The Doctor can see you virtually now by Chris Fyles

While Googling recently (for Technology Enabled Care related reasons!) I happened to come across PawSquad.  They provide “instant, qualified online vet advice” through the provision of video or text chat consultations to keep your pet “as happy and healthy as they can be”.

Amazing! Whatever will they think of next?

How about similar services for you, me and everyone else? Wouldn’t it be nice to be able to use these options to support you and your family’s health or to deliver services differently?  We can do that… can’t we?

YES WE CAN!

There are other health and social care partnerships in Scotland that support people to manage their health and wellbeing by video consultations and text message.  There is also demand from the public with the rise of commercial companies that offer GP appointment by video with the ability to deliver medication to your door the next day or email you a prescription.  Need a Physio? Initial and follow up consultations can be provided through video and exercise packages sent to your device for you to follow.

Now, some of you will be thinking “that’s all well and good but the internet connection at where I live and work is terrible!”  While that may be the case right now in some of the areas across our region, it is getting better.

Don’t just take my word for it – there is an ongoing programme of work being led by the Scottish Government and Dumfries & Galloway Council to support the roll out of superfast internet access and improve the speed of regular broadband.  It began in early 2014 and is planned to continue to the end of March 2018 enabling access to superfast broadband for 95% of premises in the region.  The Scottish Government have also committed to deliver 100% superfast broadband by 2021.  At the moment, our region looks like this:

Maybe you are thinking that the people that use your services don’t access the internet? It may surprise you to know that the internet was used daily or almost daily by 82% of adults (41.8 million) in Great Britain in 2016, compared with 78% (39.3 million) in 2015 and 35% (16.2 million) in 2006.

Or that during 2016, 70% of adults accessed the internet ‘on the go’ using a mobile phone or Smartphone, up from 66% in 2015 and nearly double the 2011 estimate of 36%.  It’s not only young people using the internet, recent internet use in the 65 to 74 age group has increased from 52% in 2011 to 78% in 2017, And finally, of those people using the internet, 51% of them were looking for health related information and 43% of people are using the internet to make telephone or video calls using applications such as Skype or Facetime.

If you wish to see some statistics on Internet users in the UK click here

If you wish to see some statistics on Internet access click here

So if we have connectivity, people are familiar with the internet, they are using it to access health information, and they are using it to make video calls why are we not offering our health and social care services via video?

In some places they already are. NHS Attend Anywhere was launched at the end of 2016 and has been developed by NHS24 in collaboration with Healthdirect Australia to enable video call access to Health services as part of normal day to day practices.  Instead of going to a health facility and physically sitting in a waiting room patients just use their device to access a virtual waiting area which the clinician comes and ‘collects’ them from to  begin the consultation. Services delivered elsewhere in Scotland include Pharmacy Reviews, Speech and Language Therapy, Dermatology, Endocrinology, GP appointments, Out of Hours care and more.

“What do I need to be able to do this?” I hear you ask.  For video consultations both the clinician and the person using the service need nothing more than a device (PC, laptop, Android or Apple tablet or Smartphone) that can access the internet with Google Chrome or an Attend Anywhere app installed and internet access of course.  NHS Attend Anywhere doesn’t need superfast internet access to work and generally speaking if you can watch a video on YouTube then you will be able to participate in a video consultation.

Curious to find out more and have a go? Try clicking the link below, follow any onscreen instructions and have a seat in our Demo Waiting Area:

Click Here

Once you are placed into the waiting area a notification will be sent to me and if I’m free I’ll come in and join you for a quick video call.  If I can’t make it you will at least have seen how easy the system is to use and begin to see opportunities to use it within your service. Preliminary results from a national survey in Scotland completed by people that have used NHS Attend Anywhere already indicate that 95% of them would use it again.

Video consultations give us options for flexible services going forward. It can help to reduce travel for people using our services and it could be a tool to help us to recruit to specialist posts from elsewhere to link in to Dumfries & Galloway. If we were offering video sessions into the home, it is possible to think that the person providing the service could also be at home and not in Dumfries & Galloway?

We expect to be able to use technology to buy shopping, make travel arrangements, manage our banking, communicate with our friends and to keep up to date with what’s happening in the world. Hopefully this blog post has made you think about new ways to use technology to deliver your service or to access a service. So what are you waiting for?

