Take Two Bottles Into The Shower? Not me, I’m a Clinical Health Psychologist by Ross Warwick

image1Because you’re worth it

Bang! And the dirt is gone!

Eat fresh

I’ve been thinking a lot about advertising these past few weeks as September is a significant time for my team in Clinical Health Psychology. This month we will be making a concerted effort to promote our service, raise our profile and increase our contact with the people we aim to help.

As part of this, Ken has kindly allowed us to take over the blog for a few weeks. I’m kicking things off with an account of what the service does and I thought I would take inspiration from psychological tricks used in the world of advertising to help draw you in and get the message out there.

image2I’ll start, then, with a summary of the service that follows the advice of a Professor of Experimental Consumer Psychology at the University of Wales, Jane Raymond. Prof Raymond advises that rather than bombard the audience with information I should break it into chunks to allow the brain time to process each component:

  • Chunk 1: The Clinical Health Psychology service helps people who have a psychological problem that is caused and maintained by a physical illness.
  • Chunk 2: These problems usually involve unpleasant feelings and unhelpful thoughts about the illness that keep someone from doing things that matter to them.
  • Chunk 3: This can cause distress, affecting overall well-being, medical treatment, self-management and health outcomes

An article in a social psychology journal showed that a wide range of people respond well and are persuaded by stories (Thompson and Haddock, 2012). So to illustrate chunks 1-3 here’s a fictionalised case based on real events:

Jane is a young teacher who has type 1 diabetes. Her condition and the things she must do to keep on top of it are often accompanied by feelings of shame, anger and loneliness. She has frequent thoughts that her condition means she is abnormal and that it must be hidden from others. Because of these unhelpful thoughts and feelings she avoids testing her blood, guesses her insulin levels, is inconsistent with her diet and keeps problems to herself.

She has been absent from work and in and out of the DGRI several times within the past twelve months. Because of this she believes friends, family and colleagues are annoyed with her for not taking proper care of herself and landing them with more responsibility. As a result, she avoids seeing people and has become more and more isolated.”

The next steps for Jane are chunked below:

  • Chunk 4: In therapy we would work with Jane to live well with her condition by addressing her unhelpful thoughts, feelings and avoidant behaviour
  • Chunk 5: As therapy is all about collaboration, Jane’s most likely to have a good outcome if she’s motivated to participate and make changes to her life
  • Chunk 6: Jane can be referred to Clinical Health Psychology by anyone who is involved in her care, be it her GP, Practice Nurse, Dietician, Diabetes Specialist Nurse or Consultant.

In Jane’s story, she’s in and out of DGRI because thoughts and feelings stop her from acting in a way that would help keep her well. So psychological therapy would add value by reducing her distress and unplanned contact with services (and by highlighting that sentence your attention has been focused on a key message about how psychology makes a difference to both the person and the hospital; Pieters and Wedel, 2004).

But would you believe that individual therapy expertly delivered by members of our experienced, compassionate, and, yes, attractive, team is but one feature of our service? In Clinical Health Psychology we also provide training, teaching, supervision and consultation because you don’t need to be a psychologist to provide psychological care (worth mentioning because (a) it’s completely true and (b) according to Goodman and Irmak, 2013, audiences are likely to prefer multi-featured products).

Already the Diabetes and Cardiac Teams are benefitting from increasing their psychological knowledge and skill through participating in Emotion Matters training, and a group of local GPs have recently completed training to introduce CBT techniques into their routine consultations. Recruitment of a second cohort will be underway soon.

Time for pictures of the product:

headshotsBy now thanks to my evidence-based and scientifically informed techniques of persuasion, you will no doubt want to know how you can benefit from working with our wonderful service.

You can contact us by email or by calling us at the psychology department to talk about matters psychological, be it complex cases, potential referrals, or training your department. Find out more about making referrals by consulting our service leaflets which are available absolutely FREE through Beacon by searching for ‘Clinical Psychology’ or looking under ‘Documents’ after following the link below. And as the Patient Information Leaflet can also be found there, you enjoy a 2 for 1 bonus!

http://hippo.citrix.dghealth.scot.nhs.uk/sorce/beacon/?pageid=Sitesearch&searchCriteria=clinical%20health%20psychology

Keep your eyes open for opportunities to attend training events we’re delivering this month and enjoy the blog posts written by the Clinical Health Psychology team over the next few weeks. Finally, to eke this advertising ruse out just a little further, comment below to be part of a Clinical Health Psychology virtual focus group.

