Guide launched to help primary care reduce harm from opioids

The West of England AHSN have launched a new easy to follow guide for healthcare professionals working in primary care. The guide will support clinicians to identify patients at risk from opioid prescribing, includes templates and ideas as well as providing information on training and examples of best practice initiatives.

The free guide has been produced as part of our work to deliver the NHS England-commissioned Medicines Safety Improvement Programme (known as MedSIP). MedSIP is focused on improving the care of people living with non-cancer chronic pain by reducing the prescribing of high-risk opioids. The guide also provides a framework for activity to support the Quality and Outcomes Framework (QOF) and Investment and Impact Fund incentives. In 2022/2023, there is a drive (as part of QOF) to use non-pharmacological alternatives, identifying review patients taking high dose medicines and to reduce the use of dependence forming medicines.

There is no evidence for the efficacy of high dose opioids (>120mg/day morphine equivalent) on long term pain. The Faculty of Pain Medicine has advised that increasing opioid load above this dose is unlikely to yield further benefits but exposes the patient to increased harm. Despite this, Public Health England’s review (2019) shows that in 2017 to 2018, 540,000 adults in England were prescribed opioid pain medicines for 3 years or more.

The effects of COVID-19 are anticipated to have exacerbated the use of opioids for chronic pain, which is linked to both deprivation and the prevalence of mental health conditions such as anxiety.

Chris Learoyd, Senior Project Manager at the AHSN, said:

“Reducing harm from opioids is vital, and we’ve had really positive feedback on this work so far. It’s important healthcare professionals working in primary care have access to the latest information and resources to lead effective conversations with patients about pain management, and this guide will support this core ambition of the Medicines Safety Improvement Programme”.

Download our harm reduction guide.

Find out more and access other resources to support delivery of MedSIP.

New evaluation shows FeNO testing project is supporting better asthma diagnosis across Gloucestershire

More patients in Gloucestershire are receiving faster and more reliable diagnoses of asthma thanks to an ambitious project designed to ensure adoption and spread of proven innovative products, according to a new evaluation.  Three Primary Care Networks in the Stroud and Berkeley Vale locality of Gloucestershire took part in a project, led by the West of England AHSN and delivered by Gloucestershire Integrated Care Board (ICB), which supported practitioners from 17 practices to deliver FeNO testing following face to face training and e-learning modules. The project resulted in 272 patients receiving a diagnosis of asthma.

FeNO testing is part of the Rapid Uptake Products (RUP) programme to increase uptake of NICE approved products. FeNO devices measure fractional exhaled oxide in the breath of patients, which provides an indication of the level of inflammation in the lungs. This can be used to aid in the diagnosis of asthma. It is a quick and easy test that can be carried out by any healthcare professional that has received training. Benefits of FeNO testing include:

  • improved speed and accuracy of diagnosis for patients suspected of having asthma
  • improved patient care and outcomes, reducing the risk of exacerbations and hospital admissions
  • reduction in inappropriate prescribing and referrals to secondary care

Prior to this project, FeNO testing was only offered at a hospital-based clinic that ran sporadically over a 5-year period and therefore wasn’t widely available across the county.  This clinic was re-established for 7 months at the start of the project to provide a blueprint for primary care based FeNO testing. The project evaluation has found during these seven months, 18 practitioners attended the clinic for training from a Senior Nurse Practitioner and to receive a FeNO device for their practice. This enabled the transfer of respiratory clinics from the hospital setting into primary care, with 431 patients accessing a FeNO test in their GP practice between October 2021 and June 2022 and 272 patients receiving a diagnosis of asthma. The evaluation also noted provision of FeNO testing at a local level has improved access and reduced travel for patients, with over 75% of patients surveyed travelling less than 6 miles and waiting less than 2 weeks for an appointment.

FeNO testing has since been rolled out at practice level across Gloucestershire to ensure equity of access as part of a system wide Respiratory Diagnostics Local Enhanced Service (LES).

