GoodHealth

SUMMER 2010 | News from NHS Health Scotland, Scotland’s health improvement agency

A helping hand for carersNew DVD resource launched

NEXT

coNteNts

Dementia

2-3 the first worD / snaPshots

news and events round-up

4-5Graham roBertson

Looking back… and forward

6-7Dementia DVD

Practical resource for carers

8i Know this mUCh

shirley windsor

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sNapshots

www.healthscotland.com

as you will probably have noticed, this is the first electronic-only edition of all in Good health – a change made in response to readers’ readiness for a more environmentally-friendly format, but which also helps us to save on print and distribution costs. other benefits include increased interactivity, with links to more online material and easy-to-navigate contents and internal links.

this issue’s cover feature showcases a new accessible DVD for carers of people with dementia. caroline Brown (see p.7) shares her experiences of caring for parents with dementia, and explains why the DVD will help others in the same position. on p.4, meanwhile, outgoing chief executive Graham Robertson shares his thoughts on the changing landscape of health improvement and the challenges ahead.

as always, we welcome your feedback so do get in touch – and please recommend all in Good health to any colleagues who may wish to subscribe.

peter Watson (left) and Iain Radcliffeeditors

NHS Health Scotland is the national resource for improving health and reducing health inequalities in Scotland.

All In Good Health is published quarterly by NHS Health Scotland.

Editorial & design by: White Light Mediawww.whitelightmedia.co.uk

© NHS Health Scotland. All rights reserved. Material contained in this publication may not be reproduced, in whole or in part, without prior permission of NHS Health Scotland (or other copyright owners). Whilst every effort is made to ensure that the information given herein is accurate, no legal responsibility is accepted for any errors, omissions or misleading statements.

In the battle to improve health and reduce health inequalities, community-led approaches are increasingly being seen as a valuable weapon. the review of ‘equally Well’ – the Ministerial task force on health inequalities, which was published last month – reiterated the importance of working with community and voluntary groups to engage with communities. It is therefore a good time for the ‘Healthy Communities: Meeting the Shared Challenge’ programme to come to fruition.

This Scotland-wide programme was funded by Scottish Government, managed by NHS Health Scotland, and delivered by the Scottish Community Development Centre (SCDC). It came to a formal end in March after

supporting local development groups – which brought together NHS and local authority staff with community and voluntary organisations – to plan for and implement community-led approaches. Methods like ‘Social capital in communities’, and ‘Co-production’ provided the framework for looking at how community members and public sector bodies can work together to commission services. Wider programme activities included conferences and seminars, training, building links and networks, and case studies of successful community-led projects.

The initiative has left a rich legacy of learning and experience, and a programme of continued learning, including resources and the popular ‘Engage’ newsletter are ongoing. Details are available from the NHS Health Scotland website www.healthscotland.com and the SCDC website www.scdc.org.uk

Better together

email us

visit our website call us0131 536 5551

write to uspeter Watson / Iain Radcliffe Nhs health scotland, Woodburn house, canaan Lane, edinburgh eh10 4sG

contact:

The first word

Nhs health scotland’s health Risks at Work working group has been awarded the 2010 safety award from the British safety Industry Federation (BsIF).

the award is made each year to recognise excellence within the safety industry, and especially innovation, leading customer service and the promotion of occupational health and safety.

the health Risks at Work initiative supports small and medium sized organisations to identify health risks and take steps towards protecting workers.

‘heaLth risKs at worK’ haiLeD

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sNapshots

‘scaLING’ the heIGhts at hIGh FRequeNcy

an Nhs health scotland specialist has set an unusual record by becoming the first person to set up a radio station at the top of one of scotland’s most challenging mountains.

Colwyn Jones, Consultant in Dental Health for NHS Health Scotland, not only conquered the Isle of Skye’s Inaccessible Pinnacle for a second time, but celebrated the achievement by setting up an aerial and broadcasting from the summit.

Colwyn achieved the unique feat with his climbing partner Adrian Hart, a Consultant Orthodontist. Adrian belongs to a select group of enthusiasts who combine the dual passions of hillwalking and amateur radio.

Reaching 3,235ft (986m), the Inaccessible Pinnacle is one of Scotland’s 283 Munros and the only one which requires rock climbing skills to get to the top.

april saw the 18th International health promoting hospitals conference take place in Manchester, with the theme of ‘tackling causes and consequences of Inequalities in health’.

Health Scotland showcased the best of its work in a hand-out CD of electronic resources, which included leaflets, briefing papers, various publications, posters and useful links.

Please click on the link below to read a summary report that collates key learning shared by the 18 Scottish delegates to the conference.

View summary report

HPH conferencesuccess

congratulations to Dundee city council, who took the award for ‘tackling health Inequalities and Improving health’ at the recent cosLa excellence awards.

Sponsored by NHS Health Scotland, the honour recognises local authorities who play an inspiring role in reducing health inequalities, and was awarded to Dundee City Council for their Peer Education Project. The initiative is based around peer-led action to increase young people’s awareness of drugs and alcohol, and to help them make positive life choices.

