Posts tagged “COVID-19”

COVID-19 response is a family affair – Jacqui’s story

Posted on May 27, 2020

Supporting NHSScotland’s battle against COVID-19 has turned out to be a family affair for Scottish Antimicrobial Prescribing Group (SAPG) lead Jacqui Sneddon.

The COVID-19 pandemic has affected families across the country in lots of different ways. Some of us can’t get to see our loved ones due to social distancing. For others, it’s been about spending much more time together at home than we might ordinarily do.

My family is no different. My husband Andy and I haven’t been able to see our eldest daughter, Nancy, for quite a few weeks now, as she lives with her fiancé. Our younger daughter, Melanie, is living back at home after six years away. On top of that, Nancy, Melanie and I are all working in NHS roles, either helping out on the frontline or helping vital services to continue during this strange and difficult time.

Nancy works in a Mental Health team and they are having to adapt to new ways of delivering services to ensure patient care can be maintained.

For Melanie, a medical student, while her hospital placements have been suspended until August, she was keen support the NHS. She is now working as an NHS24 call handler, dealing with calls on the COVID 111 line. While not a clinical role it has been a valuable opportunity to develop her communication skills and support people worried about their symptoms.

“When I started work at St John’s Hospital, Livingston, back in 1990, I couldn’t have imagined that what I’d learn there would one day result in me leading a national work programme to protect a vital group of medicines.”

My work, meanwhile, has seen me step away from my day to day role as project lead for SAPG and return to a role I last did 18 years ago: clinical pharmacist in an intensive care unit (ICU)

When I started work at St John’s Hospital, Livingston, back in 1990, I couldn’t have imagined that what I’d learn there would one day result in me leading a national work programme to protect a vital group of medicines.

I worked at St John’s for 12 years managing the Aseptic Unit which prepared intravenous antibiotics for patients across the hospital and was also the ICU pharmacist. It was this work that sparked my interest in use of antibiotics. Through multidisciplinary ward rounds in ICU that involved myself and the Consultant Microbiologist, I learned a great deal about appropriate antibiotic use, and the fact that as a group of medicines, antibiotics were at risk of over-use, something which could have significant consequences.

“I’m very conscious of the challenges my daughters are facing in their current working lives … and proud of the fact that our family is helping support NHSScotland’s COVID-19 efforts.”

To prepare for going back to ICU I had to apply for a PVG Disclosure certificate as I only had a basic Disclosure, but there is a rapid process for this. NHS Lothian has a specific training programme for pharmacists returning or moving into critical care practice, and there are some excellent resources from NES and the Royal Pharmaceutical Society.

My role is to support the ICU pharmacist. This involves reviewing patients in both the COVID ICU (done virtually) and the ‘clean’ ICU which involves ward visits as these patients don’t have COVID-19. The principles of the work are similar to my past experience, but now all patient episodes are available online via the Trakcare system which makes it easier to find the information required to review potential medication issues. The rest of the hospital is fairly quiet as currently there is no planned surgery.

While my work with SAPG is far removed from the front line, it’s been useful to see what life is like for my colleagues at St John’s – it’s certainly helped me to refresh my memory and appreciate the challenges they face.

I’m also very conscious of the challenges my daughters are facing in their current working lives. I’m proud of my girls, and the fact that our family is helping support NHSScotland’s COVID-19 efforts, but I do worry that one of us could become ill. It’s also been a bit of an adjustment to go from having no kids at home to having one back full time and the other you just can’t see, but we’re dealing with it as best we can, keeping in touch using FaceTime and our family WhatsApp group. What we’re all really looking forward to is lockdown being lifted so we can finally celebrate Andy’s 60^th birthday together – he hit the milestone back in April, so being able to celebrate as a family will be the icing on the cake.

Jacqui Sneddon is Scottish Antimicrobial Prescribing Group (SAPG) lead with Healthcare Improvement Scotland.

