Since it was set up in 2020, this service has transformed continence care for children and young people in Lincolnshire. It provides a single point of access for healthcare professionals and parents to make referrals for specialist support for constipation, daytime wetting and enuresis. Referrals to secondary care have been reduced and children can be seen closer to home. Spending on continence products across the county was reduced by £32,748 in 2020-21 and £28,772 in 2021-22. The team has also provided training for the children's health team to improve the early identification of constipation and the promotion of toileting skills to prevent delayed toileting.
Staff nurse Imogen Spencer drove the implementation of a vCreate secure video messaging service to minimise separation anxiety when parents of sick children and infants on a surgical ward were not able to be with their children. She approached the company to set up a pilot, securing quotes for sponsorship from the trust’s charity. She led a working group to look at implementation and training of staff and offered parents who would benefit from the service the opportunity to receive videos and photographs of their child. Parents and carers report that the service has provided them with contact and memories they would otherwise not have had.
This team has developed a paediatric virtual ward that allows children to be cared for in their own home when previously they would have to be seen in hospital. This has reduced the length of hospital stay by an average of three days per child. Parents and carers now feel fully supported when caring for a sick child at home as they have direct access to specialist nurses and doctors. This has reduced the need for GP appointments and the use of emergency services. Families and carers are relieved they can stay in their homes and they are empowered to be able to look after their child with the reassurance of having access to specialist support.
Head of nursing for children and young people Robert Cole and head of nursing for mental health Kevin Ramjeet have significantly improved the experience of the surging number of children, family and carers presenting with mental health problems or behavioural crisis in the acute paediatric unit of the trust’s district general hospital. They recruited a dedicated specialist team to support children and their families and provide therapeutic interventions. Children with eating disorders are better supported, there has been a reduction in episodes of self-harm, and violent incidents and the use of restraint have been reduced. Feedback from parents and carers has been very positive.
The collaborative SUNBEAM, or Supporting Uncertainty for Babies Early in Antenatal Management, project was developed to better integrate work of the fetal medicine, palliative care and perinatal teams in Wales for families facing antenatal identification of potentially life-limiting fetal congenital anomalies. Raising awareness of the role of the palliative care team to families and professionals was key to this, the aim of facilitating local multidisciplinary teams to lead perinatal palliative care planning where end-of-life care was anticipated postnatally. This work has supported delivery of truly family-centred care by the multidisciplinary team in Hywel Dda Health Board, which covers a large rural area, recently supporting two families the option of delivering close to home through a coordinated local MDT approach. Spreading sunbeams enabled early discussion around wishes, expectations with choice/place of care and making memories central to the team ethos.
Carers lead Andrea Hone acted quickly when the National Inpatient Survey showed that her trust had scored below average for considering patients’ home situation and involving patients in discharge decisions. Working with the hospital’s integrated discharge team and Hertfordshire County Council, she started the Connecting with Carers Discharge Project/recruited a Carer Coordinator. Scoping the needs of carers of patients in Watford General Hospital’s frailty unit and what mattered most to them following identification. Following this, carers are supported during a patient’s admission at the hospital, and there are prompt referrals for support as required working alongside the voluntary organisations. Carers received follow-up calls at two and four weeks after discharge to review referrals, check on well-being and to discuss any concerns.
This team brings specialist dementia support closer to home for carers and families in areas where there are currently no Admiral Nurse services by providing nurse-led clinics on a virtual platform. Evaluation of the project has shown that carers feel more equipped to cope with their caring role and more informed to make decisions on behalf of the person who is living with dementia. They report increased understanding of the condition and a better ability to support the person with some of their symptoms and behaviours. Importantly, carers also feel more able to care for themselves and recognise their own needs. Mobile clinics are being planned to offer face-to-face support now that pandemic restrictions are no longer in place.
To meet the challenge of the pandemic, Dementia Carers Count (DCC) adapted its face-to-face multidisciplinary collaboration with family carers and delivered live online learning sessions covering a range of topics. These sessions enhanced carers’ knowledge and resilience with a blend of bite-sized learning and carer-to-carer support. Our online Virtual Carers Centre is a reliable and versatile interactive arena, hosting all our digital support including live learning a community forum, rooms/portals with articles, podcasts and other audio-visual resources. The service has been described as a ‘lifeline’ by carers.
Jeanette Hogg’s Admiral Nurse Service, funded by the Forget Me Not charity, has already provided one-to-one support for 39 carers and 38 people living with dementia since July 2021. It builds a therapeutic, person-centred, three-way relationship with patients, carers and health professionals. Carers are given time to talk, air their worries and explore their feelings. There are sessions for people living with dementia and their carers, and specialised training and peer support for carers. It also provides support for families up to and post-bereavement, when carers quite often have a huge void in their life after the 24/7 demands of their caring role.
