We’re quickly reaching the end of LGBT History Month and as an openly gay member of the Board, I was asked to write a blog to give you some perspectives from my own experiences, and also my perspectives of life for lesbian, gay, bisexual and transgender people within NHS Dumfries and Galloway. The theme of LGBT History Month in Scotland this year is ‘Unsung People’, and seeks to find and share stories, as there is empowerment in representation. Here’s just a wee bit of my story.
I’m Grace Cardozo, and I’ve been a Non-Executive Director on the Board of NHS Dumfries and Galloway since 2015. I’m also a voting member on the IJB where I’m chair of the Clinical and Care Governance Committee.
I came out in the early 90s after (like many others) moving away to the relative anonymity of the big city – in Edinburgh I found my tribe, pretty much immersing myself in gay culture in the city, feeling for the first time that I could properly be myself.
Although the LGBT pubs, clubs and groups I accessed felt like a safe haven, sadly it wasn’t always like that in the big bad world and as someone who ‘looked gay’ (whatever that means) I was an easy target for various forms of homophobia, discrimination and abuse. At that time, the LGBT plus community still didn’t really have any legal rights, and overall, the experience of being treated differently, as an outsider, as somehow ‘less’ than other people left its mark and meant that I (like many other LGBT people) have had to battle through feelings of low self-worth, feeling terrified about what people might think of me, trying to hide who I was from family, friends and work colleagues, all of which eventually led to a range of mental health difficulties.
Fortunately, I was blessed with a loving family who eventually accepted me, a group of supportive friends and a good education, all of which offered me the resilience I needed to get my life back on track, and now almost 30 years later, I live a very ordinary and content life with my partner, daughter and dogs in rural Dumfries and Galloway, accepted by everyone in my wee village, and in the places I socialise and work.
Without those safe spaces in the early days however, and that peer group of other LGBT people which gave me both personal support and a louder, collective voice about the issues that concerned me as an LGBT plus person, I know I would not be nearly as confident, happy and (relatively!) well-adjusted as I am now.
I think what people who are not LGBT plus don’t always realise is that the fear of prejudice is just as paralysing as the real thing, and that sometimes we are programmed to assume people will reject us, when we have had so many experiences of that in the past. I also think that sometimes we ourselves forget about the toxic shame that many of us felt growing up, and which can stay with us in different forms into adulthood and can impact on how confident and empowered we can feel in social situations, in relationships, when we access services and certainly in our places of work.
That’s just one reason why I’m so delighted that NHS Dumfries and Galloway and the other public bodies across the Region have come together to support the development of a new LGBT+ staff network which aims to bring staff together to give that sense of mutual support, solidarity and to help drive forward improvements for LGBT+ people in our workplaces. It’s not just a ‘nice’ thing to do – for many members of staff across the public agencies it will prove to be a life-line – a safe space where they can finally be themselves and have a voice, without the worry that they might be judged, bullied or treated differently that their colleagues.
You only need to look at the equality data from NHS Dumfries and Galloway to know that there are many LGBT plus people who don’t feel confident enough to disclose their sexual orientation or gender identity in the workplace. These are our colleagues, our friends. The ones that help hold us up at the end of a bad day. The ones that agree to do that extra shift to help a colleague out. The ones that bring cakes in on a Friday, well… just because the team deserve it. But some of these NHS colleagues are also people who don’t feel safe to mention their partners when people ask how their weekend was; or don’t feel able to bring their loved one to a work night out; or worry every day if their friends and colleagues would still be their friends if they ‘knew’.
I know that most people in NHS Dumfries and Galloway are committed to promoting equality and diversity, and to making sure that everyone irrespective of background or identity can feel safe and supported and thrive in our organisation, either as a patient or a staff member. But this desire to be inclusive only goes so far, and it needs to be translated into creating a culture where people feel safe enough to be themselves, which surely is a simple, basic human right.
The LGBT+ staff network will go some way towards creating this culture, but there’s so much more that we can ALL do for all of our friends, colleagues and team-mates which could make a huge difference to people’s lives. I’ll leave you with 8 wee tips on how to be a good LGBT ally and to help all our LGBT+ colleagues to confidently reveal the unheard stories about their real life and love.
Believe that all people, regardless of gender identity and sexual orientation, should be treated with dignity and respect.
Confront your own prejudices and bias, even if it is uncomfortable to do so. Try to educate yourself on LGBT+ issues – remember one day it might be a close friend or relative that needs your support too.
Don’t assume that all your friends and co-workers are straight. Someone close to you could be looking for support in their coming-out process. Not making assumptions will give them the space they need.
Bring LGBT+ issues out in conversation in the workplace “Did you see Channel 4’s It’s a Sin – It was really great and moving”, “Did you read those blogs about LGBT History Month – isn’t it great we’ve got an LGBT staff network” etc.
Be inclusive with your language – Say “partner” rather than “boyfriend / husband”, “wife/ girlfriend”.
Anti-LGBT comments and jokes are harmful. Let your friends, family and co-workers know that you find them offensive.
Don’t gossip about people’s sexuality or gender identity, or tell anyone else if you know someone to be LGBT+ (unless you know they are 100% out) – you could put someone in an unsafe situation.
Defend your LGBT friends and colleagues against discrimination and stand up for LGBT+ rights where you can. Remember sometimes because of our own fear we find it hard to stand up for ourselves.
If you would like to know more about the Dumfries and Galloway LGBT+ staff network please contact us (in confidence) at
Grace Cardozo is a Non Executive Member of the NHS Dumfries and Galloway Health Board.
As part of the Mental Health and Winter Wellbeing programme in Dumfries and Galloway we are pleased to launch the Self Care Pack for People Living with a Chronic Health Condition. The ACORNS acronym for the Winter Wellbeing stands for Active, Creative, Online, Routine, New and Support is very much embedded within the Self Care Resource Pack.
The Self Care Resource Pack was developed by the Clinical Health Psychology (CHP) Team which includes two Clinical Health Psychologists; Dr Alison Wren and Dr Ross Warwick and me, Elaine Ferguson a Cognitive Behaviour Therapist. Sometimes we have the great addition of a Trainee Clinical Psychologist like Deidre Holly that helped me and Alison develop our Self-Care Resource Pack.
