Healthy Lifestyle Service Walk Leeds

On Sunday the Healthy Lifestyle Service were at the launch of Walk Leeds, a walking festival that is running until Sunday 7 June. Tasha, a healthy lifestyle practitioner from the team recaps the event... 

"Thankfully the weather held out for us and didn't rain, which was a good start. The event was well attended and we got the opportunity to speak to over 100 people, some of which we referred on to use the Healthy Lifestyle Service. 

The Mayoress of Leeds, joined by Janet Street Porter, opened the event and then took part in a two mile brisk walk returning to collect packs, information and advice from Janine, one of the dieticians from Weigh Ahead, and myself.

People we spoke to said the service sounded great, particularly because of what we offer which includes 12 weeks of support, Bodyline Gym membership cards and LLGS sessions plus lots of motivation which people do struggle with. 

If you are needing some extra support or advice to improve your lifestyle, you can get in touch with the team by calling 0113 843 4537. We're available on the phone Monday to Friday between 9am and 5pm but clinics run at various times. For example, we run an evening clinic at Armley Moor Health Centre, which you can drop in to." 

If you're interested in finding out more about Walk Leeds, visit www.walkleeds.com

All about that paste…

All about that paste…

Kathy (left) alongside her colleague, Dawn,
at a Mouth Cancer Awareness Event

For the past 25 years Kathy Fox has been ‘All about that paste’, working in the Community Dental team, educating people about good oral health.

“I have worked for LCH 25 years this year. My career began as a dental nurse before I studied post graduate qualifications that led me on to work in oral health, which I have done for the last 15 years. 

My role is to lead, deliver and evaluate preventative programmes for children, young people and vulnerable adults at risk of oral health inequalities. I enjoy the variety of work and the people I work with and meet in my role. There is such a rich diversity in the staff and members of the public. 

As part of my role, I train a wide variety of services, for example, teachers and Early Start teams; provide expert knowledge and up to date resources about oral health promotion; lead citywide public health campaigns; promote dental registration and attendance at general dental practices. I enjoy the belief I have helped someone and educated them on how to maintain good oral health and access oral health care. 

As well as all the role responsibilities things I’ve listed above, I continue to work as a dental nurse at the Out Of Hours service so I see the difficulties patients experience in trying to register and the bad experiences some patients have had.

I get to work on lots of new exciting projects as part of my role. Recently one of these projects was creating ‘All about the paste’, a parody pop video. We came up with the idea of creating the film as a fun way to engage with young people and we think we have achieved that. We’ve had lots of positive feedback – if you haven’t seen it yet, you can watch it here.

If anyone is thinking of joining LCH, whether as part of the dental team or another service, go for it. There are lots of new opportunities and challenges to enrich your career here.”

Dying Matters Awareness

Next week is Dying Matters Awareness Week. The aim of the week is to encourage people to talk about dying, death and bereavement and making plans for their end of life care. The trust's end of life team, part of District Nursing, works alongside other organisations in the city to support and care for people who are in the final stages of life. You can find out more about this collaborative care at www.leedspalliativecare.co.uk 

Jane and Dianne 

Jane and her colleague, Dianne, have written a post about what their roles as a palliative care discharge facilitators involves, and how they work with patients and their families. 

"Dianne and myself are both district nurses. We began our role as palliative care discharge facilitators in 2011 after it was recognised improvements could be made to discharging patients who wish to die at home. Improvements included speeding up referrals to the District Nursing teams and cutting down on the delays in care planning meetings and care packages. Transfer of care at end of life needs to be organised safely and often within hours to ensure people can get home or to their care home quickly, if that is their wish and families feel well supported.

We support district nursing teams to deliver high quality end of life care by ensuring everything is well organised and the transfer of care is seamless e.g. completing the community nursing documentation, ensuring medications are available. This enables district nurses to spend more time with the patient and their family when they arrive home. Also as part of our role, we support district nursing teams by attending discharge care planning meetings on their behalf, often on the day of referral. If patients have a Leeds GP we will attend care planning meetings at Leeds or neighbouring hospitals and hospices. Care planning meetings are arranged either by a joint care manager or a medical social worker. The meeting gives the patient and relatives / carers the opportunity to express any concerns or anxieties regarding the discharge home and explore all options. Following  the  meeting, we co-ordinate equipment / care with the other healthcare professionals involved. The ward staff handover the patient's care and the home circumstances and environment are taken into consideration. The hospital occupational therapist and physiotherapist work closely with us to identify equipment required for discharge.

We both spent many years as part of the district nursing team looking after palliative patients at the end of their life and have developed advanced communication skills enabling us to have sensitive conversations at this difficult time. We have also built strong relationships with ward and community staff, acting as a link between the staff and patients / families when their care is transferred.

We are both passionate about what we do and endeavour to deliver a quality service. The most fulfilling part of our role is enabling patients to die in their place of choice and families feeling well supported at such a difficult time." 

Jane Wilde and Dianne Fawcett, palliative care discharge facilitators

Here is one example showing how the district nursing and end of life care staff recently worked together to ensure a patient's wishes were respected and the patient and family were well supported and cared for in the final stages of the patients life. 

On hearing the devastating news that his cancer had spread, there were no further treatment options left and his life expectancy was only weeks left, the patient felt very numb and fearful of what was ahead. His only thought was to return home to spend time with his wife and dog.

