The view of a student health visitor

We welcome many students on placements at LCH and aim to give them opportunities that will help them develop in their chosen field. Jenanne joined our Health Visiting team on a placement, and below she shares not only her experience of working in that service but also shadowing the senior management team...

"As a student health visitor who is soon to qualify, the opportunity to spend part of my training on Alternative Practice was attractive. This afforded me time to shadow other professionals and services to gain an insight into their practice and as such, I spent time with community midwives, school nurses, those who provide services for children with additional needs and shadowing health visitors in another NHS trust (amongst others). As illuminating as these experiences were, I couldn’t help but wonder what life was like at the top of the tree – and was very gratified when Thea, chief executive at LCH, agreed to have me shadow her for the day.

On the surface of it, spending the day in the Quality Committee and Senior Management Team meetings may not sound that interesting. But I was astonished at the breadth and scope of the services which LCH provides – and the commitment that those involved have towards providing quality care to all our service users. One guiding principle, it emerged, should underpin all care: would you want a loved one being cared for by this service?  If the answer is no, then concepts of ‘quality’ and ‘targets’ are irrelevant. We should all strive towards this gold standard, and not tolerate anything less no matter how challenging our clinical environment.

Another powerful message which I took away was that decision-making can be characterised by clarity and speed. It is appropriate to ask ‘why not?’ when others put up barriers to change; it is not enough to accept that things cannot be changed because they have always been done that way, or because there are personal politics at stake. Instead we must all ensure we are working as a team in both our locality and as part of the trust as a whole.

Far from being abstract and aloof, the fundamental message that I took away from the day was that those in senior management have an acute perception of what things are really like for staff ‘on the ground’ and that we are all working together towards the same goal: providing safe, transparent and top quality care for all who use our services."

Jenanne Fletcher, student health visitor

To find out more about the Health Visiting team, click here. 

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.