Team of the Year
High-quality healthcare is a team effort, often involving collaboration between a range of professions. This is particularly important in the development and implementation of initiatives to improve healthcare delivery. This category is open to teams from the NHS or independent sector who have undertaken projects that demonstrate the value of teamwork in improving a service. Entrants must show how an entire team has contributed to the initiative, its implementation and ongoing delivery, demonstrating the input of different team members and/or collaboration with other specialties, professions and/or services. They must also be able to demonstrate the benefits of their initiative to patient care or service delivery.
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Blackpool Teaching Hospitals NHS Foundation Trust
Early parenthood service – supporting families to be the best they can be
Blackpool has the highest rate of Children in Need and Looked After Children in the country, with the rate for those under the age of one being over four times higher than the national average. The Early Parenthood Service (EPS) was designed as a response to this and the decommissioning of Family Nurse Partnership (FNP) in order that the needs of a broader population could be better met, particularly those expecting parents with learning difficulties, difficult experiences in their own childhood and may be care experienced. Had children who are no longer in their care. Are experiencing vulnerabilities and whose lifestyle may pose a risk. The aim is to support Parents to be the Best They Can Be, by providing consistent and intensive support utilising a tool kit of evidenced based interventions throughout the antenatal period until the baby is up to three months old. EPS supports parents who may go home with their baby and those born into care. We considered recommendations of research, independent reviews, child safeguarding practice reviews, local information, and data to design a bespoke service integrated into the Blackpool Start for Life offer. A shared goal enabled a smooth and rapid development of a complex service. Putting the baby and their family at the centre enabled challenges to be considered as opportunities for growth and learning. EPS has been commissioned initially until 2027. 59 families have been referred to date, with amongst them 4 babies at significant risk of being removed have gone home with their parents. 4 families have been supported whose babies were born into care. We are currently working with 10 families in pregnancy whose babies are at significant risk of being born into care. Future plans are to evaluate, adapt, expand and integrate further into the Blackpool Partnership offer to families.
Calderdale and Huddersfield NHS Foundation Trust
My Forever Box – A multi-disciplinary approach to improve care for the pre-bereaved child
In November 2021, Rebecca, an adult palliative care nurse was completing a palliative care assessment. She recognised that there was no service provision for the care provided for Children and Young People (CYP) who were facing the loss of a parent/grandparent/sibling, and this had further been exacerbated due to restricted visiting during the COVID19 pandemic. A plea for help from Rebecca to the Lead Nurse for CYP. Julie, led to immediate intervention to support a 5-year-old child whose father was actively dying. From here, the concept of "My Forever Box" was born. This has led to a quality improvement initiative that has made a significant difference to the care of local families facing the loss of a loved one. Discussions took place and a Task and Finish group was created to consider how to best address this issue across the whole organisation. We used a "Work together to get results" methodology to address the key challenges of minimal knowledge and confidence in caring for CYP by adult nurses and others and the impact of restricted visiting for CYP under 16 years during COVID 19. To date, we have helped support 75 families with the resource and have worked with the local Trust charity to secure funding for the project. We are committed to ensuring that all children and young people who are facing bereavement have access to the personalised resources. My Forever Box is a personal memory making box to help a child process death and it can help them make sense of what is happening to their loved one and allow them to create special memories of this person. This could be adopted nationally to help support other CYP in line with Child Death Review: Statutory and Operational Guidance, October 2018’ and Children Act 2004.
Derbyshire Community Health Services NHS Foundation Trust
NQN System Rotations Programme: the Derbyshire nurse
"Recruitment and retention continue to be a challenge and the system in Derbyshire is no different. The ambition was to support Joined up Care Derbyshire (JUCD), an integrated care system, to deliver an improved experience for newly qualified nurses (NQN) leading to improved staff recruitment and retention, contributing to the ‘one workforce’ ambition of the NHS. Research shows NQN leave the profession at a high rate, demonstrating the importance of support in retention. The rotations programme was developed through collaboration with system-wide operational areas, researching existing programmes and discussions with student nurses from the University of Derby, shaping the design of the project. Pathways were developed to include three six-month rotations across JUCD from September 2022.In March 2024, the programme became a ‘business as usual’ recruitment workstream across JUCD. Three cohorts of NQN are continuously rotating system-wide; our pilot cohort have completed the programme and secured permanent positions. Our fifth cohort have been recruited for September 2024. The ambition is to have 36 NQN rotating across the system at any one time. Initially, the challenge was recruiting NQN; many students had secured jobs, some with financial incentives. However, the team promoted the programme and the NQNs on rotation have told peers about it. The most recent round of interviews saw 64 students apply for the programme. There have been challenges around cross-system working, resolved by clear line management and the development of a secondment agreement, all of which require much liaison and collaboration to ensure policies, procedures and contracts are in place. The vision is that rotations become available to all Registered nurses and registered Nursing Associates, embedding rotational posts to become the ‘norm’ as career choices. Rotational nurses will demonstrate wider system knowledge and experience, increased confidence, greater resilience, strengthening the workforce and developing leaders of the future.
