Health inequalities and the impact of racism on child health, kindness and advocacy

Health inequities is an issue I keep returning to in this blog. Perhaps it’s the complexity and vastness of addressing the economic, political, and social challenges, including racism that impact so heavily on health outcomes that frustrate me on a seemingly daily basis currently at the moment.

The American Academy of Pediatrics @AmerAcadPeds this week published a statement on the impact of racism on child health, I think there’s much we can take note of and challenge ourselves on here in the UK

The AAP share that racism has a profound impact on the health status of children, adolescents, emerging adults, and their families. Whilst they acknowledge progress has been made toward racial equality and equity, the evidence to support the continued negative impact of racism on health and well-being through implicit and explicit biases, institutional structures, and interpersonal relationships still exists, I’d suggest this certainly isn’t unique to the USA.

Through discussing these issues openly they suggest health professionals can proactively engage in strategies to optimize clinical care, workforce development, professional education, systems engagement, and research in a manner designed to reduce the health effects of structural, personally mediated, and internalized racism and as a result improve the health and well-being of all children, adolescents, emerging adults, and their families. If we fail to address this, health inequalities will remain.

The New York Times also covered this and in a interview with a paediatrician they shared that clinical settings need to make everyone feel explicitly welcome, with images of diverse families up on the wall and with the capacity to provide care in different languages. The reception families get at the front desk, who is staffing it, as well as who is seeing patients all play a part. Toys, dolls, books, videos should they encourage all be multicultural.

They go on to state that ‘Our diverse pediatric workforce is critically important to begin untangling the thread of racism sewn through the fabric of society and affecting the health of pediatric populations.’

As Child Health professionals our challenge is to examine and acknowledge our own biases, seek out, embrace and advocate for innovative policies and cross-sector partnerships designed to improve medical, economic, environmental, housing, judicial, and educational equity for optimal child, adolescent, and emerging adult developmental outcomes. It’s an issue I think we can become more activated and engaged with.

As I continue to immerse myself back into being in a provider organisation, seeing the societal challenges faced by children and young people, advocating for and with those in our local communities seems increasingly important.

I met Lillian of @PinPointIncorp, an amazing not for profit organisation based in Walthamstow this week. Lillian shared feedback from a vulnerable young person who completed one of her programmes, on being asked what have you got out of this bike mechanics course, they wrote ‘kindness’, it was the first time they’d experienced such kindness …. it was the kindness rather than the mechanical skills that had had the greatest impact on that young person.

And I’ve just finished listening to the David Nott’s ‘War Doctor’ whose advocacy is inspiring, I’d really recommend listening on @audibleuk and do follow the difference the @NottFoundation is making.

So my reflections this week include acknowledging and tackling racism, the power of kindness and the impact of advocacy….

…. I’ve much to ponder on….

Stop apologising, start thanking… #ForcesforChange

There was a tweet from @kennygibsonnhs that captured my imagination this week it included a visual (NB Tweets with images have far more impact 😉) ... it suggested we should stop apologising and start thanking. It was something that resonated with me, here are some ideas for us to try.

Next time I’m late for a meeting, due to train hassles or trying to fit too much into a day, I’m going to thank those on the receiving end for being so patient!

I wonder if the women profiled in Vogue this month have this issue?

Vogue isn’t my usual magazine of choice but this issue is rather special as it profiles 15 women making a difference in world and it’s been guest edited by Megan, HRH Duchess of Sussex here’s an overview and a summary of those profiled

If you haven’t got a copy yet… DO… its AWESOME the photography is beautiful and totally inclusive, HRH The Duchess of Sussex writes in her guest editorial ‘and amongst all of these strong women on the cover, a mirror – a space for you, the reader, to see yourself. Because you too are part of this collective’. Jane @NHS_Jane the awesome woman who co-ordinated the ASCEND Women’s Leadership programme for @NHSLLA with @drgemmamunro and creator of @quiet_the_hive showed us how it’s done…

Hunt down a copy, at £3.99 it’s a bargain, although you may end up feeling like you’ve found a ‘golden ticket 🎫 ‘ as Charlie did in Roald Dahl’s ‘Charlie and the Chocolate Factory’ as copies in newsagents are understandably elusive.

