Time for a Fair Share

Guest blog by Nick Hay – NHS Health Scotland

Sometimes it’s easy to get caught up in the rhetoric of why we want to live in a society that’s fairer and healthier.  There hasn’t yet been someone to stand up and say that this would be a bad thing; we can all agree that these are good things to strive for.  That’s been evident in the sheer number of recent debates, both political and cultural about why we need to bring in concepts of human rights and social justice into the mix. What we now need is agreement on what areas to prioritise to make a fairer, healthier Scotland a reality.

My colleague, Pam Duncan-Glancy, recently blogged about the need to thread human rights throughout health and social care and bring in a human rights based approach to all that we do.  Working in the health field, we sometimes highlight statistics about the impact of inequalities and the inherent unfairness in how health different groups in unequal ways.  Given that we’re all working to make Scotland fairer, and therefore healthier, we can all agree that it’s time to turn rhetoric into reality.  But what does that actually mean?  What can we do to turn words into action?

Recently, the Joseph Rowntree Foundation published their manifesto for a Scotland that’s free from poverty, highlighting figures showing that currently more than 200,000 children, 600,000 working age adults and 100,000 retired people live in poverty.  That’s a staggering statistic.  My own organisation, NHS Health Scotland, the national health board which works to reduce health inequalities and improve health, looks at a number of areas that have a profound impact on a person’s health and wellbeing to consider what we can do to make our system fairer and therefore healthier.  These “social determinants of health” include; childhood experience; housing; education; social support; family income; work; the community in which we live; and access to services.  We argue that health inequalities are avoidable because they are rooted in political and social decisions.  They are caused by an unequal distribution of income, power and wealth and result in the poverty and marginalisation of certain groups.  This is obviously not fair, nor is it socially just.

These National Conversations have been vital in bringing opinion together and highlighting the relationship between fairness and better health.  We’ve already contributed to the Scottish Government’s Fairer and Healthier conversations.  We think it’s time to start thinking about what our priorities should be to make this a reality.

If health inequalities are avoidable because they are rooted in political and social decisions, we need to change the structure in which these inequalities originate.  That means that action is needed at societal, environmental and individual levels to undo, prevent and mitigate health inequalities to make this a fairer and healthier country.

NHS Health Scotland provides evidence to suggest that action is needed to ensure everyone has an adequate income.  The introduction of a minimum income for healthy living and making sure that welfare system provides sufficient income for healthy living are two examples to do this.

We also need to empower communities experiencing inequalities, making sure their voices are heard in decisions which affect them in all aspects of their lives.

We’ve proposed that action should focus on reducing unemployment in vulnerable groups or deprived areas.  What’s considered to be ‘good work’ should be available for everyone, with greater job flexibility and participation in workplace decision-making important areas for action.

We need action to address inequalities in the physical places that we live.  Improving physical environments with better transport links, traffic calming schemes and a high standard of build that’s also affordable should be some of the areas that we focus on to improve the place in which we live.  NHS Health Scotland has produced a “Place Standard”, a tool to improve the physical and social environment in supporting health, wellbeing and a high quality of life.

We also need programmes that target vulnerable groups by investing in more intensive services.  Services that are proportionate to need would ensure that disadvantaged groups get a fairer share of resources.

We need to provide high-quality early childhood education and adult learning services. This could mean accessible support and advice for young people on life skills or training and employment opportunities.

Policies that use regulation and price are also effective at reducing health inequalities.  Evidence has shown that policies which raise the price of harmful substances like tobacco and alcohol through taxation are practical examples of what works to change risky behaviours. At the same time we also need to reduce or eradicate the price barrier for healthy products such as healthy foods and essential services like water, education, healthcare.

These are some of the actions that we argue should be priorities for Scottish society as a whole.  It’s heartening to see that more communities are having conversations about how we make Scotland fairer and healthier.

Ambitious it may be, but one we think worth striving for.

Social determinants of health infographic

For more information about NHS Health Scotland and to explore the evidence around what would make a fairer, healthier Scotland, please visit our website.

Nick Hay – NHS Health Scotland

www.healthscotland.com

Twitter – @NHS_HS

Walking Towards a Healthier Scotland

Guest blog by Ian McCall – Senior Development Officer at Paths for All

PFA_Logo_Blue_Box_cmykGetting active through walking is the easiest path to better health and longer healthy lives and will take pressure off our hard pressed health and social care services.

