NHS Education for Scotland
fOCUS Winter 2013/14
Accessible Word Version
Contents
Welcome to the Winter 2013 edition of fOCUS. ................................................................ 3
Cleanliness Champions: ten years of improving patient safety ......................................... 4
Dr Ailsa Powers on how virtual patients are helping pharmacists ..................................... 7
Emotion Matters ................................................................................................................ 8
Quality Will Out ................................................................................................................10
Lights in the Constellation of the Crab .............................................................................16
Alzheimer Champions ......................................................................................................26
NES Annual Review 2013 ................................................................................................30
Board meetings ................................................................................................................32
The Outro .........................................................................................................................33
Welcome to the Winter 2013 edition of fOCUS.
This winter edition of Focus rounds off a busy but productive year for NHS Education for Scotland.
We hope this edition will once again give you a glimpse of the work of NES. Starting with our
fabulous Cleanliness Champions – who every day are having an impact on reducing infections –
to the winners of the Scottish Dementia Awards. On the way we’ll take in a virtual family who are
assisting pharmacists, resources for people with long-term conditions and some rather good
poetry. And as if that wasn’t enough, there are also three examples of outstanding work from the
nominees to the Daily Record Scottish Health Awards.
We hope you’ll find this edition stimulating, informative and interesting. We welcome your views,
so if you have any comments on fOCUS, or the work of NES generally, please do get in touch.
Malcolm Wright and Lindsay Burley
As always, you can join in the conversation by liking us on Facebook and following us on Twitter
Cleanliness Champions: ten years of improving patient safety
More than 130 delegates, across a wide range of disciplines came together in Glasgow recently to
celebrate the tenth anniversary of the largest unique education programme of its kind in the world,
before going on to discuss and shape its future direction.
The Cleanliness Champions Programme (CCP), developed and managed by NHS Education for
Scotland (NES), was launched in September 2003 to equip healthcare workers with the skills and
knowledge necessary to ensure good local practice in the prevention and control of Healthcare
Associated Infections (HAI). CCP enables staff to use their knowledge and skills to assess risks
and act as a role model. The programme is now a key element of the Scottish Government Task
Force delivery plan which coordinates all Healthcare Associated Infection activities.
To date the programme has been completed by over 16,500 NHSScotland staff, some 10% of the
total workforce. Over 10,000 students and non-NHS health and social care staff have also
undertaken the programme. Currently 5,000 learners are active on the programme.
The programme has received support from the highest levels. NES Chief Executive, Malcolm
Wright, told fOCUS: “The Cleanliness Champions Programme is widely regarded as a high quality
and successful educational initiative. Our 2012 Annual Review with the Health Minister saw him
praise the success of the Programme and its contribution to the reduction of hospital infection.”
Malcolm went on to explain that Cleanliness Champions had also been adopted outside Scotland.
“The Programme has been used in NHS Wales and Northern Ireland and we have also received
international interest, with enquiries received from as far afield as New Zealand. This is a great
tribute to the team who have developed an educational programme that makes a real difference to
healthcare practice and patient safety.
“In many Health Boards, It is a key part of their local HAI learning strategy and is an essential tool
for personal development planning. Completion is often required for employment or career
development.”
Learners and mentors have committed considerable time and effort to the Programme which has
been adapted over time to reflect user needs and feedback, and the need to respond to emerging
policy.
One of the keys to the success of the programme has been a flexible approach to delivery. NES
offers both online and paper formats as well as customising module content for particular sector
needs, for example, for the Scottish Ambulance Service, medical and dental undergraduates.
There were a range of speakers including Professor Jacqui Reilly, demonstrating the impact the
programme has had at a national level and Susan Brimelow, Chief Inspector, Healthcare
Environment Inspectorate, celebrating success through inspection. But perhaps the best measure
of success is the high regard in which the programme is held by those who have undertaken it.
Lesley Brady, is a community-based Podiatrist with NHS Lothian, and she sings the praises of the
programme. “I have found the Cleanliness Champions Programme extremely rewarding. It has
enabled me to develop my career further within NHS Lothian’s Podiatry department.
“Since completing the Programme I am involved with on- going audits and training my colleagues
to undertake these. I have also developed presentations which are used to update staff on all
matters relating to infection control.
“I would encourage any Allied Health Professional (acute or community) to consider undertaking
this Programme. We can all do our part to prevent HAIs".
The Cleanliness Champions Programme is now also embedded in HAI education curricula in the
Higher and Further Education sectors, raising awareness before students are in practice, offering
both theory and practical experience during practice placement.
During the celebration event, Cabinet Secretary for Health and Well-being, Alex Neil, added his
best wishes via a podcast. “Increasing patient safety in all our healthcare settings remains of
critical importance. Staff at all levels must play their part in continuing to drive down incidences of
Healthcare Associated Infection.
“We know that rates are reducing but we cannot take this for granted. The Champions who have
completed the programme are in the vanguard of improving practice and we must not
underestimate their role in sharing knowledge and learning and in supporting colleagues to
understand the importance of adhering to cleanliness guidelines.
