21st Northern Ireland Healthcare Awards

Rising to the Challenge

Serving as an annual showcase of the sector’s ongoing success stories and exemplary potential, the 21st Northern Ireland Healthcare Awards is almost here.

From innovation and education to the introduction of exciting new services and paths of patient care, the progress of our healthcare sector moves at a staggering pace. With this in mind, the Northern Ireland Healthcare Awards is thrilled to provide an opportunity for both reflection and celebration – in which we shine a light on the plethora of accomplishments which have been attained over the last 12 months.

Marking its 21st year bringing together the different corners of the healthcare arena for the event, the Northern Ireland Healthcare Awards is taking place on 27th February at Belfast’s Europa Hotel, fronted by reputable Television Presenter, Pamela Ballantine.

Throughout the evening, the victors in the 10 different categories will be unveiled, concluding with the announcement of the 2020 Lifetime Achievement Award recipient.

We are delighted to announce that this year’s nominated charity is Northern Ireland Crohn’s and Colitis UK. Right now, over 300,000 people in the UK are living with a life-long disease that many people have never heard of, and the real number could be almost double that.  Because of the stigma and misunderstanding surrounding these diseases, thousands of people are suffering in silence – but they are not alone. The charity works to bring people affected by Crohn’s and colitis together, and raise awareness of the conditions. From educational talks to social events, Northern Ireland Crohn’s and Colitis UK helps give people the comfort and confidence to live fuller lives.

Sponsored by – Teva UK Respiratory

Sponsored by – UCB Pharma

Sponsored by – The Pharmacists’ Defence Association in Association with Queen’s University Belfast

Sponsored by – Napp Pharmaceuticals Limited

Sponsored by – Ethypharm UK

Sponsored by – Kent Pharma

Sponsored by – Ethypharm UK

Sponsored by – UCB Pharma

Asthma / COPD Project of the Year

Sponsored Teva UK Respiratory

Respiratory Ambulatory Unit, Craigavon Area Hospital

An initial pilot in the winter of 2015 / 2016 was commenced as part of the Southern Health & Social Care Trust’s action plan to reduce winter pressures and the demand on the ED. The Rapid Access Respiratory Clinic team have subsequently worked closely with the Integrated Care Partnership (ICPs) group to include service-user input to clearly identify local issues and set up a clinic aimed to transform the care that is delivered to these patients.

The initial pilot showcased an overall improved patient experience and bed-days saved. Following on from this enormously successful pilot, a purpose-built ambulatory unit opened in May 2019 with a three-room suite solely for the respiratory service.

Various improvements to patient care have been secured as a result of the initiative’s introduction – notably, the vast majority of the attending patients would have required ED attendance and admission without the intervention of the team.

North Belfast Federation of GP Practices

With North Belfast experiencing one of the highest rates of respiratory disease in Northern Ireland, GP pharmacists in North Belfast were keen to review these patients in light of the National Review of Asthma Deaths (NRAD) report and its recommendations.

The GP pharmacists searched their patient population to identify initially the overuse of reliever inhalers (SABA) in the previous 12 months. This was achieved by running searches and reviewing the patients highlighted, but throughout the initiative all GP pharmacists – while undertaking medication review and the issuing of acute and repeat prescriptions – were able to reduce the use of SABAs and educate patients on the appropriate use of inhalers.

Given the robust nature of the asthma project and the dedication of the pharmacists, the practices have reported improvements in the way they manage their asthma review, while patients have also reported improved control.

Holywood Arches Health Centre, Belfast

Regularly assisting patients who had been referred from the GP with respiratory symptoms and no diagnosis, the introduction of a FeNO machine has equipped the team with the means to provide a speedier diagnosis, accurate choice of treatment, and prompt onward referral if necessary.

Tapping into its extensive potential, the team utilise the device to support a diagnosis due to the fact that it can in steroid-respondent patients give a good indication regarding inflammation in the airways and help the professional know as to whether the patient would benefit from a steroid inhaler.

A key benefit of the FeNO machine has been its role in helping the team to alleviate the worry for patients who are concerned about their child taking any steroid medication. This objective tool helps the parent to see a measurement before and after preventer steroid treatment. Their child begins to demonstrate an improvement in symptoms, and levels in nitric oxide decrease, which reinforces the need for this medication and better adherence to treatment, as well as less hospital admissions or GP / nurse appointments.

