EdgeTalks, March 3 2017, Transcript

NHS IQ Webinar (UKNHSI0303A)

SPEAKER: We have two presenters today. Let's go to the first slide.

If you are joining for the live session, you can contribute to the session, or you can tweet using the hash tag #EdgeTalks.

We also have a Facebook group which is great for change agents. Feel free to join that. So, let's look at who is in the team today. Today, we have got Louis monitoring the chat. I will be your session chair, and then we have Paul behind the scenes who is supporting us with the technical aspects of running WebEx. Thank you all for your help today.

We are really thrilled to have our two presenters today. I met Pip Hardy from Patient Voices about three years ago, and I have learned so much from her. We also have Karen who works for Staff Experience in NHS England.

This has been such a fantastic piece of research that they have been doing and I really thrilled to have them both here today to be sharing with us the importance of sharing staff stories and developing the improved care. I would like to hand over to Pip now.

PIP HARDY: Thank you. Good morning everybody, it is lovely to be here. Doing this talk on a rainy Friday morning. We thought we would just start off with introducing ourselves very briefly before launching into the rest of the presentation. We probably don't need to say very much more because Kate has done such a lovely job of introducing us. Karen, you may want to say something.

KAREN DEENY: Thank you, Pip. Good morning. It is an absolute pleasure to be able to join Pip, Kate and the team today. Just very briefly, I wanted to say, at this point, that the staff experience work programme that I am leading is within the patients' experience team at NHS England as I hope that we work through our slides today, the significance will become very clear. This is very much about the interface of staff experience and patient experience. The whole program is about that and specifically the DNA of care relate strongly to that. Before we move on, I just wanted to ask Damon Canning to take the opportunity to introduce himself. Damon is one of the very special people that made a story, a digital story as part of the DNA of care program and we are delighted that they have been able to join us today. If I can just ask Damon to introduce himself before we go on with the rest of the slides. Damon.

DAMON KAMMING: Thanks, Karen. I am Damon Kamming. I am a consultant anaesthetist and have been for 11 years at UCLH. I had the pleasure of working with Pip, and I was happy to have an opportunity to listen to each other and learn from each other. I am delighted to be here. Thank you.

KAREN DEENY: Thank you, Damon. I am delighted that we will hear your story in your presentation this morning. Could we have the next slide. Thank you. With the, why we are here today and what we would

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like to share with you. We want to give you some background about the DNA of care project and we want to talk about the potential of digital stories and what we have learnt through them, particularly about how they reveal really important truth about the staff experience and the essence of those experiences. We want to share some of the stories with you. We would like you to hear from some of the storytellers. Damon is with us today and making recordings to share. We would also really like to inspire you to share your own stories. The next slide. The essence of why this is so important.

Staff experience absolutely drives patient experience. I have just lost my slide but focusing on that, it is absolutely the most important thing for the system to do. We have tended in the past to focus either on staff experience or on patient experience separately. And they really important move for it to make as a health and care system is to focus on the interface, the interface of staff and patient experience.

Lots of you will be familiar with the work of Michael West. That evidence is very strong that employee engagement is just the best predictor as NHS outcome. Nothing else is as affect live in gaining outcomes. We have known that for some time. What is really important now is to work in ways that really respond to that evidence. And take it very seriously. The DNA of care is one example of that. Put simply, as in this graphic here, that captures a conversation, I have an Expo last year with one of our patient leaders. His patient experience and staff experience put simply are two sides of the same coin. We really need to understand what matters to patients clearly but also what matters to staff. It is very difficult to see both sides at the same time. Very important to that the coin to look at patient experience and staff experience, pay attention to both and recognise that they are inextricably linked.

Even more simply, from Michael West. Just so clear that the staff and patients need care, compassion and respect. This is not a staffing or a patient thing, it is a people thing.

