“Time’s a wasting!” By Ruth Griffith and Chris Fyles

Ruth 1“Time is what we want most, but what we use worst.” (William Penn)

We live in a fast paced, rapidly changing world. The internet is now the dominant form of communication between people. About 90% of people have access to mobile technology enabling us to communicate, access services, shop and bank instantly. However people are not currently able to access health and social care in the same way.

Those of us who work within health and care services are aware that these are stretched locally, with demand often exceeding capacity. We know that over the next 20 years in Dumfries and Galloway that there will be an increase in the number of older people and fewer working age people. If we continue to deliver health and care in the same way as we do now, then every school leaver in Dumfries and Galloway would have to choose to work in delivering health and/or care.

Ruth 2

Ruth 3The Sustainability and Modernisation Programme (SAM) has challenged us to think of ways to deliver health and social care differently so that people have improved health and wellbeing outcomes, are enabled to live well for longer and resources are used differently to increase sustainability. With over 800 ideas submitted to SAM so far it will come as no surprise that one of the themes emerging is ‘better use of digital technology’. There are many ways that people can use digital technology that is already familiar to them to better manage their health and wellbeing.

For example, using video technology similar to ‘Skype’ or ‘Facetime’ enables people to attend appointments in a different way. Every year there are about 300,000 outpatient appointments for people in Dumfries and Galloway. The majority of these will involve people travelling to DGRI from various locations across the region and some will involve travel by people who deliver care and support. The Scottish Access Collaborative has been looking at ‘health miles’, these are the miles travelled by people to get to appointments. They looked at 572 gastronomy appointments in NHS Grampian and found that 71% of people travelled by car, for an average of 42 miles and 35% of people had to take unpaid or annual leave to attend. We need to consider the economic and social impact on people travelling to appointments as well as the environmental impact, and of course the impact this may have on people who have health conditions that make travelling difficult.

A colleague told me last week that if by offering her appointments by video from her base in Dumfries instead of travelling to Stranraer that this would save 4 hours per day and create an additional 7 appointments. So using video appointments could potentially save valuable time for people who use and deliver services and reduce waiting times.

Last December the Scottish Government’s Technology Enabled Care Programme awarded Dumfries and Galloway Health and Social Care Partnership (DGHSCP) £109,000 as part of a national project to increase the use of video consultations using NHS Attend Anywhere. NHS Attend Anywhere is a web-based platform that enables the use of video consulting using everyday personal technology such as a smartphones, tablets, laptops or PC with webcam. Our colleagues in NHS Highlands have used NHS Attend Anywhere to develop a new service called “NHS Near Me” which enables people to attend outpatient appointments by video nearer home. We wanted to use their learning to develop “NHS Near Me Dumfries and Galloway.

Ruth 4NHS Near Me Dumfries and Galloway will initially offer people the choice of attending their return outpatient appointment either at home or at a local NHS facility. Obviously we won’t be able to offer this service for every appointment immediately so we are starting with clinics run by Diabetes, Rheumatology, Respiratory, Renal, Speech and Language Therapy and Psychological services but over time we hope that this will increase.

Over the last year 6 video consultation rooms have been developed across the four localities for people to use for appointments. They are located at Lockerbie Medical Practice, Sanquhar Medical Practice, Gardenhill Primary Care Centre, Newton Stewart Health Centre and two rooms at Galloway Community Hospital.

DGRI, Mountainhall and the Willows are also equipped with rooms for people delivering services to use. Video appointments started to be offered to people from 2nd December and it is expected the first appointments to take place the week beginning 13th January 2020 https://www.dghscp.co.uk/nhs-near-me

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For people delivering health and care, it’s as easy as 1-2-3.   Ruth 6            .

  1. Log into NHS Attend Anywhere
  2. You should be taken straight into your service waiting area – click on the waiting area you are due to see people in
  3. Click the name of the person you are due to see and click on ‘Join call’.

While the new NHS Near Me service is a great step forward for offering people return outpatient appointments this is only the first step. The NHS Attend Anywhere platform can be used across DGHSCP to enable people to attend video appointments with Primary Care, Social Work, Third and Independent Sector organisations.

So in future when you are arranging appointments take a moment to consider

  • Is this appointment really necessary
  • Will travelling to this appointment be difficult for the person
  • Could this appointment be delivered by video

Ruth Griffith is Strategic Planning & Commissioning Manager for Digital Health, Long Term Conditions and Palliative Care

Chris Fyles is Technology Enabled Care Project Lead for Health and Social Care Integration

Ruth 7

I do not like that SAM-I-am! by Valerie White

Are you going to the SAM meeting? A colleague asked me last week.

I am, I replied………but why is this conversation making me think about Green Eggs and Ham?

Somewhere in the back of my mind a memory was stirring…………

I knew that it was something to do with the Dr Seuss book Green Eggs and Ham, but I couldn’t quite work it out. It left me feeling puzzled all day.

So later on whilst hanging around Castle Douglas waiting for my daughters swimming lesson to finish I popped into the library. As luck would have it I managed to get a copy of the book.