Cross Lane Hospital healthcare assistant Laura Blake developed a carers liaison service to support carers when visits to wards were stopped during the pandemic. She contacts carers when the person is first admitted and offers them updates about the patient, provides feedback from the carer to the multidisciplinary team and supports the carer during the hospital stay and in any meetings they might be invited to. Ms Blake’s drive to constantly develop her role has seen her work grow into a carer’s network, where she offers online peer support groups where carers can share their experiences.
Specialist health visitor for the Baby in Mind team Sarah Terrett works with parents at an early stage of pregnancy to try to prevent babies entering the care system. Ms Terrett develops and delivers bespoke programmes of health education, support and care to empower and encourage parents to change entrenched and complex behaviours and improve how they care for their child. The Baby in Mind team provides weekly contact during pregnancy, sometimes as soon as it is confirmed, and up to twice-daily visits after the baby is born. The programme has had an 86% success rate by tackling issues such as drug and alcohol abuse, domestic violence and poor parenting experiences.
Coming out of retirement to deliver vaccinations to housebound patients during the pandemic, Helen McIver and Stephanie Smith were shocked at the loneliness, despair and poor health they found among vulnerable people in Chelmsford, Essex. With Sally Coughlan and Moira Mitchell and social prescriber Frank Gyasi, the team now offers proactive, holistic, physical, social and mental health assessment, treatment and support to isolated patients and vulnerable families. They support families to care for their loved ones, liaise with the GP if urgent care is required, carry out annual reviews of chronic conditions and immunise babies. Patients and their families seen by the team have reported improved levels of care and say they feel more supported.
Deanna Mezen’s passion for ensuring the people she cares for receive high-quality care, particularly at the end of their lives, has seen her embed the Dying Well in Custody Charter in HMP Oakwood, West Midlands. The advanced nurse practitioner built excellent relationships with senior managers and worked closely with staff at the prison to change its culture to embrace a ‘good death’ where historically security would have been regarded as the higher priority. Patients are now choosing to die in prison rather than at a hospice. Ms Mezen has spread the learning to other prisons, which are now embracing the importance of dying well and making excellent palliative care the norm.
This 18-strong team actively seeks out and offers timely support to people of all ages with frailty, recognising that they are at risk of dramatic deterioration in their physical and mental well-being if they further lose their independence. Their integrated approach brings together health and social care providers and community organisations and focuses on the things that matter to people. It enables people to make choices that are right for them by offering coaching, and this ensures changes are more sustainable. Some of those they have supported who were previously considered ‘non-compliant’ have now got jobs, started volunteering roles and reduced their dependency on services.
This dedicated nurse-led 'one-stop shop' was initiated by advanced nurse practitioner Rebecca Bullingham after she encountered extreme health poverty among homeless people in Caerphilly. Patients receive a detailed assessment to identify immediate health concerns and the need for secondary care referrals. This enables the patients to have a detailed care plan that meets their social and health needs. People with mental health issues have been treated after attending the service and are now living in stable accommodation. Rough sleepers who have not accessed healthcare for more than a decade are now being treated for conditions such as blood-borne viruses, cancer and genetic disorders that had previously gone unidentified.
Cancer Research UK senior research nurse and joint lead cancer research nurse at University College London Hospital Jo Hargroves believed her team should share its experience and expertise through an education programme for staff who are new to clinical research. She designed the course’s content, delivery and evaluation. After a pilot for internal staff was a huge success, Ms Hargroves launched the course externally in March 2022, inviting any new staff working across local cancer research networks. In total, 27 speakers delivered a variety of sessions over four days to 69 attendees. Feedback has been positive, and Ms Hargroves now plans to deliver the course biannually, opening registration nationally.
Margot Creighton has been shortlisted for her leadership in the multi-centre randomised controlled trial examining psychoeducational interventions for people with advanced cancer and their informal caregivers (the Europe-wide DIAdIC study). The only DIAdIC study nurse in Belfast, Ms Creighton’s clinical research role is novel given the dual dimensions of trial coordination/conduct alongside intervention delivery. Her leadership has been demonstrated throughout the course of the study. She has been the driving force, maintaining momentum during set-up, facilitating prompt adoption by clinical teams, providing patient and caregiver-focused care and contributing a unique perspective to the DIAdIC teams in Belfast and beyond.