More information

Visit the Healthcare Improvement Scotland website for information on our response to COVID-19.

Categories: COVID-19 blogs

Tagged: COVID-19

Rolling back the years – June’s story

Posted on May 26, 2020

Retirement loomed for June Wylie, but little did she know that COVID-19 was about to disrupt her final months and give her one last challenge …

At the beginning of this year, as my retirement from my post as Head of Improvement Support with Healthcare Improvement Scotland’s ihub approached, it was understandable that I was in a reflective mood. But at that point in time, I most definitely didn’t foresee my final months being thrown into turmoil by a health pandemic that has disrupted every element of life in Scotland.

Instead, my intended period of handover and winding down turned out to be one of the most stressful, but satisfying periods of my career.

Being involved in establishing NHS Louisa Jordan, a brand new emergency hospital in an exhibition centre, at a furious pace was challenging to say the least. My job was to lead on the planning for the AHP workforce and services including Occupational Therapy, Physiotherapy, Dietetics and Speech and Language Therapy.

“Within Healthcare Improvement Scotland and across our health and care system we have seen the most amazing response to COVID 19, with staff being prepared to rapidly change their routines and practice, and going the extra mile to support service priorities and ensure delivery of essential care. The opportunity to let go of old practices and embrace new and innovate ways of working has never been greater.”

In many ways, this took me back to my roots. I couldn’t have done the work without the support of a whole range of people including AHP Directors from across the west of Scotland. Despite very challenging working conditions, I was impressed by the good nature, willingness to help and the pragmatic ‘can do’ attitude of so many people.

Within Healthcare Improvement Scotland and across our health and care system we have seen the most amazing response to COVID 19, with staff being prepared to rapidly change their routines and practice, and going the extra mile to support service priorities and ensure delivery of essential care. The opportunity to let go of old practices and embrace new and innovate ways of working has never been greater. Now that retirement is here, I will watch with interest how Healthcare Improvement Scotland, and health and social care in general, embrace the opportunity to adopt and adapt to new ways of working.

**A young June Wylie starting out her career as an OT.**

Hospital At home

The COVID-19 response also touched upon a project dear to my heart that was the last piece of work prior to the pandemic: Hospital At Home.

The rapid production of the Guiding Principles on Hospital at Home was exciting and an excellent example of how the range of skills and expertise across our organisation can come together to create a high quality product. The timing for this guidance couldn’t have been better as COVID 19 has brought home the urgent need for us to transform the way we deliver services and truly shift the balance of care.

At last … time for reflection

As I now approach the final days of my professional life, I’m finding some time to ask myself where the past 39 years have gone and how did I get to have the career that I’ve had? How did a wee girl from a small village in the West of Scotland end up working in a range of senior and national roles, including Scottish Government?

I started my career as an Occupational Therapist (OT) in 1981 and worked in Stobhill Hospital in Glasgow before moving to Ayrshire and then Edinburgh in 1985. I spent eighteen years working in NHS Lothian as the Head of Occupational Therapy and then as Divisional Therapist for Medicine before taking on a general management role in Acute Medicine at the Western General. My overarching memories of my time at the Royal Infirmary of Edinburgh (RIE) was that of constant change and adaptation, hospitals were closed and merged, clinical areas were improved as we moved from Nightingale wards to four bed areas and single rooms, and the pressure on hospital beds and delayed discharge just grew and grew. The resilience of staff to deal with daily staffing pressures and constant change never ceased to amaze and impress me. In some ways then, our national response to COVID-19 hasn’t surprised me!

“As I now approach the final days of my professional life, I’m finding some time to ask myself where the past 39 years have gone and how did I get to have the career that I’ve had? How did a wee girl from a small village in the West of Scotland end up working in a range of senior and national roles, including Scottish Government?”

