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 , , , , , , , , , , , , , | Leave a comment

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.

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

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 , , , , , , , , , , , , , , , , | 1 Comment

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.


The network as a connective – new ways of working. Graphic by 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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In the shoes of … | Barry Rainey helping his Mum live well with dementia

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Regular readers will remember the exciting series of Whose Shoes? workshops and associated events last year in Kent, in partnership with a fantastic group of passionate people from the Age UK Consortium, led by Sandra Springett, CEO of Age UK, Tunbridge Wells and Diane Aslett who manages the consortium.

I personally ran the opening events and then handed over to this local team to run over 20 workshops themselves before joining them for the final workshop. I was delighted and intrigued when they told me that a family of three – a man (who turned out to be Barry – the writer of this guest blog) and his sister and niece, kept signing up for different workshops as they moved round the county over the course of the project. So I was delighted to meet Barry and his family and learn more about their quest to understand dementia and help their Mum / grandmother to live well with the condition. Barry agreed to tell his story. I love it for its insights and honesty:


042_DSC_2187c 038_DSC_2180c 074_DSC_2282c 059_DSC_2230cOver the last year or so I have gone to quite a few meetings concerning dementia, mainly to learn more about what my Mum is going through, and also to meet others going through the same experience.

I was asked recently why I went to the big meeting of Whose Shoes? (Barry means the ’round-up workshop we held at the end of our programme of 16 workshops in West Kent, commissioned by West Kent CCG)  and what I got from it.

Well there where three reasons I went.

1) We had been to four similar Whose Shoes? sessions leading to the big one and, though I learn new things as I go, I thought going to this final session would be a great opportunity and was not disappointed.

2) It seems at times the more confused I am about dementia, the more I am hoping to take  the confusion away. Alas that was not so successful – there is always more to learn!

3) The main reason I went to this particular event was because I had heard a lot about a guy called Ken Howard who got dementia at a young age and goes to meetings to talk about his experiences. Ken is truly a celebrity  in his own right, and to put icing on the cake, I was lucky enough to have a one to one chat with him about the subject.

Dementia, is it an illness? Well yes it is. Dementia is an illness of the mind. There are different types (such as Alzheimer’s) and they all affect people in different ways.

Dementia can be very hard to live with, especially for say wives looking after husbands 24 /7 or vice versa, but with determination and help, people can live with it very well. Ken Howard is living proof of this. Since he was diagnosed a few years ago, he has re-built his Harley Davison motorbike. As I say, he has become a bit of a celebrity in the world of dementia, doing talks and has also made a video of what happened to lead up to his current life. Remarkable.

My Mum was diagnosed with dementia only a short while ago, though she had had what they call early onset dementia for about five years. Before the dementia, Mum could be a very stubborn person – in fact truth be known she could be a pain in the rear. I do not mean that in a bad way, as an example Mum worked full time when we were younger and expected help with the housework and woe betide if it wasn’t done before she got home from work. And being a young teenage male, I definitely loved housework – but between us all we got it done so I guess she won that one.

My father died about 40 years ago and at the time Mum went through a very hard time. Not only had she lost the man she loved, but now she had two children to bring up on her own. I was 12 at the time and my sister Elaine was 9, and also Nan was living with us, and in those days there was no help like there is in this day and age, you where just expected to pick up the pieces and get on with it. Hence with a lack of help from family and experts, except for some tablets for depression, Mum went through many years in a depressed state. But with determination to do the best she could for her family  and hold down a full time job into the bargain I am today proud to say she got through it, and though she had other bouts of depression over the years, she has always managed to win out and stay  in control of her life.

Though Mum and I have not always seen eye to eye, we have always loved each other in our own way, though till I left home people would have said tolerated more than loved. Both stubborn people who clashed a lot I guess.

After I had left home, got married and started a family of my own, Mum played a big part in our lives and she enjoyed being a grandmother. She visited us regularly and us her, even taking her eldest granddaughter Amy to Spain with her on holiday. We also had holidays all together. The most memorable was a trip to Jersey where Mum enjoyed showing the girls around an island we visited regularly as Mum had an Aunt there we went to see a lot.

Mum worked for many years at Reed Mill in the offices till she was made redundant at about 54 years old, then for a couple of years she did some temping work until my sister Elaine started a family. Then she gave up work so that she could look after Abigail and Simon, Elaine’s two children so that she could go back to work for Kent County Council.

Mum enjoyed this time in her life very much and was a little disappointed when the kids became old enough to look after themselves after school till Elaine got home from work. And so was not needed so much, though she still visited regularly and helped when she could.

Mum has always enjoyed a couple of weeks holiday every year and up till a few years ago, before she became unable to go on her own, she alternated between Spain and Greece, but as the dementia started to take hold we decided that it would be better if she holidayed in this country, and so this year my sister Elaine took her to Cornwall for a week.