Some trials involve up to ten years' follow-up, even after the patient is discharged as their cancer is in remission. As a result, some are lost to the trial, so this team developed and implemented a nurse-led clinic to keep patients in the system. Lead research nurse for oncology Nicola Johnson came up with the idea, working closely with the multidisciplinary team, to develop a safe and robust patient referral pathway and management system. Senior clinical research nurse Lie Wah Johnson led on the clinic set up, raised awareness and developed guidelines. Colleague Jennifer Osei-Bobi reviews bookings, ensures follow-ups and evaluates success. Patient feedback has been positive.
This facility offers patients access to the latest cancer therapies as the delivery hub for the Leicester National Institute for Health and Care Research/Cancer Research UK Experimental Cancer Medicine Centre. When the facility reached capacity, so the team launched an expansion project with an increased clinical trials portfolio offering greater access to life-changing treatments. As well as maintaining clinical service delivery by decanting patients and equipment to different wards during lockdown, the team helped with fundraising in their spare time. It has even expanded its focus by developing expertise in bio-specifics, a new generation of targeted treatments.
Senior research nurse Vivienne Wilson has been nominated for her long service and outstanding impact in cancer research in Scotland and the innovative Patient Trial Advocate project she led during the pandemic. Research suggested there was a real need for a service that would support patients with breast cancer in getting better access to clinical trial treatment. Working with charity Make 2nds Count, Ms Wilson developed ambitious objectives for the project and set it up with the support of a research coordinator who has secondary breast cancer. The service has been effective and feedback from service users has been very positive.
Royal Bournemouth Hospital’s recovery unit staff nurse Helen Spencer Jones’s passion and enthusiasm for the protection of the environment has seen her lead on a significant reduction in the use of ethyl chloride spray in recovery and theatres. After more than 60 empty cans were unable to be recycled and were put into domestic waste, she sourced a company to produce cold sticks to replace the cans. She achieved medical device board approval, a licence with the Medicines and Healthcare products Regulatory Agency and the sticks are now on the hospital ordering system. The carbon savings per year are estimated to be 2,968 kg CO2 equivalent and the cost savings are £3,110.
Endoscopy is a major contributor to the environmental footprint of healthcare. It is the third highest carbon emitting hospital department in the NHS, generating about 3.09 kg of waste per bed-day. Nurse manager Leigh Donnelly has been shortlisted for her determination to see small changes make a big difference to improving the endoscopy department’s sustainability. They have a team of green champions at the trust who raise awareness of the need to recycle and replace single-use plastics. She has worked across the region on the production and use of sterile water, challenging suppliers on waste and packaging, the use of nitrous oxide, and recycling plastics. Ms Donnelly has also written blogs and spoken at international meetings about the need to improve sustainability in healthcare.
Practice nurse Helena Phelan and her team have been reducing their surgery’s carbon footprint by using a 30-minute holistic asthma review of 480 patients. At the start of the project, 65% of patients were prescribed three or more short-acting beta agonist (SABA) inhalers in the preceding 12 months and 42% more than six SABA inhalers in the same period. This has been reduced to 45% and 28% respectively. There have been 1,146 fewer SABA inhalers prescribed this year, equivalent to 32 tonnes of carbon dioxide. Prescriptions of oral corticosteroids have also been reduced from 12% to 7% in the same period.
Inspired by the focus on sustainability in the workplace in his home country of the Philippines, Robert Vicente, charge nurse on T8 infection ward at University College London Hospitals NHS Foundation Trust, recognised that his team could reduce the use of disposable items – especially gloves –despite dealing with the most infectious patients in the hospital during a pandemic. He identified instances where the team could avoid the use of disposable gloves and galvanised support from the trust’s infection control team while his team actively promoted excellent hand hygiene with a poster campaign. The ward reduced its use by 36,500 disposable gloves over a four-month period.
This team, led by tissue viability lead nurse Jeanette Milne, has demonstrated how their simplification of wound care can help the NHS meet its sustainability targets of net zero carbon emissions by 2040. After a successful investigation with colleagues from three trusts, they established the efficacy of using a foam dressing without a filler for shallow wounds and analysed the environmental impact. This change created a 12-month reduction of 22,200 gelling fibre dressings with a saving of 331 tonnes of plastic and other materials and 1,195 tonnes of CO2 based on savings from manufacturing, transport and distribution. This is equivalent to taking 260 cars off the road for a year.