East Kent Hospitals University NHS Foundation Trust
Recruitment, patient safety and experience
Having undergone CQC inspections in 2020 and 2023, nursing establishment and training actions required urgent action to minimise patient safety risk. These could not be addressed unless there was an entire team response. Key improvement areas identified at governance meetings, staff engagement events and exit interviews mirrored the external reviewer observations, and communication was a recurring theme, covid further identifying this this a continuing priority. Turnover of registered staff was high, exit interviews identified lack of progression and education were common themes for leaving the department along with burnout. This meant approximately 60% of registered staff had less than 1 years’ experience in ED. Reliance on educationally educated nurse cohorts to fill our vacancies, with varying degrees of experience and coming from a multitude of healthcare models, meant we needed a standardised approach to embed staff so they felt valued and part of the team from day one. Eight team days were used as forum to identify route cause, engaging every team member on the floor to identify and deliver the solution, having created a safe environment to discuss concerns. Working alongside Canterbury Christ Church university the nursing team developed an accredited emergency department nursing module. Module content is delivered by ED nursing staff, competency supervision is provided by the senior ED nursing team and PDN’s, with final sign off from the nursing education lead. We implemented own ED care plan, based on Bristol ED checklist ensuring it was tailored to the needs of our patients in the environment we were looking after them in. The Patient Family liaison role was also created to support the patient care and communication. All in a department undergoing a complete new build without change in establishment, in an ever changing environment, and corridor care levels at those not experienced before.
Lincolnshire Community and Hospitals NHS Group
The Cardiac Advanced Clinical Practitioner Team
Lincolnshire is England’s second largest county incorporating both a rural and coastal population. We have an above average incidence of Atherosclerotic Cardiovascular Disease (ASCVD), areas of extreme social deprivation, poor road and rail communication infrastructure and difficult to access minority populations. This combination, when combined with recruitment and retention concerns meant that we had to think differently and innovate our service delivery. Over the last decade we have established a team of Cardiology Advanced Clinical Practitioners (ACPs) to improve the experience of our patients. The raison d'être of the team is to deliver patient centred, high quality, cost and clinically effective cardiovascular healthcare. We provide specialist care 7-days a week (24 hours a day) in a variety of settings that include patients homes, clinics, x2 district general hospitals and a further general hospital (all 30-miles apart). The team not only delivers direct care but also supports a variety of multi-professionals (AHP, medical, clinical scientific, public health, third sector) with specialist advice and support. Activities undertaken by the team include (but is not exhaustive):• 24/7 emergency department support • 24/7 delivery of primary angioplasty (PPCI)• 7/7 heart failure ward rounds/ review• 7/7 virtual ward• Daily short stay unit ward rounds• Nurse-led cardioversion• Nurse-led loop recorder implantation • Rehabilitation• Outpatient clinicso Post-acute coronary syndromeo Cardio/ diabeteso Heart failure (rapid access and chronic disease)o Arrhythmiao Rapid Access Chest Pain o Lipid (cholesterol) management The team has achieved an excellent reputation for quality and patient centred care. Our supportive evidence in this submission focusses largely on recent developments in cardio/ diabetes leaving us plenty to discuss should we be shortlisted for ‘dragons den’.
