About dghealth

dghealth has been established to provide an opportunity for all employees of NHS DG to blog and share ideas and opinions and start conversations. There will be a weekly post. All blogs will be the personal work of the contributor and NOT official NHSDG policy. NHSDG have an Information Policy doc available on the Hippo website under useful I.T. forms

Culture Club by Wendy Copeland

How do you describe workplace culture to an alien… I hoped ‘google’ would have an answer, they didn’t.

I then thought of 80s pop culture and two bands jumped into my head ‘Fun Boy Three and Banarama’ when they covered a 1939 jazz standard – “It Ain’t What You Do (It’s The Way That You Do It)” (1982)

I then thought of Culture Club, and the pop culture that they helped form, which still influences popular culture today.

The Blitz Kids were a group of young people who frequented the weekly Blitz club-night in Covent GardenLondon in 1979-80, and are credited with launching the New Romantic cultural movement.

They had a common set of values, beliefs and behaviours, as well as a unique style. All part of the new romantic  culture.

(watch David Bowie’s Ashes to Ashes video – an early culture adopter filmed with extras from The Blitz).

Wendy Cop 1

Come on Wendy back into the room, what does this all mean to all of us that work in Health and Social Care and the culture we help create and work within.

Here’s a more appropriate definition

An organisation’s culture consists of the values, beliefs, attitudes, and behaviours that employees share and use on a daily basis in their work.

The culture determines how our workforce describes where they work, how they understand the system, and how they see themselves as part of the organisation. Culture is also a driver of decisions, actions, and ultimately the overall performance of the organisation.

Our Board invested in measuring our cultural norms a few months ago, you may have contributed to the survey. We are in the process of rolling out a further cohort of individual feedback reports, that helps the person get to know them self, and identifies their own beliefs, values behaviours and assumptions, and measures how others experience them.

We used a tool called Life Style Inventory (LSI), we choose this tool as it looks at strengths as well as self -defeating behaviours, in the hope that the person will further improve what is good and work to change what they could be better at.

The tool measures 12 styles  in which we choose to think about our self and how others see us operate whilst at work.

Think about it like a big 12 slice pizza, some are tasty some are not.

We all love the blue slices!     We could do with less green ones……… and let’s keep reducing the red

Wendy Cop 2Wendy Cop 3Wendy Cop 4

For people who would like more detail https://www.humansynergistics.com/change-solutions/change-solutions-for-individuals/assessments-for-individuals/life-styles-inventory

In the spirit of transparency here’s some of the learning that we, as accredited LSI practitioners have learnt about our self.

Caroline Sharp, Workforce Director NHS. Asking for feedback is a pretty scary thing to do when, like me, you’re as green as the Grinch in your thinking styles. In my head, quite a lot of green stuff churns around, especially the ‘approval’ slice of the pizza, and so of course I was anxious for ‘approval’ from others in how they experience me as a leader in our organisation. To my relief, and curiosity, my feedback from others shows me that whilst I may be ‘thinking  Grinch green’, I am ‘behaving blue’, and in particular, my ‘humanistic encouraging’ behaviour, which is about supporting others to develop and be the best that they can be, is my Constructive, people focused primary style . I also noticed in my results that there is still some white at the top of each blue ‘slice’ – so lots of opportunity to be even more blue than I am currently felt to be by others. So, I am currently wondering, and exploring how to let go of some of my passive aggressive Grinch thinking, and fully embrace the blueness that others see in me – and that feels really good in the moment, not scary at all!

Wendy Copeland: I thought I knew myself pretty well, I was confident that I would have lots of ‘blue’ and that’s what others would see when I was interacting with them.

However I was kinda gutted to see that my primary style was a pesky green. I had the approval slice of pizza! So what did that mean for me? It means I had have a tendency to agree with everyone, I like to be accepted and get upset if I am not, and I can be generous to a fault.

My second slice is Affliliative, I like to cooperate, include others and am I am friendly.

So what… what have I learnt about myself? Through reflection and coaching, I have learnt that I am a people pleaser; however I have not accepted that I always need to be like this. I am working on learning to think and act for myself, and accept that not everything I do will be met with ‘jazz hand’ approval. I am practising facing confrontation and recently handled a challenging situation as a mindful adult rather than the petulant child. I am a work in progress however already I am feeling less stressed and a belief that my view matters.

Oh and I am pleased to report that others see lots of Constructive Blue behaviours.

Wendy Copeland is Service Manager for Nithsdale in Partnership



When We Were Young… by Lynsey Fitzpatrick

LGBT (Lesbian, Gay, Bisexual and Transgender) History Month takes place every February. It’s an opportunity to celebrate LGBT life and culture and to recognise the achievements of LGBT people and communities.

History month is not just for those who identify as LGB or T – it’s for everyone; community groups, organisations, individuals, activists, service providers, non-LGBT people and allies. It gives organisations like ours the chance to show our support for LGBT staff, patients and their families. The theme for 2018 is ‘When We Were Young’ to tie in with the Scottish Government’s Year of Young People 2018.

There is no doubt that LGBT equality has progressed over the decades – it would be difficult to argue that things haven’t progressed at all for LGBT people. But is there still some way to go? Have things progressed enough?

