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

Posted on June 6, 2022

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."

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 38^th 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

Categories: Uncategorized

Volunteering changed my life for the better – Sophie Ross

Posted on June 6, 2022

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

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 38^th 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

Categories: Uncategorized

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

Posted on June 1, 2022

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 1-7^th 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 38^th 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.

Categories: Uncategorized

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:

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.
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.
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.
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

Categories: Uncategorized

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

Posted on May 17, 2022

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.

Categories: Uncategorized

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.

Categories: Uncategorized

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.

Categories: Uncategorized

Quality improvement is continuing to support positive changes in maternal and newborn care in Scotland – Angela Cunningham

Posted on May 4, 2022

Angela Cunningham is our Midwifery Clinical Lead for our organisation. Angela has practised as a midwife for over 39 years in both Scotland and England. To mark International day of the Midwife, Angela explains how quality improvement continues to support real changes for mothers and babies in Scotland. Angela encourages all staff working in maternity services in Scotland to engage with quality improvement. Our organisation offers virtual visits, informal meetings and a range of webinars, all aimed at improving outcomes.

As a student midwife in the early 1980’s, and following that practicing as a midwife, we really did not have access to the levels of data immediately available to us now. By the time we had access, the data was often two to three years out of date. We all thought things had improved, we were doing it differently and doing it better. However, we had no up-to-date data to support these claims.

Now we have access to up-to-date data, we can track what is happening in the system and we can put in place systems and processes, tried and tested, by using the PDSA (Plan Do Study Act) methodology.

Safe and respectful childbirth should be the right of every woman. This is never more important than now, following the publication of the Ockenden report, which criticises the care delivered to women and families. We all need to hold up that mirror and ensure we are the best we can be and offer true informed consent to the users of the services.

Improved outcomes

In Scotland, through the Scottish Patient Safety Programme’s Maternity and Children’s Quality Improvement Collaborative (SPSP MCQIC), we continue to work hard to improve outcomes for babies, children and mothers. Our work in the area of stillbirth is recognised as world leading. From the inception of the programme in 2013, MCQIC has supported NHS boards to understand their local data and introduce changes to support efforts to reduce stillbirth rates. As always this is ongoing work. In the NHS boards, colleagues are passionate regarding our aim to further reduce the stillbirth rate in Scotland. As the Midwifery Clinical Lead for Healthcare Improvement Scotland, working with the multidisciplinary team, I am really proud to be part of a programme which has helped services make changes which mean more mothers taking their healthy babies home to start a new family. When all is said and done this is our purpose at Healthcare Improvement Scotland.

The introduction of the Scottish Patient Safety Programme gave maternity staff the opportunity to run small tests of change through the Model for Improvement and Plan Do Study Act (PDSA) process. These incremental changes have had a major impact on outcomes, giving staff permission to make changes which have improved outcomes for families across Scotland. Applying Quality Improvement (QI) methodology has helped to develop a consistent approach to service delivery at local and national level. It has improved communication between teams and more importantly improved the quality of the care and advice given to women and families. When I hear stories from frontline staff about the difference they have made to the families they work with it makes me very proud that in the background we in HIS are contributing to this through #SPSPMCQIC

Engaging with the clinical community

Everything we do is based on improving outcomes and we do this by engaging with frontline clinical staff. Safety is paramount in maternity services. Across the UK and the world, too many women and babies are still dying in pregnancy and childbirth. For some of those dying in pregnancy, experiencing a stillbirth, a neonatal death or a baby harmed at birth, it is due to systems and process failures and human error. We all have a responsibility to do everything we can to learn from things that go wrong, listen to the parents involved, as they are closest to the process and know the timelines of what happened to them, and support staff through the learning from adverse events process in a supportive environment.

Fast paced and making a difference

Working in Healthcare Improvement Scotland has been strange over the last two years. However, we have risen to the challenge, engaged without colleagues remotely and were involved in the implementation of the home monitoring and Near Me technology. It was amazing how quickly using the PDSA methodology that we could implement a change safely and rapidly. I’m part of the team that supports continuous improvement and the re-design of services for the better in healthcare settings. My training with patients and clinicians gave me transferable skills in negotiation and communication so I can engage in discussions with the same clinicians I am working with now. The training, coaching and mentoring support that I have received since I started has been invaluable and it has helped me become more confident in my role. If you want to work in a fast-paced and exciting team where you can make a huge difference in improving healthcare services, becoming an improvement advisor is the first step towards that goal.