“This is an excellent Programme and I congratulate those who have developed and completed it.”
The face of healthcare is changing especially with the integration of health and social care and
technological advances and infection prevention and control is paramount in these changes. All
staff, including those working in support roles in clinical, administrative and estates & facilities
services, have major roles to play in the delivery of safe, effective and person-centred services.
They are the staff who are likely to have initial and sustained contact with the individual at each
stage in their health journey. Even staff who rarely see a patient contribute to infection prevention
and control. We all need to work together on this important agenda. Being a Cleanliness
Champion is everybody’s business.
Videos of the presentations and the podcast by the Cabinet Secretary for Health are available
here.
And you can find the Cleanliness Champions page, here.
For more information, please contact HAI enquiries, hai@nes.scot.nhs.uk
Dr Ailsa Powers on how virtual patients are helping pharmacists
NES Pharmacy recently commissioned the University of Keele to develop a ‘virtual family’
to help support community pharmacists deliver the Chronic Medication Service (CMS) in
Scotland. The CMS allows patients with long-term conditions to register with a community
pharmacy of their choice for the provision of pharmaceutical care as part of a shared
agreement between the patient, community pharmacist and General Practitioner. An
important part of CMS is the community pharmacist assessing registered patients to identify
and prioritise individuals with unmet pharmaceutical care needs in order to target patients
most in need of their support. These needs are documented on an electronic
pharmaceutical care plan.
The first e-case available was Tom Cullen, a 72 year old man suffering from Chronic
Obstructive Pulmonary Disease (COPD). The e-case allows Scottish community
pharmacists to question the patient and receive immediate verbal answers while completing
on-line documentation similar to that used for CMS. When the pharmacist has completed
the risk assessment form and the care plan, they can compare this to pre-prepared
documentation for that patient, with an option to print either or both plans for reference
purposes. The patient will also provide a short verbal assessment of the pharmacist’s
consultation skills at the end of the scenario.
Other family members soon to be introduced are Sam, a fifty year old with hyperlipidaemia
(November 2013), Elaine a 55 year old with hypertension (January 2014), Barbara a 68
year old with back pain, and Beth, an 11 year old with asthma.
Emotion Matters
Around two million people in Scotland have at least one long term health condition. One of the
consistent features of this group is that they report that their treatment could be improved if
healthcare staff paid more attention to the emotional and psychological impacts of their conditions.
At the same time, feedback from health and social care staff is that one of the major challenges
they face when working with this group, is how to support them in managing those impacts.
To address this issue, NES recently launched Emotion Matters, a training resource aimed at
health and social care professionals. Marie Claire Shankland, is the NES Programme Director
responsible its development. She told fOCUS, “The prompt to develop this education resource
came from feedback from health and social care staff that they felt deskilled when talking to
people with long-term conditions about the emotional and psychological issues they were facing.
“Thanks to our close working relationship with the ALLIANCE- Involvement Network – (a group of
people who are disabled or live with long term conditions who want to contribute to campaigning
and policy activities) - this training includes clips of the experiences of four people living with a
range of long term conditions. This has been invaluable in helping staff understand the emotional
demands that people have to face in managing long term physical conditions and gain confidence
in being able to provide appropriate support.”
And the response from people living with a long term condition has been very positive, as is shown
by the following comments.
“I think this module is brilliant, it is really comprehensive and should be a compulsory training
component for ALL medical professionals.” Lisa Mortin
“It should be compulsory that anyone who deals with people with long term conditions have an
understanding of the effect that being given the news of what a condition is, whether it is life
threatening or not, what the outcome of that condition is, any treatment available – this can mean
a heap of leaflets and further appointments, but often the person concerned is overwhelmed and
does not know who to talk to...or if anyone understands the devastating effect the news has on
them...” Irena Paterson.
Ian Welsh, ALLIANCE Chief Executive, also praised the resource saying, “We are delighted that
one of the main of the recommendations from Emotional Support Matters (2011) that there needs
to be continuing professional development for health and social care professionals in
communication is being taken forward by NES. We are also very happy about this exciting
collaboration which has drawn from the experiences of people living with long term conditions and
involved them in the development of this resource.
Learners can access the resource through Learn Pro and the Knowledge Network here.
You can also watch a clip, here.
Feedback from health care staff who have reviewed the modules is overwhelmingly positive:
“..extremely good, really relevant to my work and full of practical information.” (Practice
Nurse)
“Appreciating that giving patients full attention even if it means more time can be beneficial
to patients mood and treatment” (Physiotherapist)
“Very well presented module which gives a good insight into how patients feel throughout
their treatment...” (Physiotherapist)
The launch of Emotion Matters coincided with Self Management Week.
Quality Will Out
NHSScotland is one of the classic 24/7 enterprises. And you can pretty much guarantee that every
hour, of every day, healthcare staff are delivering excellent service. That said, it’s good to
sometimes shine the spotlight on individuals and teams who deliver consistently outstanding work.
