The pandemic has highlighted the pre-existing challenges we face to recruit and retain specialist staff in the region’s stroke and neurorehabilitation services, both in our hospitals and the community.
The Network has been conducting a detailed scoping exercise to gather information around staffing that supports these care pathways, as well as examining teams’ ways of working to help share best practice on the use of new/advanced roles, recruitment and retention strategies and talent spotting to develop new leaders.
The information will be used to help develop plans to address issues at a local level, supported by funding for dedicated expertise in workforce development made available via the NHS England stroke programme.
We are immensely proud of the healthcare professionals who have worked so hard to maintain services during the last 18 months, often in extremely difficult circumstances.
The Network was delighted to support AHP Day on October 14, which celebrated the role of 14 Allied Healthcare Professions, including therapists (and their assistants), paramedics, orthoptists and dietitians.
A cake competition was held locally, with Bolton’s community team winning with a very impressive brain themed entry (see photo above). Our facilitators Chris and Gemma, both AHPs, recorded some short videos outlining how they use their clinical experience and skills as an AHP to help improve services.
Follow us on Twitter: @GMNISDN or visit our websites www.gmisdn.org.uk www.gmeurorehab.org.uk (soon to be relaunched as one).
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The Children and Young People Network is working on a campaign to raise the awareness of bronchiolitis.
The virus affects thousands of children in GM every year and puts great pressure on NHS services – the PR campaign aims to give parents the information they need to treat the virus at home and stop it spreading.
National statistics show one in three babies under 12 months catch it, with some needing hospital treatment. Despite its prevalence, many parents are not aware of the symptoms, how they can treat their child at home or when to seek advice from a health care professional.
There was a big, unexpected increase in the number of babies and toddlers needing hospital treatment for bronchiolitis over the summer as many of them mixed socially with other children for the first time following the relaxation of Covid-19 restrictions.
Latest information shows there has been a rise in bronchiolitis over the past week in the North West and there is an expectation busy hospitals will be put under pressure with admissions over the autumn and winter, when the virus is traditionally at its height.
The campaign is currently under design, with the help and support of paediatricians across Greater Manchester, and will use social media, information cards and a webpage to raise the profile of bronchiolitis.
We will update you on this work in the next issue, but if you see the campaign in the meantime, please help by liking and sharing the posts via your social media channels.
Our clinical director, Dr Peter Elton (pictured right), writes in his occasional blog series about how many health and social care policies are born from single events.
"I was struck by the tragic report of a death of a teenager’s baby after she gave birth alone in her cell at HMP Bronzefield, Ashford, the largest women’s prison in Europe.
Understandably, a common reaction was that it is unsuitable to incarcerate pregnant women in prison. But 40 years ago, my research at HMP Styal showed, as measured by birthweight, that the longer a woman was in prison, the better the outcome of the pregnancy.
This was presumably because the woman was smoking less, not drinking, not taking drugs, having a regular diet and not being abused by their partner. To avoid the potential neglect in prison whilst a female offender is often removed from a chaotic environment, the Welsh plans for 12 bed residential centres seems a better option.
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Many policies in health and social care arise from recommendations of enquiries into single events.
This approach, rather than looking wider at all benefits and harms can lead to poorer services. For example, the criminalisation of drugs is based on the deaths and harm to individuals rather than whether a public health approach would limit the overall damage to health.
Historically there have been many other examples of an overconcentration on individual harm that lead to policies as diverse as keeping people in bed after a heart attack to the preaching of sexual abstinence. It is very difficult when a person dies or suffers severely not to overreact. It is a temptation we need to resist."
In earlier newsletters we shared headline results from the Peppy Baby App pilot that took place in certain parts of GM.
The app provided expert support for women antenatally and postnatally as an addition to support already available.
The programme covered core topics such as infant feeding support, mental health, pelvic floor care and broader support in adapting to new parenthood. Support was delivered via the app which connected parents with perinatal practitioners and services such as group chats, live broadcasts and referrals to specialist services if needed.
This pilot had support from the Greater Manchester and Eastern Cheshire Local Maternity System (which the Strategic Clinical Network is part of). The lead maternity provider for the pilot was Saint Mary’s Managed Clinical Service, Manchester Foundation Trust.
The final report is now available and can be accessed via the Maternity Network’s resources webpage.
The Maternity Network is keen to underline the key messages around vaccination and pregnancy.
Midwifery clinical lead Eileen Stringer offered the following guidance for women who are pregnant or couples trying for a child, as well as women breastfeeding.
General information
- The Covid-19 vaccines available in the UK have been shown to be effective and to have a good safety profile.
