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Good evening and welcome to this share the pressure launch event. My name is joanne whores, I'm a nurse, I'm a cardiovascular specialist nurse by background, and I do a number of other jobs as well, absolutely delighted to be here this evening with you to talk about are really exciting new project, which is funded by the Burdick Transfer nurses share the pressure is a new initiative. We're looking to address high BP among black people of african and caribbean descent using a shared decision making tool. Our partners in this project are the race equality Foundation, younger lives, and BP uk, and we are here from Smart Health solution, so I'm going to get the rest of the team to introduce themselves before we tell you all about Makayla let's come to you. Thank you jay, so my name is Michaela nuttall, I too am a cardiovascular nous, and I'm based in Southeast London. I have quite a few rolls, a bit like j, like many of us do have quite a few roles, but I have delivered lots of training particularly around the Nhs health check program and cardiovascular disease too many of the boroughs across London, but in particular Southeast London. Thank you. Thanks Makayla and david, let's come to you hi, everyone, my name is david, okoro and I am not a vascular nurse, but I am a education and training consultants and leadership coach, and I work with communities in Southeast London, fabulous thanks david, so I guess the first question to ask is why why we've embarked upon this project, so david I'm going to invite you to tell us all about it. Thank you very much so. Um As you know, this project is here to address high BP in the african and caribbean communities in Southeast London, and we know as well that ethnicity is a significant factor, a significant risk factor when it comes to cardio and vascular disease within that community. All of the data, all of the evidence over many years has indicated this and we know the high BP disproportionately affects um black people from the african and caribbean communities, so um we are also aware as well that there are higher incidences of strokes and end stage renal failure within those communities too, and the unfortunate thing is is that people from those communities are less likely to come forward for for routine screening and also for health checks and I'm sorry to say in particular men, and even if even if people from those communities have had checks or a routine screening, they are less likely to have high BP controlled even if they've been given medication or any other support to help with the condition. The situation has become worse like many uh many health conditions as a result of CoVID 19, it's made the situation much worse so our objective as an organization as a project as a program is to help to address this. That's why we are here, lovely, Thanks david for setting the scene for us on why we're looking at this particular area of high BP in this particular community, so what I'd like to do next is come to you makayla to tell us all about the what we're doing lovely. I will do thank you so uh share the pressure, is a, is a platform and it's an interactive platform that people can go online and put in the usual variables that you would do for a traditional cardiovascular risk assessment and get your heart age and your heart age in comparison to your biological age, so so I'm sorry, jeff, I can have the next slide, so this project for sure the pressure in people with hypertension is actually the second one that we've done, the first one was from a successful bid, uh european bid, and it was funded by by actress and there we worked with anybody who was interested in hypertension, so not geographically challenged like we're just doing it now in one area and for anybody with hypertension now. If you can see the date on here, we started that in july 2020 so we wrote the proposal back in 2019, and like many services, Covid really had a massive impact on everything, so we couldn't deliver it in quite the same way as what we hope to, however, however, what we did do is we learned a lot about when we were going through Covid and what people were worried about and it probably wasn't their BP for a while, but also that healthcare professionals that was who we mostly engaged with, we're really keen to still do stuff that wasn't covid related, and we ended up delivering training to over 1000 healthcare professionals across 37 different countries. We took it from being uh an in person training program, we were winning and we made go online and what we did do though for the people that were involved in exploring heart age for patient's and people with hypertension, they found the heart age test to be really motivating that made them want to be able to make lifestyle changes as well as taking medication, so now we've got to share the pressure part too and that's the project we're on now and that's as we've heard it's across South East London and it is for specific people, we've instead of saying anything for everybody were saying something that these people in this area, um So we have done this with a variety as j, mentioned different different partnerships that are they're headed up by the Race Equality Foundation, who've already done a lot of work with hypertension, particularly in men who are black, and so they've been engaging quite a lot across the community of Southeast London holding focus groups, um interviews to really get the