For more information or help with any of this, please contact Chris Fyles, Technology Enabled Care Project Lead for Dumfries & Galloway by email: chris.fyles1@nhs.net
LYNC:  cfyles@citrix.dghealth.scot.nhs.uk  or by phone:      07979357010 / 01387220006

Video consultation is one of four areas of focus for the Dumfries & Galloway Technology Enabled Care Programme. The others include Telecare, Digital Apps & Services and Home and Mobile Health Monitoring (HMHM).

How Advanced is your ANP knowledge? by Barbara Tamburrini

Advanced nursing practice is not a new concept. Indeed, specialist nursing roles, from which advanced nursing practice has evolved, have been around since as early as the 1920’s. The advent of World War 2 dramatically enhanced the specialist nurse role through the significant development of new skills which were required to meet the huge and urgent demand in hospitals and infirmaries throughout the world. The clinical nurse specialist (CNS) role was underpinned by academic qualifications as early as 1954 and over the following decades, these nurses were fully embraced as experts in their fields. This academic foundation represented a momentous shift in the educational vision for nurses towards university-based knowledge development with expertise achieving the application of this knowledge in practice.

With CNS roles being conceptualised as fundamental to in-patient care quality, the nurse practitioner role was developed to replicate this degree of specialism in primary and community care. During the 1990’s, universities within the UK began to affiliate nurse practitioner courses with graduates predominantly practising in GP practises to address the targets around 24 hour access to healthcare professionals and 48 hour access to a GP. These nurse practitioners were trained to assess minor injuries & illnesses which freed GPs up to review and manage patients with more complex needs.

During the 1970’s, very specialised nursing roles emerged in areas such as pain management and colorectal surgery and less than 20 years later, academic institutions were making BSc Nurse Practitioner qualifications widely available with paediatric, primary care or hospital based routes all an option for graduation. This was further enhanced by the advent of the Hospital at Night (H@N) concept, piloted early in the 21^st century and rolled out across the UK by 2006.

Here in NHSD&G, we have had nurse practitioners achieving significant levels of specialist nursing in GP surgeries for 2 decades and in the Acute and diagnostics Directorate, the H@N concept was introduced in 2006 with an initial team of 6 advanced nurse practitioners (ANPs). These nurses hit the ground running with assessing unwell & deteriorating adult in-patients overnight and gradual recruitment has enabled development into a weekend daytime role. The manifestations of this role evolution is evidenced by increased continuity and quality of in-patient care, decreased residual clinical tasks and reduced numbers of un-planned critical care admissions by promoting the early recognition and management of deteriorating patients. Furthermore, a presence has been fully established within the medical admission unit and an ambulatory care pathway has been formulated which is delivering on its commitment to reduce medical emergency admissions.

Within the Emergency Department, ANPs have been managing a case load of stream 1 (minors) presentations since 2005 when 2 existing members of staff commenced their ANP course & carved out this new role. This team gradually increased to 3 ANPs once the benefit on improved ED flow was realised. In recent years, the ANP presence in ED, has developed to include presentations in stream 2 (majors) and stream 3 (resuscitation) and this has contributed significantly to achievements in ED HEAT targets whilst also maximising ED patient care.

The Galloway Community Hospital also now has an ANP presence with a crucial role to play in the acute “Garrick” ward in addition to supporting the patients within the “Dalrymple” rehabilitation ward. In addition, advanced practitioners are now clinically active in the neonatal, obstetrics, gynaecology and paediatric specialities within NHSD&G and a number of GP practices around the region benefit from ANPs working alongside their GP, practice nurse, CNS, district nurse & health visiting colleagues. Indeed, a new and exciting venture comes to us in the form of advanced allied health practitioners which is currently in the recruitment process and this opens yet another door to the advanced practice house.

However, fundamental to all of these roles, is the definition of advanced practice and the demonstration of this achievement. For the first time, this area of healthcare is firmly on the Scottish political agenda with the Chief Nursing Officer’s Transforming Nursing Roles programme providing the following agreed definition for an ANP role:

1. An Advanced Nurse Practitioner (ANP) is an experienced and highly educated Registered Nurse who manages the complete clinical care for their patient, not solely any specific condition. Advanced practice is a level of practice, rather than a type or speciality of practice.