The CHP team work with adults from school leaving age and beyond who have unhelpful thoughts and feelings about their long-term health condition. This can include breathing problems, stroke, kidney disease, heart trouble, chronic pain, cancer, ME / CFS, and diabetes, amongst others. We use Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT). Currently we are offering Therapy by telephone or NHS Near Me video consultations. Due to COVID19 restrictions we are unable to offer appointments in person unless there are specific mitigating circumstances.
The research evidence shows that people with long-term conditions are two to three times more likely to experience mental health problems. Much of the evidence relates specifically to affective disorders such as depression and anxiety. There is particularly strong evidence for a close association with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease (COPD) and musculoskeletal disorders. There is also higher than usual levels of mental health problems among people with other conditions, including asthma, arthritis and cancer. Problems with health can affect quality of life and emotional wellbeing. As a result of these co-morbid problems, the prognosis for their long-term condition and the quality of life they experience can both deteriorate markedly. Unhelpful thoughts and feelings about health, loss of independence, changing roles, avoidance, low mood and uncertainty can make people feel stuck. Problems like these can sometimes take over, affecting all aspects of life.
People may need extra support to help make adjustments and get back on track. The CHP Service aims to provide psychological care and support to help people to live well with their health condition. This underlying commitment of the Service and the impact of Covid 19 highlighted the need for resources to be readily available to people who are often referred to us with some core symptoms and challenges. From this thought (a little acorn), grew the Self-Care Resource Pack for people with Chronic Health conditions.
Adjustment is a process a person goes through when they have a long-term health condition; it can take time and has its ups and downs but is completely normal. Adjustment to having a health condition can lead to a wide range of emotions; some can be strong and feel overwhelming! Individuals have strengths and resources of their own and important relationships that can help to develop the resilience that is needed living with a long-term condition. Self-management is an important tool for meeting their individual needs and values in a positive planned way.
The Kings Fund paper, “Long-term conditions and mental health. The cost of co-morbidities” (2012) amongst others, shone a light on the need for Self-Management tools as a key element of the prevailing approach towards chronic disease management. People with co-morbid mental health problems can gain particularly large benefits from inclusion in self-management support strategies and programmes.
The Self-Care Resource Pack was developed by the CHP Team to give people with chronic health conditions some additional self-management tools to help them deal with difficult thoughts, feelings and behaviours which can get in the way of living well with a chronic health condition. It is centred on issues that can be difficult no matter what chronic health condition a person has. Topics covered are:
Dealing with Uncertainty
Managing Stress- Managing Stress in Daily Life
Re-Activate and Re-Engage
Managing Unhelpful Thoughts and Feelings
Chronic Pain and Chronic Fatigue
Relaxation and Breathing
Sleep and Sleep Problems
Managing Set backs
Other Useful Website links
The Resource Pack will be used as the core structure of information provided to people with chronic health conditions. You can access a copy of the Self Care Resource pack and download it from this link.
It is also available for NHSDG Staff on the Beacon page under Patient and Carer Information in the Psychology folder.
We plan now to roll out the Resource Pack directly to people through social media, NHS websites, the Winter Wellbeing programme and by professionals in Acute and Mental Health services.
By Elaine FergusonCognitive Behaviour Therapist with the Clinical Health Psychology Team at NHS D&G
Did you know that LGBT (Lesbian, Gay, Bisexual and Transgender) History Month takes place every February? It’s an opportunity to
celebrate LGBT life and culture
recognise the achievements of LGBT people and communities
raise awareness of the history of the gay rights movement
The theme this year is ‘Body-Mind-Spirit’ reminding us that our wellness comes not just from physical health, but from mental and spiritual health as well. To be “healthy,” we must pay attention to all three aspects, even more important as we navigate our way through the current pandemic. Feeling accepted for who we are contributes greatly to good health We live in a society which now has legislation in place to protect members of the LGBT community from explicit homophobia and ensure that we have equal rights. But this is a fairly recent development and LGBT men and women who went before us kept their sexuality secret, living in fear of being found out. And those that were brave enough to fight for LGBT rights were often publicly vilified, impacting their body-mind-spirit. Throughout history LGBT+ men and women have made great contributions but often failed to get any recognition.
“History, despite its wrenching pain, cannot be unlived, but if faced with courage, need not be lived again”
Sophia Jex-Blake, born in Sussex in 1840, was the first practising female doctor in Scotland. Having fought her parents for her schooling, Jex-Blake was blocked from attending university. She went to the US where she learnt more about women’s education. On returning to the UK, she and 6 other women successfully lobbied Edinburgh University to admit them but were not allowed to graduate at the end of their studies. Jex-Blake eventually qualified as a doctor in Switzerland enjoyed a lengthy career in medicine. She helped found 2 medical schools for women. She met her partner Dr Margaret Todd at one of these schools.
Roberta Cowell was a hero of World War 2, a racing driver turned Spitfire pilot who survived being imprisoned in a Nazi camp. Towards the end of the 1940s she came out as a trans woman and became the first person in the UK to undergo gender-affirming surgery which enabled her to change the gender marker on her birth certificate.
Alan Turing was a famous mathematician and computer scientist, his work during World War Two played a crucial role in intercepting coded and it has been estimated that his work shortened the war by up to 2 years and saved around 14 million lives. However, despite these accomplishments, he was never fully recognised in the UK during his lifetime due the prevalence of homophobia and the Official Secrets Act. Turing was prosecuted in 1952 for homosexual acts and gross indecency. Instead of going to prison, Turing accepted a sentence of chemical castration. Turing died in 1954 at the age of 41. In 2009, Prime Minister Gordon Brown made an official public apology on behalf of the government for “the appalling way he was treated.” The Queen granted Turing a posthumous pardon in 2013. In 2017, the “Alan Turing Law” as it is informally called, granted retroactive pardons to men cautioned or convicted under historical legislation which made homosexual acts illegal.
Peter Tatchell has devoted his life to fighting for civil rights, especially LGBT+ rights. Born in Melbourne Australia, Peter’s civil rights journey started at the age of 15, protesting against the Australian death penalty, and in favour of Aboriginal land rights. Describing himself as a gay, atheist vegan he has risked his life campaigning for justice and equality. Vilified by the right-wing UK media, when the Admiral Duncan gay bar in Soho was bombed by a neo-Nazi fanatic, Peter exposed how the press ignored the gay victims of the bombing, and focussed entirely on the ‘innocent’ heterosexuals also killed in the bar. No one in the past 50 years has done more for the advancement of LGBT and human rights than Peter, and for no personal gain.
