My Heads no back yet by Ken Donaldson

For some inexplicable reason (more details later) I am going to be running, or attempting to run, the London Marathon this Sunday, 2nd October. This blog, however, is not about why I have made this crazy decision, but more about the charity that I am raising money for – Dumfries and Galloway Blood Bikes.

I would hope that many of you reading this will be aware of DG Blood Bikes and what they do but for those of you who don’t; they are a charity which provide a free service, run entirely by Volunteers, transporting urgent blood, blood samples, medical equipment, medical notes and medications for the Patients of the NHS in all the communities across Dumfries and Galloway. It is important to stress that they are not employed by the NHS and operate completely independently, although within all the appropriate regulations.

The work they do is often unnoticed, often due to confidentiality but also simply due to the nature of what they do. A few examples:

Imagine a mother sending their 12 year old child off to school. The usual waves at the window. At 1pm the school calls to say that their child is not well, sickly and has a headache. They come home but by 5pm they are vomiting, have a rash and holding their head in agony. They rush to hospital and by 8pm are in a paediatric ward and undergoing tests…it looks like meningitis and the family are terrified. After their poorly child has undergone a lumbar puncture, not the nicest procedure to have done or witness, they sit and wait. What they do not know is that one of the samples, that is vitally important, must get to Coventry, 245 miles and over 4 hours away. A volunteer for DG Blood Bikes will drive through the night to get the sample there as quickly as possible. The results phoned through first thing in the morning may make the difference between life and death. The family, the child, most of the staff never know how it was delivered.

Imagine another family in a very different situation. They have come to hospital because their 25 year old son/daughter has been in a car crash and is in critical care. They are about to hear the worst possible news; their loved one is brain dead, can we harvest and use their organs? When they decide yes, within a very short period of time another DG Blood biker is heading north to Glasgow to deliver an important blood sample and utterly transform up to 12 other lives; a young man with liver disease who is days from death, a woman on renal dialysis for 8 years who is starting to struggle with arteriovenous access, a man in his 60s dying of heart failure. Dozens of professionals will contribute to the miracle that is transplantation but not many will be aware of the role carried out by the biker.

And finally imagine the family sitting at home with their beloved relative who is at the end of their life. Caring for the dying patient at home can be challenging and requires lots of thought, planning and input, often at short notice, by many individuals. However the DG Blood Bikers are regularly required to deliver urgent medications or other treatments to patients homes that negate the requirement for an admission, which we know is a really awful outcome for someone at the end of their life who wishes to remain at home. A small deed making a big difference.

These may feel like insignificant cogs in the overall machine but they are vitally important. They also deliver hundreds of samples to Glasgow and Edinburgh every week that impact on patient care. Would this happen if DG Blood Bikes didn’t exist? Yes, of course it would, but at greater cost (to the detriment of other services) and probably with not quite as speedy a service.

All the work they do is funded entirely by donations, so every penny donated is used to keep the wheels turning and help save lives. During the Pandemic this became harder as costs increased and means of fundraising came to a halt. Now the cost of fuel and other running costs have significantly increased putting more pressure on the service.

Worth remembering that they are the only free Blood Bike Charity in Scotland to operate 24 hours  a day, 365 days a year.

I know times are hard but please consider donating to this really worthy cause via my marathon fund-raising site www.justgiving.com/Ken-Donaldson1

So how did this all happen? I watched a good friend run the London Marathon last year and found myself getting all emotional so I entered the lottery for a place in this years event. Everyone told me no one ever gets a place on the first go. None of my friends who tried with me did. But I was successful. I may enter another lottery soon if that is how my luck goes but for now, its off to London and try to do my best.

I have always loved the film Chariots of Fire and one bit that always gets me is when Eric Liddell is struggling and when it looks like he won’t win his friend mutters “His heads no back yet”. The head goes back and win he does. I clearly won’t win but will try and put my head back at the end!!