The Daily Record Scottish Health Awards is just such an opportunity. This year, NES is
sponsoring the award in the Leading and Managing for Quality section. Before the awards were
announced, fOCUS spoke to all three of the nominees.
Andrew Pender
Andrew Pender is a Senior Charge Nurse in the Emergency Care Unit at Wishaw General. A
nurse for 31 years, he describes himself as an unashamed ‘hands-on’ person.
Andrew’s NHS journey began in 1981, when he joined as a Clinical Support Worker; a move that
was not, at the time, universally welcomed. “It was just supposed to be a summer job. I went to
work at my local Mental Health Unit, while I waited to start training as a P.E. teacher. When I
decided I was going to stay on my mam and dad didn’t speak to me for about two months. They
didn’t approve of the change of career. They didn’t see it as a valued job at that time. They came
round to it later.”
The teaching world’s loss was most definitely health’s gain however. He started nurse training in
1983 at Lanarkshire College of Nursing, qualifying in January 1987. His first post was on a medical
ward that had, in his own words, “Six beds added on to it as a coronary care unit. Only it didn’t
really function as a coronary care unit.” Luckily, after a while, funding was forthcoming and so
Andrew went on a Coronary Care Unit course.
“At that time,” says Andrew, “a vacancy came up for a band ‘F’ nurse. Normally you had to be
there for about 18 years before you got to band F, but I was encouraged to apply and I got it; with
just three years experience. It was the talk of the schemie at the time!”
“I then took over a brand new unit and implemented a programme for patients post myocardial
infarction and those recovering from cardiac surgery. A big part of it was teaching resuscitation
skills. In those days we just had basic life support, not the big resuscitation skills training we have
now.”
In 1992, Andrew was offered a managerial role at a medical unit supporting the Matron of the
hospital. “I was only 27,” he told fOCUS but I was ambitious and I’d done a lot of learning, a lot of
education, and I was a quick learner.
“I received a lot of encouragement from the Matron, Jeanette Norman, she saw something in me.
She still comes into the hospital sometimes. I saw her the other week and I stood straight up and
said, ‘Good Morning Mrs. Norman.’
Andrew stayed in that post for five years but part of him knew it wasn’t really what he wanted to do
and so he decided that the managerial route was not for him. “It was taking me away from the
patient, so I decided to step back a bit and go back to the grassroots, back to being a Charge
Nurse.”
That was in 1998. How does he feel about that decision today? “Best thing I ever done! I’m still
there today. I’ve had plenty of opportunities for promotion but each one would have taken me
further away from the patients and that’s where I want to be.”
So how did he feel when he was put forward for the Leading And Managing For Quality Award? “I
was a bit astounded! Then I thought, ‘Well, I guess that is what I’ve been doing for a good part of
twenty years.’ You do need people on the coalface who are strong leaders.”
It seems that the NHS isn’t the only organisation to recognise Andrew’s talent for leadership He’s
a member of the Royal Air Force Volunteer Reserve, serving with 612 Squadron at RAF Leuchars
and just this year, they sent him on a leadership course. “That brought some things into focus. To
be a good leader, you also have to be a good follower and understand the value of your team.
Here at Wishaw I have a great team. I’ve known some of my charge nurses for twenty years. We
don’t have a high turnover because we have a happy team, morale is good.”
At the heart of that team working is a willingness to understand and engage with the patient
experience. Some of this is remarkably simple. Within the GP bay at Wishaw is a white board with
a mission statement, ‘One Team, One Purpose – Caring for you’ and two columns headed, ‘YOU
SAID’ and ‘WE DID’. “It’s a way of finding out what we could have done better. Some of the
comments on there are positive, some are negative but it’s a way of showing that we’ve listened
and we’ve acted on what we’ve been told.”
Andrew has also canvassed his team on their wishes. “I’ve asked them to come up with the top
ten things they want for the next year. They’ve come up with things like, ‘Reduce the number of
HAIs’, ‘Ensure that sepsis 6 is implemented’, ‘Reduce adverse events at blood transfusion’
‘Reduce errors on medicine rounds’, things like that.” To address that last point, Andrew has
introduced ‘Quiet Zones’. “Notices go up at the time saying, ‘Quiet Zone: Medicine Round’, people
see the signs, noise levels drop and there’s less distraction. Simple as that. What we’re aiming at
is zero medicine errors.”
The team had a ringing endorsement of their approach to patient care in June when inspectors
from the Healthcare Environment Inspectorate told them that the Wishaw unit was the best they
had seen in four years of visits. “They asked the managers to come down and see what we were
doing and then roll it out to the rest of Lanarkshire.”
So what’s the secret of his success? Andrew hesitates just a moment before answering “I think it’s
because I know my job. I know what’s expected of the nurses. Today the healthcare industry is
becoming more complex and that’s why we need to supply as much support as we can to the
people on the floor. Not just for the staff but to make sure the patient experience is good. It’s about
getting it right for patients every time.”
Angela O’Neill
Some people travel the globe looking for new adventures and fresh horizons. Others find life’s
challenges right upon their doorstep. Angela O’Neill, Associate Nurse Director in the Integrated
Care and Emergency Services Directorate at NHS Ayrshire and Arran is firmly in the latter camp.
