Three Little Words (Make a Difference) by @weemac63 & @gbhaining

Here’s a story about 3 people, 3 days, 3 towns, 333 miles, 3 words.

We recently had the great privilege of hosting a 3 day mini tour in Dumfries and Galloway with Tommy Whitelaw. Tommy spent many years touring the world running global merchandising operations for people such as The Spice Girls, U2 and Kylie Minogue, before giving it all up to look after his mum Joan, who had dementia. Sadly his mum passed away in 2012, and Tommy has tirelessly campaigned to raise awareness of dementia and the impact on carers.

Tommy’s inspirational talks encourage people to think about dementia and how it can affect each and every one of us, professionally and personally. You can watch some of his talks and videos here on his blog. The theme of Tommy’s tour for 2014 is “You Can Make a Difference”.

In April 2014, for the Dumfries and Galloway leg of his tour, Kylie and The Spice Girls were not available, so he was forced to go on the road with two new sidekicks.

(Us! – Linda and Gladys: @weemac63 and @gbhaining)

Here are the highlights of our tour with Tommy….

Tuesday 8^th April 2014.

We headed to our Transport Department to collect our “tour bus” for the 3 days.

“Oh no!” was our first reaction, It’s a Corsa! Never mind, there are only 3 of us and Tommy will just have a wee rucksack with the essentials. So off we went to pick Tommy up at Lockerbie station via a well known supermarket as we wanted to ensure a supply of sweeties, sandwiches and drinks to keep us well nourished and hydrated over the next 3 days.

We arrived at Lockerbie station just in time to see several bags, rucksacks and packages of many shapes and sizes advancing towards us at an alarming rate down the steps of the station platform. We soon discovered the smiley face of Tommy Whitelaw peeking out from beneath one of the bags!

After enthusiastic greetings all round, we made our way to the tour bus where the “roadies” ( us!) managed to squeeze all the gear into the boot of the aforementioned Corsa, and off we set to our first gig at Stranraer!

We arrived at Waverly Medical Centre and unloaded the “gear” to start the events. A quick sound check confirmed that the technology was going to play its usual tricks on us but we soon “made do” and the audiences at the two sessions were treated to emotional and inspiring talks from Tommy.

After a brief photo call, we were back on the road, heading for our next gig at Palmerston Football Ground.

We arrived at Palmerston with a little time to spare and again Tommy delivered a very emotive, inspiring and thought provoking talk to the invited guests. We had a wide range of people from our community at the event and it was a huge success. The football ground was an ideal location as Tommy during his tour has visited many other grounds across Scotland.

 

 

 

 

 

 

 

The lack of half time Bovril was made up for by a fantastic supper provided by the girls at Palmerston (including the customary pies and sausage rolls!)

Wednesday 9th April 2014

Another busy day ahead which kicked off with two very well attended open sessions in Crichton Hall.

After navigating the “tour bus” through all the interesting road works of Dumfries, we then arrived at Alzheimer Scotland’s resource centre in Gordon Street, where the three of us were very privileged to be invited to join some of the day care service users for lunch.

Tommy was then given a tour of the resource centre meeting staff and volunteers.

In the afternoon we popped back up to Crichton Hall where Tommy presented to members of our Person Centred Care Committee.

With a busy morning and afternoon there was a little time for Tommy to return to his hotel and relax before joining a few of us for dinner. (A welcome change from the sandwiches and junk food we had been consuming over the past two days!)

Thursday 10^th April 2014.

Our final day with Tommy and we’re not letting him slow down, so the tour bus was loaded up with a plentiful supply of Lucozade (the healthy version of course!)

The first session was held in Midpark Hospital. Word had obviously got round, as it was standing room only in the packed venue. Jeff Ace our CEO even had to give up his seat in the VIP area and move to the cheap seats. Despite technical problems which left us without sound and vision, the audience were moved to tears listening to Tommy. Afterwards, he had a short visit to the dementia assessment ward to see the wonderful facilities and meet with some of the staff.

 

No time to stop (even for another sandwich!) before rushing back over to Crichton Hall for a session with the dementia champions.

We were then back in the car heading to Annan for the last session of the tour, feeling sad as the tour is coming to an end, but so happy with the positive feedback we had received along the way.

As expected, this final session was inspirational and thanks to Brian Cluckie we had no hiccups with the I.T.!!!

The final leg of our tour was soon upon us, and we headed back to Lockerbie Station to bid farewell to Tommy, who had another talk with student nurses in Glasgow later that evening. As we left Tommy at the station platform, with slightly lighter luggage, and the last of the now stale sandwiches clutched in his hand, we felt exhausted, and sad to say goodbye, but with happy hearts that so many people had the opportunity to meet Tommy and hear his message. After 3 days, 3 towns, 333 miles, 33 sandwiches, the 3 of us hoped that everyone left thinking about 3 important words:-

WE can all “make a difference”.