I wanted to hear from people who identify as LGBT to hear some personal stories and reflections from their point of view to try to find out more about what, in their minds, has changed since they were younger. With this in mind, I spoke to some staff members and members of the local community who were happy to share their stories and some reflections from ‘when they were young’, and have shared some of these below. It may be my name at the top of the page but this week’s blog wouldn’t exist without the input from others and sharing of experiences – to those people I give thanks.

My first job in the public sector was back in 1999, out with D&G. After a few months in post, I decided to tell my colleagues that I was gay. They were all very friendly (apart from a few homophobic jokes), so I had no real concerns about telling them, but was still nervous. I knew from my previous experiences of coming out that a little ‘Dutch courage’ would come in handy, so I decided to do it on the Christmas night out.
I’d already confided in one of my colleagues, and she knew what I was planning to do; she bought me several large vodkas, but towards the end of the night, I still hadn’t built up the courage to say anything. Finally, she asked if I wanted her to say ‘it’, and I nodded. The response from all of them was very positive. All except one that is; the manager started shouting at me, asserting that I should have told the interview panel about my sexuality! Needless to say, I was quite taken aback by this, but managed to stay calm – maybe the vodka helped!

Going back to work after the Christmas break was nerve wracking; what would happen? I needn’t have worried, because as soon as I arrived, the manager walked into my office and apologised for his behaviour. Maybe he was worried that I was going to complain about him, or maybe he was genuinely sorry for what he had done.

I stayed in that job for ten years, and despite the rocky start, things settled down. I made some friends for life there.

In 2009, I started working for NHS D&G. From the start, I’ve felt equal. All of my colleagues know that I’m gay, and I can talk about my life – husband, family, home etc – in the same way as they do about theirs. All of the team (including the manager!) are very friendly and inclusive. There are no homophobic jokes and I’ve not had to come out to anyone, I can just be me.

I feel lucky to have been able to be openly gay to my colleagues for all of my working life – bar those first few months. There’s still a long way to go until all workplaces are inclusive, but our society has progressed a lot, and that is something to be celebrated. Equality and diversity is a human right and Scotland should be proud that it’s a world leader in this field.

Employee, age 41

As a member of the LGBT community I am glad to see that acceptance in the community is both growing and improving. There are still some shops, some people and some services, that need people to challenge with respect the outdated views they hold on the freedom and the rights of LGBT people. 

In particular trans and non binary people in our communities can be treated as if they have something wrong with them and are forced to negotiate daily aspects of their life in the community in a way that can ‘out them’ even thought they are protected by both the Gender Recognition Act and the Equality Act. For example, being told to ‘just use the disabled toilets’ and are being ill considered when it comes to new services and buildings, resulting in the potential for them to identify themselves as trans or non binary, even when it is not appropriate. They may be a small minority, yet it is an identity which is growing in numbers across Scotland the UK and yet still services are not being developed in a way that is fit for purpose of the expected change in our local demographics. 

However, LGBT people, in general, have a positive experience in D&G, especially the young adults coming through our community now, who are great advocates of their rights, who do not stand for inequality and are skilled and confident to challenge any discrimination they experience. Let’s hope their strength and confidence continues and those with more vulnerabilities can follow in the wake of the standards they demand. 

Through the diversity of the few, we change the impact on the many.

Member of the local community, age 42

I still remember vividly applying for my first senior post in the mid 90’s and being taken aside afterwards by my line manager who noted that someone on the panel senior to her had suggested that, whilst I had been successful in my application, she should feed back to me ”not to put on future applications – under personal information/ background – that I was gay and lived with my partner”.

At the time, I didn’t question it but there was a climate post AIDS of ‘ tolerance’, and rarely would I speak about my personal life at work unless I knew someone very well and felt it was safe to ‘disclose’.

I also recall my partner and I moving into our first home together, and a neighbour coming to the door to let us know that they, and everyone in the street, had received a letter telling them to ”stay away from the paedophiles at number…..”

So, have things changed for the better?

Most definitely, but to those who would say ‘ Why make a big deal out of it these days, as I treat everyone the same, sexuality isn’t an issue’ I would reply that generally what that means is ‘I treat everyone as if they are straight’, and that the battle for equality was exactly that – a struggle over many decades by many who didn’t live to see the benefits of their efforts.  As many people across the world know, rights can be given and rights can just as easily be taken away.

However, in this LGBT history month 2018, we should celebrate the fact that many LGBT young people can enter adulthood feeling good and not ashamed re. who they are, and that employees can feel welcomed and not just accommodated in a diverse, inclusive NHS.

Employee, Age 52

Discovering who you are and finding your ‘tribe’ can be a long, challenging and often puzzling process. There are highs, lows and an entire spectrum of emotions in between. A recurring theme throughout my storyline has been the importance of learning through watching, listening and talking to others about their experiences, although, it took a long time for me to build up the courage to do so. While some find comfort outdoors or in books, looking back on my adolescent years, I realise that my escapism was through television. Whichever medium we choose, it is important to remember that they play an important part in establishing how we see ourselves fitting into the world around us.

