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Helping ensure excellence prevents the mistakes of the past – Gareth Bourhill

Posted on August 18, 2022

Having lost his mum in the Vale of Leven c-difficile outbreak of 2007-8, Gareth Bourhill was determined to prevent other families having to experience the same thing. Now a patient representative on Healthcare Improvement Scotland’s recently relaunched Excellence in Care Programme Board, he tells us why team work and communication are key to good quality care for all.

Just before Christmas 2007, my mum, Janet Fitzsimmons, was admitted to the Vale of Leven Hospital. She was diabetic and had a blood sugar issue. It had happened before, and we expected her home after a few days when her blood sugar levels were back to normal. But this time it was different and she contracted horrific diarrhoea. Doctors couldn’t find a cause or a suitable treatment and within 24 hours she was put in isolation. She had contracted clostridium difficile (C. diff).

While she came very close to passing away over those few days, she made a limited recovery. She died eight months later, on 9 August 2008 aged 69, one of the youngest victim of the Vale of Leven outbreak.

The story of my mum’s final illness has been summarised and reported on in the many documents and reports at the C.diff public inquiry. Police Scotland carried out a criminal investigation and I spent two full days with police officers in my home, writing down every single word, date, time, things about my mother’s care, confirming on hospital ward drawings exactly what bed she was in and for how long as she moved from ward to ward.

Helping ensure the past doesn’t happen in the future

After all this, after everything my mum went through, that we as a family went through, you might wonder why I wanted to get involved with Excellence in Care, with anything to do with the healthcare system.

Well, quite simply I lost someone who was important to me. Like my fellow public reps on the Excellence in Care programme board, I could have easily walked away and continued my family life as best I could after the conclusion of the public inquiry and the publication of Lord MacLean’s report in November 2014.

But, like my fellow reps, the knowledge I gained from the infection outbreak to publication of that report, I knew that until all 75 of the report recommendations were addressed and executed within all areas of NHS Scotland, a similar or indeed worse occurrence wasn’t just likely, it was likely to be a certainty.

What is Excellence in Care?

Excellence in Care is about the patient, their family and health care staff working together as a team for a positive outcome and experience for all. Ultimately that leads to less complaints and better outcomes for all.

My colleagues on the programme board have to keep reminding me that these things are what they call the “Fundamentals of Care”. Being a consultant electrical engineer, I go into engineering mode and call them the basic skills or foundation skills, but we’re all talking about the same things here. There’s no point in having a stunning looking skyscraper if you don’t get the foundations of the building right. Even if they are out of sight, out of mind buried in the ground, the building will eventually fall over.

When I started as an apprentice electrician in 1981 my new boss said to me: “Gareth, you are now an apprentice electrician, please don’t ever do anything while at work that will cause any embarrassment to your family or the good name and reputation of this firm”. To me that philosophy is also very much part of the fundamentals of Excellence in Care.

At the end of each shift, can you honestly say that the work you carried out, or were responsible for, was in line with your professional training and experience and protocols? If everyone does that, the outcome for patients will be better, family representatives will see that, there will be fewer complaints and far less chance of another Vale of Leven C.diff outbreak happening again.

Excellence in Care is very much part of every minute, every hour and every shift a health care professional works.

Gareth Bourhill is a public representative on the programme board of Excellence in Care, a programme led by Healthcare Improvement Scotland.

More information

To find out more about Excellence in Care, visit: the Healthcare Improvement Scotland website.

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How we engage with patients and their families is key to care improvements – Lynsey Cleland

Posted on June 22, 2022

Placing patients and families at the heart of everything we do is key to improving Scotland’s healthcare, says Lynsey Cleland, Director of Quality Assurance at Healthcare Improvement Scotland.

As we look at the recovery of our health and care services following the COVID-19 pandemic, we are beginning to look towards the future and what quality patient care should look like going forward. The more we look, the more we see that the key to our improvement is patients and their families – without their feedback and their involvement we will miss a vital opportunity which can help us succeed in our mission of delivering outstanding care to everyone in Scotland.

Two important reports

In the course of the last few months, our organisation carried out two pieces of work looking at incredibly challenging areas of healthcare – adverse event reviews (an adverse event is when something happens while care is being delivered which could have, or has resulted in, harm to people) and the experiences of families and carers who lost a child. Both of these areas have a profound emotional impact on those involved, lasting years, if not entire lifetimes. Despite these pieces of work focusing on different areas of healthcare, they set out to establish similar objectives – what did those with lived experience of these events need from their health service? What was truly important to them? What could health providers, local authorities and the third sector do to make a difference and improve?

