Latest news from the Greater Manchester and Eastern Cheshire Strategic Clinical Networks

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July 2021

Mum making smoking history

Summer success stories 


The latest smoking in pregnancy figures are the stand out success story in this month’s newsletter.

A total of 945 more babies have been born smoke-free since work started in 2018. A remarkable achievement.

Our vision is to provide people with services comparable with the best in the world and our drive towards that target is helping lives in their very earliest stages.

Another encouraging development is the growth of Greater Manchester’s long Covid services, which our Respiratory Network is coordinating.

We are still in the process of understanding what problems this condition is creating, but what is certain is that many people are in need of treatment and care and they are very grateful when they receive it.

Also, in this month’s newsletter, we have exciting updates on our Palliative and End of Life Care, Diabetes, Cardiovascular, Children and Young People Networks and the Greater Manchester Integrated Stroke Delivery Network.

And our clinical lead for frailty, Dr Martin Vernon, answers questions about the challenge of Covid-19.

Many thanks for your continued support.


Best wishes

Julie Cheetham - Director 

Dr Peter Elton - Clinical Director 


(Photo above shows Rochdale mum Tierney-Rose, who stopped smoking in pregnancy, and daughter Maddie.)

Julie Cheetham and Peter Elton

Maternity Network

New figures have revealed that smoking in pregnancy rates are at an all-time low in Greater Manchester (GM).

The Smokefree Pregnancy Programme is an important part of the Saving Babies’ Lives programme, the latter led by the SCNs, and latest ‘smoking at the time of delivery’ (SATOD) data shows rates have fallen by around a quarter in the past four years – down from 1 in 8 (12.6%) new mothers in 2017-18 to fewer than 1 in 10 (9.8%) in 2020-21.

This means 945 more babies were born smokefree since the programme was launched in 2018.

Jane Coyne, Strategic Lead for the Making Smoking History programme, works for the population health team at the GMHSC Partnership, and collaborates with the SCNs’ Maternity Network on the Smokefree Pregnancy Programme, which is an important part of Saving Babies Lives. 

She said: “Every parent wants the best for their child, but quitting smoking is not easy, and it is a serious addiction, not a lifestyle choice. That’s why the Smokefree Pregnancy programme is so important in making sure everyone gets the individual help and support they need.

“The programme is saving babies’ lives and it shows the vital role that health professionals play. I’m incredibly proud of what the team has achieved over the last three years – we must keep going with this vital work and deliver a smokefree start for every baby.”

The Greater Manchester Health and Social Care Partnership’s Smokefree Pregnancy Programme was created as part of efforts to give every baby the best start to life.

The SCNs’ Maternity Network helps NHS maternity staff get comprehensive training to have open and honest conversations about the risks of smoking, use carbon monoxide (CO) screening to check for exposure to tobacco smoke and refer people who need help to a maternity-led stop smoking service.

Tierney-Rose, 21, from Rochdale, had smoked for six years when she became pregnant. She was supported by the maternity-led stop smoking service and is now enjoying a smoke-free life with one-year-old daughter Maddie.

She said: “I wanted to do everything I could to ensure that my baby was safe and well. I researched how to give her the best start in life and had read that when you smoke a cigarette, the poisons from the smoke are passed on to your baby. I didn’t want that for her.”


Supporting immediate actions to ensure safety

The Local Maternity System is supporting maternity services to implement the 7 Immediate and Essential Actions (IEA) with 12 clinician priorities highlighted in the interim report by Donna Ockenden to ensure safety for mothers and their babies.

This includes recommendations for enhancing patient safety, how we can best listen to women and families, developing more effective staff training and ways of working, managing complex pregnancies and risk assessments throughout pregnancies, monitoring fetal wellbeing, and how to ensure patients have enough information to make informed consent.

Across Greater Manchester and Eastern Cheshire, all maternity providers are currently implementing the IEA’s and a national portal opened in June for submission of evidence of compliance against the IEA’s with a very small window for completion.

The Maternity Network was pivotal in coordinating a plan to ensure trusts understood the ask and supported production of evidence which included provider information packs, audit proformas, guidelines, SOP and standardised risk assessments in a very tight timescale which was completed successfully.

The portal is now closed and the regional maternity team will now be exploring the evidence, to feedback to each trust which the SCN will continue to support.


