Blog

Our blogs create the opportunity for interesting, thought provoking content on health and social care and the future to be generated and published.

Citizen bloggers

A team citizen bloggers will blog for the Academy.  These bloggers will be interested in spreading their views about health and social care and the future.  If you are interested in providing a blog for the Academy email academy@alliance-scotland.org.uk

Blog

Creative Competition 2017 – Short Story Winner

We are delighted to share the results of the Creative Competition 2017.

This year was on the theme of ‘change’. We partnered with Scottish Recovery Network, Write To Recovery, Reach out with Arts in Mind and Mind Waves and asked entrants to tell us:

  • What you think needs to change in Scotland to keep you living well?
  • What you do to stay healthy and well?
  • What one thing would you change where you live to keep you well?

Entrants shared their views by submitting to categories of poetry, short story, photography, film and arts and crafts.

The winner of the Creative Competition 2017 Short Story category is:

The Beach by Write To Recovery user ihatemytwin

” Next stop Phi Phi Islan ” the Thai tour guide shouts in broken English.  The rickety boat speeds through the water with black diesel fumes spouting from the motor like an old jakey puffing out the smoke from his black lungs.

The boat slows to a stop before we see the beach. I look at my reflection in the water the hot sun beats down on my neck warming me. I’m happy and I remember why I’m here.

My mind tumbles back to that night in marshmallow towers. My almost empty, 13 floors up coffin. I was the pay master again that night . Paying for the white lines and green plastic bottles of apple flavoured acidic ,gut rot.  I paid for the company of a cardboard friend , giving him my drugs and drink in exchange for a few hours of fast conversation and a break in the routine of loneliness,  and talking to my monkey mind. Talking to my walls.

I take another fat stinging line up ma hooter and in my intoxicated haze I notice that the film ” The Beach” is on the TV . Leonardo jumps off a cliff into the most beautiful peaceful place I have ever seen . White sands, turquoise water, green, green jungle and peace. Oh the peace.  Paradise!

” I’m going there John!” I exclaim. ” Don’t talk shite Dave, you’re schizophrenic and ye canny even get yer arse on a bus. Only place you’re going is fuckin Gartnavel Royal” John sneers at me.  I shrink into myself and retourt nothing because I know he’s right.

The drugs are gone and my cardboard companion leaves,….but his remarks don’t.  The soft edges of Marshmallow towers become sharp and jaggy again as I sober up.

The voices start  and then the disorganised thoughts and delusions .  “I’m being watched, ….they are after me! I’m evil. I’m worthless.” …. CPN help!  they’re  coming to get me !…… And off I go …..McNair house here I come!!!…. Paranoia and fear.

Safe place.

John’s comments going through my head, cutting and slashing me.

Resentment turned to determination, I was going to get better.

I thought I was a million miles away from the Beach, but really I was only 12 steps away.

Coffee and a regal king size and its….
” keep coming back son” ” Don’t lift the first drink and you can’t get drunk” ” if you stay sober you can have a life beyond you’re wildest dreams ” ” do lots of meetings ” …..” God’s good Son! ”

Determination turned to forgiveness, not just for others, but myself too . I righted wrongs and humbly asked others if I could make things right to them.

Compassion came too and lots of it,  Compassion for others who suffer. Compassion for me.

As my addictions were removed my mental health improved. Prayer and medication.

So I trudged the road to happy destiny and five years later…… here I am , looking at my reflection in the turquoise water.  ” you okay? You excited? Kirsty asks . “Aye am great”.  “It is beautiful here and looks much better than it did in the film” .

The boat bobs in the shallows and Kirsty and I jump into the cool water. I inhale deeply and feel the gratitude. We swim to the beach and I’m there. Peace. Paradise. Maybe we will get married, have two kids a house and a dog? Who knows. Stay in the present. Not in the future. Enjoy the beach. I can’t help it.  My mind wanders again and I think…

I could still be in Marshmallow Towers talking to the walls, if it wasn’t for someone’s observation of the way my life was going…… thank you John and thank you ” The Beach”

“Aye God’s good Son!”

