Alison Moggarch, Karen Kindness and Rachel Taylor lead the Advanced Care Academy, which employs 12 master’s-level fellows to provide instant peer support and mentoring for trainee and current advanced practitioners in nursing, midwifery and allied health professions. Feedback from the health and social care partnership, GPs and trainees has been extremely positive and patients are now cared for by knowledgeable, experienced and compassionate advanced practitioners in a wide range of sectors including urgent care, primary care, out-of-hours care, the acute sector, district nursing, and prison and custody care.
These advanced nurse practitioners are working to improve the uptake of vaccinations by identifying ‘pro-vac champions’ in Northern Ireland and the UK. They train the champions to have positive and informed conversations with families who are unsure about vaccinations. The multidisciplinary movement has a two-pronged approach. There are antenatal clinics for vaccine-hesitant mothers who have concerns about toxins, pain and side-effects. There are also bespoke information sessions on vaccine safety and having conversations with vaccine-hesitant parents for healthcare professionals in primary care, secondary care and for nursing and medical students. Healthcare professionals and families taking part in the sessions report a significant increase in knowledge and confidence about vaccination.
As the first advanced nurse practitioner in Lancaster Farms prison, Helen Bishton has improved complex care in this challenging environment. She understands the men’s health needs and behaviours, and works one-to-one to help them appreciate the risks surrounding traded drugs, understand changes that affect them and de-escalate potential confrontations. Access to healthcare has improved with average waiting times for GP appointments down from 5.5 to 2.5 weeks. Patients now have a central nurse contact who manages their care from triage to assessment, diagnosis and review. The supervision and training Ms Bishton gives to upskill the wider nursing team has meant fewer prisoners have to travel with an escort to hospitals or clinics for care.
The advanced nurse practitioner team at the breast unit at Royal Stoke University Hospital has transformed the experience of cancer survivors by devising and implementing a new self-managed pathway. Instead of attending a follow-up meeting every 6-12 months, patients are supported and empowered to manage their own recovery and live well without needing to come to hospital. At the end of their treatment, they receive a holistic needs assessment and advice. Patients value the personalised and comprehensive follow-up and are reassured by swift access to telephone clinics. This success has seen the project taken up by other cancer teams at the trust.
Rosa Ungpakorn’s research has involved designing and leading the Westminster street nurse project, delivering on-the-spot advanced nursing care – clinical assessments, diagnosis and treatment – directly to the most vulnerable homeless people. Street outreach had been limited to signposting but now nurses assess a range of issues including infections, musculoskeletal pain, respiratory issues and parasitic infestations. They prescribe medication and basic wound care as well as referrals to mental health, midwifery, safeguarding and substance misuse services. Despite having no additional funding, the project has seen a 400% increase in the number of patients seen on street outreach, 80% of whom had not been accessing in-reach services.
Families with children and young people requiring invasive ventilation wanted to access palliative care services, but the Chestnut Tree House Hospice workforce was unable to provide it. Led by practice development nurse Anna Jones, the clinical team launched Ventilation Month, which included 200 individual training sessions. With a new integrated care model, community nurses built trust and developed their skills by caring for patients at home, then during their first hospice stays. The team offers palliative care services to 15 invasively ventilated young people, including inhouse short breaks and respite care in the community. Feedback from families has been excellent.
Children and young people who needed intravenous (IV) antibiotics outside 9am to 5pm, Monday to Friday, were forced to stay in hospital. This team set about transforming itself to support IV delivery at home. A programme of supervision and support ensures all the nurses are trained to safely administer and monitor any effects as lone workers. The initiative has reduced hospital visits and, in many cases, prevented admissions, dramatically improving the experience for the child/young person who can enjoy a more normal family life. It has also saved hundreds of inpatient bed days.
Roald Dahl transition senior nurse specialist Ms Padmore Payne supports and empowers children and young people with non-malignant haematological conditions, such as sickle cell and thalassaemia, as they move to adult services. As well as providing young people with one-to-one guidance and advocacy, engaging this hard-to-reach group through social media, WhatsApp and video presentations, Ms Padmore-Payne tirelessly organises transition workshops, patient support groups and peer mentoring. She receives excellent feedback for her patient-led pathway and has also developed training and resources for her colleagues.