Rockfield Medical Centre, Ballymena

The merging of the Causeway and Ballymena Easy Breathe Groups – part of the British Lung Foundation – has been a hugely successful endeavor; offering information, support and access to patients suffering from a range of respiratory problems, namely COPD, idiopathic pulmonary fibrosis, chronic asthma, bronchiectasis, emphysema and chronic bronchitis.

Breathe Easy Causeway / Ballymena work tirelessly to raise awareness of lung disease in Northern Ireland within the remit of the British Lung Foundation and healthcare professionals in the Northern Health & Social Care Trust area, with the focus of the group being on the provision of activities to help people understand their condition, including access via the British Lung Foundation website and helpline.

The group have also been unwavering in their support of GP practices, particularly in terms of the purchase of equipment, such as oximetery equipment for use both in GP surgeries and out-of-hours GP services.

Innovation in Rheumatology Service

Sponsored UCB Pharma

Antrim Area Hospital, Northern Health & Social Care Trust

A new giant cell arteritis (GCA) pathway was developed and implemented in December 2018 in Antrim Area Hospital in which patients presenting with GCA would be reviewed that day by a rheumatologist, commenced on appropriate steroid therapy, and discharged home with a patient information leaflet explaining the temporal artery biopsy (TAB) procedure. The patient would then receive an appointment to attend as a surgical day-case for their TAB – subsequently followed up with their TAB results in a rheumatology outpatient clinic.
Since the new GCA route has commenced, patients with suspected GCA no longer require admission to hospital to obtain a TAB, avoiding lengthy inpatient stays. The impact of this change is far-reaching, limiting the demand on vital medical inpatient beds and trust resources which can now be redirected to benefit other patients.
Patients also now receive their TAB within an average of six days from the date of initial presentation which is an improvement compared with the previous average waiting time of seven days.

Western Health & Social Care Trust

Prior to the establishment of the initiative, an extremely long waiting list for rheumatology specialist OT intervention persisted, with little time left for service improvement. However, following the completion of a business case, the team were awarded a Band 7 to reduce the waiting list and transform the service via the transformational confidence and supply funding initiative.

The new Band 7 started in June and in the six months since, the strides towards improvement have been significant. For example, the service has been able to complete assessments to form the basis of disability assessments. These assessments and intervention include comprehensive hand function assessments, and a range of treatment interventions, such as splinting, energy conservation, fatigue management, exercise programmes, equipment, vocational support and self-management strategies in accordance with NICE guidelines.

Notably, the waiting list for new assessments has been reduced from 13.7 weeks to 4.5 weeks. Due to this enhanced service patients are being educated about their new diagnosis and how to implement self-management principles and improve self-efficacy.

Southern Health & Social Care Trust

The Virtual Rheumatology Biologic Clinic (VRBC) is a new service model introduced to address some of the challenges facing the rheumatology biologics service in the Southern Health & Social Care Trust.

The use of biologic therapies has transformed the management of inflammatory arthritis, however a number of challenges have been encountered. Infrastructure has thus been put in place to establish a weekly virtual biologics clinic to address these challenges.

Prior to the commencement of the clinic, a biologic drug pathway for the treatment of rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis – taking into consideration drug cost, current guidelines, evidence base and patient factors – was agreed by the rheumatology team. This is used by clinicians to choose the most cost-effective and clinically-appropriate drug treatment for each patient. A drug tapering protocol was also agreed.

Results from the first 12 weeks of the VRBC demonstrate that the aims of the clinic are being met, with there being regular multidisciplinary review of patients with medicines optimisation within the rheumatology biologics service.

Pharmacy Student Leadership

Sponsored Sponsored by
The Pharmacists’ Defence Association in Association with Queen’s University Belfast

Queen’s University Belfast

As the leader of the mental health and wellbeing team within the school – which consists of 24 student members – Aine has embraced the opportunity to open the minds of future pharmacists and challenge the way in which they view mental health conditions.

Since completing the mental health first aid training and becoming part of the team in first year, Aine’s dedication and passion for the cause have been unwavering. She has worked hard to merge the old and newly-trained members to form the current team in the school, and the consistent organisation of events, such as coffee mornings, small presentations, and information stands, has led to a huge growth in engagement.

Aine is currently in the process of launching a social media page to promote good mental health habits, as well as foster open conversation.