During the mid-late 90s it felt like all LGBT storylines were met with a wave of controversy and widespread debate about whether it was right to have that kind of thing on television. From the lesbian kiss on Brookside, to the mockery of a trans character being introduced to Coronation Street and the seemingly endless number of affairs which resulted in the destruction of a normal relationship, it seemed like being gay would always go hand in hand with shame and isolation.

This came to a head with the transmission of Queer as Folk. Even for this 14 year-old it was clear that this was an important time – a landmark piece of television which would either blow the closet doors wide open or set our place on screen back decades. Fortunately, the strength of Russel T Davies’ writing meant that the series was shocking not for daring to exhibit a set of predominately LGBT characters, but for daring to show them as having normal everyday lives. Being gay was not the drama; it was a starting point for a cultural landscape which promotes acceptance by establishing strong LGBT characters within the fabric of everyday life.

While entrainment only plays a small part in influencing the choices made within society, it is comforting to know that today’s young people can learn about themselves in a more open and vibrant environment. While there is still work to do, particularly in regards to services and support provided for the bisexual and trans communities, the fact that we have the term LGBT, support groups in schools, networking groups within workplaces and even this blog are all signs that times are changing for the better.

Member of the local community, age 32

I remember age 11, during sex education class in school asking how 2 men or 2 women who loved each other had sex.  I was angrily told by the teacher that this was not an appropriate question to be asking, and that I should be quiet.  In the early 80s as a young girl experiencing my first feelings of same sex attraction, this was pretty much the attitude of everyone – my parents, my peers, the school, the media – lesbian, gay, bisexual and transgender people were almost totally invisible, only being mentioned as objects of ridicule or disgust.  The message it gave me as a young lesbian was “your feelings are very wrong, tell no-one”, and that’s what I did, for a very long 10 years, until I was 21 and could contain it no longer.  

Even when I did come out at University, life was very different then – schools were prohibited from talking about homosexuality by Section 28; there was no formal recognition of same sex relationships; you could be sacked from your job for being LGBT; indeed you could be sent to a psychiatric institution to be cured, as homosexuality was still considered a mental disorder until 1992.  Although relationships between same sex partners was legal, the age of consent was still 21 and I remember that my friend Hugo’s boyfriend had been arrested because he was 24 and Hugo was 20, so in the eyes of the law he was abusing a minor. 

When I finally did come out, I made the decision to be VERY out, however this didn’t come without its problems:  I was physically assaulted 3 times, sexually assaulted once; had graffiti written about me and my girlfriend at the time within university buildings and received hate mail from a neighbour in my block of flats.  I also had to go through the difficult period of estrangement from my family and disownment from some friends, until they came to terms with the ‘new me’, even although for me it was the way I had always been.   It was a difficult time and predictably, mental health issues resulted from feelings of being different, unlovable and somehow ‘wrong’.  Luckily, I did have a loving family who were willing to love me despite their prejudices, and a good group of supportive friends, which gave me the resilience to get to where I am today.  For people who don’t have that though, the outcomes can be really different.

25 years on, looking back, for me all that seems a million miles away.  In Dumfries and Galloway (although it took time) I have a life where I am accepted, loved and included in my work, in my community and by everyone I meet, and my sexual orientation is a ‘non-issue’ the vast majority of the time.  LGBT people have more or less full legislative equality now (although there is still a way to go for trans and intersex people) and many LGBT people are thriving within loving, stable families and communities, with children, great jobs and good lives.  The media portrays many LGBT role models now and certainly for the younger generation there is a normality about LGBT issues and most children are growing up knowing about and accepting LGBT issues and LGBT people.  However, that is not to say that there is no bullying in schools and that it is yet easy for LGBT young people to come out – people of my age (44) and older still grew up in an era when homosexuality was outlawed and considered wrong, and so there are still attitudes like this that exist within our communities and which impact on people of all ages within our communities every day. 

When I was 11, what I needed were adults to give me the very strong message that being LGBT was OK.  Although we have moved on a huge amount in rights for and attitudes towards LGBT people, surely every young person and adult still needs to be given that message, and that’s something we can all do. 

Board Member, age 44    


The last Friday in History Month is Purple Friday. This year celebrate the #EverydayHero, those people in our lives who do the little things everyday that make our world more inclusive.

Take pictures and tweet using the hashtag #EverydayHero


Lynsey Fitzpatrick is Equality and Diversity Lead at NHS Dumfries and Galloway

Charity – What Charity? by Nick Mitchell

Dumfries and Galloway Health Board Endowment Fund Charity


How many of you have heard of our charity and how many actually knew the ‘endowment funds’ were managed by a charity? No?  This is nothing to be ashamed of as the Charity has never really advertised itself or the good work that it has undertaken over the years, utilising donated money to support worthy causes and projects both within the Health Board and the wider Dumfries and Galloway community.

Nick 1

Hopefully this introduction to the Charity will help you understand what the charity is, what the charity does and what the charity will be doing over the forthcoming years.


The history of charitable endowment giving dates back to the Roman Empire when Marcus Aurelius endowed four teachers in Athens to head up schools of philosophy. Aurelius believed that man should be led by his reason. From this point on charitable endowment giving has developed in all areas of life.

