Somerset Covid Community Champion

The people of Somerset responded positively to the offer of the Covid-19 Vaccination, with 87.5 of residents aged over 12 having had a least one dose (June 2022). Uptake is amongst the highest in the country. However, we felt there was a need for a service to enable people to make informed decisions about the vaccination.

Early in the pandemic, it was identified that some communities, such as ethnic minority groups are particularly vulnerable to Covid-19 and its long-term effects. These communities, along with people from Eastern Europe are likely to be wary of having the vaccination. In Somerset. Although we don’t have a large ethnic minority community, many people from mainland Europe live in Somerset and work in care and agriculture.  We also have a comparatively sizable proportion of the community living alternative lifestyles.

Helen Fielden, Project Coordinator said:

“Based on the success of the Covid Community Champion network, Spark Somerset set up the Vaccination Buddy Scheme to engage with and reassure people with concerns around Covid-19, alongside empowering workers in Somerset to support people to make informed decisions about vaccination’.

The project aimed to support people anxious about accessing a Covid-19 vaccine to make an informed decision about whether to have one, thus increasing vaccination uptake. 

It was funded and supported by Public Health at Somerset County Council.

About the service

Vaccination Buddies were volunteers recruited from a range of backgrounds including health, business and teaching. They all had a shared interest in providing objective, non-judgemental support and information to enable people to make informed decision about their Covid-19 vaccination.

The buddies received initial training via Zoom in the science of the vaccine, safeguarding, boundaries, and providing objective support and advice.  We also ran regular update sessions to enable buddies to keep their knowledge up to date as the pandemic and vaccination roll out developed.

Potential service users contacted the service by phone, or via an online form. Their needs were assessed and providing they had no specific medical questions they were matched with a buddy. Buddies were matched according to availability and relevant skills. For example, we were able to match the concerned mother of an autistic teenager with a buddy who had a background of supporting autistic students in school.

Figure 1: Referral process

In addition, nine Vaccination Myth Buster training sessions took place, attended by more than 80 people. Attendees ranged from youth workers, college tutors, charity and community workers to the general public.

Training was provided by Somerset Council’s Public Health Team and Talking Therapies from Somerset Foundation Trust.

Working with the public and stakeholders

The service was promoted by partners in a range of settings including video such as Clinton’s Covid Catch Up, social media  posts, articles and interviews in the media, posters in Portuguese and Polish were sent to community businesses and promotion through health, voluntary and local government services.

Challenges faced

Despite a lot of promotion, only eighteen calls took place. This may have been because the project was launched several months after the vaccination programme began. People would have had time to do their own research and reach their own conclusions about whether vaccination would be good for them.  And, because there has been high uptake of vaccination in the county, there was a comparatively small proportion of the population that we were trying to reach.

Many of the referrals we received had specific medical questions which needed to be handled by a medic. It would have been helpful to have better links with medical services, so that service users could get clinical reassurance, then talk through other issues they had with buddies.

No one took up the offer of support in Polish or Portuguese, even though these are among the most commonly spoken minority languages in the county.

More promotion and outreach into under-served communities via voluntary and community partners may have enabled community leaders and professionals to become key referrers. Although given the restrictions on face-to-face meetings and events during the height of the pandemic, the traditional ways of reaching communities were not open to us.

Next steps:

The service has now been wound down and learnings incorporated into the development of other community-based health connector programmes

Measuring success:

  • Fifteen buddies were recruited from a range of backgrounds. They spoke a range of languages including Portuguese (first language), Polish (first language), Spanish, German and French.
  • Eighteen calls took place, with very positive feedback from service users:

“It was good to have someone to talk to. I would 100 percent recommend people talk to a Vaccination Buddy if they have questions. I have told my work colleagues about it.” 

“She gave me more insight and reasons to say “Yes” to the vaccine. She was non-judgmental and not pushy.” 

  • Of the 18 calls that took place, 3 were with people whose first language wasn’t English. Their first languages were Hungarian, Spanish and Romanian. These people were all care workers.
  • More than 80 people attended Vaccination Myth Buster Training, skilling them to have supportive conversations about the Covid-19 vaccination.

As the aim of the work was to enable people to make informed choices, rather than encourage them to be vaccinated, we didn’t feel able to ask participants whether they had gone on to be vaccinated. 

Spotlight on Emma Ralph – New lead healthcare scientist for Somerset

Somerset Foundation Trusts audiology manager Emma Ralph has recently been appointed to the lead healthcare scientist role across the Somerset Integrated Care System.