Mum is coping quite well at home, she no longer does any real work on her own but with a little encouragement she does help with things like dusting and doing the washing. I think one of the best things that helps is that she is routine orientated, i.e  she has a cuppa at certain times throughout the day. The routine is put kettle on, put coffee in cup, add milk, put water in stir then go back to the telly. She also has carers in a couple of times a day, and with help from my sister and daughter, and of cause me chipping in, which is nowhere near as much as the others, but I find being a night worker I am more restricted in what I can do, in fact if Elaine and Amy did not do as much as they do, I do not think we would be coping anywhere near as well as we do, God bless them.

Not understanding dementia and how bad it can get, we live and hope that with love and care and a bit of help she will be good for a few more years yet.

Dementia is still a huge learning curve for everyone including the experts. Mum is now at what they call stage 3 and I am told there are 5 stages to Dementia, so don’t know what is round the corner but I am told some people are slower than others at going through the various stages, so it’s a case of seeing what happens next.

At the moment we are going ok, and with the help of people such as Age Concern, and a pretty good set of carers that Mum has we move forwards daily.

Thank you Barry for taking the time to share your story and we wish you, your Mum and whole family – and indeed all our readers…

Best wishes for 2015

Please post comments and particularly messages of encouragement for Barry and other family carers who look after loved ones and help them live well with dementia.

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In the shoes of… | Gill’s Mum – Remembering Christmas Past…

Have you been following Sarah Reed’s super advent series, posting Christmas reminiscences from some of her friends and colleagues? If not, have a browse, because it is lovely! I was delighted to be featured this week remembering my very simple Christmas stocking.

It has also brought back memories for me of looking after Betty, my Mum-in-law, living with dementia, and a story I wrote about writing her Christmas cards together. I made an audioboo for the Department of Health that featured in their ‘Time to Remember series – with David Cameron on Day 1!

Well, some of Mum’s Twitter friends were keen to hear Mum’s Christmas memories, including Saffy from Australia …

Xmas treePc270143Anyway, this is what Mum wrote …

With all that is going on about Christmas, all the carol services and concerts etc, I have
been reminiscing about what went on years ago.

Well, of course, it was all very much simpler then. There was no TV, not a lot on radio, and the radio had to be fiddled with and, as I remember, tuned in. But people made their own entertainment and got together more – probably round the piano, which was fun and lively.

I remember one Christmas particularly, because my father was home; unusual in itself because he was in the Merchant Navy and away a lot. My parents had bought me a doll’s pram. Now somehow I knew this, although I wasn’t supposed to, and they had put it in the front room, which wasn’t much used.  One evening when it was dark, I took my courage in both hands and crept in to look at it! Talk about state of the art! It was a mini Silver Cross with all the trimmings! In fact when I took it out shopping later, Mum used to put me in it, when I got tired, and wheeled me home! I was just under four years old at that time, so wasn’t very big.

I don’t remember church services as early as that. But in later years they were very much part of Christmas (as, of course, they should be). I do remember other presents that I and my brother (10 years older than me) got. Mainly annuals (do they still have these books?) and probably sports equipment a bit later. I loved books and could never have too many.

One year my brother had a Hornby Train Set. And, little sister, I was a right pain. We had a big hall and the boys laid the tracks all over it. Little sister usually tried to walk in all the wrong places. I was not popular!

We got together with relatives and played games and charades. I think that still goes on and is enjoyed just as much now. Nice to think that some things persist.

I think my Mum used to put a threepenny bit in the pudding – which cooked for hours – but I never found one. The pudding was lovely though. Don’t have threepenny bits now, of course, they wouldn’t be worth much but they augmented pocket money in those days. We didn’t get a lot of pocket money. Most things were just bought for us. Money was different, of course. In fact it shows how different in the fact that for my first job, at 17, I got 17 shillings and sixpence a week. Not even equal to a pound now!

Mum would love to hear whether these memories strike a chord with any of you or what your own Christmas  memories are.

Posted in Blogs, Gill's Mum, Guest blog, personalisation, well-being | Tagged , , , , , , , | 1 Comment

Transformational change – through vibrant, inclusive collaborative projects! #MatExp

The 26th Annual IHI National Forum on Quality Improvement in Health Care took place in Orlando, Florida last week: the largest such conference in the world – #IHI26forum. I was not there but sometimes I felt as if I were (apart from the sunshine!) as I found it compelling. I followed it closely; indeed at one point I was listed by @Symplur as among the top influencers, once again showing the power of Twitter and building global networks. ;-)

But that somewhat ephemeral moment of glory is not the point of this blog.

