#NHS1000miles for #NHS75, are you up for a challenge?

This time of year offers an opportunity for us to look back as well as providing time to look forward to the year ahead, what will 2023 bring?

2022 has been complex and frustrating in so many ways, yet I am in total awe of public sector workers who remain committed to making a difference to others, whether in local authorities, social care, public health, education, policing, emergency services and our NHS. Our public services are delivered by people juggling super busy lives, often holding multiple personal and professional roles, including caring for family members.

The community of #NHS1000miles will this year celebrate the 75th birthday of the NHS, NHS England have blogged about the ways we can get involved in marking this fantastic year and have profiled #NHS1000miles https://www.england.nhs.uk/nhsbirthday/get-involved/ In 2018 we celebrated the 70th birthday year and commenced this annual challenge, as a result we’ve grown a community of wonderful people who’ve all been determined to be a bit more active in daily life. Each Sunday evening at 7.30 we all post a mileage update, along with a picture from our week. It’s often a quick tweet as people are juggling dinner, catching up on a TV show/good book/radio show or podcast and no doubt pondering and prepping for the week ahead. Yet a scroll through the timeline of #NHS1000miles (often at 5am on a Monday morning over my first of many coffees) offers great inspiration and fab people to follow too, I find it really uplifting as the new week commences. It reminds me regularly that activity can fitted into busy lives, whether it’s a Saturday morning ParkRun or a commitment to dumping the lift at work, taking the stairs each day or walking a bit more on a daily commute.

Whilst #NHS1000miles is about banking miles in anyway, walking, cycling, swimming etc, it’s running that’s my activity of choice. Running for me offers me a meditative plod and headspace to ponder issues, it gives me the space to ‘just be’ along with appreciating the changing seasons. Seeking out snowdrops, daffodils, followed by bluebells, will carry me through the winter and spring until lighter days return when I’ll have the chance to enjoy pre-work warmer sunrise runs again.

2022 gave me my longest run yet, 62 miles in one go, ‘race to the stones’, enjoying a sunset and sunrise in one adventure with wonderful friends was a real treat. The wettest and wildest run of the year was definitely ‘Brecon to Cardiff’ a 43 miler that was ‘character building’, getting lost added to the experience and the memories too! It’s also been good to get travelling again, visiting the Northern Irish coast and doing the ‘Giants Causeway Marathon’ was a highlight and Chicago Marathon was a fun city running experience. Yet it’s the regular weekly ParkRuns that are highlight of my week, a natter with my friend Louise on the way there and on the way back, seems to put the world into perspective and smiles from regulars including Alison (of #NHS1000miles) are always appreciated.

So some thoughts as we head into 2023, let’s all make small steps in being a bit more active, #NHS1000miles isn’t a competition, it’s a community of encouragers. Every step forward makes us stronger, why not join us? If you haven’t tried a ParkRun perhaps give one a go in 2023? I’ve lined up a number of challenges to keep me active in the year ahead which I’ll share with you in the year ahead and this year I’ll also be fundraising for brilliant Barts Charity https://www.justgiving.com/fundraising/kath-evansnhs75

Finally a thank you and a shout out to all those who’ve been part of #NHS1000miles over the past 5years, it’s exciting to see that this inclusive challenge keeps growing!

A highlight of 2022!

#NHS1000miles 2022 calls

As we come to the end of 2021 members of the #NHS1000miles community from across the country are adding up their mileage, selecting pics and composing their final tweets, celebrating a year of being a bit more active than perhaps they normally are because they are nudged gently onwards by others, knowing that investing in our well-being pays dividends in so many ways. Yet ‘knowing and ‘doing’ are sometimes different, hence the importance of the #NHS1000miles community which inspires us all! Thank you to everyone who’s contributed in 2021 💫

But where did #NHS1000miles start? Back in 2017 Antony Tiernan who tweets as @AntonyTiernan was leading on the 70th Birthday celebration arrangements for the NHS, he was encouraging us to think up fun ways to mark the occasion, so a few of us thought that making an effort to be more active would make a great practical gift. And so in the 70th birthday year of the NHS the inclusive community of #NHS1000miles was born, all miles, anyway count, walking, swimming, cycling, running. Here’s the link to the first blog, kindly supported by the @wenurses team Teresa and Nick Chinn http://wecommunities.org/blogs/3338

So 2018 saw a phenomenal community of people regularly adding up their miles and posting updates on a Sunday evening at 7.30pm, the end of the year 2018 blog shouts out some of the fab people who helped get #NHS1000miles going http://www.wecommunities.org/blogs/3443

The 2019 blog celebrates how the community continued to grow https://kathevans.com/2019/12/26/running-to-2020-and-resetting-the-nhs1000miles-clock/

And the 2020 blog provided a visual summary of how we make our own adventures https://kathevans.com/2020/12/27/nhs1000miles-2021-are-you-in/

So as we reflect back on 2021, what have been the highlights?

