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Today Blue Stream Academy’s Healthcare & Lifestyle Magazine Summer 2019 Issue 2

Taboo

Body Art and the NHS Page 5

Myths

Misconceptions & Misinformation Page 10

Social Prescribing Look Who’s Talking Dr Marie-Anne Essam Page 16

Issue 2 Front Cover

Simply follow these steps: BSA Today is the brand new Healthcare & Lifestyle magazine from Blue Stream Academy. We are the UK’s leading provider of online training for GP Practices, Nursing & Care Homes, Hospices and Urgent Care Centres. Our mission is to standardise the UK’s healthcare training for a consistent delivery of quality care, through better staff education, experience and development. We have developed a suite of interactive training modules that are easy to use, cost effective and in line with CQC guidelines. All our modules are also RCGP accredited and CPD certified, providing over 70 hours of online training. If you have any comments, suggestions or ideas, please contact our editor Brady Braddock via email: brady@bluestreamacademy.com. Alternatively, you can write to us at the address below: Blue Stream Academy Suites 11, 12 & 16 Riverside Business Centre Foundry Lane Milford Derbyshire DE56 0RN Phone: 01773 822549

www.bluestreamacademy.com

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BSA Today | Issue 2

contents

From the Editors Desk...

ow -first and foremost we would like to thank our readers for the amazing feedback we received from our very first issue. We are now incredibly excited to present the Summer edition of BSA Today, packed with even more great content and features.

16 Look Who’s Talking The ‘Godmother of Social Prescribing’, Dr. Marie-Anne Essam, talks to us about Social Prescribing and why it's important.

This issue has been lots of fun to put together and we have once again got to work with some great contributors, who I would personally like to thank for their involvement. We have also doubled the size of the magazine which has meant a lot more work for all of us here at BSA Today, but I’m proud to say that we pulled together, through hard work, lots of laughter, and the occasional meltdown! Now, what started off as a suggestion to create a newsletter has become a successful stand-alone magazine, committed to bringing you the latest and greatest topics

across the Healthcare sector. In September six of us, also known as the ‘BSA Super Six’, have decided to get together and do something extraordinary for a good cause. We are participating in a charity skydive to raise money for Bluebell Wood Children’s Hospice. This is a big challenge for all of us involved, especially myself as I have a fear of heights, but its always good to try new things. If I hadn’t stepped out of my comfort zone to take risks, I wouldn’t be here at BSA Today, working with this great bunch of people, who all share the same commitment to this industry and towards each other. After all, we’re Blue Stream Academy and we’re willing to throw ourselves out of a plane in the name of Healthcare!

Brady Braddock Editor

Pharmacists on the Front Line

Root Cause Analysis

Tattoo Taboo: Body Art and the NHS

Fun in the Sun

Laser Tattoo Removal

The Best Sun Cream of 2019

Good Business Practice

Summer Recipes

Ask Abi

#TeamBSA & @BlueStreamNews

Blue Stream Academy’s Photo Competition

Puzzle Corner

We spoke to Davina Gadhia, a Senior Clinical Pharmacist at a GP practice in Leicestershire, who gave us an insight into this important and developing pharmacy role. Government service ACAS estimates that 1 in 3 young people have a tattoo, including many healthcare professionals that work for the NHS.

Dr. Ben Mills, a GP who set up and runs The Tattoo Removal Company gives his insight into laser tattoo removal. Time To Change share their key elements to encourage a healthier workplace.

GDPR: Myths, Misconceptions and Misinformation

Hospice Develops VR for Terminally Ill Patients

With a year having passed since the implementation of GDPR; we reflect upon some of the most common myths, misconception and misinformation.

I Experience VR has been pioneered by LOROS Hospice in Leicester, creating an innovative library of theraputic and immersive 360-degree films.

Look Who’s Talking

The ‘Godmother of Social Prescribing’, Dr. Marie-Anne Essam, talks to us about Social Prescribing and why it’s important.

www.bluestreamacademy.com

Root Cause Analysis is a set of tools and approaches that can be used, as part of an investigation to establish what happened, how it happened and why.

Get prepared for your holiday with our handy packing tips and other essential advice.

Stay safe in the sun this summer with Blue Stream Academy’s top sun cream picks, from sports to lounging around, we’ve got you With summer fast approaching, evenings and weekends will be mostly spent basking in the sunshine and enjoying the light,warm nights. And with this, what is better than eating ‘al fresco’ or inviting friends and family over for a get together and food?

Our resident agony aunt Abi answers your healthcare questions.

Find out what has been happening over at Blue Stream HQ and what we have planned for the summer. Introducing our new photography competition, where you can win a print of your photo. See page 30 for details. Just for fun, see if you can solve our sudoku.

Pharmacists on the Front Line

Since the 2015 pilot launch of the NHS England Clinical Pharmacists in General Practice Programme, there are now over 1000 full-time equivalent Clinical Pharmacists working across England. We spoke to Davina Gadhia, a Senior Clinical Pharmacist at a GP practice in Leicestershire, who gave us an insight into this important and developing pharmacy role.

s a senior clinical pharmacist working in general practice, I am passionate about pharmacists utilising their skills and expertise to help improve patient care. Modern pharmacy has progressed significantly, moving away from traditional dispensing roles known by the public to more clinical roles. Although, community and hospital pharmacists will still be required for essential medication advice and ensuring safe provision of medicines. The Role in Action Pharmacists already have clinical knowledge of medications and therefore access to GP records, including blood tests and hospital letters, as well as a patient’s medical history. Thus, allowing pharmacists to do level 3 clinical medication reviews. In my practice, I am able to work in a multidisciplinary team to refer on patients who I feel are outside my competency. I work in a supportive practice alongside approachable GPs, allowing me to refer the patients with more complex conditions, and work with confidence knowing that I am within my competency.

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We are all working in collaboration, bringing different skills and expertise to the table to help improve and deliver a high quality of care. Davina Gadhia

Multidisciplinary working and shared decision-making helps improve patient care, as well as easing clinicians’ workloads, freeing up the number of appointments available for patients. In terms of lifting the workload from GPs, Clinical Pharmacists allow GPs to focus on more complex conditions. Pharmacists are taking on more responsibility and utilising their skills and expertise to help with patient care, working in a forwardthinking practice to use the correct professionals to give patients a more holistic model of care.

How Patients Are Supported Patients are open to seeing a pharmacist in general practice and I have had many positive experiences with them. Patients are supported with information on their medications, giving them the opportunity to utilise the pharmacists’ knowledge on medication and ask questions. For example, a patient may be on multiple medications and the pharmacist is able to contribute to the best effective use of them, therefore a pharmacist appointment would be offered instead of a GP. The pharmacist would go through appropriate use of the medication and any side-effects (if experienced), the pharmacist has the knowledge required to offer alternatives. The pharmacist is also able to identify drug interactions and also look at reasons for poor concordance. Deprescribing is also considered during the consultation where appropriate. Pharmacists not only see patients for medication reviews, but also for the monitoring of patients’ long-term conditions such as asthma, diabetes, high blood pressure and high cholesterol. Combined, this creates a significant amount of appointment time that we are freeing up from GPs, allowing more quality time for patients face-to-face. In my opinion, every GP practice should be looking at having pharmacists in general practice. I feel that I am a valued member of my team and my practice is looking at recruiting more pharmacists as it has been positively welcomed. Working in general practice is a fantastic incentive and I feel privileged to be able to utilise my skills in this role.

