Health and social care

Health and social care

Health and social care

Introduction

Our Covid-19 Action Fund provides grants for Churchill Fellows to run projects combating the effects of Covid-19 in all areas of society. Hundreds of pandemic projects nationwide are being run or assisted by Churchill Fellows, using the international expertise they gained during their Fellowships overseas. Here are the Action Fund recipients working on health and social care issues.

December 2020 awards

Chloe Reeves: advocating for people with long-term health conditions in social care reform

The pandemic has had a dramatic impact on health and social care with many services being paused or reconfigured. People living with long-term conditions or disability, and their unpaid carers, have been significantly impacted by these changes, yet their voices often go unheard. The current government has begun work on adult social care reform – the Department of Health and Social Care has recruited people to lead this agenda – and it is important that the people who depend upon adult social care are included in this work.

Chloe Reeves, from St Leonards-on-Sea, is Director of London Road Policy and Projects, a health and social care consultancy, and an associate of National Voices, the coalition of charities that advocates for people having more control of their health and care. During the pandemic, she worked with National Voices to launch Our Covid Voices, an online platform inviting members of the public to share their stories and experiences of health and social care, which are brought together in the report What We Need Now.

She will use her grant to support National Voices to develop and implement an influencing plan, sharing these stories, requests and recurring themes with policymakers and healthcare providers so that the people most affected by health and care reform are at the heart of it. Chloe's Churchill Fellowship to Sweden and the Netherlands in 2018 explored third sector contribution to the Buurtzorg model of care.

Dorothy Smith: supporting students in recovery from addiction

The impact of lockdown, disconnection and social isolation have led to an increase in alcohol and drug use. The Royal College of Psychiatrists has reported that, during the pandemic, nearly 8.5 million adults have been drinking 'at high risk', and the number of people addicted to opiates seeking help in 2021 was at its highest level since 2015. Additionally, there has been a rise in the problematic use of gaming, gambling and screen-time particularly among the student population, who are undergoing a much more isolated university experience.

Dorothy Smith from Sedgefield in Durham is the CEO of Recovery Connections, a charity supporting people with experience of addiction into recovery.

She will use her grant to develop and launch a website to connect and encourage peer support among students who are recovering from addiction. The website will provide a platform for students to get information, connect with others through a chatroom and be signposted to specialist advice and support services. In this way, they will not have to go through recovery alone. Dorothy hopes that this platform will raise awareness of the need to provide recovering students with increased and more visible support across UK campuses, in order to reduce stigma, meet the needs of this group and prevent relapse. Dorothy's Churchill Fellowship to Czechia and the USA in 2017 explored collegiate recovery programmes.

Kerry Wykes: supporting the wellbeing of healthcare workers

During the pandemic, healthcare workers have faced increased risk to their mental health and wellbeing, with purported risks of PTSD higher than 10% on the front line. Many of them fear for their own health whilst treating patients with Covid-19, as well as experiencing increased workload pressures and responsibilities in an often changing and uncertain environment. Working patterns such as night shifts could be a barrier to accessing support services.

Kerry Wykes, an emergency nurse by background, now works as Assistant Professor in Emergency Care for Coventry University. She will use her grant to launch a series of online workshops for healthcare workers to explore their experiences of Covid-19 through the arts, in conjunction with China Plate Theatre.

Each workshop will be open to ten participants to share their experiences with each other in order to encourage compassion and self-care, and will inspire an artistic output that will be exhibited online, to reach much larger numbers. Kerry has already run a pilot project which was very well-received and allowed a number of healthcare workers to feel that their voices were heard. She plans to publish the research from her project to promote understanding of healthcare worker experiences as well as to show the benefit of the arts, particularly at a time when arts organisations are under threat. Kerry's Churchill Fellowship to Bangladesh in 2014 explored domestic abuse services and one of her findings was how the arts can be used to tackle sensitive subjects. It was supported by The Burdett Trust for Nursing.

Leah Macaden: providing specialised Covid-19 training for care-home workers

The Covid-19 crisis has had a disproportionate effect on care homes, their staff, patients and families. As well as high death rates from the virus amongst care-home patients, care groups such as Age UK and the National Care Forum have warned that many are at risk from premature deaths due to the visiting ban and not being able to see their loved ones. Changes in care and staff shortages have had a particular impact on the 50% of care-home residents who have dementia and complex care needs. Care-home staff, who are generally on low wages and can feel undervalued, have also experienced higher levels of psychological distress during the pandemic.

