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Today Blue Stream Academy’s Healthcare & Lifestyle Magazine Autumn 2021 | Issue 11

A Spotlight On...

Confidence Building

Introducing our brand-new eLearning modules: Confidence Building Awareness and Supporting Confidence Building in a Team

Skin Deep: What is Maskne? Julie Van Onselen

Lecturer Practitioner for Dermatology Education Partnership Ltd

ANNOUNCING

ON TI DI

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Blue Stream Academy’s NEW Discussion Forum: Blue Voice Giving health and social care a platform to voice the matters that matter most!

100% of the quality for 50% of the price! BSA Today Issue 11 Front Cover

Blue Stream Academy’s greatest sales offer to date has now landed! BSA Today is the exciting healthcare & lifestyle magazine from Blue Stream Academy - the UK’s leading provider of online training for GP Practices, Nursing & Care Homes, Hospices and Urgent and Tailored Care Centres. Our mission is to standardise healthcare training to ensure consistent delivery of quality care through better staff education, learning and development. Providing over 100 hours of CPD-certified eLearning, Blue Stream Academy’s suite of interactive training modules is easy to use, cost-effective and in line with CQC guidelines. If you have any comments, suggestions or ideas for future articles, please feel free to contact our editor, Brady Braddock, by email:

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In this issue BSA Today | Issue 11

From the Editor's Desk...

his is a rather special issue for us here at BSA Today – conversation, dialogue and open discussion are the first steps in developing any idea, in this instance, uniting professionals across the board through one centralised platform. In giving health and social care a voice, we have the opportunity to introduce Blue Stream Academy’s newest feature: Blue Voice – a discussion forum developed to do exactly that. Working as part of a team, much of my work here at Blue Stream involves interacting with HCPs, specialists and other industry professionals to shine a light on many of the current key topics in health and social care. In short, we cover the matters that matter most to our customers – a quarter of a million trainees and counting. In fact, the response to BSA Today so far has been phenomenal - our readership has increased over 500% since the start of this year alone, with so many of you getting in touch to praise the concept, contribute ideas or just to say you liked a particular article. Well, none of this interaction goes unnoticed and we would like to take this opportunity to say thank you for your continued support. So, without further ado, here is what we have in store for Issue 11. Julie Van Onselen, Lecturer Practitioner for Dermatology Education Partnership Ltd, talks about ‘maskne’ - a very real problem for health and social care professionals, especially as the COVID-19 pandemic continues and adhering to stringent PPE guidelines is a must. In the latest of our ‘Spotlight On…’ series, we look at two of Blue Stream Academy’s newest eLearning training modules: Confidence Building Awareness and Supporting Confidence Building in a Team. Datawatch is back too, as we catch up with Stuart Walsh, our Chief Information

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Words mean more than what is set down on paper. It takes the human voice to infuse them with deeper meaning.

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Security Officer (CISO), who looks at the benefits of sharing patient data and why the various attempts to do so have attracted so much controversy. In a break from the norm, Dr Jeff Foster, a GP, men’s health specialist and regular BSA Today contributor, gives his views about testosterone deficiency, and Health and Wellbeing Coach, Caroline Haines, talks about her work with patients within East Merton PCN. This is complemented by our ever-popular lifestyle & wellness segment as we partner up with our local Instagram foodies, ‘Two Greedy Gals’, to provide the first in a series of delicious, yet nutritious, seasonal recipes in our NEW ‘Great Food’ feature. For all you caffeine lovers out there, we explore the potential benefits of drinking coffee and aim to settle the age old debate, is freshly ground better than instant? We also present our choice of key awareness days for your diary to help you acknowledge and celebrate your colleagues and raise awareness of important conditions, treatments and the support that is available. With so much great content, plus our own in-house news and developments, module releases and LiveChat queries, this issue is one not to be missed and once again, on behalf of the whole team, we hope you enjoy reading!

Brady

Brady Braddock BSA Today Editor

Expert Panel

Our Team

Meet the experts who have contributed their information and insight to this issue of BSA Today.

EDITORIAL

Dr Jeff Foster GP and Men’s Health Specialist Caroline Haines Health and Wellbeing Coach, East Merton PCN

Maya Angelou

Brady Braddock | Editor Sian Ratcliffe | HR

Lewis Cowlishaw | Content Development Stuart Walsh | Information Security

Keely Jennings | Content Development ART & DESIGN

Courteney Barlow-Ferguson | Graphic Designer Craig Goodall | Creative Services

Julie Van Onselen Lecturer Practitioner for Dermatology Education Partnership Ltd www.bluestreamacademy.com

COMMUNICATIONS

Abi Bowler | Marketing & Media

33 Cover Stories 18 A Spotlight On... Confidence Building

Being confident is something that many people find challenging or struggle with, especially at work. In the latest of our ‘Spotlight On…’ series, we look at the various ways to build, improve and, most importantly, maintain confidence with two of Blue Stream Academy’s newest eLearning modules: Confidence Building Awareness and Supporting Confidence Building in a Team.

All Things Blue Stream 06 Eye on Healthcare

Showcasing cutting edge, academic content from The Conversation, we keep you up to date with our chosen hot topics from across health and social care, written by the professionals who share a passion to report the issues that matter most.

Skin Deep: What is Maskne?

‘Maskne’ is new terminology describing acne and irritant dermatitis caused by PPE, which particularly affects healthcare and other workers who wear face masks for prolonged periods of time. Here we talk to Julie Van Onselen, Lecturer Practitioner for Dermatology Education Partnership Ltd, about the emergence of maskne during the COVID-19 pandemic and how to prevent and treat this condition.

Data Watch: The NHS Digital Database

42 #TeamBSA & LiveChat Lounge We catch up with #TeamBSA to hear about what we’ve been up to since our last issue and, in our LiveChat Lounge segment, we check in with our support team to answer some of the most frequently asked questions that have been discussed via Blue Stream Academy’s LiveChat feature.

The creation of a centralised NHS 43 @BlueStreamNews Digital database of GP records has Trusted training at your fingertips! proved to be highly contentious We keep you up to date with with its implementation once the latest module releases from again being delayed. In this our industry renowned Content issue, Stuart Walsh, our Chief Development Team. In this issue, Information Security Officer we look at Postural Care, Falls (CISO), looks at the benefits of Prevention and the updated sharing patient data and why the versions of our three Basic Life various attempts to do so have Support modules. attracted so much controversy.

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36 Lifestyle & Wellness 33 Health and Wellbeing Coaching in Primary Care

28 Testosterone: Why it’s So Much More Than Sex and Six Packs

Health and wellbeing coaching helps encourage people to develop the knowledge, skills and confidence to address their pre-existing health issues through behaviour change to avoid further medical decline. Here, Health and Wellbeing Coach (HWBC), Caroline Haines, talks about her job as an HWBC and the impact of her work with patients within East Merton PCN.

Testosterone plays a critical role throughout the male life cycle and the lack of clinical awareness about low testosterone is a very real problem. Often referred to as the ‘male menopause’, more than 10% of men over the age of 40 in the UK have low testosterone levels. Dr Jeff Foster, a GP and men’s health specialist, gives his views about testosterone deficiency.

Bluebell Wood Launches ‘Light Up the Lake’ Appeal

38 Coffee: Instant Versus Filter

We are raising awareness for Bluebell Wood Children’s Hospice and their latest fundraising plans, including their brand-new ‘Light up the Lake’ appeal which offers people the chance to celebrate someone who has brightened up their life by dedicating a candle-lit lantern in their name.

40 Great Food with ‘Two Greedy Gals’ Our recipes section has been a huge hit since the get-go. So, to take us to the next level, we have partnered with our local Instagram foodies, ‘Two Greedy Gals.’ The Gals have been challenged with creating a selection of delicious, yet nutritious, seasonal recipes exclusively for BSA Today. Enjoy!

For a lot of us, nothing beats a nice warm cup of coffee first thing in the morning. But can we be bothered with the hassle of preparing actual ground coffee beans, or will some instant coffee do for a quick fix? From a health perspective, aren’t they basically just the same?

Announcing

Blue Stream Academy’s NEW Discussion Forum: Blue Voice

14 www.bluestreamacademy.com

To celebrate the launch of our new discussion forum, Blue Voice, we are utilising this issue’s ‘Look Who’s Talking’ to help highlight the benefits of open discussion. In July, we created a set of questions relating to changes during the pandemic and sent them to our Subscribers’ Club members – made up of health and social care professionals from across the board. So, here is what they had to say about their experiences of working during COVID-19. 05

Care Homes Have Long Been Neglected - The Pandemic Has Shown Us How Bad Things Are

efore COVID-19, there were around 10,000 deaths in care homes in England and Wales every month. Then, between March 27 and April 24 2020, the number more than doubled to 23,113. The Office for National Statistics (ONS) later reported 17,422 deaths of care home residents from COVID-19 between the end of

March and June 5, accounting for 47% of the total number of deaths caused by the virus. So it is unsurprising that the pandemic has led to much greater interest in what happens inside care homes. As well as the significant increase in the number of residents dying, concerns have been raised about a lack of access to testing and personal protective equipment

(PPE), the discharge of coronaviruspositive patients from hospital to care homes, rationalisation of the health care received, and a lack of clarity about the numbers of residents dying from COVID-19. Even before the pandemic, the private ownership of most care home establishments isolated them from accessing appropriate training and support from NHS professionals, such as specialist nurses and palliative care teams. Some members of the care home sector have since called for doctors and nurses to be deployed to care homes to help manage the crisis. Care home staffing is also a challenge, with vacancy rates of 11% and a workforce that is ageing, low paid and reliant on immigration.