Over 50,000 healthcare scientists work in the NHS and public health services and together they provide the scientific backbone of the NHS and their work underpins 80 per cent of all diagnoses.

Emma has worked at Musgrove Park Hospital for over 21 years, having initially trained as an audiologist, before stepping into an audiology manager position for the last six years.

She has taken up the lead healthcare scientist post on a 12 month secondment and will also continue in her audiology role for two days a week.

Emma said she was very excited to bring her skills and experience to the new role. “I have found that working within health and social care has given me a greater understanding of the issues and challenges that our patients face,” she said.

“I know how important it is that our NHS colleagues are acknowledged and represented so I’m excited to be taking on this role where I can be that professional voice to help the many science-related specialties to be heard and come together.

“One of the first things I’m doing as part of the role is getting out there and speaking to colleagues throughout the services – not just managers and leads – so I can fully understand their aspirations.

“I’m very proud to be able to represent our healthcare sciences and I have many ambitions for the role, including creating more opportunities for local, regional and national collaboration, as well as helping colleagues in service lead roles to work more closely together.

“I’ll also use the platform to support colleagues with the introduction of training, which will include rethinking traditional clinical roles and responsibilities and opportunities for upskilling colleagues to take on advanced roles.

“Most people think healthcare science is just about diagnostics, but it’s so much more than that – in fact healthcare scientists work in more than 50 specialisms.

“The scope of healthcare science is vast and many specialties tend to fall under the remit of diagnostic services such as audiology, neurology and cardiology, however alongside this other support services play critical roles, such as mortuary, sterile services, medical electronics and engineering colleagues. Without their support, many services would simply be unable to operate.

“Nurses, doctors, allied healthcare professionals and other traditional roles are of course a vital part of the NHS, but healthcare scientists are also an essential cog in the machine, and many patients are not even aware of the role they play in our healthcare system.

“Many colleagues who work in these specialisms are behind the scenes and don’t always get the recognition they deserve.

“As part of my role I’ll looking to understand what resources and time they need to work efficiently – this has never been so important than during the recovery from COVID-19 and recent development of diagnostic centres across Somerset.

“Lots of great work and collaboration has already taken place as part of our NHS trust’s Healthcare Science Network, and this is something we want to grow. It would be great to have wider representation and to continue and expand on the work already underway.”

If you would like to hear more about healthcare sciences or would like to get involved, contact Emma on Emma.Ralph@SomersetFT.nhs.uk or 07768328189.

Let’s Kick It Together

‘Let’s Kick It Together’ is a systems-wide campaign co-created through a partnership between Mums2Be Smokefree; a community-based service of Somerset County Council, and the midwifery services at Somerset Foundation Trust and Yeovil District Hospital.

The 12-month campaign was launched on 25th May  2022 with a hook to World No Tobacco Day on 31 May.

How does the service work?

In 2021, the National Target for Smoking at Time of Delivery was set at 4% or below by 2026 (after it failed the original target of 6% or below by 2022). Somerset rates were 10.5% which was 1% above the National Average.

‘Let’s Kick It Together’ was set up to help improve the health of the whole family by enabling smokefree pregnancies and homes. Taking a family well-being approach, this systems-wide campaign aims to raise awareness of the risks, and benefits of not, smoking pre, during, and post-pregnancy.

It enables increased self-referrals and provider client referrals to the community based Mums2Be Smokefree Service of Somerset County Council.

During 2021 Mums2Be Smokefree received 629 referrals from the midwifery services and self-referrals. 133 of these referrals had declined contact from the service and a further 236 women did not engage.

How does the service benefit the public?

The campaign provides information, free support, treatment, and incentives when needed to expectant parents and their significant others to help them kick their smoking habits, before, during or after pregnancy.

To aid information sharing, the service provides an extensive package of promotional and educational materials in digital and print formats via various community and facility-based hubs across Somerset. The co-branded materials (Somerset County Council, Mums2Be and NHS) include press releases, posters, leaflets, case studies, and a regular newsletter.

The campaign has also been designed  to help  support midwives conducting the difficult conversations around smoking in pregnancy by facilitating a positive, comprehensive, and knowledgeable Very Brief Advice discussion.  (This is designed to inform all pregnant people of the risks of smoking and second-hand smoke in pregnancy).