Ulster University

Christine’s engagement in Staff-Student Consultative Committees and Subject Committees as class representative is an integral part of developing current teaching methods within the School of Pharmacy at Ulster University. She plays an important role in providing feedback to course directors on learning and teaching methods so that her organisation can continue to adapt and improve.

Throughout Christine’s studies she has forged a strong passion for Public and Patient Involvement within the curriculum.

This interest has encouraged her to take up the role of student ambassador for Public and Patient Involvement within undergraduate studies. As part of this, she has become involved in research currently being undertaken at Ulster University, investigating new and innovative strategies for the delivery of these seminars. In November 2019, Christine also represented the pharmacy student body at a ‘think-tank’ discussion at the Jordanstown campus of the university as part of their Involve Week.

Queen’s University Belfast

Having been elected student representative for her year group, Shauna has undertaken extensive responsibilities to help set the future for budding pharmacists in greater stead.

The role has involved her reaching out to her peers, listening to their viewpoints on the course, and collating this information and feeding it back to the Staff-Student Consultative Committee. During these meetings Shauna would speak on behalf of the year group, while the staff would listen and work with them to make changes. For example, at the last meeting she suggested that it would be more beneficial if the students were introduced to more patients in the Advanced Pharmaceutical Care workshops. The staff have since considered the proposal and are working to implement this.

Shauna has also played a key role in raising awareness of the purpose of the Pharmacy Society by standing before several lectures, and encouraging different year groups to enrol as members.

Queen’s University Belfast

As a mentor serving in the Queen’s University Belfast School of Pharmacy Peer Mentoring Scheme, Rachel helps support international students and provide appropriate guidance throughout the course. She has also organised various social and academic events to inspire the juniors to distinguish their visions regarding the profession / career starting from level one which will ultimately improve the pharmacy sector in the future.

As one of the NICE Evidence Search Student Champions 2019, Rachel has taken up the opportunity to receive proper training on how to perform evidence search on NICE and has conducted a class to MPharm level three students in which she emphasised and explained the importance of evidence-based healthcare and demonstrated when and where the search is appropriate throughout their course and future career. Building on this, Rachel has further conducted another teaching session at the peer mentoring scheme to teach more level one and two students.

Ulster University

Fatimah’s role as course representative for the past two years has afforded her many opportunities to help innovate and improve the School of Pharmacy at Ulster University. In particular, through Staff-Student Consultative Committees and Subject Committees, she has been able to voice concerns of students, provide feedback, and add a unique student perspective.

Striving to cultivate her leadership skills and enhance her impact, Fatimah has undertaken numerous trainings, such as her attendance at the 2019 Student Voice Conference, which brought together academic representatives and student councilors from all four Ulster campuses. More recently, she has embarked on Peer Assisted Study Sessions training, which is a new undertaking within the School of Pharmacy.

Through Fatimah’s contribution as a Pharmacy Student Ambassador for several open day events at the School of Pharmacy, she has effectively engaged with potential students.

Diabetes Project of the Year

Sponsored by Napp Pharmaceuticals Limited

Strand Road, Western Health & Social Care Trust

Aware of the rapidly rising prevalence of type 2 diabetes, the team created an innovative model of multidisciplinary management of diabetes at a primary care level. The extensive quality improvement initiative particularly focused on the management of type 2 diabetes for patients registered at Aberfoyle Medical Practice, as measured by HbA1c control.

A computer search was initially performed to establish how many patients had attended for a diabetic review appointment within the last 12 months, and how many had an HbA1c reading within the last 12 months. Following this, a multidisciplinary team meeting was conducted to perform a process map with the starting point of diagnosis of diabetes, to the end point of continuing recall and engagement – with the process map identifying multiple issues and areas for improvement.

The team have successfully been able to bolster the quality of care received by patients as evidenced by improved HbA1c readings and increased patient access.

Waterside Health Centre, Western Health & Social Care Trust

The implementation of a pre-diabetes patient education session within a primary care setting in the Western Health & Social Care Trust area has been an empowering addition for individuals – encouraging them to make lifestyle changes in order to prevent a future diagnosis of diabetes.

The service was developed within the patient’s own GP practice, with the practice holding a register which includes all patients who have a diagnosis of impaired glucose regulation or pre-diabetes.

This ensured inclusivity of all patients within the practice who were eligible for the service, with the individuals in question being invited to attend by both their GP and via text message.

The outcome of the service has been that as a practice, the team have rolled out the service to a longer sustainable programme. The audit completed at practice level has gained an understanding as to why participants felt it was important to take part in the session.

