This year marks the 10th anniversary of the Greater Manchester and Eastern Cheshire Strategic Clinical Networks – something we are very proud to achieve.
Over the past decade we have worked across many areas, including dementia, diabetes, maternity, palliative and end of life care and stroke, always with the vision of making health and social care services comparable with the best in the world by putting the clinical voice at the centre of decision-making.
Back in 2013, we started life covering Greater Manchester, Lancashire and Cumbria, and changed in 2016 to our current geographical area.
The ebb and flow of the health and social care world meant we said goodbye to some networks, such as mental health and cancer, but also welcomed new areas, like respiratory.
We have always taken a pure network approach, carefully building our infrastructure of clinicians, support teams, service users and voluntary, community and social enterprise groups, to create a robust team with a clear purpose and vision.
This has served us well, creating many achievements and allowing us to be agile and well-connected enough to support our clinical teams during Covid.
Julie Cheetham, the SCNs’ director, said: “Where does time go! The Strategic Clinical Networks are 10 years in the making this year.
“The dedicated hard work our clinical leaders have given over this past decade has been amazing. They are our one constant, always striving to improve care, find solutions to difficult system issues, whilst doing their hands-on clinical day jobs.
“Over the years, our networks have been flexible and adaptable to the challenges of the NHS and now the NHS and care system. We are more integrated than ever, working with our partners across social care and the voluntary care sector, joining forces to improve health care, outcomes and experience of all our services.”
Clinical director, Dr Peter Elton, said: “It has been a privilege to witness clinicians working together tirelessly to agree ways to improve the health of their patients.
"It has led to many changes in clinical practice, combined with judicious investments, which has benefited so many patients."
A charity which works closely with the Network has started a four-week campaign to raise awareness of heart failure across Greater Manchester.
The Pumping Marvellous Foundation is visiting railway stations and promoting its messages across the region with digital advertising on busy routes and posts on social media, as part of its aim of alerting people to the symptoms of the condition.
More than 37,500 people in Greater Manchester are living with a diagnosis of heart failure and many more will be unaware they have the condition.
The work in the region is part of the charity’s national ‘BEAT HF’ campaign and will see pop-up stands at railway stations, including Manchester Piccadilly Station, from 10am-3pm on Friday, May 12.
The campaign van will also visit heart failure teams at hospitals at Manchester Royal Infirmary, Trafford, Wythenshawe and Oldham. It will also be visiting the Caribbean and African Health Network.
Dr Fozia Ahmed, a member of the Pumping Marvellous Foundation Clinical Advisory Board and a heart failure cardiologist from Manchester University NHS Foundation Trust University Hospitals NHS FT, said: “It is estimated that 1 in 5 people will develop heart failure, a disease with no cure but which is largely preventable. If you live in Manchester you are more likely to develop heart disease, leading to heart failure, than if you lived in most other parts of the UK. People aged over 65, those with high blood pressure, a history of heart attacks and diabetes are at even higher risk.
“Undiagnosed heart failure has a worse prognosis than most types of cancer. However, with early diagnosis and prompt effective treatment, we can improve life expectancy for the majority of people.”
He added: “Detecting heart failure early can make a huge difference for patients. Yet, public awareness about heart failure and its consequences if diagnosed too late is extremely low. Many people aren't aware of when they should seek medical attention.”
The tour of Greater Manchester will run from Tuesday, May 2 to Friday, May 12, and coincide with Heart Failure Awareness Week.
The Rapid Access for Acute Coronary Syndrome (RAACS) pathway – designed to speed-up the time from patient admission to hospital to angiogram - was relaunched within Greater Manchester in February and has made a good start.
Following the relaunch of the pathway there has been a steady increase across all our providers which we will continue to track over the coming months
RAACS was piloted previously but came to a standstill due to the pandemic.
Within Greater Manchester, there is currently a target of admission to angiography of 72 hours, but within this pathway, higher risk patients are identified, and the target is for admission to angiography within 24 hours.
