Welcome to our regular online bulletin bringing you news about the network and the wider world of stroke and neurorehabilitation
Network stroke conference We were delighted to welcome over 130 people who attended our event in person, with over 50 more joining us via our live stream on YouTube. We heard from a range of speakers covering topics from across the care pathway including keynote addresses from national experts.
Consultant Therapist Dr Louise Johnson from the University of Southampton (pictured left) focused our thoughts on the intensity of neurorehabilitation (NR) and touched on the benefits of technology. Unfortunately, the train strike put pay to Dr David Hargroves (national stroke GiRFT lead) speaking in person but he kindly recorded his talk on hyper acute and pre-hospital care for us to play. We had many other great presentations on topics such as blood pressure monitoring at home, 6 month reviews and virtual reality assisted rehabilitation. Nick Davis, our stroke Patient and Carer Group Chair, spoke movingly about the need for involvement in our work, with Madhura from the Stroke Association sharing early results from a listening project we have funded (more on this later).
Our poster competition was a huge success with prizes awarded to 4 different teams in the inpatient and community categories. The day ended with the presentation of the Tyrrell Award for outstanding contribution to stroke care in Greater Manchester. This year we made two awards (we skipped 2021 due to the pandemic) with Lorraine Azam (pictured left) and Paula Beech (pictured in the middle), both from Salford Royal stroke service receiving the accolade from the "grandmother of stroke" Professor Pippa Tyrrell (pictured right).
Network team news We are delighted to welcome Dr Janice Mackenzie as our new Clinical Lead for Psychology. She will start in early July supporting the development our emotional wellbeing pathway which includes psychological rehabilitation. Janice is a Consultant Clinical Neuropsychologist and the Lead for Clinical Neuropsychology in Manchester for Greater Manchester Mental Health Trust. She currently works in the Intermediate Neuro-rehabilitation Unit at Trafford and is due to start working with the community teams in Central and South Manchester in August.
Also joining the team is Julie Emerson who commenced in early May as our SQuIRe regional lead. This is an NHS England stroke programme initiative being run across all 20 stroke networks to support transformation of community services to the integrated model. As we began this work in 2015 and have largely completed changes to local delivery models, Julie will be focusing on workforce development. She is a Speech and Language Therapist by background and is on secondment from Health Education England and has plenty of workforce development expertise to share with us. She will be working across the North West and we will share more on her work as it develops.
You can meet all the network team here.
Hearing the patient and carer voice We have successfully appointed a Chair to help establish and lead a new NR Patient and Carer Group. Mike Carpenter (pictured left) will commence in July and currently works closely with the Multiple Sclerosis Society having lived with the condition for over a decade. We will be working with Mike to recruit new members and who we hope will start meeting in September. We will advertise shortly via local charities with information also shared on our Twitter account and website.
We are carefully reviewing the recently published Neurological Alliance patient experience survey and will receive a breakdown of responses from Greater Manchester in July. The organisation's CEO Georgina Carr presented a summary at our recent Board and we plan to work with her and the Manchester Centre for Clinical Neurosciences to review how we can use the findings to better improve NR services.
In May 2021, we were awarded funding to support improving health inequalities. We used part of the monies to fund a Stroke Association led project that sought to learn about stroke survivors’ experiences of accessing support for life after stroke and to analyse the impact of health inequalities. The project was led by Madhura (pictured left), ran between November 2021-June 2022, and involved people living in Oldham, Rochdale, Bury, and North Manchester who had a stroke during 2021. Madhura listened to their experiences via small events and video calls and the results of her work will be shared more fully in July. We will feed the information into our work programme and also local stroke service improvement plans.
Pathway updates Vocational rehabilitation
We have restarted work in this important area and hope to tie in with national initiatives through the SQuIRe project. We recently held a training session led by local Occupational Therapists Kath Swithenbank and Sarah Williams to help upskill our teams. We are establishing a peer support group in the coming months and will be scoping out provision across inpatient and community teams as well.