Megan calls out women from across the world who are making a difference, such as Jacinda Arden…

Brene Brown….

Sinéad Burke, diversity advocate and lecturer highlights that ”We need to constantly be asking what voices are not in the world, which perspectives are not being considered, and make sure that change occurs with as much intersectionality as possible.” I’m in awe of her gracefulness and fab outfit!

Michelle O’bama @MichelleObama writes to Megan … dip in to find out more 😉

And there’s poetry too, the ‘Beach’ asks us all to be ourselves, a reminder it’s ok to ‘just be…’

Perhaps one women I’d add to Megan’s list is Edith Edgar, I’ve just finished listening to ‘The Choice’ on @AudibleUk Its a powerful narrative that shares the horrors of the Holocaust. She shares how her experiences in Auschwitz, even though it claimed her parents, didn’t break Edith. Her experiences helped her appreciate and live life with strength and remarkable resilience. Edith shares ‘We have the capacity to hate and the capacity to love. Which one we reach for,” she writes, “is up to us.” As she comments throughout the book, it’s our choice. The New York Times shares ‘Eger’s book is a triumph, and should be read by all who care about both their inner freedom and the future of humanity.’ I think it should be a compulsory read on the GCSE English curriculum.

Melinda Gates also launched #Equalitycantwait this week highlighting it will horrifyingly take 208 years for women to be equal to men in the USA are we further ahead in the UK I wonder?

Whilst all of these women are in the public eye, I’m surrounded by amazing women in work, at home and in my community who are making a difference day in day, who often get on with ‘doing the doing’ often quietly and very effectively. So my reflections this week? Let’s stop apologising and start thanking, let’s take our place in the mirror, challenge inequalities, and embrace the fact that we all have choices.

Bring on #NursesActive

I love the summer months, bright light early mornings seem to nudge me out of the door to get an early plod in. I’m always grateful to my dad for his gift of an ‘early riser’ gene, and I’m a regular member of the #earlyrisersclub. It feels good to bank an early morning plod by 6.30am when I need to get my act together, head out to catch a train and embrace the day. The summer seems to make this so much easier than dark winter mornings!

It was a family holiday to Centre Parks back in 2006 when I knew I needed to take action and become a bit more focused with my exercise. Beth my daughter was 3 and I wanted to be fit for her and knew if I was a bit fitter I’d feel better in myself. I was also in a job I loved yet it was consuming physically and emotionally, I knew getting some balance by introducing regular activity would be helpful in many ways for me personally, my family and for work. So I treated myself to a new pair of trainers and some running kit and headed out to a local bit of greenery. It was the couch to 5k that got me going

There have been lulls over the years when I haven’t run as much as I’d like, I’ve lost my running mojo and found it again along the way, but it was 2016 when I decided to start doing organised runs. I set my sights on a half marathon and once that was achieved I looked around for a marathon. It was the Cancer Research UK Race for Life Marathon in September 2016 that confirmed that even I could run a marathon. It was the start of my ongoing commitment to trying (not always successfully) to keep my weight in check, keep my resting heart rate at less than 65 (less than 60 would be amazing) and creating a bit of space or ‘headroom’ for my thoughts to wander.

Regular Saturday morning ParkRuns at beautiful Panshanger and friendly Ellenbrook fields are part of my weekend routine. Yet it was my local running club that if I’m honest has made a huge difference to my sustained commitment to exercise. They say that you become most like the people you spend time with and I think this picture sums up the joy of a Saturday morning, normal people with busy full on lives trying to keep active and have fun too (even in the rain). I am forever grateful I was brave enough to join my local club, Garden City Runners.