A discharge planning meeting was quickly organised. He and his wife said they were relieved to hear about the services and equipment available at home and to know funding was available to ensure they had adequate support. He commented it was good to hear he had choices and could change his mind about the decisions he had made if he wanted too. Also, knowing who would be involved in his care before they went home and that they could contact a nurse at any time day and night really reassured them and made them less fearful about returning home. 

The patient was impressed by how quickly everything happened to get him home and said his dog was happy to see him. A few weeks later he died peacefully at home.  

Being mindful of your mental health

Stress, depression, anxiety can affect anyone. One in three of us regularly feel stressed. One in four of us feel anxious One in five of us feel depressed.* 

Sabina, Dave and Berni all recognised they were struggling to control their stress. Signs of stress can vary by person but common signs include feeling on edge, angry, unable to switch off, tearful, having poor concentration. 

Each of them reached out to Leeds IAPT, either through their GP or by referring themselves by calling 0113 843 4388. To help manage their stress, anxiety or depression, it was recommended they attended the 'Stress Control' course. This runs for six weeks  at venues across Leeds, at times in the day or evening. Each session has a different focus, from learning to control your thoughts to controlling your body to helping you get a good night's sleep.

In these short films, they have described how the course has helped them:

If you feel like you need help with managing stress, you can get in touch with our Leeds IAPT team on 0113 843 4388. Find out more about Leeds IAPT - www.leedscommunityhealthcare.nhs.uk/our_services_az/leeds_iapt/

*Mental Health Foundation

The business of delivering specialist services

Meet Dan, he’s the Business Manager for our specialist services which are healthcare services for specialist communities (such as prisoners, detainees in custody, the homeless and asylum seekers), or specialist conditions (such as dental, podiatry, MSK, healthy living, mental health).

Dan has shared with us what his role as a business manager entails…

Dan collecting an award at the
LCH Achievement Awards in 2014.

Tell us, what does your job involve?

I am a key link for our services with commissioners. I ensure we have fair contracts that are value for money, that are well specified and that have effective and realistic performance measures. I help services compete for new business or compete to retain their existing business when it goes out to tender. I manage the innovation and business change functions so that services are supported to innovate, improve and embed any changes.

What attracted you to this role?

I've always worked in healthcare and had got into quite strategic roles which felt detached from services and real people. I saw this role advertised and had worked with York Street Practice in a past life and had enjoyed it so I thought I would give it a go. It's a very busy and challenging role, I've never worked so hard in my life! However, it is extremely rewarding as I can see how I am impacting on healthcare for real people despite not being a clinician myself.

What is the best bit about doing your job?

No day is the same. I get to go all over the city, meeting all sorts of people. I'm often working with services that have problems but this doesn't get me down as I feel that I am helping them overcome issues or barriers.

Do you have a particular highlight from your career to date?

I think it was when we won the very first NHSE 'Excellence in Public Participation' award last year. It was for a piece of work where we collaborated with homeless and asylum seeker clients at York Street Practice to improve how they access services and as part of this we won some funding so that patients could use digital technology to manage their own healthcare. When we went to collect the award for this innovation we got to take service users with us. It was extremely powerful and so rewarding to have national acclaim for what was essentially a very simple project. Also when we won the police custody bids it was so exciting - it was hard to believe that months of hard work and late nights had paid off and it made me extremely proud to work for LCH and to have been part of that team.

How has your past experience helped with your role?

I did a Communications degree back in the day so people often think it's weird I've ended up with the job that I do in the NHS. However, the key competency I need for my day to day working is communication skills and the ability to form effective relationships, so perhaps it wasn't such a waste of time after all! I also did a lot of voluntary caring roles at university which made me realise early on that I wanted a career in the NHS and not in the cut throat media industry!

If someone was thinking of joining the trust in a similar role, what advice would you give them?

Regardless of whether a role in LCH is clinical or managerial we need people who have the right values and who have good people skills - if this is you then do come and work for us. We can train people in all manner of skills and knowledge areas but we cannot train you in the values - this has to be core to you. If you have our values then get in touch!

If you would like to join our team, click here for our latest roles being advertised. 

The Heart of Nursing

Caroline is a cardiac nurse specialist and as part of her role cares for heart failure patients, monitors their symptoms and helps them to plan their long-term care. She is one of 17 community cardiac nurses providing long-term care to patients within the trust.

Heart failure patients require ongoing monitoring because their symptoms, which include shortness of breath, fluid retention and fatigue. It can vary greatly from patient to patient, and also day to day.

“Often we see patients who are really uncomfortable but because of the intervention that we do and the adjustments we make to their medication, their symptoms improve dramatically. Often, within a week or two, patients say they can breathe easier again,” she explains.

Many of these interventions are carried out in Caroline’s heart failure clinic. Caroline spends time with the patients discussing their symptoms and taking blood tests. Based on this information, she can adjust doses of medication accordingly and give lifestyle advice, which can help people to manage heart failure.

Caroline also sees patients in their own home when they are too unwell to attend the clinic. If a patient who is retaining fluid doesn’t respond to an increase in water tablets, they often find that they benefit from having it delivered intravenously via a drip. In the past, dealing with this would mean admitting the patient to hospital. A few years ago, our community cardiac team in Leeds received a grant from the British Heart Foundation’s ground breaking scheme to pilot delivery of intravenous diuretics at home. The trial was a great success, and since, the service has been able to improve the lives of many patients that have been able to receive treatment in their own homes. 

Find out more about the community cardiac service here. 

Positive about Change?

'Learning is the discovery that something is possible.' 