Just do it.

Ross Warwick is a Consultant Clinical Health Psychologist and Lead for Clinical Health Psychology at NHS Dumfries and Galloway

What a waste! by Dot Kirkpatrick

It cannot have escaped your attention that the media has been writing about food waste. The Guardian recently reported the latest figures, showing that UK households are throwing away £13bn of food each year. This equates to 7.3m tones of household food waste. Of this, 4.4m tones were deemed to be avoidable. This set me thinking about my own food waste. I can honestly state that apart from the occasional out of date yogurts caused “buy” 2 packs for £3 scenario, I either cook and freeze or make the ingredients into soup! I am not precious about sell by dates unless associated with a dairy product, fish or chicken, apart from when I am having people for dinner! I can’t be poisoning the guests? A plaque in my kitchen states… “Many people have eaten here and lived!”

Dot 2This brings me around to the purpose of this blog. Medicines waste. I feel a bit of a turncoat as I have given many a presentation clearly stating that you cannot compare the difference between Kellogg’s cornflakes and a supermarket cheaper own brand with branded drugs and their generic equivalent. However in this instance there is an analogy.

A report by the Department of Health estimates that unused medicines cost the NHS around £ 300 million every year, with an estimated £ 110 million worth of medicines returned to pharmacies, £90 million worth of unused prescriptions being stored in homes and £50 million worth of medicines disposed by Care Homes.

These figures don’t even take into account the cost to patient’s health and well being if medications are not being correctly taken. If medicines are left unused, this could lead to worsening symptoms and extra treatments that could have been avoided.

Due to the complexity of the causes of medicines wastage, a multifaceted and long-term approach across all healthcare sectors is required including partnership working with third sector organisations, public health, voluntary groups and local councils.  Coming to a surgery, pharmacy, library, council office near you soon, will be posters(designed and printed by our local council)  letting you know that each year in Dumfries & Galloway, we waste £3m worth of medicines of which over half is avoidable.  Look out also, for twitter feeds, Facebook postings and press releases. The posters and social media messages will attempt to engage with the public on how we can work together to reduce medicines waste. Simple tips such as “Only order what you need”; “Check before ordering”; “Don’t stockpile medicines” will feature in our waste campaign. With £3m required to be saved from our drugs budget this year, we cannot afford to ignore the unnecessary cost of waste.

Dot 1Waste campaigns have been featuring on the Prescribing Support Team’s remit for many years. There was Derek the Digger whose sole purpose in life was to pick up medicines waste by the ton. Then there was our Big Red Bus Campaign. We had a range of items with catchy slogans e.g. erasers stating “Wipe out Medicines Waste”. Last but not least was our ferret, carrying a bag of drugs out of which coins were leaking and going down a drain This time our Waste Campaign will be ongoing. The posters will change, the messages will vary but our mission will stay the same. Medicines cost money and we do not have an endless supply of resources. We need to use our allocated funding for medications where it will benefit patients by improving health outcomes.

And back to the analogy. I must admit that my husband randomly buys jars of chutney despite having adequate supplies in the cupboard. There are far worse faults and I can live with that.  I however know what is in my fridge/cupboards/freezer and so I don’t stockpile resulting in wasting food supplies. I think what I need, I buy what is necessary and I don’t buy items that I don’t want. Simple no waste!

It is everyone’s responsibility to promote the messages around using medicines responsibly and I hope we can rely on your support by promoting our campaign.

Dot Kirkpatrick is a Prescribing Support Pharmacist at NHS Dumfries and Galloway

I walk and cycle to work because I’m lazy by Rhian Davies

It’s true, I’m lazy. If I didn’t travel on foot or by bike to work, the shops, the pub, I’d need to find the time, inclination and means to exercise. So I walk and cycle because it:

  • Gets me there

Walking is the oldest form of transport. In fact we’ve evolved to do it – having been walking around for about 1.9million years. Cycling has been a means of getting from A to B for nearly 200 years.

