A Medical and Mental Health Unit (MMHU) developed by Nottinghamshire Healthcare in collaboration with Nottingham University Hospitals NHS Trust has won a National Health and Social Care Award.
The Unit was awarded the top accolade in the Mental Health and Wellbeing category and was also named as runner up in the category of Putting the Public and Patient First.
The MMHU is a demonstration model of best practice to improve the care of older people in hospital with dementia or delirium, and has been implemented on Ward B47, a medical mental health ward at Queen’s Medical Centre.
Simon Hammond, Clinical Nurse Specialist in Dementia Care said: “We are all absolutely delighted to have won this award. I am proud to be part of this exciting new venture improving standards of care for people with dementia in the acute care setting. With both Trusts working in collaboration it is bridging the gap between medical and mental health care. Ward B47 staff should be proud to accept this award for their hard work to deliver quality care in an innovative way, changing attitudes with their approach and ensuring equal consideration is given to patients’ mental health and wellbeing as to their medical needs.”
Additional mental health trained staff have been recruited to the ward and an intensive staff education programme has been implemented. The team is multi-disciplinary and offers holistic care and comprehensive geriatric assessment. They meet regularly to make decisions about patient care and have adopted a proactive approach to communicating with patients’ carers.
The approach has resulted in a reduction in distress behaviour shown by the patients, including agitation, pacing, exit-seeking, combativeness, withdrawal or repetitive vocalisations. This has been achieved by introducing a non-confrontational and 'person-centred care' approach, which focuses on understanding the feelings and experiences of the person with dementia.
The ward environment is being adapted to meet the specific needs of the patients with clear signs, de-cluttering and reduced noise levels. The team has also developed an 'About me' document which is completed by the patient's carer at admission, and records the patient's biography, likes, dislikes, interests and how they respond to stress and what helps them.
On admission patients are assessed to determine the level of activity they can participate in and this is incorporated into the routine nursing care and also planned activities and social interaction such as games, painting and singing which are designed to decrease boredom and maintain levels of independent functioning and autonomy.
The Health and Social Care Awards are run in partnership between the Department of Health and the NHS Institute for Innovation and Improvement and are designed to highlight and recognise innovation and excellence in frontline health and social care.
Bernard Crump, Chief Executive of the NHS Institute and Co-Chair of the national judging panel, said: “This project demonstrated a high quality, evidence based approach to a major issue - ensuring better physical healthcare for older people with mental health problems – that helps to maintain patients’ independence. The judging panel felt that there was potential for the service to be replicated in other hospitals.”
Professor Rowan Harwood, who led the development along with nursing and therapist colleagues said: “I am very proud of what the ward team have achieved. It was a leap of faith to take on a project like this, and they have worked very hard to make it work. I hope that patients and their families will be noticing the difference, during what are always difficult times; I personally have never before worked on a ward that can do the things they now do. I hope very much that other hospitals elsewhere can learn from our experience and we can spread the benefits even more widely. The research evaluation is part of this, giving us the evidence about benefits that we can take to the rest of the NHS.”
