Posts from the “Uncategorized” Category

Could you be the next Clinical Lead for our neonatal improvement programme? – Colin Peters

Posted on November 16, 2021

As Colin Peters leaves us as Clinical Lead for our organisation’s neonatal improvement work after five years, in this blog he describes the rewards of the role of clinical lead and how he made the role work alongside his day job.

Interesting, rewarding and enjoyable. After five years as the Neonatal Clinical Lead for Healthcare Improvement Scotland, that’s how I would describe the role. Now that I’ve moved on from the role and I reflect on the time with the organisation’s Scottish Patient Safety Programme, I feel grateful for the tremendous support of the team and the engagement of neonatal teams from around Scotland in order to deliver improvements.

There have been lots of highlights during the five years, but I particularly enjoyed the learning sessions where we had such engagement from everyone involved: nurses, midwives, doctors, improvement advisors and more. Post-it notes and marker pens were the order of the day with roaming microphones and ideas aplenty.

While I’ll miss being in the role, it does mean that there is a fantastic opportunity waiting for someone to take up the mantle of Neonatal Clinical Lead.

The role of the MCQIC Neonatal Clinical Lead

So what does the role of Neonatal Clinical Lead entail? First up, the role is essentially for one day a week, so you undertake the role alongside your clinical duties within your NHS board.

The key responsibility is to provide clinical direction to the neonatal improvement work of the organisation. This includes identifying new areas of work and ensuring that existing areas are up to date. Here it’s important to seek new ideas from around the UK and abroad, as well as draw on recent publications, national guidelines and evidence.

Within the role, you get to visit each NHS board to provide support, share ideas, motivate and inspire. I really enjoyed these as I inevitably came away with a new idea or reflection on something that could be developed.

The importance of collaboration and leadership

Working collaboratively with Midwifery and Obstetric Leads and NHS board teams on measures that sit across the whole MCQIC programme, is a vital part of what the clinical lead will do. In my view, improvement in neonatal outcomes depends on improvements in obstetrics and midwifery. The collaborative work on the Preterm Perinatal Wellbeing Package was a fine example of working across teams to come up with a message for everyone caring for a woman delivering prematurely and her baby.

Leadership is another key element of the role, for example, leading sessions at Scotland-wide meetings. These are really interesting sessions with a fair bit of work involved to put together an engaging presentation / session that leaves the delegates inspired to go back to their NHS boards with ideas and a motivation to improve.

You will also develop and participate in regular webinars. These are now more familiar to us all and although talking to your own screen, hoping that there are people out there, is strange, the responses and conversations are really rewarding.

The Clinical Lead for Neonatal will also contribute to national networks and groups. In my time I’ve worked with the Scottish Perinatal Network, the MANDALS group and Clevermed. Strengthening these relationships have ensured that we’ve been able to take consistent approaches across Scotland and avoided duplication of effort.

I’ve found the support from the project officers to be excellent, and I’ve put many of their ideas into practice. Moreover, the support from the Senior Improvement Advisor has been really helpful. I felt that I wanted to come out with more than just having worked one day a week, so I completed the Scottish Improvement Leader course. The new lead may have some particular area or skill that they want to develop.

Ways of working

I tended to work flexibly, especially in the virtual world which now exists on Teams. Before the pandemic I’d work in Delta House (Glasgow) or Gyle Square (Edinburgh) some days, site visits on other days and at home on some days. Sometimes I’d work whole days, on others it would be broken up across a week trying to average one day a week.

And what advice to my successor as Clinical Lead for Neonatal? There is lots of support from all teams within Healthcare Improvement Scotland, so don’t worry about the practical matters of the job. Enjoy, laugh, and don’t be afraid to voice your opinion. Make the role your own.

Colin Peters is Consultant Neonatologist in Greater Glasgow & Clyde and is the former Clinical Lead for Neonatal for Healthcare Improvement Scotland.

Visit NHSScotland to see the list of current job vacancies.

Categories: Uncategorized

Tagged: impact campaign

Learning from the death of every child – Dr Alison Rennie

Posted on September 28, 2021

From 1 October 2021, Healthcare Improvement Scotland and the Care Inspectorate will be collecting national data on the deaths of every single child in Scotland to age 18, or 26 if receiving continuing care or aftercare. Dr Alison Rennie, Consultant Paediatrician and Clinical Director of Community Paediatrics at NHS Greater Glasgow and Clyde, and the National Clinical Lead for the implementation of the National Hub for Reviewing and Learning from Child Deaths, explains why this work is important and how we will make a difference.

