All Good Things Come in 3’s (or 4’s or more?) by Phil Myers

What would Stanley make of it?

Stronger through Technology by Laura Lennox

Love it or hate it we have all heard of social media sites such as Facebook and Twitter. If you do use social media you will definitely have heard of and even participated in the ‘bare face selfie’ or the ‘ice bucket challenge’ successfully raising awareness of specific conditions and increasing donations for certain charities. With this in mind, our speech and language therapy team decided to create our own department Facebook page and Twitter account in order to raise awareness of the specific speech, language, communication and swallowing needs our service users encounter and how this impacts on their lives. “How hard could it be?” we naively thought.

Several hours later the job was done and, although it was slightly harder and time consuming to do than we initially thought, our reason for sharing this experience is because we could not have predicted how successful this venture has become. If you aren’t already familiar with us, we are the small(ish) adult team made up of speech and language therapists (SLTs), SLT support workers and one A&C based at DGRI and the Galloway Community hospital. So for a small(ish) department, you can understand our excitement at the fact that we currently have over 100 Facebook and twitter followers and this number continues to grow. So we’ve come up with four reasons why we believe the use of social media in professional practice can be a positive experience.

1. If we can do it then anyone can.

I have already hinted that it was initially harder than we thought but that’s because the social media skills within our team were (and still are) pretty limited. So if you’re in a similar position, then here are a few pointers as to how we went about it. Our first step was to check in with D&G NHS Communications department to make them aware of our plans and gain advice as to how best to do this in a way that would not get us sacked or struck off the HCPC register. Joke! (I think….). The next step was to sign up to Facebook and Twitter using our generic NHS email account. For Facebook, we followed their straightforward online instructions on creating a business page (we had to google it!). The admin section allows for each SLT and support worker to be involved in managing the page and posting information. This was important to us, not only because it is less time consuming than one individual being the sole person responsible, but because we all have our own particular areas of specialist interest. (It means we can post out information that is relevant in all professional areas within speech and language therapy). We then linked our Facebook page to our Twitter account meaning our Facebook posts would also be tweeted and vice versa, saving even more time than trying to manage the two accounts. Twitter is somewhat easier and anyone with an email address can create an account.

2. Raising our profile.

Our professional body, the Royal College of Speech and Language Therapists (RCSLT), have been involved in creating a campaign called Giving Voice. The aim of the #GivingVoice campaign is to raise the profile of our speech and language therapy profession and in their words “demonstrate SLTs unique value and evidence of our efficiency and value for money in a time of financial constraints”. Very important stuff that every NHS department can relate to. We do this by sharing posts and retweeting from the relevant larger organisations social media sites such as the RCSLT, Chest Heart and Stroke Scotland (CHSS), Alzheimer Scotland, Parkinson’s UK, British Voice Association, among the many other organisations where speech, language, communication and swallowing difficulties can be a symptom of the associated medical condition they represent. But the more exciting part for us comes when trying to think up our own ideas to raise our profile.

Remember I mentioned the social media ‘ice bucket challenge’ campaign earlier? Well you have our permission to have a good laugh at this video we posted on Facebook and Twitter with the very good intention of raising awareness of our role in supporting people with communication and swallowing difficulties as symptoms of Motor Neurone Disease:

 

SLT Ice Bucket Challenge

https://www.youtube.com/watch?v=chM8NR5j32U

Definitely think our friends from domestics enjoyed this more than us!

 

 

3. Health Promotion.

Using social media has even inspired us to get creative in our approach to health promotion. A recent project at the beginning of this year was for World Voice Day, 16 April 2014. Approximately a third of people working in the UK depend on their voice to do their work. The British Voice Association estimates that the cost of voice problems (dysphonia) to the British economy is approximately £200 million a year. Not including the impact dysphonia can have on general health through associated stress and depression from potential loss of work and social isolation. We created a social media blog and video to raise awareness of the importance of our voice for work and when and how to seek help early. We uploaded the social media video on to YouTube and shared it and the blog with DGhealth and our followers on Facebook and Twitter. Over 600 people took the time to engage in our World Voice Day social media campaign. It’s hard to think of any other more effective way to reach so many people in such a short space of time