  • Gets me there quickly

No searching for car keys, waiting in traffic and finding parking spaces. A journey by bike in Dumfries takes about the same time as a journey by car. Walking or cycling on traffic free and quiet routes means I don’t get held up by queues and stay clear of road works.

Rhian 1

  • Saves time

No need to find time to get to the gym or go for a run as travel is my exercise. Most people say they would exercise more if they had the time. As I’m travelling anyway, that time is put to use as exercise time too.

  • Is enjoyable

Rhian 2The main thing for me is the fresh air, being outside and enjoying the wildflowers and wildlife that I see and hear, especially at this time of year. Winter has an upside too – no need to get up early to see a beautiful sunrise and the moonrises can be pretty spectacular too. I’ve also seen shooting stars on my way home from work. And despite what it feels like, it doesn’t rain that much! In fact, there’s a 95% chance of NOT getting rained on, on your way to work.

  • Is sociable

I often see people I know on the way and enjoy having a chat with them. Waving to the lollipop lady on the way to work or chatting with the nice man who walks his spaniel adds a little happiness to my day.

  • Is safe

The most recent figures from the Department of Transport show the fatality rate for pedestrians and cyclists is the same, with one death per 29 million miles walked or cycled. Looking at how many people were killed or seriously injured, it works out at one person for every 1 million miles cycled and one person for every 2 million miles walked.

  • Keeps me fit

The main difference compared to driving is that whenever you walk or cycle your health benefits, whereas remaining seated in a car does nothing to improve it. Typically I cycle to work, a 20 minute journey each way, which easily meets the guidelines for 150 minutes of moderate exercise a week.

  • Benefits people and planet

You only have to look at the news and you’ll see an almost daily report on worsening air pollution and the effect this is having on people and the environment. Walking and cycling isn’t the only way to tackle this problem but it is a difference we can make every day to the people and place we live.

  • Is easy to get parked

Rhian 3In my role as Active Travel Officer, I’m here to help anyone who is thinking of travelling by foot or by bike. I’m working with staff at DGRI, the new hospital, Crichton Hall and The Willows.

Over summer I’m running events including basic bike maintenance workshops, Essential Cycling Skills, information stalls on route finding and guidance on buying a tax free bike through Cyclescheme. Upcoming events are posted online and advertised in the core briefing and posters around DGRI, Crichton Hall and The Willows.

So if you’re feeling inspired come along to:

Bike Maintenance for beginners

Drop in session – not sure how to change an inner tube? Need to know how to check your bike is safe to ride? Find out how and have a go.
Monday 22 May and Friday 26 May: 12noon – 2pm and 4pm – 6pm

Venue: Garage 26, the hospital residences

Cyclescheme information stall

Come along to find information on applying for a tax free bike

Crichton Hall Canteen on Tuesday 23 May: 12 – 2pm

Essential Cycling Skills (Beginner)

Can’t remember the last time you’ve ridden, or feeling wobbly when you ride? This is the course for you. Please book here.
Part 1 Wednesday 24 May: 11.30am – 1pm, Part 2 Thursday 25 May: 11.30am – 1pm

Part 1 Monday 5 June: 5pm – 6:30 pm, Part 2 Tuesday 6 June: 5pm – 6:30pm

Meeting point: Garage 26, the hospital residences 

Essential Cycling Skills (Intermediate)

Are you happy cycling on quiet roads but not sure how to navigate roundabouts or junctions confidently? Then this is the course for you. Please book here.
Part 1 Wednesday 24 May: 5:30pm –7pm, Part 2 Thursday 25 May: 5:30pm –7pm

Part 1 Wednesday 7 June: 11am – 12:30pm, Part 2 Thursday 8 June: 11am – 12:30pm

Meeting point: Garage 26, the hospital residences 

Bike Security Marking

Thursday 1 June: 12 – 2pm and 4pm – 6pm

Meeting point: Garage 26, the hospital residences 

I also want to hear from you about what would help you get out and about on two feet or two wheels. Are there facilities or infrastructure improvements that would allow you to walk and cycle? Have you heard about electric bikes but never had a go on one? Just let me know!

