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NHS England and NHS Improvement have released Advance Care Planning - high level principles- March 2022.
It is a document that is co-branded, having had input from 28 organisations, and its purpose is to set out six high level principles for advance care planning in England.
In 2021, the Care Quality Commission report ‘Protect, Connect, Respect – decisions about living and dying well’ - included recommendations for a consistent national approach to advance care planning.
This should enable people, their families and/or representatives, clinicians, professionals and workers to share the same understanding and expectations of advance care planning.
The Department of Health and Social Care (DHSC) set up a Ministerial Oversight Group to provide assurances that progress was being made towards implementing the recommendations of that report.
This document has been co-produced on behalf of the Ministerial Oversight Group. The Chair of the group Marie Caulfield MP, Parliamentary under–secretary of state for primary care and patient safety, said: ”By unifying the approach to advance care planning conversations…we can ensure that people are supported as partners in their personalised care across the health and social care system”.
The six Universal Principles for Advance Care Planning are:
- The person is central to developing and agreeing their advance care plan including deciding who else should be involved in the process.
- The person has personalised conversations about their future care focused on what matters to them and their needs.
- The person agrees the outcomes of their advance care planning conversation through a shared decision-making process in partnership with relevant professionals.
- The person has a shareable advance care plan which records what matters to them, and their preferences and decisions about future care and treatment.
- The person has the opportunity, and is encouraged, to review and revise their advance care plan.
- Anyone involved in advance care planning is able to speak up if they feel that these universal principles are not being followed.
Find out more about the six principles https://www.england.nhs.uk/eolc/resource
The Palliative and End of Life Care Network continues to support the North West Advance Care Planning Mayfly training.
Queens Court Hospice has availability for health and social care professionals to book places for Mayfly Train the Trainer two-day course and one day refresher course.
Times are 9.30am-4.30pm and dates available are:
18 May Update for existing Facilitators
25-26 May New Facilitators 2-day course
7-8 November New Facilitators 2-day course
To book a place please contact lorna.chamberlain@nhs.net
A dad of two is taking on an epic challenge as he prepares to run 100 miles over four days - visiting 10 local hospices on his route to raising awareness and valuable funds for the specialist care they provide.
Martin Foster, 38, from Urmston, works as programme lead for GM Hospices, coordinating relationships between health and care organisations like the SCNs and the hospices, and his job means he is all too aware of the invaluable role hospices play in providing a unique, holistic approach to palliative and end of life care.
That insight and the knowledge that with only around a third of funding (or less in some hospice cases) coming from the NHS, the 10 hospices in Greater Manchester have to raise £20 million a year to continue providing care, spurred him on to come up with his very special challenge.
He said: “Patients are cared for right through their journey and there’s a whole range of services that local people simply wouldn’t have access to if hospices didn’t exist. They rely heavily on their communities fundraising, and having worked so closely with them I just had to put my trainers on and do my bit to support them.”
Martin started his challenge this week at Derian House Children’s Hospice, in Chorley, and has been running 40km each day. He will visit each of the other hospices in the area – Bolton, Bury, Dr Kershaw’s, East Cheshire, Francis House, Springhill, St Ann’s, Wigan and Leigh, and Willow Wood – before ending his epic run at Piccadilly Place, where the SCNs’ offices are based, in Manchester city centre tomorrow (Friday, April 1).
You can donate to Martin's fundraising here.
This month, we say farewell to our clinical advisor for children’s services, Julie Flaherty MBE, who is retiring after working for the NHS for 50 years.
Peter Elton, our clinical director, paid tribute to her work in the region. He said: “Julie has had a remarkable ability to draw clinicians together across GM to work in the interest of all children in the conurbation.
“A mixture of credibility, experience and charm created a team spirit which, for example, meant we were better able to deal with service pressures which became especially important during the Covid-19 pandemic. She is leaving an indelible mark on paediatrics within our region."
