Leadership in a digital world by @dtbarron

Over the past few weeks, because of various activities I’ve been involved in, I have been considering leadership within a digital environment, specifically related to social media. derek1

Instantly two questions spring to mind 1) what do I mean by leadership? and 2) what is social media?


Malby in 1997 described leadership as “an interpersonal relationship of influence, the product of personal character rather than mere occupation of managerial positions”.   Bennis and Nanus add to this by described leadership as ‘influencing and guiding’ as having a ‘future focus’, a ‘vision for the future’ while remaining in the present.

The key aspects that interest me in relation to digital and social media leadership is the ‘interpersonal relationship’ and ‘influencing/guiding’ components of these descriptions.  To me they are key in my own engagement with social media, my own role as a leader.

Social Media

So, what is social media – it’s those FaceBook and Twitter things isn’t it, celebrity gossip and nonsense about what someone is having for their dinner?  Yes, these two systems are part of the social media landscape, and yes there are celebrities on them – however it’s so much more than that.  Perhaps you haven’t consider that the very act of reading this blog means you are engaged with social media albeit it in what can be described as a more traditional approach to it.

Social media is an overarching term describing a wide range of ‘platforms’ that enable people to interact with one another:

derek2  The infographic (www.fredcavazz.net) visually helps to describe the core aspects of social media.  NB the 2013 version of the infographic has been simplified into four categories, follow the link if you want to see the 2013 version.

The infographic shows clearly that social media has multiple uses and multiple systems to use depending on what it is you want to achieve, who you want to engage with and who you want to share your message with.

In this blog I only want to focus on one platform – Twitter and share why I use it.

Some stats

80% of the UK population access the internet on a regular basis

60% of the UK population have a smartphone

The sixth most used app on a smartphone is – the phone: behind SMS, camera, Twitter, Facebook and internet browsing.

These stats simply demonstrate we are living in a changing world, the landscape around us is a dynamic place where people are doing things differently, where engagement happens in ‘new’ ways.  We have a choice embrace these developing networks as leaders or be left behind.  To be honest, I know some people who are very happy to be left behind – is that you?  If it is, don’t worry social media isn’t for everyone, we went through the same ‘pain’ with email and some still don’t see the need for it – to be fair, why would they when we’ve still got pigeons?


derek3  From my personal perspective I use a variety of social media platforms to engage with a wider community – Twitter, Google+ (struggle to understand it), WordPress (use it frequently), About.me (use it but not sure the point of it), Tumblr (just started to use it), LinkedIn (got it, but not sure why), Instagram (got it, seems pointless), Vine (too old to understand it or find a reason to use it) and even have a Facebook account (only post my blog to it – I’m not a fan!).  Some of them I don’t really understand and only have them because I’m curious what they do, others I use more frequently to share and shape opinion, to listen to the views of other healthcare professionals as well as people using our services.

My most used medium is Twitter which is a key engagement tool for me in sharing with a much wider community than I could every have hoped to do by ‘traditional’ means.  At an event I was at last week #techlearnscot @jonbolton used a quote from Douglas Adam’s  Hitchikers Guide to the Galaxy

 “I’ve come up with a set of rules that describe our reactions to technologies:

1. Anything that is in the world when you’re born is normal and ordinary and is just a natural part of the way the world works.

2. Anything that’s invented between when you’re fifteen and thirty-five is new and exciting and revolutionary and you can probably get a career in it.

3. Anything invented after you’re thirty-five is against the natural order of things.”

 We are all aware of the age profile of NHS Scotland (indeed Scotland as a whole) – perhaps Adam’s explanation helps us understand why I’m often told “I don’t do Twitter”  as it’s obviously against the natural order.  In fairness, since 35 was a long time ago for me, it might also explain why I don’t really understand some of the other social media systems I mentioned above.

I’ve been on Twitter for two years, the first six/eight months I didn’t tweet and only looked at it perhaps once a day or once every couple of days.  I now use it daily, I enjoy engaging with a wide network of people from across the world.  I get to share events as they occur and help to influence thinking of others, while also being influenced.

A key use for me is to access contemporary information, research and academic papers.  The fascinating thing for me is, as I now follow people who have similar interest e.g. mental health or leadership, I have information that is of interest ‘pushed’ to me, I don’t always need to go looking for it.  However it also widens my interests by having information ‘pushed’ to me that I ordinarily wouldn’t go looking for, simply being on Twitter has expanded my interests and knowledge.