This is coupled with the knockon effects of shrinking local government adult social care budgets, meaning that the care home market is increasingly fragile. For my recent research, I spoke with residents of care homes about their experiences of living – and the prospect of dying – in them. Many said they had disagreed with the decision to move into a care home, but their views were not listened to or considered. Despite paying up to £4,000 per month to do so, living in this environment is often associated with imposed routines and a loss of control and independence. Despite this, some people I spoke to did have positive things to say. There was the 94-year-old man who clearly valued the efforts of the staff who care for him. He told me: “They sit on the bed and they have a good old natter and a laugh too, which is the best medicine. They pinch my sweets. But yes, we have a good laugh. This is a very happy place, actually.”

Important conversations As a GP, I have seen firsthand the difference it can make if care home residents and their families have the opportunity to have important conversations about their wishes and preferences for care at the end of life. Not everyone is keen, of course. Asked whether or not she discussed death and dying with her family, one 96-year-old woman told me: “No, I don’t speak [about death]. I’m not a person like that. I think my daughter knows me, she knows how I feel about things.”

Author Lucy Pocock GP Career Progression Fellow University of Bristol Lucy Pocock receives funding from the National Institute for Health Research School for Primary Care Research The original article can be found at: https://theconversation.com/ care-homes-have-long-beenneglected-the-pandemic-has-shownus-how-bad-things-are-137458ng-butcalmer-world-153065

Unfortunately, some organisations appear to have dispensed with a personal approach to these conversations since the pandemic. One GP surgery sent letters to vulnerable patients stating that they would like to complete DNACPR (do not attempt cardio-pulmonary resuscitation) forms on their behalf. Continued on Page 08

One 86-year-old woman, weighing up the pros and cons of where she received her care, explained: “At the moment I prefer care home to hospital because I feel perhaps a hospital is a bit impersonal – but on the other hand they tend to you quicker. But I wouldn’t like to be in a hospital now. The last time I [was] there I was thinking [the] care home would be more comfortable.” Those residents will have seen major changes in the homes they live in over the last few months, with visits heavily restricted and staff wearing masks. GPs also switched to remote consultations, by telephone or video, which will also have affected the experience of some residents – such as planning for care at the end of life. www.bluestreamacademy.com

Continued from Page 07

Brighton and Hove Clinical Commissioning Group also wrote to all GP practices suggesting that all residents of the 98 care homes in that area should have a resuscitation plan in place.

Peace and dignity are surely the things we would wish for anyone nearing the end of their lives. Yet our most vulnerable members of society have suffered greatly during this pandemic.

On this particular issue, more open discussion is required about the reality of resuscitation following a cardiac arrest. This should include the fact that all cardiac arrests have an underlying cause and that resuscitation attempts will only be successful if this cause can be identified and reversed.

Care homes have long been neglected, partly due to widespread privatisation and low levels of funding for social care.

The underlying cause of cardiac arrests in older, more frail people is usually due to a range of factors and rarely easily reversible. The chance of them surviving a resuscitation attempt is very low. Resuscitation, involving electric shocks to the heart and chest compressions, can be a brutal process, and not what most people would describe as a “good death”. It can be helpful to think about not attempting to resuscitate as allowing the natural process of death to occur peacefully and with dignity. 08

We should all hope that the coronavirus crisis marks a turning point – and a change that means care homes are finally given the funding, staffing and support they so desperately need

Skin Deep: What is Maskne?

‘Maskne’ has emerged as a facial skin condition, resulting from prolonged personal protective equipment (PPE) use (facial mask wearing).

ealth care professionals (HCPs) often present with facial skin symptoms, due to lengthy facial mask usage, whether they have had no previous facial irritation or have a predisposing skin condition. What is Maskne? Maskne is a new terminology which relates to facial skin symptoms caused by the need for prolonged use of facial masks as PPE. Maskne can occur due to the continued use of any protective facial mask, including full face shields, visors, safety spectacles, surgical masks, fluid resistant surgical masks and respirator masks. Maskne is an umbrella term for any facial symptom, which may include dryness, scaling, itching, redness, erosions, papules and pustules, with irritant contact dermatitis (ICD) and acne being the most common. In people with skin of colour, inflammation appears as hyperpigmented darker patches. ICD can also include friction from pressure, which is more likely with close fitting or respirator masks, seen on the bridge of the nose and cheeks. ICD is a cutaneous response to the physical/toxic effects of a wide range of environmental exposures.

This may be acute (toxic dermatitis) or cumulative (insult dermatitis)[1]. Maskne can cause ICD due to the humid and warm environment; presentations range from a discrete, dry, scaly patch to oedema and vesicles, erosions and ulceration[2]. Occasionally, an individual may develop a contact allergy to a face mask, for example, the mask material or straps. Allergic contact dermatitis (ACD) is an eczematous reaction that occurs as an immunological response following exposure to a substance to which the immune system has previously been sensitised. It is more common in individuals with a history of or current atopic eczema[1]. If ACD is suspected, referral to dermatology for patch testing to confirm the allergy is advised. Continued on Page 12

www.bluestreamacademy.com

Continued from Page 11

Julie Van Onselen Lecturer Practitioner Dermatology Education Partnership Ltd. Julie has worked as a dermatology clinical nurse specialist in both primary and secondary care for 30 years. Dermatology Education Partnership Ltd focuses on dermatology educational projects and training courses in practical dermatology. Julie works for skin support groups and in an NHS primary care dermatology service for SkinHealth UK. She is passionate about improving care and support for people with skin conditions through developing educational initiatives. www.dermatologyeducation.co.uk

Acne related to PPE can occur in people with an acne history as well as those who have been previously unaffected[2]. The humid, occlusive environment causes the skin to become more oily (due to the over production of sebum), which then blocks the sebaceous gland duct, resulting in papules and pustules. The humid microclimate of the mask environment is thought to encourage mucosa to be colonised by bacteria which may increase bacterial load on the surrounding skin[2]. Acne caused by pressure or friction from mask wearing is considered a subtype of acne mechanica[3]. How Common is Maskne in HCPs? Maskne appears to be extremely common in HCPs. An occupational report of selfreported skin

symptoms due to PPE in HCPs in London and Manchester, found high rates of irritant facial and pressure dermatitis (due to filtering face piece [FFP3] respirator masks), which had not been observed in HCPs and had only been previously reported by fighter pilots[4]. ICD was observed due to sanitising reusable masks[4]. A prospective study of occupational dermatoses in the COVID-19 pandemic found 16.6% developed acne, which was attributed to all types of facial masks[5]. How to Treat Maskne Skin assessment of the affected HCP is important to correctly diagnose skin symptoms, as treatment of ICD and acne will be different. When taking a patient’s history, ask about existing skin conditions exacerbated by PPE, for example, atopic or seborrheic

eczema and rosacea, or the development of new skin conditions including perioral dermatitis, folliculitis (where facial hair is present) or urticaria (which can be caused by pressure)[2].

Outside the clinical workplace, wearing masks with soft breathable fabric, with a cotton inside layer that will absorb oily residue, can prevent facial skin irritation and maskne.

An assessment of the duration of mask wearing is important to help diagnose maskne. Examination of the face and any other areas of the body affected by skin symptoms should be documented with a diagnosis of maskne (or other facial dermatosis), and a treatment plan developed according to evidencebased dermatology guidelines. ICD should be treated with emollients (for washing and moisturising) and mild-to-moderate topical steroids (applied for a 2-week treatment).

Washing cotton masks daily is important to remove oil and skin cell residue, which will further aggravate maskne.

Acne should be treated with antimicrobial facial washes, salicylic acid or retinoid topical treatment, applied daily for 2 months. If skin breakdown has occurred, a silicone-based dressing (for example Mepilex) is helpful for pressure distribution and protection[2]. Recommended treatment for acne mechanica is topical retinoids, such as adapalene cream alone or in combination with benzoyl peroxide cream once daily, which can be used for mild cases, with the addition of an oral tetracycline, such as lymecycline 408 mg once daily for up to 12 weeks, for moderate-to-severe cases [2],[3] .

PPE and facial masks will continue in clinical environments. HCPs can help prevent maskne by the skin care measures discussed in this article. If maskne symptoms become clinically significant, assessment, diagnosis and treatment will be required, according to dermatology guidance

DermNetNZ. Contact Dermatitis. 2012. Available at: https://dermnetnz.org/topics/contact-dermatitis/ [accessed 14 July 2021]

Rudd E and Walsh S. Mask related acne (“maskne”) and other facial dermatoses. British Medical Journal 2021;373 doi: https://doi.org/10.1136/bmj.n1304 (Published 07 June 2021)

Draelos ZD. Acne Mechanica. Acneiform Eruptions in Dermatology. Joshua A Zeichner, ed. Springer 2014;125-28

Fergurson F, Street G, Cunningham L. Occupational dermatology in the time of the COVID-19 pandemic: a report of experience from London and Manchester, UK. 2021;184:180-182

O’Neil Hl, Narang I, Buckley DA. Occupational dermatoses during the COVID-19 pandemic: a multicentre audit in the UK and Ireland. Research letter. BJD. 2021:184; 574-575.

How to Prevent Maskne Skin care and avoiding prolonged mask wearing where possible are both essential to preventing maskne. Maskne may also be prevented by applying a protective layer of emollient and lip balm before wearing a mask. Generally, a lotion formulation is preferable, as thicker emollients may block skin pores. Silicon barrier films are also recommended for HCPs with no pre-existing eczema. Following prolonged mask wearing, cleanse the face with bland emollients and avoid soap and cosmetic washes. Moisturise the face with bland medical emollients (if skin is dry and scaly a cream formulation would be preferrable) before bedtime, or several times a day, if possible, to treat dry and scaly skin. For additional skin protection, silicone tape, removed at each doffing to prevent contamination, can be applied over the bridge of the nose and cheeks and can be used for additional protection from FFP3 masks[2]. HCPs should ensure regular breaks from wearing a mask to prevent moisture build up and also to prevent pressure with FFP3 masks.