Throughout the three days Tommy has engaged with and shared his story with people from our community including the public, health care, social care, third sector, police, clergy, carers, care providers ,footballers and many more.

Tommy has had lots of pledges from Dumfries and Galloway and it’s not too late… You can still pledge online at http://dementiacarervoices.wordpress.com/you-can-make-a-difference/

Here are some quotes from people who attended the sessions.

 

 

 

 

 

 

 

 

 

 

 

 

 

This blog has been compiled by:-

Gladys Haining (@gbhaining gbhaining@nhs.net) and Linda Mckechnie (@weemac63 linda.mckechnie@nhs.net). Gladys is our Alzheimer Scotland Dementia Nurse Consultant and Linda is a Service Development Manager at the Mental Health Directorate both at NHS Dumfries and Galloway.

 

 

 

 

Broken Arms to Hopeful Hands by @garethadkins

In the last month I have experienced the NHS as a parent, as an improvement advisor and as the programme lead for the Person Centred Health and Care Collaborative. This has taken me from disappointment with the system to great hope for the future.

My youngest son is a typical 6 year old and likes trees, with the usual hazard of falling out of them leading to a fractured forearm. This happened at around 6.30pm on a Monday night about a hour after his tea, which will become relevant later in this story. We went straight to nearest minor injuries unit where he was treated quickly as it was quiet and the staff were great with him. He had been given pain relief and had a temporary plaster in place and was no longer ashen grey. This is where things started to go wrong with a telephone consultation at about 7.45pm with the orthopaedic registrar at the nearest larger hospital. He viewed the digital x-ray and advised that we come to the fracture clinic that evening to have the fracture set properly. The minor injuries unit staff were surprised as it was usual to go home and go to the clinic in the morning but we were assured that if we got there before the clinic shut at 9.00pm we would be OK, so off we dashed.

We arrived at the fracture clinic at about 8.20pm to be told rather abruptly that the clinic does not accept referrals after 8.00pm and we would have to go to accident and emergency. So the long wait started with the triage nurse frustratedly commenting that the fracture clinic staff had no patients but they had fifty-eight! We waited until about 11.20pm for a doctor to see my son and do another telephone consultation with an orthopaedic registrar who decided he would be treated in the morning. He was then admitted at about 12.30am even though I questioned the need for this and was told they wanted to keep an eye on him. Fortunately my wife was able to stay on the ward on a z-bed and eventually he was taken to theatre at around 12.00pm on Tuesday and then finally able to drink and eat something at around 2.30pm. This last point is where the experience was poor for my son as he had not had anything to eat or drink since 5.30pm the previous day, 21 hours ago. This was all due to the presumption that he might have a general anaesthetic whilst waiting in A and E and then by the time the decision to defer treatment had been made the pre-surgery protocol kicked in with fasting from midnight the day before surgery.

Apart from the abrupt manner of the fracture clinic staff all the other staff were great with my son. However, the system failed in several ways leading to a poor experience, an unnecessary admission and an extra person waiting in A and E putting pressure an already busy system.

At several steps we could have been involved in the decision making and given choices. At the fracture clinic we could have been told honestly that you can wait at A and E but it will be a long wait and he may not get treated tonight or he can go home have something to eat and drink and return in the morning. We could also have been offered the option to be admitted or return home with a checklist of things to keep an eye on, which as concerned parents we would have done.

It was the system that caused care to be less than person centred even though each member of staff was doing the right thing from their perspective and in a pleasant and caring way. The challenge is to think differently and involve people in both the delivery of care and identifying ways we can improve it.

This is what I saw as an improvement advisor on a visit to Dumfries Royal Infirmary where I saw the work ward 12 have started with a staff ‘huddle’ everyday for 10 minutes to reflect on the day and discuss what has worked well and what could be improved.

This picture shows how they are using systematic approach to measure if they are achieving their aim by marking if the huddle happened for each day during the month on an adapted ‘safety cross’. It also shows boxes used to collect notes identifying things that are going well and things that could be improved to aid their reflection and also prioritise what ideas they will test to improve care for the people on their ward. They are also about to test a method for regularly asking people on the ward ‘what matters to them’. This ‘system’ approach helps to make it easy for staff, people receiving care and those closest to them to share concerns, make suggestions for improvement and work in partnership.

Many places where care is provided could use improvement methods like ward 12 to develop a reliable system to support person-centred care and make doing the right thing easier. Sharing these great ideas and ways of working was the main purpose of learning session 4 of the Person-Centred Health and Care Collaborative. Healthcare Improvement Scotland hosted the event with over 500 people attending over 2 days at the SECC in Glasgow to share their experiences and learn from each other. It filled me with great hope as I heard many people talk of the new ideas they were going to take back to where they work and test with their staff and the people who use their services.

