Posts from the “Uncategorized” Category

How the Moira Anderson Foundation is helping create a new model of care for children affected by abuse – Gillian Urquhart

Posted on August 9, 2019

Barnahus is a Scandinavian term that most in Scotland will not be familiar with. But that’s all set to change. The word translates as Children’s House (Barn meaning ‘children’ and Hus meaning ‘house’) and the first Barnahus was founded in Iceland in 1998. Since then many countries have developed their own Barnahus model, most in Scandinavia. Closer to home, an English version of Barnahus called The Lighthouse was launched in London in October 2018. Since inception in 2000, MAF has supported people affected by Child Sexual Abuse. We were instrumental in forming the coalition group, Justice for Children in 2002. The clear message given by the group 17 years ago was that children should be nowhere near a court building. So what exactly is…

Categories: Uncategorized

Tagged: children and young people, standards and guidelines

Barnahus – a new model of care and support for children who have experienced abuse – Rachel Hewitt

Posted on August 8, 2019

According to research by Children 1st, children who have experienced abuse may have to tell their story to 14 different people before they get the support they need. Sometimes, children and young people have to tell their stories to people from up to nine different organisations—everyone from their schoolteacher to a High Court judge, which potentially adds more traumatic experiences to those they’ve already been through. To help address this issue, the Standards and Indicators Team within Healthcare Improvement Scotland (HIS) were commissioned by the Scottish Government to jointly develop standards which will outline what a Barnahus model should be like in Scotland. Like many people, the term Barnahus was relatively new to me before I started to work on the standards project. I’d…

Categories: Uncategorized

Tagged: children and young people, standards and guidelines

How equality and diversity can help create better care for all – Mario Medina

Posted on July 25, 2019

You might think equality and diversity has little to do with health and social care, and that complying with the Equality Act is just a tick box exercise that we all feel duty-bound to comply with. Yet I believe that these two factors are crucial in ensuring Healthcare Improvement Scotland’s work has impact, and that it truly improves health and social care for everyone in Scotland.

Assuming that a programme of work will lead to improvements for all, without trying to really understand the diverse needs of those we want to benefit from the work, can lead to us discriminating against individuals, as well as widening Scotland’s health inequalities gap. Moreover, it can be a sure-fire way to ensure that the aims of the project fall short of our intentions.

Assuming that a programme of work will lead to improvements for all, without trying to really understand the diverse needs of those we want to benefit from the work, can lead to us discriminating against individuals, as well as widening Scotland’s health inequalities gap.

As a health body, the Equality Act requires us to eliminate discrimination, advance equality, tackle prejudice and promote understanding across nine protected characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. It’s a responsibility that we all share, particularly as each of us has at least five of the nine characteristics. That’s why it’s important to consider the potential impact of our work at the beginning of each project to ensure that it is set up in order to improve care for as many people as possible. To achieve this, a tick box exercise will fail all of us. To really bring about improvements for all of us, equality and diversity have to be factors that we wholeheartedly commit to.

But how exactly do we ensure that a genuine commitment to equality and diversity is built into our work? Let me give you some examples of strategies that have worked for us.

Our Standards and Indicators team considered how the new cervical screening standards might be received fairly by everyone. Potential issues were identified and action taken to engage with different groups who might be impacted, improving our understanding of how to address these issues. Engagement with minority ethnic people identified potential cultural barriers to accessing cervical screening. The standards therefore included a stipulation about the provision of good quality information and strategies that NHS boards can adopt to identify those most unlikely to attend. We also identified issues from the trans community and built that perspective into the standards to ensure assumptions would not be made based on gender when identifying those eligible for screening.

Due to this type of engagement with people whose views are often under-represented in decision-making processes, we were able to design and develop standards with equality and diversity at their heart.

But to ensure we’re factoring equality and diversity into everything we do, we also need to recruit and retain a diverse workforce. We’ve taken a number of steps to improve in this area. We’re part of the Disability Confident scheme, which helps employers recruit and retain disabled people. Each year we complete Stonewall’s Workplace Equality Index (WEI), a tool for employers to measure their progress on lesbian, gay, bi and trans (LGBT) inclusion. During Mental Health Awareness Week, our staff took part in See Me’s Pass the Badge campaign, which encourages people to talk about mental health. We’ve also successfully recruited Modern Apprentices to Trainee Administrative Assistant roles. These actions and initiatives have improved career opportunities for people from a broad range of backgrounds.

Due to this type of engagement with people whose views are often underrepresented in decision-making processes, we were able to design and develop standards with equality and diversity at their heart.

