A Pioneering Scheme - Meaningful Activities Coordinator 

Before joining the NHS I worked in social media and advertising for many years, supporting local businesses in and around Launceston. My clients were quite varied businesses including holiday cottages, restaurants and cafes, tourism associations and various retail outlets In June 2019 I decided to open my own business. I opened a Bistro called "Earth Bistro and Deli". It was a small family run establishment with the emphasis on traditional values.   Then in early 2020 Covid-19 struck. I can remember standing in Earth thinking "This really isn't happening, is it?"  On 23rd March 2020 we were told by the government we had to close our doors indefinitely.

I saw an advert on the NHS recruitment website for General Workers at Launceston Community Hospital and applied. I had never worked in the care sector, healthcare or for the NHS before. I had no idea what it entailed. After a brief online interview, I was offered the position in May 2020.   Turning up for the first shift was daunting! But I had wonderful support from all the other staff and soon found my feet. Yes, it was scary as we had no clue what was happening with Covid. Some have said taking on a frontline position at that time was brave. I just wanted to help where I could.  With a heavy heart I made the decision to close Earth permanently in June 2020.

In September 2020 I joined the Flexi Team at Cornwall Partnership NHS Foundation Trust as a Healthcare Assistant.  Then a permanent position became available at Launceston Hospital which I applied for and was overjoyed to get. In May 2021 I was approached by my Matron, Sarah Washer, and asked to lead the new pioneering Meaningful Activities Coordinator scheme at Launceston Hospital. Naturally I jumped at this exciting opportunity, as I had always been frustrated at the lack of stimulation for the patients in our care. Currently the project is growing from strength to strength and is changing the culture of the hospital dramatically.

As MACs (Meaningful Activities Coordinators) our primary focus is our level 3 patients and keeping them busy to avoid escalations and falls especially, but obviously all patients are welcome to join in! Since starting the MAC program we have seen a massive reduction in falls at Launceston Hospital. We are proud to say there has been zero falls whilst the patients have been under the care of a MAC, which we feel is a massive achievement. Activities are a tool we use to achieve this, but we have a variety of resources we use including:

Social Prescribing

Quite often our doctor will socially prescribe me to work with a patient who is having challenging behaviours. " I'm prescribing a dose of Anna our MAC for this patient." Having the time to understand the patients' needs and worries is invaluable. Having the time to spend with patients reduces the need for medical interventions which then breaks a cycle which can occur. On occasions whilst in our care patients have refused painkillers, as they are too absorbed in the activity and what we are doing. Preoccupying the patient's minds distracts them from concentrating on any pain or problems.  Spending time with patients creates a bond as they find someone they recognise and trust, so sometimes simply being there is enough.

Cultural Changing the Hospital Environment

When I started as a Healthcare Assistant in the first lockdown I was frustrated at the lack of stimulation for the patients and there seemed to be a "stressful" atmosphere in the hospital amongst both patients and staff. Changing the way, we do things and having a "go to" person alleviates such stresses for all parties. The staff know that their high-risk patients are safe so can easily get on with their HCA work. It has been noted by many visitors, staff and patients that there is now a calm atmosphere across the hospital.

Nutrition and Mealtimes

We have been focusing on making mealtimes a positive and sociable event which then encourages eating habits and improved appetites of our patients.

We encourage patients to come into our day rooms before lunch to participate in activities and then enjoy lunch together which encourages eating and interaction between them. We remove the trays and set cutlery out on the tables, we have music playing and we encourage talking. We also now eat with our patients as they were continually asking, "where was our meal?" "Why weren't we eating with them?" which does not encourage them to eat. Being able to sit with them and discuss the food encourages them to eat. We have had a few patients who refused to eat but with this technique they started to eat again which improves their recovery. One lady refused to eat anything, so we started to sit and eat with her. Over the next week she began to eat again and by the end of the week she was finishing her meals.  We have actively challenged ingrained routines around mealtimes. Just because "it has always been done that way" doesn't make it the right thing to do or make it in the patients' best interests. By breaking these patterns we have delivered a different environment and, more importantly, provided significant benefit to patient nutrition. It has not always been an easy battle to change the culture and has taken some time to bring everyone on board, but the benefits to patients have justified the culture change.  The patients made some "mocktails" recently which they loved.   Not only did we get an extra 500mls of fluid into them and lots of fruit, but they talked about it for days!

Outdoor Activities

We spend many hours outside gardening, chatting and playing games. Just being outside improves the overall wellbeing of our patients. You really cant beat sunshine, fresh air and watching the world go by. Our doctor can often be found searching for the patients she needs to treat to be told, "they are outside with Anna gardening in the sunshine."  We also hold outdoor music events for our patients to entertain them. We are lucky enough to have amazing support from local organisation to name a few Launceston Town Band, Double Ambition, Royal British Legion, the Rotary. Who have all helped us put on events for the patients including a bugler playing the last post on Remembrance Day and music in the garden, which is a massive lift for patients and staff alike. As the saying goes, "if they cant go to it, bring it to them. We have had some amazing events sat listening to music in the sunshine, what more could ask for!

Gardening for All

In the summer, we utilised planters (purchased with funds raised from a staff organised cake sale) and generously donated plants and compost. The patients planted flowers and vegetables and took charge of looking after and watering them.

Christmas Activities

The patients have decorated the day rooms for Christmas, making their own decorations such as Christmas pom-poms and Gonks which we sold to raise funds. We made and painted fireplaces from cardboard complete with stockings and Santa's legs and boots.  The male end were absolutely passionate about this project and continued with it even if I wasn't on shift.

Funding and Working with Outside Agencies

As we are still in the trial period of the MAC project, we are self-funded, so part of my job is to source funding to grow the project and improve it. We have recently received grants from two Cornwall Councillors and Launceston Rotary. This enables us to purchase equipment to create activities for our patients. We recently took delivery of a piano donated by a local school and within moment of its arrival the wards were filled with beautiful music from a patient reminiscing of when she used to play and rediscovering her musical talents. It's special moments like that which fill our hearts with joy! Launceston has a fantastic local community. We work alongside likes of the Launceston Foodbank and the Tesco Community Champion who are very happy to help. We recently had two patients who didn't have any personal possessions with them on arrival. So, we contacted the foodbank and within hours they had delivered clothing, footwear and toiletries for the patients. Being able to do this helps protect a patient's dignity and maintains their sense of pride.

What it means to be a MAC

I absolutely love my role! It means so much to make such a difference to our patients' stays with us. Being the lead on the program gives me a chance to shape things to improve the hospital stay and experience. Always in my mind is "imagine it's you. How would you feel? What would you want to do?" We all get caught up in the focus of providing primary health and care needs, but we must always remember there is so much more to an individual. Improving the overall health and wellbeing, including mental stimulation, provides a positive frame of mind to be able to feel comfortable and confident in helping the patients move to the next chapter of their lives. Our patients can be with us for anything from a few weeks to many months. Addressing worries, concerns and fears will help the patients transfer to wherever they are going next with less issues and worries. We have started being a part of that transfer and ensure that we go with the patient on the day wherever possible. It is said that laughter is the best medicine. I couldn't agree more.  There are some downsides to being a MAC. Sometimes you create a bond with some of your patients and so sometimes it is hard to say goodbye. But knowing you have given them the best possible stay in Launceston Hospital is so rewarding and being able to make that difference is amazing.

Personally, I feel I have finally found my vocation. 

Anna Mitchell  Lead Meaningful Activities Coordinator at Launceston Community Hospital Jan 2022