I convinced my daughter that I should read her this as a bedtime story, and suddenly things began to fall into place……

 

“I am SAM      Valerie 1         

I am SAM         

SAM I am”

 

The Grinch Responds

 

                                                                                           “That SAM I-am

That SAM-I-am

Valerie 2I do not like that SAM-I-am”

 

 

I started to recall being told this story endlessly as a child and I hated it! (I think the cover at the time had something to do with it.)

Valerie 3

But as I started to read on a new interpretation of this tale was dawning on me……….

The Grinch doesn’t like SAM and he is adamant that he doesn’t like Green Eggs and Ham. He refuses to try them no matter how persuasive SAM is – he will not change his mind………

 

“Would you, could you, on a boat”?

 

“I could not, would not, on a boat.

I will not, will not, with a goat.

I will not eat them in the rain.

I will not eat them on a train.

Not in the dark! Not in a tree!

Not in a car! You let me be!

I do not like them in a box.

I do not like them with a fox.

I will not eat them in a house.

I do not like them with a mouse.

I do not like them here or there.

I do not like them ANYWHERE!

 

I do not like green eggs and ham!”

………until he actually tries the Green Eggs and Ham and finds out he really likes them.

 

“You do not like them.

So you say.

Try them! Try them!

And you may.

Try them and you may, I say!”

 

“SAM!

If you will let me be,

I will try them.

You will see.

 

SAM!

I like green eggs and ham!

I do! I like them, SAM-I-AM!

And I would eat them in a boat.

And I would eat them with a goat……..”

I was at a meeting recently where a group of us were asked why doesn’t change happen? The response – it is hard, and why is it hard came the next question – because it is new and it is scary and it is easier to keep doing things the way we know and the way we feel comfortable with – in essence it is easy to be the Grinch.

The Sustainability and Modernisation Programme – “Our SAM” is a bit like SAM in Green Eggs and Ham – asking us to try new things (thankfully not green eggs and ham) and make changes that will help sustain our organisation to deliver the services we provide for our population. Just like the Grinch we can become fixed in our thinking and not take on new ways of doing things, but just look at what happened when the Grinch took a risk and tried something new!

So folks, lets open our minds, take some chances and see where “Our SAM” takes us!

Valerie 4

(And yes in case you were wondering – just like my younger self my daughter was not very impressed with the tale even with its shiny new cover!)

Valerie 5

To hear a narration of Green Eggs and Ham click here. Valerie White is a Consultant in Dental Public Health and Interim Director of Public Health at NHS Dumfries and Galloway

The Journey North by Mhairi Hastings

A few weeks ago  (26th October, 2019)  I smiled and laughed more than I have in a very long time.  I mean, real belly laughing, at times side splitting and crossed legged hilarity.  So, was I at some amazing new comedians gig?  Was I out with my friends catching up on old stories?  No, last night I spent over 11 hours trying to get home to Dumfries from an NHS recruitment event in London through floods on the West Coast Train Service! With two NHS Dumfries and Galloway Colleagues.

Mhairi GroupYou might wonder then if I am being ever so sarcastic in my saying I laughed and had a good time.  The truth is I’m not.  Yes it was a totally dire situation.  And I am most definitely not saying I (we) won’t be claiming for the disruption and additional cost of this travel disaster (just in case Virgin Trains read this), but what I am about to tell you, I think, is a fine example of how NHS colleagues battle in the face of adversity and demonstrate the resilience required in our normal day to day work to get to our final destinations.

Allister Kelly and Craig Nicol are at the heart of this story- they were my trusty (tall) travel companions.  Together as a team, for the 11 hours it took to get from London Euston to Dumfries, we kept each other’s spirits up, maintained our dignity (mostly) and professionalism and conquered our mission to the North!

It started with us all on a high from spending the previous 10 hours chatting to people who might be interested in coming to work in NHS Dumfries and Galloway at a recruitment event.  (0ver 100 contacts were made).   Boy did we hard sell our region, hospitals, community, housing stock, our colleagues and our work.  In fact as a team, I feel like we won our task, made it through the board room with Lord Sugar and back to the house.  After managing to dismantle the stand (that in itself could be another blog) and navigating ourselves on the tube back to Euston Station we hit Café Rouge for our treat.  For the boys a well earned, well known American Brand soft drink.  For me, sorry but it was much more Italian, white and flat.  Having quenched our thirst, we headed for the train.  We noted there was potential that it might be delayed due to the severe weather somewhere in the midlands but as the train was ‘being prepared’ all was looking good.  Sure enough, the platform was announced and we made our way to our train and respective seats.  Allister and Craig were together in one carriage and I was at the other (much more refined end) of the train.  This happened due to us having booked separately at different times and to my being much more financially savvy than the others.  Once settled the announcements started about the pressure on the Train Manager.  There was a staff shortage on board.    Staff shortages being nothing new to us, indeed the main reason for our journey I wasn’t that worried.  But it was impacting my end of the train more than theirs.  Needless to say, a WhatsApp group was established so that the gentle ribbing of my situation could commence.  Note here please the quick establishment of remote technology enabled communications by this team.  Some witty banter (apparently) later we started to hear the announcements from poor Helen the Train Manager about potential delays and floods that might impact our travel plans and journey North.    We then start to begin the real comms about what we as a team plan to do- together- we all agreed that even with different final destinations, we would not separate.  No man (or short woman) would be left behind.