Creative Competition 2017 – Arts and Crafts

We are delighted to share the results of the Creative Competition 2017.

This year was on the theme of ‘change’. We partnered with Scottish Recovery Network, Write To Recovery, Reach out with Arts in Mind and Mind Waves and asked entrants to tell us:

  • What you think needs to change in Scotland to keep you living well?
  • What you do to stay healthy and well?
  • What one thing would you change where you live to keep you well?

Entrants shared their views by submitting to categories of poetry, short story, photography, film and arts and crafts.

The winner of the Creative Competition 2017 Arts and Crafts category is:

Delirium by Stephen Borland

Creative Competition 2017 – Photography Winner

We are delighted to share the results of the Creative Competition 2017.

This year was on the theme of ‘change’. We partnered with Scottish Recovery Network, Write To Recovery, Reach out with Arts in Mind and Mind Waves and asked entrants to tell us:

  • What you think needs to change in Scotland to keep you living well?
  • What you do to stay healthy and well?
  • What one thing would you change where you live to keep you well?

Entrants shared their views by submitting to categories of poetry, short story, photography, film and arts and crafts.

The winner of the Creative Competition 2017 Photography category is:

Hope by Junfei Hu

 

Creative Competition 2017 – Film Winner

We are delighted to share the results of the Creative Competition 2017.

This year was on the theme of ‘change’. We partnered with Scottish Recovery Network, Write To Recovery, Reach out with Arts in Mind and Mind Waves and asked entrants to tell us:

  • What you think needs to change in Scotland to keep you living well?
  • What you do to stay healthy and well?
  • What one thing would you change where you live to keep you well?

Entrants shared their views by submitting to categories of poetry, short story, photography, film and arts and crafts.

The winner of the Creative Competition 2017 Film category is:

Creative Present, Past and Future by Elaine Kordys

 

Creative Competition 2017 – Poetry Winner

We are delighted to share the results of the Creative Competition 2017.

This year was on the theme of ‘change’. We partnered with Scottish Recovery Network, Write To Recovery, Reach out with Arts in Mind and Mind Waves and asked entrants to tell us:

  • What you think needs to change in Scotland to keep you living well?
  • What you do to stay healthy and well?
  • What one thing would you change where you live to keep you well?

Entrants shared their views by submitting to categories of poetry, short story, photography, film and arts and crafts.

The winner of the Creative Competition 2017 Poetry category is:

‘Heard’ by Write to Recovery user Sa_raPreston

If the illness, the struggle, the fear and the pain,

Were not all trapped inside, but used for others to gain.

So the time and the opportunities missed – were no loss,

If employed as currency, so the next bear no cost.

 

If I can use my voice – have my experiences told,

So from diagnosis, I’m not just ‘a label’‘like this’ ‘til I’m old.

If I can share my own negatives and turn into good,

Without hesitation – raised hand – I’d stand up and I would.

 

For this cannot continue – year after year,

A new generation living in fear,

Of the stigma, and the shortage, in services mental,

It’s unjust, not enough – if we’re seen as inconsequential.

 

But is this a pipe dream? Of a mind ill, unstable, unsound?

No good for board meeting, handover or round?

Is my voice valid, or will I forever be ‘sick?’

Am I tarnished, categorised, in a check-box now ticked?

 

If I could voice what I’ve been through,

And have you hear, not just listen.

With care, insight and patience,

Where you understand, not dismiss it.

 

And when I got to the end,

Not speak for me, what you’ve learned.

Instead be a medium and an amplifier,

For my voice to be heard.

 

Citizen’s Basic Income – Brave enough or stupid enough?

The Health and Social Care Academy have released a new insight paper around Citizen’s Basic Income. Assistant Director of Policy and Communications at the ALLIANCE, Andrew Strong writes about the debate surrounding CBI. 

