Imagine a world………… by Laura Lennox

 

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Elaine has dysarthria (motor speech disorder):

 “I hate using the phone simply because I am so self-conscious of my speech.  And if they say “Pardon?” to me, it makes me more flustered because I automatically assume it’s my speech that’s the issue.  I would never think it could be that a noise distracted them at their end.  And the more flustered I get when trying to talk, the worse my speech becomes”.

 

“I love that some companies now have the ‘chat online’ service.  I will use that instead of the phone even though it takes longer”.

 

“The other day I saw some valuable looking equipment seemingly dumped under a bridge.  When I got home I went on to the Police Facebook page to message them, but they didn’t have messaging as an option.  I googled a contact email for them but to no avail. In the end I was forced to phone but it really is a last option for me”.

 

“I hate phoning for appointments, taxi’s, takeaways- all the things other people do without thinking about it – it’s a big issue for me and I often work myself up in to a state.  I try to remember the sound advice from my speech and language therapist to speak slowly and clearly but the minute I hear “Pardon?” I break out in a cold sweat

Last year I decided to get back into studying and registered for a three-year MSc in Advancing Healthcare Practice through the Open University.  I was asked to look at a small-scale innovation in a healthcare setting that could lead to a significant impact.  Straight away I knew what I was going to look at.  Listening to people’s stories time and time over – THE DREADED TELEPHONE!!

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William and Bob both had throat cancer.

 

William:

“Speaking for myself, contact through email is the only way for me to go. I cannot carry a conversation by telephone due to the amount of Mucous and or phlegm talking generates.  I can listen on the phone to any conversation but can only give a limited response to any questions”. 

 

Bob:

“I do not answer the phone as usually the valve needs cleaned for me to speak clearly.  If I need to make a phone call I need to clean the valve first and tend to just phone immediate family due to other people possibly not understanding me.  It’s embarrassing answering the phone and not being able to speak.  An email is so much easier to correspond with. No embarrassment.”

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Typically, the main or only method for contacting any public service is by telephone.  In the 21st century we have so many more ways of communicating:

 

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A Scottish Executive report published on communication support needs (Law et al, 2007) estimates there are between 1% and 2% of the population in Scotland who have complex communication needs.  Complex meaning to the degree that they cannot communicate effectively using speech, whether temporarily or permanently.  This is likely an underestimate given that the study is based only on people who were accessing speech and language therapy services.

 

If we consider the findings of this Scottish Executive report, having telephone contact as the only method of access within an organisation may be perceived as an inequality.

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(International Communication Project, 2016)

The Scottish Government (2011) recognises the requirement for public organisations to become more inclusive of people with communication support needs and has set guidance for public authorities on Principles of Inclusive Communication.  The legislative driver for this stemming from the Equality Act (2010) and the United Nations Convention on the Rights of Disabled People (2009), Articles 9 and 21, which set out a person’s right to have access to information and communication in different forms.

 

Individuals and the wider community benefit from all people being more independent and participating in public life.

Lorraine has Aphonia (loss of voice):

 “I have difficulty with communication as my voice is a whisper and everyday there is a hurdle I have to try and jump.  One of these is appointments with NHS either hospital appointments or Dr Surgery appointments. I have lost appointments at the hospital as I can’t phone to cancel and rearrange. Also, when they send you a letter saying to phone up to arrange an appointment, I have to rely on other people to do this for me which is very hard as they work during the hours you have to phone, or they forget it’s also not very private. If you wanted to keep it private I can’t even have a phone consultation. I find it upsetting and frustrating that I have lost a lot of my independence having to rely on other people to make phone calls and appointments for me. There is a simple way to help people like me to give us part of our independence back and the answer is email. Most of us use it these days and I would have my privacy too. All they need to do is have on my records responds by email only, how hard is that? I don’t like to be one of those statistics that don’t turn up for appointments or when you don’t phone to make your appointment and think you do not need one. And that is just a small part of what I have to go through on a daily basis”.

 

Putting knowledge into action is what counts.  We could all work towards becoming more inclusive to people with complex communication needs by adding alternative options for contacting our services and departments.  It could be as simple as adding an email address to start with.

 

Now imagine if every service and department within health and social care did this then it would indeed be a giant leap towards a more inclusive communication world.

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If you have an interest in Inclusive Communication and want more information or to become involved in any future projects, please contact:

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Laura Lennox is a Speech and Language Therapist & Allied Health Professional for NHS Dumfries and Galloway

Cathy’s Journey by Amy Conley

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Friday night, admissions unit is where we first met Cathy……

I say met; we heard her before we met her – Cathy was shouting out, incoherent, clearly agitated. In her room, we found a tiny lady lost in a huge nightie, scrunched up on the bed, clinging onto the bedrail.  Cathy was 95, frightened and distressed.