Sit rep: Announcement on train for all to get off, this after agreement of the team that we would stay on.

From Mhairi “I’m hoping you stayed on the train [at that station] (smiley face)”

From Craig “Yes we did”

From Craig “I was nearly going to joke with you there but by the time I told you I was joking you could’ve been off and stranded (Smiley face)”

On arrival into Nuneaton, we wait for 45 minutes on the platform, to be informed about what is going to happen as we move north.  I would just say at this point that I don’t have the time or the energy today, to document all the changes in this plan from Helen- who was most definitely doing a sterling job.  Nor do I have the energy to document all our team planning and decision making to all of these changes.    I did however have a long game of eye spy, via messenger, with my nurse friends in Newton Stewart.  Something beginning with ‘T’.

We finally left Nuneaton at a snail’s pace- quote from Helen ‘Right, we are leaving.  We will be moving at less than 5 miles per hour, in fact at times, it may not feel like we are even moving’. We weren’t.    We were advised that we were going to Stafford, where it was advisable that as we needed to go further north, we should try to book either onward alternative transport – taxis etc, or book hotel rooms which will be refunded by Virgin.  Some more WhatsApping took place between the team and after a quick search on some well known hotel apps, it became apparent that all people on the train and the three trains ahead of us were doing exactly the same.  I missed rooms in the hotel chain App by seconds, so on the WhatsApp communication advice of the team we agreed I should go for any rooms available I could get.  With 60 people looking at the rooms I had just found 6 miles outside of Stafford  I decided to hit ‘book’ as quickly as possible.  Secured by my trusty plastic debit card (I didn’t take my credit card for fear of spending too much money in the big smoke) and confirmed by phone we had 3 rooms for when we finally were to arrive.  The hotel informed they had received many a call in the last half hour, but not to worry they would look after us.    They didn’t have to; we never got to that hotel.

On arrival in Stafford, the train doors opened and a deluge of people poured onto all areas of the train.   Any hope of our team managing to get back together totally lost.  This mass of people consisted of the poor northerners who had been on the three trains ahead of us, who had been told to get off the train at Stafford.   So why did we not get off and go to our hotel you might ask.  Well a few reasons.  These comrades in travel joining us had been advised that our train was going to carry on through the stops to Glasgow, may be slow and delayed but it was going.  They had also been told prior to this, that they should book rooms in Birmingham or back in London (which many had) or find alternative transport which Virgin would pay for.  One reported an Uber quote of over £500 to go 50 miles to go to Birmingham.    Those that had booked rooms in Stafford had found that the town was surrounded in water and they were unable to get to their hotels due to this – also due to a lack of taxis to take them.    A further announcement confirmed we were forging on, albeit it might only be to Preston where again alternative travel should be considered and arranged by us at Virgins expense, or indeed book more hotels.  Twitter was very interesting during all of this and proved a useful, additional, but confusing information stream.  As were the many conversations taking place around me and my team members 6 carriages up.  However, our team maintained our comms and agreed we were staying put, nothing ventured,  nothing gained.  Virgin announcement on board confirmed that room’s booked and unused could still be claimed for.  At this point it is 11 pm.  We are all cold, getting a bit hungry , tried and thirsty (lack of staff situation on train and overcrowding ) and not really caring about the money bit…..however, we agreed that I would not cancel  those rooms – not yet- thinking we still might need to turn back and attempt to get to them.

Finally, 90 minutes and over 40 Witty WhatsApp lines later at 0021 we arrive in Preston.  I cancel the hotel politely via email as I am unable to get a phone signal.

During the twenty minutes prior to arrival, there was lots of chat throughout the train of ‘sit ins’ combining this, appropriately for the situation, with climate protests.  On arrival though, different story, we were ‘told’ we had to get off – the train was leaving for the sidings and as such staff would instruct us on the platform. We disembarked.

I walked up the platform craning my neck to find my 6 foot companions over the masses.  Needless to say, I saw them before they remembered to look down to find me in amongst the poor cold children with their very angry and stressed parents.    A few ‘short’ jokes later, we took up our stance opposite the closed Starbucks coffee stand (Craig loves a Starbucks) and beside the shop window full of Gin and Tonic!

Mhairi preston train stationWe immediately go into a well rehearsed ‘huddle’ and stamp our feet.  We consider those windows and potential opening devices, consider emptying our cases and putting on all the clothes we have with us to keep warm.  We discuss TV programmes and films – many of which Craig happily told us he didn’t remember as he wasn’t old enough to.  We think he was joking; no one working with us can be that young!  We banter, laugh, smile, swap stories with others-many of who are not in such good spirits.  Of course we also with our laughter, attract the chat of very happily  drunk young man joining the masses after a night out in Preston who thinks he is in line for a taxi home to Lancaster and who has never seen such a queue in all his life!  ‘were you all our in Preston for the night?  I didn’t think Preston was that good’.  ‘Why is that Mhairi Edward the traintrain sitting there [on the platform] it could take us home; did the fat controller tell Edward to stay there?’  We had to admit, he had a point about the train still sitting there. With heating!