Contact me on:

rhian.davies@sustrans.org.uk

Mob: 07788336211

Tel:  01387 246246 EXT: 36821

 

Rhian Davies is an Active Travel Officer for NHS D&G

Lochar North

Crichton Hall

Bankend Road

Dumfries

DG1 4TG

 

 

 

 

 

Can I make a difference? by Paul Gray

It’s a big question – can I make a difference?  How does it feel to ask yourself that?  For some of us, the answer will be different on different days.  My experience suggests that your answer depends much less on what you do, than it does on how you feel.  In this blog, I’d like to offer some thoughts on making a difference.

However, some context first.  I fully recognise the challenges we face.  Health budgets are going up – but pressures on recruitment, and the demands of an aging population, are also very real.  There is also still much to do in tackling inequalities, and improving the health of the population, which NHS Scotland can’t do on its own.  And we do know that people have the best outcomes when they are treated and cared for at home, or in a homely setting.  So our current models of care are transforming to meet these demands, and to provide the most appropriate care and treatment for people, when they need it, and change brings its own challenges.

So my first suggestion is to turn the question, “Can I make a difference?” into a statement – I can make a difference.  If you start from that standpoint, you’re much more likely to succeed.  It’s easy to become pre-occupied with the things we can’t change, and the barriers and problems – I know that I fall into that trap from time to time.  But wherever I go, I see people throughout the NHS, and in our partner organisations, making a difference every day.  So ask yourself, what is the one thing I can do today that would make a difference?  And then do it!

paul-1Now, give yourself some credit – think of an example where you did something that was appreciated.  Write it down and remember it.  If you’re having a team meeting, take time to share examples of things that the team did, that were appreciated by others.  Sharing these examples will give you a bank of ideas about simple things that matter to other people.  And it also gives you something to fall back on, if times are tough.

Next – think of an example when someone did something for you, which you appreciated.  Find a way to share these examples too – if it worked for you, it might work for someone else as well.  Ask yourself when you last thanked someone for something they did well, or something you appreciated.  It’s easier to go on making a difference if others notice what you’re doing!

If you’re leading or managing a team, ask yourself how much time the team spends discussing what went well.  It’s essential to be open and transparent about problems and adverse events, but if that’s the whole focus of team discussions, we overlook a huge pool of learning, resources and ideas from all the positive actions and outcomes.  And we risk an atmosphere where making a difference is only about fixing problems, rather than about improvement.  So, as yourself and your team, what proportion of time should be spent on what went well?

Remember to ask “What Matters to You?”.  I know that the focus of this question is on patients, and that’s right because they are our priority, but it’s a good question to ask our colleagues and our teams as well.  Just asking the question makes a difference – it gives you access to someone else’s thoughts and perspectives, and is likely to lead to better outcomes.

paul-2Will any of this change the world?  Not on its own, of course.  But you could change one person’s world, by a simple act of kindness, or listening, or a word of thanks.  You can make difference!

Paul Gray is the Chief Executive Officer for NHS Scotland and the Director General for Health and Social Care at the Scottish Government

Honest Reflections by Barbara Tamburrini

As this is now the third blog I have written for DGHealth, either there is a shortage of ‘willing volunteers’ or others have found better ways to say “maybe, possibly, perhaps soon” to Ken Donaldson when his charming request drops in the email ‘in-box’. Whatever the reason, I find myself agreeing to contribute and construct another brief moment of interest in our increasingly busy days. Having written previously about handover processes and the importance of good communication, I thought I would flip this on its head for this blog and consider the ‘inward’ communication reaching our ears from eager and sometimes over-active media sources and outlets.