collateral and the evidence to be able to adapt the tool to make sure that the language the images are all really going to resonate for the people that we hope will use this tool in parallel. I've been speaking to the healthcare professionals across southeast london, um, and so we went to the i. C s and we've been I've been speaking to practices. I've been speaking to cease well, not CCgs, but the whatever the structures are called now, So the structures are always changing aren't they but the sort of the PcN directors, I've been chatting to as well as public health departments pretty much across most of the bullets. I've spoken to pharmacy teams, the community pharmacy teams really to make sure that whatever we're going to be able to offer here, really complements and supports all the amazing right that's going on at the moment because it's a fantastic amount of work going on in hypertension across South East London. The Heart Age tool is being developed as I said um It's not live yet uh well. It's live, but the adaptation, the adapted version isn't live um and so that's just going through its final throes and it's final testing, pulling in all the outputs from the focus groups to make sure that it is absolutely tailored and we're at the education program. This is this is where we are now and this education program well. I'm going to hand over to my colleague job to tell us some more about that thanks Michaela, so as I mentioned earlier on uh Michaela and I are from Smart Health solutions and we're training organization, and so we've got the great job of delivering the training element for healthcare professionals on the share the pressure project, so on our website here at Smart health solutions, dot, co dot uk and uh Michaela, perhaps you could tap that into the chat box so that we've got it there for future reference. Um You'll find that we've got a dedicated web page for share the pressure now, this is a screenshot of the opening page once you get into their, which tells you who it's for and and all about it and what it can do, but you'll see that there are three main boxes there at the bottom resources for healthcare professionals, resources for patient's, and there's a link through to the share the pressure website now as Michaela has said that that link is live at the moment. It take you through to the original share the pressure website, so by all means have a look at it see what it's all about and see how it works, but as we've already heard this work underway at the moment to tailor this to the population that we are seeking to engage with uh for this, share the pressure Project resources for your patient um is still under construction at the moment, what we're going to have in there is a variety of links that will take people through to patient facing resources to support this part population with BP. Um You know that BP uk our one of our partners in this and they are doing a lot of work. They do some fantastic work in producing resources for patient's and there will be some specific resources they're tailored for this population. We're also going to have a BP quiz in there for again this population and we would encourage you to ask your patient's to participate in this and see what they know about BP and perhaps see what they've yet to learn about BP, but I'm going to focus now on the resources for healthcare professionals section that we are working on at the moment, so if I just click through to where that will take you, it will take you to the share the pressure community of practice and this community of practice is open to all healthcare professionals who will be working with us through this proge, perfect and we really want you to provide lots of interactive learning opportunities and lots of resources that are going to be useful to you in your everyday practice now, some of you may know Michaela and I already from a lot of the webinars that we deliver through the learn with nurses platform, and these will take a similar sort of uh similar sort of way as I learn with nurses, we are hosting or medal are lovely friends at Medal are hosting our webinars through the medal platform, which some of you may be familiar with, and we've got a range of webinars that we are already booked um to deliver. So do have a look and see if there's anything that's going to be of interest to you obviously one the welcome event today, but we have other webinars, so we've got Michaela doing her wonderful understanding BP webinar, where she takes us through all of the kind of introduction to BP to really help us understand what that is and I think you talk about dinosaurs and dinner ladies. If I remember, oh, I do, I do those barrier receptors always confused me until I turn them into dinner ladies and he doesn't have a dinner lady and we've also got Michaela doing a session on understanding heart age and so once we have the live heart age system there. For this stage of the project, take you through that and really take you through the evidence behind heart age and how to use it to communicate with patient's and help them to understand their risk and to generate questions and things for them to think about. In terms of their BP, I'm going to do a couple of webinars as well, that they're available to book on understanding medications to help hypertension and also on BP and lifestyle. So we're going to be running these webinars live, so feel free to share with all your mates and get people signed up to join those. They're