Walking is such an outstanding opportunity for effective preventative spending that we must bring it back into our daily lives and put it at the heart of our health service.

What support do we need in Scotland to live healthier lives?

One of the most effective ways to improve the health of our population is to increase physical activity levels – and walking has been proven to be the most popular, accessible and effective way of doing this.

We need to help people be more active by making walking part of all our daily lives – with walking for health and travel being seen as the social norm. This needs to be supported by an environment that is conducive, safe and welcoming. Community led, effective, local walking opportunities are also an important way to get people active.

The National Walking Strategy and Long-term Vision for Active Travel in Scotland should deliver this.

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What areas of health and social care matter most to you?

Getting people active through walking is a great way to support better health and longer healthy lives – taking pressure off health and social care services. This is an important opportunity for effective preventative spend as recommended by the Christie Commission and is particularly important in a time of increasing pressure on budgets, reduced resources and an ageing population. It is also important to support self-management of long term conditions – including enabling people to keep active.

The economic benefits associated with increased physical activity levels far outweigh the costs. Cost Benefit Ratios for walking developments show significant value for money. Social Return on Investment (SROI) evidence shows a return of approximately £8 for every £1 invested in health walk and path development projects.

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Thinking about the future of health and social care services, where should our focus be?

Walking should be at the heart of our health and social care services and we should focus on providing opportunities, signposting activities and informing Health & Social Care Professionals. Avenues that should be explored are including the provision of physical activity advice in GP contracts and on relevant content in undergraduate courses.

The importance of preventative spending and the need for sustained funding for walking as part of that cannot be overemphasised. The work of Paths for All and our partners can play an important role in getting people walking more – which will bring multiple health benefits over the longer term. Supporting older adults to be active must be a priority.

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The National Walking Strategy

Increasing physical activity is crucially important for the mental and physical health of our country. Big health gains come from getting inactive people more active, particularly in the outdoors, and the easiest way for most of us is through walking more.

Walking is cheap, accessible and fun – almost everyone can do it – and has been described as the “magic pill” for health.

The National Walking Strategy makes the links between getting active and health and has three strategic aims:

  • Create a culture of walking
  • Better walking environments throughout Scotland
  • Ensure easy, convenient independent mobility for all

Paths for All is a Scottish charity founded in 1996. We champion everyday walking as the way to a happier, healthier Scotland. We want to get Scotland walking: everyone, everyday, everywhere.

Our aim is to significantly increase the number of people who choose to walk in Scotland – whether that’s for leisure or walking to work, school, the shops or to a nearby public transport hub. We want to create a happier, healthier Scotland where increased physical activity improves quality of life and wellbeing for all. We work to develop more opportunities and better environments not just for walking, but also for cycling and other activities, to help make Scotland a more active, more prosperous, greener country.

Our work supports the delivery of the Scottish Government’s National Walking Strategy (NWS) and the Long-term Vision for Active Travel in Scotland, community and workplace health walking, path network development and active travel policy development. We are a partnership organisation with 28 national partners. Our funders include the Scottish Government, Transport Scotland, Scottish Natural Heritage, Macmillan, The Life Changes Trust, Forestry Commission Scotland and Awards for All.

Paths for All and our partners are involved in a number of key areas of work that support the National Walking Strategy and plans for a healthier Scotland. We are very keen to engage more with the health and social care sector to share our experience and raise awareness of the opportunities.

  • Health walks – local walking projects across Scotland – training, resources and support
  • Strength and Balance – for example in care homes – training, resources and support
  • Step count challenge – workplace team walking challenges
  • Workplace – training, resources and support
  • The Alliance – promoting walking for staff and patients in Links/Deep End GP practices and for people with long term conditions
  • Medal Routes and app – including hubs in health care settings
  • World Walking and app
  • Macmillan – promoting walking for people affected by cancer
  • Dementia Friendly Walking Project – training, resources and support – funded by the Life Changes Trust
  • Community paths – training, resources and support to create active environments
  • Active travel – including the Smarter Choices Smarter Places Fund – encouraging travel behaviour change
  • Walking football – supporting the development of local Walking Football opportunities across Scotland
  • Working with NHS Health Scotland in developing the Exemplar Physical Activity Employer Award
  • Cobranded research project into increasing the activity of dog walkers on the National Forest Estate in Scotland.
  • The Big Fit Walk takes place annually in June and aims to inspire communities across Scotland to come together for a short walk to celebrate the benefits of being active.

