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Locally Nottinghamshire is divided into six clinical commissioning groups, each have commissioned services to support care homes in a variety of ways. This has resulted in teams creating new resources, including training packages, information leaflets, and processes of identifying residents at risk of admission.  The majority of this work has been done in isolation and not been shared across the county.


Recommendations of collaborative working feature in a number of reports including: Darzi (2008), Berwick (2013) and Francis (2013). Whilst NHS England (2014) advocates organisations working in partnership in order to maximise output with the current constraints, ensuring a consistent and cost effective approach to health and social care service delivery.


Lave and Wegner developed the concept of Communities of Practice almost three decades ago. Defined as a group of people who share common interest, learning how to improve as they interact on a frequent basis (Wenger- Trayner & Wenger- Trayner, 2015). We have set about creating a dedicated Community of Practice bringing together health and social care professionals working in the care home sector across Nottinghamshire. The Community meets monthly and has a dedicated Twitter account which enables free interaction between members and sharing of resources, experience and ideas.


The introduction of Nottinghamshire’s Community of Practice for health and social care professionals, has enabled people to come together and share existing resources, whilst identifying what works well and areas that require further development. This collaborative approach enables quality improvement initiatives that have been trialled in one locality to be spread across the county. This reduces waste and colleagues are able to look to each other for support instead of trying to reinvent the wheel.


The group currently has 60 members from 14 organisations and meets on a monthly basis, with an average attendance of 20 people. Due to limited space available we are unable to accommodate more than 20 at one meeting.  Minutes are recorded and distributed to the group to ensure that all members are communicated with.


A celebration event is planned for July and over 20 new members will be attending. At the event we will be hearing from care homes who have implemented new initiatives, who will be able to provide guidance and support to group members on further implementation.


Professionals from neighbouring counties have also expressed an interest in the group and there are plans to develop an online platform for a community of practice to operate regionally across the East Midlands.


Links have also been made to other areas that operate communities of practice and there will be an ability to share work nationally and learn what works well in other areas and share best practice.


Building on the existing foundations of the group, we plan to be expand this community of practice, ensuring we are reaching as many professionals as possible. We want to explore the potential of replicating the model and applying to professionals working directly in the social care sector with a link between the two. We also want to use the group to act as a platform to identify areas of good practice taking place in care homes and promote these areas so other care homes can learn what works well. We hope to try and improve the relationships between those working in the care sector and other professionals and enable them to develop a better understanding of each other’s roles.


Benefits & Evaluation
We have completed an initial scoping exercise which has:


1, Identified what training is currently available to care homes; and


2, Asked members to identify what they want from the group, what they can offer the group and any tasks/ focus they would like to see undertaken.


Key outcomes to date include improved communication between professionals, collaborative working, and consistent approach to training delivered to care homes.


We now want to undertake a formal evaluation of the Community of Practice initiative to understand:


What were benefits of participating in the CoP?
Did they face any challenges in participating in the CoP?
Were their needs and priorities met?
Examples where there has been a change to practice as a result of participation.


This project will add to the literature and evidence base on Communities of Practice and health and social care. Resources that have been developed by group members will be shared with Q members for adoption and use in their own areas of practice.


We will also share our experience and learning from establishing and growing the community of practice and how we approached and overcame challenges and barriers.  A summary and presentation of our work can be shared with Q members as required.


References:


Berwick, D. (2013) A promise to learn – a commitment to act: improving the safety of patients in England [online]. Available at: https://www.gov.uk/government/publications/berwick-review-into-patient-safety


Darzi, AW. (2008) High Quality Care For All [online]. London: Department of Health. Available at: http://www.nhshistory.net/darzifinal.pdf


Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive Summary [online] Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/279124/0947.pdf


National Health Service (NHS) England (2014) 5 Year Forward View [online]. Available at: https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf


Comments

  1. Excellent idea, as it builds on all the good work that is going on across the local care homes

  2. Hi Nicola,

     

    This sounds like a great idea - especially useful for sharing areas of good practice that have worked already across a care homes patch. It helps to emphasis the importance of learning from best practice and avoid care homes acting in isolation. It is also a good mechanism of ensuring care homes can stay up to date with current evidence on best practice.

    Good luck with it!

     

  3. Hi Nicola - This sounds like a great idea. I am a great fan of Communities of Practice as a way to share knowledge and learn together across our complex landscapes. I think it is great that you are going to try to evaluate your success - not an easy thing to do! I wish you all the best with this and look forward to hearing about your journey.

  4. I support this work as the Patient Safety Collaborative lead for the East Midlands. We currently have a safety in care home sproject called LPZ which is an internationally validated benchmarking audit of prevalence of six common Care problems.

  5. Hi Nicola and all,

    We'll be learning about the Health Innovation Network/S London AHSN's journey with their Communities of Practice in a Zoom call on 13 July:   https://q.health.org.uk/event/the-sustainability-and-impact-of-nhs-communities-of-practice-lessons-from-a-rand-europe-evaluation/ (all welcome)

    We'll be hearing from Prof Tom Ling, who’s co-authored an evaluation of Hin's CoPs and Cleo Butterworth, co-convener of HIN's Medicines Optimisation CoP.

    It should be fun, and illuminating – do join us (please register, to receive the login info).

    I hope there'll be insights that will help Nottinghamshire's Community of Practice project - bring any questions and challenges.

     

  6. This sounds like a great idea and we would be really interested in the evaluation.  We have a similar network in the Thames Valley, with health professionals who 'in-reach' into care homes and would find it valuable to have discussions at some point to share experiences. We don't currently have social care professionals in our group.

