Earlier this year, the NHS asked health professionals and patients to share their thoughts on the past, present and future of the organisation, as it approached its 75th anniversary.
Our Children and Young People Network clinical advisor, Dr Carol Ewing (pictured above), who marks her 45th year of working in the NHS this year, responded with her personal insights.
Carol, who is currently the Greater Manchester ambassador for the Royal College of Paediatricians and Child Health, as well as chair of the Greater Manchester Children’s Health and Wellbeing Stakeholder Board and co–chair of the Greater Manchester Children’s Health and Wellbeing Executive Board, writes: “My key reflection is that I have been proud to work for the NHS for 45 years and the founding principles and values of the NHS are what I believe in.
“The NHS is getting better at acknowledging the needs of children and young people and that NHS leaders realise that good health and wellbeing starts in infancy and childhood, backed up by good preconception and maternity health care.”
The NHS was founded on 5 July 1948 and has always innovated and adapted to meet the needs of each generation. Its founding principles remain as relevant today as they were then.
Despite the challenges, the public still overwhelmingly supports having a national health service, and it is what makes our people most proud to be British.
The SCNs will be marking the 75th anniversary by highlighting on social media how it has improved services for patients since 2013.
The Network is delighted to welcome Dr Sarah Steven PhD (pictured above) as a new member of the diabetes clinical leads group.
Working with programme team members Krista Williams and Adam Wallis, Sarah’s main focus will be on clinical leadership of the NHS Type 2 Diabetes Path to Remission programme in Greater Manchester (formerly known as the NHS Low-Calorie Diet programme).
Sarah’s previous research study experience, looking at the effect of a very low calorie diet in individuals with different diabetes durations, will be of immense benefit in this new role.
She will be a valuable addition to the SCN team and Greater Manchester diabetes board meetings.
Sarah is a consultant diabetologist at Manchester University NHS Foundation Trust and was a Diabetes UK Clinical Champion from 2020-2022.
With wide-ranging background in research contributions, teaching and leadership experience, Sarah will also help the clinical leads group to develop strategic and policy initiatives for Greater Manchester.
NHS England has announced a new offer to all integrated care boards (ICBs) in England to fund additional services for people aged 18-39. In Greater Manchester, it will allow us to fund additional patient reviews.
Early onset type 2 diabetes (EOT2D) is defined as the development of type 2 diabetes below the age of 40 years. It is more common in people from ethnic minorities (particularity in people with South Asian ethnicity) and people living in the most socio-economically deprived areas.
Prevalence is increasing annually and the National Diabetes Audit records 7,280 people aged 18-39 living with T2D in Greater Manchester, the majority of whom are cared for exclusively in general practice.
EOT2D is associated with a more aggressive diabetes phenotype than older-onset type 2 diabetes, including more rapid progression of glycaemia and early development of complications with significant reduction in life expectancy.
NHS England is therefore launching the T2Day (Type 2 Diabetes in the Young) Programme, a two-year funded initiative for 2023/24 and 2024/25 aiming to improve care for people with EOT2D.
Funding is expected from the end of August 2023 and the SCN team will work with the ICB and place-based teams to develop our plans to meet the needs of young adults with diabetes.
Further information is available from Ewan Jones.
The Cardiac Network is holding an event in September to focus on cardiovascular disease (CVD) prevention in Greater Manchester.
The summit, called Heart of the Matter, is being held at the Etihad Stadium and aims to continue the momentum in improvements in the region, as well as showcase the excellent CVD-related work taking place across organisations, areas and different levels of the healthcare system.
A full agenda and booking details will be released shortly, but anyone who works in health, social, community and voluntary care is welcome to attend the event, which will be held from 9am to 4pm on Thursday, September 14, 2023.
Cardiovascular disease is the leading cause of disability and premature mortality and is intimately linked with causing, worsening and perpetuating health inequalities; making it a central issue diminishing the wellbeing and quality of life of many people in Greater Manchester.
CVD prevention covers many areas, from primary prevention and health checks, community outreach and engagement, to better caring for those we already know have high risk conditions and rehabilitating people back into life after a potentially life changing event.
Read the flyer for more details.
