Collaborating to reduce restrictive practice: reflections from a visit to an acute psychiatric mental health ward

Image of Ayo, Nokuthula and Igoche at the Goddington site visit


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Restrictive practices are techniques such as physical restraint, seclusion and rapid tranquilisation used to limit a person’s liberties, movements or freedom to act independently in potentially dangerous situations.

The inappropriate or overuse of restrictive practice in mental health services has been identified as an area of concern in healthcare since at least 2015.

Beginning in 2021, the Health Innovation Network has been involved in local efforts to reduce restrictive practice based on the findings of a successful pilot led by the National Collaborating Centre for Mental Health. 

We speak to HIN Patient Safety Project Manager Ayobola Chike-Michael, Practice Development Nurse Nokuthula Marks, and Expert by Experience Igoche Ikwue about the programme team’s recent visit to an acute psychiatric mental health ward and their reflections on how sharing personal experiences and perspectives are key for further reducing restrictive practice.


As a patient safety project manager, I know how important it is to involve people and communities in shaping health and care services. The experiences of service users and carers make them experts in their own right and they should be viewed as equal partners – “Experts by Experience” – in  improving services and treatments alongside healthcare professionals.

We have worked with Experts by Experience as part of our Reducing Restrictive Practice Quality Improvement Collaborative throughout the project.

Personal perspectives are always enlightening for people like me tasked with helping services to improve, but the insights that have been shared during this project have – being truthful – been emotionally challenging.

Some service users have recounted their experiences of restrictive practice with words like ‘powerless’, ‘dehumanised’, ‘traumatic’ or even ‘haunted’. These words evoke painful, negative experiences and feelings of being actively hurt by the very health and care system that is designed to keep them well.

With these raw emotions in mind, I was nervous about what our planned visit to a local mental health ward might entail.

My experience visiting the ward

During our visit, we met the Ward Manager, some members of staff and inpatients on the ward.

We spoke with the Ward Manager, Nokuthula, for over an hour, opening our eyes to the complex nature of the multidisciplinary team operating at the service and their efforts to look after people living with a range of mental health conditions.

We were taken on a tour around the ward to gain a better feel of how the dynamics of the ward came together; it was positive to see so much interaction between service users and staff.

The atmosphere was calm and peaceful. We observed some service users watching TV, some in the activity room and others in their rooms. We asked many questions as we walked around the ward – not least why anyone would be restrained at all in such an environment.

The ward manager shared some of their own successful change interventions which helped keep the use of restraints low. They talked us through initiatives such as the use of safety pods and the Bröset checklist for risk assessments. An important theme was reflection and evaluation – taking time each month for staff to consider and assess their use of restrictive practices in order to reduce them where possible.

We also talked about how important it was for both staff and service users to be encouraged to share their feelings about life on the ward. Personal relationships based on trust and understanding are vital for everyone involved in the service.

Restrictive practice is a complex issue and does not have one solution.Nokuthula Marks, Ward Manager

Reducing restrictive practice is a complex challenge, but the visit brought home to me that many of the practical interventions making a difference really boil down to doing more to understand and be compassionate towards the people involved, whether through motivating staff and providing staff wellbeing programmes, or creating a psychologically safe environment on the ward through looking at the physical space or ways in which people communicate.


I’ve spent eight years as a mental health nurse, and more than two-and-a-half as a Ward Manager. Working in acute inpatient settings is something that has always appealed to me; we see people who are very unwell and who have complex care needs, but showing the difference care and compassion can make to their recovery is incredibly rewarding.

Reducing restrictive practice is something that I think everyone involved in delivering mental health care wants to work towards, and over the past two years it has been a real focus for me personally.

The reality of working on a ward does mean it can be difficult to maintain perspective on restrictive practice. It takes conscious effort to avoid becoming “institutionalised” and treating interventions such as medication as being the only option. That is why projects such as the Reducing Restrictive Practice Quality Improvement Collaborative are so valuable – they allow for sharing best practice beyond our busy “day-to-day” lives, allowing us to gain inspiration and confidence from how other people are taking on this big, difficult challenge.

My experience welcoming Ayo and Igoche to the ward  

I understand that the view many people have of acute inpatient mental health wards can be quite negative. People worry that these are chaotic, dangerous places. That is why I love having the opportunity to show people first hand the hard work that goes in to making them a positive environment and a place that helps people to recover.

It was so nice to speak with Ayo and Igoche about life on our ward. We shared insights on the approaches that have worked for us such as de-escalation techniques and spotting the early signs of distress to allow for early interventions. We also discussed specific tactics which have helped to make a difference on our ward such as the safety cross, a visual tool for recording uses of restrictive practice and prompting us to think about how we might be able to reduce them going forward.

