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

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Newsletter

February 2022

technological improvements

 

New technology leading the way

Reading through this month’s newsletter, it is noticeable how technology is playing an increasingly central role in our programmes.

New innovations are helping us monitor patients at home, or allowing patients to monitor themselves, as well as opening-up fresh ways of communicating directly to people.  

In this newsletter, we have news and updates on remote monitoring of cardiology patients, an asthma app for young people, online diabetes events and even the continued use of Tableau, which has revolutionised much of our work.

The bulletin also has information about our maternity equity and equality plan, the Diabetes Low Calorie Programme, stroke’s continued integration of community services and a report of the latest Children and Young People’s Stakeholder Forum.

Many thanks for your continued support and see you again next month.

 

Best wishes

Julie Cheetham - Director 

Dr Peter Elton - Clinical Director 

Julie Cheetham and Peter Elton

Cardiac Network

help us to help you

The GM Cardiac Network has been successful in winning an NHSX bid to support the implementation of timely treatment through remote monitoring.   

As part of the elective care recovery programme, £751,706 is being made available to the Network to pilot pathways that will improve the health and wellbeing of GM cardiology patients through high quality services that enable the adoption and use of remote technology for elective cardiac surgery patients.

Regional heart attach campaign launched

In mid-February, a regional ‘Help Us Help You’ campaign (see photo above) was launched to help raise awareness of heart and circulatory disease, which causes a quarter of all deaths in the UK, and is the largest cause of premature mortality in deprived areas.

This is one of the biggest areas where the NHS can save lives over the next 10 years. The campaign aims to: 

  • increase understanding of the symptoms of a heart attack 
  • increase the number of people calling 999 if they see or experience any one of the signs 
  • increase earlier presentation of heart attacks, leading to earlier treatment and improved outcomes for patients  

The key target audiences for the campaign are adults 50+ upweighted to C2DE, ethnic minority groups (particularly South Asian and black groups with high incidence) and adults who may act as a ‘heart attack helper’ by dialling 999 on behalf of someone else.  

 

Heart valve disease refresh

The team has also been working alongside Heart Valve Voice and the heart valve disease (HVD) clinical leads to reinvigorate the HVD project work.

The aims for the project have been agreed as:

  • Public awareness
  • Develop clinical pathways against defined standards of care 
  • Public and clinical education

HVD is increasing in incidence due to an ageing population, but is substantially undiagnosed. The number of patients with heart valve disease is predicted to double by 2046.

The overall belief is that developing a cohesive clinical network is the key to success. The team wants to establish a GM-HVD team to deliver a collaborative and well-coordinated system of HVD care.

 

Cardiac data Tableau dashboard

Work is now well underway on developing a comprehensive cardiac data dashboard in Tableau which will capture and visualise the key metrics requested by the Cardiac Pathways Improvement Programme, with the facility to drill down on them by locality and/or provider.

The cardiac team is very much indebted to both the Partnership Business Intelligence Team and the SCNs’ data analysts for their support with this project.  

Tableau is an analytical tool which connects disparate data sources throughout the NHS, giving teams fast, easy access to information, allowing them to see where improvements can be made.


Palliative and End of Life Care Network

There is a national drive to have a seven-day NHS and this includes palliative and end of life care services, with steps being taken in Greater Manchester to put this in place.

The NHS’s Ambitions for Palliative and End of Life Care (refreshed in 2021) state:

“Every person at the end of life should have access to 24/7 services as needed as a matter of course. The distress of uncontrolled pain and symptoms cannot wait for ‘opening hours’. This is a necessary system-wide expectation and good end of life care cannot be achieved without it. All commissioners and providers have to engage in defining how their services will operate to ensure expert responsiveness to needs at any time of day and night."

The Greater Manchester Commitments for Palliative and End of Life Care document built on this in the first underpinning system commitment, which was:

Specialist Palliative Care Services 

I Statement - I should have access to specialist level palliative and end of life care in my place of care if I need their support, advice, and care.

