Case Study

Leeds Teaching Hospitals NHS Trust (LTHT) is one of the largest Trusts in Europe and treats around 2 million patients a year. There are seven hospitals within the Trust; one of them, embedded within Leeds General Hospital is Leeds Children’s Hospital. LTHT is the tertiary centre for many childhood long term conditions. Many specialities, i.e. cancer, renal, diabetes etc., will care for patients from Yorkshire and Humber and UK wide. In some instances, i.e. children’s liver transplantation, cardiac surgery, LTHT is one of the few tertiary centres in the UK, therefore taking referrals from many cities in the UK.

Children and young people in hospital (CYP) need to be informed in order to be involved in their care and treatment. This leads to better control for them, helps with self-management of care, allays fears and positively enhances their experience and improve health outcomes.

In partnership with Leeds Hospitals Charitable Foundation and Mosaic North (a film company) we have developed the first online platform in the country called Leeds Children’s Hospital TV – www.lchtv.com. This has been developed with and for, the CYP in Leeds Teaching Hospitals Trust (LTHT). Patient and professional short films introduce each ward and staff, show common procedures, patient stories and provide feedback in a way that is understood by the young people of today. It is a 21st Century approach to information giving.

This has been led by senior nurses within children’s services, and the Director of a film company, and has the views, input and work of CYP firmly embedded within it.
The site has had over 9000 hits since we first launched in June 2016 (June – Nov).� The CQC recently rated it as ‘outstanding, and recently won the Nursing Times Award in the Child and Adolescent category.

This project received further funding from the Charitable Trust to continue for a further two years, and will continue to grow and keep up with the times. This model has now been developed and, with funding, can be replicated to all children’s hospitals across the country

We have achieved an online website for children and young people, hosting a variety of self-made and professionally directed films. We have had verbal evidence from professionals, CYP and families who have stated that it has helped them in their experience and have placed these on the site, they have used our video booth, film and iPad films to present a dialogue of their experiences.

This project has exceeded expectations as it has:

• Produced high quality films
• It has had over 9000 hits (June – Nov) from cities all over the UK (the largest being from Leeds areas)
• Developed awareness of Leeds Children’s Hospital, both in the local and national arena
• Created an awareness about CYP in LTHT and has aided the implementation of young person friendly care across the largest Trust in Europe
• Provided an unparalleled resource for CYP and for obtaining feedback from our service users
• The recent CQC Report 2016: Commended it as an area of outstanding practice� in LTHT
• There are currently have over 88 films, which is constantly growing, and we have just been given a further 2 years funding. Further films are under development. It is also being used by CYP in LTHT as well as with adults with learning disabilities; it is a visual tool, therefore accessible to the diverse group of CYP.
• LTHT Executive Board has used the films at the start of their Board meetings.This IS the future of information given to ALL patients, not just children and young people. It is a blueprint for all other Children’s Hospitals and has been collaboration with other individual departments within the Region � e.g. DigiBete (Diabetes), Cystic Fibrosis and Cardiac services, as well as a commissioned film explaining cardiac services by a young man with Down’s Syndrome using Makaton.

The company, Mosaic North, already had the infrastructure in place in order to deliver this. For the last 10 years we have been involved in working with them whilst they develop a national platform for young people with cancer to share their experiences (www.jtvcancersupport.com ). This model is highly successful and that this process helps CYP deal with their diagnosis, share their thoughts and feelings and help others in similar situations. We knew that we would be able to use the build of this website and create a different model for children and young people who are in hospital.

Rather than a support site, it would be an educational/information film site where CYP could share their views, show common procedures and give feedback about services. CYP have had full input into the project, helping to guide and lead it and to have a strong presence when making the films.

The project is overseen by Mosaic North under the leadership of Mark Wilkinson and guided by Senior Nurses and Play Specialists in Leeds Children’s Hospital (LCH) It is a CYP focussed development – providing a virtual, age appropriate environment.

Leeds Children’s Hospital TV (LCHTV) is the first Children’s Hospital in the UK to develop such an entity.

• It has developed user-driven, creative content for the web, in a safe and controlled environment, offering best practice in terms of safeguarding and signposting. It has involved children, young people, families, friends and professionals.
• It helps to allay some of the unknowns of admission by showing them the personal faces of LCH – providing short films about how the wards look before they are admitted, and virtually meeting some of the staff.
• It helps children and young people (CYP) who have been admitted to hospital, or who are receiving treatment, to share their personal experiences in a creative way though drama, documentary, procedural films, music or animation. It gives the professionals who lead the services unprecedented access to feedback – helping to drive standards up.
• It is providing the CYP treated in Leeds Children’s Hospital and their families with a forum to share experiences and to learn from others. This is a therapeutic resource for CYP, and also generates content that is unique and a lasting testimony. It can help to pass the time whilst they are in hospital and can also give them a project to complete when they are at home.