Successful findings from Peppy Baby Pilot

Greater Manchester and Eastern Cheshire Local Maternity System (GMEC LMS) - which the SCNs’ Maternity Network is a part of - was the only LMS involved in a recent pilot of the Peppy Baby app. 

The lead maternity provider St Mary's Managed Clinical Service worked with stakeholders across Manchester, Trafford and Salford with support from the SCN Maternity team on the pilot of the Peppy Baby app.

This was for those in late pregnancy through to eight weeks post birth, providing additional free expert support including 1-2-1 text chat with perinatal practitioners, infant feeding consultations, mental health advice, tailored group webinar sessions on a wide range of topics, peer support group chat and more. 

The external evaluation by Swansea University found positive outcomes for the support the app provided to parents as well as positive outcomes for infant feeding, mental wellbeing and parental confidence. 

Some of the outcomes included:

  • At eight weeks, 80% of women were breastfeeding, (this is higher than the average across Greater Manchester)
  • 95% said Peppy helped them feel more knowledgeable about breastfeeding
  • At eight weeks, 82% of parents were feeding their babies as they had planned (importance of this on parental wellbeing)
  • Mental wellbeing improved during the pilot, with the percentage of mothers reporting normal or high wellbeing increasing from 69% at baseline to 89.9% at the end of the pilot. There was a particularly high increase in mental wellbeing at end of the pilot from those of Black, Asian or minority ethnic background 
  • 5% reported Peppy Baby gave them greater confidence in their parenting
  • 8% said they would like to see Peppy Baby continue.

If you are interested in receiving the full evaluation report, once this has been released, please email


Respiratory Network

This month saw the submission of our GM plans to support long Covid treatment and care to NHS England/Improvement.  

Our GM plans propose the development of a person-centred, menu-based approach to treatment and care across all ages, and will act as a framework to support local provider planning and support a co-ordinated approach to physical and mental health assessments and rehabilitation.

Our Respiratory Network, in collaboration with other networks, has led the development of our long Covid plans on behalf of GM. The planning and decision-making has been overseen by our newly established post-Covid Oversight Board, consisting of executive leadership.

Over the next few months the Network will be supporting the development of local provider planning and the implementation of those plans.

Jonny Lee

This month we welcome two new clinical advisors who along with our Respiratory Network leads, will be supporting the enhancement and expansion of our local pulmonary rehabilitation services.

Sue Mason, respiratory nurse practitioner, Manchester NHS Foundation Trust, and Jonny Lee (pictured right), senior practitioner physiotherapist, Trafford Local Care Organisation, will be providing clinical expertise to the Respiratory Network programme team on the provision of structured education and exercise for people with respiratory disease. 

They will also be facilitating GM level discussions on improving structured education and exercise, supporting local teams to embed changes and proposing ways in which change can be adopted through a path of least resistance.

Our GM plans to improve structured education and exercise include early education sessions, providing a menu of treatment options, using technology to enhance the offer and refresher sessions for those who require them.

Covid-19 Q&A

Dr Martin Vernon


In our regular series, Dr Martin Vernon, our clinical lead for frailty and consultant geriatrician at Tameside and Glossop Integrated Care NHS Foundation Trust, answers questions about the Covid-19 pandemic.


Q: When did you first become aware of Covid-19?

A: Although the disease was not officially named until mid-February 2020, I became aware in late January via news and social media channels of a SARS-like viral illness in China and that other cases were being reported in neighbouring countries. By the end of January 2020 I was already aware that the World Health Organisation had declared a global health emergency caused by this illness.


Q: Do you remember when you first realised this would be the first worldwide pandemic in over 100 years and change your working life for months?

A: As soon as the news emerged of two cases in the UK testing positive for coronavirus at the end of January 2020 it seemed highly likely that the virus would spread quickly around the world as a result of air travel.

This was reinforced by the widely reported decision of US authorities in late January 2020 to close its borders to any foreign nationals travelling to China in the preceding 14 days. Following large numbers of reported deaths and cases in China in the first week of February 2020 and the official naming of Covid-19 there were then multiple reports of outbreaks hitting the media which made it clear that we were heading into a pandemic that would affect us all for a long time ahead.

