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okay now okay i thought i had turned off my notifications on my phone but um it still seems to give me notifications so thanks everyone uh for coming to this practical session on setting up peer support i know some of you in the audience are obviously my peer support master trainers so you know a bit more and some of you aren't so i'm gonna start from scratch but keep it very very practical with some slides and then we'll have q a discussion in terms of the local variation at the end so i hope that sort of suits what you're expecting okay so just a quick thing to say that actually the reason why we in the intensive care society are able to deliver peer support to um our icus for free is because of the covered healthcare support appeal um which is a limited charity uh that gave us a grant a two-year grant to to roll out the peer support program and we're really grateful for that alongside the support of our intensive care society donors to be able to sustain this project pay our um master trainers to deliver the training but be able to deliver it to units for free okay so first question the burning question on everyone's mind is what is peer support anyway i think a really good way of thinking about this is when it's little p peer support versus capital p peer supports little people support is what we all do to varying degrees anyway we are colleagues at work and we look after our colleagues at work but peer support as a framework with a big p is just a little bit of a step up from that it isn't professional psychology or counseling or psychotherapy it is an enhanced way of supporting our peers so it's a mo the model is a model of training staff to support their tits so giving them just that little bit more skill set the awareness of workplace stresses some skills in listening and just reflecting on their ability to deliver supportive conversations um and the idea is is that that framework of delivering supportive conversations should be supported by a healthcare professional in some way someone like a clinical psychologist or counselor something sim similar to that someone who can offer that framework for reflection understanding where peer support begins and ends thinking about boundaries and thinking about actually when we should be signposting people and the idea is is that it's a systematic approach to help the staff who are having a wobble so generally coping well but sometimes struggling and make sure that they get that just in time response from their peers it's not intended as i say as a psychological intervention of any kind but it may be the starting point for encouraging people to access that professional support if they need to so what does that look like in practice well peer supporters provide brief conversations one-to-one focusing on listening to their experience rather than advising or intervening from that conversation they can sign post staff to self-help or perhaps to their manager or perhaps to some kind of employee well-being support depending on the local circumstances the peer support framework encourages it to be a semi-formal conversation in that it's an arranged time it's an arranged specific space be that on on a video conference meeting or be that in a um in a sort of room on the unit or off the unit but we do understand that actually when your peer supporters get known on your unit that lots of people will start to make the more informal approach and part of the training is working out for those people about how to do that nip and above informal and when to formalize and that's the full day training that we provide so some of you are already on this some of you are at the start of your journey but i'm going to take you through the stages of what you need to get in place to get going with this so first things first do some reading so all of our documentation is now on our peer support website um it's a bit of a long url so the thing to do is to go to the intensive care society website click on the web wellbeing hub click on peer support you'll find three documents in there and it's alex two that's the most practical of those documents but um the overarching one is the one to give to your managers because it's the full evidence base for why peer support works okay then once you've read that document and you're sure you know what peer support is about you really need to make sure that the system that you're in supports the concept of peer support so this is talking to the managers and the budget holders um so that might be your lead nurse or matron your clinical director or lead clinician make sure that they're happy for peer support to go ahead as a program but also that they're happy to free up staff to turn up to a day's worth of training um and make sure that there is someone and that's probably you in the audience right now that is allocated as a coordinator for that program so someone who oversees the the group of um peer supporters and then you need to select who those peer supporters are so really it's selecting your local team and we recommend it's multi-disciplinary although we acknowledge that it will be mostly nurses that pick this up but select your team of staff who have the right skills to become peer supporters so a methodology that has been used elsewhere that we recommend is if you advertise the um the program and run comms in your team and ask for people to put in an expression of interest through a personal statement so 200 words 300 words statement why i think i would be a good peer supporter and you can use that one it's a motivational check if someone can't quite be bothered to put in the statement then they're not going to really engage with the day of training and the ongoing supervision so it's a motivational check in the first instance but also you can pick up on their and their understanding their attitudes and their approach if you have more peer supporters then you've got space for on your unit you might want to do some informal um interviews with them as well we certainly found that actually it's usually the right people who self-select for this but there have been one or two people who put themselves forward and for whatever reason they're not quite ready yet so it may be that actually they want to be a peer supporter but they're in the thick of their own stresses um what we have said to those people is that either not now later or we'll train you up now but we'll keep you in the reserves to help others when you've worked through your own needs so that's just a good way of being as inclusive as possible