The club has meant I’ve met people who like me embrace the joy of distance running and over the last 2 years I’ve given ultra running (that’s any distance over 26.2miles) a try. My ultra running buddy Elaine would say we’ve chatted, got lost, eaten lots and had plenty of adventures along the way too. Ultra Running has also provided some cracking multi day challenges along the Cotswold way and Jurassic Coast too

The challenge of #NHS1000miles and the #WeActiveChallenge have provided an online community, again with others who are juggling being active in busy lives. People like Cat Wilson, Marc Harder and Jackie Smith are the best encouragers, true motivators in Chief 😉

We’re all aware of benefits of physical activity @LauraKoehli brilliant blog summarises them here

yet there’s something about ‘taking action’ on this information that we need to take a personal decision to do…

For me being part of a likeminded community both physical and virtual is helpful in refreshing, refocusing habits. The #WeActivechallenge offers us this August a chance to have fun, try something new and create a bit more ‘headspace’ to achieve some balance in our lives.

We’ll no doubt have a real giggle on twitter again in August with the #AHPsActive and it looks like #DoctorsActive may be ‘in it to win it’ this year, but seriously it’s our year isn’t it Nurses?! #NursesActive


This week I had the pleasure of speaking to nurses about to qualify from City University @CityUniHealth. It was a day of excitement as they prepared to qualify and enter the profession of nursing. Their anticipation of the journey ahead was palpable, smiling faces and hugs abounded, along with plenty of ‘we made it’ comments.

It was a privilege to share their joy and I reflected on the tools I depend on day in and day out 31 years into my nursing career. Those that are most useful I’ve picked up along the way, these are the top ones in my toolkit:

#Hellomynameis is how we should start all our interactions

#WhatMatterstoyou rather than ‘what’s the matter with you’ is what we need to be asking

#Communication is the top skill that we need to get right and requires ongoing focus, this key report from @mariecurieuk sums up its importance so well

#NMCCode underpins all we do

#NHSConstitution eloquently shares the values and beliefs of the NHS

#AskListenDo isn’t just about seeking out insight from people with Learning Disabilities it should be our approach for everyone

Just as we care for others we need to be #HereforNurses too and the @CavellTrust helps us do this

#LeadershipSkills are always developing! Have a look online at the @NHSLeadership for courses and resources

I asked twitter for help in bringing key messages together and as always they delivered, here’s the resulting poem ….

Be the Nurse… 

Be the Nurse who is connected to patients, who says #Hellomynameis and asks #Whatmatterstoyou with a smile and an engaging manner.

Who takes time to find out what makes the person in front of you the person they really are by listening 

Who’s kind and offers thoughtful care, someone you’d chose to care for you, your child, your family or someone you love.

And who, however bad things are, radiates calmness, inspires confidence in patients, families and carers. 

Be the Nurse who practices safely, 

Is brave, bold, curious, asks questions, speaks up, is inquisitive and challenges the status quo,

Who’s in touch with and uses up to date evidence to always improve care, 

Who never stops learning and seeks to play a part in expanding knowledge too.

Who challenges poor practice and does the right thing, even when everyone else seems to be doing it wrong.

Be the Nurse who considers health inequalities and plays a part in calling them out and seeks solutions, 

Who works with patients, families and carers as partners,

Who is an ally and shares stories waiting to be told.  

Be the Nurse who’s connected to the community and looks beyond the workplace. 

Who knows the NMC Code and the NHS Constitution and lives by them too,

Who joins twitter and is a role model in using it.

Remember you’re now part of society’s most Trusted Profession; be proud of the difference we make.

 Be the Nurse who gives a little bit of themselves and reflects your true self,  

Who has fun, perhaps has stickers and a finger puppet in a pocket as magical tools!

Be the Nurse who looks out for colleagues, not just other nurses, but the cleaners, housekeepers, the reception team, the doctors, HCAs, associates, AHPs and the managers too, 

Who encourages and celebrates the achievements of others, 

Offers thanks freely and meaningfully, and sprinkles kindness and joy along the way too.   

Be the Nurse who takes care of  yourself, know your strengths as well as your limitations. 

Nursing is only a part of what defines you, 

Nursing will nourish part of you, yet don’t forget to feed the other passions that make you who you are. 