And also learning from Kenneth Schwartz, the inspiration behind the Schwartz brand. He said something very powerful at a time when he was at the end of his own life. And particularly brought to our attention the importance of patient experience and their interaction with staff when staff reveal something about themselves. That makes a personal connection with that patient. Kenneth recognise when he said this that some of the rulebooks may frown on that kind of very intimate and close arrangement between those delivering care and receiving care when the staff reveal something of themselves. Their experiences, their feelings. I think Kenneth asks a really powerful question when he suggests that it is maybe time to rewrite the rulebook and start, think, and act different. A good story and this presentation today will be very much about stories. A good story is so much more than simply a good story.

Certainly, the digital story that we will share with you today are precious opportunities for learning, for reflection and for transformation.

I think at this point I'm going to hand over to Pip and Pip will take us through the next three sides.

PIP: Thank you, some of you may know the work of Cotter and Cohen. They wrote a book about the heart of change and what they really found, the most important thing was that we need to speak to people's feelings if we are really thinking about change, but if we have all the data in the



world, if they are not feeling something, change may not happen. Change has got to happen at an individual level before it happens at an organisational or social level. People's feelings are an important aspect of change. One of the things that stories and this is another work from René Brown, she does a lot of research about the vulnerability and courage and the links between the two. She talks about stories being data with the soul. Consider stories as a different kind of data, a kind of data that can complement the data that is presented in statistics and graphs and charts and so forth.

We started the patient program in 2003 because we wanted to offer a kind of different data because what seemed to us and Tony Sumner is my colleague and patient with us is that statistics tell us that the experience of the individual but we need stories to tell us about the individual pars experience of the system. For us, that has been a really important part of why the process is important. This is probably the other most significant reason that we feel that stories are important, there are so many people engaged in a massive enterprise of healthcare who are waiting to be heard and who don't have a chance to be heard because one of the hardest things in life is having words in your heart that you are unable to talk about, feelings that you are unable to express.

With patient voices, will were very clear from the outset that we did not want to his stories only from patients although, of course, that is very important and back in 2003, it was even more important. We wanted to hear from all of the people involved in healthcare that were waiting patiently to be heard and the digital story format, as you will see gives people a wonderful opportunity to be heard and seen, these are the words that matter to them. All of the ideas and questions that might matter to the researcher or the consultant or the interviewer.

Moving along to 2015, if you years after patient voices had been going. We had done work with NHS England, actually with people with a learning disability and we worked with them to create digital stories and they are being used in education and training and so forth and Mia Churchill, the head of patient experience said, would you be interested in doing staff stories? We left at the chance. It has always seemed to us that the staff experience and the patient experience are as inextricably linked and we need to listen to the stories that will connect all of us in order to learn the important lessons that are necessary to provide the best possible care. So, we ran five workshops, we were hoping to get a table to each workshop but as inevitably happen, people got easy at the last minute all the children were sick or we were sick but we still had 33 storytellers which is a good number. One ambitious person had 82 stories and what they told us about was that the workshop opportunity provided them a chance to reflect, to gain insight into their own experiences as well as the experiences of other people to connect with one another and also offer to connect with the reason that they went into health care in the first place and for many people, it was an opportunity for personal healing. I just wanted to tell you a little bit about what happens in a storytelling workshop.

It is not really quite like anything else. They take over three days during which time people have an opportunity to share their ideas and stories and they work really hard to find those ideas. 200-300 words. That is approximately 2.5 to 3 minutes. That coincides with the 21st-century attention span. People get bored after three minutes and start looking out of the window. It is a story that takes a considerable amount of work to hang your ideas down to a relatively small number of words. Because people use pictures as well, you can actually say more, of course, with pictures then you can with words.



These are just a collection of pictures from the workshop but what I wanted you to see was the complete absorption of people working, how diligently they are looking at their laptops, thinking about their scripts so we then, if people may bring along pictures that they want to use and we scan them and have them on memory sticks, we show them how to use digital video editing software so they can actually put together their own video so, having recorded their voice-over and identify what images they want to use, they basically get to play with really cool software to make their own movies which the many people is really empowering but I think the important thing for us is that it means that the storyteller gets to tell exactly what they want to tell and once they are happy with that, we won't edit it or chop it up or change it.

Interestingly, when we fed the scripts into Wordle, the most used word was patient, which I think is a lovely tribute to their commitment indication to the people whose stories we were hearing.