During the peak of COVID-19 infection in India in April/May 2021, Indian nurses lacked the skills, knowledge and resources to manage the scale and severity of the pandemic. This team from the British Indian Nurses Association (BINA) acted swiftly to upskill about 400 colleagues working in small-to-large multi-specialty hospitals in three states of India by sharing best practice learnt during the waves of infection in the UK. The tailored programme was delivered during three one-hour sessions every week for four weeks using video conferencing and there was an emphasis on practical information. The sessions were projected on auditorium screens to enhance uptake. Post-session evaluation was overwhelmingly positive.
Nurse practitioner Nicola Robinson’s innovative project has seen a dramatic increase in the uptake of cervical screening at HMP Styal in Cheshire. Nurses carry out health promotion to boost screening uptake, and review each woman’s health history and offer targeted advice. Many of the women at the prison who are reluctant to be tested have experienced sexual violence and they are able to share their concerns about screening in one-to-one sessions. The uptake rate has risen from 63% to 90.9% of 25-49-year-olds and 92.8% in the 50-64 years range. Of the 418 women screened through the programme, 43 have been referred to colposcopy after an abnormal result and a further 86 have tested positive for human papillomavirus.
Despite numerous preventive measures being in place, such as risk assessments and screening tools, early-stage pressure ulcers continue to go unrecognised in people with dark skin tones. Neesha Oozageer Gunowa has been shortlisted for addressing this inequality in patient care using research and nurse education to improve clinical practice and outcomes for patients. Her research confirmed that teaching and learning materials only contained brief and superficial information on pressure ulcers in dark skin tones. She has interviewed nurse educators and held focus groups with students and has published numerous articles highlighting her findings. Her work has changed perceptions and policy at an international, national and local level.
The burden of headaches on patients, health services and society as a whole is extremely high. Studies show they are underestimated, under-diagnosed and under-treated. To improve patients’ quality of life through effective diagnosis and treatment, advanced nurse practitioner Susie Lagrata has transformed services for patients by being the first nurse in the UK and Europe to complete training and write policies and protocols to increase access to specialised treatments for headaches, such as multiple cranial nerve blocks and botulinum toxin injections. Her work has reduced waiting times from four to six months to 2 weeks, and she has since trained many nurses and doctors in her trust and across the UK.
This team’s excellent partnership working with the acute sector and community partners delivers high-quality care to patients at home so they can avoid being admitted to hospital. In its first 18 months, 26,740 patients were referred to the single point of access unscheduled care coordination centre, with 25,462 avoiding emergency department attendance. The service responds within two hours, with community rapid intervention service advanced nurse practitioners undertaking clinical assessments. It delivers clinical interventions and management plans, including monitoring and treatment at home for up to five days to prevent further unnecessary attendances and admissions.
Social movement Compassionate Inverclyde fosters kindness and compassion in its community driven by director of care at Ardgowan Hospice Alison Bunce. She has held a series of community engagement events generating practical ideas for compassionate citizenship across all the life stages. These ideas became initiatives, such as ensuring nobody dies alone and befriending the vulnerable, which were designed, developed and refined by volunteers, supported initially by Ms Bunce. The inspirational organisation has transformed attitudes and practices addressing social isolation, death and bereavement across Inverclyde encouraging people to help and support each other at times of increased need.
Staff feedback from the emergency department at Leicester Royal Infirmary highlighted a disparity in opportunities and a visible lack of staff from minority ethnicities in senior leadership roles. A lack of representation on senior leadership interview panels was highlighted along with a general negative workplace culture and a large gap in knowledge for staff from minority ethnicities on how to apply for more senior positions, write applications and CVs and perform well in interviews. Since then, Derek Apawo and Hetal Vagharia challenged and changed that culture and became a voice for colleagues. They engaged senior leadership and created staff networks, working with individuals and larger collectives to identify areas for improvement. They also provide one-to-one career coaching and mentoring.
Clinical services and Governance Manager Lesley Quinn has designed and delivered an out-of-hours menopause clinic offering evidence-based information, support and advice to women in Bedfordshire. Her clinics run weekday evenings, weekends and bank holidays throughout the year. Women are able to have progesterone coils fitted where needed as part of the treatment options on offer. Ms Quinn first improved her clinical skills before launching her clinic, which is now offered in five venues with an extended team. She raises awareness of the clinic among health colleagues and through social media and regularly speaks at events. Patients can refer themselves directly to the clinic.
Research and innovation head of nursing and patient experience Lorraine Hodsdon established the successful 12-month chief nurse junior fellowship programme, open to all band 5 nurses at the end of their 18-month rotation or band 5 nurses new to Great Ormond Street Hospital with similar post-registration experience. It supports them to develop new leadership skills and gain an insight into the senior nursing leadership roles by working alongside a senior nurse. It offers 23 hours per month protected time for participation and includes undertaking an evidence-based quality improvement project linked to an organisational priority that will improve patient care.