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Let’s Talk About Palliative Care

Guest Blog by Professor Craig White – Divisional Clinical Lead of the Quality and Planning Division of the Healthcare Quality and Strategy Directorate at the Scottish Government and Honorary Professor in the College of Medicine, Veterinary and Life Sciences at the University of Glasgow

Assets and Expertise

As a society we are facing a growing need for appropriate care in the face of ageing, life limiting illness and death. Although the scale and complexity of this makes this challenging – we have substantial assets and expertise within Scotland with which to respond to this need.cw1

In 2014 the World Health Assembly – the governing body of the World Health Organisation – passed a resolution requiring all governments to recognise palliative care and to make provision for it in their national health policies.

The Strategic Framework for Action on Palliative and End of Life Care is the Scottish Government’s response to that call (http://www.gov.scot/Publications/2015/12/4053/downloads).

Health and Sports Committee

The Health and Sport Committee of the Scottish Parliament has published its report entitled:

‘We Need to Talk About Palliative Care”

(http://www.scottish.parliament.uk/S4_HealthandSportCommittee/Reports/HSS042015R15.pdf ). The Scottish Government have responded to this

(http://www.scottish.parliament.uk/S4_HealthandSportCommittee/Inquiries/20160121-SG_Response.pdf )

and recently welcomed the opportunity to provide evidence to MSPs on progress and future plans

http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=10336&mode=pdf.

cw2The Framework outlines the vision that by 2021 everyone who needs access to palliative care will have access to it.

Surely everyone in Scotland currently has access to palliative care – after all most people have a GP and everyone who has been diagnosed with a progressive, incurable and/or life-limiting illness has been in touch with a Consultant ?

Theoretically yes, but the vision is for access to the sort of palliative care that the World Health Assembly refers to, where there is “:…palliation across the continuum of care, especially at the primary care level, recognizing that inadequate integration of palliative care into health and social care systems is a major contributing factor to the lack of equitable access to such care.”

This is the vision for what this means for Scotland.

We were fortunate to be able to appoint Professor David Clark as the Consulting Editor for the Framework, ensuring that all of the views received throughout the engagement process were considered objectively against the best available international evidence and expert opinion.

The publication of the Framework and supporting evidence has been welcomed internationally (http://endoflifestudies.academicblogs.co.uk/scottish-government-launches-its-strategic-framework-for-action-on-palliative-and-end-of-life-care/).  As with any change on the scale of that envisaged in a national strategic framework, there are a wide range of ideas and views on how this might be achieved.

Conversations

The Scottish Government has outlined it’s commitment to supporting changes required to support access to palliative and end of life care being available to all who can benefit from it, regardless of age, gender, diagnosis, social group or location.cw3.png

It has been recognized that people, their families and carers will need to have timely and focused conversations with appropriately skilled professionals to plan their care and support towards the end of life, and to ensure this accords with their needs and preferences.

This will in turn require that a wider range of communities, groups and organisations understand the importance of good palliative and end of life care to the well-being of society.

The health and social care system will be increasingly configured to maximize the changes that people receive health and social care that supports their wellbeing, irrespective of their diagnosis, age, socio-economic background, care setting or proximity to death.  Many more people will have more opportunities to discuss and plan for future possible decline in health, preferably before a crisis occurs, and will be supported to retain independence for as long as possible.   People will need to know how to help and support each other at times of increased health need and in bereavement, recognising the importance of families and communities working alongside formal services.

All of this will be supported by a culture, through resources, systems and processes within health and social care services that empower staff to exercise their skills and provide high quality person-centred care.

Enhanced contribution

All of this can be achieved through improved identification of people who may benefit from palliative and end of life care, supported by an enhanced contribution of  a  wider  range  of  health  and  care  staff.

cw4There must be a stronger sense among staff of feeling adequately trained and supported to provide the palliative and end of life care that is needed, including a better understanding of how people’s health literacy needs can be addressed.