We would like to show you a story by Natasha Curran, an anaesthetist and pain consultant. We will show you her story, and she has done an audio recording, just to tell you a little bit about her experience, so here is her story.

NATASHA CURRAN: I thought I was invincible. I regularly cycled 60 miles a day. I climbed Kilimanjaro in three days. I was never sick and worked hard.

The nurse asked me if I was OK. I couldn't find words. I said I was having problems sleeping, slurring. "Your speech?" The consultants were worried. I entered accident and emergency for the first time to the customer's entrance. I couldn't be having a stroke, could I?

By the time I left, I knew that it wasn't. It was a migraine, but I couldn't do anything. I couldn't read, write, go outside, watch television. Everything irritated my brain. I couldn't sleep, remember names, find words, type. For the first time, I understood what it meant to be a patient. One has to be patient.

Three weeks later, I went back to work. The next six months were pretty hideous. Nausea, headaches, not feeling like myself, not being able to do the things I had always done and wanted to do.

I have a lot of patients who are very happy on a small dose of amitriptyline. I didn't want to take the medicine I prescribed routinely for my patients. I didn't want to be ale or thought of as ill.

One evening, I phoned my friend Polly. "There is this tablet that might help but the side-effects might mean that you won't be able to do your clinic tomorrow. But you feel so awful that you would come in anyway."

She said we should take it anywhere and see how I felt. This was when I admitted I was a patient. I swallowed my pride and the medication. The next day, I felt so much better. Over the next months and years, I develop strategies to manage migraine. I have learned several compassion-based meditation practices and it was a surprise to realise that the person I needed to be most compassionate with was myself, then my colleagues.

I had always listened empathetically to my patients, but maybe I took some of their pain. Slowly, gingerly, I realised I could share my personal experience with patients; when they feel reluctant



to take medication, when their sense of self is challenged.

Gaining awareness and an ability has maybe more resilient and caring, better than invincible.

I recently cycled 60 miles a day through Myanmar. I haven't taken Amitriptyline in three years. I still have my medication in my cupboard, just in case.

PIP: So, I hope you liked that lovely story that Natasha made. This is her, a very beautiful picture of her, and I will play the audio that she recorded because she wasn't able to be with us today.

NATASHA CURRAN: My name is Natasha and I work as a consultant in anaesthesia in London. I recorded this short piece. I apologise for any poor sound quality as I am recording on my phone, rather than a nice studio.

On a personal level, the process of making a story and making it public… I did feel vulnerable at first, just like in my story. Increasing my vulnerability actually increased my strength and resilience.

When I was unwell, I thought people would think I was weak, but the opposite has happened. People have told me that my story has resonated with them, that they have had a similar experience, and that we needed more often about looking after ourselves.

Damon and I shared other stories. There were a lot of misty eyes that day; they really touched people. Now my story has been used in a mindful compassion course.

I was also able to crystallise the inextricably linked relationship between patients and staff, and I was able to tell the work of a pilot project I had set up, the complex pain team. We will have 15 stories of patients, the team and other staff members who have been affected by our work.

I have been told that the way I modelled being open and nonhierarchical in my original story enabled some really transformative stories. It felt great to co-create this, and I really look forward to seeing any changes that might result.

They do very much for listening to me this morning. I hope you have a lovely day.

PIP: so, thanks to Natasha. We would love to hear from any of you now who have questions or comments. Unfortunately, Natalie is not with us, but we will try to answer your questions. I guess there are enough of us that if you would like to ask a question, you could unmute yourself open to question in the chat box.

Any comments or thoughts? I am seeing some things in the chat box. People are finding this quite powerful, but I wonder if you have any more comments.

MEL SMITH: Hello. I am partly crying, partly smiling, just finding this really fantastic. I love the digitalised aspect of the stories. I do sometimes wonder… Not everyone finds it so comfortable to be so



open and nonhierarchical, and some people find this very uncomfortable. How do we combat that?

PIP: Karen and Damon, you have been through the process. Would you like to respond?