Tattoo Taboo: Body Art and the NHS

No, you’re not hallucinating, tattoos are everywhere lately as body art has officially become a mainstream movement. Now people from all sorts of backgrounds and professions are going under the needle in the name of art. In fact, according to a recent Acas study, one in three millennials now has a tattoo, including many healthcare professionals currently working within the NHS. By Brady Braddock

aattoos come in all shapes and sizes and they can represent anything – that’s the beauty of them, if you can dream it, they can tattoo it. Tattooing techniques can even be adapted to disguise operation scars and treat hair loss. This procedure is known as micropigmentation and it can boost a person’s self-confidence and transform their day-to-day lives, meaning perhaps tattoos aren’t just skin deep after all. In the UK tattooing is big business and is now so popular that the number of tattoo shops in Britain has tripled to more than 1,000 over the past decade. Tattoos are now embraced as a form of self-expression, just like haircuts, clothing and jewellery. This is perhaps www.bluestreamacademy.com

due to the rise of social media and the British public’s newfound obsession with celebrity culture. People in their thousands flock to tattoo shops with new ideas, drawing influence from famous actors, musicians and footballers, such as exEngland captain David Beckham, who’s tattoos are widely copied by a generation of adoring fans. In Britain, the tattoo industry is heavily regulated by local councils and all registered tattoo studios must comply with strict hygiene and safety laws, however in the past things were very different.

Continued on Page 6

Historically, tattooing is known as one of humanity’s oldest art forms and each ancient civilisation has its own unique tattoo history, dating back centuries. The Romans used tattoos as a way to brand criminals and slaves, whereas the Polynesians used them as a way to mark achievements and celebrate tribal rankings. In the early 1900’s, tattooing gained notoriety due to its association with prison inmates, motor-cycle gangs and other social outsiders. This era perhaps spawned the negative stereotypes and stigma that still exists today, especially amongst older generations and more conservative cultures. Even as recently as 15 years ago, visible tattoos, whether you had too many, or just one in the wrong place, could have had a negative impact on your chances of gaining employment.

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Staff employed by the Trust are permitted to have tattoos on display, as long as they are not offensive or intimidating... For years, tattoos were considered a taboo in the workplace – fast forward to 2019 and it’s almost the norm to see people sporting full sleeve designs in all types of jobs. Acas indicates that attitudes towards tattoos are finally softening and many businesses have moved with the times, keen to create a more open-minded and inclusive working environment. Some body art fans are keen to push social boundaries even further with hand, neck and face tattoos (aka ‘job stoppers’) becoming more and more popular in recent years. These tattoos are known as the ‘final frontier’ in the industry, in other words there’s no way back.

Most respected tattooists feel that tattooing these areas on people with no previous ink is ethically questionable, as many employers have an outright ban on tattoos of this kind, including the Metropolitan Police. Unfortunately for the tattooed workforce, some businesses still view body art as an undesirable feature and there is currently NO law that prevents employers from discriminating against visible tattoos. In the UK, employers can legally promote a certain image through staff appearance and the NHS is no different, although each Trust does have its own specific policies and procedures. It goes without saying that a healthcare professional wouldn't be allowed to display a tattoo that could be deemed offensive, but what about other tattoos? Afterall, physical appearance doesn’t determine the quality of care a healthcare professional can provide. Southern Health NHS Foundation Trust is keen to embrace individuality in its employees, but also recognises the importance of creating a positive and professional image. “Staff employed by the Trust are permitted to have tattoos on display, as long as they are not offensive or intimidating, for example, images and words of a sexual or violent nature or discriminatory language.” Whilst tattoos are generally becoming more accepted by the patient population, tattoos can mean different things to different people. Some patients and visitors may see them as a symbol of self-expression and personal identity, whereas others may see them as rebellious and unprofessional, which could lead to a lack of trust.

Alec, a healthcare support worker for the Trust says; “During my time in forensic services I’ve had many conversations with patients about my tattoos. It has been a useful tool to build rapport quickly with patients who have them too”. Whatever your opinions about body art, there’s no doubt about it, times have changed, and tattoos are here to stay Source: acas.org.uk

Laser Tattoo Removal

Dr Ben Mills, a GP, who set up and runs The Tattoo Removal Company in Derby, offers high quality laser tattoo removal with the unique addition of carrying out the procedure under local anaesthetic.

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A large number of individuals come to regret their tattoos - often from the moment they get them because it’s not what they imagined, or months and years later as they no longer feel the tattoo suits the person they’ve become. So, they look to have them removed. Dr Ben Mills

s the rapid rise in body art shows no sign of slowing down, some people will undoubtedly fall out of love with their ink for a variety of different reasons, whether it’s an ex partners name, a silly decision or just a badly executed design. Other than hiding it with another tattoo also known as a ‘cover-up’ in the industry, laser tattoo removal is the only viable option. Contrary to popular belief, laser tattoo removal is available on the NHS, but only if its existence is causing a person mental anguish or distress. In other words, it won’t simply be removed because a person no longer likes it. “A large number of individuals come to regret their tattoos - often from the moment they get them because it’s not what they imagined, or months and years later as they no longer feel the tattoo suits the person they’ve become. So, they look to have them removed. It’s nowhere near as easy to remove them as it is to get them in the first place. Laser is the most effective method if done well, but it’s a slow process of repeated treatments over typically 2-3 years and each actual treatment is very painful, unless, like us you are able to offer local anaesthetic (we’ve found topical treatments have

www.bluestreamacademy.com

very poor efficacy). Some colours of ink are very difficult to remove, different colours require different laser wavelengths, which increases laser costs. Tattoos that may have been inexpensive to put on can cost hundreds or thousands of pounds to remove successfully. It’s also very difficult for the individual to safely choose a laser provider. There are no minimum qualifications, no standards of treatment and no standards of equipment - meaning owners of unloved ink will often choose based on price. But the lower the price, the less will have been invested in qualifications, training and lasers. At best, the individual choosing the cheapest service has laser treatment that simply doesn’t work, or at worst they are left with a partially treated and now scarred tattoo. But it can be done, with great results, if done well i.e. with the right equipment, the right people and with clear and honest discussions with the unhappy tattoo owner about time scales and costs at the outset. The clients we see that successfully remove their ink are so relieved and pleased. They all say, ‘I wish I’d done it sooner!”

