Staff at Bradford District Care NHS Foundation Trust have embraced change and implemented a range of innovations to ensure community, learning disability, dementia, dental and mental health services across Bradford, Airedale, Craven and Wharfedale, as well as children’s services in Wakefield, can continue to be delivered in the best way possible, despite the challenges posed by the pandemic.

So effective have some of the changes proved to be, that many will continue and be developed further as we return to more normal times.

The Trust’s Director of Human Resources and Organisational Development Sandra Knight says: “So much has been achieved behind the scenes in such a short space of time, to ensure we could continue to effectively deliver our services and keep everyone safe. Staff in the Trust have truly lived our values of ‘We Care, We Listen, We Deliver’.

“Talent, teamwork and collaboration have enabled us to make changes in practice to respond to the needs of patients, service users and their families, as well as partners and staff. This has resulted in changes not only in what we deliver, in terms of service innovation and improvements, but in how we deliver it, including how we communicate and work with each other to deliver services, and our use of technology.”

Examples of recent innovations include:

COVID-19 Home Visiting team

In just three days, a dedicated, multi-disciplinary COVID-19 Home Visiting team for adults was brought together to visit people in the community who are symptomatic or diagnosed with the condition.

The team includes the Out of Hours District Nursing Team, supported by colleagues redeployed from the Immunisation and Vaccination team, School Nursing, Specialist Services, Community Dentistry and Infection Prevention. As well as visits to individual homes and care homes the new team is also involved in swabbing staff and patients.

Personalised patient newsletters
The innovations have been large and small, from community-wide initiatives to support for individuals. As COVID-19 restrictions meant no visits for people at the Assessment and Treatment Unit (ATU) at Lynfield Mount Hospital,  Trust staff have ensured that families and carers can stay connected by creating personalised patient newsletters.

The newsletters give details of the activities each person is involved in, as well as their overall mood and physical and mental health during these difficult times. They have proved a great way to keep in touch and a good alternative to video or phone communication which some service users find difficult.

Home-based continence procedures
Certain services which would usually be carried out in hospital have been moved into the community during the pandemic. When Bradford Royal Infirmary (BRI) had to redeploy wards to support the COVID-19 response, Bradford District Care NHS Foundation Trust’s Continence and District Nursing teams worked closely with the hospital’s urology staff to rethink how urology procedures could be delivered to ensure service continuity for patients.

Now, instead of going to hospital to have a surgically fitted catheter removed, or for the half-day Trial Without Catheter procedure, patients are being referred from BRI to the district nursing team, who ensure a management plan is in place before referring on to the Continence Service to carry out the procedure at the patient’s home.

Cluster-based home clinics for patients with complex wounds
Team working across trusts has also supported patients with complex wounds. Following the closure of the regular leg ulcer clinic at BRI, teams from the two trusts worked together to group patients into local clusters with nurses allocated to each cluster.

After a risk assessment and phone screening, the nurses visit patients at home using the required personal protective equipment (PPE) to undertake specialist services, including complex leg ulcer management and wound care, as well as providing patients with support for self-care where possible.

Video based patient consultation and resources for parents
Technology has played an important part in how Trust teams have continued to deliver services during the pandemic.

Little Minds Matter (LMM), Bradford’s Infant Mental Health Service has embraced it to provide parent/infant therapeutic services virtually via video or phone call, rather than a face-to-face in person clinic appointment. This has led to a 20 per cent increase in patient consultations since the start of lockdown.

Working in partnership with Better Start Bradford and Bradford Council, the team has also produced a video to help parents in caring for a crying baby – which has reached over 45,000 people on social media.

These examples are just some of many collated by Bradford District Care NHS Foundation Trust’s Staff Ideas Programme (iCare) in a campaign to recognise innovative and creative solutions. They demonstrate new ways of working for staff at the Trust and their partners in the district which have ensured that services could continue to be delivered in a safe way during the pandemic.