All midwives received a Practitioner Guide to help increase their awareness of the risks, and benefits of not, smoking during pregnancy, and increasing their healthy conversation skills. This in turn she-centred campaign and materials developedould result in a positive experience for families, who will then be encouraged to engage with the Mums2Be Smokefree Service.

             

             

             

             

             

            Key milestones

            • Audience
            • Promotional and educational materials disseminated community and systems-wide
            • 1st Press Release shared locally and nationally

            How have the public/stakeholders been involved?

            A series of focus groups were conducted with key stakeholders – including community representatives (Diversity Voice), families, health visitors, midwives, and Mums2Be Stop Smoking Practitioners – to inform the development of the campaign and the extensive package of promotional and educational materials.

            This participatory approach ensured that the materials were not only suitable but also designed to replicate what families and providers felt were appropriate.

            Working with the public and wider stakeholders enabled:

            • Co-creation and evaluation of an audience-centred (public and provider) campaign and materials.
            • Systems-wide buy-in and support for the campaign

            What challenges did you face along the way?

            The press release was picked up slowly by the media. A further two news releases are planned with stronger news angles.

             Next steps

            • Social Marketing campaign
            • 2nd Press Release
            • Monthly newsletter

            This is a legacy campaign with additional plans developed based on evaluation of the campaign to date.

            Measuring success

            The planned key outcomes are to:

            • Reduce the number of clients declining a Mums2Be referral at the booking appointment with midwives
            • Decrease the number of clients who decline Mums2Be Stop Smoking Practitioner support
            • Increase the number of client referrals to Mums2Be from midwives and other providers
            • Increase the number of client self-referrals to Mums2Be
            • Decrease the number of women and their significant others smoking at the time of delivery
            • Increase the number of smokefree pregnancies and homes in Somerset

            Key benefits for patients/stakeholders

            • An increased understanding among clients/providers/the public of the benefits of not smoking and the risks associated with smoking in pre, during and post pregnancy.
            • Not starting or stopping smoking during pregnancy increases the likelihood of having a well-baby, with a healthy weight and reduces the chance of complications and interventions during pregnancy, birth and beyond.
            • An increase understanding of them Mums2Be Smokefree Service offers which include a free App (My Quit Route), free behavioural support and free treatment when needed – and incentives to motivate and remain quit.
            • Increased signposting and access to stop smoking support.
            • Strengthened care and referral pathway for quitting.
            • Increase in the number of smokefree pregnancies and homes in Somerset.
            • Reduction in cost implications to the NHS.

            Bereavement support in Somerset

            Lucy was appointed as a Bereavement Project Lead Midwife for Somerset Local Maternity & Neonatal System to align how Somerset Foundation Trust and Yeovil District hospitals  care for families experiencing pregnancy or baby loss using the National bereavement Care Pathway (NBCP).

            (The NBCP was devised by a range of charities and organisations to highlight the core standards that should be in place for families who sadly experience a pregnancy or baby loss).

            The aim is to ensure the highest standards of bereavement care is given to families experiencing a miscarriage, ectopic or molar pregnancy, termination for foetal anomaly, stillbirth, neonatal death, or sudden unexpected death in infancy up to a year of age, for all families across Somerset.

            How the service works

            Lucy’s role started in February 2021 for two years, with the aim of ensuring all families in Somerset can access the same high levels of bereavement care and support across the county.

            SFT and YDH have signed up to the NBCP pledge to implement their national standards to support families. This ensures that is a minimum standard of what should be offered and delivered nationally, with access to this at whatever hospital they attend.

            These standards focus on ensuring.

            • a personalised care plan is in place
            • staff training is provided
            • emotional and mental health support is offered
            • bereavement leads are in place in all areas
            • bereavement rooms are available
            • informed choices are offered
            • there are options to make memories
            • a system is in place to signal a bereavement
            • support and resources are given to staff.

            Working with the public and stakeholders

            The Bereavement Project Lead Midwife for Somerset Local Maternity & Neonatal System works with a wide range of  stakeholders, including the public, mental health services, hospitals, and primary care.

            This helps ensure that women and their families get the best possible support,  that we gather as much information as possible to make informed decisions with our team and put families at the heart of everything we do.

            Working with Somerset Maternity Voices Partnership , a specific pregnancy and baby loss group was created. This group have co-produced a pregnancy and baby loss care in Somerset survey and developed a new draft personal bereavement care plan.

            We have supported the Somerset bereavement strategy work, working with local charity leads with the development of a baby loss section within the “End of life care and bereavement” website. This is a centralised website signposting all local pregnancy and baby loss charities, locally and nationally.

