Helping peple feel less alone

Alice Curling, who facilities our stress control classes, blogs about her work as part of the Leeds IAPT service.

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"I have been interested in mental health ever since studying psychology at A-level about 10 years ago and since then I have studied, worked or volunteered in or around the field of mental health.

I have worked for the Leeds IAPT service for just over a year now and am really enjoying my job. Of course there are difficult days when things haven’t gone as well as you would hope or when sessions are difficult, but the good days; when you can see people improving, really make up for it.

My job is also really varied; I do face to face and telephone assessments, one to one treatment sessions and have recently begun to facilitate a stress control class. The class was definitely outside of my comfort zone, but I’m really pleased that I put myself forward for it. The classes cover very similar material to what we would usually use in one to one sessions but you are able to reach more people in a shorter space of time. We also get to cover a range of interventions which we sometimes don’t have the time to do in the one to one sessions. The course material has also taught me new things and techniques which I have incorporated into my one to one sessions.

Facilitating the class has definitely improved my understanding of stress and has improved my one to one practise at the same time. I would certainly encourage other workers to facilitate the groups. Although you don’t get the same immediate feedback from people that you get from one to one sessions, you can see the improvement in many people. I would also definitely encourage people who think they would benefit from attending the class to contact the service. Many people fear a group or class situation but once you come you will see it’s not as bad as you think! People are also surprised at just how many people are going through similar difficulties as them which can help people feel less alone.

I am learning all the time, not only from my colleagues but from people accessing the service as well. No day is ever the same, and I hope I can continue to learn and grow so that I am constantly improving my practise."

Alice Curling - Stress control class facilitator

Treating patients as individuals

Gemma Crabtree is one of our community podiatrists who looks after the people of Leeds feet! She tells us what here role involves...

“I'm passionate about community services
because we provide quality evidence
based treatment and treat patients as individuals.”

"I work as a Community Podiatrist and have been with the trust for nine years. At present I am acting up in my role and working as a clinical lead.

After qualifying as a podiatrist, I applied for a job with the trust and was successful in this. Although I live in Harrogate, I much preferred to work in Leeds.

Like with most community services, there is no typical day. Although I am based at Kirkstall Health Centre, where I deliver a clinic daily, my colleagues work across Leeds, providing treatment in a number of locations that is as close to home as possible for the patient.

Each day is very busy, seeing clients for 20 minutes at a time. Within this time it is important to find out if there have been any problems since the last appointment and see if any further actions need to be taken i.e. referrals or requests for insoles. I will then provide treatment if necessary and update their records.

Through the Community Podiatry Service, we deliver core podiatry, management of high risk feet and nail surgery as well as specialised clinics that for example, people with high risk diabetics, high risk feet and chronic painful skin lesions would attend. We also work with vulnerable people such as those with mental ill-health or those receiving healthcare in prison. To meet the individual treatment needs of patients, care is personalised and planned.

Although I provide treatment for both adults and children, I work with children quite a lot and find this area very satisfying. The service offers special support for children include flat foot, curly toe, growing pain, hypermobility and toe walking. Each child tends to attend and present different problems which makes the day more interesting when I have to find a solution."  

Care in the community

Jade Griffiths is one of our nurses who provides care to people in their own home. 

“I'm passionate about community services
because I can care for people in their
own homes and help them get back
on track with their own lives.”

"It was during the 2^nd year of university whilst on my nursing placement that I fell in love with working with people in the community. I found working in hospital quite impersonal so much prefer working in people’s homes where you get to know them, their families and their home circumstances so much more.

Working in the community as a nurse means no two days are ever the same, whether I’m helping a person manage their diabetes or supporting a person at the end of their life. Generally my day will start with going to the office, seeing what appointments I have, catching up with the team before setting off on the road. I could either be seeing a patient that receives regular care or a new patient. Last minute changes can happen too if an urgent appointment crops up. Although I work on my own whilst on the road, I always feel supported, whether it is by my community nursing colleagues or the Multi-Disciplinary Teams.  

What encourages me to get out of bed in the morning? Simply knowing that I can make a different to a person’s life."

Three Easy Traps

Lisa and I recently had a deep discussion about how we create the best cultures for staff and how services become best spaces for staff and personal development. As we thought over what we had written a number of key themes came to mind. One area we covered was how we easily fall into 'traps'. Traps are mental and practical illusions that hold us in a place of no power while taking all our energy and vision away. Traps are pretty awful things. They are workplace vampires and yet we can walk into one tomorrow as easily as walking through a door. In this post we look at three work traps and how we might escape and even avoid them.