The real evidence of our commitment to equality and diversity came with the creation of the Margaret McAlees Award in collaboration with Unison’s Scottish Health Care Branch. Established in honour of our late colleague Margaret McAlees, a Unison steward renowned for helping advance equality and promoting diversity, the nominations highlighted some of the great work our staff are doing. Our SIGN guidelines development team promoted the rights of young people to be involved in decisions which affect them, and worked to ensure patient versions of guidelines were accessible for them. The team behind our Scottish Patient Safety Programme for Mental Health were nominated as early adopters of a human rights-based approach to their work and for their efforts to tackle mental health stigma and discrimination. The award winners, our Focus on Dementia team, demonstrated a commitment to improving the lives of people living with dementia over and above what could be expected of them, undertaking voluntary work and participating in fundraising events in their own time. This work has improved the wider public’s understanding of dementia and how it affects people’s lives.

As an improvement organisation, we’re always looking to do things better. That’s no different when it comes to equality and diversity. We don’t want to simply meet our duties, we want to exceed them. I’m delighted to be in a position where I can look back on excellent work that is making equality and diversity a key part of what we do, and also to support its further development.

Mario Medina is Equality and Diversity Advisor for Healthcare Improvement Scotland.

More information

Healthcare Improvement Scotland website

Categories: Uncategorized

Tagged: equality and diversity, ihub, impact campaign, standards and guidelines

How the Scottish perspective is helping combat antibiotic resistance in Ghana – Jacqueline Sneddon

Posted on July 9, 2019

Antibiotic resistance is a threat on a global scale. Protecting these vital medicines for the future is everyone’s problem, not just an issue for one country or continent. There’s little point in ensuring Scotland or even the UK carefully manages its antibiotic use if other countries don’t do the same. There are no boundaries to spread of resistant bacteria. One of the best ways to safeguard these vital medicines is through cooperation and learning from each other. That’s why I’m passionate about sharing the work the Scottish Antimicrobial Prescribing Group (SAPG) have undertaken over the last decade to safeguard antibiotics – and to learn from others’ experiences. Antibiotic resistance is a threat on a global scale. Protecting these vital medicines for the future is…

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How the patient voice helps identify technologies to stop cancer in its tracks – Claire Donaghy

Posted on July 3, 2019

rptoz Each year more than 3,700 people are diagnosed with bowel cancer, making the disease the third most common cancer in Scotland. It’s also the second biggest cancer killer in the country, with 1,600 dying every year. But it shouldn’t be: bowel cancer is treatable and curable, especially if diagnosed early.

As the Head of Scotland for Bowel Cancer UK, I work to ensure people affected by bowel cancer receive the best treatment and care available. It’s vitally important that any new technology is thoroughly researched and the evidence base reviewed before being introduced to the NHS. The work of the Scottish Health Technologies Group (SHTG) – part of Healthcare Improvement Scotland – ensures this happens, and that’s why I am proud to be involved with them as a Patient Organisation Representative.

To date, I’ve been involved in three different health technology assessments. Each one has been very different but all have the potential to improve the treatment and care people with bowel cancer receive.

To date, I’ve been involved in three different health technology assessments. Each one has been very different but all have the potential to improve the treatment and care people with bowel cancer receive. The first SHTG assessment I was asked to be involved in explored the use of robot-assisted surgery for some patients who have rectal cancer. While SHTG conducted the important task of reviewing the evidence of the technology’s effectiveness by looking at previous studies, they were keen to find out what’s most important to those diagnosed with rectal cancer to ensure their voice also played an important role in shaping the final advice. As a patient group that works closely with patients and their carers, Bowel Cancer UK were ideally placed to help.

In putting together our submission for the review, we wanted to demonstrate what outcomes patients would regard as benefitting them, and what information they would need to make an informed choice about robot-assisted surgery. To do this, we were able to use a combination of our existing knowledge and expertise, as well as gather additional patient views from a short survey we promoted online through our patient forum and social media channels. We found patients wanted fewer treatment-related side effects, faster recovery time and the ability to return to work more quickly. They also valued smaller scars as a result of the surgery, as well as knowing that an experienced team would be undertaking the surgery, plus more information generally about robotic surgery.

These responses helped us provide an informative patient organisation submission, which I presented to the SHTG committee. At the committee meeting itself, I felt the key points I presented were listened to, and that the contribution of Bowel Cancer UK was valued by committee members. The subsequent advice published by SHTG stated that robot-assisted surgery should be considered for some patients with rectal cancer who fit the agreed criteria. In those patients, there is evidence of a clinical benefit as it reduces the risks that come with open surgery.