Cathy had been transferred from another hospital, for assessment of pain.  It was impossible to know if Cathy was in pain or not – she couldn’t tell us.

We looked at her notes…

With a diagnosis of dementia and arthritis, Cathy had been living fairly independently with carer support, hadn’t been in hospital for some years.

A few weeks before, carers worried that Cathy may have fallen, an ambulance was called.  Cathy went to ED – no broken bones, but concern that Cathy couldn’t mobilise safely resulted in admission.

Over the next 6 weeks, Cathy was moved seven times between three different hospitals, from community to acute and back; staff worried about pain, falls and possible injuries, worried they were missing something, worried that more tests were needed…

Over this time, staff reported increasing difficulty with Cathy’s behaviours and confusion; she was distressed, agitated and uncooperative. Other patients were frightened.  Staff felt unable to manage.  Cathy was prescribed sedation.

Cathy by now was very confused, unable to communicate what she needed, not eating, not drinking.  She had become incontinent.

Back to Friday night…….

The sight of Cathy was heart-breaking; crying out, unable to tell us why, unable to understand what we were doing. She was dehydrated, in pain and encumbered by various medical contraptions.

We talked to Cathy’s family.  We decided that Cathy didn’t need any more interventions or hospital moves.  We did our best and made her comfortable.

Cathy died six days later…

 

Cathy, like many people admitted to hospital, was frail; she was frail before she came to hospital that first time.

If we had recognised her frailty at the hospital’s front door and intervened, well, perhaps Cathy’s story might have been different – different conversations, different interventions, different decisions and different plans made.

We talk a lot about frailty but it’s not always easy to explain or to understand.  Frailty is one of those words that get bandied about but what do we mean when we call someone frail?

The dictionary definition is “the condition of being weak and delicate”, something we all feel at times, but not really helpful in identifying frailty in our patients.

Within medicine, after years of vagueness and uncertainty, we have defined frailty as “the reduced ability to withstand illness without loss of function”.

 So……

A minor illness or injury, that would be no more than troublesome to you or I, affects a frail person more profoundly, leaving them struggling to walk, to wash or to dress, to eat or to communicate.

In reality though, how do we recognise the frail patient?  Does it matter?  Does it make any difference?

Age alone does not make people frail – people don’t become frail simply because they live too long.  Frailty doesn’t come with a diagnostic test, but there are signs we can look for – older people, with cognitive problems, mobility problems or functional problems, people on many medications or who live in care homes.  People who present to us with falls, incontinence or confusion.

“Frailty is everyone’s business”

The population is getting older and frailer, particularly here in Dumfries and Galloway.

Older, frail people have higher demands on health and social care services and more unplanned hospital admissions.  Once admitted, frail people are more susceptible to hospital-acquired infections, delirium, nutritional problems, falls and skincare issues.

In comparison to other patients, frail elderly patients are more likely to have prolonged hospital stays, to lose their mobility and functional abilities; they are more likely to be admitted to residential care, more likely to die.

I am a geriatrician.  I’m not at the glamorous end of medicine and I don’t have a bag full of fancy equipment, tests and treatments.  But within our medical specialty, we do have one intervention that has been shown to improve outcomes for the frail elderly –Comprehensive Geriatric Assessment

CGA means that frail older people are much more likely to be well and living at home 12 months after admission, and much less likely to be admitted to care homes or to die within those twelve months.

CGA is a multidisciplinary assessment of a patient and their physical, psychological and functional needs.  It allows us to develop a personalised, holistic and integrated plan for that patient’s care, now and in the future.  We think about how patients walk, talk, eat, drink, see, hear, think, remember, socialise, mobilise, and take their medications.  We think about how we can make all of those things better and easier for frail elderly people and their carers and families.

We all need to understand and recognise frailty.  Think about it, see it and talk about it, and allow a person’s frailty to influence decisions for their care and future.

Over 18 months we are working collaboratively with other health boards and Health Improvement Scotland to improve recognition of frailty at the front door.

Hopefully, if we get it right we can influence a better outcome, one that recognises and considers the specialist needs of our frail elderly people, one that supports them to continue to live happily and safely in a place that they can call home…

 

“We’ve put more effort into helping folks reach old age than into helping them enjoy it…”

Frank A. Clark, American Politician 1860-1936

 

If you have an interest in frailty and want more information or to become involved in our project please contact   amy.conley@nhs.net or lorna.carr2@nhs.net

Amy Conley is a Consultant in Geriatric Medicine at Dumfries and Galloway Royal Infirmary.

 

 

 

 

Culture Club by Wendy Copeland

How do you describe workplace culture to an alien… I hoped ‘google’ would have an answer, they didn’t.

I then thought of 80s pop culture and two bands jumped into my head ‘Fun Boy Three and Banarama’ when they covered a 1939 jazz standard – “It Ain’t What You Do (It’s The Way That You Do It)” (1982)

I then thought of Culture Club, and the pop culture that they helped form, which still influences popular culture today.

