LCH Gets Taken Over

Leeds Community Healthcare NHS Trust (LCH) gained seven new members of its communications team, as students from Leeds West Academy in Rodley spent a day at trust headquarters learning about the role of the team as part of the Children's Commissioner's Takeover Challenge. As part of proceedings, the group blogged about spending the day with LCH.  

For the first time ever, Leeds West Academy sent seven children to Stockdale House to have an amazing opportunity, taking over the communication team and, to see how people work behinds the scenes of the NHS.

Leeds Community Healthcare NHS Trust brought seven children to the work place to explore what happens at in the working world. Many of us were nervous and had different ideas. Some of us thought it would be handing out food and drinks, others thought that we would be shadowing some of the workers and working with the team. However it was different from these ideas.

We arrived at Stockdale House around 9:30am, none of us knew what we were going to do. We were met by our first guide, Chloe, and she brought us to the meeting room and we met by Helen and James. We got involved in observing, reviewing and suggesting changes to real service users leaflets, and documents to help the trust to see how younger people react. We were showered by grapes and cookies and by the end we ate them all!! 

After lunch we interviewed four different workers and saw how they got into the kind of jobs. The first co-worker we spoke to was Amanda and she worked in the review department, she spoke to us about how she helps people, she said “it is very rewarding and never the same so it’s never boring.” One of the other co-workers was, Chris was part of the pharmacy department and he sorted out all medication and drug doses going out. 

We felt we have made an impact because they presented their ideas and when they were given feedback which helped them a lot, and our points were taken into consideration. 

- Jodie, Tyler, Lauren and Beth 

Takeover Challenge happens every November and is a national opportunity from the Children's Commissioner for children and young people to 'take over' different aspects of organisations to get involved in making decisions about issues that affect them.  

A Secondment- Three perspectives

Susan Holley, Associate Service Improvement Facilitator 

I managed to secure a 3 day a week temporary secondment within the Service Improvement team as an Associated Service Improvement Facilitator.  I would continue to work in my substantive post as a Podiatrist for the remaining 2 days.

My initial thoughts were how would this work in practice?  Would I be able to juggle the 2 roles and still manage to learn new skills from the secondment whilst not compromising the work that needed doing as a Lead Podiatrist.  Initially this proved tricky as due to recruitment issues there was no backfill for my work.  After my 3 day per week Podiatry role was offered as a secondment I found the workload much easier to manage.  This involved lots of communication between my Podiatry Team Manager , S.I. mentor and and myself.  I think that this close working relationship helped make the secondment possible.

So, what would this secondment mean to me and the Podiatry department?  What would I be doing and what skills would I learn and develop?

During my secondment I have been exposed to lots of new experiences.  This has included being involved in service reviews and facilitating sessions.  I have found that I had a lot more to offer than I originally thought I would.  Sharing my knowledge and ideas gained as a Podiatrist with other services during their service review has been one positive outcome.  I have also been given the opportunity to facilitate sessions which is something that I had never done before.  I was worried that I would not have the skills necessary but with support from my mentor and the other members of the Service Improvement team I have facilitated sessions with positive feedback, including a session within the Podiatry service with my colleagues.

I have really enjoyed my secondment in particular the contrast in work between a clinical and corporate role.  The 2 roles are so different however the vision of both roles is the same, to provide high quality care to our patients. 

I hope that when my secondment ends I will be able to use my newly learned knowledge and skills, whether this is within my role as a Podiatrist or within a wider context within L.C.H.

If anyone is contemplating applying for a secondment role my advice would be to go for it.  

The new skills you learn, and your knowledge you can share with others may surprise you!

Kenny Brown, Podiatry Team Manager

What worked well? Excellent communication between Myself, Lisa and Susan supporting each other and ensuring we are ‘on the same page’ in terms of direction, supporting Susan and ourselves and having clarity of purpose. There has been excellent flexibility on all sides, enabling Susan to flex/swap her sessions when needed between both roles.

Susan has been able to share best practice in her secondment role with other services and we have been able to use Susan’s new knowledge and skills within Podiatry. The most recent workshop Susan facilitated being an ideal example, which has encouraged and inspired others as well as strengthening relationships.