because sometimes when you've been through something that's when you can really kind of empathize with people but we also need people to be in the right headspace to be able to focus on their peer and not make it all about their needs or issues so we we don't have an absolute rule of thumb in terms of numbers but just giving it an idea um most units are around the medium size so go for 10 peer supporters if you're less than 20 beds maybe you want more like five peer supporters and if you're a big site so more more like the 40 beds plus then it's a good idea to have 15 peer supporters largely in terms of continuity and drop-off there will be some people who just don't get into the swing of it and drop off over time and of course the larger the icu typically the bigger the turnover of staff anyway so it just allows a little bit of buffer zone in that way and then it's really important to have this in place first do make sure that you have someone locally who's either a psychologist or a similarly trained professional who is willing to provide the clinical supervision and reflective practice you need someone looking after your peer supporters and even though as a coordinator you may feel that you have some of those skills it's actually having someone who has that professional mental health knowledge is really going to help those peer supporters keep their boundaries know where their work ends and professional work um professional mental health services begin and have a good idea about the local pathways in terms of signposting obviously not every icu has someone like that in-house so thinking about your local um either your local uh employee wellbeing counselling service or occupational health or perhaps you have a clinical health psychology service so you might have a psychologist working in stroke or maternity services or something like that that will be able to offer that support and we're recommending an hour and a half every six weeks or thereabouts and it's a good idea to make sure that you keep a record of people's attendance um and we have a we've developed a code of conduct and what we've said in that code of conduct is people should attend 70 plus of that clinical supervision to maintain their standards um it's also a really good idea and this is where this this local person may be able to help with you um with this is is to just really have an idea of if if people do come through peer support and they need something more what's your local pathway for that because if you don't know where you can escalate people to you may end up holding problems that actually are more complicated than you have the time or skill set to do so that those are really important things to get in place and then in terms of us and kind of uh the intensive care society we're aiming uh to train all the peer supporters for each site in one day where we can that works really well if there's five or ten of you if there's more like 15 you might want to split into two groups just because of managing staffing right now but to cluster your trainees together is a really good idea we're able to offer around about 20 spaces on each day we're a bit flexible you know it might be slightly less it might be slightly more depending on the site so what that means is that going forward we're hoping to start to potentially train two sites on a day um the positive of that is the kind of cross compare and you don't get too caught up in your internal site politics so it kind of helps people see the wood for the trees a little bit so we were booked up for our pilot sites for february and march and i know some of the people who are on the court today who are those pilot sites but after that we'll be running um a training a full day's training every two months until december 2022 we may increase that if demand is great but in essence if you're watching this video later and you think i really want this there is time to to get your house in order to sign up for this training the worst thing that can happen is you put in the training far too soon this systems aren't there to support it and it crashes um and then then your local icu becomes suspicious of the program so it's really worth doing the bedrock and making sure this isn't a quick fix for the pandemic this is a good icu culture from here on in for the future so for you the guys who are the coordinators so it's really really good for on the ground in terms of setting it up so that your peer supporters are known to everyone so having a peer supporter badge having a poster with photos saying these are your peer supporters this is how you can get access that's really really important and finding your different ways whether it's coffee room back of toilet doors your clothes facebook groups whatever you have locally we think it's really important to have a single point of entry to the more formalized side of things mostly in terms of protecting your peer supporters and having a channel in but also in a little bit of kind of answering back to your management and showing the utility of peer support so just keeping an idea of how many people are accessing this um so having that generic uh peer support email if possible or having a single person's email or two people's emails as the coordinators for that group usually that will be the the common point in via the email and then you allocate the next available supporter unless they request a specific supporter we're discouraging the requesting of one person because we don't want to overwhelm one person but we encourage the requesting of not a particular person so if you know that you don't get on with that person or you know that you're actually incredibly close to that person and you wouldn't be able to keep that boundary it's a good idea to have the choice and that's why you need more than five people in a peer support program so that you've got a range of of different peers to to choose from and also one pair doesn't get overwhelmed so absolutely the idea is that the sessions are designed to be one-off there may be an occasional follow-up and check-in depending on the problem but really um your peer supporters should be sign posting if there's ongoing needs it's a good idea through the supervision group that if there are incidents or themes that actually a group reflection would be of benefit to the staff but that's a really good way of flagging that up especially if you've got local well-being leads who are providing that kind of support on a very pragmatic basis uh try not to ask your peer supporters to do this all in their own time uh to no credit it's a really