The Blitz Kids were a group of young people who frequented the weekly Blitz club-night in Covent GardenLondon in 1979-80, and are credited with launching the New Romantic cultural movement.

They had a common set of values, beliefs and behaviours, as well as a unique style. All part of the new romantic  culture.

(watch David Bowie’s Ashes to Ashes video – an early culture adopter filmed with extras from The Blitz).

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Come on Wendy back into the room, what does this all mean to all of us that work in Health and Social Care and the culture we help create and work within.

Here’s a more appropriate definition

An organisation’s culture consists of the values, beliefs, attitudes, and behaviours that employees share and use on a daily basis in their work.

The culture determines how our workforce describes where they work, how they understand the system, and how they see themselves as part of the organisation. Culture is also a driver of decisions, actions, and ultimately the overall performance of the organisation.

Our Board invested in measuring our cultural norms a few months ago, you may have contributed to the survey. We are in the process of rolling out a further cohort of individual feedback reports, that helps the person get to know them self, and identifies their own beliefs, values behaviours and assumptions, and measures how others experience them.

We used a tool called Life Style Inventory (LSI), we choose this tool as it looks at strengths as well as self -defeating behaviours, in the hope that the person will further improve what is good and work to change what they could be better at.

The tool measures 12 styles  in which we choose to think about our self and how others see us operate whilst at work.

Think about it like a big 12 slice pizza, some are tasty some are not.

We all love the blue slices!     We could do with less green ones……… and let’s keep reducing the red

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For people who would like more detail https://www.humansynergistics.com/change-solutions/change-solutions-for-individuals/assessments-for-individuals/life-styles-inventory

In the spirit of transparency here’s some of the learning that we, as accredited LSI practitioners have learnt about our self.

Caroline Sharp, Workforce Director NHS. Asking for feedback is a pretty scary thing to do when, like me, you’re as green as the Grinch in your thinking styles. In my head, quite a lot of green stuff churns around, especially the ‘approval’ slice of the pizza, and so of course I was anxious for ‘approval’ from others in how they experience me as a leader in our organisation. To my relief, and curiosity, my feedback from others shows me that whilst I may be ‘thinking  Grinch green’, I am ‘behaving blue’, and in particular, my ‘humanistic encouraging’ behaviour, which is about supporting others to develop and be the best that they can be, is my Constructive, people focused primary style . I also noticed in my results that there is still some white at the top of each blue ‘slice’ – so lots of opportunity to be even more blue than I am currently felt to be by others. So, I am currently wondering, and exploring how to let go of some of my passive aggressive Grinch thinking, and fully embrace the blueness that others see in me – and that feels really good in the moment, not scary at all!

Wendy Copeland: I thought I knew myself pretty well, I was confident that I would have lots of ‘blue’ and that’s what others would see when I was interacting with them.

However I was kinda gutted to see that my primary style was a pesky green. I had the approval slice of pizza! So what did that mean for me? It means I had have a tendency to agree with everyone, I like to be accepted and get upset if I am not, and I can be generous to a fault.

My second slice is Affliliative, I like to cooperate, include others and am I am friendly.

So what… what have I learnt about myself? Through reflection and coaching, I have learnt that I am a people pleaser; however I have not accepted that I always need to be like this. I am working on learning to think and act for myself, and accept that not everything I do will be met with ‘jazz hand’ approval. I am practising facing confrontation and recently handled a challenging situation as a mindful adult rather than the petulant child. I am a work in progress however already I am feeling less stressed and a belief that my view matters.

Oh and I am pleased to report that others see lots of Constructive Blue behaviours.

Wendy Copeland is Service Manager for Nithsdale in Partnership

 

 

When We Were Young… by Lynsey Fitzpatrick

LGBT (Lesbian, Gay, Bisexual and Transgender) History Month takes place every February. It’s an opportunity to celebrate LGBT life and culture and to recognise the achievements of LGBT people and communities.

 
History month is not just for those who identify as LGB or T – it’s for everyone; community groups, organisations, individuals, activists, service providers, non-LGBT people and allies. It gives organisations like ours the chance to show our support for LGBT staff, patients and their families. The theme for 2018 is ‘When We Were Young’ to tie in with the Scottish Government’s Year of Young People 2018.

 
There is no doubt that LGBT equality has progressed over the decades – it would be difficult to argue that things haven’t progressed at all for LGBT people. But is there still some way to go? Have things progressed enough?

 
I wanted to hear from people who identify as LGBT to hear some personal stories and reflections from their point of view to try to find out more about what, in their minds, has changed since they were younger. With this in mind, I spoke to some staff members and members of the local community who were happy to share their stories and some reflections from ‘when they were young’, and have shared some of these below. It may be my name at the top of the page but this week’s blog wouldn’t exist without the input from others and sharing of experiences – to those people I give thanks.