 

2. ANPs are educated at Masters Level in advanced practice and are assessed as competent in this level of practice. As a clinical leader they have the freedom and authority to act and accept the responsibility and accountability for those actions. This level of practice is characterized by high level autonomous decision making, including assessment, diagnosis, treatment including prescribing, of patients with complex multi-dimensional problems. Decisions are made using high-level expert knowledge and skills. This includes the authority to refer, admit and discharge within appropriate clinical areas.

 

3. Working as part of the multidisciplinary team ANPs can work in or across all clinical settings, dependent on their area of expertise.

 

Advanced nursing has 4 pillars of practice which ANP’s must have as part of their core role and function and although the primary focus is on clinical practice, all 4 practice pillars must be demonstrated. These are:

• Clinical practice
• Leadership
• Facilitation of learning
• Evidence, research and development.

The demonstration of achievement of the pillars of practice and consequently the ANP role has also been clearly defined at national level and this involves the outlining of professional competencies, participation in effective clinical supervision and meeting robust continuous personal development. Within NHSD&G Acute & Diagnostics Directorate, the value placed upon this level of practice has been highlighted by the appointment of an ANP clinical manager to deliver this national agenda in a cohesive, collaborative and joined-up way across NHSDG to ensure we are meeting our strategic responsibilities within this national framework.

Both nationally and locally, discussion and debate has taken place on the differences between advanced and specialist practice and as these nursing roles have progressed, differences and similarities have become evident. This is a wide-ranging area for debate encompassing all aspects of specialist practice but it is worthwhile to clarify that advanced and specialist practice should not be seen as directly hierarchical relationships; advanced nursing is not more senior than specialist and the reverse is equally applicable. Both levels of practitioners function at an extremely high level of practice, but with very different clinical focuses.

In summary therefore, it is obvious that advanced practice has evolved over a significant period of time and has ‘proved its worth’ in a number of healthcare areas with significant benefits for the delivery, safety and quality of patient care. Even though this concept has been fairly consistently on the agenda, the momentum around the role, its function and the measures of achievement and effectiveness has significantly gathered pace over the last 10 years with a further ‘injection’ since the implementation of Transforming Nursing Roles. This galloping horse (it is Ascot Week after all!) will only gather pace as more healthcare professionals such as physiotherapists, dieticians, pharmacists to name but a few, begin to realise the potential for their own advanced roles. This can only be a good thing with advanced practitioners now able to drive their own development whilst clearly evidencing their clinical confidence and competence for a discerning public who, quite rightly expect the best.

Exciting times ahead – are you ready to jump aboard?

Barbara Tamburrini is the ANP Clinical Manager

Being Carer Positive by Lesley Bryce

This week (12-18^th June 2017) is Carers Week.

Carers week is a national awareness week that celebrates and recognises the vital contribution made by people across the UK who currently provide unpaid care.

A Carer is someone of any age who provides unpaid help and support to a relative, friend or neighbour who cannot manage to live independently without the Carer’s help due to frailty, illness, disability or addiction (Scottish Government 2016).

The focus this year is on building communities which support Carers to look after their loved ones well, while recognising that they are individuals with needs of their own.

3 in 4 carers don’t feel their caring role is understood or valued buy their community.    (http://www.carersweek.org/)

In Scotland, there are at least 759,000 Carers aged 16 or over and 29,000 young carers. The value of care provided by Carers in Scotland is £10,347,400,000 a year. Unpaid Carers are the largest group of carers in Scotland, providing more care than the NHS and council combined. Carers should be seen as a vital and valued part of our health and social care system. Three out of 5 of us will become Carers at some stage in our lives and I in 10 of us is already fulfilling some sort of caring role.

(https://carers.org/country/carers-trust-scotland)

In Dumfries and Galloway, unpaid Carers provide over half of all care required, approximately 410,000 hours per week. There are 14,995 Carers in D&G (2011 census) although the figures are likely to be significantly higher as many people do not identify themselves as a Carer. Latest figures reveal that Carers in D&G make up 10% of the population and of this group, 29% provide more than 50 hours of support a week.

NHS Dumfries & Galloway recognise the important role that Carers play in our community and are determined to ensure that staff who have an unpaid caring role are supported to manage their own caring responsibilities with confidence and good health, whilst remaining in work.