The first is the not accepting responsibility trap. This is easily enough to do yet its effects are deadly. We may not be able to control our workplace or economic factors but there is one area where we can exercise dominion and that's with ourselves. Whatever the issue or challenge ( and we have many ) we can be responsible for ourselves. We can make the commitment to be the best we can be; the best nurse, doctor, support worker and manager. It may not be easy but it can be done. People who are bullied often feel there is nothing they can do about it. This is one of bullying's great triumphs - to make us believe we have no power or choice to change things. The giving up of power and refusing to accept responsibility for one's self and our responses is a trap that can bring misery for us and others. Once we accept the power to be or in the words of the theologian, Paul Tillich, 'the courage to be' we enter a new dimension of living. That is the dimension we call integrity. It's where we own our behaviour and are open to change, criticism and growth.  It's where the blaming others stops and the work for self development starts . We grow when we are honest about ourselves and seek to own our process of becoming. Paul Tillich also warned that, 'Neurosis is the way of avoiding nonbeing by avoiding being' . By refusing to be what we are and can be we open up the possibility of becoming ill.

The second trap is rescuing. This is a trap good and kind people fall into. We meet a client and want to 'fix' them. We want on some level to be their rescuer. The problem with this is that it doesn't work usually as people don't dance to our agendas. If it happens to work it still isn't the best way as it means us sorting people like models rather than people finding their own power and possibility. People caught in this trap can often end up in one of two states. The first is self defeat and blaming themselves. 'I can't do this. I've tried but I have failed.' The other is where the blame gets projected outwards to the client. 'They don't want to change. I have tried and tried and these people aren't interested.' What both states have in common is that they view clients as problems to be fixed rather than people with real choices. The journey model is a richer and more respectful picture of work. The journey model is where we walk alongside others as a positive and supportive presence not necessarily agreeing with their choices but still walking with them. This model rather than the 'fixing' rescuing one respects choice and offers the possibility of real change and healing.

The last trap is resigning. By this we do not mean resigning from work. We mean resigning from working for better cultures and approaches. Resigning from hope. It's easy to give up. It's also easy to slide into a 'It's only  a job' viewpoint. When we go down this road we lose our passion, our vision and our hope. It's a terribly depressing thought to think of someone who has lost their soul for the work they do. That their work is just 'doing the job' rather than building and supporting a service that heals and cares.  Everyday we have a hundred and one opportunities to be a wonderful difference for the better. To be the kind ward sister. To be the compassionate doctor whose presence and words bring calm to a patient. To be the service development worker who listens to staff and supports them through a difficult time. These are not extras. They are fundamental to good compassionate care and service. They are transformation and workplace wellbeing.

A part of any solution is awareness. For us to see and change our own attitudes and conditioning. To become aware of when we are not taking the power, when we are trying to rescue others ( rather than support them ) and when we are resigning to just be another worker rather than a person who can make a difference and contribution. As we write this the need for a  clear vision, firm values, good support and a willingness to honestly see the need for change and work towards it become apparent. This is a work that can take time, commitment and focus. It's also an escape from the prison these three traps represent and that can only be real freedom. These words may sound very dramatic. But then again they describe us moving away from giving away our power, boundaries and hope so they are, in our opinion, deeply true.

John Walsh. York Street Health Practice. Leeds Community Healthcare

Lisa Falkingham. Service Improvement Team. Leeds Community Healthcare 

Hearing the homeless - working for best services

We all favour client participation, joint working with key partners, having a strategic vision and making a difference. But how do we do it? How do we make sure one of the key elements is not lost or ignored? Some may say there isn't always an easy answer to this. Some recent work between Healthwatch Leeds and Leeds Community Healthcare / York Street Health Practice offer a good model of how this can happen. In this blog two of the participants describe the work and its lessons.

Healthwatch Leeds is committed to a great vision - 'Healthwatch Leeds gives people a powerful voice on health and social care services in Leeds and beyond. Healthwatch Leeds helps the people of Leeds to get the best out of their local health and social care services, whether it's improving them today or helping to shape them for tomorrow. Healthwatch Leeds is all about local voices being able to influence the delivery and design of local services. Not just people who use them, but anyone who might need to in future'. Healthwatch is the official body that represents patient voice and concerns in the field of health and social care. Its work is vital and everybody in health and social care should actively and positively welcome it. 

Healthwatch Leeds contacted York Street Practice as it needed to produce a report on homeless people and health in Leeds for the Health and Wellbeing Board. The two agencies had already met and were both committed to the provision of the best patient care and experience possible in the city. In the conversation about the report, York Street decided not to host the event for the voice of the homeless to be heard. The reason was we wanted a neutral place where our patients could speak and be as open and honest as possible. We discussed with two key partners in the city - St Anne's Resource Centre and St George's Crypt. They agreed to host the event where Parveen Ayub, Community Project Worker, and volunteers at Healthwatch could meet homeless people and talk to them about health issues and services in Leeds. This work was supported by the agencies involved. It was written into a report that was presented to the Leeds Health and Wellbeing Board. The report looked at difficulties homeless people encounter when accessing health and social care services and the impact it has on their health and well-being. The report supported outcome 5 of the Leeds Joint Health and Well-Being Strategy 2013-15. In this way the voices of those who have few to speak for them was presented to the key strategic health and social care body in Leeds. The homeless were heard! 