System Commitment - specialist level palliative care services should be available for face to face contact seven days a week across all settings, and advice should be available 24 hours a day. Inpatient specialist palliative care provision should be available to those requiring it, with admissions seven days a week. 

Dr Sophie Harrison has been leading on workforce for the end of life care programme with a variety of workstreams that are gaining national interest. Currently underway is a specialist palliative care nursing scoping led by advanced clinical nurse specialist Debra Morris, with a final report due in spring 2022. Previous work has included medical staff scoping and SAS Doctor continued professional development. 

Two localities within Greater Manchester, Salford and Wigan, have participated in a Macmillan funded Seven Day Enhanced Specialist Palliative Care Advice and Assessment Programme. The programme was evaluated by Lancaster University and gave evidence of the effectiveness of 7 day working in two sites presented in the publication ‘Thank goodness you’re here’ (An evaluation of the reach and impact of the Macmillan 7-day Specialist Palliative  Care Advice and Assessment Programme).

The Network followed up the report with a document to support other localities in choosing a model to move towards a 7-day service.

The team has recently been successful in being awarded funding to develop a business case to outline all of the recent scoping and review models for the future to ensure there is a sustainable approach to the palliative and end of life care workforce to meet the outlined vision in the Greater Manchester Commitments.

 


Maternity Network

New maternity clinical leads

We are delighted to announce the appointment of two new maternity clinical leads.

Akila Anbazhagan (pictured above left) is the new clinical lead for the Greater Manchester and Eastern Cheshire Local Maternity System (GMEC LMS), while Ghazia Saleemi (above right), is the Maternity Network’s clinical lead.

Dr Anbazhagan has been a consultant obstetrician for the past 10 years and is the maternity governance and risk lead at St Mary's @ Wythenshawe.

Her special interests include materno-fetal medicine and high risk obstetrics and her clinics include care for women with diabetes and endocrine disorders, cystic fibrosis and asthma. Regionally, she co-chairs the GMEC Black and Asian maternity advisory group.

Dr Saleemi studied at the University of Dundee and qualified in 2000. She completed her specialist training in the Mersey region and was appointed as a consultant at Wythenshawe in 2016.

She has a special interest in pre-term labour and has set up this service at Wythenshawe.  She also has a specialist interest in multiple pregnancies, runs specialist clinics for these pregnancies and also sees other high-risk pregnancies in her obstetric clinic. As well as her role with the Network, she is the obstetric clinical lead for the maternity neonatal safety improvement programme for Greater Manchester and Eastern Cheshire. 

 

Taking action on inequality

The GMEC LMS, which the SCNs are a partner of, is currently working on a project which aims to improve safety for black, Asian and mixed ethnic groups, as well as those living in deprived areas.

The work follows the publication of NHS England’s Equity and Equality guidance last year, which addresses the disparity in maternal and perinatal outcomes, as highlighted by the MBRRACE-UK reports.

The guidance asks the LMS to conduct an equity and equality analysis (covering health outcomes, community assets and staff experience) and co-produce an equity and equality 5-year action plan.

They have completed and submitted the analysis and aim to have the action plan ready for a date that is still to be confirmed by the national team.

The findings will be shared shortly and they are currently at the stage where they have established a task and finish group in order to co-produce their action plan with those people and communities most likely to be affected by the inequalities.

Members of the task and finish group have assigned themselves high level actions to work through with the relevant people to make sure they put steps in place to implement the action effectively.

 


Applications open for collaborative fellowship

The Royal College of Physicians of Edinburgh is inviting applications to join its Quality Governance Collaborative (QGC).

A total of 12 multi-professional places are available and clinicians, patients and other healthcare professionals who are passionate about healthcare governance are welcome to apply.

