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

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Newsletter

September 2022

 

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Determination to improve health and wellbeing

 

With the holiday season over, we were ready to press on with our busy programmes of work when the news broke of the death of Her Late Majesty Queen Elizabeth II.

We were deeply saddened to hear the news.

Many of us saw the Queen as she visited health care services throughout the country to support our work during her long reign. Our emotional response to her passing was a fitting tribute to her dedication to us.

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After a pause to mourn and reflect, we are now back in gear after the summer, with a busy schedule ahead of us and lots to report on.

This month saw our clinical leads, associates and advisors come together face-to-face for the first time since the pandemic, when we held a leadership session.

It was wonderful to see everyone again and there was a great energy in the room, together with a shared determination to improve services and the health and wellbeing of the population.

There was a good discussion about how we can increase clinical involvement so that we can help the Greater Manchester Integrated Care Board develop policies to improve health and healthcare. See the report below.

Also this month, we have a Q&A with our new chief medical director, Manisha Kumar, as well as stories about the Greater Manchester primary care summit, the cardiac bus tour visiting Manchester, online resources for people waiting to have planned hospital treatment or suffering from long Covid, the appointment of a new clinical director and staff news.

 

Best wishes

Julie Cheetham

Director

 

Dr Peter Elton

Clinical Director

 

Julie Cheetham and Peter Elton
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Leadership session for our clinical family

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Around 30 clinical leads, associates and advisors met this month for a leadership session, marking the first get together since the start of the pandemic.

The guests enjoyed discussing how to attract wider clinical involvement as we move into the new world of NHS Greater Manchester Integrated Care.

We had a session, led by Manisha Kumar, chief medical director at NHS Greater Manchester Integrated Care Board (ICB) to discuss how the SCN will add value to its work.

Claire Vaughan, head of medicines optimisation at Salford, also facilitated a session about how we evaluate our work with the Greater Manchester Medicines Management Group.

Dr Peter Elton, clinical director at the SCNs, said: “It was good to see our clinical leaders reflect on the improvements made as a result of their work and their zest for continuing that work.”

 

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A Q&A with Manisha Kumar

Dr Manisha Kumar

This month we spoke to Manisha Kumar, chief medical director at NHS Greater Manchester Integrated Care, about her new role, what she thinks about networks and the importance of the clinical voice being heard.
 
What have you enjoyed the most about your role in the first few months?
 The last few months have been challenging. Complex system change is never easy. What I have enjoyed the most is seeing and meeting the huge amount of talent we have across GM – we have such strong clinical leadership with a real enthusiasm to drive change. 
 
Why did you decide to apply for the role? What appealed to you about it? 
I have been involved in system leadership for 15 years – the last 6 years as the Medical Director for Manchester Health and Care Commissioning (the CCG). What was important to me was that we build on the best of what we have achieved as a system and to do that we need to bring all our teams with us. The opportunity – and responsibility - we have as an ICB and ICS is critical due to widening health inequalities and the impact of Covid. 
 
What have you been impressed with the most since you started?
Resilience. The ability of all our teams to get up and carry on – despite new relationships and increasing pressure on the health and care system. . .to put personal uncertainty aside and continue to focus on patients. Workforce is really important to me 
 
Do you think the clinical network, including those that are part of the SCNs, have an important role to play in the reorganised health service?
Absolutely. The clinical networks are critical to how we develop Clinical Excellence across GM. I would like to see the networks empowered to champion and support delivery working alongside partners. I think the new arrangements should break down some of the previous barriers. 
 
What do you think are the biggest contribution that the SCNs can make?
I think that’s a question I would like to ask you all – to understand where each network has strengths. My role will then be to support you all to deliver that contribution. I know it’s an important anniversary for the networks next year – and I’m looking forward to reflecting back on the achievements. 
 
Can we do anything to increase the value of the SCNs?
There is a lot we should share about the role of SCNs – I would like to see the leads from the SCNs more visible in programme boards and at different parts of the system – from neighbourhoods to boardrooms -   improving understanding of the role of SCNs and drawing on skills. 
 