To us this linked together many key needs. These include; positive partnerships between health and patient groups, allowing the patient to be heard in neutral but supportive environments that they trust, for patient groups to reach out to where people are, for those without power and a voice to be supported so their voice and needs are heard and for the leading authorities in the city to have this presented to them so they can feature it into their work for the whole city. This circle approach - from patients to strategy - from patient groups to health services - from the creation of positive space where dialogue can occur to changes in the system - all offer great hope and models of how we can work. 

This is how we can make Leeds the best city for health and wellbeing. It's a tremendous thing that we can work to make sure that not only the poorest receive healthcare the fastest but that their voice can be heard quickly through initiatives such as this. This might be the first time in the UK that Healthwatch and a health service have written a joint article celebrating joint great work and offering a key model of how we can work for the vulnerable. If it isn't the first time that's good. If it is, that's something good too. We see what we have tried to describe as best practice for those most in need now and a promise what future work can look like. Hearing the homeless and vulnerable is how we work for best services.

Parveen Ayub -  Healthwatch Leeds

John Walsh - York Street Health Practice

Meet our staff...

Sharon Underwood, a Health Visitor with the Early Start Team has been awarded the Deans Prize by Leeds Metropolitan University following the completion of her Master’s in Public Health. 

“After a break from studying after my first degree in health visiting, I decided to start a new course and discovered the MSc in Public Health: Health Promotion at Leeds Metropolitan University. Completing the course was as much about doing something for my own personal achievement as well as knowing it would assist with my everyday role as a Health Visitor.

There have been many elements to the course that I have found interesting, one of which was my research project for my 12,000 word dissertation. I decided to look in to the attitudes parents have towards supplying alcohol to their underage teenagers.

Alcohol consumption in adolescence is a source of increasing concern. In England, it is illegal for persons under the age of 18 years to purchase alcohol, and the reduction or prevention of under-age alcohol consumption is a government priority, with supply of and access to alcohol being key aims in the national strategy. The Department of Health’s Chief Medical Officer advocates that an alcohol-free childhood is the healthiest and best option for children. However, research implies that the consumption of alcohol by young people frequently ignores these recommendations.

Parental supply has been identified within a number of studies as a significant point of access to alcohol by teenagers. They may do this for many reasons; to demystify drinking alcohol, be in control of how much they consume or some see it as a rite of passage. A recent Drinkaware study identified a correlation between parental drinking habits, and influences upon children. I specifically chose to recruit and interview parents, aged between 44 and 64 years, from middleclass families as research shows there is an increase in the weekly drinking habits of this group. 

Of the seven parents I spoke with there was a varying degree of attitudes, awareness and lack of knowledge. One mum even took away with her some prompt cards describing different scenarios where her children may her approach her for alcohol to use during discussions with her children.

It was evident through the interviews that parents aren’t given much advice and support on what they should do if their teenage son or daughter comes to them to ask for alcohol to take to a party, etc. As a nurse by background and working in the healthcare profession for 30 years, I have seen the short and long term health impacts for people and their families who have been affected by excessive drinking of alcohol and as health care professionals we should get better at having these conversations early.”

Congratulations to Sharon on her degree and well deserved prize.

You can access information and support from your local Health Centre or GP surgery or your child’s school/college pastoral services. In addition, you may find the following websites a useful source of information:

• Drinkaware: Alcohol and your child
• Drinkaware: What do other parents
• NHS Choices

Celebrating Positive Pathways

Positive Pathways celebrated their first year of existence yesterday at St George's Centre in Leeds. Positive Pathways 'supports people who need to find suitable housing or are having difficulty managingwhere they live due to issues connected to their mental health'. The service is led by Community Links and is a partnership with Touchstone, Leeds Mind, Leeds Irish Health and Homes, St Anne’s Community Services and Leeds Federated Housing Association.

The event was opened by Catherine Donnelly, Service Manager at Community Links, who I first met 20 years ago when we both worked for Leeds Shaftesbury Project, the forerunner of Community Links. Catherine epitomizes everything that is good about the work we all try to do -  compassion, professionalism, vision, values, hope and commitment. Catherine introduced the event and the speakers. Chris Dickinson, Head of Commissioning at Leeds City Council spoke first about the work of Positive Pathways and the support of the local council for the scheme to deliver this valuable service to vulnerable people in Leeds. The next speaker was Councillor Bill Urry. Cllr Urry is the new lead for homelessness in Leeds and has already started to go out and meet services and clients. He visited York Street last week and the previous week had been out on the streets with services working with those rough sleeping. Cllr Urry gave a humble and gentle speech. He celebrated the event and asked what he could do for the agencies and service users there. He mentioned his predecessor Cllr John Hardy who worked so hard and so passionately for the homeless. It's a great thing that Leeds has a lead for homelessness and we commit ourselves to work with Cllr Urry to develop the best we can for our people who are homeless.