Fritz Perls

'The problems of the world cannot possibly be solved by skeptics or cynics whose horizons are limited by the obvious realities. We need men who can dream of things that never were' 

John Keats

Dr Martin Seligman is a Professor of Psychology at the University of Pennsylvania. He is famous for his work in the field of Positive Psychology. This school of psychological thought doesn't seek to replace mainstream psychology but complement it through the study of what gives life meaning and what makes it worth living. It asks how we can extend and amplify the good that is already working in our lives and shining the light on our creative assets and seeking their growth and unfolding.

One of the authors at the beginning of his academic career attended a presentation where Dr Seligman outlined his early ideas about the need for Positive Psychology. Dr Seligman received a series of challenging questions around 'why bother with all this positive stuff?', Dr Seligman replied that he had to because he was a born pessimist. He said he needed a practice that helped him see through problems to positive options and be more optimistic about outcomes. His natural temperament would lead him to be locked in the problem. He needed a key to unlock this process and move to another place to address the issue. This echoes well the comments of Einstein and Jung that we often cannot solve problems on the same level of consciousness that generated them. We need new spaces and thinking to break the code of the problem.

This positive, more optimistic approach echoes much of what we see crossing our services and on forums like Twitter. People and networks are sharing fresh, kind and affirming ways of being and doing as the future framework for change. These new movements offer such promise, potency and energy. Yet it is not always an easy walk although a much needed one, especially if we are talking about the deep, sustainable change that so many of us see as possible and work so hard to achieve. All too often we have experienced changes in services that only touch surface structures, policies and procedures rather than going to the heart of the issues. And sometimes people propose a ‘be positive approach’ as part of these initiatives, failing to really appreciate the complexity of issues, acknowledge the scale of the challenges or engage the difficulties that the people involved deal with on a day to day basis when they see the potential of what could be possible in the face of a reality that seems intractable.

The kind of positivity Seligman is promoting has nothing to do with creating false positive-ness that can only ever skim along the surface of change. Rather, a Positive Psychology approach invites us to name the problems and the pains and see how we can learn from them to work them through in constructive and compassionate ways. Positive Psychology offers much for us to learn. It is not just about being positive, its about engaging with the complexity of a challenge and bringing positive approaches to working with it. Authentic listening, mutual support, empathy, knowing we don't have all the answers, a commitment to deep and open dialogue and the creation of new ways to think and do health and care is the DNA of these new movements. At it’s heart is the belief that all of us have tremendous goodness, gifts and potential. We believe that is from the activation of these wellsprings that the solutions and new forms of service will emerge.

- John Walsh. York Street Health Practice, Leeds Community Healthcare NHS Trust

- Dr Andrew McDowell  http://www.theperformancecoach.com

(The authors of this met recently at an initiative of the NHS Health Trusts and Public Health in Leeds. They have brought Health Coaching into the city so we can look at and change the quality of our health conversations with patients. The old model is where the patient is the passive recipient and the clinician the expert. This is a move to a new terrain where both are experts and co-create health plans and solutions together. At the heart of this approach lies a view of people as not problems but as people with assets, gifts and potency. This more humanistic and positive model offers great promise to people and the city.)

Seeds for the Future

I believe there is a real need for dreamers, poets and writers. These people – men, women and children – draw the pictures of what tomorrow can be. They offer maps and landmarks to the future. While some may see them as hopeless utopians they are actually the midwives of new possibilities. This article is about a book that helped changed the landscape.

The book is ‘The Citadel’ by A J Cronin. Cronin was a doctor and a very popular and respected author. The book written in 1937 tells the story of a young caring doctor Andrew Manson who works in Wales.  He works among the people and helps them. Later he moves to London and is tempted by money. He starts to seek money from the wealthy and this starts to corrupt him. He re-finds himself and despite major challenges walks ahead in his old values and commitment. The book was seen as a damning indictment on the old health system. Cronin stated that, “I have written in The Citadel all I feel about the medical profession, its injustices, its hide-bound unscientific stubbornness, its humbug … The horrors and inequities detailed in the story I have personally witnessed. This is not an attack against individuals, but against a system.”

The book was a bestseller and sold over 150, 000 copies in the first three months in Britain. It was also a hit in the USA and Europe. The book was made into a Oscar winning film in 1938. A Gallup poll in 1938 revealed that those polled said the book impressed them more than any other book apart from the Bible. Many people have argued that the book laid the foundations for the National Health Service in the United Kingdom. Both Cronin and Aneurin Bevan ( the Minister of Health from 1945 to 1951 ) had worked at Tredegar Cottage Hospital though at different times. Tredegar was used as a model for the NHS. The book showed the grave problems with the old system and pointed to something better. The foundation of the NHS was due to a number of factors including people after a World War wishing for and expecting something better. Cronin’s work filled the air with a critique and question that supported the foundation of the NHS. It was part of a movement, people and energy that birthed this service for the people.

There are a number of things that face us here. There is the power of ideas and the written word. Cronin’s book gave voice to the feelings and experiences of many. He became a voice for change. This teaches us that our words and what we share can shape the future. We may never achieve the effect of an A J Cronin but our voice and dreams can be part of a movement for the best care and culture for all. Ours may be a small cry and impact but together we can move mountains. Vincent Van Gogh the artist noted how ‘Great things are done by a series of small things brought together.’  The impact of ‘The Citadel’ tells us also that we will never know what our good actions and honest words will achieve. Cronin when writing his book would not have realised how his book would help a shift for the good and health of so many. To step forward and speak the truth, seek the best and create the vision is what we must do. Cronin’s work was a key element in a diverse movement hungry and visionary about change. This also tells us we need each other and diverse alliances around common themes.