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Look Who’s Talking

Announcing Blue Stream Academy’s NEW Discussion Forum: Blue Voice

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Over the past 18 months, Blue Stream Academy has witnessed the immense effect that COVID-19 has taken on our trainee community of over a quarter of a million health and care professionals. We have seen many stretched beyond their limits, retired professionals returning to the sector to support the COVID-19 response and an incredible nationwide appreciation for every individual who stepped up to the unknown.

s the UK begins to adjust to new forms of normality, we wanted to find out how our health and care professionals really feel. So, for this issue of BSA Today, we have decided to do things a little differently with regards to our Look Who’s Talking feature. Instead of inviting one specific industry expert to have their say, we have handed this issue over to our Subscribers’ Club members to give them a dedicated platform to share their views on how the pandemic has changed their lives and practices. More importantly, this article serves to highlight the benefits of open discussion as a way to improve standards and raise awareness of specific issues within health and social care. We provided each subscriber with the same 4 questions, and here is what they had to say… With every single individual adapting to some new form of normal, we wanted to know which of the changes they thought should stay for good.

What changes due to COVID would you like to see continued?

Many subscribers felt that the increased hygiene and safety of wearing facemasks, along with limited physical contact, should be maintained, with a plea for increased awareness of the benefits of these practices being highlighted: “Strangers should not shake hands, and fake hugging and kissing colleagues should be a thing of the past! We all need to respect frontline workers in all industries, not just healthcare.” “Wearing of facemasks to be continued. Social distancing where possible.” “The awareness and acceptance of good practices around hygiene.” “Would like to see the continuation of wearing masks in public.” “Increased use of online consulting/ telephone triage as I feel this also benefits the patients and reduces packed waiting rooms.”

“Technology being adopted more into communications between patients and practices.” “Continue with the virtual meetings, saves time and travelling.” “Working from home to continue if suitable to job role.” “GP telephone triage, telephone consultations, video consultations.” These views were reflected in our second question, as we asked our subscribers: Has your experience with Q remote technologies – for example, video calls and telephone appointments – been positive and would you recommend the continued use of these practices/ processes? For many, the experience of using remote technologies was positive: “This has made a huge difference to patients as they can have either a GP phone appointment or video appointment without having to book time out from their work for a (face-to-face) GP appointment.” “I was sceptical at first using remote technologies, but I feel they have been overwhelmingly positive and have enabled us to stay in touch and up to date with colleagues, partners, patients and their families in ways that would not have been possible (otherwise). Obviously, some contact will need to go back to face-to-face/ in-person meetings, however, I do like the fact that we would be able to save money on train journeys if we are able to attend meetings and conferences from our desks!” For many, the benefits of technology have proven invaluable for patients and professionals alike, with many subscribers highlighting the importance of communication.

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“I think doctor telephone triage first is good - then, if the doctor wishes to see a patient F2F, they make the decision.” “Yes, has worked very well with clinical and non-clinical staff able to undertake a lot more training. And appointment times are kept too.” “I would definitely say that the video calls are a positive especially during COVID when trying to keep the amount of patients coming to the surgery down and, though restrictions are lifting, there will still be some patients who are hesitant to come to the surgery, so video calls are the way to go.” “I think telephone and online consulting has been great. It has given patients more choice and this should definitely continue once things are back to normal. It’s shown not everyone needs a face-to-face appointment every time.” “Yes I think the use of Zoom meetings has been great and should continue.” Continued on Page 16

Continued from Page 15

However, there was some concern over the experience not having that personal touch: “In most cases no. They are too impersonal, but to prevent infection they should be used.” Do you feel that there is adequate mental health support for NHS staff at present?

Many of our subscribers felt that there was an urgent need to increase the availability of mental health support, due to the rapidly rising numbers of people needing to access these services: “Yes I do but I also believe that, as the pandemic continues, more staff will be needing the support and then perhaps there won’t be adequate support to go round.” “I find we need more resources in mental health and more mental health first aiders in the workplace.“ “We can always do with more mental health support for NHS staff as we deal with so much complex and clinical information.” “I haven’t used it, but we have had lots of emails advising where we can get support from if needed. I think they have done a good job.” The nature of the pandemic has left many feeling isolated and unsupported: “Not at present, recently the RCN has published (figures showing) an alarming number of nurses are off sick or have resigned through mental health reasons and this has made me sad to know that our very skeleton NHS will dwindle even further away.”

“No. I don’t think anybody realises how isolating it is to live alone and work from home if they have not experienced it. I was dumped into a new position during the pandemic and given very little mentoring or orientation. Many colleagues must be very stressed out and have nobody to talk too.” Has the COVID-19 pandemic Q affected the future of your role or your chosen career path? The impact of technology will have an effect on some subscribers’ job roles, through elements such as the introduction of onlinebased training and, for some, the pandemic has led them to a new career in healthcare: “Yes, it has (had) some effect, my current role has changed via more technology and for the better.” “Yes, it certainly has. I am now training as a Medical Receptionist and thoroughly enjoying it. This has really been a mind-blowing 15 months for me whose career had been in the casino industry in London for over 40 years. I also feel very proud to have been working in the vaccine sites and helping out with the COVID-19 vaccine roll-outs.” “Difficult to say at this point as restrictions are still in place. One of the roles I look after is in-house training which has not been organised in the last year. This has led to courses online for all. It would be nice to see the practice together again at training sessions, but this may be a long way off.” “We learnt how to change the way we work in a matter of hours/days. Should pandemics or emergency situations happen again in future years, the change to working practices should be

a lot easier to adopt. Personally speaking, I have adopted the skills of flexibility and prioritising!” It also looks like the pandemic hasn’t affected some people’s decision to stick with their chosen career path as they plan to stay until retirement: “Not really, I plan to work until retirement age anyway.” “No, my role or career path have not been affected.” “COVID-19 hasn’t affected the future of my role or chosen career path as I’m 66 years of age and will be retiring at the end of September 2021. If I was younger I would be staying in primary care but I will have completed 40 years by then.” “No it hasn't. As a full equity partner I'm here until I retire!” “No, it has not directly affected my role in substance misuse – what I have noticed is the rise in people’s anxiety levels and that clients are displaying anxiety symptoms and mixing them up with withdrawal symptoms so they are thinking themselves into withdrawal (and) then they are using more.”

This Look Who’s Talking feature has helped us to clarify the often confusing and mixed messages that we read in the media by reporting the true thoughts and feelings of those working on the front line – in their very own words! For many, the benefits of technology have proven invaluable during the pandemic, and some technology changes have shown such strong, beneficial potential that they could be here to stay. Over half of our subscribers called for better mental health support, highlighting the ongoing mental health issues that health and care professionals face each day. Some of our subscribers saw changes to their roles and career paths, whilst others pledged to continue as planned until retirement. Over the past 18 months our trainee community has demonstrated immense resilience, and the nation has witnessed and acknowledged the sector’s bravery and determination.

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But this is not the end of the story. Here at Blue Stream Academy, we are committed to stand by our trainee community, uniting with professionals across all health and care sectors to promote the recognition that every one of them deserves, not just during the pandemic, but moving forwards too. Blue Stream Academy has recently released the Blue Voice discussion forum. Blue Voice gives our trainee community a dedicated platform to express their concerns, share their positive experiences, consult with colleagues, and come together through the highs and lows

A Spotlight On... Confidence Building “You need to be more confident”. For many of us, the need to build confidence may be a subject that is discussed frequently in the workplace. You might feel that you are constantly being told to ‘be more confident’ at each supervision session or appraisal that you attend with your manager, team leader or supervisor.

s a result, some of us can be left feeling helpless or despondent as we assume that we are simply not confident people and we can’t do anything to change the situation. But what exactly is self-confidence? What are the signs that self-confidence is low? And is it possible to increase, improve and, importantly, maintain this much sought-after quality? To help answer these important questions and explore the benefits of confidence building at work, Blue Stream Academy has recently released two new eLearning modules: Confidence Building Awareness and Supporting Confidence Building in a Team. Confidence Building Awareness Our Confidence Building Awareness module has been created for all trainees. As you will learn, confidence is a flexible trait and even the most self-confident person can experience periods when their confidence levels decrease or they are faced with a task or situation that affects or knocks their confidence.

Issues with confidence can impact the individual, their work performance, and the organisation itself, so an awareness of confidence building is vital for all members of an organisation. As a good starting point if you are developing an understanding of confidence building, this module helps the user to think about what self-confidence actually is before looking at possible signs or characteristics that someone might benefit from building their confidence. Other key considerations that are covered in this module include looking at the various factors which might be causing – or maintaining – low confidence levels. This is another essential element which can help you to establish a better understanding of how issues with confidence can affect someone’s work performance and personal wellbeing.