4. Social Networking

Social networking can be an innovative way to share your practice based evidence directly with the people and organisations that will be most likely to benefit from it the most. As part of NHS DG dementia champion’s project, Rebecca Kellett, our SLT #dementiachampion, created the ‘communication and mealtimes toolkit’. She has since been invited to present the toolkit at both the RCSLT and Alzheimer Scotland day and also at the European Alzheimer’s Conference. The slide below demonstrates some of the Facebook posts and @SLT_DG tweets highlighting these exciting opportunities:  

But before you think this is all about blowing our own trumpet (!) – If you look more closely at the examples given, can you see the use of # and @? The use of # ensures that anyone searching twitter for information on dementia, for example, will find this tweet. The use of @ means you are directly ensuring any relevant organisations or person’s will receive this information via their twitter notifications. And if you are really lucky, as we were in this example, then hopefully these people/organisations will retweet your message. Alzheimer Scotland retweeted the link to the toolkit to their 10,000 or so followers meaning that many carers across Scotland are now aware of this practical and useful resource for the people with dementia they are caring for.

So as we are drawing closer to the end of this blog maybe you are now hopefully feeling the love for social media a bit more? And maybe even inspired to give it a go if you haven’t already? I should say at this point that we don’t have access to these social media sites through the NHS unless requested and rightly so. But this is something that we are all happy to do out with working hours because it really doesn’t take up too much of our own time. I guess this is also a good time to say, if you are thinking of giving this a go, then stay professional at ALL times. There is no denying that the use of social media is open to abuse; no one wants to know what you are having for your tea. I keep my own personal social media accounts for this more personal information (and even then people really don’t want to know what I’m having for my tea). There is guidance on the use of social media on the intranet that you can refer to if you’re not sure what acceptable use is. You don’t even have to do what we are doing and create a department account; many people within NHS Dumfries and Galloway have their own professional social media accounts. And lastly, you don’t even have to do daft things like tipping icy cold water over your head to create interest. The example below shows how one wee tweet, every now and again, can go a long way.

We tweeted a happy world voice day message to @kendonaldson, Associate Medical Director, Renal Consultant and dghealth guru, who replied and retweeted our message. This then led to Paul Gray (CEO, NHS Scotland and Director General Health and Social Care, Scottish Government (if you didn’t already know)) joining in the conversation and retweeting also. Result! 

 

The Office of National Statistics suggests that eight out of 10 adults in the UK now use the internet on a regular basis. If you haven’t already used social media to raise your professional and service profile, then we would highly recommend it. If you have done so already, then find us, follow us, like, share and retweet us, and we will repay the compliment. We can stay stronger through technology.

 

Further Links:

• Facebook: https://www.facebook.com/SpeechandLanguageTherapyadultServiceNHSDG
• Twitter: https://twitter.com/SLT_DG
• World Voice Day: ‘The Little Mermaid’ video.

Pictured from left to right is Kim Harkness, FairyBodMother. Jade McIntyre, Fitness instructor. Laura Lennox, Speech and Language Therapist and Lynsey Swales, fitness instructor. Thanks again to FBM fitness academy and all the Fairy Bodlings who participated.

     http://www.youtube.com/watch?v=A_dqPuXpPDQ

• And, if you didn’t get the chance to read Becky Davy (SLT) World Voice Day blog first time round then here it is again:

https://dghealth.wordpress.com/2014/04/11/world-voice-day-april-16th-by-becky-davy/

• Please click on me for more information

 

Laura Lennox is a Speech and language therapist at NHS Dumfries and Galloway

NHS Scotland Event Day 2 by @PAG1962 & @craigwhitephd

This week saw the annual 2 day NHS Scotland Event 2014 held at the SECC on 3^rd and 4^th June. Paul Gray blogged about day 1 on the Ayrshirehealth blog and it can be read here. Paul is joined by Professor Craig White in blogging about day 2 below.

 

Paul Gray. Chief Executive, NHS Scotland and Director General, Health and Social care

 

 

 

 

Day 2 and more to motivate and inspire. The opening speech by Cabinet Secretary Alex Neil emphasises, among other things, the critical importance of putting the experience of patients at the centre of what we do.  I had some important conversations with the unsung heroes of primary care – particularly the AHPs, who have so much to offer, and great insights into what would make a real difference to patients as we move forward with the integration of health and social care. 

NHS Board Chief Executives met in the middle of the day. One issue that created animated discussion was the vexed question of banning smoking on NHS property, and enforcement of any such ban. Chief Executive of Health Scotland, Gerry McLaughlin @McLGerry is going to develop some proposals for discussion.

