Thursday 31 March 2022

How can a Compassion Focused Model help Felindre Ward?


by Baz Van de Vegte – Wards' Psychology Student


The Felindre Ward is an acute facility in Bronllys Hospital perched on the hills of Brecon’s countryside. The ward welcomes patients to its beds who maybe experiencing a significant crisis in their mental health. The staff who dedicate their time to supporting the patients vary from nurses, doctors, occupational therapists, health care support workers, domestics, clinical psychologists and students. Time and care go into interventions such as nursing assistance, community support, psychological therapies and engagement with activities towards the improvement of well-being.

The Journey of Psychology on Felindre

Felindre introduced its first dedicated psychologist on the ward in September 2021. I was fortunate to be given the opportunity to join the psychologist within Felindre Ward in October 2021. At this point we were just starting to build relationships across the teams and establish the potential role for psychology on the ward. It was clear from the start that staff and patients alike were tired and weary from the ongoing Covid-19 pandemic, which drastically impacted the processes in place for patient and staff safety.

Getting to know the Team

We wanted to find out what staff most appreciated whilst working on the ward. We shared a survey with staff, asking questions such as ‘what do you most like and dislike about your role on the ward?’. The overwhelming response was that staff mostly loved spending time with patients and caring for their needs. 

It also highlighted that staff mostly disliked it when tasks got in the way of this time with patients. This told us that interacting with patients played a vital role in staff wellbeing and role satisfaction. However, it felt as if we were all on autopilot and somehow that core passion was worn out from the ongoing tiredness of the pandemic. We wondered ‘how we could reintroduce that important sense of connection between staff and patients?’.

Introducing Mindfulness

Shortly after our research, we developed daily mindfulness sessions that are now being run for patients and staff to explore breathing techniques, notice bodily sensations and engage in group activities. 

Mindfulness is a way to focus one’s mental state on the here and now and away from memories in the past or anxieties in the future. It expands awareness of what we are doing, how we are feeling and what’s going on around us. By practicing techniques that helps ground oneself to the present, anxiety levels can reduce creating feelings of calm and wellness. Daily mindfulness sessions have proven to be well received by patients who started to practice calming techniques when under stress. 

However, whilst staff also engaged in the sessions we noticed that they some seemed to struggle to allow themselves this luxury on their shifts.

A Compassion Focused Model enabled us to understand why this could be.

Baz Van de Vegte – Wards' Psychology Student

A Compassion Focused understanding

We used a Compassion Focused Model to help us understand why staff showed some resistance to practicing mindfulness. According to a Compassion Focused Model, there are three systems in the brain that are in sync helping us makes sense of how and why our brain triggers the arousal of emotions - we call these the threat, drive and soothe systems.

Our drive system is what we depend on to keep ourselves motivated to achieve, complete that short-term goal or stay active with our hobbies. We then get rewarded for such activities by the release of dopamine which in turn drives us to keep motivated. 

The soothe system is what we rely on to keep relaxed when we get overstressed or full of anxiety. The system regulates any feelings of threat and keeps us relaxed so that we can think rationally to reduce levels of anxiety. 

Our threat system tells us when we feel under threat so that we can try and self-protect from a given situation. It’s closely linked with our flight, fright and freeze responses when under stress - causing hormones like adrenaline to be rushed through the body. As a result, this activates as a safety mechanism to help us avoid any immediate danger.




How does this apply to Felindre Ward?

Ideally for our emotions to be regulated efficiently, all three systems need to be evenly active in our everyday lives. As staff go through ongoing stressors, the threat system can grow out of proportion and tower over the soothe and drive systems. The threat system can be activated by perceived threats as well as actual threats. Therefore factors such as staff shortages, environmental noise, too many demands, could act as possible threats. 

Prolonged periods in threat mode can result in burnout, reducing energy and motivation. In order to reduce the threat system it is essential to increase the soothe system. This can be done by mindfulness for example, which can increase self-compassion and rekindling energy for the drive system. 

We knew that if staff were able to increase their own self-compassion and self-care, this could have a direct influence on patient care. The idea of introducing the Compassionate Focused Model to Felindre could be an opportunity to establish compassionate thinking and keep an evenly balanced soothe, drive and threat system amongst our fantastic team.