Listening and empathy

Two themes emerged – listening to patients and their families is essential if we want to understand what went wrong, and that clear, empathetic, human communication was fundamental if we wanted to provide patients and families with the support they need as they move through what is unquestionably, an incredibly challenging time. Both studies talked about examples of patients and families experiencing extraordinary levels of care and consideration across NHS Scotland, with healthcare professionals really tuning into their needs, listening to their experiences and showcasing demonstrable learnings. However, both studies also showed that approaches to reviews, for adverse events and child deaths alike, were inconsistent and didn’t always take account of individual patient and family needs. Families and patients highlighted that in order to benefit from a review process, they needed to understand exactly what the purpose of the review was, how they can contribute and be safe in the knowledge that their emotions will be taken into consideration.

For example, the National Hub for Reviewing and Learning from the Deaths of Children and Young People set up by the Scottish Government and overseen by us and the Care Inspectorate to review and learn from the deaths of all children and young people in Scotland up to age 18, or 26 if receiving continuing care or aftercare, at the time of their death, found in its found in its consultation of bereaved families and carers that following a harrowing event like the death of a child, many families and carers were often unable to digest the information given to them and would benefit from having a review at a later stage. On the other hand, the adverse event reviews study found that some reviews were not timely enough, with those affected saying that they understood that NHS services were under significant pressure and that they would benefit from a timeline, or updates when delays had to happen.

Unprecedented numbers

So, what can we do going forward? We must listen to our patients, their families and carers – that much is clear. We already know that NHS boards across Scotland are paying attention – an unprecedented number of healthcare professionals has expressed interest in receiving compassionate communications training, while examples of outstanding care are reported by patients across the board. It is also paramount that we never forget that people are at the heart of everything we do and that their needs should be placed at the centre of how we shape and improve our health services. Community engagement is a core part of what we do at Healthcare Improvement Scotland, working with the NHS, our partners and patients to make sure that real human experiences and opinions shape national policy. From the recent findings of our work, it is clear that this collaboration is now more vital than ever and that we focus our efforts on three key elements – listening, learning and improving. We will continue to play a key role in ensuring this happens, through producing national information for families, as well as instituting a single point of contact for families to keep them engaged in review process.

Lynsey Cleland is Director of Quality Assurance for Healthcare Improvement Scotland.

More information

Read ‘When a child dies: Learning from the experiences of bereaved families and carers on the Healthcare Improvement Scotland website.

Access the study on the British Medical Journal website.

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Personal pronouns and why you should start sharing yours today – Rosie Tyler-Greig

Posted on June 13, 2022

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Thumbnail image of author: Rosie Tyler-Greig

As part of our celebration of Pride month, Rosie Tyler-Greig, our Equality and Diversity Officer, has spoken with our internal Pride Network for LGBT+ identifying staff and allies, to explore the importance of personal pronouns and why we should all start sharing them in our working environment. We would like to thank Rosie and everyone who took part by contributing their thoughts and reflections.

We use personal pronouns every single day – when talking about ourselves, about our colleagues, friends, families and strangers. Yet, how often do most of us actively think about other people’s pronouns or even our own? How many of us state our pronouns in our email signatures, or say them out loud when introducing ourselves? Do many of us understand why doing so is actually important? Since pronouns can be particularly important for members of the LGBT+ community, we have spoken with our Pride Network to get their thoughts on some of these questions. Members also offered ideas that could help Healthcare Improvement Scotland be an even more inclusive environment. 

Pull quote image: "How many of us state our pronouns in our email signatures or say them out loud when introducing ourselves?”

Personal pronouns = identity

The first thing to understand is that personal pronouns impact everyone – whether you have never questioned your birth gender (so are cis-gender) or realised your gender is different to the one assigned (so are trans). We have all, at one point or another, come across unfamiliar or uncommon names, or names that could belong to different genders. In a situation like this, you may take special care to pronounce or spell a name correctly. Our pronouns are as much a part of our identity as our name – we use them throughout the day when talking about ourselves and those around us, so it is only natural that by using the right pronouns we are being respectful of someone’s individuality and identity.

Stating your pronouns = safe space

Using a person’s preferred pronoun is a sign of respect for them as an individual. Sharing your own, regardless of your gender or how ‘obvious’ your pronoun is, is an active step towards creating a safe space for everyone around you. This is because doing so normalises something that may be ‘less obvious’ and take bravery for someone else.  

Pull quote image: “Using a person’s preferred pronouns is a sign of respect”

Our gender is at the core of who we are. Calling someone by the wrong pronoun feels the same as using the wrong name – it can invalidate who they are and undermine trust.  It would be hard to feel safe expressing opinions or needs in any environment where people consistently called you the wrong name.