The third speaker was myself. I spoke about how Leeds can become best city. The day before I had meet with two good colleagues who work with the Health and Wellbeing Board - Peter Roderick and Rob Newton. We had talked about York Street, the passion we all have that Leeds is the best city for health and wellbeing and how we can proceed with this compassionate dynamic vision. I think I was still filled with the hope that meeting gave me as I decided to focus on that theme. I said that we become the best city by creating the best services for clients and the best cultures for staff. The two are not separate - it's all about caring for people. The need and hour for 'Integral Inclusion ' is now. I tried to map out ways for us to make those services that truly care for staff and service users.        

In attending the event and reflecting afterwards many things enter my mind. To pick three key things would not be easy but I'll try. The first was that it was so appropriate that Chris, Bill and myself spoke about what out third sector colleagues were doing. It was so right for the local authority and NHS to publicly acclaim and honour Positive Pathways and by implication third sector work. These three forces - the local authority, health and third sector working together and learning together offer a real hope to this city. This partnership triangle offers a sign and possibility for the future. This work can offer the most potent and supportive options for Leeds and it's people. The event was a microcosm of what we are and where we can go.

This brings me to the second key feature. We heard the voice of the service users. This was so key. That partnership triangle always needs to have that voice at its very centre. If we don't have patient- centred care then we are not offering the best models and practice. To hear the service users and volunteers was so powerful. Their stories, hopes and optimism touched, I think, everyone in the room. Anthony de Mello, the spiritual writer, once said that the shortest distance between a human being and truth is a story. The stories we heard connected us to people's lives and the work of the partners in Positive Pathways - work that helps people change their lives. The great health and wellbeing vision of Leeds mentions as an outcome 'People will be involved in decisions made about them'. This has to be key to our work. We have to make sure service users aren't just consulted but at the heart of what we do and are involved in what affects them.

 

The last thing that touched me was where we are in services locally and nationally. I think we are at a moment where we can do great things but to do this we have to think and act differently. As the events at Mid Staffs unfolded I remember wanting to know more. One Friday night I started to read and watch about what had happened. It was a heartbreaking experience. The next day a strange thing occurred. As I worked around the city centre I was still thinking about what had happened at Mid Staffs. Unbidden into my mind came a quote I had read a long time ago. The quote was, 'The darker the night the brighter the stars'. I didn't know who is was who said this but I knew what it meant. I looked the author up when I went home and it was the Russian novelist Dostoevsky who wrote this. Not that I have read him. I had not and still haven't. The quote however appeared as a real answer. The stars, despite the darkness, were the opportunity for something new and authentic. Not just the opportunity but that this was actually happening in different places. Those of us who want and work for new inclusive cultures for staff and great services for clients - this is our hour. The old cultures and  systems have shown in graphic deadly detail where they can lead. I believe those of us who have new visions, dream brighter pictures and work to make them come true that this is our time. Of course history and life will not automatically deliver these best services and cultures to us. We have to work for them and we have to fight for them. There are many of us in the third and statutory sectors who are sowing the seeds for this future and even seeing it happen before our eyes. If you are part of this work, thank you for what you do. If not, then why not join us? 

Happy birthday NHS

Margaret Thatcher retired from the House of Commons at age 66. Many people used to retire at 65. The NHS is 66 on July 4. Rather than retirement, a recent study by a prestigious American health body suggests the opposite is the case. The report actually points to vitality, life and plenty of work to do yet. The Commonwealth Fund is a non partisan and private health foundation based in New York. Its mission is 'to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.' Its board includes key health experts such as James R Tallon. A report called 'Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally' makes some interesting points. It compares the USA health system with 10 other health systems including our own. The other countries are Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden and Switzerland. The really key point is that the study looked at what really matters. Key elements such as access, health care quality, equity, efficiency and key indicators of healthy lives (e.g. infant mortality) were used. The result was that the best overall health ranking was......the NHS. Switzerland and Sweden were second and third respectively. (http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror).

When we often hear how bad things are in the NHS, this health specialist study says something else. So how do we square the bad news we hear and the scholarly study done by this Foundation? One doesn't have to be a genius to see that bad things happen in good services. That things in a service may be wrong yet a service can be right and good. This leads to the need for renewal and reform not ditching the service. I hope if we found a dirty plate at home we would wash it, not smash it. The study also suggests that there are powerful energies and practices in the NHS that are working well. If there wasn't, how could it be rated the best in overall health ranking?