Infant feeding midwife Zoe Meakin has ensured her trust is the first in Europe to provide staff with ‘Mumpods’ – a secure, safe place to express and store breast milk when returning from maternity leave. It also offers service users including people from LGBTQ+ communities a place to breast/chest feed in private while at the hospital. After presenting her idea to hospital charities and trust directors, she was awarded funding and adapted the name to 'Mypod' to be inclusive. The space provides a reclining chair, television, fridge and breast pump. The success of the facilities in Colchester and Ipswich has seen Ms Meakin secure funding for five more pods.
Gerard Wainwright has led the Unsafe Swallow Project, which aims to address health inequalities that result in a disproportionately high number of people with learning disabilities dying because of aspiration pneumonia caused by swallowing difficulties. As the project started at the same time as the pandemic, it initially provided webinar-based training to non-nursing services identified as supporting people with learning disabilities at risk of unsafe swallowing. Free video learning resources were developed that have been used by hundreds of people globally. Webinar training has also been delivered to NHS trusts, nurse graduates and other organisations. Services have reported improved confidence of healthcare staff and improved health for the people they care for.
Local evidence showed that those caring for people with learning disabilities were not experts in end of life and palliative care, while end of life specialists did not have the expertise in caring for people with learning disabilities. So this team, led by Wokingham Hospital nurse practitioner Mary Codling, developed a seamless, multiagency care pathway for people with learning disabilities at the end of life, supported by improved training. Previously, people with learning disabilities would have gone to hospital to die and now deaths at home are becoming more common with staff reporting feeling better supported, knowledgeable and empowered to deliver compassionate end of life care.
Learning disability health facilitation nurse Megan Ware and community children’s nurse for transition Eden Carlisle have worked tirelessly to improve the transition from paediatric to adult services for young people with a learning disability using a new pathway. Easy-read information and a transition passport that follows the young person's journey and improves communication between professionals, have been developed. A transition clinic for young people and their families has been developed to encourage a more family-centred approach. This includes holistic assessment with a clear transition plan that is shared between agencies that empowers young people to be at the heart of decisions.
Inspiring nurse leader Norah Quinn has transformed her board’s learning disability service to reduce the health inequalities experienced by this group. Among her many significant achievements are the integration of services, improved access to annual health checks through primary care, development of the learning disabilities advanced nurse practitioner post, revolutionised data collection to provide evidence to support change, and improved training in trauma across health and social care partnerships. She has also secured access to training in positive behavioural support. Nurses are now implementing a model that enhances the quality of life of service users in the region.
Poor access to healthcare causes avoidable death for people with a learning disability. Barriers include, lack of awareness, difficulties around access, failure to recognise early symptoms, and missed follow-up. Your Healthcare learning disability community nursing team, led by Susan Fitzgerald, developed Project 2020 to optimising uptake of annual health checks and screening programmes. In an initial trial of nine residential homes staff report being better able to support hospital passports, annual health checks, health action plans, vaccinations and specific health screening. The project is now being rolled out to all residential services within the two Borough that the team supports.
Mental health nurse Lisa Gartshore has developed a digital safety plan for self-harm and suicidal ideation. In collaboration with their clinician, patients create and store a customised plan on their phones, including the information that is important to them. Plans include pages for prompting grounding or mindfulness techniques. It can add music or sensory aids for people with autism spectrum conditions or use symbols or pictures to support people with reading difficulties. There are also names and telephone numbers of professional support agencies with hyperlinks. Feedback from clinicians and patients has been excellent and the plans are now in place throughout NHS Lanarkshire, with another board about to start a pilot.
This team is improving the mental health of young people by talking about animals and their protective behaviours and working with young people to explore their own protective behaviours and what they need to feel mentally safe and well. The programme, co-designed by young people in conjunction with mental health nurses and animal welfare workers, is targeted at young people who struggle to engage in education or one-to-one and group therapies. They receive one-to-one nursing support during sessions but friendships are fostered by working with other young people on practical projects. Completing the programme offers young people recognition of their achievements through accreditation and a bridge to education and job opportunities.
The nurse team on Moredun Ward, a 22-bed inpatient acute admissions ward, has been shortlisted for the significant improvements it has made to observation practice, which has improved care and outcomes. Despite the increased demands of the pandemic, the team used improvement methodology to change practice and culture in line with updated and evidence-based observation practice. In some cases, the consequent changes in behaviour have seen people return more quickly to their communities. The work has now been introduced in mental health services throughout NHS Tayside and patient feedback has been extremely positive.