Manchester University NHS Foundation Trust
Nurse-led sustainable plastic surgery trauma service transformation: a positive Covid-19 legacy
The aim of this quality improvement project was to develop a sustainable nurse-led 'See and Treat' service in a regional plastic surgery unit for patients requiring surgery under local anaesthetic following traumatic injury. Trauma related injuries are a substantial part of the workload in the plastic surgery unit in question with people with the most minor injuries requiring surgery under local anaesthetic accounting for 17%. COVID-19 threatened the continuation of any minor surgery service, but the initial crisis-driven response to the pandemic provided the opportunity to develop a new, more effective , nurse led service for this patient group. The Model for Improvement was used and four @Plan, Do, Study, Act' cycles deployed over an 8-week period involving 102 patients. Routine qualitative and quantitative data in the form of a semi structured patient feedback proforma were used to guide the improvement process, optimising the new service design and delivery. The results demonstrated that 98% (n=100) of patients received same day surgery via the new 'See and Treat' service. Staff and patient satisfaction remained high throughout; all patients preferred same day surgery . No unintended consequences were identified. One positive unintended consequence was the reduction in carbon footprint achieved by reducing clinical waste and patient travel. Improvement methodology was successfully used by a nurse-led team to enable the continuation and enhancement of surgical services for trauma patients during COVID-19 driven service disruption. The transformation has resulted in the revised service delivery model becoming the 'new normal' approximately 2 years later. COVID-19 challenged the resilience of the trauma surgery service but led to positive long-term legacy that sustainably improved waiting times and patient experience while maintaining safety. Future plans are to increase the scope of procedures that are undertaken in the service to improve waiting times further and patient experience.
NHS Practitioner Health
First Contact Team
NHS Practitioner Health (PH) has provided mental health and addiction treatment to health and social care practitioners (HCP) since 2008. As one of the largest publicly funded providers of its kind globally, PH offers a free and confidential self-referral service in England and Scotland. The current numbers of those accessing primary care services increasing dramatically, necessitating the urgent need to restructure and rethink the service delivery model was essential.PH created a mental health nurse led multidisciplinary First Contact Team to provide initial assessment, early intervention, and onward referral to other parts of the service. This nursing team played a major role in service delivery, developing care pathways, using validated questionnaires to assist triage, conduct assessments and treatment. It helped join the dots between the 200 or so clinicians, ensuring seamless, safe, accessible care during these difficult times (and continues to do so).With the nursing team assessing all new presentations, PH was able to cope with nearly 5000 new presentations in the pandemic year, exceeding the number presenting in the first decade of operation. The team continue to deliver approximately 220 appointments per week to cope with the rapid increase in demand and severity of presentations. The nursing team was also instrumental in creating a suite of online health material available freely to all HCPs across the UK and leading webinars, on-line chat rooms and support groups. The numbers presenting to PH continues to rise, with around 600 new presentations per month. In response, PH has grown its nurse-first-led model, providing care to patients with over 95% of patients improving in mental health outcomes on independent and standardised measures and around 84% who were not at work/training returning after treatment with PH. We hope to replicate our service in Northern Ireland after successfully doing so in Scotland in 2021.
Royal Wolverhampton NHS Trust
Virtual ward and paediatric virtual ward
The Virtual ward is a rapidly growing and innovative service that caters for children and adults of all ages, delivering acute care at home utilising digital technology The Virtual ward began as a response to the covid pandemic to keep covid patients at home using remote monitoring. Since then we have gone from strength to strength rapidly upscaling the service that we deliver. We are now nearing to reach our 5000 referral into the service after developing multiple speciality pathways delivering acute care that mirrors that which patients would otherwise receive in hospital. Initially the service predominantly cared for patients with respiratory conditions, we quickly identified that there were patients admitted to the respiratory virtual ward who also had heart failure and were at times admitted to hospital due to their heart failure, this helped us recognise that there was a need to work on developing a heart failure pathway for these patients. We engaged with the speciality team to map how a heart failure virtual ward would look to enable more patients with heart failure to receive acute care at home whilst having speciality input via daily multi disciplinary meetings. We are now continuing to build on engaging with the acute sector to build upon the strong foundations and develop virtual wards for each speciality so that it becomes an embedded practice. We also aspire to work towards a 24/7 service for paediatrics continuing to build upon paediatric speciality pathways that additionally becomes an embedded practice.