A scan of headlines published over recent times don’t make happy reading for hard-working and dedicated NHS employees trying their best to simply ‘stay afloat and fight the fire’. Over the last 4 days, a number of reports sum up the general gist of current NHS news:

  • 9th Feb 17 – “Worst A&E waits ever, leak suggests” – BBC News
  • 8th Feb 17 – “The NHS and its crisis: Myths and realities” – Sky News
  • 7th Feb 17 – “Scotland’s A&E departments miss key waiting time targets over festive period” – Daily Record
  • 7th Feb 17 – “Maternity services in Scotland ‘beginning to buckle’” – BBC News
  • 7th Feb 17 – “Ageing UK midwife workforce on ‘cliff edge’, warns RCM” – Nursing Times
  • 7th Feb 17 – “NHS [Scotland] cancels 7740 operations due to lack of resources” – STV News
  • 5th Feb 17 – “Scotland patients waited more than a year for hospital discharge” – Sky News
  • 5th Feb 17 – “Revealed: The hidden waiting list scandal for Scotland’s NHS” – Sunday Post
  • 5th Feb 17 – “Growing waiting times threat to NHS” – BBC News

The recent coverage by the BBC assessing the state of the NHS across the UK in their NHS Health Check Week raised issues including a perception of desperate times inside A&E departments, analysis of patient flow reducing to a halt and “clogging up” hospital wards and frontline services being radically changed in attempts to overhaul health provision in the wake of the publication of NHS England’s five-year plan for the NHS in 2014. Indeed, as recently as 15th January 2017, chair of the BMA, Dr Peter Bennie was quoted as stating the Scottish NHS was “stretched to pretty much breaking point” and “heading for a breakdown” unless the government acknowledge the disparity between the current comprehensive service provision and existing funding levels.

So what does all this mean for humble workers ‘at the coal face’ and patients who so desperately rely on the NHS and our contribution within it? Dr Bennie wisely points out that honesty is required when assessing all elements of our much loved but potentially deeply troubled NHS. Honest reflection on our actions and behaviours as NHS staff is required to ensure we are all maintaining a focus firmly centred on our patients and clients. In a profession which is becoming more and more challenging with morale which seems to be ebbing lower and lower, can I really state with certainty that my focus is always upon my patients?

If I am looking at my last shift on duty, as part of the DGRI capacity team, I know that the greatest majority of my time was spent considering patient care but, the complexities of the work involved in capacity management mean a constant ‘juggle struggle’ between complicated discharges, patients keenly attending for their long-awaited surgery and fast and furious emergency admission rates with significant staff shortages thrown in to make life really interesting. This is a really difficult environment to function effectively, positively and proactively.

Its exceptionally difficult to have to say “I’m really sorry but I don’t have anyone who can give you a hand at the moment” to hard-working and struggling colleagues whom you respect and want to help. This inevitably influences work-focus and morale, sometimes away from patients and onto less fruitful, less important areas – we’re only human after all! I’m sure many of you reading this blog can identify with this and acknowledge that there can be times when we recognise that our concentration has slipped away from the real reason we are all here. This honest reflection is being actively encouraged in nursing through the revalidation process which will positively impact the profession in the future with a similar process in place for medical staff.

Honesty is also required from patients and clients using NHS services with individual ownership of health and the impact of lifestyle choices upon this of fundamental importance. The vast majority of NHS patients freely and actively claim this responsibility but this is not always the case in some crucial clinical areas like Emergency Departments. For the headlines to stop, the public also need to do their part. In a recent article in Glasgow’s ‘Evening Times’ (9th January 2017), it was stated that around 1 in 6 Scottish ED attendances may be unnecessary at a potential cost of £33 million and whilst ministers have provided responses aimed at removing any punitive element and reassuring the public that they are right to be concerned about their health, this concern needs to be correctly channelled for current pressures on health services to be eased. Patients with 3-month history of injuries, minor ailments which could be assessed elsewhere and those telling us they didn’t bother trying their GP as “they wouldn’t get an appointment anyway” are all too frequent presentations in busy ED’s. In my ‘other role’ as an ANP in ED, every time a patient told me this, I called the surgery myself and was given an appointment that day for their patient so, as well as accepting ownership of their own health, patients and service-users also need to be well-informed, confident and comfortable about the health services they access and when they utilise these valuable resources.

