Introduction	The LSEBN Operational Delivery Network is a managed, clinical network and clinicians play a key role in the work of the network. We have a small dedicated Network Team David Barnes - Consultant Burns Surgeon, Chair & Clinical Lead (email) Nicole Lee - Network Lead Nurse (email) Lisa Williams - Network Lead for Psychosocial Care (email) Victoria Dudman - Network Therapies Lead (email) Pete Saggers - Network Manager (email)
Downloads	The LSEBN publishes burn care guidelines and guidance for health care professionals, including referral and treatment guidelines Download page
Network professional groups	We have a comprehensive work programme and this is supported by Network Clinical Lead and the three professional leads for nursing, therapies and psychosocial care. The network professional leads work with their colleagues across the whole network and have developed a number of professional forums. Senior Nurse Forum Network Therapy Group Network Psychosocial Forum
Emergency Preparedness	The LSEBN works closely with NHS England and other networks to prepare and manage a response to above normal levels of referrals and activity. This work includes the burns service and networks response to a rapid surge in referrals Emergency Preparedness (EPRR) SOP 2020 Surge & Escalation
National Burn Care Standards	All specialised burn services are working to a national service specification and nationally agreed standards Burn Care Standards (2018) NHS England Specification for Specialised Burn Care (All ages)

Downloads

The LSEBN publishes burn care guidance and guidelines for health care professionals. The documents have been developed by senior clinical members of the burns multi-disciplinary team, and approved by the ODN Board.

Senior Nurse Forum

Introduction

The LSEBN Senior Nurse Forum is one of a number of advisory sub-groups to the LSEBN Operational Delivery Network Board. The aim of the Forum is to provide expert, professional advice to the ODN Board on matters related to nursing care across the whole pathway of burn care. The Forum works alongside the network Therapy and Psychotherapy Groups, in order to deliver a patient-focused, high-quality and consistent service across the network.

LSEBN Senior Nursing Forum is concerned with aspects of nursing care for individuals who have suffered a burn injury. The Forum provides a platform for sharing ideas and practice, an opportunity for burn nurses to network with colleagues, maintain communication and collaboration specifically related to the delivery of nursing care to burn-injured patients and to promote issues relevant to burn nursing.

The Forum consists of the senior, lead nurses (covering both adult and paediatric care) and the Burn Care Advisors from each of the designated burn care providers in the network. The Forum Lead is Nicole Lee, Network Lead Nurse, based at the Chelsea & Westminster Hospital.

The objective of the Forum is to develop and deliver a project-based work programme, focussing on the need to constantly seek improvements in patient care and standards and to seek consistency in the delivery of burn nursing care across the whole network.

LSEBN Senior Nursing Forum Resources:

London and the South East Burns Network Therapy Group

The London and South East Burns Network Therapy Group includes Physiotherapists, Occupational Therapists, Dieticians and other Physical Therapists working in the designated Burns Services across the region. The group is currently led by Lead Therapist Rachel Wiltshire. The aim of the group is to contribute to the continuing improvement of specialist burns services. This is achieved by close working between experienced specialists from each burn service provider within the London and South East Burns Network.

The group works alongside the Nursing and Psychotherapies Groups, working towards goals agreed by the network operational delivery board. The work plan for the Therapy Group includes professional, organisational and clinical projects. The Lead Therapist represents the Therapy Group at network and national level.

The Therapy Group meets four times a year, hosted by one of the burns services, to deliver network projects, undertake research and audit, provide specialist training, staff development and peer support to all physical therapy professionals within the burns network.

Recent projects completed by the group include writing agreed Competency Packages for Physiotherapists and Occupational Therapists working in Burns (specific to each banding), Competency Pack for On Call Physiotherapy for Adults with Burn Injuries and Competency Pack for On Call Physiotherapy for Children with Burn Injuries.

The Role of Therapy in Burn Care

A burn injury may affect both the physical and psychosocial wellbeing of the individual affected and people close to that individual. Therapists have a unique role to play in the care and management of burn injured people.