When A J Cronin wrote patients would have had no voice. Things are changing and we have – thankfully – a growing patients movement. Carers also would have had no real voice and today carers are often overlooked. We hope the voice of carers can feature more and more in the future and services. Today we have many voices on social media and elsewhere pointing out the faults and flaws in the systems we have. Do all these words connect? Do they generate change? My guess is that some do. The reasons why some words fall and some reach is an interesting one.

Healthcare is all about humans.  It will never be as perfect as we all would like.  Each generation needs someone or something for it to maintain it’s moral compass. The 19th century writer John Henry Newman spoke of ‘ to live is to change and to change often is to become more perfect.’ This is a good charter of how we must always seek change and innovation. We never reach Nirvana but we can improve things and help more people.

The message of A J Cronin is that one person can make a difference, that words and ideas when linked to wider forces can change the picture before us and that we need to keep on speaking the truth and seeking authentic renewal of our services. If we do this we will contribute to the dreams, poetry and writing of tomorrow. And not only contribute - we will help write and author them.

John Walsh, York Street Practice

This post arose through transatlantic dialogue and reflection. Sometime work with others brings  a freshness, wisdom and vision. This collaboration was and is one of those times. I would like to dedicate this blog to the three good people involved.The first is Marie Ennis O’Connor (@JBBC ) who connected people together for this to happen. The second is Dr Brian Stork an American  physician (@StorkBrian) who is writing on this subject in an American context for his blog. The third participant is @HealthIsCool who offered such kind and helpful advice about format, content and presentation. It is a joy to be connected to these friends. The blog is all about a message which linked to a movement changed history for the better. I hope that we all find our messages and movements and do likewise.  

Meet our members: Lynda Cooper

Lynda is one of our members who has been volunteering at the tea parties at both South Leeds Independence Centre (SLIC) and the Community Intermediate Care Unit (CICU). Lynda wrote this post as she has been particularly struck by her involvement and the work that those at the centres do.  

Andrew and Lynda

"I can remember my first visit to SLIC so clearly.  I was welcomed by Chloe, membership and involvement officer, who introduced me to Andrew, the centre manager.  Andrew chatted about the set up of the building and very kindly took us on a tour.  The facilities were excellent and very much aimed at making the patients stay as comfortable as possible, whilst also maintaining a positive environment to enable improvement in their physical wellbeing.

 The staff are amazing, they are very busy individuals but they never let it get in the way of keeping a cheerful persona.  The patience and care given is beyond anything I have seen in hospital wards for the elderly in the city.

I personally find it very enjoyable talking to the patients at the tea parties and it gives us all the  chance to chat to someone new, even if only for a short while.  I feel we are being given an opportunity to make a difference to the patients stay by introducing new interests.  The Steering Group is soon to meet at the centre to discuss what initiatives might be welcomed by both staff and patients to improve their stay.

I think there is an opportunity to involve members of LCH and the community to spend some time visiting the centre.  There are surely a lot of people out there who would enjoy and indeed benefit from visiting the patients.  I also think the time is right to give the local community encouragement to become involved.  Perhaps children at the local schools could in agreement with the Head of the school be asked to visit the centre, both age groups could benefit from the visits and it would ensure that the young ones realise how valuable, knowledgeable and entertaining elderly people can be. 

Maybe there is a need for climate change in the way the elderly are perceived, people now go on about how people are living longer and therefore increasing the cost to the NHS. Perhaps people need to start talking about our elderly who have worked hard all their lives in much less lugubrious surroundings and circumstances, with far less opportunities, and yet seem to be ignored and undervalued by the younger generations."

Lynda Cooper

Enabling partnerships for change

We live in a simultaneously challenging and encouraging time. It is challenging as economic austerity impacts on public services and we are faced with growing social and health problems which cannot be simply diagnosed or easily solved. These problems have multiple causes and complex inter-relationships. It is encouraging as we see new energy, ideas, movements and initiatives emerging as innovative ways forward. In this era of constant challenge and change we must keep positively focused on seeing new possibilities and co-creating new futures. Fundamental to making this happen is the notion of effective partnerships. hence our reference to 'co-creation' of new futures. How can we bring together existing expertise and services in effective, authentic and supportive partnerships to make the difference?

This post is co-authored (partnership working in action!)  by Professor Ieuan Ellis, Dean and Pro-Vice Chancellor at Leeds Beckett University and John Walsh, Practice Manager at York Street Health practice, part of the Leeds Community Healthcare NHS Trust (LCH). In this post we outline some elements of partnerships established between York Street Practice and Leeds Beckett University, and reflect of how partnership working has happened and the dynamics that stimulate its work and life.

Leeds Beckett is a modern, professional regional university with a population over 2,900 staff, 28,000 students and with a firm commitment to be a catalyst for social and economic progress in and for the region as well as making its contribution and impact nationally and internationally. The university has been estimated to contribute over £450m to the local economy every year. The Faculty of Health and Social Sciences is one of the four university faculties and plays a key role in establishing and enabling partnership working 

Leeds Community Healthcare NHS Trust is a family of 65 community health services. This includes services  such as community dental, prison healthcare, district nursing and health visiting. Within the trust, York Street Health Practice is the health team for people who are homeless and in the asylum system.