I’ve always thought of myself as a pretty unremarkable OT who just did her job as well as she could, but as I reflect on my career I realise that I was at the forefront of a number of changes and improvements that are now routine practice. I, along with a fellow OT, were the first women to be allowed to job share at the RIE in 1992, a request which required permission from the Board of Directors! We were the first OT department in Scotland to move to seven day working and the first to have Occupational Therapists and Physiotherapists working in the Acute Receiving Units and A&E. Despite the challenges in making some of these changes happen it was the recognition by staff that if services and outcomes for patients could be improved then the change to their own ways of working was worth it.

The importance of people

As I reflect on my career and some of the key milestones the thing that comes to mind the most are the people. The psychology and human dimensions of change have always been an area of interest for me, and even now as I reflect on the next stage of the life I’m drawn to William Bridges work on Transitions and the psychological process we need to go through to adapt and change.

Bridges believes that every new beginning has to start with an ending. The need to let go of old ways of working brings with it uncertainty and anxiety and yet it is only by letting go and ending that we can create new ways of working and beginnings.

His framework resonates with me not just on a personal basis as I end this phase of my career, but also as we enter a new reality for health and social care services.

I am immensely proud to have worked in the organisation for the past seventeen year and from my first day to now I am impressed by the skills and expertise of staff across the organisation and the potential for HIS to play a key role in helping to transform health and social care across Scotland.

So in ending the key learning and reflections from my career, my main piece of advice is to pay attention to people and relationships. Be kind to each other and value the tremendous skills, and expertise we have within our organisation and the tremendous opportunities ahead.

As I enter my own period of transition, I’m looking forward to adapting to a new rhythm of life and simply seeing what comes. I wish you all well and I hope our paths will cross again.

June Wylie has now retired from her post as Head of Improvement Support, Living Well in Communities and Professional Lead Allied Health Professions with Healthcare Improvement Scotland.

More information

Visit the Healthcare Improvement Scotland website for information on our response to COVID-19.

Categories: COVID-19 blogs

Tagged: COVID-19

Making a difference – with spreadsheets – Katy’s story

Posted on May 20, 2020

When the programme she works on got paused, Excellence in Care’s Katy Haslam wondered what she could do to help NHSScotland combat COVID-19. A lot, as it turns out…

My name is Katy and I love spreadsheets, processes and being busy. So finding out the programme I work on, NMAHP directorate’s Excellence in Care (EiC), was being paused due to the COVID-19 pandemic meant my busy working life as Project Officer, the spreadsheets and the processes were all suddenly gone. What was I going to do now?

The answer came in a team call. Would you like to volunteer to work in our nearest NHS board? I immediately thought: “Yes please!” and then, “But what can someone with no clinical background do to help, really?”

“Would you like to volunteer to work in our nearest NHS board? I immediately thought: ‘Yes please!’ and then, ‘But what can someone with no clinical background do to help, really?'”

Quite a bit, it turns out. I think people forget how much admin sits behind the lovely clinical staff that make up our frontline NHS. And thanks to my colleague Norma Dodds, EiC Lead Nurse for NHS Lothian, I’m now helping out NHS Lothian’s Corporate Nursing division with their workforce planning. It’s a busy task to administrate. Actually, that is a massive understatement. But with my love of spreadsheets and being kept busy, it’s my little corner of heaven for the foreseeable.

I’m supporting Norma with the governance processes involved in recruitment and redeployment of nursing and midwifery staff, including returning staff, students, and volunteers from healthcare partnerships… eesh, I think there are about six routes into NHS Lothian! These processes are required for each of the routes, some have secondment agreements, some have service level agreements and others have pre-employment checks done on appointment. Mapping the different routes into the system helps ensure staff are safe, as they highlight the need for pre-employment checks and what training and PPE are needed for each staff member coming on board. It feels good to be a part of ensuring the steps are clear for the staff recruiting and placing the candidates.