This is likely to be helped through a greater openness about death, dying and bereavement in Scotland – which will in turn be enabled through the recognition of wider sources of support within communities that enable people to live and die well.

I recently had the privilege of working with the Chief Medical Officer and some colleagues on her Annual Report for 2014/15 (http://www.gov.scot/Resource/0049/00492520.pdf).  This report included the suggestion that “Clinical leaders need to challenge their own thinking and ask themselves whether they have a growth mindset.

cw5.pngThis will mean an enhanced awareness of opportunity for self improvement, more engagement with challenge and a greater persistence in the face of obstacles.”  This is pertinent to all of the commitments outlined in the new Framework.

To achieve our vision many people, organisations and agencies will have to work together in a culture of collaboration – ensuring that there is a balance of constructive challenge and a recognition of the benefits of aligning support, engagement and delivery mechanisms for maximum benefit.

Much of the co-ordination, leadership and support for this work will come through the Health and Social Care Partnerships across Scotland.   The way in which these changes will be delivered may require significant changes in the way in which organisations approach the delivery of palliative care provision.

I would be delighted to hear from you, through this blog, email (craig.white@gov.scot) or on twitter  (@craigwhitephd) if you have an interest in this work.

The Strategic Framework for Action on Palliative Care and Supporting Evidence Summary are available at: http://www.gov.scot/Publications/2015/12/4053/downloads

Craig’s blog was originally previously featured on the Ayrshire Health website.

https://ayrshirehealth.wordpress.com/2016/02/10/lets-talk-about-palliative-care-by-craigwhitephd/

Building the Capacity of Parents

We recently showcased how the Early Years Collaborative is contributing to the Early Years Strategy in the Scottish Borders.

Here, Linda  Pople, One Parent Families Scotland Project Manager in North Lanarkshire highlights how local partnerships are helping to improve outcomes for children and families

“One Parent Families Scotland (OPFS), through delivering one to one and group work support services in North Lanarkshire, has identified that targeted parenting programmes to support the most vulnerable parents is required to help improve outcomes for children in the early years. OPFS has received over £1 million from the Scottish Government Third Sector Early Intervention Fund [2013-14 to 2015-16] and has recently been awarded funding for a further three years – receiving £354,000 in 2016-17. Peer led Mellow Parenting (MP) Programmes were developed to improve the parenting capacity of lone fathers and young parents and OPFS has received funding through the Early Years Change Fund to test this work In North Lanarkshire using Early Years Collaborative (EYC) Improvement Methodology.

“The MP family of programmes has been developed to support parents and their children to build good relationships. The foundation of the programme is attachment theory with particular emphasis on the transmission of attachment and relationship styles over generations.  This relationship based intervention promotes positive parent-child interaction and the strength of this programme is that it does not dictate how to parent but instead it aims to change parents’ philosophy.

“To enhance the MP programme a tailored package of support is provided by volunteer Peer Mentors to all families taking part, to address any issues or concerns quickly and encourage participation.   Peer Mentors are lone fathers or young parents and act as positive role models.   They co-deliver the programme alongside professional workers and their observations are an important aspect of measuring the impact on families.  Since September 2014, four programmes have been delivered with eight to ten parents participating in each.  Improvement, using EYC methodology tests and measures the effectiveness of the programme:

  • 79 per cent of parents felt a significant decrease in in overall stress levels ,
  • 83 per cent of parents reported a decrease in intensity of daily hassle such as shopping with and dressing and feeding children
  • 75 per cent of parents reported an increase in confidence when dealing with challenging situations.
  • 79% parents have reported improved interactions with their children – such as reading and playing with them and in turn they feel better able to recognise and respond to their children’s feelings.

“Peer and professional observations have also reported an increase in appropriate social behaviour and that children are more ready to take part in play and social activities within their home and in groups within their local community such as Bookbug and play groups.   Parents have also reported that they are now less socially isolated.  There has also been a significant increase in uptake of local services, for example Social work, Health and Addiction Services.  The programme has been extremely successful in allowing parents to share their life stories, address the root cause of their problem and seek the specialist support they need to move on in their lives.”

