Posted by: ayrshirehealth | March 9, 2016

We took her to Rehab by Anne Fisher

Now that’s what I call Integration

Integration of health and social care is one of Scotland’s major programmes of reform. Integration

At its heart, health and social care integration is about ensuring that those who use services get the right care and support whatever their needs, at any point in their care journey.

NAHSCP LogoFor some members of NHS staff within a ward setting, the integration of health and social care services is still an aspiration which seems a bit distant and something that is happening “out there”.

However for the Nursing staff within the rehabilitation unit in Ailsa Hospital, integration is very much active and forging ahead.

Woodland View

Woodland ViewWith the impending closure of the rehabilitation unit and the move to Woodland View at Ayrshire Central Hospital taking place in May 2016, assessments and plans have been put in place over the last 18 months to ensure that the destination for each lady is appropriate ensuring that any interventions are person centred and recovery focussed.

During this process, Multidisciplinary assessments have been vital to ensure that each patient gets the right care and support whatever their needs.

This was viewed as an opportunity to try a test of change which may enhance the experience and process for both patients and staff.  With this in mind, the Charge Nurse within Glenrosa ward worked in partnership with South Ayrshire’s Practice Learning Programme for Social Work to explore the possibility of supporting a social work student.

The South Ayrshire Health and Social Care Partnership place a number of Social Work Students each year although placements are traditionally arranged within social work teams. An opportunity was identified to place a social work student within the Rehabilitation unit at Ailsa Hospital and following discussions and agreement from senior staff in NHS, Social Work services and the Universities, a final year Masters student was placed within the rehabilitation unit at Ailsa Hospital.

Barriers and opportunities

In South Ayrshire, this arrangement was new but exciting in the context that we would offer the ability for a social work student to work directly within a ward environment. Social WorkersIn addition to the prescribed placements requirements, this would enable further analysis of the experience, thoughts and views from staff/patients, their appreciation of the social work role, and consideration of any barriers or opportunities that existed, how these were managed and any key impact that the placement had from the perspective of health and social care integration.

The rehabilitation unit consists of one fast stream rehabilitation ward (Kildonan), two slow stream rehabilitation wards (Lochranza – male & Glenrosa – female) and one forensic rehabilitation ward (Elgin).

The Charge Nurse within Glenrosa ward was appointed as the Link Worker for the student who would carried day to day management and support of the student. Additional support and assessment was provided by a designated Practice Teacher, Practice Tutor and the Practice Learning Programme Coordinator all of which formed a Practice Learning Team

Leanne – invaluable and practical advice

Leanne Marshall has been on placement in the rehabilitation unit at Ailsa Hospital since October 2015.  It is a planned 100 day placement which will end in March 2016.  Ailsa HospitalThe placement will be evaluated in the normal way from Strathclyde University, however there will also be a fuller evaluation that will take into account the specific learning from the placement.

During her time within the rehabilitation unit, Leanne has supported the Multidisciplinary discharge planning for two ladies within Glenrosa ward (slow stream rehabilitation), one gentleman within Kildonan ward (fast stream rehabilitation) and one gentleman within Elgin ward (Forensic rehabilitation).  She has been instrumental in processing a number of assessments and applications in relation to housing and benefits.  She has supported nursing staff to navigate their way around the very complex systems of benefits, housing and social care, as well as providing invaluable and practical advice.

The co-location of the social work student within the ward setting has allowed readily available access for patients and staff to ask questions as they arise, preventing the need for a formal appointment system.  Being located within the ward settings, Leanne has been able to build therapeutic relationships a great deal faster than if she were making set appointments to complete assessments/forms as a visiting member of staff.

The wider rehabilitation team

Leanne has very quickly become a valued member of the wider team within the rehabilitation unit.

A full evaluation of the placement will be published however early indications are interesting and assist us in thinking and exploring our appreciation and perceptions of our roles. This includes thinking around ensuring that we keep the person at the centre and minimising any negative impact from processes and systems. From small things, come big changes!

Staff  & Patient comments

“Having the Social Work student based in the rehabilitation unit has demonstrated the aspects of care that we were unable to deliver in rehab.  Glenrosa Senior TeamNow that we know the gaps, it would be remiss of us not to act on it and aim to continue this model” (Stuart McKenzie – Clinical Nurse Manager)

“Absolute godsend, we would never have been able to progress the discharges so smoothly” (Peggy Ann Campbell – Deputy Charge Nurse)

“ having Leanne as a close member of the team has improved my knowledge and understanding of the housing and benefits systems as well as the role of a Social Worker.” (Anne Fisher – Senior Charge Nurse)

 “Leanne helped me,

So I can see

That I can walk free

And I can be me” (LL – patient)

“ …awfa nice lassie, awfa helpful…I widnae be where I am now if it wisnae for Leanne…I’m gonny miss her” (WG – patient)

“Having my placement within the rehabilitation wards has been an invaluable learning experience for me, one which I will never forget. I feel very lucky to have been given this opportunity and I believe the placement has been very successful for all involved. I have seen first-hand the benefits of working as an integrated team in order to support service users throughout their transitions from living in psychiatric hospital wards to their own tenancy’s in the local community. I now have a sound knowledge of the roles of my health colleagues and their support throughout my placement has been great, I felt welcomed and part of their team very quickly. The ease in communication, relationship building and information sharing has been well evidenced and has been instrumental in supporting service users to achieve their outcomes. I cannot rate the placement highly enough!” (Leanne Marshall – SW Student)

Watch this space for updates on the continued progress and evaluation feedback.

This week’s blog  was by Anne Fisher, Senior Charge Nurse, Glenrosa Ward, North Ayrshire Health and Social Care Partnership, NHS Ayrshire & Arran.


  1. Thanks for the blog Anne, this has to be part of the future if we are truly integrating – I look forward to the formal evaluation

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