Evan Davis’ opening lines in this 2015 Newsnight piece to camera tell you a lot about the divisive nature of the concept behind a citizen’s basic income (CBI).  The Dragon’s Den presenter turns to camera and, with a sigh, says “few countries have been brave enough… or perhaps stupid enough to adopt it” before rolling VT on a report its introduction in Finland.

CBI isn’t a new idea – but has been often met with such cynicism when introduced to discussions about the future of social security.  The idea is simple – scrap the existing pensions and social security system, with its riddle of mazes and bureaucratic assessment processes, and replace them with a flat, tax free payment to every adult.  This would not include any form of means testing or conditionality and is paid on an individual basis to everyone, in cash, who can then decide how they spend it.

One of the most interesting aspects of CBI is that it throws up unusual alliances from across the political spectrum – as people who have interest in both increasing and reducing the state’s influence in people’s lives see it as a catalyst to reaching their aims.

Its recent re-emergence coincides with attempts across Europe to introduce it – at varying scales. In Scotland, this includes two pilot sites in Glasgow and Fife where anti-poverty measures are being trialled.  The Scottish National Party, in Government at Holyrood, passed a resolution at a recent party conference supporting the principle of a universal income.

Within this context that the Health and Social Care Academy’s new insight paper links CBI to “emphasising humanity, values and flourishing”, one of our provocations for the future of health and social care, as it places an overdue emphasis on breaking down the existing ‘them’ and ‘us’ relationship which has evolved over time between people and the state in relation to social security.

Our paper argues that a basic income has the potential to transform the relationship between people who live with long term conditions, disabled people and unpaid carers and the state – but its certainly not a magic bullet.  Policy makers must closely consider both the political and the social impact of introducing a CBI and the difference it could make to existing service provision and the potential unintended consequence of shrinking state support.

Close consideration and learning from the pilot sites should give us some insight and enable the debate to move on from simply “bravery or stupidity”.

 Andrew Strong

Assistant Director (Policy and Communications)

Health and Social Care Alliance Scotland (the ALLIANCE)

Health and Social Care Academy: Emphasising Humanity and Human Rights: Citizen’s Basic Income

Power – a health issue!

In our latest blog Elinor Dickie and Emma Doyle of NHS Health Scotland explore how power, and how it is shared between individuals, communities and statutory bodies, can affect health inequalities. 

Unequal distributions of power, income and wealth are the fundamental causes (or the main causes) of health inequalities. At NHS Health Scotland, we know a lot about how having, or not having, income and wealth impacts on our health, but we are just starting to explore the relationship between power and health. Unlike money or wealth, power does not belong to any one person, but exists in the relationships between people and groups of people. We know that those who have power over their lives and the environments in which they live are likely to have better physical, mental, and social well-being. So power is protective of health.

We’ve defined power as the ability to act in a particular way, as a capacity, shared resource or relation. It is a complex concept which includes the ability or capacity to do (or not to do) something and to exercise influence or control in a variety of different ways. People may have power in some situations, such as at home, but less power in others, such as at work or in their community.

If you have power, you are more able to make or influence the decisions that affect aspects of your life, such as where you live and where your children go to school. You are more likely to understand choices available to you and have some confidence that you can make your voice heard in decisions that relate to you and to the community in which you live. When you are able to do this, it seems normal. You might not even recognise it as power.

 However, if you don’t have power, you are likely to feel this lack of control in many parts of your life. You may feel that your voice goes unheard, or is not valued or respected, or that others know better and you will have little sense of control, even over the things that are important to you. People who do not have power may have limited choices, may not be able to make informed decisions and may not get the services that they need.

This means that empowering people at the individual, community and national level is necessary to improve health and wellbeing and to tackle disadvantage and inequality. So how do we do this?

One way is to think about power as a fluid resource, not a limited one. There are many different sources of power, positions of power, and spaces or levels where power is exercised. Understanding this helps us to identify where there may be opportunities to tackle inequalities in how power is distributed. For example, where can power be shared, where can it be ceded and where can it be claimed? We can start by understanding human relationships – who holds power over a certain matter? What influences them? Who or what do they listen to – research evidence? Public opinion? Corporate interests? We are all part of a complex social and political system in which power is exercised to advantage some groups over others.