Sylvia Jones has delivered a wide range of activities to engage the young people she cares for at HMP Parc and Young Offender Institute to talk about their mental health, which would usually be avoided as it is seen as a weakness and carries stigma. She organised a fundraiser for the Fight for Young People’s Mental Health campaign by charity YoungMinds to show the support available. The mental health-themed activities included a food bake-off, rapping, street dance, art and a poetry competition. Young people in different groups mixed and talked about the issues affecting them. It also broke down barriers for the young people to talk to staff about how they were feeling.
This service works exclusively with adults who experience post-traumatic stress disorder and complex trauma. Returning from a pandemic redeployment, Aimee Kidd and Linda Crothers could see colleagues’ well-being had suffered. They first sent out a questionnaire and discovered that colleagues wanted to prioritise being together, recognising the team’s success and being more active so they implemented a wide range of initiatives including a well-being information board, retirement garden parties and competitions. They negotiated a protected lunch break and encouraged staff to go for lunchtime walks. They also created a successes booklet, which documents all individual and team achievements and success is prioritised as part of its monthly meeting agenda.
Christine McNamara has achieved a significant reduction in falls among older mental health patients and a near 50% reduction in falls that harm. Believing passionately that cultural change was required to raise the profile of falls prevention and that this could best be achieved by providing all nursing staff with evidence-based falls prevention training, she was supported by her manger to pursue this goal. She developed a project charter and training, and evaluated the agreed outcome measures. She also undertakes in-depth reviews of complex patients with a history of falls and has appointed falls champions.
Team lead and dementia nurse specialist Frances Aitken ensures that St John’s Hospital patients with cognitive decline undergo expert assessment and their stress and distress is minimised with interventions including effective pain control and visits to the team’s Meaningful Activity Centre. Improvements she has delivered include better working with family and carers and improved knowledge and confidence in recognising and managing delirium and dementia throughout the hospital. There has been a reduction in complaints and fewer one-to-one care requests, and the use of sedation and the number of emergency call-outs have fallen along with the need for referrals to psychiatry.
Kate O'Donoghue pioneered the role of specialist frailty practitioner in her trust’s emergency department but could only see a fraction of the people who attended. The service has now expanded to include three additional Band 7 posts. The nurses offer advice, assessment and treatment to people identified through routine screening for people aged over 65. As well as improving the quality of the care experienced by frail patients, they help avoid hospital admissions where appropriate and provide discharge planning, fast-track admission, advance care planning, management of delirium, carer support, and staff training and advice.
Katherine Matthews, manager of Perry Manor Care Home in Worcester, realised people with neurological challenges and mental health needs were being placed out of county which made it difficult to maintain contact with family and loved ones. Determined to provide a local home-from-home alternative, she designed a tailored service. At the 14-person Malvern Suite, each resident from secure psychiatric services receives one-to-one care for at least a month while the team assesses their needs and works to reduce their anxiety and distressed behaviour. As a result, they feel safe and understood, with no need for safety interventions. Since its introduction, the administration of antipsychotic medications and benzodiazepines has halved.
These advanced nurse practitioners (ANPs) have been improving early interventions for physical and mental health and reducing hospital admissions in care homes that care for former servicemen and women and their families. Laura MacDonald and Kim Barron quickly developed a service based around residents’ needs, triaging GP referrals and dealing with 70% of the patients themselves. Residents are seen much quicker, reducing deterioration and illness severity. Both ANPs are non-medical prescribers meaning commencing, changing or discontinuing medications happens much quicker and more regularly. The ANPs support the development of staff in two homes by providing shadowing opportunities during interventions, holding teaching sessions and supporting the development of nursing students on placement.
Year three adult nursing student Abby Waddingham was inspired by her placement in the emergency department to develop a set of communication cards featuring a range of languages that were accessible to people with learning disabilities. She worked with an illustrator to design each flashcard for objects and situations that she noticed were regularly encountered in a hospital or in an emergency setting and included translations into Polish, Punjabi and Urdu. The cards have been given out to fellow students, classmates and healthcare professionals while on placement to help overcome communication barriers and improve patient care.
Mental health nursing student Dave Richens was once addicted to opioid medication after having brain surgery. He overcame this to set up and run the Drink 'n' Drugs initiative, supporting people to overcome addiction, particularly among the homeless and rough sleeping community. His organisation provides signposting to services such as housing and support when applying for benefits. It also issues naloxone emergency kits to those who are at risk of overdosing from opioid-based drugs. It offers support meetings and peer support activities and provides hot meals, drinks, warm clothing, personal hygiene products, sleeping bags and tents to people sleeping rough. It also provides therapies such as hypnotherapy, acupuncture and counselling.