also going to be available on demand so that people will be able to catch them at a time to suit them now as well as our traditional webinars. We've got a number of other resources available, Michaela, david, and myself have been busy over the last few weeks, recording some podcasts for those of you that might like to listen on the go, so we have a couple that are already up their understanding BP and understanding hard what age we've got a third one on managing BP that are there now, They're really nice easy to listen to chatty podcast that you can have a listen to while you're doing the dishes, walking the dog or even when you're tucked in at bed at night. Whatever takes your fancy, do have a listen to those, and then the remainder of resources that we've got on there and there are plenty and there's lots more to come so what's on there at the moment really is an introduction. We're still building and gathering um resources to pop on there, so if there's anything particular that you would like to see again, do reach out to us, and we want to include as much as we possibly can, we've already written some articles. The wider team have written some articles about the project and about hypertension in black communities. Uh Michaela and I have had something um in, I think nursing standard and with david as well, we've got some top tips around BP in another journal and our colleague tracy, from the Race equality Foundation has also had a good piece published as well alongside are published articles. We have also got you'll see they're a section for the Clinical effectiveness Group of Southeast London who have worked really hard to produce some amazing resources in terms of guides for the management or the diagnosis and management of hypertension, and there are individual guides there per area so you can see effectually bromley, Greenwich, Greenwich lambeth, lewisham, and sub it down on there now. I'm sure you may have already seen these guidelines you may well be using them in your everyday practice. I'm not from South East London. I'm way up in Norfolk, I teach a lot of hypertension, and I very often referenced these guidelines and share bits of these guidelines when I'm teaching on hypertension because I find them to be really clear, really concern and really helpful for directing healthcare professionals around the management of hypertension, so you'll find those on there too. What you'll also find is links to resources on the british and irish Hypertension Society website in Makayla leah, both involved in working groups for the b. I. H. S, so there'll be information there on how to take BP, too the right equipment guidelines and a variety of other things that will be on there for you and we've also got links in there to other guidance around lifestyle management of hypertension, so there will be guidelines around healthy eating around physical activity, stock, smoking, and all of the things that we know your help to improve your BP. They do have a look on the website. We're hoping there's going to be something there for everyone. We're going to be developing some clinical stories, some paste studies as well, and again, if there's something that you'd like to help with that, something you would like to see something you'd like to join in and and grow over to us, then please do would be absolutely delighted to hear from you, so I'm going to go back to Mikayla now you've heard about why we're doing this project, what we have to offer so michaela, when, when, is it all happening well, we're in the middle of it at the moment. We uh this is a, it is a tight timeline that we have the Boudette Award was for one year, so we kicked off in august and um that was a lot of the getting it together and start building things time we have just launched you know, this is, this is the first of our sessions that are dedicated towards the actual training element of it. The web sites up and running and the training will be available from fed through to july um And you know I was like you never know what happens with funding where you get the next little bit of funding from so things will be you know, we're not going to take anything down, that will be still available for people to keep an eye on and keep updated with. They're also the tool, The adaptations of that should be ready for march, so we're hoping that that's something and the tool I think you know it can be used either with healthcare professionals by people people doing it by themselves as a whole variety of ways, we're going to have to think about getting that out we we do have to produce a final report, So evaluation is happening throughout as as it always should happen and we submit our final report in in uh in august so that's the job done then, so as with lots of things, it's always thinking about well how can we share the word as well, so share the pressure part warm, was hopefully coming out in the british journal of Cardiology very soon. I was a bit late in doing the doing the reviews, you know with the edits from the reviews, and I'm already in conversations with these guys about the ready getting ready for, share the pressure part too and seeing how that's gon, and how that's going said That's pretty much our timeline, it's going to be fast, but I think we're in a fast moving river at the moment that is hypertension and uh we're all here and delighted that hypertension has got such a well. It's such, got such a place in the front of our hearts and minds. I think