We need to work with individuals and groups, as well as with the processes and structures that determine the interaction between communities and the state. It’s for us to think about our role in the system and how we can use our power to bring about change.

The Community Empowerment Act is an important new piece of Scottish legislation with opportunities to reduce health inequalities, giving communities greater control through the redistribution of power –  but that depends on us really understanding what power is and where power lies. In partnership with Glasgow Centre for Population Health, we have produced a new animation which explores these issues further.

It’s time for all of us to be part of creating a fairer, healthier Scotland.

‘Consultation is not co-production’ in the development of a suicide prevention strategy

Emma Goodlad, Grants and Impact Officer at the Health and Social Care Allliance Scotland (the ALLIANCE) blogs for the Academy this week. Emma powerfully makes the case for meaningful public involvement and co-production in the development of a suicide prevention strategy. 

New statistics published earlier this month reflecting the impact of suicide on people in Scotland were somewhat worrying, with a sharp increase in deaths by suicide in 2016. With suicide being the leading cause of death for young people in Scotland and the biggest killer of men aged 20-49 in the UK, the new suicide prevention strategy being developed by the Scottish Government needs to be forward thinking and brave in its aims and ambitions.

To develop a truly effective and useful suicide prevention strategy, one which guides people and professionals across Scotland on how to support people who are experiencing crisis because of intrusive suicidal thoughts and ideations, the Scottish Government needs to be led by people with real lived experience of suicidal thoughts, attempts and those who have lost loved ones to suicide.

This cannot simply be a consultation. When asked to be consulted on the recently published Mental Health Strategy, some third sector organisations expressed that they felt that the Scottish Government has a culture of over consulting, but under delivering on the feedback. People feel that they have opened up and told very personal, and often quite painful, stories of their own lived experience to try and guide and influence policy and strategy but are not seeing their experiences reflected in the final outputs.

To make sure that they are doing the right thing by people they need to put lived experience at the heart of the process from the very beginning to ensure that consultation is undertaken in an appropriate, sensitive and realistic way where people feel like their voices are truly heard and being used to improve the lives of others in the future.

As someone with both lived experience of attempting to take my own life, and working at an organisation who works in partnership with our members to influence and develop Scottish Government policy and strategy, I can see both sides of the coin. I understand that the state cannot realistically meet every demand or provide the necessary changes to services and support overnight, however when I most needed support I was let down by the very system we are told to tap into and ask for help from. If there was a clear suicide prevention strategy with realistic outputs and therefore outcomes, I may have never reached the point where I felt I could no longer cope and tried to take my own life. On the other hand I may still have reached that point and if I had, again, a clear and realistic strategy could have ensured that there was a clear pathway of support on hospital discharge to support me in the time between discharge and CMHT appointment.

Instead I was discharged, still in a state of disconnectedness from the world, with no involvement of my family in the lead up to my discharge from a High Dependency Unit and no coping plan put in place to keep me going until my appointment 8 days later with a Community Psychiatric Nurse. My family, friends and I were left to muddle through that week and deal with my ongoing depression and suicidal thoughts with no professional support purely because I had seen liaison psychiatry while still in a blur, recovering from the after effects and trauma of an overdose and had lied, like so many others, about still feeling suicidal because I was terrified that I would be sectioned under the mental health act.

I was lucky to have an incredible support network who got me through that incredibly difficult period and who now actively support me to look after my mental health and identify any issues.  But what if that happens again? Would anything be different? Yes, it would be, but not necessarily because the support services are any different, but because my family and I know what needs to be different and would fight for different support.

Consultation is not co-production. I want my voice to be heard by policy makers, I want my experience of the darkest period in my life to be used for good.  But I don’t want to be involved in a tokenistic consultation where nothing really changes, because the Government are afraid of raising expectations and letting people down if they cannot meet them.