The aim is to achieve better clinical outcomes, reduce length of stay and improve the patient journey.
Primary care staff are invited to sign-up to an exciting, flexible learning programme which will help them develop their skills in personalised care for diabetes patients.
Applications are still open for the next programme, with the deadline for registration being Friday, May 12.
The learning is designed to help primary care staff to develop their skills in personalised care, especially when caring for patients with diabetes, and use them to help more people attend structured diabetes education.
With CPD accreditation, the programme is a mix of e-learning, live webinars and interactive face-to-face workshops, delivered by experienced trainers and primary care professionals. The core modules featured cover a number of transferrable skills in personalised care approaches.
The SCN, in partnership with GP Excellence and the Personalised Care Institute, is offering this opportunity to all Greater Manchester primary care staff who deliver diabetes care or support to encourage greater uptake of structured diabetes education.
Core modules include:
- Shared decision making
- Motivational interviewing
- Creating a high-quality person-centred support plan
- SNOMED training
For further information contact natasha.hirst@nhs.net or register directly here.
The Diabetes Network, working with Birmingham City University, is setting up a post-graduate certificate programme for GM primary care clinicians.
There will be 20 funded places available across GM in this 9 month, 60 credit, level 7 course. The programme content under consideration includes modules such as:
- Effective person-centred diabetes education
- Leadership in diabetes care
- Caring for People with diabetes
- Psychological and psychosocial aspects of diabetes care
- Physical activity management in diabetes care
Expressions of interest will open in the coming weeks. If you would like further details, please contact natasha.hirst@nhs.net or jennifer.schofield7@nhs.net.
The Low-Calorie Diet Programme will relaunch under a new name and provider in June this year.
The programme will now be called the Type 2 Diabetes Path to Remission Programme and Momenta Newcastle will replace Xyla as the provider of the service in Greater Manchester.
Momenta Newcastle will be accepting GP referrals from the beginning of June however practices can continue to refer patients to the current provider, Xyla, until May 31 using the referral form on clinical systems.
The programme will continue to provide life changing support for people who are overweight and living with type 2 diabetes. The programme provides a low-calorie diet treatment for people to improve their diabetes control, reduce diabetes-related medication and in some cases, put their type 2 diabetes into remission.
Harry MacMillan, chief executive of Momenta Newcastle, said: “Momenta is both delighted and grateful to have been selected as the provider of the NHS Type 2 Diabetes Path to Remission Programme across Greater Manchester.
"We look forward to working with ICB and Primary Care colleagues to combine the best of your and our experience over a smooth transition and delivering a responsive, localised and patient-focused service. We look forward to meeting you and working with the patients you refer.”
Momenta Newcastle are currently recruiting to number of positions, please see their job ads at the link here.
The Network will follow-up with further details of the new service, referral routes and patient experience in due course. In the meantime, if you have any queries regarding the service or transition, please contact adam.wallis1@nhs.net.
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The pulmonary rehabilitation (PR) campaign was launched last month, as reported in the last newsletter, and is communicating with thousands of people across Greater Manchester.
It has so far reached 27,000 people via social media, with just under 100 people a day visiting the website to find out more information.
Here, Sue Mason and Jonny Lee (pictured above), two of our Respiratory Network clinical advisors, answer questions about PR and the campaign.
Q: What is your job title and what does your day-to-day job involve? How many years have you worked for the NHS?
Sue: I’ve worked for the NHS for 36 years, mostly specialising in respiratory medicine. My current job role, as an ARAS Lead Nurse, I have been doing for over 20 years. The service was set up in October 2001 delivering hospital at home for chronic obstructive pulmonary disease (COPD) patients. It now provides hospital at home and chronic support, PR programmes, oxygen assessment clinics and COVID clinics
A typical working day would include both clinical and non-clinical duties, ranging from working with the team supporting respiratory patients and delivering clinics, to building links with the community to enhance the care for our patients, or doing all that managing 18 members of staff involves.
