On being an LGBT+ Ally

To mark LGBT History Month, the Dumfries & Galloway HSCP LGBT+ Staff Network reached out to our Allies to ask them what being an LGBT+ Ally means to them. These wonderful folk have signed up to the Pride Pledge to show their support and understanding for members of the LGBT+ and ethnic minority communities working within NHS Dumfries and Galloway Health & Social Care Partnership.

Wearing the Pride badge has a huge impact for both staff and patients/clients, knowing they can approach and speak to a person who is supportive, understanding and non-judgemental towards their specific characteristics is massively reassuring.  You can sign up for the Pride Pledge and Badge by contacting dg.ODL@nhs.scot. 

We’re delighted to share reflections on allyship and the value of the Pride Badge from four of our Allies: Karen Clapperton, Jan Crooks, Euan MacLeod and Nick Morriss and are very grateful to them for their contributions.

If you’d like to join the LGBT+ Staff Network, or support us as an ally, get in touch at dg.LGBTNetwork@nhs.scot

Anne Allison

Chair,  LGBT+ Staff Network

Karen Clapperton, St Michaels and New Abbey Community Nursing Teams

I am very happy to be a LGBT+ ally and I wear my badge with pride (see what I did there?). I have a lovely story I would really like to share.

Some time ago, I had arranged to meet a student who was joining my team to do her penultimate nursing placement. I went to the meeting place arranged and was met with a wee bit nervous, but warm and friendly smile. I introduced myself and off we went.

We had a lovely day, she was friendly, down to earth, keen to learn and very good with the patients.

A few weeks into her placement, she told me that she had never come out as gay during her placements until the very end and usually after she had been graded. I asked why and she said that she normally felt uncomfortable because she had heard people talking unkindly about gay people she was always guarded. She said on the first day when I went to meet her, she noticed I was wearing my NHS pride badge and she felt relaxed and that she could be herself.

I can’t deny that it is a bit disappointing that it took nearly to the end of her 3 years of training to feel comfortable enough to be open and be herself but she wasn’t like that with me simply because I was wearing my wee badge! You never know the difference the smallest gesture can make to someone. Congratulations to the team responsible for the badge pledge project. It has made a difference!

I am happy also to report that she qualified and has made an excellent, caring, compassionate and conscientious nurse. She wears the wee badge too!

Jan Crooks, Family Nurse Partnership

I pledge to ensure within my work, volunteering and personal life that;

• I welcome the entire diversity of LGBT and community
• I try my best to never make assumptions about pronouns 
• I will never be judgmental 
• When I ask anyone’s names, I will also ask how they want me to address them 
• I will respect and use the pronouns my clients and everyone I meet in my life asks to be called
•  I will apologise if I get things wrong and will reflectively learn if I do 
• I value individuals for who they are
• I ensure that within my clinical practice I promote and practice the health, well being and equality of everyone 
• If I am unsure about anything I will ask the individual and will seek advice from recognised LGBT support networks
•  I will support my colleagues, friends, family, volunteers I meet, to prioritise all the things I pledge 

Euan McLeod, Strategic Planning and Commissioning

Prejudice has many faces – sometimes it is overt and destructive-sometimes it is more subtle and disguised-but whatever form or face it presents it needs challenged. That is why being an ally is important – I am happy to do my bit to challenge that prejudice.

I know many people who have faced prejudice because of their orientation – within my Christian circles this has provoked much dialogue – some of it constructive, some less so.

Rob Bell in his book “Love Wins” writes about the need to recover the message of love within the Christian doctrine, “Love Wins” is an affirmation to triumph over hate, discrimination, and other negative energies. It calls for people to recognize the power of love and its ability to overcome obstacles encouraging understanding and nurturing balance. Why wouldn’t you?

Nick Morris, Chair, NHS Dumfries and Galloway

I have spent 43 years working in Health and Social care across a range of organisations, and throughout that time the most enjoyable times have been spent in teams where we challenge each other, learn from each other and value the contributions that others have brought to the work we deliver

No one person will have the answers to all the challenges we face. A strong team that draws on the diversity of its members is more likely to develop an approach that best meets the needs of the patient, the staff and the organisation. To gain this advantage however, all members of the team need to respect the contribution of all the members. We all walk in our own shoes and whilst we might try to gain an understanding of someone else’s lived experience, we can never truly feel or think as others do – hence we need to enable a culture that enables the voice of all members so that we all feel an equal part of the team that benefits from the unique insights we all bring 

How does this relate to the LBTI+ workforce and my role as an LGBT+ Ally?

An organisation that respects the diversity of thought and opinion of all its members is one that is likely to effectively meet the needs of the people who look to us for support. An organisation that is in conversation with itself, encourager debate, is curious to learn and to challenge what we do, why and how we do it and how we can improve, is safer for its staff and its patients. (Michael West et al).

Such an organisation will have a thorough respect and a positive attitude to all the diversity of its membership. The equality and respect with which this organisation provides to the LGBT+ community within us and as part of the D&G population is a test of the approach we take generally, and if, as an LBTG+ Ally, I sense that all members of that community are being treated fairly, equitable and respectfully then it gives me confidence that we would treat all other individuals in a similar manner.

