Welcome to the spring/summer edition of the Live Life Well (LLW) newsletter!

It's so nice to see the lighter evenings, the sun shining (at least sometimes) and the flowers blooming.  

I'd like to thank everyone who has contributed to this edition of the newsletter and hope that the articles inspire you to seek new ways to boost your own health and wellbeing.   

We know that the pandemic and the rising cost of living have left many people with money worries and have therefore incorporated a new financial wellbeing section into this edition. Here you'll find a plethora of resources including budgeting tools, videos and webinars. In addition, I’d encourage you to check out our financial wellbeing partner Salary Finance’s learn platform which is brimming with helpful articles, tips and advice.

The last two years have been hugely challenging for all of us but as ever, your compassion and exceptional commitment to one another and those who use our services has shone through.    

Thank you to everyone who took part in last year’s NHS staff survey, I can’t stress enough how important it is to hear your feedback on how things have been for you. Your responses reflect the incredible culture we’ve built together, based on kindness, compassion and putting people first. However, there’s always more we can do, and we'll be talking with all our staff networks and to as many of you as possible to identify actions we can take to continue to develop and improve our working lives.

We'd love to hear your tips for promoting a positive work-life balance so if you’d like to contribute to the next issue of the LLW newsletter, please email ccs.livelifewell@nhs.net. Additionally, if you’d like to learn more about our Live Life Well programme, please click here or email ccs.livelifewell@nhs.net with your questions or ideas.

Finally, happy reading and remember to keep taking breaks and book in your annual leave whether you’re working from home, the office or delivering services face-to-face!
 
Best wishes, Anita

Our Health and Wellbeing Champions Network has now been running for around a year with a group of 44 members from across the Trust - find out who they are here!

The Champions' role is to promote and signpost colleagues to health and wellbeing support offers. They undertake initial training to help prepare them for the role and on-going training is available through the national Health and Wellbeing Champions Network.

Champions have recently been supporting staff with a range of issues including loneliness, stress, money worries, bereavement and illness.

We meet as a group at least once a quarter to share challenges, generate ideas to support staff, and hear from guest speakers on a range of topics. Recently we had a presentation on the ‘Time to Test’ initiative which asks employers to support staff to access cervical screening in work time, and this led to the Trust signing up to the scheme (more details below).

To find out more or become a Health and Wellbeing Champion, please contact Julie Nicholson Julie.nicholson15@nhs.net

When one CCS manager noticed that a lack of social contact during the pandemic was having a detrimental effect on her team, she sought advice from one of our HR advisors and discovered that implementing a minor change could have a positive impact.

She said: “The team used to have social events three or four times a year but during the pandemic, morale in the clinic was very low. Staff were voicing concerns and expressing unhappiness. Sickness was higher than usual, Covid restrictions and isolation were impacting on the team and staff appeared generally tired.

“I discussed this with our HR advisor who came up with the brilliant idea of allowing 10 minutes at the beginning of each team meeting for general chit-chat, whilst also providing tea and cake. 

“Although the general chit-chat didn’t go to plan due to staff being unable to join the meeting on time, we did make time to discuss how we could support one another with the pressures and suggestions were made. 

“By recognising and voicing together how difficult things had been and taking time to reflect, I’ve noticed a shift in the general mood of the team, it feels a little lighter in clinic, with staff joking with each other and smiling more.

“I think by taking 5-10mins at the start of each meeting to have a breather and recognising we’re all in this together, albeit feeling pressures in different ways, has helped and fingers crossed it continues this way!”

If the sunshine is giving you the urge to do some spring cleaning or go for a walk, why not take the opportunity to listen to an app or podcast at the same time? Here are some recommendations from colleagues:

The English Channel swim is seen as the Mount Everest of all swims as more people have climbed Mount Everest than have swum the English Channel! What inspired you to get involved?

I was always fascinated about swimming and crossing the English Channel. Ever since I got into open water swimming (ows) and heard other swimmers' stories about swimming the Channel, it inspired me to train more and apply to the Channel Swimming and Piloting Federation.

One year ago, I read about SwimTayka and their founder Bryan Avery who successfully attempted a solo English Channel swim in 2014 and I was keen to learn more about relay attempts and also help to raise money.

SwimTayka’s vision and purpose resonated with me and I decided to join the English Channel Relay Swim team for 2022. Every penny I raise will go towards funding and teaching swimming to children in coastal areas such as Peru, Brazil, Mozambique, Indonesia and other countries where SwimTayka works. 