 

Sally Magnusson hosted a lovely closing plenary, drawing on three short case studies which set out our approach to engaging with patients, families and carers at every life stage to design services which genuinely meet patient needs. Her deceptively gentle but incisive interviewing style drew out some important points about the way we engage with our workforce and the people we serve, to deliver in a way that makes a real difference to people’s lives.

 

 

 

So, in an event designed to enhance our understanding of what works, and to energise everyone to spread sustainable improvements, I came away with real confidence that we can face the challenges ahead with assurance. There’s no place for arrogance or complacency – we face real and daily pressures – but we have a real basis of strength on which to build.

Paul Gray Twitter @PAG1962

 

 

Craig White, Divisional Clinical Lead, The Quality Unit, Scottish Government Health and Social Care Directorates

 

 

 

Day two of the NHS Scotland event started with an opening address by Alex Neil, Cabinet Secretary for Health and Wellbeing. He reminded us that providing health and social care that is truly person-centred is at the heart of ensuring Scotland’s health and social care services evolve to meet the challenges of the future. Being consistently person-centred in word and deed is a central guiding principle of our caring services. Mr Neil announced that a new system of listening to, and promoting people’s voices in our health and social care system will be developed.

 

Within minutes of this announcement colleagues already started to welcome this on social media…

..and then later a blog posting from the Chief Executive of the ALLIANCE:http://www.alliance-scotland.org.uk/viewpoint/2014/06/citizen-voice-at-the-heart-of-health-and-social-care/

We now have a strong sense of what matters most to people – this person-centred focus and commitment has already seen us make tangible progress in recent years with continuous improvement of the quality of services, making our services more accountable, and ensuring that people’s experiences inform action at all levels of our health and social care system. We want people to be the lead partners in decision-making about their care at all levels – individually, locally and nationally. We want these ‘Always Events’ to become part of the way we do things in NHSScotland.

 

The Person-Centred Health and Care Collaborative, the People-Powered Health and Wellbeing Programme and Scottish Health Council’s work are already demonstrating what best practice looks like – the challenge is to make sure that this is experienced by every citizen of Scotland. Wednesday’s announcement will accelerate the progress required to make this a reality. We need to make sure that all of the wonderful ideas, plans and decisions are informed by what has worked well so far. This way we can create an effective and truly independent voice that will ask people what matters to them – then we will systematically support work to ensure people are at the heart of all we do.  Exciting times indeed, and a wonderful chance to shine a light on the bright spots already happening, spread this and scale up across the country.

 

Staff, of course, are people too – their experiences, ideas and concerns must also be listened and responded to. The Cabinet Secretary emphasised his commitment to this and also to ensuring that NHSScotland staff are supported to develop to the fullest extent of their potential. Although this applies to all NHS Scotland staff, Mr Neil announced specific actions that will focus on making NHS Scotland the most attractive system in the world for medical staff to train. NHS Education for Scotland will work in partnership with the Scottish Academy of Medical Royal Colleges and NHS Boards to make this a reality.  The announcement of the creation of a Health & Social Care Innovation Fund was a further sign of the Scottish Government’s commitment to support Scotland’s track record as a world leader in development, improvement and innovation. I know that staff will welcome this across the country – after all it is our staff that know best what the challenges are, where and how we might support innovation.

NHS Scotland is already a world leader in so many respects – the vision, leadership commitment, resources and clarity of direction that have been set out in Wednesday’s announcements; combined with the ideas, will and expertise among all of the delegates at the breakout sessions will be a powerful combination for further change, improvement and innovation.

We now have the strongest possible platform for Scotland’s to deliver integrated clinical and care services that are of the highest quality – person-centred, safe and effective for everyone, every time. The initiatives announced today will accelerate progress in the direction outlined in the 2020 vision, a vision of a health and social care system that:

• Gives people a strong voice about their NHS, their health & care system
• Supports all staff to fulfil their potential
• Fosters innovation
• Further supports our world leading patient safety programme
• Is demonstrably and truly person-centred in everything

The vision and direction has been set, is clear and extremely compelling – we now all have a big opportunity to reach ‘escape velocity’ (see http://www.ihi.org/Engage/Initiatives/EscapeVelocity/Pages/default.aspx)

Here’s to next year’s NHS Scotland Event – or maybe ‘Health and Social Care Scotland Event’? (thanks to @GeoffHuggins, Acting Director of Health & Social Care Integration, Scottish Government for raising that idea).