at the moment, we know that you know hypertension got missed a lot whether it's diagnosis or the management and we've much to catch up on as a result of that pandemic, so I think we are we're here helping out in a space that's already quite this, and we just really want to add value to what people are already doing and we hope for this point in time, we can make a difference and then even when our project might be over the knowledge, should hopefully, we will have left knowledge behind that's, that's my aim for that, one joe, lovely, thank you very much, and it's that legacy isn't it that we're always looking to leave behind to make me better, so what I'm gonna do now is I'm gonna stop sharing those slides because uh of course we all want to be seen bigger, and I'm I'm gonna invite some questions from our audience and thank you una, um for starting us off with the question there um and is this just for Southeast London, so uh Michaela do you want to take that one yes, I will and and actually is just for Southeast London. That's that's what when we've submitted our bids. That's what we said, it's for now, we can't control, Really are people slip in for training and people can access the platform from anywhere, but everything that we're doing is tailored towards Southeast london, So all of our supporting guidance, all of our references, everything we're going to be doing it is about just Southeast london now, we do know you know so that might be doing something slightly different to lamberth, will be doing something different to louis ship and we're gathering all of the whatever people want to share with us that's useful that they would like incorporating as part of the suite of stuff that joe's just talked us through, So so for now, Yes, this is just for Southeast London, but we'd like have to do it somewhere else. That's you know not saying they never love to do it somewhere else and the resources are going to be relevant aren't they, for populations all around the country and the world. In fact, so we never mind a cheeky bonus do, if somebody else has come in and benefited from absolutely absolutely, I think I think that's the important point isn't it really that even though this is targeted communities in Southeast London, it could have a really big impact across the country and beyond, so yeah there could be some real benefits and bonuses for our small project in Southeast london nationally and globally. Even so, yeah, I think I think you're totally right there david and you know, we're hoping that people will be able to take stuff away. We we know that Heart age works, and when I say works, motivates change, There's been quite a few studies now published as a result of uh with heart age and there was a really good one in Spain that took healthcare professionals and split them into three groups so one they they measured their risk factors and told them their risk factors. The second group they measured their risk factors and told them their risk factors and told them their cardiovascular risk, their chance of having a heart attack or stroke in the next 10 years and the third group got all the same and they got their heart age and overwhelmingly the group who got their heartache, with the ones that we're most likely to make changes so whether that was losing weight stopped smoking, better control of BP, better control of cholesterol. Um It was that knowing that heart age, even when the risk was low, so even when people's absolute risk would say less than 10% because the heart age will still be different. We saw a really big benefit in that group and even more interesting the values that were just given the risk factors and the leaflets and didn't have any context for it. The risk factors actually got worse. That you know their BP continued to get worse. We'll continue to go up so so this taking what is unique, taking this concept and putting it into hypertension is really what we're doing quite different and then applying it to a group of people within a geographical area is new as well, so it is quite exciting, I think is quite exciting, so I've got a question uh sorry there are questions just come in again, so shall I read this question out, I'll read this question out so someone wants to know can I use the tool for people of any ethnic background. Do you want to do that one joe well, I've used it for myself, and I'm not sure if I should even tell you my actual age, let alone, let alone what my heart age was, but yeah you can use the tool for absolutely anybody a tool you can use it for yourself. In fact, I'd recommend doing that first of all just to get the feel of how it works. Um so it is suitable for anyone, so the actual tool in the algorithm that within the Heart age tool within share the pressure is going to be the same as the old one. What we're trying to do is is make the information that's given more relevant for our population that we're actually aiming to target um in this phase of the program, but the actual result putting in your ethnicity is part of the algorithm anyway, because we know that um ethnicity make such a big difference to your cardiovascular risk, so yeah, in answer to that question you could use it for anybody at all, but it's going to be the supporting materials and some of the communications that um we hope that's why we've been doing a lot of the background work and the focus groups with the race equality Foundation. We hope that the way this information is presented is going