What do you think is the biggest challenge for clinicians over the next​ two to five years?
That’s a really good question. From my perspective this is ensuring we retain professional values and good clinical governance. We know we are facing increasing unmet need across all specialities and that can feel overwhelming. I would like clinicians to remain proud of the care they offer. Burn out is a major issue and how we can develop space to develop as well as deliver.
 
Many are forecasting a very difficult winter for the NHS. What would be your message to reassure clinicians over the coming, possibly challenging months?
To remind themselves that they are good at what they do – to stay present in the moment and take each day at a time. It can feel isolating so remember you are not alone – to share and debrief on the bad days and remember to find time to step away. The whole system is focussed on Winter and to reassure you all that system leaders are absolutely aware of what is going on. On a personal level – I am always here for a coffee or a conversation.
 
Outside of work, what do you do to relax and recharge your batteries?
I am a mum of a 14-year-old – so a lot of time is spent as a taxi driver, cook and finder of football socks! I enjoy spending time with friends and family, movies, walking – and of course – as I’m a Manchester medic – music!

 

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Cardiovascular Network

Heart-checking bus calls into Manchester

The Manchester leg of the national bus tour offering free stethoscope checks was a huge success.

The bus called into St Anne’s Square, in the city centre, and listened to around 430 hearts, raising awareness of heart valve disease, with the aim of saving lives.

The visit was also filmed and broadcast by BBC North West Tonight. 

Manchester-based charity Heart Valve Voice, an important partner of the network, organised the tour, which has been to locations across the country. The Valve for Life initiative was also involved in the funding. 

The network team supported the initiative, which saw the bus arrive in the city with staff having already listened to 2,000 hearts nationally, finding more than 200 previously undetected cardiac conditions.

Pictured above: The bus and GM Cardiac Network team who spoke to people on the day.

 

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Networks at primary care summit

Gill Bailey at primary care summit

Representatives from our networks attended the Greater Manchester Primary Care Summit this month.

The event was jointly hosted by the Greater Manchester Primary Care Provider Board, one of the first primary care collaboratives in England, and NHS Greater Manchester Integrated Care, bringing together the four primary care disciplines of community pharmacy, dentistry, general practice and optometry.

Delegates had the opportunity to hear directly from national and Greater Manchester system leaders on the future of the sector and the wider strategic direction.

A key theme on the day was that primary care is an integral part of the NHS Greater Manchester Integrated Care System and will be key to the delivery of its vision for health and care. An agreed principle was to engage with the wider system. 

The SCNs were represented at the event by Gill Bailey from our Palliative and End of Life Care Network and Krista Williams from the Diabetes Network.

The Palliative and End of Life Care Network supported the event with an exhibition stand, sharing their work taking place in primary care, which includes the EARLY identification tool, which helps GPs confirm people with palliative and end of life care needs, resources to support advance care planning using a personalised conversational approach and the electronic sharing of information using the EPaCCS summary care record in the Greater Manchester Care Record, which is accessible across primary care.

The Diabetes team also attended the event to promote the work of the team, in particular the tailored support for practices in terms of referrals into Healthier You and the Low Calorie Diet Pilot.

More information on the Low Calorie Diet Pilot.

Further information on Healthier You.

 

Pictured above: Gill Bailey at the SCNs' stand at the event. 

 

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Maternity Network

New standards highlighted at BAME event

Raising standards of maternity care for women of Black and Asian backgrounds was highlighted at an event held by the Caribbean African Health Network.

Akila Anbazhagan, the network’s maternity clinical lead and co-chair of the Black and Asian Maternity Advisory Group, spoke to people at Manchester Cathedral this month about the 12 new standards of care for families in Greater Manchester and Eastern Cheshire.

The Maternity Network’s programme lead, Dr Alison McGovern, also spoke to the guests about the Greater Manchester and Eastern Cheshire Local Maternity and Neonatal System (LMNS).

It has been well established that women/birthing people and babies from Black and Asian backgrounds have worse outcomes than those who are white.

Greater Manchester and Eastern Cheshire LMNS established the Black and Asian Maternity Advisory Group in 2021 to explore the contributory factors and draw actions to reduce this disparity.

The advisory group comprised of Black and Asian voluntary, community and social enterprise organisations, Maternity Voices Partnerships, professionals from maternity providers, primary care and higher education institutions. 