            Lucy Blackmore says “Joint working with families has enabled me to gain a better and deeper understanding of individual situations that our families might experience. It has been invaluable to have their input and thoughts about their care to help drive improvements and shape the guidance and resources we are implementing. This ensures we are creating meaningful resources for parents that they can use.

            “I have also been working with the third sector, which has helped to identify the support that is already on offer and highlight any gaps that need addressing, whilst establishing the best method and tools to signpost families in one, easy to find place.”

            A woman who has experienced loss and is part of the Somerset Maternity Voices Partnership said

            “I have felt honoured to be a part of something that will help so many bereaved parents. Having suffered baby loss, myself and provided with no care or support, to see something coming together to make a difference to other parents in future is a massive step towards creating the right support for everyone. Including people with lived experience in the design and implementation has been so valuable and really shows how co-production ensures a service meets the needs of those that need it.”

            Jackie Shrimpton, Somerset Bereavement Network Co-ordinator “Lucy’s bereavement project work has developed an in-depth understanding of the impact of pregnancy and baby loss. She has linked with the Somerset Bereavement Network (a group of local and national bereavement support providers and representatives from across ICS organisations) and more widely to share valuable insight advising and support other members.

            “In addition, through leading a strategy sub-group on this topic and through project work, Lucy has identified key areas of development going forward as input for wider Somerset bereavement strategy development work.

            Just one example of this sharing of project expertise is the creation of public bereavement support webpages for pregnancy and baby loss, highlighting local and national support provision available for Somerset residents.”

            Available at:

            www.Somersetbereavement.uk .  (Selecting ‘Member of the Public’ will present the option for the bereavement support information for a range of type of losses including pregnancy and baby loss).  

            Programme Highlights

            • Pregnancy and baby loss care in Somerset survey introduced
            • Introduction of maternity mandatory training for all midwives
            • New furniture for the bereavement room in Yeovil’s maternity department, with soundproofing on order
            • New furniture ordered for the Early Pregnancy Assessment Clinic in Yeovil
            • Abigail cold cots have just arrived at both hospitals to allow parents to spend more time with their babies, alongside the facilities we already have.
            • Your care plan if your baby dies during pregnancy, shortly after birth or is expected to’
            • Joint hospital maternity guidelines in development
            • “Cradle charity” implementation imminently, to support early pregnancy loss, with tissue packs and comfort bags for those requiring an inpatient stay following a miscarriage or ectopic pregnancy
            • 3D casting introduced at Yeovil District Hospital
            • Post mortem update session delivered by perinatal pathologist
            • Supporting the implementation of the new Maternal Mental Health Service
            • Funding to support counselling being offered to families across Somerset through the voluntary sector
            • Wave of Light event – held at both hospitals as part of baby loss awareness week
            • Multiple training days with (midwives, nurses, and counsellors) in conjunction with the maternal mental health service and local charities.

            Lessons Learnt

            Starting the project during Covid has meant our hospitals have had to adapt to caring for patients in unprecedented times. This has had an impact on care with visitor restrictions negatively impacting on people’s experiences and engaging with stakeholders who have been extremely busy providing clinical care. Although the need to continue to provide highest standards remained throughout.

            Next steps

             Personal care plan is in development

            • Develop an e-learning resource for early pregnancy
            • Look at maternity pathways
            • Rainbow clinic provision across county to support those who are pregnant again following a loss, (this is a specialist clinic that cares for women in subsequent pregnancies after a loss)

            Measuring success

            Since the role started in 2021,  we have made lots of progress across the core areas identified, including staff and family feedback, improving spaces in the hospitals and valuable staff training.

            The key outcomes have been to align services against the NBCP standards, including a quality improvement project which aims to increase use of personalised care plans to support and empower families in their care.

            We also want to have a clear pathway, involving specialised obstetric care, for women who become pregnant again following a loss across Somerset so that families have continuity of care.

             Key benefits for families that sadly experience this would be equity to ensure that everyone regardless of the type of loss experiences a high standard of care compliant with the NBCP standards.

             

            Somerset Apps Library

            The Somerset Apps Library project was developed to help people in Somerset with advice and information around their health and wellbeing, by providing a central resource for people to access safe health apps, which work best for them.

            The project was launched in January 2022 and will initially run for three years.

            Health apps are a great way to get health and mental wellbeing support, helping us to improve our health and live healthier lives.

