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An integrated and community based approach

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There is something really special about the Nursing Times Awards that I shall miss when I stop being editor of Nursing Times next month.

I will be honest, it’s the thing I shall miss the most – standing up on stage, seeing the delight and joy on the faces of the nurses – and student nurses – that we pay tribute to in both the Student Nursing Times Awards and Nursing Times Awards.

And it is right they feel that way. The work that goes into the innovations and quality improvement projects that grace our shortlists for these awards deserves to be heralded with a great deal of celebratory back-slapping and fist pumping, and I am proud of all the winners and finalists.

I am also proud of Nursing Times in those moments – because we shine a light on the achievements of a group of people who never get much attention. And they come and tell me afterwards – even if they haven’t won – how much those occasions have meant to them. It is the highlight of their careers for many of those finalists.

One of the best afternoons of the year – after the Student Nursing Times Awards of course – is the time I spend with the winners and finalists afterwards – trying to work out a way that we can spread news about their project and disseminate those amazing ideas.

We always arrange a meeting with Nuffield Health, the sponsor of HRH The Prince of Wales Integrated Approaches to Care category at the Nursing Times Award and the winners of that trophy.

In it, we work out in detail how the various projects that have won, succeeded, and how we can try to introduce them to other parts of healthcare, and if Nuffield Health can be of any support.

As part of that process, recently, we welcomed the winners of this award in 2017 back into the Nursing Times office to meet again with Carol Kefford, clinical director and chief nurse at Nuffield Health, and the Nursing Times team.

The winners of this award had introduced free tai chi for patients with rheumatoid arthritis (RA). Specialist RA nurse Alice Muir at Circle Nottingham had realised the benefits of the practice after using it to help her recover from a serious illness.

She introduced a scheme offering free classes in tai chi, and referred her own patients and encouraged other health practitioners to do the same, and spread the word so that people could self-refer.

”The sessions became social classes where people cared about and for the other attendees”

Having trained as an instructor, she generated interest, secured free venues, launched the first classes, then convinced participants to become instructors themselves.

What I love about this project is that it worked with the local community – a park donated space and volunteers were trained to deliver the classes. This was a winner that truly embodied the spirit of the HRH Integrated Approaches to Care Award – it was genuinely integrated and community-based.

The sessions became social classes where people cared about and for the other attendees – and the classes didn’t just offer benefits to movement, balance and strength. The mental and emotional wellbeing of the attendees was just as important as the physical wellbeing, and the classes became social occasions.

Carol Tarlton, a Weatherall volunteer instructor, talked about this during our meeting recently. “I find the slowness of tai chi calms me down,” she said. “It reduced the severity of my physical symptoms but it has helped me grow in confidence too in my movements.

”But I also like the social side of it. I’ve been introduced to others with these symptoms, and we email each other between classes. We look out for each other.”

The group had several examples of people who had benefitted from the classes – a dance instructor who had had a stroke under anaesthetic during cardiac surgery, older people who were unsteady on their feet (there is a lot of evidence around using tai chi in falls prevention), people with long-term respiratory conditions and people with multiple sclerosis.

Chris Coates of the Tai Chi for Health Institute said at our meeting that the sessions work by the health practitioner or instructor picking out from the four various forms of tai chi the movements that are most appropriate for health, selecting the flows that work to have a positive impact on the parts of the body that you want to focus on.

The mind and body do influence each other, and stress can switch on the sympathetic nervous system so from both a Western perspective and traditional Chinese medicine philosophy, we know that tai chi can benefit people.”

Zoe Fordham, Rushcliffe Country Park Weatherall volunteer instructor, said: “Tai chi does a lot for the whole body instead of individual exercises. Our council are very pro-healthy living and these classes support that.”

The group’s philosophy is that “exercise is the new pill”. And for those people who can’t do cycling, running or something more strenuous, tai chi works.

It has certainly proved popular. The classes started with one session of about 30 people in Rushcliffe Park, and there are now two classes in Rushcliffe and another two in Circle Nottingham. Classes are free at Circle, and are £3 per person at Rushcliffe. One of the instructors has set up a community class for people with multiple sclerosis, and another has established two classes in a local complementary therapy centre.

And now, after the not-for-profit organisation sponsored the award and met the winners, it is likely to find a new lease of life through the health and wellbeing chain, Nuffield Health. 

“We understand the impact exercise can have to improve conditions,” says Carol. “We really want to see if we can work with this and offer it to our members through our gyms or as a wellbeing strategy.”

”This project was stunning in its ability to achieve so much with so little resources”

According to Ms Muir, there are five evidence-based strategies for wellbeing. This tai chi programme uses all of them – connect; be active; learn something new; give to others and take note or notice yourself.

This project was stunning in its ability to achieve so much with so little resources – and all led by a nurse. As I said, this makes me proud of our awards winners, and particularly proud of her.

There’s still a tiny bit of time left to enter the Nursing Times Awards, go to and you have until midnight on Wednesday 24 May to enter. Go on, show us how much nursing has to be proud of. Show us how much you have to be proud of.

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