good idea to have time sheets for claiming um the time back if you look at annex 2 we've we've done a bit of a guesstimate of a group of 10 people over a year and just how many shifts we expect that to be and basically we expect that at the very very most to cost half of a band 5 for a year so and that's that's being over generous so if if that's the kind of thing that you need to argue locally in terms of will this cost a lot actually in the grand scheme of things not much but what you symbolically gain is potentially huge and also from a very pragmatic point of view having that rotor available so that you know that you're not calling on peer supporters when they're off on their annual leave when they're struggling themselves and they just need a bit of time out or when they've got a particularly heavy working week or they're in so what we have set up in my local peer support group is people have just said his here's my day every two weeks that i'm willing that if there's someone that needs peer support arranging on that day i'm your person for that day and then they sign up to the timesheets and claim the time back good idea as a coordinator to just have a very simple spreadsheet that just says date and you know person but not not any identifying um information from a gdpr point of view but just a maybe a number allocation for that person if that person comes back for two or three sessions just to keep a track of one so you can uh counter sign the time sheets and what your peer supporters are doing from a managerial point of view but two to just keep a track of are people making use of peer support so that when your management are asking you know is this a good use of people's time you have a record of saying or 10 people requested that this month or whatever that is so you can give them very very very basic data so i will stop sharing my screen and we'll have a bit of a discussion so there you go just a practical overview what are your questions hi dewey hi sarah good to see you again hi good to see you um i like the fact that you talked about um allocating the next available supporter i think it's important you know we'll all be trained to the same standard and to me it just kept striking a chord that i think it shouldn't be the popularity contest you know the same person being requested so um i'm glad you've you've you know touched upon that and that we should try and join up you know match personality to personality if there is a personality clash that would just be a terrible idea but equally i think just in life in general we can be quite surprised by the people that we um that support us the most so yeah yeah absolutely yeah we don't want to overburden one peer supporter um and also we don't want peer supporters who may be uh maybe less experienced or less popular for whatever reason to not actually realize their potential to support others and and sometimes that little bit of variety in life actually can surprise us can't in terms of uh who's able to to help so amy's very good with her um zoom and has raised her hand amy what would you like to ask or say i think i think it's really important as well that when you've highlighted that we need to understand what supervision and support is actually available out there and i think that has been our trust um brought our trust together shall we say for well-being and it was a little bit of a stumbling block at first but really embedding that as kind as pushed forward the peer support and the need for it within our unit so just in case you need that bit more support from your stakeholders that's how we've gained it yeah that's that's fantastic and it really is about looking after the people who are looking after others you need needs that kind of governance framework as well and developing those skills over time the one day training is the starting point but it's on the job and doing the supportive conversations that people will learn so having that in place to start off with will really help to sustain the program thanks amy jules hi there thank you it's really informative um my only concern are a couple of people i've been chatting to about it have just said where do you go if for example someone comes to you and you would see a red flag but they don't necessarily want to be signposted but you feel that they need to be signed posted what i don't want to happen is for me to sign post somebody and then that break the system completely and everybody stops utilizing it i mean that's a common concern and it comes up and is discussed in the day's training i think it's it's really important to um consider that you as a peer supporter may think well here's a good signpost but the person coming for support needs to be ready for that signpost and to agree to that signpost so you have to kind of trust in the autonomy of that individual everyone's jumping around screening there you are and you have to trust in the autonomy of that individual obviously when it comes to the sign posting when you're considering serious concern and risk actually that needs to be in place locally and what we have we teach in the training is that the sessions are confidential but of course there is always duty of care so the good way a really kind of empathic way that we teach our peer supporters to and talk about this is to say you know this conversation between you and i is confidential but there are times when i might need help from someone else to help you and it's just a really nice way of not not burdening the peer supporter to hold something that feels scary and risky and this again comes back to the governance framework and having that mental health trained professional supporting the peer supporters and i think that's what's really key is that in terms that you have the regular supervision reflective practice group but you need to be able to contact both the coordinators and the supervisor in the event of something like that happening but at the end of the day people are able to make their own choices and i think that's one of the most important things about sign posting um just in case someone doesn't take on the sign posting doesn't mean that the work of peer support hasn't been helpful in some way and sewn a seed for them in some way so it may be that that that seed just needs a little bit more watering and a bit more time to grow that's quite an important subject so i wonder if anyone else has any comments on that i've got hands upper they knew hans amy and m in relation to that yeah yeah go on emma you're mute now you're not on mute but we can't hear you have a play maybe type or