She joined the NHS in 1985, starting her training at the then Ayrshire and Arran School of Nursing
and Midwifery. Qualifying as a Registered Nurse in 1988 she began her rapid progress through
the levels of nursing without ever having to go outwith Ayrshire. When fOCUS spoke to her, we
asked if she had ever seriously thought about moving elsewhere?
“No.” She replied promptly, with just a hint of amusement that we should have ever considered the
idea. “I was born here. I love the lifestyle, the landscape, the community and the people of
Ayrshire. I’ve never had any desire to go and have been lucky that so far I’ve never had to
seriously consider it but you never know what the future holds.
“That said, I’ve never been static. I’ve had a number of very varied roles with Ayrshire and Arran,
and it’s always provided me with what I’m looking for, in terms of opportunities and challenges.”
And it’s clear that Angela likes a challenge. While working as a nurse, she attended night school at
the University of Paisley and gained her first degree in Health Care Studies. By 1993, she had
risen to Charge Nurse and was working on acute medical receiving where she was part of the
team designing the new ambulatory care pathways. This experience led her to question how much
we knew about the patient experience of ambulatory care and on the back of this went on to do a
Masters degree in Nursing, looking at the patients perceived experience. “We had an idea,” says
Angela. “But we needed to find out what patients and the public thought. Was ambulatory care
what the patient wanted?”
The Masters degree was gained via distance learning through the RCN and the University of
Manchester while working full time as a Charge Nurse. When we asked how she found the time
for this, she laughed. “I did it when my kids were sleeping.”
The work Angela had done on her Masters proved that ambulatory care was indeed what patients
wanted, so she then went on, with Dr McGuffie, then Clinical Director for Emergency Medicine at
Ayrshire and Arran, to set up a Clinical Decisions Unit (CDU), the first of its kind in Scotland. She
is still proud of the achievement. “The CDU fits in with patients’ lives, instead of them having to fit
in with the hospital. I always think that admission to hospital is a deviation from normal life, and we
should only take that deviation when we have to. The CDU is an alternative for patients that allows
them to have a more normal life.”
Nowadays, Angela’s life is divided between her two boys and husband, Brian, with whom she’s
just celebrated her Silver Wedding anniversary, and taking on a more strategic role in Ayrshire.
A member of the sixth cohort of the NHS Delivering the Future Leadership programme, (an
experience she describes as “One of the best things I’ve ever done”), she is responsible for
leading and managing the nursing workforce across six hospital sites in Ayrshire.
“My main role is about making sure that standards of nursing care are at a high level, and that we
have systems in place to make sure that every patient gets the best care they can from every
nurse that they come in contact with. It’s about working with the wider teams: managers, clinicians,
Clinical Nurse Managers, Charge Nurses, and many others, to constantly challenge each other
and look at ways of improving. We need to focus on shared learning from the everyday
experiences that we encounter.”
Angela also has an eye on the future. “Our next big challenge is making sure that the nursing
workforce is fit for purpose to meet the challenges ahead; in terms of the increasing demand, the
changing demographics of our population, and meeting public expectation. We as nursing leaders
have to be creative in our leadership and look to new ways of working that will really make a
difference to every patients experience. Fundamentally we need to ensure that the workforce is
equipped with the right skills and the tools and the leadership, to deliver high quality patient care;
because that’s what we’re about. If we can’t do that, then we’re failing. And I’m going to do my part
in making sure that doesn’t happen.”
Julian Heng
Julian Heng works at Open Road in Glasgow. A service aimed at males of any age who have
experienced, or are vulnerable, to any form of sexual exploitation. He joined the NHS in 2002,
working as a training officer in the then NHS Argyll and Clyde and NHS Lanarkshire before setting
up Open Road in 2006.
Prior to this, there were services for women involved in prostitution but there was no service aimed
specifically at men. The impetus to establish such provision was kick-started by a 2003 report by
the Medical Research Council into male “sex work” in Edinburgh and Glasgow. This was followed
in 2005, by the publication of the Scottish Government’s paper on sexual health, ‘Respect and
Responsibility’. There was now some initial evidence and a government strategy. But could these
be put into positive action? Julian takes up the story.
“The first big challenge we faced was to identify men involved in prostitution, to find out more
about their experience. They were a group of men who were involved in an activity that is hugely
stigmatised. There hadn’t previously been a service for them, so it seemed that to disclose that
information, the penalties might outweigh the benefits. We had to work with colleagues across all
the health settings – sexual health, mental health, addiction and homelessness – to help identify
men who might be involved in prostitution so that we could show them the benefits of working with
Open Road. They would ask clients if they had ever been involved in exchanging sexual acts for
payment as a means of survival. If they answered yes, they would be offered a referral into Open
Road.
“The first referrals came from Addiction Services – we worked really closely with the Equalities
Manager of Addiction Services and the Women’s Support Project in Glasgow to provide multiagency training on routine enquiry around prostitution for both men and women. That really got the
ball rolling and we then set about replicating that across the other health settings.