Jonny: I’ve worked for the NHS now for just over 10 years, mostly specialising in cardiorespiratory care. My current job role is a senior practitioner physiotherapist, whereby I provide leadership for the Trafford Pulmonary Rehabilitation team.
A typical working day would include both clinical and non-clinical duties, ranging from working with the team running an exercise and education class to analysing data about our service performance or building links with the community to enhance the care for our patients.
What is your role at the GMEC Strategic Clinical Networks and what does it entail?
Sue: My role as a clinical advisor allows us to gather those delivering PR, those who traditionally commissioned it and the SCN together, to enable whole scale system change which hopefully promotes better outcomes for patients. We provide clinical information to the SCN and support the respiratory steering groups hopefully keeping patients at the forefront of discussions and plans.
Jonny: My role as a clinical advisor allows the gap between the clinical perspective and the GMEC SCN to be connected. Myself and Sue provide assistance and guidance from the GMEC SCN to the Pulmonary rehab GM service leads and vice versa.
You have been involved recently in the PR campaign. Why was it decided to promote the exercise programme in particular?
Sue: Although we know that PR is the golden treatment for our patients, over the years I have been involved we have struggled to get people onto the programmes. This is due to several reasons but a main one is inappropriate referrals which take up a lot of the services’ time to sort. We hope that the PR campaign will raise awareness of what PR really is, both to patients and referrers, so that the right people are referred at the right time leading to more patients completing the course and continuing to keep active and breathe better!
Pictured above: a social media graphic from the campaign.
Can you briefly explain what the programme is? How has the exercise programme improved the lives of people who you have worked with?
Jonny: Pulmonary rehab is an exercise and education programme which aims to improve the quality of life of people with long-term lung disease. This is done following a thorough assessment, 6- week programme of education focusing on self-management tools and an individual tailored exercise regime involving aerobic and strength fitness.
Social and physical activity schemes are offered following the completion of the programme in order to continue the progress made.
How has the campaign been received by your colleagues in your PR teams?
Sue: For us in North Manchester, the campaign has fulfilled a dream we have had for a while of getting a ‘northern’ video to promote the course that GPs could use to both educate patients and be informed themselves about PR and its role in the self-management of respiratory patients.
Across GM, hopefully by the one message getting out across the system and area, everyone is better informed in a way that as individual teams we would have struggled to get set up.
Jonny: The campaign has set up foundations to build upon and has enabled us to utilise new resources to work towards the NHS long term plan of increasing referral, access, uptake and completion rates of pulmonary rehab.
It is critical the ‘sell’ of pulmonary rehab is delivered with high quality, at the right time.
How can clinicians in Greater Manchester support the campaign?
Jonny: Firstly, please familiarise yourselves with your local pulmonary rehab service and ensure you are confident of ‘’selling’’ our programme. Consider contacting your local pulmonary rehab to observe a class and build links with the team. Ensure you check out the new GM PR website for all the relevant information.
Sue: As Jonny has said really:
- Check out the new GM PR website for all the relevant information.
- Know your local PR courses – the where, who and when - go to see a course, or education events your local teams may be holding in the summer, so you are fully able to explain the sessions to patients.
- Promote activity for all your respiratory patients and discuss with them – be that PR, local exercise classes/gyms, local walks or even tea dances!
The Network has helped promote safe fasting in local Muslim communities during the recent Holy month of Ramadan, which started at the end of March.
They wanted to help equip health professionals, especially those in general practice, with the information needed to support safe fasting in patients with chronic health conditions such as diabetes.
The Network’s Ramadan leaflet was formulated through its health inequality workstream and in collaboration with the British Muslim Heritage Centre.
It highlights the importance of making healthier choices and consulting a GP or health practitioner when considering fasting whilst living with a chronic condition.