Sheffield Teaching Hospitals NHS Foundation Trust
Nurse-led late effects screening service
Modern cancer management is an impressive medical success story. The goal of treatments maximises efficacy and minimises toxicity. Trade-offs include co-morbidities, impacting quality of life. Late effects may occur weeks, months or even decades later, can affect any system, may be physical, emotional, social or financial and include second cancers. The earlier late effects are identified, the sooner and more effective the intervention. Cancer nurses are ideally placed to work holistically to assess and screen for potential late effects and patient concerns. We have established a Sheffield Nurse-led Late Effects service to do just this. A key senior nurse leader worked collaboratively with multi-professional colleagues across multiple specialties to extend an established paediatric service into haematopoietic stem cell transplantation by implementing international guidelines, the first in Europe. The appointment of a dedicated Clinical Nurse Specialist embedded care into pathways. A further nurse-led late effects clinic was established within oncology focusing on adults of fertile age and survivors of solid cancers. Whilst these services grew, novel therapies were developing in parallel and presenting with their own novel toxicities. A more recent opportunity for a further senior nurse appointment enabled the transferability into immunotherapy late effects. Oncology faces significant challenges with increasing demand, an overstretched workforce, growing elderly demographics. Within this context, late effects services never represent burning platforms. We have persisted by raising the profile of our work and advocating for patients with evidence, tenacity and dedication. We are currently writing a late effects strategy for the regional cancer alliance. We have extending our Community of Practice working with radiography colleagues to pilot a Pelvic Radiation Late Effects Clinic and within haematology, recruited a Clinical Nurse Specialist to support a Late Effects Clinic for Multiple Myeloma. A successful research grant will develop a digital monitoring pathway for immunotherapy late effects.
St Joseph's Hospice
Accessible information project
At St Joseph's Hospice we have always had very good links with our colleagues in health and social care who support people with learning disabilities. We have always provided direct support to individuals either in the own home or in our inpatient unit working in collaboration with the individuals usual care team and family to ensure our care and support is tailored to meet the preferences of the individuals and support those they live with. We identified that obtaining and retaining information for this group of people was a challenge and that there was a huge gap in easy read information on death and dying. A few years ago, we collaborated with our colleagues from the learning disability team at East London Foundation NHS Trust and we produced our first easy-read leaflet ‘In the last few days of life’. Reflecting on this experience and reviewing the other information the Hospice provides we are aware that we had to expand this work. Therefore, we have worked in partnership with the experts by experience form Empowering Voices based at the Creative Hub in Tower Hamlets. We co-created eight easy-read leaflets which focus what a hospice is. The support offered by our various teams, medicines at end of life, and eating and drinking at end of life. Finally we created a leaflet about volunteering, as we are keen to support those with a learning disability to access volunteering opportunities at the hospice. The experts at Create challenged us to produce a film as they don’t like reading leaflets. So we commissioned a film maker and wrote a script. We felt it as essential to find an actor who our target audience could identify with. We were delighted that Justin Melluish who is an actor with downs syndrome agreed to do our film.
Tees, Esk and Wear Valleys NHS Foundation Trust
ADHD Pathway
Attention deficit hyperactivity disorder (ADHD) at the beginning of our project was an “issue”. There were hundreds of individual’s placed on a waiting list for assessment with no clear pathway for assessment to take place. Assessments were held within one main team which made their figures even more eyewatering. Our pathway looked at way we could assess these patients that sat on a waiting list within our area. The plan was to minimise the wait times for these patients to enable them to have diagnostic clarity and support in the same way a patient with depression for example would have. We wanted to create equality in a largely majority group of clients who in their own words were stuck and frustrated with wait times and help on offer. The same is to be said for individual’s with a potential diagnosis of autism. The pathway was initially driven by Rachel, a band 6 nurse with high expectations and driven by outcomes for each of the patients we came into contact with. The 1st steps where determining the numbers and individuals in referral date order, the 2nd step completing training to enable assessment, 3rd step diagnostic MDT’s and training. There were many challenges to overcome, training, time, man power, figures and ensuring a pathway that was developed with patients at the very centre of what already had an extremely large wait time of approximately 3-5 years. The goal was indeed achieved and within 18 months we have transformed from the longest patient waiting being 1652 days to the present which is 267 days. Within four months we will have no waiting list for ADHD. The future plan is to proceed with the same pathway for autism and this has begun with the goal to reduce waiting times for assessment and diagnostic.
Tees, Esk and Wear Valleys NHS Foundation Trust
Integrated Support Unit
The team have worked tirelessly to ensure that they work in partnership with the prison to provide the clinical care and support for the patient group. Liaising with HMP, Primary care and NHS Colleagues to ensure that assessment, risk assessments and communication is consistent to provide a high standard of care for all. In the event that the service can assess, support and provide treatment to only two/three individuals a year this would see that the value of the service being recognised. The pathway for most people into MH care from HMPPS is to a secure hospital.