Stephen’s and Suzanne’s stories:

Stephen

Stephen who took part in the MP Programme said:  “I feel a lot closer to my kids and more confident in getting my children to do things I have asked them to do. My children are so much happier and my oldest son Lewis doesn’t mind doing things with the dads’ group because it isn’t social work – as he has been involved with Social Work for most of his young life.  And since I have been working with Neil, my MP Mentor I feel I have a better relationship with my social worker.  Neil has made me realise they are there to help and are only there to look out for the kids.  I now have someone I can talk to and someone who will support me if I need help with anything that is worrying me, the kids, money, anything; he’s always at the end of the phone and always makes time for me.  My time keeping is so much better and I am going to all of my appointments and my social worker is happy with my progress

My middle child has now turned and told me ‘I love you daddy because you are really good at looking after me’. I now feel like there is light at the end of the tunnel.  My life is so much better and I am happy to wake up each morning. I no longer feel like looking after my kids as a job but as a blessing.”

Stephen continues to meet with his Neil regularly.  There have been significant changes in his confidence and his understanding of his children‘s needs.  His children are now tidy, clean and seem happier.  This has resulted in Home Care no longer being required to support the family.  Stephen and his children’s now have regular weekly outings accompanied by his mentor who has observed that the children now seem happy to take part in local activities resulting in increased interaction with their father and a decreased level of challenging behaviour.

Suzanne

“Before I came MP, I mostly sat indoors myself or with Kian, only leaving to take Kian to Nursery or to do a weekly shop. Before my son came to MP he could hardly speak, he had outbursts and tantrums daily and his behaviour was very erratic, up one minute and down the next. Right from the first day at PM, I made friends, something I hadn’t really had for a long time.   Kian’s behaviour always made me wary of getting involved in anything.  I had been very depressed for a period of time and getting out of the house had made a huge difference to me.  Kian was also invited to another participant’s son’s birthday party. This is something that had never happened before.  My family never wanted me or my son around them as they said he was a problem child.  It felt good to receive an invite it made me feel I was no longer alone and that people actual liked me and my son, He isn’t a problem child he is just different from other kids because of his autism.  Through MP, Kian has come on leaps and bounds with his speech and behaviour.  I have now set a routine and Kian is much calmer. The crèche staff were brilliant with him and helped me to understand Kian’s specific stage of development.  MP has made me realise that I am a good parent but just needed some help and support to understand how to deal with Kian and why he was having tantrums”.

Suzanne is currently sourcing autism awareness training and Kian is in a new nursery that has autism specialist staff to provide him with the best possible start in mainstream education.  Suzanne now has more confidence in accessing other additional support services.

Common Ground

Guest blog by Pam Duncan-Glancy – NHS Health Scotland

For people like me who have been campaigning on social justice and human rights for many years, the First Minister’s commitment to “do even more, even better at incorporating human rights in Scotland” felt a bit like all our birthdays had come at once.  Add the Scottish Government’s National Conversations on a Fairer and Healthier Scotland to the mix and one could be forgiven for quietly saying to fellow campaigners, ‘our work here is done’.  Both signal strong assurances of a commitment to human rights and both are long awaited and much welcomed.  But, as ever, complacency is not an option; warm words are not enough, or as I have recently heard it put, hope is not an action.  If we are serious about a socially just Scotland, then we must do everything we can to ensure that human rights are explicitly built into everything we do, to borrow the wise words of Kofi Annan, it’s time to move from an era of declaration to and era of implementation.  Simple.  Well…not quite, but it’s certainly not rocket science either and with the Political wind in our sails, what better time than now to launch into action.

Where to start?  Well, first we need to be specific, we need to pick a theme and focus relentlessly on threading human rights all the way through it.  For many disabled women like me, social justice means a lot of things, but a crucial part of it is about having access, by right, to enough, fairly funded, good quality and appropriate social care.  So (since you’re asking) in our move from declaring our human rights intentions to acting on them, our theme should be social care and we should work to create a social care system in Scotland that is available, accessible, appropriate, fairly funded and of a high quality.  That is what human rights would mean in social care and a human rights based approach can help us get there.  And here’s why.