For me the turning point came with the widely reported surge in cases in Italy at the end of February 2020. The lockdown in Lombardy together with emerging stories of Italian hospital oxygen supplies under pressure and outbreaks in care homes led to a quick realisation that the UK would also be in lockdown soon, with the NHS likely to be under the same pressure being experienced by colleagues in mainland Europe.


Q: What has been the most challenging aspect of working in your area during Covid-19?

A: I moved jobs at the end of January 2020, simultaneously taking up a clinical role in a new hospital and moving from a national leadership role to more regionally focused leadership roles in both London and Greater Manchester.

Not only did I have to rapidly decide where to optimally deploy myself clinically, but also, I quickly realised that travelling around the country to undertake other roles was out of the question. This meant quickly getting to know new teams, a new clinical environment and its systems, establishing new service offers and adopting new ways of remote working.

All of this was extremely challenging from the outset. Yet despite this, there rapidly emerged a sense of shared purpose and liberation promoted through remote and digital working. This helped to quickly break down barriers and promote effective team working in ways that I had never previously experienced in over 30 years of providing healthcare.


Q: Has there been a low point during the pandemic professionally and if so, what was it and how did you overcome it?

A: In late March and early April 2020 I realised that national policy decisions appeared to have left care homes, their residents and care staff largely unprotected from the impact of the pandemic.

Elsewhere in Europe we had already seen the catastrophic impact of Covid-19 on older people in care homes. Along with colleagues with whom I conferred locally, nationally and internationally, I felt growing alarm that more had to be done if we were to avoid the same catastrophe in England.

Witnessing care home outbreaks with high mortality across the country was a particular low point, subsequently revisited many times over as ONS data emerged confirming considerable excess care home mortality in England.

Despite this, I was fortunate to work with academic, clinical and industry colleagues in Greater Manchester and nationally to quickly do all we could to develop and deploy digital tools and use the resources available to help care homes deal with the pandemic in real time. On my own patch, working with colleagues in the local authority, CCG, public health, primary and secondary care, we were able to develop and test effective new ways of detecting and responding proactively to clinical deterioration among care home residents.

This helped identify outbreaks early and optimise public health responses to better support and protect residents and staff.  The learning derived from this work has been recurrently shared across Greater Manchester clinical networks and with colleagues around the country.

Alongside multidisciplinary leaders nationally, I was also privileged to help successfully lobby Government to shift policy towards implementing systematic care home testing and bring greater scrutiny through research on the impacts and opportunities presented by the pandemic to do more to enhance care for care home residents.


Q: Are there any positives you can take from the pandemic professionally?

I have been particularly struck by the commitment, professionalism and team spirit shared by colleagues across all parts of the health and care system.

While facing the biggest challenge of our careers, everyone deployed in the public sector has gone well above and beyond the call of duty.

Despite us all experiencing overwhelming work and professional demands, tiredness and at times personal and professional tragedy, we have kept going.

The country is incredibly fortunate to have a dedicated workforce with such widespread compassion and dedication to preserving the health, safety and dignity of the people for whom they provide care, regardless of how and where they live.


Palliative and End of Life Care Network

The Network is supporting the further roll out of the ‘EARLY’ identification tool - a new electronic search device which supports shared decision making and having well-planned, coordinated care.

The tool has been developed in the North West and piloted across primary care in the region, as well as in London. It is responsive to a person’s changing needs, with the aim of always improving the experience of care.

The Network will be expanding on the successful pilot and supporting further roll out of the EARLY identification tool in primary care, with a package of support from a GP Facilitator.

If people can be identified early enough it will provide the opportunity to engage in planning with people, through a personalised care conversation, enabling people to explore their wishes and preferences for their care both now and in the future. 

As part of the EARLY process, conversations can be recorded and with consent shared on a local Electronic Palliative Care Coordination System (EPaCCS). The EARLY process supports the system in working towards personalised care and crucially it increases the choice and control people receiving palliative care have over their lives.

If you would like further information of how to get involved please contact England.GMEC-EOLC@nhs.netbefore Friday, August 20, 2021.

More information can be found on the EARLY identification tool here.


Diabetes Network

The Network is aiming to boost the promotion of two major diabetes programmes following the appointment of three engagement officers.

