In the shoes of … | Maria Booker, Mum of 2 in pursuit of empowered women in control of their maternity journey

Today’s guest blog feels a bit like the TV show ‘Room 101′ in which celebrities discuss their pet hates and try to persuade the host to consign them to oblivion in Room 101.

Maria Booker brings a slightly different angle to Dr Kate Granger’s brilliant ‘Hello my name is’ campaign – we would love to have your views on this, Kate! Indeed it may well be that there has already been much debate about this and we have missed it…

We have seen name badges with #hellomynameis Mr Surname. It seems somewhat strange that doctors want to be Dr or Mr etc whereas the CEO or medical director is generally known by their first name… 

Anyway, Florence Wilcock and I love the fact that our #MatExp campaign is sparking new conversations or applying them to new areas and particularly that people are feeling motivated to write blogs and take action to challenge accepted practice and bring about positive change. Please post comments and tell us what you think…

maria booker

Maria Booker

As part of the #MatExp campaign for NHS Change Day there have been some brilliant conversations about some commonly used jargon and how this makes women feel (see Jen Phillips’ blog ). Language is so important in any arena of care but none more so that maternity. We still talk about doctors and midwives delivering babies but the reality is that for the most part, babies are grown, nurtured and delivered by women. The evidence is clear. If we can build women up to feel confident and empowered then better birth outcomes follow.  If we are serious about empowering women to take control of their maternity care, and working alongside them to maximise the wellbeing of the family unit, there is no place for status, and that is why I have made a NHS Change Day pledge to encourage doctors and all NHS staff who don’t already, to drop their titles. The picture your name and role create is just perfect- the frame is unnecessary.

TitleOn the rare occasion I get called Mrs Booker I feel as if someone is holding me at arms-length, being formal, deferential. And if someone introduces themselves as Mr or Mrs, I am immediately transported back to being at school. It’s no coincidence that these titles go hand in hand with the expectation of obedience which means for those of us who don’t work in a classroom, or a warzone, the use of such titles is pretty rare. I am no stranger to hierarchy having spent a decade in the corridors of Whitehall.  But even as Private Secretary to a junior Minister, I called him by his first name. The Secretary of State was referred to by her first name. The many politicians, captains of industry, regulators, campaigners, who passed through introduced themselves by name – never Mr or Mrs. I don’t often hold the civil service up as a model of progress but the days when you deferred to your boss using Mr (generally it was Mr) were long gone even when I joined.  And yet in the medical profession this custom remains entrenched.

So why does it matter? It matters because the way doctors introduce themselves lays the foundations for the doctor/patient relationship before another word has been spoken. And once those have been laid, it’s hard to start again.

A few years ago I met with a consultant obstetrician to discuss whether I could have a normal birth following a caesarean (known as a VBAC). I did get an introduction. The midwives and secretaries referred to my appointment with Mr Somebody. The consultant introduced himself as Mr Somebody and then went on to tell me what my birth would be like – I would need to be continuously monitored, the water birth I was hoping for would not be possible. It was clear that he was not expecting a discussion. I asked some technicalities about how long overdue I would be “allowed” to go before being induced whilst suppressing my internal scream of “WHAT IF I DON’T LIKE THE PLAN?”.

Would the conversation have gone differently if the consultant had given me his first name? Probably not. But it would have set a tone- a more equal relationship, a hint of teamwork, the possibility of compromise. In the end I had a water birth at home with the help of independent midwives (against accepted guidelines I should add). That meeting had sapped my confidence that I would be listened to, respected, or taken seriously. Maybe, just maybe, if it had started differently I would have found the confidence to find a different ending.

Because Mr or Mrs says to me – I have authority and you don’t, I’m in charge round here, you need to respect my knowledge and experience, don’t get too close.

Giving your first name says to me – I’m a human too – although I know a lot more about the medical side of this, you know things I don’t know – your  values, what’s important to you and together we’ll find a way through. I know that there are many wonderful doctors working in maternity care who treat women with the respect and compassion they deserve, many of whom have already ditched their titles, and some of whom just won’t have thought about the impression a title creates.

For me what’s been so refreshingly different about the #MatExp campaign is the constructive, non-judgemental way which it has drawn together a wide range of people in a spirit of understanding and shared purpose. This pledge is not intended to create a stick to bash doctors with – one of the privileges of seeing the #MatExp experience unfold is to learn much more about what it’s like to be an obstetrician.  But it is intended to shine a light on the impact of these tiny words. Letting go of these handful of letters might mean a woman asking a question she might not have asked, exploring an avenue she thought was shut off and having an experience of birth that might have been denied to her – that’s the prize.

Kate Granger’s  #hellomynameis campaign has done an amazing job of raising awareness throughout the NHS of the importance of a very simple yet significant act- introducing yourself to a patient. This NHS Change Day I would ask doctors in all fields in the #MatExp spirit of understanding to drop your title and let all your much valued knowledge and skill do the talking.

Maria is passionate about women’s experience of maternity care. She is currently the UK General Manager of Maternity Neighbourhood which makes a digital maternity health record which women can access, contribute to, and use to message midwives at any time. Prior to that Maria lead the development of Which? Birth Choice for ‘Which?’
The website was developed in collaboration with BirthChoiceUK to bring together everything expectant parents need to know to decide where to give birth and present it in a user friendly way. Maria’s interest in maternity stemmed from her own experience of having two children and then going on to Chair her local NCT branch and represent users on her local Maternity Services Liaison Committee.

 

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NHS Change day #MatExp Lithotomy Challenge – A blog for Mother’s Day

A Mother’s Day special !  Florence Wilcock, my ‘partner in crime’ on the #MatExp project has already written a very popular blog, writing as a mother who happens also to be an obstetrician – or perhaps vice versa. Who knows?  People are so keen to put everything and everyone in boxes – and Flo and I and so many more are desperate to throw the boxes away!
MatExp necklace cUnless of course they are pretty little boxes like the one I received yesterday with this beautiful Mother’s Day gift (complete with little shoe !)  Thank you Flo – that is SO lovely. 

Look out for us wearing our matching necklaces (Flo has one too) at some interesting forthcoming events… !

Well, on Wednesday it was NHS Change Day and obviously a big highlight of our #MatExp campaign – indeed it got mentioned in the Guardian as one of the top 10 campaigns!
I wrote a blog about what we were planning to do and we had a brilliant time together with Flo’s colleagues at Kingston Hospital.

The hospital was buzzing with different activities, including us doing a Whose Shoes? taster session with the Executive Management team and another in the antenatal clinic.
It was a real honour that Dr Helen Bevan and colleagues from the NHS Horizons Team dropped in to see what we were up to at Kingston and do some filming as part of the 12 hour Changeathon, which hopefully we will be able to share with you shortly. Meanwhile, the photos give a taster of our day…

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Fab images by Carrie Lewis, New Possibilities
Fab images by Carrie Lewis, New Possibilities

But Florence ensured that her roles as obstetrician and mother blurred a bit more (and took many of her colleagues by surprise) when she did something truly wonderful in terms of making people think, really think about the experience of the women they are caring for. She walked in their shoes – which, on this occasion,  involved taking off her shoes…

It is brilliant that Flo has taken the time and trouble to reflect in such detail and share the learning…

Lithotomy challenge graphic

Graphic by Carrie Lewis, New Possibilities

Florence Wilcock writes: For NHS change day I wanted something that made a statement that said “#MatExp has arrived, take notice, we are improving maternity experience, get involved!” I couldn’t quite think of the right action until I saw a twitter exchange with Damian Roland back in December and watched a video where he described his spinal board challenge from NHS Change day, 2014. I had a light bulb moment thinking what would be the maternity equivalent? Lithotomy!

