New Year’s Resolutions – focus on the Little Things!

As we enter a new year it is often a time for new starts, new beginnings. As part of this an estimated 32% of us will set ourselves New Year’s Resolutions.

The top 4 New Year’s Resolutions focus on health and appearance – to lose weight, to get fitter, to eat more healthily and to take more care of my appearance[1].

Of course we should applaud these attempts to improve our health. Recent figures released by Public Health England suggest that 80% of those aged 40-60 are overweight, drink too much or get too little exercise[2] – obviously the impact of this on our health has an impact on our over stretched NHS.

However the motivation for many is appearance and confidence rather than the health benefits. So perhaps they suggest that we are too focussed on the superficial and on what others think of us? And perhaps they should give us cause for concern? An estimated 66% of people fail to keep their resolution for even 1 month – the effect of making and then breaking one of these resolutions actually could actually have a detrimental impact on our self-esteem.

Experts argue that you are more likely to succeed in your resolution if you focus on one thing at a time[3]. They also suggest you are more likely to success if you tell someone your resolution and if you change your behaviour with others.

So we have a suggestion – why don’t we all commit on Twitter to a shared New Year’s Resolution to do a little thing every day for someone else and to ‘be the reason someone smiles today’.

Surely those resolutions are achievable? No grand gestures, no expensive gym membership, no beating yourself up that you are not Instagram perfect by the end of year – just one small thing every day that touches someone else. It could be as simple as saying hello to someone, asking someone how they are, making a colleague a cup of tea when they look like they might need one, letting a car out in front of you on a busy road…one small thing that makes someone smile or makes their lives easier just for that moment.

Do more of what makes you happy – do not beat yourself up by failing to keep your New Year’s Resolution past the end of January – it makes perfect sense that you are more likely to stick to a resolution that is shared and not just for yourself. Make yourself and others think more of you for what you do rather than just what you look like.

Picture yourself on December 31st 2017 – will you feel more successful fitting into that size 10 dress or having made 365 people smile over the year?  Let 2017 be the year you make yourself happy by focussing on the little things. Are you in? Please join in at #littlethings2017

 

Laura Stuart-Neil is Lead for Quality Improvement and Allied Health Professionals at NELFT.

 

References:

[1] The Guardian, ‘How long do people keep their New Year resolutions’, 31/12/15

[2] BBC News, ‘Middle age health crisis warning’, 28/12/16

[3] Independent, ‘New Year 2016 resolutions: how to keep them’, 01/01/16

Five little words: a tribute to the inspiring Kate Granger

Hello, my name is Fi. Those five words seem really little but they’re big, huge even, and they demonstrate the very essence of this blog and what we are trying to do here. Let’s start at the end though and go backwards.

We at Little Things were so sad to hear that the inspirational Dr Kate Granger passed away last weekend. Our thoughts are with her husband Chris and family and friends as they mourn her death. Kate, through her humility and honesty, inspired many people to be better (including us). Her story, resilience and approach has well-documented but it’s worth re-stating she stared death in the face for 6 years and found depths of courage to fight for better care through it.

On the #hellomynameis website, Kate introduces this campaign:

I’m a doctor, but also a terminally ill cancer patient. During a hospital stay in August 2013 with post-operative sepsis, I made the stark observation that many staff looking after me did not introduce themselves before delivering my care. It felt incredibly wrong that such a basic step in communication was missing. After ranting at my husband during one evening visiting time he encouraged me to “stop whinging and do something!” We decided to start a campaign, primarily using social media initially, to encourage and remind healthcare staff about the importance of introductions in healthcare.”

The rest, as they say, is history. According to the website, #hellomynameis has made over 1 billion impressions since its inception with an average of 6 tweets an hour and as you’ll read it is, most importantly, changing the personal interactions around healthcare today. Here’s three reflections from us about why this is:

  1. In the busy, messy, always-on life we live these days sometimes it can be difficult to remember to start with a greeting. In a lot of cultures though, greeting others is very important. It is an opportunity for people to show respect, through the language used and its accompanying actions, and the tone for the interaction is set. Whether the greeting is written or spoken, choosing the appropriate language is important.
  2. It takes bravery to be the person who genuinely starts #hellomynameis in almost any situation (remember the palpitations of introducing yourself to new colleagues, friends, potential partners at the beginning?), whether you might be feeling empowered by the professional role that brings you there or not. There is this point, here around ‘my name’ where you can choose to authentically go ‘all in’ and build a relationship with this person or choose to speed through who you are and get on with ‘the business at hand’. There’s a lot written and said about first impressions but the thing that sticks with me more than anything else is that it’s not necessarily what you say but how you say it – how you make them feel. Saying #hellomynameis is really important but meaning it is even more crucial.
  3. I’ve just started in a new job, in a really new organisation, and we’ve been reflecting on how you get people to work well together. The answer is in some ways really simple, it’s through relationships and trust. How do I build that with people I want to work with? I start by telling them my name. It’s a springboard to finding the commonalities that exist between us all that allow us to comprehend the humanity in all of us. My full name is Fiona Kirsten McKenzie but lots people call me Fi and telling you (as readers) that is a choice that gives you power. It starts a conversation about who I am as a person, and who you are and what matters most to both of us.

