I would like to discuss a subject which I find deeply fascinating and intriguing, but more importantly, it’s one which really matters to me: how we can make a difference in an individuals’ life through good conversations.

It is crucial, I believe, that I deliver in my role, and try to make a difference for everyone I come into contact with, regardless of the reason that brings us together. They could be my managers, my colleagues, the care and support staff and other professionals, the individuals we provide care and support for, or indeed, my family and friends. We are all individuals who deserve to be treated as the independent, fascinating people we are.

Dare I say it, but let’s forget the National Care Standards for just a moment. I, like many others brought up in the 1970’s and 80’s, understood and shared the positive, ‘old-fashioned’ values of being respectful, keeping true to your morals, demonstrating self-discipline, keeping a firm determination, and thinking of others and not just oneself. The National Care Standards Principles very much mirror these values. They propagate the ability to empathise with respect. It promotes a compassionate dignity and a responsiveness to need. Many of us already commend and admire these principles in our private lives, as we know the true value they hold in our relationships and in communication with others. So why then, in our working lives, do we need a manual to sanctify what should be so self-obviously apparent?

When we step back from our subjective view, we may even notice that as a society, we show tremendous exertion in obtaining personal rights and liberties, whilst all too often neglecting the responsibilities that these entail. This is a sad indictment, but one that I come across all too often. Within health and social care, this tendency is continuously impacting our roles. Some individuals are resolute in acquiring their rightful due, whilst disregarding the duty they have to themselves and others in our workforce.

Personal Outcomes are at the heart of the Scottish Government’s policy and, if used effectively, should go some way to reverse a dependency culture that is manifest, and re-instate a positive value and focus on responsibility and resilience. With a quick change of perception, and a touch of empowerment, we can change the recipe; we can build a model of a responsible society.

We all know why we have to change. In addition to the values and principles I have mentioned, our demographics are changing. Our population is getting older; there are more illnesses and multi- morbidity. This is set against the backdrop of decreasing financial resources, cuts in services, and lower funding in many other vital public sector bodies.

When I was first employed in my role with Social Care Services, I used to wonder how I would interpret someone’s ‘personal outcomes’ after a brief introduction. We really have to understand that individual, and what matters most to them, in a short space of time. The same is true when inducting a new member of staff, too. Whether you are supervising a team or mentoring a specific colleague, you are aware that what matters to them and what impacts them will also impact yourself.

What I have learned over the years, throughout my various experiences, is that a good conversation can inform us of an individual’s outcomes.  After the initial greeting, once the pleasantries are over, we can then begin to connect. However, conversing is a skill some of us are better at than others. Our purpose – why we need this information – will motivate and direct the progression of holding a meaningful good conversation with someone.  If it is an individual we have not seen for a while, we may ask them what they have been doing; to catch up with them. If it is someone we are in regular contact with, we might chat about a specific topic from a previous conversation. If we are sharing instructional learning we should have the specific training and skills to do this effectively, for different learning styles.

So, what is a Good Conversation?  It is a process, with applied techniques and skills, for the facilitator to use while with an individual.  The techniques support an individual to share their issues, investigate their opportunities, make use of their abilities and strengths, and display resilience, in order to achieve what is important to them. These methods include listening skills, with deeper listening, various types of exploratory questioning, asset mapping, and measuring what is important to them; scaling/scoring how they can to improve on this.

Good conversation skills and techniques are so vitally essential to empowering change in resilience in the lives of the individual’s support. Still maintaining their personal rights but shifting more towards their personal outcomes. I am a campaigner at Good Conversations training courses that the same skills and techniques can also positively impact on the resilience of our staff teams. How do we change society as a whole? Well, we are making the first ripples and that is important to me.

Elaine McCourtney

Scottish Care Liaison Officer, Dumfries & Galloway

Test of Change

We are living and working in an inter-connected environment. The use of email for sending messages, exchanging information and assisting with workflow is common place across the public sector. There are many links between the health and care system, but it’s often difficult for health and care professionals to share information. Access to the right information about patients and users of services at the right time is essential to ensure continuity of care.

When patients are discharged from hospital, care homes are still receiving information about that individual by fax, in person or post. Often, key pieces of information are not received at all. This makes it difficult for care homes to prepare for a new patient’s/resident’s arrival or the return of a resident who has been in hospital. As well as being inefficient and slow, paper-based communication is not a secure delivery method.

Lothian Unscheduled Care Board have agreed to fund costs for a one year test of change –Secure emails access for all care independent care homes (circa 103) in Lothian. Each care home will be provided with up to three nhs.net accounts for a period of one year. Care homes coming on stream during the next few months have also been included in this test of change.

CEO’s or equivalent of each individual independent care home must sign the Data Sharing Contract, as must the staff identified as secure email recipients. Following on from this each identified recipient must sign a NHS Lothian User ID Request Form

The provision of secure emails to all care homes in Lothian will markedly improve communications between care homes general practice and social work. Specifically, it will enable faster discharge of patients through the electronic communication of patient assessments and subsequent discussions rather than this being by post.

Secure email will transform how healthcare organizations in Lothian share and work collectively to provide coherent joined up services for the people concerned the public. Good timeous information underpins good care and on-going support.

Care homes will benefit greatly from having a consistent electronic transfer of medical discharge summaries (typically sent to a GP within 24 hours). This will enable the care home to fully prepare their service for supporting people discharged from hospital by preparing for the persons needs well in advance of their arrival.

Pre admission assessments will be carried out and shared timeously thus supporting early discharge to the care home and help improve the efficiency of the discharge process generally.

Secure emails offers the potential to share Anticipatory Care Plans from statutory services. E.g Person moving into a care home. Referrals, assessments, multidisciplinary review summaries, flu vaccine consent forms will be immediately accessible to care homes. Opportunities for Tissue Viability, Health Protection, Care Home Liaison, CPN’s and pharmacy specialists instant ability to network and support and safely communicate sensitive information with care home staff.

Other benefits are the ability to send and receive patient/resident information quickly and securely. No confusion from messages taken over the phone or illegible writing on faxes. Improved awareness of care home staff in relation to  information governance rules on handling patient information. Secure paper trail in place for example, time emails were sent, removal of fax machines which are costly and require maintenance. Costs of postage for partnership reduced. Reciprocal communication time by health and social care professionals markedly reduced and this initiative supports positive change in service.

This test of change Secure e-mail access for care homes in Lothian should seek to demonstrate measurable improvement in outcomes either directly to individuals or indirectly through improved service design and delivery. There will be on going monitoring to make sure the project is achieving the desired results and to demonstrate the impact of the project to others; as well as to identify issues or problems as they arise within the project so that actions can be taken to change or redesign the project while it is in progress.

Rene Rigby

Local Integration Lead, Edinburgh City