NHS Health Scotland also exhibited at the concurrent COSLA conference, helping to ensure that improving public health remains at the forefront of the local government agenda.

pRoMotING exceLLeNce

the inaccessible Pinnacle on the

Cuillin ridge, isle of skye

NHS Health Scotland’s Annual Review will be held on 7 september 2010 in Thistle House, Edinburgh.

DateTOnote

www.healthscotland.com

For more information, contact Duncan Robertson at duncanrobertson@nhs.net

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GRahaM RoBeRtsoN

Much has changed since Graham Robertson took up his first appointment as a health education officer in 1978 – and not just the disappearance of curly perms and platform shoes.

“It is now widely accepted that social determinants have an impact on the health of our communities, and they are an important factor in how we set about health improvement,” Graham says. “In the past, however, while people working in healthcare knew that redressing health inequalities was vitally important, it was difficult to articulate that idea explicitly. People would talk about‘variations’ in health, rather than inequalities.”

Today, engaging with disadvantaged communities to tackle health inequalities is firmly established as a key health priority. And, since Graham became its first Chief Executive in 2003, NHS Health Scotland has grown and developed to become a large, joined-up organisation that works with a diverse range of partners – in local authorities, in central government, in the community and voluntary sector, and within the NHS – to deliver a wide variety of health improvement programmes across Scotland.

Now, as he prepares to leave the post, Graham outlines what he believes will be the challenges of the future.

Looking forward

After 32 years service within the NHS, NHS Health Scotland’s Chief Executive Graham robertson is stepping down.

He looks back on his career and outlines the challenges ahead

www.healthscotland.com

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GRahaM RoBeRtsoN

Another ongoing challenge is the inevitable convergence of politics and policy. “Health improvement is about politics. Wherever individuals are involved, politics are involved – there is no escape from that,” Graham concedes. “Unfortunately, there is an extent to which the adversarial form of politics can hinder our achievement of public health goals, if people are tempted to score points by undermining well-intentioned policies.”

A bright forecastYet while the gloomy economic climate and threat of financial cuts is an issue that concerns many, Graham is optimistic on this point.

“There are people who, understandably, are concerned that funding for health improvement initiatives could suffer as a result of the downturn,” he says. “However we are in a stronger position than we have been in the past, because the value of these initiatives is well recognised – and not only by practitioners and researchers, but also by government. That

is very important. Our work is vital part of achieving our health targets for Scotland. And an important part of our role now is to make sure we can demonstrate that.”

One key to achieving success, Graham believes is better “systems knowledge”. “I have become more and more convinced of the importance and need for theories of organisational change and management,” he says. “An understanding of how systems work is central to what we do.”

So, as Graham prepares to take a bow after a career spanning three decades, and which has culminated in his appointment as a Fellow of the UK Faculty of Public Health, what does he feel has been the highlight?

“For me, it’s got to have been the people I’ve worked with,” he says. “I don’t know what it is, but we always seem to attract hugely intelligent, committed and analytical people, who are committed to the cause and who all share a strong ethic of mutual support. I have been constantly proud of the commitment and dedication shown by our teams throughout my tenure, and I am sure that the organisation will continue to have an important impact in improving the health, and quality of life, of people across the country.”

“Evidence has always been important when it comes to making policy: you have to be able to back up ideas with proof they will work. That goes without saying. But here’s the rub. If we’re dealing with age-old problems – such as smoking and alcohol – then clearly the programmes we have been running haven’t been working for everybody. So what do we do next?” He explains: “I believe we need to find new ways of working to reach those who are switching off. Sometimes this is about coming up with ideas for which there may not yet be any hard and fast supporting evidence – using creativity and innovation and taking a considered, calculated risk, based on our knowledge and experience. This applies, for instance, with some of the

work we are currently looking into as part of our social marketing behaviour

change initiatives – taking quit smoking sessions to

tower blocks and setting up clubs for

young mums.”

www.healthscotland.com

Lasting legacy: some of the campaigns launched during Graham’s tenure

Graham will be wearing a different hat soon… managerial consultancy while catching up on running and hobbies

Around 71,000 people in Scotland today have a diagnosis of dementia, and that figure is expected to double over the next 25 years. The majority (63.5%) of these are cared for in the community, often by their own relatives, and for some this can be a difficult and isolating experience.

To help support those caring for someone in the middle to late stages of dementia, therefore, NHS Health Scotland has worked in partnership with Alzheimer Scotland to produce the resource – ‘Coping with dementia: a practical DVD for carers’.

“It’s first and foremost a practical resource,” says Fiona Borrowman, NHS Health Scotland Health Improvement Programme Manager. “However, the psychological support it provides is also key, because caring for a loved one with dementia is an exhausting journey that has a huge emotional, physical and mental impact that really can’t be underestimated.”

The DVD will help carers understand dementia and learn from other carers’ experiences. It also provides practical suggestions about caring, including advice on how to deal with challenging behaviour, money and legal matters, and coping with loss and bereavement.

