I first heard about ‘Dining Companions’ through the work I am currently doing with Florence Wilcock and colleagues at Kingston Hospital, building on our #MatExp project and starting to use Whose Shoes? to explore and improve other areas of patient experience. I love simple things that play to people’s strengths and encourage community involvement – so needless to say I thought helping people in hospital enjoy (and actually eat!) their meals was a great idea.
I was hoping to be able to see the volunteers in action on NHS Change Day when Helen Bevan and the team from the Edge managed to visit them but I was too busy abandoning Florence in her lithotomy challenge to go off to run a drop-in session in ante-natal!
I had ‘met’ Elizabeth Meatyard, the founder of the scheme, on Twitter where she is both positive and disruptive – a great combination.
I did finally get the chance to meet her in person when she came along and joined our Whose Shoes? session at Kingston Hospital’s Open Day. Here is the popular Steller story about the day – a story told in pictures! steller.co/s/4Zab2RE7A3F
I know that the best ideas very often come about as a result of personal experience of something that needs to improve. I asked Elizabeth if she would like to write a blog to tell us the story behind the ‘Dining Companions’ initiative; I had no idea that it would be quite so powerful…
A Little Thing to have Great Impact
As an ex Nurse, I am on the outside looking in although I have a sister, a most wonderful ITU nurse, who returned to nursing following a 10 year holiday!! ( bringing up the kids, ha ha)
We get together far too infrequently but when we do the talk, much to the irritation of the rest of the family, it is always about the NHS. What she would do ,what I would do, if only….
Two years ago, ‘if only’ became a reality, in that I grasped an opportunity to do something about a ‘little’ bit of the NHS which I was unhappy about. Very unhappy about.
A very dear family friend aged just 55 years had spent nearly 8 weeks in hospital , with a final week in ITU before he lost his battle with life.
He was a very popular guy, a funny man. Nearly 300 came to his memorial service to pay their respects He had been a central pin in many friendship groups; I could go on and on…
It was a very painful time and so his memorial, a wonderful two hours on an October afternoon was so uplifting, as we ventured beyond the image of the person we had just lost to the ravages of alcoholism and a long fought battle with mental health, and found the person he had been .
So this is a little of the background…
Mental health problems are challenging for the individual , but also for all who know and love that person. Add to that the label of ‘Alcoholic’ and life becomes very lonely, no matter how many of your friends and family are trying their very best to help support and protect you.
Our friend was no different; we supported him through private rehabilitation clinics and tried to continue to do this as he, time after time, tried to pick up the pieces and start afresh. Family life in tatters, job also hanging by a thread we had drawn on every bit of expertise we had within our friendship circle to find a way.
It didn’t work and the final 8 weeks of his life were spent in hospital where in spite of the very best efforts, his cause was lost.
During this long hospital stay we had set up a visiting rota so that someone would spend time each day just being with our friend coaxing, cajoling, trying to find a glimmer of hope.
During the many visits I noticed too often that his meals were left untouched, clingfilm in situ. Salad that he usually ordered but then didn’t manage to eat. Fluids: same thing. The ability to do anything for himself had gone; he was dependent.
This became a focus for me. I could see that mealtimes were problematic on the ward, as there were always quite a few patients requiring help with their meals, and many more who just needed a little encouragement, or simply packets opening (those tomato ketchup sachets are a nightmare). Added to this, staff of course needed to begin their lunch-time breaks.
Should I complain?
NO. My sister was emphatic. Don’t complain, do something about it. Absolutely, what would I achieve by complaining, and what could I achieve if I came up with a solution?
Dining Companions was the solution
Volunteer help on wards at mealtimes specifically to help patients with their meal was the answer. From opening those wretched ketchup sachets to assisting the patient to eat their meal, even a little sing song if it could help!
The plan: to recruit volunteers from the community, but also to recruit volunteers from within the non-clinical departments of the hospital. Seek a commitment to volunteer for at least 1 mealtime session (1hr) every 3 weeks. I wanted to be able to attract volunteers from all age groups and felt that 1 session every 3 weeks was very ‘doable’.
Although this is a little unorthodox, in that most hospitals run volunteer programmes which ask you to give a few hours per week, it works and we have many people who are still working, giving of their time.
The benefits to the patients I hope are obvious, but the additional benefits I would like to just spell out.
Much of the rhetoric around the way forward within the NHS is about the need for a more collaborative approach across the piste. Better decisions will be made if there is connection from the Executive Leadership through to the front line, and it is embedded. This would allow bottom-up decision making to meet with top-down in a much more harmonious way.
So ‘Dining Companions’ at my local Hospital, Kingston Upon Thames Foundation Trust has been welcomed, supported and embraced by the Executive Leadership Team. The Chief Executive Kate Grimes is a regular volunteer on the wards, as is the Chairman Sian Bates, the Director of Communications Lisa Ward, many of the Non Executive Directors , a few Governors , staff within the finance department…. shall I go on?!
If you know Kate, ask her what the benefits are. I hope she would say that ‘Dining Companions’ affords an opportunity to help as part of the ward team, to deliver a better mealtime service to patients. This is so much more useful than set piece observations, because now you are doing it, seeing it, and, understanding it. Taking a different perspective which may give you some very different answers to all manner of issues you have discussed in the meeting room.
Recruiting volunteers from the community is also hugely beneficial as they have a role as a patient advocate. Dining Companions are encouraged to ‘notice’ things that perhaps could be done better. They have an opportunity to voice their thoughts at regular review meetings and of course contact the hospital at any time if there is a pressing need
My own group of Dining Companions is a group of friends many of whom still work, but could offer 1 hour every 3 weeks to help. We have called ourselves the ‘Hardy Perennials’, as this is the ward we have adopted. It is the ward our friend was on, and so it seemed the right thing to do.
We manage our own google calendar so that flexibility is assured. The calendar is online of course and fed through to the Hospital so that they can monitor. It is important to make the point that all volunteers undergo specifically tailored training and of course all the required security checks before being allowed to take part in the scheme.
I have spoken at the Kings Fund about Collaborative Leadership and I am convinced that this is the only way forward. You cannot achieve integrated services unless a collaborative approach is first in place. Hands-on collective Collaborative Leadership will ultimately bring about the changes we need to see in a Modern 21st Century NHS. We must welcome the objections, and embrace those that can help to find a way to resolve the challenges.
Accept that we must take small steps and embed the resultant changes with close monitoring. Never tick a box because there is always more to do.
Elizabeth Meatyard – Vision into Practice. Trying to offer simple solutions to workplace challenges within the NHS.
emeatyard@btinternet 07723 034645 @