Without social care, I couldn’t get out of bed in the morning, go to work, see friends, play my part in our society, and oh yeah…7 other people would be out of a job.  Put quite simply, I wouldn’t be healthy, I wouldn’t have fair and equal access to society and I wouldn’t enjoy my human rights on an equal basis to non-disabled people.  But, (as my husband often tells me) it’s not all about me!  And here’s the thing, if we get it right, if we take a human rights based approach to social care there won’t only be individual benefits, but countless societal and economic benefits too.  Good social care can support people into employment and it can provide employment, it can support people to participate in society and lead an ordinary life and it can help them to stay healthy – and of course, a healthy society is a more prosperous one – and so the cycle continues.  Social care is an all-round essential infrastructure of a fair, equal and prosperous society.  So that’s why I think it’s a perfect place to start, but I didn’t say it’d be easy!

Social care as it stands is not readily available or accessible, so there’s a way to go if we are to make it live up to our human rights intentions.  When it comes to divvying up the coffers social care is always left behind:  spending on social care in Scotland has decreased by 5% between 2009 and 2013* and the Scottish Government predicts that to meet demand on current trends, spending would need to double by 2031*. We just don’t seem to appreciate or understand the social or economic value that comes both from having and providing enough good quality care and support.  The questions we need to answer in Scotland to change this and ensure our social care is fit for the future are biggies – how can we end the post code lottery of social care provision; how do we disinvest to support prevention; how should we pay for social care in Scotland; should people have to pay for something that is essential for them to enjoy their human rights and if not where will the money come from; what is social care for, who is it for and what can they expect from it; and those are just some.  Tinkering around the edges is not going to cut it.  If we are serious about social justice we have to address social care on a system-wide basis and we have to be brave.  But fear not, for this is where our human rights based approach comes into its own.

If the first thing we need to do in our era of implementation is pick a theme, the second thing to do is to work in partnership and take the bold and necessary steps needed to make sustainable change happen, together.  We need a national, focussed conversation directed at creating a human rights proofed system of social care.  That means listening to and involving the people who need our support, the people who work in social care and the people with the purse strings (remember, resources will need to follow our ambitions).  Now there’s a lot of perspectives in that list, and some of them competing.  But a human rights based approach can support these discussions.  It brings focus to the people who need most support whilst at the same time ensuring the systems in place to do this are sustainable.  And bingo, we have our common ground on which to move from intentions to action.

I am in the privileged position to have worked on human rights and health in a variety of settings, including in the Third Sector for over 15 years, and now in the public sector where I work for NHS Health Scotland, focussing on health inequalities.  In both jobs I have heard frustrations that change isn’t fast enough or actions and policies don’t go far enough.  And I’ve heard each say of the other that they are ‘missing a crucial point’ be that of sustainability or reality.  But you know what heartens me; across both sectors the desire for change is so strong that the people are impatient for it.  That’s how I know change must be coming.

So there you are, I said turning human rights from intent to action wasn’t rocket science and I hope you can see that our launch pad is a strong one.  We have our shared ambitions for social justice, a human rights based approach to help us put our hopes into action and the theme of social care to get our teeth into.  All we need now is the bravery to get on with it and show the world how it’s done.

Pam Duncan-Glancy

NHS Health Scotland

www.healthscotland.com

Twitter – @NHS_HS

References:    

*1 Audit Scotland; “Self Directed Support”; 2014

*2 Scottish Government, COSLA and NHS Scotland, 2010; “Reshaping Care for Older People – A Programme for Change”; 2011–21

SNAP

SNAP – Scotland’s National Action Plan for Human Rights – was launched on 10 December 2013, marking International Human Rights Day.

More information on Scotland’s National Action Plan for Human Rights can be found at http://www.healthandsocialcare-snap.com/ and http://www.scottishhumanrights.com/actionplan/

Maggie’s Dundee welcomes Health Secretary Shona Robison for National Conversation

Maggie’s Dundee, the charity which provides free practical, emotional and social support for people with cancer and their family and friends, welcomed Health Secretary Shona Robison to the Centre to meet with visitors and staff for a Healthier Scotland national conversation event on Friday (22 January 2016).

The meeting at Maggie’s Dundee’s big kitchen table was part of a series of events and discussions about creating a healthier Scotland which are taking place around the country.  Maggie’s Centre visitors had the opportunity to ask questions and to share their experience of the treatment and support available for people affected by cancer in Scotland.

The event came about following a visit to the Centre last October by Chris Law MP and Joe FitzPatrick MSP.