‘Don’t accept the world as it is. Dream of what the world could be- and then help make it happen’
Mohsin Zaidi was the “first person from his school to go to Oxford University” before going on to become, an accomplished criminal barrister, a board member of Stonewall, the UK’s biggest LGBT rights charity, and a governor of his former school in east London. Mohsin has twice been ranked in the Financial Times Outstanding list of Future Leaders. He has worked on a number of high profile cases of public importance, including Bull v Hall, the case involving Christian hotel owners who refused a double-bedded room to a same-sex couple. His first book was the 2020 coming of agememoirA Dutiful Boy about growing up gay in a Muslim household in Britain.
Did you know that in 2020 an LGBT+ Staff Network for Council and NHS workers was started? Its aim is to reduce inequalities for LGBT+ staff, across the Public Sector in Dumfries and Galloway and is a consultative, support and social group. Anita Hall in her role as UNISON LGBT+ officer approached the Council and NHS to see if it would be possible to create this network.
Anita says that “I was driven to do this because I am acutely aware of a lack of staff focused services in this regards. My role as a UNISON LGBT+ officer has given me a lot of insight into this area and was the primary driving force behind my desire to create a safe space for LGBT+ staff to meet and socialise. I hope that this Network will inspire my LGBT+ colleagues to forge friendships and working partnerships in a group in which we can focus on such diverse topics as LGBT+ history, Pride events or just have some banter”.
One member of the group has said “when I saw that there was an LGBT+ Staff Network group advertised at NHS D&G I was excited at the prospect of meeting some like-minded individuals to get to know. I am fairly new to the area and also not “out” so it was a big step to approach Anita Hall and ask when the first meeting would be. I am very glad that I did! I have found the group to be exceptionally warm and welcoming. I appreciate that the group has big ideas with regards to Pride and observing events such as LGBT+ History Month, but to be honest, I am just relieved to have found a group in which I feel that I can be myself. I would encourage any LGBT+ staff member who has an interest to join the Network. I believe that the more we can put in to this endeavour; the more we will get out of it”.
If you would like to know more about the Dumfries and Galloway LGBT+ staff network please contact us at
The insights of MSK AHPs stepping up to the challenge of redeployment to the vaccination team and acute wards in response to the COVID surge.
Since March 2020 The world has been fighting COVID-19, it has affected each and every one of us. As Healthcare Professionals we have stepped up to the challenges of working in new ways, and have embraced this rapid change, knowing we needed to continue to help our patients in the best ways we can.
When the news that both Pfizer/ BioNTech and Oxford AstraZeneca vaccine were licensed for use in the UK in Dec 2020, it signaled the start of the biggest mass vaccination program ever undertaken in the UK and beyond.
Within NHS D&G, AHPs were asked to volunteer to upskill to become part of the vaccine roll out, as well as continuing to provide their own MSK services and some to be redeployed to support acute and community services.
There was a sense of ‘here we go again’ following the initial lockdown of March 2020, but also the awareness of how urgent the situation was this time. The number of positive cases was surging and secondary care was coming under intense pressure with the escalating numbers. NHS D&G had to react quickly and decisively to mobilise staff and resources to help both treat those COVID patients in acute care as well as start the mass vaccination roll out.
I find it hard to say just how dedicated the staff have been pulling together and taking on this enormous task. Working above and beyond their comfort zones without question.
The team work and professionalism everyone has shown has been inspiring, and as a team everyone has felt proud to be part of both the MSK AHP team and NHS D&G.
This blog serves to capture the observations, feelings and reflections of the staff involved and patients we have had the privilege to support throughout this last month, as we became part of the vaccination and acute teams within D&G.
Enjoy reading them and I think the words reflect the sentiment that
“The Good we do today becomes the happiness of tomorrow”
” A great team effort from all the Podiatrists, Physiotherapists and Occupational Therapists involved with the vaccination roll out with fantastic support from the Occupational Health staff. It felt great to be involved and I look forward to joining the team once more when the time comes to start administering the second doses.” PODIATRY
I ‘ll tell you what’s app- a great way to share, support, have a laugh at a time when things can get a bit intense and it’s amazing what a GIF, Emoji or Picture can do to help…In a few words or pictures everyone shared their learning, a cheery photo, the highlight of the “first immunisation done” and cheered everyone on, as well as the disappointment when clinics cancelled, (not sure why) and would we be needed every week? It definitely was an only positive support group and so much easier than e-mail.
“I have been working shifts for the past couple of weeks with the Occupational Health Vaccination team at DGRI. Being able to volunteer for the Vaccine programme made me very happy and it meant I could help with something so important during the Pandemic. I felt very nervous about the training and vaccinating people, but I was made to feel at ease by Charlotte the lead Occupational Health nurse. II felt very proud to be representing Podiatry and am very grateful to have been given this opportunity to learn, develop and help in the delivery of vaccines.” PODIATRY.
“Helping out with the vaccination clinic has been a mixed boat of emotions. Its felt amazing to be able to help out a little to those who have gave up so much working on the Covid wards. It’s been lovely to build new relationships. It’s also been a massive learning curve, working different hours and having a constant fear that something might happen. Overall though it is one of those experiences I’m glad to have taken part in.” PODIATRY “
“it’s been nice being a part of some patient’s journey’s on the wards. Had lots’ who have been really sick and now being able to send them home is great”
Working with Orthopedics allowed me to be part of fracture clinic and aware of the MSK pathway. Able to give advice and support for non-COVID injuries be part of the team. ACUTE WARDS.
“it has been a challenge, with lots to learn in a short time, but I’m very glad to have been able to offer to help deliver such an important programme. It has been great to see AHPs rise to the challenge, some clinics have been all AHPs. It shows how versatile we are! OCCUPATIONAL THERAPY.
The Reflective Tool captures the emotions and thoughts of the AHP team, with an overwhelming feeling of solidarity. Everyone is working toward the shared goal of helping us all to return to some kind of normality in the year ahead. The key objective of NHS D&G is to support the vaccination program, and this is driving our current resources to primarily support this but also maintain our own MSK services to those most in need.
As I write this blog the Government has announced the intense ramping up of the vaccination program across the nation.
We have learned as a team how quickly we can utilise our transferable skills in response to the urgency and enormity of the task. It most certainly has shown that team work makes the dream work and when we have a common goal/vision we can work seamlessly at a pace to achieve it.