A common theme for making progress in reducing restrictive practice is building time for reflection into our work. On the ward that can mean scheduling regular time for multidisciplinary team staff to come together in “safety huddles” to discuss recent instances of restrictive practice. In some ways the ward visit itself was an extension of our commitment to reflective practice, and I hope our experiences can aid those working in other services.

I believe that my experiences can be used to help improve mental health services.Igoche Ikwue, Expert by Experience

Reducing restrictive practice is a journey and we still have a long way to go. Our ward is continuing to work hard to be the most supportive environment it can be for our service users; we have just moved to a new, brighter location, which our service users are enjoying. We have also invested in training in “See Think Actrelational security to enable us to use the knowledge and understanding that we have of our patients and apply this to planning and providing care.

As long as we strive to communicate and collaborate, I am confident we will keep on making positive progress in reducing restrictive practice.


My experience of caring for a family member who was suffering from poor mental health was very challenging. I was isolated in my own home and it put immense strain on my own health; it was the most difficult time of my life. It makes me sad as I reflect back and recall the lack of support that I needed in times of crisis.

However, I believe that my experiences can be used to help improve mental health services – which is why I am a part of the Reducing Restrictive Practice Quality Improvement Collaborative.

My experience visiting the ward

Like Ayo, I was anxious as I walked through the door of the acute psychiatric ward we were visiting. Despite being an expert by experience, and wanting to help reduce restrictive practice, I had no idea of what to expect.

With that in mind, I was pleased and relieved that common themes running through our conversations on the ward included compassion, kindness, and humanity. We talked at length about the importance of listening and learning from service users.

My time speaking to service users and staff on the ward also made me think about my own experiences. Most service users on the ward have their own families and homes, and in many cases they will have sole carers who can be put under huge strain by the demands of looking after very unwell people. The support on offer from these services needs to extend to families – or else we risk a vicious cycle of mental ill-health and people having to spend more time as inpatients than they should need to.

The visit also gave me insight into the personal connections that underpin services, and how we could seek to improve them to reduce restrictive practice and enable better care for service users.

Whilst staff on the ward seemed to value personal relationships, I wondered if more could be done to “close the gap” between operational staff and senior leaders; understanding service user stories and experiences is of benefit to everyone and should inform decisions being made at all levels.

In the same vein, what else could be done to support staff to develop themselves and bring their best selves to work?

I was particularly struck by our discussions with Nokuthula about staff struggling with being assaulted by service users, and we discussed the importance of consistently and appropriately supporting staff wellbeing.

Personal relationships based on trust and understanding are vital for everyone involved in the service.Ayobola Chike-Michael, Project Manager, Health Innovation Network

Mentoring is another good way to help motivate and inspire staff and provide them with personal support to help to develop their confidence and willingness to try new things.

I also think more should be done to build confidence and skills in communication between team members. For example, activities like lunch-and-learns that showcase hidden talents and hobbies may be helpful, allowing team members to bond over shared or new interests. From my experience teams that engage in fun activities together have a stronger sense of trust and transparency.

Restrictive practice should always be a last resort. My visit to a ward reinforced that focusing on building understanding between staff and service users is really important in making sure it truly remains only a last resort – I hope that more effective communication, engagement and co-production of solutions between everyone involved in inpatient mental health services will continue to reduce its use.

2022 at the Health Innovation Network

Cohort 4 of the Care Home Pioneers programme


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It’s been a busy year at the Health Innovation Network, from publishing new reports on digital health inequalities and diabetes care for mental health inpatients, to starting new workforce development programmes for cardiovascular disease and opioids, through the launch of our new involvement strategy and supporting over £600,000 to pilot new automation solutions.

Find out more about the projects we’ve worked on in 2022:

Using leadership development to improve the quality of care provided to people living with dementia


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With more people living with dementia, it’s important that care home leaders feel well equipped in supporting those living with it.  Dr Caroline Chill, the Clinical Director for the Healthy Ageing Programme at the Health Innovation Network (HIN), spoke at the 16th UK Dementia Congress in Birmingham on how we can use leadership development to improve care for people living with dementia.

At the HIN, helping develop skills of those working in the health and care systems is one of our top priorities. Our flagship programme aimed at professional development in the care sector is the South London Care Home Pioneers Leadership Programme, facilitated in partnership with My Home Life England. Having recently completed its fourth cohort, the programme has helped over 70 care home managers and senior staff across south London to develop their skills, share learning and become champions for improving dementia care in their local area.

Dr Chill used the presentation to explore the Service Improvement Projects, which Pioneers undertook as part of the programme within their homes, many of which focus on care home residents living with dementia. To celebrate the work that the senior care home staff have been doing, we interviewed, and filmed two Pioneers from care homes in Bromley: Natasha Leslie and Nicola Orme. Nicola focused on helping relatives understand more about dementia while Natasha explained how she had introduced activities to respond to ‘sundowning’ – a period of agitation commonly experienced by people living with dementia in the late afternoon.