Nick 2


Charitable endowment giving does not date as far back as this within Dumfries and Galloway but records do show that the regions ‘health provider’ received endowment and donation support from the late 1700s with regards to the first Dumfries Infirmary sited at Mill Hole on Burns Street. Most hospitals at this time would not exist or function without the generosity and support of benefactors.


Dumfries and Galloway Health Services have developed tremendously since the opening of the first hospital. During this period of change the receipt of donations from benefactors has remained constant and to this day the current Charity still receives significant donations from the community.


All endowment funds are held in individual fund accounts in accordance with their purpose by the current charity which was established in 1974 – Dumfries and Galloway Health Board Endowment Fund.



Dumfries and Galloway Health Board Endowment Fund is a registered charity (SC001116) with the Office of the Scottish Charity Regulator and is bound by current legislation.

Nick 3


There are 14 elected Board Trustees that collectively have the responsibility for the management and safe custody all funds held by the Charity. The Trustees are responsible for all decision and policy making on behalf of the Charity (These individuals are better known to you as our Health Board Members).


The day to day responsibility for management and implementation of Charity governance is designated to the Endowment Operational Manager (me). All financial transactions and financial reporting is undertaken by our Senior Finance Assistant (Shirley McClymont).


The General Managers have delegated responsibility for the appropriate use of fund accounts that are within their directorate areas. These individuals are the fund managers. To help support the fund managers each individual fund account has appointed authorised signatories. These individuals are appointed by the fund managers for their specific knowledge of the areas that the individual fund supports. Authorised signatories also provide advice to the fund manager on the most appropriate use at the ward / departmental level.

What does the Charity do?

Nick 4


The Charity supports a wide range of activities and projects both within the Health Board and the local community by providing funding. The Charity Trustees balance the Charity objectives with the requirements of the grant applicant when making their decision. In addition, and most importantly, the wishes of the original donor are also taken into consideration before any funds are released.


The Charity also manages an investment portfolio which provides an income to the organisation which in turn also supports our activities.

 What has the Charity Funded?


The Charity aims to have a fair and transparent approach to funding grant applications. Historically the Charity has been involved in a significant number of projects, equipment purchases and staff development work within the Health Board. In addition the Charity has delivered funding for a number of major community based projects and supported a number of smaller local charities and third sector groups within the regions                         Nick 5

Some of the more recent supported projects and initiatives include:


  • The provision for LGBT plus running costs for their Transforming Self Management project. This project aims to build the capacity of the LGBT adults and older people and their unpaid carers to more effectively self-manage their long term conditions, and to access the support and services they need. The project also hopes to build capacity for the local health, social care and third party agencies to better support LGBT plus people with long term conditions.




  • Funding for two motorcycles for Dumfries and Galloway Blood Bikes. This funding was granted to help the Blood Bikes charity establish their service and provide reliable and functional transport. Since this initial support the Blood Bikes charity has provided a reliable service to the Health Board.


 Nick 6




  • Fully funded the patient entertainment and visitor information system installed in the new hospital. The new Dumfries and Galloway Royal Infirmary has a state of art patient entertainment and visitor information system. This ensures that inpatients and visitors are able to receive both normal television entertainment and also relevant directed clinical support and information within their bedroom.

 Nick 7


  • Supported the Sensitive Spaces arts project for the new hospital – making clinical areas appear less clinical for patients and visitors. The Health Board identified the need to have certain areas of the hospital less clinical and more comfortable for both patients and visitors. The charity fully supported this project and contributed to the overall hospital arts project.


 Nick 8



  • Fully funded the Health and Social Care Partnership Power of Attorney campaign last year and follow-up campaign due to be held this year. This campaign’s aim was to encourage individuals to consider the requirement of establishing a Power of Attorney. This would mean that if they became too ill to make their own decision regarding healthcare there would be a nominated person able to make decisions for them and this in turn would support their wishes.



  • Funding for advanced training of a number of individuals and staff groups. The Charity encourages the workforce to develop their knowledge and skills which in turn helps clinical services to develop and allow the Health Board to offer better patient care.



  • Funded the Good Conversations training project. The training has been designed to build confidence in holding outcome focussed conversations and all training sessions are highly participatory. The training is facilitated using a variety of learning techniques. To date feedback received from attendees has been excellent.


  • Funding for the Greystone Rovers Foundation for their work with individuals with both physical and mental disabilities. The project supports those individuals that would not normally be able to get involved in sport and fitness due to their physical and/or mental disability. The project offers qualified coaches and the plan over the next two years is to offer the sessions across Dumfries and Galloway.

The Future

 Nick 9


The Charity is currently undertaking a full review of its objectives, governance procedures and overall strategy. Work is currently being undertaken to reorganise the individual Charity funds to allow for easier and better use of the resources. There are a number of historical funds that were established for specific purposes that the Charity can no longer meet. The intention is to apply for a change in use for these funds which will release monies for charitable purposes – however, the process is slow and there are a number of legal requirements to be met before the funds can be released.