One in five Carers give up work to care (https://carers.org/key-facts-about-carers-and-people-they-care). I gave up my employment when my son was 4. I returned to work after a long break. I personally know how much of a struggle it can be to juggle work and caring responsibilities and the effect this can have on your own health and well-being. I also understand the impact that giving up work can have on your personal finances and self- esteem.

Most of you will know that NHS Dumfries & Galloway were successful in achieving the Carer Positive engaged award in 2016. Carer Positive provides a framework around which employers can develop and implement positive working environments which support staff who are unpaid Carers. NHS Dumfries is moving forward with our Carer Positive journey to improve and progress to established level. We are working in partnership with D&G Council and the Third Sector to embed a culture of support for Carers across the health and social care partnership.

During Carers Week, there has been lots of activities to support Carers including those in the workplace.

Arrangements have been made to promote the Special Leave Policy via workforce briefings and intranet flash ads so look out for these.

Carers Leave for NHS D&G is detailed in the Special Leave Policy which can be accessed from the BEACON intranet pages. If you do not have access speak with your manager in the first instance or contact a member of the Workforce Directorate team.

The new Carers information ‘z’ card is being promoted soon so look out for these 😊

Carer online training modules are available to all staff on learnProNHS (under the CPD tab) and through the Open University Open Learn platform. It includes NES EPiC levels 1-3. NES in partnership with the Open University in Scotland have developed Caring Counts in the Workplace. This is an online course for managers and policy makers. The course sits on the OU’s free Open learn platform, with a link from the EPiC e-learning site.

( http://www.open.edu/openlearncreate/course/view.php?id=1841)

I am one of the Carer stories in this web based learning and it really shows how far I have come when I look back on the last 4 years. From that pilot with the Open University, I went back to UWS then I got a role on the board as a Non- Executive Director where I am also proud to be the Carers champion.

I know that it is exhausting sometimes having caring responsibilities and working and it has certainly helped me to have support to continue in my role.

The Hospital Carers project offers support and advice. It is based in the centre opposite the lifts in the main entrance lobby at DGRI where you can also find their Carer’s Week information display.  You can contact Lindsay sim or Jennifer Cranmer on 01387 241384.

Dumfries and Galloway Carers centre provides information, advice and support to anyone who cares for a relative or friend. They can be contacted on 01387 248600 or email info@dgalcarers.org . The centre has been an invaluable lifeline to me for the last 15 years.

The current Dumfries and Galloway Carers Strategy expires in 2017.Following consultation with Carers, Carers organisations and partners, a draft strategy has been developed for 2017-2021.The consultation closes on 30^th June 2017. Here is the link:

https://www.surveymonkey.co.uk/r/dgcarers

For more information or assistance to complete the survey, please email Carers@dumgal.gov.uk or phone 01387-246941. Hard copies are available on request.

If you are a staff member who is a Carer and would like to be involved in Carer Positive, please feel free to get in touch. Please contact Philip Myers, Health and Wellbeing Specialist (philip.myers@nhs.net) or Larel Currie, Commissioning Officer, Joint Strategic Planning and commissioning (larel.currie@dumgal.gov.uk).

Lesley Bryce is a Non Executive member of NHS Dumfries and Galloway Health Board

 

 

Eat Fact, not Fiction….by Laura King

Barely a week passes without headlines (or Twitter trends) about diets and how to lose weight, improve your energy levels / skin/ hair / libido / life expectancy. Often these are contradictory and can lead to confusion. Whenever the headline suggests that a fad diet or miracle food is the holy grail that will solve all our health problems alarm bells should ring!

Dietitians are trained to examine the evidence behind such claims and sift out the facts from the fanciful. Unlike many medical trials where a drug is tested for effectiveness (usually against a placebo), nutrition trials are usually more complex and difficult to interpret. Mainly because nearly everybody eats, and people’s baseline diets and habits are so varied it makes it difficult to isolate the effect of altering one aspect of the diet.

We also consider the person as a whole and aim to prioritise dietary aims. An example of this is a referral that came through recently for a lady in her 80’s who wanted advice for diverticular disease and type 2 diabetes. When we saw her, it became evident that she had lost a considerable amount of weight since losing her husband. We were able to explain to the patient and her family that this was the greatest nutritional risk to her so we would encourage her to prioritise eating a little of what she fancied to try and boost her weight rather than follow a restrictive diet for her other conditions, particularly while she was an inpatient when we know that people are vulnerable to malnutrition.