During my 30 year career as a children’s doctor, I have seen children who died from neurological conditions, congenital disorders, prematurity, malignancies, infections, trauma, neglect and abuse. Each one stays with you. I have also witnessed exciting developments in treatments for conditions such a Spinal Muscular Atrophy, once previously universally fatal, and now hopefully curable. However, it is disappointing to note that Scotland still has a higher mortality rate for under 18s than any other Western European country, with over 300 children and young people dying every year. It is estimated that around a quarter of those deaths could be prevented. How can we make a difference? What can we learn and how can we change?

With no national system to support reviews into those deaths or to share national learning, there has been variation across services and across Scotland as to the quality of reviews and even whether reviews are carried out at all.

However, that is all about to change: from 1 October, the health and social care system in Scotland will work collaboratively to reduce avoidable deaths of children and young people by reviewing every death to inform the redesign of pathways and services, or to recommend legislative change. This includes the deaths of all live born children up to the date of their 18th birthday, or 26th birthday for care leavers who are in receipt of aftercare or continuing care at the time of their death.

Where death is inevitable, we aim to improve this process for children, families and carers by learning from quality reviews.

How this work is coordinated

In response to a request from the Scottish Government, Healthcare Improvement Scotland, in collaboration with the Care Inspectorate, set up the National Hub for reviewing and learning from the circumstances surrounding the deaths of all children and young people in Scotland.

The National Hub brings together representatives from across health and social care to develop quality guidance and develop a core data set to help services implement the methodology and to learn from each other’s experiences.

We also established an expert advisory group with representatives from health and social care as well as other agencies such as Police Scotland, the Procurator Fiscal and third sector organisations for their specialist advice around child bereavement.

The National Hub also channels learning from all over the UK to help reduce preventable deaths.

Next steps

We’re working with National Records of Scotland (NRS) to develop a notification system for receiving data regarding the deaths of children and young people and we’ll directly collect national data from health and social care partnerships across Scotland from 1 October. Once we have enough data, the National Hub will assess how the methodology has been adopted nationally and identify important learning about preventable deaths of children and young people. All of this will feed into an annual report to share what we have learned over the previous year. We will highlight areas for change, and recognise aspects of good practice.

I hope that this exciting development is our opportunity to make a change to Scotland’s grim mortality data for children and young people. Can we make Scotland the best country to grow up in and one in which you are less likely to die before adulthood? I am proud to be part of the National Hub and join my many colleagues who will be using the Hub’s guidance to conduct quality reviews, share learning and change outcomes. Through working together in this way, we hope to make a tangible, positive difference to the lives and deaths of children and young people as well as the families and carers surrounding them. They deserve nothing less.

Dr Alison Rennie is a consultant community paediatrician in NHS GGC with a special interest in children with complex disability. Her background of working with vulnerable families, and her experience in significant case reviews led to her interest in understanding and learning from deaths in childhood. She is seconded to Healthcare Improvement Scotland as national clinical lead for the National Hub for Reviewing and Learning from Child Deaths.

Follow Alison @AlisonRennie7 and follow the National Hub at @online_his using #CDRNationalHub

Find out more

Read our guidance, download resources and find out more about our work on the Healthcare Improvement Scotland website.

You can also get in touch with the National Hub team at his.cdrnationalhub@nhs.scot

Categories: Uncategorized

Living with Long COVID – Mabli Godden

Posted on December 18, 2020

Ten months ago, Mabli Godden couldn’t imagine how much her life was about to be changed by COVID-19. But now, as one of the many people experiencing the effects of the virus, she is trying to recover, as well as helping Healthcare Improvement Scotland develop the first UK guideline on Long COVID. In our blog, she tells her story. In March of this year I was the most active I have ever been: commuting from Glasgow to Edinburgh daily for work, running two youth arts programmes, cultivating my own arts practice, lifting weights regularly, taking care of an active dog and all the typical things someone in their late twenties and early thirties might do with their lives. But this was all brought to…

Categories: Uncategorized

Safer staffing? Call the midwife! – Laura Boyce

Posted on February 13, 2020

Two years ago I was a senior charge midwife in a busy labour ward.