Asking questions = curious respect

All that said, what can we do to respect pronouns? Being respectful of others is a huge part of any healthy work environment and at one point or another, all of us will worry about accidentally offending or upsetting someone. If you find yourself unsure about someone’s pronouns, the easiest thing to do is just ask! Asking the question and learning in the process is so much better than making assumptions, or even worse, avoiding someone entirely because you are worried about saying the wrong thing. Similarly, if you find yourself making a mistake, apologise and move on just like you would if you mispronounced a name. There is no need to make it into a big issue.

Practice = perfect

Sometimes we may need to remind ourselves of the pronoun a person uses.  Non-binary pronouns, they/them, seem to be an area people trip up at more often. Some people have assumed – incorrectly – that using ‘they/them’ in the singular is grammatically incorrect. Imagine someone, who you don’t know has left behind their phone. You would automatically say ‘they forgot their phone’. If you’re talking about an appointment with a clinician you haven’t met before, you’d say ‘I’m going to see them to ask them about…’ If you don’t know someone’s gender, you may just use ‘they’ until you get clarity.  If you still find yourself tripping up, then practice – tell anecdotes about people using they/them pronouns, talk about your friends who identify as they/them when they aren’t around. Eventually, this will come more naturally.

Pull quote image: “Some people have assumed – incorrectly – that using ‘they/them’ in the singular is grammatically incorrect”

Next steps

We hope this article has clarified the important role that personal pronouns have. So how can you help make our communications more inclusive? Start by adding your personal pronouns to your email signature and stating them whenever you introduce yourself to someone new. For example, ‘Hi, I’m [name], my pronouns are [pronouns] and I [job]’

This shows that you are taking responsibility and sharing your knowledge. In turn, this takes some pressure off the LGBT+ community, who are so often expected to do the teaching. And remember – mistakes do happen, the key is that you learn from them!

Rosie Tyler-Greig is Equality and Diversity officer with Healthcare Improvement Scotland.

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Leaving the NHS doesn’t mean the caring ends – Linda Gunn

Posted on June 6, 2022

Thumbnail image of author: Linda Gunn

Linda Gunn is a volunteer Public Partner with Healthcare Improvement Scotland. Following her retirement from the NHS after 42 years, Linda still wanted to play her part in helping others and saw the role with our organisation as a perfect way to keep making a difference.

The NHS has been through a most difficult time in the last few years, in all its forms of healthcare delivery and in the education of new healthcare workers.

Even though I had retired from working in dental care, I felt I still had something to offer and that my experience might be helpful to another part of the NHS. Initially I thought I would be able to help in the response to COVID-19, but I was open to different challenges.

An initial web-based search for volunteering roles in the NHS brought up Healthcare Improvement Scotland (HIS) and the name caught my attention, as my own motivation for volunteering would be to improve care. I felt, from that moment on, a new, interesting and enlightening world opened up for me.

I applied to Healthcare Improvement Scotland to become volunteer, otherwise known as a Public Partner, at the beginning of 2022, so it is still early days. Since then I have undertaken a comprehensive induction programme and completed an online module on Health Technology Assessment – more of that later.

Meaningful involvement

It does not matter whether we, as patients or carers, have to use the NHS regularly or not. Having the reassurance that it is available to us is one thing, but having the comfort of knowing that we will be treated in the best way by the right healthcare staff who are well trained and professional is, I think, the most important thing to us. This scrutiny of the service in its many forms is what being a Public Partner allows me to be a part of and to contribute to.

As a Public Partner, I have found myself involved in major projects such as the quality assurance of Healthcare Improvement Scotland itself and quick questionnaires such as those of the citizen’s panel.

Pull quote graphic: "As a Public Partner, I have found myself involved in major projects such as the quality assurance of Healthcare Improvement Scotland itself and quick questionnaires such as those of the citizen’s panel."

was not sure which area I wanted to focus on but when I joined HIS, the Scottish Medicines Consortium (SMC) – another part of Healthcare Improvement Scotland – was looking for a new Public Partner. I joined SMC in February as one of three Public Partners. We are full voting members of the SMC Committee, and as members of the public, we use our judgement on the value of a new medicine to NHS Scotland. This has been so interesting and a completely new subject for me, so there has been a huge amount to learn, although we are fully supported by the SMC Public Involvement Team.

I was not sure which area I wanted to focus on but when I joined HIS, the Scottish Medicines Consortium (SMC) – another part of Healthcare Improvement Scotland – was looking for a new Public Partner. I joined SMC in February as one of three Public Partners. We are full voting members of the SMC Committee, and as members of the public, we use our judgement on the value of a new medicine to NHS Scotland. This has been so interesting and a completely new subject for me, so there has been a huge amount to learn, although we are fully supported by the SMC Public Involvement Team.