Ten targeted focus groups consisting of Black and Asian women/birthing people shared their maternity experiences antenatally and postnatally. Based on the themes that emerged from the focus groups, 12 maternity standards of care for Black and Asian women were co-produced with input from all stakeholders, VCSEs, MVPs and the women/birthing people themselves.

The purpose of these standards is to help improve the experience and outcome and to enhance the care of Black and Asian women/birthing people accessing maternity services within Greater Manchester and Eastern Cheshire.

These standards will be embedded and implemented as an integral part of providing care for women/birthing people, their families and for staff.

New training pilot

The North West Maternal Medicine Network Board has been successful in becoming a Royal College of Physicians (RCP) training pilot.

The pilot will test a new approach to training obstetric physicians to provide complex clinical services to Maternal Medicine Networks.

The North West MMN was the only successful application in the north of England. Previously, this training was only available in Oxford and London, so the board, which includes representatives from the SCNs’ Maternity Network, is extremely pleased to have been successful in its bid to provide a facility here.

They will be working closely with the RCP to implement the pilot which is due to start towards the end of the year, initially training a registrar from within the NW MMN for the pilot, but then possibly opening it up wider in future. 

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Dr Shavi

GM Neurorehabilitation & Integrated Stroke

Delivery Network

New clinical director appointed

The Network has announced the appointment of Dr Shivakumar Krishnamoorthy (pictured above) as its new hospital clinical director.

Dr Shivakumar will take over from Dr Adrian Parry-Jones on November 1, while Dr Parry-Jones will be converting his time into a stroke hyper acute clinical lead role half a day a week while also continuing to lead the NHS England pre-hospital telemedicine pilot project. 

He is a senior stroke consultant at Stepping Hill Hospital and was clinical director for older people and stroke services for seven years.

He is stepping down as associate medical director in the Trust as he takes on his new role with the network a day a week.

The network is very excited that such an experienced clinical leader is joining the team and Dr Shivakumar will clinically lead the inpatient stroke pathway whilst working closely with our community clinical director Tracy Walker to provide leadership support for the network as a whole.

In other developments, the team has been collaborating with the Stroke Association on a pilot project to better understand health inequalities in our life after stroke pathways in the North East sector of our region.

Stroke survivors and carers from Bury, Oldham, North Manchester and Rochdale were interviewed to hear their experiences, with a focus on learning about the barriers, especially from those who come from an ethnic minority background.

The findings clearly showed there is a need to do better at signposting and supporting people into life after stroke services.

Services also need to ensure they share people’s preferred language and provide more culturally appropriate information to families.

You can view the report here and please get in touch with sarah.rickard@nca.nhs.uk if you want to discuss any aspects further.

 

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Palliative & End of Life Care Network

Summit to be rescheduled

The planned Palliative and End of Life Care Summit this month was postponed due to the country’s period of mourning following the death of Her Late Majesty Queen Elizabeth II.

We are currently working to confirm a new date, which will be circulated in the coming weeks.

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Frailty Network

The importance of mouth care

The Greater Manchester Frailty Care Reference Group, which is hosted by the network, held a session recently on the importance of good oral care for people living with frailty. 

They invited Helen Parsley from NHS England/Improvement’s North West region to update the group on the Mouth Care Matters in the Community intervention, which is part of a series of programmes aimed at reducing mouth care health inequalities and improving equity of dental provision for vulnerable and frail older people.

The rationale for the intervention includes:

  • Poor mouth care substantially increases the risk of cardiovascular disease and pneumonia.
  • Community and residential care providers are delivering more complex care for an increasing number of vulnerable and older people, who are living longer with complex health and social care needs. 
  • Due to improvements in dental health, an increasing number of vulnerable and older people are keeping their own teeth for longer and need more complex dental care at a time when they are least likely to be able to access or manage clinical treatment.
  • Good mouth care and independence are linked.
  • Loss of function - physical or cognitive - can impact on people’s ability to care for their mouth and rapidly increases the risk of dental disease.  