- The vaccines do not contain live coronavirus and cannot infect a pregnant woman or her unborn baby in the womb
- Evidence on Covid-19 vaccines is being continuously reviewed by the World Health Organization and the regulatory bodies in the UK, USA, Canada and Europe.
Getting pregnant
- There is no need to avoid getting pregnant after Covid-19 vaccination.
- There is no evidence that Covid-19 vaccines have any effect on fertility or your chances of becoming pregnant.
If you are pregnant
- Covid-19 vaccines offer pregnant women the best protection against Covid-19 disease which can be serious in later pregnancy for some women. Other vaccines are safely given in pregnancy to millions of women. For example, the flu vaccine.
- 1 in 8 women admitted with Covid-19 will require intensive care and there is a high chance their baby will be born prematurely
- The first dose of Covid-19 vaccine will give you good protection. You need the second dose to get longer lasting protection. You do not need to delay this second dose (second dose can be given 4 weeks after the first dose).
Breast feeding
- Covid-19 vaccination can be given to breastfeeding women
- There is no plausible mechanism by which any vaccine ingredient could pass to a baby through the breast milk
- You should not stop breastfeeding in order to be vaccinated against Covid-19.
A reminder that our Diabetes Network has launched an information leaflet to help people self-manage their condition.
The guide makes it easier for people living with diabetes to understand which resources and tools are available to them. It is aimed at both adults and children.
The leaflet tells people how to access prevention services, education, weight management, digital tools, education and more.
Tools and courses are available to support type 1, type 2 and gestational diabetes, insulin pump use and explains how patients can get access to their own diabetes care records.
The leaflet can be downloaded, shared or printed out and complements the clinical assessment tool we provided over the summer to help primary care navigate the options for patients.
The Network has been working with Dr Helen Martin to support the implementation of the Rules of Thumb programme which was developed with Dementia United, based on the work of Nathan Davies.
The programme offers a flexible way to address some of the aspects of care that professionals come across when working with people with dementia at the very end-of-life and aims to enhance care by increasing the knowledge, skills and confidence of those providing support from primary care networks and care home teams. It is designed to be consistent across GM and Eastern Cheshire, while allowing for flexibility in delivery to suit locality needs.
Dementia and Alzheimer’s disease have been the leading cause of death in England since 2015 (Office for National Statistics). However, dementia is still not universally recognised as life-limiting and when people are in the dying phase, they are often no longer in contact with dementia specialists, consequently, people with dementia may receive below standard end of life care.
The Network has worked with the End of Life Care Partnership to design the programme so it can be delivered in a single session, as an extended half day sitting, across several mini-sessions or it may be incorporated into other programmes, such as the Six Steps end of life care home programme. All resources are provided for the programme and can be found here: www.sixsteps.net.
The Network is delighted to be working with palliative and end of life facilitators/educators from localities across GM and Eastern Cheshire in supporting them to deliver The Rules of Thumb. The facilitators have been joining the Network in learning and reflection sessions as part of testing out the materials and refining the package during this initial delivery phase.
It is hoped that by delivering the programme, partnerships between the primary care network and care home teams will be further strengthened, that it will support a shared conversation between the multidisciplinary team and provide a consistent framework to help professionals caring for people with dementia at end of life be more confident in meeting the unique needs of those dying with dementia and supporting those close to them.
For more information about the rules of thumb running in your locality please contact gillian.bailey3@nhs.net
The Network would like to congratulate Fiona Sanderson from St Ann’s Hospice, Manchester, who has won an award from the British Lymphology Society for an oral presentation she delivered.
Her presentation was about the development of a document which Fiona created for the Greater Manchester Palliative and End of Life Care Advisory Group on how to support the assessment and management of lymphoedema at the end of life.
Fiona has invested a large part of her work in improving care in this area and we are pleased for her to receive this award.
The judges said: “We were very impressed by developments for healthcare professionals working in palliative care environment. It can be very emotional, on top of complex, to be working in that environment, and so something that can help you do that assessment and help you with your decision-making can be really helpful and important to us.”
St Ann’s Hospice has worked closely with the Palliative and End of Life Care Network in the past on the vulnerable population lecture series.
Last month we announced Lyndsey Kavanagh was taking maternity leave for a year from early October – she’d barely had a chance to say goodbye to us when she was saying ‘hello’ to her baby son Reuben!
The 7lb 8oz bundle of joy, pictured left, is doing well at home with Lyndsey and husband Connor.
Congratulations from the team!
And congratulations to the Respiratory Network’s project officer, Alex Pegg, who has just passed his PRINCE2 Foundation Certificate in Project Management.
Alex said: ““It was the first time I’ve done an exam remotely with the invigilator on-line which was interesting. Hopefully I’ll also be successful with the Practitioner certificate.”
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