Winner: Brighton Health Care trust

Project: Patient Advocate

Contact: Penny Dunman, tel: 01273-644588

The patient advocate project has been running for nine years. It started as one of two pilot projects funded by the Department of Health and the King's Fund, and evaluated by the then National Association of Health Authorities and Trusts. The idea was to explore whether a patient advocate would enable patients to be heard and supported, bring about change and alert the trust to good and bad trends. More than 1,000 people a year now contact the Brighton Patient Advocate office. It acts as a 'friend within the system' - cutting across bureaucracy and working with staff to bring about a resolution. This empowers users and quickly diffuses situations, reducing stress. People are seen on the wards, in their own homes and on a walk-in basis.


The patient advocate is managed weekly by the director of nursing. Patient advocate Penny Dunman has access to all staff and immediate contact, if required, to any board member, the chief executive and chair. In addition, she reports annually to the board in an open forum attended by the public and press.

Innovations and successes

The service is backed by senior managers and, while working quietly and confidentially, it carries real clout. In addition to helping thousands of families in distressing situations, Penny has become actively involved in staff training, particularly the induction programme for clinical and nursing staff. Many staff raise problems with her, and, at her instigation, a trust-wide group to explore work-related stress has been set up. The patient's advocacy and liaison service outlined in the NHS plan is largely based on the success Penny has made of her role in Brighton.

The judges said: Setting the gold standard for the approach to patient-centred services. Clear and passionate vision that goes well beyond the care role, seeing all trust staff as potential patient advocates.

Proven transferability. Excellent value for money.

Runner-up: Health Promotion Agency for Northern Ireland

Project: Folic Acid - one of life's essentials

Contact: Margaret Slane, tel: 028-9031 1611

Increasing the amount of folic acid taken before and during pregnancy could significantly reduce the number of babies born with neural tube defects, such as spina bifida.

Yet research in Northern Ireland in 1996 found that only 45 per cent of respondents had heard of folic acid, and only 28 per cent knew it did not have to be taken after the 13th week of pregnancy. A public information campaign was run in Northern Ireland and positively evaluated.

Following this, the Department of Health and Children in the Republic of Ireland suggested running Folic Acid: one of life's essentials as an all-Ireland campaign - the first of its kind.

Innovations and successes

A women's-style magazine called It is You was developed on the grounds that young women would be unlikely to pick up a leaflet. It was distributed free through hairdressers and morning newspapers - as well as the normal outlets - and has been cited on an Open University course.

Evaluation of the Northern Ireland campaign found 75 per cent of those surveyed were aware of folic acid after it ran, with awareness at 94 per cent among the target group of women aged 18 to 44. More than 80 per cent of respondents knew folic acid did not have to be taken after the 13th week of pregnancy. The allIreland version is being evaluated.

The judges said: Excellently planned, implemented and evaluated. A model health education campaign. Extremely professional.

Very good value for money.

Runner-up: Bandolier

Project: Bandolier

Contact: Professor Henry McQuay, tel: 01865


A project team was established within the agency to work on the campaign and team members were given responsibility for particular parts.

225404 Bandolier publishes information about evidence of effectiveness (or lack of it) in print and on the Internet. It started as a newsletter for the Oxford region in 1994.

The thinking was that a set of bullet points was needed to clarify what was known to work and not work - hence the name: a bandolier is somewhere to put bullets. The monthly print run is 25,000 copies, while 320,000 people visit the main website each month. Many more people visit a Spanish version and intranet versions.


Income for the paper version of Bandolier comes from sales to NHS regions, which pay 60p per copy per month for bulk copies. It has a half-time editor, Andrew Moore. The web version receives no NHS funding and the costs are defrayed by sponsors.

Innovations and successesHigh-quality, systematic reviews are published in learned journals, but hardpressed staff do not have the time or stamina to read them.

Bandolier provides a digest, and the simplest indication of its success is the growth of the print issue. Bandolier has also been voted best NHS intranet site. It has been used by national newspapers to generate copy, and more than 5,000 other sites now link to it. Surveys suggest that between 40 and 60 per cent of GPs and 20 per cent of hospital doctors read Bandolier, and there is no sign yet of a 'plateau' effect.

The judges said: Enormous commitment and energy to meet the needs of frontline clinicians, managers and patients. Bandolier 's extensive and worldwide circulation shows the need for clear and independent information. Refreshingly practical and jargon-free.