How’s your training going?

I'd like to say my training is going as well as it can, with a full-time job and responsibility for a young family (I have two children and a bouncy chocolate Labrador)! I try and train at least four to five times a week - this includes at least three pool sessions which comprises drill/technique and sprint sessions, and a couple of sea or lake swims where I aim to swim at least 1.5 to 2kms in a single session. I also do weekly yoga sessions and cross train to maintain my fitness and increase my stamina. 

With the water temperatures in England reaching double figures (10 -11 degrees), I'll be mostly swimming in the sea or lake to get as much ows practice as possible. 

Who’s in your team of six and do you train together?

My relay team is named SwimTayka Peru and the team has five females (including myself) and one male. Yes, we've trained together on a couple of occasions, first at CSS pace test in Swindon and then in Dover for a training weekend in January (it was an indoor pool training session, followed by a sea swim, and the water temperature was 6 degrees). I usually train at West Mersea Beach, Mersea Boating Lake, Parliament Hill Lido in London and Brightlingsea.

Where will you start and end your swim and how many miles will you cover?

We'll start our swim from Swimmer’s Beach in Dover at 2.30am in the morning until we reach Calais in France. The total swimming distance is 33kms which can take anywhere from 12 to 18 hours, depending on the tide, each swimmer’s pace and of course the weather on the day.

Each swimmer goes in the water for 90 minutes then the next swimmer goes in and so on; we're on repeat mode until we reach destination France. Thankfully, we have a boat to bring us back, so we only swim one way and then celebrate on our way back!

How long do you envisage you’ll be in the water for?

90 minutes at least three times. 

What are you most looking forward to?

Being together as a team and motivating each other whilst the other is swimming. Resting between relay sessions will be a challenge as we'll all be filled with adrenaline but I’m looking forward to it and will certainly have a story to share. 

What's making you nervous?

I’d be lying if I say I’m not nervous! I'm slightly nervous but at the same time I'm confident that my training and commitment will pay off. On the day, I'm anxious about being seasick as the boat can experience turbulence, but I’ll be carrying anti-sickness medicines. 

You’re raising funds for SwimTayka, could you tell us more about the charity please?

I plan to raise £1500 or more for SwimTayka whose mission is to give disadvantaged communities around the world access to swimming teachers. 

Drowning is the third leading cause of unintentional injury death worldwide, and SwimTayka's mission is to give disadvantaged communities around the world access to swimming teachers who can not only provide the life skills of swimming, but create a legacy for today's children who will grow up to teach the next generation.

How does swimming help your diabetes?

Swimming helps me keep active and increases my insulin sensitivity, active lifestyle and positive mindset. Living with a long-term condition such as type1 diabetes has its ups and downs and it’s hard to do the job of my pancreas 24/7. However, with time I’ve learnt more about effective management of my condition and how my body reacts to longer distance swims. I’m grateful that I have a fantastic clinical team and nutritionist who are there to support me every step of the way.
  
Do you have any more swimming events in the pipeline?

Yes, I have an upcoming Channel qualifying swim – I have to swim in water temperature no more than 16 degrees for 90 minutes, rest for 60 minutes and then swim for 60 minutes. 

In addition to the main relay swim in July, I’ve signed up for the Paddle Fish 3km swim in Brighton, Rutland Night Swim in September and Mill2Mill Swim in Dedham, Essex. 

by Heather Bennett
Staff Side Business Partner
Network Chair

The Long-Term Condition and Disability (LTC&D) Network has been running for about a year now and is still growing and supporting its members. At our last meeting in February, we discussed the upcoming AGM and that we'd be looking to fill the officer posts (eg. Chair, Secretary, Deputies etc) at the meeting.

We also discussed the frequency of the meetings, which had been bi-monthly, however it was requested we have them monthly for the next six months to see if this worked better for members.

Over the last year, we've had a few different speakers and are always looking for ideas/suggestions for new speakers to invite. If you have any ideas, please do get in touch with me.

The main purpose of the meetings is to provide peer support and help members navigate their way at work while coping with their long-term condition or disability. One of the main topics discussed has been the My CCS Employment (Adjustments) Passport and how it's helped members to have a conversation with their manager around the support they need at work.