Our director Julie Cheetham said: “Julie has been an instrumental clinical leader within the Children and Young People Network over the past 9 years, her vast nursing knowledge and inclusive and collaborative way of working has ensured that the needs for our GM children and young people across both physical and mental health have been at the forefront of improving outcomes and reducing variation.
“Her style of clinical leadership has supported many different areas of improvement, completing and compiling comprehensive reviews for urgent and emergency care, Children’s Community Nursing teams and leading our Covid response to name a few. We will be truly miss her expertise, humility and compassion. Happy Retirement!”
Before she leaves us, we asked Julie a few questions about her life and NHS career.
What was your first job and how did your NHS career develop?
Following leaving school I joined the NHS as a cadet nurse at Booth Hall Children’s Hospital in 1972. I started my Combined Sick Children’s Nursing and General Nursing in 1974.
The course was 3 years 8 months with alternating 3 months at either North Manchester General (formally known as Crumpsall Hospital) and Booth Hall. I lived in the nurses’ home which was great for that community of togetherness.
At Booth Hall there was a social club and chapel on site and also tennis courts. There were lots of activities, albeit professionals were very respective with a medical dining room where meals were served, a ‘sisters’ dining room and then a general dining room. My first pay packet was £27 for the month!! I still have my pay slip.
Care was very different, babies had ‘terry-nappies’, we used glass feeding bottles and spent many hours washing the teats out with salt and water. All the children wore hospital clothes with very small nighties and PJs. They wore dungarees during the day. How times have changed.
There were 32 new starters in my nursing group but after first year exams that went down to 17 and by final exam day there were 12 who took finals with only 8 of us successfully passing.
My first job was where I had my last placement on the children’s burns unit which was an exceptionally busy unit in the day. We routinely had 22 children in beds with varying injuries, many of which were life threatening. We never had any interviews in those days, it was par for the course that you would become ‘sister’ and my turn came in 1980.
I remained on the burns unit until 1988, then transferred to children’s accident and emergency, or casualty as it was in its day.
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During these former years in emergency care, I became involved in all sorts of groups and activities, including quality and early throes at clinical governance, development of Manchester triage and advanced paediatric life support.
In 1994, the two children’s hospitals came together as one, known as Manchester Children’s Hospital, bringing Booth Hall and Royal Pendlebury children’s hospital under the one management authority. I worked my way up the ranks to become clinical manager, head of nursing for the division, ultimately to become executive director of nursing in 1998.
The Children’s Hospitals merged with Manchester Royal infirmary in 2000. The plans for the ‘New Manchester Children’s Hospitals’ were rapidly developing with the final scheme sign off in 2000, with building commencing in 2005 and completion in 2009.
With the newly merged organisation came a slimming down of management and newly defined roles and responsibilities. Having maintained my grounding in children’s clinical practice, I became a consultant nurse (one of the very first group).
I maintained my hand in leadership with invites to join in strategic boards overseeing the way forward for children’s services across GM. One of the most influential pieces of work was ‘Making it Better’ which commenced in 2003 and continued to 2011. The strategic move to reconfigure services for children across GM saw the move from 14 inpatient units to the existing 8 children’s units we have today.
How did you get involved with the SCNs?
I first became involved from 2011 as the SCN matured to purpose by 2013. I have maintained my role as clinical advisor children’s services since that time.
What other work outside the NHS have you been involved with?
Alongside the NHS work, I also undertake humanitarian work, which involves deployment overseas to areas of natural or man-made disasters. I have been deployed to Uganda, working at Mulago children’s assessment unit, Mumbai India with the resettlement of the slums, Sierra Leonne development of the Ebola treatment centre and Samoa South Pacific, working with the measles epidemic. I was awarded a Medal for Bravery from the Ministry of Defence in 2016.
More recently I was deployed to help set up the ‘GM Nightingale Hospital’ using the experiences I have had setting up field hospitals and development of standard operating procedures.
What has been your career highlight?
I cannot say what has been the greatest of highlight of my career, but what I can say is that there have been very few days when I didn’t want to go to work in the last 50 years. And, those that know me, will say I am a happy smiley person (I hope).