The Charity is committed to the continued support of the Health Board and the wider Dumfries and Galloway community and there are changes to current practice and new initiatives identified to ensure the continued support is maintained. Over the next few years the charity aim to meet the following long and short term plans:


  • Establishing a robust strategy for the future
  • Undertaking a branding and marketing exercise
  • Develop and introduce a fundraising strategy to take into account those areas where the need for charity support is required the most
  • Establish a dedicated website to support fundraisers, potential grant applicants and the general community in understanding our work
  • Working with all Clinical Management Teams and General Managers in developing annual endowment budgets and spending plans.


As the Endowment Operational Manager I am committed to supporting and furthering the Charity’s work. The future of the Charity is both challenging and exciting and with the support of Health Board staff and the wider community I am sure we can ensure that the good work undertaken will be maintained.


For further information about the Charity or arrange a visit to your management team / staff meeting please contact me by email or phone:


Email:             Nick.mitchell@nhs.net


External:        01387 244673

Internal:         ext 34673





Forests of the future by Joan Pollard

Having agreed to provide a blog I then faced the challenge of what to write, decision making not being my greatest strength when the world is my oyster. However a trip to a favourite local wildlife sanctuary and Viv, Linda and Chris’s blog of last week struck a chord.

Viv likened the health and social care system to a beat up old 1940’s car, I think of it like a traffic jam. Albeit the success of our system to date meaning that this is a jam of cars of all ages, varieties and in varying state of health.


At the weekend I went to visit the local wildlife sanctuary, at dusk, in the hope of catching sight of red squirrels. Leaving behind the road and walking into the woods we ignored (not to be recommended) the warning signs that forestry work was underway. It was after all a Sunday afternoon and was peaceful so we believed (rightly as it turned out) that nothing would be happening.

En route to the hide we were shocked to see the impact of the forestry works with huge swathes of the forest having been felled and piles of logs lying beside the path. The stillness of the evening was broken by the constant noise of the cars on the nearby road. How different the perspective for only having travelled a few hundred metres. The unexpectedness of the noise was reminiscent of a visit to the allied health professionals who have remained in the Mountainhall Treatment Centre with the echoing empty clip, clip, clip of footsteps on the floor as I walked down the corridor towards the department. A corridor I have travelled thousands of times before but change brings a different perspective. Like the forest, when listening more deeply the sounds of thriving life were evident and like the forest this is only one step in a journey towards a new future.

There were no squirrels to be seen as they had taken wise council and moved out for the moment. Meantime, however, there was a beautiful sunset silhouetting the remaining trees against the sky. The half light reminded me of a weekend spent in DGRI in the middle of January when the hospital was coping with the increased demands that Viv referred to. Indeed a nurse described the previous day as one of the busiest in their career . Despite this, the beauty of a hospital waking up was evident. Walking in through the atrium I was met with the tired faces of the night shift as they head home for the day, further into the hospital the corridors were lit with the nurses working their way round the wards providing care and breakfast to their patients. All felt well and peaceful.

The pressures were immediately apparent upon attending the whole hospital huddle and, as I joined a multidisciplinary and multiagency team, of doctors, nurses, allied health professionals, pharmacists and members of the team from Social Work Services and Scottish Ambulance Services, to work together to support flow. Many of this team had not met before this weekend but all worked towards the same goal. Communication between the team was excellent and frequent and at points throughout the weekend each member of the team stepped forwards to lead. It was an honour to participate.

The structural changes to mark the start of new ways of working have taken place with the migration of the new hospital complete and the Health and Social Care Partnership established and now we are in the business of transition. William Bridges would suggest that there are three phases: ending, neutral zone and then new beginnings which involve new understandings and should give people a part to play in the transition.

In moving towards the new beginnings it may be that we should take lessons from the geese that are currently flying overhead,

They know where they are heading and everyone in the team is important. When the lead tires everyone should be brave and step up to take their turn to lead. They communicate constantly and look after each other on the way. Perhaps in this way we can streamline our traffic jam



Like my favourite local wildlife sanctuary this transition from newly planted saplings to fully developed forest will take time and care. The replanting of the forestry will be diverse as a successful natural forest, including many different types of tree, is the best for supporting its wildlife community. I am hopeful that in developing new ways of working to support the population of Dumfries and Galloway our teams will be equally diverse including and valuing the unique contributions of doctors, nurses, social work services, third and independent sectors and each of the allied health professions.


Joan Pollard is Associate Director of Allied Health Professions at NHS Dumfries and Galloway


Is a sustainable health and social care system in Dumfries and Galloway possible? by Viv Gration

We’ve all seen and heard the stories on the news and are experiencing first hand for ourselves that health and social care services are under pressure. The whole health and care system is struggling to cope with increasing demand and stretched resources. So what can we do to try and help this situation? How can we find sustainability within health and social care services in Dumfries and Galloway?

At the moment when I think about the health and social care system I see a beat up old 1940s car that has been overloaded, it has been patched up and repaired, a roof rack has been added (for extra capacity) and it is limping along trying hard to keep up with the modern world. When things reach this stage it’s surely time to re-evaluate what is needed and consider changing our mode of transport to a modern, efficient and reliable car that has the technology to make our journey easier. Or perhaps re-evaluation will lead us to a different way to travel altogether – a train, an aeroplane, a bicycle, on foot, or even stop travelling at all – it’s important that we are open to all potential alternative options.