The partnership between our two organisations has grown over the past two years. It embodies a number of different facets, themes and partnership links with other organisations which include the following examples;

  * A partnership between York Street and academics from social work, social care and youth and community studies to create best theory and practice in working with the marginalised, vulnerable and bringing street work perspectives. This is part of a wider international partnership with the universities of Amsterdam, Prague and Barcelona and involving Leeds Adult Social Care Services and so has an integrated care approach to the teaching and development of the work. Last year colleagues from Leeds Beckett, Leeds Adult Social Care and York Street attended a conference in Prague with students and colleagues from these universities and offered teaching and joint collaboration on academic perspectives. This partnership has resulted in funding for research into York Street Practice and its model of care and how adult social care works in addressing homelessness from a street perspective in Leeds.

* Funding has been acquired to hold an international conference in Leeds on new themes in inclusion. This conference will bring together managers, academics, organisational development specialists, practitioners and service users to look at how we create best culture for staff and best care for patients and carers. The conference will highlight international, national and local ideas and practice.

   * The development of a new undergraduate course at Leeds Beckett on youth, communities and society has York Street as key advisory partner. York Street is presently talking to key NHS figures and organisations about ensuring this course achieves recognition for best innovative practice and transformational change.

   * York Street is working with Alan White, Leeds Beckett Professor in Men's Health, looking at how we reach out to some of the most vulnerable people in the city. This partnership work was celebrated during Men's Health week last year in partnership with St George's Crypt. This brought wellbeing practice and health intervention to homeless men. It offered a move away from traditional model of health consultations to one of health conversations over food and dialogue. Health workers from LCH and other health services took part in this holistic and co-delivered event.

   * York Street is presently discussing some mental health and wellbeing research work with Professor White. York Street is also in discussions with Michelle Briggs, Professor of Nursing and Jane South, Professor of Healthy Communities at Leeds Beckett, to develop ideas and map out joint-working for the future

   * Paul Mackreth, a senior lecturer in community nursing at Leeds Beckett, is working with York Street. The team will be offering teaching on leadership this year for student district nurses.

The tripartite partnership of Leeds Beckett, York Street and St Georges Crypt has helped inform the work of CommUNity, a Leeds Beckett community campus partnership. This is an initiative that builds sustainable partnerships between voluntary/community organisations and Leeds Beckett with an emphasis on projects focused on health and wellbeing. The overarching goal is to find new, more effective ways to improve health and reduce health inequalities in communities. Combining the resources and knowledge of community organisations with those of the university creates benefits for both partners: it improves knowledge exchange and gives staff from both sectors access to different sources of expertise, widens participation and opens up opportunities for students and research.

In reflecting how and why this work happens, a number of key elements come through, three of them described here.

To start with there is a shared purpose and vision. The key people involved have moved beyond 'silo' thinking and working to what Kate Cowie, the social change specialist, would term 'a world centric view'. This view is panoramic. This vision is one that respects different disciplines and seeks to create a meeting point for them to develop and learn together. It is an explicit recognition that we work better together and can only deeply learn from and each other in listening dialogue. It looks outward and is open to the new. This provides the framework and field for the work and ideas to appear. The focus has always been on something bigger than ourselves. It has been what can support best health and care interventions with homeless and vulnerable people.

The second key to this successful partnership is that it is capable of creating positive and creative space. We may all have attended meetings where there is no freshness or innovation or inspiration. The joint meetings between Leeds Beckett and York Street have been places of trust, openness and clarity. They have been where it is possible to test and sift ideas and options. We would venture that one key ingredient here has been that the participants haven't seen partnerships as what we can get but more about what we can all contribute to the common good.

A third key aspect of this fruitful partnership has been the human element. Support, kindness, humour and respect have marked the work and tell us that partnerships are fundamentally not just about what we do but who we are. They offer the possibility to bring our best gifts to the present.

As this new year of 2015 starts we will continue on this road of trying to create a health and education partnership that makes the difference in our city and beyond. This post is a sign and witness to that commitment. We believe we are only at the start of a journey that offers potent and engaging models of how we can all work and learn together. This offers something for all of us. It also offers a future. 

John Walsh, Practice Manager, York Street Health Practice

john.walsh@nhs.net @johnwalsh88

Professor Ieuan Ellis,  Dean Faculty of Health and Social Sciences & Pro-Vice Chancellor, Leeds Beckett University

i.ellis@leedsbeckett.ac.uk  @Prof_IeuanEllis

Inspiration and the way forward

The NHS and social care along with other services face major challenges. There are financial, economic and social issues affecting the care people need. In this difficult period we are faced with different views and options for the future. In this post, myself and Pria will reflect on two themes which seem to us so vital. They are our vision and the tools to help us make it real.

The future will be decided not only by what we do, it will be shaped by what we see now. Our vision will create what appears and generate the ideas to realize it. The author, Joel Barker, says it well: "Vision without action is merely a dream. Action without vision just passes the time. Vision with action can change the world." We need to elaborate a vision of how social care, health and other sectors can come together to create new ways of working. How silos can fall and new integrated solutions be created to meet need in the fastest and most effective caring manner. This vision would enthusiastically embrace co-learning and co-work with patients and carers. It could in alliance with people and communities work on a holistic approach to those in need. The Maori people speak of well being. This is a fascinating word as it is not well arm or well house or well mind but the whole person. The Maori vision sees well being as a house with four walls; the physical, the mental / emotional, the social and the spiritual ( in terms of meaning and purpose ). This holistic vision offers the possibility of circular care where all the four walls reverberate and work off each other. It is also circular as it can only be delivered by different people and services working together in a circle with and around the person. This vision could focus on the person first and foremost. The phrase 'person centred care' is used a great deal today and rightly so. However, we can only really have people centred care if we move away from seeing people as problems. The challenge is to look through the problem to the person and their gifts. This is a move to the person and their potential.