 

We discuss anatomy and physiology, mainly focussed on the length of time for frostbite and hypothermia to develop.  The Glaswegians are put in a queue by the one stressed out, red fleeced wearing, and loud Virgin employee.  They were then joined by the folks from Falkirk, the socialites from Stirling and the tourists heading for our capital city.     The rest of us for Carlisle, Lockerbie, Dumfries etc are kept at the bottom of the ramp.  More trains arrive, more people get off, more people are a bit shouty and eventually conform (or leave) and join queues.

We carry on our stamping of feet, banter and general chat about our Planes, Trains and Automobiles malarkey.   We even laugh about how this is building into a good story for our partners and colleagues.  Allister mentioned grandkids, but he was the mature one in the group.    I generally hint that my story could only now be made better if Freddie Flintoff appears home in Preston and helps to keep us entertained.   The addition of his chip van being with him was also considered a good idea.  We laugh more at the fact that the team who went to recruit in Dublin thought they had a story as they missed the shuttle bus from the Airport to the venue!

Oh how I now wish this was the end of our story…….the hysteria was yet to arrive!

Having eventually been called to the top of the ramp and the top of the queue, we have a good wee chat with a Police Constable from the British Transport Police, who is on overtime due to the situation.  He informs us of some interesting facts :  Virgin were not going to arrange transport at which he says they as a statutory service did not think ‘was a good idea’.  So his overtime was granted. He informed us that they were not aware of any closure of the M6 which would have limited travel by road north.  The story we had been told earlier.   He also informed us that had a three month old baby at home, who his wife had just texted to say had woken up unusually and so he had extended his overtime shiftJ.    Clearly disgruntled travellers are a better option than a crying baby.  We observed the atrocious behaviours of some citizens, who really did not appreciate that we were ’all in this together’ and that the small team now on site were trying to help them.    We observed a mini bus driver being dropped off by what looked like his wife and settling himself at the wheel of an already full mini bus full of the folk from Falkirk.  We noted how tired he looks and exclaim a bit of concern at this….

Mhairi end of the lineWe waited and bantered a bit more with our friendly constable.    We shared with him a need for him to go look at our own D&G Constabulary Facebook page, so that he could see that our behaviour, calmness, general friendliness and lack of stress is something which is fairly normal for our region.  We also gave him a mission, as like Craig, he too is totally unaware of who Red Adair is (this is an ongoing concern of mine currently, as I have been quoting this man of late and finding I get blank looks).

Eventually, we get a black Hackney Carriage allocated to us and the driver is informed he is taking us to Carlisle.   We are joined by a man from Carlisle who has probably had a worse day than us. He had travelled to London to watch Carlisle play football (1-1 draw).  He left his sons in a hotel in Stafford.

We set off out of Preston.   We stop at a Petrol Station, full of black cabs and mini buses.  We laugh when the taxi driver informs us he needs to fill up, ‘Carlisle is long way’.    We chat to the new member of our team about our adventure so far.

We hit the M6.  For the next 86 miles (94 minutes), none of us speak.  Craig looks at his phone (notably the M6 map he was following us on).  Allister is in the middle looking straight between the seats to the front window, he occasionally closes his eyes.   Carlisle man, travelling backwards facing me, looks out into the dark, holding tightly to the same yellow grab rail as me.  I try hard not to get too close in contact with either Allister or Carlisle man until I don’t care about that anymore as I am too (sweary word here) scared to care!

The driver stays in the middle lane, cars undertake us.  Cars overtake us.  I watch the clock and the road signs for Carlisle, counting down the minutes.  He moves to the inside lane.  His foot appears to be very heavy on the pedal and we are speeding up rapidly.  He drives onto the cats eyes for a while, we eventually slow again for a bit and move into one lane (as opposed to across all 3).    Repeat.  We overtake Lorries; I close my eyes every time we overtake.  We drive on the cats eyes- bumpity,  bumpity bump.   We drive with the cats eyes between the wheels.  We lose body fluid when the car overtaking us blasts his horn and flashes his lights and we move again into one lane again.  I’m freezing, but if the driver’s window being open and no heating on is what is keeping him driving as safely as he is, then I resign myself to frostbite.   I don’t want to shout are you awake, for fear the driver is sleeping and the fright sends him across the road again, so I cough a few times in the hope he hears it.   I consider messaging my husband to tell him I love him.  I wonder if I it is better to crash high speed into the central reservation or onto the banking.    I wonder this again when there appears to be a 200 foot black hole to the left of the road; I think we are about Shap.  It is dark.  I look at the others; they seem okay, smiling at each other.  I think to myself, ‘stop it, you’re paranoid and a bad passenger’.  I wonder if my driving has this effect on people.  I wonder if I did tell my husband what I want for my funeral.  I see Southwaite Services and think it would be really unlucky to crash at this point in the journey, so close to Carlisle.  We take the slip road for Carlisle and I am almost thanking a religious god I don’t necessarily believe in.  I am thankful too early.  We are now driving in the wrong lane in the city.  There is little traffic I thank that religious being again.

We arrive in front of the road closure at Botchergate.  The driver informs us he cannot get us to the station.  There are some comments made from Carlisle man about going down a little road, we exchange some glances and we get out.  We check the cab for all bags that have been thrown around.  We shout ‘thanks’, Carlisle man leaves us.  Taxi drives off.  We stand on the pavement, look at one another and then……..all exclaim rapidly how we thought we were going to die!  We literally bend over laughing…. It is probably the closest I have ever come to actual ROFL!

