Sussex partnership NHS trust: winner, hospital admissions award

Dr Lisa Page says the way the trust uses mental health triage nurses is unique. Photograph: Sussex Partnership NHS Trust

A year ago people with mental health problems turning up at A&E in Brighton often had to wait four hours to be seen. Around 12% of patients would get fed up waiting and leave; those who were prepared to sit it out frequently ended up being inappropriately admitted to the hospital's observation ward, where they stayed until being assessed by the specialist mental health team.

But today, the number of patients with mental health problems being admitted to the observation ward at the Royal Sussex county hospital through A&E has dropped by 50%. More than 85% of patients are seen and assessed by the mental health team within four hours. Anybody turning up and A&E with a mental health problem is automatically referred to a specialist mental health triage nurse within an hour – something which Dr Lisa Page, consultant in liaison psychiatry at Sussex partnership NHS trust, says is unique. "I don't know of any other hospital which uses the triage nurse in the way that we do, although others do have proactive teams in A&E."

The improvement in waiting times and the introduction of the mental health triage nurse is part of the Brighton Urgent Response Service (Burs), which was introduced in January to tackle the 30% year-on-year rise in unscheduled mental health attendances at the East Sussex seaside town's A&E.

Page says the reduction in observation ward admissions is good news for patients and A&E staff but also for the clinical commissioning group (CCG) because of the high tariff associated with this kind of admission. "That is where the savings are coming from as we are no longer having that large number of patients admitted," she says.

Burs, set up by Sussex partnership NHS trust in collaboration with Brighton CCG and the acute trust, also includes a 24-hour urgent phone line for GPs, mental health patients and carers who are new to the system. GPs can book a patient a next-day appointment at the mental health clinic – rather than the previous minimum five-day referral. Patients and carers are offered telephone advice from a Burs practitioner and are referred as necessary. A dedicated mental health nurse is also available in the community between 8am and 8pm Monday to Friday and from 8am to 6pm at weekends. A new waiting room for people with mental health problems, which provides a calm and quiet environment has also been established at the Royal Sussex as part of the scheme.

Page says her mental health team is busier than ever and that it is too soon to say whether the number of people turning up at A&E has pulled back from its 30% year-on-year rise. But she feels Burs is ensuring that people are seen more appropriately and more quickly. She says: "Referrals to our team have gone up by a third because we are now seeing people who in the past would have come to A&E and left. We haven't curtailed the 30% but we have made some inroads – it would have been even busier without Burs."

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here

Spice and the Young Foundation: partnership innovation award runner-up

The Uplift scheme 'helps you anchor yourself, to anchor your place in society and your sense of identity', says one service user. Photograph: Spice

A time-bank project designed for health and social care service users is helping them feel less isolated and has the potential to transform their lives.

Under the Uplift scheme service users spend time volunteering for local organisations in return for time credits. They receive a credit for every hour given; in return the earned credits can be spent at local leisure or cultural venues which have signed up to the scheme.

Uplift has been established by the social enterprises Spice and the Young Foundation. It involves four local authorities in England, more than 200 local organisations and 1,000 service users who have notched up 20,000 credits.

As part of Uplift, each local authority hosts a Spice facilitator whose job it is to create a local time credit network made up of service users, community organisations, public services and private businesses. Each network offers a mix of earn or spend opportunities.

David Russell, head of health and social care at Spice, says: "Uplift is a large and ambitious project across four geographical areas, involving a wide range of service types and communities.

"On average we find that 40-60% of participants have never given time before ... this is having a wide range of positive outcomes particularly around culture change, increased physical activity, mental wellbeing, confidence and community pride."

One service user from Norfolk who has signed up to Upflit says it has made him more "anchored". He says: "It's opened up social avenues – I've now got a group of nodding acquaintances at the gym, which helps you anchor yourself, to anchor your place in society, and your sense of identity."

Spice and the Young Foundation are also working with commissioners, service heads, support workers and service users to see how the idea of time credits can be adopted more widely into their own systems and approaches to work. Russell says: "This can range from large scale service asset mapping to redesigning support working systems, to building co-production into the commissioning process."