Ken Donaldson is Board Medical Director at NHS Dumfries and Galloway

What has prescribing got to do with climate change? by Emily Kennedy

I have just started a new secondment with the Effective Prescribing and Therapeutics division, working on respiratory and polypharmacy guidelines and forming an implementation plan for the climate change and sustainability aspects of these guidelines. My job title is something grand, like ‘Climate change and sustainability pharmacist’ or ‘Pharmacist in green prescribing’……when I got the job, I remember a fair few people expressing confusion as to how pharmacists and prescribing had anything to do with climate change.

Everything we do has an impact on carbon emissions and that includes our use of medicines.

The Climate Emergency and Sustainability Strategy published recently by NHS Scotland stated the aim to reduce carbon emissions from the propellants in metered dose inhalers by 70% by 2028. The ask is for clinicians to review patients to improve respiratory disease control, avoid over-use of inhalers and consider inhalers with a lower carbon footprint where appropriate, for example the dry powder inhalers (DPIs) like an Easyhaler or an Ellipta. Inhalers are targeted as they form a measurable 3% of the total NHS Scotland carbon emissions. It can be a tricky one to tackle with a patient, especially when you consider that asthma is not a choice and the right inhalers provide essential therapy – but there is the key – the right inhalers! Relievers, that is, short acting beta agonist (SABA) metered dose inhalers (MDIs) account for around 2/3 of carbon emissions from inhalers, with the UK being amongst the highest users of relievers. Too many of our patients with asthma are over-reliant on reliever inhalers instead of using the regular preventer inhalers, so if we can help with that, we not only improve outcomes for patients but also reduce carbon emissions from inappropriate reliever inhalers.

We need to reduce pharmaceutical waste by ensuring that regular medication reviews are undertaken. This may involve de-prescribing as well as clinician and patient education and support.

We need to continue to maximise utilisation of non-pharmaceutical forms of treatment as much as possible, for example, encouraging physical activity, healthy eating, utilising green spaces and nature, often described as social prescribing. The benefits of this are manifold and we see evidence in many disease areas, for example mental health and diabetes.

We can reduce our single use plastic in prescribing and as a prescribing team working with the clinical areas, we have started to do this e.g. re-useable insulin pens rather than disposable pens, re-useable plastic applicators for vaginal oestrogen rather than disposable plastic applicators.

We have formed a ‘Green prescribing group’ as part of the Medicines Transformation work stream in order to stimulate discussion, generate ideas of more environmentally friendly prescribing and helping them to happen in practice. We are always open to more interested members or even if you have a suggestion for us to consider, please drop me an email.

It’s Scotland’s Climate Week from 26^th September, to raise awareness of the global climate emergency and to encourage climate action across the country. Scotland has committed to Net Zero carbon emissions by 2045 to protect people and our planet. In the Climate Emergency and Sustainability Strategy published by NHS Scotland last month, there is a commitment to become a net-zero health service by 2040 – an ambitious target.

Does it affect you….yes, it should affect everyone! The impact of climate change is already being felt around the world, we saw the dreadful impact of the floods recently in Pakistan and in the UK, even in Scotland, we see the effect on the weather.

Everyone can do their bit – however small. What our Green Prescribing Group would like to suggest is that you think about one or two actions that you will personally action and make a climate pledge for Dumfries and Galloway. Please follow the link below in order to make your pledge.

‘We don’t need a handful of people doing zero waste perfectly. We need millions of people doing it imperfectly’ – Anne-Marie Bonneau

Examples of small changes you could consider are:

• Have a meat free meal once a week
• Ditch the car and walk, bike or bus to work for a day a week
• Reduce food waste – plan your menu for the week and check your fridge before shopping
• Look at single-use plastic in your home – can you convert to soap, refill plastic bottles (e.g. Flourish in Dumfries, Loch Arthur Farm shop in Beeswing and the Wee shop in Lochmaben have refill stations for shampoo, shower gel, laundry liquid etc – I’m sure there are other shops that do this too)
• Opt for foods with less packaging, and food that has not been freighted by air (such as asparagus, green beans and berries not grown in the UK)
• Commit to not purchasing any new clothes for a year (I have done this……in 2020, Covid helped me enormously then, less going out!). Use second hand shops or repair or re-purpose clothes (think Sewing Bee)
• Check the insulation around your house – turn the thermostat down by 1 degree
• Use public transport for longer journeys or car-share if possible
• Re-wild part of your garden – leaving twigs and leaves to provide a habitat for local animals
• If you use inhalers, could you manage a dry powder inhaler (DPI)? Contact your GP practice to discuss this with your GP, nurse or pharmacist
• If you feel that your asthma is not well controlled and you are using more than 3 puffs of a reliever a week, check in for an asthma review with your GP practice

We are looking forward to reading your climate control pledges. We can all do our bit, however small and it would be great to see staff Dumfries and Galloway leading the way.

