2019 Finalists: Where are they now?

Category: Innovation in Quality Improvement Winner

Project: Flow Coaching Academy
Since being shortlisted the Flow Coaching Academy (FCA) programme has continued to spread. We have recently recruited two new academies; Kings College Hospital NHS Foundation Trust and Barnet, Enfield and Haringey Mental Health NHS Trust. The number of active Big Rooms is continually growing as front-line staff from across the UK come together and design improvements for their pathway. The programme has been a powerful career development tool and FCA coaches from across the UK are moving into more senior roles. To see how staff are owning change through the FCA programme, stay connected through Twitter – @FCA_Coaching
Nick Deayton, Sheffield Teaching Hospitals

Category: Dermatology Winner

Project: Establishing a National Xeroderma Pigmentosum Service
The National XP Service has continued to develop and flourish in the 8 months since the 2019 BMJ Awards. The number of XP patients under the care of the Service has continued to steadily rise.

The expansion of the Service to provide a National Service for the other DNA repair disorders, Cockayne Syndrome and Trichothiodystrophy, has now occurred. This new part of the Service has had a remarkably smooth and successful start. In December we held our first joint Workshop on Xeroderma Pigmentosum and Cockayne Syndrome/Trichothiodystrophy.

2019 was a year where we worked on improving scientific and clinical collaboration internationally in XP, hosting the XP and DNA Repair Disorders World Congress (‘International Symposium’) in Cambridge earlier in the year, and then organising the European XP Society Symposium in Madrid in October.

Finally, this summer we completed the Randomised Clinical Trial of the complex Behaviour Change Intervention to improve ultraviolet protection in XP, developed by our NIHR-funded Research Team. We look forward to continuing to develop and improve Services for this group of patients and their families, in the 2020s.
Dr Bob Sarkany, Guy’s & St Thomas’ NHS Foundation Trust, St John’s Institute

Category: Clinical Leadership Winner

Project title: Fetal Surgery for Spina Bifida
Our fetal surgery service from University College London Hospital and Great Ormond Street Hospital, in collaboration with UZ Leuven won the Clinical Leadership category at the BMJ Awards 2019. Receiving this award was a great honour and a recognition of the dedication of the whole extended team in bringing this new treatment option to the UK.

Since our BMJ Award success our service has gone from strength to strength, with increasing numbers of patients having open fetal surgery for spina bifida at our unit and good outcomes continuing to be reported. We have high satisfaction from patients and other healthcare professionals across the UK and we won the UCLH Celebrating Excellence Chair’s Achievement Award later in 2019.

At the time of the award, our clinical service was charitably funded and was the only service of its kind in the UK. In January 2019 NHS England announced that it would be specialist commissioning two Fetal Surgery centres and began a procurement process to provide this service for UK patients. In the autumn of 2019 UCLH was competitively awarded to be one of two Fetal Surgery centres, the other being UZ Leuven in Belgium. The NHS England specialist commissioned service of open fetal surgery to treat fetuses with congenital open spina bifida launched in December 2019 and covers England, Scotland, Northern Ireland and Wales.

Input from our team members has contributed to the significant media interest in fetal surgery for spina bifida in the last year, with items in the press, radio and television, a storyline in a leading UK soap and on social media. The effect has been to increase the knowledge of the fetal surgery option amongst patients and healthcare professionals. We believe that this has contributed to a wider discussion about spina bifida and disability in general in the UK.
Anna David, University College London Hospital and Great Ormond Street Hospital, in collaboration with UZ Leuven

View this short video and find out how the impact of winning a BMJ Award benefited their team and hospital.

Category: Diabetes Winner

Project: Poole’s Young People’s Diabetes Service
The Poole YPDS team continues to try different methods to engage with young people and have piloted a new Inspirational Postcard project where  young people choose 1 of 10 inspirational postcards and write themselves a ‘note to self’ following clinic. The postcard is then posted to them in 2-3 week’s time in an envelope so nobody at home can read what they’ve written. The audit showed that participants liked to receive something from the team when they were away from the clinic and felt more able to contact us if they needed advice. We have asked if this idea can be spread to other diabetes teams across the UK, and may also be helpful to use with others with long term medical conditions.

Poole YPDS is also working with our Dorset neighbours to see if we can have a Dorset-wide diabetes transition service as there is currently a postcode lottery of service provision for 15-23 year olds. We were instrumental in bringing a Diabetes UK Change Lab project to the Wessex region which focused on diabetes care for young people.  The Change Lab is now complete, but the work generated from this project has allowed Poole, Bournemouth and Dorchester hospitals to work together to find all those lost to follow-up in our county. We worked with our local CCG and have future plans to progress this work and hope to launch the service on the centenary of the first human life saved with insulin on 11th January 2022.

