Self Care Week is the annual national event that aims to raise awareness of what we can do to improve our physical health and mental wellbeing.  This year’s theme is Live Self Care For Life.

This message is particularly important in these trying times, and organisers, the Self Care Forum believes it is crucial that we do all we can for ourselves, our families and our colleagues to live as healthily as possible to keep up our resolve and to be able to cope with whatever comes our way.

Self Care Week is a time to take stock and make small changes that will help us take care of us.

The NHS website has lots of information. https://www.nhs.uk/

Creating a new role to bridge the gap between Care Workers and Registered Nurses.

Four care workers from East London have been enrolled as Apprentice Nursing Associates (ANA) at the University of East London. Unusually, they are employed by Care Providers who do not employ a Registered Nurse, only accessing the apprenticeship through a unique system partnership.

The Nursing Associate role was introduced in 2016^[1] as a highly trained support role within nursing, bridging between unregulated Healthcare Assistants (HCA) and Registered Nurses. Nursing Associates are regulated by the Nursing and Midwifery Council (NMC) and work under the direction of Registered Nurses to deliver care based on agreed plans. 

Care City is leading on this ground breaking pilot, with grant funding from Skills for Care through the Workforce Development Innovation Fund and East London Health and Care Partnership and supported by North East London NHS Foundation Trust (NELFT), Barking, Havering & Redbridge Community Education Provider Networks (BHR CEPN) and the University of East London (UEL).  The pilot is focussed on a system challenge; as care homes and domiciliary care providers support people who are sicker and more complex, they need greater clinical skills. They would benefit hugely from developing Apprentice Nursing Associates within their teams, but they do not have a Registered Nurse who can fulfil the essential supervision and assessment functions required for the programme. This ‘ANA Catch-22’ is a barrier to innovation, and to the ambitions of many care workers across the country.

Together with UEL, BHR CEPN and NELFT, Care City is working to solve this problem, beginning with the four pioneers who enrol today. They will receive a new model of ‘arms-length’ supervision from a nurse at NELFT, Lauren Thorpe. With Lauren’s support, over time they will build collaborative networks of supervision, learning from the GPs, District Nurses and other clinicians who support their service users.

The long-term aim is to remodel the Residential Home and Domiciliary Care Agency workforce to include the qualified Nursing Associate role, continuing to utilise this ‘arms length’ supervision model, so helping to integrate health and care. At the same time, we aim to create a pathway into nursing for care staff, helping talented East London care workers to enhance both the support they provide to service users and their own careers.

Care Workers from Kallar Lodge Residential Care Home and Ebury Court Care Home, both based in Romford and Lodge Group Care, a domiciliary care provider are the first to participate in this pilot.

Benefits of having a registered Nursing Associate on the team include:

• increasing the capacity to deal with the increasing clinical needs of residents/clients.
• helping to reduce emergency admissions to hospital.
• providing a cost effective clinical team.
• Promoting career progression from care staff towards nursing, as well as supporting staff retention and attracting good quality staff.

Carer, Gisele Bolozi, Lodge Group Care commented “I have been a carer for 20 years. I love my job and the feeling of looking after others. I have learnt so many skills over the years and worked my way up to a senior carer giving me more responsibility and sharing my skill and knowledge with new staff. I am so excited to start the Apprentice Nursing Associate programme as I feel this is the next step for me in my career, and with having a young son I felt that I wouldn't be able to go to university. However the ANA programme has given me the opportunity to progress into a role I have always aspired to do”.

Katie Coffey, Lead Trainer, Lodge Group Care commented “We are very lucky to have a skilled, passionate, workforce who have a passion for learning. We encourage and support our carers to follow their goals and dreams in whatever career path they wish to pursue. Working in the healthcare sector, many of our carers aspire to become trained nurses, but due to family commitments, financial worries, to name just a few, many of them feel that it will always just be a dream. However, the ANA programme has helped them to make a real step towards this dream, providing an opportunity to learn whilst still working. This will not only benefit our carer who is extremely excited to start the course, but our company also, who will now have an Apprentice Nursing Associate in training, on the team”.

^[1] Shape of caring Review (Willis, 2015)

A partnership between Feebris and Care City has been announced as one of 18 digital solutions that have been awarded funding under the Techforce19 challenge to roll out the Feebris app to care homes in East London to support their residents.