Maggie’s Dundee offers a free programme of high-quality support for people with cancer, as well as their family and friends, which includes practical support such as nutrition and benefits advice or stress management workshops, emotional support such as one-to-one time with a psychologist and the social support of talking and sharing a pot of tea with people who understand what it means to be living with cancer.

Health Secretary Shona Robison said: “Earlier this year I announced my intention to hold a national conversation about the future of our health and social care services.

“We want to know what really matters to people and their families and what support they need to lead healthier lives, whatever stage of life they are at.

“We held the first national conversation in Dundee in August and I was very pleased that we were able to hold another meeting at Maggie’s Dundee, in response to a request made to Joe FitzPatrick.

“It’s important for me to hear first-hand the issues that people have when they engage with our health and social services provision.”

Joe FitzPatrick, MSP for Dundee City West, said: “I visited Maggie’s Dundee, together with Chris Law, MP for Dundee West, in October and from our discussions with Lesley Howells, the Centre Head at Maggie’s Dundee, we agreed it would be useful for Maggie’s Centre visitors to come along and ask questions directly of the Health Secretary.

“I am delighted that the Health Secretary was able to do this and I know the people who came along were very pleased to be able to speak to her in person and voice their views on different aspects of health and social care provision and what they’d like to see in the future.”

Lesley Howells, Centre Head at Maggie’s Dundee, said: “We are delighted to have had the opportunity to join the national conversation on the future of health care in Scotland.  The people who visit Maggie’s Dundee have an extremely valuable contribution to make to the debate, sharing their experiences and discussing with the Health Secretary what matters most to them when thinking about healthcare.

“In addition, this year marks 20 years since the first Maggie’s Centre opened in Edinburgh, and it was wonderful to have the opportunity to discuss with Ms Robison how Maggie’s can best help to support people affected by cancer in Scotland in the next 20 years.”

Built in the grounds of Ninewells Hospital Maggie’s Dundee is a warm and welcoming place, with qualified professionals on hand to offer an evidence-based core programme of support that has been shown to improve physical and emotional wellbeing.

Maggie’s Dundee relies on voluntary donations to support and grow its network of Centres and to develop its unique, high quality programme of support. The charity’s aim is to make the biggest difference possible to people living with cancer and their family and friends.

To find out more about Maggie’s Dundee and to see how the Centre supports people with cancer across Dundee and Angus please visit the Centre at Ninewells Hospital, Tom McDonald Avenue, Dundee or get in touch on 01382 632999 or a Dundee@maggiescentres.org.

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Photo: (l to r) Maggie’s Dundee Centre visitors Bill Martin and Pauline Kinsman, Health Secretary Shona Robison, Centre visitors Rachel Gorrie and Arlene Fenton, Maggie’s Dundee Centre Head Lesley Howells, MSP Joe FitzPatrick.

For further information about Maggie’s Dundee please go to www.maggiescentres.org/dundee

Follow Maggie’s Dundee on Facebook for the latest news and stories and tweet us @maggiesdundee

www.facebook.com/maggiesdundee

Terrence Higgins Trust Scotland Contributes to the National Conversation

Guest Blog by Kevin Ditcham Health Promotion Specialist: Men Only TaysideTerrence Higgins Trust Scotland

Terrence Higgins Trust Scotland (THTS) is part of the UK’s leading HIV and sexual health charity. Founded in 1982, it has been at the forefront combating  the HIV epidemic for the past 33 years.

Th1When Terry Higgins died with AIDS on 4th July 1982, his friends and partner took the love they had for him and the anger they felt at what he had gone through, and decided to make a change. They founded Terrence Higgins Trust in his name so that others wouldn’t have to endure the pain and stigma that he had suffered.

From just a handful of people, our charity has grown to become the largest voluntary sector provider of HIV and sexual health support across Great Britain. We staff phone lines, display posters, visit schools and run sexual health/HIV testing clinics. Other activities include, counselling services, youth groups and deliver high quality information via the web and social media.  At times we hold  the UK Government and devolved governments to account  in order to ensure the best outcomes for those we support. For a time we helped people to die with dignity, but for the last 16 years we have helped children, young people and adults with HIV to live their lives to the fullest.