The enthusiasm is reflected in this photo of the commitment of a thousand hands with 500 delegates making an action based pledge for each hand and sharing at the event. With this commitment we can transform health and care so that we always see the person rather than the patient and make progress towards a more person-centred health and care system. Hopefully this will lead to fewer experiences like my sons in the future.

Gareth Adkins is Implementation and Improvement Team Lead at Healthcare Improvement Scotland

 

The Value of Values by Julie Booth

Fred Lee’s book “If Disney ran your hospital 9 ½ things you would differently” argues that nobody has ‘moved the cheese’ when it comes to things that matter most to the patient or what motivates and keeps good employees. Whilst healthcare can’t be compared to Disney there is no denying that as an organisation it is amongst the top in providing excellent service to its guests

With that statement in mind let my first blog begin.

Its hard to imagine a more magical place than Walt Disney World, yet its secret is not magic pixie dust. It is its well trained, enthusiastic and motivated workforce.

 As Walt Disney himself realized

 “you can dream, create and design the most wonderful place in the world, but it takes people to make the dream a reality”.

Whilst there is no doubt that the patient is at the centre of healthcare, I had the notion that as we prepare to “create and design the most the wonderful place “ in the form the new Dumfries and Galloway Royal Infirmary, it would be an opportunity to reflect on our own values and behaviours.

Within NHS Dumfries and Galloway there is no disputing that we have an excellent workforce that, combined, have thousands of years of service. Yet time marches on (even though in my head I still think I am in my twenties) and this workforce is diminishing through retirements. So how do we ensure that the future workforce that we are recruiting continues this legacy? 

The high profile case of care failure at Mid Staffordshire Foundation Trust and the subsequent Francis Report that followed, focused on the quality of care. Within the Francis Report the importance of  values ismentioned no fewer than 49 times. Although it contained a raft of recommendations one key area commented on was that staff recruited into the NHS should have their values and behaviours tested.

Driven by the need to ensure quality care and person centred outcomes there has been a huge increase in the concept of values based recruitment. 

Values based recruitment (VBR) is defined as an approach which attracts and selects employees on the basis that their individual values and behaviours align with the values of the NHS constitution. VBR is about using a range of tools and techniques to help employee recruit staff who have the right attitudes and values for the job.

NHS VALUES

Now where does Disney fit into this? At Disney they audition prospective staff. This starts with a pre interview process which clearly outlines Disney’s expectations of its future employees (or cast members as they are known) which align with its core values. It is at this stage some prospective candidates withdraw from the face to face interview process.

So how did I get so absorbed with values and standards. Over a year ago as part of a development project which linked to various initiatives such as the 15 Steps Campaign and Leading Excellence in Care as a team we developed our ward based values and standards

The starting point was asking three simple questions:

What did the ward look like?

What did the ward feel like?

What did the ward sound like?

The responses from everyone were then framed around the Healthcare Quality Strategy for NHS Scotland  

The purpose of these values and standards is to enable us as a team to have a framework for behaviour within our ward which will empower staff to take action and challenge poor behaviours. It has been interesting whilst researching the initial project and for this blog that various NHS and healthcare organisations are moving to developing their own set of values and behaviours.

Given that 50% of complaints received in the NHS involve issues with attitude and behaviour is it time that we reflect on our own attitudes and behaviours!

I will end this blog on the following quotes

“Much of what needs to be done does not require additional financial resources, but changes in attitudes, culture, values and behaviour”. (Francis, 2013)

 

 Julie Booth is the Senior Charge Nurse on Ward 3 Dumfries and Galloway Royal Infirmary

 

 

 

 

NHS Scotland Event Day 2 by @PAG1962 & @craigwhitephd

This week saw the annual 2 day NHS Scotland Event 2014 held at the SECC on 3^rd and 4^th June. Paul Gray blogged about day 1 on the Ayrshirehealth blog and it can be read here. Paul is joined by Professor Craig White in blogging about day 2 below.

 

Paul Gray. Chief Executive, NHS Scotland and Director General, Health and Social care

 

 

 

 

Day 2 and more to motivate and inspire. The opening speech by Cabinet Secretary Alex Neil emphasises, among other things, the critical importance of putting the experience of patients at the centre of what we do.  I had some important conversations with the unsung heroes of primary care – particularly the AHPs, who have so much to offer, and great insights into what would make a real difference to patients as we move forward with the integration of health and social care. 