While Norma was waiting for the redeployment processes to be agreed, I was asked to cover a week of annual leave at the Staff Bank. I was trained to use HealthRoster and helped field requests for booking agency staff onto shifts for the Edinburgh Royal Infirmary, Western General Hospital and St John’s. During this time I created a ‘How to…’ guide for their online programme, Allocate. I wanted to help make asking someone to step into this role easier and my love of processes came in helpful here. It was a natural step to take the notes I made during training and type them up, so it wasn’t a huge leap to add screenshots to illustrate the steps for the various tasks the staff there undertake every day.

“I’ve learned that I don’t miss the 22 bus commute to the Gyle in the slightest, but I do miss seeing my lovely Healthcare Improvement Scotland colleagues.”

On the whole I don’t feel I’m doing anything different from my usual role, only that the circle I am working in is smaller. Instead of reaching out to all NHS boards I am working within just the one. Thanks to the EiC programme, the staff names are familiar to me but now I have the opportunity to put faces to them – from a distance of two metres, obviously.

I’ve learned that I don’t miss the 22 bus commute to the Gyle in the slightest, but I do miss seeing my lovely Healthcare Improvement Scotland colleagues. Zoom, MS Teams, Skype, WhatsApp, whatever the means, the times we check in, whether it is the EiC team or the NMAHP directorate, is always filled with anecdotes and information and many giggles. People rise up to challenges and support each other – it’s lovely to see and still feel included while I am redeployed. I also appreciate the opportunity to see first-hand what Norma does when she’s not working on the EiC programme and I’m blown away by how much is going on everyday behind the scenes. It’s made me realise how important the improvement work we do at Healthcare Improvement Scotland is and that my usual role is a worthwhile one to be in. That might be an odd observation to be making, but we’re all guilty of taking things for granted and losing sight of our purpose, and I’m no exception. I’m exceedingly grateful for my roles in both Healthcare Improvement Scotland and NHS Lothian and what it allows me to experience in and out of the workplace. I hope I don’t lose sight of this again.

Katy Haslam is a Project Officer with Excellence in Care, part of Healthcare Improvement Scotland.

More information

Visit the Healthcare Improvement Scotland website for information on our response to COVID-19.

Categories: COVID-19 blogs

Tagged: COVID-19

Juggling staff, spaces and spreadsheets – Norma’s story

Posted on May 18, 2020

Making sure the right people with the right skills are in the right place at the right time is all part of the job for Excellence in Care’s Norma Dodds. Setting up a nursing staff hub as part of NHS Lothian’s response to COVID-19 has put her to the test…and has her dreaming some unusual dreams…

I used to dream of flowers. The petals, the leaves, the shapes, the structures. I dreamed of how I would put them together, arranging the colours and creating great clusters and clouds of them for displays or wedding bouquets.

Now, I dream of spreadsheets.

Spreadsheets take up my days. I have them for everything and I needthem for everything. I’m painfully aware that I never had a spread sheet for lilies. Yes, COVID-19 has changed me.

I’m NHS Lothian’s Programme Manager for Excellence in Care (EiC). For two days a week, I’m on secondment with Healthcare Improvement Scotland (HIS). Or I was, until the COVID-19 pandemic started. Now, back at NHS Lothian, it’s my job to help pull together the nursing and midwifery workforce plan that will help us deal with the pandemic.

“suddenly I had a few thousand staff to deploy where they were most needed, but that didn’t necessarily match where they wanted to go. This was a huge challenge as I had never been involved in this type work before. HR were my allies, keeping me right on what was and what was not acceptable to the organisation.”

Prioritisation of services to support patients meant rapid changes had to be implemented across NHSScotland, and NHS Lothian was no different. As some existing services were stepped down, staff were redeployed to other services. This all had to happen at speed, and I was the key contact for helping set up the COVID-19 Nurse Staffing Hub.

The idea was to allow managers to ask for assistance with staffing resources or to offer staff to be deployed to other services. Trying to balance requests for staff with actual people to be deployed was a bit of a juggling act, but one of my past roles was Staff Bank Manager for Nursing within NHS Lothian, so this gave me confidence to undertake the role of supporting with the employment and deployment of the workforce into areas of need.