“A lot of work had been done on delivering health messages to women involved in prostitution so
we could adapt some of that to get key messages across to men. In fact, one of the most
rewarding parts has been the operational and strategic links that we’ve made with all the service
provision in terms of gender-based violence and violence against women. The work that we do
supports the messages in terms of violence against women and how that fits in to a wider
continuum of gender-based violence because we feel that the issue of men involved in prostitution
is a form, or an expression, of gender-based violence. A lot of the work that we do has supported
the messages that the NHS has been putting out over the past 20 years concerning violence
against women in terms of abuse of power, use of deprivation and exploitation. A lot of the very
vulnerable men we see have experiences similar to those of very vulnerable women. We just had
to adapt some of the messages for our client group. There were always going to be some key
differences and we had to learn that.”
The service is now well established and the motivation behind the work remains as strong as ever.
“As far as my team here goes, I’ve been in the hugely – I was going to say lucky but it’s not really
luck – I’ve always had the benefit of having colleagues who were greatly knowledgeable and
massively committed to what we’re doing. They are so fantastic at their job, that it makes my job
easier. They are strong and resilient, because sometimes you are witness to some harrowing
descriptions of life. They are my motivation. We have the belief that people can change, that
people can get better, that we can get our clients to a position where they are better able to
consider their options and maybe identify healthier options than the ones they are currently
involved in. We’re trying to help clients so that healthier choices become easier choices for them.”
And the winner is...
Angela O'Neill from NHS Argyle and Arran.
Angela received her award from Lindsay Burley, Chair of the NES Board.
Afterwards she told fOCUS, "I am surprised, delighted and very humbled. It is a real privilege
to be recognised for putting quality at the heart of what we do and for leading a
tremendous team who strive to make a difference to patients lives every day. "
Lights in the Constellation of the Crab
In 2008 while working in Africa, Angus Ogilvy was diagnosed with an advanced form of cancer –
Non-Hodgkin Mantle Cell Lymphoma. During the next twelve months of his own personal
encounter with cancer, he used his love of poetry – writing and reading aloud – to support him
along the way and to capture the myriad feelings, experiences and people that punctuated this lifechanging, life-intensifying and challenging journey.
Lights in the Constellation of the Crab is a collection of poems he wrote during this period.
Together with his wife, Carol, and with the encouragement of others, Angus self-published the
anthology to help people by expressing aspects of living with cancer in a different way and to raise
funds for Maggie’s Centre in Edinburgh which played such an important part in his life during this
period and for which he continues to raise funds.
The collection was aimed primarily at people with cancer, their families and friends.
However,
increasingly Angus is asked to speak and give readings at healthcare conferences where the
impact of his poetry is equally strong and reinforces the need for a person-centred, holistic
approach to patient care.
After his diagnosis was confirmed, Angus entered a year-long round of tests and treatments and
became very familiar with NHS cancer services in Edinburgh. He had confidence in his team and
was happy with the ‘medical side’ of his treatment. However, he quickly realised that the
separation of mind and body plays a major and totally understandable role in medical practice.
With so many patients to see on a daily basis, Angus fully understands the need for healthcare
staff to distance themselves to a degree from patients but could not ignore the obvious irony:
“There we are, one human being talking to another human being, neither feeling like a machine
and both being aware of that but not able or willing to bring feelings into the conversation”.
“There’s more to treating an illness than the mechanics of diagnosis and treatment. I had to find a
way of managing the emotional and spiritual impact of what I was going through and was
convinced I had to do this to give my treatment the best possible chance of being successful.
“Earlier in my life, I had written quite a lot of poetry and had had some of it published. Life and
work then intervened. I always loved the medium and still wrote the occasional poem, but my
cancer diagnosis seemed to open the floodgates and I wrote prolifically to express what I was
feeling and experiencing. Many of the poems have expressions of light and dark running through
them which reflected much of what I felt.
“Through a friend of mine, who had also had cancer, I knew about Maggie’s Centre in Edinburgh
and went there at the first opportunity. The Maggie's Centres complement the NHS by giving
space for the human being rather than just the illness or condition. They are all based in hospitals
with cancer units but deliberately look and feel entirely different. The majority of the staff have a
medical or healthcare background and understand about cancer, the impact it has on people, and
the various treatments and side effects so they can really provide appropriate and relevant
practical and emotional support to a cancer patient and their families”.
Angus would write poems during his visits to Maggie’s, about his own and other peoples’
experiences, taking care to use language that would be accessible and not overly ‘literary’ so that
they would be easily read and understood by anyone who came upon them.
He began to share them with patients and then groups and found that more and more people were
asking for copies. It was at this point, he decided to pull together a collection of his poems and so
Lights in the Constellation of the Crab was born. It has also proven to be a wonderful fund-raising
vehicle for Maggie’s with around £4,000 raised to date and with copies of the book continuing to
sell.
“It is a win-win situation for me. My poems get to reach the people who want them most, and they
give generously to benefit an excellent cause.”
