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Finalists selected for NHS awards shortlist.

PREVENTING falls, managing antibiotics wisely and improving clinical outcomes for patients are just some of the projects in the running for an NHS Wales Awards this year.

Six health boards, one trust and two universities have made the shortlist with new and creative projects that aim to transform healthcare services for patients.

The winners will be announced in a ceremony in Cardiff on September 21.

Entries were received from across Wales and the judging panel of NHS experts had the tough task of selecting the finalists in the seven award categories.

Here the judges highlight five of the worthy finalists.

| Cwm Taf UHB - Improving access to healthcare for the armed forces community Armed forces personnel (AFP) are entitled to receive priority treatment for healthcare services in line with Welsh Government guidelines.

But concerns were raised about the length of time it took for these patients to receive an outpatient appointment following a GP referral.

They also noted that some GPs were not identifying AFP on their referral letter, which meant that priority was not always given.

Following research across Cwm Taf UHB, it was discovered that there was no clear pathway or guidelines available for staff.

Steps were undertaken to engage with AFP across the wider community to understand their concerns.

A key factor of this work was managing the expectations of the AFP and their families, and educating them on what they were entitled to under the criteria for "priority referral".

Other changes made as a result of this project were the promotion and raising awareness of AFP with frontline staff across the organisation, and the identification of a key contact for AFP to raise concerns.

A "Healthcare Provision for the Armed Forces Community" plan has now been developed in collaboration with armed forces groups across the community.

| Abertawe Bro Morgannwg UHB - The Fodmap diet Patients with irritable bowel syndrome are being urged to try a "life-changing" new diet which Welsh doctors claim can reduce or even eradicate their condition.

The "Fodmap" diet, which is being piloted by five GP surgeries in Bridgend, identifies and eliminates foods believed to trigger the symptoms.

Abertawe Bro Morgannwg University Health Board claims the results have been "remarkable", with more than three-quarters of patients reporting their IBS has eased or even disappeared.

Latest figures show that as many as one in five people in Wales have IBS, a condition which can cause stomach cramps, bloating and diarrhoea or constipation. But many people don't even realise they have it or are being misdiagnosed.

Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (Fodmap) are carbohydrates that aren't easily broken down and absorbed by the gut.They ferment relatively quickly, releasing gases which can lead to bloating and other characteristic IBS symptoms.

High-Fodmap foods include some fruits and vegetables, animal milk, wheat products and beans.

GPs in the pilot project refer appropriate patients to prescribing support dietitian Debbie Thomas, who sees them in their local surgery usually within two weeks.

Since starting the pilot in early 2015, Debbie said she has seen around 200 patients.

| Abertawe Bro Morgannwg UHB - Managing antibiotics wisely Microbial resistance to antibiotics is a serious global health problem.

It is compounded by antibiotic misuse and scarce investment in new antibiotics research.

Health experts say hospital neonatal units are particularly at risk because the perception of risk is greater, leading to "defensive practice" and misuse of antibiotics.

As the only neonatal unit in the UK, Singleton Hospital in Swansea joined an international collaboration to reduce antibiotic use.

Guided by experts and through multiple deliberations, a SMART aim was agreed to reduce antibiotic usage rate (AUR) by 20% by the end of 2016 without compromising patient safety.

Initial focus was on raising awareness and changing the unit's culture through highly-visible posters and parent information leaflets.

Following implementation of the changes, three-monthly running median AUR fell from a baseline of 347/1,000 to 198/1,000 patient days - a reduction of 43%.

| Aneurin Bevan UHB - Developing a blended diet for children with complex needs in the community There is a growing interest on the use of a "blended diet" for children with complex needs - and this has been driven by families.

Significant professional interest has been expressed in this innovative practice which has far-reaching implications for patients of all ages requiring gastrostomy feeding.

In response to patient need, Aneurin Bevan UHB developed a risk-assessed approach to support this practice for a child in the community.

Having obtained full support for the initiative, the consultant nurse brought together the parents and key professionals in health and education. A consensus of support and commitment was developed to implement the new practice, in order that the child could receive the blended diet at school, administered by nonhealthcare professionals. The clinical team worked closely with the parent and education colleagues to safely implement the bespoke multi-agency care plan, which was regularly reviewed and adapted for the child.

Having tested and gained confidence in the process, the initiative was widened by the clinical team to support a further eight children to receive a blended diet within ABUHB.

The protocol was then shared and adopted across Wales - there are currently 27 children in receipt of a blended diet.

| Aneurin Bevan UHB - Reducing falls in older people and improving bone health Falls are a major cause of disability and the leading cause of death in people aged over 75.

To tackle this issue, "evidencebased" prevention was described as the most effective strategy to reduce the risk of future falls.

The Torfaen Falls Service was set up in 2009 and is designed to provide a holistic, seamless approach, with multiple partners, to support people over the age of 65 who have fallen or are at risk of falling within the community.

Torfaen developed a falls risk register and, since 2009, approximately 3,000 older people have been referred to the falls service (18% of the total population in the over 65s).

The service uses a variety of measuring tools to monitor its effectiveness, including patient satisfaction questionnaires, a telephone audit carried out six months after discharge from the falls service, and risk register monitoring activity.

Physiotherapists now work in partnership with the falls team, sharing information and resulting in a more timely intervention.


Staff from Cwm Taf UHB

Staff from Abertawe Bro Morgannwg University Health Board

Aneurin Bevan UHB

Aneurin Bevan UHB
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Title Annotation:Features
Publication:Western Mail (Cardiff, Wales)
Geographic Code:4EUUK
Date:Aug 28, 2017
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