The TechForce19 programme is an NHSX Covid-19 response initiative, supported by PUBLIC and the AHSN Network, focussed on creating a pool of technologies that have the potential to rapidly scale regionally and nationally.

Feebris is a London based health AI company, developing deep tech that helps vulnerable patients get early access to care. The company first developed its AI-powered platform to help community workers in India detect childhood pneumonia. The platform has since evolved to help carers and health assistants identify health risks and deterioration within elderly communities. This technology enables vulnerable individuals to still receive quality care whilst staying safe and isolated during the pandemic.

The Feebris app guides a carer through a 10-minute check-up, including capture of vital signs from connected medical-grade sensors (such as digital stethoscope and pulse oximeter). Feebris uses artificial intelligence to help carers triage their patient’s day-to-day needs, and supports GPs remotely assess their patient’s condition

Care City, a healthcare Community Interest Company with a track record of integrating innovation into health and care settings, has already been working with Feebris, to introduce its technology to thirteen care homes in Barking & Dagenham, Havering and Redbridge. However, this funding from Techforce19 will see the technology introduced to another ten across East London.

Adam Bacon, Co-Founder and COO, Feebris commented “With patients and clinicians isolating, the pandemic has brought into focus the need for precision medicine in the community. It is important that we act now to continue meeting the existing and emergent healthcare needs of vulnerable patients in isolation. We are privileged to receive the support of organisations like Care City and now the TechForce19 programme to deliver this mission.”

John Craig, Chief Executive, Care City commented “Our health system and innovators across the world are working at speed to identify, design and develop solutions to help fight coronavirus. We are delighted that Care City and Feebris have been selected from over 1600 innovations to take part in a rapid testing phase to meet this pandemic challenge. Enabling a carer to collect observations and lung sounds and share them with a patient’s GP enhances the virtual ward rounds that are rapidly being set up and allows the GP to focus where they can most help.”

Join the national effort and sign up for the NHS COVID-19 vaccine research registry. Be part of the fightback against the virus by volunteering to be contacted by researchers to take part in COVID-19 vaccine research.

There are a number of vaccines being identified and safety-tested at the moment, but only large scale studies can give researchers the information needed about how effective they are.

The NIHR is working with the NHS and aims to recruit half a million people onto the registry by October, which will allow people to be put in touch with the vaccine studies in the coming months.

Researchers are looking for people from all backgrounds, ages and parts of the UK - including both people with or without existing health conditions - to take part in vaccine studies, to make sure that any vaccines developed will work for everyone.

The service is available to anyone aged 18 or over, living in the UK. There is no obligation to join in any study, if you are contacted. But by taking part, you could help researchers find vaccines to protect us all more quickly - which in turn could help the NHS and save lives. Sign up today!

Care City has been selected by the Health Foundation, an independent charity, to be part of its programme to help research teams bridge the gap between academic research findings and actionable learning for people practising in health and care.

Having previously received funding from the Health Foundation, the team from Care City will now be able to use innovative and creative approaches to translate their findings into practical tools for practitioners in health services and health policy.   

The team will receive up to £50,000 for the development of tools and resources to support the implementation of their findings into practice, and to develop innovative ways to promote their findings to those who influence, plan and deliver health and care services. The project will be funded for between 12 and 14 months. 

Across Barking and Dagenham, Care City has used joined up data to better understand population characteristics and behaviours, and how people use services. Through an Advancing Applied Analytics project, the impact of social isolation on health and care utilisation was explored, using an existing linked dataset. 

For example, the research into people living alone found that they had a higher use of services across all care settings. These findings are important, but they are also easy to misunderstand. Care City want a deeper understanding of the issues - including through qualitative work with the people concerned - before recommendations are made about provision. This programme will enable that deep work and give Care City the time and space to share it with decision-makers. 

The work on living alone is one of numerous studies using the Care City local dataset which could benefit from translational work for local policy audiences. However most recently the data has been used to pro-actively help with the current COVID-19 crisis. 

Councillor Maureen Worby, Barking and Dagenham Council’s Cabinet Member for Social Care and Health Integration, commented: “The Care City joined dataset has really proved its worth 10 times over during the current crisis. Just before lockdown the council used the dataset to identify high priority areas to target using key health and demographic data. This resulted in a hotspot priority map which was used by council teams in partnership with local voluntary organisations to mobilise volunteers to these areas to leaflet, offer assistance and raise awareness. We produced the maps within two hours and our volunteers were on the ground within two days from the initial request”. 