DAMON KAMMING: Part of the process is that Pip and Tony gently supported us and we felt very safe. We were encouraged to be fearlessly vulnerable, and that vulnerability is where the real power is, I think. You can't get that without the loving nurturing environment that Pip and Tony were able to provide.

KAREN DEENY: I asked Pip how I might be able to understand, and if she could explain more to me about making a digital story, and she responded that there was no way of explaining it and I would have to participate in a workshop, which was absolutely right.

I completely echo Damon's thoughts about the nature of the workshop, and I guess, having no share my story with colleagues and listening to Natasha's account and others, what it is that might perhaps enable others to feel braver about sharing their stories and responding to Kenneth Schwartz'message about not hiding behind our professional selves and connecting more with ourselves, I think it needs more of us to do that.

The more people who do this, the more others have the opportunity to be more comfortable with it. The challenge we have is, as you say, it is new. But everybody is comfortable with that.

MEL SMITH: Thank you for this. Yesterday, I was talking to staff about how we look at the relationship between carers and the staff at respite services, and they are really worried about being themselves. It gives people a bit of a wall to hide behind because it is not...

KAREN DEENY: I agree. We have had patients involved in sharing the stories, and having patients feed back on how they respond, and I have to say, it is enormously positive to have the opportunity to connect on a different level, and to connect us as people.

It would be something for everybody, but we need to open up the conversation and creates a different conversations.

PIP: the other thing I wanted to say is that we do try to make the workshop space very safe. The other thing about the digital storytelling process, it encourages people to tell the story they want to tell. They decide how much they want to reveal. It really is up for everybody.

Natasha went for it and I think it is very courageous, and interestingly, we do have very many courageous stories.

We have people that are prepared to talk about X but not Y. It is important we have a place for people to share themselves.



KAREN DEENY: I agree. And your point, Mel, about people feeling brave. There is really something about how having experienced this kind of story yourself or watching someone else's story, it makes people braver about aspects of themselves to share with patients or staff members. One of the other things that is emerging from this work, it is that staff members work alongside each other, we really know one another. There is a conversation that the stories can prompt. Not everybody might want to make a digital story although it would be lovely, if more and more people did. But I think the benefits of hearing other people share can be a real catalyst for how people think about their professional selves and how they engage with others.

PIP: interestingly, I think similar things, Karen, and David you have been saying, has been echoed, but certainly somebody in the evaluation after the workshop. They just talked about that it takes a lot of guts to share this deeply and not hide behind our professional selves and it is OK to share our stories and hopefully it will allow us to communicate better in the future. I think all of the points you have been making about vulnerability are really relevant and important here.

So, unless anybody else has any particular comments or questions...

KAREN: would you mind if I just had one tiny thing? I was thinking about Natasha's lovely recording and one other point towards the end of that about the way she was using her story and that she really felt that we had the real power to censor messages that a business plan or business case might not be able to connect with and I do that Natasha is trying to use her story and the story that she has gone on to create with her team and the patient in that way to really try to convey to others the essence of what is a team they are trying to achieve. I really want to highlight that point.

PIP: thank you, that is a really important point that the stories can contribute to change and I am getting that Damon may say a little bit more about that as well. Damon, would you like to introduce your story and then we can play your story and you can talk about it afterwards?

DAMON: sure, like many of us here today, I have also experienced life at the sharp and of the needle. As a patient. I thought it would be useful to share my anxious experience as an anaesthetist. And be vulnerable enough to accept anxiety as being a patient and a member of staff. I hope you enjoy my story.

Looking out. There is a lot of snow...

I am three years old. I am standing at the living room window looking out. There is a lot of snow. There is a lot of blood in the snow. There is an ambulance. There is a stretcher, my mum is on the stretcher. She is being carried away. I put my hand on the cold window. My breath misses the glass and my mum disappears. I really want to hug. I am afraid.