Nicola found that families’ understanding of dementia had increased following her Service Improvement Project, scoring on average 3.0 on a pre-workshop questionnaire and 4.75 post-workshop. Natasha also reported residents felt more supported and engaged in activities, with fewer incidents in the care homes such as falls and behaviours of concern. This had a knock-on effect with fewer 999 and 111 calls. Both projects have made a difference in the quality of care for residents, as well as a reduction in complaints and improvement in relationships between residents, staff, and their families. You can watch the full interview below.

“Presenting at the 16th UK Dementia Congress was a great opportunity to showcase the achievements of care home staff and to demonstrate the importance and value of quality improvement work in care home settings.” Dr Caroline Chill, Clinical Director, Healthy Ageing, Health Innovation Network

More information on the programme

The South London Care Home Pioneers Programme is a leadership support and professional development programme delivered to Care Home Managers, Deputies, and Senior Nurses to advance their skills, facilitate personal growth and help them manage the complex everyday issues that impact on the quality of their service. The programme consists of a combination of four workshops, three which cover the managing of self, others, and change, and one service improvement workshop. Additionally, participants on the programme undergo nine monthly action learning sets, which involve experiential learning through a continuous process of action and reflection, supported by colleagues. The Pioneers on the programme also benefit from working alongside mentors from the HIN, who provide support to deliver a service improvement project within their care homes.

If you would like to learn more about dementia, and understand how it affects the brain and memories, take a look at this video from Dementia UK. Alternatively, if you are interested in learning more about the Care Home Pioneer Programme and how it can support leaders to deal with the complexities of dementia, please get in touch.

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If you would like to find out more on the Care Home Pioneers programme and our work supporting people living with dementia, please get in touch.

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Bromley residents to benefit from wound care breakthrough

Hundreds of thousands of people in the UK experience painful slow-healing lower leg wounds such as ulcers each year.

A new collaborative project led by the Health Innovation Network (HIN) and Bromley Healthcare Community Interest Company (CIC) hopes to test evidence-based approaches to transforming care for these types of wounds, with the aim of improving the quality of life for patients and reducing costs to the NHS.

The AHSN Network Transforming Wound Care national spread and adoption programme aims to ensure all patients with lower limb wounds receive evidence-based care. This leads to:​

  • faster healing of wounds
  • improved quality of life for patients​
  • reduced likelihood of wound recurrence ​
  • uses health and care resources more effectively​

The programme uses the evidence, learning and recommendations from the National Wound Care Strategy Programme (NWCSP).

The Health Innovation Network, the Academic Health Science Network (AHSN) for south London, is taking part in Phase 1 of the programme and is supporting Bromley Healthcare CIC to establish a dedicated Lower Limb Wound Clinic Test and Evaluation Site.

The challenge

Most wounds to lower limbs heal within a few weeks. Chronic lower limb wounds are those below the knee that are slow or fail to heal. Chronic lower limb wounds account for at least 42% of all wounds in the UK, with leg ulcers being the most common type (34% of the total wound population, compared to 7% pressure ulcers and 8% diabetic foot ulcers).

A large proportion of the total wound care spend is for these chronic lower limb wounds because of their slower healing rates. In 2019, there were an estimated 739,000 leg ulcers in England with estimated associated healthcare costs of £3.1 billion per annum year.

Based on evidence from the National Wound Care Strategy Programme, the prevalence of total leg ulcers is expected to increase by around 4% annually, to over 1 million by 2036 if there is no intervention. This is driven by an increase in leg ulcers that either recur after healing or those that do not heal.

“Bromley Healthcare is delighted to be selected as a pilot Test and Evaluation Site for the new national Transforming Wound Care programme. The national wound care strategy will significantly reduce healing times for people, provide a better quality of life and maximise our nursing time. We feel honoured to be part of such an important programme working to improve wound care for people closer to home.

As a community service provider for people in South East London, we work closely with GPs and acute colleagues to ensure wound care is joined up. Through becoming a Test and Evaluation Site, we look forward to strengthening our joint work to support the early identification of wounds and continue to build our shared knowledge to improve care for people with wounds” – Jacqui Scott, Chief Executive Officer, Bromley Healthcare

How will we do it?

The three key elements of the programme are:

  • People: the delivery of training to all staff supporting patients with wounds
  • Processes: implementing a new evidence-based model based on the recommendations of the NWCSP
  • Technology & design: supporting data collection and provision of care through a new digital wound management system

Find out more about the national programme.

National Wound Care Strategy Programme logo

Get involved

If you would like to be involved in the programme, please get in touch.