The West of England AHSN supported the application for Pathway Transformation Funding to enable the purchase of FeNO devices, in addition to the use of the hospital-based clinic as a route to delivering training to practice staff. Project management support was provided by the AHSN to monitor the project timeline, collect and analyse data and record risks and issues.  Surveys were co-created and regularly reviewed to measure and continuously improve staff and patient experience of the new service.  As part of the AHSN’s regional FeNO Programme, it co-ordinated the delivery of education webinars that were open to healthcare professionals across the West of England – these were attended by 90 delegates.

“Having previously offered FeNO testing following referral and seen the improvements in accurate diagnosis, patient education and confidence in self-management, we are now able to offer the test without the delays associated with referral, close to the patient in their GP practice with competent health care professionals in a way that is sustainable in the longer term. We achieved the aims of our project and have also been able to roll out the model across the whole ICB”.

Carol Stonham, Senior Nurse Practitioner – Respiratory, Gloucestershire ICB

“It has been great to work with the ICB on this project, who have really championed the use of FeNO testing in primary care.  The data from this evaluation demonstrates how patients are benefitting from easier access to FeNO testing, which will continue thanks to system wide support”.

Charlotte Hallett, Senior Project Manager, West of England AHSN

Read more about FeNO testing with our patient stories and free implementation resources.

Working with BSW CCG to improve diabetes care

The West of England AHSN and Bath, North East Somerset, Swindon and Wiltshire CCG (BSW CCG) are reaching the end of a 12-month project to improve care for patients with type 2 diabetes.

Since the project launched in February 2021, a community of practice has been established with 174 members from 58 practices alongside secondary care staff.  22 practices have made positive changes as a result of the project thus far, with a further 44 practices continuing to implement changes. Interim results show the percentage of BSW patients with type 2 diabetes in the high-risk category has reduced from 33.3% to 28.9%.

Hear more in this short video from Wiltshire GP and BSW CCG Diabetes GP Champion, Dr Julia Hempenstall:


The project used an innovative care framework which aims to support those living with type 2 diabetes. Multiple long-term condition frameworks, developed by UCL Partners, are freely available and they help practices manage large numbers of patients with long-term conditions, whilst empowering the primary care workforce and the patients themselves. This ten-minute summary video from UCLPartners outlines the approach and resources available.

BSW CCG chose to adopt this approach, utilising education and training, as part of a multidisciplinary team, with a focus on supporting practices with the greatest treatment gap and in areas of greatest deprivation. A treatment gap is the actual versus the target % of the population whose treatment has been optimised.

The AHSN have provided project management, developed local implementation resources and facilitated workshops and virtual events.

So far:

  • 58 practices have joined the community of practice
  • Seven BSW primary care networks have all their practices either implementing or engaged with the approach
  • 22 practices are implementing the approach with more planning to start in April 2022
  • 33 delegates have attended motivational coaching training

The community of practice aims to connect clinicians across the CCG to improve their confidence in diabetes management and add a sense of belonging following two years of changes to usual work practices due to the pandemic.  With these improved connections, practice resilience, workforce capacity and integrated diabetes care can also flourish.

Brian Leitch, Commissioning Manager at BSW CCG said:

“As commissioner for diabetes, it’s been great watching practices come together on their own terms in the community of practice, to share information and resources and to discuss how to best support their patients”.

An Advanced Nurse Practitioner working on the project said:

“This has streamlined how we work, reduced the burden on the practice through calls as well as helped support patients to become more responsible for their care. We have identified issues and improved staff and patient awareness of diagnosis as well as treatment of diabetes”

Director of Service and System Transformation at the West of England AHSN, Kay Haughton, said:

“The care frameworks have been a fantastic launch pad for us to support primary care colleagues in BSW. They offer a great opportunity to consider redesigning delivery of care, providing those with diabetes, and other long-term conditions, greater autonomy and support in self-management. It has been a privilege to work with our CCG and primary care colleagues to help transform services for people who have diabetes.”

BSW CCG will continue to progress the improvement programme with longer term impact measures reviewed in the next 12 months, including:

  • Reduced number of practice visits
  • Improvement in patient satisfaction
  • Downward trend in numbers of high-risk patients
  • Changes in medication and potential cost savings

The West of England AHSN will continue to support the roll out of long term condition care frameworks through a new blood pressure optimisation programme. The programme aims to prevent heart attacks, strokes, and vascular dementia in patients with hypertension.