While labour wards can be joyful places, as parents welcome a new little one into the world, they can also be very intense, stressful places as staff try their very best to make sure birth is a positive, safe experience for both parents and child.

“When the Scottish Government published The Best Start report for maternity and neonatal services, I was excited, enthused and apprehensive.”

Maternity services in Scotland vary hugely not just in relation to geography, but also to the workforce, the location of care delivery and capacity of services. So when the Scottish Government published The Best Start report for maternity and neonatal services in 2017, I was excited and enthused but equally apprehensive.

The key recommendations of Best Start included continuity of carer, putting women and babies at the centre of care, multi-professional working and a new model of neonatal intensive care service.

While midwifery student numbers were receiving substantial investment, I was aware that the experience and expertise of the midwives I was working alongside would be lost just as these younger, less experienced staff were coming into the workplace: almost 40% of midwives were aged in the 50 and over bracket.

Therefore, Best Start was a BIG ask, and I had a LOT of questions.

How will such ambitious recommendations ever be achievable? How can we ensure the staff are confidently skilled in all areas of the pregnancy journey? How can I as a clinical leader support this in a busy, high risk obstetric unit?

When the Government announced in 2018 its intentions to enshrine safe staffing in law, I had even more questions.

What is safe staffing? What would this mean for the staff on the shop floor? How will this impact midwifery care and, wider than that, nursing care?

“The basic aim of the Bill was to provide high quality care by ensuring the right people were in the right place, with the right skills at the right time”

I became engrossed in the new Bill and its progress through parliament. The basic aim of the Bill was to provide high quality care by ensuring the right people were in the right place, with the right skills at the right time to ensure the best health and care outcomes. Throughout my work as a clinical midwife, research midwife and senior midwife, in a variety of boards I’ve come to see these factors as central to the work of not just midwives but to the wider workforce of the NHS. So when a secondment opportunity arose to work as part of the advisory team supporting NHSScotland Boards with the use of workload and workforce planning tools, I went for it.

Initially based in the Chief Nursing Officer’s Directorate before moving to Healthcare Improvement Scotland in 2019, being a programme advisor has allowed me to look closely at the workforce planning processes not just in midwifery, but across a range of healthcare professions. It’s allowed me to explore the wide variation in tools and resources that are used in clinical service. To really understand the basic fundamentals of budgets, planning and service redesign for the best service user experience. To appreciate the positives of good governance and risk assessment. All of these are areas I knew about as a midwife, but can I really say I understood them?

Now, in my role with Healthcare Improvement Scotland, I’m working to answer for others all the questions that I’ve had.

“Supporting boards to understand the demands of the new Safer Staffing legislation and prepare for meeting its requirements as we move towards final enactment, I have been on a rollercoaster of learning and overcoming challenges.”

Supporting boards to understand the demands of the new legislation and prepare for meeting its requirements as we move towards final enactment, I have been on a rollercoaster of learning and overcoming challenges. My role has evolved massively in a short period of time and I now find myself speaking at national events and presenting abstracts for improvement work in this field. I have forged networks and empowered so many wonderful professionals and like-minded individuals who all aspire to that safe, effective and high quality care goal.

How we will monitor and report on the compliance of the legislation is in its infancy, but it’s exciting and uplifting to be a part of something that is shaping healthcare for future generations.

Find out more about the Health and Care (Staffing) (Scotland) Act:

Link to information on the Healthcare Improvement Scotland website.

Link to the Act on the Scottish Parliament website

Contact the mailbox: HCIS.HSP@nhs.net

Laura Boyce is a Programme Advisor with the Healthcare Staffing Programme.

Categories: Uncategorized

Tagged: Healthcare Staffing Programme, safer staffing

The heart of the matter: the need for standards around congenital heart disease – Dr Liza Morton

Posted on October 22, 2019

Since I was 11 days old, my every heartbeat has been dependant on a pacemaker. I was born with complete heart block, an abnormal heart rhythm that means the electrical impulses that control my heartbeat are blocked and do not reach the bottom chambers (ventricles) of my heart.