This year, we will celebrate 70 years of the NHS (established in post war Britain 1948). The primary model of care is the same today as it was in 1948 remaining relatively unchanged through the decades. The King’s Fund’s video ‘Sam’s Story’ describes this ‘old’ model of care well https://www.youtube.com/watch?v=3Fd-S66Nqio .

Reviewing what we do, working together with partners and stakeholders to find new ways to deliver care and support will help us to adapt to the current and future demands on services. The single fact that applies to all organisations is their ability to survive depends on their ability to change and adapt to the environment in which they operate. For example:

Shopping –

There has been a major shift, even in the last 5 years, in the way that people shop. Shopping habits have been influenced greatly by the internet and the most successful organisations have responded to the change in how people want to shop.

Most of the major supermarkets have recognised the preferences of a large number of people to order food online and have it delivered. In September 2017 it was reported that 35% of UK shoppers now use the internet for their grocery shopping. But there is also change in the way people do their grocery shopping in store. Just last month Amazon opened their first grocery store Amazon Go, but it is not at all a traditional store –there are no checkouts, no queues and no people to take payment from you, just use the app to enter the store and pick up what you need, and go! https://www.youtube.com/watch?v=NrmMk1Myrxc

Banking –

Technology is also playing a major role in changing the banking sector. From 2007 to 2017 the number of people regularly accessing online banking services doubled. The banks with branches still on the high street have also changed to have more technology within the branch and there are even examples of banks promoting training in technology for their customers – we’re sure many of you have seen the adverts on TV for Barclays Digital Eagles. https://www.barclays.co.uk/digital-confidence/eagles/

Considering new technology is just one way to affect change and it is important. But there are a range of things we can think about and do to progress towards sustainability. Let’s understand what people need and want from the health and social care system, what good outcomes are, what we do well, what practice we should expand and promote, what we should stop doing and what we should do differently. By having conversations like this within teams, with the people who use services and with partners across the whole system we will be able to find new ways of working that will take us closer to an adaptable and sustainable system.

The new Service Planning Framework has been developed to help us have a consistent approach to these conversations and approaches. It sets out six essential planning principles and suggests a range of potential actions to help teams to do this.

Viv 1

Using the Service Planning Framework will help us to have a consistent approach to:
Understanding the balance of resource and capacity, anticipate future requirements and plan for this
Ensuring that service delivery is up to date and in line with evidence of effectiveness and best practice guidance
Ensuring that service is comparable with other areas in terms of quality, activity, outcomes, costs etc
Identifying actual or potential gaps in need, service delivery
Generating alternative options/ service models (eg. partnerships with other providers, third sector, independent sector)


So we’re suggesting that we all invest time to think about what we can do to change/transform our models of delivery to become an adaptable, more efficient, modern and ultimately sustainable system.

Service Planning Framework


To answer our initial question about whether sustainable services are possible in Dumfries and Galloway, we suggest they are. But it is going to take some time and effort, working together across the whole system to adapt to the environment we are working in. No doubt services will look and feel different and that is what is needed to become sustainable.

“No transformation of great scale occurs without innovation, hard work and significant change – or disrupting the norm” Chief Executive of General Motor, Canada.

Viv Gration, Strategic Planning & Commissioning Manager
Linda Owen, Strategic Planning & Commissioning Manager
Chris Fyles, TEC Project Team Lead

Ask, Listen & Do by Lindsay Sim and Jennifer Cranmer

Carers Support within

Dumfries & Galloway Royal Infirmary

There are three 8 hour shifts in every day, when you’ve finished yours, Carers still have another 2 to do – or at least be on call for!

Who is looking after your patient once they leave your clinic or are discharged from your ward? Most of these people are going home to continued care from a family member. In some circumstances, the Carer is thrown in to a completely new situation, for example a husband discharged home from hospital after a stroke, a wifes cancer diagnosis or a young person going home to his parents after a serious car crash. Many issues are thrown into the pot –– ‘we live in a second floor flat’ – ‘how are we going to manage financially’? – ‘one of us will need to give up work and care for him’ and the list goes on. As we all settle into our new wards, departments and offices within the new build – ask yourself how you have coped with the change. You may have found the change exciting or even difficult to deal with but one thing remains the same for all of us………we all knew it was coming and had the time to prepare ourselves – unlike a Carer whose life can be changed forever after a chat with a Nurse or Consultant or a phone call from the Police.

A Project such as ours is designed to meet the needs of Carers who require up to date information, advice and support in order to continue to carry on caring in good health, fully informed and knowing where to go when the road gets a little bumpier and that we are there to support them throughout their whole caring journey.

As Carers Support Coordinators we ASK the Carer what matters to them, LISTEN to what matters to them and try our best to DO what matters to them. In order to carry this out we need referrals for Carers from hospital workers. Supporting Carers within the hospital should start from the cared for’s admission – a referral at discharge can mean vital support is missed during the hospital stay. ‘We define a Carer as anyone who provides support to a member of their family or a friend who is affected by a long term illness, disability, age related condition or addiction who couldn’t otherwise manage without their help’.

