supports the successful transition of registered adult nurses moving from secondary care to general practice posts in north west London. Its success lies in the ability to combine the acquisition of new theoretical knowledge with practical skill development and a framework to support personal development, ensuring the candidates are employment ready. Importantly, candidates can continue with their current employment whilst undertaking the programme, minimising personal and financial risk and maximising recruitment. The programme includes clinical knowledge and skills development, leadership development, mentorship development and clinical expert support and guidance. This results in nurses who are better informed regarding primary care which positively impacts on the patient journey. 6