As an established team we are sharing our resources with other teams in the UK and talking at local, regional and national meetings to share our data and ideas.
Jo Dalton, Poole Hospital NHS Foundation Trust

Category: Prevention and Lifestyle Finalist

Project: Ways to Wellness
Ways to Wellness continues to thrive. Total referrals at the end of September 2019 stood 6,781. Wellbeing improvements measured by the Wellbeing Star showed an average improvement of 3.3 points at 6 months. Secondary care cost savings compared to control group show that costs are 14% less for the intervention than the control group. The team is actively exploring sustaining and spreading their rigorous approach to social prescribing by increasing the area of geographical coverage and by expanding referral criteria. Funds have been found to appoint a Business Development Manager and active discussions are taking place with a variety of stakeholders including the CCG.
Chris Drinkwater, Ways to Wellness Ltd

Category: Anaesthesia and Perioperative Highly Commended Finalist

Project: Reducing Cancellations
The project used phone calls 5 days prior to surgery as a final check point that the patient is ready for surgery. That they still want and need the surgery, have no infections and have correct starvation and admission instructions. Plus, they have no further questions. We have been able to avoid on the day cancellations from minor illness, as well as by working with waiting lists reallocating their slots to maintain theatre maximal utilisation.
Rebecca Barker, Sherwood Forest Hospitals Perioperative Team

Category: Prevention and Lifestyle Highly Commended Finalist

Project: Save kids from sugar
Childhood obesity is one of the biggest health problems this country faces. Regularly eating and drinking sugary items has a fundamental role in increasing levels of obesity and tooth decay. Which is why Liverpool City Council is taking the bold step to name and shame the top children’s branded drinks, breakfast cereals and yogurts and clearly show the shocking amounts of sugar in each.

Since being highly commended at the 2019 BMJ awards Liverpool City Council’s Save Kids from Sugar campaign has grown a life of its own. Given severe budget cuts in local authority little money has been available to promote the campaign but this has not stopped the campaign growing. Its use has grown from strength to strength and the number of children, parents and professionals using the campaign has grown. The campaign has been used as part of a whole systems approach to tackling obesity and tooth decay in Liverpool. During 2019:

• The campaign website has received 11,639 new visitors. With 36,718-page views. (via organic and direct searches)
• Two local football clubs, Liverpool Football Club foundation and Everton Football Club in the community have agreed to partner with Public Health to promote the campaign in all Primary schools as part of Public Health’s healthy weight in school’s strategy. Lesson plans are being built giving age appropriate messages across key stages. As part of this education we will also deliver ‘whole family’ based cooking classes during and after school, getting the whole family involved.
• The campaign has featured in the Local Government Association ‘A whole systems approach to tackling childhood tooth decay’ report.
• Featured on Annabel Karmel’s website under advice for looking after children’s teeth. Information endorsed by BDA. https://www.annabelkarmel.com/advice/looking-after-childrens-teeth/
• Local Dentist has started an Instagram blog (@dentalmummy) with over 2,270 follower’s signposting parents to our campaign.

Sue Cumming, Public Health, Liverpool City Council

Category: Care of the Older Person Finalist

Project: Proactive Frailty Management in Surrey Heath
Our frailty MDT continues to run and acts as a virtual CGA with a standardised and comprehensive holistic list of interventions which are recommended based on individual need and are then delivered across services. Since being shortlisted for a BMJ award we have focused on supporting more people with moderate frailty. Our way of working has improved care and experience and led to better health and wellbeing outcomes for residents and their carers including positive impact on their health, wellbeing and independence.

As part of our ongoing and evolving work to support our local population we have introduced a new service to proactively identify people living with frailty who would benefit from an assessment and additional support and would not otherwise be known to our Integrated Care Team. This service is run by our Community Frailty Practitioner who works in partnership with GP practices to identify people appropriate for the service, for example people with moderate eFI scores who are on more than 10 medications, have had a fall in the past 6 months and/or are a carer. 

The Community Frailty Practitioner carries out holistic assessments at the person’s home or their practice and identifies what matters to them before making recommendations to keep them safe and well at home. The Community Frailty Practitioner also delivers proactive frailty related interventions including providing equipment, falls advice, signposting and referring to other services such as social prescribing. Early feedback indicates that people felt supported and made positive steps forward to help them in their everyday life.

We continue to explore outcome measures for our work and have recently used Experience Based Design to better understand how people feel about various aspects of their care and to identify areas for improvement to ensure people have a positive experience.
Dr Emma Whitehouse, Surrey Heath Integrated Care