 
My first job in the public sector was back in 1999, out with D&G. After a few months in post, I decided to tell my colleagues that I was gay. They were all very friendly (apart from a few homophobic jokes), so I had no real concerns about telling them, but was still nervous. I knew from my previous experiences of coming out that a little ‘Dutch courage’ would come in handy, so I decided to do it on the Christmas night out.
I’d already confided in one of my colleagues, and she knew what I was planning to do; she bought me several large vodkas, but towards the end of the night, I still hadn’t built up the courage to say anything. Finally, she asked if I wanted her to say ‘it’, and I nodded. The response from all of them was very positive. All except one that is; the manager started shouting at me, asserting that I should have told the interview panel about my sexuality! Needless to say, I was quite taken aback by this, but managed to stay calm – maybe the vodka helped!

Going back to work after the Christmas break was nerve wracking; what would happen? I needn’t have worried, because as soon as I arrived, the manager walked into my office and apologised for his behaviour. Maybe he was worried that I was going to complain about him, or maybe he was genuinely sorry for what he had done.

I stayed in that job for ten years, and despite the rocky start, things settled down. I made some friends for life there.

In 2009, I started working for NHS D&G. From the start, I’ve felt equal. All of my colleagues know that I’m gay, and I can talk about my life – husband, family, home etc – in the same way as they do about theirs. All of the team (including the manager!) are very friendly and inclusive. There are no homophobic jokes and I’ve not had to come out to anyone, I can just be me.

I feel lucky to have been able to be openly gay to my colleagues for all of my working life – bar those first few months. There’s still a long way to go until all workplaces are inclusive, but our society has progressed a lot, and that is something to be celebrated. Equality and diversity is a human right and Scotland should be proud that it’s a world leader in this field.

Employee, age 41

As a member of the LGBT community I am glad to see that acceptance in the community is both growing and improving. There are still some shops, some people and some services, that need people to challenge with respect the outdated views they hold on the freedom and the rights of LGBT people. 

In particular trans and non binary people in our communities can be treated as if they have something wrong with them and are forced to negotiate daily aspects of their life in the community in a way that can ‘out them’ even thought they are protected by both the Gender Recognition Act and the Equality Act. For example, being told to ‘just use the disabled toilets’ and are being ill considered when it comes to new services and buildings, resulting in the potential for them to identify themselves as trans or non binary, even when it is not appropriate. They may be a small minority, yet it is an identity which is growing in numbers across Scotland the UK and yet still services are not being developed in a way that is fit for purpose of the expected change in our local demographics. 

However, LGBT people, in general, have a positive experience in D&G, especially the young adults coming through our community now, who are great advocates of their rights, who do not stand for inequality and are skilled and confident to challenge any discrimination they experience. Let’s hope their strength and confidence continues and those with more vulnerabilities can follow in the wake of the standards they demand. 

Through the diversity of the few, we change the impact on the many.

Member of the local community, age 42

I still remember vividly applying for my first senior post in the mid 90’s and being taken aside afterwards by my line manager who noted that someone on the panel senior to her had suggested that, whilst I had been successful in my application, she should feed back to me ”not to put on future applications – under personal information/ background – that I was gay and lived with my partner”.

At the time, I didn’t question it but there was a climate post AIDS of ‘ tolerance’, and rarely would I speak about my personal life at work unless I knew someone very well and felt it was safe to ‘disclose’.

I also recall my partner and I moving into our first home together, and a neighbour coming to the door to let us know that they, and everyone in the street, had received a letter telling them to ”stay away from the paedophiles at number…..”

So, have things changed for the better?

Most definitely, but to those who would say ‘ Why make a big deal out of it these days, as I treat everyone the same, sexuality isn’t an issue’ I would reply that generally what that means is ‘I treat everyone as if they are straight’, and that the battle for equality was exactly that – a struggle over many decades by many who didn’t live to see the benefits of their efforts.  As many people across the world know, rights can be given and rights can just as easily be taken away.

However, in this LGBT history month 2018, we should celebrate the fact that many LGBT young people can enter adulthood feeling good and not ashamed re. who they are, and that employees can feel welcomed and not just accommodated in a diverse, inclusive NHS.

Employee, Age 52

 
Discovering who you are and finding your ‘tribe’ can be a long, challenging and often puzzling process. There are highs, lows and an entire spectrum of emotions in between. A recurring theme throughout my storyline has been the importance of learning through watching, listening and talking to others about their experiences, although, it took a long time for me to build up the courage to do so. While some find comfort outdoors or in books, looking back on my adolescent years, I realise that my escapism was through television. Whichever medium we choose, it is important to remember that they play an important part in establishing how we see ourselves fitting into the world around us.