There has been an openness, transparency and honesty on all sides, monitoring progress and how the secondment has developed. We have discussed different options regarding the end of the secondment and if there is a return to Podiatry, how Susan’s skills can be used not only within Podiatry but also across the Trust.

What’s hasn’t worked so well? For me, not only in this secondment but in others is that part time secondments are really tricky particularly on the secondee. In Susan’s case, not only did it mean programming changes pulling her away from the clinic she had spent the best part of 20 years in, but also Susan had to try to keep her head in both camps, keeping abreast of all that’s going on which is extremely challenging. This is no reflection on Susan personally, rather this situation has become evident in other part time secondments also.

Nonetheless, the Secondment has developed Susan , had a hugely positive effect on the Podiatry Service, and other Services whom  Susan has had contact with. Susan has  been an agent of positive change!

Lisa Falkingham, Service Improvement Facilitator

Susan joined our team in September 2014 on secondment from podiatry. As a mentor I remember being slightly apprehensive as it had taken a while to secure the secondment and I was determined that Susan should have the best experience possible. It’s always good to have someone ask you ‘why’ with fresh eyes, its made me think differently.

From day one Susan was able to share her knowledge in podiatry with other services which has been received positively and from a service improvement perspective has met the desired outcome of share and spread of improvement knowledge.

Susan and I have worked closely with her manager Kenny Brown to ensure that we offer the best support for development for Susan as an individual, podiatry as a service and service improvement across the organisation. This working relationship has been a real strength and point of learning for us all. I have gained knowledge and insight into the pressures  and tensions of front line service delivery, Susan has gained improvement knowledge, training and opportunities which she wouldn’t have when working exclusively clinically and Kenny has been reading and role modelling improvements in podiatry with the help of Susan and through a commitment to live the values of LCH.

It’s not all been plain sailing it’s fair to say and I think Susan has had to carry the largest burden of challenge in working two jobs ( I know because I’ve been there and it is never easy).The challenges have also brought learning and more questions. Our big question now is how we ensure Susan can use and build on her learning as she returns to full time clinical practice. This is work in progress.

Building Community Capacity Health Visiting project

With a renewed commitment to fulfilling the 'community level' aspect of the role, Rebekah Besford and Amy Prytherch, two student health visitors, explain their part in a pilot project to embrace 'Building Community Capacity' within our health visiting service. 

We are two student health visitors coming to the end of our training and have been chosen to play an integral role in Building Community Capacity within two local projects in South Leeds.

Health visitors are trained to deliver the Healthy Child Programme. This includes an expectation that health visitors are aware of and actively involved in community development work. This has been a recent challenge for the health visiting profession across the country. With the completion of the Health Visitor Implementation Plan in 2015 and the subsequent increase in numbers of health visitors, there is renewed commitment to fulfilling the ‘Community Level’ aspect of the health visiting role. Leeds Community Healthcare Trust is undertaking a pilot project to embrace ‘Building Community Capacity’ within its health visiting service.

Skinner (2006) defines community capacity building as ‘Activities, resources and support that strengthen the skills, abilities and confidence of people and community groups to take effective action and leading roles in the development of communities.’

Health visitors are seen as bridging and guiding the complex networks of people required to support children, families and communities to achieve the best possible health outcomes.

Working in partnership with ‘Health for All’ based in South Leeds we attend the projects on a weekly basis.  The two projects we are involved with are:

• Happy Chinese Families Group- with the aim of providing an opportunity for local Chinese people to meet and socialise as well and healthy eating and cooking.  This group meets every Monday 9 – 2.30pm at Beeston Village Community Centre.

• Global Families Breakfast Club- with the aim of providing a social meeting space and sharing breakfast cooked and prepared by volunteers form different countries. This group meets every Wednesday 9 - 12 at Beeston Village Community Centre.  

Our role is to play a part in establishing and strengthening the groups. This involves being a part of the volunteer workforce to contribute our knowledge, skills and enthusiasm to help achieve needs led sustainable community development.  This will be done in many different ways including: support with funding applications, contributing to enhancing conversational English, highlighting healthier food options and conversations around responsive parenting.