The NHS is where ordinary people do extraordinary things everyday. The NHS is a sign of what a civilized nation looks like. It embodies the highest principles - social care, social justice and social equality. It says that health should be based on our need not our bank account. The NHS is ours - it belongs to the people. This report says she is still delivering 66 years on. We know that she is what her best practice and foundation express - great vision, values, care and compassion. That's why so many of us are so proud of the NHS and so many of us are humbled to be part of her service.

 

Happy birthday NHS - thanks for all you do and have done for people. 

 

John Walsh, York Street Practice

Meet our staff...

Lisa, Rosie and Deanna are three Occupational Therapy students from Leeds Metropolitan University, working with Integrated Services. During their three month placement, they have been undertaking a project, which they explain below.

We are a group of three students studying Occupational Therapy at Leeds Metropolitan University, currently on a role emerging placement with Integrated Services until the 11th July. 

For role emerging placements, students enter into a non-traditional placement setting and introduce or expand the role of occupational therapy within the service and develop a project around this. Occupational therapists (OTs) enable people to overcome obstacles which prevent them from participating in the occupations that matter to them. This may be a result of the aging process, illness, disability or other circumstances.

Our project is to promote occupational therapy to the other professionals working within Integrated Services in Beeston (where we are mainly based) who are predominantly District Nurses and Community Matrons.

During the beginning stages of the placement we gathered information to help us devise our project by shadowing nurses and OTs on client visits, conducting a focus group with OTs and surveying the nurses based at Beeston. Our rationale for the project was that most OT referrals are for equipment or adaptation provision and the OTs in Integrated Services are aiming to work more holistically. This includes enabling clients to engage in occupations that are important to them, such as being able to socialise with friends at a weekly coffee morning, being able to take their dog for a walk, or knitting a scarf for a grandchild.

As part of the project, we have created several posters which will be displayed at Beeston Health Centre, as well as leaflets which will be distributed to staff and patients, explaining the role of Occupational Therapy. During the last week of our placement, we are holding an interactive session with the nurses based at Beeston to explore the meaning of occupation and how beneficial engaging in meaningful occupations is to a person’s health and wellbeing. We will then discuss potential interventions OTs can provide, using case studies to illustrate the role of OT with several different clients.  

Our placement mentors believe there is an unmet need where occupational therapy could improve clients overall health and wellbeing (e.g. clients experiencing social isolation, disruption in roles and routines) however due to the perception of OT within the service these clients are not getting referred. Integrated working requires professionals to understand one another’s roles so we believe promoting OT to other professionals will serve this purpose while also addressing the unmet need of clients. We hope that when the placement is finished our mentors will continue to use the resources we have produced to promote OT across Leeds. 

Lisa Downing,  Rosie Longshaw and Deanna Stephens

Informatics Revolution

Three weeks ago three interesting things happened to me over three days.

The first was that three civil servants from the newly established National Information Board visited York Street. Peter Hall, Jane Pawson and Tracey Dibdin came to visit the practice and see what we try to do to respond to the health and social needs of homeless people in Leeds. Over a cup of coffee we discussed the work we had accomplished with digital technology and inclusion. This work funded by the Tinder Foundation was to allow ourselves and five partner agencies (Genesis, Refugee Council / Health Befriending Network, Meeting Point, St Anne's Resource Centre, St George's Crypt) to host space where some of the most vulnerable people in Leeds could access appointments to York Street, book in advance and receive accurate information around health matters.

Dan Barnett, business manager for Specialist Services, led this work and it won the Excellence in Public Participation (Provider) Award at the NHS England Excellence in Participation awards. As I talked to these colleagues from Quarry House I began to see more and more how informatics (the use of the resources, technology and methods of modern technology to deliver and support best quality health and social care) potentially touched so much of what we did. For someone whose IT knowledge ends with YouTube and Amazon books this was a bit of revelation. I could see how informatics was a key to so much of the work we try to deliver and create. Informatics moved from a 'useful' category to a 'key' one in my work consciousness at that discussion. I'm grateful to these three good colleagues for this conversation and opening my mind up to these new roads to how we do health.

Following this meeting, Dan and myself presented at the launch of the National Information Board in London at St Thomas's Hospital. The NIB has the high level leadership role in setting the strategy and direction for the health and care system on technology and information. The event was attended by leading figures form the Health and Social Care world and was opened by the Secretary of State, Jeremy Hunt. Tim Kelsey, the first National Director for Patients and Information in the National Health Service, chaired the meeting. We presented about how Leeds has drawn a Health and Wellbeing Vision which challenges and calls the whole city to work for the most vulnerable. The great wording of the vision is about working for a healthy caring city and that 'people who are poorest will improve their health the fastest'( http://www.leeds.gov.uk/docs/JHWS_FINAL_webREV%20ZI.pdf ).