I want to be part of a strategy which is brave, forward thinking and truly strives to make a difference in people’s lives and isn’t another strategy which goes into desk drawers across Scotland. I want to be involved in the development of a strategy where the consultation is a two-way discussion which is open and honest about what is realistic, what the challenges will be and work together to find realistic solutions to overcome these.

Let’s not forget that they have done this before. In 2008 members of the ALLIANCE worked with the Scottish Government to develop and produce Gaun Yersel’ The Self Management Strategy for Scotland. Gaun Yersel’ 9 years on is still held up as an excellent example of effective co-production to produce a realistic strategy document.

I call on the Scottish Government to be brave, put aside the fear of raising expectations and let’s work together for a Scotland where death by suicide rates are reducing, not increasing and strive for a support system to be held up as an example across the globe.

‘It’s about unleashing, not controlling’

On 26th June, the Health and Social Care Academy hosted ‘Emphasising Humanity over Bureaucracy in Social Care‘; an event that explored what emphasising humanity looks like in practice, not just for those receiving care but for those providing it. 

 William Kløverød Griffiths Policy and Information Intern, Dementia Carer Voices spoke at the event about the work of Dementia Carer Project and the emerging themes from the pledges that have been gathered. In this blog William writes about the You Can Make a Difference campaign and the importance of celebrating the kindness of people with dementia, their families and carers.

President of Institute for Healthcare Improvement, Don Berwick, has been credited with saying “The heart of improvement is not in controlling, it is in unleashing.” For me this really sums up the work of Dementia Carer VoicesYou Can Make a Difference’ campaign. The work we do is about unleashing not in controlling what people do, their messages and their stories.

The campaign is about celebrating and unleashing the kindness and dedication of people with dementia, their families and carers. It is to emphasise that they are equal partners in the care they receive. To this end we collect the stories and experiences unpaid carers have in providing care to their loved ones. Dementia Carer Voices are building a range of multi medium case studies, asking people what matters to them. It is our hope that these will provide useful evidence about the lived experience of the lives of unpaid carers. In that regard, we hope to be a platform to unleash the messages of unpaid carers.

youcanmakeadiff

The project also shows the lived experiences of people with dementia, their families and carers to those who work in the health and social care system. It is a difficult and underappreciated role that health and social care staff do every single day, day in and day out, but it is essential to the health and wellbeing of millions of people. Thousands of people come into contact with NHS Scotland every day, an estimated 37,000 people living in care homes in Scotland, and many more receiving home care visits. If our campaign can unleash some compassion, care and consideration into every one of those human contacts, then we will make our health and social care system better.

So the work we do at Dementia Carer Voices is about unleashing the passion and kindness of unpaid carers. It is about those people who sit by our beds, knock on our front doors and who we speak to on the phone. It is about the people who treat us when we are unwell, about those who offer kindness when we are vulnerable and are able to make a difference in people’s lives. To all those who follow the five must dos of caring for someone, and place the person at the centre of their care.

nothingaboutmewome

When I first joined this project a little over two months ago, I took out a selection of the pledges we have received over the years. Just over 13,000 people have made a personal pledge to make a difference, giving people the opportunity to commit to, to share and celebrate the difference they and we can all make every time we meet someone. That is what this project is about, it is about unleashing the voice of people with dementia, their families and carers. These are people seldom heard, but with our project hopefully gives them the chance to express themselves and take this message to people who make policy.

Dementia is everyone’s business. It is not about buildings or organisations, it’s about the people within and the people we meet, on every occasion it’s about people and relationships. It’s about the life and love stories of families all across the county. So I truly hope the people the pledges, the life and the love stories are about unleashing what matters, who matters and about unleashing the parts we can all play in every moment, every day and every time.

If you would like to learn more about the project, or to sign up to our mailing list, please email dementiacarervoices@alliance-scotland.org.uk

@WK_Griffiths
@DementiaCarerVo

 

 

 

 

 

 

 

How can we work in ways that will enable everyone to flourish?