As we go into February, the vaccination program will continue to gather pace, and hopefully the numbers in CCU will continue to decline, meaning we as a community can start to get closer to some kind of normal.
As a team we can then return fully to our ‘day jobs’, reflect on the year gone by and we can maybe visit family and friends.
We all have to believe that…
The Good we do today becomes the happiness of tomorrow….
Well done team AHP and NHS D&G: Resilient,
Professional,Supportive and Skilled.
Alison Howie is MSK Team Lead West at Galloway Community Hospital
There is no real need for me to remind everyone what we are currently going through; Covid is all over the news and social media as it has been for the past 12 months and it is all becoming a little tiresome. However the past month in D&G has been different as we have been hit hard for the first time in this pandemic with a massive surge in the community, particularly with this new transmissible variant, that has resulted in enormous pressure being put on our secondary care services. The response from across the partnership has been incredible with all staff rising to the occasion to ensure our services continue to function.
This blog is partly about thanking everyone for those efforts and proving once again that D&G is the best place to live and work but it is also about focussing in on a few specific areas which I feel merit special attention. These areas are our Critical Care Unit and the wards which have taken the majority of our Covid inpatients; B2, C5, D8, D7, Galloway Community Hospital and our front door services the Combined Assessment Unit and Emergency Department.
Most days I have been wandering around DGRI popping into these areas to see how they are. Every day I leave them feeling proud and humbled. The sense of calm, control and teamwork is beyond my abilities to describe. I am very aware that this sense of calm is deceptive, everyone is incredibly busy and often many of the staff are in full PPE in restricted Covid areas. Those individuals who need to wear ‘sessional’ PPE ie. they put on the full works, gown, FFP3 mask and visor and then wear them for hours on end, need special mention. For anyone reading this who is not familiar with sessional PPE it is onerous and exhausting. For hours you cannot get a drink or nip to the loo and the effect of the mask on your face is best illustrated by this image:
As healthcare professionals working in these areas they are used to their patients dying, it is an unavoidable aspect of the job, however the past few weeks have been relentless with a significant mortality from this disease. That, and the fact that almost all end of life discussions with families and loved ones takes place over the phone, has had an enormous emotional impact. This video clip from the BBC demonstrates how difficult it can be and if you haven’t seen it is worth a watch.
Our CCU and ward staff have been working in this environment for weeks now. Thankfully the numbers of positive cases in the community are falling and this will mean a reduction in admissions but its likely that these areas have weeks left of sessional work as the length of stay of Covid patients can be considerable. So on behalf of all your patients and their families, on behalf of NHS D&G and from myself I want to say Thank you so much for your dedication and commitment. You are all truly amazing and we are all extremely proud of you.
At the beginning of this Pandemic I wrote a blog titled ‘Enough Love’ where I postulated that the future was grim but that we in D&G had enough love to get us through it. A lot has changed since I wrote that but the sentiment remains the same. What I have described of our colleagues in CCU and on the wards shows this is the case, as they do what they do for many reasons but a love of the job, their teammates and the welfare of their patients lies at the heart of it. This applies to all of us whether we are in CCU or in a Care Home or a non-clinical role, like mine.
The end is in sight. Numbers are falling, our vaccination programme is progressing beyond expectations and there is real hope of a return to some form of normality in the months ahead. In the meantime please look after yourselves and each other, be kinder than necessary, and thank you for all that you are doing.
Ken Donaldson is Board Medical Director at NHS Dumfries and Galloway
No-one in Dumfries and Galloway is blind to its beauty.
To pay homage to probably my favourite Prime Minister to date (Hugh Grant in Love Actually, obviously), our region may be small, but we are great.
And how grateful we are, that during the pandemic, when travel has been restricted, that we live and work in a place as beautiful as this.
Yet the very nature of our unequivocal greatness, comes great tribulations.
The region, in particular the west, has its own challenges just now. However, despite a wide and flourishing region, comes the contrast of urban living in the east compared with the vast rurality extending far west, to Newton Stewart, the Southern Machars, Straraer, Drummore, our most southerly point, and everything in between.
Like the east of the region, the West is blessed with beauty; picturesque villages and idyllic beaches, yet the treasures often seem to be hidden to anyone outside the Toon. Consequently, services, agencies and communities have been forever swimming against the tide; working tirelessly to provide services that our communities deserve while often running at a fraction of the capacity.
But what we lack in bums on seats, we make up for in resilience and enthusiasm – in bucket loads. Because without it, I really don’t know where we would be – or where the children and families of Wigtownshire would be. It is only through commitment, compassion and care for the families on our caseloads, that we have got this far.
The new-year has continues to throw challenges to everyone across the region, and the Wigtownshire teams are no exception. Like many, continuing to deliver services during a pandemic, manage our own anxieties, organising our families, can be an uphill battle.
The Health visiting team in Stranraer need a mention here – and it is not to discredit any of the other teams across the region; this team have worked at a significantly reduced capacity for a number of years. But despite this, with fantastic support from the wider HVAP (Health visiting assistant practitioner) and Newton Stewart HV team, they have continued to deliver health visiting services to the town’s community, as well as committing to training student health visitors, and supporting pre-registration student nurses.
A heath visitor said recently, “we’ve just got used to it” – and it would be easy to think the future looks bleak – bleaker than Emma Thompson’s face when she unwraps the Joni Mitchell CD. But we no longer need to get used to it. Despite all the challenges we face in 2021, this is the year of hope and expectation.
We have lots to celebrate; new life, new-year, new vaccines, new hope, new teams.
2021 brings new health visitors to the west; Russell and Alison, both who have very definitely been courted by the loveliness of Dumfries & Galloway, and we welcome them with open arms. In, addition, we also welcome Karin and Harriet, coming to the end of their HV training, and who will continue to work within Wigtownshire, and complete our teams.
2120 is a celebration of what we have and what is to come.
A celebration of the resilience and aptitude to still shine when the going gets tough and the pressure is on. And it has been tough for a long time. Even without Covid.
Health visiting services across the region have not stopped during Covid lockdown, but have continued to use creative ways to connect and provide support with families – and all the HV teams have seen first-hand the impact of covid on our communities.
But we rise in the face of adversity, and are now rewarded for our patience.
Our teams in the west are strong, our commitment unwavering, deserving of renewed hope. Deserving of our Christmas angels who have landed to complete the team. The people of Wigtownshire deserve this; deserve to have teams that are fully equipped to meet their needs, and staff that are happy and well.