The next stage of the journey is to look at the skills and techniques which can help with confidence building. Developing a more positive sense of self is the focus of confidence building. This module discusses practical ways in which you can help to build your confidence, which can, in turn, improve personal wellbeing, work performance and team building. So, to answer one of our original questions, by learning and practising these skills and techniques, you can help to boost your confidence and, in doing so, challenge the perception that some people are just born confident and others are not. Supporting Confidence Building in a Team Our Confidence Building Awareness module provides the detailed and informative foundation for our complementary module – Supporting Confidence Building in a Team – which has been developed for those members of an organisation who have responsibility for supporting their colleagues with confidence building. If you are a manager, team leader or supervisor, and you have completed our Confidence Building Awareness module, we recommend that you now complete this corresponding module. Utilising the knowledge you have gained from the Confidence Building Awareness module, Supporting Confidence Building in a Team focuses on useful ways in which you can help to build confidence in your team. There are several clear benefits for an organisation which recognises the importance of confidence building as part of maintaining an interest in, and concern for, their employees’ physical and mental health and wellbeing. These can include improvements in key areas such as work performance, employee engagement, job satisfaction and staff retention. Continued on Page 20

www.bluestreamacademy.com

Continued from Page 19

Keely’s Personal Perspective of Confidence Building When I was at university, I remember reading the following quotation in Virginia Woolf’s A Room of One’s Own: “Without selfconfidence we are as babes in the cradle. And how can we generate this imponderable quality, which is yet so invaluable, most quickly?” At the age of 19, these words struck such a cord with me that I copied them into my diary and I can still recall that moment very clearly to this day.

Keely Jennings Content Developer at Blue Stream Academy As a member of our Content Development team, Keely researches and writes content for our eLearning modules. Working alongside external subject matter experts and our in-house programming and Creative Services teams, Keely is involved with each stage of module development, from initial brief to launch.

While Virginia Woolf’s essay was published in 1929 and the extended section of the text reflects the era in which it was written, it was the description of self-confidence being an ‘imponderable’ or ‘mysterious’ quality – but also ‘invaluable’ – that I could really relate to at the time. And, feeling that I lacked selfconfidence, I was also keen to know how I too could generate this vital quality as quickly as possible! In the years following university, I have continued to think about what self-confidence is and how it can be improved and maintained. Being involved in the development of our

Want to Find out More?

confidence building modules, and working alongside an experienced, knowledgeable and insightful subject matter expert, has given me a great opportunity to focus on what self-confidence is, what the signs of low confidence might be, and what might cause issues with confidence levels. This has really enhanced my understanding of confidence issues and how they can affect individuals, teams and organisations. Importantly, I have also been able to learn about – and subsequently put into practice – several practical, everyday skills and techniques that can help build confidence in the workplace. Instead of assuming that I am just someone who can lack confidence when faced with certain situations or tasks, I now feel much better informed about the reasons behind these thoughts. I also feel better prepared and more equipped to deal with such situations and feelings as they occur

If you would like to enhance your awareness of confidence building and learn about the skills and techniques that can help to boost confidence – either for yourself or members of your team – please get in touch with our team via phone on 01773 822549 or email info@bluestreamacademy.com to find out more about our new confidence building modules.

The NHS Digital Database

new scheme which will see NHS Digital collate patient data from GP practices into a centralised database that was originally scheduled to be introduced in July 2021, and was subsequently delayed until September 2021 amongst significant controversy, has now been postponed indefinitely. This announcement was made just as this issue of BSA Today was all set to be signed-off. As this Data Watch article focused on the NHS Digital database and the controversy surrounding it, we have chosen to publish it in full below, followed by the letter from Parliamentary under Secretary of State for Primary Care and Health Promotion, Jo Churchill, announcing the postponement. What is it? The General Practice Data for Planning and Research (GPDPR) System, as it is formally known, will involve the transfer of GP medical records from the last 10 years into a centralised database. Why is this Data Being Shared? The data gathered on a national level can provide crucial information to support healthcare planning and research leading to better treatments and improved patient outcomes. This data is already collected centrally for hospital patients; however, given the scale, frequency and number of conditions treated, researchers believe this additional information could provide exponential benefits.

“

Data saves lives and has huge potential to rapidly improve care and outcomes, as the response to the COVID-19 pandemic has shown. The vaccine rollout could not have been delivered without effective use of data to ensure it reached the whole population.

Continued on Page 22 www.bluestreamacademy.com

Simon Bolton CEO NHS Digital[1] 21

continued

Continued from Page 21

Given the experience of the COVID-19 pandemic, this could prove to be vital in ensuring that the NHS can identify and protect the most vulnerable members of society, whilst reducing the long-term impact on the country as a whole. Stuart Walsh Chief Information Security Officer at Blue Stream Academy As the Chief Information Security Officer (CISO) for Blue Stream Academy, Stuart provides an article for each issue of BSA Today to highlight how we strongly believe that promoting better information security practices improves the threat landscape for all organisations that work alongside us.

https://digital.nhs.uk/news-and-events/latest-news/collection-of-gp-data-for-planning-andresearch-to-go-ahead-on-1-september-2021

https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/ general-practice-data-for-planning-and-research

https://www.rcgp.org.uk/-/media/Files/News/rcgp-bma-letter-gpdpr.ashx

https://theconversation.com/nhs-data-gathering-government-plans-to-collect-and-sharehealth-records-are-hugely-concerning-heres-why-162699

https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/ general-practice-data-for-planning-and-research/transparency-notice

What Data Will be Collected? Data may be shared from the GP medical records about: • Any living patient registered at a GP practice in England when the collection started; this includes children and adults. • Any patient who died after 1 September 2021 and was previously registered at a GP practice in England when the data collection started. • NHS Digital will not collect patients’ names or addresses. Any other data that could directly identify patients (such as NHS Number, date of birth, full postcode) is replaced with unique codes which are produced by de-identification software before the data is shared with NHS Digital.*

NHS Digital will collect: • Data about diagnoses, symptoms, observations, test results, medications, allergies, immunisations, referrals, recalls and appointments, including information about physical, mental and sexual health. •

Data on sex, ethnicity and sexual orientation.

•

Data about staff who have treated patients.

NHS Digital does not collect: • Name and address (except for postcode, protected in a unique coded form). •

Written notes (free text), such as the details of conversations with doctors and nurses.

•

Images, letters and documents.

•

Coded data that is not needed due to its age; for example medication, referral and appointment data that is over 10 years old.

•

Coded data that GPs are not permitted to share by law; for example certain codes about IVF treatment, and certain information about gender reassignment.

*This process is called pseudonymisation and means that patients will not be identified directly in the data. NHS Digital will be able to use the software to convert the unique codes back to data that could directly identify patients in certain circumstances, and where there is a valid legal reason[2]. Why Has the Scheme Been so Controversial? Back in 2016 a similar scheme called Care.data was abandoned when reviews by Dame Fiona Caldicott and the Care Quality Commission (CQC) raised concerns that the public information campaign explaining its use was not clear enough and did not reach everyone.

And, in 2019, it was revealed that international pharmaceutical companies had obtained access to NHS patient data. More recently, the involvement of big data company Palantir in the NHS COVID-19 datastore has generated significant controversy[4]. How Can Patients Opt-out?

Critics have voiced the same concerns with the new scheme, with organisations such as the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP) arguing that the public had not been provided with enough information, were not aware they could opt-out, or what the process was to do so. In a joint letter, the BMA and RCGP said: “Individual practices have had no choice in this collection and cannot be responsible for ensuring patients are appropriately informed. We would ask that NHSD reconsider your stance on this and take immediate action to run a public information campaign.”[3] Additionally, whilst NHS Digital has stated that the data will never be used for advertising, insurance, marketing or promotional purposes, there are important questions being asked regarding the third-party organisations that may have access to this data, how they will use it, and how it will be safeguarded. These concerns aren’t unwarranted. Back in November 2015, the health records of NHS patients held by the Royal Free London Trust were transferred, without explicit consent from patients, and in a way that was found not to fully comply with the UK’s Data Protection Act, to Google DeepMind. Around the same time, personal data from NHS patients were shared with the Home Office to trace individuals tagged as “potential immigration offenders.”

Type 1 Opt-out Opting out of NHS Digital collecting your data. Patients who do not want their data to be shared outside of their GP practice for purposes other than direct care must opt out by completing a Type 1 Optout Form and returning it to their practice prior to 1 September 2021. Whilst it is possible to opt-out after this date, data from the past 10 years may have already been transferred. Type 2 Opt-out (also known as National Data Opt-out) Opting out of NHS Digital sharing your data. This applies to identifiable confidential patient data concerning health (including GP, hospital and other data) and the process was implemented on 25 May 2018. Patients who do not want this data to be shared by NHS Digital for purposes other than direct care should register a National Data Opt-out. If you have registered a National Data Opt-out, NHS Digital won’t share any confidential patient information about you with other organisations unless there is an exemption to this, such as where there is a legal requirement or where it is in the public interest to do Continued on Page 24

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FYI: NHS Digital has produced the following statement which GP practices can add to their current privacy notices:

“This practice is supporting vital health and care planning and research by sharing your data with NHS Digital. For more information about this see the GP Practice Privacy Notice for General Practice Data for Planning and Research.” Practices are also advised to provide communications to their patients about the new system via, for example, newsletters, posters, social media, and waiting room screens. Data will only be provided to NHS Digital by your GP system suppliers after the practice has confirmed with the system supplier that they have complied with the Data Provision Notice. Continued from Page 23

so, such as helping to manage contagious diseases like coronavirus. From 1 October 2021, the National Data Opt-out will also apply to any confidential patient information shared by your GP practice with other organisations for purposes except your individual care. It won’t apply to this data being shared by GP practices with NHS Digital, as it is a legal requirement for GP practices to share this data with NHS Digital and the National Data Opt-out does not apply where there is a legal requirement to share data[5]. What do we Need to do as a GP Practice? Under the UK General Data Protection Regulation (GDPR), GP practices have a legal obligation to provide patients with information about the data they are sharing with others.

