Working in Community Response

Sarah's Story

Interview with Sarah, Crisis Response Team

Name and role?

“My name is Sarah. I’m a trainee ACP at the moment in the Crisis Response Team. I’m also doing my advanced Clinical Practise Masters so I’m based with the team for two days a week, and then I’m at University two days a week.”


How long have you been in this role for?

“I’ve been here since January last year. Before that, I was the IV team lead in North Manchester from November 2016 and I still help them out sometimes!”


What’s a good day like in community response?

“When I joined the IV team in North Manchester, everything was separate but now we’re a citywide service — everyone works together.

Yesterday (Wednesday) for example, I went to the IV team help out in Central, and then they needed me in North Manchester, so I went over to North and helped them out.  This is how we work now — as a City.

It’s the same with Crisis Response and IV. We’ve shown how well it can be done; with nurses able to go across to different teams and this is the vision for all community-based teams. We want us all working together.

And I think IV is probably the leading team that’s managed to do it. They’re all working together and the nurses are able to go across to the different teams. Eventually, I will qualify as an ACP (Advanced Clinical Practitioner), but I’ll be able to move between the Crisis and IV team because I’ve got multiple skills.

So that’s Wednesday — an example of a good day because we’re working together to meet the services needs across the city. To see all the patients that we need to see in that day, essentially.”


What are the most challenging parts of the role?

“I guess the most challenging in our role, I’d say, and across the different services is when it’s very busy and you have multiple referrals. Then, the trickiest patients in crisis and IV are the refusal patients. These are the patients declining hospital admission.

My dissertation at University is actually based on improving that pathway. To spread awareness of the refusal process and how everyone works together in managing the patient’s needs because if they’re very complex, they often shouldn’t be at home. So it’s about us all working together to help. The patient is taking responsibility that they want to stay at home so we have to adapt as a team to facilitate care at home, as well as we can.”


So you’re doing your masters at the moment? 

“Yes, the course you do has on-the-job training. It really does show how these services can offer progression. I started in the IV team and I went on to lead the team, and now I’m doing the advanced clinical position. I think they have eight placements across the city, including Trafford every year. And they fund you to go on that. They pay for it and they train you on the job. So you do two days at University and you get supervised in Practise.

At the end of it, you’ll work within one of the teams in the community services. So it’s basically training to hopefully progress with the advanced skills to manage more complex patients. It’s a fantastic opportunity and you learn loads at University. I am enjoying it.

The first part between January and now was our literature review, which is mostly academic. Then next we have quality improvement projects, during which I will lead on the regulatory pathway, update the whole team, and then I’ll implement those changes before finally evaluating them.

It’s interesting because you can actually physically see what you’ve done to make a difference.”


Why join Community response?

“I’ve worked in a lot of different teams across the city, but here everyone’s really enthusiastic. Everyone works really well together. The community services are always adapting because we got complex patients that we’re trying to treat at home. Everyone pushes together to make changes. It’s quite innovative. It changes all the time.

If you look at the IV team and the way that that’s changed over the years, since I first started, it’s changed massively. So it’s constantly pushing you, it’s constantly new challenges and everyone works together. It’s such a positive place to be. And in terms of the future of the NHS, they want to move to manage more costs and be able to impact patients at home. So there’s going to be more changes to come.”