Healthcare Improvement Scotland offers a variety of activities which Public Partners can become involved in, because everything that happens in the NHS can be enhanced by including the opinions of those who use the service; the public.

It is clear that much of this is new to me but from the start everyone in Healthcare Improvement Scotland have been so helpful and patient to ensure I understand. As well as talking me through things, an online module was provided through the University of Glasgow which I completed over a few days.

There was a bit of anxiety when I did the ‘tests’ but once I realised I could go back and revise, that helped – after all, it was more about me learning than achieving a score or pass mark.

Astonished and grateful

While I was totally unaware of the processes involved in how new medicines get approved in Scotland, I am both astonished and grateful that when SMC look at new medicines they take into account patients’ views, the views of their families, the experts and clinicians’ views, cost-effectiveness, and as a Public Partner, my opinions. It is such an incredible, sensitive, caring process which is in place to ensure the patients get the best treatment. I feel very honoured to be part of it.

Pull quote graphic: "My passion for volunteering is a big part of my life and I’m always trying to find other opportunities to help."

Healthcare Improvement Scotland offers a variety of activities which Public Partners can become involved in, because everything that happens in the NHS can be enhanced by including the opinions of those who use the service; the public.

It is clear that much of this is new to me but from the start everyone in Healthcare Improvement Scotland have been so helpful and patient to ensure I understand. As well as talking me through things, an online module was provided through the University of Glasgow which I completed over a few days.

There was a bit of anxiety when I did the ‘tests’ but once I realised I could go back and revise, that helped – after all, it was more about me learning than achieving a score or pass mark.

New opportunities

New opportunities to volunteer within Healthcare Improvement Scotland come up regularly but I don’t feel I need to contribute to everything, and no-one puts pressure on me. The trouble is, it’s all so interesting it’s hard to say ‘no’.

I am also hugely aware that everyone in the organisation appreciates my time and recognises that I am a volunteer.

I said I wanted to continue to contribute and I still wanted a challenge and to continue to learn. I have learned so much in the last few months and my thoughts and opinions have been appreciated and respected. It is gratifying to see how such an organisation works for the people in Scotland, so that they continue to receive the best care delivered by professionals at their highest professional standards.

Anyone can contribute and have their own opinions valued, and you don’t need to have an NHS background.

Linda Gunn previously worked in dental education in the NHS in Scotland is a Public Partner with healthcare Improvement Scotland.

Call to action – find out more about being a Public Partner at Healthcare Improvement Scotland and the work of the Scottish Medicines Consortium.

  • Find out more about the role of a SMC Public Partner.
  • As part of a rolling Public Partner recruitment programme, SMC will be recruiting another new Public Partner later this year. To find out more please email his.smcpublicinvolvement@nhs.scot
  • Find out more about Volunteers’ Week 2022. This is the 38th Volunteers’ Week, with the focus this year on saying thank you to those who give up their time to help others.  Find out more on social media, using the hashtag #VolunteersWeekScot
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Volunteering changed my life for the better – Sophie Ross

Posted on June 6, 2022

Thumbnail image of author: Sophie Ross

As part of Volunteers’ Week, Healthcare Improvement Scotland is sharing the stories of NHS staff who give up their own time to help others. Healthcare Improvement Scotland manages the Volunteering in NHSScotland Programme, and one of the aims of the work is to have a positive impact on the NHS and on the volunteers themselves. Sophie Ross, a call handler with NHS24, discovered that volunteering helped her go from being out of work to finding her current position, perfectly demonstrating how giving up her own time changed her life – and others – for the better.

I grew up with my mum, my role model, who was always offering to help others in some way whether it be charity work or volunteering and I would always be there behind her closely following.

I sadly lost my mum in 2013 and afterwards went through one of the darkest times in my life, involving depression and unemployment.

Pull quote graphic: "Volunteering was a great way to build my CV up and it also shows employers you are committed to using your spare time to help others."

I knew I needed a way out of this vicious cycle so I turned to volunteering again, hoping it would get my life back on track – and it certainly did!

Volunteering was a great way to build my CV up and it also shows employers you are committed to using your spare time to help others.

After gaining employment through The Princes Trust at NHS24 I decided to become a Princes Trust Young Ambassador to encourage other young people to take steps toward using the support that is out there for those who are struggling.

My passion for volunteering is a big part of my life and I’m always trying to find other opportunities to help.

I recently became a Give & Go Volunteer for NHSGGC providing a link to patients throughout the pandemic by bringing gifts in from loved ones.

Just being able to provide that small amount of joy meant everything.

Volunteering – for yourself and others

Pull quote graphic: "My passion for volunteering is a big part of my life and I’m always trying to find other opportunities to help."

Not all of volunteering is glamorous but to me it is such a good thing to do for yourself and others.

