There is no truth, only Perception by Emma Murphy

I recently started as the new Patient Feedback Manager for NHS Dumfries and Galloway. Just as I was settling in to my new role, life popped a little bump in the road and I found myself rushing through the doors of A&E one Friday morning with my poorly toddler. After a number of tests and assessments we found ourselves on Ward 15 for the weekend. I’m usually a reasonably laid back parent and when the kids get unwell, I generally believe in ‘keeping it til it gets better’, but watching my baby girl lie listless in my arms stirred up something almost primal in me. I needed to protect her and I needed to do whatever I could to get her better. Of course, this was paired with the realisation that I alone couldn’t fix this and that we were almost entirely reliant on the doctors and nurses. So there I was, anxious, frustrated, frightened and feeling more than a little helpless. Feelings I am sure many of you have experienced in similar situations.
Later that weekend, as things began to calm, I took some time to reflect. Whilst the treatment we were receiving was of course important, the key thing that was making our experience so positive was the kindness; the gentle tones, the sweet smiles directed at my daughter, the hand placed on my shoulder when I was particularly worried and most of all, the fact that those looking after us genuinely cared. I thought about how I had felt when I first arrived at A&E and how determined I was to ensure that my daughter received urgent help. I imagined how I would have felt if the care had been different. What if the kindness hadn’t been there? What if I was dismissed as an over anxious mother? What if somehow they missed something or didn’t give us the right treatment?
I can see how any one of those scenarios could occur and after many years working in the public sector I can also understand how sometimes, there are justifiable reasons for such. As patients and family members we often don’t know what the doctors and nurses are facing. It’s difficult to fully comprehend the overwhelming task they face each and every day with limited resources, conflicting demands and huge, often unpredictable, pressures. We must remember too that they are juggling all of this alongside their own lives, challenges and all. Whilst sitting here on the other side of this experience it is easy for me to apply that logic and understanding, it would however have been very different had any of those things happened when I was actually in that moment, dealing with those big emotions.
image2-2It can be thoroughly unpleasant when someone complains about you. Even more so if you feel that it is unfair or unjustified. We must appreciate however that it is often about perception. The view from every angle is slightly different. We must too remember that nothing occurs in isolation. Just as a complainant may not know what you are facing that day, you may not know their story. Someone once told me that people shout because they feel they are not being listened to. The anger we sometimes see from complainants often stems from fear or frustration. The same emotions that can make us defensive or even dismissive, when we are on the receiving end of that anger. If we approach complaints from a position of empathy and with a genuine desire to learn and improve, we will go a long way towards reaching more positive resolutions.
Until recently, different parts of the public sector had different approaches to dealing with complaints. This meant that patients, service users and customers were facing challenges negotiating the different procedures which, on top of an existing complaint, often escalated their frustration. Staff were also unclear about how to deal with complaints which led to a further variety of approaches. This issue was identified by the Scottish Government a number of years ago and as a result they have been working towards a standardised approach to complaints handling across the public sector in Scotland. The Scottish Public Services Ombudsman (SPSO) has led on this work, already delivering a model Complaints Handling Procedure to local authorities which they implemented in 2013. They are now working with the NHS to help us to implement a very similar procedure from 1 April 2017 and it is a key part of my role to support NHS Dumfries and Galloway with that task.
image3.pngI know my NHS colleagues care deeply about their patients and the experience they have during their time with us. It is however a little more challenging to try to ignite that same passion about legislation, process and statutory timescales. We all know they are crucially important, but colleagues generally just want to get on with the job they are here to do, which is caring for people. It’s my job to help them understand that these changes will make everyone’s lives a little easier. It will ensure we have a clear procedure and a consistent approach to dealing with complaints. It will also ensure that we are offering the best support we can to those that wish to provide us with their feedback. This will help them to tell us their story and will better assist us in our quest to deliver the best possible care to those in need. Something we are all committed to.

