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

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.

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

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

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

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

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.

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

I would definitely recommend it 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

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