For the health visiting service the benefits of the pilot are to gain experience in seeing community development/building community capacity in practice and take our learning, reflections and insights back to the service.

We will endeavour to do this through LCH Health visiting facebook page and twitter accounts; feeding back at PIC meetings and writing a final reflective blog on our experience.

You can find out more information on our Early Start Service on our website.

Lights! Camera! Action! CAMHS staff and service users shoot new videos

Staff and service users from our Child and Adolescent Mental Health Service (CAMHS) took part in a number of workshops during August at the West Yorkshire Playhouse to create videos for the new CAMHS website.

Below is an email received by the service from the mother of one service user after the workshops sharing her experiences.

 I just wanted to say thank you for the last two days. C.E. has come home glowing both days, but she was on cloud 9 after yesterday! Thanks for telling Annie you were impressed with C.E.. Annie has helped C.E. so much since she took over her case in November and has worked so hard to build her confidence and self-esteem again. She will be so pleased to know how well it went. 

I'm sure you gain so much in your job from seeing young people begin to recover from difficult times & would share my happiness in seeing the change in C.E. since CAMHS took her under their wing just over a year ago. She was a very different girl in a very dark place and she has come such a long way in her recovery. Doing something like this has helped so much with her confidence and self-belief and she is starting to realise she has a lot to offer. I can't tell you how good that makes me feel as her mum because it gives me so much hope for the future.

This is why C.E. wanted to do the project so much. She wanted to thank CAMHS for helping her and is interested in helping other young people. I knew she would enjoy the video project from what Annie had said, but she has absolutely loved it. She has new friends and is going to join the WYP youth theatre in September. Best of all she is happy that she made such a good impression and I know she is proud that she could share her story and experiences. I think that is amazing - such a fantastic example and a great way to break down the stigma of mental illness. I couldn't be prouder of C.E. 

Thank you again for a brilliant project. I wanted you to know how grateful I am. 

Best wishes, Mum of C.E.

Click here to find out more about the work of the Child and Adolescent Mental Health Service (CAMHS). 

Giving a Voice Online

Speech and Language Therapist Julie Carr joined LCH a year ago and is passionate about helping children to achieve their communicative potential. In this blog, Julie talks about how this passion for her profession has lead her to be an example to others. 

I am a speech and language therapist working in the Children’s Speech and Language Therapy department. I have been qualified 4 years and have been working in Leeds Community Healthcare since September 2014. I love working with children and helping them to achieve their communicative potential.

During my final year as a student at Newcastle University, the Royal College of Speech and Language Therapists (RCSLT) launched Giving Voice – a campaign to raise awareness of Speech and Language Therapy and demonstrate SLT's unique value, to local and national decision makers. Passionate about the profession and keen to spread the word about our work I eagerly joined the campaign and became an active participant.

I was involved in raising awareness of Giving Voice in a range of activities including writing to my local MP (Ian Lavery, Wansbeck, Northumberland) to tell him about the importance and value of Speech and Language Therapy. I was delighted when he said he wanted to meet with me to learn more and this was the start of a number of meetings and a long term working relationship with him.

Due to my extensive involvement in Giving Voice over the last 4 years and also my work engaging with a local MP, RCSLT invited me to be a guest speaker at a webinar event in London last month - 'Giving Voice: local heroes make national champions: engaging with MPs'. RCSLT invited me (and two other members) to share best practice examples of positive engagement activities.

I was delighted to be asked to speak at this event and I travelled to London early on Friday morning, keen to share my experiences. I have spoken at a number of events about Speech and Language since qualifying but this was my first experience of speaking at a webinar. Not sure what to expect, I arrived slightly apprehensive but the staff at RCSLT quickly put me at ease as they talked through the running order of the day and explained how the equipment worked.

The webinar was live online at 1pm and RCSLT members began logging on 10 minutes before, ready to engage in the session. Derek Munn, Head of Policy and Public Affairs at RCSLT chaired the meeting and welcomed everyone to the event.  Peter Just, Public Affairs advisor at RCSLT was the first speaker and explained the importance of engaging with MPs and what RCSLT have been doing and plan to do to continue keeping Speech and Language Therapy on the agenda.