Wigtownshire is thriving; health visitors and school nurses provide the bedrock of early interventions that support families and reduce inequalities, by creating ambitious, prosperous and confident people who can achieve their potential. Without these services, inequalities would widen, opportunities would be fewer, and our society would suffer.
But the people of Wigtownshire wont let that happen.
This is a new year, and a new us.
Kerry Ellis is a Senior Charge Nurse for Health Visiting & School Nursing (Wigtownshire & Stewartry) for NHS D&G
Unless you have been avoiding social media, local press, your emails and possibly your payslip recently I am hoping that you have seen an email, advert or poster about engaging in the process of developing the next Dumfries and Galloway Integration Joint Board Strategic Commissioning Plan for Health and Adult Social Care (SCP). To date, we have shared this information with over 6000 people, organisations, groups and teams within Dumfries and Galloway.
My name is Liz Forsyth and I am the Programme Manager co-ordinating the development of the SCP and also the person responsible for the any cross posting and repetition of requests for you to ‘Join the Conversation’. I’m happy to report that, despite the need to adopt a virtual approach to engagement due to Covid-19 lots of people have already taken part in the development of the next SCP for Dumfries and Galloway.
Whilst addressing the challenges of and recovery from the Covid-19 pandemic is a priority for all Health and Social Care Partnerships in Scotland, it is vital that, we also continue to work together to identify health and social care and support needs in the future and plan to make provision for these.
The SCP is a document that is relevant to everyone. It supports the Dumfries and Galloway Health and Social Care Partnership to deliver better outcomes for the people who access care and support, their families, friends and Carers, communities, health and social care professionals and all of the organisations in all of the different sectors that deliver health and social care and support.
The Integration Joint Board SCP for Dumfries and Galloway is a document that
states the vision and strategic direction for health and social care and support in the region
describes the model within which health and social care and support will be delivered
identifies the strategic priorities for the IJB over the life of the SCP through a set of strategic commissioning intentions
identifies the tactical priorities beneath each of the commissioning intentions and
identifies key, high level actions that will be taken to deliver these
The SCP will include details of resources and how these will be prioritised and used to address the challenges we face in the provision of health and social care and support that is sustainable into the future. This includes changing demographics, workforce, finance and performance, as well as those presented by the Covid-19 pandemic.
There can be no one better placed than the people who use and deliver health, care and support to help to develop the next SCP, to ensure it meets their needs…. your views matter and are really important!
So what have people been telling us so far?
The feedback we have had so far has highlighted some common themes. Do any of these resonate with you? What would you like to add?
The clock is ticking, so if you have not already done so, please read the consultation document (see link below) ‘join the conversation’ and tell us what you think. We record and consider every comment or suggestion we receive so believe me when I tell you it matters.
You can complete the survey as an individual or as a team/group. We have extended the deadline for the engagement to midnight on the 31st of January to provide more opportunities to get involved.
The feedback that we receive from people through this period of engagement will shape and influence the SCP as it develops. A draft of the full SCP will be made available for consultation in the spring of 2021.
Liz Forsyth is Strategic Planning Programme Manager for NHS Dumfries and Galloway
On World Kindness Day I posted a blog about how we need to be kinder to ourselves. Here I am, back again, to talk about other things we do to keep ourselves well. As part of my work at the Organisational Development and Learning (ODL) Team we have focussed on supporting health and social care staff wellbeing over the winter months. Recently we have given a lot of thought to the things we can do to recharge our batteries and subsequently keep ourselves well.
The self-care battery
The concept of keeping your batteries charged may be a familiar one. The idea is that certain things that happen in our everyday life consumes our physical and mental energy (Hayman, 2018). These may be things like work commitments, lack of sleep or even domestic tasks. Unfortunately, there is often no avoiding these. If we continue to run low on energy it can have a significant impact on our health and wellbeing. We are more likely to experience burn out, changes in sleeping patterns, headaches, muscle pains and reduced efficiency of our immune systems making us more prone to illnesses (Smith, Segal and Robinson, 2020). Yet all is not lost, we can recharge ourselves.
We can recharge ourselves by building up a variety of activities to engage in when we start to feel like we are running low on energy. These activities will be ones that we know help us to feel more energised such as reading, a bubble bath or arts and crafts. As we have entered a New Year it feels like the perfect time to really consider our own wellbeing needs and start building up a library of things that we can do to recharge our batteries and reduce the risk of us becoming unwell.
Recharging your batteries
So, what are the things I recognise that deplete my own battery and what activities do I do to recharge? Well my battery often feels depleted. This is usually due to working too much, studying too much, lack of sleep and drinking mainly caffeine. You would think by noticing I would be able to put time aside to re-energise but that is not always the case. I find it too easy to continue running on amber or red. Like I said in my last blog, these are the times that I find myself in a bathroom stall weeping at cowboy hatted pigs.
Yet, the past few months I have took the time to step back, to recharge by doing things I know help to keep me well. One of my favourite recharging activities is being out amidst nature or visiting new and unfamiliar outdoor spaces. This always make me feel calmer, less overwhelmed, helping me to put things back into perspective by filling me with gratitude.
I absolutely love nothing more as an energy boost than seeing live music, having a sing-along and a good boogie. As this is not happening at the moment, I have instead put together a playlist of all the songs that make me feel happy. I turn on my speaker and play them full blast. Another thing that works wonders for me is laughter. When I feel a bit low on energy, I seek out laughter like a bloodhound. It perks me back up. If I struggle to find it in the everyday, I will revisit old TV programmes that I know make me laugh until my stomach hurts. These are just a few things that I do to recharge my battery, replenishing my energy.
Sharing our battery charging stories
Given the challenges we faced last year, things that we used to do to reenergise might no longer be easy to do. Especially social ways of recharging such as seeing friends and/or family or my beloved concerts. Therefore, we need to consider new ways to keep ourselves well.
To support this, throughout January we want to create a digital photo quilt. This will include images of all the things we do to recharge. By sharing stories through the quilt, we can support each other to consider new ways of doing. We can help each other build up our charging supplies and learn what works for us when our batteries need a little oomph!
So, lets support and encourage each other to keep ourselves well this New Year. Please share with us what it is that you do to recharge your batteries?
If you wish to contribute to our photo quilt, please send your images (like the ones above) to firstname.lastname@example.org and/or share them on Twitter using the hashtags #RechargeMyBattery #WellbeingDG #Ontheground.