I’ve spent the week staring this post in the face, struggling to find the perfect words to explain why what Dr Kate Granger did was so momentous and why those 5 words matter so much. Instead let me tell you a story.

There’s a staff nurse named Peter who catches the train with me each morning. I know his name and job because he proudly wears a ‘hello my name is Peter’ badge and #hellomynameis lanyard each and every day. This simple ‘little thing’ has changed the relationship between us, he looked up as I scrutinised his badge – I smiled, he smiled and now we smile at each other every morning. It’s a very human moment in a commute full of people avoiding each other’s eyes. One day, very soon, I will be brave and introduce myself to Peter properly and learn more about his life on the front line providing much needed care and concern for our patients and communities.

#hellomynameis has built many genuine connections between staff and patients across the country. Long may it continue – we are in your debt Kate.

hello-my-name-is-logo-square

Fiona McKenzie, Deputy Director, UK Improvement Alliance

http://www.ukimprovement.co.uk

 

Population-based health and care – what will it mean for patients?

This blog was originally published on the UCLPartners website on 31st May 2016.

Over the past few months there has been a growing focus on population-based approaches to health and social care. The Kings Fund and others have published a number of documents on place-based care and accountable care organisations. We have also heard increasingly about devolution with the developments in Manchester and London, where five devolution pilots were announced in December 2015. The Five Year Forward View described the need to address the triple aim: improved health outcomes; quality of care; and cost. These aims, plus the recent advent of sustainability and transformation plans (STPs), signals a clear direction from NHS England – that plans should be delivered through a population-based approach.

UCLPartners hosted an event on 18 May 2016 to initiate discussion on how we can begin to do this in London. Over 120 healthcare leaders from across London were joined by representatives from national organisations at City Hall and, overlooking some of the icons of London such as the Gherkin and Tower Bridge, discussed how we can work better across health and social care to improve the health of our populations.

There were three main topics on the day: reviewing the evidence for change, introducing the London devolution pilots, and discussing how we overcome some of the barriers to enable such change. There was a lot of great discussion but, for me, there were two main themes:

1. We must view devolution as a process and an enabler for change – not the goal.

The STPs and devolution pilots give us the opportunity to do things differently – to really think about how we integrate services and develop more of a focus on prevention and wellbeing. It is vital to consider workforce and relationships to achieve this change. David Fish, our managing director, reminded us how key the workforce is to change. The national bodies represented at the event appeared to share the vision of the need for transformation. A recurring theme during the discussions was the need to focus and nurture relationships at all levels if we are going to achieve whole system change; one of the devolution pilots reminded us that the organisations all need to ‘hold hands and jump together’.

2. We must not lose sight of our ultimate goal – patient benefit.

Will Tuckley, chair of the London devolution board reminded us not to forget that this work is about the health and wellbeing of Londoners. Jeremy Taylor of National Voices also reminded us not get distracted by structure and reorganisation – but focus on what matters and what impacts on our patients. Patients are not interested in what transformation programmes we are engaged in – they just want good or better care. We should focus on doing the right thing for patients. For many patients it is often the little things that matter the most – the interactions that they have with the staff providing their care.

The event had a sense of anticipation and excitement – the opportunity for our health and social care system to really look at doing things differently to improve care and outcomes for our patients, whilst also addressing the financial deficit. Personally, I am excited to see what the next few months bring as the STPS and devolution pilots continue to develop. I hope that our health and social care leaders retain the optimism expressed at this event and the desire to think creatively and push boundaries, whilst always keeping at the forefront what matters and impacts most on the health of our population.

 

Laura Stuart-Neil is programme manager within the System Transformation Team at UCLPartners. Laura.Stuart-Neil@uclpartners.com @laurajstuart

‘Mony a mickle maks a muckle’

An apt Scottish phrase to consider is “mony a mickle maks a muckle”. For those not familiar with this glorious expression, it means “many little things, make a big thing”.

Within bigger programmes of change underway in Scotland, little nuggets are capturing the imagination and playing a huge role in driving improvements. I was really pleased to share some of these with the UCLP Involvement Leads Forum, as part of a day I spent in London catching up on many aspects of what UCLP does.