The key to the success of safe recruitment and redeployment of staff is ensuring a robust governance process is in place and streamlining processes to support this. From previous roles, I was aware of the governance process around recruitment, but due to the rapid changes and the number of different routes into the system for staff and volunteers, I knew this role was going to test my knowledge.

A plan had been put in place for a rapid recruitment drive as soon as the pandemic started. The aim was to get people through the recruitment process in less than the normal six week timeframe. We had about 1600 applications – not all for nursing.

Then we heard NES were going to have a portal for staff returning to the NHS, so suddenly there were another few hundred potential recruits applying by that route. Add in the student nurses in year 2 and 3 that were offered an opportunity to work in NHS Boards as paid students as part of the workforce, and that was another six or seven hundred for us to deal with.

Staff from external organisations, universities or partner boards were also keen to volunteer, but they would all need to have either SLAs or secondment agreements to be safe to operate in NHS Lothian.

So suddenly I had a few thousand staff to deploy where they were most needed, but that didn’t necessarily match where they wanted to go. This was a huge challenge as I had never been involved in this type work before. HR were my allies, keeping me right on what was and what was not acceptable to the organisation.

I undertook some of the interviews over the phone. I’ve always preferred meeting and interviewing people face to face, so I found it a bit difficult. Once staff had been interviewed, their pre-employment checks completed and their induction underway I had to place them in a pool of staff per hospital or locality site, trying to ensure everyone got what they needed

My role is really still evolving. Every day something different happens and although I’m enjoying the challenge I do miss the normality of what I had before. I also miss the teaching side of what I was doing with EiC, but now I could teach anybody how to build a spreadsheet! Having Katy Haslam seconded from EiC to work with me three days a week has been invaluable – she loves a spreadsheet and has been my mentor on the process front, writing processes as we go and turning them into something that is visibly good and easy to use. I’m sure my role will continue to change as we move forward. The pandemic is something that happened and needed a quick response – we had no control over that, something that’s difficult for a control freak like me! But I’ve risen to the challenge and just got on with what has needed to be done. You could say I’ve gone from dreaming about flowers to turning over a new leaf.

Norma Dodds is Lead Nurse with Excellence in Care, part of Healthcare Improvement Scotland.

More information

Visit the Healthcare Improvement Scotland website for information on our response to COVID-19.

Categories: COVID-19 blogs

Tagged: COVID-19

Returning to a familiar part of the frontline – Jen’s story

Posted on May 13, 2020

In our latest blog, Improvement Advisor Jen Pennycook describes what it’s been like to return to her previous team at the Beatson West of Scotland Cancer Centre, and shares her insights on working on the frontline, looking after family and staying resilient.

Before joining Healthcare Improvement Scotland full time as an Improvement Advisor in the ihub’s Acute Care Portfolio in 2019, I was a Practice Development Nurse at the Beatson for five years. I’d been seconded to Healthcare Improvement Scotland part time as Nursing Clinical Lead since October 2017, so by the time I joined full time, I was already familiar with my colleagues and our work.

During that time, I also mentored one of my Beatson colleagues, a staff nurse, to act up on those days I was on secondment. I was delighted that when I moved to Healthcare Improvement Scotland she got the job full time.

“My role has been to train staff to use PPE, whether they’re porters, nurses, domestics or consultants. Our small team has already trained around 300 to 400 staff across the Beatson in the four weeks since I came back.“

Nearly one year on, the COVID-19 crisis hit us all. Improvement programmes were paused and we were deployed to support the system. I was keen to return to the Beatson as I knew the team was busy educating staff around using, fitting and ensuring an adequate supply of personal protective equipment (PPE), not to mention alleviating fears by teaching them how to stay safe.

My role has been to train staff to use PPE, whether they’re porters, nurses, domestics or consultants. Our small team has already trained around 300 to 400 staff across the Beatson in the four weeks since I came back.