The team is excited to announce it has appointed Wendy Javaid, from Manchester University NHS Foundation Trust, as its new Greater Manchester diagnostics education facilitator.
She said: "I'm very excited to be taking on this new role and am looking forward to getting to know everyone within the network.”
Wendy will be liaising with the cardiac physiology leads/service managers from across Greater Manchester and Eastern Cheshire trusts to set up and manage the GM Cardiac Physiology Training and Education Consortium.
The Your Heart Matters bus will be returning to the city on Friday, July 7, calling in at Manchester Central Mosque.
This event will focus on detection of heart failure, vale disease and arrhythmias.
Members of the community will be invited to jump on the bus and have a blood pressure measurement, auscultation of heart sounds and an ECG along with finger prick tests for those with signs and symptoms of heart failure.
The Cardiac Network is excited to work alongside Pumping Marvellous and Heart Valve Voice for this event.
Midwives at Macclesfield Hospital are celebrating the return of full maternity services three years after they were suspended due to the Covid-19 pandemic.
The Maternity Network has supported the services since 2020 and we will run a full report on its work in the July newsletter.
Chief Executive of East Cheshire NHS Trust, Ged Murphy, said: “It gives me great pleasure to share the news that we have now met the robust safety criteria required to return our maternity service.
“The return of this service could not have happened without the ongoing support of all our staff and partners, and I would like to express my sincere thanks to everyone who has worked alongside us over the past three years.
When the service was suspended in March 2020, the team of midwives were either relocated to host hospital sites at Stepping Hill, Wythenshawe and Leighton for women who preferred a hospital-setting birth, or remained as community midwives for women who chose a home birth.
Preventing stroke is a key priority for the Network and it has been working in a number of ways to help patients reduce their risk.
The community stroke care pathway was a trailblazer for the NHS England Blood Pressure Monitoring @ Home initiative, rolled out in 2021/22 in response to the pandemic.
The Network’s community teams successfully provided patients who have hypertension with their own BP monitor, with the teams educating patients to ensure they submitted regular measurements so medication could be adjusted.
The scheme was successful and resulted in around half of patients found not to be hypertensive when measured at home. Many of those that did have high BP saw a significant fall.
The Network has just had the work published in the British Medical Journal: Community stroke team use of home blood pressure monitoring improves blood pressure control after stroke: a quality improvement report.
The Network would like to thank its BP@Home team, which included nurses from all the community teams plus clinical expert Dr Philip Lewis from Stockport NHS Foundation Trust.
The team has also been successful in securing a grant from Daiichi Sankyo to test using ECG wearable patches to monitor for atrial fibrillation (AF) in our two Primary Stroke Centres at Stepping Hill Hospital, in Stockport, and Fairfield General Hospital, in Bury.
AF is also a major risk factor for stroke and long waits to access cardiology outpatient monitoring is leading to patients suspected of having AF being at risk while they wait to be seen unmedicated.
The pilot projects will trial using the devices in selected patients when discharged home, and should help identify more AF cases and lead to a reduction in further strokes in this high risk group of patients.
(Pictured above: Lydia from the BP@Home team).
The Network marked this year’s Pulmonary Rehabilitation Week by highlighting positive feedback from people taking part in the sessions.
Pulmonary rehabilitation (PR) teams in Salford and Oldham spoke to people about how the light exercise sessions were improving their health and wellbeing, with their photos and quotes used by the team as part of the week’s Twitter campaign (see the post above of Stephen from Oldham).
Michael, from Oldham, said: "I have felt tired through the day. I now have more energy to do things."
"For me, the result is enabling me to walk further, do housework easier and all by learning to breathe differently too!" said Barbara, from Salford.
"I enjoy learning new things about my condition and how to control my breathing with exercises. I also like the fact that I can speak to other people with the same condition," William, from Salford, said.
PR teams across Greater Manchester have helped create and launch a campaign this year, called Keep Active, Breathe Better, to increase awareness of the free sessions, in a bid to support more people. The campaign has also seen teams meeting GPs in localities to make them aware how to refer patients.
The Network partnered with Health Innovation Manchester (HiM) to deliver a workshop which explored the concept of a palliative and end of life care virtual ward.