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Award-winning Accelerator pays testament to six years of AHSN support for innovators

As DigitalHealth.London’s Accelerator programme is recognised for its role in supporting innovators, we reflect on the vital importance of AHSNs and their partners in helping the patients and the wider health and social care system benefit from commercial innovation.

On 7 July, DigitalHealth.London’s Accelerator programme was selected as winner of Accelerator of the Year award at the UKBAA Angel Investment Awards 2022. We are delighted that this award recognises the impact and importance of collaborative working by Academic Health Science Networks (AHSNs) to help innovators bring their digital health solutions to bear against some of the biggest challenges facing the NHS.

The DigitalHealth.London Accelerator is a highly competitive 12-month programme for digital health companies that have products or services with high potential to meet NHS and social care challenges. High potential SMEs undertaking the programme are given bespoke support and advice, expert-led workshops and events to broker meaningful connections between innovators and NHS organisations.

The programme is delivered by Health Innovation Network and UCLPartners, MedCity and Chelsea and Westminster Hospital Charity (CW+), and has benefited from AHSN funding from NHS England, the Office of Life Sciences and Greater London Authority ERDF. The delivery of the Accelerator programme has connected industry, academia and the NHS to exchange ideas and collaborate to support innovation and the adoption of digital health.

“I am extremely proud to see the DigitalHealth.London Accelerator being recognised as pivotal programme, supporting high potential innovators to tackle health challenges within the complex NHS market. Being selected as winner of Accelerator of the Year award is a fantastic achievement that reflects the collaborative efforts of everyone involved across the London AHSNs and our partners.”Anna King, Commercial Director, Health Innovation Network

With the NHS under continued pressure following the Covid-19 pandemic, innovative solutions are already proving crucial for tackling issues such as the elective care backlog and widespread workforce challenges, with new approaches also helping to counteract existing health inequalities.

Beyond its positive impact on patients and NHS services, the Accelerator is also a significant catalyst for economic growth in the capital.

In the six years since its inception, the Accelerator has supported 143 digital health companies and 591 new contracts have been secured by these companies because of Accelerator support. The companies on the Accelerator have created a gross total of 1,498 new jobs during the programme and 45 new products have been launched to the NHS market.

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Get in touch to find out more about DigitalHealth.London and their Accelerator programme.

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Over 100 clinicians to champion CVD Prevention in south London

Over 100 clinicians working in primary care in south London have today (Monday 21 March 2022) been welcomed on to the Health Innovation Network’s (HIN) first ever Cardiovascular Disease (CVD) Prevention Fellowship.

This free HIN programme is designed to help improve outcomes for patients across south London who are at risk of CVD by supporting clinicians working in primary care to develop their skills and knowledge and champion CVD prevention in their practice or wider Primary Care Network.

In total there are 104 Fellows who are either pharmacists, GPs, practice nurses or physician associates. From Richmond to Bexley all 12 south London boroughs are represented and Fellows come from a range of backgrounds and are representative of the communities they serve.

The programme will provide free expert clinical advice and quality improvement support to help Fellows become CVD prevention champions. It will also help them identify and implement specific local CVD prevention initiatives in their practice and local area.

With six million people living with CVD in England with a combined cost of £16 billion every year improving outcomes for at risk patients is an NHS priority. This programme will help to speed up the adoption of innovative initiatives to help prevent CVD across south London.

Applications to the programme have now closed.

Dr Roy Jogiya, Cardiovascular Disease Prevention Clinical Director, Health Innovation Network, said:

“It gives me great pleasure to welcome over 100 clinicians to our first ever Cardiovascular Disease Prevention Fellowship. This is an exciting learning opportunity that will include teaching from a number of national experts in cardiovascular disease. This will empower Fellows to be up to date in their knowledge base and feel more confident in managing cardiovascular disease prevention within their community of pratice.”

Oliver Brady, Programme Director for CVD Prevention, Health Innovation Network, said:

“It is fantastic that so many clinicians from a wide variety of backgrounds applied to be Fellows. And it is great that every borough of south London is represented on the programme. We will support these Fellows to champion cardiovascular disease prevention in their local area and together we have the opportunity to make a real difference to people who are at risk of cardiovascular disease.”

Running from April to October and culminating with a graduation ceremony in November the programme will consist of six monthly lunch time webinars led by experts in a range of areas including lipid management, hypertension and atrial fibrillation. There will also be ongoing Improvement Collaborative sessions and peer to peer networking opportunities.

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For more information about our Cardiovascular team and the CVD Prevention Fellowship Programme, please get in touch.

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What has working through a pandemic taught us about recruitment?

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In our latest blog Rayvathi John, Health Innovation Network People Lead, reflects on how we get the recruitment process right and what is important in the hiring process in an ever competitive employment market.