South and East Belfast Community Diabetes Team and Carryduff Surgery

Underscored by a passion for promoting the benefits of collaboration, the service initiative was to upskill practice staff, especially practice-based pharmacists, on treating more complex diabetes patients in their practice diabetes clinic by the targeted education of practice staff on the holistic treatment of diabetes.

The first course of action involved identifying the practice within the South and East Belfast area that provided the most referrals in one year to the diabetes medical or nursing team. A questionnaire was then developed to highlight individual learning needs so that all education could be targeted, with eight two-hour upskilling clinics being subsequently established, attended by the practice-based pharmacist along with the DSN and lead diabetes dietitian. This provided the time for the consultation and for the practice-based pharmacist to ask any questions and discuss individual patient plans and decision-making.

The initiative has ultimately demonstrated an increase in knowledge for the practice-based pharmacist, and for the multidisciplinary diabetes team the clinics have granted a chance to enhance the relationship with the practice staff which has already seen a benefit in both directions for the patient.

On Behalf of 12 GP Practice Pharmacists in West Belfast Federation

Comprised of a number of general practice pharmacists working in the West Belfast GP federation, the group serve a patient population size of just under 100,000. The project’s inspiration was sparked as a result of significant concern relating to the risk of hypos in type 2 diabetes patients 65+ years old on sulphonylurea or insulin.

Each general practice pharmacist carried out a search in their GP practice to pinpoint type 2 diabetic patients over the age of 65 years on sulphonylurea or insulin and identify those patients with a HbA1c < 48mmol/mol. Following this, all individuals with a HbA1c < 48 were invited to a pharmacist-led clinic in which all of their medicines were reviewed. All these patients on sulphonylurea had their medication reduced or stopped depending on their dose.

The review has resulted in a series of sustainable changes in practice that benefit the individuals. Notably, there has been a reduction in patients’ risk of hypos and collapse, thus increasing patient safety and wellbeing.

Hospital Pharmacy Team of the Year

Sponsored by Ethypharm UK

Southern Health & Social Care Trust

The Acute Care at Home Team was originally set up as a pilot in 2014 in response to the challenges of demographic changes and financial constraint. The service has now expanded to cover the whole Southern Health & Social Care Trust area and provides multidisciplinary consultant-led acute care with reduced length of stay to treat elderly patients without the need for hospital admission. The team have prevented around 4,050 hospital admissions and supported earlier discharge for over 1,400 people from three hospital sites across the trust.

Belfast Health & Social Care Trust

The project’s objective was to help implement a switch over / upgrade of a number of bedside medication lockers that are in place across various areas within the trust for the safe and secure storage of patient medications. As a result, areas are able to move toward a keyless system, minimising the associated risks with physical keys, as well as improving governance in relation to medication storage and security, as the new system is auditable and can be monitored as appropriate.

Southern Health & Social Care Trust

The service has been reformed with a concentration on quality with a dedicated microbiologist, antimicrobial pharmacists and IV nurse co-ordinators. Their aims centre on the facilitation of early discharge, the reduction of inpatient stay, and the provision of the same or improved standard of care at home as in the hospital.

Patients are referred to the OPAT service and reviewed by all members of the team prior to discharge to ensure that a clinical plan is in place, and once discharged from hospital the patients are monitored at a weekly, virtual, multidisciplinary team meeting and reviewed at fortnightly patient clinics.

South Eastern Health & Social Care Trust

Consisting of four pharmacist independent prescribers, one member of medical staff, and two lead pharmacists, the service is integrated within four of the speciality teams (respiratory, stroke and GI and acute medicine). The prescribing pharmacist works within the multidisciplinary team and prepares the immediate discharge and medication advice letter in its entirety, including the clinical section, follow-up, and the prescribing of medicines at discharge. The team have transformed the way in which these wards work and have taken on tasks which were historically undertaken by medical staff.

Northern Health & Social Care Trust

Established in early 2019 following a successful pilot, the service model is to provide a telephone call-based service to patients within one week, and then again within one month, of discharge, with the option for a further call at the pharmacist’s discretion if it is thought to be beneficial. The service specifically targets patients at the transitions of care where medication-related problems frequently arise, and identifies patients most at risk of medication-related harm.