Physical, functional, psychological and aesthetics rehabilitation must be commenced immediately post burn in order to achieve optimal outcome. The ultimate goal of burn rehabilitation is to assist the individual in their return to pre injury status. The nature of some burn injuries may make this impossible and in such cases, the focus is on returning the individual to as near their pre-morbid status as possible. For some individuals, in particular those who have sustained major burns or who have complex additional needs, the entire rehabilitation process may last for many years.

It is essential that burn rehabilitation is multi-disciplinary, co-ordinated, individualised and holistic. The affected individual will require the services of a team of highly specialised, dedicated healthcare professionals. Burns Care is a specialised service.

Physiotherapy and Occupational Therapy

The Physiotherapist and Occupational Therapist will often work closely together with some overlapping of their roles. The Occupational Therapist or Physiotherapist may be referred to as the Burns Therapist.

The Burn Therapist plays a vital role throughout the recovery from Burn Injury and the emphasis will change throughout the rehabilitation process. Therapists working in Burns Services will have specific training and experience in the care of people with burns and so are able to provide the best possible care.

Physiotherapists and Occupational Therapists work in all burns settings from critical care, rehabilitation, outpatients and in the community providing outreach services.

The therapist will carry out detailed assessments and provide a range of treatments tailored to the needs of the patient. Treatments may include-

Respiratory Physiotherapy treatments
Positioning and Splinting
Early rehabilitation, strength training and mobility
Stretching and movement exercises
Scar management
Functional retraining and adaptations.

The therapist plays an important role in providing information to the patient and carers about the recovery process and expected outcomes.

Therapy Standards

All therapists working in Burns work to the National Burn Care Standards and also there is a published document on Occupational and Physiotherapy specific standards available via the link below:

Standards of Physiotherapy and Occupational Therapy in the Management of Burn Injured Adults and Children

The following documents are available on request;

- Working with Burn Injured Children

-Burns Therapy Competencies Occupational Therapy and Physiotherapy Band 5,6 and 7.

- Physiotherapy for Burn Injured Adults On Call Pack

- Physiotherapy for Burn Injured Children On Call Pack

Network Psychosocial Forum

The LSEBN Psychosocial Forum is one of a number of advisory sub-groups to the LSEBN Operational Delivery Network Board. The aim of the forum is to provide expert, professional advice to the ODN Board on matters related to psycho-social care across the whole pathway of burn care. The objective of the Psychosocial Forum is to develop and deliver a project-based work programme, focussing on the need to constantly seek improvements in patient care and standards and to seek consistency in the delivery of care across the whole network. Membership is drawn from all professional groups within the psychosocial care team, including social workers, psychologists, psychotherapists, counsellors, psychological therapists and health play specialists from each of the designated burn care providers in the network, covering both adult and paediatric care.

The Psychosocial Forum Lead is currently Lisa Williams, Principal Clinical Psychologist, based at Chelsea and Westminster Burns Service. Members will meet several times each year as a specific group and as part of larger meetings of the LSEBN.

Work Plan 2016-2017

5.1 Documentation, guidelines and policies

To review the existing guidelines and policies related to psychosocial burn care. This will include review of existing documentation, and where appropriate, agreeing a consistent policy and approach across the whole network or cluster

5.2 Psychosocial training and education

Continue to implement the delivery of training and education for members of the burns MDT

5.3 Activity and Reporting

To review and develop a minimum dataset for psychosocial care, to be included in the Network Annual Report

Training

Psychosocial teams are involved in the training and education of their MDT colleagues in order to ensure that they provide good quality psychosocial care as part of their core professional duties, e.g. nursing, medicine, physiotherapy, occupational therapy and dietetics. This training generally follows a specific programme that was designed in conjunction with Changing Faces for those MDT members working with either adult patients or with children and their families. The adult training has 5 modules and should be delivered according to the level of psychosocial care required within the individual’s professional role. For example non-clinical staff such as receptionists and domestic staff (Tier One) should only complete modules 1 & 2. The majority of clinical staff (Tier Two) should complete modules 1-4 and only those professionals whose core role involves psychosocial treatment and assessment (Tier Three) undertake module 5. The paediatric training is suitable only for those working clinically with children and families (Tier Two and above).