If you identify with this network, please get in touch and we can add you to the mailing list. We run the group on a closed network basis to ensure a safe space for members to share their own experiences and support one other.

Find out more about the LTC&D Network on the intranet here.

by Solitaire Adams   
HR Business Partner 

Empowering LGBTQIA+ staff to achieve their potential through creating positive change

This year has seen the LGBTQIA+ Network really start to establish itself, with many great events having been shared, remembered and celebrated both as a network, and across the Trust too. Some of these include:

National Coming Out Day (11th October)
International Pronouns Day (20th October)
World AIDS Day (1st December)

Our LGBTQIA+ intranet pages are regularly updated, so please do take a look for all the latest news.

To date, we're most proud of how we were able to come together to celebrate LGBT+ History Month. 

Our very own Thomas O’Connor put together this video, which explains how the rainbow gay pride flag came to exist, and how it's recently come to symbolise hope within the NHS.

Resources were also made accessible for all staff with thanks to Norfolk and Suffolk NHS Foundation Trust’s ‘Out and Proud’ Network which held an LGBT+ History Conference.

What’s happening next? Watch out for further work on collaborating with other NHS Trust networks and how we're planning to celebrate more key dates. 
 
We're very excited to announce the launch of our LGBTQIA+ lanyards and are asking staff to submit a pledge form to show their solidarity with the LGBTQIA+ community to receive one.

1. Download the pledge form here
2. Email your completed form to solitaire.adams@nhs.net 
3. Await confirmation for delivery of your new lanyard
4. Wear your lanyard with pride and in solidarity with the LGBTQIA+ community.

A special thank you to Unison who have kindly paid for the lanyards.

As always, please remember the network is for everyone, whether you identify as part of the LGBTQIA+ community or are a committed ally.  

If you'd like further information on the network or would like to take on an active role or be added to our network, please contact Solitaire Adams at solitaire.adams@nhs.net 

We look forward to welcoming you all at the next meeting!

‘Peace of Mind’ (a feeling of being safe or protected)

Peace is defined in the Oxford Dictionary as freedom from disturbance; Tranquillity. The last two years have been a clear demonstration of how as a society, we can easily lose this tranquillity. As a belief, peace is defined as a concept of societal friendship and harmony in the absence of hostility and violence. In a social sense, peace is commonly used to mean a lack of conflict and freedom from fear of violence between individuals or groups.

We’re all very much disturbed by the current despicable acts of harassment, aggression and bullying happening in Ukraine and at the same time in awe of how their society has come together and united to build resilience and fight a common enemy to bring back peace. Who would have thought that in 2022, a European country would have had the audacity to invade another, causing such destruction and human suffering to such a scale? Wars have been raging in other parts of the world too including Syria, Yemen, Afghanistan, Somalia, and Nepal to name a few prominent examples. Displacement of societies and the movement of people across borders has become such a mainstay of our lives that sometimes we forget and are only reminded when something closer to home hits us in the face.

My point is, as we prepare to welcome the new wave of refugees with open arms and love, could we also spare a thought for others who have come over the last 10 years languishing in the system while their settlement applications and relocations are being resolved? It can take years for people to go through this process and these poor souls over time become the burden of society and are turned into ‘political footballs’ during election cycles. They’re mostly placed in areas already suffering from poor health and social outcomes and this has caused deepening societal divisions and suspicions. We all know of these ‘no go areas’ at the periphery of our communities. Areas that have such a diverse demographic that it’s hard to make head nor tail as to what’s really going on. It’s in these communities that our new arrivals find themselves making their way into. It’s indeed in these communities that our most vulnerable also live which then creates a melting pot and vicious cycle of poverty and deprivation.

We all sometimes shy away from associating with or getting to know these groups due to our fears and insecurities but just imagine living in fear, finding refuge and then discovering you belong to the fringes of society? I think we need to get the house in order for those already here and ready for those on their way. We also need to ensure that we’re not leaving others behind and must include those with protected characteristics as alluded to in the Equalities Act 2010. 

The only way we can do this in a tangible way here at CCS is to really work hard towards understanding ALL our communities. We can all focus our thoughts on supporting the eradication of health inequalities and the improvement of services to meet EVERYONE’s health needs. Let’s build a culture of inclusion within the workforce and support community-led service improvements where all voices are heard. 