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here

Rivington and Blackrod and Ladybridge high schools: winner, partnership innovation award

Pupils have also been trained as 'health ambassadors' and hold theme-led assemblies on a range of health issues. Photograph: Rivington and Blackrod high school

It could easily have been a bureaucratic nightmare that failed at the first hurdle. The dilemma was how do you bring together the NHS, local government, education and sports centres to deliver a school-based health project that the students would be happy to use?

The answer, according to Michelle Howard, director of business development at Rivington and Blackrod high school in Lancashire, was to be committed to the vision and have the confidence and trust in each other to share information and best practice.

"We worked with all our partners to ensure that all our procedures and practices worked well together," she says. "We learned so much more about each other and how we could best use our skills, resources and specialisms to deliver the best outcomes for us all. It was also about sharing that responsibility."

The teenage health project at Rivington and Blackrod high school and the Active Health scheme at its linked federated school, Ladybridge high school, has gone from strength to strength since it was first established in 2007.

The intention, following wide consultation with parents, young people, the local community and public services, was to create a student-friendly accessible health and wellbeing service offering advice, guidance and information on the school site. "It started out when we were looking at Every Child Matters, which was on everybody's minds at the time," says Howard. "It was about looking at what we could do to help young people stay healthy and safe."

A steering party was set up, which included representatives from parents, pupils, schools, the local authority and leisure providers to design and develop the project, which had £450,000 of Big Lottery Fund money.

Today more than 3,000 young people have made use of the project, which offers them a range of advice and information including healthy eating, sexual health and contraception and drug and alcohol awareness.

Support for emotional wellbeing and advice about how to cope with stress is also offered by the project, which is run by school nurses alongside a project co-ordinator who can refer students to different services as required. "There isn't one aspect of health that we shy away from," says Howard.

School students have also been trained as "health ambassadors" – taking the healthy message to their classmates by holding theme-led assemblies and teaching them how to carry out CPR and other lifesaving first aid skills.

At the same time, 13 members of staff have learned about healthy eating and nutrition and are now passing on their knowledge to students across the school.

The project, says Howard, has generally improved the students' physical and emotional health. But there have been more tangible results: the behaviour of 81% of children who attended its anger management programme has improved; the local teenage pregnancy rate has started to fall and 87% of children who received counselling said they were feeling better.

Howard attributes the success of the project to the depth of the relationships between the different partners. She says: "It's about trust and acknowledging that 'I am really good at this' and saying 'how can we work together to get the best outcomes?'. We also had a very strong vision, which we all focused on and never lost sight of."

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here

Michael Yoakley's Charity: partnership innovation award runner-up

Manager Julie Wickenden shows off one of the hospital avoidance beds, which helps prevent inappropriate hospital admissions. Photograph: Michael Yoakley's Charity

A care home in Kent is helping to free up hospital beds and preventing older people being inappropriately admitted to hospital, following a partnership with a local GP surgery.

The Michael Yoakley's Charity in Margate provides the North Down surgery with two short-term hospital avoidance beds, which are offered to older patients who are unable to be cared for at home and need support.

The patients spend a maximum of seven days in the home at a charge of £500 a week, which is significantly cheaper than the £500-a-day it would cost to pay for a high-dependency NHS hospital bed. So far this year the home has looked after 24 older people who have been recovering from common infections and viruses, including chicken pox.

The charity's executive manager Julie Wickenden says the scheme turns on its head the traditional relationship between the home and GPs, where family doctors have traditionally served the needs of the home.

"We have a large local hospital where we have many elderly people clogging the system when they don't need to be there," she says. "Our seaside area also has a high proportion of elderly residents many of whom are geographically distanced from their family members who might otherwise care for them, so the default when they are unwell, or even just vulnerable, is a hospital admission.

"A lot of care homes are looking to develop different kinds of initiatives because they are not having so much success with social services funding as the councils are really holding back putting people into residential care, so we have had to look for other ways of making up the finances."

The initiative, which allows continuity of care by the patient's own GP, has been so successful that the home is now in the process of building an extension, so that it can provide more hospital-avoidance beds.

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here