John Craig, Chief Executive, Care City commented “This project will provide resources for policy makers and commissioners that describe the evidence base, deepen understanding of the data, and familiarise them with simple analytical approaches”. 

Shaun Leamon, Research Manager at the Health Foundation, said: “We are very pleased to be funding the four selected projects for this round of the Evidence into Practice programme, which will result in resources being developed that will provide actionable tools for those working in practice or policy to implement change, and will have an impact on the improvement of health or social care services in the UK.” 

We must do more to address this imbalance. We aim to deliver real change, using insights from our linked data & practical work with our health and care system to ensure population health is for everyone.

What are Long Term Conditions?

Long-term conditions or chronic diseases are conditions for which there is currently no cure, and which are managed with drugs and other treatment, for example: diabetes, chronic obstructive pulmonary disease, arthritis and hypertension.

Long-term conditions are more prevalent in older people (58% of people over 60 compared to 14% under 40), in more deprived groups (60% more people in the poorest social class than the richest social class and 30% more severity of disease) and among black people. 

What are we doing about it?

Care City is based in London's poorest borough and exists to improve health and the determinants of health. That means it’s our job - in partnership with many others - to tackle poverty and racism, and the insidious connections between them. Across our work, we seek to open up access to healthcare, and lower barriers of stigma, language, place, cost and culture.

Through our Care City Cohort linked dataset (data from across 5 settings of care - hospital, primary, community, mental health and social care), we can see the part that race and racism plays in il-health. We will keep measuring and sharing this gap, and we hope to see it close.

As an organisation, our mission is not defined by racial injustice, and we don’t seek to pretend otherwise. However, unless we stand together with people and partners across Barking and Dagenham to tackle it, we cannot hope to achieve the mission that does define us; creating a happier, healthier older age for everyone.

For an example of our work to open up access to healthcare for people with long-term conditions, read here about our Test Bed programme.

Using a smartphone app to facilitate better care coordination for patients with long term conditions

In partnership with Healthy.io we are testing several new technological solutions to facilitate better care coordination as well as  prevention and management of chronic disease for residents of East London. Working collaboratively with personal carers, general practice, community nursing teams and nurses, we are testing the use of smartphone cameras as portable testing devices.

People with long-term conditions are significant users of both health and social care services: for every £10 spent on health and social care, around £7 is spent on people with long-term conditions. They also account for around 50% of all GP appointments, 64% of all outpatient appointments and 70% of all inpatient bed days*.

As a healthy ageing innovation centre, our mission is to transform the health and wellbeing of our east London population who generally live shorter lives and live more of these years in ill health compared to the national average. This mission has resulted in a partnership with healthcare technology company Healthy.io, embarking on a joint program to assess different technologies with the potential to aid the ageing and caregiver communities. 

This partnership began one year ago with the stated mission of detecting and preventing long term conditions by educating and supporting both paid and unpaid caregivers with new technology to improve health outcomes across the East London population. The partnership is currently examining three key services that empower patients, medical professionals and caregivers by using the smartphone camera as a portable testing device: urinalysis, Chronic Kidney Disease (CKD) screening, and wound management. 

• Carers in 3 care agencies in East London have been extensively trained to use Healthy.io’s 10 parameter urinalysis dipstick, providing GPs with a rich dataset of results upon which they can decide to intervene in patient care. 
• 4 local GP practices have partnered with Healthy.io to facilitate screening for CKD among high-risk populations using Healthy.io’s home ACR testing kit. According to a YHEC study published in 2018, using the kit among at-risk populations could prevent 11,376 cases of end-stage kidney disease and identify 276,790 cases of undiagnosed kidney disease within 5 years. 
• Working with NELFT District Nurses in Hawkwell Court to explore new ways of assisting tissue viability nurses to monitor and assess wounds.  

Hannah Harniess, Deputy Chief Executive, Care City commented “Technology which can help GP’s, carers and nurses more accurately monitor and manage the health of their patients and provide pro-active and rapid treatment and support can not only reduce cost burdens on the NHS, but improve health outcomes for the patient. We are therefore delighted to be able to support NELFT and Healthy.io to implement and evaluate the use of this digital technology in our East London communities.”

Katherine Ward, Chief Commercial Officer and European GM, Healthy.io, said: “We are delighted to partner with Care City and to provide local healthcare professionals with new tools to improve care for the community in East London.”

*Long-term conditions compendium of information third edition Department of Health