Myself and the other two speakers (Rachel Clare, student at UCL, and Janet Cooper SLT manger, Stoke Speaks Out) shared our experiences of raising awareness of Speech and Language Therapy with MPs, to inspire other members to get involved.

I enjoyed taking part in the webinar, meeting the other speakers and hearing about their experiences too. It has reignited my passion for raising awareness of the profession and I hope to continue spreading awareness of the valuable work of SLTs in Leeds also. I am hoping we get schools involved in a national joke telling competition ‘Voice Box’ in the autumn term, which is organised by RCSLT and The Communication Trust.  

If you want to view the webinar, click here.

More details on Giving Voice can be found online. 

What do you know about the trust's Board of Directors?

The Trust’s Board Meeting takes place every month with members of the public welcome to attend. But what do the people of Leeds really know about what happens around the table? Three members of staff, who attended their first Board meeting in July, share their experiences.

“I wasn't entirely sure what to expect, and to be really honest, I thought it might be a little dull! I imagined there would be a focus on the money we need to save as an organisation, and that I wouldn't understand a lot of the discussion, but it wasn't, and I did. It was interesting, informative and reassuring.

The meeting was far from dull because it was about people and the work that we are all doing in the trust. There were familiar things being discussed, like recruitment and retention, capacity and demand, nurse revalidation, pressure in the neighbourhood teams and the impact on us of increased admissions to Leeds Teaching Hospitals Trust. The overriding priority however, was how we best support our greatest asset- our staff, in service of the patients we serve.

Being an observer is always interesting, and of particular note was the dynamic between the people around the table. There was seriousness and laughter. The challenge from the Non-Executive Directors for the Senior Management Team was reassuring in terms of being held to account. The challenge was received, not in a defensive way, but as a platform to clarify, share actions and learning, and determine where further work may be required.

I left the meeting with a sense of hope that the focus is on the right thing- ‘our people’, and that we have a real opportunity together to create the culture we all aspire to be part of. I would highly recommend any one to attend and observe.”

Lisa Falkingham

Service Improvement Team

“I have been to a number of Board meetings outside Leeds Community Healthcare and they are more like a ‘talk shop’ where actually nothing gets agreed or decided. Was this Board meeting going to be different? I went with an open mind!  

In return, I found the LCH Board meeting captivating, as they were discussing topical issues which are being experienced by front line staff, and the knowledge round the table was fantastic. It made me understand the wider context of health and social care within Leeds, including the pressures of recruitment, retention and training, all whilst continuing to provide the highest possible quality of care. I found it very inspiring to watch the Board, including Non-Execs, discuss a range of issues with passion and energy in a very challenging economic environment.  My respect for each one of them was raised a notch, and actually felt lucky to be living and working in Leeds.” 

Arifa Chakera

Programme Management Office

“I found the Board meeting interesting and informative, and came away with the impression that our board are a good mix of people. The Non-Executive Directors positively challenge our Directors on many aspects, who in turn are happy to provide more narrative on each topic.  I would recommend people to go along to the Public Board meeting as we so often get stuck in our own individual silos of work we miss the bigger picture.”

Linda Dobrzanska

Research Team

Minutes for the Board Meeting can be found on LCH's website here. 

Leeds Special Educational Needs and Disabilities (SEND) Information and Fun Day

On Saturday 27 June, staff from our children's physiotherapy and occupational therapy teams attended a special Fun Day for the families of disabled children at the John Charles Centre for Sport. Here, Julie Cliffe, clinical pathway lead for children's physiotherapy looks back on the day. 

For a number of years, Leeds has held a well-attended Special Educational Need (SEN) marketplace, to provide families of disabled children with the most up to date information about what is available for their children, and for the last few years EPIC Leeds has hosted a Fun Day in partnership with Breeze and Scope. In response to the financial difficulties that every council and their partner organisations are experiencing, it was agreed this year to host a joint event at the John Charles Centre. The aim was to offer families an opportunity to gain information, provide feedback and have some fun.