This team has devised a rotation system to meet the growing need of nurses to have the skills to provide mental and physical health nursing care to children and young people in their respective settings. All the nurses who took part from a general paediatric ward at Whipps Cross University Hospital in London, Brookside mental health inpatient ward and the community children’s nursing team are now more skilled in providing holistic care, and the children and young people and their families have responded positively through feedback. Each setting has adopted elements of best practice from the others to improve the experience of their patients.
Uptake of vaccinations among children with autism and learning disabilities in Bradford and Keighley was low and the process was distressing for all involved. This school nurse team introduced an immunisation desensitisation programme. All preparation and vaccinations are delivered in the school by a familiar school nurse with the child’s support worker. The process is safer, less distressing for all, and more children are accepting vaccinations. Parents and carers are trained in desensitisation techniques and report their children are now able to have blood tests during annual health checks. The initiative is being developed into a package to support practitioners across the country.
Strategic transformation hub clinical lead Julie Bates has worked with parent carer forums to improve services for children and young people with learning disabilities. Through a Children and Young People’s Network they have built they ensure that parent carers lead strategic planning. Parent carers have co-designed and co-deliver an accelerator schools project, which works with children and young people with autism to prevent family breakdown and school exclusions. Parent carers report positive changes at home and say their children can see that their education is valued. The parent carers have greater confidence in talking to schools and raising concerns, feel less isolated and more confident in what their children are entitled to.
This team of nurses has put in place a range of measures to improve the support given to hundreds of people informally caring for someone with dementia. More than 500 carers have been visited in the community or hospital, with more than 370 using the peer support group. There is a dedicated support clinic for hospital staff who are also carers. The team’s intervention prevented more than 80 admissions in its first nine months. Carers themselves have driven the content of the team’s Carers Equip programme. Weekly training and support sessions, held in community centres, cover continence, end of life, resilience and well-being for carers as well as falls prevention.
Ms Walker has dramatically improved the experience of carers by developing a package of support that is individualised and person-centred. She has trained others in and piloted the use of carer needs assessments. Feedback demonstrates how carers value the peer support, advice, education and social opportunities they can access through the drop-in group she started. Working with Carer Support West Sussex she designed and delivers an end of life seminar for carers that has been so successful it is now used through West Sussex. Carers report being ‘given their life back’ by her individualised support plans. She also conducted a survey to identify staff carers and provide them with support.
Clinical lead in school nursing Lynda Edwards has led her team in improving the support they give to this vulnerable group. She engages young carer services across the country, and new guidance and procedures have been written and introduced so that every school nurse can identify young carers in schools and provide high quality support. School nurses raise their visibility by attending young carers’ events and conferences and holding workshops with them. They identify young carers through online health assessments. Tailored care packages taking account of family circumstances, age and culture, written in consultation with the young carers, are tailored to meeting mental and physical health needs. The effectiveness of the packages is regularly tested.
Nurse Rachel Wright launched Born at the Right Time to support healthcare professionals in communicating effectively and working in partnership with relatives and carers after her son was born with severe brain damage and she began to experience the gap between professionals and families. To bridge that gap she designed training in communicating and care co-production with relatives and carers, and provides sessions all over the country in social, education and health settings. Feedback shows participants leave the training with a better understanding of carers’ lived experience that will inform their practice. She also provides workshops for carers and relatives.
The Carers Academy empowers informal carers of people with dementia to develop practical skills and knowledge and give them emotional support through a one-day programme backed by telephone follow-up. Dementia nurse consultant Susan Holland shaped the schedule for the programme, which is delivered by a multidisciplinary team, including peer support sessions in the morning. A practical skills workshop in the afternoon includes moving and handling and oral care. There are sessions on technology, advocacy services and maintaining the carers’ own well-being. Carers report that their understanding and empathy increased, as did their levels of confidence in supporting care and planning for future needs. They also felt less isolated.
Ms Domingo Lacasa has been nominated by a colleague for the way in which she has taken on a new, innovative clinical practice facilitator role in the 100-strong research team at University College London Hospital’s clinical trials unit and made it a success through her drive, enthusiasm and evidence-based approach. To ensure standardised, safe and effective care for patients enrolled in trials, she has designed, piloted and evaluated an induction programme for new starters, assigned them a mentor and given them eight-week supernumerary status. She has also introduced a programme of clinical skills training and reflective practice sessions.