Good Business Practice Outstanding; defined as ‘clearly much better than what is usual’. As of 31 July 2018, 91% of GP services in England were rated as ‘good’ by the Care Quality Commission (CQC) with 5% rated as ‘outstanding’. Considering these figures that seems like a very fitting description. But what does it take to be outstanding?

ealthcare Provider AT Medics run 40 primary care services in London (four of which have an outstanding CQC rating) discusses their approach to becoming ‘outstanding’. Despite having five standards, and a range of criteria in order to meet those standards, achieving an outstanding CQC rating is far from a tick-box exercise. It has to be approached with pride and confidence rather than dread. I once heard someone suggest that the difference between providers with outstanding ratings was based on how they viewed inspections. If the entire team sees an inspection as an opportunity to showcase the positive work they are doing then it is this team that is likely to see an outstanding rating. This is an interesting theory and certainly one that rings true at AT Medics. We are confident in the services we provide and take pride in the difference we make to our patients lives every day. So back to the question…what does it take to achieve an ‘outstanding’ CQC rating? It might sound a strange place to start considering we are discussing how to be ‘clearly much better than usual’ but the recognition and acceptance of error goes a long way towards achieving greatness (from a CQC perspective). The reality is that, sometimes, things go wrong. It is important to be accepting of this fact and ensure that there are effective systems in place that allow for the reporting and recording of these issues. Above and beyond this, any issues need to be handled in a transparent and honest manner. At AT Medics we strive to inform patients as soon as possible, provide an honest and open dialogue, support and a written apology. I appreciate that this isn’t always easy. Unfortunately fear is alive and kicking but, I believe, the courage to admit mistakes comes from positive leadership. In addition to having the right processes and procedures that not only flag, but then prevent further issues you also have to have a leadership approach that embraces openness and honesty. Staff need to feel confident that they will find a supportive listener if they

identify that mistakes have occurred. Resilient people aren’t afraid to admit they have weaknesses but, instead, learn from them and use them to drive improvements. Resilience is something that is required in bucketloads in the present economic and political climate. How else can we expect to improve or, at the very least, maintain standards despite increasing demands and budgetary pressures if we don’t show resilience? We have been able to ensure this through the development of bespoke solutions that enable us to have relevant data and analytics at our fingertips. One of the issues, often, with scale is that you begin to lose sight of the detail. We have turned this on its head by having a ‘Hub and Spoke’ model where, for every seven practices, we have a centralised resource which monitors performance and is able to identify when extra resources are required. With a supportive environment also comes morale. I defy any organisation to achieve an outstanding rating without first having focussed on the team within. According to the CQC themselves, deterioration in CQC ratings can be attributed to the poor management of staffing levels, staff deployment, training and turnover. It doesn’t take a genius to figure out that unhappy staff are unlikely to provide a welcoming and engaging environment for patients.

Dr. Aumran Tahir

Founder & Director of AT Medics Dr. Tahir is directly responsible for two of the four ‘Outstanding’ AT Medics’ practices.

For further information on AT Medics: www.atmedics.com www.attech.london info@atmedics.com

The ‘Hub and Spoke’ model helps ensure that a surgery is not overwhelmed and has the resilience to operate smoothly. By combining this with other, relatively simple and costeffective measures such as regular staff meetings, regular staff communication and staff performance reports, we received comments from the one of our CQC inspections which included:

“A genuine open culture in which all safety concerns raised by staff were highly valued and integral to learning and improvement”. “Staff has been trained to provide them with the skills and knowledge to deliver effective care and treatment”. When you consider 15 months prior, the practice in question had significant staff issues with incredibly low morale and were not registered with the CQC – it was at this point that AT Medics began to manage the practice. Following the changes the practice achieved an ‘outstanding’ rating. An obvious testament to the impact such interventions can have. We also try and look at areas where we could improve the roles for individuals and enable them to focus on the tasks more relevant to their skills. For example, an average GP receives between 40 and 60 letters per day and may spend up to two hours per day managing documents. Now whilst I appreciate that might be a symptom of the role (no pun intended) I very much doubt any medical student sat studying for their exams relishing the chance to tackle a pile of admin. Through the development of a bespoke solution (yes another one!) we have developed a range of programmes that through upskilling the workforce and centralising admin, we successfully reduced the GP admin burden by up to 80% enabling more time to be spent on patient care (we are sharing these programs with practices across the UK). As a result, the GPs in our AT Medics family and others who have adopted our solutions feel less stressed and rushed and, therefore, have greater job satisfaction.

times more likely to be homeless. In order to support these specialist needs, a substance misuse clinician was recruited to deliver alcohol and substance reduction programmes. Another of our ‘outstanding’ examples, Kings Road Medical Centre, provides primary medical services to just over 11,000 patients in the London Borough of Kensington and Chelsea. The practice has a much higher than England average of patients aged between 20 and 39 years and a far lower than average number of patients aged under 19 and over 40. Despite being one of the smallest boroughs in London (at just over 4.7 square miles) it is one of the most densely populated areas in Europe. With a diverse population, half of which are from ethnic minority groups, the area also has a higher incidence of mental health problems than most urban areas. As a result this is a key area of focus for the Practice. This is an area that requires experience, knowledge and a genuine understanding of the local community and their beliefs. In some communities, there is a hesitancy to discuss mental health as it can be viewed as something that could bring shame to a family. Regardless of the scientific validity of this claim, beliefs are something that deserve respect, especially if we want to earn the trust and respect of the local community. In response to this, we teamed up with a local charity to tackle health and social issues affecting Muslim communities, such as mental health. In partnership we produced a set of multilingual short films called ‘Talking from the heart’ which explored mental health diagnosis and therapy combined with medical and faith advice from local respected leaders. According to the CQC you need to go ‘above and beyond’ to achieve an ‘outstanding' rating. At AT Medics, that has become central to everything we do. There is always more that can be achieved. So what does it take to become outstanding? The belief that ‘outstanding’ is what you can achieve is a very good start!

It sounds simple (a developing theme) but being able to support the needs of differing population groups is also key. Despite all of our primary care services being in London, they have very differing patient populations and, as such, differing needs. One of our ‘outstanding’ services is a case in point: The Greenhouse Surgery provides primary medical services to approximately 1000 patients in the London Borough of City and Hackney. It is a specialist service providing GP services to Street Homeless people or those in temporary or hostel accommodation in Hackney. 40% of the population are rough sleepers and 60% live in hostels or other temporary accommodation. The social and economic issues surrounding homelessness can mean that individuals often struggle to book appointments in advance or have difficulty adhering to a scheduled appointment. In recognition of this, the Practice now has no limit on the number of walk-in appointments available on any one day. Two thirds of homeless people in the UK cite drug or alcohol abuse as a reason for first becoming homeless and those who use drugs are seven www.bluestreamacademy.com

GDPR: Myths, Misconceptions & Misinformation

Article by Stuart Walsh, Blue Stream Academy's Chief Information Security Officer (CISO).

The General Data Protection Regulation (GDPR) has affected everyone, from individuals to global corporations, companies and organisations, both inside and outside of the European Union (EU); it has transformed marketing practices, the way in which data is managed and given people control of their own personal information.

tith a year having passed since it’s implementation; now seems to be an appropriate time to look back and reflect upon some of the most common myths, misconceptions and misinformation surrounding GDPR. Consent Whilst a lawful basis is required in order to utilise personal data, there are six to chose from: • Consent: The individual has given clear consent for you to process their personal data for a specific purpose. • Contract: The processing is necessary for a contract you have with the individual, or because they have asked you to take specific steps before entering into a contract. • Legal Obligation: The processing is necessary for you to comply with the law (not including contractual obligations). • Vital Interests: The processing is necessary to protect someone’s life. • Public Task: The processing is necessary for you to perform a task in the public interest or for your official functions, and the task or function has a clear basis in law. • Legitimate Interests: The processing is necessary for your legitimate interests or the legitimate interests of a third party, unless there is a good reason to protect the individual’s personal data which overrides those legitimate interests. (This cannot apply if you are a public authority processing data to perform your official tasks).

Due to the high standard for consent set out by the GDPR, the complexities involved and the potential to significantly affect the way in which an organisation operates, more often than not, it is in fact preferable for them to rely upon another lawful basis. Individual’s Rights The GDPR provides the following rights for individuals: • The right to be informed • The right of access • The right to rectification • The right to erasure • The right to restrict processing • The right to data portability • The right to object • Rights in relation to automated decision making and profiling.