The day was hosted by Epic and Scope in partnership with various colleagues. Most of the John Charles Centre was booked with both indoor and outdoor facilities and the space was used for fun sessions and informative stalls for all the family. There were inflatables supplied by Breeze, specially adapted bikes and lots more fun activities and information.

The Children’s Physiotherapy Team and Occupational TherapyTeam set up stalls to provide information on the services they provide within the Integrated Children’s Additional Needs Service (ICAN) for children and families within the Leeds area.

The day was a great success with lots of interest in the stalls and also an opportunity for staff concerned to network with other staff, service providers and local organisations.

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. 

1001 Critical Days

1001 critical days 

Sue Ranger, consultant clinical psychologist, within our Infants Mental Health team was invited to help develop the  1001 Critical Days Report, which was launched recently. Here she shares details of her experience...

  

"Tim Loughton, MP and former Children’s Minister, said that tackling child mental health issues and maltreatment in the first two years of life should be no less of a priority for politicians as defending the realm.

He made the comments ahead of the launch of an Inquiry conducted by the All Party Parliamentary Groups for Conception to Age 2- first 1001 days into perinatal mental health and child maltreatment. It suggests that the cost of failing to deal with these issues is estimated to be £23 billion, half of annual defence spending of £43billion, and that poor parental / child attachment can be passed down from one generation to the next, creating a vicious cycle and damaging environment in which to grow up.

The report is the culmination of months of inquiry sessions, which took evidence from a committee panels of experts and parliamentarians, to investigate the various factors that affect the emotional and social development of children from conception to age 2. The report was launched on Wednesday 25 February at the Speaker’s House in Parliament where a number of leading academics, clinicians and policy makers in the field were in attendance.

The over-arching inquiry pulls together previous research in the area to offer two main conclusions:

One is that to deliver socially and emotionally capable children at age 2, local policies need to be based on a commitment to primary prevention. The evidence presented in the Inquiry strongly indicates that identification of need should take place before the child is harmed, not after. Therefore, inspection should look closely at primary prevention measures which would deliver this result.

The second conclusion is that, without intervention, there will be in the future, as there has been in the past, high intergenerational transmission of disadvantage, inequality, dysfunction and child maltreatment and the economic value of breaking these cycles will be enormous. In addition, the report offers nine recommendations, which it says are practical, achievable but, above all, the minimum essential if society is to tackle these issues. 

I was lucky enough to be one of those invited to contribute to the process of gathering evidence and opinion to inform the new ‘Building Great Britons’ report on the vital importance of supporting infants and their families in the period from conception to the child’s second birthday. My involvement meant attending a series of several meetings in the beautiful wood panelled meeting rooms in the Houses of Parliament over a period of five months from September 2014 to February 2015 and providing verbal and written comments on the importance of early attachment relationships and support for infants and their families in the earliest days of a child’s life.

A significant and rapidly growing body of research now exists to support the clinical evidence that tells us that an infant’s environment and experiences in utero and in the care they receive in the first months of life will dramatically influence outcomes throughout their lives. If babies have positive and loving care before and after birth from parents who are physically and emotionally healthy then they will grow healthy brains and become secure and resilient children who make good progress and do well in school and beyond. Relationships are a key part of this process and that includes the relationships that parents have with professionals and services to support them in caring for their babies and young children. Proactive and preventative services are less costly in the long term than reactive services to address established difficulties so the policy makes good economic sense too.

I was formally invited to attend the launch of the 1001 Critical Days Report on Wednesday 25 February, along with various others including our local CCG Children’s Commissioner, Jane Mischenko,  by the Rt Hon Frank Field MP and Tim Loughton MP who chaired the APPG meetings. Speakers at the launch included Mr Speaker, The Rt Hon John Bercow MP, The Rt Hon Paul Burstow MP as well as MPs Tim Loughton, Sharon Hodgson and George Hosking OBE, CEO and Research Director of the WAVE Trust. It was quite a line up! The surroundings of the state rooms at Speaker’s House at the House of Commons were equally grand and impressive. Even gaining access to the event required airport style security checks and an escort to the Speaker’s House!