NHS Board Chief Executives met in the middle of the day. One issue that created animated discussion was the vexed question of banning smoking on NHS property, and enforcement of any such ban. Chief Executive of Health Scotland, Gerry McLaughlin @McLGerry is going to develop some proposals for discussion.

 

Sally Magnusson hosted a lovely closing plenary, drawing on three short case studies which set out our approach to engaging with patients, families and carers at every life stage to design services which genuinely meet patient needs. Her deceptively gentle but incisive interviewing style drew out some important points about the way we engage with our workforce and the people we serve, to deliver in a way that makes a real difference to people’s lives.

 

 

 

So, in an event designed to enhance our understanding of what works, and to energise everyone to spread sustainable improvements, I came away with real confidence that we can face the challenges ahead with assurance. There’s no place for arrogance or complacency – we face real and daily pressures – but we have a real basis of strength on which to build.

Paul Gray Twitter @PAG1962

 

 

Craig White, Divisional Clinical Lead, The Quality Unit, Scottish Government Health and Social Care Directorates

 

 

 

Day two of the NHS Scotland event started with an opening address by Alex Neil, Cabinet Secretary for Health and Wellbeing. He reminded us that providing health and social care that is truly person-centred is at the heart of ensuring Scotland’s health and social care services evolve to meet the challenges of the future. Being consistently person-centred in word and deed is a central guiding principle of our caring services. Mr Neil announced that a new system of listening to, and promoting people’s voices in our health and social care system will be developed.

 

Within minutes of this announcement colleagues already started to welcome this on social media…

..and then later a blog posting from the Chief Executive of the ALLIANCE:http://www.alliance-scotland.org.uk/viewpoint/2014/06/citizen-voice-at-the-heart-of-health-and-social-care/

We now have a strong sense of what matters most to people – this person-centred focus and commitment has already seen us make tangible progress in recent years with continuous improvement of the quality of services, making our services more accountable, and ensuring that people’s experiences inform action at all levels of our health and social care system. We want people to be the lead partners in decision-making about their care at all levels – individually, locally and nationally. We want these ‘Always Events’ to become part of the way we do things in NHSScotland.

 

The Person-Centred Health and Care Collaborative, the People-Powered Health and Wellbeing Programme and Scottish Health Council’s work are already demonstrating what best practice looks like – the challenge is to make sure that this is experienced by every citizen of Scotland. Wednesday’s announcement will accelerate the progress required to make this a reality. We need to make sure that all of the wonderful ideas, plans and decisions are informed by what has worked well so far. This way we can create an effective and truly independent voice that will ask people what matters to them – then we will systematically support work to ensure people are at the heart of all we do.  Exciting times indeed, and a wonderful chance to shine a light on the bright spots already happening, spread this and scale up across the country.

 

Staff, of course, are people too – their experiences, ideas and concerns must also be listened and responded to. The Cabinet Secretary emphasised his commitment to this and also to ensuring that NHSScotland staff are supported to develop to the fullest extent of their potential. Although this applies to all NHS Scotland staff, Mr Neil announced specific actions that will focus on making NHS Scotland the most attractive system in the world for medical staff to train. NHS Education for Scotland will work in partnership with the Scottish Academy of Medical Royal Colleges and NHS Boards to make this a reality.  The announcement of the creation of a Health & Social Care Innovation Fund was a further sign of the Scottish Government’s commitment to support Scotland’s track record as a world leader in development, improvement and innovation. I know that staff will welcome this across the country – after all it is our staff that know best what the challenges are, where and how we might support innovation.

NHS Scotland is already a world leader in so many respects – the vision, leadership commitment, resources and clarity of direction that have been set out in Wednesday’s announcements; combined with the ideas, will and expertise among all of the delegates at the breakout sessions will be a powerful combination for further change, improvement and innovation.

We now have the strongest possible platform for Scotland’s to deliver integrated clinical and care services that are of the highest quality – person-centred, safe and effective for everyone, every time. The initiatives announced today will accelerate progress in the direction outlined in the 2020 vision, a vision of a health and social care system that:

• Gives people a strong voice about their NHS, their health & care system
• Supports all staff to fulfil their potential
• Fosters innovation
• Further supports our world leading patient safety programme
• Is demonstrably and truly person-centred in everything

The vision and direction has been set, is clear and extremely compelling – we now all have a big opportunity to reach ‘escape velocity’ (see http://www.ihi.org/Engage/Initiatives/EscapeVelocity/Pages/default.aspx)

Here’s to next year’s NHS Scotland Event – or maybe ‘Health and Social Care Scotland Event’? (thanks to @GeoffHuggins, Acting Director of Health & Social Care Integration, Scottish Government for raising that idea).

Craig White

Email: craig.white@scotland.gsi.gov.uk Twitter: @craigwhitephd