Getting recruitment right, for every post, it is crucial to ensure not just that our important work is completed to a high level, but also that we engender the right culture at any organisation. A lot has changed in the way we hire and onboard our new starters at the Health Innovation Network (HIN) over the last two years. We have made some significant changes, and I am keen to share some of my experiences.

As People Lead, there are two questions I ask myself when it comes to recruitment.

The first is what is important in the hiring process? Is it simply finding the right candidate who can do the job or appointing the right candidate through a fair process which is without any hiring biases? NHS appointments and recruitment systems are robust and compliant with the Equality Act. This helps mitigate some of the issues of unfair practices at the application stage.

The second question is how can we attract the right candidates? How can we be the employer of choice? Gone are the days where it was the employer’s market. With globalisation and the HIN being located in the capital of the country, it is important to be competitive in the employment market. This is getting harder for the NHS as the demands of the workforce have changed and many more employers are also offering great pension schemes and improved work life balance schemes. So, how can we sell and promote our job roles to attract the right candidate where we have limitations in what we can offer to the candidate? How can we seek the best candidate from across the sectors to make NHS teams reflect with wider experience?

So what does attract candidates?

According to Hays’ data, 62 percent of professionals would be willing to take a pay cut for a job with more purpose. “Money is important, but it’s about having that compelling purpose and visions,” says Cathy Donnelly, Sr Director, Talent at Liberty IT. “We need to help people understand the difference they can make.” We are fortunate at the HIN that our jobs do have purpose and make a difference to NHS staff and patients and innovators in south London and we need to demonstrate our understanding of that. For example some of our latest projects have demonstrated the value that remote consultations, teledermatology, and virtual wards can add.

This is why it is vital during interviews that we promote the projects the HIN undertakes and the impact they have on the lives of patients and society – did you know that one of our Innovation Grant funded projects provided health checks for 441 people across six health clinics at local Black Caribbean and Black African Churches, a Tamil template and two mosques? We need to ‘recruit with reputation’ by emphasising our values of being kind, brave, open, together and different, so candidates are able to feel the culture as well as the work we deliver.

We were able to put this into practice in 2020 and 2021 when we had a number of business-critical appointments in the organisation, including a new CEO and a Chair. The process for the appointment of the CEO and Chair was intense but with a clear expectation that we wanted to appoint based on merit with equality of opportunity for all. Jobs were advertised externally on NHS jobs, NHS Executives, LinkedIn and Twitter for maximum coverage.

We engaged with stakeholders who know how the HIN operates and how the success of the appointment would be measured, including using our key external stakeholders, Board members, diverse panels and our host organisation. As with all recruitments, there was a need to balance conducting an efficient process but making sure the right candidate was appointed so that there was not an adverse impact on the HIN’s performance.

Having been a candidate using NHS Jobs or Trac to apply for a vacancy, I have at times felt extremely frustrated trying to complete the online application form. I am sure all the applicants who applied to the role of the CEO and Chair might have felt the same frustration. While the application process can still do with some improvement, the improvements to the anonymous shortlisting and online working have helped make the process run more smoothly and is a practical step to protect against bias.

We are a great place to work and we invest a lot of time getting our recruitment right. As we continue our journey towards becoming an outstanding organisation, we will be focusing on improving the responsiveness of our services, and looking for innovative ways to further promote equality, diversity and inclusion in our recruitment process.

If you would like to share your innovative ways of recruitment or if you need more information on our processes, please feel free to connect with me at


How getting people involved can help make the NHS even better

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Catherine Dale, HIN Programme Director for Patient Safety and Experience and Sophie Lowry, Implementation and Involvement Manger, provide an update on the HIN’s Involvement Strategy – also a key theme of lively discussions in episode 2 of our Looking After The NHS podcast series now available for listening.

Catherine Dale reflects on episode two of our Looking After the NHS podcast:

“The mechanic doesn’t ask me where they need to put the fanbelt. So why should healthcare experts, who have trained for years, have to listen to someone else?” 

Ayo Chike-Michael and I get to grips with this issue in Episode 2 of our podcast series ‘Looking After the NHS’ which I am delighted to say you can now listen to below.

In this episode we are joined by Cristina Serrão – Lived Experience Ambassador in the Experience of Care Team at NHS England and Improvement. If you want to find out the answer to this question – give it a listen.

We have a great discussion about how involving people in the design and development of services can make the NHS even better. We cover a range of topics including why we should involve patients and what co-production actually looks like in reality. We also grapple with a range of challenges around involvement and consider the benefits, including reducing health inequalities.

I loved recording this episode, Cristina has a real wealth of insights and her passion for involvement is truly infectious! Involvement really is a real priority for me and for the HIN, and I hope this episode brings to life why it is such an important topic for us to address.