I would recommend working in Healthcare Improvement Scotland to any colleagues. No matter what your background or previous experience, we can learn from you and you can learn from us.

‘All share, all learn’ really is our moto.

Angela Cunningham is our Midwifery Clinical Lead.

More information

More examples of the work of SPSP MCQIC and resources to help make maternity care as safe as possible are available on our website: www.ihub.scot.

Categories: ihub

Prison pilot scheme proves its worth during pandemic – Dr Steve Conroy

Posted on April 6, 2022

COVID-19 has created new challenges for the delivery of treatment and care to individuals with a drug problem within the prison population. Dr Steve Conroy tells us how the rapid rollout of a successful pilot scheme involving Healthcare Improvement Scotland has helped both prisoners recovering from addiction and the staff who are there to treat them.

Treating opiate addiction takes time. The most frequently prescribed treatments (opiate agonist therapy, or OAT) need to be taken every day, and it’s estimated that there are 1800 people in prison in Scotland who need it. Every day, each individual will be taken to and from a dispensing area by Scottish Prison Service staff and have their medication supervised by at least two NHS staff. That’s around 12,500 contacts between patients, the clinicians who treat them and the prison staff whose role is to facilitate that treatment every week.

In HMP Shotts where I work, over 170 of the 545 people in custody are prescribed OAT. That amounts to 63,145 interactions with them across the space of a year simply to administer their medicine. That’s a lot of time on the part of both staff and prisoners that might be better spent on work which can support them to recover from addiction in other ways. It’s also time that could be spent supporting other prisoners with other vital rehabilitation work. Throw a pandemic into the mix, where physical distance and constant cleaning of contact surfaces is vital, and those timeframes increase even further.

A vital decision

Generally, the OAT of choice is methadone, with far fewer patients on oral buprenorphine products. Buprenorphine, although a very valuable medicine in treating addictions, comes with many problems in the prisons, where it can be used as currency – creating problems with diversion, bullying and coercion. But it’s used because methadone is not a suitable treatment for all patients. Thanks to a decision taken by the Scottish Medicines Consortium in August 2019, there is now an alternative to daily treatment.

Buvidal is a form of buprenorphine which is a longer acting treatment and can be given monthly or weekly through a slow-release injection compared to daily doses of oral forms. When given within a framework of medical, social and psychological treatment, it may enable patients to focus on recovery and returning to normal daily routines without the daily visits to a pharmacy to receive treatment.

Time for change

Following the SMC’s decision, Healthcare Improvement Scotland’s Prisoner Healthcare team, with whom I work closely, began looking at a pilot scheme for the medicine in prisons. A business case was approved by Scottish Government in January 2020. But as the COVID-19 pandemic progressed, it became clear that the reasons to support the pilot became even more compelling and the team was asked to scale up their proposals.

Under our revised plan, all prisoners with at least six months left to serve of their sentence would be transferred to the new form of buprenorphine during the pandemic, provided patients gave consent to switch treatment.

As well as supporting social distancing measures, our proposals also meant, in theory, that staff and patients alike would have more time to spend on other activities which could support recovery from drug addiction – within the parameters afforded by COVID-19 restrictions. While it’s too early for data to confirm this, logic tells us that if we only see someone twice in 28 days rather than 28 times, staff and prisoners will have more time to spend on other things. In addition, the reduction in the quantity of controlled drugs being used prisons would help to reduce the potential for their use as currency, and improve overall safety.

To support the move to the prescription of this slow release form of buprenorphine in prisons, the team engaged with clinicians with experience of prescribing the medicine at local, national and international level in order to develop guidance. Crucially, given how the pandemic affected supply chains, we also worked closely with the pharmaceutical company to ensure there was sufficient stock of the product to meet requirements.

Game changer

The decision to move to slow-release buprenorphine has been widely welcomed by prison staff and those receiving treatment alike. People have described it to me as “a game changer”, “nothing but good” and “the way forward”. In HMP Shotts, we have only had two people choosing to come off the treatment and going back to their previous medication. Those I’ve prescribed it to have said they feel better generally, enjoy the clarity of thought and really appreciate not having to wait in the daily “methadone queue”. Prison staff, meanwhile, have said that they have noticed a marked improvement in the general condition of people prescribed this medication. It’s incredibly satisfying to have worked with colleagues at Healthcare Improvement Scotland to have delivered a simple and effective change that has made such a difference to people’s lives.