The surgery I received in 1978 at Glasgow’s Yorkhill Hospital was a world first. Since then, while I’ve lived a very full life, it’s one that’s been reliant on pioneering cardiac treatment. Life as a ‘heart child’ involved countless invasive, painful and often frightening cardiac interventions. By the age of seven I had been fitted with five pacemakers, each by thoracotomy – my ribs were split to gain access to my heart. Early pacemakers were set at a fixed rate, making active play, gym and sports day impossible. They were unreliable and often needing reprogramming. I remember lying still and feeling dizzy as a team of men in white coats armed with a magnet, leads, cold gel, stethoscopes, and electrodes made my heart beat faster, then slower as they learned how to interrogate the pacemaker. I was a medical curiosity, although my team always did their very best to support us. I needed open heart surgery at 13 years old to repair a hole in my heart and around this time I was fitted with a more physiologically responsive, variable rate pacemaker. The challenges don’t end, last summer I was fitted with my 11^th pacemaker involving complex surgery to extract and replace pacing leads.

“By the age of seven I had been fitted with five pacemakers, each by thoracotomy – my ribs were split to gain access to my heart.”

Complex congenital heart disease (CHD) cannot be cured, but due to medical advances a growing number of people are living with a lifelong heart condition. Babies born in the 1940s, had a 20% chance of surviving into adulthood. Today, the chances for a baby born with CHD living that long are 90%. Yet the success story of enhanced detection, medical and surgical advances yields new challenges which healthcare services have not developed to meet. Having overcome significant childhood adversity, many ‘medical orphans’, once celebrated as pioneers of medical advancements, are being let down in adulthood. But with adequate, reliable care many of us can live full lives.

Developing standards to improve services

Healthcare standards offer a means to significantly improve care by engendering trust, safety and patient empowerment. That’s why I’m delighted to be involved with Healthcare Improvement Scotland’s development group to create standards for CHD, and work with them to enable people with this condition to live as normal a life as possible.

Standards are statements relating to levels of performance that people should expect from health services. They are based on evidence relating to effective clinical practice, feasibility and service provision that is responsive to patients’ needs and views. They cover the key issues relating to the provision of safe, effective and person-centred care and treatment.

It’s been a long journey to get to this stage, supported by the cardiologists, nurses and surgeons involved in our specialist care, who witness daily what it means to live with CHD. Given my own experience, and my voluntary work as the Scottish Campaign Manager for The Somerville Foundation (a UK charity supporting adults with CHD), in 2012 I sought to raise awareness of CHD, submitting a petition to The Scottish Public Petitions Committee at the Scottish Parliament asking for healthcare standards and improved care provision, joining Cross Party Groups, asking MSPs to submit parliamentary questions and lobbying through social media.

“It’s vital that healthcare provision for CHD is underpinned by a psychologically-informed approach consistent with recent drives for trauma-informed care and to address adverse childhood experiences.”

The challenges for people with CHD

But what exactly are the issues that people with CHD can face that the standards will look to address?

CHD is the most common congenital anomaly, affecting approximately 1% of babies. A quarter of these babies require medical intervention in the first year of life. Around 20,000 people with CHD currently live in Scotland. Approximately half of this estimated adult population are lost to specialist services, often having been discharged before the need for specialist lifelong care was recognised.

It’s vital that healthcare provision for CHD is underpinned by a psychologically-informed approach consistent with recent drives for trauma-informed care and to address adverse childhood experiences. While medical advances have saved many lives, they can involve invasive procedures which can be frightening, painful and overwhelming. Early separation due to medical care may also impact on attachment to parents. Living with CHD can reach far beyond any medical limitations to affect schooling, employment, finances, discrimination, missing out and issues having and raising a family, to name a few. Perhaps not surprisingly, CHD significantly increases vulnerability to neurodevelopmental issues, depression, anxiety and post-traumatic stress disorder (PTSD) while parental psychological wellbeing can also be affected. Yet these outcomes need not be inevitable. By adopting a psychologically-informed approach to care, these risks could be mitigated, improving wellbeing, physical health, recovery and ultimately reduce costs.

Although I am grateful to the NHS for saving my life, I have experienced multiple life-threatening challenges in my care provision and a lack of understanding about the psychological impact of living with a serious lifelong health condition. At times, living with CHD can seem relentless. Having to fight for appropriate medical care, at your most vulnerable, can feel overwhelming. The challenges don’t end. Many of the challenges we face occur at a local level, for example, when we present to our GPs and emergency care. Standards for local care provision are vital to inform safe, equitable and consistent care. I am far from alone experiencing these challenges.