As all illnesses and disabilities are different, the Carers that are providing the care are different too. They can be young, middle aged or elderly, working as well as caring, retired and caring and all have their own story to tell which in some cases can affect their ability to care for a person. They can be husbands, wives, a daughter, a son, a grandchild, Mothers, Fathers, Aunts and Uncles and all have to juggle their lives whilst fitting in a caring role that they never anticipated. Every caring role is different, no two Carers are the same and no two caring situations are the same. It is everyone’s responsibility to recognise Carers – please do not assume that someone else has already referred them to our Project, we would rather receive two referrals than none at all.

Carers 5

The issues we are presented with as Carers Support Coordinators may seem unimportant to some, but to a Carer they are vitally important. Here are a few scenarios’ that come to us during a typical day………….

  • An NHS staff member, Mr White approached us whose daughter with special needs required extra support during her morning routine. He asked us how he should go about asking his line manager for flexibility at work in order to meet both his and his daughter’s needs. We gave him Carers in employment information and offered support at any meetings with his line manager or HR should they arise. We referred to Community Social Work and registered Mr White as a Carer with our Carers Centre service. He then accessed an Adult Carers Support Plan which identified how he was coping with is caring role for his daughter and the areas in which he needed support with.


  • Mr Brown was signposted to us from a nurse in a ward as his son was having difficulties due to housing issues because of his paralysis and wheelchair use. His grandson was also identified as a Young Carer and referred to our Young Carers Project. We identified funding for travel to and from hospital for him to bring his grandson to visit his Father as he did not drive. We referred on to the Advocacy Service, FIAT, Capability Scotland and liaised with his son’s Community Social Worker. Mr Brown continues to be supported in the community by a Carers Support Worker and has had an Adult Carer Support Plan carried out.


  • Mr Green is already registered with the Carers Centre as a Carer for his wife, he got in touch because he had asked a ward staff member to contact the Spiritual Lead – Dawn Allan and this had not been done. Mr Green was understandably anxious as he had been diagnosed with a terminal illness and being a minister himself he wanted to speak with a likeminded person. We got in touch with Dawn and Mr Green was delighted to have spent some time with her as was Dawn.


  • Spent an hour with a male Carer whose wife had been diagnosed 2 years previously with a brain tumour and was nearing the end of her life. He appreciated having someone to ‘vent’ to and said that someone taking the time to listen to him was worth its weight in gold.


  • We went up to a ward to visit a registered Carer with our service who has been in hospital for most of the year and back and forward to Edinburgh for further treatment. The Carer lives some distance from DGRI and doesn’t have many visitors. His wife has mental health problems and his community Carers Support Worker has been checking that she is ok so that we can relay this information back to the Carer and alleviate any worries that he may have about being away from her for so long.


  • A member of NHS staff emailed us to ask what benefits they would be entitled to should they give up work to care for their elderly Father. They were finding the working/caring role too demanding and felt that something had to give. They registered with our service and we referred them to the FIAT team to discuss their financial situation further. The NHS member of staff gave up work but prior to this applied for a short break away through our ‘Time to Live’ fund as they hadn’t had a break from caring for over 3 years.


  • Senior member of NHS staff approached us to ask what support someone they line manage could receive from our service if they registered with us. They were worried about their staff member coping with such a heavy caring role and they had noticed how tired and withdrawn they had become. The staff member agreed to a referral to us and now there is support from community care services going into her family members house hold which has alleviated a huge amount of stress and guilt from the staff member and her work performance has risen due to feeling more supported from her Manager and the Carers Centre.


  • A Carer came to us in distress due to their elderly Mother not accepting support upon discharge. We liaised with staff on the ward to support them in discussions with the family and advised around other local support which can be accessed. The staff were appreciative of our input in a difficult situation and the Carer continued to receive support from the Carers Centre after her Mothers discharge home.

We are happy to be invited to attend huddles or MDT meetings. This has proven beneficial in the past in identifying Carer referrals. The Communications Team has/ will be sent out our newest referral form, please save this to your desk top computers and if any of the above sound familiar to you or you come across someone who you feel would benefit from accessing our service; you can refer them to us.

For further information, please visit our Carers Centre website here

Please like  our Facebook page here

Find our referral form here please save it to your desk top for future use.


Carers 6









Carers 7










Lindsay Sim & Jennifer Cranmer


Carers Support Coordinators

Hospital Carers Support Project

Support & Advice Centre

(behind ‘Cashiers Office’ in main atrium)

t: 01387 241384


e: dgcarers@nhs.net


Tuesday & Wednesday 11am-4pm

Thursday 4pm-8pm

Friday 9am-3pm











What effect is porn having on your service users? by Laura Gibson

Gibson 1Gibson 2Gibson 3Gibson 4Gibson 5Gibson 6

Blogs are usually written from the perspective of an individual voicing their views, experience or message. However, for today’s blog that approach isn’t really appropriate. Instead, with the purpose of igniting thinking and conversations around a contentious topic, the following has been drafted by a small group of multi-agency staff with subject knowledge…

 Dumfries and Galloway’s Sexual Health Awareness Week 2018

Let’s Talk About Sex – Pornography

22nd – 28th January 2018

Each year Dumfries and Galloway’s Sexual Health Awareness Week aims to encourage discussion about Sexual Health and Wellbeing with a particular focus on an emerging theme or issue of interest to the public and partner organisations.