As part of the fourth annual Dietitians Week being held June 12-16, the BDA and dietitians in Dumfries & Galloway are encouraging the public to get their advice on diet from the properly qualified experts. The public should also ensure any diet plan they follow is based on scientific evidence. Some of the advice given in relation to fad diets is not just ineffective, it can actually be harmful to people’s health.

Evidence-based nutrition advice is important because often the trials that are reported may be based on small, specific experiments and the results may not translate easily to real life or real people. Dietitians can interpret the evidence and help people make adjustments that fit into their lifestyle and are sustainable.

Eg. There is evidence that eating large quantities of soya can reduce cholesterol, but for the majority of people, having large quantities of soya-based products for breakfast, lunch, dinner and snacks is not going to be an achievable goal.

Dietitians Week

Annually, the BDA run a weeklong event called Dietitians Week, aiming to promote the importance of dietitians and the great impact they can have on the nation’s health and wellbeing. This year the week runs from 12-16 June and is taking the theme of Evidence and Expertise and you will spot our myth-busting displays around DGRI. This is to promote the importance of ensuring that dietary and nutrition advice comes from evidence-based sources, whilst highlighting the risk of following guidance that is not scientifically credible.

Please take time to look at our displays next week and when you see us out and about in the hospital, grab us for a chat about nutrition, fad diets and separating the fact from fiction.

Laura King is Lead Acute Dietitian at NHS Dumfries and Galloway

What Matters to You? by Alice Wilson (& many others!)

“What matters to you?” day is on 6^th June and you may have seen information about it around the place. We are encouraged to think about what matters to us and to have conversations with individual service users, their families and our colleagues about what matters to them, so we can use that information to improve the care and support we give to individuals and their families and promote a healthy working environment.

I thought it would be an idea to focus this blog on people who work in our health and care system and asked them to share what matters to them in and out of work and to share a few photos if they wish. I am grateful to those people who have shared what matters to them. Thank you, this blog is yours:

 

Emma Jackson is a physiotherapist at Newton Stewart Hospital:

In work

Up to date handovers and good communication between staff

Being able to build trusting relationships with patients by using appreciative inquiry, and having the time to get to know them as a person

Out of work

Being able to spend quality time with my family, friends and pets

Having personal goals to work towards

– Being able to get outside as often as possible – walking in long grass with my dogs is my fix

 

Morag McMinn, support services assistant, Gerry McDermott, support services manager, Kay Shepherd, support services supervisor

Liz Jardine, support services assistant, Linsey Wharram, support services assistant, Helen McCaig, support services assistant

 

Morag McMinn:

In work

To come into work and not get hassle.

That staff get things right, especially the care and the care of people with dementia

Out of work

My two granddaughters

 

Gerry McDermott:

In work

My staff feel respected and part of the whole network of the NHS

Out of work

My kids and the football (Celtic FC)

The kids are growing up fast and I want them to fulfil their dreams

CFC has fulfilled its dreams this year!

Kay Shepherd:

In work

Staff are happy and get on well, there is mutual respect

Staff trust me to come and speak to me

 

Out of work

My four kids – my weans

Liz Jardine:

In work

It’s all about the patients; I enjoy talking to them and being part of the team

Being able to go to the supervisors and talk to them

Being happy in work

 

Out of work

My two sons and spending time with my husband as well as my wider family.

Supporting our sons to achieve in life

Lynsey Wharram:

In work

Being involved with the patients, additional responsibility is a privilege, such as taking people on their last journey to the mortuary

Being part of the team, uniform colours don’t matter

Out of work

My wee brother (Murrey) and people now recognising disability more

Proper training for people about disability and dementia

 

Helen McCaig:

In work

To come to work and being happy working

Being part of making patients feel their privacy is respected

Out of work

My husband and son – we are really proud of our son who is now doing his Masters at

Cambridge University

My cat, Salem

Helping my father who has dementia

 

Pictured: Jeanie Gallacher and Stephanie Phillips, Primary Care Mental Health Liaison, Stewartry. Norma Cunningham, Community Mental Health Team Support Worker, Stewartry.

 

Jeannie Gallacher & Stephanie Phillips

In work

As staff working within a new project in Primary Care Mental Health Liaison, it matters to us that patients feel they can have quick access to appropriate mental health treatment.  It matters to us that we forge good working relationships with our colleagues and that the service we provide is supportive and effective.