The title presented itself to Angus through his use of a meditation practice as part of his personal
therapy in which he would visualise his cancer cells as small crabs being chased by light out of his
body. He also wanted to express the experience of cancer as not being all dark. Julia Krone
Oliver, an artist friend he met in a Maggie's activity group, produced the painting for the book cover
that can be viewed either as stars in the vast firmament or microscopic cancer cells at work.
A visit to Maggie’s by Dr Anna Gregor then drew Angus into giving presentations to healthcare
staff and giving readings at a number of conferences beginning with a group from Sweden and
Scotland. “I thought this appropriate as my chemo-therapy was called the Nordic protocol! I found
presenting to medical staff a really fascinating experience.
“When I started to read, I could see a fair few quizzical looks but gradually people became
engrossed in the words and somehow released to experience the feelings I was attempting to
convey. One of the most satisfying comments I ever had was from a consultant who came to me
after a reading at an international patient safety conference in Paris and said, ‘thank you for
reminding me of why I decided to do this with my life’. Poems aimed primarily at healthcare staff
are now also a focus of his creative energy.
“My own NHS cancer experience was positive – and most people say the same. As a patient, I
would look at staff as they performed their daily tasks and saw the stress that they must be under
– and I felt for them. I wanted to write poems that would speak to them through a patient's eyes
and be a bridge. Many patients, I think, feel and want to feel compassion for those who are
treating them. Sometimes the system and the pressures of the work place can make that difficult.”
Angus’s cancer is now in remission but says, “it’s always there, sitting on my shoulder. There is
always the fear factor. I find I actually have to see it as a part of me, not some alien invader. It
evolved within me. Sometimes I speak to it with a poem.
“My year-long treatment acted as a sort of crutch: I had a job to do, targets to reach, appointments
to attend, physical challenges to meet. The primary focus was to generally work to get well.
“When that stopped, writing and sharing poetry became and remains a powerful way of coping and
staying emotionally strong. I am convinced that staying open rather than closing has a hugely
positive effect on treatment outcomes and survival. Those who turn in on themselves tend not to
do so well.”
Angus chose five poems to include in this article. At the end of each is a brief explanation of why
he chose them.
New Blood
The infusion machines ring
like electronic icicles
dripping in a bowl of synthesized air.
Someone else’s blood
is flushing through
the back of my hand.
Strange to be merged
with an unknown other:
Donation number: G101 608 802 614F.
Now
whose bruises will I bear?
whose shame or anger flush the cheeks?
whose dread will drain the vessels of this face?
whose anticipation thrum these ears?
whose love assault the tight pump of the heart?
Interconnection made manifest
by that scarlet bag than drains
another’s life blood through the veins
of recipient CHI 110 541 293:
the previously imagined
me.
Medics seem to like this one. When I read it to medical audiences I ask how many people
have received a transfusion. It is usually remarkably few! I try to provide an insight to the
human aspect of receiving someone else’s blood in a clinical depersonalised way, and the
thoughts that pass through the mind of the recipient
Gentle Man Jim
Jim’s my phlebotomist; he takes my bloods.
He proudly detects the faintest of thuds
in my pulse, then slips in his needle
without any fuss or need to fiddle,
or – even worse – miss and cause me pain
and do the procedure all over again.
He works with the stealth of a gentlemen mugger.
Jim’s not your average bloody vein bugger.
This poem raises a smile, as it is meant to. But there is a very serious point here. Jim was just a
great human being and a great phlebotomist. He exuded a sense of relaxation and confidence in
his ability. He knew how to connect with patients and put them at their ease. He had good
chemistry with them. Other staff would call on him when they had difficulties and he would do it,
first time. Jim died of cancer – I went to his funeral. He was a great example of a caring, highly
professional member of NHS staff.
When They Told Me
When they told me,
earth transformed to water;
water, in a rush of air,
dissolved to space.
All around were nurseries of fire:
the lonely angers of the burning self
that could not look on failing
with a mother’s eyes
and understand it didn’t matter.
Through glass, I watched the process
of the chemistries of change;
observed its deformations, reformations;
saw the way thing strived to re-arrange,
now that I had left me
to the mercy of its own devises.
Maggie’s found me,
I found Maggie’s,
re-introduced us with a mug of lemon tea,
the gentle cheer of knowing, feeling,
seeing there was yet an I that could,
despite the poor prognosis,
purposefully engage with me.
I wanted to highlight the two different aspects of the experience of a cancer
diagnosis: the need for information and the science facts (I) and the person who is
going through an emotional maelstrom (me). It is like the dissolving of the elements.
Somehow you need to reconcile and merge to be a real, whole person. You need to
be able to open your inner being to the full experience.
Coruscation
Light accentuates dark.
In winter dawns
I turn on my lamp
and morning rolls over to midnight.
Dark accentuates light.
Relinquishing gloom
I am dazzled
by the lustre of the universe.
It doesn't matter that
the house burns down in the night
in a pre-emptive attack on murk.
It doesn't matter that
hope's slim candle splutters
on its see-saw dance with dread.