Whilst these rights are a significant part of the GDPR, they’re not absolute and may be superseded by other legal rights and/or obligations. For example, an individual’s right to erasure does not apply if processing is necessary for one of the following reasons: • To exercise the right of freedom of expression and information. • To comply with a legal obligation. • For the performance of a task carried out in the public interest or in the exercise of official authority. • For archiving purposes in the public interest, scientific research historical research or statistical purposes where erasure is likely to render impossible or seriously impair the achievement of that processing. • For the establishment, exercise or defence of legal claims. The GDPR also specifies two circumstances where the right to erasure will not apply to special category data:

Data Must Be Stored in the EU Many organisations hold the mistaken belief that under the GDPR all personal data must reside within the EU and cannot transferred outside of it. This would be particularly problematic given the nature and increasing proliferation of cloud storage solutions. The GDPR framework states that, “flows of personal data to and from countries outside the Union and international organisations are necessary for the expansion of international trade and international cooperation”. A requirement of the GDPR is that the transfer of data outside of the EU must only occur with countries deemed as having adequate data protection laws. Whilst the US is not considered to meet this requirement, the Privacy Shield is an agreement between the EU and US that allows for transfer of personal data; this is based upon the participating organisation being regarded as having satisfactory protection in place.

Continued on Page 12

• If the processing is necessary for public health purposes in the public interest (e.g. protecting against serious crossborder threats to health or ensuring high standards of quality and safety of health care and of medicinal products or medical devices). • If the processing is necessary for the purposes of preventative or occupational medicine (e.g. where the processing is necessary for the working capacity of an employee; for medical diagnosis; for the provision of health or social care; or for the management of health or social care systems or services). This only applies where the data is being processed by or under the responsibility of a professional subject to a legal obligation of professional secrecy (e.g. a health professional). www.bluestreamacademy.com

All Data Breaches Must Be Reported to the Information Commissioners Office (ICO) and the Individuals Affected Immediately Continued from Page 11 A significant change that the GDPR brought about was the requirement for data controllers to notify the ICO of certain types of personal data breach within 72 hours of them becoming aware of the breach, where feasible. In instances where the breach has the significant potential to have a negative effect on individuals’ rights and freedoms, then those individuals must also be informed, and without any undue delay.

In the event of a suspected data breach, it is always advisable to contact the ICO who will ascertain the level of risk posed to the individuals affected and be able to recommend the best course of action. You may also be required to report the breach under other laws such as the Privacy and Electronic Communications Regulation (PECR), the Electronic Identification and Trust Services (eIDAS) Regulation or the NIS Directive. Regardless of whether or not you are required to notify the ICO, you must keep a record of the incident.

It should be noted that it is the data controllers’ responsibility to notify the data subjects and ICO of any high-risk breach; the data processor must inform the data controller of any such occurrence but are not obligated to notify the ICO. Unfortunately, it’s not always practical for organisations to provide accurate details of data breaches straight away, as the incident will need to be investigated so as to ensure the accuracy of the information supplied; remedial and/or preventative measures may also need to be put in place to prevent further adverse impact or related occurrences in the future. So, whilst the ICO should be notified as soon as is reasonably possible; they will not expect to be provided with in-depth analysis and reports, which can be provided later; they will be more concerned with the cause of the breach, the way in which the incident is being dealt with and the actions being taken to mitigate the problem. 1781_Head.Hip.Derma.Pillow_A5_Advert.qxp_Layout 1 09/01/2019 10:31 Page 1

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Hospice Develops VR for Terminally Ill Patients

'I Experience VR' has been pioneered by LOROS Hospice in Leicester, who have created an innovative library of therapeutic and immersive 360-degree Virtual Reality (VR) films, that are safely stored and accessed via an App.

hhe library of specially commissioned films enables terminally ill patients, who have found themselves restricted due to their illness, explore a familiar location from the comfort of their chair. Smartphones and other devices keep us ever connected to the rest of the world, but recovering, disabled and seriously ill patients often find themselves indoors, and longing for a change of scenery. This Virtual Reality (VR) technology is changing lives! John Lee, 70, a patient with Motor Neurone Disease (MND), was the first patient at the Hospice to try on the headsets. He was transported virtually to Bradgate Park in Leicester, which he described as “almost as good as the real thing”. As the patient turns their head, the camera follows, giving a 360-degree view of their virtual surroundings.

“You soon relax, it’s just like you’re there, I loved it,” he said. “I nearly waved at somebody, as they walked past.” “Since being diagnosed with MND, I can get out, but I can’t spend a lot of time out of the wheelchair, so being able to have these experiences through the VR glasses is really good,” he added. VR experiences have been long discussed as a helpful new therapeutic tool for terminally ill patients, allowing them to absorb themselves within a familiar but otherwise inaccessible environment, so it’s great to see a Hospice leading the way. LOROS CEO John Knight said: “This is a really exciting project for us, and I believe we are the first Hospice in the country to have specifically commissioned such films as therapeutic tools using familiar local settings.

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To see the responses from our patients is quite overwhelming. You can really see how much it means to them, John Knight

A couple holding hands can share a joint experience and take a stroll through the park or a walk on the beach. One of our patients, Mick Jones, described almost feeling the wind in his hair or feeling the sand between his toes. “We recognise that some of our patients are often restricted to where they can go due to their illness, so we wanted to help give them the opportunity to still enjoy life, wider than their restrictions allow, through Virtual Reality. To see the responses from our patients is quite overwhelming. You can really see how much it means to them,” added John. LOROS has been working with specialist Virtual Reality production company CATS are not PEAS since last year, and as well as commissioning and creating a number of films, have jointly launched one of the world’s first VR for Good film-making competitions. As a result, the ‘I Experience VR’ film library now contains a large selection of valuable experiences for patients to access and enjoy. As well as providing relaxation, calmness and provoking heart-warming conversations, ’I Experience VR’ is also a great way for health and social care professionals to engage with patients and their families in a different way. ‘I Experience VR’ is simple to use for all Health and Social Care professionals, even if they have little or no experience with Virtual Reality. The impact of ‘I Experience VR’ An ongoing evaluation study is underway to gather data surrounding patient experiences. The results of the evaluation study have been extremely positive. Patients taking part have reported feeling calm and relaxed after immersing themselves in our selection of high quality 4k 360-degree films. Patients that reported having some pain before viewing ‘I Experience VR’ said that their pain was less noticeable, or that the ‘I Experience VR’ distracted them to the point that they were not aware of their pain whilst immersed in the experience.

Interested in becoming a partner? LOROS Hospice is seeking partners to join ‘I Experience VR’, making it easy to share therapeutic experiences with people restricted in their mobility, in a hospice, care home or similar environment. This approach is equally valuable in a corporate or community organisation seeking to promote relaxation and wellbeing for its staff, students or members in an accessible and innovative way. Benefits include: • • • • • • •

Access to our growing library of therapeutic films Trusted technical support and training package Expert advice for purchasing required equipment Easy to use operating guides Health and Safety usage guidance Infection prevention guidelines Evaluation study templates.

‘I Experience VR’ is subscription based with funds put directly back into the production of more ‘I Experience VR’ films chosen by partners, patients and residents.