I would encourage anyone to consider volunteering – no matter how big or small the role, or how little time you can commit, you are providing something to someone somewhere to make things better in your own way.  Find out more about Volunteers’ Week 2022. This is the 38th Volunteers’ Week, with the focus this year on saying thank you to those who give up their time to help others.  Find out more on social media, using the hashtag #VolunteersWeekScot

Sophie Ross is a call handler with NHS24.

More information

You can read more about volunteering in NHSScotland through the case studies at Healthcare Improvement Scotland – Community Engagement.

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Saying thanks to all who are involved in volunteering across Scotland – Janice Malone

Posted on June 1, 2022

Image thumbnail: Janice Malone

To coincide with Volunteers Week and the launch of our report on volunteering in Scotland, Janice Malone from our Volunteering in NHSScotland Programme gives thanks all of the staff who give up their time.

Every year as my team and I begin to think about and plan for our Volunteers’ Week activity, I have a very distinct sense and feeling that no matter what we do to thank and to celebrate the efforts of volunteers will ever be enough to convey the levels of gratitude that I feel for the gift that volunteers give to our society.

Every 1-7th June volunteer managers up and down the country say their own personal thank you to their volunteers, we all shout from the rooftops – well, all over social media really – saying thank you to volunteers in all sorts of creative and fun ways, but it never really feels like enough.

What more could we do? What different ways to celebrate the incredible value that volunteering brings to our lives? As professionals in health and care, we can see the positive impact that volunteers can make, every single day when we are working alongside them.

Pull quote: The satisfaction I get from supporting the organisation to grow and to thrive is why I volunteer

We say thank you every day, through striving to provide the best volunteer experience for our volunteers.

I am a volunteer, I am honoured to have the opportunity to be a trustee at SupportED, a small eating disorders support charity. The satisfaction I get from supporting the organisation to grow and to thrive is why I volunteer.

Inspiring

I also work in the world of volunteering, and have done for some 15 plus years. It is the most inspiring line of work, being there to create the opportunities for people to get involved in volunteering; to champion volunteering as a profession; to ensure that volunteers are treated with the respect that they deserve; to influence change in the sector. I consider myself to be very fortunate.

But when I really think about it, volunteering is all about the people, it’s about giving and kindness. Millions of people all over the world, who decide to get involved in something that they care deeply about.

Pullquote: But when I really think about it, volunteering is all about the people, it’s about giving and kindness. Millions of people all over the world, who decide to get involved in something that they care deeply about

Millions of people who give their own time freely. Millions of people who make an incredible difference to the people, causes and communities that they support. What’s not to love about that?

From my heart to yours, if you are a volunteer, have volunteered in the past or are thinking about volunteering – THANK YOU.

More information

  • Find out more about Volunteers’ Week 2022  at https://volunteersweek.scot/ . This is the 38th Volunteers’ Week, with the focus this year on saying thank you to those who give up their time to help others.  Find out more on social media, using the hashtag #VolunteersWeekScot

Our Volunteering in NHSScotland Programme drives forward the volunteering agenda in NHSScotland through effective leadership, governance, consultancy and expert advice for volunteering across NHSScotland. Read our Volunteering in NHSScotland Programme Annual Report 2021-22.

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Have your say and help deliver Healthcare Improvement Scotland’s future strategy – Robbie Pearson

Posted on May 20, 2022

Healthcare Improvement Scotland’s Chief Executive Robbie Pearson shares our organisation’s vision to deliver safe, effective and person-centred care through the Leading quality health and care for Scotland: Our strategy 2022-27. He also outlines how you can have your say in how the final strategy is shaped to meet the needs of all the people of Scotland.

As Scotland recovers from the pandemic, Healthcare Improvement Scotland recognises that there’s a need for boldness – boldness in our actions to improve health outcomes for people, and boldness to ensure we meet the needs of diverse groups and to tackle deep-rooted inequalities.

Our organisation is here to support the highest quality, safest care for everyone, and this approach can be found in our draft strategy for 2022-2027 which is currently out for consultation. But in order to meet such a broad range of needs across society, we have to reach out; to communicate our thinking and to gather in opinions.

Therefore, I’d like to take this opportunity to summarise the key points of our strategy and to reach out to you, whatever your circumstance, to ensure that our intended approach is meeting everyone’s needs.

Meeting unprecedented challenges

As we all know, the health and care system in Scotland is facing unprecedented challenges.

