It is a historic time for mental health. As we celebrate our NHS 70th birthday, we are looking at how far we have come over 70 years and the exciting future of mental health service delivery.
There has been monumental progress in our area of care and with Greater Manchester devolution, we have a fantastic opportunity to prioritise mental health services and provide equal status for both physical and mental health. With a reduction in stigma both self and societal, increased accessibility of treatment and the use of new innovation techniques and tools, we are delivering truly innovative mental health care and will continue to do so.
We are celebrating this amazing milestone throughout the week and on our social media channels. Follow us on Twitter and like us on Facebook to see all the action from our 5,500 staff members across 130 locations.
Reflecting on 70 years of the NHS and the people who made it all possible
A message from Andrew Maloney, Director of HR and Corporate Affairs, on the NHS70 anniversary.
Today marks the 70th birthday of the National Health Service. From the organisation’s early beginnings in 1948, we should all be proud of the advancements made in providing the public with access to all aspects of healthcare, and of the people who are working to improve services; staff, volunteers, service users and the public.
More locally, our own Trust has experienced a great deal of change and transformation. The recent creation of Greater Manchester Mental Health (GMMH) in January of 2017 has been one in a series of progressive steps to provide exemplary healthcare services to the people of Greater Manchester.
Over the last year, we have seen GMMH continue to grow, developing new services and receiving national recognition in the process. The launch of services such as Honeysuckle Lodge, Achieve Bolton, Salford and Trafford, and Manchester’s first Section 136 suite at Park House, are all positive steps to supporting our service users in all areas of Greater Manchester.
Our people have worked tirelessly to provide outstanding care, and this has been recognised in our latest overall CQC inspection outcome of ‘Good’, with our substance misuse services achieving an ‘Outstanding’ rating and the Trust being rated as ‘Outstanding’ for being Well Led. We have had countless nominations and awards for various staff members and departments within GMMH, demonstrating the commitment and dedication of our workforce. We have some of those staff representing us all today in the celebrations being held in Westminster Cathedral this afternoon and at York Minster tonight.
Throughout the UK, trusts are similarly celebrating their own achievements, and praising the thousands of people who have kept the NHS running, even in the most challenging of circumstances.
Today is also an opportunity for us all to reflect on the fact that we are part of something bigger than our own role and our own organisation. We are part of the NHS, the nations’ most loved treasured institution. We can all be proud to say that we have played some part in making it what it is today, one of the most effective universal healthcare systems in the world that treats everyone as an equal.
Enjoy the celebrations and happy 70th birthday to the NHS.
Over this week, we will showcase innovative projects from our Dragons Den initiative that empower our staff and benefit our service users.
Spotlight on Dragons Den
The Dragon’s Den is a Quality Innovation fund, unique to Greater Manchester Mental Health NHS Foundation Trust (GMMH). It was established to encourage quality improvement at local service level, and to support the delivery of the Quality Improvement Priorities which are developed and published each year within the within GMMH annual Quality Accounts. For 2018/19, 60 fantastic bids have been funded from across the breadth of our services. The projects range from animal assisted therapy, community radio and accessible gardening, through to music therapy, outdoor sports activities and dementia friendly external spaces. Financial support for the projects ranges from £189, right up to £10,000.
All the below projects have secured funding through our innovative Dragons' Den fund.
Young Voices – Talking Out Loud
'Young Voices' a unique, innovative project (the first of its kind in the UK) works with young carers in Bolton who live with parental mental health, to produce a range of digital and broadcast carer-centred resources.
‘I'm so very aware of the lack of resources for this group of young people locally, I’ve seen this project and I think it’s fantastic.’
Bolton’s Young Carers Partnership Board.
‘If I could say anything to a young carer who might be afraid to ask for help, I’d tell them you should never, ever feel ashamed or scared to speak up.'