Craig White

Email: craig.white@scotland.gsi.gov.uk Twitter: @craigwhitephd

 

Whisky with Water by Nigel Calvert

A man dies and goes to Heaven. When he arrives he sees that there is a long line to the Pearly Gates. After some time he hears a commotion behind him and turns to see a man in a long white coat with a stethoscope in the pocket cutting past everone. He strides right through the gates without a pause and past everyone who had been waiting forever. When the man gets to St. Peter he says, “Say, who was that guy who cut past everybody and walked right through?” St. Peter replied, “Oh. That’s God. Sometimes he likes to think he’s a doctor.”⁽¹⁾.

There was a time when only doctors and nurses had access to the medical information necessary to make a diagnosis and decide on the treatment that was needed. The World Wide Web has changed all of this and now anyone can have access to an almost inconceivable amount of information, both accurate and poor quality. According to the Office for National Statistics, eight out of ten Brits use the web regularly ⁽²⁾. It is interesting to consider the ways that this can impact on health. That, together with a shameless plug for our new Health Protection and Screening website ⁽³⁾ is the subject of today’s blog.

It’s very easy to “Google” a few search terms and come up with a wide range of material, some legitimate and peer-reviewed, some of dubious provenance and quality. With unfettered access to all kinds of health information, we need to help people to make sense of it all. I’m reminded of “J.” the narrator in Jerome K Jerome’s Three Men in a Boat who went to the British Museum one day to read up the treatment for hay fever. In an unthinking moment, he idly turned the pages of the book and discovered that (apart from Housemaid’s Knee) he suffered from every complaint listed ⁽⁴⁾. The scare stories erroneously linking MMR to autism happened in the early days of the web and certainly before today’s almost universal access, yet various anti-vaccine websites still managed to stir up public opposition to the vaccine despite any credible evidence. How much worse might this be now?

But what about the positive ways in which the web can affect health? Using the web as a means of interacting, and even as a tool for delivering healthcare has exciting possibilities. Peer support forums, often run as self help groups – with or without the support of charities – are common. These are perhaps most beneficial for stigmatising or embarrassing conditions where the relative anonymity of the internet can be an advantage. People with rare conditions can also benefit from the global reach of the web. Online consultations with GPs now take place using email, and increasingly with Skype/FaceTime etc. In a rural area, telemedicine can help an isolated GP to get a quick dermatological opinion about an unusual rash. In Scotland we have many national Managed Clinical Networks and teleconferencing over the web can sometimes save hours of travelling for some more productive use of the time.

The web has enabled a shift in the balance of power between health professionals and the public. More than a decade ago, there were reports ⁽⁵⁾ of patients bringing printouts of websites into their consultations with health professionals and today this is commonplace. Interestingly in that survey, the patients reported far more benefit in bringing in material from the web than did the health professionals.

The wider public health can also be affected by the web. An internet-enabled society means that more of us can “home work”. Whilst this may reduce traffic pollution, congestion and potentially accidents, it can also lead to isolation and perhaps a reduction in physical exercise. When whole communities come together on the web it can build social capital. Inevitably when talking about public health, we must consider inequity. The term “digital divide” has been coined to describe the gap in web access that exists between the “have nets and the have nots”. As we grapple with ever decreasing budgets and more printed health information is replaced with web pages (with all the benefits that this brings) we may, paradoxically, be making it much harder for the very people we are trying to reach to actually get access to information about breast screening, immunisation and how to stop smoking.

As healthcare professionals we have to adapt our practice to embrace the world wide web. It provides exciting opportunities to improve quality of care and access to services, particularly in a rural area such as ours. It is true that not everyone has access to a computer, and that in some remote areas internet speeds are still very slow, but in time that will improve.

By its nature, the health related material on the web can’t be controlled so we have to provide easy access to high quality health information. Many charities such Marie Curie, Meningitis UK and Diabetes UK do a great job. The NHS too has some websites of which it can be justifiably proud – NHS Inform is a good example. Now for my shameless plug. Just before Christmas we launched our new Health Protection and Screening website. It provides some original content, such as our policies and newsletters, but much of it consists of links to other material on the web – there’s some great stuff out there if you know where to find it. So far, we’ve had about two and a half thousand hits – a reasonable start. Please have a look – just remember Gavin and Stacey’s Uncle Bryn’s ⁽⁶⁾ sage advice to put w-w-w (whisky with water) in front of absolutely everything – www.dghps.org.