 
During the mid-late 90s it felt like all LGBT storylines were met with a wave of controversy and widespread debate about whether it was right to have that kind of thing on television. From the lesbian kiss on Brookside, to the mockery of a trans character being introduced to Coronation Street and the seemingly endless number of affairs which resulted in the destruction of a normal relationship, it seemed like being gay would always go hand in hand with shame and isolation.

 
This came to a head with the transmission of Queer as Folk. Even for this 14 year-old it was clear that this was an important time – a landmark piece of television which would either blow the closet doors wide open or set our place on screen back decades. Fortunately, the strength of Russel T Davies’ writing meant that the series was shocking not for daring to exhibit a set of predominately LGBT characters, but for daring to show them as having normal everyday lives. Being gay was not the drama; it was a starting point for a cultural landscape which promotes acceptance by establishing strong LGBT characters within the fabric of everyday life.

 
While entrainment only plays a small part in influencing the choices made within society, it is comforting to know that today’s young people can learn about themselves in a more open and vibrant environment. While there is still work to do, particularly in regards to services and support provided for the bisexual and trans communities, the fact that we have the term LGBT, support groups in schools, networking groups within workplaces and even this blog are all signs that times are changing for the better.

 
Member of the local community, age 32

 
I remember age 11, during sex education class in school asking how 2 men or 2 women who loved each other had sex.  I was angrily told by the teacher that this was not an appropriate question to be asking, and that I should be quiet.  In the early 80s as a young girl experiencing my first feelings of same sex attraction, this was pretty much the attitude of everyone – my parents, my peers, the school, the media – lesbian, gay, bisexual and transgender people were almost totally invisible, only being mentioned as objects of ridicule or disgust.  The message it gave me as a young lesbian was “your feelings are very wrong, tell no-one”, and that’s what I did, for a very long 10 years, until I was 21 and could contain it no longer.  

 
Even when I did come out at University, life was very different then – schools were prohibited from talking about homosexuality by Section 28; there was no formal recognition of same sex relationships; you could be sacked from your job for being LGBT; indeed you could be sent to a psychiatric institution to be cured, as homosexuality was still considered a mental disorder until 1992.  Although relationships between same sex partners was legal, the age of consent was still 21 and I remember that my friend Hugo’s boyfriend had been arrested because he was 24 and Hugo was 20, so in the eyes of the law he was abusing a minor. 

 
When I finally did come out, I made the decision to be VERY out, however this didn’t come without its problems:  I was physically assaulted 3 times, sexually assaulted once; had graffiti written about me and my girlfriend at the time within university buildings and received hate mail from a neighbour in my block of flats.  I also had to go through the difficult period of estrangement from my family and disownment from some friends, until they came to terms with the ‘new me’, even although for me it was the way I had always been.   It was a difficult time and predictably, mental health issues resulted from feelings of being different, unlovable and somehow ‘wrong’.  Luckily, I did have a loving family who were willing to love me despite their prejudices, and a good group of supportive friends, which gave me the resilience to get to where I am today.  For people who don’t have that though, the outcomes can be really different.

 
25 years on, looking back, for me all that seems a million miles away.  In Dumfries and Galloway (although it took time) I have a life where I am accepted, loved and included in my work, in my community and by everyone I meet, and my sexual orientation is a ‘non-issue’ the vast majority of the time.  LGBT people have more or less full legislative equality now (although there is still a way to go for trans and intersex people) and many LGBT people are thriving within loving, stable families and communities, with children, great jobs and good lives.  The media portrays many LGBT role models now and certainly for the younger generation there is a normality about LGBT issues and most children are growing up knowing about and accepting LGBT issues and LGBT people.  However, that is not to say that there is no bullying in schools and that it is yet easy for LGBT young people to come out – people of my age (44) and older still grew up in an era when homosexuality was outlawed and considered wrong, and so there are still attitudes like this that exist within our communities and which impact on people of all ages within our communities every day. 

 
When I was 11, what I needed were adults to give me the very strong message that being LGBT was OK.  Although we have moved on a huge amount in rights for and attitudes towards LGBT people, surely every young person and adult still needs to be given that message, and that’s something we can all do. 

 
Board Member, age 44    

 

The last Friday in History Month is Purple Friday. This year celebrate the #EverydayHero, those people in our lives who do the little things everyday that make our world more inclusive.

 
Take pictures and tweet using the hashtag #EverydayHero

 

Lynsey Fitzpatrick is Equality and Diversity Lead at NHS Dumfries and Galloway

Charity – What Charity? by Nick Mitchell

Dumfries and Galloway Health Board Endowment Fund Charity

 

How many of you have heard of our charity and how many actually knew the ‘endowment funds’ were managed by a charity? No?  This is nothing to be ashamed of as the Charity has never really advertised itself or the good work that it has undertaken over the years, utilising donated money to support worthy causes and projects both within the Health Board and the wider Dumfries and Galloway community.