Sophie Lowry provides an update on the HIN's Involvement Strategy:

Over the last few months Catherine and I have been working with colleagues and people who live and work in south London to develop the HIN’s Involvement Strategy. We heard:

“No one person, no one part of the system knows the 'right' answer.”
“Patients are people who are more than their condition and diagnosis.”
“You can’t do innovation without involvement.”

Well, here at the HIN we wholeheartedly agree with all of these statements.

This week we brought together some of the people who have contributed to our Involvement Strategy to update them on the progress we have made and also to gather feedback on our emerging approach and delivery plan. This was the first opportunity we had to meet some people in person, and we felt such a buzz being able to socialise in person and use real post-it notes! We were also able to trial a “hybrid” approach, with some people dialling in to join in the discussion. It provided a great opportunity to connect, and our Chief Executive Rishi Das Gupta was able to thank people first hand for their insights, ideas and experiences that are centre stage of our Strategy.

We were delighted to hear that there was broad consensus that we have the basis of a strong strategy, one that will make a real difference to the way which we work and to the impact we have on local health and care systems. We were also pleased to hear that people were encouraged by the fact they could see the outputs from the workshop feeding into the strategy.

You may be asking “why does the HIN need an Involvement Strategy”? Well, we want to build on the HIN’s history of involvement and co-design activity and create a more embedded and consistent approach. We truly believe that the best way to achieve the HIN’s mission to ‘speed up the best of health and care together’, is to work in partnership with people in south London. As we believe that, by sharing their insights and knowledge, people with lived experience of health and social care services can help us to improve and innovate health and social care.

That is why this strategy, and the plan that will deliver it, has been co-developed with people with lived experience, HIN colleagues, other partners and stakeholders (over 65 people in total). We have had some incredibly open and honest discussions looking at both the psychological and practical barriers to involvement and how they can be overcome. And we believe that this transparency has been vital in developing a meaningful strategy that will make a genuine difference.

Catherine and I are so grateful for everyone’s ongoing support in helping to get this right. We will now work to finalise the Strategy and look forward to publishing it shortly and working with our colleagues, both at the HIN and wider, to put it into practice!

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More information about the HIN's Involvement Strategy

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Applications open for first ever Cardiovascular Disease Prevention Fellowship Programme

The Health Innovation Network has launched a new Cardiovascular Disease (CVD) Prevention Fellowship Programme to develop clinical skills and knowledge to help improve outcomes for patients across south London who are at risk of CVD.

Did you know?

  • Six million people live with CVD in England
  • CVD results in £16 billion in combined costs every year
  • It causes one death every four minutes
*NICE Impact – Cardiovascular  disease prevention (September 2021)

This free programme is the first of its kind and is aimed at nurses, GPs and pharmacists working in primary care in south London who are keen to develop their skills and knowledge and champion CVD prevention in their practice or wider Primary Care Network.

It is Continuing Professional Development (CPD) accredited and will provide free expert clinical advice and quality improvement support to help fellows become CVD prevention champions. It will also help them identify and implement specific local CVD prevention initiatives in their practice and local area.

Running from April to October 2022 and culminating with a graduation ceremony in November the programme will consist of six monthly lunch time webinars led by experts in a range of areas including lipid management, hypertension and atrial fibrillation. There will also be ongoing Community of Practice sessions and peer to peer networking opportunities.

With six million people living with CVD in England with a combined cost of £16 billion every year improving outcomes for at risk patients is an NHS priority. This programme will help to speed up the adoption of innovative initiatives to help prevent CVD across south London.

Applications for the programme have now closed.

“We are delighted to launch our first ever CVD Prevention Fellowship Programme. Our free programme will be delivered by experts in their field and will arm clinicians with the knowledge, skills and confidence they need to drive forward innovative schemes and make a real difference to patients at risk of CVD in their area.”Oliver Brady, CVD Prevention Programme Director, Health Innovation Network

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Applications open for HIN and My Home Life’s Care Home Pioneer Programme 2022

The Health Innovation Network and My Home Life are delighted to announce the fourth Care Home Pioneer Programme – a  leadership support and professional development programme delivered FREE of charge to Care Home Managers, Deputies, and Senior Nurses to advance their skills, facilitate personal growth and enable them to effectively manage the complex everyday issues that impact on the quality of their service.

Did you know?

  • Since the programme started in 2017, 23 managers have attended from South East London and 21 from South West London
  • The Pioneer programme has had representatives from all of the South London boroughs

The ‘Pioneers’ programme is a collaboration between My Home Life England and Health Innovation Network, which has delivered leadership development to 44 care home managers across South London, over 3 cohorts since 2017.

The Care Home Pioneer Programme will use Action Learning techniques which involve experiential learning through a continuous process of action, learning and reflection, supported by colleagues, with an intention of improving practice. The Pioneers will also work alongside mentors from the HIN to deliver a service improvement project within their care homes, such as reducing falls or improving oral health.