The QGC was established as an independent, neutral, non-governmental body committed to a new integrated approach to quality governance in healthcare. It brings together national and international experts and organisations in collaboration to explore and improve the practice of quality governance, particularly, but not exclusively, in healthcare.

It works with a number of agencies including hospitals, board directors and other healthcare professionals or individuals with an interest in the delivery of health and care.

More information on this can be found here. The programme curriculum provides a comprehensive overview of governance, including the current literature and best practice. 

Organisations may choose to nominate individuals, duos or trios to work together on organisationally-driven priorities. Participants will undertake a project relevant to their organisation aimed at improving governance in a particular area or work stream.

 


Diabetes Network

A series of online events are being held for people who are interested in support from the free NHS Low Calorie Diet Programme.

The sessions are being held during March and will give patients the opportunity to find out more about the service before they register.

Available via a referral from a GP practice, this innovative programme is helping people across Greater Manchester to lose weight and live a healthier lifestyle.

It helps people diagnosed with diabetes better control their blood sugar levels – reducing the need for diabetes-related medication and potentially achieving remission of their Type 2 diabetes when their levels return to a healthy range.

The programme in Greater Manchester, provided by Xyla Health & Wellbeing, is a one-year programme that combines specialist nutrition, psychology and physical activity.

Starting with a 12-week diet replacement using the NHS soups and shakes, participants are then supported to reintroduce food and make healthier choices. A diabetes practitioner is on hand throughout the year to offer support.

People on the programme lose weight consuming the low-calorie soups and shakes and maintain significant weight loss as a more normal diet is reintroduced.

The average weight loss in Greater Manchester after 3 months is 13.4kg (over two stone). These findings are a significant step forward and come after trials showed that around half of people who had similar weight loss were able to achieve remission of their Type 2 diabetes after one year.

Dr Naresh Kanumilli, clinical lead for the Greater Manchester Low Calorie Diet Programme, said: “I would encourage anyone with Type 2 Diabetes to consider the support of our local NHS Low Calorie Diet Programme. Losing weight can go a long way to help you to stay well and avoid preventable illness. The results in Greater Manchester are really encouraging and the programme is helping people to make changes that they can sustain going forward”.

Derek, from Stockport, has taken part in the programme. He said: “My lifestyle before the programme was busy with work and social life, the impact of taking medication for type 2 was that I was relying on the medication to maintain blood glucose levels which led to regular side effects and limited activity.

“I received a call from my local doctor’s surgery, from the nurse who regularly monitors my HbA1c and progress. The nurse referred me into the programme, and I agreed, as I wanted to commit to a target of no medication.

“Since starting the programme I have lost 12kg (over two stone). I feel healthier and more active. I have stopped my medication now and my last HbA1c check was 46 and is expected to be lower once my second check is performed.”

Patients can call the programme support team on 0333 577 3561 to find out more about the online information sessions, which are being held on:

  • 1 March, 1pm (session in Urdu/Hindi)
  • 2 March, 12.30pm
  • 16 March, 5.30pm
  • 17 March, 1pm (session in Urdu/Hindi)
  • 30 March, 5pm (session in Urdu/Hindi)

 

Diabetes and Ramadam

Diabetes Ramadam session poster

People living with diabetes, their carers and healthcare professionals are invited to attend a free online course which discusses preparing for Ramadam.

The session on March 17 will include meal plan tips, videos and a live Q&A.

Register via the details in the poster above.


Children and Young People Network

More than 120 people attended the latest Children and Young People’s Stakeholder Forum, which focused on speech, language and communication needs.

An exciting agenda started with Dr Carol Ewing, children’s clinical adviser with the SCNs, opening the event, followed by Kamini Gadhok MBE, chief executive officer with the Royal College of Speech and Language Therapists, who provided a national overview of speech and language issues for Children and Young People.

The Network was also fortunate to have young person and parent carer representatives with lived experience inspiring the audience with their personal accounts of how speech, language and communication needs impacted their lives.