Published research shows that CYP patients, undertaking a project developing a music video over three weeks, found that the group that made music videos reported feeling more resilient and better able to cope with their treatment than another group not offered music/video therapy.

The aims of the project are:

•  – To help to allay fears by providing information in an up-to-date way to aid better understanding of the diagnosis, treatment and facilities available
•  – Provide online peer group support by showing examples of the experiences of other  – CYP going through the same diagnosis/treatment/illness as them.
•  – To help allay anxieties by showing virtual tours of the ward areas and meeting the staff
•  – To aid staff training and create an ethos of young person friendly care Provide feedback about CYP experience in an innovative way – which will help to raise care standards and awareness of issue.
•  – To provide a forum where the CYP/families/staff can observe procedures explained by professionals and the CYP – to prepare and desensitise CYP prior to having tests/scans/procedures.
•  – To help support the process of transition from children’s to adult services.

After establishing a working partnership with the film company we wrote a bid to the Leeds Hospitals Charitable Foundation for funding over two years to develop this project. This was awarded and we then began more planning discussions.

Those involved in the planning and delivery have been:
Children, young people and their families
The Leeds Hospital Youth Forum
Head of Nursing, Children
Consultant Nurse – teenagers and young adults with cancer
Lead Nurse Healthcare Transition
Communications team
Mosaic North
Youth Workers
Play Specialists
Ward Managers

Once funding was awarded we then disseminated the information throughout children’s services who then bid for the films to be made. We started by making ‘Welcome to the Ward’ films and then moved on to other common procedure films.
Areas for filming identified by professionals are led by Senior Nurses – filming largely took place on the wards/clinical areas. This was then edited, checked by professionals and the CYP and then placed on the site.

The CYP can either make their own films via their own smartphones/tablets etc., or can be helped to do so by the Play Specialist/Youth Support Workers/professional from Mosaic North.

Once the films have been recorded they are then simply uploaded to the ‘Edit Suite’� on LCHTV. The films are then edited and sent back to the CYP/Professional who filmed it for approval. Once approved, they are put online for public viewing.

There is also a process for obtaining feedback using a portable video booth placed in play rooms/day rooms and the CYP just needs to press a button and record feedback. This is then edited and placed on the site.

Full consent and safeguarding procedures are in place. Films can be taken down from the site immediately if warranted.

Leeds Children’s Hospital TV (LCHTV) is the first Children’s Hospital in the UK to develop such an entity. It has developed user-driven, creative content for the web, in a safe and controlled environment, offering best practice in terms of safeguarding and signposting. It has involved children, young people, families, friends and professionals.

It helps to allay some of the fears of admission before coming into hospital.
It helps children and young people (CYP) who have been admitted to hospital, or who are receiving treatment, to share their personal experiences in a creative way though drama, documentary, procedural films, music or animation. It gives the professionals who lead the services unprecedented access to feedback – helping to drive standards up.

It is providing the CYP treated in Leeds Children’s Hospital and their families with a forum to share experiences and to learn from others. It is a site which teaches the CYP the skills with which to help them to self-manage their care as well as learning new skills with regard to media work.

This is a therapeutic resource for CYP, and also generates content that is unique and a lasting testimony. It can help to pass the time whilst they are in hospital and can also give them a project to complete when they are at home. The therapeutic effects of sharing their experiences through film by creating a safe space for them to express their emotions, is well known.

The key elements have been that we have ensured that the CYP have been at the centre of all developments and have helped to form the site. The views of the young people have been central to the initiative, and no decisions were made without their input.

It is patient centred, aids the empowerment of CYP in taking control and helping with their self-management of care, particularly those with long term conditions.
It has also been a true collaboration with many teams both within the NHS and externally

Collaborate with other – garner expertise

• Identify and acknowledge funders
• Involve young people and families
• Engage management teams
• Disseminate continuously
• Safeguarding and consent with the ability to remove films if required
• Engage the Comms teams early on
• Prompt feedback and editing
• Robust systems for the checking of films
• Must be simple and easy to use – not too flash
• Have someone to coordinate the films/lead
• Accessibility – use on a number of devices
• Accessible to all patients regardless of ability
• Be proud and tell everyone about it!

Watch this short video to find out more about Leeds Children’s Hospital TV