NHS England to recruit 1,000 social prescribing link workers

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An army of advisers will be recruited to help patients live fitter, healthier lives and combat anxiety, loneliness and depression under recent plans by NHS England to ramp up social prescribing.

Around half of GP appointments are not directly related to medical conditions, according to experts. Growing evidence shows that referrals to community services such as exercise or art classes, history groups and even ballroom dancing can boost health and wellbeing more than dishing out pills or other treatments.

Now NHS England plans to recruit 1,000 social prescribing ‘link workers’ as part of the NHS Long Term Plan. The link workers will be able to give people time to talk about what matters to them and support them to find suitable activities that are a better alternative to medication as part of a step change in the provision of ‘personalised care’.

FHT Conference Michael Dixon

Dr Michael Dixon, Chair of the College of Medicine, welcomed the news. The GP and social prescribing campaigner said: ‘This is excellent news for general practice, which is on its knees. This extra support of pharmacists, physiotherapists, social prescribers and others will make a great difference to the workload of each GP.

‘Patients want a return to the time when they had ‘their doctor’. These new developments will greatly help that, but we will also require more GPs at a time when their numbers have actually been going down during years when the number of specialists has vastly increased.

‘Enabling practice to provide accessible, personal and continuing care should now be the NHS’s number one priority as all the research shows that this is the best way to reduce deaths, improve health and enable the NHS to be financially sustainable.

‘This announcement is also a paradigm change for general practice. Every GP and patient will in future have access to social prescription.

‘It is recognition that medicine now needs to go beyond pills and procedures and that the future sustainability of our health system will depend upon enabling people and communities to maximise their role as agents of health and healing themselves. This is a red-letter day for the College of Medicine, which has pressed the cause for change during times when medicine has been too narrow and biomedical.’

Michael will be offering FHT members some tips on how to connect with these new link workers in the Spring issue of International Therapist magazine.

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School for thought

FHT’s Editor and Communications Manager, Karen Young, visits the NHS Natural Health School team in North Yorkshire

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From left to right: Karen Young, Gwyn Featonby, Beverley Harrison, Sarah Grant, and NHS Natural Health School student, Lorraine Cole

One cold morning in January, I travelled from Southampton to Harrogate to meet with Gwyn Featonby, Sarah Grant and Beverley Harrison – three members of the award-winning team that head up the NHS Natural Health School, based at Harrogate District Hospital, Harrogate and District Foundation Trust (HDFT).

I only had time to spend a few hours with this lovely trio but it was well worth the 500-mile round trip (actually, make that 507, because I overshot Harrogate station, checking emails on my phone!).

The school, which was officially launched in May 2018, is the first NHS-approved and owned complementary therapy school, run by NHS employees. It was developed to create a self-sustaining model of care for patients, delivered by therapists trained to the highest standards of care expected of any health professional working within the NHS. But as the team will be more than happy to tell you, this didn’t just happen ‘overnight’ – it took four years and a lot of hard work to get to where they are today.

When Sarah took on the role of Patient Information and Health and Wellbeing Manager at the Sir Robert Ogden Macmillan Centre, HDFT, in 2014, part of her responsibility was to develop and improve the existing complementary therapy service. At the time, it comprised of six self-employed therapists, who took turns to provide four hours of treatment a week to self-referring patients. While the therapists offered a very good level of service, there was no consistency for those accessing treatment, and no measures in place to show the true value of the service to patients and staff. As such, it was seen as more of a ‘nice to have’, informal spa, than a service that offered real therapeutic potential.

Sarah quickly set to work to future-proof and improve the complementary therapy service. As well as securing dedicated space for delivering therapies and training within the newly built Centre, Julie Crossman, MFHT – one of the original therapy team members – was tasked with overseeing an audit of the complementary therapy service using MYCAW*, so that they could start to build an evidence base of the treatments provided. A little later Sarah brought Gwyn on board, to develop a therapy training programme that would meet both CQC (Care Quality Commission) and industry standards and equip students with the necessary skills and knowledge to work confidently and safely with patients with complex health needs.