This continues for about three minutes and then still laughing and supporting one another, we head up Botchergate to the station.  The local police, herding the drunk, walking dead youngsters of Carlisle give us a cheery hello in passing.  I note the youngsters out and about probably look more like their Halloween characters now than they would have when they left their homes to come out tonight.  (Halloween week).   Although, as Allister said, if scary, grim, death masked, horror faces were a competition criteria, it would have been a no- contest as we had miraculously emerged from  “Indiana Jones and the Taxi of Doom”

I wonder if any of them even wondered what we were about.  What are a 5 foot woman and two six feet tall men, with cases, in business attire, doing walking up the Botchergate at 3 am (or 2 am, as the clocks changed an hour ago).  We laugh at the fact that we are all now looking at these young people and expressing the same things our parents said to us 30 years ago (10 for Craig).     It all makes sense now….but I do still wonder if that girl really did actually have any clothes on?!

We arrive at the car in the car park.  The ticket machine to pay for parking is in the locked station.  We drive to the barrier and Craig presses the telephone help button.  A guy answers.  Craig says “I’ve been on a delayed train then in a taxi to get to here and now I don’t know how to pay to get my car out as the machine is in the station”.  Note, even after all this, there is a hint we might even pay for the parking.  The best answer arrives “ah, okay, is that the barrier opening for you now?” at this the barrier rises and signals our freedom to the open road, with a good driver (I hoped and was relieved).  We set off to Lockerbie to get my Jiggy (my mini’s name) and head for home.

Mhairi burglarJiggy picked up at Lockerbie and a convoy into Dumfries ensues, with my arriving home at 5 am.  I had a last little bit of hassle breaking into my own house as my husband thinks I am in a hotel in Stafford (what he doesn’t know in times like this doesn’t hurt him) and collapse.

So this morning, I do two things of importance when I get up.

  1.  Check the news to make sure no  taxi drivers died on the M6 between Carlisle and Preston (they didn’t)
  2. Messaged my colleagues  friends on WhatsApp to thank them for making this terrible journey the best if possible could be.
  3. Write this down…..

Now all we need is for all of that to result in some health or social care staff to be successfully recruited from our trip to London.   Who needs team building when you can attend a recruitment event!

 

 

 

SAM Thanks You

image1-2Following the SAM tour in August of this year, the level of engagement from staff and our partners has been fantastic and has given us some serious food for thought.

Being honest however, we had not anticipated nor fully prepared ourselves for the volume of ideas that have been received so far. As we are fast approaching 800 ideas, we are working hard to ensure that your ideas are being directed appropriately to reach an outcome.

Every new idea receives an automated response. This system has been developed over the past few months (there are a few tweaked versions out there), with the response advising what will happen next.  There are essentially two options:

  • Your idea will be forwarded to a workstream, of which there are four, for detailed review and where possible implementation.  More about these later.
  • Your idea will be passed to the management lead for that area who will review same and, if appropriate, action. 

You might then feel that there is a time lapse between you submitting your idea, receiving an acknowledgement and then getting feedback from SAM. Please stick with us… with 745 ideas on our hands (as of 21/11/2019), many are going to take time, planning and potentially investment to action – you will receive a response to your idea once we have something concrete to share with you

SAM Workstreams

To take forward SAM, four high level workstreams have been established against which ideas are being allocated. These workstream are: Modernisation and Transformation (incorporating Digital Transformation), Clinical Efficiency, Workforce and Finance. It will be the responsibility of the Workstream Leads to facilitate the delivery of these ideas, a number of which will be worked up into feasible projects. The following chart illustrates the allocation of ideas by workstream to date:

image2

SAM Ideas 

There are two routes for ideas submission; the Ideas Pool hosted on the NHS intranet page Beacon and the dg.asksam@nhs.net email address. The ideas received so far cover a wide range of subjects however, we have managed to categorise them into themes, as shown below:

image3

 A number of your ideas are being progressed; have you seen our poster campaign yet? image4 For those of you that haven’t, watch this space! 

Clinical waste disposal costs hundreds of thousands of pounds annually; in fact, did you know that one bag of clinical waste (orange bag) costs more than twice that of one bag of general waste (black bag)? Now, whilst there are policies and procedures to be followed in the safe handling of waste that we must abide, we must also take care to ensure that these waste streams are used appropriately.

One department has done just that; CSSD has reduced their clinical waste bill by 50%! They have achieved this by undertaking a review within their department, considering the appropriate placement of clinical waste bins and removing them where they are not needed, in accordance with local policy. This will have a direct impact on our waste spend and is something that can be considered by other areas across our organisation.

Another popular SAM theme relates to the reduction of single use plastics; all of the ideas submitted on this topic have been allocated to a workstream for further investigation and action.

What’s next?

We are often asked “let us see the ideas” and “we don’t want to duplicate ideas”. We are developing our intranet and internet presence as part of the SAM Communications Plan, with a view to sharing ideas with you. Also, we do not mind seeing duplication of ideas; duplication drives home the need to seriously review what we do and communicates to us the appetite for changing how we do things!