The grandeur of the setting only served to emphasise the importance of the agenda and the significance of this report for me as an Infant Mental Health practitioner in Leeds. Our city is one of few in the UK to have already acknowledged the importance of the first 1001 Critical Days and to already have in place a Best Start Strategy that prioritises proactive and preventative services to support families through pregnancy and the first two years of a child’s life.  Indeed, we held an excellent conference in October 2013 on this very subject at which I was able to present a paper on the ways that Leeds is delivering services for infants and their families to promote infant well-being and outcomes.  We were lucky enough to have several brilliant national speakers on the podium at the conference including George Hosking from the WAVE Trust.

A number of services and initiatives are already in place in Leeds doing sterling work in supporting these families and the infants who are the most vulnerable of our citizens. These include Early Start teams, Family Nurse Partnership Team, Preparation for Birth and Beyond, BabySteps, and the Infant Mental Health Service, to name but a few. An ambitious programme of training and consultation to support practitioners to support families is well underway.

The ‘Building Great Britons’ report is an inspiring and exciting publication that very much endorses the Best Start Strategy in Leeds and the commitment we have made to the first 1001 Critical Days. It has been a privilege to be part of the process of making a little bit of history happen in such an important area of policy. Getting things right for infants produces positive outcomes for them and for society. Truly an investment in the future!"

Sue Ranger

Consultant Clinical Psychologist 

More information can be found at www.1001criticaldays.co.uk

What are the 'communities of practice'?

"Without leaps of imagination or dreaming, we lose the excitement of possibilities. Dreaming, after all is a form of planning." Gloria Steinem 


We live in an evolving and unfolding universe. We see change at tremendous rates. The early 20th century started with the Wright Brothers flying a plane a short distance. Before the end of that century we were not only flying to the moon but landing on it. We live in a world of paradoxes. She is dynamic and at the same time fragile The world is interconnected and yet divided. The world is technologically accelerating and yet poverty, disease and war remain. Wall Street and poor neighbourhoods exist in the same state. This is our world with all its mess, marvels and mystery. It is beautiful, frightening and engaging. And it's all interconnected in some way with ourselves. As Carl Sagan, the astronomer, said: "The nitrogen in our DNA, the calcium in our teeth, the iron in our blood, the carbon in our apple pies were made in the interiors of collapsing stars. We are all made of starstuff."

Our organisations and services reflect a similar paradox. We see great service, innovation and kindness on wards and in communities. Yet there are financial worries and the awful episodes that inhabit our systems and cultures. In this complicated and complex setting there is an interesting phenomena to be sensed and seen. Across the NHS and other services new movements are arising. New energies are flowing across our systems. These networks and alliances are creating new ways of seeing and doing health and care like new seeds. They are focussed on people and putting people first. They embrace digital technology, are values driven and work intuitively as well as rationally. In a wintery time for the services we love there are signs and sources of hope and renewal. They are the summoning of spring.

These new movements take many forms and shapes. One of the most promising and fresh forms are the 'Communities of Practice'. What are 'Communities of Practice'? They are many things and no one definition exhausts their mission, role and possibility. One way to see the communities is as centres. They are centres of sharing. People who both work in and use services come together to share stories, experience and practice to develop deep dialogue and learning. From these encounters and co-learning arises a new form of shared wisdom and meaning.

They are centres of energy. They are spaces where we meet to explore issues and support each other. They are a terrain where freedom, connection and respect must be central. We hope these communities will be wellsprings for all who seek kind, better and effective cultures and practice. They are centres of life. Life and work should not be competitors or opponents. Through 'Communities of Practice' we can grow as people and workers. We seek personal and corporate development through the communities. In this way we seek to model how systems and services can be and indeed should be. In this way the communities are both dream and gift.

We invite you to join these communities, alliances and networks. Explore with us and work with the communities. Together we can make a difference. If we wish to learn and grow together we have great potential within us to create, despite everything, a future that works and cares for everyone.

Visit the Co-Creation Network website for information or watch an animation about the network here. 

John Walsh. York Street Health Practice. Leeds Community Healthcare NHS Trust
Angela Green, Improvement Academy.
Jane Pightling, Yorkshire &Humber Leadership Academy
Lucy Scarisbrick, Yorkshire &Humber Leadership Academy  

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.)