‘Little by little, a little becomes a lot’ – Tanzanian proverb

To make a pledge Click here  

Emily Kennedy, on behalf of the Green Prescribing Group (Gordon Loughran, Amy Sellors, Katie Percival, Jennifer Inch, Sam Farish, Ashley Henderson, Jo Kopela)

Stroke Association Support Offers for People Affected by Stroke in Dumfries and Galloway

As a charity working solely on stroke in Scotland, our focus is to make stroke a priority and provide support to help people rebuild their lives after stroke.   We want to ensure people affected by stroke in Dumfries and Galloway are aware of our support, and are able to access it, when they need it.

Stroke is Scotland’s biggest single cause of disability. Two out of three people who have a stroke, leave hospital with disabilities. These can be life-changing.  That is why we are here to help improve stroke recovery.

Hospitals in Dumfries and Galloway have made significant progress in their performance against stroke standards as shown in June’s Stroke Improvement Programme report.  Whilst the standards for stroke rehabilitation are currently in development, we, like the Scottish Government, are committed to supporting life after stroke issues both in hospital and the community through our services and support.

One of our volunteers from Wigtownshire, brings some of our support offers to life by describing his experience of promoting and delivering our life after stroke support.

Stewart is a lived experience Here For You volunteer as well as one of our Community Connectors in Dumfries and Galloway. Here For You is a telephone support service which aims to combat feelings of loneliness and isolation often experienced by stroke survivors.  This involves talking to someone who has experience of living with a stroke.    This is invaluable to those who need someone who can listen and understand the experience that a person may be going through.

Stewart says:

Sometimes, simply the encouragement that it was quite ‘normal’ to feel fatigued, emotional, etc post-stroke was all the reassurance that was needed.

Here For You also provides an opportunity to inform others of practical support including our information services – Helpline, Website, My Stroke Guide; and our face-to-face and online groups and cafes, where meeting people, sharing experiences and building confidence are so important.

As a Community Connector Stewart has helped bring people affected by Stroke together, both by meeting face to face or joining our online cafes.  This has provided much needed peer support whilst enjoying a coffee and chat together.

We are aware there are many remote and rural areas in Dumfriesshire, so believe our face to face and online support could prove invaluable for those who need our help wherever they are in the area.

You can find a short summary of the services and support the Stroke Association offers here: [KG1] [AM2] 

We have also started working with the stroke team in Dumfries and Galloway Royal where our Stroke Connect support offer is being established. 

We have heard from many people across the country who are affected by Stroke  that the support needs to start during their time in hospital and continue on for as long as they need. It’s vital that they are provided with a variety of different support offers that suits their needs. 

The Stroke Association is very appreciative of the excellent work that stroke teams are delivering in Dumfries and Galloway.  We want to support them in improving stroke recoveries and rebuilding lives.

As an organisation we are beginning to work more closely with Third Sector organisations as well as the Health and Social Care Partnerships to identify support offers that are already working well across Dumfries and Galloway.

We are also grateful to have the support of local MSP Colin Smyth:

“As one of the local MSPs for NHS Dumfries and Galloway, I would like to thank all those who are involved in the delivery of these services by the Stroke Association.

It is brilliant to see such a breath of offer to all stroke survivors in the area for free whenever they might need it. The benefit of these support offers is clear, and they will be a great support to the wider health and social care system to alleviate system pressures. I encourage those working in D&G health board to direct their stroke patients to these universal services. I look forward to hearing how the community connectors progress this work in the coming months.”

To find out more about Stroke Association services and support available to people in your area view here, or email: EngagementTeamScotland@stroke.org.uk

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