Belfast Health & Social Care Trust

Over the past 40 years, the renal pharmacy service has evolved to provide an extensive range of pharmacy services for renal patients. It is common now for patients with chronic kidney disease to be on a complex cocktail of medications, and the renal pharmacy team play an important role, especially when a patient is admitted to hospital. Specialised work for the renal pharmacy team in chronic kidney disease patients includes the management of regional peritoneal dialysis fluid supplies and anaemia management. The renal pharmacists have been independent prescribers since 2007.

Improvements in Cardiac Services for Chest Pain Management

Sponsored by A. Menarini

Southern Health & Social Care Trust

The Southern Health & Social Care Trust’s service for chest pain management has been developed through a comprehensive, multi-faceted lens. Bolstering the care available for individuals, outpatient services have been homed in on, with a new cardiology clinic model commencing, including earlier investigation and embedded secondary prevention nursing. Having helped set up and audit the Northern Ireland Rapid Access Chest Pain Clinic service at Royal Victoria Hospital, Ian also thus helped to introduce a similar model at Craigavon.

Furthermore, the team now provide a wide range of chest pain diagnostics, including EST, DSE, MPI, cardiac CT, and some stress MRI (regional and now in-house staff), and have participated extensively in local and international clinical trials.

The large expansion in permanent medical, nursing and healthcare staff within cardiology has been central to the assessment of patients presenting with chest pain.

Belfast Health & Social Care Trust

The chest pain service consists of a small team of cardiology nurse practitioners based in the ED responsible for the assessment and management of patients presenting to the ED with undifferentiated chest pain.

Review of the existing chest pain pathway in accordance with recent research published by the European Society of Cardiology led to an internal audit to establish if the implementation of a zero and 1hr high sensitivity troponin (hs-TnT) testing protocol was a safe and effective way to manage patients. Positive findings initiated changes to the existing pathway with new guidance on troponin results and risk stratification of patients presenting with chest pain. This has led to a rapid assessment of patients presenting to the ED with undifferentiated chest pain. Low-risk patients are discharged earlier, and patients in the observation group can be ruled in and treated earlier, while patients determined high-risk on the risk stratification section can be treated faster and referral expedited to cardiology sooner.

The pathway has both promoted patient safety and enhanced the patient experience.

Western Health & Social Care Trust

The Cardiac Assessment Unit is a unique nurse-led 24-hour / seven days per week service in which patients can self-present with symptoms of chest pain, palpitations, dyspnoea and syncope / pre-syncope episodes. Patients are seen immediately upon arrival.

Following this, the patient is attached to a cardiac monitor by the cardiac nurse who then obtains ECG, bloods, and clinical observations, as well as ordering a chest x-ray and obtaining a clinical history alongside data reviewed from ECR to formulate a management plan and diagnosis in order to initiate appropriate treatment in line with current guidelines. Patients are then either transferred to an acute hospital or discharged home with appropriate investigations ordered as an outpatient, such as cardiac echo, exercise stress test or cardiac monitors as necessary.

The service has represented an important and efficient addition to the health sector as a whole, particularly by way of reducing the number of patients attending acute hospitals and GP practices.

South Eastern Health & Social Care Trust

The revision of the CG95 NICE guidelines published in November 2016 sparked an opportunity for the team to reflect on their current practice at that time. This resulted in a change to the day-to-day routine of the Rapid Access Angina Assessment Clinic by providing on-the-day access to four CT angiography sessions per week, leading to patients having access to an appropriate first-line imaging test in a timely manner.

The implementation of the improvements also kickstarted a more meaningful conversation in that the team were able to shift their focus and offer personalised risk factor and lifestyle modification advice.

The nature of the CT angiography clinics has ensured not only an increase in the capacity and equity of services across the three sites within the South Eastern Health & Social Care Trust, but also the strengthening of post-test conversations. Due to same-day diagnosis, the team can supply education where appropriate and the immediate commencement of targeted medical therapy.

Community Pharmacy Practice of the Year

Sponsored by Kent Pharma

Bannside Pharmacy, Portglenone

Since its establishment in 1960, Bannside Pharmacy’s success has been underscored by the team’s continued commitment to securing the highest quality of services for patients, as well as adopting new, innovative pathways in this pursuit.

For example, at the end of 2017 the pharmacy received funding from the Diabetes UK Innovation & Improvement Fund to conduct a 12-week programme in 2018 for 10 people with type 2 diabetes, entitled the Portglenone Diabetes Partnership, with the aim of helping them achieve better control and / or reversal of this condition, provided that they were willing to make changes in what they ate and drank; their physical activity levels; and how they managed their stress.

