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Today Blue Stream Academy’s Healthcare & Lifestyle Magazine Spring 2022 | Issue 13

Look Who’s Talking:

Cervical Screening

Data Watch:

Securing the Supply Chain

Dr Toni Hazell

National Cyber Security Centre

Wellbeing for All: A Trauma-Sensitive Perspective Alison Carter

BSA Today Issue 13 Front Cover

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: brady@bluestreamacademy.com Alternatively, you can write to us, phone us, or visit our website: Blue Stream Academy Suites 11, 12 & 16 Riverside Business Centre Foundry Lane Milford Derbyshire DE56 0RN 01773 822549 www.bluestreamacademy.com Disclaimer:

The views and opinions expressed within this publication are that of the original authors of the relevant content and do not necessarily reflect the official views and opinions of Blue Stream Academy Ltd. © 2022 Blue Stream Academy

Would you like to join our Subscribers’ Club to receive future issues of BSA Today before anyone else? Plus, gain access to our exclusive prize draws and competitions? If so, you can join today at www.bluestreamacademy.com/subscribe. Alternatively, you can phone us on 01773 822549 or drop us an email at bsatoday@bluestreamacademy.com

In this issue BSA Today | Issue 13

From the Editor's Desk...

s we embrace spring – the season of hope – we’re excited to present the latest issue of BSA Today. Since our last issue, we’ve made some format changes by adding extra space for a cleaner, easy-to-read style. We’re also now available via a new channel: Blue Stream Academy’s brand-new online discussion forum, Blue Voice. Now, you can ‘have your say with BSA’ by joining our digital community and sharing posts with thousands of other likeminded health and social care professionals. With the gradual easing of COVID-19 restrictions over the past few months, many of us have decided to assess our lifestyle choices. It is important to mention that for lots of people, mental health has been especially difficult to manage during the pandemic. In fact, health and social care professionals are among those most affected, as many have had to endure the pandemic’s psychological effects, whilst continuing to provide treatment and support to patients.

This certainly hasn’t gone unnoticed by us, so we decided to dedicate a large portion of this issue’s lifestyle & wellness section to self-care and looking after our mental health. This is of course complemented by our usual blend of quality content written exclusively for BSA Today. As always, on behalf of the team here, we want to thank you for your continued support, and we hope you enjoy reading this issue!

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 Brady Braddock | Editor Sian Ratcliffe | HR Lewis Cowlishaw | Content Development Stuart Walsh | Information Security

National Cyber Security Centre (NCSC) UK Government Agency

Dr Toni Hazell GP, freelance medical writer, blogger and editor Alison Carter Trauma-informed movement teacher and experienced healthcare editor and writer www.bluestreamacademy.com

ART & DESIGN Courteney Barlow-Ferguson | Graphic Designer Craig Goodall | Creative Services COMMUNICATIONS Abi Bowler | Marketing & Media

Cover Stories 11

Data Watch: Securing the Supply Chain

With cyber-attacks on the increase and the health and care sector continuing to be targeted by cyber criminals, it’s as important as ever to be vigilant. We look at the National Cyber Security Centre’s advice on how to stay safe.

Wellbeing for All: A Trauma-Sensitive Perspective

With a focus on stress, trauma and the nervous system, Alison Carter, trauma-informed movement teacher and healthcare editor and writer, discusses the importance of health and wellness for everyone in the sector in today’s challenging circumstances.

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 for reporting on the issues that matter most.

A Spotlight On... Parkinson’s Awareness

With our brand-new Parkinson’s Awareness module now live, we focus the spotlight on how knowledge and treatments have developed over centuries into the promising advances we are seeing today.

@BlueStreamNews

Direct from Blue Stream HQ, we recap the last few months at Blue Stream Academy and talk news and events with Team BSA. We also have some key dates for your 2022 diary.

LiveChat Lounge

Check in with our friendly and enthusiastic support team to find the answers to recent customer questions on our LiveChat feature.

24 Lifestyle & Wellness 28

Little Tasks, Big Rewards!

As part of our lifestyle and wellness extravaganza, our editor Brady Braddock has written a short poem about how completing little everyday tasks can make a big difference to your general outlook and mindset.

30 The Power of Positive Psychology

Can you talk your way out of anxiety? Mental illness is on the rise, especially post COVID-19. Here, Suzanna Hayes-Goldfinch explains how small steps like positive thinking and self-talk can help to combat those feelings of unease, so that you are more confident and capable in your daily life.

Great Food with Two Greedy Gals

It’s time to swap those hearty stews for something a little lighter and fresher as we celebrate spring with Two Greedy Gals, who are back with even more delicious recipes written exclusively for BSA Today.

Look Who’s Talking Cervical Screening

19 www.bluestreamacademy.com

Due to the success of human papillomavirus (HPV) testing, cervical cancer screening is now being offered every 5 years instead of 3 years in Wales. Here, Dr Toni Hazell, London GP and freelance medical writer, gives her views on this important topic. 05

Adult Social Care Was Hit Hard During the Pandemic – It Will Need Help to Recover

micron cases are falling, and the UK government is focusing on a return to normal. But far from entering a post-pandemic recovery phase, the adult social care sector – which provides crucial services to people who are disabled, elderly or ill – is facing more acute pressure than ever.

Social care in England was under severe stress well before any of us had heard of COVID. Years of austerity had led to a chronically overstretched and undervalued workforce, long waiting lists for assessments and services, and unprecedented levels of unmet need. The pandemic exacerbated these problems.

