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.


Fiona McKenzie, Deputy Director, UK Improvement Alliance


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. @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:


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_m_7 #uclpeolc


What matters most to older people – it’s the little things!

I’m Still Me
Last year UCLPartners published ‘I’m Still Me: a narrative for co-ordinated support for older people’ in association with Age UK and National Voices. Our research included interviews with 74 older people about what was important to them in their lives. The main themes to arise from the research related to independence, community interactions, decision making and terminology. The full report can be viewed here.
We hope that the report will challenge health and social care services and professionals to reflect on the services that they provide and whether they are in fact truly meeting the needs of older people. I conducted many of the interviews and despite having worked with older people for most of my 20 year career, the findings challenged many of my assumptions about what is most important to them. For the purpose of this blog I am going to focus on what older people told us matters most to them regarding the care and support they received – because it is all about the little things!
We asked people what had been good or what could be better about the care and services that they had received and almost all of the answers related to the social relationships with those who delivered the care rather than the care itself. For example, ‘I’ve had my carer for years, she’s like one of the family’, ‘my carer doesn’t have long enough to speak to me’ or ‘I have a different carer every day, I don’t feel I get to know them’. Very few people commented on the actual care that they had received – rather on, whether they had a relationship with the professional and how that had made them feel.

Remembering the ‘little things’
Everyone working within health and social care is busy – our caseloads are usually too large and we always have 101 things to do! But we all chose this career path because we wanted to help people. We need to remember this and think about how we treat people and how our actions make them feel.
Often this does not take any more time.
It can be as simple as thinking about how we refer to someone: one lady said to us ‘I like to be known by my name and not that old woman’.
It can be as simple as remembering a personal detail, asking after a relative, or commenting on last night’s Coronation Street if you know they are a fan!
It can be as simple as listening. A patient recently was describing severe, and as yet undiagnosed, pain to me and I said that I wished I could do something to help. She replied, ‘you’ve listened to me and that is enough’.
It can be as simple as remembering someone’s birthday. In my last blog I mentioned that I was in hospital on my birthday earlier this year and was greatly cheered up when the nursing staff brought me a birthday cake! I would like to think that it also cheered up some of the staff and other patients who were lucky enough to get a piece! But it was not about the cake – it was about knowing that someone had taken the time at handover to remind staff that it was my birthday and not to describe me only as the woman who had surgery on both feet. Every single member of staff who saw me that day wished me happy birthday!

‘I like the company of the carer coming into my home and I feel she’s part of it now…I wish she had more time’

‘I miss social interactions. I don’t mean going out…I mean having a good conversation’

We need to think of every patient contact as a social opportunity because that is how they see it – for them we may be their only social contact that day. So whilst we are doing what we need to do, we can engage in some social conversation and make someone smile, make them laugh, make their day slightly more bearable and make them feel that someone cares for them.

‘Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.’

Leo Buscaglia

Laura Stuart is frailty programme manager at UCLPartners and an occupational therapist by background. @laurajstuart