My mum was in hospital for seven weeks. My baby rather Aidan born too soon, died after two days. My happy mum was no longer happy. I was afraid. Afraid to ask for a hug, a frayed of



ambulances, afraid of the sound of sirens, afraid of the antiseptic smell of hospitals. Despite this may be because of this, I became a doctor. Accident and emergency where there is a lot of blood and anaesthetic where there is a lot of fear. I travelled around the world try to find a way to make medicine less frightening. Along my journey I personally experienced injuries, hospitals, operations, Scottish teeth, broken bones, and kidney stones.

I'm in hospital, standing over the toilet. There is a lot of blood. I'm afraid. That if I have cancer, how would my children cope? Is is how my mum felt? I am on the CT scan table waiting for the diagnosis. There is a huge kidney stone. I will need surgery. I am afraid.

I am lying on the anaesthetic Charlie. My colleague puts his hand warmly on my shoulder. Don't worry, he says. We will look after you. Then I understood how many of my patients must be feeling. Then I understood how many of my staff must be feeling. Then I finally understood the importance of a kind, reassuring touch.

Now I understand the expense of it as a patient and as a member of staff. Now I am a consultant anaesthetist and I'm not afraid to put a hand on a patient was back shoulder and say, "Don't worry. I will look after you."

PIP: it is so nice to see your story again, Damon. I do love watching your story.

DAMON: thank you.

PIP: are you happy to take questions?

DAMON: I thought I would give a little bit of information about what has happened since the story. One of the things that has happened is there has been a catalysing of different conversations within the organisation and... the strategic corporate objectives have now been amended to include a desire for the organisation to piece the use of patient stories. That may be sensibly influenced partly by the story as a member of staff. This story was spread throughout the organisation on our intranet site.

I think it has just slightly raised the impression that staff, as well as patients, can be anxious. There is a very important drive for staff well-being. At the moment. Certainly, within my department, we have raised this anxiety as a major issue. Certainly for patients but also as staff. It has been very important and quite successful, I think.

PIP: Thank you, Damon. Does anybody have any other questions or comments that Damon might be able to help you with at this stage?

SPEAKER: I'm not sure if there have been any questions posted in the chat box. Maybe Lewis can help with those.



PIP: Good idea. Apart from the huge question...

SPEAKER: Lewis, are there any questions that you have got from Twitter or the chat box?

LOUIS: on twitter a lot of the conversation about compassion and how you have got to be open with yourself and others as well. How the grieving process needs to be open but also safe. That has come from the chat box. Really interesting to see people really are more talking in the chat box then on Twitter at the moment because they are enthralled by what is on the screen. Twitter is a bit quiet but the chat box is really interested to see actual conversations going on. Our thanks to Damien coming in on Twitter as well now. Thank you for telling your story. And how that has helped them as well.

DAMON: I think one of the things I started to realise that conversation influences the culture. Culture is a corporation of conversations. The more we talk about it, the more it improves the culture in the NHS.

KAREN: it's Karen. I love the way you describe the impact of your story as may be slightly influencing the (inaudible). It was like an enormous step forward. I think you raise an important point there and a challenge for the future is to really understand much better about how making digital stories and staring digital stories really works as a catalyst for change and for improvement. Enter really begin to track and maybe monitor some of the journeys and some of the stories. That is something that I think we really, is a challenge for us all to understand that better. I'm sure we won't understand all of it and as the stories begin to move in, in strange giveaways, tracking and monitoring that could be really valuable. I think they are probably even more powerful and even more impactful in changing conversations that we have been able to just be aware of so far.

PIP: Damon, would you mind saying something about other places you have shared your story or other people you have shared your story with and how they responded?

DAMON: I think the biggest impact I had was with medical students. I gave a lecture at their anchor day which is the last lecture they get at UCL before they become junior doctors. I opened the lecture with my story and the feedback from the medical students was profound, actually. They had never seen a doctor being vulnerable before. I think, as an anaesthetist, you have to be very calm and you have to be very self-assured so I think it was very, very useful for the medical students to see that it was OK as a doctor to admit some vulnerability. That was one of the most powerful feedbacks I got from the students. I also gave a talk to school students who are thinking about a career in healthcare. And again showing self compassion and admitting vulnerability I think was very powerful for a school student to think about embarking on a career in healthcare.