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Hopefully this introduction to the Charity will help you understand what the charity is, what the charity does and what the charity will be doing over the forthcoming years.

History

The history of charitable endowment giving dates back to the Roman Empire when Marcus Aurelius endowed four teachers in Athens to head up schools of philosophy. Aurelius believed that man should be led by his reason. From this point on charitable endowment giving has developed in all areas of life.

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Charitable endowment giving does not date as far back as this within Dumfries and Galloway but records do show that the regions ‘health provider’ received endowment and donation support from the late 1700s with regards to the first Dumfries Infirmary sited at Mill Hole on Burns Street. Most hospitals at this time would not exist or function without the generosity and support of benefactors.

 

Dumfries and Galloway Health Services have developed tremendously since the opening of the first hospital. During this period of change the receipt of donations from benefactors has remained constant and to this day the current Charity still receives significant donations from the community.

 

All endowment funds are held in individual fund accounts in accordance with their purpose by the current charity which was established in 1974 – Dumfries and Galloway Health Board Endowment Fund.

Structure

 

Dumfries and Galloway Health Board Endowment Fund is a registered charity (SC001116) with the Office of the Scottish Charity Regulator and is bound by current legislation.

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There are 14 elected Board Trustees that collectively have the responsibility for the management and safe custody all funds held by the Charity. The Trustees are responsible for all decision and policy making on behalf of the Charity (These individuals are better known to you as our Health Board Members).

 

The day to day responsibility for management and implementation of Charity governance is designated to the Endowment Operational Manager (me). All financial transactions and financial reporting is undertaken by our Senior Finance Assistant (Shirley McClymont).

 

The General Managers have delegated responsibility for the appropriate use of fund accounts that are within their directorate areas. These individuals are the fund managers. To help support the fund managers each individual fund account has appointed authorised signatories. These individuals are appointed by the fund managers for their specific knowledge of the areas that the individual fund supports. Authorised signatories also provide advice to the fund manager on the most appropriate use at the ward / departmental level.

What does the Charity do?

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The Charity supports a wide range of activities and projects both within the Health Board and the local community by providing funding. The Charity Trustees balance the Charity objectives with the requirements of the grant applicant when making their decision. In addition, and most importantly, the wishes of the original donor are also taken into consideration before any funds are released.

 

The Charity also manages an investment portfolio which provides an income to the organisation which in turn also supports our activities.

 What has the Charity Funded?

 

The Charity aims to have a fair and transparent approach to funding grant applications. Historically the Charity has been involved in a significant number of projects, equipment purchases and staff development work within the Health Board. In addition the Charity has delivered funding for a number of major community based projects and supported a number of smaller local charities and third sector groups within the regions                         Nick 5

Some of the more recent supported projects and initiatives include:

 

  • The provision for LGBT plus running costs for their Transforming Self Management project. This project aims to build the capacity of the LGBT adults and older people and their unpaid carers to more effectively self-manage their long term conditions, and to access the support and services they need. The project also hopes to build capacity for the local health, social care and third party agencies to better support LGBT plus people with long term conditions.

 

 

 

  • Funding for two motorcycles for Dumfries and Galloway Blood Bikes. This funding was granted to help the Blood Bikes charity establish their service and provide reliable and functional transport. Since this initial support the Blood Bikes charity has provided a reliable service to the Health Board.

 

 Nick 6

 

 

 

  • Fully funded the patient entertainment and visitor information system installed in the new hospital. The new Dumfries and Galloway Royal Infirmary has a state of art patient entertainment and visitor information system. This ensures that inpatients and visitors are able to receive both normal television entertainment and also relevant directed clinical support and information within their bedroom.

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  • Supported the Sensitive Spaces arts project for the new hospital – making clinical areas appear less clinical for patients and visitors. The Health Board identified the need to have certain areas of the hospital less clinical and more comfortable for both patients and visitors. The charity fully supported this project and contributed to the overall hospital arts project.

 

 Nick 8

 

 

  • Fully funded the Health and Social Care Partnership Power of Attorney campaign last year and follow-up campaign due to be held this year. This campaign’s aim was to encourage individuals to consider the requirement of establishing a Power of Attorney. This would mean that if they became too ill to make their own decision regarding healthcare there would be a nominated person able to make decisions for them and this in turn would support their wishes.

   

 

  • Funding for advanced training of a number of individuals and staff groups. The Charity encourages the workforce to develop their knowledge and skills which in turn helps clinical services to develop and allow the Health Board to offer better patient care.

 

 

  • Funded the Good Conversations training project. The training has been designed to build confidence in holding outcome focussed conversations and all training sessions are highly participatory. The training is facilitated using a variety of learning techniques. To date feedback received from attendees has been excellent.