The National Experimental Cancer Medicine Nurse Steering Group was concerned that nurse recruitment, gaps in undergraduate education and lack of awareness of the role of clinical research nurses would have an impact on early and late phase cancer research and the patients who might benefit from it. Steering group member Mr Hood volunteered to develop a pilot project to highlight the role of clinical research nurses in cancer services that could be used across the UK. He delivered education sessions to 2,000 students in north east England, and presentations for Edinburgh Napier University and is currently developing this work into an E-learning resource for undergraduate nurses in partnership with the National Institute for Health Research. There are plans to develop the work nationally.
Led by advanced research practitioner Jennie Derham, this team has been making early phase trials accessible to all patients in Cheshire and Merseyside many of whom have exhausted their treatment options. It has developed a successful early phase trials clinic after securing resources and space. The team raises awareness of the new service across the trust with a monthly newsletter and has seen an increase in referrals. The team’s work means that it can open and manage a larger portfolio of trials, and it has been able to offer more early phase treatment options to patients.
Led by Sharon Woolley, this team has worked enthusiastically to ensure a package of training is available for all research nurses who support oncology clinical research in their practice. The training covers the basics of cancer and its treatments as well as helping nurses appreciate the impact of a cancer diagnosis on a patient and their family. Participants’ improved knowledge and skills, and understanding of patient pathways and the breadth of treatments available is enhancing the patient experience and the support they receive. The nurses’ response to the training has been extremely positive and there is a waiting list for further cohorts.
This nurse team’s strategy of continual improvement and review and its work to embed research as part of Clatterbridge’s culture has resulted in more patients receiving faster access to pioneering clinical trials. It has been central to the development and introduction of a new feasibility process in which nurses are involved at a much earlier stage. New trial set-up times have been slashed from 198 days to 27 days. There has also been a significant increase in recruitment with 975 patients recruited by month nine of 2019/20 compared with 513 patients recruited in the whole of 2018/19. The number of commercial studies open at the centre has increased from 20 to 27.
Ben Bowers was concerned about guidance that advocated prescribing injectable end of life drugs weeks or months in advance. The Queen’s Nurse’s systematic review found an inadequate evidence base and his rigorous research identified that GPs and community nurses were making decisions to prescribe the drugs weeks or months ahead of a person’s anticipated death. He has used his research to improve the safety of this prescribing practice through targeted social media, clinical conferences and workshops to get balanced information out to clinicians. He has also met senior directors at NHS England and the Care Quality Commission to discuss how his findings can inform the response to the Gosport War Memorial Hospital scandal.
Queen’s Nurse Donna-Marie Thomas has been nominated by her colleague for being the ‘driver, leader and visionary’ of Homeless Hope, a street care charity in South Wales. She drew on her own experience of living on the streets from the age of nine, after fleeing abuse, to build trusting relationships with disengaged and vulnerable rough sleepers. The 120-strong volunteers she leads treat swollen feet from continuous walking, calluses, dried skin, blisters that are often de-roofed, and trench foot in three Welsh cities. She collaborates with other voluntary services and ensures referral to secondary care when needed.
The care of homeless people in Swansea has been transformed by Janet Keauffling’s hard work and unfaltering dedication over the past 15 years. Her comprehensive, flexible, non-judgemental outreach and in-surgery service covers health promotion and disease prevention, alcohol and drug misuse, and referrals for specialist services, such as sexual health. Her proactive approach engages hard-to-reach, chaotic patients with multiple needs. Evaluation shows the dramatic improvement she has made to people’s lives. She also offers daily shadowing and learning opportunities for colleagues, and regularly presents at conferences and multidisciplinary team meetings to ensure the voice of people who are homeless is heard.
Nurse manager Joyce Pickering set up a nurse-led social prescribing model for patients needing support for non-medical problems, such as isolation, pre-diabetes and mental ill health. Her work enables patients to find their own solutions by giving them the right tools. She wrote a business plan, sourced training and consulted the patient participation group. The 12-week programme has seen participants lose up to 10% of body weight, an average reduction in HbA1c of 18% and a reduction in hypertension medication. Patients report feeling in control of their health and say they have more energy and motivation. The successful pilot is being developed for group consultations, including for isolated young mothers.