Different psychosocial teams deliver their training in different ways. Some offer full or half-day workshops, others provide single modules and there is also a self-study option available. Each team has agreed to make their training available to professionals from other burns services within the LSEBN network. The table below will show any upcoming face-to-face training. In order to secure a place on the training events please click on the name of the tutor and send them a request. You are not confirmed on the training and should not attend until you have received a confirmation email back from them, which will contain all the relevant training details.

Should anyone wish to explore the self-study option then please go to the Documentation section and you will be able to download the training manuals for all versions of the training package and the accompanying audiovisual material.

The Psychosocial teams are now in the process of creating new Refresher Training for those staff who completed their initial training more than a year ago. In response to feedback from the burns multi-disciplinary teams they will create a series of shorter case-study related presentations for teams to work through. These case studies will highlight specific challenging or recurring issues seen in adult and paediatric services. This initiative will be included in the 2017-2018 Work Plan.

LSEBN Psychosocial Forum - next meeting

Tuesday April 4th 2016 11 AM - 3 PM, MDT Room, Adult Burns, Fifth Floor, Chelsea & Wesminster Hospital, 369 Fulham Road, London SW10 9NH

Burns Psychosocial Training Dates

Date	Time	Type	Venue & Contact Details (click name to email tutor)
TBA	TBA	Adult - full day workshop	TBA
TBA	TBA	Paeds - full day workshop	TBA

Documentation

Burns Psychosocial Teaching Pack Resources

Adult Tier One Training Pack for trainers

Adult Tier One Training Pack for students

Adult Tier Two Training Pack for trainers

Adult Tier Two Training Pack for students

Adult Tier Three Training Pack for trainers

Adult Tier Three Training Pack for students

Paediatric Training Pack for trainers

Paediatric Training Pack for students

Adult Pre-Training Questionnaire

Paediatric Pre-Training Questionnaire

Adult Post-Training Questionnaire

Paediatric Post-Training Questionnaire

Adult Training Certificate of Completion

Screening

QVH Trauma Assessment Questionnaire

Stoke Mandeville Adult Screen

Stoke Mandeville Paediatric Screen

C&W Adult - Time One

C&W Adult - Time One (without intention to follow-up in three months)

C&W Adult - Follow-up (3 month)

C&W Paediatric Time One 0-4 years

C&W Paediatric Time One (without intention to follow-up) 0-4 years

C&W Paediatric Follow-up (3 month) 0-2 years

C&W Paediatric Follow-up (3 month) 2-4 years

C&W Paediatric Time One 5-10 years

C&W Paediatric Time One (without intention to follow-up) 5-10 years

C&W Paediatric Follow-up (3 month) 5-7 years

C&W Paediatric Time One 11-15 years

C&W Paediatric Time One (without intention to follow-up) 11-15 years

C&W Paediatric Follow-up (3 month) 8-12 years

C&W Paediatric Time One 16+ years

C&W Paediatric Time One (without intention to follow-up) 16+ years

C&W Paediatric Follow-up (3 month) 13-18 years

Scaling and Scoring of Pediatric Quality of Life Inventory - PedsQL

Pathways and Referrals

QVH Paediatric Burns Referral Pathways

QVH Burns Referral Process

QVH Referral Codes

QVH Paediatric Referral Colour Flowchart

QVH Paediatric Referral

QVH Psychological Therapy Referral

QVH Referral Outcomes

Working with Self Injury

QVH Advice for HCAs

QVH Procedure for accepting a patient with self injuries

QVH Supervision Flowchart

QVH Guidelines for working with self injury in burns

Leaflets

QVH Burns and Major Tissue Loss Rehabilitation

QVH Psychological Therapy

QVH Psychological Therapy for children

QVH Psychological Support

QVH Reactions to Trauma

C&W Trauma Leaflet

Stoke Mandeville psychology leaflet paeds service

Stoke Mandeville psychology leaflet adult service

Working with Mental Health Professionals

QVH Psychiatry Referral

QVH Local guidelines for accessing AMHPs

QVH RMN role description

Resources

Sleep Diary Sheet

PCL 5 Checklist

Contacts

Adult Psychosocial Burns Services (July 2015)

