The Florence Nightingale Foundation Travel Scholarship: Igniting leaders and fuelling potential

Lucy Lewis is a Consultant Practitioner in Frailty and Chair of the British Geriatrics Society's Nurses and AHPs Council. She was awarded a Florence Nightingale Foundation Travel Scholarship in 2019 during her final year of the Health Education England (South East) Consultant Practitioner Development programme.  

The Florence Nightingale Foundation (FNF) seeks to “ignite leaders and fuel potential. In addition to leadership and research scholarships, the FNF provides travel scholarships to Nurses and midwives based in the United Kingdom (UK). This gives successful applicants the opportunity to study best practice in the UK and overseas to make a difference to person centred care, policy and practice in [their] chosen specialities.’

Scholarship Aim:

To compare and contrast health services for older people and those living with Frailty in Scotland, Nova Scotia and Toronto, with the ongoing work streams within the Wessex region of England.

Scholarship learning outcomes:

Service development/Quality Improvement learning outcomes:

• To explore health services for older people and those living with frailty in Scotland, Nova Scotia and Toronto
• To understand provision for forward-thinking strategic health and social care planning and investments for long term interventions
• To explore what local, regional and national service improvement projects are being implemented and evaluated to make positive changes to service delivery
• To establish principles of successful approaches that have been adopted and the successful system protocols in place to address urgent care pathways and hospital admission avoidance for older people and those living with frailty

Research learning Outcomes:

• To develop knowledge of research relating to my PhD topic of older people’s involvement in decision-making around cancer treatment and support. This will enhance the breadth and depth of my research, and contribute towards my literature review and critical analysis

The learning from Scotland has been extensive. I have written about the need to identify older adults living with frailty within the community and acute hospital setting and how we can best support these individuals here.

The Clinical Frailty Scale (Rockwood et al 2005) is widely used across the Wessex region and I gained valuable insights from my time with Professor Rockwood and the research team at Dalhousie University in Halifax. This has informed my discussions and strategic planning within the Wessex region, particularly with the Wessex Academic Health Science Network (AHSN) Healthy Ageing programme and also within clinical practice.

The older adults cancer clinic at The Princess Margaret Hospital in Toronto, Canada seeks to identify areas of possible risk, aiming to help people maintain function, independence and quality of life as much as possible before, during, and after their cancer treatment. This is achieved by providing an appointment of up to two hours to aid treatment decision-making and consider optimisation of health in preparation for any urgent proposed cancer treatment. The team aim to see people within 2-3 weeks of referral and also review people who experience any onset of additional complexity or vulnerability during active cancer treatment that may interfere with, or require modification of, their treatment.

I was invited to present my PhD plans to the onco-geriatrics research group and the geriatric nursing research group at the University of Toronto, proving valuable insight and broadening my ideas of how to progress my project further. I also attended the first Annual Canadian network on Cancer and Ageing conference.

The scholarship has given me a great deal to consider from a quality improvement, leadership, research and policy perspective. I was impressed by the many skilled, inspiring nurses and Allied Health Professionals (AHPs) I met, many of whom are key leaders in the development of these services. I was challenged to consider how we can engage more nurses and AHPs from north of the border within the BGS and also with Wales and Northern Ireland. I look forward to further collaboration with Scotland and Canada in the future and would encourage any BGS nurses to apply for a FNF scholarship as it will directly improve older people’s healthcare within your locality, regionally and nationally.

Acknowledgements:

This learning opportunity was funded by a travel scholarship from The Florence Nightingale Foundation with sponsorship from the Sandra Charitable Trust. Thank you to all the people who kindly gave of their time and generously shared their resources. Specifically, Professor Graham Ellis for connecting me with Scottish contacts, Professor Ken Rockwood for allowing me to shadow him and his departmental colleagues and the Nova Scotia Health Authority in Halifax and Associate Professor Martine Puts for hosting my two weeks in Toronto.

Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005 Aug 30;173(5):489-95