The workshop took place at the University of South Manchester Education Centre and was delivered using a hybrid approach to enable a virtual delivery alongside face-to-face networking and discussion.
Dr Bushra Alam, consultant acute physician and Greater Manchester virtual ward lead (HiM), chaired the workshop and gave the audience an update on the current implementation of virtual wards in the city region that has been taking place for respiratory and frailty.
Dr David Waterman, consultant in palliative medicine and Greater Manchester palliative and end of life care SCN programme clinical lead, then presented to the group (pictured above) some of the principles outlined in the draft national guidance for the use of palliative and end of life care virtual wards to support the workshop thinking:
- Would otherwise have to be admitted to, or remain in, a hospital or hospice bed
- Can be safely and effectively managed in community
- Delivered by those with knowledge and experience of caring for those with palliative and end of life care needs
- In patient’s own home or in their usual place of residence
- Compliment existing community services
- Palliative and end of life care expertise and input may be needed as part of other virtual wards (respiratory/frailty for example).
Two organisations gave practice examples of palliative and end of life care virtual wards:
- Dr Matthias Hohmann - medical director of Dr Kershaw’s Hospice presented the work that has been led by the hospice in Oldham in developing a virtual ward model and the building blocks used to create a virtual offer.
- Sara Black – chief operating officer of St Rocco’s Hospice, and Barry Geden and Jacqui Tudor, from NHS Cheshire and Merseyside, presented a hub model currently being run across Warrington and shared their experience in developing and refining the hub and the service.
Both the online group and face to face participants engaged in a group discussion focused on what opportunities are available currently to develop a virtual ward model and what a strategic vision for a palliative and end of life care version could be.
A full report will be developed from the workshop and shared across the network.
The Network has produced a new poster to help organisations promote important training for people who work with children or young people with asthma.
The National Capability Framework for the Care of Children and Young People with Asthma has been developed to allow individuals, employers, and integrated care systems to be aware of the skills and knowledge that are required to ensure they can safely care for a child or young person with the condition.
It is aimed at both health and non-healthcare professionals, including childcare providers, education providers, uniformed services, sports coaches, social services and health care workers.
To date in Greater Manchester, 2,153 professionals have accessed the Tier’s 1-3 free training.
The Network would like to see all professionals who come into contact with a child or young person who has asthma to complete the training and has created a poster which you can download, print and display, or cascade electronically to contacts.
The framework divides different roles into 5 ‘tiers’. A tier describes the level of care a person may be expected to deliver to a child or young person with asthma. The more involved the care, the higher the level of tier.
The tiers are not profession specific, but rather describe the minimum required knowledge and skills any individual must possess to safely carry out their role in caring for a child or young person with asthma.
Individuals should look at their own role and choose the tier most appropriate to the care they deliver.
If you would like any more information please contact afia.ali@nhs.net.
The Network supported this year’s Child Safety Week (June 5-11) with a series of posts on social media.
The team used the Child Accident Prevention Trust’s campaign designs to link parents to useful online information to reduce the risk of, for example, their child falling or burning themselves (see post above).
NHS England highlighted its sickle cell awareness campaign for World Sickle Cell Day 2023, which was held on June 19.
The campaign, which is part of a bigger drive to improve sickle cell care across the NHS, aims to increase awareness of the key signs and symptoms of a sickle cell crisis, particularly among urgent emergency care staff and those living with the condition and their carers.
A training module for NHS staff is available to support increased knowledge of the condition and how to treat it. The training module also includes information on healthcare inequalities related to the condition.
Anyone can be born with sickle cell disorder, but it is most common among people from a black Caribbean or black African background.
If a person has any of these symptoms, immediate action should be taken as they could be showing signs of a sickle cell crisis or complication:
- Pain
- Signs of infection including fever
- One-sided paralysis or weakness in the face, arms or legs
- Confusion
- Difficulty walking or talking
- Sudden visual changes
- Unexplained numbness
- Severe headache
- Breathlessness, chest pain or low oxygen levels
Patients admitted to the hospital for sickle cell complications should be referred promptly and treated by haematologists or clinicians with expertise in sickle cell disorders.
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