I’ve recently been involved with work to consider an approach to better using the power of storytelling to articulate things in more straightforward and engaging ways.

One story that seemed to strongly resonate with the Involvement Leads draws its origins from an experience shared on Patient Opinion, the online forum to capture good, bad and indifferent experiences that people have with health and care services.

A man had been impressed by the colour pathways at the hospital, which help to direct people to particular wards or parts of the building. However, he wasn’t sure which colour pathway he should be on. Wouldn’t it be great if the colour pathway he should follow could be included on the letter? Hey presto, one of the services responds by making the colour pathway match the colour of the letter. Other services follow suit. A simple story and a great idea brought about a fantastic and eminently sensible change.

Drawing upon personal connections with the creative sector in Scotland, I’ve been having a lot of fun with a group of interested innovators where we’ve been considering one of the littlest literary forms I’ve come across: the anchored terset.

At a recent meeting, I set the attendees the challenge producing one terset each to sum up the discussions. By the end of the session, we’d collectively produced over 80.

I set the Involvement Leads the same challenge and we collectively produced a multi-coloured wall of notes. Particular highlights for me were:

LittleThings_Words

It seems a really good technique for capturing condensed notes in ways that are brief and memorable.

Our challenge is to allow these distilled ideas to inform a wider vision and set of actions for how we more effectively engage and involve people, via the emerging Our Voice framework.

We have many strands of work that come together within our person-centred work in Scotland. This recently published handy guide provides a good digest.

Thanks to everyone at UCLP for the invitation to come along, and a further thanks to all of those who attended the Involvement Leads Network session. It was a real delight to share some of our work with you.

 

Blythe Robertson is the Policy Manager for Person-Centred Care and Self-Management: Healthcare Quality & Strategy, Scottish Government

End of Life Care– The Little Things still mean the most

Dying Matters Awareness Week 9-15 May 2016

Death and dying is a morbid topic to most people. It seems people want to talk about it but are afraid to, or aren’t sure how to approach it. Statistics show that over 70% of people in Britain feel if it was easier to talk about death, dying and bereavement their end of life care wishes and preferences would be better met. But still less than 40% have a written will and only 7% have written down their wishes with regards to future care.

When I told friends and family I had applied for a job in the End of Life Care team at UCLPartners, few asked me what I would actually be doing and most asked ‘would that not be really depressing?’. I knew it wouldn’t be depressing. I interviewed for the role having read about the project, and I was just excited to have the opportunity to work in a healthcare organisation that was working to improve the care patients receive. It didn’t put me off that it was End of Life Care – it made me more determined to get the job. Both my parents worked in nursing homes when I was younger, and so spending time around elderly and dying people, I inherently developed a compassion for their care. One of my earliest memories is of an elderly lady with Dementia who my Dad looked after. She had this very large bunny teddy bear which she thought was her baby, she carried it everywhere with her and the staff even gave her food for it at dinner time!

When I interviewed for the role and met the Clinical Lead for the project, Dr Caroline Stirling, I wanted the job even more. Caroline has so much passion it is infectious. I’d met people like this before throughout my engineering career, but the impact they had on me pales in comparison. Here is someone who cares so much about people, someone who wants to talk about the taboo subject of death and dying in a positive way – how can we improve that experience for patients, after all, everyone will inevitably go through it once.

Once I started working with the team I quickly realised there was much more to caring for a dying patient than I had ever imagined. But what stood out almost instantly was that the most important aspects all seemed to relate to the patient and their loved ones wishes and preferences. What are their cultural and spiritual beliefs? Do they wish to die at home, in a hospice or at hospital? How much do they actually want to know and how involved do they want to be in decisions about their care?

Things that seem so simple like staff introducing themselves and speaking to the patient directly (even if they are not fully cognisant), the very basic skills – these are the little things than can sometimes be the most memorable both for the dying person, and for their loved ones left behind.

Being exposed to all this has made me think more about myself and my family, what my wishes are, and theirs, should the inevitable happen. I want my loved ones to be treated with dignity and respect, a dying person is still a person, not to be dismissed.

This year’s Dying Matters Awareness Week is focussed on The Big Conversation and it’s something we should all think about having, so that the little things important to us are respected, even when approaching the end of our lives. As everybody’s wishes are different clinicians need guidance so they can provide truly person centred care.

Some things you can do to record the things that matter to you;

  • Write your will
  • Record your funeral wishes
  • Plan your future care and support
  • Consider registering as an organ donor
  • Tell your loved ones your wishes

 

Michelle Mooney is project manager, End of Life team, UCLPartners. Find out more about their work here. michelle.mooney@uclpartners.com  @michelle_m_7 #uclpeolc