Find out more about the West of England’s work to support those with long term conditions by contacting us.

Regional neonatal units celebrate highest delayed cord clamping rates in England

Maternity and neonatal (MatNeo) units across the South West are celebrating achieving the highest delayed cord clamping rates in 2020 in England, as measured by the National Neonatal Audit Programme (NNAP). On average, units across the South West also achieved the third lowest rates of mortality to discharge, the second lowest rates of necrotising enterocolitis, alongside the fourth highest administration levels of magnesium sulphate (MgSO4) across England.

The NNAP assesses whether babies admitted to neonatal units in England, Scotland and Wales receive consistent high-quality care, and identify areas for quality improvement. The NNAP’s most recent audit shows delayed cord clamping was at its highest level in units in the South West. More than a 20% difference was illustrated between South West units (at 60.6%) and the second highest performing region (39%). Evidence shows that avoiding immediate cord clamping reduces death in preterm babies by nearly a third.

These results follow intensive activity across the region to drive adoption and spread of a range of neonatal interventions, including delayed cord clamping and MgSO4, through a unique care bundle known as PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth).

Implementing PERIPrem

Launched in April 2020, PERIPrem is a perinatal bundle designed to improve the outcomes for babies born before 34 weeks. The West of England Academic Health Science Network (AHSN) is delivering PERIPrem in partnership with South West AHSN and South West Neonatal Network. The bundle consists of eleven interventions that demonstrate a significant impact on brain injury and mortality rates amongst babies born prematurely.

The bundle was the first of its kind, and co-created by clinicians, MatNeo teams and parents. Since April 2021 PERIPrem has continued to be delivered across the region as part of the NHS Improvement Maternal and Neonatal Safety Improvement Programme. A number of NHS Trusts across England are now implementing care bundles based on the PERIPrem model.

Achieving results

By providing frequent share and learns, 360 simulation videos, toolkits and quality improvement coaching to facilitate the spread of knowledge and best practice, PERIPrem increased confidence in delayed cord clamping. This incudes when babies are extremely premature, require resuscitation at delivery or are part of a twin delivery. Free cord clamping resources can be accessed on the PERIPrem webpages.

The NNAP explains that necrotising enterocolitis (NEC) “is a devastating illness which can follow preterm birth. Bowel inflammation prevents milk feeding and surgery may be needed. Babies who develop NEC typically stay in hospital for a long time. Rates of mortality in babies with NEC are high, at over 20%. Babies who survive NEC can have developmental as well as long-term feeding and bowel problems”. Units in the South West achieved the second lowest levels of NEC (at 4.7%) in England. Rates of NEC are directly influenced by two PERIPrem bundle elements: probiotics and early breast milk.

Learning from PReCePT

Building on the progress made nationally through the AHSN Network PReCePT programme (which was developed in the West of England region), the administration of MgSO4 remained a core intervention of the PERIPrem care bundle.  The administration of MgSO4 to all eligible women in England during preterm labour (less than 30 weeks) reduces the incidence of cerebral palsy. Magnesium sulphate costs from just £1 per dose. Free MgSO4 resources can be accessed on the PERIPrem website.

The focus across a broad range of interventions known to reduce mortality led to the region achieving the third lowest rate of pre-term mortality to discharge home in England (at 5.6%).

Natasha Swinscoe, Chief Executive of the West of England AHSN and Patient Safety Lead for the AHSN Network said:

“To December 2021 over 1090 babies have benefited from the PERIPrem bundle. It is a testament to the hard work of all South West MatNeo staff, and everyone who contributed to our PERIPrem project, that the South West region has the highest levels of delayed cord clamping alongside multiple other positive results which crucially include the third lowest level of pre-term mortality in England.

Launching PERIPrem during a pandemic, and at a time of extreme pressure on the NHS, wasn’t easy but these results illustrate the dedication and enthusiasm to improve the safety and life chances of the most vulnerable babies and their mothers”.