9th-13th May is Equality, Diversity and Human Rights Week and I’d like to invite suggestions from EVERYONE as to how we can celebrate this in light of the current war context. I believe we’re better together and the unpredictable nature of the future we face should bring us even closer. We share the same fears about the future of our children and grandchildren, so let us all collectively bring a ‘peace of mind’ to our work colleagues, ensuring they bring their ‘whole selves’ to work and the communities we serve by listening to them and understanding them better.

The humanitarian crisis in Ukraine continues to grow and the images we see reported in the media leave us all wondering what we can do to help, with many staff already demonstrating their heart-warming compassion by coordinating collections or donating money or goods to charities.  

NHS England and the UK Government continue to advise Trusts to work together nationally, through established existing charities to offer support in a coordinated effort. The Government website suggests that one of the best ways to help is by donating cash through trusted charities and aid organisations, as cash can be transferred quickly to areas where it’s needed and individuals and aid organisations can use it to buy what’s most needed.   

However you may choose to help, the Charity Commission and Fundraising Regulator have urged the public to ‘give safely’ to registered charities. One of many such bodies is the Disasters Emergency Committee, a coalition of 15 leading UK charities, which has launched its collective appeal to provide emergency aid and rapid relief to civilians suffering during the conflict.

Please remember that if you have family and friends in Ukraine, or are impacted by this or anything else that’s causing you concern, national resources are available to support you, as well as many others on our staff health and wellbeing page.

Hello, I'm Kayleigh Morton and I've worked for CCS in the Norfolk Healthy Child Programme for nearly six years.

I've had type 1 diabetes since the age of 2, so 33 years now. No, I didn’t get it because I ate too much sugar or was an overweight child, there are lots of myths about why: the truth is my immune system attacked itself, so my pancreas no longer produces insulin. Insulin is needed to regulate your blood sugar levels, so instead I need to inject insulin 5-6 times a day. One of my earliest memories in childhood is my mum standing at the kitchen sink for ages at a time, flicking a needle full of insulin to get rid of the bubbles before it was injected. Thankfully things have moved on dramatically since then and now there are several ways insulin can get into the body, including insulin pens and intravenous pumps.

As a child, I also remember the finger pricks for monitoring blood sugar levels. Often the ends of my finger would hurt and the skin would go hard, but again thankfully there are now more comfortable ways to check this. I currently have a continuous glucose monitoring system which is attached to my arm and changed every two weeks. These days, I read my blood sugars through an app on my phone and then have to work out the carbohydrates I'm about to eat, which gives me a basis to work out the correct dosage of insulin I need to inject every time I eat.

For anyone who's a type 1 diabetic, I strongly advise you to complete the DAFNE course (Dose Altering for Normal Eating). After being diabetic for so long, I was convinced no one could teach me anything new but I was so wrong and it changed my outdated diabetic management for life. 

Whilst it's positive that there's lots of technology around diabetes, it doesn’t always make the day-to-day management as easy as it sounds. Every single thing imaginable often affects blood sugars, meaning a dose that works one day may not the next. It's a constant balancing act on both working and rest days. 

Working as a person with type 1 diabetes has been interesting over the years. Many employers haven't supported the constant medical appointments or calling in sick because I've had a night of high or low sugars and feel absolutely pants. 

Once I started working for CCS, my life changed. My managers have been nothing but supportive with the number of medical appointments and sickness days, not just for my diabetes but also with the number of additional medical complications that come with having diabetes. Those of us with diabetes are after all covered under The Equality Act. The policy CCS has in place and the support from my managers works brilliantly in helping me manage my diabetes and remain working. I'm extremely appreciative of this as it reduces unnecessary stress (another thing that can affect your blood sugar!) and show they really care. 

One last thing, type 1 diabetes doesn't always require a special diet and doses of insulin worked out are not by how much sugar we have, it's by carbohydrates. If you see a type 1 diabetic eating a nice big slice of cake, remember the amount of working out they need to do to manage this decision is something you can only imagine. Please don’t judge, let us eat and enjoy the cake knowing we're doing our best to enjoy life whilst completing the repetitive task of managing our condition every single day to keep us alive. 

#Type1DiabetesAwareness #LetUsEatTheCake

Hobbies are often thought of as activities for people who lead quiet, relaxed lives, but those with full, busy, even stressful lives may need hobbies more than the average person. Discover more about the benefits of having a hobby here. We'd love to know more about your hobby! If you fancy sharing it with your colleagues in the next LLW newsletter, please email ccs.livelifewell@nhs.net.