The pharmacy have also introduced the Afinion 2 Point of Care Analyser which has been utilised primarily for two diagnostic tests: HbA1c – for the Portglenone Diabetes Partnership programme, and CRP – for the Acute Cough Assessment pilot running.

LloydsPharmacy Team, Broughshane Street, Ballymena

For more than 20 years, LloydsPharmacy has been steadfast and reputable in the provision of care for the community.

Always keen to improve accessibility for patients, the branch is currently transitioning to a text message service called P2P in order to alert customers to pick up their medication; subsequently boosting patient compliance with their medication and reducing waste. The pharmacy also has an exclusive dispensing area for trays which the branch has taken advantage of to supply medication to a 50-bed nursing home and two residential homes, while also providing monitored dosage trays to patients in the surrounding area.

The team have recently started up a MASTA travel vaccine clinic which provides travel vaccinations to patients in the local community in an area where this is becoming more in demand. The clinic involves a 30-minute consultation with Gwen who can then administer a vaccine for diseases ranging from typhoid, hepatitis and yellow fever.

LloydsPharmacy, Trench Road Shopping Centre, Derry

The pharmacy has been well-established in the community for 24 years, serving thousands of patients and becoming a health and wellbeing hub for the local area. The ACT and supervisor have been there since it first opened, and Shauna Doherty has been the regular pharmacist for the past three years.

Reflective of the team’s industriousness in helping the local population, Shauna has been involved with a BCPPP project, fostering self-care and initiatives to stay healthy. Every week a range of topics are discussed, from blood pressure and blood glucose testing, to tips for staying well in winter, sleep hygiene, and pain management. The group are also aiming for a yoga day and pink ladies day to highlight the significance of wellbeing and checking – with these outreach initiatives ultimately bolstering awareness and understanding of key health issues within the community.

Meigh Pharmacy, Killeavy

Meigh Pharmacy has been providing a comprehensive array of services, as well as valuable advice to patients, for 15 years. The team relocated within the village of Meigh two years ago with their vision of establishing a more patient / public-driven pharmacy. With the relocation, they increased the size and layout of the dispensary to allow for improved working areas and enhanced storage.

Further integrating the role of technology into the pharmacy’s day-to-day operation, the team installed a screen within the pharmacy with Screen Cloud – a digital signage software used to portray information to customers regarding the wide range of services on offer. The installation of a state-of-the-art dispensing robot has also created the opportunity for improved efficiency when handling stock and prescriptions.

Well Pharmacy, Crumlin Road, Belfast

Well Pharmacy Crumlin Road has been at its current location for four years, prior to that being the co-operative pharmacy at the same site for many years. In line with their consistent passion for reflecting what matters most to customers, the team have introduced a number of systems within the pharmacy which have increased efficiency and allowed them to make the most of the facilities available to them.

With a new pharmacist manager – John Kennedy – in post since April 2019, the pharmacy has particularly flourished. Prescription numbers are up 24 per cent on the previous year and OTC sales are up over eight per cent. The pharmacy has also scored at least 80 per cent in its last two mystery shopper reports.

Well has additionally all but completed a huge project to change to a new Patient Medication Record system which is faster, more stable, and more intuitive than the previous structure.

Managing Substance Dependency in the Community

Sponsored by Ethypharm UK

Drug Alcohol Mental Health Service, Belfast Health & Social Care Trust

The Drug Alcohol Mental Health Service (DAMHS) was launched in 2007, joining the Children Adolescent Mental Health Service.

The specialist drug and alcohol mental health initiative provides assessment and targeted specialist therapeutic intervention for children and young people who present with a significant substance misuse problem, as well as moderate-to-severe emotional and psychological needs.

In recognition of the complexities of the patients suffering from the co-morbid poly substance-using presentation, the DAMHS team’s primary purpose became to endeavour to reach and treat the most isolated vulnerable and often stigmatised chronic drug-using, risk-taking young people. Where possible, the service-users with significant mental health difficulties are included, along with families and voluntary and community networks, to join in the treatment process, collaboratively working to understand better, and participate more often, on the road to change.

Belfast Health & Social Care Trust

The Belfast Community Addiction Team (CAT) are a tier three specialist service providing assessment, co-ordinated care-planning, and treatment of individuals with harmful and / or dependent alcohol and / or drug misuse. Referrals for CAT, in the main, come from three sources – GPs; internally within the Belfast Health & Social Care Trust; and external partners e.g. probation.