Sarah Bates, Consultant Paediatrician & Neonatologist at Great Western Hospitals NHS Foundation Trust and PERIPrem Neonatal Operational Clinical Lead said:

“Working as part of the PERIPrem team has been an inspiring experience. The results of the NNAP illustrate the impact the bundle is having – it’s particularly striking to see average delayed cord clamping rates in our units at least 21% higher than in other regions. In all my years looking at similar data I don’t think I’ve ever seen such a wide range.

Knowing that PERIPrem has longevity locally and is now being adopted in other parts of England, illustrates the potential it has to change the lives of pre-term babies – that is something everyone who contributed to the project can be very proud of”.

At the 2021 HSJ Patient Safety Awards, PERIPrem was highly commended in the category of Patient Safety Pilot of the Year. PERIPrem was also shortlisted for Provider Collaboration of the Year at the HSJ Awards in 2021.

Read more in our PERIPrem case study.

The full NNAP report and data can be accessed here.

Why every healthcare professional or commissioner has a role to play on No Smoking Day and beyond.

Mark Juniper is a consultant in respiratory medicine at the Great Western Hospital in Swindon. He also works as a clinical lead at the West of England AHSN. Over the last year, Mark has been working on our adoption and spread safety improvement programme. This is part of a national programme using a collaborative approach between acute hospitals helping to deliver improved care for patients with respiratory problems such as severe asthma and COPD.

In this blog, Mark reflects on how vital it remains, as the adoption and spread programme draws to a close and we mark No Smoking Day on 9 March, that colleagues across healthcare systems encourage patients to stop smoking…

As a doctor who sees people with lung disease, I have spent a lot of time encouraging people to stop smoking. Smoking tobacco is the single most important cause of preventable death and illness and services that support smokers to quit are very cost effective. Every healthcare contact represents an opportunity to help smokers to quit. This starts with very brief advice and continues with the provision of treatments that help patients to stop. Ideally all of these people should be referred to specialist smoking cessation services. Sadly, this doesn’t always happen and in some areas, there is limited service provision.

No Smoking Day gives us a great opportunity to highlight the impact of smoking on health and help our patients to improve their health by quitting. Every hospital admission represents a chance both to identify current smokers and to provide them with advice and support to stop. Hospital admission is a particularly good area to focus on as people are not able to smoke while on the hospital ward. A short period of enforced abstinence gives us a chance to offer treatment that will help patients to quit.

I have been involved in quality improvement work in the NHS for much of the last ten years. For me, variation in how things are done has become a ‘red flag’ that identifies an opportunity for improvement. Sadly, smoking cessation is one of these areas. We don’t always ask people if they smoke and even when we do, we aren’t consistent in offering advice and treatment. Sometimes it can feel as if we are too busy even to take the time to offer brief advice. What this actually does is add to our future workload!

Over the last two years, hospitals across the West of England have been working together to deliver a group of interventions that reduce readmission rates for patients admitted with chronic obstructive pulmonary disease (COPD). This is one of the diseases caused by smoking and also one of the most common reasons for hospital admission. During this time, we have increased the referral rate to smoking cessation services in our hospitals from 41 to 58%. There is clearly lots more to do but every patient who quits will experience less ill health – and that will help to make us all less busy in the future. Surely a win-win like that is a good reason to act!

No Smoking Day is a call to all of us to take action – and that should include personal reflection if we ourselves are smokers. Everyone can play a part in helping smokers to quit. That includes healthcare professionals working in primary and community care, acute hospitals, mental health and maternity services. It also includes those with responsibility for designing and commissioning local services. Don’t forget the influence we can have on friends and family too. To make the most of all opportunities that will help improve health – remember that every contact counts. All of us can make a difference!

FeNO testing improving asthma diagnosis in region

The West of England AHSN has been supporting several projects to implement FeNO testing in primary care over the past six months.  There are now 16 GP practices across the region that have access to FeNO devices, with a further 60 practices planning to go live in the next two months.  The South West Respiratory Clinical Network has provided funding for a further 7 devices across the West of England region which improves access for patients.