Nurse apprentice Jade Wareham has been shortlisted for promoting and creating resources to inspire students with neurodivergence to express their needs and better support themselves during placements and their academic studies. Inspired by a survey she undertook, she encouraged the creation of the Sharing Student Healthcare Initiative for Neurodiversity and Equality (SSHINE) – which includes nursing, radiography, occupational therapy, speech and language students. Mrs Wareham, who works at Isle of Wight NHS Trust, has set up and led meetings of the groups and created templates and instructions for sections of its upcoming resource book.
Passionate learning disability nursing student Lincoln Gombedza is the student and West Midlands region voice on the Digital Shared Professional Decision-Making Council, which brings together nurses and midwives to discuss digital transformation in their areas. He showed colleagues how to use technology to enhance the care of patients with learning disabilities during the pandemic when visiting was restricted, and he shared his work to improve care in his trust, using virtual reality and collaborating on care and resources. Mr Gombedza has presented to NHSX and has been part of the national programme of work providing insight into the use of digital technologies.
This team worked alongside practice nurses, pharmacy and a digital weight management service to create a diabetes prevention event. They saw 70 patients in one morning, offering blood pressure, height and weight checks, alcohol and smoking screening, and blood tests when needed. Thirty patients needed blood pressure reviews, four were diagnosed with diabetes and every patient was followed up and given advice on how to reduce their risks of developing type 2 diabetes. The nursing students produced patient information leaflets which included family activities, recipes and ideas about exercising, and explored the mental health impact of being diagnosed with a long-term condition. Feedback from patients has been outstanding. This event has inspired a new initiative named Nurses on Tour, which encourages similar events like this from student nurses within Northumberland CCG.
Chelsea Wynne has been nominated for her vital work supporting and educating people in Denbighshire with a learning disability about COVID-19 and ensuring they have equal access to care. She set up a recording system including dynamic risk assessments, files with information for staff and easy-read resources which she distributed to carers and families. She carried out educational work virtually with individuals and supported staff to follow up on this work. When the vaccine became available, she supported and educated people with learning disabilities to have it, collating information on those who might find the process difficult.
Support worker Jemima Lacey is kind and caring as well as clinically skilled, going over and above to support, empower and collaborate with the young people she works with on her ward. As well as breaking down barriers with young people and being the Safewards lead, she leads on supporting newer or more inexperienced staff, ensuring her high standards are passed on. Activities she has organised include a mock Olympics, yoga, baking, art and badminton. Jemima also organises activities off the unit and enabled young people to attend a firework display on bonfire night in 2021.
Rebecca Fell supports healthcare support worker (HCSW) colleagues throughout her trust to ensure that patients get the highest quality care. She provides support at interviews and encourages and develops successful HCSWs in their roles. She teaches the Care Certificate, and has been instrumental in revamping the induction process so staff take up their roles being more confident and competent. She has established and chairs a shared professional decision-making council to enable others to have a voice and has set up training and development opportunities including a bespoke Prepare to Progress programme that will prepare HCSWs for successful completion of the trainee nursing associate programme.
Kevin Hale and Dorian Wood have been nominated for their work for reducing loneliness and improving the physical health of scores of people with mental ill-health. Initiatives at their all-inclusive support group include a football group and a walking rugby group for the less fit, which are attended by forensic patients, patients under community teams and those cared for in the private sector. They have linked up with Gwent Dragons rugby club, Mind and have worked hard to raise awareness of the group. They have also secured donated kits from Abergavenny Town football club and have forged links with older adult and learning disability teams.
When Samantha Busby-Newman took up her post supporting mechanically ventilated patients, she made a huge difference to the way the team delivered rehabilitation care. The pandemic meant she reverted to her respiratory nurse assistant role delivering bedside care. Despite the pressures, she continued to develop and implement patient and staff well-being initiatives, such as a Winter Olympics to reduce therapy fatigue and encourage patient activity. She also created a bedside poster so staff can see patient’s wishes at a glance. Staff ‘Hello’ badges now include preferred pronouns and Valentine’s Day thank you postcards for staff to send to each other were a huge success.
Christine McCaughey has nominated community nurse Diane Lyttle as the rock that has helped her family through her son’s complex care. She says: ‘If every family of a disabled child had a Diane their troubles would be halved. She’s been a rock, especially during the pandemic. She stands up for families’ rights and cares for the kids like they are her own. Whether running around the country to get the equipment he needs, sorting and attending meetings and ensuring all Blake’s care needs are met despite her shift having ended, or bringing fresh food for me at the hospital, Diane has been a rock of support.’