My feeling is that an organisational honesty also exits within current healthcare with ‘the powers that be’ having a responsibility to consistently and carefully examine the healthcare delivered with rectitude and reliability. We are somewhat fortunate in that we have an organisation who actively engages with staff through measures such as #ontheground, weekly core briefings, active and lively facebook and twitter accounts and the informative and interesting DG Change website (http://www.dg-change.org.uk). Indeed, this weekly blog also serves as a useful interactive communication with reflections and comments on posts actively encouraged. But is this enough? I would argue that even though these proactive measures exist in NHSDG along with many other approaches, staff morale remains low in some clinical areas and sickness absence rates are running well above optimum levels in some departments. So, are the current measures of engagement between the organisation and its employees inaccessible, uninteresting or unimportant to some staff, not effective enough, not addressing the correct issues or simply not delivering the desired impact? Although impossible to answer within this blog, the significance of this question and the consequences associated with it, must remain high on the agenda if staff empowerment, engagement, motivation and morale are to be maximised as we hurtle head-long towards a new hospital and evolving chapter in our healthcare provision.

Every ward I go in to during my capacity shift has AHP’s, nursing and medical staff who look tired, strained and burdened by an ever-increasing workload with constant financial and resource pressures making the job all the more difficult. But, and this is crucial, staff continue to come to work to do the best job they can given these constraints. They continue to change rota’s to cover absences, work through breaks and past finishing times to help their colleagues and patients and they continue to ‘fight the fire’ with dedication, sometimes in the face of adversity. Healthcare staff MUST care about the service they provide, to deliver care which remains meaningful, appropriate, safe, effective and patient-centred.

Whilst we as staff have a responsibility to continually reflect on our own practice, this must be fully supported, actively encouraged and consistently underpinned by honest reflection at a strategic level on the current ‘state-of-affairs’ and how this can be promoted and enhanced within the existing inflexibility of financial austerity.

Therefore, returning to our news headlines, what does the future hold for the NHS locally and nationally? Locally, despite considerable challenges, there are exciting times ahead as we look to fully embed health and social care integration and also move our main hospital services into our new build. Nationally, the picture is less clear with ever-increasing financial pressures being placed on continually growing workloads in a society with greater demands in terms of health due to conditions such as obesity, diabetes, heart and respiratory diseases. This is compounded by an ageing population sometimes presenting with chronic conditions which one simply did not survive from a decade or two ago.

hould we as NHS employees, the general public, healthcare service providers and users be concerned about the growing tide of negative headlines? Perhaps. Maybe these give an insight into the ‘health of our NHS’ – gosh, that’s a worrying thought. Or maybe, we now live in an environment feeding off news negativity and scandal in which we have all become de-sensitised to minor challenges therefore pushing media providers to ‘raise-the-bar’ in their reactionary reporting of our beloved NHS which would have, until relatively recently, been ‘off-limits’ to the eager reporter looking for a scoop however vague, misleading or sensational.

Lets return to our honesty theme. Within this blog, I have suggested that some honesty is required in our NHS and this should also extend to the reporting of challenges and issues to a certain extent. The antonym to sensationalism, where bad, critical or damming NHS news is forbidden with offenders punished by a stint taking minutes for certain western hemisphere parliamentary press conferences, is also not good for contemporary healthcare since this stifles and prevents honest reflection from which, lessons can be learned and development thrives.

There is every likelihood that the headlines wont go away and they may even increase in frequency or adversity. Perhaps though, if we all contribute in our own way, positive, honest and transparent analysis at individual, peer, organisational and national level will drive, develop and sustain an NHS we are all proud of and which we want to protect, however difficult or complex the discussions and decisions.

Barbara Tamburrini is an Advanced Nurse Practitioner at NHS Dumfries and Galloway

 

 

Gender Matters by Lynsey Fitzpatrick

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image5On 6th September 2016 in Lockerbie Town Hall, NHS Dumfries and Galloway and Dumfries and Galloway Council, supported by the national feminist organisation ‘Engender’, jointly hosted ‘Gender Matters’ – an opportunity, in the form of a workshop, to explore the issues surrounding gender equality.