Recognising that oral care was not being completed efficiently, lead clinical facilitator for supportive palliative care for care homes Marie Roberts created a working group with the dentistry team and persuaded an oral hygiene company to provide free and frequent training to 374 healthcare staff. Alongside her full-time role, she developed a teaching package and resource for each care home and district nursing team to help them assess, plan, manage and evaluate oral care issues. Her passion and the support she offered care home staff secured their engagement. Oral care across all the trust’s settings has improved, with the acute sector also adapting the work and sending staff for training.
Nurse practitioner Philippa Hynam successfully planned, secured funding for, and implemented group consultations across five East Devon practices for adults with poorly-controlled type 2 diabetes. Patients were able to co-design their care and receive more support to self-manage their illness. She negotiated back fill payments so practice nurses could access training and supported them to deliver the pilot scheme. Blood pressure, HBa1c and weight averages have improved and patient satisfaction is high. Patients report feeling better supported and less isolated. Practice nurses have embraced the model and plan to upscale group consultations, reporting improved relationships and more time with patients.
Wolverhampton has the highest rate of infant deaths nationally. Led by Sue Watts, these school nurses and health visitors developed and piloted an education programme for Year 12 students, raising awareness of risk factors and empowering them in future decision-making. A teacher-training package was also devised. Evaluation shows a huge increase in students’ understanding of risk factors and the impact of risk-taking behaviour, as well as the benefits of breastfeeding and planned pregnancies. The five-school pilot was so successful that it has been rolled out through the city’s other 18 schools. It will be adapted for special schools, pupil-referral units and young offender institutions.
Nursing sister Ana Waddington took action in frustration over the number of young people arriving at her emergency department as victims of serious youth violence. One teenager died unnecessarily because his friends were unaware they needed to apply pressure to his wound. Ms Waddington set up the YourStance project, which runs workshops that teach young people aged 13-25 lifesaving skills. She started with three volunteers using a manikin in Feltham Young Offenders Institution near London but now, in her own time, coordinates the 150 NHS volunteers she has recruited, including nurses, doctors and paramedics. Using her savings and working extra bank shifts to help fund the project, she has reached hundreds of young people.
Ms Woodley has transformed a failing dermatology service into one that is outstanding and person-centred through clinical leadership, co-designing improvements with patients, and using technology from the US in this isolated location. As service lead she vets all referrals, performs complex diagnostics, delivers multiple complex therapies and initiates medication and treatment plans. Waiting time breaches for urgent referrals have gone from 55% to zero. Weekly rather than monthly clinics are improving outcomes for patients with suspected cancer, and all patients are put on a treatment plan within a week of referral. Patient satisfaction questionnaires are all positive. The patients say they feel listened to, appropriately treated and reassured.
Evidence showed that patients were receiving containment products even though incontinence can be significantly improved or cured in 80% of cases. This team of nurse specialists, led by Fiona Tynan, devised a person-centred bladder and bowel assessment tool and treatment pathway for community nurses and acute hospitals, and embedded it in electronic patient records. In the first 18 months the number of new patients prescribed continence pads fell 78% thanks to assessment and treatment. Feedback shows the assessment process has picked up undiagnosed diabetes and that patients’ overall well-being has improved. It has saved 782 referrals to district nursing.
Led by Denise Lyons, this team co-produced a comic book with young people in custody highlighting the dangers of drug misuse in prison by bringing their personal stories to life. The comic book, called Biz in the Pris, is a fun but credible and authentic education resource now being used by community addiction teams, child and adolescent mental health services, juvenile justice services and adult prisons. Feedback from the men who co-created it has been positive. They have learned new skills and overcome their own drug problems, and are now mentoring others. They are already working on their next publication, which will be on self-harm.
This team, led by home manager Deborah Payne, wanted to improve the nutrition of residents with complex and advanced dementia, who often forgot to eat or drink, or paced about during mealtimes. It planned, implemented and evaluated the effect of a five-minute activity conducted five minutes before mealtimes, supported by analysing and documenting food preferences and supporting staff to interpret verbal signs. The study was filmed on a phone camera with families consulted throughout the study. All but one resident gained weight, mealtimes were calmer, people who had needed assistance were able to eat unaided, and a marked increase in positive behaviours was noted.
Ms Bagley has been responsible for implementing and supporting a multidisciplinary specialised memory clinic for people diagnosed with Down’s syndrome, a learning disability and/or autism. As well as delivering training to the multidisciplinary team, the senior practitioner developed a range of pre-assessment tools and undertakes a comprehensive pre-screening of each referral. Feedback shows that patient experience has improved. More clients have received a diagnosis of dementia and receive tailored ongoing support. Assessments are complete within an hour in collaboration with the service user, their family member or carer, and the client receives feedback and a proactive follow-up plan delivered the next day.