Sarah Geidesz is a Student Occupational Therapist at Edinburgh Napier University
Part 1- Forming to Storming A new team a new start…again.
Hello, and welcome to part 1 of my Team Work Blog.
My name is Ali Howie and I work as Team Lead (West) in MSK Physiotherapy based at the Galloway Community Hospital. I have worked in healthcare for 27years and wow what a journey it’s been, never more so than in 2020.
I have had the opportunity to work in a variety of teams in a variety of Health Boards and business’. Every team and every outcome has been different. But when everything comes together and you achieve your goal, there really is no greater feeling, of achieving something as a group. The lift you get is euphoric, and being able to enjoy that lovely phase of Adjournment, when we can congratulate ourselves, and look back on our journey with a smile, and a feeling of achievement and pride.
Unfortunately, that feeling is not always guaranteed, and there have been many times when the team never performs or reaches its potential. There are various reasons for this which we shall explore in this Blog series. Within Health and Social care, particularly at this time, new teams and new goals are being established. There are a lot of services which are pressing the restart button and maybe, hopefully, looking to redesign our services. The rules have changed with COVID. This means New Teams are forming, and the journey of team development begins.
The one thing I feel is at the heart of good healthcare is Team work, and I truly believe that ‘Team work can make the dream work’. The phrase is attributed to an American- John Maxwell, and is often used but rarely achieved.
He said “Teamwork makes the dream work, but a vision becomes a nightmare when a leader has a big dream and a bad team”.
If we can’t work as a team to provide safe and effective healthcare at a time of need, then we don’t score a goal, and often head home defeated. Worst case scenario, someone gets hurt and patient safety is compromised. Sometimes we have a bad day, but if the team isn’t performing, we have to find out why?
In health and social care we don’t often have the luxury of setting up a completely new team with all the right skills and dynamics. More often we work on upskilling and developing a team to perform. Barriers to team development, such as loss of staff (retirement, maternity leave, new jobs, long term illness, secondment), lack of training opportunities, time restraints, poor strategy and leadership. All these can stop a team from developing, as they don’t work together long enough to reach the performance phase. But, there is lots we can do to make things work.
In 1965 the Psychologist Bruce Tuckman coined the phrase “forming, storming, norming and performing” … describing the 4 phases of team development, and later added the fifth stage of “Adjourning”. This model of how teams develop, is widely used, and follows the stages of development. The goal being to get to the performance stage where a team can work independently and achieve their tasks. A highly efficient team can almost run on its own but still needs to go through the stages to achieve this. How long it takes can vary depending on a number of factors.
In all services not least health and social care, this model can be seen over and over again in all the Teams working simultaneously, 24/7, 365days a year to provide health and social care to our population.
So why am I sharing this with you and writing this blog?
Well, I have recently joined a new team –by being part of the NES nMAHPs digital Leadership course. I am learning leadership skills in the context of digital innovation, and looking at how digital technology can enhance our healthcare systems and efficiencies. The project for this course is to integrate MORSE into MSK Physiotherapy practice. This involved setting up/forming a Super User Team working closely with IT- forming -which is where the Blog comes in.
Will we achieve our team goal of Morse Implementation?
And What will myself and the Team learn along the way?
As part of my course I have to challenge myself to try new ways of sharing information and communicate my learning to the teams I am part of. Writing a blog was one way, I felt I could communicate what I was leaning, to everyone working in D&G. So after much pondering, procrastination and delays (as I am very nervous about writing this) I decided to do a 3-part piece on Team work.
I truly feel it is the most important part of what we do. Particularly in these challenging but exciting times of change on the back of COVID 2020.
I have always loved Team Sports, and in my younger days, was always playing Hockey, like football there are 11 players and a ball with the addition of sticks. There are rules, time limits, penalties and everyone on the pitch has a specific positon or job. If you are not into hockey think of it like football, the beautiful game.
Working in a team in the NHS is just the same as being part of a sports team and it’s a good way of demonstrating how teams work and perform. Refer back to Tuckman’s Model.
Stage 1- Forming: A new team.
When we have a new team it generally begins life in the forming stage. For my Journey I felt a little like someone had packed my suitcase and bought tickets and given me them and off to the airport- not really sure what I was doing where I was going or why I needed half the things in the bag… So initially trying to figure out the purpose of the team was key. You always get a little worried about how well you will gel with the other members of the Team. Keeping an open, positive attitude is really important here. Assumptions and your ladder of inference can impact your initial relationships and perceptions, and be a barrier to progress.
Make sure you Know or have an idea of what the Goal/Purpose of your team is. If we don’t know where we are going, how can we plan the route? So spending time meeting the team and trying to see who has what skills and what skills we needed took a while…On reflection pre planning and more information would have been better but we formed and eventually after discussion decided on task.
Purpose: To implement Morse use in MSK Physiotherapy practice to improve patient safety by real time information sharing.
Stage 2: Storming
Sometimes it is very difficult to get past this stage. Being open honest and learning to trust each other is a key factor here. Understanding each other’s skills and attributes and how these will help achieve the goals/task in hand is crucial. If the Team can’t agree and unite then they can’t move forward. I know in the past, projects have fallen here, as no one takes the steering wheel. If no one is quite sure what is happening and what their roles are. They don’t know who they can trust, and the loud annoying person is rubbing everyone up the wrong way. No one says anything, and the Team Captain does not seem sure of themselves. It turns out that everyone is confused. As the initial stage develop it also turns out that there is very little variation in the team, everyone seems to want to be in charge but no one wants to do the work!!
Luckily for me with this new team there was generally a good variation of personalities and skills. There was a lot of resistance to the task initially, and criticism of the process, which was expected and at this stage good points were highlighted about clarity of communication. It was productive allowing everyone an opportunity to speak and not avoid conflict or disagreement. Ideas come from discussion that is open and honest not closed and narrow. Some members are much quieter, and took time to make their voices heard, as often an extrovert can put an introvert off from being open. This is something I think worked well by allowing and encouraging everyone to have their point of view. So this stage has taken a little longer than I would have hoped, especially with travel restrictions and restart of services. Time is often the most difficult resource to manage, being patient is a key trait as there is no definite timeframe for people to form and Norm. But norming was fast approaching thanks to a number of TEAMS meetings, emails and communication between the Team. Getting to know your team mates is really important.
So after 4 months since initial start of this new Team, we are almost in Norming stages.