You can learn more about the national changes to complaints handling here – http://www.valuingcomplaints.org.uk
To tell us your story about the care you have received, please contact Patient Services by phone on 01387 272 733 by email at dumf-uhb.PatientServices@nhs.net or by visiting the national Patient Opinion website at http://www.patientopinion.org.uk/

Emma Murphy is the Patient Feedback Manager at NHS Dumfries and Galloway.

Opening Doors by Shaben Begum

SIAA_PrimaryThe Scottish Independent Advocacy Alliance (SIAA) has recently launched an animated film Opening Doors which shows the difference that independent advocacy can make to the lives of parents going through child protection procedures.

Opening Doors follows 3 characters, Laura a young woman with learning difficulties who is pregnant, Ahmed who has a young son and has issues with alcohol and Teresa who has mental health issues. It shows how Moira their advocate helps them know and understand their rights, navigate the system, ensure they are listened to and speak for themselves. The film was made with the help of a focus group made up of parents and advocates with experience of child protection procedures. The focus group helped identify the key issues and used their experience to highlight the difference advocacy makes. Members of the focus group met with the writer to inform the script and ensure that the language was clear and accessible they also met with the animator to ensure that scenes were realistic and that characters were portrayed positively.

The whole process of producing and launching the film was a collaboration with Media Co-op who have a track record of producing high quality, award winning films with a social message.  They worked with us to recruit a professional writer, animator and cast of actors. The part of Laura was played by a woman with learning difficulties.

Intelligence we gathered indicated that advocates were increasingly being involved in advocating for parents with mental health issues, learning disabilities and substance misuse issues who were in danger of losing access to their children.

It’s not unusual for advocates to get involved in supporting people in various situations but the feedback we received showed there was a real need for advocates to know and properly understand the complexities of child protection.

The film is the culmination of our three year Families at Risk project funded by the Scottish Government Third Sector Early Intervention Fund which was administered by the Big Lottery. The initial project was designed to raise awareness about child protection issues amongst advocates and to inform social care professionals and children’s hearing panel members about independent advocacy. Phase 1 developed and delivered training specifically for advocates, providing grounding in key legislation and policy.  Alongside this, guidelines for advocates working with Families at Risk were developed in consultation with advocacy organisations. The guidelines provide a useful reference to best practice in advocacy. They also are used by people using advocacy to get clarity about what they can expect from an advocate and for professionals who want to understand the advocacy role further.

Opening Doors was launched at the Glasgow Film Theatre with approximately 100 people in the audience. The showing was followed by a plenary session made up of representatives from Scottish Government, Children’s Hearings, an independent Safeguarder and an advocate.  The discussion and questions from the audience raised interesting issues around how complex the child protection system is, how difficult parents find it to engage with and how disempowered they feel and crucially the difference support from an advocate can make for everyone involved even if the outcome isn’t what the parents are looking for.

We have received a great deal of positive feedback on the film and it has been viewed and promoted by a range of individuals and organisations across the UK.

Opening Doors will be used as part of training programmes for a range of professionals wanting to learn more about the difference advocacy can make in emotionally difficult and legally complex situations. The film is available in a number of different languages including; Arabic, Urdu, Punjabi, French, Polish and BSL (British Sign Language).

We know that there isn’t enough independent advocacy for people who have a statutory right to access it but we believe that in situations where decisions are made that have a long term and life changing impact then advocacy should be available. We believe that in the ideal world services would be person centred following a human rights based approach so that no one needed the support of an independent advocate but until that day arrives we believe that where families are going through child protection procedures then both parents and children should have access to separate advocates.

Some facts about independent advocacy in Scotland

Research carried out by the SIAA shows that during 2013-14 £11.3 million was spent on advocacy. There are advocacy organisations in every LA area in Scotland and during 2013-14 over 27,000 people accessed advocacy.

Find your local advocacy organisation through Find an Advocate on the SIAA website.

For more information about independent advocacy in Scotland visit www.siaa.org.uk or email us at enquiry@siaa.org.uk

Shaben Begum MBE is the Director of the Scottish Independent Advocacy Alliance