@NorthwayRuth is a regular ParkRun volunteer and a member of her local running club who supports others on their running journey… @wendyjnicholson has shared amazing wild swimming pics!

@MarcHarder has made a remarkable recovery ❤️‍🩹 this year after a significant cardiac episode and has shared how we can get active again when health issues challenges us…

@Ushert head of staff well-being at the Royal London hospital won an ultra run this year!!! … talk about awesome 💫

@Triciahandley who leads on improving care for people with Learning Disabilities regularly shares her ParkRun adventures and has recently been posting about her chilly lido swimming adventures 🏊‍♀️

@LindaChibuzor is always glamorous (there’s usually a fab splash of pink in her outfit!) and inspires us all to squeeze in activity in amongst busy jobs.

@THCPrimarycare has some big adventures ahead in 2022. She blends her active life with supporting primary care and is definitely worth a follow!

@SaraTurle our ever chirpy early morning runner posts her wisdom each day with beautiful pics to encourage us all.

@JackieSmith_nmc our #ChiefCoach has continued to encourage us all even though an injury has caused significant challenges in 2021 … we’re all so delighted to see her running again!

I could go on forever! The #NHS1000miles community is full of fabulous ‘normal’ people with very busy lives, who are making a choice to keep active by counting the miles, snapping fun pics and sharing adventures…knowing others are willing us onwards always helps!

So I suppose in this community, we’re accountability pals, and we’d love others to join us in 2022

Everyone is welcome, here’s what’s needed …

1. Set a goal to reach 1000miles in the year

2. Prioritise being more active (all ways count) … a flight of stairs … a brisk walk .. starting couch to 5k …

3. Using the ‘check-in’ at 7.30pm on a Sunday to share progress and pics if you can

4. Use a spirit of encouragement and empathy to support the community, recognising life can and indeed is pretty tough on occasions YET exercise can be hugely therapeutic.

I’m certainly looking forward to hearing about about your adventures in 2022 💫🏃🏻‍♀️🚴🏻‍♂️🏊🏼

Finally a final massive shout out to @suecollins2 @hoffiOT @Hannahdementia @michBS3 @niamhie53 @AnitaRolfe @CalvinMoorley @mirri1970 @PeterDraper3 @AliNewt5 @dover_nicola @sarahholbrook92 @pcei_jane @QmMudie @sue_wilkinson @pauljebb1 @wilkoloopylu @shiv_smith @hepworth_becky @rachblacklabel @lindawain444 @l_wasinski @critchleyanna @juliafairhall3 @jeansaunders2 @rosetintedlass @DebDjh @LucyBray9 @HelenLa58276920 @clairem7523 @AllanTallan64 @DrSuparnaDas @sfenwickelliott @APegrum @ShrewsGav @MarcelleTauber @K_G_Spearpoint @J_Critcher @firogers3 @jakeahess @JoConnolly_ @saraht40 @DianaBelshaw @jomwlever @ADigitalWitch @chrisbowdenOT @MawdsleyMark @bestwick_hannah @judestonenhs @RL_MHnurse @datt_colette @AbbieFBarnes @JocelynKurtulaj @CJThomo @PaulJSams @logan_angie @BecksBDaniels @nikkilouh for fabulous posts in 2021, thank you all! 👏🏻

Pondering on #StressAwareness Month, a personal well-being plan to strengthen resilience and grow self compassion?

Did you know that April is stress awareness month? Public Health England have a great quiz to help you explore routes of our stress and provides some suggested interactions, I had a go and it got me thinking https://www.nhs.uk/oneyou/every-mind-matters/ Why not have a go and share with others?

A recent Barts Health Twitter chat about well-being got me thinking about about personal well-being plans, and I’ve been pondering if can they help us become more intentional in promoting our own well-being? Could they encourage us to pause and reflect on where we are now and what we need to do more of? We’re used to creating ‘Care Plans’ for patients, but perhaps we can adopt the nursing process of ‘Assessment, Diagnosis, Planning, Implementation and Evaluation’ for ourselves when it comes to reviewing where we’re at personally and what we need to ensure we keep flourishing.

There are many reasons why we may not prioritise this, why we do allow ourselves to focus on ourselves? Perhaps some of our thinking includes …I don’t have enough time; I don’t have enough energy; I have more important things to do; I have to take care of everyone else first; it’s too hard; it’s not going to make a difference; I don’t know how to do that; I’ll have more time tomorrow; it’s going to be to uncomfortable or painful; I’m not worthy, important enough to focus on …

As managers and leaders in health and care, our actions can encourage others to address some of these thoughts. Perhaps through role modelling and encouragement we could nudge others to develop their own personal plans too just as we expect people to have continuous professional development plans?