The learning disability nurses at HMP Parc have transformed the experience of people with learning disabilities through their wide-ranging Cynnwys (inclusion) project. A specific wing has been developed to safeguard and support people with learning disabilities and autism spectrum conditions. A holistic and person-centred approach encompasses their education, complex health and sensory needs, including meaningful and therapeutic activities and behaviour management plans in a way never before achieved in a prison setting. The nurses have also built relationships to improve the transition from custody to community, and put safeguarding measures in place to reduce the risk of reoffending, harm and behaviours that challenge.
Nurse Jennifer Hudson, along with a sexual health promotion practitioner, delivers relationship and sex education sessions to adults with learning disabilities. The sessions cover self-care, emotion management, sexuality, consent and sexual health, helping participants to make safe choices in safe relationships and safeguarding against exploitation and abuse. As well as planning and evaluating the service, Ms Hudson assesses individuals to ensure a holistic and tailored approach. Accessible resources have been created to meet the diverse range of participants’ needs. The sessions have also led to a number of participants identifying breast lumps, and accessing cervical screening and sexual health services. Training is offered to staff supporting people with learning disabilities.
Mr Fullerton is the driving force behind Raising the Bar – Core and Essential Service Standards, which, for the first time, benchmark what good support looks like for adults and children with profound and multiple learning disabilities. Families, commissioners and service providers can use them to ensure support is focused on positive outcomes. Mr Fullerton sought the support of a wide range of stakeholders to develop his idea before launching them at a Raise the Bar conference. The standards have improved the support his own organisation provides, leading to improved community access and better use of assistive technology for communication. Other organisations report similar results from using the standards.
Realising the service users with learning disabilities that they supported would not use traditional weight management programmes, this nurse team devised the Step-Up scheme. They supported their clients to apply for a personal health budget, which was then pooled so the group could access a specially adapted programme at a local fitness centre and receive intensive dietary advice and support. The nurses support individuals to access the programme, including home visits and activities, such as supermarket trips and deliver nutrition advice. Participants found the programme fun, interactive and they enjoyed learning about exercise from a personal fitness trainer and being active with their peers. They lost on average 4kg each.
Interim clinical nurse manager Emma Watts has led the introduction of trauma-informed care in women’s secure services. She developed e-learning and face-to-face training, including a multidisciplinary team and patients, to improve understanding of how everyday interactions are affected by historical traumatic experiences. There are self-care boxes on wards that staff can use to role-play coping strategies for service users. Nurse-led mini debriefs for staff and service users prioritise well-being and learning. Independent evaluation has been positive. Patients feel they are treated with kindness and compassion while staff feel empowered to make changes and that the impact of working with challenging patients is recognised and supported.
Euan Hails developed training so child and adolescent mental health nurses can make young people and their families a full partner in identifying problems and creating treatment plans that inform their journey from initial assessment. The consultant nurse went on to develop and deliver an 18-month psychological therapy training course for nurses, including monthly supervision. The initiative has improved young people’s access to psychological therapies and reduced waiting lists. Nurses trained so far report that their knowledge and skills have increased and they are confident in using them in their practice. The initiative has been adopted by two other Welsh health boards and Welsh mental health charity Hafal.
Mr Brennan is committed to eliminating restraint and restrictive practices used on inpatients with mental ill health or learning disabilities throughout the UK and across the world. He inspires and encourages the use of other ways to minimise aggression and challenging behaviour while promoting safety and maintaining personal dignity for people who are in crisis on acute inpatient wards. Over the past 30 years he has created carers’ groups and benchmarks, delivered projects and research, undertaken inspections and chaired acute care forums. He is executive director for Star Wards – part of social justice charity Bright – providing practical ideas and sharing examples from and for mental health ward staff.
Amid concerns about the level of restraint used at their trust, this team developed the Talk 1st programme. It leads all wards – and some community services – to develop their own strategies to reduce violence and aggression, with follow-up support to implement them. It also models co-production and multidisciplinary collaboration to find creative solutions in different settings including CAMHS, forensic, learning disability and general psychiatry. Since it started in 2016, the initiative has seen restraint reduced by 23%, prone restraint reduced by 38% and a nearly 21% reduction in the use of mechanical restraint equipment. The use of seclusion is down 35% and assaults on staff have fallen 18%.
