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Acute Health Improvement Team

The Acute Health Improvement Team consists of a Programme Manager, 2 Health Improvement Leads and a Health Improvement Senior. The team work with staff across all sector/directorates in acute services and their current main areas of work are detailed below:

Support & Information Services

The Support & Information Services can be found across most acute sites in Greater Glasgow & Clyde.  Whether you are a patient, a carer, a family member or a member of staff, we offer a friendly, comfortable and confidential environment where there is time for you to ask questions & receive support on any matter that may be important to you or your family.

Holistic needs assessment 

Holistic needs assessment (HNA) and care planning was first introduced by the National Cancer Survivorship Programme to help identify the concerns and needs of people living with cancer[1]. The holistic needs assessment and care planning tool provides a useful framework for the basis of a person-centred discussion based on what matters to the person at that time.  Used with appropriate training, information and knowledge of available supports to meet needs, the tool facilitates the following:

  • Identification of need / impact of wider determinants;
  • Self management, self-care;
  • Person-led care or goal-setting, health and wellbeing improvement;
  • Social-prescribing, mitigating impact of poverty and life circumstances;
  • Applied health improvement, developing the wider health improvement workforce, embedding health improvement in clinical care.

In recognition that many of the issues faced by people living with cancer are similar to those for people living with other life changing and/or deteriorating conditions, the Acute Health Improvement Team identified areas where this approach could be tested:

  • Parent/Carers within Royal Hospital for Children
  • People undergoing lower limb amputation at QEUH
  • People attending Physical Disability Rehabilitation Unit at QEUH campus
  • People attending for renal dialysis at IRH. 

The concerns in the cancer focused tool required review with clinical colleagues to tailor concerns to meet the needs of each of the different groups.  A monitoring and evaluation framework for the work was developed to ensure outcomes were captured. 

National Cancer Survivorship Initiative. Living with and beyond cancer: taking action to improve outcomes,

Department of Health,  2013   

In April 2017 tests of change were developed in adult acute services to determine how the HNA and care planning model works in adult hospital settings beyond cancer services.  As a result, three locations were chosen, reflecting patients who were experienced permanent changes to their lives as a result of health conditions or traumatic events:

  • Renal Dialysis Unit, Inverclyde Royal Hospital,
  • Physically Disabled Rehabilitation Unit (PDRU), Queen Elizabeth University Hospital, Glasgow
  • Ward 11A (lower limb amputees), Queen Elizabeth University Hospital, Glasgow

Each location chosen was allocated a member of the health improvement team to liaise with them to facilitate the process in their location. This was in recognition of the fact that the implementation process was likely to be different in each location, reflecting the differing patient groups, nature of clinical interactions, and experience of conducting health behaviour change discussions in each clinical area.

The delivery model for implementing the Supporting People in Hospital approach varied amongst the three locations as follows:

  • Nurse led – Renal Dialysis Unit
  • Key worker led (both AHP’s and Nursing staff) – PDRU
  • Health Improvement Led from Support & Information Service – Ward 11A (and Ward 11D). 

The HNA has been rolled out to further to Renal services at the QEUH with other areas planned. Over time, the completion of the tools has been incorporated into routine practice within these areas.

Below is a video clip of Katharine Montgomery, Staff Nurse, Renal Unit IRH talking about how the HNA has been implemented in their area.

 An initial evaluation on the HNA was completed in July 2017 and a learning event took place October 2017 where findings were disseminated. The evaluation found that:

The patients welcomed this approach:

  • “It’s about helping me if I have anything that is worrying me”  
  • “It gives me the chance to tell someone if I need help with things at home”.
  • “It gave me the chance to talk to my family about how I felt and for them to tell me how they felt too”.

The staff welcomed this approach:

  • “Our patients go out of here different to when they come in.  They usually come in mobile and leave in a wheelchair.  It’s a huge psychological as well as physical change and it affects every part of their lives.  Nothing is the same for them anymore and this is a great opportunity for them to talk to someone about more than just their medical condition”
  • “Coming in here is a massive part of their weekly lives and they are exhausted.  We talk to them about how they feel physically but they have many other issues – particularly money, so this is a really good way of helping them deal with things which are affecting them and their families”

The Acute team have been working to support the implementation of the Cares (Scotland) Act. 

The Census data (2011) suggests that approx 10% of Greater Glasgow and Clyde residents identify themselves as having caring responsibilities. Three in every 10 patients admitted report having a health condition that significantly limits daily living and as such are likely to require additional caring support.

The Carers (Scotland) Act was passed on 4th February 2016 and gained Royal Assent on 9th March 2016.  The implementation of the provisions in the Carers Act, which are designed to support carers’ health and wellbeing, will commence on 1st April 2018, and build on the aims and objectives set out in the National Carers and Young Carers Strategy 2010-2015.

Under the Act, there are specific requirements for acute and these include:

  • The involvement of carers (where carers can be identified without delay) in the context of any admission and discharge to any location
  • Changes to local discharge guidance to ensure the health board must take account, so far as reasonable and practicable to do so the views of carers in relation to decisions relation to the discharge of the cared for person.
  • Expectation that documentation will capture of patient’s consent to involve carer and to record carer views on discharge planning and intended discharge date
  • Development of an assessment of carer’s ability to care post-discharge. 

Work has taken place with acute staff and local Carers Centres to support this work. Further information on support available to carers can be found here:

It is recognised that many NHSGGGC staff have caring responsibilities and further support for staff can be found here:

Support & Information Services also have information and resources on support available to carers and can make referrals to the carer’s centres.

Resources and Publications