Out of work

Jeanie –   I feel it is important to have lots of quality time with my family and it matters to me that we try to get away for family days out and holidays!

Stephanie – It’s important to me in my home life that my family are healthy.  I enjoy walking my dog every day and this matters to me.

 

Norma Cunningham: 

In work

Firstly what matters to me is that I provide a good service to our patients.

It also matters to me that staff feel valued and encouraged to reflect and develop, and that staff receive positive feedback when there have good outcomes for patients.

Out of work

I have learned that it is not what you have in life but who you have in your life. My life is richer for having a family to love, grand children to cherish, friends you can rely on and pampered pets.

 

Grecy Bell is a GP and Deputy Medical Director in Primary Care

 

In work

Team work, having a shared understanding of each other’s role and common goals

Out of work

Having time to enjoy shared memories with family and friends

 

 

Linda Williamson is a General Manager in Women Children & Sexual Health

Linda has a pictorial creation, representing her in work and out of work “what matters to me”

 

Then there’s me:

Alice Wilson, Deputy Nurse Director

In work

Being able to see the impact of my work on individuals and teams

Knowing that what I do makes a positive difference to the people we care for and their families

Being proud of my profession

Out of work

Spending time with my family and friends and living in a lovely place which feels a million miles away from the hustle and bustle of work. I’m part of a big family and a small community – ideal

Knowing (through whatever means necessary!) that someone will make sure I have nice shoes even when I am no longer able to walk in them!

Pictured: the view I see every day from the front of my house…it is amazing even at the close of the day – the bike is just there to fool you into thinking that’s the only mode of transport I use!

On 6^th June and every other day, take a minute to think about what matters to you and ask yourself if you know what matters to your colleagues and those people you care for and support; if not, why not ask them?

Alice Wilson is Deputy Nurse Director at NHS Dumfries and Galloway

Be Prepared ….Have the Power by Graham Abrines

I think all of us would agree that making informed decisions for ourselves or others is one of the most responsible and indeed worthwhile things we do on a regular basis. It’s something we largely take for granted.

It’s only when matters begin to stray from the norm that we question our or others ability to make informed decisions. How many of us have parents, aunt’s uncle’s, partners even whose steady decline is becoming increasingly evident? Bring that same question into the professional arena; it will be more relevant for some than others, watching patients who you may have known for some time or perhaps only just met who are just struggling to make informed decisions.

Having conversations with people, whatever the context, about their wishes around how they want to be supported when they are not in a position to make informed decisions is important. It’s important for a whole raft of reason. The primary one for me; knowing how that person wants to be treated, cared for and supported  when they are unable to make informed decisions for themselves!

That’s why we all need to be better prepared

The message is quite simple if you have family members, patients or even yourself, who haven’t yet thought about how they would like to be supported if they lose the ability to make informed decisions for themselves then now is a good time to consider doing something about it.

Power of Attorney (POA) allows people, whilst they still have full decision making capacity, to state how they want to be treated and who and it can be more than one person, should be making decisions on their behalf when they are no longer able to do so. Quite simply it takes away many of the dilemmas that families and on occasion clinicians find themselves in when deciding what or what not to do in supporting the person.

There are some patients across our hospital settings, who with no POA  in place, require  an application by a family member or the local authority  for a Guardianship Order which is required to be heard in the Sheriff Court  to establish who should be making those informed decisions on their behalf. Take a moment; if that was you, or somebody you knew how does that make you feel? Particularly if you know there was an easier alternative where the person’s wishes were fully known?

POA is a legal process and the POA documents need to be very clear and detail the powers the adult proposes to grant to the prospective attorney/s.  As it’s a legal process involving a solicitor at an early point may be useful and most local solicitors should be able to assist in the drafting of a POA and can provide legal advice on this matter. A solicitor will charge a fee for this service.

Over the next number of weeks the Health & Social Care Partnership, via work within the Delayed Discharge Partnership, Local Authority Communications Unit & Local Authority legal services will be running a media campaign on local radio & TV supported via other methods, buses, bus shelters, flyers & local newspapers to encourage people to think about Power of Attorney.

Many of the local solicitors across our whole region, who are fully supportive of this approach will give a 10% discount to anyone wanting to progress with a POA until the end of June.