This strategy is shaped by the need to concentrate our efforts in four key areas:

  1. A recovered and strengthened health and care system – the COVID-19 pandemic has been the most significant threat to our health and care system, and it has also highlighted some deep seated inequalities in Scotland. The recovery from the pandemic will be a long and difficult road and there will be a need to retain and strengthen aspects of our capability to respond to similar future challenges. Adjusting to these circumstances is a recurrent theme through this strategy. We must use this opportunity to redesign services so we reliably deliver what people need, when they need it.
  2. A person-centred system of health and social care – the commitment to establish a National Care Service is a central aspect of our future priorities. We will support the creation of a fit for purpose service which works to consistent standards, supports people to remain independent and which affords everyone fair access to high quality care.
  3. A systematic drive to address inequalities and injustice – the pandemic has disproportionately impacted groups who already experience disadvantage in society, including on the basis of socio-economic circumstances. Particularly impacted are minority ethnic groups, disabled people, people with long-term health conditions, people living in poverty, unpaid carers, older people, children and young people and women. Impacts range from more severe illness and death to increased poverty and social isolation. A priority must be to highlight pre-existing injustice and take concerted action to narrow health inequalities.
  4. A healthier and more sustainable future – there is a need to take radical steps in supporting improvements in the health of our population and to actively address sustainability and the global climate emergency.

Our actions will also remain firmly anchored in the ambitions of Scotland’s Healthcare Quality Strategy – to deliver safe, effective and person-centred care.

Assurance and improvement

There is not one single step to achieving higher quality care. It’s about balancing different dimensions and actions that help to make improvements.

We’ll provide independent assurance of the quality and safety of care provided in the health and care system in Scotland, and we’ll review how health and care services are improving outcomes for people and reducing inequalities in their care. With partner organisations, we will consider how services are working together within an integrated system, as well as how the system is performing as a whole.

We will provide national leadership and play our part in creating a National Care Service; one that ensures everyone receives the same standard of care wherever they live and empowers people to thrive.

By having a range of responsibilities for improvement we can make the most appropriate choices about how to tackle the problems or challenges that confront those who provide or require care, striking an appropriate balance between both supporting improvements on the care front line and in making the necessary larger scale changes across Scotland.

The need to adapt

We believe it is important that we continue to reflect on progress over the coming months and years, and adapt our strategic approach as required to ensure we continue to address the quality challenges in the system and are maximising our impact.

Over the next five years we will make a demonstrable and measurable contribution to meet these challenges by focusing on safety, quality and access to care which is equitable and person-centred.

We can ensure that we are able to adapt appropriately by reaching out to you and by continuing to engage and to listen to your opinions. We look forward to hearing your opinion and continuing to work with you all to take the bold and confident steps that will ensure our health and care services both recover and transform to meet the needs of us all.

We welcome all views on our draft plan: Leading quality health and care for Scotland: Our strategy 2022-27

You can take part in an online survey: Leading quality health and care for Scotland: Our strategy 2022-27

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Giving people and communities their say on their health and care services – Ruth Jays

Posted on May 17, 2022

Thumbnail headshot image of author: Ruth Jays

Ruth Jays, Director, Healthcare Improvement Scotland – Community Engagement, wants the public to make their voices known when it comes to their health and care.

HIS-Community Engagement’s purpose is to promote the involvement and participation of people in the development and delivery of health and social care services.

And there has never been a more important time to engage.

HIS-Community Engagement is the operational and delivery arm of the Scottish Health Council and we relaunched in April 2020. We had plans for a bells and whistles relaunch – but the red carpet had to be rolled up due to COVID- 19.

We have continued to support and promote community engagement throughout the last two years, with the lifting of the emergency footing on NHS Scotland. As an organisation, we are now ramping up our work to ensure that the voices of all communities across Scotland play a role in shaping health and social care services.

Engaged

Arguably, since the pandemic we now have a more health literate population than ever before, a public who are more engaged in their healthcare and have a new-found respect for the NHS and staff, as well as an understanding of the tough operating environment and a willingness to help support it.

The public has seen what has happened when they haven’t had a say in how their healthcare is delivered – whether that was not being able to be with a loved one in hospital or not being able to access their GP in the way that they would want.

Pull quote image. Text reads "The way healthcare is designed and delivered has changed over the past two years, and will continue to change as the NHS recovers and responds to emerging challenges. It’s vital that the public’s views are taken into account."

And we know now that the impact of COVID will reverberate for years to come and has thrown into sharp relief the health inequalities already in Scotland.

We need to capitalise on all of this and ensure the voices of diverse communities across Scotland are harnessed in shaping the NHS as it emerges from the pandemic.

Change

The way healthcare is designed and delivered has changed over the past two years, and will continue to change as the NHS recovers and responds to emerging challenges. It’s vital that the public’s views are taken into account.  But why? Understanding the views of a wide range of people and using these to shape and develop services is absolutely critical to creating and delivering person-centred health and care services. Without doing so, you run the risk of developing services which don’t meet the needs of the populations they serve.