Leah Macaden from Inverness in Scotland is Senior Lecturer in Nursing at the University of the Highlands and Islands (UHI). Leah has expertise in leading dementia nurse education initiatives for pre-registration nurse education and has developed Being Dementia Smart (2013) and Dementia Enhanced Education to Promote Excellence (DEEPE) (2017).

She will use her grant to develop a new project called Training of Trainers (TOT) Programme: Covid-19 Dementia Education for Care Homes (CODECH). Leah will work with another Churchill Fellow, Ruth Mantle, and colleagues in nurse education and educational technology at UHI to develop a tailored online dementia training programme for care-home workers in the context of the pandemic. The programme will include three web-based workbooks and virtual interactive sessions. CODECH will train 20 care-home workers working with a Care Home Group as trainers themselves, who will then cascade the training to the rest of their staff to provide dementia care tailored to the context of the Covid-19 crisis. The project hopes to boost morale amongst staff, who will be better trained and equipped for dealing with the changing demands of the pandemic. Leah's Churchill Fellowship to the USA in 2019 explored models of dementia nurse education and training and was supported by The Burdett Trust for Nursing.

Nicholas Ambler: building resilience amongst intensive care staff

The Covid-19 crisis has led to chronic exhaustion amongst Intensive Care Unit (ICU) staff, caused by extremely challenging working conditions, inadequate rest, high numbers of deaths, and little news of survivors after discharge. In many cases, the intensity of the frontline work will lead to long-term health problems and, in some, a premature end to their career. Attrition depletes hospital teams and services.

Nicholas Ambler from Bristol is a clinical psychologist at North Bristol NHS Trust, which is home to one of the largest ICUs in the UK.

He will use his grant to launch a recuperation strategy for ICU staff based on the framework for resilience described by the Institute for Healthcare Improvement. The strategy will be co-produced with ICU staff and will involve training a lead in each of the four ICU wards, as well as creating a feedback system for patient recovery stories, known to be cherished by the staff who had earlier looked after them. Nick hopes that the strategy will build staff resilience and prevent burnout. He will share the learning with frontline healthcare workers elsewhere to help them recuperate from this exceptionally intense period. His Churchill Fellowship to the USA in 1993 explored the care of complex pain and trauma.

June 2020 awards

Ceinwen Giles: supporting young adults with cancer

Individuals with cancer are at high risk from Covid-19 because many cancer treatments, as well as cancer itself, affect the body's immune system and its ability to fight infection. Additionally, the pandemic is having a significant effect on the ability of cancer patients to access or maintain their treatment, and shielding measures for cancer patients are also negatively impacting their mental health.

Ceinwen Giles from south-east London is Co-Director of Shine Cancer Support, a patient-led UK charity that supports adults in their 20s, 30s and 40s who have experienced a cancer diagnosis. During the pandemic they have adapted some of their services online, setting up video groups and online workshops, despite experiencing a dramatic fall in income due to fundraising events being cancelled.

Ceinwen will use her grant to grow this online support and develop peer-to-peer services that support young adults with cancer through the pandemic and its aftermath. A recent survey by her charity revealed that 56% of cancer patients feel socially isolated from others, 36% have experienced symptoms of depression more frequently, and 60% are experiencing anxiety more often than before lockdown. Ceinwen will pilot the development of small online groups of up to eight young adults with cancer to meet on a regular basis and support each other. She aims to create a minimum of eight groups by November 2020, including specific groups for young adults who are newly diagnosed, those from minority backgrounds and those with incurable cancer. Further expansion is planned for next year. She will document the lessons learnt through these groups, to share them with the wider cancer community. Ceinwen's Fellowship explored innovative support to young adult cancer survivors in the USA and Canada.

E.A. Draffan: enhancing communication between healthcare workers and their patients

Speech and language experts worldwide are concerned about a lack of support for people with communication difficulties during the Covid-19 pandemic. Patients who may not be fluent in English, who have an underlying condition that inhibits speech, who are using a ventilator so can't speak, or who have poor literacy skills – all are at higher risk of developing a serious adverse medical condition if they cannot communicate with their healthcare providers.

Speech and language therapist E.A. Draffan, from Rackham, near Pulborough in West Sussex, will use her grant to enhance the development of an app she has helped to create, which enables health and social care workers to communicate with patients who have difficulty communicating.

