NICE has just updated its heart failure algorithms for remote monitoring in people with cardiac implantable electronic devices. It replaces its briefing on TriageHF Plus for remotely monitoring people with cardiac implantable electronic devices at risk of heart failure or worsening heart failure.

The new pathway will dramatically reduce the number of hospitalisations due to heart failure. Researchers at Manchester University NHS Foundation Trust (MFT), working with partners including the Network, developed the pathway ‘TriageHF’ to help people with cardiac implantable electronic devices, such as pacemakers, who have heart failure.

Many heart failure patients are fitted with a pacemaker or implantable cardioverter defibrillator (ICD) to help their heart to beat regularly and more effectively. These devices are continuously collecting health data about the person’s condition such as heart rate, heart rhythm, physical activity, and fluid build-up in the lungs, all of which can be used to assess the risk of being hospitalised.

The new approach, developed in collaboration with medical technology company Medtronic, takes advantage of the remote monitoring capability of these devices and uses real-time data to automatically alert the hospital team when a person’s condition becomes ‘high risk’ of them being hospitalised within 30 days.

Following the success of this research, TriageHF has been implemented in eight hospitals across Greater Manchester to evaluate further the performance of the remote monitoring system.

Prevention

Dr Fozia Ahmed (pictured above), consultant cardiologist at MFT, who led the research, said: “I am delighted that NICE recommended the use of the TriageHF pathway which will have a positive impact on patients across the country.

“We routinely see patients with heart failure in the hospital clinic for a check-up every six months, but we know that their condition can deteriorate rapidly between appointments.

“Having an automatic system that alerts us to early signs of deterioration enables us to intervene quickly, preventing hospitalisations and potentially deaths, due to heart failure.

“Additionally, from our experience of using this technology in Manchester we know that heart failure alerts can also lead us to pick up on other health problems a patient may be experiencing during our phone consultations such as pneumonia or frailty.”

Heart failure is a debilitating condition that impacts the lives of nearly one million people in the UK. It remains a leading cause of unplanned hospital admissions and is the most common cause of admission in people over 65 years of age.

Through Triage HF monitoring, patients have a simple transmitter box attached to their phoneline which automatically sends alerts from the patient’s pacemaker or ICD to the Heart Failure Team at the hospital if any dangerous, abnormal readings are identified.

Following an alert, patients deemed at high risk of hospitalisation are then telephoned by the heart failure team and any changes that are needed to be made to help manage their condition in a different way are discussed and implemented.

Research involving 758 participants with heart failure across three hospitals in Greater Manchester, including Manchester Royal Infirmary and Wythenshawe Hospital, both part of MFT, was published earlier this year in the European Society of Cardiology (ESC) Heart Failure Journal. It found that the rate of hospitalisation was 58% lower in patients whose devices were monitored by TriageHF than those who received standard level of care from their device.

United event focuses on improving care for younger generations

Two of the SCNs’ Networks united to hold a joint engagement event with system providers and commissioners to address the variation in providing palliative and end of life care services for babies, children, young people, and their families.

The Palliative and End of Life Care Network (P&EoLC) and the Children and Young People’s Network collaborated to review patient and carers’ experiences. 

Speakers at the event included a patient’s carer, who recounted a powerful story which highlighted the benefits of advance care planning in allowing a child to die at home, as the place of their choice, and the beneficial impact for the family in managing their grief.

Dr Maddy French and Anna Oddy (the P&EoLC Network’s co-clinical lead for babies, children and young people) gave insightful presentations on the prevalence of babies, children and young people with palliative and end of life care needs in Greater Manchester. They presented the recent service mapping across the city region which highlighted some significant gaps in provision.

The delegates discussed the present provision and potential scope for commission of social care support, as outlined in the national palliative and end of life care children and young people service specification. Their feedback demonstrated considerable variability across Greater Manchester in both the provision and commissioning of support services.

Dr Helena Dunbar (director of service development and improvement, Together for Short Lives) and Katie Horrocks (Kentown Wizard Charity nurse) presented a model in NHS Lancashire and South Cumbria that has been supported by the charity to provide specialist palliative care services.

The service and team are growing in their delivery and have been able to align a coordinated service health and social care model with a Kentown nurse to each locality in Lancashire.

Feedback from the event has been collated and will be discussed with the children and young people’s locality commissioners and transformation leads to explore opportunities to address unwarranted variation across Greater Manchester.

Pictured above: delegates at the event.

The latest insights, challenges and opportunities for collaboration were shared at the recent successful Diabetes Clinical Network event.

Led by the team’s clinical leads, the event brought together a number of clinicians and stakeholders to discuss care in Greater Manchester.