Thank you!

We would like to take this opportunity to thank everyone for their overwhelming support so far for the SAM Programme. This will only be successful with the continued input and support from our staff and partners!

Please keep your ideas coming – have you SAM’d it yet?

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This blog was by the SAM Programme Management Team who are; John Knox, Nicole Hamlet, Kelly Armstrong and Asha Chauhan, Sustainability and Modernisation Programme Management Office, NHS Dumfries & Galloway and Dumfries & Galloway Health and Social Care Partnership

 

Holly

HollyThis Beautiful young woman called ‘Holly Butcher’ posted her advice to the world  24 hours before she died of cancer.

This was her message for you…

“It’s a strange thing to realise and accept your mortality at 26 years young. It’s just one of those things you ignore. The days tick by and you just expect they will keep on coming; Until the unexpected happens. I always imagined myself growing old, wrinkled and grey- most likely caused by the beautiful family (lots of kiddies) I planned on building with the love of my life. I want that so bad it hurts.

That’s the thing about life; It is fragile, precious and unpredictable and each day is a gift, not a given right.

I’m 27 now. I don’t want to go. I love my life. I am happy.. I owe that to my loved ones. But the control is out of my hands.

I haven’t started this ‘note before I die’ so that death is feared – I like the fact that we are mostly ignorant to it’s inevitability.. Except when I want to talk about it and it is treated like a ‘taboo’ topic that will never happen to any of us.. That’s been a bit tough. I just want people to stop worrying so much about the small, meaningless stresses in life and try to remember that we all have the same fate after it all so do what you can to make your time feel worthy and great, minus the bullsh*t.

I have dropped lots of my thoughts below as I have had a lot of time to ponder life these last few months. Of course it’s the middle of the night when these random things pop in my head most!

1) Those times you are whinging about ridiculous things (something I have noticed so much these past few months), just think about someone who is really facing a problem. Be grateful for your minor issue and get over it. It’s okay to acknowledge that something is annoying but try not to carry on about it and negatively effect other people’s days.

2) Once you do that, get out there and take a freaking big breath of that fresh Aussie air deep in your lungs, look at how blue the sky is and how green the trees are; It is so beautiful. Think how lucky you are to be able to do just that – breathe.

3) You might have got caught in bad traffic today, or had a bad sleep because your beautiful babies kept you awake, or your hairdresser cut your hair too short. Your new fake nails might have got a chip, your boobs are too small, or you have cellulite on your arse and your belly is wobbling.

Let all that shit go.. I swear you will not be thinking of those things when it is your turn to go. It is all SO insignificant when you look at life as a whole. I’m watching my body waste away right before my eyes with nothing I can do about it and all I wish for now is that I could have just one more Birthday or Christmas with my family, or just one more day with my partner and dog. Just one more.

4) I hear people complaining about how terrible work is or about how hard it is to exercise – Be grateful you are physically able to. Work and exercise may seem like such trivial things … until your body doesn’t allow you to do either of them.

I tried to live a healthy life, in fact, that was probably my major passion. Appreciate your good health and functioning body- even if it isn’t your ideal size. Look after it and embrace how amazing it is. Move it and nourish it with fresh food. Don’t obsess over it.

5) Remember there are more aspects to good health than the physical body.. work just as hard on finding your mental, emotional and spiritual happiness too. That way you might realise just how insignificant and unimportant having this stupidly portrayed perfect social media body really is.. While on this topic, delete any account that pops up on your news feeds that gives you any sense of feeling shit about yourself. Friend or not.. Be ruthless for your own well-being.

6) Be grateful for each day you don’t have pain and even the days where you are unwell with man flu, a sore back or a sprained ankle, accept it is sh*t but be thankful it isn’t life threatening and will go away.

7) Whinge less, people! .. And help each other more.

😎 Give, give, give. It is true that you gain more happiness doing things for others than doing them for yourself. I wish I did this more. Since I have been sick, I have met the most incredibly giving and kind people and been the receiver of the most thoughtful and loving words and support from my family, friends and strangers; More than I could I ever give in return. I will never forget this and will be forever grateful to all of these people.

9) It is a weird thing having money to spend at the end.. when you’re dying. It’s not a time you go out and buy material things that you usually would, like a new dress. It makes you think how silly it is that we think it is worth spending so much money on new clothes and ‘things’ in our lives.

Buy your friend something kind instead of another dress, beauty product or jewellery for that next wedding. 1. No-one cares if you wear the same thing twice 2. It feels good. Take them out for a meal, or better yet, cook them a meal. Shout their coffee. Give/ buy them a plant, a massage or a candle and tell them you love them when you give it to them.

10) Value other people’s time. Don’t keep them waiting because you are sh*t at being on time. Get ready earlier if you are one of those people and appreciate that your friends want to share their time with you, not sit by themselves, waiting on a mate. You will gain respect too! Amen sister.

11) This year, our family agreed to do no presents and despite the tree looking rather sad and empty (I nearly cracked Christmas Eve!), it was so nice because people didn’t have the pressure of shopping and the effort went into writing a nice card for each other. Plus imagine my family trying to buy me a present knowing they would probably end up with it themselves.. strange! It might seem lame but those cards mean more to me than any impulse purchase could. Mind you, it was also easier to do in our house because we had no little kiddies there. Anyway, moral of the story- presents are not needed for a meaningful Christmas. Moving on.