The DVD format was chosen to make the information as accessible as possible, as Fiona explains. “It’s based on a publication which we have been producing since 1995, which has received a lot of very positive feedback from both family carers and care home staff,” she says. ”The DVD builds on that success, with the new format designed

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the recent launch of the scottish Government’s Dementia strategy has reinforced dementia as a national priority in scotland. we take a look at a new DVD that offers help and support to carers

to be particularly accessible for carers who may have limited language or literacy skills, or who may have sensory impairments or learning disabilities.” One of the key features of the DVD is that it was developed in partnership with and features carers from a range of backgrounds, ethnic groups and ages, who were invited to workshops to share their views on what information they would like to see included.

Fiona comments: “The voice of carers is absolutely key. The content of the DVD has been fine-tuned and adapted according to suggestions made by our carer workshops, and we’ve included a lot of interviews with real-life carers – ordinary people, who talk about their different challenges and share their experiences.

“The main message we really wanted to communicate through this DVD is: ‘You don’t have to go through this alone – there are people and organisations out there that can help.’”

DeMeNtIa

supportingcarers

Fiona Borrowman

www.healthscotland.com

Caroline Brown and her family care for her parents, who both live with dementia. her mother was diagnosed with alzheimer’s disease four years ago, and her father was diagnosed last year with vascular dementia.

“When my mum was diagnosed, I felt completely isolated and cried every day. It changed some relationships, as others couldn’t understand, and I felt really on my own. I didn’t think there was any information or support out there, and I struggled with absolutely everything.

I understand much more now, and I recognise that, for me, it is an ongoing grieving process. But in the early stages you just feel so lost. You don’t really know what Alzheimer’s is, and you’re not sure if you want more information, because that somehow makes it seem too real. And even when you are given advice, you’re so emotional, and exhausted, and so desperately sad, seeing these changes in this person you love, that you just can’t retain it. It’s like you’re coming through a kind of fog.

What’s good about the DVD, therefore, is that it’s broken down into different chapters, so you can access the information in different stages, and, importantly, when you feel ready for it.

It’s also important that you can see and hear real carers talking about their experiences. One of the most difficult things to deal with when caring for someone with dementia is the sense of isolation. When you realise that other people are going through something similar it seems somehow to take the edge off the pain. It helps to hear other people, and to realise that you’re not on your own. And that authenticity really comes across in the DVD – a different kind of empathy that comes from someone who knows what it’s like.

I watched the DVD with my husband and when I asked him to give me his feedback, he just said: ‘I wish we’d had this four years ago’”.

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it’s like you’re coming though a kind of fog…

Coping with dEMEntiA – a practical dVd for carerscan be ordered for free from the Alzheimer Scotland 24-hour Dementia Helpline – 0808 808 3000.

watch online Download Coping with Dementia PDf

Caroline Brown, one of the many carers sharing their experiences on the new DVD

DeMeNtIacase stuDy

www.healthscotland.com

Shirley WindsorI know this much:

I KNoW thIs Much3. Giving and receiving praise can be upliftingIt is human nature to focus on the negative rather than the positive. And when we get positive feedback, it is sometimes hard to accept it on face value – it’s something I have been guilty of in the past, and which I blame on my Scottish psyche! Nevertheless, giving praise really does encourage the recipient to ‘go the extra mile’ next time around, and it works for people of all ages (including little ones), at work, at play and at home.

4. work – life balance is possible Those who know me will now be doubling up with laughter or raising a quizzical eyebrow – but read on! Some years ago, I would have been the first one in the office and the last one home, but then came the pitter patter of tiny four-legged feet. There is nothing quite like the demands of a six-week-old puppy to drag you away from the computer, TV or workplace. And it doesn’t change over time, as you still need to go out for ‘walkies’ in all weathers. But then please don’t follow me, as you may well hear me shouting in the background – as I’m composing that email or taking part in that phone discussion – “Heel!”, “Come back!” or “No, not rabbit chasing again..!”

5. if you wait long enough… …things will come round again – reorganisation, revised computer systems, mini skirts and paisley patterns, to name just a few examples.

8

1. People can still surprise me No matter how well I think I can read people, they still always come up with the unexpected. Whether that’s in relation to a creative visual, a suggested way of working, or even how to make a decent cup of tea, there is always someone who says something totally different to what I have heard before – and which usually makes me smile!

2. You will always make an impact Your actions will have an impact, no matter how small, on what goes on around you. Equally, knowing what your spheres of influence are (for all initiates of Dr Covey) can help your wellbeing. Why worry about something that is totally outwith your control when you cannot influence the outcome? Once I understood and put this into practice, it felt like a huge weight was lifted from my shoulders, and now I can concentrate on what really matters.

Health Improvement Programme Manager Shirley Windsor shares five of the most valuable lessons she has

learnt over her career so far

there is nothing quite like the demands of a six-week-old

puppy to drag you away from the computer”

www.healthscotland.com

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