Lithotomy is when we put a woman’s legs up in stirrup; sometimes this can be essential for an assisted birth with forceps or ventouse (suction cup) or if stitching is required. But sometimes we use lithotomy position for normal birth or when stitches are minimal.
Changing times - castor oil2In our #MatExp Whose Shoes? workshops, my favourite card is one based on Gill Phillips’ Mum (now aged 93) being made to take castor oil, despite telling the midwife it would make her sick. And it did. The card asks what is common practice now that will similarly seem wrong or odd in the future: the unanimous answer given at Kingston was lithotomy.

I started to think about whether we use lithotomy more than we should and wondered what does it feel like? Although I have two daughters, they were both born by emergency Caesarean so I do not have personal experience of lithotomy although I know some of my midwifery and consultant colleagues already do. It seemed the perfect challenge. I chose to do try it for one hour as that is a quite realistic time that a woman might be in that position, sometimes it can be less, but sometimes it can be far longer.

I decided to wear a hospital gown and some running shorts as it didn’t feel quite right to do it in normal clothes. The first thing I learnt was that the hospital gown was stiff and itchy, I couldn’t get it to do up properly without assistance and when I had finally tied it I sat down to discover it felt as if I was being strangled by the neck line so had to loosen it off immediately. I adjusted the back of the bed but found it quite hard to swivel round & reach the buttons to do so. We put on a fetal heart monitor which just felt like a normal waistband, a blood pressure cuff and stuck an IV line on my arm. We also used a doll to give me a bump. I know not all women will have all these attachments but many will. During this time Tom, who was going to follow me with the challenge, commented that I looked anxious from my body language before I had even begun and it was true I felt quite apprehensive with all these people running around being aware I was about to be totally in their power as it were.

Flo 1We were finally ready for ‘legs up’! The first thing I discovered with a slight shock was that the stirrups were very cold which I hadn’t expected at all. The other observation was that the people started adjusting my legs without asking me. I thought one leg was going to fall off as the stirrup wasn’t tightly fixed enough and I was in a slightly twisted position which I asked them to adjust. Once that was done I felt reasonably comfortable and relaxed. They took my blood pressure with an automated cuff which was surprisingly painful. I decided to have a breech baby and we took a few photos.

Twenty five minutes in we decided it was time to take the bottom of the bed off which we would do for an assisted birth. I felt immediately more precariously positioned and vulnerable like I might fall off of the bed. The midwives put my legs higher and the bed much higher off the ground which was the right position for delivery without causing them back problems. This felt quite odd to be high up in the air or as one midwife put it ‘face to vagina’ so that she could see what she was doing at eye level! I definitely could not have got down from there unaided especially not when contracting and in pain. A midwife walked into the room with the door & curtain open and I realised I could see all the way down the corridor which meant everyone in the corridor could potentially see me. Obviously this was a simulation but it did emphasise to me even more the importance of closing the door & curtain behind you to maintain privacy.

A series of people then came to talk to me. Our chief executive Kate Grimes popped in for a chat and asked if I was willing for a film crew to come in to which I agreed.  By this point my bottom (sacrum) was getting pretty sore & I had neck ache. I was feeling fairly uncomfortable. My abdomen felt quite compressed and I thought if I was a woman in labour having to push it would probably make me feel quite nauseous.

I was prepared to be filmed and photographed but it was interesting that a number of people walked in and out to look without talking to me. Helen and the presenter introduced themselves to me but the camera man did not and did a series of sound checks over me and proceeded to film without even speaking to me. I am sure it was an oversight but it gave me an amazing sense of being dehumanised and re-emphasised the importance of #hellomynameis.

Flo - Helen & camera crewIn the middle of this Kate Greenstock, our MSLC co-chair arrived. Kate is a doula and came straight to me and asked if I would like a foot massage. Although I thought I was fine, as soon as she asked me I realised actually that I wasn’t fine and here was a person who wasn’t laughing or making a spectacle of me but who actually cared about how I felt. That isn’t to say all the wonderful midwives didn’t but at that moment I felt like Kate and I understood one another and that this was tough and she was ‘on my side’ as it were here to support me.

She gave me a foot massage which was immediately relaxing. I have always understood the importance of support in labour but felt that women could get that from our wonderful midwives and struggled to understand why they wanted a doula too. This experience gave me some inkling of why in some situations a midwife might be focusing on other things and a doula might be able to focus on how the woman is feeling and that alone.

My hour challenge was ticking by and for a short time after the film crew the room emptied out and I was left almost alone. I felt slightly abandoned after such a crowd before and realised if the midwives didn’t come back I was rather stranded in an undignified position. It is not unusual after an assisted delivery for many people to come in and then gradually disappear leaving me as the obstetrician to suture on my own, the midwife popping in and out to get things so in a way this behaviour seemed quite apt.

The midwives returned with a nice plastic baby so that I could have #skintoskin and then my hour was up. The end of the bed was put back in place with the bed rocking as they pushed the parts together and then finally they brought my legs down and it was over.

So what was the impact of me undertaking the lithotomy challenge?

My action has certainly got others thinking and talking. I started tweeting about it in the weeks before change day and challenged a few colleagues.  I’m greatly indebted to Professor Jim Thornton who was the first to accept and kicked off a whole week ahead of NHS Change Day.

I know of at least twelve others who have undertaken the challenge and five more who have promised to. The challenges are spread across 10 organisations so I am hoping for a ripple of conversations as a result. Even those that say ‘no’ learn something from asking themselves the question.

An obvious action as a result is for staff to think about trying to avoid lithotomy altogether. There are a multitude of options for positions and care in labour that we can employ. The Better Births initiative is an ideal example of a resource any midwife can access. Environment is also all important: birthing pools, stools, mats, balls are something tangible people can change. Antenatal education and preparation, both NHS and with our partners in the community, is also vital.

For us obstetricians there are certainly situations in which lithotomy is invaluable and necessary however this challenge has definitely made me think about the consequences of the length of time and how to keep it to a minimum as the position became much more uncomfortable after half an hour. Sometime in the pressure of work, helpful midwives get women ready for us in position before we enter the room and I had not given much thought to the impact of additional time or someone new entering the room when you are already in this position. The careful use of sheets or drapes to minimise exposure was also a topic for discussion.

In conclusion my hope with my challenge is that in each Trust conversations will happen that change practice and via networks and social media good practice will spread. I hope it will have the ‘butterfly effect’ where one small change in one place will result in large differences later.

So Happy Mother’s Day from #MatExp …

and remember it is never  too late to take part!

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Huge thanks to everyone taking part in the lithotomy challenge – a scrolling gallery of people prepared to go the extra mile. Leaders who are learning so much by walking in the shoes of people in their care.

UPDATE: And here is the Kingston Hospital #NHSChangeDay film – powerful interviews with Kate Grimes and Florence Wilcock during their experiential challenges.
And a ‘wee flash’ of Whose Shoes? at 7 mins 30!

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#MatExp on #NHSChangeDay – working together to improve maternity care!