This team of nurses and young people with lived experience has developed and delivers innovative training to hospital staff to improve the experience and outcomes for children and young people attending hospital in mental health crisis following self-harm or attempted suicide. The training has been delivered to more than 2,000 staff across England, with the overwhelming majority reporting improved knowledge and confidence, and 99% saying it would change their practice. Trusts have reported a reduction in the number of risk incidents – where previously they had been routine –and improved management of children and young people waiting for mental health assessments.
Adult nursing student Fiona Fitch has extensively researched how students can contribute to improving care of deteriorating patients. She registered to speak at a Health Education England (HEE) learner engagement event to provide feedback from her student perspective on recognising and prioritising deteriorating patients, and the effectiveness of NICE pathways and sepsis decision support tools. The second-year student’s presentation was such a success that she is now delivering it to adult nursing students at her university and has been invited to talk to HEE again about her experience of learning to help other adult nursing students. In practice, her research gave her the confidence to challenge the opinion of senior colleagues.
As a mother, a full-time student and a part-time healthcare assistant working with patients with complex needs, Lynsey McLaughlin recognised that nursing students needed more support. Having undertaken the nursing school student representative role, she met many students facing distressing situations, challenging academic obligations, pressures in practice and financial struggles. After numerous meetings, engaging students and stakeholders, she was given a space and funding to create a safe and supportive place for her peers to meet and eat a healthy, affordable meal they prepared at home.
Second-year student Nathan Harrison created the Parent and Carer Support Network at his university in response to nursing students with caring responsibilities expressing their frustration at the demands of the course and being unable to discuss their concerns. He set up a Facebook page to facilitate discussions with other students facing these challenges. He has used feedback to ensure content remains relevant and has completed training on safeguarding and signposting to university support systems. Feedback shows the page has improved morale and he is working with other universities interested in developing similar projects.
Believing there is a huge gap in care and treatment of people from the Deaf community, first-year adult nursing students Rebecca Lennox and Robyn Mills introduced two days of British Sign Language classes for university staff and students, enlisting the help of charity Deaf Active. Participants report more confidence in approaching and communicating with people from the Deaf community, enhancing their care, and in some cases have been able to ask patients about pain or if they needed a drink. Demand for places has been so high that the students are pushing for them to be on the curriculum for all healthcare students and they plan to deliver the classes every semester.
This third-year children’s nursing student created a national peer support network based on child health on Twitter. The Children and Young People Student Nurse Network – @CYPStNN – has more than 1,000 followers and acts as an information hub where students can access support and advice from around the country and share information through regular Twitter chats. Mr Baker researches and creates content that students need, as well as advising a team of volunteers tweeting on the account. He spreads the word by speaking at universities and conferences and hosting stalls at events in his spare time.
Sean Prendergast and Laura McAdam led a diverse committee, across four universities, to deliver the first Scottish Future of Mental Health Nursing conference, which featured speakers, workshops and more than 25 recruitment stalls and charities. Ms McAdam’s clear communication was crucial in ensuring a seamless flow of information through online and face-to-face meetings, a packed programme and a workable venue layout. Mr Prendergast secured the £40K needed to finance the event through selling stalls to health boards and trusts UK-wide. They secured a fantastic turn out of 500 students and 100 healthcare professionals through universities paying a nominal fee and agreeing to support their students to attend.
This group attends programme planning meetings to give a student voice to the developing and current curriculum to maximise the opportunities for student empowerment. It gives feedback while modules are being developed to ensure the student perspective is considered. As its workload increased, the group, supported by lecturer Peg Murphy, successfully developed a business plan to see the students paid as empowerment consultants. It continues to co-produce the new curriculum and has developed guidance for students going on placement. It is also developing a collection of reflections on placement experiences to help new students feel more comfortable about the challenges they face.
Temitope Babajide decided to undertake her elective in a regional hospital in Ghana, fundraising to ship medical equipment and supplies donated by her placement trust. Once there, as part of a service improvement project she gave a presentation on using gloves to nurses, colleagues and the wider multidisciplinary team, adapting resources from a gloves awareness conference she had attended at home. She helped run a sport event at a local orphanage and organised a widows’ event, which included a health check, empowerment session and free lunch. Through that screening, some patients received diagnosis of underlying conditions and are now receiving appropriate treatment.