to be particularly relevant from the black communities that that we're aiming to reach um in this program, who so it's gone up my head now joe, I have one and it's got that was it, that was it, so so can I use can people attend taking more than once, so if they've done a session once, are they welcome to listen more than once joining more than once is that is that allowed, yeah absolutely fill your boots come as often as you like um the sessions, the webinars that we do all those we are going to present them live. We're gonna do each one of them um at least a couple of times in the first instants and being live as we are now. It gives you the opportunity to interact and to ask questions, and it also um if you are a healthcare professional who needs to think about revalidation, then joining a live event and joining in through asking your questions. Um Actually then counts as participatory learning, so it can be very helpful to you from that perspective um to be able to attend a live event, however, they will be recorded. They will be available. The podcasts are there now. All of the other resources are either there now or are coming in shortly. So you know, treat it as the all you can eat buffet and just come and help yourself take as much as you like and enjoy. Please don't mention all you can eat buffets on this uh this particular from the vegetable uh salt uh. Of course what I mean david you're familiar with that. One of course we do have another great question actually from a healthcare provider in Southeast London, It's how can we as healthcare providers help to push this forward, so he would like to answer that yeah, I think well. You know, I was pondering on, I was pondering on because I think it ties in with this in that whilst we are you know, we're going out saying okay healthcare professionals come along joining and I think you know we are, we are and just to respond to that how we can do it, so the South East London Training has taken all of this and their share ing, and promoting it as well, So we are we now you know that we're going to be able to get out there in a variety of different ways to people because there's more than one route to people so, um but even if you just want to sign post and say to someone you know there's this session going on, there's free training, you get it's a difficult you know, it can help with your revalidation um and actually Medal is brilliant for that. There's a great place for being reflective and then you can log all your training hours in there, but I'm also wondering if there's a challenge back to the patience of Southeast London, the people living in Southeast London into saying um was twofold one you can use heart aid yourself, you don't have to do that with a healthcare professional, it's designed to be able to be anyone can go in and do it. Um We do sign post though back to healthcare professionals if all totally in line with nice guidance, using the language that replicates the language that should be used in in every day well. So you know, depending on the BP, then they'll be advised to make an appointment to call their gp practice for a routine appointment or a participating pharmacy because we know, there's a lot of pharmacies doing blood pressures um so, yeah, so I think we can as healthcare professionals we can get out there, but I want to know david and I'm gonna ask you do you think we should how do you think people would respond, but they feel comfortable in saying to a healthcare professional do you know have become, across heart age. This is something that's tailored for me and have you do not am I, making sense coming at it from the other direction. Yeah I think if people um if the participants understand that it's something that is specifically tailored for you for your community for your family and your friends, I think people will feel much more comfortable and confident engaging with it and you know the key part is about is this actually for me and this is what we need to get across the people um in those communities that this is this is actually something for you um and that will help too take down some of the barriers that might have ordinarily prevented people from engaging, I like that also, maybe that's a definite one we need to think about in inspiring and encouraging others to be able to do that and and one thing I what I do like about the tool that we keep saying tool and platform, it's the same thing just to let you know tool platform, it's the same thing share the pressure is once you've got your heart age result, So let's imagine you are 47 your heart age is 58. Oh She's frozen frozen in time. I'd like to be able to finish Michaela sentence and I know her very well, so normally, I can end her sentences for her, but on this occasion she might come back in there, she is there. I am so I thought it was all you lot that froze, but it was me there's nothing like having telecommunication issues is it, so I was just saying that actually that shared decision making element allows people to see what happens if they I do want to make a decision to make lifestyle changes or if they want to make a decision of the impact of that decision to make lifestyle changes and take medication, So it really will hopefully enable people to feel much more positive about understanding why those those changes are going to be important and you can see that real impact from it. I think I'm just going slightly away from um share the pressure for a minute, I'm involved