Special Offer For more information about becoming a partner please contact LOROS by emailing info@loros.co.uk and quote reference IExVR15% for 15% off an agreed start up package. Offer ends on July 31st, 2019. www.bluestreamacademy.com

Look Who’s Talking Dr. Marie-Anne Essam

The ‘Godmother of Social Prescribing’

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I am constantly amazed and delighted by the changes I see when my patients return to me, very evidently more confident, proactive and happy in their own unique life contexts. Dr. Marie-Anne Essam

’ve been a GP for 30 years, and for the last 15 years involved in trying to integrate care around patients. People’s health is dependent, however, on a lot more than the clinical aspects and the help provided by many separate bodies. 70 years of medicine, free at the point of access, has inadvertently overemphasised the importance of what doctors can do, and has resulted in individual and organisational behaviours which need to change if we are to enable people, families, communities and nations to live their lives as well and fulfilled as possible. People tend to have multiple obstacles to being well. There are historic and generational obstacles to personal freedom and quality of life. As a GP, I meet individuals and whole families who have often been unable to progress for years.

They often appear powerless, frustrated; have dysfunctional relationships, experience poor mental health, lack employment, stability and have a tendency towards health harming habits. Social Prescribing gives a fresh opportunity to find a way out of these negative and toxic mind-sets, behaviours and circumstances. When meeting with these individuals and families, the first wider health factor that becomes apparent could be housing, neighbours, debt, isolation, poor physical fitness affecting long term conditions, stress related to their role as a carer, or poor mental health often not given a definitive diagnosis by psychiatry. Someone with a long term health condition may be unable to change detrimental lifestyle habits, despite doctors’ advice and even referrals. As a GP, whilst I may recognise these problems, I am not best equipped to deal with them. I don’t have the expertise, resources or time needed. Much effort has been previously exerted by staff kindly phoning around, trying to help in a crisis, with varied success. However, there is no capacity to provide the appropriate follow through and support. Sometimes patients just come frequently to see a GP because non-medical issues, even hidden from view, are robbing them of being well. Let me introduce you to the Link Worker: They have the time, the expertise and the resources which my patients need to find the personal motivation, courage and strategy to improve their well-being. By intuitive, non-judgmental listening, establishing trust and effective communication, the Link Worker provides what for some is the first opportunity to move from a very difficult and damaging place, to one where they are motivated and supported to make sustainable progress. A plan is co-produced in the context of this mentoring relationship according to the patient’s preferences and priorities.

Community groups, advice, programmes, key worker schemes, advocacy, creativity, activity, connections and counselling are just some of the options which might be included. The Link Worker will, where needed, attend groups or meetings with the patient, using their time as seems most effective. Sometimes attending hospital appointments or benefits assessments catalyses the necessary change process. Typically, that first conversation with the Link Worker lasts 60-90 minutes, often in the patient’s own home. As trust is established, 'What matters most' to the individual is understood and an action plan is devised together. The Link Worker commits to contact and support for the next 3-6 months, occasionally longer, with maybe 12 contact points in that time, to help the person find their confidence, motivation, and ability to connect with and make best use of the solutions found. So where someone has previously failed to see something through, or been unable to navigate their way to suitable help, the Link Worker makes that vital difference. So the Link Worker straddles the divide between the medical world, in which I am best trained and equipped, and all the other necessary help, furnished through a kaleidoscope of community-based assets. I am constantly amazed and delighted by the changes I see when my patients return to me, very evidently more confident, proactive and happy in their own unique life contexts. Here are two examples of patient stories that I have personally encountered - just a couple of the emerging testimonies of the benefits of Social Prescribing: A mannin his forties, long-term unemployed, living in a damp and derelict flat who admitted to me his 10 year old weekend-visitor son was getting embarrassed about coming. The Link Worker was able to help him resolve the housing issues, he then worked as a community leader in the whole block of flats as he championed the resolution of the damp on the outside. His relationship with his son and his entire neighbourhood were marked with dignity and enjoyment.

At the start of the story, this man had a presumed diagnosis of Anti-Social Personality Disorder, and a cannabis habit. Sincerely, his psycho social health is now sound, and he gave up cannabis half way through the story. The outlook for this man’s son is also different, as he is proud of the way his father has overcome longstanding difficulties and changed the environment around them both. A lady who I had known for years would never let me in beyond the “I’m fine”, despite an obviously anxious and fearful body language. After an unplanned time off work with a musculoskeletal problem, she became more anxious, and admitted that work was the only place she could at least act happy and productive. Her personal life consisted of shutting herself indoors, not answering the door or phone, not opening her post. No one else knew this. It took a few attempts to get her together with the Link Worker, but once I had got them both to attend her consultation with me, trust began to build. That pile of envelopes included an eviction order. After some swift advocacy, work with the Citizens Advice Bureau, and the attendance of the Link Worker with the patient to court, the situation was resolved. The CAB still provide a backstop support in case the old habits return, and my lady is not anxious anymore: the secret life of shame and fear which controlled her behaviours has gone hopefully forever. The principle of Social Prescribing is now recognised and promoted by the NHS as a key part of the Long Term Plan; specifically hosted by the Personalised Care Team. A Link Worker will be available to every Primary Care Network from July this year (2019), and the guidance for Primary Care Networks will probably be released in May. Continued on Page 18

The Link Worker encouraged him to take up a part-time cleaning job, early in the mornings. Within a few months rather than getting away swiftly at the end of his shift, he made friends with those working there. www.bluestreamacademy.com

Education for these new workers will be provided by NHS England; who will also undertake for regular Continuing Professional Development (CPD) updates. The best use of this team member will be to align them with Link Worker Schemes already nearby, so they are networked with peers, and enabled to build local bridges with the community groups and problem-solving opportunities available. They should become an integral part of both the clinical teams, and the resources around the practices. The Link Workers will become part of practice MultiDisciplinary Teams, and act as advocates and “connectors” to ensure that personalised care is integrated and as successful as possible. These colleagues will help the whole system use its resources more effectively, and promote community development. Evaluation of outcomes will be increasingly streamlined as the new NHS guidance for Networks is embedded, which also contains toolkits to help Link Workers support local organisations. Social Prescribing marks a culture change in our society. This is vital as the relationship between the State and the individual is also undergoing reforms. Our community agencies need our commitment and support as a society, so that there is the capacity, the sustainability, the resourcefulness and the robustness critical to meet individual and local population needs. Social Prescribing helps us all close the gap between the help available and those needing it most. It leverages social mobility, addresses inequality in constructive and innovative ways and it shines a spotlight on the initiatives

which are urgently requiring the investment of public and private funds.Social Prescribing is the most transformative initiative I have ever been a part of - and I do not apologise for being passionate about it. I have been involved in its design and development with colleagues right across the public and community sector.