Today is NHS Change Day! 11 March 2015

Magic happens

 I will be spending the day with Florence Wilcock, my #MatExp ‘partner in crime’ at Kingston Hospital with a great programme of activities planned. Helen Bevan and the NHS Change Day film crew are coming to see what we are up to. We are taking part in the 12 hour Changeathon.  Comfort zones are long gone.

https://twitter.com/wildrubiescoach/status/575451997609926657

In some ways it is the sparkling highlight of our #MatExp maternity experience campaign. But in so many ways, it feels refreshingly like just another *very exciting day* in our growing grassroots social movement. They seem to be coming along now like the proverbial London buses. Only yesterday, award-winning journalist Pippa Kelly published a fantastic blog about #MatExp and NHS Change Day – and basically me.
I felt hugely honoured.

#NHSChangeDay has added extra impetus. A focus. A bit of fun.

It would have been very difficult to do things like the ‘lithotomy challenge’ without this national context of people being encouraged to try something outside their normal experience, seeing new perspectives – and of course such actions are a perfect ‘fit’ with my Whose Shoes? approach.

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The first men have been brave enough to take up the challenge. Huge thanks to Professor Jim Thornton, Professor of Obstetrics, University of Nottingham, and Matthew Hopkins, CEO of Barking, Havering and Redbridge University Hospitals, where we held our 4th workshop (see video below). I will aim to add some more photos as they come in – and also pin on the #MatExp Pinterest board!

Coincidentally today is EDD+! (baby a day overdue!) in terms of when #MatExp was conceived, if we take it from our first phone call to discuss possibilities. But now it feels as if, appropriately, #MatExp has a life of its own. #FabObs Flo and I are like two proud parents watching the baby progress from tentative first steps to independence and hardly believing ‘how quickly they grow up’.

We have been blown away by the passion for positive change, and real action, of the growing band of Mums springing up to lead the campaign. Fantastic blogs are being written, stories shared, new initiatives taken on a daily basis. I would like to curate some of the excellent blogs – and I bet just by mentioning this, someone will step up and do it! ;-)

I could post some of the fantastic tweets, but I wouldn’t know where to start. #MatExp has now had over 50 million Twitter ‘impressions’ – and that is just from people actually using the hashtag, whereas most tweets are just spontaneous conversations that build and draw in more and more people. I have wondered if we need a ‘tweet chat’ but again the conversations are happening regularly and spontaneously, so who knows?

Anyway, as part of the day Flo and I have been invited to run a Whose Shoes? session for the Executive Team at Kingston. It has been put together very quickly. Some real scenarios, exploring a real complaint. It is just an hour but I hope we can spark some new ways of thinking.

I realised yesterday that we didn’t have any poems for ‘Poet’s Corner’. I set out to write a couple of short ones – and ended up with one long one – the nature of creativity, I guess.
It sets out some of the things we are doing.

Here it is. Wish us luck!

Gills poem - NHS Change day header

NHS Change Day – Kingston Hospital

Today at Kingston Hospital
We have exciting news
It’s NHS Change Day
And we’ll be walking in your shoes!

Helen Bevan
Queen of transformation
Is paying a special visit
To join the conversation.

Some fantastic individuals are giving up their time
Chief Exec Kate Grimes is currently in her prime
But an ‘Age simulation suit’ will help her understand
How it feels to get old and frail
When your body starts to fail
And it is difficult to stand.

Fab Flo the obstetrician
Will be in an awkward position!
Spending an hour in stirrups. As you do.
Her lithotomy challenge
Is challenging the norm.
And, ice bucket style,
Taking Twitter by storm.

Male obstetricians who have perhaps never thought
How they make women feel
Will indeed be taught.
The hard way.
Something you remember. Experiential.
It has so much potential.
Learning how it feels. Making it real.

 Let’s all think differently.
Exploring – if we dare
How these very simple actions
Can improve women’s care.

#MatExp #NHSChangeDay

Gill Phillips
Creator of Whose Shoes?®
11 March 2015

Looking forward to the cake too – thanks Flo’s daughters!

Join our campaign. Browse our suggested actions
and consider how YOU could get involved!

Posted in Blogs, co-production, community engagement, compassion, education, health, in my shoes, maternity, personalisation, well-being | Tagged , , , , , , , , , , , | 1 Comment

Happy Birthday, Gill’s Mum – 93 today … and very much still HERE!

IMG_7679A little break today from #dementiachallengers and #MatExp and generally trying to change the world. Instead I am using the blog to say ‘Happy Birthday – 93 today” to my lovely Mum.

Many of you follow Mum’s ups and downs through her occasional blogs and intermittent tweets; she tweets as @Gills_Mum – until she gets fed up and sends her trademark ‘over and out’ message.

Mum has settled really well in her excellent assisted living accommodation. It is a whole new life with many new friends. Today my daughter and I will be joining them all for lunch, taking some wine and a big cake and generally having a good time. Tonight she will be enjoying a very good standard of ‘no holds barred’ Scrabble.

Mum lives in the centre of a very nice town – right in the middle of her old stomping ground, with everything to hand, but she cannot really go out on her own now.

She gave me this little poem a few weeks ago and I found it really poignant. I am hoping that as time passes her new residence really will become ‘home’ – but I think as a hugely independent person, she will always hanker after catching the little bus into town. 

We both know that at 93 and with a big sparkle in her eye, we are both extremely lucky. So I intend to carry on loving her to bits, live from day to day and not worry too much about what the future may bring.

 HERERed tape

I used to catch the Little Bus
Now I am here in clover
This really is the perfect place
But am I lost without a trace
Just being well looked after?

It’s not a care home with everything done
We really have a lot of fun
But I don’t want to disappear
So I am saying, loud and clear
Here I am – I’m HERE.

Please say ‘hello’ in the comments so that Mum knows there is still
a big wide world out there and lots of lovely people
keen to keep her from ‘disappearing’. :)

Posted in Blogs, compassion, Gill's Mum, Guest blog, housing, personalisation, well-being | Tagged , , , , , , , , , , , , , , , | 12 Comments

In the shoes of … | Jen Phillips. Word nerd and mum of two.

Last week I was a speaker at a conference in London called “Developing your skills in Social Media: Twitter: #TwitterNHS”Twitter NHS

The programme consisted of a series of NHS Twitter stars – people like Teresa Chinn (@agencynurse) and Kath Evans (@KathEvans2) – talking about the power of Twitter and why it is important to people in the NHS. I spoke about blogging and how this can take Twitter to the next level, particularly when ‘140 characters are not enough’.

Today’s guest blog by Jen Phillips is an excellent example of this. 

I posted a tweet on 12 February about negative language used in maternity services – language such as ‘failure’ – and how it can make the mother feel inadequate and depressed.

It sparked a huge debate on Twitter that ran for about a week as more and more Mums joined the conversation giving examples of language and how it had made them feel. Here are just a couple of examples:

Improving language in maternity care is one of the eight specific actions we have included in our NHS Change Day campaign - you can find out more about the #MatExp campaign here and join the action.

Jen Phillips joined the conversation. She is, among other things, the lay chair of the North Staffs MSLC. She asked if anyone had written a summary of ‘what professionals say’ and ‘what women hear’. She emailed me some examples and I thought it was brilliant so I invited her to write a guest blog: 

I do not think it means what you think it means

Jen Phillips

Jen Phillips

It was 4AM. I was 37 weeks pregnant and a day and a half into an unplanned and unexpected induction. I’d been in hospital since my midwife had sent me for tests four days previously. Everything had been taken out of my hands by the needs of my medical situation and I didn’t think things could get much worse. That’s when the bombshell landed.