On Monday 26th June, the Academy will be hosting Emphasising Humanity over Bureaucracy in Social Care, an interactive event that aims to explore what emphasising humanity looks like in practice, not just for those receiving care but for the care workers too. What would human rights look like if we focused on the human rights of the system? 

Speaker Helen Sanderson poses the question of how we can work in ways that will enable everyone to flourish in this blog written ahead of the event: 

The Guardian, in November last year tells the story of Jean. Jean works for a home care agency in the north of England. She starts work at 6.30 am, and completes 23 calls in 12 hours. She drives 20 miles between appointments, and is not paid for her travel time, and earns £64.80 before tax.  Jean is on a zero hours contract. She does not know how many appointments she will have each week, and therefore how much she will be paid. Her list of appointments comes through on a Friday.

It is stressful work, she says, and she feels she has little support.

“It’s a lonely job…you are in the care on your own, you get to peoples houses and often face problems on your own. They tell you all of their worries and then you take them home. Often at night I’m tossing and turning worrying about them.” But Jean still loves her job.

Jean’s experience could explain why there is up to 40% turnover in home care. Yesterday I spoke to a manager of a large home care organisation in the south of England. She said that they lose 50% of their new recruits before their 6 month of employment.  How close is Jean’s experience to Alan’s?

 Michael Marmot, in his book ‘The Health Gap’ tells Alan’s story.

Alan was a picker in a warehouse, and Michael described in detail his daily experiences of work and ends the story with this statement.

“It was as if his employers had taken everything we know about the damaging aspects of work, concentrated them in a syringe and injected them into Alan.”

The damaging effects that he refers to are high demand with no control over the work task, high effort and little reward, social isolation at work, job insecurity and working antisocial hours.

I am not suggesting that every carer who works in home care experiences these damaging aspects, but I am sure many do, and it does resonate with Jean’s experience.  In changing home care most of the focus is on the experience of people using the service, or on making efficiencies. Both of these are important, however we must consider the experience of the staff. If we don’t not only will turnover continue to be very high, but we are also building health challenges for the future. The challenge therefore is to create a different way of delivering support for people at home, that is truly person-centred, where they have choice and control, and delivered by an engaged, happy workforce.

There is a lot of interest in happy workplaces. It almost sounds frivolous to talk about happiness in home care.  Ron Friedman, in his book ‘The Best places to Work’ talks about how meeting psychological needs are at the heart of employee engagement and wellbeing.

The psychological needs that he refers to are autonomy and relationships. It is clear that having choice and control matters to staff as well as people using services, and that having friends at work is critical to productivity and happiness. Jean has no autonomy over her work – she is told where to go and when, and for how long. She describes the work as lonely.

We care trying to build choice, control, and relationships into the DNA of Wellbeing Teams. Wellbeing Teams are small, neighbourhood, self-managed teams inspired by Buurtzorg. (link: https://www.youtube.com/watch?v=MNJ3iTw0AXw)

 For people who are supported at home

People choose what they want support with (their outcomes and priorities), how they want to be supported, when and where. We enable them to choose their team too, either through looking at the team’s one-page profiles or a 30 minute film of a team member introducing themselves. No more than four team members work with an individual, to provide consistency and to develop good relationships.

For team members

The team meets every week to share information, address any problems or issues and support teach other. Each team member has a buddy. The team shares the roles needed in a self-managed team together, and they choose the roles based on their strengths. Each person has a coach to support them to become confident in their role (for 3 – 4 months) and then the team has a coach to help them work well together. The team develops the rota/schedule together after the team meeting.

There are two Wellbeing Teams starting in Dumfries, and we will be learning from practice in how to deliver choice, control and focus on relationships.

Michael Marmot is compelling that we need a radical change in the way we think about health and society. This means not only ensuring that older people are supported well at home, but that the health and happiness of staff is critical too.

If you are interested in attending Emphasising Humanity over Bureaucracy in Social Care please email event@alliance-scotland.org.uk to register your place.