Most of our conferences and events across NHS Scotland have twitter #tags, this allows me an insight into what is happening elsewhere when I am unable to attend.  I enjoy being influenced and challenged in my thinking, often tweets from conferences contain simple reminders of why I am a nurse – I never get tired of refreshing my commitment.


Traditional hierarchies do not exist in the same way within the social media environment, access to people who you would not ordinarily have contact with are open to anyone (I blogged previously on this topic).  We work in a system that aims to be more transparent, to be more approachable to ensure we have people at the very centre of care.  Twitter is one more medium through which we can listen to the views of others – those using services, colleagues and the wider healthcare world.  Our new Director General and Chief Executive of NHS Scotland is on Twitter (@pag1962) why not open an account and connect with him today?

Quick tips

Open an account (free) add a picture and a short biography (my advice for those who are professionals is to identify yourself as a professional).

Find someone you know is on Twitter and look through who they are following – if anyone they are following is of interest then you simply follow them as well.

Check it once a day, just have a look, no need to tweet anything.  Retweet something that interested you, only once you feel comfortable do you actually need to tweet something original.

Enjoy it – and if you find you are not enjoying the interaction and the engagement, then simply stop.  At the very least you’ll have empirical evidence of why its not for you and not simply because your over thirty five! (NB youngster <35yrs can ignore the last statement).

Some suggestions to get you started:

  •  @kendonaldson
  • @hazelNMAHPDir
  • @personcntrd_DG
  • @jeffAce3
  • @davidTheMains
  • @weemac63
  • @dghealth
  • @ayrshirehealth
  • and of course my own Twitter account @dtbarron

A final thought – does anyone know what the sixth most used app on a smartphone is?  Tweet me for the answer – hope to see you on Twitter in the near future.

Derek Barron is an Associate Nurse Director in Mental Health at NHS Ayrshire and Arran. he is also the Editor-in-Chief of our sister (?brother) blog @ayrshirehealth

We choose to go to the Moon by @kendonaldson

John_F_Kennedy_Official_PortraitI’ve always held a deep fascination for John F Kennedy which is partly down to my Mother, who greatly admired him and spoke of him often when I was a child and the tragedy of his early death. As today marks the 50th anniversary of his assassination I thought I would put together a blog in his honour.

Kennedy has been described as one of the most gifted orators of modern times. He was appealing partly due to his youth, good looks and wealth but also in his ability to tap into the optimistic spirit of the age. He was also extremely lucky to have a dedicated team behind which included the great speech writer Ted Sorensen. For this blog I have chosen 3 great quotes from 3 great speeches and I want explore how they can influence those of us who work in healthcare today. If you wish to watch him deliver the whole speech then click on the quote.

And so, my fellow Americans: ask not what your country can do for you – ask what you can do for your country.”

This great rallying call to the American Nation was part of Kennedys inaugural address on Friday 20th January 1961. Don’t just sit back and wait for things to happen to and for you, get up, start ‘doing’ and make a difference.  In this age of fiscal austerity working in a publicly funded body like the NHS can be tough but its up to us, the workers, to make that difference. We are all capable of making small changes, measuring the effect and, ultimately, improving how we deliver care. Ask yourselves “Is this the best for my patients? Whose needs are being met?” If the answers are’ No’, and ‘The Systems’ then start changing. In the words of my ex-colleague…Just Do It.

“We choose to go to the Moon in this decade and do the other things – not because they are easy but because they are haaard!”

kennedy-moonThese words (deliberately misspelt as thats how he spoke) were spoken at Rice University on 12th September 1962 as he lay down the challenge that ultimately put man on the moon in 1969. He spoke at length in a sweltering heat but famously never lost his cool. This quote also reminds me of one by Tom Hanks in the film A League of Their Own. He is a baseball coach and when his best player decides to leave because “It just got too hard” his response is “It’s supposed to be hard. If it wasn’t hard, everyone would do it. The hard….is what makes it great.”