in another project in another area of the country where we're looking at cardiovascular disease and cardiovascular risk, and one of the things that we're doing at the moment because you know through clinical engagement where we've been um told that there's a real issue in getting people from ethnic minority backgrounds to come forward for and it's just health checks and for BP um follow up appointments and things like that so one of the things that we're doing is looking at practice. Data looking at the population of that practice and looking at the breakdown of the people that are coming forward for all of these relevant checks, Just thinking about does this look right are the people that were seeing representative of our population or our community or or have we got massive gaps here, which then sort of starts to ask the question about you know what are we doing to reach out to those people who are not necessarily coming forward and being seen in our clinics and you know we know that for Nhs health checks and for everything that we're doing in primary care, you know, there's there's such a big focus on reducing health inequalities and making sure that the right people are coming forward for the right things at the right time that um you know it depends how far you're you're able to push really to look to see what things are like in your area, but of course appreciating that this is probably the busiest and the most challenging time that any of us have ever seen in the NHS um and certainly in primary care, so um I would also see this very much as a door opener um. That will help to give information that can then be supported and backed up by healthcare professionals and you know, we really hope that by engaging with the local communities and putting this tool out there, we can do some of that work in encouraging people to come forward for you as well, we're certainly not wanting to make life harder just wanting to support and enhance what you already have there and and try and get the right people in no, I don't know if we have any any final questions coming in at all. I think we're all right, I think it's a good point to it, I can't see anything else coming in, so I think um what we've done hopefully is taken you through the why we're doing this and what we have to offer and hopefully you've got a better idea of what it's all about resources there are and hopefully um you'll agree that this is something useful that is is going to be available for the population in southeast london, but as david has said you know for everybody, um there is going to be a value to here, so I think what I'm gonna do oh look somebody has just popped in the chat that they have calculate, just calculated their heart age um not a great answer sorry about that, probably a similar scenario to what I had when I did my own um but so easy to use, so that's brilliant to hear that that you found it easy to use um even if it wasn't great news, but hopefully you can pick up some tips of how you might make that news better If you really did it. Um So david I'm going to come back to you you, you set the scene for us at the very beginning, so are you gonna just wrap us up now and give us some some parting words to think about as we all go about our evening. Yes most definitely, I've noticed that I've frozen, but hopefully you can hear me yeah, we can hear you and you're moving all right okay just on my screen, then, so why are we here well before we talk about that. We're here to address the high BP in people from African Academy and communities in Southeast London, but I think we need to be a bit more real really and for me, I think it's about um from my point of view having watched people around me who have died before their time even though they have a treatable condition and also watching the uh the um what's in the quality of watching their quality of life decrease that's what it's about, isn't it that's what it's about, so I'm hoping that our colleagues here with us today can get involved. They can spread the word about share the pressure and encourage their colleagues, their friends, their family members to use the tool to use the two, and I think what we want to do is add to the great work that's already been taking place in Southeast London and beyond, and this really is a fantastic opportunity to make a difference and have a big impact on those affected communities and we know Heart age works. I'll say that again apartheid works and it can save lives so thank you very much and I'm going to hand back to jail for the final words and thank you well, thank you david and what more can I add to that thank you so much for bringing it back home to us. You know that making a difference, we know that people are dying and being ill when they don't need to be, because we have the tools to do this job um And these are people, these are dad's brothers, uncles, Mom's everyone, so um thanks for bringing that back to so. Thank you david for um being on our panel this evening. Thank you Michaela um pleasure to be with you both again again this evening. Thank you for your questions and your involvement this evening as david says tell your mates about it. This um session is going to be available on demand for others to come and have a look at, so please do point people in our direction um and stay with us on the share the pressure journey and uh we look forward to seeing you on one of our webinars soon. Thank you very much. Everyone, thank you, bye bye.