Self Care isn’t selfish, we need to apply our own oxygen masks before helping others

Leigh Kendall of NHS Horizons blogged on the subject https://nhshorizons.passle.net/post/102gnwb/creating-a-wellbeing-action-plan and signposts us to Mind UK who have developed resources to support us in proactively considering the actions that support our Mental Health https://www.mind.org.uk/workplace/mental-health-at-work/taking-care-of-your-staff/employer-resources/wellness-action-plan-download/.

Promoting well-being supports us to address lots of different areas in our lives, this graphic highlights that our self-care plans can cover a whole range of interventions to help us feel better about things, take control …

Then yesterday a colleague tweeted about a very tough day and another colleague responded suggested watching a Ted Talk by @drlucyhone on resilience, I have to admit it blew me away, if you can please invest 16 minutes in watching it https://www.ted.com/talks/lucy_hone_3_secrets_of_resilient_people Lucy shares that rubbish stuff happens to us all, focus on the stuff we can change and find things to be grateful for. And importantly ‘Ask yourself, is what I am doing helpful or harmful?’ Do more of what is helpful to you, stop doing what’s harmful to you. Thank you @researchnursed 💫

#NHS1000miles 2021 are you in?

How has 2020 been for you?

As Nessa, played by Ruth Jones in Gavin and Stacey would say ‘I’m not gonna lie to you…’ it’s been an odd, frustrating and on occasions very very sad year. I’ve said goodbye to too many people in 2020 and am acutely worried about the long term impact of the global pandemic on our children and young people. However something that has kept me grounded has been running and the wonderful team #NHS1000miles. As I scroll through my camera roll I’m reminded of lots of happy times in 2020 …

January 2020 ‘Cold Christmas’ ultra
with Elaine & Alex
Park Running with Karen, Charlotte & Jerry,
Feb 2020
March 2020 provided the final official run before the Pandemic took hold …
April 2020 brought out rainbow running shirts
When the official ultras are cancelled we make our own, thanks Barbara, May 2020
June 2020 meant running through glorious fields of poppies
July meant Saturday morning running with Sharon and Louise
August meant a self organised marathon from Rhossili to Mumbles. I think coastal runs are my all time favourite!
The month of August brought the #WeActive challenge with @WeNurses which was so much fun! Wonderfully the nurses won again! Whoop 🙌 can we smash it 2021?!
September meant celebrating a 50th birthday whilst playing aeroplanes
October was the very hilly and windy Beachy Head, which was brilliantly organised!
November offered beautiful views of Hertfordshire, lots of muddy trails explored in 2020
And December provided Santa’s helper, the wonderful ever cheerful Jane! So as we reach the end of 2020 I’m grateful for the friendships and adventures that have been accumulated despite Covid19, the resilience and positivity of fellow exercise pals has been so appreciated, grateful to you all..

Hoping you’ll join us on the adventure of #NHS1000miles in 2021 😉

Here are the links to previous #NHS1000miles blogs for inspiration

2017/2018 http://wecommunities.org/blogs/3338

2018/2019 http://www.wecommunities.org/blogs/3443

2019/2020 https://kathevans.com/2019/12/26/running-to-2020-and-resetting-the-nhs1000miles-clock/

& here’s the bling of 2020

Doughnuts and the courage to continue…

When did you last have a doughnut?

It’s been a wonderful ‘homework’ task set by ‘Partners in Paediatrics’ to reflect on resilience, and for me it’s been about everyone having the courage to continue in the most challenging of times. Let me tell you more ….

Doughnuts were a bit of a theme here in North East London throughout wave one of the pandemic as we learnt to adapt to the challenges that were presented to us. The sugar boost I’m sure helped to draw on hidden reserves of strength, both physically and mentally seeing us through, although I’m not sure Public Health England would approve!

At the centre of every good doughnut is the jammy bit in the middle, for me it’s what a good doughnut is all about, a bit like the babies, children, young people and families who were and remain our central focus, the jammy bit!

Our absolute priority as champions for child health is to shine the light on issues that matter most to them, keep them safe and wherever appropriate and possible, out, of a hospital environment. Whilst thankfully children were not the face of the pandemic, mostly being spared the direct effects medically of Covid19, they are and will be the biggest victims of this evolving crisis. The crisis is having and continues to have a profound effect on their wellbeing.