Today there are more people living with HIV than ever before and the latest figures show that there are now almost 7,000 people with the condition in Scotland. Of these, a quarter are unaware that they’re infected; this equates to approximately 1,600 people living in Scotland with HIV who don’t even know it. This places their health and wellbeing and that of others at risk.

For many people, HIV is perceived as something which has either gone away, is not relevant to them or is something that happens thousands of miles away in developing countries. The reality is that men and women from all walks of life are living with the virus and many more are at risk of infection. It is therefore vital that THT continues to deliver targeted prevention programmes, particularly for young people, and continues to raise awareness and provide testing for HIV and other STIs, as well as providing direct services to people living with HIV.

Our vision is a world where people with HIV live healthy lives free from prejudice and discrimination, and good sexual health is a right and reality for all.

Terrence Higgins Trust’s mission is to:

  •  Maximise sexual health in the UK, and minimise the spread of HIV and STIs, by encouraging people to value their sexual health and by leading innovation to increase access to local sexual health services;
  • Empower everyone living with HIV in the UK to maximise their health and wellbeing by working to ensure the best possible HIV treatment and support services;
  • Lead public and political support for HIV and sexual health issues, and campaign to eradicate stigma and discrimination

A national organisation helping improve the lives of people in Scotland:

Th2Much has changed since the early days of HIV and as the shape of the epidemic has changed, so has the Trust. Our existing services across Scotland have been developed and we have introduced new services which are modern and innovative, thus meeting with the changing needs of people living with or affected by HIV and poor sexual health.

We are  a national organisation with stability and infrastructure but have local roots, embedded within communities all across Scotland. We are confident that this ensures a long-term response to the HIV and sexual health needs of the people of Scotland.

THTS offer a range of practical, community-based services in Scotland, which include:

  • Support services, such as mentoring for people living with HIV
  • Counselling, advice and information
  • Health promotion work targeting key at-risk groups
  • HIV and STI testing services

Th3We have a strong track record of delivering a successful programme of services in Scotland and with limited statutory income; most of our services in the country are funded through voluntary charitable donations. This funding has recently enabled us to launch a postal HIV testing service for anyone, living anywhere, in Scotland. This approach is unique and innovative within the UK as it does not simply target those who are perceived to be most at risk.

This new project, Fastest Direct, was developed following extensive research carried out by THT which showed that some people at risk of HIV would be more likely to test, or to test more regularly, if they could test themselves at home.

People who are diagnosed with HIV today can expect to live a long and healthy life. However, late diagnosis is a particular problem in Scotland, which  can make it harder for treatment to work effectively and increases the risk of onward transmission to others if the person doesn’t know they have it. A large proportion of HIV transmission is due to people who are not aware of their diagnosis. By improving the availability of testing, THTS hopes to reduce the levels of undiagnosed HIV in Scotland and in turn reduce the chances of further onward transmission.

Th4Research shows that reluctance to test in a clinical setting can typically be down to time pressure, the stigma of being seen at a sexual health clinic or discomfort when talking about sexual history with a medical practitioner. THTS developed the postal testing service to enable all people, including those in rural locations and young people, to access HIV testing. So far, it has helped us to access people who have previously been difficult to reach with conventional testing services and health promotion activities, from Shetland to the Borders.

Launched in November 2014, Fastest Direct has tested over 1,400 people and helped a number to know their status and get the essential treatment and care they need. Anyone in Scotland can order an HIV test from www.tht.org.uk/fastest. We’d encourage you to order one and take a test yourself; think of it as a routine MOT!

We recognise assets

We are a huge believer in asset-based approaches in all aspects of what we do. Whether this is about one to one support with individuals, empowering them to take greater influence in managing their health, or working with volunteers; it is about releasing their potential and capabilities. We recognise that everyone has assets, even if they don’t realise it yet. It’s our mission to work with people in providing the best outcomes for individuals and communities. Volunteers play a huge part in what we do and we really couldn’t achieve so much without them. Volunteers in Scotland support us in working with communities, health promotion work, staffing clinics, doing HIV testing, working on our phone line (THT Direct) as well as talking about HIV with their peers – one of the best ways to challenge the stigma!

If you’d like to find out about our work in Scotland, visit www.tht.org.uk/scotland. Follow us on Twitter @thtscotland, or search ‘Terrence Higgins Trust Scotland’ on Facebook. You can also email info.scotland@tht.org.uk.

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