Only my light,
which accentuates
and is accentuated
by dark,
shall pass.
This was selected for the recent anthology, Heart Shoots, published by Indigo
Dreams to aid the work of Macmillan Cancer Support. I was privileged to be on the
page after Maya Angelou! Privileged also that my cancer experiences have often
been filled with the intensity of the wonder of life. It has not by any means been all
dark!
Final Consultation
She told him he was normal, free to go;
the world’s your oyster – she described it well:
something soft and vulnerable in a shell,
prone to contamination, slow to grow
its random irritation into pearl.
Discharged, released, induced to pick things up
where he’d left off, as if his dwindling cup
had been refilled with light to wash the world.
He hesitated, conjured fantasies
of what is would be like to walk away
into before, revisit the places
and the faces he’d known previously,
framed in their meanings from another time,
returned to normal, diagnosis: fine.
I wanted to reflect the sense of abandonment I had at the end of the treatment
period. My emotional crutch had gone, my life had irrevocably changed and I no
longer had the ‘cancer job to do’.
forward.
I needed to find a place of equilibrium to move
If you would like to buy a copy of his book to support the work of Maggie’s Centres or to ask
Angus to speak, you can reach him at: hermitcrabpoems@gmail.com
You can also hear and see Angus read his poems here
Alzheimer Champions
There are currently 86,000 people in Scotland with some form of dementia. The most common
form of dementia is Alzheimer’s disease, followed by vascular dementia. The number of people in
Scotland with dementia is set to double within a generation. As yet, there is no cure.
Scotland’s Dementia Awards celebrate the work of both professionals and community groups who
are committed to helping people with dementia and their families. The awards showcase the
creativity, innovation and dedication that make a real difference to the daily lives of people with
dementia and their families across Scotland when organisations, groups and teams work together.
NES Vice Chair, Murray Duncanson, presented two of the awards: Best Educational Initiative and
Best Acute Care Initiative. Prior to announcing the winner of the Educational Initiative, Murray
commented: “As Vice Chair of NHS Education for Scotland, a national educational organisation, it
is my pleasure to present the awards in the ‘best educational initiative’ category.
“I am also delighted that NES is continuing to work in partnership with Alzheimer Scotland, SSSC
and NHS Health Scotland in supporting these awards---and also in our continued partnership with
Alzheimer Scotland and SSSC in continuing to drive forward our ‘Promoting Excellence’ workforce
development programme.
“This category was open to health and social care staff from all sectors, schools, higher education
institutions, colleges, training organisations and companies, local communities and projects.
“I know this was a hugely competitive category, with entries of an exceptionally high standard, that
reflected educational initiatives which are really helping to drive improvements in dementia care
and support. The judges had a difficult task and all of the finalists should be incredibly proud of
their achievements.”
Winners and Finalists
• Best acute care initiative
o Dementia Box – NHS Fife
o Beacon Ward (Ward 3) at Raigmore Hospital – NHS Highland
o ASSET – NHS Lanarkshire
WINNER: ASSET – NHS Lanarkshire
• Best innovation in continuing care
o Viewpoint/Strategy – Viewpoint & Impact Arts
o Dundonald House (Ayrshire)
o Strive Intergenerational Befriending Project – Strive Befriending Service (East
Lothian)
WINNER: Strive Intergenerational Befriending Project
• Best community support initiative
o Taking Charge: self-directed support – Alzheimer Scotland
o North Edinburgh Dementia Care
o Family Group Conferencing – Midlothian Dementia Demonstrator Site
WINNER: Taking Charge – Alzheimer Scotland
• Best dementia friendly community initiative
o Dementia Friendly Communities CIC (East Sutherland)
o Dementia: everyone’s business! – North Lanarkshire Partnership
o Cauldeen Primary School Project – Alzheimer Scotland and Cauldeen Primary
School (Inverness)
WINNER: Dementia Everyone’s Business! –
North Lanarkshire Partnership
• Best educational initiative
o Scottish Ambulance Service
o Implementing national training to meet local needs – NHS Lanarkshire, North
Lanarkshire and South Lanarkshire
o Preparing the nurses of the future – University of the West of Scotland
WINNER: Preparing the nurses of the future –
University of the West of Scotland
• Most innovative partnership
o VisitWoods – Woodland Trust Scotland
o WDCHCP Integrated Day Service – West Dunbartonshire CHCP: Mental Health
o Actively EngAged – NHS Ayrshire & Arran
WINNER: VisitWoods – Woodland Trust Scotland
Lifetime Achievement Award
Agnes Houston (from Coatbridge), member of the Scottish Dementia Working Group and longterm campaigner on dementia rights and issues, was awarded the Lifetime Achievement Award
and received a standing ovation from the audience.
Agnes Houston receiving her Lifetime Achievement Award from Henry Simmons of Alzheimer
Scotland. Pic: Peter Devlin, Alzheimer Scotland
The Awards continue to receive strong support from Alex Neil MSP, Cabinet Secretary for Health
and Wellbeing: “In only its second year, Scotland’s Dementia Awards is already a much
anticipated event and a hugely positive showcase not only for the breadth of dementia initiatives
across Scotland but, most importantly, for the dedication and expertise that individuals and teams
bring to those initiatives.