Building on NICE quality standard QS151, the work recommends that:

  • Care staff are required to assess the mouth care needs and preferences of all individuals as soon as admitted. They are reviewed regularly utilising a mouth care assessment tool, regardless of the length or purpose of their stay. 
  • Where carers, family and friends are involved in ongoing care, and there is permission, consider involving them in the initial assessment, if it will help staff understand the individual’s usual oral hygiene and mouth care needs and preferences.
  • Consider how the individual usually manages their daily mouth care.
  • Record the results of the assessment and any clinical appointments in the individual’s personal care plan.
  • Review and update individual mouth care needs in their personal mouth care plan as requirements and preferences change.

For care and clinical staff in Greater Manchester, there are training programmes available to support improved mouth care in both community and hospital settings. 

These can be accessed at:

These are structured online e-learning programmes broken down into modules with video instruction, evaluation and supporting resources and publications.

 

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Respiratory Network

The network has linked in with Greater Manchester Shared Services (GMSS) to gain primary care data on patients eligible for the pulmonary rehabilitation (PR) programme, which helps improve the lives of people who suffer from long-term lung conditions.

The information will enable PR services across Greater Manchester to increase referrals, attendances and address inequalities. Some of the information will be new to the services, such as data on people offered the courses who decline.

Data will also include information on cohorts with learning disabilities, mental health issues and from areas of deprivation, which teams can use to address inequalities and raise awareness.

The Respiratory Network, working with PR health care professionals, has created a draft PR patient education booklet which will cover areas including exercise, medication, diet, chest infections, giving up smoking, voice problems and support at home.

The booklet will have the same branding and photographs as are being used in the video and website. The finished document will be for the use of patients attending PR classes across Greater Manchester.

 

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New online support for patients

People waiting for planned hospital treatment can now find extra information and advice on a refreshed website.

The Greater Manchester website, called www.whileyouwait.org.uk, is designed to provide support for  people on waiting lists on how best to manage physical and mental health, with the aim of them staying as well as possible and preparing for treatment to get the best possible outcome from treatment. 

Approximately 1 in 6 people living in Greater Manchester are on a hospital waiting list and a wide range of work is underway by the NHS to manage the demand and to support people while they wait. 

Working with doctors and nurses, the website now features more information for people waiting for procedures under orthopaedics, gastroenterology and children’s surgical hospital services. 

The new pages, which can be found under the ‘Your treatment’ section, give information on how to prepare for specific procedures, whether that be exercises or lifestyle changes that will help. There is also more information on important signs and symptoms to look out for while you wait.

If you have any questions or feedback about While You Wait, please don’t hesitate to contact rachel.richardson23@nhs.net strategic communications lead for both the SCNs and the GM Elective Care Recovery and Reform Programme.

The SCNs have also been involved in collating information for a website for patients suffering from the symptoms of long Covid. 

The web page is now live. People will be able to find this via the Service A-Z and Keep Well sections on the website.

 

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Diabetes Network

Free online training for young people and families

DigiBete - a free, clinically approved, video platform and app to support children and young people manage their type 1 diabetes – is offering free online training for young people.

It is providing the support over Zoom to help young people and their families understand how the app could help their condition. It is recommended that people under-17 have an adult with them if possible when they do the training.

Digibete is widely used in clinics across the North West, including Greater Manchester. 

There is a lunchtime slot and an evening slot. There is no need to register and you can join any session that works for you. However if you can't make these dates then please feel free to contact Michelle on the DigiBete team who is running these sessions to find out about more dates in the future. You can contact her on: michelle@digibete.org.

Session 1  Tuesday, October 4, 11:30am to 12:30pm via Zoom

Session 2 Tuesday, October 4, 7pm to 8pm, via Zoom 

Separate training is provided for clinical staff who would like to use DigiBete in their paediatric and/or young adult diabetes clinics. For more information please contact Sarka.grayson@nhs.net

 

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Staff news

We say hello and wave goodbye this month to two team members.

Rebecca Carnegie is joining our Maternity Network as project officer, arriving on secondment from Greater Manchester Shared Services. A big welcome to Rebecca.

Also, we say farewell to Jessica Raphael, project manager at the LMNS, who has left the team to pursue a doctorate in psychology. Thanks to Jess for all her hard work and we wish her the best of luck with her studies.

 

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See our website for more information on all our networks.

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