            There are so many apps on the market, it can be hard to know which ones you can trust. Google play and the Apple store are unregulated so people may assume that apps are safe when they are not.

            Who is delivering this project?

            The project has been funded by NHS England. To develop the site, Somerset CCG teamed up with ORCHA (the Organisation for the Review of Care and Health Applications), to create a website which shows health and care related apps (which have been reviewed for data privacy, professional clinical assurance and how usable and accessible they are).

            How does it work?

            All apps hosted on the Somerset Apps Library have been reviewed by ORCHA (The Organisation for the Review of Health and Care Apps) against clinical effectiveness, data privacy and security and usability and accessibility.  

            The library works in two ways:

            • the public can use the website to find apps they want to use
            • we offer fully funded professional licences to health and care professionals across Somerset allowing them to send specific apps to service users via text or email

            Working with our stakeholders

            Somerset CCG is working with social care, the voluntary sector, primary care and our acute hospitals and community services.  Libraries and digital inclusion organisations are also working with us to encourage those who are currently digitally excluded to be able to access the website.

            To develop the website, we worked with;

            • Somerset County Council
            • Somerset Foundation Trust
            • Yeovil District Hospital NHS Foundation Trust
            • St Margaret’s Hospice
            • 111/OOH service
            • Local Pharmacy Committee
            • Local Medical Committee
            • GP practices
            • SPARK Somerset

            We have also presented and discussed this project with the public at meetings through planning and implementation stages including;

            • Patient Participation Groups
            • Digital Peoples Champion Group
            • Somerset Engagement and Advisory Group
            • Colleges and schools, Freshers Fairs, Digital T Level student lectures for feedback from young people
            • Attending countywide events including the End-Of-Life Conference

            Key benefits

            The library has two key benefits:

            • It protects the public from potentially finding and using unsafe apps on unregulated app stores
            • It protects health and social care organisations in Somerset from promoting potentially unsafe apps to their service users/patients.

            Everybody can benefit as there are apps for all ages and for all stages of a person’s health journey.  There are preventative apps, informational apps, some that perform an administrative function, plus those that support people with a long-term conditions or are on a waiting list. 

            The apps include;

            • Preventative support (e.g., inhaler technique, stress management, fitness and diet apps)
            • Helping people to help themselves (e.g., diabetes apps, symptom checkers, condition monitoring and mood diaries)
            • Administrative support such as appointment management and service signposting (e.g., NHS App)
            • Delivery of services (e.g., Cognitive Behavioural Therapy (CBT) and mole checkers)

            Key achievements to date

            Since going live in January 2002 there have been;

            • 20,000 visits to the web page
            • 100+ pro account licences allocated to health and care staff
            • 100+ recommendations of apps achieved

            Working as an ICS and proactive promotional campaigns including using social media, has meant that our figures for uptake and usage are the highest in the whole of the South West rollout so far.

            We have also

            Next steps

            A pilot is currently underway with Frome PCN (Primary Care Network) and the Somerset Leaving Care Service are planning to use this tool to help support those leaving care and young families. 

            We also aim to:

            • double the current number of licenses allocated to professionals and double the number of recommendations made for additional apps.
            • achieve 50,000 page visits
            • by the end of the project to have allocated all the professional licenses available to us and have most licence holders regularly recommending apps to service users
            • continue the pilots and develop benefits cases, gather feedback from those using it.
            • link with other ICS to share learning and strategies

            What challenges did we face along the way?

            Many people use apps to manage their shopping or banking, but they don’t always realise they could support and manage their health in the same way, so we need to be able to promote the benefits of using health apps on an ongoing basis. 

            Most people love the concept but for busy health and care staff this involves new ways of thinking and working. We need to invest in staff education about new ways of accessing information about health and care services, as well as continuing to provide information through more traditional means.

            It is very much about enhancing rather than replacing traditional channels. We recognise that digital health is not for everybody but it should be available for those that want to use it. 

            How was joint working helped to deliver the project?

            • The Frome PCN pilot shares what works well for them so we can roll out and share the learning to other Primary Care Networks.
            • By working with the council and voluntary sector we can support those who are currently digitally excluded.
            • By liaising with our stakeholder organisations who can shae information via their websites and staff newsletters, we can raise awareness and engagement with the public and wider stakeholders

            Measuring success

            Analysing our data shows that the go live has gained significant traction which we want to build on moving forward.  The outcome is a tool which the public and stakeholders can trust and nurtures the trust that the public have in the NHS and what it delivers.