We spoke about York Street and how we seek to make this vision a reality on the streets and in the lives of the homeless. We talked about the model we use at York Street - a model about how we should work as well as what we do. This inner model offers identity to the work and team. It is focused on three fundamental human developmental needs - positive space, supportive relationships and hope. Dan spoke powerfully about how the use of digital technology following on the social value work pioneered by the Centre for Innovation in Healthcare Management (http://www.cihm.leeds.ac.uk/new/programmes-workshops/change-programmes/social-value/social-value-toolkit/) had benefited the poorest in our city. I felt proud that the CIHM, LCH and others in Leeds had worked together and from this these initiatives to use modern technology to support clients use IT to improve their health and the health of others had arisen. It showed what we can create when we work together and how we can support clients to access health more easily. The event was televised live over the internet and can be seen here - http://www.dh-national-information-board.public-i.tv/core/.

The third thing was that returning to work the next day, walking down the Headrow in Leeds, I thought further how the vision we wish to create is linked integrally to digital possibilities. I could see how integration, inclusion and informatics had to go together. If we really want the best, most effective and quickest routes and delivery of care these three must coalesce. At York Street and in Leeds they had created real gains and improvements for homeless people, those involved in prostitution and the asylum system. What we have seen in microcosm at York Street could be developed in many other places and arenas.
These three experiences haven't worn off. Today I met with Victoria Betton to talk about how York Street could develop it's digital work. Victoria is the Mental Health Programme Director at Leeds & York Partnership NHS Foundation Trust & Leeds Community Healthcare NHS Trust. To talk to Victoria is to walk into a vivid world of IT possibilities and opportunities. Her knowledge and ideas seemed limitless ( www.digitalmentalhealth.co.uk ) We talked about and generated some fascinating ideas to test and look at. While I am still linked solidly to YouTube and Amazon something else has started to happen to me around the use of digital technology. I hope it happens to you too

John Walsh, York Street Practice

Nursing and what really matters

John Walsh at Men's Health Week event at the Crypt
alongside Councillor Mulherin

On Monday 9 June I attended the Nursing Times Leaders event in London. This was an award ceremony for the top 50 nursing leaders in the UK. It was to honour nurses and midwives who are "pioneers, entrepreneurs and inspirational role models in their profession...practitioners who have changed practice for the better, shown visionary thinking, had a major positive impact." (Jenni Middleton, editor of the Nursing Times, official brochure). The awards were decided by a very esteemed panel including Dame Christine Beasley. The night was a wonderful celebration of people who have made the NHS what it is at its best. It was a great privilege to be there. I was there as the guest of my dear friend, colleague and mentor, Yvonne Coghill, the national lead for inclusion at the NHS Leadership Academy. Yvonne herself won one of the awards.

I met many good people that evening. It was great to meet NHS leaders such as Jane Cummings, chief nursing officer and Caroline Alexander, chief nurse for the London region. It was a special moment to join senior colleagues from the NHS Leadership Academy to support and celebrate our Yvonne winning this award. Meeting Dr Dave Ashton and Karen Lynas from the Academy was a real joy too. They are two fabulous people and we had some great discussions about how the Leadership Academy and York Street/Leeds Community Healthcare (LCH) can work together to develop the best patient care models, staff and leadership development and work for and in the city of Leeds.  I hope these exchanges can continue as they hold tremendous promise and possibility.

 

So what really matters for nursing and all health professions in the NHS? To answer this I think we have to answer why, despite all the current problems, the NHS is still popular with the mass of British people. Why it still holds such a special place in the minds and hearts of a nation? I think the answer is that the NHS is special because it makes us feel special. And it makes us feel special because it promotes and incarnates the most powerful of human virtues - goodness. It connects us with this in a very real way. It is a commitment to care, to heal, to do good. It represents this a social body and daily practice. That's why Mid Staffs was so appalling and shocking to us. The very spirit and heart of the NHS was denied and subverted by awful practice and culture. A healing service ended up it's opposite. When people see the NHS in it's real form, they remember the fantastic nursing team that looked after their mum. They think of the kind doctor who was so helpful to them when they had a medical problem. After nearly twenty years working with homeless people on the streets of Leeds, it's exactly the same. It's the goodness and kindness that breaks through. It's goodness that starts to transform us. I've seen big tough men, no strangers to the police and prison system, crying at some act of genuine goodness that has affected their lives. I have also seen where homeless people have been lit up with happiness as they have shared what little they had with others. There's an immense energy and power in goodness. Yet I think goodness isn't an easy thing to define. It's more felt than spelt out. Most of us will know when we encounter it. It lifts us up and makes us open to hope and engagement. Goodness is a mirror that shows us what we can be. I believe goodness is what all of us in the NHS need. It is what makes everything else tick. From the 6 C's through to vision and values to good patient care, goodness has to be the core and life.