 

  • Funding for the Greystone Rovers Foundation for their work with individuals with both physical and mental disabilities. The project supports those individuals that would not normally be able to get involved in sport and fitness due to their physical and/or mental disability. The project offers qualified coaches and the plan over the next two years is to offer the sessions across Dumfries and Galloway.

The Future

 Nick 9

 

The Charity is currently undertaking a full review of its objectives, governance procedures and overall strategy. Work is currently being undertaken to reorganise the individual Charity funds to allow for easier and better use of the resources. There are a number of historical funds that were established for specific purposes that the Charity can no longer meet. The intention is to apply for a change in use for these funds which will release monies for charitable purposes – however, the process is slow and there are a number of legal requirements to be met before the funds can be released.

 

The Charity is committed to the continued support of the Health Board and the wider Dumfries and Galloway community and there are changes to current practice and new initiatives identified to ensure the continued support is maintained. Over the next few years the charity aim to meet the following long and short term plans:

 

  • Establishing a robust strategy for the future
  • Undertaking a branding and marketing exercise
  • Develop and introduce a fundraising strategy to take into account those areas where the need for charity support is required the most
  • Establish a dedicated website to support fundraisers, potential grant applicants and the general community in understanding our work
  • Working with all Clinical Management Teams and General Managers in developing annual endowment budgets and spending plans.

 

As the Endowment Operational Manager I am committed to supporting and furthering the Charity’s work. The future of the Charity is both challenging and exciting and with the support of Health Board staff and the wider community I am sure we can ensure that the good work undertaken will be maintained.

 

For further information about the Charity or arrange a visit to your management team / staff meeting please contact me by email or phone:

 

Email:             Nick.mitchell@nhs.net

 

External:        01387 244673

Internal:         ext 34673

 

 

 

 

Forests of the future by Joan Pollard

Having agreed to provide a blog I then faced the challenge of what to write, decision making not being my greatest strength when the world is my oyster. However a trip to a favourite local wildlife sanctuary and Viv, Linda and Chris’s blog of last week struck a chord.

 
Viv likened the health and social care system to a beat up old 1940’s car, I think of it like a traffic jam. Albeit the success of our system to date meaning that this is a jam of cars of all ages, varieties and in varying state of health.

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At the weekend I went to visit the local wildlife sanctuary, at dusk, in the hope of catching sight of red squirrels. Leaving behind the road and walking into the woods we ignored (not to be recommended) the warning signs that forestry work was underway. It was after all a Sunday afternoon and was peaceful so we believed (rightly as it turned out) that nothing would be happening.

 
En route to the hide we were shocked to see the impact of the forestry works with huge swathes of the forest having been felled and piles of logs lying beside the path. The stillness of the evening was broken by the constant noise of the cars on the nearby road. How different the perspective for only having travelled a few hundred metres. The unexpectedness of the noise was reminiscent of a visit to the allied health professionals who have remained in the Mountainhall Treatment Centre with the echoing empty clip, clip, clip of footsteps on the floor as I walked down the corridor towards the department. A corridor I have travelled thousands of times before but change brings a different perspective. Like the forest, when listening more deeply the sounds of thriving life were evident and like the forest this is only one step in a journey towards a new future.

 
There were no squirrels to be seen as they had taken wise council and moved out for the moment. Meantime, however, there was a beautiful sunset silhouetting the remaining trees against the sky. The half light reminded me of a weekend spent in DGRI in the middle of January when the hospital was coping with the increased demands that Viv referred to. Indeed a nurse described the previous day as one of the busiest in their career . Despite this, the beauty of a hospital waking up was evident. Walking in through the atrium I was met with the tired faces of the night shift as they head home for the day, further into the hospital the corridors were lit with the nurses working their way round the wards providing care and breakfast to their patients. All felt well and peaceful.

 
The pressures were immediately apparent upon attending the whole hospital huddle and, as I joined a multidisciplinary and multiagency team, of doctors, nurses, allied health professionals, pharmacists and members of the team from Social Work Services and Scottish Ambulance Services, to work together to support flow. Many of this team had not met before this weekend but all worked towards the same goal. Communication between the team was excellent and frequent and at points throughout the weekend each member of the team stepped forwards to lead. It was an honour to participate.

 
The structural changes to mark the start of new ways of working have taken place with the migration of the new hospital complete and the Health and Social Care Partnership established and now we are in the business of transition. William Bridges would suggest that there are three phases: ending, neutral zone and then new beginnings which involve new understandings and should give people a part to play in the transition.