Our Pathway to Compassion

Now that we are starting to understand how compassion has an incredibly important role in the lives of our patients and staff alike, we can start to build towards a more compassionate focused direction. By allocating tasks to staff members which are closer in line with their interests and values, tasks could be more rewarding than stressful. 

Introducing staff training to help with these tasks could help drive our team to expand their knowledge and bring the best services to their patients. More time spent on reflecting with patients and staff would also help us understand ongoing changes in attitudes and passions so that we can adjust to accommodate all. Taking the time to join mindfulness sessions would also really ground staff members who may benefit from a moment of self-compassion or who generally need to destress from a busy morning. 

By introducing the more compassionate focused practices to the ward, we could help guide our patients and staff to think and reason compassionately by behaving caringly and kindly to themselves and others.

Psychology Notice Board – Felindre Ward


“Compassion is the courage to descend into the reality of human experience.”

Paul Gilbert - founder of Compassion Focused Model

Tuesday 8 March 2022

NHS Forest – growing forests for health

 

We recently found out about an amazing project called NHS Forest which aims to improve the health and wellbeing of patients, staff and communities by increasing access to green space on or near to NHS land.

As trees are known to have a positive impact on mental health we wondered if anything was happening in Powys and how we might encourage projects in Mid Wales.

We recently spoke to Miriam Dobson at the Centre for Sustainable Healthcare, which coordinates NHS Forest, to find out more about the initiative.


What is your role with NHS Forest?

I coordinate the NHS Forest network and our tree planting scheme. On a day to day level, this takes the form of advising healthcare sites on how to use greenspace and nature connection to benefit staff, patients and the wider community; how to improve the ecological quality of NHS sites to help support biodiversity and improve their environmental impact; and coordinating our tree donation scheme – in the 2022/23 tree planting season, we are planting over 12,000 trees at nearly eighty sites across the UK!

How did NHS Forest come about?

The NHS Forest began in 2009 as a tree planting campaign, launched by the “Campaign for Greener Healthcare”, which is now known as the Centre for Sustainable Healthcare and is the independent charity that runs the NHS Forest. By 2013, 100 sites had joined the NHS Forest – we now have around 250! Over the course of its history the NHS Forest has expanded from being a tree planting campaign to a nationwide good practice network for any NHS site looking to improve and increase its use of greenspace in healthcare – from tree planting to dementia gardens, to wildflower planting, and so much more.

How does NHS Forest work in brief?

Any NHS site – from hospitals to GP surgeries to ambulance stations – can join the NHS Forest network by visiting our website. We provide advice, guidance and inspiration on all forms of greenspace development in healthcare – whether for environmental benefit, staff wellbeing, use in patient care – or all of the above! 

We collate the latest evidence and resources on green spaces and health to provide an easy to use resource database on our website to help educate people on the benefits of green spaces. If a site has a project in the pipeline or plans to develop a green space, and wants to chat through or hear about other hospitals that have done similar projects, they can get in touch and we can advise and connect them with others in the network. 

copyright Claire Blakey all rights reserved

We also still offer our flagship tree donation scheme where sites can work with us to develop tree planting plans and receive free saplings for planting in the tree planting season which runs from November to March every year. 

We also do other work on green spaces, particularly with our Nature Recovery Rangers, who are full-time members of staff embedded at hospitals to conduct a programme of environmental work to green hospital grounds, improve support for biodiversity, and run activities for staff and patients on nature connection and spending time outdoors. 

We also run an annual conference and awards scheme and produce a bimonthly newsletter full of the latest inspirational news on green space work across the NHS, and a course on Green Space for Health to help people learn about the links between nature and health and begin developing their own projects.

How can people – patients, staff & communities – use their NHS Forest?

The variety of ways that people use their NHS Forest trees, or indeed the wider network, is seemingly endless! 

We have sites who have planted coppice woodlands for use in therapeutic woodworking classes, whilst providing habitats for wildlife and creating a beautiful walkway amongst the coppice willow woodland. Another site has used the NHS Forest tree donation scheme to replace damaged or dying trees in a native woodland in the Cairngorms that is adjacent to their site and has a beautiful walkway and benches where staff and the community can take time out and relax. We have also planted orchards for fruit provision, and standard trees to provide shade in open spaces. Another site has worked with the local council to plant trees along a river bank in a nearby green space, which will help with drainage and flood prevention as well as beautifying this area that is enjoyed by staff, patients and the wider community.