I’d only fallen into fitful sleep out of exhaustion. I was woken by a team of people standing around staring at me. I could barely focus on their shapes and have no recollection of them even having faces, I just remember the words:

“Your baby is showing signs of distress. You need an emergency caesarean.”

What they meant was that they needed to intervene to keep us both safe. What I heard was something very different. The fog of waking up left instantly, replaced with nightmarish visions of me lying on an operating table in a pool of blood, or worse: of my child dying inside me.

Words can be far more powerful than we give them credit for. We use them all day every day, letting them fall from our mouths and fingers like rivers, but they can cut like knives. Midwives are, on the whole, excellent communicators. They have to form close bonds quickly with a huge variety of women and their partners. They know when to tell a mum she’s doing great, how to tell her there’s a problem, and when to fade into the background. But sometimes they slip up; they’re only human. They also suffer from the same problem as any highly trained professional in a specialised field: they learn and use a whole language of their own that sounds like English but is somehow not. Stock medical terms are entirely ordinary to midwives, but they can sound scary and incomprehensible to untrained ears.

Sometimes, what a midwife says and what a mum thinks when she hears it can be two very different things.

It’s not recommended I’m insane for thinking about it

We don’t just pluck ideas out of the air. We think, feel and research. Dismissing what we ask for dismisses all of our thoughts and feelings. It’s important to find out why we want something done a certain way – and accept that those reasons are important to us even if they seem small to you.

There are risks My baby is in danger

Healthcare professionals talk about risks all the time. They understand the full and varied implications of the word, how risks need to be considered and mitigated. Parents tend to see them as something to worry about. I for one would rather talk about putting plans in place “just in case.”

Are you having pains? This is supposed to hurt. A lot.

Telling someone labour will hurt is a self-fulfilling prophecy. There’s nothing wrong with giving contractions their proper name, but I quite like “tightenings” for a word that’s descriptive and tame.

You are not in established labour I’m pathetic and wasting their time

When a woman hears this, she’s basically being told that she’s wrong, that someone else knows her body and her pain tolerance better than she does, and that things are going to get a lot worse. It can be disheartening and deflating. I’d much rather be told I’m doing well and don’t need midwives fussing round me yet.

Progress is slow I’m wasting everyone’s time, I have to hurry!

Getting a labouring woman stressed is a good way of slowing things down even more. Because of specific medical problems I was closely monitored. Every few hours someone would tell me that I hadn’t made any progress since the last check. Instantly, I felt my stress levels jump up and I had to fight hard to regain my calm. Just as I felt like I was getting back to it and things were going well, it was time for the next check. My progress was continually undermined by telling me something I didn’t need to know. If no action was to be taken beyond leaving me alone for another couple of hours, they could have just left me alone for another couple of hours.

You are failing to progress / dilate I have failed, I can’t do this

Dilation isn’t something women have any conscious control over, so telling us we’re failing to do it isn’t going to help anything. Thankfully this phrase is falling out of use, with it now being referred to as “a delay” which doesn’t come across as an accusation.

You need to… My choice and consent are irrelevant

Sometimes, in extreme situations, she really does need to follow a particular path. I really did need that caesarean. But if it’s not one of those situations, please don’t disempower us. “Perhaps we should think about..?” is a much better way to suggest things.

Emergency caesarean If I’m not under the knife in two minutes my baby will die

Despite my introductory paragraph, this one is a good news point. More often I hear people talking about an “unplanned” caesarean. It doesn’t conjure up the same blue lights, shouting and fade-to-white that “emergency” does. Unplanned implies not being what we set out for, but an acceptable destination reached by mutual discussion and consent.

There is an abnormality My baby is hideously deformed and may die

To a healthcare professional the word “abnormality” is a very broad term that could be as insignificant as a birth mark. To a parent it’s long term disability, special schools, being stared at in the street, maybe even a tiny coffin. See also “there’s something wrong.” We wouldn’t worry so much over something “slightly unusual” or “a minor thing we need to take a better look at.” 

Yes, words can be devastating. But they can be uplifting and restorative, too. 

After my second unplanned (not emergency) caesarean I lost a lot of blood. I was sent back to labour ward so I could be treated and monitored. Stationed in my room was the same student midwife who had spent the previous night watching over me in labour. At one point, after everything had calmed down and I was feeling a little more stable, I asked her to hold my baby while I used the bathroom. She said that she’d love to, that she didn’t often get to hold the babies she saw being born and it was wonderful to have the chance. And with those words, with the simple pleasure expressed in them, the upset and worry of the previous few hours faded away. I was finally given permission to enjoy my newborn.

Thank you Jen for writing this extremely thought-provoking blog – a real challenge to health professionals to realise how language is perceived and how negative language sticks with women, in some cases forever.

Join our NHS Change Day #MatExp campaign and sign up for a specific action that will make a difference.

Watch out for our NHS Change Day special, as part of the  12 hour ‘Changeathon’, live from Kingston Hospital on 11 March, with Florence Wilcock (@fwmaternitykhft) and I doing some rather exciting stuff … ;-)

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In the shoes of … | Florence Wilcock, Divisional Director Specialist Services & Obstetrician, Kingston Hospital FT

Flo's shoes

Flo’s theatre shoes

Last week I wrote a blog about how we have built the #MatExp project to improve maternity experience and the campaign was launched on the NHS Change Day site

Our constantly evolving MatExp story has since been published in NHS #100daysofchange . If you are in any doubt about the difference NHS Change Day makes, take a look at these wonderful stories.

So I am delighted to introduce my J*DI ‘partner in crime’ Florence Wilcock, a.k.a . #FabObs Flo @fwmaternitykhft, who tells her powerful and very human story:

Flo and a midwife3am the phone rings “There’s a massive obstetric haemorrhage in maternity theatre 2”, I leap out of bed, throw clothes on and get into the car. My mind is racing through causes of haemorrhage, how severe is it? what have the team already done? As I drive into work, I ring to speak to the midwife in charge seeking information and checking off a mental list: pulse, blood pressure, estimated blood loss, blood cross matched, consultant anaesthetist. Brain whirring. By the time I get there, it could be sorted or life threatening, which will it be tonight? Drive carefully, ignore your heart pounding, the adrenaline flowing; don’t be distracted, people are depending on you.

In my role I might be invisible to you if everything is going well and all is normal. You will never meet me, know my face or name, despite my being an essential part of the team and often the lead. One component of my job is to do nothing, to stand back, to not intervene and to teach others how to do likewise. My job is to master the art of being there only at the critical time, to run in and save the day, keep calm whilst doing so and to never get that judgement wrong. An impossible balance of risk vs. choice, art vs. science, clinical outcome vs maternal experience.

My name is Florence. I am an obstetrician.

I’d like to tell you the story of two births.