The community addiction hub has been devised to ensure that service-users access the right service with the right person at the right time, all the while reducing waiting times. The impact of the efforts is reflected in the stream of improvements attained, in that the waiting time for a CAT assessment has reduced from six months to two weeks and there are now zero breaches. 95 per cent of assessments are suitable for CAT compared to the previous 35 per cent who were referred on to tier two services. Feedback from service-users is also indicative of the effectiveness of the treatment journey, as the responses to date have been 98 per cent positive.

Boots Pharmacy, Queen Street, Ballymena

The Building the Community-Pharmacy Partnership-funded project between Boots Pharmacy and the Hope Centre is targeted specifically for those with addictions to drugs and alcohol.

Each fortnight Caroline conducts an interactive health talk on various topics followed by lunch and a one-to-one opportunity for the individuals to speak to her about their own personal health queries, whether it be physical, mental or emotional. Some of the subjects incorporated within the sessions include dealing with depression, anxiety, and sleep disorders, which are problems commonly associated with addictions.

During the one-to-one sessions there have been a number of referrals which have required GP interventions. For example, one particular case involved a client who was in his 60s who had diabetes and memory problems due to previous alcohol abuse As a result of taking action and ringing his GP, Caroline was able to help get a medication system set up which was easier for him to manage.

Dunluce Health Centre

In the face of a huge increase in demand, the Belfast Health & Social Care Trust Substitute Prescribing Team faced significant challenges in the assessment, treatment and ongoing retention of patients in the opioid substitution programme.

The team were thus passionate about implementing a system in which patients who required the service were seen in a safe, timely manner by the appropriate healthcare professional, and that the existing patients within the service continued to receive personalised, recovery-based care for as long as was required.

The team aimed to create capacity within the service to allow a greater number of patients to be assessed and treated and ‘future proof’ the service for the ongoing increasing demand and rising referral rates. This was to involve creating new posts, including developing a non-medical prescriber position and a general practitioner with special interest position to work closely with other interested GPs, in addition to advancing the recovery pathway for patients within the service.

Innovative Developments in the Management of Inflammatory Bowel Disease

Sponsored by Tillotts Pharma

Northern Health & Social Care Trust

Representatives from Crohn’s and Colitis UK approached the School of Pharmacy at QUB to be involved in the education of pharmacy students in inflammatory bowel disease (IBD). As a result, a workshop was hosted as a pilot for third year pharmacy students, designed and developed over several months and led by representatives from Crohn’s and Colitis UK, a teacher practitioner pharmacist, and an IBD nurse from the Northern Health & Social Care Trust.

The aims of the workshop included increasing awareness of IBD and understanding of the patient experience, in addition to building on the knowledge and treatment of IBD, encouraging appreciation of the impact which pharmacists can make, and understanding the multi-professional care of IBD patients. At the end of the workshop students had the opportunity to undertake some pre-prescribing skills e.g. blood pressure, temperature and pulse measurement, mirroring those completed in an IBD biologics clinic, and were able to practice self-injecting an adalimumab pen.

Belfast Health & Social Care Trust

In 2018, GP pharmacists recognised that improvement was needed in polypharmacy management of IBD, while a recent report recognised that GP pharmacists could undertake reviews with IBD patients to cover medication compliance, flare management, dietary and lifestyle advice, and contraception, fertility and pregnancy.

Local training delivered by a specialist IBD nurse was rolled out to regional level and local commissioning group funding was secured for 15 GP pharmacists to undertake medication review for IBD patients. Extra funding additionally allowed it to be expanded to 23 practices due to the initial under-estimated interest.

With the service having paved the way for enhanced care and confidence for individuals, IBD patients in these practices can now ask for a pharmacist-led medication review in their GP practice, where a more focused review of their condition and medicines can take place, establishing any issues with medication, dosing, concordance etc.

Belfast Health & Social Care Trust

The roots of the project were forged with the objective of further strengthening the MD IBD team by calculating the financial impact of Humira losing its patent and the early adoption of the best value product.

The initiative was led by the IBD nursing team and pharmacist, but supported by trust management and GI consultants with IBD patients.

The project successfully identified funding for a further IBD nurse, GI pharmacist and pathology support at the weekly MDM. This increase in resources will prove a great benefit to IBD patients, providing further cover for the IBD nursing service and valuable pharmacy input for GI acute admissions.