Dr Steve Conroy is Lead Medical Practitioner in NHS Lanarkshire’s Addictions Community Prescribing Service.

More information

Read our position statement on long-acting buprenorphine for opioid substitution therapy.

Categories: COVID-19 blogs

Life on the Board of Healthcare Improvement Scotland – Suzanne Dawson

Posted on March 17, 2022

_{In this video Suzanne Dawson explains the role of Board Member within Healthcare Improvement Scotland}

As Healthcare Improvement Scotland recruits for new Board members, Suzanne Dawson, a Non-Executive Director on our Board, explains the role, how she joined the Board and the importance of diversity and collaboration.

Healthcare Improvement Scotland (HIS) is currently looking to appoint three new Non-Executive Directors to our Board. To many, being on a board may seem like a mysterious role, but they may not be aware that they could be exactly what a board is looking for.

My own journey to the Board

I have been a member of the HIS Board for three years, three of the most turbulent years in the history of the NHS in Scotland.

Before I outline some of my reflections on my role, let me tell you just a little bit about how I got here. Although I had previous board experience, it certainly isn’t a necessary requirement for us, and each of us has to start somewhere. For me, it was as a member of a Further Education College Board.

My professional career was in marketing, primarily in economic development, promoting Scotland in key sectors such as the life sciences, tourism, and the creative industries. Following maternity leave I decided to take a different approach to my working life and set up my own marketing consultancy business. Around the same time, I saw the College Board position advertised and, thinking it would provide me with a great new opportunity to contribute to my local community while gaining new skills and experience which I could bring to my business, I took the jump and applied. I didn’t have any previous board experience and I wasn’t wrong about what I would get from the experience. By the time I left the College at the end of my two terms I recognised just what an important and influential role a board member plays. It certainly wasn’t always easy and with a major estates project happening during my time with the College, there was a whole lot of learning to do.

Board life before and during lockdown

I was appointed to the Board of Healthcare Improvement Scotland a full year before our first COVID-19 lockdown and so was lucky to be able to spend time getting to know my new colleagues face to face. Like now, there were three of us starting around the same time, which was a great support and helped create a collaborative induction process. Like everywhere else, we had to change ways of working in March 2020 and Board business was no different. We adapted very quickly to Board meetings by MS Teams, and it is our intention to take some of the learning from our experience into the future. It is likely that some Committee meetings will continue to be held online, and others will offer hybrid alternatives.

The role of governance committees

Each Board member sits on a couple of governance Committees. In my case I Chair the Committee which is responsible for ensuring public and community engagement across NHS boards and healthcare providers. I also sit on the Quality & Performance and Succession Planning Committees. As Board members it is our role to provide scrutiny, to seek assurance around decisions which are being made and to hold executives to account through effective challenge. Committee work provides a good opportunity to dig deep and ask questions: where’s the evidence for this and are there any gaps in the evidence; what actions are being taken to mitigate risk; how might this proposal impact on patients or local communities; how will we recognise, monitor and evaluate success. These are just some of the questions I have heard asked while I’ve been a Board member.

Diversity makes us stronger

In my experience a strong board is a diverse board. By that I am talking about diversity of thought which goes beyond protected characteristics. Life or community experience which brings a different perspective adds real value to decision making. As our organisation operates across Scotland it is also important for us to fully understand the impact of any proposal across diverse communities, including both rural and urban.

While we can be a diverse Board, with Non-Executive Directors coming from different backgrounds and with a wide range of skills and experience, the key to the Board’s effectiveness is around how we all work together as a team. We are not simply a group of individuals, but are at our best when we work collaboratively, building relationships based on a clear set of values around trust, openness, compassion, dignity, and respect.

Could this role be for you?

If any of what I have said here chimes with you. If you have a real desire to help shape the future of the NHS in Scotland, while broadening your own skills and experience, I would encourage you to apply. You don’t need years of board experience, you just need the commitment to make a difference, to challenge effectively and influence decision making based on your skills, knowledge and experience however that might have been acquired. You have nothing to lose by applying and you, our Board and the people of Scotland have plenty to gain.

Suzanne Dawson is a Non-Executive Director on the Board of Healthcare Improvement Scotland.

More information

Visit the Scottish Government website to apply for this role.

Categories: Uncategorized