So how does this relate to those of us who work in healthcare? Well, I don’t know about the rest of you reading this, but for me some days can be really hard. Whether it is just volume of work, a particularly troubling patient or trying to fill a shift at short notice, it can be exhausting. Working in any public service can be challenging but when the service users are sick, lonely and scared then the pressure really mounts. But so do the rewards when we get it right. The small acts of kindness that make all the difference, that prove that we really do care. The ‘thank you’ that you can tell is truly heartfelt. Yes, it is hard, but that is what makes it great.

“For in the final analysis, our most common link is that we all inhabit this small planet. We all breathe the same air. We all cherish our children’s futures. And we are all mortal.”

These fine words were part of his American University Speech titled A Strategy of Peace on June 10th 1963. Following on from the Cuban Missile crisis in October 1962 Kennedy was determined to improve relations with the Soviet Union to try and prevent a nuclear war. It is said Nikita Khrushchev was deeply moved by this speech and subsequently agreed to negotiations around reduction of nuclear weapons. It is fascinating to think what might have been if Kennedy hadn’t died 5 months later.

Forgive me but I think you can change the words ever so slightly to “…our most common link is that we are all employed by the same organisation. We all have the same goal, to provide the safest, most effective and person centred care for our patients. We all want our patients and staff to have the best possible experience. And we are all mortal.”

jfk1Yes, I do cringe a little as I read that but I do firmly believe it. If Kennedy and Khrushchev could work together then I think we should be able cast aside some of our more outdated attitudes and behaviours and ensure that we all work together in harmony.  Let us not just do ‘ok’. Let us not just do our best. Let us choose to go to the Moon.

Ken Donaldson is a Consultant Physician and Associate Medical Director at NHS Dumfries and Galloway

Ask yourself – “ is there a real difference…..with eHealth” by Graham Gault

I like painting. Which one of these paintings would you hang in your house?

 GG blog

 One is a PICASSO, the most expensive painting ever sold at auction ($136million) and one is by an “unnamed artist” and made for around £15.00.

The point is……..

  1. on one hand there is a real difference; one is by the most influential painter in our modern era, a very significant statement in art history, owned by the most wealthy family in America for 45 years, only viewable by the public for less than a year of its existence, said to have hidden insight about the painter’s life……but ….
  2. on the other hand, they comprise only of about £15.00 worth of materials, people will either love or hate it irrespective of the artist, and the value is what the highest bidder is prepared to pay.

So what do my views on art have to do with eHealth?

 “eHealth is better healthcare and a healthier life through digital technology”

Have a look at this short video to explain the idea……

click the logo> gg2 blog

Just as other technologies have revolutionised the way we manage our lives, eHealth has the potential to change how we manage our health care. Technology is part of daily life for most people. Now, one of the most important aspects of your life — your health — will also benefit from new information technology.

As we prepare to open a new District General Hospital in 2017 for the citizens of Dumfries & Galloway, eHealth is being implemented to improve service delivery through a series of innovations and developments.

What does this mean for our patients and staff? More importantly, why are we doing this?

……because we believe it brings real value and genuine improvements to the quality of clinical services and the patient experience.

  • All paper casenotes will be scanned and available on-line anywhere across our region. The hospital will operate as “paperless” offering simultaneous and immediate access to a more comprehensive medical record 24 hrs a day from any healthcare facility across our region.
  • The Electronic Health Record will have automatic updating of patient information from GP systems, remote hospitals (e.g., Golden Jubilee) and social work and will be communicated  in real time by all acute and community clinical  staff.
  • All X-ray and Lab diagnostic test requests will be ordered on-line which will streamline the process and speed up the reporting of clinical results.
  • A new ePrescribing  (medicines management) system will be implemented to optimise the management of patients’ drugs at point of hospital admission and discharge.
  • All areas of the new hospital will have strong wireless signal available offering both private/secure and public internet access. This will support clinical Unified Communication    (Mobile Voice/Messaging/Video) facilities as well as Internet based communications facilities for patients.
  • We will develop our TOPAS patient administration system to include ED (Emergency Dept) functionality which will streamline patient flows through our Combined Assessment Unit removing current communication difficulties with the Wards.
  • High speed broadband circuits will be installed to link our Community Hospitals allowing patients to treated in their local community with the same access to all eHealth systems as in the new hospital.
  • Check in kiosks, on-line check in, Internet booking service will be deployed to facilitate more convenient services for patients resulting in fewer patient DNAs and a more efficient service.
  • Video links will be available from every PC and mobile device and linked to the NHS National Video service allowing clinical and administration teams to communicate face to face with tertiary hospitals in the central belt reducing existing delays in paper communication.
  • Electronic whiteboards on all wards will display relevant patient status information and performance will provide “real time” key performance indicators to allow staff to manage workloads.