We should be proud of our NHS as testament of our collective humanity. But having experienced it at its best and worst since my first pacemaker all those years ago, I want to help to make it better. I owe that in return.

More information

Take part in the consultation on the scope of our congenital heart disease standards.

Liza is a Chartered Counselling Psychologist working in private practice and at Strathclyde University. She is actively involved in research and advocacy to promote psychologically informed medicine and improved care for people living with a heart condition from birth. Liza represents patients on the Standards Development Group for CHD for Healthcare Improvement Scotland. You can follow her on Twitter @drlizamorton.

Categories: Uncategorized

Tagged: impact campaign

How volunteering in NHSScotland can be transformational – Alan Bigham

Posted on October 10, 2019

Volunteering matters. There are an estimated 6,500 directly-engaged volunteers supporting patients, families and communities of NHSScotland, and many thousands more complementing the delivery of health and social care in the third sector. Many roles are centred on interacting with patients on wards; often something as simple as taking some time to have a chat, providing that vital social interaction and company for
people in hospital wards.

There is clear evidence that volunteering has many benefits for patients as well as volunteers themselves. It can improve an individual’s physical and mental health and wellbeing, strengthen social networks and bonds within communities and can also help to create experiences and connections that lead to better lives.

Volunteering roles are extremely varied. From drivers who help to transport visiting relatives or support patients to access support groups, to community volunteers helping with leading ‘healthy walks’, with others providing peer support to new mothers who are breastfeeding. The annual value of volunteering in Scotland is estimated to be £2.26 billion – it is clearly of great social and economic importance to the people and communities of Scotland.

“There is clear evidence that volunteering has many benefits for patients as well as volunteers themselves. It can improve an individual’s physical and mental health and wellbeing, strengthen social networks and bonds within communities and can also help to create experiences and connections that lead to better lives.”

Being able to demonstrate the impact of volunteering throughout NHS Scotland was of central importance to me when I took on the role of leading the Volunteering in NHSScotland Programme in the Scottish Health Council and Healthcare Improvement Scotland. A key objective of my role has been to help NHS Boards to develop their local volunteering into sustainable and robust programmes.

Since the work began in 2011, the impact of the programme has included:

Four NHS Boards creating paid roles to manage and support volunteers and another NHS Board almost doubling its volunteer management staffing from four to eight WTE
Influencing NHS Boards to adopt more sustainable volunteer management models, reducing the ratio of volunteer manager to volunteer to a far more sustainable and reliable level (from one manager to 144 volunteers in 2012 to one manager to 36 volunteers in 2017)
Deploying the Volunteering Information System across 18 of the 22 NHS organisations, increasing information governance and legal compliance, improving the efficiency and accuracy of reporting and reducing the administrative burden on volunteer managers to free up their time for their core work.

The influence and outputs of the Programme help to ensure that leadership for volunteering is embedded at a strategic and operational level across NHSScotland. Our work in developing policies and processes assist volunteering programmes to increase efficiency and compliance.
Additionally, the responsive nature of the Programme helps NHS Boards adapt to meet emerging needs.

“Being able to demonstrate the impact of volunteering throughout NHS Scotland was of central importance to me when I took on the role of leading the Volunteering in NHSScotland Programme in the Scottish Health Council and Healthcare Improvement Scotland. A key objective of my role has been to help NHS Boards to develop their local volunteering into sustainable and robust programmes.”

Within NHS Boards, volunteering can be traced back as far as 1970. The engagement of volunteers in health and social care has shown the impact it can have on volunteers, staff and patients. In collating case studies of volunteering, volunteers and staff told us that:

Volunteers have a positive impact on staff time and morale
Volunteering reduces social isolation for patients and volunteers
Patients look forward to seeing someone who’s not in a uniform
Volunteers have a positive impact on volunteers, providing structure, quality of life and improving confidence and self-esteem.

Over the past two years we have been contributing to the development of ‘Volunteering for All’ a national outcomes framework for Scotland. We’re now in an implementation phase where our contribution will be developing and publishing case studies of volunteering in health and social care that demonstrate progress towards these outcomes.

It’s only by demonstrating the impact of volunteering that we will break down the last remaining institutional barriers and myths on the subject. It can be transformational for the lives of many people, and has been so for myself.

More information

Read the ‘Volunteering for All’ Framework on the Scottish Government website.

View Scottish Health Council’s series of videos showcasing case studies from volunteers.