These are two examples that really felt very powerful for me as an individual.



PIP: It is really nice to hear that, Damon, especially about medical students. We have actually done some work with medical students as you may know, helping with their own stories and what was interesting about that is that it offers them an opportunity to really think about why they have gone into medicine and to consider the kind of doctors they may become.

I think the opportunity to watch somebody else's story is very profound. And to make your own story is potentially even more profound, I think.

DAMON: I agree.

KAREN: that is wonderful to hear about your courage in sharing the story with students. That is just fantastic example of how we need to think about building in this way of thinking, this way of working, this way of sharing with one another. Actually, on people plasma journey towards the healthcare staff and health care professionals so we are building it in, building it into people plasma DNA as part of the professional story right from the start. PIP: We have about 15 minutes left, and we have one more story left. It is really nice to see people talking in the chat box about building capacity and promoting greater compassion.

I think Rachel's story will also reinforce that. She has suggested that we might play her recording first and then her story. So, here is what she had to say.

RACHEL SCANLAN: My name is Rachel. Pip and Karen have asked me to participate in this talk.

I am a midwife and I work in the NHS in a busy North London maternity hospital. I became involved with the Care Project in 2016, and attended my first workshop, and I have to say, the process had a profound effect on me, and actually, for me, it felt like I had about 10 years worth of therapy condensed into three days.

I have since gone on to create another reflective story, and I am 100% committed to the importance of digital stories, especially for staff.

So, there is some research out there on patient care, improving patient experience, how to transform service, making a difference, making things better, and this includes healthcare professionals. It seems clear that digital stories can provoke changes within departments and hospitals, and I think that is of massive significance when you consider the size and nature of the NHS, which doesn't really do transformational change.

There is also research about digital storytelling. A short digital story can promote conversation in the classroom, as can contribute to continuing professional development.

There is no research on the impact of digital storytelling, the making, the process, on health professionals. I am proposing to interview my group of storytellers and see what impact making digital stories had on them, how is change their practice, if it's changed their practice, how it



impacted on their professional selves, with whom they had shared their stories.

Stories are powerful, and on this, there seems to be universal agreement. The stories that were made at the workshop were incredibly powerful. They were stories of NHS staff continuing to provide the best care they could in spite of inadequate facilities, a lack of funding and so on.

Patient versus program has allowed the patients voices to be heard, and it has inspired change, but only in service provision. The staff stories are the other half of the story.

The Care Project shows the human side of the NHS, and I hope my research will explore the impact and implications of digital storytelling on healthcare professionals. This will give an indication of the impact and influence of the project as a whole.

PIP: Thank you for that. I will play Rachel's story, and I would love to hear your comments. You might want to have a tissue handy. Don't worry if you can't hear at first, she doesn't start speaking until a few seconds in.

SPEAKER: When my mum died, I had to leave the room. I just couldn't bear to be in there anymore. We had been in there all day, and I just had to get out. When I went back in, my brothers were taking down the pictures from her walls. This deconstruction, though pragmatic, was too much for me to watch, and I had to leave again; I couldn't stay.

Years later, when I walked into a maternity theatre and saw the cardiac arrest him actively resuscitating a new mother, I was frightened and underprepared. There was no expectation for me to take part. My role was to be there and support the midwifes and family. I didn't really know how.

I was an inexperienced supervisor, and nothing in my training had prepared me for this. I stayed in theatre with that team for over four hours. I watched as the anaesthetist explained to the obstetrician that the woman was clinically dead. The obstetrician said, "I have to finish the operation, even though it wouldn't make a difference." I don't think he could quite believe it.

I told my midwife colleague that the woman was going to die. She didn't want to believe me but she did, and then she looked at me and said, "Don't leave me." I said, "I won't leave you. I will stay."

We got ready to transfer her to ICU, but she started slipping away. We had just enough time to get her family back in, and then she died. I stayed, my colleague stayed. We stayed with her and we stayed with each other.

Together, the two of us washed her and laid her out so her family could spend more time with her. I haven't been able to do this for my own mother, but I stayed with her former colleague.