“

I was informally awarded the title as ‘Godmother of Social Prescribing’ a few years ago when I realised I need to spend the rest of my working career promoting and supporting the work. I work as an ambassador for Social Prescribing in a number of arenas, which includes work with a Primary Care organisation in Ontario, Canada, and I support some national organisations here in the UK furthering the excellence and governance of Social Prescribing. Recently, I was thrilled to speak to medical students who are members of the National Social Prescribing Champion Schemeand who are working to get Social Prescribing onto every medical school curriculum. This is the substance of better health in our nation, and others, as we acknowledge that our health is not defined by our medical diagnoses, and that there are pathways close by us in solution-building communities to fulfilment of personal potential: when we realise that what our patients need most is a hope and a future.

www.bluestreamacademy.com

Root Cause Analysis When an incident occurs within an organisation, it may be necessary to investigate how and why it happened so that the most appropriate solutions can be implemented.

oot Cause Analysis is a set of tools and approaches that can be used, as part of this investigation, to establish:

should be seen as a learning and development tool, that allows organisations to learn how and why an incident happened so that appropriate solutions can be implemented to ensure that the incident does not occur again.

WHAT happened? HOW it happened? WHY it happened?

Providing a Root Cause Analysis toolkit will give organisations the information and guidance they may require when undertaking a Root Cause Analysis investigation.

If undertaken well, a Root Cause Analysis investigation will go beyond the obvious symptoms and get to the bottom of why an incident happened. It can be easy to identify the obvious symptoms of an incident, however there may be deeper reasons as to why the incident occurred: the root cause. It is important that time is taken to determine the root cause of an incident. If you try and fix the problem too quickly, you may only be dealing with the symptoms. Think of an issue such as a broken leg, symptoms such as pain can be fixed with painkillers, however, unless the broken leg is fixed the symptoms of pain will continue. Blue Stream Academy believe that Root Cause Analysis

Our toolkit gives information and provides examples of how the '5 Whys' and 'Fishbone' (cause and effect) diagrams can be used as part of the Root Cause Analysis process. The 5 Whys By repeatedly asking the question Why? you can quickly identify the root cause of a problem allowing you to focus resources in the right areas. Fishbone Diagrams By using a fishbone diagram, you can think through the causes of a problem, including possible root causes, before you start to think of a solution. By identifying all possible causes and not just the most obvious, you can walk towards removing the problem.

How has RCA benefited your organisation? RCA is a blameless process that can be as simple or as complicated as you need it to be. It provides us with a structured approach to dealing with issues. It is a clear and concise methodology that has brought simple clarity in some difficult situations.

Sentinel Healthcare Southwest Community Interest Company

Has there been a specific incident where RCA was used? Yes, we use it for all of our Serious Incident Reviews but also for some of our minor challenges for example in understanding how our telephone systems work.

At the request of NHS England, Blue Stream Academy have been working with Devon Training Hub to develop our Root Cause Analysis Toolkit. We recently had a Q&A session with Roland Gude on the topic of Root Cause Analysis.

Why is RCA important? I think it is extremely important because it provides a simple and consistent methodology. Teams can see that it is a blameless process and will be able to use the processes in all aspects of their work.

Roland Gude Strategic Director

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Fun in the Sun...

It’s that time of the year again! Summer holidays are fast approaching and although it’s exciting, the prospect of packing and organising can be daunting for some people.

hether you’re jetting off to some exotic destination or exploring the beautiful British countryside, here are our top tips to ‘lighten the load’ and make your holiday a more relaxing experience. Make a list It may sound trivial but lists really do help! Make a list for each person that you need to pack for (lucky for you if you only have yourself to think about!). Make sub sections so that nothing is forgotten i.e. toiletries, day outfits, night outfits, shoes etc. Choose the right luggage If you’re flying, check with your airline what your baggage allowance is. Weight allowances can range from 10kg to 20kg (and more if you’re lucky depending on who you are flying with). Remember that most budget airlines allow you to take your luggage on-board if it weighs 10kg or less BUT your case size must be the same as their required dimensions (or less). If you don’t comply, you will have to pay! Research the place you’re visiting If you are lucky enough to be travelling abroad this summer, check online or with your travel operator regarding the entry requirements of your chosen destination. Some countries require a Visa or ESTA and others charge an entry or exit tax. It is a good idea to carry local currency with you if this is the case! Vaccinations With the excitement of booking a holiday, it is sometimes easy to forget that you might need vaccinations before visiting certain countries. If possible, seek advice at least 8 weeks before you travel, especially if you are travelling to places such as India, Africa, Thailand and South America. Travel insurance Even on holiday the unforeseen can sometimes happen and it is a good idea to make sure that you have valid travel insurance to cover any medical expenses, trip cancellations, lost luggage, accidents and other losses incurred whilst traveling. It can be purchased online or at your local Post Office and it may also be worth checking with your bank to see whether your account offers it. Documentation Print off all your documentation such as boarding passes and Insurance policies and keep it with you in a small travel bag or bum-bag. Some airlines will charge you if you forget to print your boarding passes! www.bluestreamacademy.com

Team BSA’s Top Tips • Before you go away, check to see if your accommodation has a hairdryer, free beach towels and a shop close to your resort to buy your toiletries from (alternatively, buy plastic bottles of allowed size and fill with your shampoo, body gel etc). • Wear your jacket to travel in so there is more room in your suitcase! • Roll your clothes instead of folding them! This takes up less space and can help reduce creases. You could also stuff socks and underwear into your shoes and use vacuum bags! • Take an appropriate extension plug so that you can plug in multiple devices at the same time. Check List

• Passport • Insurance Documents • Boarding passes • Visa documentation • Driving Licence and driving history details (if you’re planning on driving) • Money/ cards • Roaming enabled phone and charger • Camera • First Aid kit • Plug converter • Sunglasses • Sun Cream etc.

You’re travelling round South America?.. ...I don’t Bolivia. My suitcase started crying when I picked it up... ...I was carrying emotional baggage.

Sophie Ellis Bextor was played on repeat in a club in Poland... ...It was murder on Gdansk floor.

The Best Sun Creams Reviewed... Stay safe in the sun with Blue Stream Academy’s pick of the best long-lasting, water-resistant and noncomedogenic sun creams!

f there’s one thing that doctors, dermatologists, beauty experts and Baz Luhrmann all agree on, it’s the importance of sun protection for your skin. Whatever cream you choose, the most important thing to get to grips with is the level of protection the product offers. What’s the difference between UVB and UVA rays? The sun emits two types of ultraviolet radiation. UVB is responsible for sunburn and can increase the risk of skin cancers, while UVA affects the skin’s elastin. The British Association of Dermatologists suggests that an SPF of 30 and a star rating of four out of five is “generally considered as a good standard of sun protection” (as long it’s paired with protective clothing and periods spent in the shade). The SPF 50+ formulation is designed for sensitive skin.

Piz Buin Mountain Sun Cream

SunSense Kids Roll On with SPF 50

Avène Very High Protection Cream with SPF 50

Price: £7.50 (50ml) | Boots

Price: £10 (50ml) | Ocado

Price: £20 (200ml) | Boots

Best for skiers and snowboarders

High altitude skiing calls for a high SPF cream. The sun is stronger at mountain level than sea-level, even if it doesn’t feel like it when you’re surrounded by snow. Areas like your nose, chin and ears are particularly vulnerable so it’s a good idea to look for a cream that offers protection from severe cold and wind as well as UVA/UVB rays. Piz Buin’s Moutain Sun Cream offers SPF 50+ protection and is enriched with Edelweiss to provide anti-oxident properties as well as a Cold Shield Complex to guard against extreme weather conditions. It’s sweat and water-resistant too and the 50ml bottle is small enough to stuff into your ski jacket pocket.