Not all of us will get it right at all times – as I said we cannot walk in each others shoes. So sometime our divergent life experiences will mean we believe, say or do something that is unintentionally contrary to that which best affords respect to the LGBT+ community. However a curiosity in the colleagues you work with and an open dialogue leading to new learning will mean we all develop and grow more harmoniously as time goes by.

While ‘unintentional’ actions and statements are part of the learning process of complex societies, purposeful disrespect is never tolerable. So whilst our collective work is to improve harmony and respect through positive conversations about difference, similarity and learning, we must all stand together to call out purposeful disrespect to each other    

Can’t find the words by Helen Bogle

In October last year I was given the chance to partake in the multiagency self evaluation file reading. This is where professionals from different multiagency sectors (e.g. health, social care, police) who have experience of working with those under Adult Support and Protection legislation, review how the multiagency acted when a vulnerable person was identified as potentially requiring some more support following referral. It was a great opportunity to step away from the concerns in real time, reflect on how our teams worked individually and together, and reflect on how we could improve outcomes for people who are often at their most vulnerable.  We reviewed 50 referrals at this time and gained a lot of valuable insight into good practice, and areas for improvement.

One file I read really struck me as an important one to explore and learn from. An adult who was struggling a lot with his mental health, advised during an inpatient assessment that he had always struggled with his reading and writing, and left school early with no qualifications because of this. He had recently ended his relationship with his partner, and had been supporting him with general tasks like dealing with letters at home. Previously he had been offered support via a mental health support app,vbut said that he struggled accessing it due to communication barriers with reading and understanding how to access the app from written instructions.  This information was not passed on to the multiagency teams that he was referred to and he was sent all communication about support and appointments by letter. He did not opt in or engage and sadly was discharged from the service; and he was also informed about this via letter. Had the information of his reading and writing details been communicated between staff dealing with his care he may have been enabled to access the help and support that he needed.  

It is important to consider all communication needs and think of how you often receive information yourself. If you think of an appointment letter you received, if this other person received it would they be able to understand the information given to them and act on this as they wished? Would they feel involved and empowered through this to make an informed decision about the care they are receiving?

It reminded me of when I was beginning in my nursing career, and there was a patient who was very quiet, he did not read or do crossword puzzles like many did to pass the time.  He did not have visitors and just sat quietly all day, every day, between the ward rounds and procedures. He would be given his menu daily to complete but would hand it back empty saying he was not hungry, or that he couldn’t face food that day. It was only when talking to him about how good the hospital macaroni and cheese was that he said he liked the sound of that. I told him I’d go back and mark this on his menu, I asked if there was anything else he wanted added in as it had been a couple of days since he had something, from memory he could have ice-cream and jelly for pudding, he asked for this happily and ate everything on his tray. The next day he was without breakfast as his previous form was empty for breakfast, I said we had some cereal spare if he wanted some and again he happily had this all. As you’ve probably already guessed, this gentleman also had reading difficulties that he did not want to share, I never asked him about them but just sat and read his menu to him as he happily said his choices, and when I was coming to the end of my shift I added to the handover sheet that he may require support filling in forms. This simple handover of information about communication meant he could now fill in his menu, and get his nutrition when in hospital. He could now be read his medical documents, and give informed consent of forms for procedures. When he was being discharged, it was handed over to Social Work that he was for communication through visits or phone, and district nurses were also aware and would read directions or instructions to support him take his medication.

What is literacy?

Literacy is the ability to read, write, speak and listen in a way that lets us communicate effectively and make sense of the world.

The most recent statistics for adult literacy levels in Scotland (2009) show that In Scotland 1 in 4 (26.7%) of adults experience challenges due to their lack of literacy skills, this is the highest in the UK, within this, 1 in 28 (3.6%) face serious challenges in their literacy practices. (National Literacy Trust). https://literacytrust.org.uk/parents-and-families/adult-literacy/#:~:text=poor%20literacy%20skills.-,Scotland,their%20lack%20of%20literacy%20skills.

Such literacy difficulties can lead to ongoing challenges with navigating everyday life; accessing employment, finances, housing, support, and many more important things we can take for granted when we do not face this same struggle.

Whilst it seems a little bit of information to share, it is so important and can make the world of difference in someone’s care and journey.

Please think:

Are there any communication barriers for this patient?

Would they understand this better if I read it out loud to them or showed pictures?

If they do have a communication barrier, how will this impact them in the care they receive from other agencies and what can I do to help?

How can I effectively hand this over to other teams involved in their care?

If submitting an AP1 form, consider ticking communication barrier and providing more information.

Helen Bogle, Public Protection Advisor, Dumfries and Galloway NHS

Contact Us

The Public Protection Team can offer supervision, advice and support to anyone who wishes to discuss concerns about any person at risk of harm.

