What went on ...

Review of event provided by Janie Gordon and colleagues from Fife Health and Social Care Partnership; 


Summary of the talks

A view from the Bridge with Robert Packman, Chief Officer, Perth and Kinross Health and Social Care Partnership

Review by Lorna Stanley, Advanced Specialist Dietitian, Older People

The view from the bridge used the current view of the River Forth with the 3 bridges - the old, the current and the future to symbolise the integration of health and social care as the most significant change to public services in recent history.  All AHP’s were encouraged to be bold and to be in the forefront of new the new design. He warned that if we’re not and our voice is not heard we may lose out. Rob highlighted that we will be unable to continue to provide our current services due to increased demands and also budget constraints and must “adapt or die”. He referred the delegates to the Nuffield Trust publication and discussed education and supportive roles. Rob also encouraged us to try new ways of doing things but not to expect things to work perfectly first time and to try- fail- learn- try............ . Rob concluded by reiterating the importance of being outcome focused, make strong relationships and collaborations, looks outwards and being innovative. Delegates were advised to look at ABC nightline-Ideo shopping cart on YouTube.

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Our voice empowering service users' with Helen McFarlane, Our Voice Programme Director, Scottish Health Council

Review by Caroline Berry

This speaker discussed working together to improve Health & Social Care. She talked about supporting and empowering service users; describing the model Armstring ‘Ladder of Participation’ and asked all participants to draw a ladder with 8 steps;

8 Citizen control
7 Delegated power
6 Partnership
5 Placation
4 Consultation
3 Informing
2 Treatment/therapy
1 Manipulation

  • The first two steps – why are we involved? Patient will be educated and will do as professional tells them.
  • The third step – information is given to patient but he patient has no opportunity to contribute
  • The four step involves listening to patients view; e.g. focus groups
  • The fifth step – patients have a more active role in consultation but decisions are still made by the Dietitian
  • The sixth step – the patient is involved in decision making
  • The seventh step – the Dietitian sets the patient goals but delegates power – the patient contributes to how goal vill be achieved. What matters to the patient is looked at. The final step is that patients have own ideas and might ask for advice.

There is a website ‘Our Voice’ looking at ‘What matters to you’ – patient opinion;

  • Was it good?
  • What could be improved?
  • How did you feel?

We were asked to consider this model when planning services and during consultations.

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Preventing Cancer in Scotland: what's happening and how we can help? with Debbie Provan, National AHP Lead for Cancer, Rehabilitation and Macmillan, TCAT Project Lead for NHS Ayrshire and Arran, Scottish Government and Macmillan Cancer Support

Review by Marj Lochtie, Advanced Specialist Dietitian, Diabetes

There is a new publication from Scottish Government 2016; ‘Beating Cancer; Ambition & Action’ which can be viewed online. A £100 million strategy to tackle cancer by improving prevention, detection, diagnosis, treatment and after care, for those affected. ‘Beating Cancer; Ambition & Action’ will service as the future blueprint for cancer care in Scotland over the next five to ten years. The strategy contains more than 50 actions, including;

  • £50 million for radiotherapy equipment and to support radiotherapy recruitment and training
  • £9 million over five years to ensure better support for people with cancer and their families, e.g. through Link Workers and other initiatives like Macmillan’s Improving the Cancer Journey
  • £5 million to target reducing inequalities in screening uptake
  • £7.5 million to support improvements in surgical treatments
  • An additional £10 million to support swift access to diagnostics for people with suspected cancer
  • £3.5 million to drive improvements across the palliative care sector and to support targeted action on training and education
  • £5 million to support waiting times performance

Act Well Programme – For the Scottish Cancer Prevention Network (SCPN, the most interesting announcement is the commitment to developing (and implementing as apprpriate0 the ActWELL programme (support for lifestyle change in women attending routine breast screening clinics) which was developed with support from the Scottish Cancer Foundation and piloted in Dundee and Glasgow by Annie Anderson. Scottish Cancer Prevention Newsletter is available on the website and information is shared by blog, facebook and twitter accounts. Better Living magazine is available to the public when they attend for screening. Bowel Cancer UK website also has a newsletter. All these are geared to inform the public of dangers and ways of preventing cancer and there is lots happening in the bid to prevent and also treat cancer.

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The role of Food Standards Scotland in Improving the Scottish Diet’ with Carrie Ruxton; Board Member, Food Standards Scotland

Review by Marj Lochtie, Advanced Specialist Dietitian, Diabetes

Food Standards Scotland is a non-ministerial government department. It is responsible for food safety, food standards, nutrition, food labelling and meat inspection in Scotland. Food Standards Scotland has taken over from the Food Standard Agency.