Using PPE like this is completely new to some staff. Our updates come from NHS Greater Glasgow and Clyde (GGC) in a core brief based around Health Protection Scotland guidance. At the Beatson, the Practice Development Education and Research Unit is responsible for monitoring the updated guidance and educating others. It’s a big responsibility, but I love it!

One of the most rewarding aspects has been seeing how well my previous colleagues are working together, not least the colleague who took on the role I left. Being back in the team also makes me realise how much I’ve grown. Although I enjoy working at the Beatson, it’s shown me how much I love being part of the Acute Care Portfolio. I enjoy working with teams in different boards and seeing the impact of implementing improvement programmes at national level.

Patient care is paramount at the Beatson, just as it is across NHSScotland. All of the staff are more flexible than ever about what tasks they take on and what hours they work – I’ve worked weekends and out of hours to deliver PPE education sessions. Across the board at every level, people are stepping up without hesitation. As a nurse, I’m ready to take on anything, including working on wards if needed. The team working has been incredible and I hope this supportive behaviour continues after this crisis is over.

The biggest challenge for me, as I’m sure it is for many of us, is maintaining a healthy work/life balance. At work, initiatives like opening the Beatson Cancer Charity Wellbeing Centre to staff as a place to relax have been a welcome move. Treats being delivered to staff have also been much appreciated! In both my Beatson and Healthcare Improvement Scotland teams, we share information and humour using WhatsApp groups – talking is essential. It’s been really inspiring to see how much we are supporting each other.

“Across the board at every level, people are stepping up without hesitation. As a nurse, I’m ready to take on anything, including working on wards if needed. The team working has been incredible and I hope this supportive behaviour continues after this crisis is over.“

While I love my work, family is also incredibly important to me. My husband is also a key worker and we’re making sure our elderly parents and our next-door neighbour, are healthy and keeping well stocked.

We’re also fitting in home schooling our daughter, Lucy, in between shifts. She’s in first year and is working to a self-made timetable. I ‘m incredibly proud of her being mature and responsible enough to manage her own schoolwork and look after herself when my husband and I are out at work. She likes to keep fit in the mornings with Strictly’s Oti Mabuse. As proud as I am of her, she made my heart swell recently when she said, “I’m so proud of you Mummy, being a nurse and helping people.”

Jen Pennycook is an Improvement Advisor within Healthcare Improvement Scotland.

More information

Visit the Healthcare Improvement Scotland website for information on our response to COVID-19.

Categories: COVID-19 blogs

Tagged: COVID-19

Back to my roots – Judy’s story

Posted on May 12, 2020

To mark International Day of the Nurse, Excellence in Care’s Judy Sinclair tells us how working in NHS Orkney’s COVID assessment centre has been a kind of homecoming.

Orkney’s not a big place. When I returned to my home board from my secondment with Healthcare Improvement Scotland’s Excellence in Care team to help with the COVID-19 pandemic, I knew that among all the unknowns about the virus and how we were going to deal with it, there was one sure thing: the support of the teams I’d be working with.

I’ve spent most my career as a nurse on Orkney. And while I do a few “back to the floor” shifts annually, going back to work in NHS Orkney’s COVID assessment centre felt slightly daunting. I was concerned I wouldn’t be an asset to the team and be able to hit the ground running. I needn’t have worried.

“When I returned to my home board from my secondment with Healthcare Improvement Scotland’s Excellence in Care team to help with the COVID-19 pandemic, I knew that among all the unknowns about the virus and how we were going to deal with it, there was one sure thing: the support of the teams I’d be working with.”