So, just as with art, everyone has a gut reaction to such technology, from the sceptics and technophobes to the gadget geeks.

The key difference with our eHealth plans is that everyone will require to embrace the new technological ways of working and over the next 3 years we have a great opportunity to develop the highest quality services to our patients in preparation for opening the doors on the most digitally advanced District General Hospital in Scotland.   



(General Manager – eHealth NHS Dumfries and Galloway)


What does work mean to you? by Vicky Widdowson

OT-Week-2013-lozengeThis week is Occupational Therapy week and with this brings a chance to promote our profession and raise awareness of the benefits of Occupational Therapy (OT).

 As Vocational Rehabilitation lead for our mental health Allied Health Professions (AHP) group I’m choosing to focus on employment.

 What does work mean to you?

 When asked this question it has to be said the first thought that comes to mind is the pay slip that lands on my desk every month.   But beyond this is the thought that while I’m here it’s a good feeling to make a difference along the way.  And out with work although I inevitably find the question of ‘so what do you do?’ is almost always followed by ‘what’s an occupational therapist?!’ I have to wonder what I would say if I didn’t have this job to talk about.  What we do for a living seems like such an important part of our culture I wonder how my clients who don’t work must cope with this question.

 As Occupational Therapists a person’s identity is core and so clients are asked about their work aspirations as part of initial contact.  It is also recognised that Allied Health Professionals play a central role in helping people to return to work and to manage their own health and wellbeing. 

 Within the mental health service work has been done to promote ‘asking the work question’, and with this challenging a perhaps traditional perspective that if people have a mental health condition it is unlikely they will work.

 I’m sure the likes of Ruby Wax, Stephen Fry or The Saturday’s Frankie Sanford would argue that it is indeed possible to make a living while experiencing mental health difficulties.  During my research on celebrities with mental health difficulties I smiled at a quote by Stephen Fry stating ‘1 in 4 people, like me, have a mental health problem.  Many more people have a problem with that.’

 However OT and work is not exclusive to mental health.  There is work across physical OT being done to promote employment, and encouragingly there is now joint working being completed to consider this agenda as a wider Dumfries and Galloway Allied Health Professions Group, based around delivery of the AHP National Delivery Plan.

 A development from this has been the promotion of an Allied Health Professions Advisory Fitness for Work Report.  This stems from a belief that people do not need to be 100% fit to engage with work, and it is a key goal of Allied Health Professionals to enable people to safely remain in or return to work wherever possible.

 How did you feel when you woke up this morning about coming to work?

         1= bad                                            10=good

 I’m sure very few honest people would answer a 10, and so why should we wait for our clients to feel 10/10 before encouraging them back to work?


At times however our clients need more than just encouragement to return to work; often they have a number of barriers to cross.  This is where AHP’s unique skills of assessing functional difficulties can be used to work alongside the client to come up with solutions that hopefully will enable a return to work.  The Fitness for Work Report is now an opportunity to record this information in a formal manner, which in itself can be beneficial and empowering for the client.  Over and above this it can also be shared with the GP and a client’s employer.

 In addition to this report, Occupational Therapist’s can use a range of tools to help clients stay in work, return to work or seek new employment.  This work is not always done alone however and often we work with a number of partnership agencies both mainstream and mental-health specific to enable a client to meet their vocational goals.

 It is also worth mentioning that not all of our client’s want to, or indeed are able to work.  I consider myself in a fortunate position within our service that we provide OT vocational input on the grounds that we see the right work as being beneficial to a person’s health and well-being.  A lot of our clients currently feel under pressure due to benefit reforms and mandates to attend work-related services.  We continue to work with clients that want to move forward because this is a goal related to their recovery.

 For those client’s who state work is not a priority, we continue to offer interventions for those who identify goals in relation to engaging in meaningful occupations involving their self-care, productivity and leisure.

 In summary I would hope to point out a few key points:

  • Good work is good for your health
  • OT’s play a central role in helping people to return to work and to manage their own health and wellbeing
  • OT’s also play a key role in helping people to move forward with non-employment focused occupational goals
  • Happy OT Week!!!!