 
In moving towards the new beginnings it may be that we should take lessons from the geese that are currently flying overhead,

 
They know where they are heading and everyone in the team is important. When the lead tires everyone should be brave and step up to take their turn to lead. They communicate constantly and look after each other on the way. Perhaps in this way we can streamline our traffic jam

 
https://7geese.com/7-lessons-we-can-learn-from-geese-to-succeed-at-work/

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Like my favourite local wildlife sanctuary this transition from newly planted saplings to fully developed forest will take time and care. The replanting of the forestry will be diverse as a successful natural forest, including many different types of tree, is the best for supporting its wildlife community. I am hopeful that in developing new ways of working to support the population of Dumfries and Galloway our teams will be equally diverse including and valuing the unique contributions of doctors, nurses, social work services, third and independent sectors and each of the allied health professions.

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Joan Pollard is Associate Director of Allied Health Professions at NHS Dumfries and Galloway

 

Is a sustainable health and social care system in Dumfries and Galloway possible? by Viv Gration

We’ve all seen and heard the stories on the news and are experiencing first hand for ourselves that health and social care services are under pressure. The whole health and care system is struggling to cope with increasing demand and stretched resources. So what can we do to try and help this situation? How can we find sustainability within health and social care services in Dumfries and Galloway?

 
At the moment when I think about the health and social care system I see a beat up old 1940s car that has been overloaded, it has been patched up and repaired, a roof rack has been added (for extra capacity) and it is limping along trying hard to keep up with the modern world. When things reach this stage it’s surely time to re-evaluate what is needed and consider changing our mode of transport to a modern, efficient and reliable car that has the technology to make our journey easier. Or perhaps re-evaluation will lead us to a different way to travel altogether – a train, an aeroplane, a bicycle, on foot, or even stop travelling at all – it’s important that we are open to all potential alternative options.

 

This year, we will celebrate 70 years of the NHS (established in post war Britain 1948). The primary model of care is the same today as it was in 1948 remaining relatively unchanged through the decades. The King’s Fund’s video ‘Sam’s Story’ describes this ‘old’ model of care well https://www.youtube.com/watch?v=3Fd-S66Nqio .

 
Reviewing what we do, working together with partners and stakeholders to find new ways to deliver care and support will help us to adapt to the current and future demands on services. The single fact that applies to all organisations is their ability to survive depends on their ability to change and adapt to the environment in which they operate. For example:

 
Shopping –

 
There has been a major shift, even in the last 5 years, in the way that people shop. Shopping habits have been influenced greatly by the internet and the most successful organisations have responded to the change in how people want to shop.

Most of the major supermarkets have recognised the preferences of a large number of people to order food online and have it delivered. In September 2017 it was reported that 35% of UK shoppers now use the internet for their grocery shopping. But there is also change in the way people do their grocery shopping in store. Just last month Amazon opened their first grocery store Amazon Go, but it is not at all a traditional store –there are no checkouts, no queues and no people to take payment from you, just use the app to enter the store and pick up what you need, and go! https://www.youtube.com/watch?v=NrmMk1Myrxc

 
Banking –

 
Technology is also playing a major role in changing the banking sector. From 2007 to 2017 the number of people regularly accessing online banking services doubled. The banks with branches still on the high street have also changed to have more technology within the branch and there are even examples of banks promoting training in technology for their customers – we’re sure many of you have seen the adverts on TV for Barclays Digital Eagles. https://www.barclays.co.uk/digital-confidence/eagles/

 
Considering new technology is just one way to affect change and it is important. But there are a range of things we can think about and do to progress towards sustainability. Let’s understand what people need and want from the health and social care system, what good outcomes are, what we do well, what practice we should expand and promote, what we should stop doing and what we should do differently. By having conversations like this within teams, with the people who use services and with partners across the whole system we will be able to find new ways of working that will take us closer to an adaptable and sustainable system.

 
The new Service Planning Framework has been developed to help us have a consistent approach to these conversations and approaches. It sets out six essential planning principles and suggests a range of potential actions to help teams to do this.

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Using the Service Planning Framework will help us to have a consistent approach to:
Understanding the balance of resource and capacity, anticipate future requirements and plan for this
Ensuring that service delivery is up to date and in line with evidence of effectiveness and best practice guidance
Ensuring that service is comparable with other areas in terms of quality, activity, outcomes, costs etc
Identifying actual or potential gaps in need, service delivery
Generating alternative options/ service models (eg. partnerships with other providers, third sector, independent sector)

 

So we’re suggesting that we all invest time to think about what we can do to change/transform our models of delivery to become an adaptable, more efficient, modern and ultimately sustainable system.

Service Planning Framework

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To answer our initial question about whether sustainable services are possible in Dumfries and Galloway, we suggest they are. But it is going to take some time and effort, working together across the whole system to adapt to the environment we are working in. No doubt services will look and feel different and that is what is needed to become sustainable.

 
“No transformation of great scale occurs without innovation, hard work and significant change – or disrupting the norm” Chief Executive of General Motor, Canada.

 
Viv Gration, Strategic Planning & Commissioning Manager
Linda Owen, Strategic Planning & Commissioning Manager
Chris Fyles, TEC Project Team Lead