12) Use your money on experiences.. Or at least don’t miss out on experiences because you spent all your money on material sh*t.

13) Put in the effort to do that day trip to the beach you keep putting off. Dip your feet in the water and dig your toes in the sand. Wet your face with salt water.

14) Get amongst nature.

15) Try just enjoying and being in moments rather than capturing them through the screen of your phone. Life isn’t meant to be lived through a screen nor is it about getting the perfect photo.. enjoy the bloody moment, people! Stop trying to capture it for everyone else.

Random rhetorical question. Are those several hours you spend doing your hair and make up each day or to go out for one night really worth it? I’ve never understood this about females

🤔.

16) Get up early sometimes and listen to the birds while you watch the beautiful colours the sun makes as it rises.

17) Listen to music.. really listen. Music is therapy. Old is best.

18) Cuddle your dog. Far out, I will miss that.

19) Talk to your friends. Put down your phone. Are they doing okay?

20) Travel if it’s your desire, don’t if it’s not.

21) Work to live, don’t live to work.

Seriously, do what makes your heart feel happy.

22) Eat the cake. Zero guilt.

23) Say no to things you really don’t want to do.

24) Don’t feel pressured to do what other people might think is a fulfilling life.. you might want a mediocre life and that is so okay.

25) Tell your loved ones you love them every time you get the chance and love them with everything you have.

26) Also, remember if something is making you miserable, you do have the power to change it – in work or love or whatever it may be. Have the guts to change. You don’t know how much time you’ve got on this earth so don’t waste it being miserable. I know that is said all the time but it couldn’t be more true.

Anyway, that’s just this one young gals life advice. Take it or leave it, I don’t mind!

Oh and one last thing, if you can, do a good deed for humanity (and myself) and start regularly donating blood. It will make you feel good with the added bonus of saving lives. I feel like it is something that is so overlooked considering every donation can save 3 lives! That is a massive impact each person can have and the process really is so simple.

Blood donation (more bags than I could keep up with counting) helped keep me alive for an extra year – a year I will be forever grateful that I got to spend it here on Earth with my family, friends and dog. A year I had some of the greatest times of my life.

..’Til we meet again.

Hol

Xoxo”

 

Appealing to the ‘yuck’ factor by Elaine Ross

I’ve decided to write this blog based on a growing awareness that what once seemed to be automatic and unquestioned is now no longer either. I’m talking about the single most important measure in preventing infection, hand hygiene.
Recent audits of hand hygiene have revealed far lower results and compliance then we have previously seen. In some areas this has been as low as 40%. That means that your loved one could have a 4 in 10 chance of being treated by someone with clean hands. For me that is just not good enough.

Now I’ve been reflecting on why this might be and I do wonder if it is because of the new hospital, busyness or have we simply forgotten its importance as we have reached the lowest levels of healthcare associated infection we have seen.
We know that audit on its own is not sufficient to sustain improvement. What needs to change is behaviour and perhaps environmental things that we now describe as human factors? So I would like to appeal to your yuck factor!
These plates were collected randomly in one ward in DGRI

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Ward Phone

The ward phone is heavily contaminated, as is the keyboard at the touch down station and yet we may not think of the bugs we have just picked up on the phone when we help ourselves to a biscuit or walking to answer a buzzer without using alcohol hand rub. In that single moment we have transferred those organisms to the buzzer and to the patient or we have eaten them!

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Keyboard at touchdown station

What doesn’t kill you makes you stronger?
Well this might be true of exercise but not of infections. Yes, you might gain some immunity but it’s possibly a chancy and painful way of gaining it and in this world of antibiotic resistance it is a growing risk.

Lessons from the past

Semmelweis recognised the importance of hand hygiene in the 1840s when

he noticed an increase in maternal deaths. Even though he reduced deaths

by introducing a hand washing regime which included Chlorinated lime used 

after post mortem examinations he was ridiculed for this suggestion and told he lacked evidence and died in 1865 unrecognised in an asylum. https://en.wikipedia.org/wiki/Ignaz_Semmelwei

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Florence Nightingale, a hero of mine since my childhood, famously said, 

“The first requirement in a hospital is that it should do the sick no harm”.

She set about achieving this by instituting standards of hand washing and cleanliness that brought about her humiliation and ridicule but eventually a sharp reduction in death rates during the Crimean war.

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There is a common theme and sadly, it is still a common theme. 

When I have asked somebody why they have not performed hand hygiene or not complied with uniform policy and have watches, rings or gel nails, I have been ignored or questioned about the evidence base. I’ve been laughed at on occasion, perhaps nervously in some cases,   and often been challenged to discuss other infection related aspects which the challenger believes to be far more worthy of my attention and action.

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Hands before alcohol rub and rings from the same hand after the alcohol rub

In 2007 there was a very successful hand hygiene campaign run across the whole of Scotland and this, together with an increased focus on cleaning, produced the lowest rates of healthcare association infection that we have seen at 4.5% HAI in Scottish hospitals in 2016. What has changed?