FeNO devices measure fractional exhaled oxide in the breath of patients, which provides an indication of the level of inflammation in the lungs.  This can be used to aid in the diagnosis of asthma.  It is a quick and easy test that can be carried out by any healthcare professional that has received training.  Benefits of FeNO testing include:

  • improved speed and accuracy of diagnosis for patients suspected of having asthma
  • improved patient care and outcomes, reducing the risk of exacerbations and hospital admissions
  • reduction in inappropriate prescribing and referrals to secondary care

Following successful bids for Pathway Transformation Funding, Bath and North East Somerset, Swindon and Wiltshire CCG (BSW CCG) and Gloucestershire CCG were awarded funding to implement FeNO testing and are currently piloting the approach using a number of different models.

In BSW, FeNO testing is being made available to all GP practices in the region and is being supported by locality clinical leads in each area.  Many of these practices are currently using a mobile model and sharing FeNO devices to ensure equity of access for their patients, with some areas trialling a fixed hub model, with a view to comparing the two approaches in a project evaluation.

Nicci Mawer, Nurse at Combe Down Surgery said:

“We have been using the FeNO machine in my practice for a couple of months now.  I started using it with a degree of scepticism but can honestly say it is a valuable tool for aiding the diagnosis of asthma as well as monitoring existing patients who are uncontrolled and needing potential treatment change or can be informed that their current treatment is working.  It is easy to use and clean and can be done in a 10 minute appointment if you are only performing FeNO.  Patients find holding and breathing into the device quick and easy and it proves to patients that there is inflammation that needs dealing with.”

Gloucestershire received funding to introduce FeNO testing in 19 practices across one locality and are implementing this with a hub and spoke model, with staff attending training at a hospital clinic with a Senior Nurse Practitioner before receiving a device to use in their own practice. This has resulted in the CCG funding a wider rollout of FeNO testing across their whole region, with another 41 devices about to be deployed.

Funding and project support available

Whilst providing project management support to the existing FeNO roll out, the West of England AHSN is also able to extend this offer to individual Primary Care Networks looking to implement FeNO testing. The AHSN can co-ordinate training and signposting to educational resources, facilitate clinical pathway design and liaise with analysts around data collection. To promote the benefits of FeNO testing more widely, webinars have been delivered throughout December and January with 63 attendees from across the West of England.

The South West Clinical Network is really pleased to support this initiative as outlined by Adrienne Rogers, Clinical Network Manager:

“We’re delighted to support the extension of FeNO use across the South West Region by the provision of additional FeNO devices to map onto gaps identified from our Primary Care Respiratory Champion programme, plus thousands of mouthpieces to enable greater delivery for the region’s AHSN -supported FeNO projects in primary care.”

FeNO offers an opportunity to support both the early and accurate diagnosis of asthma, as well as monitoring compliance and effectiveness of asthma management. This will all help our regional systems to deliver on their commitment to the NHS Long Term Plan, and support our respiratory populations to access the right care at the right time.”

You can find out more about FeNO testing here.

If you’re interested in implementing FeNO  in your practice and would like to find out more about accessing funding and support please contact Senior Project Manager, Charlotte Hallett.

Find out more about the West of England’s work to identify gaps and priorities and signpost proven treatments and diagnostics through programmes such as Rapid Uptake Products and Med Tech Funding Mandate.




Bringing together mental health teams to improve patient safety and health equity

On 30 November the South of England Mental Health Quality and Patient Safety Improvement Collaborative (known as the MHC) held an all-day learning event for mental health teams across the South of England. The event – held online – was an opportunity for sharing learning and networking, which has been particularly challenging for large geographic collaboratives during the pandemic.

Hosted by the West of England AHSN, the collaborative was created in partnership with the South West AHSN, and now includes Kent, Surrey and Sussex AHSN, Oxford AHSN, and Wessex AHSN alongside 16 mental health trusts across the south of the country. The MHC aims to improve the quality and safety of services for people with mental health conditions.

MHC learning events enable collaboration across the mental health sector in order to foster quality improvement (QI) approaches to patient safety, drive health equity and review progress against the ambitions of the NHS England Mental Health Patient Safety Improvement Programme (MHSIP), which includes reducing restrictive practice.

The event was chaired by Dr Helen Smith, chair of the MHC and National Clinical Lead for MHSIP with around 90 people joining the event from project teams across the South of England.

