Working within community and social care settings is core to CLAHRC NWL. Whilst evident in all themes, two notable research projects are highlighted. A shared finding across these projects is the importance of having care networks in place. David Sunkersing discusses his work in the ‘Frailty’ theme exploring patient networks. Sophie Spitters covers healthcare professional networks as part of her work in the ‘Early Years’ theme.

Frail individuals’ care networks

David Sunkersing

Ongoing research within the Frailty theme has illustrated the importance of the care support network of an individual – and, indeed, the interplay between physical, social, mental and environmental domains. One project at CLAHRC NWL seeks to greater understand the holistic and proactive approaches used in the care of a frail individual, the importance of the ‘patient network’ (e.g. family, friends, physio) – and aims to understand its impacts from both a patient and healthcare professional perspective.

Looking at these networks in more detail, we find that amongst the healthcare professionals in these networks, a variation in assessments used to assess frail individuals exists. Though recently published guidelines emphasise the importance of assessing frailty in individuals with existing comorbidities1, a lack of standardisation and a consequent variation in assessment practices and support given across healthcare settings and professions exists2,3. Establishing the assessment practices for frail individuals – and whether existing networks of an individual can be leveraged to maximise the management of their frailty, are areas that both require further research. As such, research into these two areas has been conducted in the community setting, acute care setting and longer-term care setting.

Ultimately, identifying, assessing and managing frailty can present many challenges; understanding that frailty is a complex, long term condition can aid in providing approaches that will contribute towards healthy ageing and capability across the life course.

Healthcare professional networks

Sophie Spitters

In the Early Years theme, ongoing research highlights the importance of networks between healthcare professionals. I follow a series of improvement projects that aim to improve the care for children with allergic diseases. All project teams started off with similar ideas. They wanted to improve the patient journey in the healthcare system and they wanted to implement nurse-led clinics in the community to do so. However, they encountered difficulties and saw opportunities that led them to change the plan. Some changes were small, some were rather hefty4. However, when asking people about their projects, I noticed one thing kept coming up. People kept mentioning the value of the interactions they had with different professionals; the value of relationships.

The relationships that were established across the allergy improvement projects came in different shapes and forms. In one project specialist doctors met up with GPs during lunch time to discuss queries about the allergic diseases of patients in general practice. In another project, school nurses shared concerns about the asthma of their pupils via phone with specialist nurses. They would give guidance on what to do or suggest to refer the child to their community clinic. A third project implemented multidisciplinary clinics in secondary care, run by consultants, nurses and dietitians together. This way, patients could get their tests, medication and education all in the same appointment. And healthcare professionals could easily check-in with their colleagues.

These relationships make a network of healthcare professionals who look after children with allergic diseases. Through this network, expertise is shared and actions are coordinated, which supports better care and better experience for patients.


The English poet John Donne once said, “No man is an island”. In support of this statement, our work in community and social care settings demonstrates that proactive use and development of networks, whether that be a patient or healthcare professional network, offers many benefits.


  1. National Institute for Health and Care Excellence. [Online]. Multimorbidity: clinical assessment and management. 2016. [Last accessed 31 August 2017]. Available here
  2. Sunkersing, D., Reed, J., Martin, F. and Bell, D. Frailty: Assessment and Communication within a Care Home Setting. Poster presented at: Past, Present and Future of Medicine: Society for Acute Medicine and the Royal College of Physicians of Edinburgh Conference; 2016 September 12-13; Edinburgh, United Kingdom.
  3. NHS Improvement. [Online]. Rapid Improvement Guide to: Identifying and managing frailty at the front door. 2016. [Last accessed 31 August 2017]. Available here
  4. Spitters, S.J.I.M., Reed, J. and Warner, J.O. Tailoring Interventions in the diffusion of an allergy program. Poster presentation at: International Forum on Quality and Safety in Healthcare; 2017 April; London, United Kingdom. Available here