The following week, my experienced colleague and I were working together again. The woman I was caring for needed an emergency Caesarean. We needed a midwife, and she looked at me and said, "I will go back into theatre if you will." We went back in together. We got through it together.



PIP: I hope you enjoyed that. It is a very touching story, and I know one thing that Rachel said, despite feeling like she had had 10 years of therapy in a few days, I think she felt it really brought home the fact that you never know what is happening with your colleague, and unless we make time to listen to one another and share stories, you never know if somebody has just lost a relative or someone dear to them, whether they have got some kind of of trauma going on in their life, so for Rachel, it was a reminder that we need to make time and space to listen to one another's stories.

So, any questions, any comments about Rachel's stories? We will do our best to try and answer them.

Is everybody stunned into silence?

KATE POUND: I don't know if people need to unmute themselves?

PAUL WOODLEY: If people raise their hands, I can unmute them.

KATE POUND: One thing is how we can use this moving forwards. I find the stories powerful, but I wondered if there was any thoughts on how we can use these, or perhaps I can put it out to the panel?

PIP: Karen?

KAREN: Events like this... We want to encourage people to do that. So, the more people that are sharing with us today can raise awareness but their colleagues, the better. I think Rachel also spoke to part of that that is really important for us now. Clearly, we have been talking about sharing stories and human actions and how that appeals to people, and they then change conversations and want to make more stories.

I think Rachel's is really helpful. She is focusing her dissertation research on the experience of making stories, but also, the impact of them. My sense is that it will help us too, not just to share stories, but to share the story of the story. What stories help us to do differently, the impact, the evidence.

To be able to put those two things alongside each other, the human side of the story and the more evidence-based side of the impact of the stories, particularly staff digital stories… Those two things will really help us promote the story is even more effectively, encouraging even more conversation.

KATE POUND: That is fantastic. People who want to get involved, they might be able to spread the stories across the systems maybe they can contact us afterwards, because we do want to build momentum..



PIP: Absolutely. We are now in, just through a range of people who have come to events and joined this kind of conversation, we have had some contact from a couple of universities who are asking us to work with them to match some of the stories to some of their module content. They want to look at encouraging stories to be included as a different way of conveying messages.

A different way of presenting information. Similarly, I guess a lot more opportunities and, for me, the real key is for staff digital stories to become embedded in the way other people do their work, facilitate change and so on.

PIP: we have got a couple of people that want to ask questions and I think Paul can unmute you, Heulwen.

SPEAKER: Thank you so much. If you can answer this in what is happening nationally, but I am very intrigued from a lot of patient stories and patient voices being prevalent through that as well. Recognising a lot of change that we can do is small-scale and at the edge, really then in the centre. You can see the question I put there is, what is happening at the senior levels in organisation but also from NHS England to change that mindset because I get a lot of, as I'm sure other people experience as well, the tokenistic padding on the head of that is a touching story but what does it mean when we have got huge waiting lists? I'm just wondering what is being done to combat that view, really?

KAREN: If I respond to that, firstly, I think the essence is trying to marry up the story and the power of the stories with a stronger narrative about the evidence base and the differences they make. And that is very much about encouraging and working with those people who use the stories and share the stories as part of the change initiatives. And people who work with them to try to capture some of the other data that reflects that. Because we have so many stories now when we watch the stories, with some of them, it is not very difficult to see how that person working differently now makes a change to the system. And may have a quality improvement story attached to it, there is a financial resource story attached to that story. And one of the things we need to do better to be more influential is to join those up. That is one.

I don't know whether you have got more to add to that, Damon, from your experience?

DAMON: one of the cultural changes that is happening is the understanding that you need, you don't need data and stories, you need them both together to really connect people to any kind of change. I think, in the small local environment, I think making time in your day to actually listen to each other's stories especially as the system is very stressed or people are busy, the most impactful thing is to take time and pause to listen to each other's stories, I think that is the potential catalyst for big cultural change.

SPEAKER: Completely agree, thank you.