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There were over 40 people from a range of organisations including NHS, Council, South West Rape Crisis and Sexual Abuse Centre, LGBT Plus, LGBT Youth Scotland, DG Mental Health Association, Support in Mind and Glasgow University, and also members of the public along with staff from other Health Board areas.
When I started to write this blog post, I was thinking back as to why the steering group behind the event decided to host this event in the first place. There is a plethora of evidence to back up why we need to support events of this nature, for example:

  • Women are twice as dependant on social security than men
  • In 2015 the gender pay gap in Scotland was 14.8% (comparing men’s full time average hourly earnings with women’s full time average hourly earnings)
  • Also gender pay gap in Scotland when comparing men’s full time average hourly earnings with women’s part time hourly earnings was 33.5%
  • This means, on average, women in Scotland earn £175.30 per week less than men.
  • The objectification and sexualisation of women’s bodies across media platforms is so commonplace and widely accepted that it generally fails to resonate as an equality issue and contributes to the perception that women are somehow inferior to men.
  • Femininity is often sexualised and passive whereas masculinity is defined by dominance and sometimes aggression and violence.
  • At least 85,000 women are raped each year in the UK.
  • 1 billion women in the world will experience physical or sexual violence in their lifetime.
  • In 2014/15, there were 59,882 incidents of domestic abuse recorded by the Police in Scotland. 79% of these incidents involved a female ‘victim’ and male perpetrator.

 

So there are plenty of reasons as to why we held this event; to challenge social gender norms, to progress thinking around changing perceptions in our homes, at work and how we confront the media (not least our legal duty under the Equality Act 2010).

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But what is it that made us so passionate about being part of this work?
image12A huge reason for me personally is that I have an (almost) 5 year old daughter. In my current post as Equality Lead for NHS D&G I have become much more aware of some of the research and facts around gender equality and often reflect on how her future is being shaped as we speak; because of the gender norms all around her, expectations from her family, her peers and her school.
I’m horrified to think that she is more likely in later life to be paid less than a male counterpart for doing the same level of work, or that her relationships and self esteem will be impacted by the stereotyping of her gender in the media.

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image29A friend and I had a discussion at one of the film screenings for “16 days of action against Gender Based Violence” which focused on the sexualisation of children from an early age. We talked in particular detail following the film about the impact the internet might have on our daughters as they grow up – the availability of porn, more opportunity to be groomed, shifting expectations of how our bodies should look and what we should be doing with them – and decided that we really wanted to do something about this, to make a difference to our daughter’s lives, and hopefully many more at the same time.
As NHS employee’s we are legally obliged to consider gender issues in everything we do. The often dreaded impact assessment process is designed to help with this. Yet at times it is seems more of a burden than a way of informing services how best to prevent discrimination and advance equality for all.

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I came across the following clip at a Close the Gap event which shows how gender mainstreaming is applicable in situations that many of us deal with on a daily basis and how this can impact on efficiency and quality of public services, benefitting not only the people who use our services, but also our key partners:

(Watch from the beginning to 3:18minutes in for a quick demonstration on how indirect gender approaches can change the way people live).
Back to the event in September: the day was split into two halves – the morning session focused on Culture and the afternoon session on Economy. The format for the day was Open Space Workshops, starting with a short presentation on each of the topics. Participants then identified topics that their group wanted to focus their discussions around. Participants were free to move around the room and join in or leave discussions as desired.
Some of the topics covered during the course of the day included:

  • Gender in the Media
    Equal pay for equal work
    Rape Culture
    Part time Work
    ‘Hidden Care’ and the economic ‘value’ of care
    Societal Norms
    Women and Sport
    Success
    Cultural Expectations
    Being non-gender specific (e.g. clothes, toys, activities)
    Women’s Only Groups
    Gender Education
    Welfare Reform

Understanding ‘double standards’
There was a real buzz in the room as each of the groups discussed their topics of interest and it was clear that participants appreciated the opportunity to discuss the issues openly, an opportunity we don’t often get.
All of the event feedback was extremely positive, and there was a real interest from participants in taking this work forward, both in the workplace setting, and in their personal lives. Some of the suggestions included the creation of a Gender Equality Network for D&G, avoiding stereotyping, creating safe spaces for women to talk openly, promoting the White Ribbon Campaign, encouraging managers to see the benefits of a work/life balance, challenging the way gender is represented and considered across society, e.g. across social media, within policies and structures. This list is by no means exhaustive of everything that was covered on the day!
I hope that having a quick read of this sh

ort blog (and hopefully a watch of the gender mainstreaming clip) will be enough to convince a few more people that gender equality really does matter.
If you are interested in being part of future discussions on gender inequality and involved in a Women’s Network then please get in touch.