Remember you’ll experience many emotions in your career, there’ll be highs and lows over your lifetime as a nurse, take the time to breathe, centre yourself, hold your nerve and seek support from others… you are never alone, 

Be the Nurse who loves the job you do, who wears an invisible Nightingale, Seacole and Cavell cloak and remembers the warriors of nursing past and present on whose shoulders we stand, 

Who’s SASSY who ‘Smiles, is Academic, Supportive, and Speaks up’ and inspires others to join the profession too.

I’ll #beTHENurse who…

feel free to take a selfie 🤳 and post on twitter with the hashtag ….

with thanks to @jomwlever @C_Carmichael83 @BeckyPlatt3 @ppi_jane @SueAn1904 @BecksBDaniels @AliceOliviaG1 @SheVC @reboverend_RNc @LisaSaysThis @DrKateOulton @JessLSainsbury @AgencyNurse @RunMoreEatMore @KayeNicoll @janette_v @organiclemon et al!


My favourite books of 2019

As a child I loved reading and Colette Datt @datt_colette reminded me of this as she challenged me to post the covers of 7 children’s books this week. As an adult fitting reading into life has become more challenging. Whilst I love an absorbing book of fiction I find if I read at night, within a paragraph I’m asleep!

Bill Gates @BillGates shares that he reads around 50 books per year. Reading is, he said, “the main way that I both learn new things and test my understanding”. I like this infographic too about why reading is so important …

My daily commute to and from London offers the perfect opportunity to expand my focus on reading with a walk to the train station, tube and sometime bus journeys too. This year I’ve really embraced @audibleuk it’s helped me to ‘read’ more by listening on the move! I often tend to have a book & audio version of the same title!

So these are some of the books I’ve enjoyed so far this year… (sadly no where near as many as Bill tho 😉)

Lift by Melinda Gates @melindagates

‘We are the lift’ says Melinda in the introduction as she shares her life and the journey she’s been on growing philanthropy through the ‘Gates Foundation’ @gatesfoundation. The book reflects on her life and what she’s learnt meeting inspiring people whilst working to change things for the better. Gender equity, empathy and the power of connection are golden threads that drew me in with the powerful narratives shared.

Dare to Lead by Brene Brown, @BreneBrown was kindly gifted to me by Lisa Ramsay @Doula_Lisa. I’ve valued Brene’s work for many years, her focus on the power of connection is one that resonates strongly with me, this book focuses on using these principles of connection to lead. Brene offers reassurance that we don’t have to have the right answers; yet we do need to stay curious and ask the right questions. She highlights that we can’t and shouldn’t avoid difficult conversations and situations; that leaning into vulnerability is necessary to ‘do our best work‘. This is a book I repeatedly go back to. I think one of the other draws to Brene is that her husband is a Paediatrician.

How to treat people by Molly Case @mollycasespeaks was published this year. Molly wowed the RCN Congress with ‘Nursing the Nation’
and this book is a wonderful insight into modern nursing it’s highs and its challenges. Molly shares herself with us all freely and her voice is beautiful on the audible version, please do take a listen and share.

The Language of Kindness by Christie Watson @tinysunbird bringing further insight into modern nursing, Christie again shares herself and reflects on the world of children’s nursing and also on her role as a resuscitation Officer. Again Christie’s voice is beautiful to listen to, and her rebellious adolescent self that desperately wanted independence is something I could identify with with.

Trauma Stewardship by Laura van Danoot was recommended Joanne Bosanquet @MrsBosanquet and I suspect this will be a reference text I’ll return to in the years ahead. The care of staff is something we’re constantly challenged by and Laura shares many narratives about the importance of sharing recognising the importance of caring for ourselves and how we role model this to others. Loads of food for thought and examples of people involved in really traumatic situations.

Becoming by Michelle Obama @MichelleObama was the book I started 2019 and it’s great! Michelle shares her childhood and her passion for education that she uses to encourage and support others, particularly girls. I hadn’t realised she’d worked in healthcare community engagement, as well as having a legal background. Michelle again shares the ups and down of living in public eye, yet her commitment to making a difference shines through.

Also on my to read list is ‘Educated’ by Tara Westover suggested by Mary @MaryNewburn1 and The Choice by Edith Egar. I have to admit they are books I’ve found harder to connect with, so are both still being read!