Young Voices – Talking Out Loud
The majority of young carers are not known to their local authority and schools through either fear and/or lack of knowledge that they themselves are a young carer. According to Social Care Institute for Excellence, at least 30% of young carers are caring for a parent with mental health difficulties. It is estimated that there are at least 1190 young carers in Bolton but this figure does not include those living with parental mental illness (Source: Bolton Council). Resources are scarce and those available are out of date and fail to address the specific needs of this group.
‘Young Voices' is reducing the impact of parental mental health on young carers and increasing their understanding of mental health and finding better ways of coping by producing age-appropriate digital and broadcast resources.
Bolton FM is a not-for-profit, local community radio station, run by over 100 volunteers. Bolton FM provide the workspace, broadcast studios and training facilities free of charge. The project has strong links with Bolton Council; Bolton Lads and Girls Club; Healthwatch Bolton; Young Carers Partnership Group; CCG and Bolton CVS.
Young carers produce bi-monthly podcasts, quarterly live radio shows, bi-monthly digital diaries, talking heads video and digital diaries to;
- Promote young carers’ resilience
- Raise awareness of young carers with parental mental health
- Enable young carers to talk about their experiences to others
- Influence local service delivery for young carers
- Allow ‘Young Voices’ to be represented locally
- Open up the conversation and engage other young carers in schools
- Increase emotional wellbeing
- Increase confidence
- Increase self-esteem
- Learn lifelong learning skills.
We are proud to support ‘Young Voices’ promoting recovery and improving outcomes through the delivery of positive and safe care.
For more information, visit Bolton CAMHS website
Oak Ward Animal Assisted Therapy
Oak Ward is an all-female inpatient ward housing 20 beds. Opened in 2017, Oak Ward is based in The Rivington Unit, Bolton. The service users on the ward requested access to Animal Assisted Therapy (AAT).
The influence of AAT is well documented. The therapy is used widely in hospital, schools and residential homes and has a multitude of benefits. We already have the therapy as an established practice in other parts of the Trust including on older adult wards and at our Prestwich site.
Many of our service users have reported that they have an interest in pets but due to financial and housing issues were unable to commit to having a pet. AAT has been shown to have a positive impact on mood including depression and anxiety. Other benefits include increasing motivation to engage in activities and increased self–esteem. The therapy takes place on the ward but is open to all our service users.
We are proud to support Oak Ward whose staff work hard to promote recovery and improve outcomes through the delivery of positive and safe care.
10k in 10 Days
The 10k in 10 Days challenge encourages service users alongside staff to ‘get moving’ through increasing the amount of time that they participate in physical activity through initially increasing their daily steps and being able to track this using pedometers/trackers.
People with severe mental health disorders such as schizophrenia are affected disproportionately by higher rates of cardiovascular disease, diabetes and obesity and are at higher risk of premature death due to physical illnesses.(1)
Whilst as a Trust we offer a range of physically based activities, motivation and participation within these can be variable, with service users spending prolonged periods engaged in sedentary activities. Public Health England recommend 150 minutes of moderate activity a week which can improve both physical and mental health. The agency recommend breaking this down into more achievable 10 minute intervals. Specialist psychiatric rehabilitation services aim to improve physical health and life expectancy as part of a wider recovery-orientated approach. However conventional methods such as dietary advice and encouraging physical exercise are not always successful. The project is an innovative approach to promoting a healthy lifestyle within rehabilitation services whilst also contributing to the development of skills to improve occupational functioning of service users.
The project increases activity through healthy competition of teams comprising of representatives from service users and staff and led by one service user whom is responsible for ensuring step readings are taken daily. The target would be to take 10,000 steps a day for 10 days. This raises awareness of physical health conditions and promoting healthy lifestyles through sessions that consider identifying how to make small changes e.g. walking instead of using the bus and also tracking individual and team progress. Working towards personal and shared goals creates a sense of responsibility and ownership alongside increasing motivation, encouraging each other and experiencing success.