The event began with a presentation on experiencing, challenging and addressing inequalities from Chris Lubbe, NHS England. Chris was previously an anti-apartheid activist and acted as Nelson Mandela’s bodyguard. He therefore offered a unique insight into inequalities.

Sussex NHS Foundation Trust then presented on delivering a reducing restrictive project as part of the National Collaborating Centre for Mental Health.

This was followed by a World Café where colleagues from four mental health teams shared their experiences of reducing restrictive practice. This offered a vital opportunity to share learning and consider different approaches.

Presentations then followed from Cornwall NHS Foundation Trust on Reducing Restrictive Practice:  Drivers linked to ‘Seni’s Law’; Creating conditions for learning, and finally QI approaches focused on the live, learn and lead methodology.

Following this event, members of the MHC will continue to meet regularly for QI coaching sessions and all-day learning events.

Feedback from attendees:

“Thank you for such a thought provoking presentation. The take home message for me is to dig deep and speak up and say something”.

“Really good ideas – we will be shamelessly stealing the calm cards in particular! Thank you”.

“What went well? Chris’ presentation to start off the day – an inspirational speaker. Amazing and really highlighted the inequalities within everyday life, including our own services. Also the interactive break out activities”.

If you would like to find out more about the MHC please email

QI in pharmacy? It’s a brave new world.

In this joint blog from Senior Project Manager, Chris Learoyd and Ola Howell, Clinical Pharmacy Lead at the West of England AHSN, we explore the value of Quality Improvement (QI) for pharmacy teams, why it hasn’t really been embedded so far and how pharmacy can get involved, including at our first-ever Pharmacy Showcase on 12 January.

First we hear from Chris…

As the Senior Project Manager for the Medicines Optimisation team at the West of England AHSN, but a former Physiotherapist, I won’t say it was always easy, but I have finally got my head around the wider challenges and issues with safe prescribing of medications.

The numbers are eye watering – circa 237 million medication errors occurring at some point in the medication cycle per year in the NHS in England and 66 million of these considered potentially clinically significant errors. Reducing medication errors can clearly have a significant and immediate effect on patient safety.

We know that as experts in medication management and optimisation, pharmacists and pharmacy technicians are ideally positioned in the healthcare system to improve current processes and reduce avoidable medication-related harm – and that QI approaches are vital to creating lasting change.

As every pharmacy team will know they are being positioned more centrally within healthcare services and have more clinical autonomy. Services such as the Discharge Medicines Service and Community Pharmacy Consultation Service provide a step change to embed pharmacy professionals as an important first point of call for healthcare information rather than traditional settings such as General Practice / Emergency Departments.

Introducing QI

Despite all this, pharmacists often lack the basic tools required to lead on or participate in QI initiatives as they’ve historically not been trained or required to perform QI projects. This is slowly changing, and here at the AHSN we’re working to drive adoption of QI approaches across pharmacy.

Here we’re handing over to Ola who gives details of the reasons for this, the impact and our new offer for pharmacy colleagues….

I’m a clinical pharmacist and over the last 12 years I’ve worked in a community pharmacy (very many of them), a General Practice (very briefly) and a hospital (or three, to be precise). Over those years I have met hundreds of pharmacy technicians and pharmacists determined to ensure their patients got the best (aka safest) care they could.

But I’ve never worked on QI before – what is it?

We are diligent, we are keen, and we are truly brilliant! No need to argue that. The thing that we are not good at is quality improvement. It is not that we don’t do it well, we simply don’t do it enough… And why would we? If you are anything like me and your registration number starts with 20*****, you would, most likely, had never been taught what QI is and how to do it well.

It wasn’t until the last couple of years that I started hearing about the QIPs, the PDSAs and the “driver diagrams”. Maybe I was not expected to know then, but I am now. (And there are masses of free resources on the West of England Academy website to help anyone embarking on QI work – but join our Pharmacy Showcase on 12 January to hear more about free, interactive and tailored support for your team).