If you require further information, please contact Phyllis Wright, Regional  Statutory Mental Health Team Manager  on 03033333001 or Phyllis.wright@dumggal.gov.uk .  The Office of the Public Guardian in Scotland registers continuing and/or welfare powers of attorney under the terms of the Adults with Incapacity (Scotland) Act 2000, and their website offers full information on the POA process. www.publicguardian-scotland.gov.uk/power-of-attorney/power-of-attorney/the-power

So please, for everyone’s benefit   …. Be prepared and Have the Power of Attorney in place.

Graham Abrines is Interim General Manager Community Health and Social Care

Life in the NHS – A Personal View by Robert Allan

I have an admission to make.  Although a non executive member of NHS Dumfries and Galloway, I have never worked in the NHS at the coal face.   However, the NHS was involved at the start of my life, and I suspect the same will be true for the end.

The NHS was five years old when I was born in an NHS maternity home in Ayrshire. Within three days I was operated on for an intestinal problem, and when my mother got me home and I made my first visit to our GP, he detected a heart murmur.   So began my life and my NHS journey.

Frequent visits to Kilmarnock Infirmary and various Glasgow Hospitals became part of the pattern of my childhood.  Some appointments lasted an hour, some necessitated week long stays in hospital for more complicated tests.

In 1965 I had open heart surgery to repair an ASD (hole in the heart) and leaking mitral valve.  I made steady if slow recovery, and by the age of 17 was told I was as good as new and went off to live life.

There followed the healthiest twenty years of my life.  I got a career, I married and we started a family.  In 1984 we moved to London.

I‘d had a minor episode with a stone in the kidney in 1978, but in 1988 this returned with more serious consequences.  It dogged the next eleven years, with frequent visits and admissions to Northwick Park Hospital, and eventually successful removal of the stone in 1999 at West Middlesex Hospital.

Now that all was well, we moved back to Scotland although I continued to work in London.   Then in 2002, out of the blue, my heart problems came back to bite me.   I was hospitalised at Northwick Park, and back in Scotland sought out the expertise of the Arrythmia Team at Glasgow Royal Infirmary.   Unfortunately, after numerous tests and a third failed cardioversion, I realised I had to live with my new condition and carve out the best quality of life possible in the circumstances.  Over the next few years I collected several more LTC’s

So a lot of my time now is devoted to medical appointments and proactively managing my conditions.   It is a bit boring, but the rewards are a quality of life denied to many suffering from the same or similar LTC’s.

My journey so far has taught me many lessons, and I have seen the best and the worst of the NHS.   Here are some of the lessons.

The patient is not always right, but has the right to be wrong.   It is their life.

Only the patient experiences the patient journey from beginning to end.

No one cares more about my health than I do.

No hospital maintains the same quality throughout.  One hospital I attended had its maternity unit put into special measures and several other wards were a disgrace.   But End of Life Care and Cardiology were outstanding.   Another, an old crumbling Victorian edifice with poor facilities, gave some wonderful nursing and clinical care through dedicated teams. It has now been demolished and a new hospital built on the site.

Patient empowerment and patient self management see much better outcomes than leaving it all to the doctor. Taking responsibility for your health is a great way of ensuring the best quality of life possible, and the best from the NHS. Managing our health should be a partnership between patient and clinicians.

I now have multiple Long Term Conditions and mobility issues, but still maintain the best quality of life possible through self managing my health and proactively seeking information on my lifestyle and health conditions.

I became an elected non executive member of NHSDG in 2012 knowing that making even the slightest difference for the better was important. Drive for continuous improvement maintains my sense of purpose.  I bring to the table experience gained from a life in the NHS, and a career in public service spanning over 40 years.    In 2014 I was appointed as a non executive member..

I know the NHS is not perfect, and never will be, but it is a fine organisation staffed by many dedicated and highly skilled people who every day do their best.

The NHS today faces many challenges.  Staff will experience frequent changes and difficulties, but so will patients.   Both need to embrace change and accept that we must do things differently if the NHS is to face the future fit for purpose.  And key is for us the patients to take responsibility for managing our own health, and clinicians and health professionals empowering us to do so.

The future should be bright for the NHS, but success will require hard work, tough decisions, and the support of patients and staff alike.

I am looking forward to many more years of life in the NHS.

Robert Allan is a Non Executive Member of the NHS Dumfries and Galloway Health Board.