Going back to the football analogy I mentioned earlier, I thought it would be fun to think of the scenario of a new football team … Luce United, and think of its relevance to the team/s you/we are part of!!
Here’s a wee story about a Team, A new Team, A football Team – Luce FC. Chapter 1:
Team Development: Luce United (stage 1 and 2)
Luce United have been set up by a group of friends who have recently retired. They had always dreamed of owning a football club and one of the syndicate’s Uncle Sani used to be a football manger- they ask him to set it up and gave him a blank cheque!
Uncle Sani’s been out the game for a couple of years “but nothing much will have changed” he thinks. l’ll call the contacts and get things going, no problem. 3 months later Sani turns up to the stadium and waits to welcome his new team to the first training session.
Eventually 25 men of varying sizes, shapes, ages and nationality turn up. Sani’s’’ friend Jim was a coach with one of the big teams back in the day ( Jaggy Thistle FC), so he had arranged everything and assured Sani it was all in Hand.
5 of the players could not speak English, 3 were injured, 3 had holidays booked so could not stay for the whole session, and no one liked the strip, no one had received the training plan or fixture list and they didn’t know what league they were to play in. Everyone knew of Jim through friends and a couple of them had played together years ago.
After some introductions, it transpired that Jim had signed 3 Goalies, 6 strikers and no Backs or sweepers. So they didn’t have all the skills they needed to play. There was a match arranged for 1 week’s time and half the team were on Holiday and the Manger had also booked a trip away. No one was willing to compromise and cancel their trip and they ran out of time so didn’t make any plans for the next session.
At least they all knew how to play football and all had experience, there was enough players for a team and reserves but they needed to work together to decide who was doing what positions, what training they needed and a proper training schedule.
The following Thursday a second training session was held. 3 folks had not turned up they said it was a shambles, and did not want involved. Some of the players said they should be captain and would sort it out.
What a disaster.
How can Luce United come back to become a Team that will be able to perform.?
Where do you go from here? Luce FC is definitely not off to a good start!
Every team needs a leader to steer the journey, they may not make all the decisions but they need some form of direction. This group had none and when that happens in health an social care it can go badly wrong and at worst end up in patient safety being compromised.
The Tuckman/Leadership model shows how directing and coaching are required in these initial stages to influence the development of the team. Sometimes members of the Team don’t want to be there, it lowers morale and prevents the team being able to rely on each other or develop trust. Negativity and conflict don’t help but regular review and discussion do. We need to ask why teams are not working and constantly review our process’ to improve our understanding of each other. If there is no goalie in the team (a key role) that’s a major problem. This happens a lot in healthcare, where someone in the team is lost or off and is not replaced. The inevitable result will be an own goal or a defeat. Morale becomes low as there is a skills gap, not everyone steps up to help out, mood drops and the established performing team regresses. This can be particularly quick if the team was not performing well before the loss.
I know from my experience in my current journey, understanding the role and complexities of the IT Team has been the most challenging part. There was a large skills and knowledge gap on our part and lack of understanding of the process of coding and digital writing. Once we established a language and translation process we were able to move forward. But new skills take time to acquire. Being patient and recognising your training needs has been a big aspect of our initial stage of development.
We have also lost a couple of team members, so having a slightly larger team to start was beneficial, as we have been able to continue without having to recruit any new members and are still moving forward. In any team it’s important to have flexible skills so not only 1 person is responsible for 1 task, then any loses will not jeopardise the project.
If we look again at Tuckman’s Model, we can try and relate to the initial stages of team development.
What will happen to Luce United?? What will happen with our Morse project??
So after reading part one, I hope you will take some time to reflect about your team and yourself. If you feel your team is not performing, think about the football team – where do you see the problems? and most importantly what are the solutions?? Write them down and bring them up at your next meeting or share your thoughts with a member of the team or team lead. If you are performing, take time to celebrate, congratulate and appreciate the feeling of being part of something that’s fun, effective and gives you a buzz. Share your tips with your networks and influence positive team work within the organisation.
Reflecting without taking action will have no impact on performance.
We can’t control all aspects of a team, staff move on, equipment changes and technology improves but ultimately we need to know what our teams purpose is, what our role is in the team, have the skills to fulfil our role and be able to be flexible and understand everyone else’s roles in the team, so we can fill in, support and cover. Open and honest communication and knowing who is in our team is vital for initial success.
Embrace your Team and although there is no I in team there is a me, and great team work does make the dream work.
Have a very very Merry Christmas and Happy New Year although it won’t be our usual parties with hugs and kisses. But we can wait till next year and keep in mind the need to keep everyone safe and avoid unnecessary risk.
See you in January for Part 2…What will Luce United be up to in 2021?
Alison Howie is MSK PhysiotherapyTeam Lead (West) at Galloway Community Hospital for NHS Dumfries and Galloway
The Covid-19 pandemic has been a huge challenge to health services across the board – the Community Midwifery service has been no different. During this time we were aiming to keep pregnant women safe, provide all necessary contacts with women and families (whilst decreasing any potential exposure to Covid 19), to ensure that all pregnant women receive all the maternity care they require. We have also been continuing to implement The Scottish Government “Best Start 5 year plan” – with particular emphasis on improving the continuity of care women receive during pregnancy, improve access to antenatal education, increase breastfeeding outcomes and give some choice about place of birth.
“During the review of maternity and neonatal services, women and midwives both expressed a desire for greater continuity of carer to improve relationships. In addition, evidence shows that midwifery continuity of carer models have proven benefits in terms of improved outcomes for women and babies. These include a potential reduction in preterm birth and miscarriages, a reduction in medical interventions during birth and an increase in natural births. The benefits for midwives include improved relationships with the women they care for, increased autonomy and increased job satisfaction.” – Scottish Government (2019).
In essence this means that we know women have better experience and better outcomes when they have a known care provider during pregnancy and labour. This makes it a top priority when we are re-structuring our service.
Planning for a community midwife to be present at the birth of a woman on their caseload is no easy task – if only births were predictable this is something we would have all our staff working towards. When this is in a home birth situation it involves an on-call commitment which covers a 4 week period. During this time 2 midwives must be on-call and for us that involves staff from across the region. The reason for this is that we cover a vast rural area. Women are made aware that some members of staff may need to travel therefore they should give us as much notice as possible when they go into labour. Women give birth at all times of the day and night, but a home birth is only safe when they reach full term – this is classed as being beyond 37 weeks gestation but as lots of women know only too well this can stretch out to 2 weeks beyond the magic due date. Having said all of that when all goes to plan it can be a wonderful experience for all involved.