Dedicated healthcare support worker Alex Worgan’s passion for improving the care and support of patients and their families saw her join the multidisciplinary dignity group at Velindre Cancer Centre. When the centre lost momentum and its chair stepped down, Ms Worgan moved out of her comfort zone to take the helm, learning new skills to write agendas, book meetings, access Welsh translation services and control group conversations. Newsletters are regularly distributed to all staff. With her infectious enthusiasm and commitment, she has reinvigorated the centre, guiding it to be an award winning, proactive and productive champion of patient dignity.
Good staff morale and well-being are paramount to ensuring staff can provide a high standard of palliative and end of life care for children and their families. Acknowledging that her colleagues worked in an emotionally and psychologically difficult environment and that morale was low, senior support worker Ms Milne initiated, developed and implemented Time4Teams. These group sessions allow teams to do something together including commando training, coastal rowing and dancing. Ms Milne negotiates with nurse managers so the sessions are in work time and contacts outside facilitators. It has been such a success that it is now an integral part of the organisation’s mandatory training.
As part of the learning disability team at Neath Port Talbot Hospital theatres, healthcare support worker Ms Pugh-Davies’ helps to maintain patient safety standards. These standards have dramatically improved her patients’ experience and health. She attends best interest meetings to ensure she knows people’s likes and dislikes before developing individualised care plans, going the extra mile to print favourite posters to display in theatres or sourcing favourite films or music to alleviate patients’ anxiety. Her precision planning and desensitisation saw one patient accept his surgery and make changes to his strict routine that have enhanced his quality of life.
As an assistant practitioner on a general medical ward with many frail patients, Rebecca Greenacre devised a booklet Beat Bedbound Boredom in Hospital to encourage exercise and mental stimulation. It also contained hospital discharge information. She wrote and printed the first draft, tested it on colleagues, patients and relatives, devising a questionnaire to gather opinions. After linking with the quality improvement lead, she has revised the booklet into a publication for every patient on the ward and is using a PDSA (Plan, Do, Study, Act) approach to evaluate patient feedback. The final publication will be edited and published with support from the trust.
North Belfast Day Centre support worker Robin Kelly delivers a programme of activities for adults with mental health challenges including schizophrenia and personality disorders. He has developed angling, exercise, arts and crafts, gardening, cooking and even jam making skills to ensure he offers what service users need and want to practise. His main focus is developing and delivering psychotherapeutic groups such as relapse prevention, anxiety management, resilience building and assertiveness training. The groups are so valued that people do not want to leave even when recovered. He is a dedicated advocate and attends community forums in his own time to raise awareness of the services.
James Birch was on a flight home from Thailand with his partner when he went into sudden cardiac arrest. He credits fellow passenger Isobel Corrie for saving his life, and has nominated her for the Patient’s Choice award. ‘Despite only recently having qualified, this brave young lady answered the call for help and pulled me back from a flat-line cardiac arrest,’ says Mr Birch. ‘In the cramped environment of a long- haul aircraft at 38,000 feet, she managed the small cabin crew team for 45 minutes until we could divert to a suitable airport. The emergency care she supervised was so thorough that despite the length of time the event continued for, I suffered very few health consequences.’
Marie Perry has been nominated by Nicola Protheroe-Jones for her work to safeguard a young man with learning disabilities who was being neglected. ‘Without her determination, he would have died,’ she says. ‘For nine months she went all out to unravel the history and make sure this information was heard. She became a medical detective, chasing leads and clinicians to collect information, to show evidence of abuse and drug misuse. She engaged every professional connected to the case – GPs, pharmacists, consultants, care providers, learning disability nurses, drug rehabilitation units, social services, commissioners and police – before formulating a plan they had to adhere to. He would want to thank her for he is now safe, happy and living his best life.’
Three patients have nominated their HIV clinical nurse specialist. ‘I was full of dreams when I was diagnosed,’ says one. ‘My hopes seemed in tatters, my family rejected me. Mary tried to enter my life but I refused to see anyone. But with infinite kindness and compassion, she pleaded with me for weeks to give her a chance. When I did, she made me understand I could enjoy a healthy, happy and fulfilling life if I took my meds. At my most distressed, I frequently called her at night and she always answered. Now I am commencing doctoral studies. It has only been possible because of Mary.’