The project combines physical health with digital innovations with the use of trackers/pedometers and other smartphone apps to support service users to set targets and achieve goals. The project is recovery focussed though its emphasis on peer support, encouraging activity and participation, skill acquisition and goal setting thus impacting on individual’s confidence, self-esteem and experience of achievement. The project supports service users to establish friendships with peers. Involvement of staff working alongside service users promotes recovery through a shared goal, development of relationships and a positive safe inpatient environments. Using the challenge of counting steps will encourage service users to get involved in other groups/activities on the unit which will support ongoing recovery.
(1) De Hart et al (2011). Physical illness in patients with severe mental disorders. Prevalence, impact of medications and disparities in health care. World Psychiatry. 10, pp52-77.
Anson Road Music Project
The Anson Road Music Project is music/creative arts programme delivering 72 creative sessions of music, writing, film making and performance with service users over a one year period. Engaging service users through the medium of music and creative arts, the project promotes client participation throughout and support individuals to develop their performance skills as well as learn skills in the development and production of music.
Anson Road is a 24-hour community rehabilitation service for adult males with mental health needs. The service aims to provide recovery focused support to enable service users to develop, enhance and sustain life skills and coping strategies which will enable the individual to achieve greater independence and quality of life.
The workshops have been run in a flexible way to structure sessions in accordance to specific client interest and tailored sessions to individual needs and ability level. The workshops have developed individual’s skills and knowledge in a variety of art forms including opportunities to play various instruments, song writing and instrument making workshops, video, film making and producing music videos, audio and developing skills in the recording of music and performances.
The focus of rehabilitation within the service is to build upon existing strengths, develop skills and coping strategies to maximise a person’s functioning. Music is closely linked with the Recovery Approach in mental health services with its focus on utilising the strengths and resources of the service users and developing a sense of meaning and purpose that extends beyond the experience of mental illness. (Grocke et al 2008).
The sessions enable clients to be part of a therapeutic group, develop friendships and engage in activity which is proven to improve mood, health and wellbeing (Chen et al 2016). The aim of the sessions are to engage individuals in a meaningful occupation, for which music is for many of our service users. (Feighan and Roberts, 2017). For people with psychosis the Department of Health has prioritised the need for employment, meaningful occupation, social networks and social inclusion (DOH, 1999). Many people with schizophrenia and our clients alike, are not engaged in occupations that support active lifestyles or social inclusion, because of barriers to inclusion such as lack of confidence, anxiety, stigma or lack of opportunity (Westwood 2003). This highlights the need for services to improve opportunities for service users to participate in mainstream, social, active and productive occupations (Shimitras et al 2003).
Music has also proven to decrease psychotic symptoms of patients with schizophrenia and has caused a positive change in their social interactions and behaviours (Naess & Ruud, 2007.) It is expected that the sessions will improve social interactions, increase confidence as well offer the service users the opportunity to develop new knowledge and skills.
One of the main barriers for our service users engaging in social inclusion activities are as a result of their negative symptoms. Ulrich, Houtmans, and Gold (2007) found that individuals in their study saw a decrease in negative symptoms after music sessions. Similar conclusions were found by Hannibal et al 2007 who found that music, when used with individuals with schizophrenia was found to increase quality of life and to decrease negative symptoms.
Music has also been proven to be especially effective in decreasing tension, anger, anxiety, depression and stress levels (Bulfone et al., 2009). These findings are reinforced by Vadas et al (2008) who observed that music positively affected hormones such as serotonin, dopamine, adrenalin and testosterone each of which influences the development of mental disorders and regulates the emotional wellbeing of individuals.
The project has improved service user engagement, increased social and interaction skills, developed confidence and self-esteem as well as to develop specific music skills.
Communication Sunburst is a functional, observation based, multi-disciplinary assessment tool. The tool captures a clinically relevant overview of a person’s communication skills in a visual format. The John Denmark Unit (JDU) is an 18 bed inpatient service specialising in mental health and deafness. JDU produced a professional assessment pack comprising of a manual booklet with photocopiable forms, a DVD with BSL explanation and software for an electronic version.