Individual Funding Requests (IFR)
The creation of the Integrated Care System in July has provided an opportunity to streamline the placement of patients with complex NR needs with private providers. We are working with the Manchester Centre for Clinical Neurosciences and local system leads to redesign the current process to take advantage of a regional rather than locality based funding model in future. We hope to use an exemplar developed in Cheshire and Merseyside as the basis for a new model.
The changes will also impact the Exceptional Utilization of Resources scheme which considers specialist support not currently commissioned. Again, we are working with the local system to scope and evaluate current funding requests to see how a single regionally allocated model would work and if some types of support could be contracted once. In both cases, the current status quo will continue until a new process is in place.
Stroke prevention
Our work with the British Muslim Heritage Centre continues and we recently held a cardiovascular disease train the trainer event attended by over 30 local Muslim "influencers". We will now be helping attendees to take back the learning to their local communities to educate and motivate Greater Manchester Muslims to make lifestyle changes that will reduce their risk of a stroke. The Centre also helped distribute a leaflet we designed on safe fasting during Ramadan which proved to be very popular.
Longer term support
The national stroke team have published a draft model for life after stroke (LAS) outlining important elements that should be available including key workers, 6 month reviews and peer support. We feel the model could potentially inform our thinking on longer term support for other neurological conditions. We recently met with stakeholders including patients and the voluntary sector to explore how we could implement the LAS model in our region, and also what may be appropriate for other neurological conditions.
North West thrombectomy quality review On the 23rd June, the network participated, along with its Lancashire and South Cumbria and Cheshire and Merseyside counterparts, in an NHS England quality improvement review. The event was attended by over 50 people and was led by the national stroke team, supported by detailed data packs for the three sub-regional thrombectomy pathways.
The morning was spent hearing from the national team, with the afternoon focused on workshops drilling down into different areas with potential for improvement. We helped facilitate workshops on effective communication and the use of imaging supported by AI software. We will be taking actions forward as a larger region and also in Greater Manchester via the various groups that support this work.
Trafford INRU pilot music therapy
A Neurologic Music Therapy (NMT) pilot service is taking place at the Intermediate Neuro Rehabilitation Unit at Trafford General run over a day per week for 12 weeks. The pilot is being funded by the Trust and run by Chiltern Music Therapy as part of their Northern partnership with MusAbility.
NMT is an evidence-based, neuroscientific model of music therapy and features 20 standardised clinical techniques for speech and language, cognitive and sensorimotor training. The emphasis is on using music to work on non-musical goals and is based on a model of music perception and production and the influence of music on functional changes in the non-musical brain and behaviour functions. NMT is endorsed by a range of international organisations and efforts are underway to get it included in NICE guidelines here. Prior to the pilot, the multidisciplinary team (MDT) completed training with Chiltern Music Therapy which explored how NMT can be combined with existing therapy goals. Dependent on specific patient needs, sessions are 1:1 or group sessions and are run independently or in collaboration with other members of the MDT. Some data gathered shows promising feedback from patients and staff including improvement in mood ratings in all patients after sessions with all attendees agreeing they would participate again. Everyone in the team agreed that NMT is beneficial to the patient’s mood, cognitive skills, speech, physical function and emotional expression and that it opens up new techniques to support rehabilitation, new ways to engage patients and provide assessments using creative approaches. Staff feedback: “Watching the patient’s enjoyment and working towards their goals is a pleasure” and “the session is meaningful for the patient”
Patient feedback: “It was the pure engagement of it. Everyone doing their best. People with disability still able to get enjoyment”. “I had a lovely time. I really enjoyed it. The people were lovely. I loved it”. “Looking forward to next week”
The use of NMT and evidence-based music therapy intervention in neurorehabilitation has a growing foundation of literature outlining positive outcomes for patients and families. Despite NMT only being on the unit for a few weeks it is clear to see the overwhelmingly positive impact it has already made on patient engagement as well as staff and patient well-being.