***Judy, back in scrubs, takes a break from shift work at NHS Orkney’s COVID assessment centre at the old Balfour hospital site.***

The assessment centre is housed in a building that’s very familiar to me: the old Balfour hospital site. NHS Orkney saw its spectacular new hospital, also called The Balfour, open in June 2019. The old site, which is next to the new one, was still empty when the pandemic started, and parts of it were re-opened to prepare for an increase in demand. This particular part had been my work ‘home’ for many years in my previous clinical roles, so it felt comfortable going back to the place I had nostalgically waved goodbye to just eight months previously.

Not only were the surroundings familiar, the team that was being assembled was, too: GPs and experienced nurses from a range backgrounds, most of whom I have worked with previously and know very well. This was a real bonus as we already knew each other’s strengths and ways of working, which helped as we began to set up the new processes and systems to welcome patients to the centre. Dental nurse colleagues joined us to make up the clinical team along with administrators, domestics and drivers, many of whom I knew but had never worked alongside.

I’ve always tried to keep up to date through reading and learning, so on the whole the transition was not nearly as bad as I first feared. I was concerned some of my technical skills might be a bit rusty, but I feel reassured and confident that with the support of colleagues, I’m brushing up fast as we refresh old skills and learn new ones together.

“The return to shift work is challenging; getting used to night shifts again after a gap of 27 years was a quite a shock to the system. However, the camaraderie, encouragement and support from all colleagues – not to mention the cake – is fantastic and really appreciated as we settle into this new way of working.”

The assessment centre is where patients are triaged from 111 if they are experiencing symptoms of COVID. They are connected with a nurse or GP who will assess them and agree a plan by telephone, or Near Me or invited to attend the centre if any physical examination/observations are required. Thankfully in Orkney we have not seen the sudden, rapid influx of very ill patients that other areas have seen which has given us time to be well prepared. At NHS Orkney, we’re already experienced in using remote solutions such as video conferencing – we have had to be as an island group – and using systems such as Microsoft Teams and Near Me has been really useful in reducing the number of face to face contacts with patients and other staff.

We’re working shifts of eight hours over a 24 hour period. This allows for as few people as possible to be in the centre at one time to ensure physical distancing. The return to shift work is challenging; getting used to night shifts again after a gap of 27 years was a quite a shock to the system. However, the camaraderie, encouragement and support from all colleagues – not to mention the cake – is fantastic and really appreciated as we settle into this new way of working. Orkney may not be big place, but it does have a big community spirit. Working in the centre as a nurse is truly enjoyable – it’s a job I love, providing care, support and advice to patients and as part of a team. That may seem strange, given the current crisis situation. While we hope none of our patients or staff to fall victim to this virus, my ultimate wish is that through these difficult times we will review, reflect and find new opportunities for an improved future for nursing and healthcare both locally and nationally.

Judy Sinclair is Excellence in Care Lead Nurse within Healthcare Improvement Scotland.

More information

Visit the Healthcare Improvement Scotland website for information on our response to COVID-19.

Categories: COVID-19 blogs

Tagged: COVID-19

Taking Community Led Support to the next level – Gillian Fergusson

Posted on May 6, 2020

The national response to COVID-19 has highlighted the value and resilience of our communities to support our health and wellbeing. At the same time, the impact of the virus has shown that the way we support the health and wellbeing of people in communities needs to change.

As we begin to transition towards recovery, this is the perfect time to start the conversation around how we can continue to build and sustain capacity for the future.

This week the National Development Team for Inclusion (NDTi) publish their most recent reports highlighting evidence and learning of the impact of Community Led Support (CLS) across the UK. In Scotland, the CLS approach is being implemented in nine Health and Social Care Partnerships (HSCPs) and is supported by NDTi, the Scottish Government and Healthcare Improvement Scotland.

A key part of any conversation about the future is to understand what we’ve learned so far in Scotland.

The importance of community

My own background is in international development and I’ve witnessed at first-hand the overwhelming strength and resilience of communities in responding to crisis, whether it’s caused by war, disaster or disease. I’ve worked for Healthcare Improvement Scotland in both community engagement and now collaborative communities, as I’m passionate about the role of involving communities in the planning of activity to ensure it truly meets needs and has the best chance of being sustained in the longer term.

