Almost four weeks ago a terrorist went into two mosques in Christchurch, New Zealand, and killed 50 people while they prayed. Another 45-50 were wounded. This wasn’t the first terrorist attack on New Zealand soil but it felt like it. It was driven by hate for people on the basis of perceived differences.  A common response in the hours and days after the attack was ‘this isn’t us’ but, for lots of reasons, I think we (pākehā – New Zealanders of European descent – particularly) are realising that there is more of this in Kiwi society than we have been conscious of or willing to admit. It has left us all reeling – so much sadness, horror, shock – with an overwhelming sense that we are mourning both a huge loss of life but also a loss of that sense of New Zealand as a place of safety and refuge. Kiwis and the Islamic community have gathered around the world (including London) to share our grief and stand together in solidarity.

In this collective response we have seen and heard of what might be called little things, small acts, that have made a difference. One such commonly-reported in the days after the attack was the New Zealand Prime Minister, Jacinda Ardern, wearing a hijab while meeting with representatives of the Muslim community at Canterbury Refugee Centre in Christchurch. “I gave it really little thought, it was so obvious to me that it would be the appropriate thing to do…What I underestimated was that it gave people a sense of security. It didn’t occur to me for a moment that there would be those women in the community who felt unsafe, wearing, so obviously, their faith”, she said. A New Zealand imam, Gamal Fouda, responded to this simple act: “Thank you for holding our families close and honouring us with a simple scarf”.

This act has been backed up time and time again over these past two weeks. By people turning up to stand in protection and solidarity of those praying last Friday. Through people showing care by reaching out to those they know and meet – expressions of grief and loss, hugs, flowers. Donations to Victim Support and gifts to foodbanks – there has been an outpouring of love and care. When the question is ‘what can I do in the face of such horror?’, it turns out the answer is a lot.

These things – turning up, offering flowers, giving someone a hug, sending messages of love – can feel tiny in response to events like this, but they aren’t. For me these glimmers of hope and care offer people who are overwhelmed far more than the act itself belies. I have been musing, following a brief conversation on Twitter, about whether the term ‘little things’ belittles the importance of these acts, and therefore the focus they receive from the powers that be (I’m paraphrasing here). I think calling them ‘little things’ or ‘small acts’ can take away from the power they have to bring light into dark times but I also think that there is something empowering about knowing that I can make a difference with something small within my gift as a human, like a smile, a hug or a message of support.

Over the past weeks, for a variety of reasons including Christchurch, I have received beautiful messages of love and support and these have felt far more important to me than a few words sent in a moment. They have given me hope, made me feel loved, reminded me I’m not alone, encouraged and supported me. These acts of humanity, of solidarity, have such power in healthcare, and life generally. An act may feel small to the giver in that moment, but be so important for the person, or people, receiving it.

In healthcare we meet people who feel overwhelmed by the circumstances they find themselves in all the time – both people using services and those providing them. I think, perhaps, we underestimate the power of a message of support, of a smile or a hug, of allowing space for the emotion. Finding ways to say “I am here with you in this” can only help us care for each other better.

 

Fiona McKenzie is a patient and runs He Tangata Consulting.

Background

Hello, my name is Chris Pointon (@pointonchris) and I am the co-founder of the #hellomynameis campaign and husband of the late Dr. Kate Granger MBE. My inspiring wife was a doctor but also a terminally ill cancer patient who was diagnosed with a desmoplastic small round cell tumour in 2011. Her experience on the other side (as a doctor turned patient) resulted in her inspiring many thousands of people across the world through the writing of two books (theothersidestory.co.uk), our tireless fundraising for charity (to date we have raised over £340,000), her dedication to healthcare and the #hellomynameis campaign that we founded almost 5 years ago now.

Her values and beliefs were around how effective communication is key in healthcare alongside the little things that make a huge difference to patient care and recognising the individual as a person and not just an illness – keeping them at the centre of all decisions.

How did the #hellomynameis campaign start?

The campaign came out of a hospital admission that Kate and I experienced in 2013. It became apparent after quite a few which was really getting to Kate because she was feeling quite low and her pain was increasing. When we talked about it that evening and Kate was moaning about it somewhat, I just said to her, “Darling, stop whinging and let’s do something about it”, let’s use your social media presence and come up with a campaign – let’s call it something like ‘#hellomynameis’ – and it was born.

Kate already had a large Twitter following, so we felt we could use the power of social media to get the message out. At the start, we thought this would be a two-week, two-month, or maybe six-month phenomena. But look how far it has come! We now operate in over 20 countries across 6 continents and receive many plaudits across the globe for a simple campaign that has revolutionised global healthcare

The campaign probably shouldn’t have been needed in the first place as many of us think we’re courteous and communicate well, but if you stop and think about it, maybe we aren’t. That’s why this campaign continues to be so important for health care and wider industries across the world.

Why is it so successful?

It takes very little time to do, helps build trust and is the start of a therapeutic relationship between 2 persons – common courtesy really.

The amount of uptake from the very start, within the NHS first and foremost, then across the world has been unbelievable. My ambition now is to keep spreading the message across as many health care and other establishments as I can, making sure that organizations embed the change into their culture.