This bring me to Yvonne. Yvonne is someone with many gifts and qualities. The list of these would be a very long one. Intelligence, courage, integrity, compassion, wisdom ,strength, gentleness, energy, panoramic vision, deep psychological insight (she's the best psychologist I know), fairness, understanding and so on. For me the one defining quality one sees shining in Yvonne - the jewel in the crown so to speak -is goodness. I don't find it a surprise that what makes the NHS an incredible service at its best is what makes Yvonne such a wonderful human being. Yvonne is a very special person in a very special service. It's people like Yvonne who show us the best in ourselves and encourage its manifestation.  I feel very blessed to know Yvonne as mentor and friend. I'll finish this posting sending Yvonne from all her friends at LCH a big well done for the award and an even bigger thank you for what she is and does for this service of ours. 

John Walsh, York Street Practice

Men, Health and Hope

 

Last week saw International Men's Health Week celebrated at St George's Crypt in Leeds (from Monday 9 June to Friday 13 June). The aim was for homeless men in Leeds to receive a week of wellbeing and health actions and events, an idea formed by Kim Parkinson at the Crypt. Kim is the training and housekeeping mentor and a great force for good among homeless people. This idea led to an initial meeting with Andrea North and myself from Leeds Community Healthcare NHS Trust (LCH), Alan White, Professor of Men's Health Studies at Leeds Metropolitan University, Jade, a social work student at Big Issue in the north, and Kim to plan and design the format and spirit of the week. Rob Newton from the Institute of Health and Wellbeing and the Health and Wellbeing Board at Leeds City Council and Karl Whitty, research officer in the Centre of Men's Health at Leeds Met joined us shortly afterwards.

 

We, as a meeting of forces, representing the local authority, health, third sector, faith sector and education, were able to create an amazing week of events. The week included massage, meditation, podiatry, theatre, physical fitness, haircuts, song and pamper bags for the men. Running throughout were a series of positive and yet serious health messages. Health professionals from a variety of LCH services (including Tuberculosis service, Community Dental, York Street, Healthy Lifestyles Service) attended, offering connection and conversation. We deliberately moved away from a model of formal structured consultations to conversations over food and coffee - to share, engage and listen. Age UK Leeds joined the week as did Leeds and York Partnership NHS Foundation Trust. Our Primary Mental Healthcare Service provided information leaflets.

 

The event was opened by Cllr Roger Harrington, Chris Fields, CEO at the Crypt and Professor White. On Thursday, Cllr Lisa Mulherin, the chair of the Health and Wellbeing Board visited the event in support. Lisa has consistently supported these events and we are grateful for her support and voice for the poor and vulnerable of our city. Andrea North and Catherine Hall, two other great supports of these initiatives at LCH also, in their busy work lives, attended to support. A big thank you too to Sarah Elwell, the new communications officer at LCH who did an incredible job managing the photography, press release, partnership agreements, Twitter, Facebook and other media actions in such a professional and helpful manner.

I was in London for the first two days at health events so missed the start of the week. I did attend the last three days and was touched by many things. Three themes shine through. The first was the theme of 'space and place'. The Crypt is an incredible centre of welcome and wellbeing. They are one of York Street's best partners and we always try to support their good work. This brings home to me one of the key aspects we use at York Street as part of our model of work.  The people who come to the Crypt and York Street are those who often have no positive space or place in their lives. From the asylum world, they may be people who have been tortured, imprisoned or raped. In the indigenous homeless world, the vast majority of those we have the honour to try to support have problems going back to childhood. We work to create what the theorists call 'psychologically informed environments', places and spaces where people can feel welcome and accepted. The Crypt and York Street are such places as are many places in this city. The creation and development of these spaces is crucial to the human development and recovery of the homeless and vulnerable.

The second theme was that of the homeless people themselves. On Wednesday when I arrived, I sat down and  looked out at a sea of faces, each etched with stories and I'd guess, in most cases, pain and loss. It was at that moment that a former client of mine came up and gave me a big hug. I had worked with her a number of years ago. As I sat with her and listened to her present story I heard of  the struggles and setbacks as she was trying to build a more positive and healthier life. In the centre of the difficulties and pain there was also hope. This was not someone giving up but keeping on to try to get to where she needed to be. In this woman, there was the courage, the hope and belief that things, including her own life, could get better. This is what inclusion and wellbeing work is all about. It's when people can find their hope and strength that changes can really start to happen. Talking to men over the three days I had the same experience. Sensing the heavy issues people carried yet a not giving up spirit - a hopefulness against so many odds. If we ever lose sight that is what our work is really about, then that will be a really sad day. If we forget the people, we lose our way. Isn't that what the tragedy of Mid Staffs teaches us? On the Monday evening I was at an event in London with the top 50 nurse leaders in the UK, truly amazing people. I was there as guest of my good friend and mentor, Yvonne Coghill, the national lead for inclusion at the NHS Leadership Academy. Yvonne walks the national stage in the NHS. She is one of the leaders in this great service of ours. Although she never mentions it, she also makes time, again and again, to reach out and support people in the most vulnerable positions. If we ever wish to know what 'best leadership' looks like, this is it. Concern for people has to be at the heart of what we do.