Paediatric Psychosocial Burns Services (July 2015)

Emergency Preparedness, Resilience and Response

The LSEBN is working with other burn care networks, NHS England and NHS Wales, to ensure a coordinated response to a significant incident or emergency which results in an increase in burn care activity across one or more Burn Care networks covering England and Wales.

NHS England have developed a new Mass Casualty Concept of Operations document (2017, updated in 2020).

The document provides details of NHS England’s arrangements for the response to mass casualty incidents and the requirements of those organisations that may support the NHS response.

NHS England ConOps 2017 (2020)

The burns Annex describes the response to an incident involving burns casualties, where processes and timescales are different to the main document. The Annex provides the template for the national Major Incident Plan for burns

Management of surge & escalation in critical care services: Standard Operating Procedure (SOP) for Adult and Paediatric Burn Care Services in England and Wales (2021)

In 2015, NHS England published a standard operating procedure (SOP) for the management of surge and escalation in burns critical care. Because of the new EPRR Burns Annex, changes to the SOP were necessary, to reflect a small number of new processes and terminology. The SOP document sets out the processes and procedures that are to be followed by all specialised burn services, burns networks and the National Burns Bed Bureau, during periods of activity and referral pressures.

This new SOP was approved by the EPRR and Trauma CRGs in late 2019 and the new SOP was published in June 2021.

Specialised Burns SOP 2021 (Opens in new window)

Training resources (Microsoft Powerpoint): SOP - MUTUAL AID GUIDE v6 Final NOVEMBER 2020

Training resources (Adobe Acrobat PDF): DOS USER GUIDE v4 NOVEMBER 2020

Please note:

The SOP Powerpoint presentation will download to PC, Mac or mobile device.
The DOS PDF file will open in a new window / tab. This can then be saved to your PC or Mac and in full screen mode, will act as a presentation.

National Burn Care Standards and NHSE Service Specification

All specialised burn services are working to a national service specification and nationally agreed standards of care.

The current (2019) Specialised Burns Specification (Adults and Children) can be seen here: NHS England D06 Burns Specification

Commencing in 2017, NHS England and the Major Trauma & Burns Clinical reference Group, began a review of the specification for burns.

This work has started with paediatric burn care and it is expected that a revised paediatric burns specification will be completed during 2021.

In November 2018, new, profession-led, national burn care standards and outcomes were written and published by the British Burns Association.

Published by the British Burn Association, the new BBA National Standards for Provision and Outcomes in Adult and Paediatric Burn Care 2018 will be used by NHS England to inform a new Specialised Burns specification for 2019.

Download a copy of the new standards document here: Burn Care Standards and Outcomes 2018

Introduction

Downloads

Network professional groups

Emergency Preparedness

National Burn Care Standards

Downloads

The LSEBN publishes burn care guidance and guidelines for health care professionals. The documents have been developed by senior clinical members of the burns multi-disciplinary team, and approved by the ODN Board.

LSEBN Guidelines - All documents are Adobe PDF and will open in a new window.

Blister Guidelines:

First Aid and Minor Injury Guidelines:

Bobby:

Dressings and Treatments:

Burn Care Advisor Leaflets:

Caring for your burn at home:

Senior Nurse Forum

Introduction

London and the South East Burns Network Therapy Group

The Role of Therapy in Burn Care

Physiotherapy and Occupational Therapy

Therapy Standards

Network Psychosocial Forum

Work Plan 2016-2017

Training

LSEBN Psychosocial Forum - next meeting

Burns Psychosocial Training Dates

Documentation

Emergency Preparedness, Resilience and Response

National Burn Care Standards and NHSE Service Specification

All specialised burn services are working to a national service specification and nationally agreed standards of care.

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