Due to the advances of the internet and mobile technology, pornography (the display of nudity or sexual activity intended for sexual arousal) has never been so accessible. There is an emerging body of evidence around the effects of pornography on a variety of health and wellbeing outcomes. The aim of this year’s Sexual Health Awareness Week is to encourage discussions about the effects of pornography on health and wellbeing. Seven key themes (one for each day of the campaign) are identified and links to further reading are included for anyone who wishes to find out more.

Gibson 7

We ask that you share this information, along with the other resources available here, with your colleagues, patients/service users and friends to facilitate discussions around the effects of pornography.

You can also tell us your thoughts by completing our short survey or attending our FREE roundtable event on Thursday 25th January 2018, 2pm-4pm at the Garroch Training Centre near Dumfries. Email dgsexualhealth@nhs.net if you’d like to book a place.

  1. Porn and relationships

Gibson 8

A report by Relate and Relationships Scotland found that almost half (47%) of relationship counsellors and therapists report seeing an increasing number of clients where pornography is causing a problem in their relationship.

The same survey found that some people viewed watching pornography alone without your partner as being unfaithful and posed the theory that increasingly unrealistic expectations fuelled by portrayals of sex in pornography might be leading to dissatisfaction with sexual relationships. Experts recently claimed that pornography is blamed for up to 70% of rocky marriages (up from 10% in the 90s).

  1. Learning about sex through porn

Many people say that they use pornography to learn about sexual relationships. But pornography isn’t reality – the relationships portrayed in porn blur the lines between fantasy and reality. This results in many people thinking that sexual relationships should be conducted in the way they are in porn films.

Young people want to learn about pornography through sex and relationships education at school, and 87% of parents also want lessons to address porn. However, pornography is not currently covered in many schools. Building the knowledge, skills and confidence of school staff to deliver effective Relationships, Sexual Health and Parenthood Education is a priority locally, and this includes encouraging discussions about pornography at an appropriate stage.

  1. Porn and violence

Violence is commonplace in porn. Research on best-selling pornographic videos where 302 scenes were analysed showed that 88% of them had physical aggression (e.g. spanking, gagging, slapping) and in 48% of these name-calling took place. The aggressors were mainly men and the people who suffered the violence were female, usually portrayed to enjoy or accept this violence.

Gibson 9

Research has also shown that women who experience domestic abuse are at more risk of sexual violence if their abusive husbands use pornography. Pornography is also part of the commercial sexual exploitation industry and is linked to the trafficking of women and girls for sexual exploitation; so sometimes the women who appear in porn videos are not just “actresses”.

  1. Porn and body image

In porn films, men have large penises, minimal body hair and toned bodies. Women have little or no body hair, large, pert breasts, are pretty and tanned. This often results in viewers feeling that the people they are watching are normal, which in turn impacts on their own body image. You can find out more here about women’s and men’s bodies in pornography.

  1. Porn and the brain

Gibson 9.1

Pornography use can have a similar effect on the brain to some substances including drugs. Studies have shown that porn stimulates the same areas of the brain as addictive drugs, making the brain release the same chemicals. As a result people can get trapped into a vicious circle where the brain is hijacked by porn.

Many neurological studies show evidence that the brain changes from internet pornography use. Scans have shown that even moderate use can cause grey matter to shrink in key areas needed for thinking and learning.

  1. Revenge porn

So called ‘Revenge Porn’ refers to the uploading of sexually explicit material to humiliate or intimidate a partner who has broken off a relationship (Citron & Franks 2014). The Abusive Behaviour and Sexual Harm (Scotland) Act 2016 came into force in Scotland 3rd July 2017 and provides guidance on the issues and implications if found guilty of sharing photographs and films without consent. There have been two recent campaigns around revenge porn, one in Scotland ‘Not yours to share’  and one in England & Wales ‘Be Aware Before You Share’. Both campaigns have information and resources suitable for use with clients/service users.

  1. Young people and porn

Every day children and young people are accessing mainstream pornography on the internet, including the most hardcore, violent and abusive images. The average age of first accessing pornography (accidently or deliberately) is 11 years and 1 in 3 children have viewed sexualised images online before the age of 10. The single largest group of internet pornography consumers is children aged 12-17.

Gibson 9.2

Evidence clearly shows pornography has a detrimental impact on children and young people including premature sexualisation, negative body image and unhealthy notions about relationships which include a tendency to view women as objects and the acceptance of aggressive attitudes and behaviours as the norm.

For further information and support around the impacts of pornography, please click on the links above or visit www.womenssupportproject.co.uk/content/pornography/206,172/ .


Laura Gibson (on behalf of a multi-agency planning group)

Health and Wellbeing Specialist

DG Health and Wellbeing

Directorate of Public Health

NHS Dumfries & Galloway


January 2018