It was developed by Kim Williams and Lindsey Gagan Speech and Language therapists at the John Denmark Unit in response to an NHS England’s Mental Health and Deaf Services (MHDS) quality initiative; for a universal approach to the assessment of language fluency. It was considered and well received by NHS England at the CQUIN Thinking day June 2017 and also at the Sharing Good Practice day in Sept 2017.
The Deafness, Cognition and Language Research Centre at UCL in London felt that Sunburst may have international relevance as the scale isn’t limited to any particular language signed or spoken. The Sunburst was piloted by some Deaf services across the country with the overall feedback being positive, e.g. reported times to complete per patient ranging from 5 to 20 minutes depending on familiarity with/or complexity of the patient’s communication.
Overview of the process
The Sunburst is designed to be used by the Multi-Disciplinary Team comprising both Deaf and hearing staff. It involves an MDT discussion (which may include the individual), considering how the person functions within each domain.
The 9 domains are scored by consensus which can then be used to comparatively to look at language variance across different parameters e.g. pre and post treatment etc. Where areas of need are identified, strategies can be put in place to support the person.
The Sunburst is designed to be quick and easy to use without creating an additional assessment process. The information needed should be observable within everyday routines. It gives a visual summary of an individual’s language abilities that can easily be compared and communicated to another service provider. Having this summary means that clinicians can then adapt their own communication accordingly and deliver more effective therapeutic interventions with optimal engagement in recovery and potentially an observable score difference that can be seen across a variety of parameters. The domains of Sunburst may provide relevant supporting evidence to particular questions of capacity and will supports the recording requirements of the Accessible Information Standard.
The Communication Sunburst increases our understanding of patients’ communication strengths and needs. NHS England have decided this will be a CQUIN in 2019 for Deaf Mental Health services across Britain.
Start Art Group
The Start Art group is run by Start In Salford. The group is creating a large piece of artwork that will be displayed on the unit to enhance and improve the main activity corridor to make it a more welcoming space.
Start in Salford provide activities in the community and by linking in with the inpatient unit they can build up strong therapeutic relationships with service users which will increase the chance of them continuing to engage after discharge in the communities activities.
In 2011, the British Medical Association published a paper on 'The psychological and social needs of patients' which found that:
Creating a therapeutic healthcare environment extends beyond the elimination of boredom. Arts and humanities programmes have been shown to have a positive effect on inpatients. The measured improvements include:
- inducing positive physiological and psychological changes in clinical outcomes
- reducing illicit substance consumption
- shortening length of hospital stay
- promoting better staff-patient relationships
- improving mental health care.
At the end of the project, there will be an exhibition to showcase all of the service users artwork. The benefit of this group is that service users from all four wards at Meadowbrook are able to attend. Group work also help to increase social skills and relationships with others in an environment that feels safe. The benefits of providing art sessions are vast; it helps boost motivation, it’s validating for service users to have their work displayed, inspiring for other service users and gives people a sense of achievement. It’s tactile, physical and visual and also brightens up the environment. Getting involved in an art project can be absorbing and can take the focus off a person’s symptoms, thoughts and feelings or can constructively channel these into something rewarding and meaningful.
Dementia Friendly Gardens
The gardens surrounding Woodlands Hospital were in need of refurbishment. The ward gardens are an important therapy space for service users to utilise. This project is to re-design the existing gardens into a safe, stimulating, dementia friendly environment.
Woodlands is an older adult inpatient facility located in Little Hulton, Salford. Our service users are either informal or detained under the Mental Health Act. Our staff offer patients and their carer’s information about mental health, recovery and the choices and resources available to them.
The outside space is as important as the inside space for service users. A welcoming garden encourages service users and their visitors in maintaining the upkeep of them, providing cognitive stimulation. The garden is visible to service users who may be attending for the first time and therefore the presentation of the garden is paramount. The ward gardens are an important therapy space for service users to utilise.
The dementia friendly gardens once complete will;
- Provide cognitive stimulation therapy
- Be good for health - vitamin D
- Provide familiar activities
- Be used for exercise
- Provide relaxation and lessen agitation and distress
- Provide sensory stimulation
- Impress a lovely, safe, caring environment
Motiv-8 Health and Wellbeing Programme
This programme is a true multi-professional and service user collaboration to improve the cardiovascular health of service users and promote self-motivation to maintain good health in long stay units, with a pilot in Adult Forensic Service. The primary goal is to achieve improved exercise endurance after 8 weeks.