The new recruits will provide GP surgeries with tailored support to help increase the take-up rate to the “Healthier You” Diabetes Prevention Programme and to support GP Surgeries with completing online registrations for Diabetes My Way.

Here are the three new recruits:

Diabetes 1Diabetes 2

There is still one vacancy available. If you would like to find out more information please contact


bronchiolitis PHE social media

Children and Young People Network

The Children and Young People Network has been working with clinicians, provider organisations and commissioners across the system to plan for an expected early winter surge of Respiratory Syncytial Virus (RSV).

The virus is among other respiratory causes of bronchiolitis which can make small babies, as well as children usually under two years old, quite poorly.

Although only a small percentage of babies will require hospital care, this year is an unusual year because last year’s babies where protected from the virus due to lockdown and school closures.

As things have opened up again, they have been exposed to RSV, so more babies are presenting with bronchiolitis than usual for the time of year.

Our hospitals have already had admissions in June and July for a virus that usually circulates in the autumn.

The issue was discussed at a recent system-wide Winter Surge Planning Summit, which more than 40 people attended. We heard some of the ways that our paediatric services are managing the impact of the early surge, and we also discussed some possible solutions to help open more beds, care for children at home where possible, and to carry on with ‘business as usual’ while managing the additional pressures.

Following the summit, a paper was produced to alert providers and commissioners of services about the current situation and what may come, as well as those solutions that were discussed. The paper was well-received and as a result we will be taking forward some actions to ensure our children and young people receive the best and safest care as close to home as possible.

(Image above shows a social media graphic which forms part of Public Health England's information campaign about RSV). 


Greater Manchester Integrated Stroke Delivery Network

Since 2015, there have been two networks in Greater Manchester overseeing service improvement of the local neuro-rehabilitation (NR) and stroke pathways.

These are the Greater Manchester Neuro-rehabilitation Network (NRN) and the Greater Manchester Integrated Stroke Delivery Network (ISDN). 

Following agreement to move to a single provider model for inpatient NR services, the NRN changed its focus in 2020 so that it only now supports the community pathway.

Unfortunately, the pandemic has delayed transfer of acute services to the single provider model led by Salford Royal but this work will resume in the coming months.

Whilst the two networks have always worked closely together, they currently operate under separate governance arrangements and associated budgets. This can lead to duplication for stakeholders involved with both organisations as well as unnecessary complication in decision making and also inefficiencies in terms of cost. 

As a result, the boards of both networks have recently approved the merger of the organisations into a single structure. The network team is currently consulting with stakeholders on some of the finer detail of the changes and has begun streamlining the way it works.

The move to a single network should bring great benefits to both the NR and stroke stakeholders each network currently works with, and help to achieve the over-arching aim of making services better for patients and their families or carers.

Cardiovascular Network

The memory of seeing Denmark footballer Christian Eriksen collapsing on the pitch at the European Championships this year will stay with many people for a long time.

Thankfully, urgent medical assistance arrived immediately, and cardiopulmonary resuscitation and defibrillation were performed on the field, which ultimately brought him back to life. 

Every week in the UK, 12 people aged under 35 die from sudden cardiac arrest. And in the UK each year, 30,000 cardiac arrests happen outside of hospitals - all requiring emergency resuscitation, with just one in 10 people surviving.

The Cardiovascular Network is currently awaiting approval to work alongside the North West Ambulance Service on an ‘Out of Hospital Cardiac Arrest (OHCA)’ programme, which aims to give people a better chance of survival.

The aim of the project is to deliver a common, seamless pathway of care for those with OHCA, from resuscitation, through to the Cardiac Arrest Centres, reducing variation in care while improving the quality of service and outcomes.

It is hoped survival rates for patients who suffer an OHCA can be improved from 5.7% to 13%, saving 240 lives across Greater Manchester and Eastern Cheshire over three years. 

Read our Achievements document

Top 10 achievements


If you haven’t already, please take a look at our Achievements 2013-2020 document.

The document reflects on how our clinical leads have helped shape changes which have improved the lives of thousands of people living in Greater Manchester and Eastern Cheshire.

The report looks at each network, explaining how our life course approach has seen sustainable improvements from maternity to children to end of life care, with many long-term conditions tackled in between.

See our website for more information on all our networks.