The app, called Boardbuilder, involves the use of charts, symbols and pictographic images, which the patient can select in order to communicate with their carer. The app is freely available to be used by anyone across the UK, but it currently doesn't allow personalisation for specific users and it lacks appropriate healthcare vocabulary – including images relating to Covid-19, which need to be captured. E.A. and her colleagues will enhance and expand the app so that it can become personalised, allowing charts for specific users to be saved and exported. They will develop a simple symbol creation tool, to allow health and care workers to rapidly add and adapt suitable images or graphics to expand communication. And they will expand the symbols and images available to include Covid-19 health-related issues. E.A. explored assistive technologies for training in literacy skills on her Churchill Fellowship to the USA in 1995.

Sara Dunn: supporting unpaid carers during Covid-19

Unpaid carers are one of the least supported groups in society and they are now carrying a huge burden of risk during the pandemic. In the absence of suitable PPE or clear guidance, many are concerned for their health and wonder how to continue safely in their caring role.

Digital inclusion consultant Sara Dunn from Dorchester in Dorset is the founder of CuppaCare, a mobile app and micro-learning platform for care workers.

She will use her grant to develop the app so that it provides a Covid-19 survival pack, available free of charge for unpaid carers. The pack will provide free guidance designed specifically for carers and presented in an accessible format. Sara will develop the pack in consultation with carers' organisations and with her own professional networks, and will promote the app through social media. Sara's Churchill Fellowship explored best practice in providing mental health information in Australia and New Zealand.

Tim Robbins: treating high-risk Covid-19 patients with diabetes

Research shows that people with diabetes are at greater risk from Covid-19 and this risk is heightened even further if they come from a deprived background or community.

Doctor Tim Robbins from Weston under Wetherley in Warwickshire will use his grant to monitor the health and wellbeing of Covid-19 patients from deprived communities who have diabetes. Tim has led work to issue digital glucose sensors for in-patients with Covid-19 and diabetes within his NHS Trust, allowing much closer monitoring than the usual finger-prick tests, so that they can be treated with the right healthcare support.

So far, this work has only been possible in hospital settings but Tim will use the grant to expand it into hard-to-reach and deprived high-risk populations after hospital discharge. This is needed because the mental and physical impacts of Covid-19 will last longer in such populations and may widen already existing health inequalities. Tim will engage further with these communities, focusing not only on blood-sugar control but also on mental health needs. He will develop and demonstrate the effectiveness of such a model via his NHS Trust – University Hospitals Coventry and Warwickshire NHS Trust – with the aim that it could be rolled out more widely. Tim’s Churchill Fellowship to the USA explored patient-centred digital health and personalised care.

December 2020 awards

Chloe Reeves: advocating for people with long-term health conditions in social care reform

The pandemic has had a dramatic impact on health and social care with many services being paused or reconfigured. People living with long-term conditions or disability, and their unpaid carers, have been significantly impacted by these changes, yet their voices often go unheard. The current government has begun work on adult social care reform – the Department of Health and Social Care has recruited people to lead this agenda – and it is important that the people who depend upon adult social care are included in this work.

Chloe Reeves, from St Leonards-on-Sea, is Director of London Road Policy and Projects, a health and social care consultancy, and an associate of National Voices, the coalition of charities that advocates for people having more control of their health and care. During the pandemic, she worked with National Voices to launch Our Covid Voices, an online platform inviting members of the public to share their stories and experiences of health and social care, which are brought together in the report What We Need Now.

She will use her grant to support National Voices to develop and implement an influencing plan, sharing these stories, requests and recurring themes with policymakers and healthcare providers so that the people most affected by health and care reform are at the heart of it. Chloe's Churchill Fellowship to Sweden and the Netherlands in 2018 explored third sector contribution to the Buurtzorg model of care.

Dorothy Smith: supporting students in recovery from addiction

The impact of lockdown, disconnection and social isolation have led to an increase in alcohol and drug use. The Royal College of Psychiatrists has reported that, during the pandemic, nearly 8.5 million adults have been drinking 'at high risk', and the number of people addicted to opiates seeking help in 2021 was at its highest level since 2015. Additionally, there has been a rise in the problematic use of gaming, gambling and screen-time particularly among the student population, who are undergoing a much more isolated university experience.

Dorothy Smith from Sedgefield in Durham is the CEO of Recovery Connections, a charity supporting people with experience of addiction into recovery.

She will use her grant to develop and launch a website to connect and encourage peer support among students who are recovering from addiction. The website will provide a platform for students to get information, connect with others through a chatroom and be signposted to specialist advice and support services. In this way, they will not have to go through recovery alone. Dorothy hopes that this platform will raise awareness of the need to provide recovering students with increased and more visible support across UK campuses, in order to reduce stigma, meet the needs of this group and prevent relapse. Dorothy's Churchill Fellowship to Czechia and the USA in 2017 explored collegiate recovery programmes.