When I walked into the Centre less than a fortnight ago, I have to say, it felt very calm and welcoming, and as if the NHS Natural Health School has been running smoothly for many years as opposed to months. Today, the model created by Sarah, Gwyn and the team means that for each cohort of students they have on a training pathway at a time, 72 patients are removed from the complementary therapy service waiting list.

Self-referring is also a thing of the past, with all patients now being referred by a health professional working at the Centre. Many of these health professionals have experienced the treatments first-hand, after accessing these when a patient has cancelled or been unable to attend an appointment. Others have simply seen how different therapies have helped to resolve issues such as pain management or sleep difficulties in patients, which previously might have required referral to a specialist, costing the NHS even more precious time and money.

Sarah also highlighted that an unexpected benefit of providing health professionals access to the complementary therapy service is that they feel valued and cared for, and as word travels fast in the medical community, this has vastly helped to improve recruitment at the hospital. Staff who feel valued are also more likely to volunteer to do overtime, because they’re happy to ‘give a little something back’.

So, what’s next? Once the team are completely happy with the model, they hope to introduce it to other departments within the hospital and then, ultimately, license it out to other Trusts, so that these too can benefit from a self-sustaining complementary therapy service, which has quality and patient-centred care at the core. It certainly seems to be a win-win situation for all involved – namely a struggling NHS system, over-burdened health professionals in danger of burn out, therapists in need of hands-on experience working with complex patients and, most importantly, patients in need of support.

Keen to learn more about the NHS Natural Health School and team?

Read an article by Gwyn about the NHS Natural Health School

Learn more about Gwyn winning 2018 FHT Tutor of the Year

Read about Gwyn and Julie winning a Complementary Therapy Award 2018

*MYCAW (Measure Yourself Concerns and Wellbeing) is a patient-reported outcome measure often use by complementary therapists working in cancer care.

Music therapy could help prevent falls in over 65s

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More than three million people are treated for fall related injuries during the winter months, with around 60,000 requiring hospital treatment.

Daniel Thomas, Joint Managing Director & neurologic music therapist at Chroma, the UK’s leading national provider of arts services, suggests winter poses a serious risk of falling to the elderly for a number of reasons:

‘Many older people take numerous medications that may have side effects including dizziness, which pose an increased risk of falling.

‘With age, sensation in feet decline, especially if there is an underlying condition such as diabetes, poor circulation, arthritis or lingering complications following a stroke. With decreased sensation, balance is affected. Slippery surfaces, such as those covered in snow or ice, can further reduce balance increasing the likelihood of a fall.

‘Many over 65s walk with an unstable gait, during any weather. Those who do not exercise have weakened muscles, increasing the likelihood of a fall.’

According to Age UK, falls in the over 65s costs the NHS around 4.6 million a day, and this could skyrocket, with this age group due to represent nearly half of the population of some areas by 2039.

Chroma believes the solution to fall prevention in the over 65s lies within neurologic music therapy (NMT) – the therapeutic application of music to cognitive, affective, sensory, language and motor dysfunctions due to disease or injury to the human nervous system.

NMT relies on engaging with patients to maintain exercise and physical activity, encouraging older people and patients to move more for therapeutic and health reasons. It recruits healthy and un-injured areas of the brain, rather than trying to fix the damaged or ‘broken’ part of their brain linked to the loss of function.

Rhythmic Auditory Stimulation (RAS) is an important aspect of NMT. Within RAS programmes, strong and predictable rhythmic patterns are used to guide the sensori-motor movements required for walking. Predictable rhythmic structure allows the sensori-motor system to move in sync with the beat. Stroke patients have reported improved stride length and symmetry with RAS.

Daniel suggests, ‘Music with high beats per minute (BPM) promotes movement, good cadence and walking speed, so songs like Nancy Sinatra’s These Boots are Made for Walkin, which has 85 BPM is ideal.

‘Walking speed correlates with functional ability and balance confidence. It has the potential to predict future health status, the risk of falls and a client’s fear of falling. BPM strongly correlates to step cadence, and therefore walking speed. Improved walking speed equates to improved balance.