Best for kids

Gloopy lotions don’t mix well with sand, so if you’re travelling with children, we’d recommend using a spray or a roll on to slather on the SPF. This deodorant-style applicator from Aussie brand SunSense is simple to use with one hand, and the small 50ml bottle is handy to slip into your changing bag or carry-on suitcase. Offering both UVB and UVA protection, it has an SPF of 50 with a three-star UVA rating. It’s unscented, water-resistant for up to four hours and specially formulated for delicate skins, so it can be used on babies from six months.

Best for sensitive skin

If you’re susceptible to redness, allergies or prickly heat – or have very fair skin – it’s best to keep things simple on the sun protection front. This high-coverage cream from French skincare brand Avène is free from fragrance, parabens and chemical filters, and is also non-comedogenic. It may be thick, but this broad-spectrum SPF 50+ product feels light and soothing on the skin and is easy to apply via a spray pump dispenser.

Garnier Ambre Solaire Dry Mist Sun Cream Spray with SPF 50

Best all-rounder

Price: £9 (200ml) | Boots Affordable, easy to apply and suitable for all skin types, this dry spray from Ambre Solaire scores highly on all fronts. It dispenses as a fine mist, and you can spray at any angle so it’s great for protecting those tricky-to-reach body parts – not to mention hosing down hyperactive kids. The SPF 50+ formulation is designed for sensitive skins, so there’s no alcohol and it’s both hypoallergenic and noncomedogenic (so it won’t clog your pores).

Alpha-H Daily Moisturiser with SPF 50

La Roche-Posay Anthelios Anti Shine Sun Cream Gel

Ultrasun Sports Gel SPF 30

Price: £29 (50ml) | Lookfantastic

Price: £16.50 (50ml) | Boots

Price: £14 (100ml) | QVC

Best facial suncream

It may seem pricey, but this lightweight cream doubles up as both an excellent moisturiser and a high-coverage SPF 50+ sun cream. It’s good for all skin types, offering a healthy dose of hydration without feeling greasy. Enriched with vitamin E, aloe vera and honeycomb extract, it has antioxidant properties and leaves a matte finish, so it also works well as a make-up base – and it’s easy to control how much you’re applying using the nifty pump dispenser. Incorporating a daily SPF moisturiser into your routine can save you minutes in the morning as well as freeing up space in your toiletry bag, and it’s a great way of protecting your face from the sun without even thinking about it. www.bluestreamacademy.com

Best for acne prone skin

If you’re prone to acne you might feel hesitant about adding an extra layer of product to your skincare mix – but this super lightweight formulation has been specially developed for oily and sensitive skin types. It’s hypoallergenic, non-comedogenic and free from preservatives, parabens and fragrance, and it mattifies quickly on application to help combat shiny T-zones.

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One of the standout ingredients is Air Licium, which forms a resistant layer on the skin’s surface and has the capacity to absorb up to 100x its weight in water as well as excess sebum.

Best water-resistant sun cream

Designed for active types, this clear, non-greasy gel from Swiss brand Ultrasun rubs in smoothly and sinks in quickly. It offers SPF 30 protection for up to eight hours and is water-resistant – although as always, it’s best to reapply after lengthy swimming sessions. It’s free from fragrance, mineral oil, silicones and preservatives and can be used for up to two years after opening, so it could well see you through more than one holiday. It also contains antioxidants (including grape seed extract) which may offer an extra layer of protection against harmful infrared rays (IR) as well as UVA and UVB rays. Source: https://www.expertreviews.co.uk (Prices subject to change)

Summer Recipes

f we experience a summer like we did in 2018, evenings and weekends will be mostly spent basking in the sunshine and enjoying the light, warm nights. With this, what is better than eating ‘al fresco’ or inviting friends and family over for a get together and food? With so many people turning to vegetarian and vegan food, throwing another burger on the barbie may not be the best choice if you want to please everyone.

Classic Guacamole

We here at Blue Stream Academy have been looking at alternative dishes to suit all taste buds! Hope you enjoy.

1. Peel ½ a small red onion and de-seed

Vegan Pulled Jackfruit Rolls Prep: 15min Cook: 2hr 15min Ready in: 2hr 30min Serves: 6

1. Preheat your oven to 350ºF (180ºC). 2. Oil a large knife and cut 450g jackfruit (fresh or canned) in half. If using fresh jackfruit, line your work surface with plastic wrap. Carefully remove the core of the jackfruit by cutting into it at an angle. Pull each fruit segment out and remove its seeds and outer coating. Rinse the fruit thoroughly then dry.

3. Heat 2tbsp of olive oil over medium heat in a large pan. Add 1 sliced medium onion and 3 minced cloves of garlic and cook until soft.

4. Add the jackfruit, 2tsp salt, 1tsp pepper, 1tsp cumin, 1tsp chili powder, 1tsp paprika, ½tsp cayenne pepper and 1tsp of vegan Worcestershire sauce, stir to coat evenly. Add 450ml of vegetable stock and bring to a simmer.

Reduce the heat, cover and simmer for 45 minutes, until the liquid is mostly absorbed and the fruit has broken down.

5. Spread the jackfruit on a prepared baking sheet. Bake for 75 minutes, until the liquid has baked out and the jackfruit has a deeper brown colour.

6. Pour 120g of vegan barbecue sauce over the jackfruit. Mix and return to the oven for 15 minutes.

7. Serve warm on vegan buns with vegan coleslaw. Enjoy!

Prep: 10min Serves: 8 one chilli, then roughly chop it all on a large board. De-stone 3 ripe avocados and scoop the flesh onto the board. Start chopping it all together until fine and well combined.

2. Pick out most of the bunch of

coriander leaves, roughly chop and add 6 cherry tomatoes, then continue chopping it all together. Add the juice from 1 lime and 1tbsp of oil, then season to taste with sea salt, black pepper and more lime juice, if needed. De-seed, finely chop and scatter over a chilli if you like more of a kick. Garnish with the coriander leaves, then serve.

Vegetable Kebabs with Halloumi

Lamb Kebabs

Prep: 5min Cook: 15min Ready in: 20min Serves: 6

Prep: 10min Cook: 35min Ready in: 45min Serves: 8

1. Put 6 wooden skewers into a tray of cold water

chilli powder, 1tbsp vegetable oil, 2tsp red wine vinegar, 1tsp garam masala and 1tsp ground cumin until smooth, and season with 1tsp salt and some black pepper. Add 900g boned leg of lamb, cut into 2cm cubes, mix well, cover and put in the fridge to marinate for as long as possible - overnight is best.

to soak – this will stop them from burning. On a chopping board, cut 120g of halloumi into 2cm cubes, then add to a large mixing bowl.

2. Carefully cut 1 yellow pepper in half from top

to bottom, then trim away the stalk, seeds and any white pith (you can use teaspoon to do this), then slice into 2cm pieces and add to the bowl.

3. Cut 1 courgette in half lengthways, then cut

into half-moon slices, roughly ½cm thick, then add to the bowl along with 140g of cherry tomatoes.

4. Put ½ bunch of mint leaves onto a board and finely chop them, discarding the stalks. Carefully de-seed and finely chop 1/2 chilli, if using. Finely grate the zest of 1 lemon onto a board, then add to the bowl along with the mint leaves, chilli and add 2tbsp of olive oil. Season with a pinch of pepper, then mix well to coat.