Mindfulness is a form of meditation originating from religious Buddhist teachings. Modern adaptations see mindfulness easily accessed in many settings, either independently or in a group. There can be many positive outcomes from mindfulness practice, the one most powerful for me is the feeling of self-regulation and allowing oneself to be present in the moment. 

Breathing is a natural automatic bodily process that keeps us alive, but we tend not to be aware of our breathing most of the time (maybe only during strenuous exercise!). During a mindfulness session, focus on breathing becomes one of the main priorities. At the beginning of a session, you’re invited to find a comfortable position, the instructor then guides focus onto the counts of your breathing, for example to breathe in for four counts and out for six. This begins to soften your breathing and with each phase becoming lengthened, you experience a physiological sense of your body slowing down. You can then focus particularly on the moment of space between the in and the out breaths. This breathing technique is called Prana-Yama, which translates literally into 'the stop/control', and also 'the rising/expansion of breath' (Zaccaro et al., 2018). This helps to become aware of the single space created by your bodily functioning and orientate yourself to be self-present.  

I find it’s quite easy to have thoughts pop into my head when doing this such as what I’ve got to do for the rest of the day or even just complete random things. This is quite natural though and the instructor may say something like: “If an intruding thought comes into your mind, imagine it as a balloon and watch the balloon float away”. This way you can observe but regulate what thoughts you decide to keep in the moment, as you keep focus on breathing. The realisation of being able to have a full influence on my own thoughts was one of the most powerful dimensions of mindfulness, and one I keep coming back to.

The best thing about mindfulness is that once you understand how to control your breathing and thoughts, you don’t need to be lying down or meditating with a gong going in the background – you can do this throughout your daily activities. I’m still learning and practising but I think this is a journey everyone could have a go at.

by Wendy Fitch
Clinical Practice Educator

There are at least nine published books I could find called The Joy of Gardening. Numerous studies demonstrate the many and varied benefits of gardening for all aspects of physical and mental health and wellbeing. Historically most renowned as the hobby of ‘oldies’, more generations are getting into the delights of all aspects of gardening.

My own gardening journey began with the first little plot of a terraced house I bought aged 19. Thanks to my parents and grandparents being keen gardeners, I surprised myself with the knowledge I'd accumulated even by then. My earliest happy garden memories are watching in awe as my dear grandfather talked me through his cactus collection housed in his greenhouse (some of them so tall he had to remove panes of glass in the roof!) or watching my parents as they divided, pruned and planted in contented companionship in their own gardens.

Horticulture is an ancient pursuit and has been around for 10,000 years. There are so many interesting things you learn as a gardener, and not just how to sow, propagate and prune! For example, did you know Irises take their name from the Greek word for rainbow, or according to Greek mythology, roses were created from the tears shed by Aphrodite over Adonis?

As I moved, each house purchase I made was decided upon for the garden size and aspect as much as, if not more than, the indoor space provided. My children grew up with their mum often to be found outside, garden implement in hand, seeding, weeding or any other garden pastime required - no change now!

The Mr F and I bonded over our love of tropical and Mediterranean planting. I was wooed by his self-built raised beds and decking planted out with colourful and structurally imposing phormiums! The pure physical and emotional enjoyment of getting your hands in the earth, growing and shaping your immediate environment into your own personal vision of happiness cannot be underestimated and always provides me with such calm and contentment. Gardening is both stimulating and relaxing, but you do need patience.

Our last garden was a third of an acre empty and unloved plot with a house similarly unloved since the 1960s. From this, over several years, we created our own little haven inside and out with a mix of exotic and more traditional planting to our outdoor space. Such enjoyment of the gardens by friends and family encouraged us to open for the National Garden Scheme which we did for five years. Wonderful feedback from visitors pushed us to consider turning our much-loved hobby into a side-line in garden design. We have done this successfully for several years, between the day jobs! Being outside amongst the plants, sun on your back (or rain more recently) the peace and calm of nature and the physical requirement of gardening offers a massive release from the continual stress and pressure of a 38-year-long career in health.

We recently moved again to another renovation project and yes, you’ve guessed it, we prioritised the outside space! We now have approximately three quarters of an acre plot which needs significant reshaping and we're in garden heaven. Hopefully within the next year or so this too will be ready to open for us to share with other garden enthusiasts.