We live in a complex period. The words of Charles Dickens in 'Tale of Two Cities' about another historical period has an echo with us today. He writes, "It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness....it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us." This period includes austerity but also great opportunities to really breakthrough old system thinking and make a shift to better more humane perspectives and practice. Today is not a time for despair but vision and action. The road will not be easy but we can build or rather grow cultures and care that offer best solutions for all. However we can only do this by thinking and doing what's needed in new innovative and potent ways.

There are many tools to support this journey. We will touch on two key skills that support the way forward. The first is to see that the future lies all about us in the present. It is found wherever people care and have passion. This folk represent what the future of our services could be. Recently I met an inspirational Doncaster GP who works in a poor area. He shared the work that he was doing. He said he shook hands with everyone who came into his surgery to welcome them and connect. He said one Saturday a month he would have clinics for carers to reach out and be there for them. The GP also shared that he visited the well as the sick. This was well being work. This GP was creating the forms of the future. These positive practices of really connecting with patients, making space and support for carers and promoting wellness in the community are a sign of what could be done and is being done. We need to capture these wonderful innovative works and share them and ask what they say to us.

The second help is the use of creative space and dialogue. This is where people come together and develop a safe space where trusting and listening discourse can occur. From these transformational hot spots come ideas, inspiration , actions and positive changes. Are the meetings we attend or set up creative dialogical spaces? If we are not learning in them or finding creative energy and visions there then probably not. We need to develop the art of dialogical exchange. Our good NHS colleague, Dr Maxine Craig, speaks of dialogic change. This is where change and creativity occurs in the locus of authentic and open sharing. It's amazing how fresh thinking and practice flow from deep dialogue and connection. When we experience it we feel inspired and caught up in possibility.

The future offers us many challenges and openings. We believe that the need of a vision that positively infects us all and calls forth clear and courageous actions is central to where we need to go. We also affirm that people of passion and vision and the power of dialogue are mechanisms for the vision to become visible. To us the choice seems pretty clear. We are will either be people of purpose and passion who make a great future that works or we won't. That's the crossroads we stand at.

John Walsh, York Street Health Practice, Leeds Community Healthcare NHS Trust  
Pria Bhabra, Leeds Adult Social Care Commissioning, Leeds City Council 

Takeover Day

We are year 6 pupils from Gledhow Primary School and we are dementia friends.

 

We have had the amazing opportunity to be part of the NHS Takeover day at the Shine Centre in Harehills. Takeover day is where children get to take over the world of work and this has been an amazing opportunity to learn about Dementia  and how it affects the sufferer we learned how to approach and talk to someone with dementia.

Today was a special day because there was some new staff for the NHS here for induction .we made a display board about dementia friends and showed it in a market stall for takeover day. New NHS staff were looking at the different stalls. Bunting and drawings were used to attract their attention, sometimes they came to ours, so we asked them a question ‘If someone reacted to you in a strange way, how would you deal with it?’   Also we had the opportunity to browse the stalls ourselves finding out about other parts of the NHS. We were able to go around and ask people in the NHS about what their favourite bit in their job. I have learnt a lot about what peoples jobs are in the NHS such as; library services, weight management, safe guarding, trade union and a lot more.

We think it was really fun and informative and think that it should definitely happen again!

Written by:

Marley, Hussein, Evie, Charlotte, Ewan, Lucy, Aimee and Mohsin

I get by with a little help from my friends

Recently I became a Dementia Friend.

Su McAlpin, Dementia Friends Champion at
LCH with 'Gina'  

I have a personal interest in the Dementia Friends campaign but in my role of Communications officer at Leeds Community Healthcare NHS Trust, I went along to one of the trust's training sessions to see what it involves and how we could help promote the campaign internally to colleagues.

On arriving at the session, I explained to the leaders I was there from a ‘comms perspective’ and said I would sit to one side so not to disrupt the session. I was encouraged to take part; I didn’t realise anyone could become a Dementia Friend, you don’t need to be a healthcare professional. The awareness is useful, regardless of whether you’re at work or doing the weekly shop.

The training session is just an hour long but gives you a really good insight in to what things we can do to make our community dementia friendly. There are lots of great analogies that help you to understand what it can be like for a person with dementia. For example, you’re walking in to a health centre and there is a black mat at the entrance. You would cross the mat, enter the building and go on to attend your appointment. To a person with dementia, they may see the mat as a black hole and don’t want to step on to it for fear of falling in to it. This could make them scared to access the building and prevent them from going to their appointment.

After talking to the trust’s Dementia Friends Champion, Su McAlpin, I found out that around 100 of the trust’s front of house staff have been trained as Dementia Friends recently with more to follow. They’re the first people that greet patients so it’s important they recognise the signs and know how to support someone. Su is running a number of training sessions internally and also externally - recently, she spoke to a local Beavers group. We’re also looking at all our buildings to make sure they are dementia friendly too.