Health visitor Noreen Ferguson has been described as ‘a guardian angel, who shows great empathy and gives the families in her rural Northern Ireland community strength and confidence’. Her nominator, Olivia McManus, says Ms Ferguson helped and guided her family through their son’s autism diagnosis, and is a source of support for the whole community. She says Ms Ferguson not only works hard to ensure families get the services and referrals they need, but that ‘her compassionate and practical approach unravels the stigma of those referrals’. ‘Whether it be bereavement in a family, special or additional needs, illness or isolation, Noreen is the one we can turn to.’
The young women at a mental health residential facility nominated Rebecca Betts-Richards. ‘Rebecca works past her hours nearly every day,’ say the nominators, residents at Chilwell House in Derbyshire, where Ms Betts-Richards works. ‘If we need to see her five minutes before she’s due to leave she stays. She never gives up on us. We have all faced negativity due to our personality disorder diagnosis, but Rebecca treats us like we have a superpower not a disability. She has stuck her neck out to challenge doctors, nurses, police and people who were not supportive. She teaches us to move forward with our lives and make them what we want them to be.’
A man who was discharged to a nursing home with just weeks to live, but thanks to exemplary care is now happily living his ‘second life’, has nominated manager Rekha Govindan and her team. Trevor Quinlan says: ‘I had a 15cm hole in my stomach, couldn’t eat or walk. Rekha came up with a plan that saved my life. She came in when she wasn’t meant to be working to check on me, and with her skill the wound healed. The team helped me to walk again. When I was a little better, they took me to a pub for pie and mash and drove me to see my mum. They filled me with hope and made me want to fight and not to die.’
These nurses have built relationships with national and regional justice and health networks and 43 prison governors and healthcare teams in their drive to eliminate hepatitis C in prisons. They have engaged this challenging group by breaking down stigma through peer workers and working with the Hepatitis C Trust. High intensity testing days ensure even patients who won’t leave their wings participate willingly. Using opt-out testing and early identification techniques, in its first seven months the team screened 19,000 patients, with 120 testing positive and immediately referred for treatment. The roll-out of training and data capture has seen sites shoot up to 100% of patients being offered and screened. Health in Justice is an independent provider of health services in prisons and youth offender establishments.
Service lead Melanie Pettitt’s commitment and vision have driven this multidisciplinary team’s integrated physical and mental health service, which has significantly improved the quality of life and end of life for care home residents. The team’s holistic approach puts care home residents and their families at the centre of all care, and its training has been delivered to more than 7,600 care home staff on 59 subjects. Emergency department admissions have plummeted and more than 8,400 hospital attendances have been avoided. All but 1% of residents died in their preferred place of death. Falls have been reduced and 39% of residents have had their medication reduced or stopped.
Ward manager Siobhan Blair has led her team in delivering Project Retain on her rehabilitation ward, aimed at retaining and recruiting more nurses to work in settings caring for older people. An inspiring ambassador for nursing older people, she supported, inspired and challenged her ward team to achieve their potential and worked enthusiastically at regional level to drive the project forward. The team felt valued and supported and were encouraged to contribute their ideas. Their ownership of the project secured its success. Evaluation shows an increase in staff and student satisfaction, improvements in care and positive feedback from patients. There are no band 5 vacancies.
This team ensures that all babies, children and young adults receive the best specialist palliative care wherever and whenever they need it. It has built relationships with every department that cares for the sickest children and young adults – paediatric intensive care/high dependency unit, neonatal, fetal medicine, adult hospices and oncology services. As a result, referrals for end of life care have quadrupled over four years. Once a referral is received, the nurses offer a 24/7 on-call service, providing comprehensive symptom management including prescribing, advanced care planning and psychosocial support for the whole family. Memory making and arranging bucket lists are core to the care it provides.
It is traumatic when your baby is born prematurely or with serious complications. This team, led by matron Maryam Kharusi, is leading the way in family-integrated care – making sure that even though their babies are in the neonatal intensive care unit, parents become equal partners in their care, with fantastic results for both. Parents are equipped with knowledge and information and feel more confident in delivering day-to-day care of their vulnerable babies, including nasogastric feeding, changing nappies and giving them a bath. They feel more confident to go home to start a more normal family life, even with babies who have complex needs.
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