Regional procurement finalised the pricing structure for Adalimumab at the end of January 2019, and by the end of April 2019, 200 patients had been identified and of those, 198 were consented to switch.

With the advancement of patient education playing a major role in the effectiveness of the initiative, each patient was counselled on the Humira brand, explaining the rationale for switching and gaining consent.

South Eastern Health & Social Care Trust

The project has focused on the development of a gastro hub which could provide consultant-led gastroenterology services, with access to allied health professionals, such as dieticians, IBD and gastrointestinal cancer nurse specialists and IBD pharmacist services. By putting this in place, a stream of positive changes to patient care occurred, including a reduced length of inpatient stay for those admitted to hospital, as well as rapid access to diagnostics and procedures, such as endoscopy and paracentesis, and rapid access to blood tests with timely follow-up of results. The unit offers a sense of security for the attendees as they now have a point of contact where they know they can be seen by a senior clinician in a timely way.

The service is currently accessible via online referral from the Emergency Department, from medical and nursing colleagues in the acute medical ward via a dedicated gastro hub email address. Patients with chronic disease, such as IBD and liver disease, can also access the gastro hub via contact with the IBD specialist nurse or pharmacist / gastro secretaries.

Management of Psoriasis

Sponsored by UCB Pharma

Day-Care Unit, Belfast Health & Social Care Trust Dermatology Service

The dermatology day-care unit in the Belfast City Hospital provides a holistic nurse-led service that supports the patient through the management and treatment of their psoriasis. In particular, the specialist dermatology unit offers high quality care to all patients suffering from psoriasis, while the experienced nursing team is available to answer patient concerns, in addition to educating the individuals and guiding them through their treatments so that they have the knowledge and skills to care for their skin at home.

Patients who have psoriasis are referred to the nurse-led unit in four south throughout different stages of their treatment journey, in which the referral may range from the application and education of topical treatments, to phototherapy, to education and commencement of sub-cutaneous methotrexate to administration of biologic infusions. There is also a dermatology outreach nurse service provided to patients who require inpatient admission with their psoriasis.

The Dermatology Biologic Nurse Service, Belfast Health & Social Care Trust

Since 2009, the role of the specialist nurse has proved invaluable to ensuring that the growing psoriasis service is managed safely and that patients are seen, treated and monitored when expected. Nurse-led biologic clinics were established to support the consultant clinics and currently there are nine clinics per week that run every day and a helpline that patients can use if required.

Every consultation is hugely important as biologic therapy requires close monitoring and making sure that patients are equipped to be as independent as possible. Attendance to appointments are high, confirming the level of importance that patients place on this.

The service has revolutionised the management of psoriasis patients on biologic therapies. Before their roles, and the service development, patients were managed in the general clinic with rotating medical teams where appointment times were 10 minutes. The development of the specialist nurse roles, however, has now resulted in increased co-ordinated care.

Northern Health & Social Care Trust

The Integrated Clinical Assessment and Treatment Service has been designed to deliver specialist, individualised and accessible care to meet the needs of patients with psoriasis.

In line with this objective, referrals for psoriasis are now sent to a nurse specialist clinic as close to the patient’s home as possible. The waiting times for nurse specialist clinics average six-to-12 weeks as opposed to much longer waiting times for consultant-led clinics.

The timely manner in which the service is provided is a much-appreciated element for patients who have a half-hour time slot during which they will have a full assessment of their skin, including PASI, DLQI, and PEST carried out, in addition to referral being made to day-care for phototherapy, the optimisation and prescribing of topical treatment, being supplied directions for employing treatments, and a work-up for systemic drugs carried out if appropriate.

NMP Nurse-Led Systemic Services, Southern Health & Social Care Trust

Nurse practitioner Maria McCreesh undertakes a nurse-led service for administration and training of subcutaneous Methotrexate – educating the patients on the chosen drug, training them on how to administer the medication, and providing a prescription for the GP to prescribe. She also arranges appropriate follow-up appointments thereafter.

The service has driven greater patient care, particularly as a result of the individuals having the valuable opportunity to develop an effective relationship on a one-to-one basis with a named nurse. Maria conducts excellent holistic assessments and easily-accessible advice. The work undertaken has thus reduced waiting times for access to the drug, provided a continuity of care, and has improved the overall quality of life for patients who are suffering from this chronic condition.

The sharing of best practice has emerged as another key outcome of this initiative.