Without engaging with people, you cannot know what the impact of something is. We’ve all seen examples – and experienced them ourselves – of when engagement hasn’t happened or when it has been limited, and the negative impact this can have. Engagement isn’t a “nice to do” – it is a “must-do” – failing to involve people in the development of services leads to poorer health outcomes and can widen health inequalities. This has never been more important than in the period ahead. As we move out of the pandemic and start grappling with the cost of living crisis, the most disproportionate impact will be felt on those who are already most at risk.

Care

Engagement ensures health and social care services are person-centred and deliver the best possible care and support for people and communities.

Engagement can seem like another ask of our already stretched health and care services. But engaging with communities has never been more important, and our team are skilled and experienced in supporting engagement. We are here to help!

We use a variety of tools and techniques, and are always testing new ways of engaging people. We provide expert advice and signposting to our stakeholders on the most successful ways to achieve meaningful engagement with people and communities.

Over the last two years we have developed the use of tools such as our Citizens’ Panel and Gathering Views exercises which have been used to capture feedback from the public – including seldom-heard groups – on important issues including accessing urgent care, priorities for future healthcare and the development of services for people living with ME and chronic fatigue.

Invaluable

HIS-Community Engagement has staff based in every territorial NHS board across Scotland. This means we have excellent links into local communities which is invaluable in terms of promoting and supporting engagement.

Pull quote image. Text reads - "Engagement ensures health and social care services are person-centred and deliver the best possible care and support for people and communities."

Working virtually has brought huge benefits for us in terms of better communication across our teams based across the country. And we have used this learning to adapt how we engage with communities.

Everyone has had to adapt their lives and the way they work over the past two years. This also meant we had to adapt how we engaged with communities and how we supported our stakeholders to do so. This resulted in some really innovative engagement methods and benefits for communities, especially in remote and rural areas. We will continue to use these going forward. We also ensure that in doing so we don’t create further inequalities – we are mindful that not everyone has access to digital technologies.

The current context we are living in – characterised by the four Cs – Covid, conflict, climate and cost of living, presents huge challenges for all of us working in health and social care. We have adapted our ways of working to continue to provide excellent support to engaging people and communities during the pandemic, and will be adapting our ways of working again to ensure we take account of the current context.

One of the programmes I am most proud of being involved in is the “What Matters to You?” movement, which HIS-CE co-ordinates. WMTY is a way of unlocking a person-centred approach to care and it never fails to amaze me that such a simple question can have such a transformational effect on care. “What Matters to You?” is what we need to ask of our communities when we are designing and delivering services.

So if you are involved in work to change how health and social care services are being delivered, please get in touch with us.

More information

You can email us at info@hisengage.scot or follow us on Twitter.

Find out more about the work of HIS-Community Engagement by visiting our website.

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New Infection Prevention and Control standards can achieve a great deal – Pauline McIntyre

Posted on May 16, 2022

Pauline McIntyre is Deputy Director of Care at Erskine, a charity caring for veterans in four care homes across Scotland. As Healthcare Improvement Scotland and the Care Inspectorate launch new infection prevention and control, Pauline explains why she’s been delighted to be a part of it.

At Erskine, our residents’ safety is paramount. Therefore, I was delighted and proud to be involved in developing new standards for infection prevention and control (IPC) in care homes in Scotland, alongside Healthcare Improvement Scotland and the Care Inspectorate.

IPC is well known to us all, never more so than during the pandemic. Now that the standards have been launched, alongside the National Infection Prevention and Control Manual, they will help us to deliver care in ways that minimise the risk of infection. This is particularly important in somewhere like a care home, which is not a clinical environment.

Achieving the standards

When the opportunity came up to be involved in developing the new IPC standards I was delighted to support this work and to offer my knowledge and experience as a care home nurse. From the outset it was important for me that the group considered the practical implications of decisions made about the standards especially around how the standards could be achieved in care home environments.

Over the past 20 months we have all been faced with profound challenges as we work tirelessly to keep our residents safe, well and living fulfilling lives. We have been responsive to implementing ever changing guidance around how best to keep our residents safe in their homes. There has been a great deal of pressure placed on us to embed new approaches, systems and processes at pace.

We continue to rise to this challenge because our resident’s quality of life and safety is paramount. Although it has been a difficult time, there have been good stories. I’m personally pleased to see more partnership and integration across health and social care.

Communications from the project team at Healthcare Improvement Scotland started in March of last year this year and the first development meeting was in April. The group met virtually to discuss, debate and direct the content of the new standards.

The project team kept us on track and everyone in the group was given opportunities to contribute throughout the development process. My input always considered aspects that we cannot forget, care homes are people’s homes.