How do you plan to spend your retirement?
I’m not sure what I will do when I retire, I have lots of holidays and travel planned for 2022 (as a fall out of travel restrictions over the last 2 years). Next year, 2023, I don’t really have any plans …. not even a holiday booked, but I am open to offers.
What are your hobbies/what do you do to relax?
My hobbies are crafts, mostly knitting, patchwork and sewing. I have been known to make something out of nothing as my friends would say!
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 Over the last eight months primary care referrals into Healthier You – the NHS diabetes prevention programme - have been increasing rapidly despite being during a worldwide pandemic.
In recognition of the efforts that each practice in GM has made in referring people at a time when there are many competing priorities, the Diabetes Network has awarded certificates to the top referring practices and Primary Care Networks, as well as those with the most programme starters and those which participated in the opt-out pilot.
Roll out of the Healthier You opt-out scheme has seen a massive uplift in practices referrals.
There is a special thank you for Heaton’s Group Network Primary Care Network (PCN) in Stockport, which achieved the highest referral and programme starter rate across GM PCNs, and Cherry Medical Centre, in Walkden and Little Hulton, achieved the highest referral and programme starter rate across practices in GM.
Healthier You Engagement Officers can provide tailored support to GP practices to improve referral rates to the programme. To take up this offer please contact Rebecca.Murray@XylaHealth.com.
The essential role of bereavement midwives was one of the topics discussed at the 8th Stillbirth Annual meeting this month.
More than 140 people attended the Teams event and watched emotional videos from parents that have experienced baby loss during the pandemic and their thoughts around the way they were cared for by their bereavement midwife.
Another topic discussed at the meeting was the MBRRACE national clinical guidance for the determination of signs of life before 24 weeks.
Sadly, we know some babies are born too early in pregnancy to survive following birth.
Babies born before 22 weeks are so small that their lungs and other organs are not developed enough for them to live for more than a few minutes or hours after they are born even with the very best neonatal care available. Some of these tiny babies die before or during birth while some babies may show signs of life for a short time after birth.
This also applies to some babies born at 22 or 23 weeks of pregnancy. Survival may be possible in some cases for babies born this early but that is not always the case, and sometimes doctors and parents will decide that the best thing for a baby born so early is to focus on their comfort.
Further topics discussed were the pre-launch of the 3rd iteration of the North West Management of Second trimester pregnancy loss guideline and care pathway and the bereavement training and care package – to promote bereavement care of the highest standard across Greater Manchester and Eastern Cheshire for midwives and obstetricians and all maternity professionals.
There was also a presentation on Covid-19 findings in the placenta following loss and a discussion on interesting and challenging cases of second trimester pregnancy loss.
Summary of the discussion:
- Illustrates importance of ongoing investigation in cases of recurrent pregnancy loss
- Crossover between stillbirth and late miscarriage – needs a pathology-based rather than gestation-based approach
- Importance of retention of slides etc for future diagnosis
- These cases are not easy
- Counselling parents needs to be honest and acknowledge uncertainty
Congratulations to our resident quiz master Colin Daffern who came first in the TV quiz show ‘Lightning’.
Colin, who is a project officer for the Cardiovascular Network, took home £3,000 in prize money in a nail-biting finish after seeing off his fellow contestants on the BBC 2 programme.
Colin, from Boothstown, said: “I had a great experience filming the show – everyone was really friendly, and I was delighted to finally win something after a few near misses in the past!”
Lightning is described as ‘the lightning-fast, quick fire quiz’ where the contestants’ motivation is simple: stay out of the light, and they’ll be alright!’
This is not the first time Colin has appeared on a TV or radio game show.
He’s been on Mastermind three times (a semi-finalist on each occasion), Only Connect, Eggheads and Fifteen To One, as well as a short-lived series called A Question Of Genius in 2009.
On radio, he was a semi-finalist on Brain Of Britain and reached the Champions League stage of Ken Bruce’s Popmaster on Radio 2.
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