So I’d love to hear from you? Which are the books I should put on my ‘to read’ list for the rest of 2019?

Cracking genomics 🧬 what’s our role?

Genomics 🧬 and personalised medicine is here, Chief Scientific Officer Sue Hill @CSOSue, @MRadford_DONi and @SigsworthJanice confirmed at a session I attended a session on genomics supported by Health Education England this week.

Judith Ellis when she was Chief Nurse at Great Ormond Street said repeatedly that the future was Genomics, yet I have to admit my knowledge of genomics if I’m honest is limited! Yes I was aware of the coverage when David Cameron launched the 100,000 genomes project back in 2012 and I was astounded to hear during the session that this target had been exceeded.

I’ve been following @GenomicsEngland on twitter for a while, and on the genomics England website is a great animation admittedly aimed at children (but I have to admit I loved how well it explained things) talking about ‘glitches’ it’s well worth a watch!

If you’re not a Children’s Nurse like me you may appreciate a more grown up explanation!

For me though what’s most exciting are the benefits to patients. We heard of children who’d been diagnosed with with diabetes who’d received insulin injections having their lives transformed when their genomic profiles had clarified the medication that would work best for them, some now on oral medication and their lives had been transformed. It was narratives such as this that brought the potential for improving lives to life.

So what’s my role as a nurse, well the session was enlightening, if you get a chance to go to a session please do! I’d also recommend following Genomics 🧬 England. Health Education run wonderful short online sessions which are accessible for us all, and if you’re really keen there’s also an opportunity to do a Masters, there’s more info here 😉

Can we #AskListenDo? …making reasonable adjustments to how we seek and use feedback to drive improvement

This week I had the privilege of attending the House of Lords (it’s such a grand building) for a really important celebration of the work that’s been happening across the NHS and beyond, in adopting the principles of #AskListenDo

So often we don’t receive feedback, hear of concerns or have complaints from people with learning disabilities/Autism or their families, purely because WE don’t make the engagement and feedback process easy. Yet we do have a duty under the equality act to have processes in place to engage, seek out, hear and act on information that service users have.

This short story shares how life can feel for someone with a learning disability and how vital it is we listen and take action on their feedback.

Families who care for, along with people with learning disabilities, have led the #Asklistendo work.

You’d think that surely we would already ask people what matters to them, intuitively pick up on concerns, actively listen and then take action, BUT what’s clear from various reports into health, education and social care, is that we sadly fail at this repeatedly.

This powerful poem explains it and provides a call to action …

The event in the House of Lords brought people with LD/Autism, families, the voluntary sector, education, social care and health together to hear from those who had already adopted the principles and are working to socialise the #AskListenDo approach.

The wonderful Tricia Handley, our LD Nurse Specialist at Barts Health spoke of the work to be truly person centred across the Trust and specifically, to make blood tests less traumatic and daunting. Kindness, patience and the commitment to make ‘reasonable adjustments’ can make all the difference to creating positive experiences of hospital care that can last a lifetime, as well as impacting on people with LD accessing healthcare confidently in the future.

Adopting the spirit of #AskListenDo can be achieved by asking ourselves:

1. Have we got our active listening right? Do we ensure people have the attention and focus needed in busy frenetic environments? How can we make environments calmer? What connections have we got with our local community and voluntary sector to hear about what matters most to people?

2. Are our basic processes for getting things done right? Are we using flagging systems effectively? Do we have easy read complaint leaflets? When we listen, do we follow up on our commitments and deliver on actions?

3. Are we supporting staff/teams delivering care with the education and skills to meet the needs of those with LD/Autism? Do our reception, call centre as well as healthcare staff have the education and insight they need to enhance their practices?

Someone commented how straightforward the #AskListenDo approach is and whilst I agree I also think we need to be committed universally to nurturing a culture that makes giving feedback easy for everyone. And of course we need to be honest about the changes we can make and get on with, or the stuff that’s really ‘wicked’ and may take a bit longer.

So an ask, will you be a champion for #AskListenDo and spread the approach?