Kerry Wykes: supporting the wellbeing of healthcare workers

During the pandemic, healthcare workers have faced increased risk to their mental health and wellbeing, with purported risks of PTSD higher than 10% on the front line. Many of them fear for their own health whilst treating patients with Covid-19, as well as experiencing increased workload pressures and responsibilities in an often changing and uncertain environment. Working patterns such as night shifts could be a barrier to accessing support services.

Kerry Wykes, an emergency nurse by background, now works as Assistant Professor in Emergency Care for Coventry University. She will use her grant to launch a series of online workshops for healthcare workers to explore their experiences of Covid-19 through the arts, in conjunction with China Plate Theatre.

Each workshop will be open to ten participants to share their experiences with each other in order to encourage compassion and self-care, and will inspire an artistic output that will be exhibited online, to reach much larger numbers. Kerry has already run a pilot project which was very well-received and allowed a number of healthcare workers to feel that their voices were heard. She plans to publish the research from her project to promote understanding of healthcare worker experiences as well as to show the benefit of the arts, particularly at a time when arts organisations are under threat. Kerry's Churchill Fellowship to Bangladesh in 2014 explored domestic abuse services and one of her findings was how the arts can be used to tackle sensitive subjects. It was supported by The Burdett Trust for Nursing.

Leah Macaden: providing specialised Covid-19 training for care-home workers

The Covid-19 crisis has had a disproportionate effect on care homes, their staff, patients and families. As well as high death rates from the virus amongst care-home patients, care groups such as Age UK and the National Care Forum have warned that many are at risk from premature deaths due to the visiting ban and not being able to see their loved ones. Changes in care and staff shortages have had a particular impact on the 50% of care-home residents who have dementia and complex care needs. Care-home staff, who are generally on low wages and can feel undervalued, have also experienced higher levels of psychological distress during the pandemic.

Leah Macaden from Inverness in Scotland is Senior Lecturer in Nursing at the University of the Highlands and Islands (UHI). Leah has expertise in leading dementia nurse education initiatives for pre-registration nurse education and has developed Being Dementia Smart (2013) and Dementia Enhanced Education to Promote Excellence (DEEPE) (2017).

She will use her grant to develop a new project called Training of Trainers (TOT) Programme: Covid-19 Dementia Education for Care Homes (CODECH). Leah will work with another Churchill Fellow, Ruth Mantle, and colleagues in nurse education and educational technology at UHI to develop a tailored online dementia training programme for care-home workers in the context of the pandemic. The programme will include three web-based workbooks and virtual interactive sessions. CODECH will train 20 care-home workers working with a Care Home Group as trainers themselves, who will then cascade the training to the rest of their staff to provide dementia care tailored to the context of the Covid-19 crisis. The project hopes to boost morale amongst staff, who will be better trained and equipped for dealing with the changing demands of the pandemic. Leah's Churchill Fellowship to the USA in 2019 explored models of dementia nurse education and training and was supported by The Burdett Trust for Nursing.

Nicholas Ambler: building resilience amongst intensive care staff

The Covid-19 crisis has led to chronic exhaustion amongst Intensive Care Unit (ICU) staff, caused by extremely challenging working conditions, inadequate rest, high numbers of deaths, and little news of survivors after discharge. In many cases, the intensity of the frontline work will lead to long-term health problems and, in some, a premature end to their career. Attrition depletes hospital teams and services.

Nicholas Ambler from Bristol is a clinical psychologist at North Bristol NHS Trust, which is home to one of the largest ICUs in the UK.

He will use his grant to launch a recuperation strategy for ICU staff based on the framework for resilience described by the Institute for Healthcare Improvement. The strategy will be co-produced with ICU staff and will involve training a lead in each of the four ICU wards, as well as creating a feedback system for patient recovery stories, known to be cherished by the staff who had earlier looked after them. Nick hopes that the strategy will build staff resilience and prevent burnout. He will share the learning with frontline healthcare workers elsewhere to help them recuperate from this exceptionally intense period. His Churchill Fellowship to the USA in 1993 explored the care of complex pain and trauma.

June 2020 awards

Ceinwen Giles: supporting young adults with cancer

Individuals with cancer are at high risk from Covid-19 because many cancer treatments, as well as cancer itself, affect the body's immune system and its ability to fight infection. Additionally, the pandemic is having a significant effect on the ability of cancer patients to access or maintain their treatment, and shielding measures for cancer patients are also negatively impacting their mental health.

