The East Midlands and West Midlands Clinical Senates are able to undertake one off projects that would provide useful information, advice or intelligence to the health and care system in the Midlands through the Clinical Leadership Fellows programme entitled proactive projects. The projects are task and finish, undertaken by a small project group of Fellows with support from interested Senate Council members and appropriate stakeholders.
The proactive work projects represent a very large and potentially useful body of work to a wide range of organisations and colleagues. They are the product of a phenomenal amount of work by the Clinical Leadership Fellows. A large number of colleagues both within the Senates' membership and also from other NHS organisations also give up their time to provide input, guidance and expertise to support the projects each year. The Clinical Senates are keen to ensure that these pieces of work have maximum reach and traction across the health and care sector and gain the recognition they deserve. Thus, it is important for the Senates to understand how best to reach the intended audience through the various mechanisms and networks available. To do this we need input from our members. Please take a moment to fill in our feedback form and support our work. Thank you for your participation.
The concept of “Lifestyle Medicine” is becoming more mainstream in both the realms of physical and mental health; should healthcare systems invest in this and if so, how is best to do it? A lot of literature exists discussing this topic. This project aimed to pull these threads together and conducts an evaluation of the topic to understand how best to progress it and channel resources effectively. The project focuses on children and young people's mental health with a further focus on social connectivity. The project objectives were:
This project presents an independent review of the evidence base for robotic assisted surgery and an analysis of the robotic surgery currently conducted in facilities across the Midlands. Its purpose is to support the robust and planned introduction and expansions of robotic surgery in an appropriate an equitable manner at the surgical procedural level through the evaluation of the evidence base for defined indications.
This project aimed to review the concept of risk in systems (actual and perceived), who owns risks and at what levels, the impact it has on service delivery and how this could be reimagined from a system perspective instead of organisational perspective to improve patient flow and experience.
A podcast has also been produced on the topic by a Midlands System which can be viewed via this link Re-imagining Risk: A new podcast about risk management in a health and care setting. - YouTube
This project reviewed the barriers to achieving a net zero NHS, focusing on sustainability in surgery. The team analysed regional green plans and found varying adherence to NHS sustainability goals. A brief video summarising the findings of this project can be viewed on the Royal College of Physicians website here
This project aimed to investigate the perceptions, enablers and barriers to integrating the NHS England Additional Roles Reimbursement Scheme (ARRS) roles into primary care within the Midlands.
The project aimed to understand the health inequalities within the backlog of particular services and make broad recommendations on how to close the gap. There are two distinct workstreams – Data and Literature Review.
This project has worked with a large GP practice to evaluate the feasibility of embedding a matrix approach to clinical governance.
To understand the barriers to adoption of AI technology in healthcare and how this can be supported to better utilise the available technology. A brief video summarising the findings of this project can be viewed on the Royal College of Physicians website here
The team have undertaken a project utilising internet search history as a repository of information on a new medical condition.
The scope of the project is to establish what a good therapeutic inpatient environment looks like and provide recommendations that can be shared with Midlands Provider Trusts to support them in providing: ‘…a therapeutic environment [which] provides the best opportunity for recovery’ (LTP 3.102).
The East Midlands and West Midlands Clinical Senates worked in collaboration with Health Education England to complete this project which looked to assess variabilities in access to imaging requests for advanced practitioners working in acute trusts across the Midlands. This included a literature review of national guidelines and organisational policies, a regional survey across professional groups and a focus group to test the working groups assessments and conclusions. Two versions of the final report are available below, the full version and a condensed version. However, a comprehensive video which runs through the key elements of the project and subsequent recommendations can be viewed here. This was presented at the 2022 National Advancing Practice Conference.
This project includes a literature review and site visits to understand the management of TRD, including the developing evidence base of innovative approaches including nasal ketamine and rTMS.
To review staff experience of communication around ICSs to date and how they would want to be communicated with in the future.
Public Health England (PHE) East Midlands in partnership with the East Midlands Clinical Senate and the University of Sheffield developed a leading evidence review on ‘multiple site, single service models of care’ (MSSS).
MSSS models of care are often the result of a number of complex factors in NHS clinical service configuration, including the difficult and often conflicting balance between inequalities in access to clinical services for patients whilst at the same time trying to improve quality and outcomes through consolidation.
To support clinical senates, commissioners and providers of services to better assess the evidence base for MSSS models of care PHE and the East Midlands Clinical Senate established a unique proactive workstream to review the clinical evidence for MSSS models of care.
The East Midlands Clinical Senate was commissioned by NHS England in response to the severe winter pressures experienced in 2017/18 to assess the evidence currently available to organisations within our region to assist in their planning for ‘Winter Pressures’, and to assess how well this guidance is being utilised in real time through qualitative focus groups with senior staff responsible for these plans.
Our conclusions and recommendations can be found in the published report.
Further to our annual event in November 2018 on Physical Activity as Treatment, which was co-hosted with Public Health England, this theme was adopted into our proactive programmes of work.
It has culminated in the brief report below that describes how and why physical activity as treatment might be commissioned system wide and across a range of conditions, based on the evidence currently available.
This reportfrom Public Health England East Midlands and the East Midlands Clinical Senate aims to support the delivery of the prevention challenge in the region.
It highlights the projected rises in demand for health and care services, provides a practical framework for prevention in the East Midlands, and identifies areas for intervention with case studies highlighting local good practice.
The East Midlands Clinical Senate facilitated a stakeholder event to identify a shared solution for dermatology services.
This report written in conjunction with the Royal College of Surgeons and with the support of the East Midlands Academic Health Science Network, Commissioning Services for an Ageing Population and Those Living with Frailty, summarises national publications with guidance on delivering services for older people and those living with frailty.
Commissioning services for an ageing population and those living with frailty needs to change. The emerging evidence around frailty, the absolute need to provide holistic person centred care and changing demographics mandate that change. This report is intended to be a useful, practical resource for commissioners; concepts like ‘frailty’ and interventions like ‘comprehensive geriatric assessment’ are incredibly important. This report is an opportunity to explain the language and help aid understanding, and ensure that value adding priorities and standards drive commissioning.
This report by the East Midlands Clinical Senate provides background information, a case for change and recommendations to encourage more people to be more active more of the time. The focus of the report is physical activity and the benefits to be obtained through its use in prevention of ill health, in risk reduction and as an active treatment.
Physical inactivity poses a serious and growing threat to our society - it is a pan-societal issue damaging our health, economy and environment. Levels of physical activity are declining and we need to act.