The practice will need to register Type 1 Opt-outs (or a withdrawal of the Type 1 Opt-out) in their system. The codes you need to use to register or withdraw the Type 1 Opt-out are: Code Type

SNOMED Code

Opt-out Dissent code

|Dissent from secondary use of general practitioner patient identifiable data (finding)|

Opt-in Dissent withdrawal code

Read2 Code

CTV3 Code

9Nu0

XaZ89

9Nu1

XaZ8A

827241000000103

827261000000102

|Dissent withdrawn for secondary use of general practitioner patient identifiable data (finding)|

Letter from Parliamentary Under Secretary of State for Health and Social Care to General Practices in England - 19 July 2021 “The following statement recently issued to all General Practices in England, and the indefinite delay in the implementation of the GPDPR system, will be welcomed by many and not just the highly vocal critics; even some of the biggest proponents of the sharing of patient data acknowledge that the scheme requires further consultation and must be better communicated to patients.” - Stuart Walsh, CISO.

Dear GP colleague, General Practice Data for Planning and Research Patient data from general practice has significantly contributed to the improvement of health and care services and treatments for many years. Patients rightly trust their GP to safeguard their data, a role that we know that all general practitioners take very seriously. This is why I am writing to share more information with you about how we are working to improve how this data is collected. NHS Digital is making improvements to how data is collected from general practice, with a new framework for data extraction called the General Practice Data for Planning and Research (GPDPR) collection. You will have seen the announcement to pause the collection of this data, to provide more time to engage with GPs, patients, health charities and others, and to strengthen the plan. We are working in collaboration with a range of partners including the Royal College of General Practitioners (RCGP) and the British Medical Association (BMA). I want to reassure you that we have heard your concerns loud and clear and will continue to listen. I am writing now to provide an update on the four key areas of work to strengthen the plan. We hope this will foster your trust in the system and provide a strong basis for you and your patients to participate in the scheme with confidence. Most importantly, I can confirm today that, while we are continuing to work on the infrastructure, and communication for the project, we are not setting a specific start date for the collection of data. Instead, we commit to start uploading data only when we have the following in place: • the ability to delete data if patients choose to opt-out of sharing their GP data with NHS Digital, even if this is after their data has been uploaded; • the backlog of opt-outs has been fully cleared; • a Trusted Research Environment has been developed and implemented in NHS Digital; • patients have been made more aware of the scheme through a campaign of engagement and communication. In this letter each of these adjustments are set out, all of which are critical to the success and impact of the programme, including through better understanding of the huge benefits the programme will have to the NHS and to our ability to provide the best and safest possible care for patients. Information from NHS Digital, licenced under the current version of the Open Government Licence www.bluestreamacademy.com

Opt-outs We want to make the position around opt-out much simpler. While 1st September has been seen by some as a cut-off date for opt-out, after which data extraction would begin, I want to reassure you that this will not be the case and data extraction will not commence until we have met the tests. We are introducing three changes to the opt-out system which mean that patients will be able to change their opt-out status at any time: • Patients do not need to register a Type 1 opt-out by 1st September to ensure their GP data will not be uploaded; • NHS Digital will create the technical means to allow GP data that has previously been uploaded to the system via the GPDPR collection to be deleted when someone registers a Type 1 opt-out; • The plan to retire Type 1 opt-outs will be deferred for at least 12 months while we get the new arrangements up and running, and will not be implemented without consultation with the RCGP, the BMA and the National Data Guardian. Together, these changes mean that patients can have confidence that they will have the ability to optin or opt-out of the system, and that the dataset will always reflect their current preference. And we will ensure it is easy for them to exercise the choice to optout. Administrative workload We have heard from many GPs and practices that there is concern about the administrative burden that Type 1 opt-outs have placed on you and your teams. We are in the process of working with colleagues across general practice to develop a way of simplifying and centralising the opt-out process in order to remove this burden on practices. This is still in development, but we will share further information with you in the coming weeks. In the meantime, given the changes we have agreed to the opt-outs there is now no urgency to process Type 1 opt-outs specifically for GPDPR in order to get people opted out before September. We will keep you updated on timelines for when we expect the programme to go live. We will also ensure that the NHS Digital Data Protection Impact Assessment (DPIA) reflecting these changes to the programme is published well before data collection commences. A template DPIA for practice use will also be made available in good time to allow practices to complete it. Data Security and Governance The Government has committed that access to GP data will only be via a Trusted Research Environment (TRE) and never copied or shipped outside the NHS secure environment, except where individuals have consented to their data being accessed e.g. written consent for a research study. This is intended to give both GPs and patients a very high degree of confidence that their data will be safe and their privacy protected. The TRE will be built in line with best practice developed in projects, such as OpenSAFELY and the Office for National Statistics’ Secure Research Service. We are also committed to adopting a transparent approach, including publishing who has run what query and used which bit of data. We are developing a TRE which will meet our specific needs and act as “best in class”. We commit to only begin the data collection once the TRE is in place. Further, we will ensure that the BMA, RCGP and the National Data Guardian have oversight of the proposed arrangements and are satisfied with them before data upload begins.

Information from NHS Digital, licenced under the current version of the Open Government Licence

I can also confirm that the previously published Data Provision Notice for this collection has been withdrawn. Once the data is collected, it will only be used for the purposes of improving health and care. Patient data is not for sale and will never be for sale. Transparency, communications and engagement There has been a great deal of concern regarding the lack of awareness amongst the healthcare system and patients. We recognise that we need to strengthen engagement, including opportunities for non-digital engagement and communication. Since the programme has been paused, we have been developing an engagement and communications campaign, with the goal of ensuring that the healthcare system and patients are aware and understand what is planned, and can make informed choices. The public rightly look to and trust general practice - through a centrally driven communication campaign, with clear messages, we will seek to ensure that the introduction of this collection does not impose an additional burden on practices. We are developing a communications strategy delivered through four phases. • Listening - where we listen to stakeholders and gather views on how best to communicate with the profession, patients and the public and give them the opportunity to inform the development of the programme in areas such as opt-outs, trusted research environments and other significant areas; • Consultation - a series of events where we can explain the programme, listen and capture feedback and co-design the information campaign; • Demonstration - show how feedback is being used to develop the programme and shape communications to the healthcare system and the public; • Delivery - of an information campaign to inform the healthcare system and the public about changes to how their GP data is used, that utilises the first three phases to ensure the campaign is accessible, has wide reach and is effective. Data saves lives. The vaccine rollout for COVID-19 could not have been achieved without patient data. The discovery that the steroid Dexamethasone could save the lives of one third of the most vulnerable patients with COVID-19 – those on ventilators - could not have been made without patient data from GP practices in England. That insight has gone on to save a million lives around the globe. That is why this programme is so important. The programme and I will be providing further information as the programme progresses. In the meantime, if you have any questions, you can contact the programme at enquiries@nhsdigital.nhs.uk. The NHS Digital web pages also provide further information at https://digital.nhs.uk/dataandinformation/data-collections-and-data-sets/data-collections/general-practice-data-forplanning-andresearch#additional-information-for-gp-practices.

Thank you for your continued support. JO CHURCHILL Parliamentary under Secretary of State for Primary Care and Health Promotion

Information from NHS Digital, licenced under the current version of the Open Government Licence www.bluestreamacademy.com

Testosterone: Why it’s So Much More Than Sex and Six Packs Everyone has heard of testosterone, and most of us have a pretty good idea of what it does. Testosterone is ‘The’ male hormone and is responsible for the majority of secondary sexual characteristics that differentiate men from women.

estosterone gives men deeper voices, stimulates beard growth, and increases muscle mass and sexual desire, as well as all the other classic physical traits we associate with being male. However, it is this widespread understanding of the outward effects of testosterone on the human body that has, in part, led to it losing credibility and relevance in modern medicine. In addition to its effects on our external physiology, testosterone is also responsible for a range of unseen metabolic, biochemical and neurological changes. Testosterone affects blood pressure, lipid profiles, insulin sensitivity, bone density, cognition, mood and a range of other aspects of health and wellbeing. Therefore, while testosterone is of course a major contributor to muscle growth and sexual function, its true purpose, and consequently our understanding of its role in overall health, has been over distorted and misrepresented by the health and fitness industry, and is now, perhaps, underappreciated by the medical profession.

“

Many men will lead long and happy lives without ever knowing they had suboptimal testosterone levels.

I have lost count of the number of adverts for over-the-counter supplements that claim to ‘boost’ testosterone, and diets that will allegedly increase its production; as if by simply eating more raisins (this is genuinely one food that has claims to increase testosterone production), our hormone levels will reach Hulk-like proportions. The biggest problem with the fitness industry is that it plays on the insecurities and desperation that many men experience in wanting to get fitter, stronger, or look better. We all start to feel less energetic as we get older, and it would be great if our poor diets, hectic lifestyles, lack of free 28

time, and little exercise, could be compensated for by taking a fenugreek pill each morning. But, in reality, this of course never works.

risk, blood pressure, osteoporosis, and the overall risk in morbidity and mortality. To complicate matters, while some men with TD may suffer all of the symptoms listed above, not all men with low testosterone become symptomatic and, more importantly, not all men with low testosterone require treatment.

So how do you know if you might be suffering with low testosterone? In many aspects, the symptoms of testosterone deficiency (TD), match those of menopause in women; with early symptoms including fatigue, decreased mental acuity, altered body shape, and lack of sex drive.

TD affects men in different ways, and a drop in testosterone production by a certain percentage does not automatically result in the same symptoms occurring in all men.