The sheer joy of wandering around a green space, seeing and feeling the natural environment around you can never be underestimated. Whatever the weather and size of your garden space, acres or window box, there can always be something of beauty to be found whilst wandering around your own little piece of heaven. Go on, give it a go!

In November 2021, I qualified in culinary medicine with the Certified Culinary Medicine Specialist® Programme.

I chose the health meets food curriculum as it’s the world’s most comprehensive, and the first culinary medicine curriculum for physicians, healthcare professionals, patients, and community members.

I’m the first clinician qualified in Europe and that was only possible during the pandemic as I completed the course online. Given the time difference, it sometimes meant cooking until midnight on a Sunday but at least I always had some lunch for the next day!

My passion for cooking healthy food started with my grandma. I was just a child when my German grandmother was under the hospital care of one of the pioneers who offered holistic care and evidence-based and scientifically-sound concepts for a plant-based whole food diet.

She returned highly motivated and started using less sugar and white flour, and incorporated mostly whole food into her already excellent cooking. I can’t remember her ever eating a ready meal and despite a range of chronic diseases, she lived until her eighties.

I think there’s a lot of pressure on the individual when saying that food is medicine and can heal, and it can be confusing knowing what food is healthy and which diet to follow.

Maybe it’s better to phrase it the other way around. Food certainly can cause illnesses but can also help to make you feel better. We know that the UK has the highest consumption of processed food in Europe, and we have an increasing number of patients with a high BMI, obesity, type 2 diabetes, and hypertension, however these afflictions are largely preventable.

According to Sally Davies (the former Chief Medical Officer) and Jonathan Pearson-Stuttard, health now influences our life chances more than education and the most inspiring phrase in terms of our health mission in their book Whose Health Is It, Anyway? was that we need to add more life to years not just years to life.

Luckily this insight has been picked up in the UK where there are courses in culinary medicine for healthcare professionals and medicine students, and don’t forget the relentless effort by Jamie Oliver to improve school meals.

Bringing this all together, I’d like to share my Granny’s recipe for my favourite lunchtime winter salad (see below), which is super easy and quick to make, and includes a couple of fermented foods. Kefir or plain yogurt with active culture and sauerkraut (it’s in the name) are a great source of live bacteria that can enhance healthy gut function and has shown to improve anxiety and cognitive function. You can also add seeds or nuts to it. My preference is walnuts as they have among the highest antioxidant and omega-3 levels, and they beat other nuts in suppressing cancer cell growth.

The taste depends on the raw unpasteurised sauerkraut you’re using – I mostly use the classic version, but it’s worth experimenting. Please be aware sauerkraut can be high in sodium and some contains up to 1.5g per 100g. Adults should eat no more than 6g of salt a day (2.4g sodium) – that's around 1 teaspoon. Sauerkraut is not only enjoyed in Germany, but in many especially eastern European countries. You can make your own but I haven’t managed to do that yet, so if anyone has a foolproof, low salt, make-your-own-sauerkraut recipe, please do share!

National Vegetarian Week is an annual event to educate people about the benefits of a meat-free diet. Have you ever tried going meat-free for a week? To inspire you, two colleagues have shared their favourite vegetarian recipes!

Lemon and Artichoke Risotto (serves 2) by Nicola Lee
HR Resourcing Business Partner   

"You'll never believe you can cook something so yummy and wholesome in under 30 minutes!"

Ingredients:       

• 200g risotto rice
• 600ml vegetable stock
• 1 tbsp olive oil
• ½ onion
• 1 garlic clove
• 1 tsp fennel seeds
• ½ jar of artichokes 
• 1 lemon
• Vegetarian parmesan 

Method: (you'll need a large saucepan with a lid, frying pan and microplane/fine grater)

1. Tip the rice and 300ml of stock into a hot saucepan. Cover and cook for 5 minutes. Pour 1 tablespoon of the olive oil into the hot frying pan. Finely chop the onion and add it to the pan with a pinch of salt and fry for 2 minutes. Peel and grate the garlic directly into the pan with the fennel seeds and cook for 1 minute. Tip the contents of the frying pan into the risotto pan and pour in the rest of the stock, stirring to combine. Cover with the lid and cook for 8-9 minutes.
2. Meanwhile, roughly chop the artichokes and tip them along with their oil into the empty frying pan, fry for about 3 minutes until they are heated through. Zest the lemon over the top of the artichokes. 
3. Remove the lid of the risotto and stir continuously for 1 minute, then squeeze the juice of the lemon into the risotto and stir. Add the artichokes. Leave to simmer for 3 minutes or until the rice is cooked. 
4. Serve the risotto and finish by grating the parmesan.