Ceinwen Giles from south-east London is Co-Director of Shine Cancer Support, a patient-led UK charity that supports adults in their 20s, 30s and 40s who have experienced a cancer diagnosis. During the pandemic they have adapted some of their services online, setting up video groups and online workshops, despite experiencing a dramatic fall in income due to fundraising events being cancelled.

Ceinwen will use her grant to grow this online support and develop peer-to-peer services that support young adults with cancer through the pandemic and its aftermath. A recent survey by her charity revealed that 56% of cancer patients feel socially isolated from others, 36% have experienced symptoms of depression more frequently, and 60% are experiencing anxiety more often than before lockdown. Ceinwen will pilot the development of small online groups of up to eight young adults with cancer to meet on a regular basis and support each other. She aims to create a minimum of eight groups by November 2020, including specific groups for young adults who are newly diagnosed, those from minority backgrounds and those with incurable cancer. Further expansion is planned for next year. She will document the lessons learnt through these groups, to share them with the wider cancer community. Ceinwen's Fellowship explored innovative support to young adult cancer survivors in the USA and Canada.

E.A. Draffan: enhancing communication between healthcare workers and their patients

Speech and language experts worldwide are concerned about a lack of support for people with communication difficulties during the Covid-19 pandemic. Patients who may not be fluent in English, who have an underlying condition that inhibits speech, who are using a ventilator so can't speak, or who have poor literacy skills – all are at higher risk of developing a serious adverse medical condition if they cannot communicate with their healthcare providers.

Speech and language therapist E.A. Draffan, from Rackham, near Pulborough in West Sussex, will use her grant to enhance the development of an app she has helped to create, which enables health and social care workers to communicate with patients who have difficulty communicating.

The app, called Boardbuilder, involves the use of charts, symbols and pictographic images, which the patient can select in order to communicate with their carer. The app is freely available to be used by anyone across the UK, but it currently doesn't allow personalisation for specific users and it lacks appropriate healthcare vocabulary – including images relating to Covid-19, which need to be captured. E.A. and her colleagues will enhance and expand the app so that it can become personalised, allowing charts for specific users to be saved and exported. They will develop a simple symbol creation tool, to allow health and care workers to rapidly add and adapt suitable images or graphics to expand communication. And they will expand the symbols and images available to include Covid-19 health-related issues. E.A. explored assistive technologies for training in literacy skills on her Churchill Fellowship to the USA in 1995.

Sara Dunn: supporting unpaid carers during Covid-19

Unpaid carers are one of the least supported groups in society and they are now carrying a huge burden of risk during the pandemic. In the absence of suitable PPE or clear guidance, many are concerned for their health and wonder how to continue safely in their caring role.

Digital inclusion consultant Sara Dunn from Dorchester in Dorset is the founder of CuppaCare, a mobile app and micro-learning platform for care workers.

She will use her grant to develop the app so that it provides a Covid-19 survival pack, available free of charge for unpaid carers. The pack will provide free guidance designed specifically for carers and presented in an accessible format. Sara will develop the pack in consultation with carers' organisations and with her own professional networks, and will promote the app through social media. Sara's Churchill Fellowship explored best practice in providing mental health information in Australia and New Zealand.

Tim Robbins: treating high-risk Covid-19 patients with diabetes

Research shows that people with diabetes are at greater risk from Covid-19 and this risk is heightened even further if they come from a deprived background or community.

Doctor Tim Robbins from Weston under Wetherley in Warwickshire will use his grant to monitor the health and wellbeing of Covid-19 patients from deprived communities who have diabetes. Tim has led work to issue digital glucose sensors for in-patients with Covid-19 and diabetes within his NHS Trust, allowing much closer monitoring than the usual finger-prick tests, so that they can be treated with the right healthcare support.

So far, this work has only been possible in hospital settings but Tim will use the grant to expand it into hard-to-reach and deprived high-risk populations after hospital discharge. This is needed because the mental and physical impacts of Covid-19 will last longer in such populations and may widen already existing health inequalities. Tim will engage further with these communities, focusing not only on blood-sugar control but also on mental health needs. He will develop and demonstrate the effectiveness of such a model via his NHS Trust – University Hospitals Coventry and Warwickshire NHS Trust – with the aim that it could be rolled out more widely. Tim’s Churchill Fellowship to the USA explored patient-centred digital health and personalised care.