Embracing QI to support our profession and wellbeing

Like never before, we are forced to do more and faster with less resources and time. We need to learn how to improve what we do in order to survive. And we need to do it now. The numbers are scary, with every fourth pharmacist reporting feeling ‘very stressed’ at work, mainly due to the increased demand for services and the lack of funding. That is 37% of community teams (up from 17% last year), 20% of hospital pharmacists (up from 10% in 2020) and 14% of GP and PCN pharmacists (up from 5% in 2020)[1]. I anticipate that the figures among pharmacy technicians follow a similar trend. Grim. Burnout alarm bells ringing all over the place.

When I asked around, I wasn’t surprised by the number of suggested solutions to various work problems we come across every day.

Not-a-surprise No. 1: We often know what goes wrong.

Not-a-surprise No. 2: We also often know a solution (or improvement) to the status quo. We sometimes even make that improvement ourselves!

For some reason, however, we rarely document the before and after and so are unable to prove our intervention has worked. “I am not wasting time on the data collection when I have so much to do”, I heard recently from a fellow pharmacist. “But your idea is brilliant! And it saves time, so if other people knew about this, the impact could be huge”, I reply. “Nah, too much effort”, I hear back. I bet this sounds familiar…

Don’t we all roll our eyes when an audit arrives and we need to fill out a spreadsheet, often without pausing for a moment to question what it’s for, and how the results will affect us in the future. Here in lies the answer – capturing our learning and experiences through QI.

Get involved

So come and meet us on the 12 January at our Pharmacy Showcase to hear about the projects our AHSN is involved in, meet the team, network with other pharmacy colleagues and learn more about a free, tailored Pharmacy for QI course coming in spring 2022.

[1] The Pharmaceutical Journal, PJ, November 2021, Vol 307, No 7955;307(7955)::DOI:10.1211/PJ.2021.1.114907

Working with the learning disability community to produce our new annual health check videos

The West of England Learning Disabilities Collaborative puts people with a learning disability at the centre of everything we do.

The Misfits Theatre Company, based in Bristol, have previously worked with the AHSN to create videos on topics such as the flu vaccine. In our latest video series, commissioned by NHS South West, we have worked with the Misfits to produce a range of videos that encourage greater uptake of annual health checks for those with a learning disability. The videos cover a range of audiences including health professionals working in primary care, with a second playlist focusing on people with a learning disability and those that care for them.

In this joint blog from members of the Misfits Theatre Company and Rosy Copping, Project Support Officer for the West of England Learning Disabilities Collaborative, we talk about how the video project came to fruition and what it was like to get involved in the filming.

The AHSN perspective from Rosy

Co-creation is the most important factor in our work at the West of England Learning Disabilities Collaborative. It is essential that we gain an insight into the lives of people with a learning disability and their carers, so that we can ensure the needs, concerns and views of the community is reflected through our work.

The video series was created to educate health professionals, carers and people living with learning disabilities on the importance of annual health checks. Annual health checks are so important for people living with learning disabilities as it can help alert them, their carers and their doctors to any underlying medical conditions, and to help manage any current medical conditions that the individual may also be living with, such as epilepsy or diabetes.

We have worked with many experts by experience to produce these videos, namely, the Misfits Theatre Company, Andrew Bright, Head of Development at Thera Trust and Ian Harper, Service Quality Director at Aspire Living. Without their help, the videos may not have spoken to people with learning disabilities in the same way and we might not have been communicating effectively how important it is to get an annual health check. We think it’s vital that when we produce resources, we ensure people from the community who will be using them, get to shape their creation and be directly involved.

We worked with Ian and Andrew on the development of the scripts, and they helped us to ensure that the wording was appropriate for people with learning disabilities to understand, and that the style and tone was friendly and informative. For example, Ian suggested that we change the phrasing of epilepsy to read “seizures”. We then worked with Misfits Theatre Company to film the videos. The Misfits added their own flair to the videos, and we hope they will inspire many others living with learning disabilities to get their annual health checks.

We very much enjoyed working with the Misfits, Andrew and Ian for this piece of work, and we hope that their depictions of why annual health checks are so important, resonate with viewers as much as they did with us.  We certainly could not have achieved this work without their help, so we’d like to say a big thank you!

The Misfits Theatre Company Perspective from Sara Melton

It was fantastic to be part of this very important project.  It is so vital that people with learning disabilities are aware of the importance of having their annual health check and what’s involved in the process.