“Nominees from across Scotland are working in extremely important areas: in acute care, in
continuing care and in communities. The nomination categories also demonstrate the importance
of education, training and innovation in supporting change and improvement. Congratulations to
all of the shortlisted nominees, and huge thanks to everyone who submitted applications this time
round.”
NES Annual Review 2013
The annual review provided an opportunity for us to share with a wide range of our
external stakeholders some key achievements during the past year. It focused on both uni‑
professional work and on our increasingly multi‑disciplinary and multi-agency approach to
developing and providing appropriate support to NHSScotland, and to the Social Care
Sector.
Our 2013 Annual Review took place in our headquarters office in Edinburgh - Westport 102.
We had no ministerial involvement this year so it was a slightly less formal event than normal.
Opening the event, our Chair, Dr Lindsay Burley commented that she is constantly surprised at
and proud of the depth and spread of NES work and, starting a theme that was to be repeated
throughout the presentation, she stressed the importance of our close partnership working
with many organisations across the public and voluntary sectors.
Our CEO, Malcolm Wright, then delivered the keynote presentation, attempting to cover the wide
breadth of our work in 20 minutes! No mean feat but one well accomplished by focussing on some
selected items.
He described what the Scottish Government 2020 Workforce Vision would mean for NES,
summarising this as:

improving our digital education

providing national leadership and management development to enable positive change

building improvement capacity and capability

improving access to education - in particular for support workers

providing workforce analysis, intelligence and modelling

developing the workplace learning environment
He rounded off his presentation by outlining his vision for the future of NES:

we must operate at both a national and local level

we must be networked and collaborative

we must continue to focus on delivering our core work for individual health professions

and, at the same time, continue to develop our cross-disciplinary focus

our work must be evidence-based and quality assured

we must continue to sustain and develop our educational infrastructure

we must continue to be active players in wider Public Service reform
He brought his presentation to an end by using a quote from Sir John Temple in his report,
Time for Training “Training is patient safety for the next thirty years.”
You can see his entire presentation here .
In addition to the 40 guests present, in person, at the review, we also brought in a wider audience
by live webstreaming the event. This gave anyone interested in our work, as well as staff
throughout NES, wherever they are based, the opportunity to take part in the event in real-time.
If you were unable to attend the event or watch the live stream, you can access a recording of the
entire event here .
In addition to the presentations, we also organised an exhibition that focused on six areas of our
work.
Recruiting & Training Key Professionals: Strategy for Attracting and Retaining Trainees
(StART) - Professor Alastair McLellan and Anne Dickson
Everyone has the best start in life and is able to live longer, healthier lives
Psychology of Parenting project - Brenda Renz
Healthcare is safe for every person, every time Infection Control is everybody’s business
- Gill Walker
Everyone has a positive experience of healthcare Can I Help You? - Lydia Burnett
Staff feel supported and engaged Learning and Development for Support Staff - Karen Adams
People are able to live well at home or in the community Equal Partners in Care (Carers
Strategy)
- Gill Ryan
To learn more about these, follow this link to interviews with colleagues whose work was featured.
Board meetings
NES Board business meetings are held throughout the year and are open to the public. The
meetings normally begin at 10.15 a.m. and last 2 - 3 hours.
If you are interested in attending a Board business meeting, please contact David Ferguson,
Board Services Manager, on 0131 656 3424 or e-mail: david.ferguson@nes.scot.nhs.uk
The Board business meeting dates from now until March 2014 are set out below. Details of the
venues will be publicised in due course, although the meetings normally take place at
Westport 102, West Port, Edinburgh, which is NES’s Edinburgh office base.
2013
Thursday 5th December
2014
Thursday 23rd January
Thursday 13th March
The Outro
We hope that you have enjoyed this edition of fOCUS. The next edition will be out around the
same time as the daffodils (fingers crossed).
We’ll be bringing you the results of our Strategic Framework Review and the Communications
Strategic Review plus a full rundown on the Improvement Science Research Awards and much
more.
Editorial Group
Karen Adams (Educational Development) karen.adams@nes.scot.nhs.uk
Christine Clark (HR) christine.clark@nes.scot.nhs.uk
Anne Dickson (Medicine) anne.dickson@nes.scot.nhs.uk
David Ferguson (Board Services) david.ferguson@nes.scot.nhs.uk
Val Findlay (Pharmacy) val.findlay@nes.scot.nhs.uk
Andrew Forgie (Dentistry) andrew.forgie@nes.scot.nhs.uk
Christine Patch (Corporate Communications) christine.patch@nes.scot.nhs.uk
Rosemary Porter (Psychology) rosemary.porter@nes.scot.nhs.uk
Ann Rae (NMHAP) ann.rae@nes.scot.nhs.uk
John Schofield (Corporate Communications) john.schofield@nes.scot.nhs.uk