Central to addressing child health is the presence of a resourced and cared for workforce, retaining staff, yet also releasing staff to support adult areas, was challenging, the redeployment of staff at the height of the crisis meant the development of additional skills and training. It was our senior ward managers who led the way, taking them out of their sphere of clinical confidence. But what we didn’t predict was the isolation and loneliness felt by many redeployed staff at this time. It was a Clinical Nurse Specialist who led the way in identifying this, she created a peer support group, circulating names and numbers on a Sunday evening for a checkin with staff at the beginning of each week, offering a listening ear, signposting to additional support and practically demonstrating that redeployed staff hadn’t been forgotten. The CNS who led this work was nominated for a ‘Cavell Star’ award, from the Cavell Nurses Trust (@CavellTrust) by a colleague to recognise her contribution. Encouraging individuals to lead the way and celebrating initiative taking, role models to everyone that we all have a part to play in shaping cultures and can take action. Helpfully the peer support programme has now led to further conversations about how the model of clinical supervision works for staff across the organisation, wonderfully its being led by practitioners directly delivering care, rather than it being imposed.

Celebrating contributions, Cavell Star

Bringing the over 50 members of staff from Children’s services who’d been redeployed together in July for a day of reflection (and you’ve guessed it doughnuts) helped to connect people to each other’s experiences and know that they were not alone in how they were feeling. There were other interventions that supported the resilience of the teams, which offered the courage to continue, regular daily briefings, a 10k fun run (on one of the hottest evenings of the year) organised by another one of our clinical nurse specialists, and recently as we’re heading into winter, a Trust wide ‘Winter Wellness’ week where we banked our steps to achieve #BHWalktheWorld. Oh and there was an online virtual biscuit baking session with a follow up soda bread making session too. All of these interventions and many more, reach out and connect people, bringing the NHS People Plan to life, in meaningful ways, building stronger resilient communities, growing a sense of belonging and strengthening our resilience for what’s ahead.

Throughout the pandemic we have worked collaboratively as a system across North East London, our Sustainability and Transformation Partnership (STP), the emerging Integrated Care System (ICS) which includes Community, Mental Health, Primary, Secondary, Tertiary Care, Local Authority and Voluntary Sector colleagues, has brought us all together to collaborate on Child Health issues.

In the height of the pandemic we were concerned about delayed presentations to A&E so information resources were created by local GPs and Paediatricians to reassure families that we were open for them https://www.eastlondonhcp.nhs.uk/ourplans/children-and-young-people.htm

Yet now we’re facing challenges with managing social distancing and the prevention of nosocomial infection. So there’s been a need to reconsider how we build resilience within families. Many years ago I worked on a programme to reduce emergency department attendance (https://www.rcem.ac.uk/RCEM/Quality_Policy/Clinical_Standards_Guidance/External_Guidance/Paediatric_EM_Guidance__NHS_Institute_/RCEM/Quality-Policy/Clinical_Standards_Guidance/Paediatric_EM_guidance__NHS_Institute_.aspx?hkey=d37183bc-4ad0-4649-b6cf-3c659f79ebe4) so we’ve recently been revisiting this, data analysts confirmed the top reasons for A&E attendance in North East London as being for

1. Accident/Injuires

2. Fever

3. Abdominal pain/diarrhoea & vomiting

4. Respiratory issues

5. and Rashes/skin presentations

It made us ask, have we got accessible parent information on accident prevention and management of these childhood illnesses? NHS Choices have them, but we took action to make sure we were promoting them locally in a range of ways. We’re also promoting culturally focused short animations developed by one of our CCGs (https://www.towerhamletstogether.com/care-confident) to supplement written information.

Another opportunity presented to us has been to explore growing resilience with young people through youth social prescribing, building on our youth volunteering and NHS Cadets programme, specifically focusing on our connections with young people who are in need of additional support.

In one of our boroughs a GP is running clinic sessions based in a youth centre alongside youth workers, mental and sexual health professionals and violence reduction programmes, its having great impact and is currently being evaluated by the Association of Young People’s Health (@AYPHCharity).

In another borough over 400 Royal Society of Public Health (RSPH) Youth champions https://www.rsph.org.uk/our-work/programmes-hub/young-health-champions-test.html have been developed by one the Public Health teams, they are now peer health influencers.

Most recently we’ve looked at how we support young people who are care experienced into employment in the NHS bringing to life the model of ‘anchor institutions’ (https://www.health.org.uk/news-and-comment/charts-and-infographics/the-nhs-as-an-anchor-institution) and exploring what the ‘care leavers covenant’ https://mycovenant.org.uk/about/ means for us in the NHS.

A key ingredient in all of these STP meetings has been the children, young people and families. Young people with mental health needs, reminded us of the importance of professionals building trusting relationships with them and the impact continuity of care has on them. A mum whose son has asthma challenged us on our lack of accessible information and how complex navigation of the system is for the population who may not be as familiar with health services. A sister of a 16 year old who had died in Haven House, one of our local Children’s Hospices, shared her sisters bucket list and how they’d laughed as they’d spent time in the hospice garden together plotting their next adventure. These were the highlights of the system wide meetings, giving us all a little bit of headspace and energy to build resilience and to keep working collaboratively on what matters most by hearing directly from users of services.