5. Preheat the grill to high. Lightly grease a baking tray with oil, then put aside. Thread and divide the halloumi cubes, cherry tomatoes, pepper and courgette pieces between the skewers. Place onto the greased tray and cook under the grill for 10 to 12 mins, or until the cheese is golden and the veg is soft, turning halfway through.

1. Blend 85g plain yogurt, 25g ginger, 5 garlic cloves, ½tsp red

2. When ready to cook, soak 8 wooden

skewers in water for 10 mins and heat a barbecue to medium-high, or heat your grill and line a baking tray with foil. Thread the lamb onto the skewers, about 4 pieces on each. Place on oiled racks of the barbecue and cook for 1214 mins, turning often, or until charred in places and cooked right through. If you’re grilling the skewers, cook for 10-12 mins. .

Why n

ot add some chopped s

pr i n g on ion

he sid e

6. Serve

with a fresh green salad and some flatbreads or pittas.

www.bluestreamacademy.com

Ask Abi...

eam member Abi Bowler is here to answer your questions and give advice to our readers. Feel free to contact Abi via email: bsatoday@bluestreamacademy.com!

Dear Abi,

As a receptionist I have been made increasingly aware of my responsibility as a Health Navigator, and because of this I have been communicating with patients to understand their issues and determine the most appropriate route of care to take. Since doing this, I have spoken to lots of patients, many of which get very angry when I ask the reason for their appointment. Some of these phone calls have left me quite distressed due to the foul language and raised voices used towards me during these calls. How can I approach this subject in a different manner to minimise this abusive behaviour?

Dear Reader,

Itâ€™s great to hear that you are committed to your role as a Health Navigator, but I am very sorry to hear about your negative experiences. The first thing that I can suggest is maintaining a calm and sensitive approach when handling these enquiries, increased stress from both parties will cause tension throughout the call. If the patient proceeds to act in an aggressive or overwhelming manor, ask them politely to calm down and assist you with the questions being asked. An explanation as to why you need this information may help them understand the process and reassure their issues. Hope this helps!

Thanks in advance! Anon

Abi

YOUR TRANSCRIPTION SAFETY NET... Respond to high volumes and/or staff shortages

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30 minute free trial with no obligation

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enquiries@accuro.co.uk

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01565 748000

Seamless integration with no setup costs

#TeamBSA

ince our first issue, we’ve had lots of exciting releases across each of our eLearning suites, including the release of the following modules: • • • • • • •

Adult, Child and Infant Basic Life Support Automated External Defibrillation (AED Training) Cervical Screening Pressure Ulcer Management & PressureUlcer Awareness Lone Working Safeguarding Adults Level 3 Root Cause Analysis.

To accompany this, we are extremely excited to announce the launch of our brand new fully integrated HR system.

Meet the Team Hi, I’m Marcus Millington and I joined Blue Stream Academy in January 2018 as a Senior Software Developer. I am involved in the technical development of our software platform and I’m very eager to make the online experience for our customers as good as it can possibly be. Blue Stream is a great place to work - my colleagues feel like friends, I am free to try out new things and am responsible for my own workload. Outside of work I enjoy spending time with my wife and two children (our favourite game at the moment is hide and seek!) I also enjoy looking for old tools to add to my collection and dry stone walling! www.bluestreamacademy.com

We understand how busy the life of a manager can be, and endless sets of login details for different sites can be a frustrating issue! That’s why our new HR system works alongside our comprehensive Management of Information System, so there’s no need to log into multiple systems to repeatedly input the same information time and time again. Our new system includes features such as: • • • • •

management of rotas shift settings managing staff absence reporting creation of custom profiles.

@BlueStreamNews

Blue Stream Academy commits to supplying our users with access to an innovative Management of Information System as well as a suite of eLearning modules, all designed in consultation with staff managers.

ach of our modules are championed by a subject matter expert, and each of the features on our eLearning suite are tested by a varied group of healthcare managers.

Throughout 2018, Blue Stream Academy trained over 150,000 trainees located at 4,500+ sites, to help achieve and/or maintain their positive CQC rating and ultimately provide the highest level of patient care. New features include:

• The release of our most efficient Management of Information System yet – including our new Training Dashboard, the ability to arrange and book face-to-face training sessions, along with more specific department and site settings, and a brand-new audit report setting.

• New module releases such as: NHS Health Check, GDPR, Basic

Oral Care, Falls Prevention, Sepsis, Anticholinergic Burden in the Elderly, Cancer Awareness, Maintaining the Cold Chain and Seasonal Influenza Vaccination. New projects will continue to be released during 2019 – watch this space!

BSA Today's Photography Competition Every picture tells a story... What's yours? We had a photo competition here at Blue Stream HQ and it was judged by our resident photographer Emily...

"The photo was taken while on a holiday to south-west Scotland on New Years day 2019. Me and my family went on a walk around the national park and came across Lake Trool. Whilst hiking up one of the mountains we found this stream running next to our path. It looked like it could make a good picture, so I hopped onto the rocks in the middle of the river and took this just before the sun went down".

- John Warren, winner.

e are delighted to reveal the above photo as the winner of the Blue Stream Academy Summer Photography competition! We received several very impressive entries which made it quite hard to pick a winner, however after much deliberation, Mr John Warren has won the top prize of £50 congratulations! See Autumns winner in the next issue! The theme for the next issue is “Light.” Submit your photo for your chance to win and get your entry printed in the next issue

of BSA Today! You will also win a framed A4 print of your photo along with £50 in prize money! To enter, simply email your entry to bsatoday@bluestreamacademy.com with the subject line “BSA Today Issue 3 Photography Competition”. The deadline for this competition is 15th July 2019 and we shall announce the winner in issue 3 of BSA Today. The successful photo chosen by Emily will win the prizes! Terms & conditions apply and can be found online at: www.bluestreamacademy.com.

ATULATI R NG

ongratulations to Lizzie Lister, Practice Manager at Addington Medical Centre in West Yorkshire, who won a hamper full of cleaning goodies by finding the word SEPSIS in the puzzle below (answers shown)!

S P I R O M E T R Y P R E V E N T C H A P E R O N I N G

S ON

Puzzle Corner

C O S H H C O M P L A I N T S C O N S E N T

L iz

z ie Li s

ter

ry and complete this sudoku puzzle - but if you would like to win ÂŁ50, why not enter our photography competition?

'Light'...

is the subject of the competition on page 30.

9 3 7 8 2 6 1 4 5

6 2 5 4 1 9 7 8 3

8 4 1 7 3 5 9 6 2

5 8 4 1 9 3 2 7 6

11 Letters

5 Letters

7 Letters

10 Letters

Chaperoning Prevent Consent

7 1 2 5 6 8 4 3 9

3 9 6 2 4 7 8 5 1

COSHH

Spirometry Complaints

2 6 3 9 7 4 5 1 8

1 7 8 3 5 2 6 9 4

4 5 9 6 8 1 3 2 7

On Sunday 8th September 2019, six members of our team, also known as the BSA ‘Super Six’ will be taking part in a charity skydive, hoping to raise at least £1,200 for Bluebell Wood Children’s Hospice. If you would like to donate, please visit our Justgiving page https://uk.virginmoneygiving.com/Team/BlueStreamAcademy or send a cheque / postal order with a covering letter referencing BLUE STREAM ACADEMY to: Matthew Sheridan, Bluebell Wood Children's Hospice, Cramfit Road, North Anston, Sheffield S25 4AJ

Thank you for your generosity!