Nursing’s Team of the Year 2023: ‘We don’t give up on anyone’
How a nurse-led project at an inner-city addiction centre was able to achieve micro-elimination of hepatitis C among a marginalised patient group
- Nurses at the Hounslow Addiction Recovery Community were able to eliminate Hepatitis C using early testing, diagnosis and a new treatment
- Tips on establishing an effective team from addiction nurse practitioner and team lead Eugenia Moyo-Hlahla
- A urology nursing team in a remote setting has been commended for dramatically reducing waiting times after introducing nurse-led pathways
An inspiring nurse-led project delivered new hepatitis C treatment to marginalised communities and achieved micro-elimination of the virus locally two years ahead of a national target.
‘We just decided that everyone who needed this treatment should have it,’ says addiction nurse practitioner Eugenia Moyo-Hlahla, who works at Central and North West London NHS Foundation Trust. ‘We weren’t going to give up on anyone.’
Improved hepatitis C treatment regimen eliminates worst side effects
It was this determined approach that saw the nurse-led team win Team of the Year at the RCN Nursing Awards 2023 on Friday November 10.
Ms Moyo-Hlahla recalls the ambitious goal that drove the team to achieve its target-busting success in testing and treatment for hepatitis C at the Addiction Recovery Community (ARC) Hounslow.
As a long-time addiction recovery nurse, Ms Moyo-Hlahla was aware of the high incidence of hepatitis C among drug users, who may engage in unsafe practices such as sharing needles. Although many people with hepatitis C don’t experience symptoms, the virus causes damage to the liver in the long term. Early detection and treatment with anti-virals can prevent serious liver damage.
‘Previously, we were treating it with interferon injections – which were effective but had lots of side effects,’ she says. ‘Many of our patients were reluctant to have the treatment because of the side effects they experienced.’
A bid to eliminate hepatitis C by 2025
In 2016, the World Health Organization launched a global effort, sparked by advances in technology and research that had seen the development of new, effective anti-virals for hepatitis C. NHS England picked up the baton and committed to eliminating the disease by 2025.
Micro-elimination can be achieved in a local area by ensuring:
- 100% of people using the service have been offered a hepatitis C test.
- 90% of service users have been tested.
- 75% of those who were diagnosed with hepatitis C have started treatment.
‘The new treatment involves taking one tablet a day for three months, and patients experience far fewer side effects, so it was a game changer,’ says Ms Moyo-Hlahla. With support from NHS England, the team began offering testing and effective treatment to everyone.
With 22 years’ experience as a nurse, Ms Moyo-Hlahla knew that effective teamwork would be crucial if the project was to be successful.
’My time was ring-fenced – I knew that on my own I wouldn’t be able to achieve much,’ she says. ‘But once colleagues understood and saw the importance of the project, they embraced it. Once the team got behind it, we were really able to make a difference.’
Tips on establishing an effective team
Project lead Eugenia Moyo-Hlahla’s strategies for a successful winning team:
- Communicate a clear vision It took time to get everyone on board, but once they understood, they bought into it
- Make everyone feel valued Each team member brought their own skills to this effort
- Identify and solve issues Reducing paperwork helped the team
- Celebrate successes We had team lunches and brought people together to mark achievements, even when we reached smaller milestones
- Give regular feedback Monthly updates on how we were doing towards our targets helped keep everyone involved
Successful outreach partnerships in the community
The team was determined to reach the people who needed the testing and treatment and understood the scale of the challenge. People living with addiction, struggling with mental health issues and often leading disorganised lives are among the hardest to reach groups.
‘We walked through parks with park rangers and approached people to offer testing and treatment. We made it clear that we weren’t condemning or judging – we were there to support and help’
Eugenia Moyo-Hlahla, addiction nurse practitioner
‘We knew that we needed outreach – we had to go to the patients,’ says Ms Moyo-Hlahla. Reaching patients in the community was made possible via effective collaboration with numerous partners, who she says carried out their roles with ‘great enthusiasm and dedication’.
‘For example, we walked through parks with park rangers and approached people to offer testing and treatment. We made it clear that we weren’t condemning or judging – we were there to support and help. Of course there were those who disengaged, but generally our message was well-received.’
Joining forces with partner agencies, including Hep C U Later, Gilead and the Hepatitis C Trust, enabled the team to offer a wider range of benefits: information awareness and testing day events increased uptake, while further support included mental and physical health assessments, access to doctors, nurses and hepatitis C specialists, recovery workers, employment specialists and peer mentors.
‘It became a joy. The times when we tested someone and they saw they did not have hepatitis C after the treatment were priceless. Others had been treated but never retested, so didn’t know what their status was and we were able to reassure them. That was what drove us on.’
Persistence pays off – ‘we didn’t give up on people’
‘We called people every day to remind them to take their tablet. If they appeared to disengage, then we would visit them. We would try to engage them and bring them back. We didn’t give up on people. Our goal was to reach everyone.
‘As the project gained momentum, we received lots of positive feedback, which also helped to spur us on.’
It is an inspiring project that impressed the judges on many levels. Ultimately, the team achieved micro-elimination of hepatitis C within their patient population in April 2023, two years ahead NHS England’s 2025 target.
Ms Moyo-Hlahla says winning the Team of the Year award is an ‘incredible testament to the ARC Hounslow team and the excellent work from all our partner agencies’.Meet the winners: more from the RCN Nursing Awards 2023
Special CNO commendation for team transforming care in rural Scotland
The Highland Urology Nursing Team, a finalist in the Team of the Year category at the RCN Nursing Awards 2023, received a special commendation from the four chief nursing officers of the UK.
The team was regarded as being an exceptional example of a nurse-led initiative, which has seen NHS Highland’s performance become one of the best in Scotland.
In 2020, long waiting lists and difficulties in recruiting consultants to vacant posts had put NHS Highland, which serves a vast, rural region, in the unenviable position of having the poorest waiting times in Scotland.
In an initiative backed by the Scottish Government, new, enhanced nursing roles and nurse-led services were introduced. Through team training and development, nurse-led pathways from referral to decision-making and treatment in all urology sub-specialties, including prostate, renal and bladder cancer and benign conditions, were successfully put in place.
Reducing waiting times in a remote setting
Senior advanced clinical nurse specialist Brian Corr says that the expansion of the nursing team, and the development of nurses’ roles has benefited patients and the clinical team. ‘Patients can now be seen sooner, and many don’t need to come back to see a consultant.’
The unit’s clinical director Karina Laing says: ‘We were reliant on locum staff who didn’t know the area or the patients, and morale was low. By contrast, the specialist nursing team we have in place now are passionate about the work, confident in their abilities and have in-depth knowledge of the local area. They also work incredibly well as a team – and our patients notice that.’
Mr Corr says that the team’s recognition in the awards shines a light on the work it does in a relatively remote setting: ‘It gives us so much confidence – what we do for our patients is being recognised nationally.’
RCN Nurse of the Year 2023: ‘We empower patients with choice’
The Team of the Year award is sponsored by LV