Attendees participated in a variety of sessions covering critical topics such as:

• The latest clinical network developments and upcoming programme priorities
• Best practice and new models of delivering diabetes care in primary care networks
• Strategic priorities and improving transition in children and young people’s diabetes care
• Reducing amputation rates through a city-wide whole systems approach
• The latest advancements in diabetes medications and making best use of diabetes technology.

Several highlights and takeaways have been identified by the clinical leads, as the Network reflects on the success of this event.

Takeaways included:

• Importance of collaboration was a recurring theme. Linking clinical systems and a shared care record will help improve care coordination and efficiency further going forward
• There were examples of new holistic approaches to diabetes care, including the Diabetes Support Team (DiaST) multidisciplinary approach. The system needs to find a way to scale up successful pilots
• A consistent all ages service was highlighted as essential for the implementation of an effective transition strategy and the findings of the Getting It Right First Time (GIRFT) Children and Young Adults (CYA) review.

Clinical lead Dr Naresh Kanumilli said: “Thank you to all who attended and were generous with their time, generous with their thoughts, ideas and commitment to improve outcomes for people living with diabetes in Greater Manchester.”

If you would like to read the presentations and resources from the event, please contact the programme team at england.gmecscn-oversightgroup@nhs.net.

Pictured above: Diabetes Network programme lead Ewan Jones, left, and clinical lead Dr Naresh Kanumilli, at the event.

National leadership award for midwife

A senior midwife from Manchester University NHS Foundation Trust has won a respected award from the Royal College of Midwives (RCM) for showing strong leadership by introducing new services in the region, leading to greater equity in care provision for women.

Kathy Murphy (pictured right), who has more than 40 years’ experience in the NHS, took home the Excellence in Midwifery for Leadership Award during a ceremony in London on 18 October.

She has brought together the largest maternity service in the UK, employing 820 midwives and supporting the births of 16,500 babies each year.

In response to the current climate within maternity services, she identified six key areas of development for the Heads of Midwifery and Directors of Midwifery. Her programme has led the way for senior midwifery leaders within the Local Maternity and Neonatal System (LMNS) to network and forge strong connections and professional working relationships which, in turn, have strengthened the maternity system in the region.

At the awards ceremony, the RCM’s chief executive, Gill Walton, said: “Kathy has demonstrated commitment and lifelong learning to midwifery since 1987. Throughout her career, she has consistently committed to personal growth and development and demonstrated a passion for quality and innovation, spanning both nursing and midwifery professions.

“An example of this was her involvement in the production of a book on midwifery for pupils in schools to encourage year eight and nine students from Black and Minority Ethnic backgrounds to enter the midwifery profession. She recognised that research had shown that midwives from a similar heritage to the women they care for can improve patient experience in hospital and lead to safer births. She is such a passionate, committed and supportive leader who inspires others to provide high quality and safe maternity care.”

SCNs director and Local Maternity and Neonatal System SRO, Julie Cheetham, said: “Kathy has been a strong leader across our Greater Manchester and Eastern Cheshire maternity service for many years. Her tireless commitment to improvement and leadership is testament to receiving this award and we grateful for all the work she does across our region.”

Positive feedback for education guide

New clinical leaders announced

Successful sessions to increase role of therapy

We have a new addition to the team, Georgiana Taylor-Kisaka (pictured left), and she tells us a bit about herself here:

“I am thrilled to take this opportunity to introduce myself to you all. My name is Georgiana, and I am the new SCNs business support /personal assistant (PA) to Alison McGovern.

My first week has been awesome, meeting team members on Teams and face-to-face that I will be working alongside.

I am here to provide comprehensive business support needs and assistance with managing and schedules, coordinating meetings, handling administrative tasks. My goal is to ensure that everything runs smoothly behind the scenes so my team can focus on driving business success.

With a background of 21 years working for the Department for Work and Pensions as an administrative officer, and 19 months of working for the Greater Manchester Mental Health North Crumpsall Mental Health Hospital as a ward administrator or ward clerk, I have experience in supporting executives, teams, and organisations. 

My last role was with the inpatient care units working on the ward, doing all kinds of administrative duties and making sure that inpatients and their carers were looked after well in the ward. I have also worked closely with stakeholders within the DWP and NHS and I take great pride in being a reliable point of contact for everyone I support.    

In my spare time, I enjoy travelling and cooking. On evenings and weekends after work, I love to watch English soaps such as the good old EastEnders, Coronation Street and Emmerdale. I watch it because of my grand/great aunt in London. When I call her, we always base our conversations on soaps to finish the conversation each week. She always says to me that it is what keeps her going. She even made my mum watch it whenever she visited her.

I have two children, both born in October, so October is a busy month for me. My husband also works for the NHS.”