The team have also been busy raising funds and on 20th May they donned their headwear to support #HatsforHeadway. Headway is a national charity that supports people to live with the long-term effects of brain injury. Once a year at the end of Action for Brain Injury Week, supporters come together to help improve life after brain injury, by wearing wacky hats. The whole team got involved and £40 was raised by the team for the charity!
Training and education We are delighted to welcome Sally Sutton (pictured left) as the new Co-Chair of our Training and Education Subgroup. Sally is an Advanced Clinical Practitioner on the Trafford General stroke unit and succeeds Nurse Consultant Paula Beech who has moved to a new role. We want to thank Paula for her efforts and support as our chair for the past 6 years.
We have a varied programme of events coming up, with hyperlinked events open for bookings:
Advanced Training on Managing Challenging Behaviour in the Community – 20th September 2022
GMNISDN Annual Neurorehabilitation Conference (AJ Bell Stadium) – 12th October
Work has also restarted a more regional approach to stroke introductory level training, with the foundation course also being reviewed. Julie will be feeding into the group with her SQuIRe project which is focused on workforce development.
You can view all our previously recorded webinars on our YouTube channel, with details of how to access restricted content at the bottom in the archive section. Our training website pages are also a useful source of information and include our events, Elearning packages, online resources and course information.
MS Society training and education opportunities Professional Networking Day
The MS Society launching their first ever professional networking day on 8th July at Swansea Bay University campus. With the theme of ‘Learning into Practice’, the day will showcase new services and ways of delivering services, based on understanding unmet need and using insight, patient experience and research to develop new responses.
The day will start with a panel discussion looking at key themes around inequity of access to service for people with Multiple Sclerosis (MS) and ideas on how we might all work together tackle some of these barriers to enable wider access to quality and effective services. Georgina Carr, CEO of the Neurological Alliance, will present findings from their recent Patient Experience Survey with a panel discussion afterwards. The interactive workshop sessions throughout the day will cover topics including:
new ways of providing cognitive assessments in MS services
understanding the communication and information needs of people diagnosed with progressive MS
New online MS awareness e-learning
The charity has developed a new online course aimed at social care staff and care workers, providing support to people with MS. The course is free, with learning outcomes and content developed by people with MS and health and social care professionals, and produced in partnership with Grey Matter Learning. The course explores the different types of MS, signs and symptoms, how MS is diagnosed and the treatments available. It looks at how to support people with MS and we explore more complex cases. An accreditation is available from Grey Matter Learning. Find out more here.
Think Ahead Stroke honoured Think Ahead Stroke, a stroke support charity based in Wigan, have just been awarded The Queen’s Award for Voluntary Service. This is the highest award a local voluntary group can receive in the UK and is equivalent to an MBE.
Think Ahead offer free support, advice, and information to stroke survivors, carers and their families throughout the Borough – and at the heart of their work is a dedicated team of devoted volunteers with vital lived experience as either a stroke survivor or a carer themselves. To refer in to Think Ahead Stroke, or to speak to a member of the dedicated team – please call 01942 824888 or email the team.
New Parkinson's Excellence Network project grants scheme The Excellence Network project grants scheme is for projects that aim to enhance the service of both health and care organisations for people with Parkinson’s Disease living in the UK. This could be through the development, testing or roll out of new clinical pathways or technology. Equally, they welcome applications relating to the development of innovative healthcare frameworks, capacity building models and resources, clinical tools or data dashboards. The funding panel will favour projects that help build the evidence base for best practice care and aim to reduce health inequalities. Grants are available for small projects up to £10,000 and large projects between £10,001 and £50,000. You can contact the Excellence Network Grants team with queries here.
Find out more Websites: www.gmnisdn.org.uk Twitter: @GMNISDN YouTube
Phone: 0161 209 2109