My Story by Grace Cardozo

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. 

1. Believe that all people, regardless of gender identity and sexual orientation, should be treated with dignity and respect.
2. 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.
3. 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.
4. 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. 
5. Be inclusive with your language – Say “partner” rather than “boyfriend / husband”, “wife/ girlfriend”. 
6. Anti-LGBT comments and jokes are harmful. Let your friends, family and co-workers know that you find them offensive.
7. 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.
8. 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

lgbtstaffnetwork@dumgal.gov.uk

Grace Cardozo is a Non Executive Member of the NHS Dumfries and Galloway Health Board.

A Self-Care Resource Pack for People living with a Chronic Health Condition by Elaine Fergusson

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 Ferguson  Cognitive Behaviour Therapist with the Clinical Health Psychology Team at NHS D&G  

Did you know? by Dumfries & Galloway LGBT+ Staff Network

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”

 (Maya Angelou)

 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’    

(Peter Tatchell)

 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 age memoir A 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

lgbtstaffnetwork@dumgal.gov.uk

The Good we do Today Becomes the Happiness of Tomorrow… by Alison Howie

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. 

https://www.gov.scot/news/vaccine-programme-moves-to-next-stage/

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