    In practical terms for the meeting size, have you considered running some of these meetings as interactive webinars?

    1. Hi Fran, thank you for taking the time to comment, it would be great to catch up and learn how you operate, my email is Nicola.payne8@nhs.net. Can I ask that if you are interested in supporting our project bid, you login and become a support on our project bid page? Many thanks Nicola

  7. Guest

    Caroline Bruckner-Holt 2 years, 10 months ago

    Dear Nicola and Neil,

    This is a very sensible (and great idea). I work in Palliative Care and at a regional forum just last week we talked about work we were involved in within care homes....it is amazing how many initiatives there are currently underway...usually addressing similar problems/ needs in care homes by various health care professionals in a similar patch....with very few people aware of what else is going on, nor using the evaluation of ideas already undertaken before formulating and launching their own programmes. Good luck with this project and I will be very interested indeed to see how you get on.....we need something like this in our region!

    1. Dear Caroline, thank you for your comments, it would be good to make contact and discuss further if possible please, my email Nicola.payne8@nhs.net. Can I ask that if you support our idea, you login and become one of our supporters of the project bid. Thanks Nicola

  8. Really good idea. As part of your evaluation, it would be nice to understand what the barriers (and solutions) to CoPs are. Personally, I am a big fan of diverse networks to support idea exchange and learning but actually doing this is hard work!

    In case you've not seen... https://www.pharmaceutical-journal.com/news-and-analysis/communities-of-practice-that-include-all-sectors-of-pharmacy-to-launch-in-merseyside/11136029.article

    Good luck.

    1. Thank you for the feedback Wasim, and the article, much appreciated!

  9. Guest

    Alison Dinning 2 years, 10 months ago

    Hi Nicola and Neil, I think the community of practice group is a great idea. I am currently scoping the introduction of NEWS and SBAR tools into care homes in Nottinghamshire for the patient safety collaborative. I firmly believe that sharing knowledge, learning and best practice from all healthcare providers across the region is essential. I would be really grateful if anyone from the CoP group would share their ideas with me. There is amazing work happening in Care Homes in Notts which we need to share widely.

    1. Hi Alison, thanks for your comments. Can I ask, if you support our idea, that you login and click on support please? many thanks Nicola

  10. Check out the ToDipOrNotToDip community of Practice hosted on Slack by Elizabeth.beech@nhs.net (mail for an invite) This community was set up 18 months ago as my challenge to myself on joining Q. It grew from an program to improve the management of UTI in care home residents in Bath and North East Somerset and now has 400+ members from 8 countries and that includes clinicians from Nottingham too. Slack works well allowing document sharing and easy comms. And permissions can be set as high and low as you like

    1. Hi Elizabeth, thank you for your comments and invitation to join Slack, it has been very informative! Can I ask that if you support our idea, you login and become one of the supporters on the project bid page please? Many thanks Nicola

  11. Hi Neil and Nicola,
    Great to see this use of communities of practices. Q's Communities of Practice SIG has heard from Dr Igor Pyrko on what makes some of the Scottish NHS thrive, and some not. We plan to heard from the HIN (S London AHSN) about RAND Europe's evaluation of their CoPs, from the Co-Creation Network's CoPs and other research into CoPs over the coming months.

    So do join the Communities of Practice SIG, if you'd like to hear about this: https://q.health.org.uk/community/groups/communities-of-practice/

    There will also be an announcement about Q's support for CoPs - which may be very valuable for you too.

    You might be interested in how the Developmental Evaluation approach has been used with CoPs. Here's an article: http://centaur.reading.ac.uk/57345/1/LO%20Paper%20FINAL_ACCEPTED%20(1).pdf

    Interestingly, Etienne Wenger is now also writing about the importance of the wider role of 'Systems Convening' and how crucial that is in spreading learning and practice across a complex landscape. It feels very relevant for Q, and for the NHS in the STPs era. I have a good chapter by the Wengers on Systems Convening. Let me know if you'd like to see it.

     

     

    1. Hi Matthew, thank you for your comments, your reading recommendations are very helpful. I have joined the Communities of Practice SIG, and will look out for the announcement. If you could send me he chapter by the Wengers I would appreciate it. Thanks, Nicola.

  12. Guest

    Elizabeth Bradbury 2 years, 11 months ago

    Sounds a great initiative with the potential to benefit residents, staff and the wider system. There are several programmes to support care home staff in the North West to improve the quality of care they offer & these include aspects of staff training e.g. Bolton Council's Care Home Excellence programme, similar work in Wigan. AQuA are in d/w the North West ADASS about a bespoke introduction to improvement programme for care home staff and some of those staff have participated in our generic QI training programmes where use Kirkpatrick to gauge impact. Contact AQuA@srft.nhs.uk to find out more

    1. Hi Elizabeth, I am trying to gather supporters for our idea, if you are able to login and become a supporter of our project bid we would be grateful. Thanks Nicola

    2. Thanks Elizabeth, that is really useful information. I will get in touch with these to learn about what worked for them. We have had fantastic feedback in our early evaluation, so I am hoping others can see the wider benefits and impact it will have.

  13. This is a great outline of the challenges and benefits of meeting together to share ideas and resources. From our work in the PEACH study (Proactive Healthcare in Care Homes, funded by Dunhill Medical Trust) we have worked with multi-sector teams in each CCG area of 'Greater Nottingham' (is it a footprint or something?!) We heard of great initiatives ongoing in each CCG area, and it would be great to facilitate sharing of this knowledge, expertise and resources across whole of Nottinghamshire.

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