Birth 1: Twelve days overdue with a first baby, this mother expected a straightforward normal birth. That was what her mother and grandmother had experienced. Her waters broke before labour. The mother was told she had to be induced. She reluctantly went into hospital where she started a hormone drip. She later had an epidural as the midwife kept pressing her to. She had an emergency caesarean after twelve hrs of drip, being only 3cm dilated; it felt the inevitable outcome. The epidural didn’t work, so she had a spinal for the surgery. On the table she felt disconnected, almost like an out of body experience, she felt vulnerable. When the baby was born, she was disinterested and didn’t want to hold her. She was in pain after the surgery but the staff didn’t believe her and told her she had already had the maximum dose of pain killers. She lay rigid and still in pain, watching the clock move slowly until she thought she could reasonably ask again. At home it took months before she could talk about the birth without crying. She had failed.

Birth 2: Same woman, four days overdue planning a VBAC (Vaginal birth after caesarean) contractions started, went to hospital overnight. Next morning, 3cm dilated, offered the birthing pool. Wonderful warm water, giggling with gas and air and the midwives keeping the obstetric team out of the room so they wouldn’t interfere. Sadly after many hours 5cm, so got out of the pool and had an epidural and her husband kept her entertained reading from the newspaper. Later, still 5cm dilated, choices offered, caesarean or hormone drip, joint decision: caesarean now probably safest. A wonderful anaesthetist distracted her with football chat and suddenly a baby daughter was here. Exact same outcome: emergency caesarean, healthy baby girl; exact same hospital: but she felt she’d had her opportunity for a VBAC. She had been listened to, supported, valued, and positively involved in her care.

That mother was me. My name is Florence. I am a mother.

At any social gathering, I inevitably get a blow by blow account of at least one birth story, if not several. A birth experience stays with us forever, we remember it like it was yesterday, it is a pivotal moment in time. I am privileged to witness incredibly special moments and emotional events on a daily basis. Often when I listen to these birth stories, we obstetricians and midwives seem to be portrayed as the villains of the piece, especially the obstetricians. I find this negative stereotype particularly annoying. No doubt there are less empathetic or more obstructive obstetricians as there are imperfect members of any profession, but most will be hard working and diligent and simply trying to do their best for women in their care. From my own personal experience both as an obstetrician and a mother I can see the importance of maternity experience. I often wonder: how have we come to this polarised position? how did maternity staff become the bad guys, upsetting the very women we are trying to care for and what can we do to change this?

How the #MatExp campaign was born

Gill and Flo

Gill Phillips and Florence Wilcock

For this reason I volunteered to lead the London maternity strategic clinical network sub group on ‘patient experience’. London had six of the seven worst performing Trusts in the country in the 2013 CQC Maternity women’s survey; we needed urgent action. In contrast, at Kingston Hospital NHS Foundation Trust where I work, we have had consistently excellent feedback from women in our CQC survey. I thought this was perhaps an opportunity to work out what it was we were doing well; to ‘bottle it’ so that others could copy.
I wanted to find an innovative way to explore the issue and ignite the feeling that experience is everybody’s business including women themselves. I had recently started tweeting (My NHSChangeday 2014 pledge) and stumbled across Gill Phillips @Whoseshoes and the idea for #MatExp workshops was born.

With the support of Kath Evans and a team at NHS England London, Gill and I have collaborated to design a bespoke maternity version of her Whose Shoes? board game. We have used real scenarios from users and staff to examine maternity experience from all angles and perspectives.
The aim is to use the workshop as an ‘ignition tool’ to build connections and relationships across the broad maternity community. We want to enable true collaboration, co-design and ongoing conversations to improve maternity user experience.

Poem by Gill Phillips written directly from a 'brainstorm' email Flo sent when we were compiling scenarios, after a middle of the night emergency

Poem by Gill Phillips written directly from a ‘brainstorm’ email Flo sent when we were compiling scenarios, after a middle of the night emergency

We have run 4 of 5 pilots in London, bringing together people from the whole broad maternity community: users and their families, acute and community staff, managers, commissioners and lay organisations. Getting everyone in mixed groups round a board game in a relaxed environment, babies welcome, refreshments on hand, gets the creative sparks flying. It is essential to remember that each person is present in multiple capacities; professionals are also mothers, fathers, sisters, friends and family with their own stories and birth experiences; users often bring knowledge and expertise from other aspects of their lives such as job, culture, education that are invaluable too. Respect and equality are essential ingredients; discussion starts from the assumptions that ‘best can always be better’ and ‘Wrong is wrong even if everyone is doing it, right is right even if no one is doing it’. We have been fortunate to have wonderful graphic facilitation by Anna Geyer @New_Possibiliti which both provides excellent feedback on the day but also a permanent visual record of actions which goes on generating new conversations.

At the end of each workshop each attendee is asked to pledge what they as an individual will do differently to improve maternity experience. This brings a personal sense of responsibility for the actions, the outcome is not the sole responsibility of the traditional hierarchical leaders but of us all.

“The resulting actions are already taking us in directions I could never have imagined such as user co-design of maternity notes, improving antenatal information for fathers and starting a midwifery team twitter account.”

Despite believing myself to be already very ‘person centred’, as I work on the project I am finding a succession of small changes spilling into my own everyday practice. I am thinking increasingly carefully about the choice of language I use and the way we behave. No more ‘are you happy with that?’ when explaining a plan but ‘how does that sound to you?’; explaining to women why we have come on a ward round; having a father in theatre when his wife had to have a general anaesthetic so that they didn’t both miss the birth; using the intense listening I have learnt in coaching to understand women’s perspectives in my clinic.

Through social media the #MatExp project has generated interest from women and maternity staff up and down the country. We have held a train-the-facilitator day to look at how to roll out the workshops both in London and more widely. But the conversation has already become much broader than the board game, with people from the maternity community energised to talk about maternity experience and actions they can take. The project appears to be prompting people to speak up, share and act on their ideas. Linking with NHS Change day on 11th March is a fantastic opportunity to spread the message and get those vital conversations started.

So what can you do?

Here is the link to our #MatExp campaign page. Or you can go straight through to a list of 8 specific actions that we are encouraging people to take.

The beauty of #MatExp is anyone can do anything, however big or small, whoever you are: user, partner, community group or NHS staff. Your action could be one of those simple suggestions listed or could be your own idea. The sky is the limit! Imagine if we designed maternity care from scratch what would it look like? Would it even be called maternity? How about transition to parenthood?  Every action we each take, however small, keeps the #MatExp conversation going and makes a small improvement. If we all take action together, we have huge potential to improve maternity services and an experience that has an impact on us all.

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Posted in Blogs, compassion, Guest blog, health, maternity, personalisation, poem, well-being | Tagged , , , , , , , , , , , , , | 3 Comments

Our #MatExp #NHSChangeDay campaign goes live … closely watched by Simon Stevens, NHS CEO ;-)

Whose Shoes? is a concept that gets people from all perspectives discussing important issues together as equals, regardless of roles or hierarchies.

Twitter is a bit like the on-line equivalent, although at our workshops people are (usually!) allowed to speak in more than 140 character sound-bites.

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The Whose Shoes? toolkit is not specific to any one subject area. The best sessions now involve co-producing bespoke material designed to help people bring about specific improvements. A lot of our work has been, and continues to be, around dementia care. I have not had much chance to blog recently (too busy!) so am delighted to share our #100days of change story recently posted on the NHS Change Day site. As you will see, Ken Howard and I have made quite a bit of progress since launching our campaign last year and Ken has been extremely effective in breaking down stereotypes about living with dementia wherever he goes – and we have had a lot of fun together along the way.