It is to give an update on our #MatExp project, using Whose Shoes? tools, with new co-produced scenarios, to explore what needs to change to deliver person-centred maternity services.

Working in partnership with the London Strategic Clinical Network, and supported by NHS England, we are very excited to be putting into action some of the ‘new power’ principles receiving huge interest at the IHI conference.

A couple of  specific  examples from the highly topical work of Helen Bevan (@HelenBevan) and the NHS IQ ‘Horizons’ team are relevant to the collaborative and inclusive way in which we are working. Internationally renowned (including a global award) as one of the REAL top influencers in global health care, Helen is a great curator and sharer of innovative approaches.

I loved this recent ‘Top 10 tips’ from Claire Cater, Founder, The Social Kinetic, particularly this quote about needing to engage people before real change is possible:

“Planning for sustainable change in today’s world means turning traditional thinking on its head. The successful leaders of today and tomorrow will begin their transformation programmes with engagement and they will be bold enough to let what comes out of that process shape their thinking”

But the main example I am thinking of is a tweet that went viral at the IHI conference when Helen shared Oscar Berg’s ‘Pyramid’.

It is just one slide from a really rich suite of slides about transformational thinking.

And it is this thinking that is feeding into our #MatExp project. And hopefully vice versa as it is fab ‘J*DI’ (ACT – right up at the top of the pyramid!) leaders such as Florence Wilcock, Divisional Director Specialist Services & Obstetrician at Kingston Hospital, and #MatExp Lead who are providing real-time ‘grassroots’ examples of how to inspire change that really engages both ‘users’ and professionals and makes a difference.

And helps people understand why things need to change

We are pulling people in, rather than pushing outwards.


People are spontaneously spreading the #MatExp word, such as Diane Menage who came down from the Midlands and wrote this lovely blog after our last workshop in Lewisham. I somehow think Diane will be in pole position when #MatExp comes to my home town of Coventry. ;-)

And word is spreading to Scotland…

And linking in with our recent #Dementiachallengers tour of Scotland, weaving threads between different ‘conditions’ because actually we are all people, united by vulnerability.

And then it is re-tweeted by Carrie Marr, a senior health care leader in Australia. And this is how Twitter and community capacity building works!

These connections will form even more powerfully and be easier to measure now that #MatExp is an ‘official’ health care hashtag.

I had gone ahead and applied to ‘register’ the hashtag with Symplur without ‘asking permission’ because that is what #boatrockers do. There is a lot of trust in our project that we are all just working to a common goal: to improve the experience of pregnant women right through to early parenthood.

This was very timely as meanwhile Florence was taking the same approach, wacking in an application to be a ‘supported’ project in #NHSChangeDay 2015.
“Help with “skills & support necessary to create a large across the
Wow, how good would that be!!

Florence had left the ‘impact line’ blank (despite the fact she is running round Kingston Hospital chasing up all the pledges people have made) confident that we can add this information as we go. “Working out loud” (another #radicals concept).

We plan to report on early impacts in the webinar we are doing  together, now scheduled for the New Year.

Symplur and ‘official hashtags’ were new concepts for Florence so I tried to explain what this all meant and how it could help #MatExp grow.

We are also planning a national  ‘Train the Facilitator’ session – more news of that soon but the date will be 2 February.

And meanwhile, our #FabOb Florence was dealing with her vital day job – and indeed night job

Linking back to the beginning of the blog, it was brilliant to find that Helen Bevan is interested in what we are doing – particularly the embryonic plans (excuse the pun) to roll the #MatExp project out through a ‘Train the facilitators approach.’

So Twitter is helping us find like-minded people quickly and regularly – and get noticed by senior leaders in the NHS and internationally. People seem to be picking up on the energy of this project and they want to be part of it. They are seeing the potential to really make a difference in maternity services, challenging accepted wisdom about who the real ‘experts’ are and putting women and families centre stage.

We have a great team, loads of passion – and it is exciting. And the project arose directly from Florence’s #NHSChangeDay pledge to use Twitter.


Huge thanks to Kath Evans, Patient Experience Lead at NHS England, for her passion (in everything!) and fantastic support for #MatExp, including taking part in all of our pilot sessions and her thoughtful, constructive feedback and ideas about how to roll the approach out across London and the regions.


I am looking forward to speaking at the NHS Twitter conference in London in February and I expect some of these slightly unconventional methods will get a mention. ;-)

Tomorrow 16 December sees the #WhoseShoes #MatExp roadshow, as it is fast becoming, moving on to West Middlesex Hospital. It will be a strange day for me – a bit like leaving the baby with an excellent childminder for the first time as this will be the first time the Maternity version of Whose Shoes? has been out of my sight.