What is the Centre for Sustainable Healthcare?

The Centre for Sustainable Healthcare is an independent charity and think tank offering strategic input and consultancy on sustainable healthcare research and practice to national and local programmes. We work across the health system, from carbon footprinting, to sustainable surgical practice, to Green Plans and our expansive green space programme, of which the NHS Forest is part.

The benefits of trees and green spaces on mental health are well documented. What feedback have you had about NHS Forest projects?

Our projects bring a huge spectrum of benefits to staff, patients, the wider community and the environment. We have had a wide range of positive feedback, from the hospitals where our Rangers are placed talking about a whole shift in culture towards focusing on the outdoors and nature connection in daily activities such as having meetings outdoors. 

One of our NHS Forest sites also recently wrote the following feedback: “We have been working alongside the NHS Forest for 8 years. A partnership working approach has enabled the service to transform the once scrub land into a beautiful tranquil green space that benefits the local environment and the people who access the space. Without the NHS Forest support this would not have been possible. The service has benefited in excess of 2,000 people over the last 8 years and we hope to increase this in 2022 by introducing a lovely outdoor woodland area connected to the growing space for more community involvement and therapeutic value.”

Wild Skills, Wild Spaces project in North Powys

Tell us about any NHS Forest projects in Powys

In 2021, a project in Powys won the NHS Forest award for engaging people with nature. This was Wild Skills, Wild Spaces – run by Montgomeryshire Wildlife Trust in partnership with Powys Teaching Health Board and Cardiff Met University. The project engages adults and young people in ecotherapy to empower people who would not typically engage with outdoor activities or prescribed therapeutic interventions. They provide free, inclusive and accessible sessions at local nature reserves, including bushcraft, food growing, and other outdoor activities. Over 50 people are currently engaged in the project. 

How can we encourage more NHS Forests in Powys?

By spreading the word and inviting people to join the network!

Tell us about a particularly inspirational NHS Forest

“Come Grow With Me” is the name of the community garden at Highbury Hospital in Nottingham, which immediately demonstrates the welcoming nature of the garden. Highbury Hospital offers Adult Mental Health Services (amongst others) in the city and set up the community garden in 2016 originally.

Food growing is at the heart of the Highbury project. Each hospital ward has its own designated raised bed, and all the participants have access to the communal shed, greenhouse and fruit trees. Other garden features include a no-mow zone and a wildflower meadow. The sensory planting area and herb circles ensure that rich aromas float around the spaces, while a garden wall screening the nearby road creates an enclosed sanctuary. Picnic benches occupy a central area, while more private seating is provided in relatively secluded corners of the garden. 

Every year the garden participates in the community arts festival, on one occasion turning the whole space into a gallery with artwork all the way around. It’s an inspirational example of using green space for therapeutic healthcare but also for celebration, community and the arts.



What are the main challenges of the role?

Keeping up with the incredible demand for trees and green space advice takes up most of my time, and it’s always disappointing if we run out of trees to match demand for the year! However, that’s just more reason to try harder to get more trees sponsored, and make more connections throughout the environmental sector, to ensure that we can provide as many saplings to as many NHS sites as are in need of them, whilst providing high quality bespoke advice to anybody who needs help in developing their green space ideas.

Tell us about some of the most rewarding work you have done at NHS Forest so far

It’s been fantastic coordinating our tree planting for the current season. A long summer and autumn of working with nearly eighty sites around the UK developing plans from planting seven to one thousand trees – so much variety! We’re planting around 12,000 trees this season which is the largest number that’s ever been planted by the NHS Forest in a single season! And now we’re into the tree planting season, it’s been so rewarding to see them be planted and hear about the wonderful projects that everyone’s been doing with volunteers in the local community. Seeing the photos and hearing about the joy the trees have brought people already is fantastic and really rewarding.

When you are not working for the Centre for Sustainable Healthcare, how do you enjoy spending your time?

I like to practice what I preach – so you can usually find me outside. I live on the edge of the Peak District National Park where I enjoy going climbing, fell running, swimming and cycling!


If you want to find out more about the NHS Forest initiative, you can contact Miriam by emailing: miriam.dobson@sustainablehealthcare.org.uk