We asked the actors working on the project to tell us what it meant to them. Here’s what they said:

Rob “I always enjoy helping create different accessible information about the importance of health care.  The fact that the people are willing to get the information out there is wonderful.  I felt the filming went smoothly.  I always have fun doing filming”. 

Beth “It was nice to be involved in the project and feel like I can make a difference by getting the important messages across.  The day was exciting.  I loved using my skills and abilities to educate and inform others”.

Bill “It was brilliant to be involved and I loved being on location filming.  It is so important for people like me to get an annual health check.  The filming went smoothly, and I really enjoyed myself.  The people we worked with were really friendly, which always helps”. 

Penny “The annual health check film went really well.  It helps people with learning disabilities to get their health check.  I really enjoyed being involved in the project.  The film is informative for people like me.  It is rewarding to know I have made a difference for other people with learning disabilities.  I always have fun being involved in films!”

As you can tell from our actors’ comments they really enjoyed being involved in the project.  It is of utmost importance for them to be able to educate others who also have learning disabilities, as well as health care professionals.  Their first-hand experience really enables them to connect and relate with their audience.  The filming also gives them a platform to educate professionals who will be working with people with learning disabilities like them.

We look forward to the next film project!

To find out more about the West of England Learning Disabilities Collaborative, including signing-up to receive newsletters, please visit the collaborative’s webpage.

AHSN Network’s COVID Oximetry @home programme wins at the HSJ Awards 2021

England’s 15 AHSNs and the AHSN Network celebrated a win at the prestigious HSJ Awards ceremony in London on 18 November.

The team were successful in the patient safety category for the significant support Patient Safety Collaboratives and AHSNs provided to implement COVID Oximetry @home and virtual wards. The programme was delivered in partnership with NHS England and NHS Improvement, NHS Digital and NHSX, and helped thousands of people most at risk from COVID-19 to be safely supported at home, through remote self-monitoring of their oxygen saturation levels.

By May 2021 over 2000 patients in the West of England had been enrolled on either COVID Oximetry @home or COVID virtual wards. Read about our rapid and collaborative implementation of pulse oximetry services across the region, as well as our local case study.

The judges said:

“The judges felt that this was an outstanding example of a true system wide collaboration. This project not only touched the UK but positively impacted people’s lives across the world. The outcomes were positively overwhelming in relation to lives saved, bed day reduction and early admissions which improved mortality and morbidity rates. It was clear that this approach contributed heavily to the prevention of the NHS becoming overwhelmed during the pandemic. The patient testimonial demonstrated the real impact to individuals and added value to the presentation coupled with the passion and authenticity of the presenters.”

Natasha Swinscoe, Chief Executive Officer at West of England AHSN and national patient safety lead for the AHSN Network said:

“We are delighted to receive this award on behalf of all our partners, frontline staff and patients.

The AHSN Network was proud to lead the rapid implementation of the COVID Oximetry @home and COVID virtual ward programmes during the coronavirus pandemic. Success would not have been possible without our partners NHSX, NHS Digital and sponsors NHS England and NHS Improvement, who fully supported this innovative and novel pathway of care.

This award recognises collaborative working across health and care systems and we share this with NHS England and NHS Improvement, particularly the NHS@home team, regional and local CCG teams, NHSX, NHS Digital, our Patient Safety Collaboratives and clinical leads.

Learning from this innovative pathway has led to the development of other pathways such as a blood pressure at home initiative, part of our cardiovascular disease management portfolio of programmes in the AHSN Network.”

Cheryl Crocker, AHSN Network Patient Safety Director, said:

“We entered this award to showcase the extraordinary achievement of multiple partners, supported by regional Patient Safety Collaboratives, who came together to respond to the pandemic and keep patients safe. This national programme is estimated to have benefitted in excess of 40,000 people.”

The West of England and South West AHSNs were also shortlisted for Provider Collaboration of the Year award for PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth).

PERIPrem is a perinatal care bundle to improve the outcomes for premature babies across the West and South West regions. The bundle consists of a number of interventions that will demonstrate a significant impact on brain injury and mortality rates amongst babies born prematurely.