by Kieran Mitham
First Contact Practitioner and Senior Physiotherapist 

Pain that radiates from the back down the leg is a very common presentation we see as physiotherapists. Commonly we hear people use the term “sciatica” to describe any sharp shooting pains in their back, buttocks, and legs. However, there are different terms we use for people with these symptoms and different treatments based on the diagnosis. The reason many clinicians and researchers have moved away from the term sciatica is because there are many nerves and nerve roots in your body which can be inflamed and cause these symptoms, the sciatic nerve being one possibility.

The first condition is known as referred pain. This often presents in people with low back pain with a dull, gnawing, aching pain in the buttock, groin, or thigh. The pain rarely travels below the knee. It's often caused when the body gets confused by the amount of stimulation in a body part and will refer pain to a body part in a similar area i.e. an extreme example of this phenomenon is left arm pain in people suffering heart attack.

The second condition is where the terminology can become a little confusing, even between clinicians there are some discrepancies. Radicular pain comes from the latin word radiculo or radicula, which means the root. Radicular pain is when there is a compression and/or inflammation of the nerve root in the back which causes an increase in sensitivity along the nerve and people present with a shocking, electric feeling down their leg, often travelling below their knee. Despite radicular pain being very painful and debilitating, research suggests most symptoms improve on average between 6-12 weeks and respond very well to gentle aerobic exercise and pain relief to reduce the inflammation of the nerve. In very rare occasions, when symptoms are not improving, an epidural injection may be considered.

The final condition is called radiculopathy. This is when there is a significant compression to the nerve root which causes reduced sensitivity along the nerve. People will present with loss of strength, reflexes and/or sensation in their leg. There doesn't necessarily need to be pain with this condition, and it's often the one that may need an MRI to see how significant the compression is and if there is a surgical target.

To summarise, most nerve symptoms are generally radicular pain and improve on their own within 12 weeks with gentle exercise and possibly anti-inflammatories for nerve pain. If people present with numbness, or complete loss of strength in lower limb, or loss of knee and ankle reflexes, then an MRI may be warranted as this could change management and need to be considered for surgery.

References

Bogduk, N. (2009). On the definitions and physiology of back pain, referred pain, and radicular pain. Pain, 147(1–3), 17–19. https://doi.org/10.1016/j.pain.2009.08.020

Jesson, T. (2018). Radiculopathy, radicular pain and referred pain - what are we really talking about? In InTouch (Issue 164, p. 6).

Konstantinou, K., Lewis, M., Dunn, K. M., Ogollah, R., Artus, M., Hill, J. C., Hughes, G., Robinson, M., Saunders, B., Bartlam, B., Kigozi, J., Jowett, S., Mallen, C. D., Hay, E. M., van der Windt, D. A., & Foster, N. E. (2020). Stratified care versus usual care for management of patients presenting with sciatica in primary care (SCOPiC): a randomised controlled trial. The Lancet Rheumatology, 2(7), e401–e411. https://doi.org/10.1016/S2665-9913(20)30099-0

Ogollah, R. O., Konstantinou, K., Stynes, S., & Dunn, K. M. (2018). Determining One-Year Trajectories of Low-Back–Related Leg Pain in Primary Care Patients: Growth Mixture Modeling of a Prospective Cohort Study. Arthritis Care and Research, 70(12), 1840–1848. https://doi.org/10.1002/acr.23556

If you have problems with your muscles, nerves or joints that are likely to cause you to be off work then, wherever you're based in the Trust, you can access our dedicated rapid access MSK physiotherapy service with a telephone assessment.

Please complete this self-referral form and email it to CCS-TR.ccsstaffphysio@nhs.net. You'll then be contacted to arrange a telephone assessment and management plan. For a visual guide of what to expect, please see this rapid access physiotherapy flow chart.

The service is in addition to any occupational health support being provided.

Adele also volunteers at Parkrun and Junior Parkrun events which she says is a great way to feel part of the community and get outdoors on a Saturday or Sunday morning!

Click here to find out more about taking part and volunteering.

