Interesting people – Gill Marsden

Meet Gill, Self-Management Team Leader, Anticipatory Care

#InterestingPeopleFulfillingCareers

It feels a bit like everything I’ve done in my career has helped prepare me for the role I now have – and I absolutely love it.

Being a St John’s cadet way back when in my formative years sparked my interest in nursing and I trained in London in the mid-eighties. I’m a Norfolk girl but married a Yorkshireman. When we moved up to Yorkshire I worked in nursing homes for a good few years, eventually becoming a matron. I also spent a couple of years at St Luke’s hospital in Bradford.

It was 2004 when I saw an ad for community nurses with Bradford District Care Trust and I’ve been with the Trust ever since. I started with the team based at Ashcroft Surgery in Bradford North and loved it.

Back then you stayed within your district nursing team, doing clinics and working out from the GP surgery. I felt like I wanted a bit of a change by 2015, so I took up a secondment in a pilot project at Bradford Royal Infirmary, doing in-reach to support early discharge.

When that ended I went back into district nursing, worked as a caseload holder at Thornton and Parklands, City and South and then team leader, before another opportunity came up at BRI to support the on-site multi-agency discharge team in 2017, working alongside hospital discharge and social services.

I had a few health issues myself and felt a hankering to be back in community nursing and my line manager mentioned a new self- management facilitator role coming up that I should apply for. I thought what on earth is all that about, found out and thought this is the sort of thing I really like, working with patients.

And the combination of hospital and community nursing and then working with discharge teams meant I had the knowledge and experience for the self-management facilitator role. I understand the pressures of being a district nurse, I have the relationships within the hospital and I’m passionate about supporting patients leaving hospital to be independent at home.

#InterestingPeopleExcitingProjects

I applied and got the job. The self management facilitator roles were created when adult physical Community Health Services was rearranged into five portfolios of work – anticipatory, planned, unplanned and specialist care, and community dental. Our team is not reactive, we’re part of the Anticipatory Care team, specifically aimed at reducing poor health and relieving pressure on community services.

District nurses refer patients to us, and we support those patients to learn how to do a whole variety of things for themselves. We actively encourage the district nurses to think outside the box when they’re with a patient, to think what that patient or carer could be capable of doing.

There’s a really wide range of things we support people to do, from dressings to catheter care, blood glucose monitoring and insulin administration, B12 injections to eye drops, we deal with nephrostomy, colostomy, ileostomy and more – and we advise patients where to get equipment as well as what to do.

We also have a well leg service, supporting people with healed leg ulcers to prevent a reoccurrence – and we’re pleased we have a zero reoccurrence record from teaching people what creams to use, giving them advice on keeping their legs healthy, making sure they’re in the right hosiery and seeing people for as long as they need just to maintain that.

Our big difference is the amount of quality time we can spend with patients, carers and families, rather than being task oriented. We want them to feel confident they know what they’re doing and be able to do it – because often they don’t believe they can.

We can spend an hour on a visit and sometimes it takes several visits to train someone. All our team are trained to work with patients to set achievable goals. 

And we know our approach works. Of 1000 self-management facilitator interventions, we’ve only had around 60 referred back to us due to dosage changes, being in hospital or occasionally lack of confidence.

We’re up for every challenge you can think of. We like our successes, not failing. We do not like failing!

We’re now involved in two multi-disciplinary team pilot projects, with our Proactive Care Team, physiotherapy and pharmacy technician. I think this MDT working is really exciting.  We’re working with the district nursing teams at Westbourne Green and Hillside Bridge, going through district nursing patients by GP surgery, selecting complex patients and looking for unmet physical or mental health needs, including people who need a self-management facilitator – and we can contact social care too if needs be. We’ll be replicating that in Airedale too.

Our team also does in-reach at BRI, walking the wards and liaising with diabetes, stoma and urology nurses, checking for referrals to district nursing and finding out if they can be referred to the self-management facilitators instead, to avoid that DN referral.

#InterestingPeopleRewardingWork

To me the whole concept of self-management facilitators has the ‘wow’ factor.  It’s so new but is hugely rewarding. The amount of patients and families our seven-strong team has been able to interact with has been excellent.

Feedback is amazing, about the care delivered and the amount of time we’re able to spend with people. The district nursing feedback is really positive too.

And yet when I first heard about the self-management facilitator role just last year, I’d no idea what it was. I quizzed people who did though and realised it was a great idea.  But it was a massive learning curve – getting to grips with the whole philosophy of anticipatory care – I’d never known anything like it.

And I did wonder what I’d done at the beginning, but I had massive support, the team leaders are amazing, and the clinical supervision is the best. Now I think it’s absolutely fantastic.

I’ve got that nice mix of managerial and clinical with my role as team leader and I love it, I just love it and think the whole SMF thing is amazing and the benefits to the district nursing team are brilliant.

You imagine if we had to refer those 1000 interventions right back onto the district nursing caseload. Getting all those patients confident and able is a massive, massive achievement for the team.

There are not many self-management facilitator teams across the country right now, but looking at the NHS 10 Year Plan I can imagine that will change, especially with the move from acute to community. We all know that nursing teams are run ragged wherever you are, so if teams like ours can take the pressure off, I’m all for it. I hope our team will grow and I hope the nurses will pass more over to us.

#InterestingPeopleBestPlaceToWork

I feel that working for Bradford District Care Trust is like a breath of fresh air compared to places I’ve worked in the past, or places I go into where the approach is very different.

Here, I feel the Trust is very open – and it sounds cheesy, but I’ve personally found people in this Trust really do live our values – we care, we listen, we deliver. Most of the managers I’ve had have been just so supportive and I’ve learned to manage that way – I believe you earn respect.

Of course, we’re not human if we don’t make mistakes, but here we learn and we care about each other. If you’ve an issue, people here do listen, and it will get resolved. I think it’s the best Trust.

At other places I’ve felt that they’re a bit like an onion – you have to peel so many layers off to get something through. Here, if I want something improved, I put it forward. I know my operations manager and my head of service. If I go into head office at New Mill everybody speaks – even Therese our chief executive. It’s just not like that in other places.

I absolutely love it.

Find out more about

Our District Nursing service
Our Community Health service
Our latest nursing vacancies