Creating cultures that deliver great care, involve everyone, work to continuously improve, recognise and value staff, and grow connectivity…


I’ve been reflecting on cultures this week, thinking about the depth and feel of a team, or system of care. The cultures we create make such a great difference to patients, staff and the ability to progress agendas.

I went searching online for a great short animation by the Foundation of Nursing Studies @FoNScharity, its a few years old now yet it sums up that culture is ‘how things get done around here’ its worth a watch

With ever greater complexity in our day to day lives it’s hardly surprising that cultures are complex, get a great one and its magic, an awful one by comparison means stress levels rise, people are anxious coming to work, keep their heads down when they are there and ultimately don’t stay, walking away.

The ‘Culture of Care Barometer Report’ published in 2015 provides a strong evidence base to reflect on cultures in organisations its a helpful tool that we can use to ‘check the climate’ of our teams. The tool addresses 4 key elements that influence cultures:

Having the resources to do a good job and deliver quality care is challenging when finances are stretched nationally, but there is certainly significant support from senior leaders for us all to do a good job. And of course something that the NHS wins outright with is an opportunity to do a worthwhile job that really makes a difference to people’s lives. Having this ‘shared purpose’ to make a difference in society is a key motivator. The NHS also offers the opportunity to always be learning and developing our knowledge and skills, whether via mandatory training, annual updates, continuous professional development, academic study or research.

What’s essential clearly is our personal drive for improvement, creating the time to step back, reflect on our behaviours and actions and the part they play in the culture we function in. West et al. (2014) indicates that culture is co-created through the interactions, communications, influences and collaborations among members of an organisation or systems.

Bob Klaber this week talked about the power of ‘connectivity’ and the impact that this can have in building trust in the system in progressing a more ‘joined up’ approach to delivering healthcare, shifting us from a traditional medical model of healthcare to a more holistic approach that’s much more person centred, focusing on ‘what matters to you’ ie the person being cared for. Bob @BobKlaber and Mando @mandowatson have led Connecting Care for Children in West London, please do follow their work via @CC4CLondon. They are really shifting cultures, taking care closer to home and into GP Practices, they’re not only thinking but doing differently.

This week also saw our school nursing team employed by the local authority, the community nursing team employed by a local community and mental health trust, along with ward based staff from the paediatric ward and NICU unit supporting Ruth May on a visit to a local primary school. This collaborative and connected approach of health teams working together with schools is something we need to keep growing.

Then there was the Partnership Board led by a Local Authority, together with the Lead Councillor for Children, the Young Mayor, we all discussed the Children and Young People’s plan for the years ahead. The local head teachers discussed how we can secure system wide support for this the pupil survey, ensuring young people who aren’t in school have an opportunity to contribute too, we were able to plug the need for few more health related questions to help young people understand the services around them.

There was also the joy of attending the @Cavelltrust conversation with Teresa Chinn on Wednesday, discussing how nurses could support each other more on social media and the positive culture we can create whilst being true to ourselves. We’re all looking forward to supporting this years 10k for Nurses challenge

Cultures are clearly the result of our behaviours and actions, we can help others to flourish and thrive or we can make things difficult. I know the type of team, organisation, system, I’d rather work in but I have to take responsibility and know that I have a part to play ….

Growing our Future Nurses, what will it mean for us day to day?

I’ve been watching ‘Years and Years’ by Russell T Davies on catch up recently. As Russell was born in Swansea and educated at Olchfa (a school we regularly pass on our trips home to Swansea) I really enjoy his writing as the Welsh connections always sing through! Years and Years follows a Manchester family, led by ‘Gran’ through the political, economic and technological changes that take place over a 15 year period. Without giving too much of the plot away, the final episode sees Edith a feisty activist, affected by a nuclear fall out in episode one, uploading memories to water molecules with two kind and compassionate nurses listening intently and guiding her through it. So is this what nurses will be doing in the future? Perhaps Russell’s imagination is a tad too creative, but it’s an issue people have been debating for many years, what will we need from our future nurses and how can the current healthcare workforce help them grow their skills? A peer review meeting last week posed the question ‘how are you preparing for the future nurse programme’. It was a good challenge!