Alan Bigham is Programme Manager (Volunteering) with Scottish Health Council, part of Healthcare Improvement Scotland.

Categories: Uncategorized

Tagged: impact campaign

Screening for swollen aorta is vital to saving lives – Vascular Disease Awareness Month – Dr Zahid Raza

Posted on September 25, 2019

Breast screening. Cervical screening. Bowel screening. These may be familiar to you. You may have even participated in one or more of them. These are three examples of the eight national population screening programmes in Scotland.

Screening for abdominal aortic – more commonly known as AAA screening – is one that many people may not have heard of before.

An AAA is a swelling (aneurysm) of the aorta. The abdominal aorta is the main blood vessel that leads away from the heart, down through the abdomen (stomach) to the rest of the body. Aneurysms are a type of vascular condition. This is the collective term for diseases of the arteries, veins and lymphatics (tissues and organs that help rid the body of toxins, waste and other unwanted materials).

If you live in a town with around 30,000 people – for example, Wishaw in North Lanarkshire – at least 1000 men may be living with an AAA at any given time. Vascular conditions account for 40% of all deaths in the UK. Crucially, many of these deaths are entirely preventable.

“If you live in a town with around 30,000 people – for example, Wishaw in North Lanarkshire – at least 1000 men may be living with an AAA at any given time.”

The importance of screening for AAA

As a vascular surgeon, I regularly see men with large AAAs who have been referred to me from the national AAA screening programme. They are referred to me because at the stage where the aorta is 5.5cm or more, the risk of it rupturing is usually higher than the risks associated with the surgery that my colleagues and I perform to repair it.

AAA screening aims to find aneurysms early and monitor or treat them. You may be unaware that you have an aneurysm as AAAs usually show no symptoms. If you do have an AAA and your aneurysm remains undetected it can grow to a point where it can burst. This is a life-threatening emergency and unfortunately many people (around 50-80%) will die from aneurysm rupture –almost half of them before reaching hospital.

Routine AAA screening is offered to eligible men during the year they turn 65. Women, and men under 65, are not routinely screened for an AAA because most ruptured AAAs occur in older men aged over 65. Men are six times more likely to have an AAA than women. Staggeringly, AAAs are estimated to be present in almost 5% of the male population of Scotland aged 65 to 74.

“Routine AAA screening is offered to eligible men during the year they turn 65. Women, and men under 65, are not routinely screened for an AAA because most ruptured AAAs occur in older men aged over 65. Men are 6 times more likely to have an AAA than women. Staggeringly, AAAs are estimated to be present in almost 5% of the male population of Scotland aged 65 to 74.”

What’s involved in AAA screening

Screening to identify whether you have an AAA involves an ultrasound scan of your abdomen. A technician who specialises in AAA screening will measure the size of your aorta (it’s usually around 2cm wide). Most men have a normal result (an aorta measuring less than 3cm) and are discharged from the screening programme. If you do have an AAA and it measures between 3cm and 5.4cm you’ll be asked to return either annually or every 3 months depending on what size it is. Men who have a large aneurysm of 5.5cm and over will be referred to a hospital vascular department to discuss AAA treatment options with someone like me.

Why standards for AAA screening are important

Along this journey patients will meet numerous healthcare professionals – from the ultrasound technicians, specialist nurses, anaesthetists, ward staff, theatre staff and of course, me.

All of the team that supports the AAA screening programme in Scotland work together to ensure that patients experience a safe and high quality standard of care and support. Healthcare Improvement Scotland has recently initiated a project to revise the AAA screening standards which were originally published in 2011. The standards will specify a minimum level of performance for AAA screening services and will apply to all healthcare organisations and all the people who will assist patients on this journey to potentially save their life.

I’m delighted to be chairing the AAA screening standards development group and look forward to working with colleagues from the AAA screening community including those with lived experience of the programme to ensure high quality care for everyone.

More information

Find out more about Vascular Disease Awareness Month

Read the latest standards for AAA screening

Dr Zahid Raza is Chair of the AAA Screening Standards Development Group and a vascular surgeon with NHS Lothian

Categories: Uncategorized

Tagged: impact campaign

Let’s talk about dementia: dementia awareness month – Marina Logan

Posted on September 16, 2019

It’s September which means its World Alzheimer’s Month – the annual international campaign to raise awareness and challenge the stigma that surrounds dementia.