go to amy amy sorry i'm trying to lower my hand we our team have said that what we'll try and do is offer to support them in that that refer that sign posting and said that we will go with them if that is the step that they need to then let them go when they've actually done that initial introduction to somebody and then follow them up afterwards to make sure that they've they've done or it's helped in any way yeah i think that that is a good idea if you are sign posting people that's where that second review session might be helpful in terms of how did the signposting go um i think sometimes you have to be a bit careful when it comes to sign posting because it can feel almost like a kind of i have to do something i have to give you something um because i i'm not happy with just having that conversation and it ending there so it if you know we're do is in the nhs aren't we we're used to doing and fixing and a signpost feels like oh that's an extra bit i've done my job i've intervened in some ways so sometimes people won't take on that sign posting because actually what they what was positive for them was the experience of being heard and that conversation sharon right can you hear me all right yes again um yes i i think this sounds brilliant and um having done a few things around well-being in the past and been a palliative care nurse in the past i think it's just invaluable having that clinical psychology input so you know if if you can all access that i think that's just fantastic because i think my experience has been obviously the burden the emotional burden on potentially on the peer supporters is something we just have to be very mindful of um so absolutely i think it's really important having that six weekly hour and a half catch up and that ability to contact them in between times but yeah i think i think this sounds really really good and really exciting so i'm looking forward to our session in march fantastic emma have you sorted out your sound yes you've muted oh you're unmuted can we hear you no we can't hear you oh put it in the chat put it in the chat and we'll read it out mary hey julie and i just wanted to check really on the recommendation as part of the the supervision with the psychologist i think um we're quite fortunate that we have a counselor and hopefully a psychologist as well um but for those sort of six weekly check-ins would you recommend that as a group thing amongst the peer supporters yeah it it absolutely makes sense that it's a group thing sorry to not make that more specific so thank you for bringing that up make it a group thing i think it works well on zoom for now i can see it working well on zoom for the future just in terms of people's kind of time in and out of work etc but you learn from each other yeah not every peer supporter is going to see as we're all they're all only going to see two or three people each time so you kind of get that cumulative effect of of hearing each other's experience so yeah absolutely and of course it's part of that group care as well and looking after each other and the the things that that sharon referred to so to the the psychologist or council whoever you have that has that core skill that will facilitate the supervision will look after the group as a whole but they'll also learn to look out for each other and and they'll start to kind of have peer support within peace yeah fabulous that's great thank you yeah i think because then certainly because understanding that their workloads are quite heavy at the moment as well so it's we're appreciating their input yeah great thank you so i'm just gonna read uh emma's uh comments out zoom's playing up with your mic it's it's it's just the the kind of modern way isn't it so in terms of having a one-off uh what do you do if the person definitely wants to see you and access peer support more often well that that's an interesting one i think you you kind of initially set it up as a one-off if someone benefits from that conversation and said i would like to have that conversation again in the future then in essence you kind of have to contract to us and say okay well how many times would it be helpful and let's potentially meet and review again and maybe a third but actually over time you're starting to meet a different need and someone so it's perhaps sort of saying i wonder what it is that you're getting from this that actually is maybe missing in your life i just one of the things i'm so aware of right now especially with our younger workforce in lockdown is loneliness actually so maybe and that would be picked up in in the supervision is maybe actually that person wants to keep coming not because they need peer support but because they need a friend actually and that's one of the trickiest things i think in in terms of peer support is these are your work friends in essence and a good kind of sense check for should i be offering peer support to my work friend is is this someone that you would buy a christmas present for if so then you're you're their friend not their peer supporter actually the peer support needs to come from one of the rest of the team um if someone becomes kind of closer as a result of the peer support then actually you almost need to kind of name that and say actually we're getting on now and i think we need to step away from this professional peer support relationship um so you know to kind of just make sure you're wearing different hats if that makes sense so so yeah are there comments or questions i mean is that a hand or just a pen waving around just repent so i know that some of you are signed up for the next couple of months um i think actually that's all of you isn't that actually everyone who's here is signed up in the february and the march one so how far along are you in your processes have you started to recruit your people i wasn't sure how to go about it so i was hoping to get that today um so that now sharon and i'll touch base and sort that out and sort of make start the ball rolling i take it it's going to be like a i know you said different members of the mdt so different bandings as well so seven sixes yeah absolutely i mean the majority that we found that are interested are the the fives and the sixes um eight i think sevens make really good coordinators um icps make really good coordinators as well you know anyone who has that kind of potential management time is is really helpful in that way but that doesn't mean to say it can't be any of the other bands it's just so you find that the band fights and sixes are the majority of your workforce really so um i don't