Ken will be using our approach as part of a post-graduate certificate in co-production next week, working with GPs and patients as part of the Darzi programme. Meanwhile I will be giving a talk about blogging at the #TwitterNHS conference - see, I told you things are busy. :)

The NHS Change Day team has also shown a big interest in our work to improve maternity services, now known as #MatExp.

This is in partnership with the London Strategic Clinical Network and NHS England so has had potential to make a bigger impact more quickly. Over the last couple of weeks we have run a Train the Facilitator event looking at how best to roll the approach out wider, following a series of successful London pilots. They have produced a lovely booklet trying to capture the leadership and facilitation formula.

It feels great to have such fantastic partners – notably Florence Wilcock, Consultant Obstetrician at Kingston Hospital who is leading the project and Kath Evans, Patient Experience Lead at NHS England, who I think is the most can-do person I have ever come across. We are all determined that it must remain a grassroots led initiative. Only people who are really passionate and personally willing to lead local change are ‘allowed’ to run a workshop! Yes, I know, it’s a strange business model. ;-)

Next week I will publish a truly fascinating and inspirational ‘in my shoes’ guest blog which will tell you more.

In the meantime it is wonderful that people coming along to our workshops are choosing to blog about the experience, and again from different perspectives. Firstly Diane Menage, a truly compassionate midwife, wrote this blog about the workshop at Lewisham Hospital.

Then Helen Calvert @heartmummy, sent these reflections after travelling down from Manchester to join our Train the facilitators session:

And now Leigh Kendall has written about the workshop at Queen’s Hospital, Romford. Leigh is Hugo’s Mummy and a wonderful writer and blogger, raising awareness of pre-eclampsia, HELLP syndrome and baby loss. . Meeting Diane, Helen and Leigh and so many others at the workshops is a huge privilege – getting to know each other first on Twitter and then in real life.

I cannot possibly capture all the great stuff that has been happening. But there is a real energy for positive change at the moment and we need to capitalise on it, bringing more and more voices into the conversation.

At the Queen’s Hospital workshop, on the day of a public transport strike, we had 40 places – and 69 people came, some a long distance.

Kath Evans supported us yet again, providing a voice of wisdom based on all the pilot sessions as we finalise the toolkit – thanks Kath!

I was not running this particular session, but went along as a guest as Queen’s Hospital is in the area where I grew up. I was staying in London with an old school friend and we both signed up for the session. Her perspective, as a local resident, was very interesting. Queen’s Hospital are rightly very proud of their improvement record – but it sometimes takes longer for the ‘reputation’ to change with the local people and my friend was really impressed by what she heard and saw.

It gave me a chance to chat to people and link up with people from the Communications and Patient Experience teams to take a bit of video (thanks Sarah and Emma!)
Click on the video to see a session in action.

Our approach is all about local leadership: Director of Midwifery, Wendy Matthews and the whole team at Barking, Havering and Redbridge University Hospitals certainly stepped up to the plate. I can feel a bit of healthy competition between the London hospitals now to make the most of the improvement opportunity. It is wonderful to hear what their ‘users’ have to say, including Felicity movingly telling her story and working with the hospital trust to ‘move from good to excellent”, which is their ambition.

Matthew Hopkins, the CEO, stayed for the whole session.

Why do people see this as unusual? Why is it assumed that the CEO will be too busy with meetings around targets and other ‘important stuff’?

What could be more important than the chance to talk, really talk, with users of your service and staff and find out how things can improve?

And news is spreading about our #MatExp lithotomy challenge!

Thank you Andy Heeps, who came to the workshop – one of a growing number of men taking our very memorable #MatExp #NHSChangeDay empathy challenge!

So far we have men in London, Scotland, the North-West and East Midlands – you know who you are! :) But it is ice-bucket style … so why not suggest a colleague too!

Anyway, I have not yet told you about my fifteen seconds of fame. ;-)

Yes, I had a very interesting and unplanned encounter last week, speaking to Simon Stevens, CEO of the NHS. It was filmed by the NHS Change Day team, so I might be able to get the clip at some point and add it in here.

The NHS Change Day team were doing a ‘takeover of Skipton House’ home of the Department of Health – as you do.

I was invited because our #MatExp campaign has been included as one of the ‘grassroots’ campaigns for NHS Change Day and I was particularly keen to do some more plotting with fab ‘Jenny the Midwife’ who was coming down from Blackpool and whose deeply human Skin to Skin campaign is such an important part of #MatExp.

Another really important theme that has come through loud and clear at the workshops is unhelpful language.

We have had some fantastic ‘lightbulb moments’ as health professionals ‘get it’ and reflect on how language is routinely used and the profound, and usually unintended effect it all too often has on the recipient.

And then a question surely worthy of Jeremy Paxman…

It feels as though the ensuing conversation has united everyone.

In Whose Shoes? terms, we have had responses from all backgrounds and perspectives: a groundswell of #thoughtdiversity, perhaps.

There have been moments of humour and moments of huge hurt and poignancy. We are all people, who happen to be in certain professional or formal positions (or birth positions) at different stages of our lives. We are all united by vulnerability and these conversations seem to have found this common thread that binds us all. It has been incredibly moving to be part of it, but also to observe: to see and feel the sparks flying and fantastic connections being made. A catalyst for change.

The #MatExp conversations have carried on now for days and show no signs of abating. This is just a flavour.

MatExp analytics8We have had 35 MILLION impressions now on this hashtag, which is all the more amazing as most people are not using it!

Words that health professionals use are never forgotten.
Poor language can traumatise.

https://twitter.com/JennytheM/status/567298583616315392

All fuelling our #MatExp J*DI campaign!

Even last night I was sent an email with some fantastic and detailed examples of poor language, which I think will make a great guest blog.

We are proud of these fantastic conversations being generated throughout the #MatExp project ?>> campaign? >> social movement!

We were particularly thrilled that Vicki has been tweeting her very real maternity experience, sending us this lovely picture and having the whole #MatExp community wishing her well!

So my light-hearted, and yet really serious conversation with Simon Stevens, led to a huge Twitter storm about language with lots of detailed examples that health professionals can explore and respond to.

Lots of great articles have been written on the subject of language. Some new ones are being written by women joining our campaign.

I know I have missed including some of the best ones – it is all happening so fast on Twitter so let me know!

And please post comments on Patient Opinion!

Our midwife super guru Sheena Byrom has a wonderful series of videos that we are linking to on our NHS Change Day page. Here is a taster:

Sign up for our highly interactive webinar 11.00am, 26 Feb  https://twitter.com/6CsLive/status/565155824977575936

What will it take to make things change so that each woman consistently gets treated with empathy, dignity and respect?

**What can YOU do?**

Do one or more specific actions as part of our
#MatExp ‘Just*Do It’
NHS Change Day campaign
which has … just gone live!

And, as I sit singing sweet lullabies to the new baby … the conversation is raging – and going global!! :)

And people are starting to sign up for some great actions , including Louise who ran one of our pilot workshops!

And a whole gang of people for the lithotomy challenge!

MatExp analytics8

Posted in Blogs, co-production, community engagement, compassion, health, in my shoes, mental health, personalisation, well-being | Tagged , , , , , , , , , , , , , , , , | 2 Comments

Meetings – and how to add a little magic

In my old life as a local government officer, I attended many meetings. I am not a big fan of meetings. I used to sit and count up in my head the approximate cost of the meetings in terms of salary and try to come up with a value for money formula, rewarding notional money for the points raised and in particular the action that was likely to follow. It was quite a complicated calculation and it kept me somewhat amused if not exactly what you might call ‘engaged’.