OT Blog 2

 Occupational Therapy

Helping People to Live Life Their Way

Vicky Widdowson is a Specialist Occupational Therapist in Mental Health in NHSDumfries and Galloway

WHO CARES……. by Lindsay Sim & Sharron McGonigle

Who really cares about Carers?

 You might think the government care – after all they give Carers a weekly allowance of £59.75!

Carers Allowance is paid to someone looking after a person for over 35 hours per week which equates to the princely sum of £1.70 per hour – does this equate to caring for the Carers?

 ‘I feel invisible. The government expects Carers to work for 35 hours a week for £59.75. How does that fit into the minimum wage criteria that applies to the rest of the population?’

Glynis, a Carer, 48 years old.

 Some Carers care for more than 35 hours per week, if you average out the day at 12 hours waking time and 12 hours sleeping time, the hourly rate goes down to 71p per hour.

Would you apply for a job advert with an advertised hourly rate of 71p?

How can we begin to make Carers feel worthy and empowered when this is all our government are willing to pay them for their services?

 ‘I’m sickened that the government thinks my value is so low when actually Carers save the government billions.’

Elisabeth, a Carer, 58 years old.

 We all care about Carers don’t we? Are we sometimes too busy to ask the questions? – are you a Carer? – do you care for someone? Can we not find a spare minute to ask someone – Can you manage this at home?

 The Hospital Carers Support Project gives information, advice and support to Carers whom we identify within the hospital setting. This can include Carers bringing the cared for to a hospital appointment, Carers visiting the person they usually care for, Carers who are inpatient’s themselves or members of NHS staff combining paid employment with their caring role.

 How can we as Carers Support Coordinators work alongside NHS staff to focus on how important Carers are and how vital a referral to a Project such as ours is in helping them through their caring journey? We all deal with Carers of newborn children with disabilities, young wives with brain tumours, children diagnosed with Cystic Fibrosis, someone’s beloved Dad who has had a life altering stroke, young men left brain damaged after a serious car crash and the list goes on. Life changing events don’t just affect the patient, they affect everyone around them. Every illness and disability, no matter how different is connected by one vital factor; the majority of cases will have a Carer.


Wordpic created from feedback from our most recent 2013 Carers Centre evaluation

 Our Project helps Carers caring for people of all ages, all disabilities, illnesses and addictions. The stories that we come across on a daily basis can be extremely harrowing but we are here to try and make the road less rocky and a little more bearable. Getting a referral for a Carer at the start of their caring role is essential in maintaining their own health, wellbeing and welfare of their cared for.

A referral to our Project is a prescription for a smoother journey and future for the Carer and their cared for. There is an average of 566 patient discharges every week from the Infirmary of which the large majority will be going home to have their care continued by someone else…….a Carer. Strike up that Carer conversation and ask those questions, there are Carers still registering with the Carers Centre after their cared for has been discharged from hospital who have stated ‘I didn’t know anything about you; I wish I had known about your service when my Dad was in the Infirmary’.

 Listening to what people are going through really puts things into perspective. Carers have as complex a life as the rest of us, family dynamics always come into the equation. Would you want your future to be spent caring for someone who had never given you the time of day or had hurt you badly in the past but now they are ill or disabled and expect your help 24/7?

We come across Carers who state that they have had enough, that they don’t want to continue caring, they now want to live their lives with more choice and the freedom of choice that the rest of us take for granted.

 Next time an onslaught of visitors pile into your ward, or someone is bringing someone along to yet another appointment, think twice, is this the person that is providing continued care when this person is at home? They are often not just bringing up new nightclothes or a magazine, juice or sweets; they may have been a Carer for your patient for many years, often without support.

 If you haven’t been a Carer yet, consider yourself extremely lucky, but be warned, you don’t choose to be a Carer, it chooses you and you never quite know when that will be…………

 Lindsay Sim / Sharron McGonigle are both Hospital Carers Support Coordinators


 Hospital Carers Support Project

Support & Advice Centre

Main Lobby

Dumfries & Galloway Royal Infirmary

Tel: 01387 241384 email: dgcarers@nhs.net

Part of the wider Dumfries & Galloway Carers Centre