In the early period of the pandemic we had concern about how our NHS would cope with the “worst case scenario” predictions – it was something none of us had seriously contemplated before – what if we had no beds in a labour ward, what if we have no staff to provide the care for a woman in labour. The only thing which was clear from the outset was that we had to do all we could to ensure that the place which must always have staff was the labour ward. A labour ward has a completely unpredictable workload and schedule, as all women know labour is a completely unpredictable event. The homebirth service “naturally” felt like something we could suspend, and instead the community teams from across the region provided on-call support for our acute colleagues, ensuring that care for women in labour, by a skilled practitioner was achievable.
As more information became available during the pandemic and the staffing situation became more stable we began to look at the possibility of restarting our home birth service. As a management team we looked at what changes we might need to make to keep both families and staff safe. From July we again started to provide the home birth service region-wide.
The reasons why a woman may wish to opt for a homebirth are numerous. Research shows that the home-birth is safe for “low risk” women. They can feel more relaxed in their own comfortable surroundings, which in turn makes the hormones required for labour flow better. They don’t need to worry about travelling to hospital which will reduce the stress hormones and lessen the chances of labour stopping, which in turn lessens the chances of interventions happening. However, it is a big decision for some women, particularly the further away from a hospital setting that they live.
Gemma who lives in Wigtownshire requested a home birth early on in her pregnancy so we were delighted that this would now be possible. This was her second child and she wanted to deliver at home in a birthing pool. Gemma, her husband Guy and their midwife Lynne worked together to ensure that everything was in place and the community midwifery team worked together to provide 24/7 on call cover to ensure that this could happen. On Saturday the 17th of October Gemma went into labour at home and delivered baby Ciana with the support of her midwife Lynne. Ciana’s big brother Enzo woke in the morning to find that his little sister had arrived.
It feels like a good point to hear some words from the people in this relationship.
Being pregnant throughout a global pandemic was different. It was a very lonely time for people at best but going through the ups and downs of pregnancy without having family and friends to share it with was hard and I felt for all the women out there going through it too.
Living in Stranraer it was an hour and a half drive away from our hospital in Dumfries. So having a homebirth was the simpler option for us, of course we were concerned if something was to go wrong, time wouldn’t be on our side but Lynne and the other midwives were able to explain any worries that I had, they were prepared for just about everything too. They brought everything they would have needed up to my house a few weeks before I was due. I wanted a homebirth with my first and ended up getting what I felt was an unnecessary induction. It was a very negative experience which ended in an episiotomy. I was so groggy due to all the drugs and the long drive home after left much to be desired. It wasn’t the euphoric experience I had hoped for and I didn’t want to go through the same again.
I had a smooth pregnancy, and was praying I didn’t go too far over my due date. I was determined not to have a second induction.
At 40 weeks 1 day, Lynne had me booked for a stretch and sweep. I wasn’t holding out much hope though, I had a few with my first and he didn’t budge.
Throughout the day I was having these twinges but they didn’t really feel like anything.
I messaged Lynne that evening and told her it was probably nothing and she said to go for a bath and relax.
10pm – Lying in bed I was starting to get twinges so I put my timer on my hypno-birthing app. They were every 7 minutes for about a minute long. I was breathing through them but they were completely bearable. Then one really strong surge came that made me grab the headboard and POP! My waters broke! this was around 11pm, I instantly started shivering, I called Lynne and she said she was on her way from her home which is about a half hour drive. Lynne arrived and I was happy for her to check me and she said I was 4/5cm but could be stretched to 6. I was using my hypo-birthing app to help me concentrate on breathing through my surges. The second midwife Hillary had came in at some point and she was lovely too.
About 1am I was feeling a lot of pressure. Lynne told me to go do a pee and see if that would make some space for baby’s head to come down, I got a massive surge when sitting on the toilet and she encouraged me to get in the pool as she thought I was close. The pool was amazing, the gas was amazing. This was next level. After about 10 minutes enjoying the bliss 😂 I leaned over the pool and felt an urge to push. From what I remember I didn’t push for long 3, maybe 4 surges. Second last surge was the oddest sensation and actually panicked me a bit. Everyone reminded me not to panic and I reached down and felt the top of baby’s head. I gave another push and thought ok that’s baby’s head out now.
1:36am I eagerly waited on the next surge to come and when it did I pushed my baby out and pulled her up to my chest. It was the most surreal moment of my life. I was so happy and smiling from ear to ear.
I had skin to skin then went into my own bath, cuddled up on my own sofa and had my own tea. The midwives stayed for a bit, did their checks and left us in our own little bubble.
Best part was my little boy waking up, running into our room in the morning and meeting his little sister.
Having Lynne throughout my whole pregnancy and birth was so important and special to me. She knew about the birth I wanted so when I was in labour she could help me in the best way possible. I trusted her and she kept me calm and guided me through my labour. I could not have asked for a better experience.
Midwife Lynne Ritchie:
As midwives we feel really privileged and it gives us great job satisfaction to be present at the birth of a baby. The experience I had with Gemma and her family was lovely. Continuity of care allowed me to form a really good relationship with Gemma and get to know her, her fiancé Guy and their son Enzo. I saw her at the clinic for her appointments and was able to discuss parent craft and understand her wishes and expectations really well. I was excited when Gemma decided she would like a home birth. Gemma wanted the use of a pool at home. A homebirth assessment was carried out and everything was put in place. Care in labour and birth is more challenging as it is not easily scheduled! As I only work 22.5hours a week I was concerned that I wouldn’t be present at the birth. Fortunately, I was lucky enough to be oncall and at the delivery which was lovely and relaxed. Gemma and Guy were delighted to have the birth she hoped to have in the pool at home. I think this illustrates how much we try to provide individualised patient centred care with very positive results.
The morning after Gemma’s home birth I got a text from Lynne. She was delighted and excited to report that the home birth had been a beautiful experience; the experience that she and her patient planned together, a patient whom she had grown to know well, and had helped to achieve her “perfect birth story”. At the end of the day as midwives that is our business. As we move towards full implementation of the Government Best Start 5 year Plan for Maternity Services, we really hope that this is a scenario we will be able to see replicated for Women and Midwives across our region.
Jenny Rendall is a Senior Charge Midwife for the Community West Team at NHS Dumfries and Galloway