Helpful national reports have emerged during this time that strengthen our voices, offering affirmation on key issues as we advocate for and with children and families.

Children’s views on well-being and what makes a happy life was published in October by ONS offering important evidence based insights into the things that children say matter for a happy life, vitally including that feeling that their views are being listened to by decision makers matters https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/childrensviewsonwellbeingandwhatmakesahappylifeuk2020/2020-10-02

Best Beginnings and Partners published ‘Babies born in lockdown’ in August (https://babiesinlockdown.files.wordpress.com/2020/08/babies-in-lockdown-main-report-final-version-1.pdf) Alison Baum, Best beginnings CEO asks us to shift from a patchy, fragmented family support landscape, to a nurturing society that supports the caregiving capacity of parents during their transition to parenthood. They ask for support to wrap around the needs of families and communities, rightly saying this will happen if parents are enabled to take a lead in designing better systems, working alongside charities, community groups, and statutory services.

Childhood in the time of Covid19 was published by the office of the children’s commissioner, (https://www.childrenscommissioner.gov.uk/wp-content/uploads/2020/09/cco-childhood-in-the-time-of-covid.pdf.) The reports highlights that before the pandemic 2.2 million children in England were living in households affected by any of the so-called ‘toxic trio’ of family issues:

domestic abuse,

parental drug and/or alcohol dependency,

and severe parental mental health issues,

During the pandemic these numbers will have swelled, fuelled by families locked down in close quarters for weeks and months, and an emerging economic crisis adding pressures on family finances.

The report asks for the full range of services which protect children to be prioritised, including children’s centres and visits from social workers, Viv Bennet and Ruth May’s letter (https://www.local.gov.uk/joint-letter-winter-planning-support-children-and-families-7-october-2020) to the system last week, specifically asked that Health Visitors and School Nurses were not redeployed in the second wave.

Experiences of Parent Carers in Lockdown from the Disabled Children’s Partnership (https://disabledchildrenspartnership.org.uk/wp-content/uploads/2020/06/LeftInLockdown-Parent-carers%E2%80%99-experiences-of-lockdown-June-2020.pdf) highlights the experiences of 400 families in lockdown, parents talk about extreme exhaustion, stress and sleepless nights, which have pushed some families to the limits. They share their overwhelming feeling of ‘being abandoned by society’, to deal with often complex care and medical procedures on their own. Parent carers also talk about siblings, non-disabled children having to take up the slack. A lot of concern about increased behaviour challenges and meltdown, children going backwards or falling behind is also highlighted.

Starlight the Children’s Play Charity, published their review on ‘the impact of play in hospital’ https://www.starlight.org.uk/wp-content/uploads/2020/10/Starlight_ImpactOfPlay_Report_Oct20.pdf and as well as offering a contemporary perspective on the evidence relating to the importance of play highlighted the impact the pandemic is having on increased isolation, lack of access to play facilities and resources, and further pressure on families.

Clearly there’s lots more to do on our journey, so we do indeed need the courage to continue, all segments of our doughnut play a part, so together let’s ….

1. As Children’s Champions, keep speaking up for and with Children, Young People and their families.

2. Keep a focus on staff wellbeing and our workforce in the most complex of circumstances.

3. Use this opportunity to continue to progress integration across all our services, particularly supporting parents with access to health information to support them make informed, empowered choices.

4. Grow Youth Social Prescribing opportunities and youth volunteering, keeping a focus on our most vulnerable young people, such as those who are care experienced.

5. Use evidence collated in national reports to make sure in our local systems #ChildHealth has a place in the spotlight.

It feels like now more than ever, across the community of child health we all need the courage to continue in our collective ambition to ensure every child’s right to healthcare to support them in achieving the very best life outcomes, it requires us to be collectively resilient, it’s a challenge that’s never been more important.

Participation holds magical, transformative qualities, #hellomynameis Kath and I’m a Children’s Champion..

This blog is based on a presentation at a ‘Don’t forget the bubbles’ @DFTBubbles online conference on 26/8/20.

I want to focus on you, just for a moment I’d like to get you to reflect. Who (outside your immediate family) believed in you as you grew, who encouraged you to speak up and be heard? What did they do? How did they do it? How did they make you feel?

There’s a wonderful Ted Talk (https://www.ted.com/talks/rita_pierson_every_kid_needs_a_champion) by an educator of over 40 years, Rita Pierson, it’s well worth a listen! Her message? ‘Every child deserves a champion’. She reminds us that every child needs an adult who will never give up on them, who understands the power of connections and insists that they become the best that they can possibly be’.

Significant learning comes from significant relationships, but let’s be in no doubt this is mutually beneficial to the child and the adult.