As testosterone levels continue to decline, symptoms progress to a loss of morning erections, erectile dysfunction, depression and irritability, cognitive impairment (patients often describe this as brain fog), night sweats, loss of muscle mass and increases in bodyfat. But, in addition to the physical symptoms we see in TD, men also start to suffer metabolic problems such as changes in cholesterol levels, diabetes Medical Conditions

Many men will lead long and happy lives without ever knowing they had suboptimal testosterone levels. This uncertainty of age of onset, range of symptoms, and variability in symptom severity can make diagnosing clinical TD particularly challenging.

Medicines

Obesity

Antifungals

Obesity

Type 2 diabetes

Some diabetic medicines

Type 2 diabetes

High blood pressure

Diuretics

Smoking

Liver disease

Chemotherapy

Alcohol

Chronic kidney disease

Anti-inflammatory steroids (prednisolone)

Sleep patterns

Certain mental health drugs

Lack of exercise

Sleep apnoea Genetic conditions

The more common conditions that affect testosterone production are listed in Table 1. Continued on Page 30

Lifestyle Factors Ageing

Underactive thyroid

However, multiple external factors can impact the hypo-pituitarygonadal (HPG) axis at any level, and can result in useable testosterone levels declining even more quickly.

This means that for most women, we are able to predict roughly when menopausal symptoms might

Opiates

(such as asthma, chronic bronchitis/ emphysema)

Testosterone levels continue to rise naturally until the age of 30, where they then begin to decline by about 1% a year. The rate of decline can be lessened, in part, by adhering to a healthy lifestyle, taking regular exercise, eating well, minimising stress, having a good sleep pattern, and avoiding obesity.

In contrast to men, every woman will go through menopause and, although premature ovarian failure can occur at any age (and we should always be mindful of this), the average age of menopause in the UK is still around 51.

Cancer

Lung disease

become significant (although, again, this is not always the case). When men are most likely to become symptomatic with low testosterone is less clear.

Cannabis/marijuana

Dr Jeff Foster GP and Men’s Health Specialist drjefffoster.co.uk Jeff is one of the founders of H3 Health (a national Men’s and Women’s Health Company). He is passionate about spreading awareness of men’s health topics, whether by lecturing, writing articles, creating videos and infographics, and of course, seeing patients within the NHS and at his private practice.

Testicular disease/trauma Table 1. Factors that affect testosterone production www.bluestreamacademy.com

Continued from Page 29

So, in addition to not having a clear age of onset, early symptoms often being non-specific, and individual variations in natural testosterone production, we also have to be mindful of the wide range of conditions that can adversely impact on the HPG axis. But the main obstacle to successfully finding men with TD is none of the factors already discussed. The biggest problem in diagnosing men with TD is actually due to established societal and cultural behaviour. Men still tend to be a population group who generally avoid seeing doctors, and often pass symptoms off as ‘working too hard’, or ‘just normal for age’. Afterall, surely you should not be able to do at 40 what you did at 20, sexual desire must be less, and it is always harder to stay fit as we get older. This behaviour leads many men to avoid seeing their doctor until their symptoms become severe. Frustratingly, for the vast majority of men, diagnosis and treatment of TD is relatively straightforward. Patients simply need to present with symptoms of low testosterone combined with two morning samples of blood testosterone (or free testosterone), below the British Society of Sexual Health Guidelines of 12nmol/l for total testosterone (or a free testosterone of <0.225nmol/l). If a patient has no reversible contributing factors that are resulting in their low testosterone (such as obesity, specific medicines, or lifestyle problems), and their safety markers are normal, treatment is with testosterone replacement therapy (TRT). In the UK, this is either with a topical preparation, or an injection. In most cases, TRT is safe, easy to monitor, and highly effective.

The key is finding the right patient, but we can only do so if we stop associating testosterone with six packs and little blue pills. Overall, TD is a condition that is likely to have a much higher prevalence than is currently diagnosed. Not all men with TD will have symptoms, and not all men with low testosterone need TRT, but we are only going to improve the quality of life for men and improve their overall mortality and morbidity risk if we start thinking more about this condition and then test for it

Heavenly Hamper BSA TODAY’S

COMPETITION

What better way to welcome the new season than with a luxury hamper, packed with 25 quality items to share or to keep all for yourself! As autumn approaches, people are preparing for cosy nights in filled with good food and great company. To embrace the change in seasons, we’re proud to present our Heavenly Hamper competition, exclusive to our Subscribers’ Club members! The rules are simple*: answer the question below for a chance to win a Fortnum & Mason Hamper worth £500! Please send your answer, name and contact details to bsatoday@bluestreamacademy.com

Where is the headquarters of the World Health Organization? A. Geneva

B. London

C. New York

The competition is open until 12 October 2021. The lucky winner will be chosen at random and the prize draw will be recorded live for Blue Stream Academy’s Facebook, Twitter and LinkedIn channels on 15 October 2021. On behalf of Team BSA, we wish you good luck! *Ts & Cs apply, please see our website for details. Not a Subscribers’ Club member?! Don’t worry, you can join now by going to www.bluestreamacademy.com/subscribe and following the steps to access each issue of BSA Today before anyone else.

Health and Wellbeing Coaching in Primary Care “This is the best thing I have ever done” said James (not his real name), a patient who was referred to me for obesity. He couldn’t believe how well he had done. He was so happy and proud of himself, and his confidence was soaring.

Caroline Haines Health and Wellbeing Coach at East Merton PCN Caroline Haines works part time as a Health and Wellbeing Coach for East Merton Primary Care Network (PCN) in Southwest London. She is also a regional Health and Wellbeing Coach Mentor for London. Caroline lives with her partner and four children. You can follow her on Instagram @carolinehainescoaching

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find it a privilege to hear people’s stories and help them on their journey to better health. James also had longstanding depression and anxiety and hadn’t really left the house for a number of months. His goal was to lose weight.

He also added in some exercise. He started off by walking up and down his garden. This snowballed over time as his confidence grew and the last time I saw James he told me that he was jogging three times a week and also playing football with his friends.

The first couple of changes he decided to make were to stop drinking alcohol and to stop snacking in the evening. Over the course of a couple of months he made many more changes.

He said he couldn’t believe the things he is eating now and the weight that he has lost (over 13 kg so far!). He has also realised that he is having far fewer down days which is contributing to a happier life.

James improved his diet by adding in some vegetables, increasing fruit intake, and removing takeaways.

The health and wellbeing coach is there to provide patients with the tools, knowledge and skills to manage their own health. Continued on Page 34

Continued from Page 33

The majority of my patients (around 70%) have conditions that could be improved with weight loss. Or they might be at serious risk of developing conditions (such as diabetes) unless they lose weight. I also see people with mental health challenges and some patients who want to give up smoking or alcohol. Health and wellbeing coaching is a relatively new role which has been introduced under the personalised care umbrella. The aim is to help those patients with long-term conditions to become active participants in their own care. Health coaching is a very different relationship to that of a doctor: patient. A doctor tells the patient what is wrong and how to fix it. A coach asks the patient what they want and then we listen to their story: how they have got here, what obstacles are keeping them stuck, and what they would like to experience instead. In between sessions, the patient decides what changes they would like to make in order to get closer to their goal. Coaching really works, especially with people who are really struggling to lose weight, because we get under the skin of why someone is eating in a particular way. So instead of treating the symptom (e.g. overeating), we will try to address the underlying cause (which might be a negative belief they hold about themselves – such as “I’m not good enough” or “My family is fat therefore I will be too” etc). How we eat is nearly always wrapped up in emotions and how we are feeling. Most people I see have been dieting their whole lives. They list off all the different diets they’ve been on or tried. Usually they are tired and exhausted of trying different eating plans. The usual dieting routine goes: 1. deprivation (you can’t eat sugar or fat or whatever that particular diet dictates) 2. utilise all your will power 3. cancel any social events so as not to have any temptation 4. lose weight 5. feeling like it is too much hard work 6. go back to how you used to eat 7. put weight back on.

What I do is to help people to gradually change their habits. This means they are no longer relying on motivation. Motivation comes and goes so what we want to do is to create habits that last. It’s like brushing your teeth in the morning, you don’t get out of bed and question whether you have the motivation to brush your teeth

or not, you just do it. And that’s what we want to create with new habits around food, exercise, sleep and stress. Coaching examines the mindset and the beliefs that we all hold about ourselves. There are many diets online that someone could follow if they didn’t know how to eat in a healthy way. But a lack of information is hardly ever what the problem is. If we have a belief about ourselves (that we are not good enough, pretty enough, skinny enough etc), what we’ll do is look for evidence everywhere that we are right because it is human nature to want to be right. For example, I have a patient, Erin (not her real name), who has strong feelings of inadequacy and when she is feeling down she will binge on sweet foods. While Erin is bingeing, she says she knows she doesn’t want the food, but she’ll eat all of it anyway because she thinks she’s a failure and these actions (eating Easter eggs late at night) are confirmation to herself that, yes, she is indeed a failure. It is possible to challenge these beliefs slowly.

as she hadn’t binged once. She couldn’t believe how well having awareness worked for her. She lost 5 kgs in 3 weeks. Health and wellbeing coaching in East Merton has taken some of the pressure off GPs and has ensured that patients are being seen by the right clinician. For example, a GP might see a patient over the course of many years, they might see their weight creeping up each year and their health declining. The GP might give them information on why weight loss would be beneficial. But for many people this isn’t enough. They need a more personalised approach, and this is exactly where health and wellbeing coaching can help

In the first session, I asked Erin to write down how she was feeling whenever she got the urge to snack. If she wasn’t hungry, then I wanted her to notice what the feeling was (boredom, sadness, anger, resentment etc), to sit with the feeling, and then go and do something that she enjoys like reading a book or going into the garden. This created a new coping mechanism when she was feeling negative. Erin came back 3 weeks later. She was so happy when she came to the next session

www.bluestreamacademy.com

Article Provided by Bluebell Wood Children's Hospice

Bluebell Wood Children’s Hospice’s brand-new Light up the Lake appeal is offering people the chance to celebrate someone who’s brightened up their life by dedicating a candle-lit lantern in their name. Whether it’s paying tribute to those who are no longer with us, or celebrating those who’ve been a light in the darkness this past year, it’s the perfect way to help your local children’s hospice while remembering someone special.

ach lantern will join many others cast across the water on September 18th at Manver’s Lake, Wath-upon-Dearne. While Bluebell Wood would love supporters to join them there on the night to witness this stunning spectacle. For those who’d rather not attend the ceremony in person, there will be a ‘virtual’ alternative so they can see their dedication floated out onto the lake under the setting sun. You can make a dedication here www.bluebellwood.org/lake. Anne and Eliot Squires, who said their heartbreaking final goodbyes to their baby boy at Bluebell Wood, will be dedicating their lantern to Wulfric. 36

Wulfric was born at 33 weeks, but just days after he was born, the family had to make the impossible decision to take him to Bluebell Wood.