I went back to a blog published by Jackie Smith, who was the CEO of the NMC in May 2018 The curriculum changes that are now being embedded follow a significant consultation that many of us inputted into.

Importantly many articulated that whilst fields of practice and in-depth knowledge of mental health, learning disabilities, adult and child were essential due to the complexity of need from each population group, all professionals need insight and experience of caring for people across all fields of practice. As a Children’s Nurse I’m delighted to see an increased focus on mental health and learning disabilities in the Children and Young People’s field of Nursing.

For us locally the new standards and associated curriculum will take affect in September 2019. It’s important our local teams are aware of the changes, so that we can proactively welcome, understand the needs and support our students as they embark on their careers and grow their ‘professional stories’ whilst working to achieve the professional proficiencies which are grouped in 7 platforms outlined here.

It’s helpful that all healthcare professionals, AHPs, Drs, Nurses and social workers can supervise nursing students going forward. Practice Supervisors (PSs) as these professionals are called, can document the student’s progress in their Practice Assessment Document (PAD). This is an important step forward in continuing to grow multi disciplinary and collaborative working cultures as the contribution of all professionals in training and educating nurses is valued and recognised.

Practice Assessors (PAs) are registered nurses who have been prepared for the role (this can now be locally delivered removing the need for attendance at a formal Approved Educational Institute/AEI Mentorship programme) PAs will support students, meeting them at the beginning of their placement, completing a mid point review and documenting progress in their ongoing record of achievement (OAR). They’ll work closely with PSs.

Academic Assessors who are University focused will support PAs to ensure that students are progressing through the programme appropriately, recording their progress in their ongoing record of achievement (OAR) too.

Getting our heads around these roles will of course become easier as the curriculum is embedded.

Our students bring so much to our environments, many are ‘digital natives’ which is incredibly helpful as the NHS continues to mature in its use of technology, no doubt our students will teach us how to use technology to its best advantage in healthcare and also offer IT solutions to our challenges too.

One of the areas that may be challenging is related to the clinical skills that are required of future nurses on which are outlined here We face some particular issues in children’s nursing as not all our nurses do venepuncture or cannulation, and catheterising boys is not something commonly done so we’re going to need consider how we address these challenges. I don’t think we’re alone in considering this and would value ideas from other units on this.

A colleague this week also flagged the importance of staff having a positive attitude to nurses embarking on this new curriculum and acquiring a range of clinical skills that some registered nurses may not have. Encouraging and creating learning opportunities is vitally important, which is why I think we need to be discussing these issues openly out in practice with nurses and healthcare professionals involved in direct care provision. I’d like to avoid student nurses having to justify in practice why they need to learn these clinical skills.

The future is full of opportunities to continue to raise the profile of nursing and grow the diversity of skills, knowledge and experience that we offer as a profession to improve lives and health outcomes across society. The Future Nurse curriculum supports us to do this.

Nursing as we know offers so many wonderful career paths. This week saw an exciting broadcast into schools by Trusts in East London supported by the local STP, East London Health and Care Partnership. It was great to see Nurses some of whom had been qualified for many years and Ahunna a student nurse reaching out and encouraging young people to consider joining us in the NHS all online, no travel required! I love this #NursingLondon film that Capital Nurse have produced And this #NHS recruitment film
is special, these were shared with the young people. I still value this Children’s Nursing recruitment film from the RCN too.

So as we continue to grow our future nursing workforce let’s encourage and nurture our students as the new curriculum is embedded across the country, after all we’re their role models… Gran in Years and Years would say it’s up to us

Advocacy in Child Health

This week I’ve been reflecting on children’s advocacy challenges. Advocacy seeks to ensure everyone is able to have their say on issues that are important to them, that their rights are met and importantly, that their wishes and views are genuinely considered when decisions are being taken about their lives.

As a Children’s Nurse you’d expect me to say I’m committed to hearing the voices of children and young people in healthcare and in ensuring their rights, outlined in the United Nations Convention Rights of the Children (UNCRC), are met. The UNCRC celebrates its 30th birthday on the 20th Nov this year and just as an aside I’m wondering how we can celebrate Children’s Rights across the NHS on this day?….