My family’s medical history has largely been characterised by heart attacks and strokes so dementia wasn’t something I had ever particularly worried about. How wrong was I? It transpired that, at various points between late 2013 and early 2014, my mum had a series of mini strokes. There were no obvious physical signs so neither we, nor mum, realised what had happened. These mini strokes interrupted the blood supply to the brain, and this is what caused her to have vascular dementia.

“It was little things the family noticed at first, things we put down to old age forgetfulness. She was in her 80s after all. At that age, anyone could put a pot on the hob and forget about it or not know what day or year it was. It really only became obvious when she couldn’t remember her own address.”

It was little things the family noticed at first, things we put down to old age forgetfulness. She was in her 80s after all. At that age, anyone could put a pot on the hob and forget about it or not know what day or year it was. It really only became obvious when she couldn’t remember her own address – she’d only lived there for 50 years! She laughed that off and said we were ‘being daft’ but it got worse. She became confused. Simple things became a challenge, like turning on the living room fire, she was convinced someone had changed the dials. She thought we were hiding things in the house to confuse her. She got frustrated and this made her quite ‘sweary’ – which could occasionally be funny when it wasn’t mortifying. Although mum had never been shy about speaking her mind, she was inappropriate at times, losing the filter that stops a person saying whatever they fancy about someone loudly in the street (again, mortifying!). Mum had lived alone since my dad died in 1996, so my brother, two sisters and I checked on her every day, visiting and phoning, and we were supported by her GP.

“I’m so proud of the work that Focus on Dementia does, in partnership, to improve the experience and quality of care and support for people living with dementia, carers and staff.”

We were lucky, in a way, that mum only lived like this for maybe 6 months. On 21 April 2014 we were left devastated when she had a major heart attack and stroke. She was in hospital until 17 June, then we were allowed to take her home to care for her, supported by the amazing community nurse team, until she died on 29 June.

I’m so proud of the work that Focus on Dementia does, in partnership, to improve the experience and quality of care and support for people living with dementia, carers and staff. Dementia can touch anyone’s life but with the right support it’s possible to live well and continue to be an active, valued member of society. The more information we have the better, the more we talk about dementia the better. So get involved, become a dementia friend, read more on the Alzheimer Scotland website, or come and talk to the Focus on Dementia team or visit the Focus on Dementia webpage.

Marina Logan is a Project Officer within the Focus on Dementia team of Healthcare Improvement Scotland

Categories: Uncategorized

Tagged: focus on dementia, ihub

Early warning system for sepsis means I got to celebrate my daughter’s first birthday – Caitlin O’Neill

Posted on September 12, 2019

Saturday 29 June was my daughter’s first birthday. It was a day I nearly didn’t get to see. Just a week after Hallie was born, I had to be carried into hospital by my dad. I had maternal sepsis, and if it hadn’t been for an early warning system used by the hospital, Hallie wouldn’t have a mum.

I had no idea what MEWS – the Maternal Early Warning System – was when I went in to hospital to give birth. But I now know that it saved my life. That’s why I want to tell people about what happened to me, to help support Healthcare Improvement Scotland as they encourage hospitals across the country to use MEWS.

I found out I was pregnant when I was 20. It was a bit of a shock at first, finding out I was going to have a baby, but once me and Dale, my boyfriend, got over it, we were fine.

The pregnancy was fine, but Hallie was two weeks overdue – she had no intentions of coming out. When she finally arrived it was a great feeling, but she was purple, like a wee alien.

I never felt 100% after the birth, but I thought that was normal, I was tired, that was how every new mum felt. But a week later I started to feel really bad. Getting up was a struggle and I was in constant pain. I kept feeling hot and cold, like I had flu. Then I started being sick, sweating. I went to bed and woke up not knowing where I was. I dreamed I was in hospital. Now I know that when I dreamed that, I was actually in hospital.

I’d phoned my mum when I started feeling bad, because I basically started having a panic attack. She works at Monklands General, thought there was something more going on and wanted to take me to hospital. Dale said by this stage I was speaking slow and not really making sense. My dad drove me to hospital and had to carry me from the car as I was so weak and kept being sick.

When we got in there they put ice on me to cool me down but I told them I was too cold and started throwing it back at them. I kept hallucinating that Hallie was there, looking for her under the covers. Apparently my temperature went up to 41 degrees and then I just passed out. I don’t remember anything else. They told me later that if we’d been 10 minutes later I probably wouldn’t have made it.