“

Bluebell Wood really is a beautiful place and I can’t thank them enough for giving us the chance to say a proper goodbye to our little boy.

Anne said: “We drove down the drive to the hospice surrounded by all the woodland and greenery; and it was almost like walking into someone’s home. A very warm, homely and friendly place.

“Our room was set up perfectly for us and we could finally take Wulfric out of the incubator for cuddles. Then they took all his tubes out, and it took him 1hr

and 27 minutes to pass away in my arms. He stopped breathing quite quickly but his heart wouldn’t stop beating. It just kept beating and beating and beating. “It’s an unbelievably hard thing to think about, but it was all done in the most dignified way. It was handled beautifully and I’ll always be grateful for that “Bluebell Wood really is a beautiful place and I can’t thank them enough for giving us the chance to say a proper goodbye to our little boy.” The charity’s Light up the Lake event, where people can dedicate a lantern in return for a small donation to the charity, will take place on Saturday, September 18th in line with the latest government guidance. Samantha Wood, Head of Fundraising at Bluebell Wood, said: “It’s been one of the toughest years we’ve ever faced as a charity from a fundraising perspective, with so many of our events and campaigns cancelled because of the pandemic. And we know that the past year’s been incredibly challenging for everyone, with so many unable to be close to family and friends, or say goodbye to loved ones in the way they would have wanted.

(LtoR) Wulfric’s siblings Odin, Persia and Arwen, grandma Lorna and Wulfric with mum and dad Anne and Eliot.

“That’s why we’re very excited about our first ever Light up the Lake appeal which will be the perfect way to reflect and remember while celebrating and paying tribute to the special people in our lives. “So please do join us for what promises to be a breathtaking and moving display as we Light up the Lake under the setting sun. Each and every donation to our appeal will help us support families like Wulfric’s through the darkest times they’ll ever face.” Everything you need to know about Bluebell Wood’s Light up the Lake appeal can be found here www.bluebellwood.org/lake or by calling 01909 508 103

www.bluestreamacademy.com

Instant Coffee... Quick and easy

Versus

air, they fast-dry into coffee • Generally contains less powder as they reach the caffeine container’s base. Then the • A large range available coffee is packaged either to buy as powder or processed • Robusta beans are into granules. The quality of usually more costtaste and aroma makes this effective for the supplier the most popular method to and these lower costs dry instant coffee. can benefit the purchaser via lowerSo, if instant coffee is made [2] priced coffee using dried filter coffee, from a health perspective, Instant Coffee... • There is no need for are they the same? additional purchases Instant coffee is just that with instant coffee, just - instant. Just a teaspoon According to healthline. some hot water, a mug, full of granules dissolves com,[3] in our modern a spoon and a jar of easily in some hot water diet, both instant and filter instant coffee is all that’s when stirred. Instant coffee coffee are a great source of required. is predominantly made via antioxidants. Coffee contains [1] two main processes . One niacin, magnesium Filter Coffee... is called freeze drying. This and potassium and an is where normal ‘filter coffee’ Filter coffee is made from average mug of black (akin to what a cafetiere roasted coffee beans that coffee has around 10 produces) is made from are either ground in a home calories. roasted and ground beans machine or purchased pre(Robusta beans are used ground. Generally, more However, instant widely for instant coffee[2]). time-consuming to make coffee generally contains than instant coffee, filter less caffeine than This liquid coffee is then coffee can be made using filter coffee, but contains frozen and the frozen liquid a variety of processes. more acrylamide is transformed into granules An electric filter which has been linked to when the temperature machine could health concerns[3]. drops to -40C. Then, within be used (some But, don’t stress, these a vacuum environment have builtconcerns are (devoid of air and any in bean apparently only an issue gases), these new frozen grinders) or when acrylamide granules are slowly dried a cafetiere is consumed in large and then packaged. (used to amounts[4]. plunge the The other process is called Instant Coffee vs Filter spray drying. This is the Coffee - the same as above, but the filter PROs coffee is sprayed into a tall • Instant container of hot air. As the coffee is droplets fall through the quick or a lot of us, when we start a new day, nothing beats a nice warm cup of coffee. But can we be bothered with the hassle of preparing actual ground coffee beans, or will some instant coffee just do for a quick fix? Also, from a health perspective, aren’t they basically the same?

Fre

coffee through a filter to remove the solids after waiting approximately 5 minutes). A pod machine system has become increasingly popular (but some pods may contain a mixture of filter and instant coffee) so there are many ways a filter coffee can be made to your own preference. People can, of course, abandon the D-I-Y approach totally and go to a coffee shop for a freshly brewed cup. How are Coffee Beans Produced? There are many varieties of coffee beans to choose from. Arabica is one of the most popular for filter machines. Around 6 months after the small coffee tree (or shrub) flowers, the fruit (actually a seed) will eventually change to a dark reddish-purple colour called the cherry. These clusters are then picked and usually sundried on trays[2]. For the next

Key Awareness Days

ilter Coffee...

eshly made from coffee beans

World Suicide Prevention Day 10 September

stage, the beans are milled to remove the parchment layer, graded and exported to the purchaser as green coffee beans. These coffee beans are roasted at 200300C, dependent on requirements, and cooled very quickly using water or air. The beans are packaged whole or ground. Speed is important to ensure that freshness is retained for the consumer[5].

As is the case for a lot of the food and drink we consume, there are some areas of concern when drinking coffee. But there are potential health benefits as well. The possible benefits of drinking coffee include[6]: • May lower stroke risk • Can make you feel happy and fight depression • Contains essential nutrients (as discussed) including vitamin B12 • Can help you burn fat.

Filter Coffee vs Instant Coffee - the PROs • Filter coffee is generally It’s all Subjective Though... more intense in aroma From a taste perspective, and taste • Many people prefer the what coffee we prefer or the drinking pleasure we taste get from it is down to • Easier to choose your personal preference. Do bean preference we drink coffee to gain a • Can be consumed in moment to savour and many different ways, for appreciate life, or do we example, latte, glug it down for a quick cappuccino, espresso hit of caffeine to wake us etc up for the day? The choice • Arguably contains less is yours - coffee is truly [4] acrylamide one of the ‘perks’ in life. After all is said and done • Can be seen as the though, I’m off to get a coffee connoisseur’s cup of tea! choice due to its nuances and intriguing Article and Artwork by Craig Goodall bean and method Creative Services Manager identification. at Blue Stream Academy 1. https://www.coffeeandhealth.org/all-about-coffee/instant-coffee/ 2. https://coffee.uk.com/about-coffee-plant/growing-and-curing-coffee 3. https://www.healthline.com/nutrition/instant-coffee-good-or-bad#TOC_TITLE_HDR_1 4. https://www.medicalnewstoday.com/articles/325295#_noHeaderPrefixedContent 5. https://www.ncausa.org/about-coffee/10-steps-from-seed-to-cup 6. https://www.healthline.com/nutrition/top-13-evidence-based-health-benefits-of-coffee#TOC_TITLE_HDR_52021)

www.iasp.info/wspd2021/

World Suicide Prevention Day aims to develop a worldwide commitment to prevent suicides through various actions and awareness activities.

World Sepsis Day 13 September

www.worldsepsisday.org

World Sepsis Day aims to increase awareness about what sepsis is, sepsis prevention and early recognition, in order to unite against the number one preventable cause of death worldwide.

Organ Donation Week 20-26 September

www.organdonation.nhs.uk/get-involved

Organ Donation Week 2021 focuses on the ‘Leave Them Certain’ campaign, encouraging people to talk to friends and family about organ donation to ensure they are aware and involved.

World Heart Day 29 September

world-heart-federation.org/world-heart-day

On World Heart Day, thousands around the world unite using the #UseHeart campaign to spread awareness of the importance of heart health.

International Stress Awareness Week 2-5 November

isma.org.uk/isma-international-stress-awareness-week

Launched in 2018, International Stress Awareness Week focuses on stress management and campaigns against the stigma associated with stress and mental health issues.

Anti-bullying Week 15-19 November

anti-bullyingalliance.org.uk/anti-bullying-week/antibullying-week-2021-one-kind-word

Anti-bullying Week 2021 focuses on the ‘One Kind Word’ campaign which promotes the idea that one kind word leads to another. www.bluestreamacademy.com

Great Food with

TWO GREEDY GALS Our recipes section has been a huge hit since the get-go. So, to take us to the next level, we have partnered with our local Instagram foodies, ‘Two Greedy Gals.’ The Gals have been challenged with creating a selection of delicious, yet nutritious, seasonal recipes exclusively for BSA Today. Enjoy!