The third aspect was how we all working together made a difference. Apart we are little. Together we make a powerful impact. Sometimes people see effective partnership work as some arcane art that 'business gurus' can teach us to generate. The truth is much simpler. Good partnerships happen when people who care connect. This is what happened at Men's Health Week at the Crypt. People who cared enough to put aside time to meet and act came together to do something. My mind fills, as I try to write this, with images of this in practice. Professor White sat with homeless men at a table talking about their health. Alex Hammond and his team from Healthy Lifestyles Service going straight into action connecting with men about how they can make positive changes. Dawn and Gill from the Community Dental Team at Armley smiling and talking about dental care to the men. Urban Spawl and Opera North offering arts, drama and theatre. Dr Phil Commons from Leeds Met with physical fitness. LYPFT were represented by my friend and colleague, Ken Cattle. Ken is a former mental health service user and now has dedicated his life to working with people in the community with mental health problems. Ken was an amazing presence talking to and connecting with the men there. Talking about mental health is not always easy but Ken did it again and again. The week made me proud of what we can do together, what we can be together. We have in Leeds 12 integrated care teams bringing together health and social care. These teams work to provide the best, quickest and most effective responses to those in the community. I saw at the Men' Health Week the same spirit, promise and potency. This city has a great health and wellbeing vision - 'that Leeds will be a caring and healthy city where the poorest receive healthcare the fastest'. I saw that happen at Men's Health Week. It really shows we can do it. If we can build on these experiences we can realise the vision and then Leeds may end up as, not just best city for health and wellbeing in the UK, but in Europe too.

The late Maya Angelou once wrote that, "I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel." I doubt any of us who participated in the week will forget how we felt in trying to make a difference. I also don't think we'll forget those faces looking to us for support and help.

 

John Walsh, York Street Practice

 

 

 

Celebrating Nursing Assistants' Day

On Thursday 12 June, we decided to recognise the hard work of nursing assistants with a celebratory day.  

Working across the city, both day and night, nursing assistants are essential to ensure the trust continues to provide a high standard of community nursing care.  

Five community nursing assistants took time out of their busy schedule to give us an insight in to the role of a nursing assistant at LCH. Huge thanks to Julie, Karen, Adele, Maggie and Janet for their time, here’s a few snippets from our chat:

What made you want to become a community nursing assistant?    

Karen: “It was my friend that is also a nursing assistant that encouraged me to consider becoming one. I first started with a one month contract as an agency nursing assistant at Meanwood Health Centre but I ended up working there for seven months, during which I fell in love with the job. As soon as a permanent band 3 post came up, I applied and was successful.”

What attracted you to join LCH as a community nursing assistant?

Maggie: “As I don’t drive, this was the first nursing assistant role I had seen where I could walk, rather than being required to have a car to get around and see patients. I really enjoy getting out and about in the community, I find it is much more relaxing than being on a ward. Plus I feel empowered to make decisions yet know I have a supportive team to contact should I need to.”

What do you enjoy about being a community nursing assistant?

Karen: “I enjoy working with some of our more challenging patients, especially when I can bring out their sparkle and find a common interest to chat to them about and bring them out of themselves.”

Adele: “I have been with the trust for four years now and enjoy every aspect of my job. Daily, it offers me the chance to meet new people, be challenged and take on responsibility.”

What would a typical day involved for a community nursing assistant?

Janet: “I work on the day shift so the first part of my day generally involves being in the community, providing treatments such as doing leg dressings, taking pressure measurements, assisting with bowel care, giving insulin and eye drops, etc. The nursing assistants and myself then head back to base (there is 12 bases across the city) at lunchtime to regroup, discuss patient care and get work schedules for the next day. After this we will all head back out, either to a patients home, day centre or residential home. No two patients are ever the same so my day is always varied.”

What has been a highlight during your time as a nursing assistant at LCH?

Adele: “In my previously role at a residential home, I only did personal care but becoming a nursing assistant has allowed me to learn more and offer the next level of healthcare to patients. The training opportunities at LCH are really good.”

Janet: “One of my personal achievements is getting my NVQ level 3, which I did through the trust.” 

What would you say to someone thinking of becoming a nursing assistant?

Julie: “Other members of my team and myself work a lot with students, taking them out in the community with us, mentoring them. For anyone thinking of a career in nursing, being a nursing assistant is a great way to start and give people insight in to healthcare.”

 

Sarah Elwell, Communications Team

Welcome to our blog

Hello and welcome to our blog. Here we will post information regarding the community services we dleiver in Leeds for children and adults.  We work across Leeds in all communities and seek to develop meaningful relationships with our partners in the city and further afield.