The key messages in the leaflet were:
- It is important to consult your GP when considering fasting when suffering from pre-existing health conditions to ensure it is safe to do so.
- Fasting against the advice of your health care practitioner can lead to serious complications and can worsen disease severity and prognosis.
This work is part of wider engagement with local communities to help address the health inequalities which can lead to a stroke and other cardiovascular diseases (CVD).
The Network continues to work closely with the other programmes across the Greater Manchester and Eastern Cheshire Strategic Clinical Networks and are an active partner in the new Greater Manchester CVD Prevention Oversight Group.
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Thousands of people who are suffering from the symptoms of long Covid in Greater Manchester have the opportunity to ask a specialist questions during a live online session.
Professor Nawar Bakerly, the SCNs’ respiratory clinical advisor, will take questions in an online ‘ask the expert’ event on Wednesday 10 May from 7pm to 8pm.
Professor Bakerly, who is also respiratory consultant at Salford Royal, part of Northern Care Alliance NHS Foundation Trust, is leading long Covid research in Greater Manchester and in March 2023 was co-author of a research paper which may provide an important first step on the road to possible treatments for Long Covid.
Guests must sign up in advance via the National Institute for Health and Care Research website where they can also enter their question for Professor Bakerly.
Attendees will also be able to ask their question during the event in the text box provided.
For more information and sign up please visit: https://local.nihr.ac.uk/news/questions-about-research-into-long-covid-ask-the-expert/32998.
As part of the continued efforts to improve safety in maternity services, the Local Maternity and Neonatal System (LMNS) is beginning to roll out the Royal College of Obstetricians and Gynaecologists Each Baby Counts Escalation Toolkit across Greater Manchester and Eastern Cheshire.
The campaign focuses on three interventions - ICA: 'Identify, Communicate, Act'.
Its overall aims are to improve clinical escalation by:
- Reducing delays in escalation by improving the response escalation and action taken
- Standardising the use of safety critical language
- Reducing feelings of hierarchy, creating a supportive environment which empowers staff of all levels to speak up when they identify deterioration or a potential mistake
- Promoting a culture of respect, kindness and civility amongst staff members, normalising positive feedback and saying thank you to each other
- Improving the ways in which we listen to women and people using our maternity services
Chloe Hughes, a senior midwife and Saving Babies’ Lives Champion, started work with the LMNS in September 2022 to roll out the programme across each provider unit.
Prior to the campaign launch an escalation behaviours questionnaire was sent out to allow units some insights into how their staff feel about escalating, the culture and the barriers. So far, there have been more than 96 responses in a week.
Chloe has had a fantastic response from all units who are completely committed, engaged and enthusiastic about adopting this approach. All staff have been eager to embed this as soon as possible.
This month, there has been train the trainer workshops/meetings with nearly all the fetal monitoring leads at each unit (see photo above). This will enable them to facilitate the behaviours workshop with their own teams to look at the escalation behaviours and language they currently use, the barriers to effective escalation and possible solutions.
This has now been launched at four sites within their fetal monitoring study days, with the others starting very soon.
Once this preliminary work is complete, the overarching campaign for the project will be launched this month and in May 2023.
Please contact Eileen.stringer1@nhs.net or Chloehughes@nhs.net for further information.
The leader of Caribbean African Health Network (CAHN) has highlighted the work being carried out in partnership with the Networks to improve maternity services for black and Asian people.
Charles Kwaku-Odoi, chief executive of the organisation, took to Twitter (see his post above) to applaud the contribution of Faye Bruce, chair of CAHN, in a BBC programme on Radio Five Live which highlighted “appalling” death rates for black women in childbirth – they are four times more likely to die within six weeks of childbirth than white women.
Faye spoke about how our Maternity Network is working with CAHN and the voluntary, community and social enterprise sector to improve standards in Greater Manchester and Eastern Cheshire.
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