Phone: 01387 244300 

Email: dg.asp@nhs.scot or dg.childprotectionteam@nhs.scot

For information on Dumfries and Galloway Public Protection Week 2024 events please see https://www.dgppp.org.uk/article/24123/Dumfries-and-Galloway-Public-Protection-Week-2024-Programme

Let’s Listen by Karen Robertson

NES AHP Career Fellowship Project by Karen Robertson, Occupational Therapist for Children and Young People          – Part one!

When I set out to undertake an Allied Health Professional Fellowship project with NES, I wasn’t fully sure what the opportunity and journey would bring.  As I now approach the half way mark, I can honestly say that I am blown away by the experience so far and the learning along the way.  This has not been from webinars, text books or journals or indeed any other CPD resource.  It is from immersing in the ‘lived experience’ of our local families who are using our service. 

Growing an idea from local dedication and passion

My Fellowship project is titled ‘What does effective family-centred AHP service delivery within neonatal and developmental follow- up really look like?’  On behalf of our close working AHP team, I set out to explore at a local level how our joint Occupational Therapy, Physiotherapy and Speech and Language Therapy team could learn from our local families’ lived experience.  As our capacity to offer this additional enhanced surveillance service continues to be pulled from our general Children and Young People Service services, protecting therapists time while enabling growth of local knowledge and skills necessary to do so, is quite a challenge.  While our post-discharge developmental follow up service mirrors some of the recommendations outlined in the relevant NICE guideline (2017), our capacity to offer a service to babies and families during their neonatal in-patient stay is very limited.  We also offer follow up only until 2 years of age rather than until 4 years of age for this healthcare population.  While what we offer is in keeping with many areas in Scotland, It is fair to say that I, together with my therapy colleagues often feel the weight of this responsibility.  We are passionate about ensuring we use this limited capacity in the most effective ways for those needing and using our service.  I believe on reflection that this is what has motivated me to shelf my imposter syndrome, and try to do something about it!

Discovering Values Based Health Care

In my early research to better understand what Family-Centred Care really looks like, I was quickly introduced to the concept of ‘Values Based Healthcare’ VBHC. 

 “The definition of VBH&C for Scotland is based on the primary principle of person centred care – care that is not only high in quality but also delivers the outcomes and experiences that really matter to people, defined by and reported by them. In addition, VBH&C seeks to reduce the waste, harm and unwarranted variation that exist across our health and care system.”

(Scottish Government 2022).  

I was encouraged to notice that my project aims align quite significantly with VBHC.  I like the concept as it acknowledges that budgets and capacity for offering and growing health care services in this current climate is not fruitful, and asks us to be realistic with what we can offer.  As a children’s therapist for over 20 years, it isn’t my first or favourite thought process when I consider how we can be doing better, but it is a necessary one to have nonetheless!  In our local predicament with our neonatal and follow up service, this is most certainly the case! 

On learning more about VBHC, I have been able to progress with more confidence that I was on to something in my quest to listen to what really matters most to our local families in order to provide care that they really value.  It has also been necessary to enquire about what wasn’t of value in order to redirect capacity to where it will have the most benefit.  Together, I hope that this will enable me to ensure I can recommend on and begin to test out a more sustainable and appropriate resource utilisation across our three teams. 

The art of listening

As I found myself sinking further into how to I could approach this Lived Experience project, I noticed that I had a steep learning curve ahead!  I thought I knew what active and effective listening looked like; but did I really?  It is fair to say that a realisation hit me; I have become hard-wired a CYPF therapist to offer advice and solve problems!  With a focus on patients’ health care problems, it can often feel like we have to offer answers and solutions with little time for silence to accommodate ponderings and wonderings!  By stark contrast, strengths based frameworks such as Appreciative Inquiry lead us into communicating in a different way, to actively listen, curiously enquire and facilitate reflection to support our communication partner to self-discover and problem-solve.

Very quickly, I pressed delete on my reams of ‘possible questions to ask’ our local families! Instead, I began preparations for an unscripted approach to explore what families really think about their neonatal and follow up journey with us locally.

Image from: https://integralcare.org

We won’t know if we don’t ask!

At the time of writing this blog, I am approaching the final project based conversation with our local families I am considering my most important lesson so far?  We as the professionals are not always the experts, as we have not lived through what our patients and service users have.  What we don’t know we may assume and so, let’s be courageous, show our vulnerabilities and ask them.  Most importantly, as David Letterman reminds us, “life experience is our best teacher”, so let’s LISTEN!

So what next?

In Part 2 of this blog, as my project nears its end I will share an update on how our teams have taken on board the lived experience shared by our local families, and essentially redesigned what we would like to offer locally to this healthcare population.

If you would like to know more about the Neonatal AHP role, any aspect of our local practice for this health care population, or about this Career AHP Fellowship project, please get in touch.

Karen Robertson Karen.Robertson8@nhs.scot; @KarenOTRob

NICE 2017  Guidance for developmental follow-up of children born preterm. NICE guideline [NG72] Published: 09 August 2017

Scottish Government 2022.  Delivering Values Based Healthcare; A Vision for Scotland. www.gov.scot

 https://integralcare.org accessed 14/09/2023