A realistic approach

Until my involvement in developing new IPC standards I had not referred to the previous Healthcare Associated Infection standards from 2015, simply because I was not aware of them. They were healthcare focused and the language and terminology did not resonate in social care.

The new standards need to be viewed in a realistic way in that not every part will apply in every care setting but where we can apply this good practice, no matter the care setting we work in, a lot can be achieved.

Pauline McIntyre is Deputy Director of Care at Erskine. Pauline is a registered nurse with over 26 years’ experience.

To find out more about Erskine, visit their website: https://www.erskine.org.uk/

More information

Visit the Healthcare Improvement Scotland website to download the IPC standards.

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Why nursing makes such a difference for us all – Ruth Thompson

Posted on May 12, 2022

Ruth Thompson, Associate Director of Nursing & Midwifery at Healthcare Improvement Scotland, started her nursing career in coronary care, and today celebrates International Nurses Day.

I started my nursing career in Glasgow, training at the Victoria Infirmary. I loved my training, so many of the registered staff were generous of their time and invested in the development of the next generation of nurses, something I try to replicate and support. During my training my biggest struggle was sewing-up my starched lace cap!

As a registered nurse I worked within Coronary Care, where I developed my love of cardiac medicine, Acute and General Medicine, starting as a staff nurse progressing to senior charge nurse, directorate senior nurse manager and then to chief nurse of both Hairmyres Hospital and Monklands Hospital in Lanarkshire.

I then joined Scottish Government as a professional advisor working with the Scottish Executive Nurse Directors to maximise the impact of robust workforce planning on patient safety and quality of care, and to reduce the reliance on supplementary staffing. I joined Healthcare Improvement Scotland in 2019, transitioning the Healthcare Staffing Programme from Scottish Government, before successfully securing the Associate Director of Nursing and Midwifery post.

Caring

During the pandemic I supported several NHS boards. Every day I witnessed nurses going above and beyond, working in new roles, environments, delaying their retirement plans or indeed coming out of retirement to support colleagues and services. All done with a can-do attitude, humour and humility. I also required ED treatment myself, the staff were amazing, kind and caring. Whilst not a surprise to me, I was overwhelmed.

I have been truly blessed to work with many inspirational nurses, who work tirelessly to enhance their own skills and knowledge to improve the care, experience and outcomes for patients.

I don’t think I could have made a better career choice, my experiences whether they made me laugh or cry have been wonderful learning opportunities and shared with fabulous colleagues of many professions.

Unique

For me, nurses are in a unique position to provide the continuum of care across the age spectrum, supporting people to manage their own health and providing that additional support when people are unable to meet their own needs. As a nurse you see people, both patients and their families, at their most vulnerable and the trust placed in you is humbling.

I believe the greatest improvements are those challenges identified and owned by the team; they know their clinical area, the ideas for improvement and then prioritise their improvement programme. Undertaking leadership walk-rounds or “back to the floor days” was a great opportunity for teams to share their successes using the improvement boards and safety crosses and for me to see them in action. Their pride in the improvements made to patient safety and care was palpable.

As a chief nurse, embracing the work of the Scottish Patient Safety Programme (SPSP) we worked tirelessly to move from the traditional ‘bed meeting’ to the hospital safety huddle. Changing the focus from an ED wait for a bed to whole site responsibility for a patient safety issue, using data to understand the blockages in the system and testing new ways of working. This significantly improved the ED quality standard performance and reduced the number of lengthy waits for patients

Impact

The SPSP programme was the foundation stone to improving patient safety and care, this was then strengthened by the Excellence in Care programme which specifically identified the impact of nursing care. None of the quality improvement work can be delivered without having the right number of staff with the right skills at the right time and this is where our Healthcare Staffing Programme supports the delivery of safe, effective care.

Nurses are educated, knowledgeable and skilled practitioners, regulated by the NMC.

I hope that nursing continues to balance the art and the science, both are equally important to patients and their families. I hope to see more nurse-led services. The enhanced and advanced skills of nurses allows patients to be assessed, treated and discharged by nurses, allowing professional relationships to flourish.

Ruth Thompson is Associate Director of Nursing & Midwifery at Healthcare Improvement Scotland.

More information:

The NMAHP directorate (Nurses, Midwives and AHPs) provides professional support and leadership, stimulating improvement in care and collaboration with multidisciplinary teams in HIS and the wider health and care system.

Visit our website for more information.

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Healthcare Improvement Scotland Blog

The purpose of Healthcare Improvement Scotland is to enable the people of Scotland to experience the best quality of health and social care.

This blog will provide updates and information on our work, highlight some of the improvements underway across health and social care in Scotland and hopefully prompt some healthy debate.

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