Elizabeth Stanley, parent to Isabel, described how speech and language was just a part of the care required to enable Isabel to achieve her goals, one of which was to be able to make toast. Gaining the motor skills and knowing the right words required input from a range of people and enabled Isabel to do something that was important to her.

Andy Smith, a 24-year-old autistic man, described some of the challenges he had faced when he was younger, and how he had gone on to form ‘Spectrum Gaming’, an online community for autistic young people, ensuring they can have their views heard.

One response from the audience was:

Speech bubble comments on forum

Further presentations were by Katie Shaw, from Rochdale’s ‘No Wrong Door’ project, and Michelle Morris, consultant speech and language therapist at Salford Royal Hospital, providing an overview of the early years pathway.

Attendees learnt about ‘the Balanced System’ approach before being allocated to break-out groups for further discussion about practical steps that can be taken to improve speech and language provision in the short to medium term.

True partnership working was at play in the delivery of the break-out sessions as colleagues from Greater Manchester Combined Authorities (GMCA) and the Greater Manchester Health and Social Care Partnership (GMHSC Partnership) worked together as facilitators and scribes to capture the key points from each group.

Chris McLoughlin OBE, director of children’s services at Stockport Metropolitan Borough Council, concluded the event by thanking contributors and Dr Ewing, who he said was “a brilliant chair and a very dear colleague”, and summarising with three ‘take-home’ messages:

  • Whole systems solutions
  • Warm respectful relationships
  • Always ask the question, “Is this good enough for my child?”

A report will be published in due course and we aim to identify actions and next steps for speech, language and communications in Greater Manchester.

 

Scan and self-manage

Asthma app

GPs and health professionals who work with young people with asthma in Manchester are being asked to spread the word about an app which gives them support to self-manage their condition at home.

The digital health passport, which has been developed by Tiny Medical Apps, will support people aged 14-18, who live in the Manchester area.

Just use a smart phone to scan the QR code and download the app.

 


Greater Manchester Neurorehabilitation & Integrated Stroke Delivery Network

The Network began its journey pioneering the implementation of integrated community services in 2016 and this approach is now part of the NHS England National Stroke Service Model.

To help speed up introduction of the model across England, funding has been allocated on a regional basis for a quality improvement project called SQuIRe.

We have been working with the other North West stroke networks to appoint a senior clinician who will help us focus on workforce development so we can fully implement the model.

We have two localities that have not yet moved to the integrated model: Trafford and South Manchester. However, our clinical director, Tracy Walker, has been instrumental in helping to translate agreed business cases into operational plans for change, with new investment in Manchester to improve stroke and NR community services in south and central localities.

For the first time, south Manchester residents with neurological conditions other than stroke will be able to access specialist community services – finally, all Greater Manchester boroughs now offer this pathway of care. 

The north Trafford stroke Early Supported Discharge Team merged with the Trafford Community Neurorehabilitation Team on February 14 as part of phase 1 of the transformation project.

The team is very excited to finally operationalise piloting a more responsive service for North Trafford stroke patients, with a view to extending this to all south Trafford stroke patients and neuro-rehabilitation patients on May 16 this year. Information has been shared on the new process for referral.

 


NICE launches new methods for greater flexibility

NICE has unveiled changes to the way it evaluates medicines and other health technologies for use in the NHS.

The new approaches will give patients earlier access to innovative treatments by allowing greater flexibility over decisions about value for money and consideration of a broader evidence base.

The changes will also provide greater predictability for industry. The change comes after one of the largest and most comprehensive reviews of all aspects of NICE’s health technology evaluations ever undertaken.

 


Staff news

Staff photo

The SCNs team enjoyed an after work social event for the first time in over two years to mark the gradual return to the office at 3 Piccadilly Place in Manchester city centre (see photo above).

The team is currently working two days a month from the newly-designed, socially-distanced office.

 


See our website for more information on all our networks.

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