The Scottish Gov report “Scottish Diet” Dec 2015 made the case for reducing the consumption of discretionary foods and drinks to make significant and measurable improvements to diet and health. Discretionary foods are items of food and drink that are high in calories and low in nutritional value, they include biscuits, cakes, confectionary, savoury snacks and sugary drinks.

Goals were set out in this report and are not being achieved. Our diets contain too much sugar and fat leading to a high calorie consumption, in turn leading to overweight and obesity. To reduce the energy density of the Scottish Diet we need to eat fewer sugary and fatty foods and replace these with low density foods such as fruit and veg. At moment energy density of the average diet in Scotland is much too high --- 40% over the target.

Hence a campaign was started to improve our eating habits; Food Standards Scotland Healthy eating Campaign Food Standards Scotland (FSS)’s new healthy eating campaign aims to highlight several of the potential health consequences of poor diet choices which can lead to overweight and obesity, and is designed to motivate people in Scotland to change their and their children’s unhealthy snacking habits. If we continue on our current trajectory, it is predicted that 40% of people in Scotland will be obese by 2030.

The Campaign is aimed at reducing the number of discretionary or junk foods that are eaten in Scotland. Given 50% of all the sugar we consume comes from unhealthy treats and snacks, it’s important for every member of society to consider cutting down on snacking and swapping for healthier alternatives.

The campaign was researched and developed with the intended target audience for the campaign (parents). The research showed us that it was important that the campaign messages come from the child’s perspective – in their language and terminology. TV adverts, outdoor and digital advertising, field marketing, social media and PR all involved in the campaign. The campaign directs people towards the FSS website where there is further information on cutting down on unhealthy snacks and ideas for healthier snacking choices.

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Innovation in Practice - ‘Use of FODMAP in Scotland’ with Mairead Keegan, Senior Specialist Dietitian, NHS Lanarkshire

Review by Simon Fevre, Clinical Lead Dietitian, Older People

This is the part of the Doit Initiative which is looking at developing a Scotland wide approach to specific conditions. It will focus on agreeing a consistent pathway for the management of FODMAP patients. Samantha Philp is NHS Fife’s representative on this group.

Mairead gave a good overview of the development of the FODMAP approach. She then described the survey that was carried out across Scotland to look at the development of FODMAP style service development. It is anticipated that an agreed pathway will be developed for Scotland.

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‘Scotland’s Workplace Health – is the NHS Leading by example?’ with Joyce Thomson, Dietetic Consultant in Public Health Nutrition, NHS Tayside & Ruth Campbell, Consultant Dietitian in Public Health Nutrition, NHS Ayrshire & Arran

Review by Vicki Bennett & Bree Goodbrand

We were asked as a group to think about the question: What does wellbeing mean to you? and What helps and hinders you to be healthy at work? We discussed this in small groups and then shared. There was discussion around the environment playing a big role and the facilitators felt we had reverted to type rather than saying what we could do as individuals. Choice within our hospitals and promotions in shops was a hot topic as was the “cake culture” and trying to make this more healthier in the workplace

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Experiences of Dietitians working with homeless people’ with Dr Myra McKenzie, Lecturer in Nutrition & Dietetics, Robert Gordon University and Tracy Moynihan, Community Dietitian, Health Promotion, NHS Ayrshire & Arran

Review by Lisa Cruickshank

Dr Myra MacKenzie, lecturer in Nutrition and Dietetics at Robert Gordon University in Aberdeen presented the results of a study carried out at RGU entitled ‘Self care amongst the homeless: A qualitative study of associated barriers and facilitators’.

Self care is ‘what people do for themselves to establish and maintain health, prevent and deal with illnesses’.

There were 34,662 homeless applications for support in Scotland from April 2015 – June 2016. Homeless people are those with ‘no fixed abode’ so although they may not be living on the streets they will be ‘sofa hopping’ or using hostels. Homeless individuals commonly experience health inequality but positive engagement in self care can allow patients to prevent and mitigate illness. About half of homeless applications are from single men. Most participants in the study understood the importance of self care but perceived that engagement was low mainly due to unstable lifestyles.

Tracy Moynihan, Community Dietitian Health Promotion, NHS Ayrshire and Arran Dietetic Health Promotion team shared a selection of laminated easy recipe posters from the ‘C.A.N. (cheap and nutritious) cook kit’ that are used to help promote inexpensive healthier meal choices. She also presented the ‘Canny cooker’, described as ‘a slow cooker without the plug’. The idea is to make a one pot recipe e.g. a vegetable soup, and heat it for 5 – 10 minutes on the stove. Then it is placed in the canny cooker which is a padded, insulated sack with an insulated cloth lid which
retains the heat and continues to cook the food. This uses about a 1/3 of the fuel normally required to produce the meal so is both cost effective and environmentally friendly! After about 45 minutes the meal is ready. Tracy demonstrated this by sharing a delicious and piping hot soup that she had prepared earlier. The canny cooker will continue to keep the food hot for a couple of hours.

