Fran Ashworth Senior Immunology and Allergy nurse Specialist

Clinical Immunology and Allergy Unit, Clinical Immunology and Allergy Unit, Sheffield Teaching Hospitals NHS Sheffield Teaching Hospitals NHS

Foundation Trust Foundation Trust

Fran Ashworth Fran Ashworth

Senior Immunology and Allergy nurse Senior Immunology and Allergy nurse SpecialistSpecialist

RGN, ONCRGN, ONC..



JS A patient perspective two years on!JS A patient perspective two years on!

• Qualifications

• RGN ONC Dip. Counselling

• BA (Hons.) Health care Practice

• Post Graduate Certificate Allergy

• MSc in Advancing Health Care and Social

• Practice




• Quick recap on previous situation

• Issues can be identified in the home that cannot be recognised over the phone or in clinic

• All aspects of training assessed in the home environment




• Disadvantages

• Needs protected nursing time to do home visits

• Geographical issues, travel time, Lone worker issues

• Mountains to climb since 2010




• Home visit identified:

• Major stress to family relationships

• Altered roles, mother / son became patient carer, this had a major impact on the whole family

• Relationships were at breaking point




• “One in four patients currently treated in hospital would be better off at home”.

Mike Farrar, Chief Executive of NHS Confederation in an interview with the Financial Times. (December 2011)




• Home visits allow us to see into the patients world

• It enhances “Quality “ care, integrating the hospital & community care

• It ensures seamless, individualised care.




• Commissioners are also looking for:

• Quality care

• Patient safety

• Improved patient experience

• Home therapy provides




• Quality of life is substantially improved

by living as normal a life as possible, this includes:

reduction of bacterial infections

increased energy levels

Carrying out normal every day activities

including employment, socialising




• Plan

• Swap to hospital infusions

• Move to Subcutaneous infusions instead of IVIg

• Give control of condition to JS

• Attended the unit twice weekly for infusions




• During this time, jobs were applied for but when informed of condition, application was denied

• Became “down in the dumps” (low mood)

• Financially life was difficult, and socialising was almost non-existent



JS A patient perspective two years onJS A patient perspective two years on!!

• This had a significant detrimental affect on the Quality of life of JS

• Further discussion and reassessing the situation

• Start home therapy training via subcutaneous route as per competency based training




• Attended the unit twice weekly due to the dose and volume of infusion

• On completion of training was ready to go out on home treatment

• Became comfortable attending the unit therefore delayed going out home



JS A patient perspective two years onJS A patient perspective two years on!!

• Continued to look for employment with little success

• Became increasingly pessimistic about the future




• Rollercoaster journey since 2010

• Breakthrough

• Applied for a post and was successful, did not disclose condition




• Care closer to home

• Shared decision making was the driver

• to get out on home therapy

• All arrangements to transfer to home therapy completed




• “Helping people with chronic and long term conditions has benefits for everyone”

• DOH. The national Service Framework for long term conditions. DH (2005) London

• Health & Social Care Act (2012) Department of Health London




• Outcome

• Self-infusing at home with minimal input from mother

• Relationships improved and family life is now back to “normal”

• Is in full time employment and social life has improved




• Other concepts of care to achieve the outcome of this case study

• Holistic approach is vital to incorporate

• Patient centred care




• DOH.(2006) Self care for people with long term conditions London

• DOH. (2001) The expert patient: new approach to chronic disease management for the 21st century London




• Thank you, any questions?

Fran Ashworth Senior Immunology and Allergy nurse Specialist

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