The FREE programme is jointly funded by care home commissioners and the NHS, and will consist of a combination of four workshops and nine monthly action learning sets. At the end of the programme, there will be a graduation day to celebrate all that has been achieved and to welcome you into the Pioneer Alumni. 

This infographic highlights key feedback from Pioneers who took part in the programme from 2020-2021.

Pioneer, Cohort 3, Care Home Pioneers, said: It’s not a training programme. We are learning from one another. The impact of it has given me a huge amount of confidence to deal with things differently.”

Pioneer, Cohort 3, Care Home Pioneers, said: “I have introduced daily team meeting with the nurses which has helped to boost self-esteem as they are able to discuss any difficulties they may have in their work”

George Croft, Healthy Ageing Project Support Officer, Health Innovation Network, said: “The feedback from the Pioneers shows that the programme has played an important role in supporting care home managers during the toughest times that the sector has faced in its history, arming leaders with an array of skills and confidence to engage with wider clinical services to help keep residents safe.”

Further information

Find out more about the programme and how to apply.


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Get in touch for more information about Cohort 4 of the Care Home Pioneers programme.

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Reflections on Cohort 3’s Care Home Pioneers Graduation event

Cohort 3 of the Care Home Pioneer programme took place amidst the backdrop of the coronavirus pandemic, meaning that all the programme’s sessions were held via Zoom. As a result, the graduation event presented an opportunity for the Pioneer care home leaders to meet in person for the first time. George Croft, the Healthy Ageing Team’s Project Support Officer, reflects on the day.

Key information

  • The Pioneer programme has graduates represented across all the south London boroughs.

  • 14 Care Home Managers started Cohort 3 of the Pioneer programme, 9 of whom went on to take part in the Quality Improvement workshops.

  • 100% of Pioneers who completed the final session feedback survey reported the skills that they learned as part of the whole programme were useful and effective in their everyday role.

On Tuesday 2 November, the Health Innovation Network (HIN) and My Home Life came together at Southwark Cathedral to celebrate the achievements of the third cohort of south London Care Home Pioneers.  The Pioneer Programme is a leadership development programme for care home managers and senior care home nurses based in south London. The HIN has run the Pioneer programme since 2018 in partnership with My Home Life, an organisation working to support quality of life for all people who live, die, work and visit in care homes.

When I joined the HIN in March 2021, I was excited to witness first-hand how the HIN’s work impacted the lives of people working “on the ground” in health and social care. My time so far supporting the Pioneer programme has proven to me the value that projects like ours can bring to the care sector and those who work within it.

At the graduation event, seven Care Home Pioneers joined us to not only celebrate their achievement of taking part in the programme but also to acknowledge the strength and compassion that they demonstrated whilst caring for their residents during the coronavirus pandemic. The Pioneers reflected that the Action Learning sessions fostered a “wellness space” as well as a way of “checking out of work and checking in with colleagues” for a few hours every couple of weeks. One care home manager explained passionately that the sessions were “where I would go to recharge my batteries, they gave me courage during difficult conversations” – a remark that has stuck with me in the weeks after the event.

Care home staff have long felt undervalued in comparison to their NHS colleagues [recently highlighted in BBC One’s Inside the Care Crisis with Ed Balls] and the Pioneer programme is one way that we can help arm leaders with a “portfolio of tools” as one Pioneer put it. Another care home manager mentioned that the programme helped her “learn how to delegate better, helped my home develop shared decision making, and hand more responsibility to staff, which reduced my stress and helped me gain a better work/life balance.”

The Action Learning component of the programme was led by My Home Life facilitator Danuta Lipinska, who commented – “I certainly felt quite emotional, not only to meet these hardy Pioneers, but to be reminded of what they had all endured and survived, and were now thriving, even though the Covid-19 virus is still with us… We celebrated the achievements of these dedicated and selfless women and men and applauded loudly as we awarded well deserved certificates to the Pioneers. We wish them continued success and stamina in the months that follow, safe in the knowledge that they are not alone and have forged strong relationships with one another and are Associates of the My Home Life and HIN community – a compassionate, skilled and formidable presence in south London.”

When the Pioneers signed up for the programme, none of them expected to be taking part in virtual workshops, with all the demands that being a care home manager brings erupting in the background. Whilst helping deliver the HIN’s quality improvement element of the programme over Zoom, it was clear to me that there were a lot of exhausted faces in the room, even after the peak of the pandemic. Cohort 3’s graduates told us that whilst the programme would have been better delivered face-to-face (which the HIN would traditionally do), a hybrid of some virtual sessions would also be helpful on occasion for future cohorts.