‘Increased muscle strength, gait and walking speed are all necessary factors required to reduce the risk of falls in the elderly. NMT has proven itself to be a cost-effective intervention to help improve such factors, and as a result, enhance the wellbeing and health of the elderly and the healthcare sector simultaneously.’

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Laughter yoga featured on This Morning

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Laughter yoga was recently featured on ITV’s This Morning, as hosts Holly Willoughby and Phillip Schofield took part in a demonstration led by Louise Claire Gates.

Louise introduced them to the therapy, explaining its origins and health benefits, saying that belly laughter can produce similar benefits to running and other exercises. She explained that when pretending to laugh, the body doesn’t really know the difference, so the pretend laughter will very soon become real laughter.

Holly and Phillip were then introduced to a number of exercises that could be practised as part of a yoga therapy session.

Watch the clip here

Read an article about the benefits of laughter by Lotte Mikkelsen (first published in International Therapist issue 124

The importance of touch

Dr Chatterjee1GP, Author and TV presenter, Dr Rangan Chatterjee talks about the importance of human touch in his latest Feel Better, Live More podcast.

Rangan speaks to leading researcher, Professor Francis McGlone, who explains why touch is essential to the healthy brain development of humans and other mammals, and what the consequences are when we don’t receive it.

Francis says that there are now fewer opportunities for children to experience social touch and physical play than there were 30 to 50 years ago. There is less physical activity and more desk-based IT work, where children often spend more time on a smart phone or tablet than interacting with each other. He believes that children who lack social touch could become less resilient in the future.

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He also says that nurturing touch in early years from the mother or caregiver is crucial for brain development and a lack of touch can lead to social exclusion. Research has shown that ‘rats whose mothers lick them regularly as they grow up are better able to cope with stress than those whose mothers don’t lick them at all’. The rats who weren’t licked became hypersensitive to stress and anxiety.

Listen to the podcast here

Read an interview with Dr Chatterjee in the Winter 2018 issue of International Therapist

High-fibre diets linked with lower heart disease risk

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Eating plenty of fibre reduces the risk of heart disease, stroke, type 2 diabetes and cancer, according to a landmark review commissioned by the World Health Organization (WHO).

As reported in The Guardian, the study will inform forthcoming WHO guidance and was led by a team at the University of Otago in New Zealand, whose last major review paved the way for sugar taxes across the world.

The review based its findings on data from 185 prospective studies and 58 clinical trials, involving more than 4500 participants. People on high fibre diets were found to be between 15-30% less likely to experience heart disease and early death than those who don’t eat much fibre.

The researchers recommend a daily minimum intake of 25g of fibre, which is similar to the 2015 UK Government guidelines of consuming around 30g each day to form part of a healthy diet.

Fibre is found in a variety of foods, such as wholegrain bread and oats, wholewheat pasta, broccoli, carrots, beans and pulses, nuts and seeds, berries, pears, oranges, and potatoes with skin.

Read an abstract of the review, published in the Lancet

 

 

 

Conference to address the integration of yoga within the NHS

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Tickets are said to be selling fast for the Yoga In Healthcare Conference, held from 15 to 17 February 2019. The conference will bring together leaders and pioneers in yoga, healthcare, research and government to express yoga’s value in public health.

One of the speakers at the event is Dr Michael Dixon, a leading figure in healthcare and Chair of the College of Medicine. FHT members will be familiar with Dr Dixon, after his exceptional talk at last year’s FHT Conference, where he discussed social prescription and the benefits of integrating complementary therapies within the NHS.

Speaking on behalf of the College of Medicine, Dr Dixon said, ‘We are delighted to be associated with the yoga conference. Therapeutic yoga should be on the menu of every social prescribing service. It is good for your physical and mental health and boosts your resilience.

‘There is also plenty of evidence suggesting that it can be helpful for those with diabetes and musculoskeletal disorders, as well as being effective for those living with injuries or recovering from illness. Therapeutic yoga combines restorative yoga (supported postures), a combination of breath work and hands on therapy, and guided meditation techniques with the aim of reducing stress on the body and improving wellbeing.’

Find out more about the Yoga in Healthcare Conference

Read more about social prescription