But change takes time

It can take several months, if not years, to embed change into an organization, but such a simple change with such a simple message can have a huge impact. I think that’s why so many organizations have chosen to make this part of their culture, to add it to their office signature, or make it part of their name badges. The campaign is about people who are willing and wanting to connect with patients in a meaningful way.

Kate’s Legacy

Kate died in July 2016 on our 11^th wedding anniversary however the legacy she leaves is immense and includes various awards across the world named after her to recognise individuals and teams that exude compassionate care and really live and breathe the values that Kate stood for.

Despite the adversity Kate still created an amazing legacy that will be here for not just our generation but for many generations to come.

Thank you

See more on hellomynameis.org.uk or @pointonchris on twitter

We started Little Things TLC in 2016; a group of us passionate about person centred care. We felt that it is often the little things that make the biggest difference. We published a few blogs and saw a little bit of reaction on Twitter, but it is fair to say we did not manage to generate any waves or rock any boats! Work and life then took over, with all of us moving jobs and roles, and whilst every so often we would mention Little Things we did not quite have the energy or time to take any action.

However, our ambition has been relit! Last month I heard Chris Pointon, widower of the late Kate Granger, speak at the Royal College of Occupational Therapists annual conference. He gave a moving speech for which he truly deserved the standing ovation he received. He started at the beginning, about when he and Kate met, their normal and happy life, until her diagnosis in 2011. He spoke about the new turn in the road in their journey and Kate’s determination to make a difference to patient lives as a result of her experiences – both to the patients she treated as a geriatrician and to many thousands the world over through the #mynameis campaign.

Chris spoke about legacy and core values. He showed a video of Kate talking about her core values and it got me reflecting about my own…

 

Empowerment

I believe that our focus with patients should be on empowerment; on enabling them to take control of their situation or condition and focus on the things that are important to them. As an occupational therapist, I believe in helping people to help themselves; enabling and equipping them with techniques and tools to self manage and be able to do the things that are important to them. This value was re-emphasised during my involvement in the #imstillme research where older people told us that they do not want to be defined by diagnoses, they want to focus on doing the things they want to do, even if they need help to do them, and even where they know there is perhaps an element of risk such as having a fall. It is the need for choice and control that is important to them.

 

In my current role in Quality Improvement, we equip our staff (and increasingly patients) to make the changes they feel are important in their part of the system in order to achieve the improvements that they want to see and which motivate and are important to them. I truly believe in this bottom up approach to change- that it is our patients and our staff who are the experts in the system; they know exactly what works and what doesn’t, where the inefficiencies lie and what improvements could be made. Where we have had to focus on an organisational aim and have a clear idea of WHAT we need to focus on, we involve our staff and teams to help us work out HOW to do this and empower them to make the changes they feel will work in their area. This motivates and energises staff- so change does actually happen- and usually has the traction and sustainability that top down initiatives rarely have. At our graduation days, staff who have participated in the Quality Improvement programme describe this feeling of empowerment, of focus within their roles and increased job satisfaction. It is great to see successful project outcomes, but this change in how staff feel, about their empowerment, never fails to move me and make me feel proud of the approach that we are taking.

In my leadership roles I try hard to collaborate and involve people- implementing my ideas, by myself is not leadership. I think good leadership is about collaboration, engagement and empowerment of others.

 

The little things

In my clinical practice I have always tried to be holistic and person focussed. This requires understanding patients backgrounds, values and goals. We are never going to motivate someone with rehabilitation, which can be hard work and painful, if we don’t understand what someone wants to achieve. Developing this therapeutic rapport sometimes means engaging in some personal conversation, it sometimes means breaking from protocol slightly, it sometimes means doing something that is not in your official job role. But it is often these things that mean the most to patients; a smile, a few minutes listening, making a cup of tea, tuning their radio…. We need to remember as health and social care professionals we may be the only person someone sees or talks to that day.

I try to follow this in my personal life as well; not always so easy, especially in London where it is often ‘survival of the fittest’ or you just wouldn’t ever squeeze into the tube carriage during rush hour! But again small moments- a smile across the tube, giving a pregnant woman your seat on the train, a thank-you to the new member of staff in Pret struggling with the till, letting someone go before you in a queue because they’re obviously in a rush to catch their train, letting a car out before you at a busy junction…

I have a sign inside my front door which says ‘be the reason someone smiles today’. If we all tried to make one person smile in I busy lives, the world might be a slightly happier place. And often all it takes is a little thing…

In my Quality Improvement role again we stress the little things- the need to start small with tests of change. To try something out with one patient, one clinic or on one day. Starting small in this way lets us be brave, creative and timely with change and improvement. We then look to gradually scaling them up so that these small tests of change lead to large scale, sustained improvement.

We find that many of our staff need some reassurance of this. They often have big ideas and need to be convinced that starting small can lead to big change despite the growing body of evidence that it can!

 

Forgive me, I have perhaps gone off topic! I started by reflecting on how we had let Little Things fall by the wayside. Hearing Chris speak and my subsequent reflections, has made me realise that what we are trying to do with Little Things is too important to let this happen! In our busy lives we sometimes need reminding of what is important and what not to take for granted. Perhaps this blog will remind you also and make you reflect on your values, and what little things you can do to live those values. It can be difficult to generate those big waves, but if we all rock our boat a little bit we might just make a big difference.

 

 

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

 

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 31^st 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