May I take you back in history? Let’s go back to 1919, Eglantyne Jebb, was a teacher and social reformer. She had a vision to achieve and protect the rights of the children, they were extended in 1954, and in 1989 the UN Convention on the Rights of the Child, a landmark human treaty was ratified. Article 12 highlights their right to express views, feelings and wishes in all matters affecting them and for them to be taken seriously, article 13 highlights the importance of accessible information.

Eglantyne formed the ‘Save the Children fund’, from the outset they listened and responded to Children’s stories of famine in Europe, and over the years extended their work to Asia and Africa. Over 100 years later stories about children’s rights are at the heart of Save the Children’s @savechildrenuk work, and why they continue to have such impact globally https://www.youtube.com/watch?v=U0RnucW3Wn0

We all have a story within us waiting to be told. The Health Foundation’s overview (https://www.health.org.uk/newsletter-feature/power-of-storytelling) on the importance of narrative in healthcare reminds us that an authentic story connects, it unleashes curiosity, taps into emotions and imagination, it uncovers the art of the possible. Stories help us understand and make sense of the world. The telling of a story can become etched in our memory, motivating us to keep improving, it can change mindsets, bringing into focus to what matters most. When someone tells us their own personal story we catch a glimpse of a world that may be radically different to our own. The experience can inspire empathy, neuroscience suggest through connecting via stories we begin to mirror one another, connecting physically as well as emotionally. We relate to an individual’s story, 1st person narratives focus on the individual, rather than on groups such as ‘Young People’, ‘patients’, ‘refugees’ or ‘the homeless’. When we connect on such a personal level the result can be transformative not only for the person telling but for the receiver of the gift of the story too.

So next let’s head to the boardroom, where either around the physical or virtual table will sit professionals with many years of experience and qualifications, yet none of them likely to be under 25. If we’re lucky in that very corporate environment, when the focus is on the 0-25 population, someone may speak up and ask, ‘so what do children, young people and families want?’. A colleague once said ‘well the engagement work has been done, we can use that and push on’. Yet it made me reflect that if we only use the engagement work of others (as important as that is) we haven’t got the magic of participation.

The personal growth and development participation brings to children and young people must not be underestimated, especially to those with complex medical conditions, young people facing economic hardship, those from Black, Asian and Minority Ethnic backgrounds or our children who are looked after for whom we are corporate parents. These young people are those most in need of enriching opportunities to support their growth in confidence, to find their voice and experience the impact of being heard. We must not miss golden opportunities to encourage children and young people, to open doors for and with them, connecting them with peers and youth workers, as well as mentoring, it’s vital social medicine.

Even as health professionals working with children and young people we still view participation through a corporate lens of providing insight, knowing if we seek information on accessing services and then listen and take action it will lead to improved experience and outcomes for current and future service users, yet we know and must continue to share that the benefits of participation are so much broader.

Children and young people who are actively supported to participate in health care acquire knowledge, develop new skills, increase their self esteem and achieve a growing sense of citizenship. It connects them to potential role models and to a glittering array of future employment opportunities. As a result they go on to convey vital health information to the peer groups, their families and communities.

The boardroom must not be a just a passive recipient of engagement work, they must open up to diverse person centred narratives, to expand thinking beyond command and control structures. Boardrooms must open up to stories from children and young people themselves, offering personal development opportunities. When young people speak directly their narratives sit on our shoulders, focusing us on what matters most, issues at the heart of the matter are articulated.

I want to take you to a conference hall in Birmingham, 2,000 professionals watched the narrative of a young lady’s experience of health care, ‘Behind the curtain’ https://youtu.be/vnUmpFP9XsU

The young lady whose experience is shared in the film was sat in amongst the professionals (they didn’t know she was there) and experienced the silence, you could hear a pin drop in the huge auditorium. We debriefed together afterwards, she reflected ‘that’s what I wanted, I wanted others to see and connect with how I’d been made to feel.’ That sense of connection and impact was more powerful that any formal complaint process. The young lady went on to do her nurse training as her confidence in the system was secured, she’s now qualified and works for our armed forces, the power of transformational listening…

Then there’s Gulwali Passarly (@GulwaliP) at 12, his dad, a Doctor in Afghanistan was killed by US forces, the Taliban wanted him and his brother to avenge their father’s death, yet his mother, scared for their futures paid people traffickers to take them to the UK, saying ‘be safe and never return’. Gulwali was separated from his brother the day after they left, and then for over a year endured hardship and incredibly tough circumstances as he travelled to the UK, spending a month in the Calais jungle, being interrogated by UK boarder forces who thought he was too smart to be someone so young, eventually making into foster care, excelling at GCSEs, Alevels & completed his degree at Manchester University. Gulwali a member of our NHS Youth forum taught so many of about the plight of refugees, his Ted Talk (https://gulwalipassarlay.wordpress.com/2014/06/22/tedxmanchester-talk-about-my-journey/) and book ‘The Lightless Sky’ are worth seeking out. Now his charity ‘my bright kite’ helps other young refugees, through his work he has grown to be the most amazing advocate for refugees, fuelled by being heard. He reflects that the toughest of times he faced was when he wasn’t believed.