It is all part of our ‘devolved leadership’ model, passing the baton from one hospital to the next and enabling the local team to take over and fire up their own community. My friend and colleague Anna Geyer, Director of New Possibilities, is ‘graphic recording’ all the pilot workshops and these records become the focus for real actions in response to what people have said. Indeed I am already seeing an element of healthy competition between hospitals slipping in and a lot of pride in terms of who will have the most impressive outcomes to report as we follow up the pilot stage next year.

So to fire up our colleagues in West Middlesex, a few images from the excellent workshop held recently in Lewisham, expertly led by Helen Knower, Head of Midwifery.

And a bit of virtual nagging from Florence to make sure everyone stays focused on that ‘ACT’ segment at the top of the triangle.

And the networking goes on.

And the workshop is judged to be a success.

So tomorrow, I will be like Florence watching nervously from the sidelines as I pass the baton onwards.

But not really as I know Louise Page and the fab West Middlesex team will take the baton and run with it. Good luck everyone!

This is the third in a series of blogs charting the progress of our #MatExp project, using a principle called ‘Working Out Loud’ which is similarly part of the New NHS Era. You can read Part 1 , outlining how the project started, and Part 2, outlining our first workshops. After the workshop in West Middlesex Hospital tomorrow, we have two more pilot sessions in London. We will be planning a wider roll out shortly, including a ‘Train the facilitator’ workshop in February. Please leave comments, including letting us know how you would like to be involved.

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Whose Shoes? – Maternity. Passing the #MatExp baton … to Lewisham!

Our baby is growing! Since its conception back in June, the Whose Shoes? #MatExp project is finding its feet and even kicking a bit. In a good way, of course!

We are also posting information about this project – and the type of improvements we are hoping to achieve, working in partnership with women and families, on our crowd-sourced #MatExp Pinterest board.

I have so far told the story of how the project came about, leading up to our first workshop at Kingston Hospital – and published a Steller (visual) story.


Our #MatExp team. Or at least some of us – as the whole approach involves constantly drawing in new people, listening to their ideas and working TOGETHER for positive change!

We ran the second of the initial series of five pilot workshops at Lewisham Hospital on 21 November and were delighted that Diane Menage, a midwife from the Midlands with a special interest in compassion in maternity services, a.k.a @Dianethemidwife came down and wrote this great blog about her experience of it.

Diane had just come back from the ‘Compassion in Healthcare Conference’ in San Francisco.
She had been telling everyone about Whose Shoes? and our project, including Roman Krznaric, a world leader on Empathy!

Our work was also showcased at the Royal College of Midwives conference.

So how did we pass the baton from Kingston Hospital to Lewisham and Greenwich – and where do we go from here?

Key factors were the firm foundations and attention to detail established in Kingston. The NHS England team had produced a ‘Hospital pack’ outlining the essentials of running a successful workshop (which, unofficially at least, now includes a cakes #Bakeoff!).

Florence Wilcock then used the experience and feedback from the first pilot to initiate some great leadership notes to ‘bring the sessions alive’.
This is such a key part of how Whose Shoes? works – creating energy and local ownership as well as a ‘process’.

We are all constantly talking to people to unearth the key themes and topics – for example interesting conversations around…

Maternal depression and possible links to housing


And to bring in as many perspectives as possible and tap into the rich experience within the wider maternity experience community

Florence was busy until the last moment drumming up support before finally handing the baton to the Lewisham team.

It is very important to involve Dads, including young Dads!

There was also plenty of social media hype with regular countdown style updates, meaning that the Lewisham event was oversubscribed!

And very pleasing indeed to see that fab Helen Knower – who was leading the Lewisham workshop and had totally refused to join Twitter… joined Twitter and got a lovely reception. Well done, Helen!

The community is growing (Anyone on Twitter interested in maternity, follow these people!)

And the Lewisham #Bakeoff was in full flow at midnight…

And lots of other creativity…

A lovely poem from Florence’s Mum…

Our first song…

And a film or two!

And sharing personal stories

The Lewisham workshop deserves its own blog as there were so many fab tweets, photos and ideas generated, captured through Anna Geyer’s wonderful graphic recording.

Suffice to say that the session went really well. It felt very action-focused, fuelled by the way Florence has been following up the conversations and pledges from the Kingston workshop so that everyone is very clear that this project is about real change and not just interesting discussions.

There is loads of really great work going on already;  this project aims to make it even better – and a lot more consistent!

We are proud to be building a change management platform!

We have a great team of passionate people and it is brilliant to see them getting some recognition for their dedication and commitment to improving maternity experience.

The next workshop is on 16th December, closely followed by our #MatExp webinar on 17th December.  Join us – we are looking forward to sharing the learning and outcomes so far!

Please post comments about any topics that you think we should be including or tell us how you would like to be involved. It seems that everyone has a birth story!


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