Sometimes the meetings were one-to-one. One would be asked at one’s one-to-one meeting what one had achieved since one’s last one-to-one meeting. Some of the things that one was asked were well-nigh impossible, such as reporting on outcomes before anyone really understood what they meant by outcomes. Certainly there was a problem around the fact that outcomes were something that needed to be planned ahead and not just dreamed up for performance data!

I worked with a fabulous team. We had a lot of fun, including a really tacky Secret Santa thing every Christmas whereby we were bought something that reflected our personality. I had some very quirky presents but one in particular served me very well.

So it was at a one-to-one meeting with a very senior manager, when I was asked whether I had achieved some particularly impossible tasks, I produced my new Christmas present. I placed it on the table without saying a word. It seemed much less tiring than babbling a lot of excuses.

The guy looked a bit shocked so I thought I had better explain. “I got it for Christmas. But it doesn’t work.”

We proceeded to have the most constructive meeting we had ever had. ;-)

And this was long before I heard about the fabulous School for Health and Care Radicals… ;-)

What is your magic wand?

Take a look at the amazing magic wand that Jenny Clarke @JennytheM found to promote #SkintoSkin as something that every mother and baby should experience!

Are you following – or better still joining – #MatExp on Twitter?

Jenny and I have teamed up for a #MatExp #NHSChangeDay event this Wednesday, 11 February … watch this space :) We will miss you Flo @fwmaternitykhft!

Gill Flo and Jenny

Gill Phillips, Florence Wilcock and Jenny Clarke

 

Posted in Blogs, in my shoes, personalisation, public sector, social care, well-being | Tagged , , , , , | 3 Comments

Looking at issues from different perspectives. Now known as #thoughtdiversity … ;-)

Capture Ali G with title”In the early days of Whose Shoes?, I worked closely with a wonderful, person-centred Senior Lecturer called Ali Gardner who was at that time working at Manchester Metropolitan University. She now has a similar role at the University of Central Lancashire – who co-incidentally are also long-term Whose Shoes? customers.

Ali and I did some really enjoyable sessions together using the Whose Shoes? toolkit, in the form of a thought-provoking board game, exploring the opportunities and challenges of personalisation with her students. The students said it helped them ‘bridge the gap’ between the theory of the classroom (where, with a passionate lecturer like Ali, they all thought they could immediately change the world!) and the real world of their placements where they found transformational change a bit trickier. One of Ali’s students wrote one of the most popular guest posts in my ‘in my shoes’ series and you can read it here. Interestingly, it talks about the need for professionals to listen…

Ali and I wanted to push the boundaries. We wanted to do some research to try and find the true potential of the Whose Shoes? tool. We secured some funding from the local Improvement Board and brainstormed to invite a really diverse group of people into the room. We had an unforgettable session at Christie’s in Manchester . I watched in awe as people came together from a really wide range of backgrounds and roles – ‘service users’/ patients/ … people’ – together with health and care professionals and became engrossed for a whole day, ‘walking in each other’s shoes’ and learning from each other. The game was merely a trigger; a catalyst. All the important learning was from the contributions made by the participants. Meaningful conversations; breaking down barriers, working across silos and make lasting connections.

That was back in 2010

In fact it was so long ago that there is even a case study about the Manchester event on the Nutshell website! I am afraid it is not updated very much these days – all the important connections are being made through social media! ;-)

This is a film made at the event:

Fast forward to last week >>>> 14 Jan 2015

Img_2283c - thought diversity poster

I was not able to attend the international #ThoughtDiversity webinar held on the 3rd December 2014 but enjoyed catching up with it afterwards. You can view the Slideshare  here and view the film below: a compilation of quotes from the webinar.

I was however very honoured to be invited to the ‘Thought Diversity Hothouse’ organised by NHS IQ and the NHS Confederation.

It was my first chance to listen to and (almost) meet Simon Stevens; a great networking and learning event.  But for me, if I am honest, a day of deep reflection about my journey and how this ‘new thinking’ fitted with my existing work.
And a day of people watching.

Inevitably, I wondered who would be in the room. I felt that, whoever they were, there would be accusations of them (us!) being the ‘usual suspects’. I don’t think they were. I’m not quite sure who the ‘usual suspects’ are at an event of this kind but ‘my table’ had a lead from a CCG, someone from the police, a CEO from a Foundation Trust, an equality activist and other interesting roles… and me and Ken. It felt exciting that my friend and colleague Ken Howard was invited – living with dementia at a non-dementia specific event. That felt different and refreshing.

‘Chatham rules’ were to be observed and I thought this was only right. Fear seems to be a big part of the transformation to a new, more enlightened era of honesty and transparency in many quarters, so people needed to be able to speak out with freedom. There was a poster inviting us to note down any elephants in the room – I wish I had written down one or two but I was probably too busy talking to people and meeting some very special people from Twitter!

Img_2214c - elephant in the roomListen - SilentI think for me the biggest elephant in the room seemed to be that some passionate people (and inevitably the room was full of passionate people) are really not very good at … listening. And until people listen, listen really deeply, and are prepared to think and behave differently themselves, nothing much will change.

I was glad to be there to support Ken to have a voice. I have never had to do this before but, to be fair, we have generally worked together at ‘dementia-specific’ events. This perhaps reinforced for me how ‘silo-ed’ things are. Ken is very charismatic, speaks huge common sense but in a quiet way. Any quieter voice in that room was going to struggle.

We need to hear the quietest voice in the room, and not just pay lip service to this.

Networks

The network as a connective – new ways of working. Graphic by Stoweboyd.com and shared through the School for Health and Care Radicals.

It will be very interesting to see how some people cope as we move increasingly into a new era; as informal networks grow in power and traditional hierarchies become less effective. For some people it will be a huge struggle.

It would be inappropriate for me to tell you about my brush with ‘Mr Hierarchy’, so I won’t. But he will find the power shift particularly painful.

All my work brings different perspectives into the room and I have always adopted the somewhat ‘radical’ idea of having names on badges, rather than roles and organisations. We did this at the Thought Diversity event too.

I take it a step further by not asking people to ‘introduce themselves around the table’, just letting them contribute as individuals, with whatever mix of personal or professional experiences they want to bring to the party. And sometimes it does feel like a party. :)

So, I will just keep finding energetic people to work with and doing what I am doing. Planning a crowd-sourced #hairybiker tour with Ken – “with Ken” in the sense of planning it with him rather than touring Scotland on the back of the Harley! Hopefully he will reach the parts that other hairy bikers living with dementia do not very often reach. Yes, Ken breaks a few stereotypes. And if you want to support him in some way, please get in touch.

Img_8264aAnd did I say that our #WhoseShoes #MatExp maternity project has been accepted as one of the ‘supported’ NHS Change Day campaigns, 2015?

Support from the fantastic team at #NHSChangeDay will give a massive boost to the social movement that is building to get ‘users’ of maternity services talking meaningfully with health professionals about their aspirations and experiences and driving positive change.

We are harnessing the power of the ‘invisible hordes’

We are blending the power of our #MatExp Whose Shoes? workshops and the energy of social media and creating a groundswell that is starting to roar. And ‘Roar behind the silence’ will be published just ahead of NHS Change Day to add to the impetus – and I am very proud to have a chapter, talking about my work, in said book, alongside about forty other amazing contributors from across the world !