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

Island reflections by Heather Currie

Holidays are for fun, relaxation, recharging the batteries, catching up, all things good. But holidays also give time to think and reflect and often holiday situations trigger a thought which may have relevance to a work situation. I think that’s ok, I don’t think I’m pathologically workaholic. I enjoy having time to reflect, whether that be on holiday or other.

heather-jettyA recent holiday in the beautiful west coast, triggered reflection on how we respond to patient’s needs, and perhaps how we could do better.

On the west coast of Mull is a ferry which goes to the tiny island of Ulva. While waiting to take a boat trip out to the Treshnish Isles (home of a huge colony of wonderful puffins), I noticed the sign indicating how to summon the ferry. No regular routine service, just a board with a moveable cover. Move the cover, red board shows, ferryman on Ulva sees red board, ferry sets out. Simples.. Ferry there when needed and when summoned. Receptive and responsive. It made me think whether or not we are receptive and responsive to our patients’ needs and what about the needs of the relatives?  A few examples make me think perhaps not enough?

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In recent times my mother in law sadly suffered from a stroke and was in an acute hospital for several months before being transferred to a Rehab unit and subsequently a nursing home. Being a patient is always a humbling and learning experience, as is being a relative and visitor of a patient. On one visit I was concerned that her finger nails were quite long and dirty. “Mum” could not speak at this stage but since she was always very particular about her appearance, I knew that this would cause her distress and asked the nurse in charge if it was at all possible, please please, thank-you so much…(it felt like asking for anything was a major challenge) could her nails be cut. To my surprise and disappointment, I was told that this was not possible since only two nurses on the ward had had the “training” and when they were on duty it was unlikely that they would have time. Receptive and responsive or too rigidly bound up in rules and protocols of questionable evidence base that basic needs are not met? Thereafter we took it upon ourselves to cut the nails ourselves!

I was very reassured on return to DGRI that this would not happen here and strongly believe that we are more receptive and responsive, but could we do better?

Recently, one of our gynaecology patients who had been diagnosed with a terminal condition was moved between wards four times as her condition deteriorated. As long as her medical and nursing needs were being met, was it fair on her at this sad stage to have so many moves? Did we really think about what was best for her and her family and were we receptive to their needs?

In outpatients, how often do we ask patients to return for a “routine” appointment when they may not need to be seen in six months time, but have problems at a later date? Could we instead be able to respond to their needs and see them or even make telephone contact when really needed?

An elderly gentleman understandably complained because he spent a whole day travelling from the west of the region to Dumfries by patient transport, for a ten minute outpatient appointment to be given the result of a scan. In his own words, “he was not told anything that could not have been told by telephone”.

What routine investigations do we carry out that are of limited clinical benefit, often subjecting patients to yet further unnecessary investigations because of slight irrelevant abnormalities?

When questioning our practice, let’s also be prepared to be curious about that of others in hospitals to which we refer—recently a patient was referred to Glasgow for a gynaecological procedure. The procedure went well but the patient subsequently contacted me concerned that she had been asked to return to Glasgow for a follow up discussion. She wondered if a phone call would be possible in view of the huge inconvenience that this appointment would cause. I wrote to the consultant and asked if this would be possible. His rapid response was enlightening and reassuring: he had always brought patients back to a clinic as routine practice and never considered an alternative. He promised that from then on he would offer all such patients a telephone follow up instead.

Let’s use common sense and be prepared to challenge and bend the rules. Remember the ferry. While we do not have a “ferryman” waiting to respond at all times, we could consider the 4 “Rs”and be –

Responsive not Rigid,

Receptive not Routine.

Heather Currie is an Associate Specialist Gynaecologist and Clinical Director for Women and Sexual Health at NHS Dumfries & Galloway