The campaign is aiming to create 1 million dementia friends by 2015. You don’t need to go along to a session, you can also sign up to be a dementia friend online at www.dementiafriends.org.uk 

Let’s all help to make Leeds a dementia friendly community!

Sarah Elwell, Communications officer

@LCHNHSTrust 

#DementiaFriends

All part of an NHS PR person's day's work

Okay so you all think the world of public relations is glamorous right? Well, maybe... Even in the NHS it's that buzzy team in the office coming up with the vibrant ideas and always talking (or tweeting) very loudly about it - when we're not out to lunch that is!

Hannah and myself at the RCN stand

Well I would like to set the record straight here and now.  Firstly, yes I am very proud that myself and my brilliant team of Sarah, Mandy, Hannah and Andrew occupy the buzzy, vibrant area of Stockdale House in Headingley and yes we do have some great ideas - we may not share some of the wilder ones with the rest of the organisation - but I am proud of everything we do.  Yes we do bake a good cake to accompany our fresh coffee or Earl Grey tea and we do enjoy the odd lunch at Hyde Park Corner or in Headingley if we're celebrating something special - but I like to think we're known for turning work around and getting some brilliant results.

Above all else, we're focussed on the needs of our organisation, our services, our staff and the patients and their families we serve - we use our communications expertise to share messages and seek engagement with key individuals and groups.

This week's activities that fall within the remit of "all in a PR person's day's work" are possibly on the less glamorous side.  Our work has involved having lots of lovingly branded items made for our current recruitment campaign.  So count them: 1,000 hessian bags, 1,000 hand sanitisers, 1,000 trolley coins, 1,000 torches, 1,000 water bottles, 10,000 (yes 10,000) pens oh and before I forget (not that it is possible to), the 1,000 air freshener dangly things fragranced with jasmine - and yes, I do regret giving Mandy and Hannah free reign to choose the scent as it's all you can smell in our office right now!  I also regret the hessian bag choice, well I don't because it looks fabulous, but when you have eczema on your hands, handling hessian bags makes your eczema bleed - but it doesn't make me exempt from mucking in to help the team effort!

Before and after 

It's all focussed on how we attract new talent to our organisation to be the future of community healthcare in our brilliant city of Leeds. We have some challenges in terms of vacancies within some of our services so it's our job as comms people to get some great messages out about working for our organisation and to make this sound attractive as possible.

So we made the biggest production line in Stockdale House history (our Leeds head office) to put one of each branded item into each hessian bag, as we've been attending some jobs fairs in Leeds in the last week to attract new staff to our current vacancies in our organisation.  Attending the fairs means getting the 1,000 filled bags to each venue and setting up what is for us, a bit of an ambitious exhibition stand.  But we're taking it in our stride and doing quite well actually!

Today and tomorrow we're at the Royal College of Nursing Jobs Fair in New Dock Hall, Clarence Dock, Leeds. Myself and Hannah from the team have been lugging round said goodie bags and lots of other boxes and racks, as well as putting up our gargantuan display graphics that include our fab campaign strapline: "A passion for community services" - that's us in 5 words - at the venue yesterday so we can attract some lovely new staff to our organisation.  So if you're interested in nursing or indeed any other role in a community focussed organisation then do stop by any time from 10am - 5pm - we're on stand number 15.  

And we have some great goodie bags to give away...in case you hadn't guessed.  Here's hoping for a great event and some new staff to join our community based organsiation.

P.S. Before I go, I just wanted to add that it's Sarah's birthday this week, so if you need us, we're out to lunch on Friday trying to put a little glamour back into our week!

P.P.S. We do have a vacancy coming up in the team so if this post has attracted you to our heady world of hessian bags, glamorous exhibitions and the odd team lunch, keep an eye on NHS Jobs for the details.

Gillian Neild, Communications, PR and Marketing Manager, Leeds Community Healthcare NHS Trust

@GillianNeild

Helping people to live independently

Debbie Slater is currently a community nurse. She first worked for the trust whilst on placement and enjoyed it so much, she wanted to return...

“I’m passionate about community services because
I help support people to live independently
in their own homes and live a fuller life as possible.”

"When I was a student nurse, I worked with the Intermediate Care Unit (ICT). It was one of the areas I enjoyed most and learnt a lot from. Once qualified, I wanted to return as a permanent part of a rehabilitation team. For the first two years after qualifying I worked at St James Hospital on an acute medical ward before joining the trust’s Intermediate Care Unit (ICT).

I wanted to work for ICT so I could experience a different type of nursing and for me, being in the community meant I could get to know patients better because they were in their own homes.

A typical day for me involves going to the office in the morning, where I will find out which patients need to be seen and what referrals have been sent in. I will then discuss and plan the day with my nursing colleagues and the Multi-Disciplinary Teams. The rest of the day I will be out in the community visiting patients. Sometimes I will have to rearrange visits through the depending on whether I get a call about new referrals or patients that need to be seen quickly. Being a community nurse allows me to work independently, however I know I can discuss any issues that have cropped up with the rest of the team, and normally have a debrief once I return to the office at the end of the day.  

For me there are many rewarding parts to my role including; preventing admission to hospital by picking up on a patient becoming unwell early, helping people recently discharged from hospital to stay at home or assisting people as they adjust from being dependant on staff to living independently.

I enjoy the variety the day brings, every patient and situation is different, I never know what I will find when I arrive to do a visit."  

Privileged to work in the community

"I’m passionate about community services because
I work with children with neurological conditions
and long term conditions to assist them in
activities and participation in their own environment."