I look forward to a planning day in London next week with Florence Wilcock, the #MatExp Lead: a chance to spend some time with other team members working out how best to channel a bit more energy that we currently know how to cope with. A roar. A tidal wave. Whatever you call it, it is growing and if you want to call it ‘thought diversity’, then I couldn’t possibly comment … ;-)

Here is a link to the NHS IQ Storify, with some of the tweets from the #ThoughtDiversity event.

Posted in Blogs, co-production, community engagement, compassion, dementia, education, health, in my shoes, maternity, personalisation, social media, well-being | Tagged , , , , , , , , , , , , , | 2 Comments

In the shoes of … | Ellie Milner, a West Midlands #NHSChangeDay Hubbie :)

Every so often – and sometimes more frantically – my phone pings with a WhatsApp message. I am not really into WhatApp so I know it is likely to be another message from one of the fab group of West Midlands NHS Change Day ‘Hubbies’. They are using it as a tool to stay in touch and plot the next moves as they co-ordinate and support people planning actions for NHS Change Day 2015, on 11 March 2015.

Helen Bevan speaking at the New Health Care voices event in Birmingham

Helen Bevan speaking at the New Health Care voices event in Birmingham

I have been a big fan of NHS Change Day from its earliest days so have been watching with interest to see how the campaign evolves; essential in my view to keep hold of the spontaneity and fun that have made it a global success and inspired countries across the world to share the ethos and energy and set up a means of anybody and everybody feeling empowered to make a difference.

I had met Lydia Salice, another passionate Hubbie,  at the New Health Care Voices event in Birmingham. I suggested that one of the group might like to write a guest blog and Ellie Milner duly sent it to me last week. It felt very timely as we had just heard that our #MatExp project had been accepted as one of this year’s campaigns and we were very excited.

The 2015 NHS Change Day campaign will be built around actual actions and how they have made a difference, rather than just pledges.  I am meeting up with Ken Howard on Wednesday. We are both very honoured to be invited to the NHS ‘Thought Diversity Day’  – and I promise that between my Whose Shoes? approach, always looking at issues from different perspectives, and Ken’s Harley-Davidson-storming approach to living well with dementia, we will offer a bit of thought diversity! Follow us on Twitter @kenhowarduk and @whoseshoes and have your say using #thoughtdiversity!

Anyway, Ken and I will also need to finalise our contribution to the ‘100 days of change’ write-up of outcomes from our ambitious NHS Change Day campaign 2014. Different stories are being published every day – take a look at #100daysofchange and get inspired to join in with your own actions.

So, a lot is happening. But here is Ellie to tell you what it is like to try and get some really good stuff up and running in the West Midlands to make NHS Change Day 2015 even bigger and better than the last two years…

****************

Ellie Milner, Lydia salice and other West Midlands NHS CHange Day hubbies making a difference ... and having fun!

Ellie Milner, Lydia Salice and other West Midlands NHS Change Day hubbies making a difference … and having fun!

Who would have thought that we would have such a diverse group of individuals all working together to take action to improve or celebrate the NHS? When I first heard about NHS Change Day, I got so unbelievably excited. I’d like to share a little bit of what it is like for me… a NHS worker, a student paediatric nurse and patient, to be involved in NHS Change Day.

Throughout my time as a Hubbie for NHS Change Day, not only have I witnessed an overwhelming amount of change within the NHS, but I have also gone through a lot of change myself. When I started my role as Hubbie, I was working at Birmingham Children’s Hospital as the Patient Experience and Participation Support. As you can imagine, NHS Change Day was right up my street. Day after day I would be speaking to children, young people and their families to see what we were doing well within the hospital and what we might be able to do better. NHS Change Day seemed perfect to bring about change, bring it about quickly and celebrate everything that we do.

For the first year I supported Birmingham Children’s Hospital with their pledge to ‘go that extra mile and make someone smile.’ The enthusiasm for this was just incredible, so many teams and departments got involved making both pledges on an individual basis and as a department. Yes, we had magicians in, yes we had balloon modelling, yes people thanked their support workers, yes there were extra tea rounds… but, shall I tell you what was incredible? Those pledges that have lasted and the fact that we can see changes still happening. I just love it! One team used NHS Change Day as a prompt to collect feedback from their patients every Wednesday and act on the feedback- months down the line and that was still happening. On the actual day that we hosted NHS Change Day, there was such a buzz, one member of frontline staff even told me ‘I wish that every day could be NHS Change Day.’ Well, actually it can.

At that point I tweeted about our day and got involved on a regional level coming together with lots of different Hubbies to do what we all love doing the most… making a difference. This is what I just love, the fact that ANYONE can make a difference and it can be done at any time of year but NHS Change Day is a fantastic prompt. At this point I moved onto different things and my life changed a little, in fact I’d go as far to say- my life turned upside down. I was admitted to a hospital myself and spent 10 months in there. I could say that I was absent from NHS Change Day, actually this just gave me even more enthusiasm to get involved. I was no longer doing this from a member of NHS staff’s perspective, I was a patient and I wanted to make a difference for others. I said that I was going to personally share my experiences and try to make improvements for others that may have been on the same journey as me. Through the power of Twitter, I linked up with the Director of Nursing at one of the local trusts and we are in the process of arranging to meet and learn from my story. How incredible is that?! There is no way that without NHS Change Day, I would have had the confidence to stand up and say ‘I have a story that needs to be told and I’m going to tell anyone that listens.’ It is thanks to NHS Change Day that I had that boost and realised that it is okay to stand up for what you believe in, it is okay to say what you think and it is okay to tell people you want change.

This year I am working both with the West Midlands Hubbies and with other Hubbies focused on patient involvement. We have a whatsapp group for our West Midlands Hubbies to share all our experiences, give advice, ask questions and celebrate the successes of NHS Change Day. Every day I look at the group and think WOW so many individuals from so many different walks of life are coming together, making changes and having fun at the same time! It feels like we’re all a big family and I have certainly made some amazing friends through the process. For me, I felt that I needed to involve patients and the wider community a little more as I am certain that everyone has something to say about the NHS. I am able to do this by linking up with other patient leaders nationally to get the ball rolling. 

It may seem like NHS Change Day is extra work or something that you may not have time for. This is a myth. We have the ethos that people contribute as much or as little as they like. I have also found that I don’t have to separate my every day time to work on NHS Change Day as I am constantly talking about it. Whilst I spent some time in a school, I was talking to the teachers about it, now that I am returning to university, I will be speaking to my fellow course mates about it and rallying everyone to get involved. NHS Change Day was even a topic of conversation on Christmas Day! I cannot praise this movement enough, I just love it. I love the fact that I am connected with so many others both in the West Midlands and nationally, I love the fact that I can see so many actions happening that do make a difference for both staff and patients.

At the end of the day, I love the NHS and being able to celebrate the incredible work that everyone does and prompt changes in areas that need it is a privilege. I truly believe that anybody who is involved in NHS Change Day is actually helping to shape the future of the NHS. WE ARE HELPING TO MAKE HISTORY.

Thank you Ellie for your great blog – I just love your infectious enthusiasm :)

If you would like to get involved in any way or find out more then please follow #NHSChangeDay and Ellie invites you to tweet her at @indecisive_23 !

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