15-20 year reduction in life expectancy for mental health patients and obesity is linked to preventable cardiovascular disease and diabetes. The benefits of this programme will result in significant long term cost reductions and more importantly quality of life improvements. Those with serious mental illness cannot simply slot into generic weight reduction programmes and a bespoke service and approach is needed which the Motiv-8 programme offers.
The aim is for service users to complete 150 minutes of moderate activity weekly. An essential component of the Motiv-8 programme is the sense of achievement the service user gets and rewards of a T-shirt, sports voucher and presentation of certificate of engagement complements the promotion strategy.
Two service users per year will co-facilitate the activity sessions with staff and offered an opportunity to study for a Level 2 gym trainers course. The service users will promote the programme, motivate and encourage as peer support which offers them work experience and vocational opportunities.
The psychology and dietician service will run groups during the programme to help support changing the way they think about food, eating and exercise. All patients will have a medication review by a senior pharmacist focusing on medication associated with weight gain and offer advice to clinical teams on options.
Potential relevant associated improvements, which will be measured as part of the programme include: weight loss, body fat reduction, resting heart rate reduction, waist circumference reduction, improved sleep, mood and mental health improvements and engagement in other aspects of care.
Mobile Interactive Floor Projection
The Mobile Interactive Floor Projector is a manoeuvrable and extremely flexible system which allows Older Adults services to create bespoke simulation content for service users. Used at Woodland Hospital, the projection is already making a difference to service user.
Control dynamic interactive displays use gesture and movement. Swipe your foot across the floor to kick a virtual football, walk through a pond to make fish swim, run through leaves to scatter them in all directions or step on the correct answer buzzer in a multiple choice quiz. Visual, audible and super-responsive the opportunities for learning, imagination, interaction and enjoyment are endless.
- Interactive and highly responsive
- Real-time multi-sensory experiences
- Meaningful and engaging activities to promote understanding of cause and effect
- Height-adjustable for variable image size – for projection onto wheelchair trays as well as large floors
- Multi-access for peer inclusivity including via eye-gaze
- Multi-platform control including devices such as Apple iOS and Android
- Compact and installation-free
- Includes 500 applications and 35 templates
- Easily customisable to create person-centred content
- Includes the highest quality and clarity short-throw projection available
- Perfect where ceiling access is limited or unwanted
This project will empower and encourages choice and control. It will enhance the quality of life for people with Dementia and Older people with functional illness.
Suicide Awareness Film Production Drama Group
For the Suicide Awareness Day in 2017 the drama group at the Recovery Academy at Edenfield Centre, facilitated by MaD Theatre Company created a poem which raised awareness of suicide and how people may spot the signs of suicidal thoughts in others. It was called “No Milk Today”. The drama group performed the poem live to staff and service users of the Edenfield Centre to a fantastic reception. Due to the positive feedback, the group are producing a high-quality film of the poem which can be accesses globally on YouTube for this year’s Suicide Awareness day on September 10 2018.
The Service users along with the writers at the MaD Theatre Company are working to create visual images which reflect their experiences of suicidal thoughts and spotting the signs in others which will be made into a film.
This project would involve a premiere of the film on September 10th 2018. This will be accompanied by a live performance of the poem by the service users at the Trust to an audience made up of staff and service users with representatives from national suicide organisations such as S.A.V.E. (Suicide Awareness Voices of Education), MIND, The Samaritans, Papyrus and other suicide prevention organisations.
In the recent past MaD Theatre Company have worked with a number of partners to produce films and plays highlighting numerous issues including domestic violence and young people getting involved in gangs.
This issue is very close to the service users and will be very meaningful for their thoughts, ideas and voices to be heard on a national level and they will also gain experience in the making, editing and story boarding of a film.