What’s in it for me?
Social marketing tells us that we that we are selfish animals and if there is a degree of discomfort or effort we make a decision about whether that effort will bring us benefit. I’d like to stimulate your “what’s in it for me?” reflex.

For you 

  • Self protection
  • That feeling of satisfaction at doing the right thing to protect one patient 
  • The common good and helping others

Our audit results for the last six months are available through Beacon, through the infection prevention and control portal. Your lead for your area will have access to individual audits and detail.

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https://audits.megsupporttools.com/dashboards/public/1104/76f0e538-761f-4c1f-932a-74a240c01fe2/
But it’s not about numbers; it’s about making a decision to change your behaviour. 

 We know how to clean our hands

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We know when

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We know with what – alcohol hand rub or gel will kill bugs and is better routinely but hand washing will remove organisms mechanically and wash them down the sink.

For further information please look at the National Infection Prevention and Control Manual (NIPCM)

http://www.nipcm.hps.scot.nhs.uk/chapter-1-standard-infection-control-precautions-sicps/#a1069
Remember though that for Norovirus and C.diff alcohol isn’t effective so 

Poo

(Thanks to my colleague Justine McCuaig for that tag line.)

What we need to do now is make an individual decision to notice each opportunity requiring hand hygiene and take the decision to do it and be prepared to gently challenge others if they miss their opportunity.

thumbs up

As patients and staff remember

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And as we enter this season of parties, Flu and Norovirus please remember that we eat more bugs than we ever breathe in so if there’s one thing you can do to protect yourself, please make sure you eat with clean hands.

Elaine Ross is Infection Control Manager at NHS Dumfries and Galloway

 

How the NHS saved me with Kindness and great care by Grecy Bell

I have always been in good health. I rarely went to see the doctor. In fact, the last (and only) time I’ve been in the hospital as a patient was to give birth to my children. However, all of that changed recently.  I unexpectedly found myself as a patient with an acute life-threatening illness. It was during my time in the hospital that I came to the realisation that kindness has a wonderful healing power.

A few weeks after being discharged from the hospital, I decided to venture outside the house (daytime TV was driving me insane!). A nearby coffee shop seemed an ideal place to sit and ponder for a while.  I started a conversation with a person sitting alone at a nearby table. We ended up talking about many things including the NHS. He told me that a renowned and very skilled professor at one of Edinburgh’s teaching hospitals had saved his life many years before. He said that the surgeon’s expertise and knowledge had successfully enabled him to carry on living an active life despite having had a complex heart operation.

I shared with him that I was recovering from a bout of pancreatitis and a gallbladder operation and told him that I echoed the sentiments he felt for his surgeon. I told him of the deep gratitude I felt towards all of the people involved in my care during my stay at Dumfries & Galloway Royal Infirmary.

There were indeed so many people to whom I felt gratitude. From the porter who took me to and from my room, to the doctors and nurses in diagnostics and theatre, to the cleaner who came to my room with a big smile every day,  to the nurse who helped me to the toilet in the middle of the night and patiently waited outside the door to bring me back to the bed, to the lab team whom I never saw but diligently processed my blood samples just a few minutes after my arrival to the Emergency Department with a self-diagnosed “awful indigestion”.  To the  doctors that  took care of me, listened to my concerns and patiently answered all my questions ( I had many..!) and also to the person that offered me a cup of tea every couple of hours.

There really is something about a smile, a name and eye contact.

Kindness is defined as “the things that people do for one another (both practically and emotionally) in response to moments of perceived need, when there is the option to do nothing”. 1

What I noticed the most as I lay in my hospital bed was the effect that kindness had on me. When the phlebotomist smiled at me, it was indeed only a scratch that I felt. Contrasting that with when I was unsure and afraid, that tiny needle felt a lot bigger and more painful. If my mind was worried and someone passed by and simply smiled, I felt better (despite the pain being excruciating!). When the people looking after me remembered my name and made eye contact with me, I felt hope.

I have counselled many patients before they went for an MRI and from a physician’s point of view, I knew what it entailed. However, lying there as a patient myself, I was not prepared for the feelings that I would have. It was a noisy, claustrophobic experience with a disembodied voice instructing me to “hold your breath” at various intervals. Again, what made the experience tolerable was the kindness that the MRI team showed me. They asked if I was comfortable before we started. They reassured me with a light touch on my shoulder that they would be right there if I needed any assistance.

We often overlook how simple acts of kindness can make a difference to us and to our patients. We tend to focus on our own areas of expertise and knowledge rather than on our human skills. I have learnt that being kind does make a difference. I like to think that being a patient has made me a nicer doctor.

“Acts of kindness are those moments in our everyday lives when we choose – in small-scale & fleeting ways – to draw our boundaries a little wider” 1

I value our NHS now more than ever. In my hour of need, the NHS saved me. Thank you to all the teams that work so tirelessly across the NHS Dumfries and Galloway every day and show kindness without appreciating what an amazing difference it can make.

Be kind, it really does make a difference.

Grecy Bell is a GP, Deputy Medical Director for Dumfries and Galloway Health and Social Care Partnership.

Public policy and infrastructure of Kindness in Scotland. Simon Anderson and Julie Brownlie.  http://www.carnagieuktrust.org.uk

Hello my name is http://www.hellomynameis.org.uk