“The feedback from the Pioneers shows that the programme has played an important role in supporting care home managers during the toughest times that the sector has faced in its history, arming leaders with an array of skills and confidence to engage with wider clinical services to help keep residents safe.”George Croft, Healthy Ageing Project Support Officer, Health Innovation Network

Whilst covid restrictions have been lifted, significant challenges remain for care homes. The existing workforce issues have been elevated further by staff burnout, as well as the government’s announcement that vaccination against Covid-19 is to become a condition of deployment in care homes. However, the feedback from the Pioneers shows that the programme has played an important role in supporting care home managers during the toughest times that the sector has faced in its history, arming leaders with an array of skills and confidence to engage with wider clinical services to help keep residents safe. Working on Cohort 3 of the Pioneer programme has been a pleasure, and I look forward to future work that we can do to support alumni and future cohorts.

The HIN are in the process of securing funding for Cohort 4 of the Pioneer programme, which will be co-designed alongside alumni of previous Pioneer cohorts, to deliver a programme that best meets the needs of care home leaders in south London.

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New report demonstrates how dermatology teams can re-design their services to streamline the patient pathway and reduce wait times

The Dermatology Improvement Collaborative was a bespoke quality improvement programme designed and delivered by the Health Innovation Network, Kent, Surrey and Sussex AHSN and supported by the Industry Dermatology Initiative (IDI). The programme was fully funded by the IDI and they also supported with the development of activities and outputs. The collaborative worked to support local south London and Surrey dermatology services to streamline the patient pathway and clear their backlog.

Key stats

  • In south west London it was found that 17% of dermatology appointments were being cancelled by the provider, compared to 10% Nationally in 2020
  • Across the three trusts in South East London, dermatology services received an average of 6750 referrals per month in 2019/20
  • It was found in Leeds and York that by using high quality dermatoscopic images, 9.5-33% of cases avoided a face-to-face consultation

Pre-pandemic, the referral to appointment time (RTT) was 16 percent over the 18-week marker in south west London and 31 per cent over in south east London. Covid-19 dramatically worsened the situation as a result of Consultant Dermatologists and other operational staff being redeployed to deal with the pandemic response, therefore further increasing patient waiting times.

However, with funding from NHSX to accelerate the introduction of teledermatology in south east and south west London ICSs, the Dermatology Improvement Collaborative was able to support each ICS to implement new technology which aim to reduce wait times for patients.

The focus for south east London ICS was utilising their clinical resources more effectively, particularly in clinical triage and referral. A technology platform was implemented to manage clinical virtual review. A joint consultant rota was generated where consultants across the three NHS Trusts in south east London could review referrals before they are actioned, in order to streamline clinical triage.

In south west London ICS it was about reducing waiting times for dermatology appointments in secondary care. Educational videos were created to support patient and GP education of the treatment and management of skin conditions. As a result, GPs could make more informed decisions and therefore more appropriate referrals, which reduces wait times.

Ashford and St Peter’s NHS Foundation Trust sought solutions to address increasing service size and demand. For their two-week wait skin cancer referral pathway, they established teledermatology ‘photohubs’ across three north west Surrey locations. Employing healthcare assistants to take high quality images, which were uploaded securely to the Trust image database for review by the dermatology consultants. Next steps are to pilot the AI tool Skin Analytics in their services as part of the NHSX’s Artificial Intelligence in Health and Care Award.

“Like many across the country, Dermatology teams in south east and south west London were put under huge pressure during the pandemic, but by embracing new technology they saw the potential to improve their services. We hope the report into their success can help more dermatology services to transform their services through introduction of technology to help to reduce wait times for patients.”Lesley Soden, Programme Director of Innovation Theme, Health Innovation Network

A number of case studies were produced using the insights gathered and have now been translated into a report to share lessons learnt for all dermatology services wanting to implement teledermatology. These case studies will be being presented at the Conference: Govconnect – NHS Long Term Plan 2021 Meeting on 30th November 2021.

The IDI is a cross-industry collaboration to improve dermatology care and includes and is funded by the following member companies: Amgen, Eli Lilly and Company, LEO Pharma UK, Sanofi and UCB.

Date of preparation: September 2021                                 Document number: GB-NPS-0921-00004

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Looking After The NHS

We absolutely love the NHS. But let’s face it, it’s not perfect. Yet.

Do you know?

  • We developed the OnlyHuman campaign to support healthcare staff prioritise their wellbeing during the pandemic
  • King’s College Hospital have adopted the OnlyHuman approach
  • You can download the OnlyHuman project here.

In our brand new podcast Looking After The NHS Catherine Dale and Ayo ChikeMichael speak to guest experts all about how we can make the NHS even better.

Listen to episode one where we explore how to improve staff wellbeing and discuss our OnlyHuman project with Deputy Chief People Officer at Maidstone and Tunbridge Wells NHS Trust, Ainne Dolan.

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