So as we work to chip away at corporate structures, the powerhouses that rely on data and indicators, let’s not forget the powerful contribution of participation in social medicine. As leaders in child health we can open doors and support young people to ensure diverse, rich narratives are heard, leading to better outcomes on so many levels.

So let’s bring this all together, as we go forward let’s…

1. Think about what’s made a different to you, use that to shape your actions with others.

2. Use our history to inspire us so we keep standing on the shoulders of giants as we continue to make progress.

3. Unleash the power of narrative directly from young people, it benefits services and young people themselves, helping us address inequalities head on.

4. Never underestimate the power of a story to make transformational change and create powerful ripples in the system, stories keep whispering in our ears and hold us all to account.

5. And my final thought, let’s remember that things do not just happen, they are made to happen, it’s up to us to work in partnership with children and young people, using the teams around us the voluntary sector, youth workers, to ensure together we transform child health outcomes.

PS can I give a huge shout out in recognition to Margo Horsley someone who really believes in #VoiceasValue this is a great blog https://www.margohorsley.co.uk/post/voice-as-value-the-people-are-rising-it-s-time-to-listen

And if you want some practical resources, dip in to the work of the @NHSYouthForum https://www.england.nhs.uk/participation/get-involved/how/forums/nhs-youth-forum/

#YellowSelfie for #IDN2020

The brilliant @wemidwives team last week got us to post a #yellowselfie to celebrate International Day of the Midwife http://www.wecommunities.org/blogs/3562. Well I wonder if we can carry this on as we celebrate International Day of the Nurse? #IDN2020

As a children’s nurse and someone who is a passionate believer in growing and nurturing the future generation of babies, children and young people, along with growing our student nurses too, I do hope you’ll join me in continuing to bring a splash of yellow cheerfulness to twitter as we celebrate the contribution of nurses. Let’s use #YellowSelfie and perhaps add what type of nurse you’re proud to be ie #Proud2baCYPNurse 😉

Nurses are brilliant, intelligent, curious and compassionate professionals who also have an ability to bring cheer to situations too. I was on a lovely #EarlyRisersClub zoom call this weekend with Claire ‪@C_Carmichael83‬ and she had sunflowers 🌻 on her background! Oh they made me smile! It reminded me of beautiful GOWER Sunflowers from last August, I’m so hoping they’ll be there this year thanks to the National Trust ‪@NTWales‬.

Sunflowers on Rhossili at the GOWER 2019

As I look at the picture I took, I can see the variation, some are flourishing, some look a tad weary, some are standing firm in the breeze, I think it’s a poignant reminder of how the nursing community are feeling at the moment. Many have been and are going through some very very tough challenging times. Some have found opportunities to take on new leadership roles and teach others, whilst others are acquiring skills they’d never dreamt of doing. Every nurse everywhere in whatever role has been touched by this pandemic…

So as we celebrate International Nurses Day and say a sincere thank you to nursing colleagues and celebrate their contribution to society on so many levels, let’s add a splash of cheer too.

That #YellowSelfie calls 😉 will you join me?

Day 1 #IND2020
Day 2 #IND2020
Day 3 #IND2020
Day 4 #IND2020 – Mary Seacole
Day 5 #IND2020

Pausing and reflecting

On Facebook this week someone shared that whilst we may feel we’re all in this Covid19 Pandemic storm together we’re certainly not in the same boat. Purely by chance I saw a post capturing an interview with Professor Cynthia Enloe (a feminist writer, best known for work on gender and for her contributions to the field of feminist international relations) she reflected ‘We aren’t all in this together. We’re in the same rough seas, but we’re in very different boats ..some of those boats are very leaky, some of those boats were never given oars, some of those boats have high-powered motors on them’ it’s worth a listen https://www.youtube.com/watch?v=Gaif6mTwFw8

Wonderful ‪@GretaThunberg‬ raises awareness of the wider social impact Cobid19 is having on children internationally, she is supporting @UNICEF’s wonderful work https://twitter.com/unicef/status/1255879798380953600?s=21

Closer to home the @NHSYouthForum celebrated young people’s contribution in the pandemic, this blog is well worth dipping into https://www.iwill.org.uk/young-people-matter I loved their key messages …

‪We’ve also been challenged by the awful loss of life of health professionals which @nursingnotesuk are diligently and compassionately documenting publicly https://nursingnotes.co.uk/covid-19-memorial/ and by concerns about the impact on BAME colleagues, @westm61 blogs for @thekingsfund asking us what we can do as individuals to address this, the blog is well worth a read too https://www.kingsfund.org.uk/blog/2020/04/ethnic-minority-deaths-covid-19

The always encouraging @charliemackesy‬ captured the need for us to hold on, that dawn is coming ….

