Healthy Together Clinic

1. Healthy Together Clinic An integrated nursing one year test and learn pilot Thursdays at the WithywoodCentre, 9am-12.30pm

2. Aims of the pilot clinic • Go 6 practices and BCH nurses working together • Wound care specialist nurse at the clinic sharing knowledge and skills • Development of a new patient pathway • Improve healing times for complex wounds • Delivering the 'gold standard' treatment for venous leg ulcers recommended by NICE through the presence of a Tissue Viability Nurse as clinical lead • A social opportunity for patients that includes informal promotion of health and self-care.

3. The Model • Better Care Bristol funding secured in 2017 to pilot the clinic for 1 year • Community venue at the Withywood Centre • Staffed by a clinical lead (TVN) and treatment room nurses and HCAs from Go6 GP practices • Age UK Bristol provide social support – speakers, volunteers, signposting • Drop in clinic • Patients can self refer • Transport provided for housebound patients

4. Providing the right care in the right place • 67 referrals in 11 months • 35 patients discharged as healed • 55% of patients are discharged as healed within 3 months of first attendance at the Healthy Together Clinic • Less than 2% of patients who attended the clinic have had a recurrence of their leg ulcer

5. Providing the right care in the right place • Patients attending the community clinic are more likely to self care. 2 patients have self referred back to the clinic • Patients report that they feel more positive about their treatment when they see other patients progress, generating increased concordance • Some patients who were previously attending treatment rooms for multiple visits per week have healed or now only require one visit to the clinic due to a change in treatment regime • The majority of patients report that they enjoy the social aspect of the clinic

6. I attended the clinic last week for the first time with a small ulcer I have been looking after myself for a year. I had a very warm welcome to the clinic, and as soon as my leg was looked at I knew it would get sorted. My ulcer is already smaller and the redness has been much better. Thank you to the team. I will definitely recommend it to anyone. Pat, patient

7. Benefits for patients • The clinic is delivered through a successful partnership with AgeUK Bristol, adding social value • 2 patients have returned to the clinic as volunteers • Dressings reduced to once a week • Faster healing • Not restricted to time slots during the morning – patients have tea and cake whilst waiting • Community setting; patients make new friends and use the other facilities at the Withywood Centre.

8. Benefits for staff ‘I have found working along a practice nurse very helpful and feel that I have gained more confidence with wound care in general not just on legs because of having more time to work along side and ask questions/share knowledge. Patients really do enjoy the experience too and being able to see their ulcers heal and the patients happy is extremely warranted.’ • All nurses and HCAs report an improvement in their clinical knowledge and practice as a direct result of working in the integrated setting supported by the specialist nurse • 100% of staff report that they have been able to use the skills gained through the Healthy Together Clinic in practice outside the clinic

9. I would definitely recommend it. I’ve been to a few leg ulcer clinics over the years, and this one is very friendly... I had a nice chat with another patient. Jenny the nurse is lovely! Liz, patient

10. Going forward…. • Model adapted to reduce impact on practices from time out of the treatment room. • Funding has been secured for 6 months for the Clinical Lead, 1 RGN and 1 HCA as well as running costs. • Additional staffing (1 RGN & 1 HCA each week) provided by practices and BCH based on the proportionate number of patients seen in clinic in 2017/2018. • Hoping to continue partnership working with AgeUK Bristol