“The CLS approach is based on the recognition that we need more sustainable, local solutions that truly meet the needs of individuals. Culture change is pivotal to this shift towards support that is flexible and innovative, designed around personal outcomes and a ‘what matters to you?’ approach.”

Working alongside NDTi in Scotland, I’ve been on a journey of discovery developing a programme of support for five HSCPs that began CLS in 2019. We have met with stakeholders working across different local services and across the statutory, third and independent sectors, who have all informed our work. We have also visited a range of communities – highlights include visiting a vegetable garden at a care home in Shetland, speaking with carers in Falkirk and being part of a lively discussion, fuelled by delicious homemade shortbread, with community members on Galson Estate, north west Lewis.

The CLS approach is based on the recognition that we need more sustainable, local solutions that truly meet the needs of individuals. Culture change is pivotal to this shift towards support that is flexible and innovative, designed around personal outcomes and a ‘what matters to you?’ approach. For example, one man in the Scottish Borders attended an open mic night in a local village to successfully address social isolation, rather than referral to traditional day services.

Community responses have flourished in response to COVID-19 as already pressurised statutory services were stretched thinner. In common with CLS, these responses have focused on the resources and strengths that already exist within individuals and our communities to support health and wellbeing. Yes, the statutory sector may have a role to play, but this may be as a facilitator or enabler rather than service provider.

Every community is different

A key principle of CLS is in recognising that the needs of every community will be different and therefore the solutions must also be locally adapted. Integral to success is taking time to develop an understanding of each local context and all the nuances, the individuals and relationships that make each ‘community’. An example of this is Talking Points in East Renfrewshire where staff worked with a local Muslim group to understand their needs and developed a tailored ‘community hub’ for health and wellbeing that included support from a dietician and diabetes nurse in collaboration with social care and the third sector.

“A key principle of CLS is in recognising that the needs of every community will be different and therefore the solutions must also be locally adapted. Integral to success is taking time to develop an understanding of each local context and all the nuances, the individuals and relationships that make each ‘community’.”

Again, successful community responses to COVID-19 have also demonstrated the importance of localised approaches with activity developed and led by those who best understand and can meet the needs: the communities themselves.

Working together

The values and principles of CLS resonate across the UK. However it has also been important to recognise the different policy landscape and culture in Scotland, especially given the strength of community and how this impacts on systems and processes that support health and wellbeing.

We have built relationships with key national organisations, such as the Care Inspectorate and the Scottish Social Services Council. This has enabled the flexibility required for changes to systems and processes. For example, the development of a light touch social work assessment that continues to meet regulatory requirements.

In the response to COVID-19 this same flexibility to do things differently has been key to breaking down system barriers and enabling communities. In fact, in one of the areas where the CLS journey had already begun, a key stakeholder reflected it has “helped us cope better with COVID-19”. This may be for a variety of factors already in place: that initial conversations focus on ‘what matters to you’ and in signposting to community assets, that a light touch assessment process exists that has contributed to reduced waiting lists, that collaborative working relationships have been built with the third sector and communities.

Starting the next stage of the conversation

Bearing in mind this breadth of knowledge and experience that we’ve gathered thus far, how might we build capacity, support our communities and enable local solutions that better meet the needs of people in Scotland?

The CLS reports provide some evidence and recommendations to start the conversation, including the importance of coproduction, trust and empowerment of communities.

As we transition into recovery, the challenge will be to answer this question by building on the learning so far. Healthcare Improvement Scotland is looking forward to being a key player in this vital journey that’s of increasing importance in a post-COVID Scotland.

Gillian Fergusson is Senior Programme Manager with the People Led Care Portfolio within Healthcare Improvement Scotland’s ihub.

More information

Visit the Healthcare Improvement Scotland website for information on our response to COVID-19.

Categories: COVID-19 blogs

Tagged: COVID-19