A young woman has nominated mental health nurse practitioner Karen Vernon for ‘giving hope that life is worth living again’. Lara, not her real name, has a diagnosis of emotionally unstable personality disorder. She says: ‘At hospital and A&E admissions, Karen sat with me in her own time. She has talked me down from very stressful feelings and suicidal intentions. She would return calls and texts outside of my appointment times on her lunch breaks. She has helped my mum understand me, and has helped me rebuild my relationship with my dad and I have restarted work.’
Care home manager Nicola Mould has been nominated by community nurse Jennifer Dodds for the outstanding care given to her mum at the end of her life. She says: ‘Nicola led the care at Orchard Mews during mum’s last few weeks. She is professional, empathetic, knowledgeable and supportive. She could not do enough for all of us. She often stayed at work hours past the end of her shift when mum deteriorated to wait for the GP to come to review her. She made sure the plan was implemented and ensured mum was comfortable and pain free.’
Elizabeth Pepper nominated specialist information and support nurse Sarah Malik for her support in ensuring her husband had a good death. Mrs Pepper says: ‘When my husband wanted to write an advance decision statement, I could only cry. Sarah gently and empathetically reassured and guided us, patiently answering our questions and helping us arrive at a consensus, sharing vital information about what happens in death with enormous sensitivity. My husband got his advance decision and I could recognise that I was empowering him. Without it, we wouldn’t have been able to resist the pressure to send him to hospital at the end of his life. He was able to die at home.’
‘Extremely competent, compassionate and caring’ nurse consultant Yvonne Millerick was nominated by John Stuart for going over and above to care for his mum, who has heart failure. He says: ‘She frequently visits mum at home to ensure her condition is effectively managed, as well as offering psychological support to mum, dad and the wider family. We can call her any time if there are changes, including out of hours and when she is off duty. Her truly personalised and holistic care has included coordinating home adaptations, financial support and respite care. It has allowed mum to remain at home surrounded by her loved ones.’
This team provides comprehensive assessment and treatment of older people presenting with falls, confusion, poor mobility, care dependence and polypharmacy at Morriston Hospital emergency department (ED) from 7am to 7pm weekdays. The service accepts minor injuries, including head injuries, non-femoral fractures and lacerations, due to the presence of an emergency nurse practitioner. As a dedicated unit in the ED, it accepts patients directly from triage and the ambulance service, providing rapid access to specialist assessment. The service has achieved excellent results in terms of admission avoidance and preventing readmissions. The service provides an excellent patient experience that has been reflected in feedback.
In recovery from cancer, Macmillan nurse Emma Harnett and patient panel lead Ann Nutt joined forces with patient engagement expert Shahid Sardar to promote the patient voice in cancer care and improve services. Now a team of ten, One Step at a Time Supporting the Cancer Journey produces non-clinical information by patients for patients. There are videos, translated into Romanian, Polish, Punjabi, Urdu and Italian, by survivors and carers, and a non-clinical patient pocket guide. The information is given to patients at diagnosis and is now part of the cancer campaign strategy.
Rates of sexually transmitted infections and terminations were above average in Croydon and the clinic’s nursing team was more than 20 years behind in terms of competence, confidence and autonomy of practice. But it has transformed itself and the care it gives through its commitment to training and cultural change. Waiting times have been slashed thanks to the empowered and highly trained workforce, and patients can now see one clinician who will deliver the whole episode of care from start to finish. Patient feedback has been exceptional and nurses report feeling their career has been ‘resuscitated’.
This early intervention team delivers tailored one-to-one support for parents and their infants, who have been identified as having socially complex needs. The focus is on improving mental health outcomes through nurturing and developing the parent-infant relationship, as well as parental engagement with services. It is an encouraging, supportive and empowering service, that encourages parents to learn more about their baby. Parent feedback is excellent, with more than 90% engagement with the service from new referrals. Parents report more confidence in meeting their baby’s needs and communicating with them, whilst learning these skills has given them confidence to try new things.
This team has been shortlisted for leading the implementation of electronic prescribing and medication administration over a 90-day period during the pandemic. Despite the huge scope of the project, the operational challenges and the profound effect on the workforce, nurse leaders reassured their teams the changes would improve care. Clinicians can now easily access data and information not available before. Records can be shared with primary care teams and there has been a significant increases in reporting of NEWS scores. Medication errors have been reduced by 34%.
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