think we should exclude the doctors um either the consultants or the trainees from this but in terms of the way they work it's ever so slightly different so you know certainly what we've found locally is we're running it with nurses to start off with and then our allied health and our consultants can kind of catch up with us and join in in our second wave so um so yeah and amy's saying you're trying to involve the ahps and medics so mary's got her hand up is it a comment that or something yeah i was just going to briefly say so we've been we have managed to roll out our sort of form for expressions of interest and it was only probably i think monday that that went out but already we've had quite a number of people so what pleases us is that there are the nurses that are kind of putting themselves forward but we've had um physios and some of the medics as well which is really good yeah yeah yeah that's great fantastic so so um jules we have a poster that was um my coordinator in cardiff and then and then sarah jazzed up further and so we've got like a baseline poster uh for you that charlie can share um so um so yeah if you need that kind of thing or you do your own version of that locally really so that'd be really helpful we'll um have at no point reinventing the wheel no no so do send us an email but also one of the things that um from from our first training which was uh was it last friday sarah feels like so long ago this time last week was this time last week wow what a long week it's been um but one of the things we really reflected on was was that kind of um longer term it would be nice to have like a a coordinator's forum together though that i in the ics can coordinate and but also kind of almost kind of like cpt cpd continued sort of um either reflective practice or potentially extra kind of bits of training for peer supporters across the uk so as we start to roll um it's that kind of peer supported supporting network if you like so we're really really hoping just from a sustainability point of view and then networking in an ideas point of view that we'll be able to grow that so um so yeah so we're hoping to kind of put those events on so emma um how are people releasing staff for the training at the moment with the way things are with great difficulty i can tell you remember so we in in my sight um we organized the day six weeks beforehand um in order to book that study day for people now we were lucky um guess in a way the the kind of the pragmatic approach to it was is they said well we're short every day and this is important so i think you know hopefully february and march we're starting to head out but you know never say never with this pandemic um but this is where you might kind of say on a pragmatic point of view depending on what percentage over capacity you are um whether you might actually say well we can afford to send half of them on this day and we'll book in the other half for another day further down the line just just let us know keep it keep us um in the mix with that because we've got people banging on our doors desperate to get on the training so we're just trying to kind of uh work it out to make sure that we we don't we make the most of each training day because it takes quite a bit of coordinating so um so amy like okay so you're planning to stagger yours that's the first i heard of it please let me know how many you're sending just so i know how many spare places i have just keep me in the loop i know it's a bit of a shifting sans pandemic um but give me a bit of a rough idea because i've got other people really really keen to get going with this so i'm just trying to just trying to max it out and make the most of it really any other question sarah you're unmuted so i put the poster out um about a week and a half ago and it was a real slow burner at first and i thought oh my goodness and then it's really picked up speed of interest over just say the last four days so i'm on tonight and yeah so the the only problem is our off duties done so far in advance so we're already up to march already so hopefully the people that are of interest and that are suitable are also free for the march day that's what i've got in my mind yes what is the march day again julie um so it's 12th of feb 12th of march because february and march this year have the exact same dates which is a bit of a it's kind of really handy for my brain i must say so yeah and i wonder if the people who are willing to put themselves forward i mean if it's going to work in this way of a bit of a time owing type thing whether they we could start that process already so actually if they're on a day off say something this is you start accruing this time now as part of this role yes absolutely that's how we did it so rather than just swapping your shifts we we coordinated it and made sure everyone was on their day off and accruing their time as a study day for that day and then we had one or two people that still got rated on anyway that we just needed to swap um and it yeah i think because the unit really support the idea of it people were willing to do that swap um so to it it really depends on on who's doing your rotor and what's going on for you locally really but just keep keep us in the mix and let us know how many are coming because then we know if we've got capacity to kind of split another site and so because there are a couple of other sites that weren't the pilot but are are raring to go i'm ready to go already so can i just ask with the coordinators so the coordinators plus the peer supporters going to be attending the session or is it just the sort of peer supporters really important as coordinators to attend to um just because then you've really really um informed as to how they're informed um but also you can help part of their development and growth throughout the day because you know them um and that i think that actually worked really well didn't it last friday sarah the the kind of coordinators being part of the group so yeah absolutely definitely you know that is the team and that is how they present themselves together so to do all the training together like that that was yeah so important it worked it worked and by the way um i love the fact that um i got so involved in in that session that your cardiff team called me sir by the end that's when you know you've made it in wales when they shorten your name seriously i i love that i am jew because it means that my staff trust me so uh so it's good to be fair so uh so yeah that's the welsh way any other questions from you guys i'm going to stop the recording