Lauren Haworth is a Community Children's Neurological Physiotherapist and tells us a little about her role with the trust...

"Initially I decided to join the trust as I wanted to be associated with such a large organisation with such a good reputation. After joining on a six month temporary contract, I never left and have been here seven years now. I love my job!

I trained in the North East at the University of Teesside and completed a previous rotational physiotherapy role in another West Yorkshire NHS trust. I specialised in Musculoskeletal Physiotherapy, but felt that Children's Physiotherapy was an opportunity and an experience I had to try. It is very rewarding working with children.  

Every day is different in my role. I am very privileged to have my treatment area in a school, or health centre, or patients home, or swimming pool or trampoline! I treat and assess children in environments appropriate to the goals we are working on and negotiate family orientated treatment plans to accommodate the child and family as much as possible.

By working in the community, I think we are able to see the real challenges and difficulties affecting our patients in their own homes and environments and I'm proud to be able to assist with this."

The oyster and the pearl

We all recognise the value and necessity of good self esteem. We all can see how low self worth can stop us believing, acting and changing. Beliefs about 'I can't' or 'I won't be able to' are mental shackles that bind us to the present limitations and close off possibility and the future. Lack of self worth can lead to illness, tiredness and always thinking the worst of ourselves. In this post we will look  at self worth and ask what it consists of and how we can focus it on. We will offer some thoughts. We know that not all will agree. That's fine. This is an area where we need dialogue and exchange. We don't claim to hold absolute answers but hope there is something of value in what we write.  

We will take as our starting point the words of the Sufi writer, Rumi, "What strikes the oyster shell does not damage the pearl". This is a deep and wise saying. What does it means? The oyster is our surface life. This means our likes and dislikes, our emotions, body, mind and preferences. It also could include what we connect with externally and our possessions. These are part and parcel of our life. They are important and need to be nurtured and nourished. Yet Rumi tells us there is something else. There is a pearl. In history people have called this by different names: the real or true self, the soul, the deep or intuitive mind,the spirit, the heart and many more. It refers to that central essence of us that might call our life or being. There is in us a deep source and this is the place where our deepest gifts and existence seem to rise from. Rumi's message is that while the oyster may be struck by illness, pain, self doubt or life experience the inner essence remains. The pearl shines and remains unharmed. To us this offers a wonderful picture of authentic self worth.

The outer may change. We may even sadly lose some things we love and depend on. Our feelings may go up and down but the centre of our being which is life, wonder and creativity remains. Self worth then is all about celebrating the oyster and holding it but fundamentally more. It is a call to see and value the pearl. The strength of this position is that it means our self worth is not based on what we do or who we know but on who and what we are. It also means that we are all amazing wonderful beings born of a universe which is too marvellous to fathom . Werner Heisenberg, the Nobel Prize winner for physics notes, "Not only is the universe stranger than we think, it is stranger than we can think." It's sometimes the case that wonderful people can't see their wonder. Instead an illusion of low self worth lives and moves in their minds. This is a real conundrum. It may be explained by negative conditioning and experiences. The difficulty is in how the good comments and reflections of friends and loved ones seem to bounce off. Perhaps this shows how the deep the lack of self worth is. It may also reflect something else. We may be looking in the wrong place for self worth. Focusing on the oyster for our self worth rather than the pearl. If we focus on the passing and temporary we may soon get disappointed. For example if we focus on feelings we may end up on a sea saw - one day feeling good and the next not. If our self worth is based on money or fame what happens if we don't have them or lose them? Our self worth will disappear too. If we base it on the oyster shell we may end up with a self worth that either isn't there or can easily disappear. If we focus on the pearl we may find we have a centre for self worth and self well-being based on being itself - who we are in the depths.

The famous existentialist philosopher Jean Paul Sartre spoke about being, having and doing. We would see being as the base of self worth and having and doing as its handmaids. The error in our opinion is that often make having and doing the base and foundation rather than the pure expressions they are mean't to be. Having and doing won't provide deep self worth. They will support it and express it. So being - our centre and life is the principle of real self worth.

We realise we are walking into philosophical territory here so perhaps a story might help our words. The story is a real one and is about a man called Peter. Peter suffered from chronic lack of self worth. He doubted himself and saw himself deep down as useless, worthless and less than all. He held a series of beliefs that confirmed this for him. When things went wrong he would beat himself up mercilessly. Peter was a man of great kindness and compassion but not to himself. When things went good and people said nice things he always batted them away, never accepting the compliment. It's a sad story. Peter today is a person who values his self worth. His friends and colleagues would never think the above description was ever him. And in a sense it wasn't. For Peter's discovery of his worth and glory has remade him into a new person. What supported Peter on this journey was to become aware of the pearl. He knew that his self esteem could not depend fundamentally on money, status, success or feelings. He saw over a period that deep down he was amazing and good. And not only him but everyone was the same. That was really good transforming news. When people say to him 'You're amazing Peter!' He now says, 'Thank you. We all are amazing  - it's just that we don't see it' Peter built his self worth on the pearl not the shell. This building led him to value and appreciate the shell in new and fresh ways.

We should focus on the visible and external aspects of life as well as the inner centre. The question is how we can live on the surface from the depths of our being. Often we live on the surface from the surface. It is the depths  - the deep - where we find the creativity, energies and potency that can make all things new. Peter found it. We hope we all can.

John Walsh. Support Manager. York Street Health Practice 

Louise Goodyear. Student Nurse. Wolverhampton University