References

1. http://jokes.cc.com/funny-god-jokes/fg98b0/heal-the-world
2. http://www.ons.gov.uk/ons/rel/rdit2/internet-access-quarterly-update/q3-2013/stb-ia-q3-2013.html
3. http://www.dghps.org
4. http://www.gutenberg.org/ebooks/308
5. http://www.ncbi.nlm.nih.gov/pubmed/11956037/
6. http://www.imdb.com/character/ch0122304/quotes

Nigel Calvert is a Consultant in Public Health Medicine at NHS Dumfries and Galloway

 

What can Plato and the Allegory of the Cave teach us about the Media? by @ychristley

In 380 BC, the Greek philosopher Plato in his most famous work ‘The Republic’ presented the ‘Allegory of the Cave.’ The ‘Allegory of the Cave’ is one of the most important and vivid metaphorical stories in the history of philosophy and outlines Plato’s assertion that most people are blind to the reality that surrounds them.

To make his point, Plato asks us to imagine an underground cave, in which prisoners are shackled by their legs and necks. The prisoners are unable to move or turn their heads and can only see the wall in front of them. Behind them, on a raised platform is a puppeteer and behind him, is a fire. The fire casts a continuous parade of puppet shadows on to the prisoners’ wall. The prisoners have never lived outside the cave and consider the shadows to be real.

The peculiar imagery in this story and the way in which it conveys the prisoners’ deep, distorted and disconnected perception of reality has always fascinated me. The notion that reality was framed for the prisoners by not only the puppets, but by the shadows of puppets, is very disturbing. To make the story even more interesting, Plato tells us that if the prisoners are suddenly released and shown the truth they become overwhelmed, confused and bewildered and will ultimately disregard the truth as false. Not all prisoners can bear to recognise that the shadows are puppets and only a few make the journey upwards and out of the cave towards the light.

Plato uses the cave to symbolise society and makes clear his view that we all, at some point, will be prisoners within it. In my view, the cave is one of the most optimistic and beautiful depictions of our human ability to cast aside the bonds of conformity, established opinion and ordinary experience, in the pursuit of enlightenment.

Although Plato wrote about the cave more than twenty four centuries ago its powerful imagery resonates intensely with the influence of mass media on our modern world. We are living through one of the most technologically advanced and intellectually stimulating periods in human history. We can access information and images from a bewildering assortment of mass media outlets (i.e. newspapers, television, radio and the internet) in an instant. Despite the growth of social and other online communication technologies, mass media remains the dominant figure with respect to local, national and global news and what that constitutes. These outlets have unparalleled reach as a communication mechanism and have enormous influence in setting the kinds of issues that we should be thinking about, concerned about and taking action on.

The availability of so much news makes it a formidable challenge for individuals to determine whether or not the information and images provided by the media are real and worthy of our belief. To illustrate the point, the veteran news reporter Jon Snow, in an article in the British Medical Journal, provided a powerful insight into the disproportionate media focus on negative news stories in the NHS. The article made visible the preoccupation amongst the media with naming and shaming hospitals and exposing failures. Little attempt was made to look beyond the immediacy of failures, and opportunities for qualification or even praise were eliminated. His critique acts as a cautionary reminder that reality as depicted by the media is not always what it should be. The way in which the NHS is reported matters, because it shapes how the NHS is perceived by patients, staff and the wider public. It is for this reason that the prevailing tendency towards negative reporting puts the NHS at risk of becoming lost in an abyss of media complacency, which puts news corporation profit above other considerations.

 

The power of Plato’s imagery amazes me with its timelessness and urges us all to recognise that everyday belief and opinion are no better than seeing shadows. Thankfully, we are not like prisoners chained with our backs to reality and all we need to do to improve our modern world is turn around, take notice and do what matters. Of course, doing what matters is never easy and I am reminded of the poem by the Greek poet Aeschylus:

“And even in our sleep, pain that cannot forget falls drop by drop upon the heart and in our own despair and against our will, comes wisdom.”

Yvonne Christley is Head of Patient Experience and Communications at NHS Dumfries and Galloway