CREAMY TOMATO & BASIL GNOCCHI BAKE Serves 4

Time 30 mins

Directions 1. Start by heating your oil on a medium heat in a large ovenproof pan, add in the diced onion and then cook until golden brown. Add in the crushed garlic and continue to cook for 2 minutes. 2. Whilst your onion and garlic are cooking, add the gnocchi to a pan of salted boiling water, cook according to packet instructions and then set aside. 3. Add the white wine to the sautéed onions and garlic and reduce on a low–medium heat. Stir in the chopped tomatoes and the sugar, season with salt and pepper, then cook until reduced for around 5-10 minutes. 4. Add in the double cream and cook for a few more minutes until a think creamy sauce is formed. Stir in the cooked gnocchi, chopped basil leaves, and half of the cherry tomatoes.

Ingredients • • • •

1tbsp olive oil 1 onion, finely diced 2 garlic cloves, crushed 400g chopped tomatoes • 125g fresh cherry tomatoes, halved Nutritional Values Per Serving

• • • • • •

500g packet gnocchi 100g fresh mozzarella 1tsp sugar 100ml dry white wine 100ml double cream 1 handful of fresh basil leaves

5. Turn the heat off, top with the mozzarella and the remaining cherry tomatoes. Bake in a pre-heated oven (200C (fan)/220C (conventional)) for 10-15 minutes until the cheese is melted. 6. Garnish with some fresh basil leaves and serve with a warm, crusty loaf of bread!

Like what you see? Be sure to follow

@TWOGREEDYGALS on Instagram!

Great Garlic

Garlic is one of the oldest cultivated plants in the world with Sanskrit records documenting the use of garlic remedies approximately 5000 years ago! Garlic is low in calories and an excellent source of vitamin B6, vitamin C and manganese. In addition, it’s a good source of minerals including calcium, iron and potassium. Supplements containing garlic can help to reduce the severity of the common cold and influenza.

Marvellous Mushrooms Edible mushrooms are low in calories and contain varying degrees of protein, fibre and antioxidants, including vitamin B through selenium. These antioxidants support the immune system and may also mitigate the risk of developing health conditions such as heart disease and diabetes. Due to this, mushrooms are being increasingly researched and used for their important health benefits, with different varieties having different medicinal properties.

PESTO STUFFED CHICKEN Serves 2

Time 30 mins (+3 hrs chilling)

Directions 1. Slice each chicken breast down the middle to create an opening, and season with salt and pepper. Sprinkle half a teaspoon of mixed herbs over each breast, and stuff each one with 2 mozzarella slices, 1tsp pesto, half a crushed garlic clove and a few spinach leaves. 2. Wrap each breast tightly with 3 slices of prosciutto and cover with a piece of cling film, place in the fridge until chilled (we suggest leaving it for around 3+ hours). 3. Preheat the oven to 170C (fan)/190C (conventional) and chop the onion and chestnut mushrooms into slices. 4. Once the chicken has chilled, remove the cling film and fry in a large frying pan with half a teaspoon of olive oil until the prosciutto is slightly brown. Take the chicken straight from the frying pan and place in an ovenproof dish. Cook in the oven for 20 minutes. Ingredients • • • • • • • •

150g penne pasta 2 chicken breasts 4 slices of mozzarella 4tsp of pesto 150g spinach leaves 6 slices of prosciutto 1tsp of olive oil 1 red onion

Nutritional Values Per Serving

www.bluestreamacademy.com

• 150g chestnut mushrooms • 2 garlic coves • 2tbsp of light cream cheese • 150ml chicken stock made up as directed • 2tsp mixed herbs • salt and pepper

5. Whilst the chicken is in the oven, boil the pasta as per the packet instructions, and in the frying pan used to brown the chicken, add half a teaspoon olive oil, the chopped red onion and mushrooms, and 1 crushed garlic clove. Fry for 5 minutes and season with salt, pepper and 1tsp mixed herbs. 6. Add 2tsp pesto to the pan, alongside 2tbsp light cream cheese and 150ml chicken stock. Cook on a high heat until the sauce is smooth and creamy. 7. Once your pasta has cooked, add this to the pan alongside the remaining spinach leaves. Cook until the spinach has wilted. Remove the chicken from the oven and slice crosswise. Serve half of the pasta and sauce per dish, topped with one of the sliced chicken breasts. 41

#TeamBSA

ince our last issue, a lot has happened at Blue Stream HQ! Our team has grown and we have been reunited in person after 16 long months, we have launched our market leading partnership with First Practice Management (FPM), and we are excited to announce the release of our very own Blue Voice discussion forum – giving over a quarter of a million trainees the opportunity to have their say with BSA! With our new FPM integration, any trainees subscribed to FPM Core will have the ability to link their Blue Stream Academy training and

Dates For Your Diary

compliance records with FPM’s policies, procedures and protocols - creating a continuous compliance system with no additional setup required.

Our new Blue Voice discussion forum enables trainees throughout the UK to connect with other HCPs, ask peers for their opinions, organise a meeting or social event with colleagues, or simply open a discussion with like-minded professionals. As autumn approaches, the sales team is preparing for a busy few months out on the road, attending exhibitions and events across the UK. Keep an eye on our events calendar to see where the team is visiting and be sure to pop along and have a chat with our friendly colleagues!

Management in Practice London

SEP

ILEC Conference Centre 47 Lillie Rd, Earl’s Court, London, SW6 1UD

15 16

Dementia, Care & Nursing Home Expo

13 14

The Care Show Birmingham NEC North Ave, Marsten Green, Birmingham, B40 1NT

Management in Practice Birmingham The National Conference Centre Coventry Rd, Bickenhill, Solihull, B92 0EJ

Management in Practice Newcastle

Birmingham NEC North Ave, Marsten Green, Birmingham, B40 1NT

SEP

OCT

NOV

LiveChat Lounge

Hi there,

I manage the training for my hospice and we are currently set up with Blue Stream Academy for our eLearning. We also have to complete a lot of manual face-to-face training each year to remain compliant – is there any way to record our face-to-face training on the Blue Stream Academy system so that everything is in one place? Many thanks, Training Manager 42

Hilton Newcastle Gateshead Hotel Bottle Bank, Gateshead, Newcastle, B92 0EJ

Hi!

Thank you for contacting us. You can absolutely record any external training on your Management of Information System (MIS).

record to one of our Blue Stream Academy modules or create a Core Module for your external course and attach the training record to it.

You will just need to use our external training feature within the staff list (Management > Staff > Staff List > +Add External Training).

It will then appear on your training matrix and will be colour coded according to its completion status (make sure you add in module settings for your core modules too).

In here you can fill in the details of the external training course, add one or more staff members and attach to their profiles. As a bonus, if you want this external training to reset upon expiry, you can attach the training

Hope this helps, but any questions, please get in touch with a member of our team! Many thanks, Team BSA

@BlueStreamNews

s the leading provider of CPD-certified eLearning for health and care professionals throughout the UK, we’d like to update you on our latest module releases.

Postural Care

Postural care is a vital practice for everyone. For individuals who have impeded mobility, it can become life-saving. The module covers how to use a 24-hour approach to protecting an individual’s body shape, whilst explaining the different ways the body can be affected by poor postural care. It also highlights the different pieces of equipment that can be used in conjunction with a postural care routine to enhance a person’s life.

Falls Prevention (Hospice eLearning Suite Only)

The topics covered in this module include understanding what is classed as a fall, and the physical, emotional and financial consequences that may arise after a fall. It also looks at understanding and identifying risk factors and how they affect an individual’s risk of falling, along with recognising how to identify who is at risk of falling and what should be included in a multifactorial risk assessment. Other topics include explaining what preventative steps should be taken to reduce an individual’s risk of falling and understanding what steps should be taken after an individual has fallen.

Basic Life Support

Our Basic Life Support modules have been updated in line with the Resuscitation Council UK’s 2021 Guidance. The updated modules, which replace Adult Basic Life Support, Child Basic Life Support, and Infant Basic Life Support, are called: • Basic Life Support Level 1 • Adult Basic Life Support Level 2 • Paediatric Basic Life Support Level 2.

www.bluestreamacademy.com

If you would like more information on these new releases, or on any of our available modules, our team is always on hand and happy to help via email at info@bluestreamacademy.com, or by phone on 01773 822549. Be sure to follow us on Twitter (@BlueStreamNews) to get our updates and module announcements as soon as they happen! 43

THIS HAS TO STOP! As the world adjusts to new forms of normality, COVID-19 has undoubtedly placed huge stress on the population. In fact, a new survey shows that 75%* of GP reception staff have reported experiencing daily abuse from patients – This Has to Stop!

Are you a receptionist currently working in health and social care?

Here is your chance to stand up and be heard!

Have you experienced abuse in the workplace – whether it has been physical, verbal, written or online? Would you like to help promote change through better staff education and increased understanding about managing these situations?

We would really appreciate hearing about your experience of working in a reception role – we want to give you the chance to have your say. For more information, please drop us an email at bsatoday@bluestreamacademy.com with the subject line ‘Change’ and one of our team will get in touch with you. Alternatively, you can phone us or visit our website:

01773 822549 www.bluestreamacademy.com Your Training. Your Way.

*NHS Tees Valley CCG. https://teesvalleyccg.nhs.uk/majority-ofgp-receptionists-face-unprecedented-levels-of-abuse-at-worknew-research-shows/ (accessed August 2021)