We’re proud to know that we play a crucial role in shaping the final advice that will influence health policy and decision-making at local and national level that will promote an efficient, safe, sustainable, equitable and high-quality health system for all patients, not just those with bowel cancer.

In addition to the robotic surgery assessment, I’ve also provided peer review comments for two other assessments on behalf of Bowel Cancer UK. The first was to explore the introduction of the use of Colon Capsule Endoscopy for detecting bowel cancer or polyps, and found that this kind of technology may be considered as an option for some patients. The second was the use of PET-CT imaging in patients with anal cancer, which found that such imaging should be considered when assessing the stage of tumours.

We’re proud to know that we play a crucial role in shaping the final advice that will influence health policy and decision-making at local and national level that will promote an efficient, safe, sustainable, equitable and high-quality health system for all patients, not just those with bowel cancer. Working with SHTG to develop evidence and advice like this will help Bowel Cancer UK achieve our vision of a future where nobody dies from the disease.

Claire Donaghy is Head of Scotland for Bowel Cancer UK.

More information

Visit our website for more information on the work of the Scottish Health Technologies Group.

Many parts one purpose (on pattern)-09

Categories: Uncategorized

Why we need to talk about dementia – Cesar Rodriguez

Posted on June 4, 2019

I have always felt very strongly that older people with mental illnesses suffer a double whammy in terms of stigma and discrimination. This is why I believe that it is extremely important to talk about the social changes and awareness required to make sure that older people are seen as a valued asset in our communities. However, it is also important to remember that not all those with dementia are what we may consider to be old. In Scotland there are around 3,200 people under 65 years of age living with dementia. As a consultant in Old Age Psychiatry and Associate Medical Director for Older People, NHS Tayside, and National Clinical Lead (Psychiatry) for the Focus on Dementia Team, part of Healthcare Improvement Scotland’s…

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How would you like to be treated after death? New standards for mortuary services – Professor Stewart Fleming

Posted on June 3, 2019

“How people die remains in the memory of those who live on.” Dame Cicely Saunders founder of the modern hospice movement 1918 – 2005 It is often said that the only certainty in life is death, but equally we can be sure that all of us will be touched by the loss at some point in our lives of a loved one. There are an average 230,000 – 250,000 people each year in Scotland who experience bereavement. As a Professor of Cellular and Molecular Pathology and Director of the Centre for Forensic and Legal Medicine at the University of Dundee, I became aware of and lent my support to a campaign to improve the mortuary services in Scotland back in 2016. I have…

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Experience counts when it comes to developing standards – Rachael Wallace

Posted on March 28, 2019

I am a PhD researcher at the University of Dundee. I also have cerebral palsy quadriplegia. I was born prematurely at 27 weeks and sustained brain damage which affects the mobility in my arms and legs and as result of this, I use a powered wheelchair. The care I experienced as a child was excellent, but unfortunately this was not the case in adulthood. I’m now 28, and I have had to navigate a complex system in order to access the care I need. Unfortunately, not everyone with a neurological condition is able to navigate the system. They can therefore slip off the radar which often results in people inappropriately self-managing their condition. A person living with a neurological condition can experience chronic pain,…

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Delirium can affect anyone – Mark Hudson recounts his experiences

Posted on March 13, 2019

On World Delirium Awareness Day, I have been reflecting on my three weeks in ICU three years ago. I suffered from delirium and it wasn’t until recently that I discovered that that’s what it was called. I was 28 years old when I was admitted to ICU. I have no memories of going to the hospital, just of having a virus leading up to it. While the world was going about its business, I was living in another world – my ‘dream state’ as I call it. I didn’t know what was going on in the real world, but my body was trying to make sense of the things that were happening to me while I was sedated. I believed I was being hunted…

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Collaborative working has led to sea change in delirium care for Scotland – Alasdair MacLullich

Posted on March 13, 2019

“It was the feeling of I couldn’t escape… a lot of it was the terror being downstairs, shut in underneath something I couldn’t get out.” “It was terrifying not knowing who were the good people and who were the bad people.” “I thought I was dying, I honestly and truly thought I was going to, I was on the way out, I thought this is it.” These quotes show how traumatic the experience of delirium can be for patients and their families. Delirium is a common and distressing medical emergency, affecting at least 15% of patients in hospitals. Until recently it has been a neglected, undetected condition. Care has therefore often been absent or inadequate. The failure to make a diagnosis not only meant…

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