KAREN: It is a really good question. I think Natasha alluded to one other thing, Natasha is making big service changes that she has alluded to and is really thinking about a digital story as a presentation, to other key leadership forums is actually a very different way of engaging people in the change that we want to see in the change that we want to drive. I think sometimes rather than talking about the impact of the story, the key move is to actually show the stories in different kinds of settings and not to restrict that to the small stale improvement. To be courageous and to take those from very similar settings, too.

SPEAKER: That built a bit on what we were talking about yesterday from the healthcare radicals, sorry, change agents. Change now, it starts with conversation and stories are a great way to start conversations and connect people. That will improve long-term efforts and sustainability and the spread of our change efforts. For me, change start a conversation, this opens back up and connects to the real values behind the actual improvement itself.

SPEAKER: Was there another question that you had?

SPEAKER: I think we are good.

SPEAKER: Thank you, so much, that has been lovely.

PIP: I think the other question has been answered and I am aware we are over our time now. I may move us onto... I think this is possibly quite important that many of the people who participated in the workshops felt as Vanier said, they were able to accept themselves and move on to what a transformation. It is interesting, what we can do with the stories and how they can make a difference. Things you may be interested in participating in a little bit later on in the year. Not too much later on, quite soon, the experience of care is coming up. You may want to watch the hashtag #ExpofCare and there will be a webinar on Wednesday the 23rd. And we will go over the stories we have talked about today.

Please complete the WebEx feedback form when we have finished the WebEx today because it is helpful for the Horizons team to get a bit of feedback about what is going on. We would love to hear from you. If you are interested in the stories, I have put my email in the chat box so if they want to contact me and Karen would be happy to be contacted.

SPEAKER: Absolutely. But I do say something very quickly about the Experience of Care week? It is a collaboration between NHS England and NHS improvement and in response to the last question, is... previously we have talked about patient experience that we have talked about staff experience and they are absolutely both critically important. The way we are beginning to frame that now and describe that is an experience of care. I think that for some might be semantics. But it is important as we frame this work going forward that we talk about experiences of care and think about patients and staff in the same conversation. In the same initiative and in a very connected way. Thank you, Pip.



SPEAKER: Thank you for the session today, I don't know if Pip or anyone else has words.

DAMON: Just to wish everyone a great weekend.

SPEAKER: If you want to see any more stories, the link is at the bottom of the slide. If you don't have anything better to do on a rainy weekend, you can watch stories.

SPEAKER: Please, if when you access the stories, if you use stories in your own work, please share with us how that goes and please share with us the impact they have because we are absolutely committed to you learning about how that works but also learning how to do even better. Please share that.

SPEAKER: Louis, could you tweet that our? That would be fantastic. And we will get it via social media. Don't worry about writing it down. That is the end of today pars session. Thank you for taking part. There will be a questionnaire sent out and we are keen to get the feedback and we will be looking at the continual way of how we can keep developing and improve the experience. Thank you, thank you for joining us today.

SPEAKER: Thank you, Kate.

SPEAKER: Yes, thanks very much by making it possible.

SPEAKER: If you want to stay on for a quick debrief, it will be four or five minutes. Just give people a chance to get sorted then we will have a quick debrief.

SPEAKER: Thanks, Kate, we will do that.

SPEAKER: Pip, I have created a breakout room. As the presenter, you can started. Then we can go and have the debrief straight away.

SPEAKER: Access panel?

SPEAKER: Just start.

SPEAKER: Then you will be the one asked to start a segment and we follow it.



SPEAKER: A break assignment?

SPEAKER: To the right which is a start.

SPEAKER: It will just say end.

SPEAKER: You should have a breakout session pop up over where the presentation is.

SPEAKER: On my computer screen?

SPEAKER: It will pop up on your computer screen. And it will ask you if you want to switch your audio over there on your computer and that will do it for you.

SPEAKER: You we go.

SPEAKER: Got it.

SPEAKER: Yes.

SPEAKER: To to continue?

SPEAKER: You should have Karen joining you now.

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EdgeTalks, March 3 2017, Transcript

Healthcare

Transcript of EdgeTalks, March 3 2017, Transcript