A demonstration video of the canny cooker is available to view on YouTube.

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BDA Work Ready Programme with Elaine Gardner - Public Health Dietitian & Member of the BDA Work Ready Steering Group

Review by Katie Cunningham, Specialist Dietitian, Diabetes

Up to 25% of the UK's working age population suffer from a long-term condition which can be weightrelated, and employers are looking to support the productivity of their workforce through improved resilience and mental wellbeing. This has led a timely review by the British Dietetic Association (BDA) on the evidence on wellness initiatives which encourage better nutritional practices. Supporting healthier working lives through dietitian-led wellness initiatives, BDA Work Ready Programme - Exec Summary.

It is well accepted that organisations benefit from investing in the wellbeing of their employees, and experts who commission employee wellbeing programmes are increasingly looking for effective solutions. Dietitians are the only qualified health professionals that assess, diagnose and treat dietary and nutritional problems at an individual and wider public health level; they have the skills to effect positive behaviour change for a workforce in partnership with an employer. The key message to employers is that supporting regular eating patterns and a quality diet for workers can improve overall wellness, driving productivity and reducing sickness absence statistics.

The BDA Work Ready programme was launched in September 2015 – there have been more than 400 enquiries from companies (NHS, local councils, transport, supermarkets, manufacturing and government) about the BDA Work Ready programme during this time. A number of accredited BDA Work Ready dietitians are currently involved in implementing the Work Ready programme but none of these projects have been completed yet. The programme offers bespoke nutritional and wellness services tailored to employers' needs. A 'pick and mix approach' affords businesses the opportunity to choose the level of support that they need as required. Whether it is a full Work Ready Programme or elements of the programme to be combined with existing services, employers can be assured that they are receiving a quality-assured service, soundly based in scientific research and principles, provided by dietitians, specifically trained in workplace nutrition.

There have been 39 Work Ready dietitians accredited by the BDA to date in different geographical areas to meet the demand of the programme. Accredited dietitians will be offered the opportunity to work with companies who express interest in the BDA Work Ready programme in their locality. The dietitian negotiates a fee for the work that will be carried out within a company and the BDA are given a portion of this fee to help in the production of resources, advertisement, website etc.

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Rabbit stew anyone? Social Care Dietetic Student Placements with Evelyn Newman, NHS Highland

Review by Gail Brown, Advanced Specilialist Dietitan, Learning Disabilities

This was a very interesting workshop on an innovative project in the Highland of having student placements in a care home setting. It was a pilot programme using a partnership approach with different organisations. This pilot project saw the first student Dietitan in the United Kingdom complete a placement in a care home setting and was nominated for a national award. The pilot placement was a huge success and much more than anticipated and especially for the residents themselves. The profile and value of the Dietitians’ work and nutrition generally, in a care home setting, have been championed and recognised by many more people. It was about exposing the students of today to the clients of tomorrow.


The student spent two days per week at a care home over a five week period. She carried out an audit of nutritional care plans, completed a case study review of a resident and presented her findings to staff and dietetic colleagues. She also developed her communication skills and understanding of the challenges in engaging with residents who have dementia.

The student spent a few hours trying to tap into memories of residents by asking them to discuss their recollections of mealtimes, special occasions and their favourite foods. The results of this exercise were great; as they rekindled thoughts of family mealtimes and favourite foods. One resident, normally a very quiet lady, become actively involved in the conversation, articulating herself really well. The residents were asked to help to create a favourite menu and the nursing home cook prepared a themed day for the student’s last day. The menu contained Scotch broth and rabbit stew and was followed by Clootie dumplings for pudding! Having a focused discussion around food memories was a great way of engaging dementia residents and their families. It gave the residents a voice in choosing their favourite menu and everyone could participate, have fun and enjoying the memory. The themed lunch tapped into the memories of some of our hard to reach residents. The learning from the audit and the students work whilst there was shared across care homes both in Highland and more widely across Scotland.


The placement was an excellent example of partnership working between different agencies.


Poster Presentations

40 poster were displayed covering the three event themes. Prizes were awarded to the top three posters and can be viewed on the website.  Thanks go to Wiley for providing a prize for the winner, to view the BDA/Wiley publications refer to the relevant pages on the website. 

Exhibitors

There were nine exhibitors at the event promoting their work and services with Dietitians. What to know who was there ....