The pandemic and the rising cost of living have left many people with new money worries. The Money and Pensions Service, which is an executive non-departmental public body sponsored by the Department for Work and Pensions (DWP), has a dedicated number for NHS workers looking to access free, impartial money guidance and regulated debt advice: 0800 448 0826. In addition, you’ll find a wide range of money guidance, tools and direct help on the Service’s website here.

As energy, fuel and food prices continue to rise, we recognise times are tough. If you’re experiencing financial hardship and are in a union, please don’t hesitate to contact the union directly as many have hardship funds. In addition, all CCS staff have access to affordable loans repaid through their salary, as well as money insights such as budgeting tips and tools, videos and webinars through our financial wellbeing partner Salary Finance. You can find out more about Salary Finance here and will find lots of helpful articles including videos and budget planners on Salary Finance's learn platform here, as well as details of other financial support available on the intranet here.

The average UK employee has £3,737 of unsecured debt (The Money Charity) and if you're one of them, your debt may be costing you more than you realise. Sometimes we take on more than we can handle, or sometimes we forget to make more than the minimum repayment. If you have debt that’s costing you a lot of interest, it’s important to remember there are options and services available that are designed to help.

Through Salary Finance, you have access to lots of handy resources to help you understand your debt better, how to pay it off quickly and ultimately how to become debt free!

You also have access to a range of financial benefits through Salary Finance, including affordable loans repaid through salary and money insights. Find out more here.
 
Important: This is an option, not a recommendation. CCS does not benefit from offering this service and all your communications will be with Salary Finance. Loan applications will be assessed to ensure the loan is appropriate and affordable for you. “Learn” content is for guidance and educational purposes only and is generic in nature. Salary Finance does not offer regulated financial advice. Please seek independent financial advice.

9th-15th May 2022 is Mental Health Awareness Week and this year's theme is loneliness.

Loneliness affects millions of people in the UK every year and is a key driver of poor mental health.

The Mental Health Foundation’s Mental Health in the Pandemic research found that loneliness has been exacerbated by the Covid pandemic and has been an important factor contributing to higher levels of distress, resulting from people’s sense of isolation and reduced ability to connect with others. Further polling also found that loneliness was one of the leading issues that the public felt needed to be addressed.

Click on the social media icons below to stay up to date with the latest on Mental Health Awareness Week and discover the practical steps we can all take to address loneliness.

To support Mental Health Awareness Week 2022, the Mental Health Foundation is running an 80 Miles in May Challenge.

Could you walk, run or jog that distance over the month to raise vital funds for the Mental Health Foundation?

You can read more here and if you're up for the challenge and would like to receive your free water bottle, you'll need to join the 80 Miles in May Challenge Facebook group.

20th-26th June is Cervical Screening Awareness Week

Did you know that two women die every day of cervical cancer in England yet it's one of the most preventable cancers?

Cervical screening helps prevent cancer by checking for a virus called HPV and cervical cell changes. If left untreated, these cells can develop into cancer.

Screening only lasts a few minutes and you only have to go once every 3 or 5 years depending on your age. 

Don’t ignore your invite letter and if you missed your last cervical screening, book an appointment with your GP practice now.

We'd like to take this opportunity to remind all staff that we already support you in accessing any health checks. When it's not possible to make routine medical and dental appointments, including health checks, outside of work time, you can agree with your manager how these appointments can be accommodated within the working day. Options may include adjusting the start or finish time or, where possible, time off will be given without the need to pay back that time.

For more information on attending medical appointments, please refer to our Staff Health and Wellbeing Policy which can be found in the Document Library on the intranet.

NHS Fit is a brand-new offering to support the physical and mental health of all NHS staff, developed in partnership with health and wellbeing provider, Be Military Fit. The platform is FREE to all NHS staff. Simply click this link and sign up with your NHS email address to get started.

Covid-19 has affected us all so please access support if and when you need it. Our staff health and wellbeing webpage is regularly updated and contains plenty of resources which provide psychological and practical support, including Our Health and Wellbeing 'Stepped Offer'.

NHS England has also pulled together a comprehensive health and wellbeing offer which can be accessed via england.nhs.uk/people

The NHS is supporting staff who have pushed their minds and bodies to the limit over the last two years to look after their mental health and wellbeing by setting up 40 dedicated support hubs across the country.

Free of charge, the hubs offer confidential advice and support for all health and social care staff. Watch the video below to find out more.