As health care professionals whether in homes, schools, primary care, youth justice settings, ED, on wards, anywhere, day in, day out, we’re constantly using advocacy skills, which include:

1. Really listening to the issue at hand;

2. Finding out more, identifying what matters most in the situation;

3. Identifying rights in the situation, using the UNCRC, including addressing issues such as consent, this summary from CQC on consent is helpful

4. Exploring solutions;

5. Encouraging children and young people to express their views, opinions and thoughts about the issues, ultimately reaching a decision CYP have actively participated in.

Children and young people however still tell us we’re still not involving them in decisions about their healthcare as much as they want to be. Of course most babies, children and young people will, although, not always, have parents who will advocate appropriately for and ideally with them (although of course children, young people and their families can and do have differing views). Our role then as healthcare professionals is to use our skills in ensuring CYP are active, empowered participants in decision making processes whilst supporting parents too.

We need to constantly work on our refining and maturing communication skills if we’re to advocate effectively for and with individuals.The ‘CYP Me first’ model helps us as professionals to do this better, to more effectively engage with young people, there are loads of great resources on their website and you can follow them on twitter @CYPMeFirst

So I wonder how can CYP using the NHS benefit from professional advocacy services? What’s their professional advocacy offer to Children and Young People across the NHS? I’ve had many conversations with respected colleagues over the years about advocacy services in health, there still seems to be an unmet need. Please correct me if you’ve got a model that we need to be sharing!

The use of professional advocacy services for those with learning disabilities or mental health needs is perhaps more commonplace than in general paediatric care. Children and Young People just as adults can benefit from neutrality in exploring issues and in making decisions.

Last week saw the publication of a Report supported by the office of the Children’s Commissioner into Advocacy Services for Children and Young People

The Children’s Commissioner report highlights advocacy services in health are commissioned via a range of routes, some from local authorities and some trusts run these services internally, the report challenges the access to these services. These are the core values they’ve highlighted as important for advocacy services to work to:

The statutory advocacy support in health is focused on supporting young people to make complaints. Processes are often adult centric, increasingly though NHS complaints processes are becoming more CYP friendly. Yet there’s more to health advocacy than making complaints.

Children and young people who have special educational needs and disabilities, who are detained under the mental health act are also named as those specifically entitled to professional advocacy services but let’s not forget those with physical health needs too. Here’s the full list of situations when statutory advocacy is identified as being needed:

So as influencers in child health do we need to ask questions about what’s available locally to the CYP we serve? how are these services advertised and what training have staff had to support CYP with health related decision making issues?

Of course we also have a system advocacy role too. As Professionals we must advocate for improvements in Children and Young People’s Care and services. Even though they are 25% of the population we often end up focusing on adult related issues. Having Children and Young People in the NHS Longterm Plan puts an imperative on local systems to ensure CYP Health issues receive the focus they deserve, but we as healthcare professionals need to take our place at the STP tables and champion children and young people.

Wonderfully Children, Young People and families advocating for improvements in Children and Young People’s Care and services is another element we’re seeing more of and it’s having huge impact. It’s even better if professionals and users collaborate in advocating for improvement. Together we can be a powerful force for change. A great example of this is that NHS England supported the establishment of the NHS Youth Forum back in 2014 and they are having great impact on collectively lobbying the NHS to think more about the needs of children and young people in healthcare. This film from the Young Reporters summarises the Youth Voice Summit held back in April where young people met with senior leaders and spoke about what mattered most to them The @NNPCF is another example of parents advocating for improved services, particularly for disabled children so that their needs are met proactively rather than reactively, the impact they are having on the SEND agenda is phenomenal, although I know they’d say there’s much more to do!

Advocacy is going to continue be in the spotlight, especially in the UNCRC 30th year, let’s ensure practitioners supporting CYP and families have these skills and let’s champion the need for professional advocacy for all CYP across health, social care and education.

Reflections post blog

this is great short film for children on consent, thanks for sharing Lisa Ramsey!