Once they got me stable they put me in the high dependency unit. When I finally came round properly Dale was in the room and Love Island was on the telly. I can only remember bits of things. I remember my arms being covered in marks from the injections, and really aching. They put me in a mother and baby room and Dale bought Hallie in but I could barely lift her because my arms hurt so much – it was like trying to pick up a dead weight. I remember saying ‘I can’t deal with this anymore!’

When I was well enough they moved me to a maternity ward. I remember they did Hallie’s first hearing test on the ward so I could be there. I later found out I’d only been in hospital a week. It felt much longer.

For a while afterwards I kept dreaming I was in hospital. I’d have nightmares and Dale would have to calm me down. Now I know it was panic attacks from the flashbacks I was having. Dale was able to explain what had happened to me and it helped me understand where it was all coming from.

Because I wasn’t fully aware of what was happening to me, it doesn’t affect me, day to day. But sometimes even now I think “that was scary”. In some ways it was a blessing that I didn’t know. Sepsis is an awful thing, but the fact the doctors and nurses were able to act so quickly when they saw the state I was in, that saved me – and it meant that Hallie still has her mum. Knowing the MEWS system they used to save me is going to be used across Scotland is great. The more doctors and nurses are able to recognise sepsis early, like they did in me, the more wee babies get to keep their mums.

Caitlin O’Neill is a mother of one and bowling alley manager from Larkhall.

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Tagged: impact campaign

How quality improvement is helping to keep mums and babies together – Colin Peters

Posted on September 12, 2019

Evidence shows us that bonding between mother and baby is hugely important. As part of the Scottish Patient Safety Programme’s improvement work for maternity, neonatal and children, we’ve been working with NHS boards across Scotland to safeguard the natural bonding of baby and mother by addressing issues that evidence tells us we can directly influence: breathing problems, body temperature, infection, low blood sugar levels and feeding challenges.

For parents-to-be, pregnancy is an exciting time planning for the new arrival. The last thing parents imagine is their baby requiring admission to the neonatal unit. When it happens it can be a difficult emotional journey for all members of the family. The resulting separation decreases the opportunity for temperature regulation and stabilisation of vital signs including breathing rates, and has a negative effect on maternal mental health, breastfeeding success rates and long-term morbidity for mother and child.

The result of the work thus far is that the number of babies separated from their mothers and placed in neo-natal units shortly after birth has been reduced by 20% in eight major neonatal units in Scotland that we’ve been working with.

Speaking to the neonatal community, they identified that decreasing the number of mothers separated from their babies was an area of need where a positive impact could be made.

Data submitted to us from NHS boards across Scotland suggest that for every 1,000 babies born at term, around 60 are admitted to the neonatal unit. According to research, over 20% of term admissions to neonatal units could have been prevented.

The result of the work thus far is that the number of babies separated from their mothers and placed in neo-natal units shortly after birth has been reduced by 20% in eight major neonatal units in Scotland that we’ve been working with. This means around 30 more babies each month in Scotland receive care at the bedside, beside mum, resulting in less disruption to breastfeeding and better long-term outcomes for both mum and baby.

The figure underlines the dedicated work of the Scottish Patient Safety Programme’s Maternity and Children Quality Improvement Collaborative (MCQIC). It’s a good news story. So good in fact that we were delighted that The Times recently picked up the story and published it.

NHS Tayside’s ‘Unite: keeping families together’ project is a good example of the type of work NHS boards have been undertaking. Through analysing their data, the team identified that almost half of neonatal admissions were attributed to babies born over 37 weeks of pregnancy.

The result of their interventions is that the unit has seen a 21% reduction in the number of babies admitted to neonatal unit and thus separated from their mum.

To find out why, the team at Tayside further analysed the data and found that breathing complications, weight loss from breastfeeding challenges and cold body temperature were the main reasons for these admissions. The result of their interventions is that the unit has seen a 21% reduction in the number of babies admitted to neonatal unit and thus separated from their mum.

We will continue to work with NHS boards across the country to implement this work, and see more mums and babies forging an unbroken bond that allows them both to thrive.

More information

Visit the ihub website to read our impact story

Dr Colin Peters is Consultant Neonatologist at Royal Hospital for Children, Glasgow and SPSP Clinical Lead for Neonatal Care