…what we can’t do is lose sight of those who are most vulnerable in this storm, we must keep sharing concerns, providing life rafts in multiple shapes and sizes so that we all weather this storm in the best way we possibly can …

‘41% of young offenders have experienced family bereavement’ how we support children who are bereaved during this pandemic matters ….

When we realise that 41% of young offenders have experienced a family bereavement in the childhood (Winstons Wish @winstonswish‬ the charity established to support bereaved children) it makes us realise how important it is that we support children who face bereavement, as it really will transform life outcomes. Whilst children may not be the face of this pandemic they risk being among its biggest victims. They have thankfully been largely spared from the direct health effects of COVID-19 – at least to date – yet the crisis is having a profound effect on their wellbeing (Policy Brief, The impact of Covid19 on Children, UN 2020 https://www.un.org/sites/un2.un.org/files/policy_brief_on_covid_impact_on_children_16_april_2020.pdf). The impact of bereavement in childhood is an element we must pay attention to, particularly as the physical face to face support of schools is missing currently.

As adults how we break life changing news to children matters, there’s some valuable information on @RCPCH Covid19 pages on how to do this from the University of Oxford https://www.rcpch.ac.uk/sites/default/files/2020-04/how_to_tell_children_that_someone_has_died_final.pdf that we can signpost people to, its a hugely daunting task that people value support with.

Ongoing conversations and sharing positive memories matter tremendously. I recall us all as a family sitting and crying together as we read ‘Badgers Parting Gifts’ when my husband’s mum died, it was a moment of unity in great sadness. The added complexity of social isolation makes loss even harder than ever and this beautiful animation summarises this powerfully ‘Saying goodbye’ https://vimeo.com/407701292 by ‪@WillisBelfast‬ and the Child Bereavement Network provide a range of resources http://www.childhoodbereavementnetwork.org.uk/

@NHSEngland also bring together contacts that are helpful, including:

How we signpost families to support during this intense period of loss will change children’s lives, we can’t change what has happened, but how we care, talk and act will be remembered forever ….

Putting the spotlight on Patient Experience in #Covid19

I have a passion for improving patient experience, I loved my previous job at NHS England where I got to focus on working with children, young people and their families along with maternity service users, to improve their experiences of care.

Our world has changed hugely in the last 102 days and things are being established, PPE is being delivered, ITU capacity extended, staff are being trained and redeployed, staff wellbeing is being focused on, so my mind has shifted to patient experience, what’s happening to address this?

It was last Saturday morning at about 7am, I was sitting in my living room with the sun streaming through the window and mug of freshly brewed steaming coffee at hand, skimming through twitter, scanning for snippets me of information that may catch my eye. My phone rang ‘Kath, it’s my mum she had chemo on Thursday and now she’s spiked a temperature, dad says she’s having a funny turn’ well as you can imagine after a brief conversation, my friend got in her car, and ensured her mum was safely transported to hospital for antibiotics and admission. That’s where things got a bit challenging.

My friend’s mum had turned up with a mobile and charger, but was feeling pretty rubbish. Staff understandably, focused on caring for patients and contact with relatives was limited to once a day, my friend uncertain about what was happening was awake for 38 hours, she was totally beside herself with worry. Her mum was and is receiving great care, but it got me thinking what can we do about situations like this? Can we do better?

One of the 1st things we did, which was really simple, was remind people to bring in mobile phones/devices and chargers with key numbers with them when they are admitted – we got this on our Trust website. Some Trusts have developed teams of family liaison people to help maintain contact, ‪@MichaelaTait8‬ is tweeting about the great work at Milton Keynes, do give her a follow!

The team at Chelsea and Westminster shared a great poster on communicating with relatives, an amazing resource for staff working in unfamiliar environments.

Talking to relatives
Thanks to the team at Chelsea and Westminster

A conversation got started on twitter this week too about what we’d say to relatives to reassure them at this time – the responses were fabulous, here are some…

And of course sadly there will be difficult conversations ahead, this really helpful guidance from the University of Oxford shared by RCPCH is well worth reading and sharing when talking to children about the death of a loved one.

Over the weeks ahead many more examples will emerge, do follow the Heads of Patient Experience network, who tweet using the hashtag #HOPENetwork ‪@lgoodbu‬ is a great follow for inspiration, as is ‪@clairem7523‬.

So as we work vitally to get all the technical stuff right in the weeks and months ahead, let’s keep sharing the work that people are doing to improve experiences, these memories will stay with people forever.

Happy Easter all x