This shouldn’t have come as a surprise. The British government knew that a viral pandemic was one of the greatest threats facing its population, and successive pandemic preparedness exercises had identified social care as a fault-line that could crack under pressure. Yet the findings of planning exercises that predicted this – such as Exercise Cygnus[1], a pandemic simulation run in 2016 – were insufficiently addressed. When COVID arrived in early 2020, the disruption it caused quickly overwhelmed the sector’s capacity to maintain business as usual. Now, as the COVID threat is subsiding, social care provision needs – at the very least – to return to pre-pandemic levels. But there are real concerns that this isn’t happening. COVID Required Emergency Legislation By March 2020, the seriousness of the COVID situation for adult

social care was becoming evident. Pressure was growing rapidly, as many care workers and unpaid carers were having to self-isolate to avoid transmitting what was clearly a deadly virus. The Coronavirus Act 2020[2] therefore introduced emergency provisions that allowed local authorities increased flexibility in how they provided care and support. These ‘easements’[3] to certain duties contained in the Care Act 2014[4] – such as the assessment of needs of adult service users and carers – provided a means to operate, legally, at reduced capacity. At their highest levels, the easements allowed where necessary for care to be changed or withdrawn[5] to meet more urgent needs elsewhere in the system, to “prioritise care so that the most urgent and acute needs are met” – effectively rationing services. These easements proved controversial[6]. Only eight local authorities formally activated them, and they then quickly reversed their decisions under sustained scrutiny[7] and pressure[8] from campaigners[9].

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Other Changes Went Under the Radar Only those local authorities that formally activated the highest levels of easements were publicly listed[10], but nationwide, the majority of local authorities still made changes to manage pressures[11]. Social work moved mostly from face-to-face to online contact. Some assessments of needs and reviews were delayed or postponed. Day-care centres and activities were reduced or closed down altogether. Council staff were redeployed across roles and departments. Yet many local authorities making these sorts of changes took the position that they had not used formal easements, but instead were just making use of the opportunity to be more flexible around how they provided care. Crucially, as the director of adult social services at one local authority noted[3] to us in an interview, those who made these under-the-radar changes didn’t attract the same scrutiny and pushback as those that had “followed the letter of the law” by formally registering themselves as easement councils.

Authors Laura Noszlopy ESRC Research Fellow, University of Birmingham Laura Noszlopy is a research fellow on a project examining the impact of Care Act easements, funded by the Economic and Social Research Council COVID-19 Rapid Response Grant ES/V015486/1. This work was supported by that grant.

Jean McHale Professor of Health Care Law, University of Birmingham Jean McHale is principal investigator on the Economic and Social Research Council COVID-19 Rapid Response Grant ES/V015486/1. This work was supported by that grant. The original article can be found at: https://theconversation.com/adultsocial-care-was-hit-hard-duringthe-pandemic-it-will-need-help-torecover-176412

Continued on Page 08

Continued from Page 07

“

He continued:

No Rebound Yet The legal provisions that allowed for social care easements expired in July 2021. But rather than recover, the adult social care situation has significantly worsened, not least due to a staffing crisis[12] fuelled by pandemic burnout, Brexit, poor pay and conditions, and mandated COVID vaccines.

We are making incredibly difficult decisions about who gets care, how much care they get and who misses out – with obvious concerns that this will lead to people becoming isolated and, ultimately, to the loss of lives … This is now a national emergency for social care.

As the easement provisions have expired, there’s currently no emergency legislation within which councils can make transparent adjustments to mitigate for reduced workforce capacity or increased demand – despite the continuing need to do so.

On December 29 2021, the government wrote to local directors of adult social services to announce some modest additional funding to address the impact of omicron. The government also acknowledged that omicron meant that local authorities were now “making extremely difficult decisions under unprecedented and exceptional pressures with limited time, resources, or information”. It accepted that councils “need greater flexibility to prioritise resource in these very challenging times”.

“Every day we are rationing care in ways that we never have before,” Stephen Chandler, president of the Association of Directors of Adult Social Services, recently stated[13].

However, it went on to say: “We would advise you to take your own legal advice regarding any specific measures you are considering to ensure you continue

to comply with your legal obligations, including those in Part 1 of the Care Act 2014.” Local authorities have effectively been left on their own, with pressures similar to those experienced earlier in the pandemic, but without the protection afforded by the Coronavirus Act 2020. While the act was initially viewed with suspicion – as a tool with which rights could be eroded – with hindsight it appears more like a pragmatic framework that had enabled decision making and accountability; flawed but now absent. In 2020, at the peak of the COVID crisis, “rationing care” was considered the very highest level of easement, almost unthinkable and to be avoided except as a last resort. But now there are real concerns that some changes to services, envisaged as temporary adjustments, may persist and be accepted as the new normal for adult social care. This leaves a very challenging legacy. It’s crucial that any changes to adult social care are subject to proper consultation and accountability. Changes that have persisted must be properly www.bluestreamacademy.com

scrutinised and mustn’t be allowed to slip through just because of COVID. On top of this, the pandemic has underlined just how badly stretched the social care sector is, and how urgently the problem of under-resourcing needs to be fixed

1. 2. 3.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/927770/exercise-cygnus-report.pdf https://www.legislation.gov.uk/ukpga/2020/7/section/16/enacted https://www.birmingham.ac.uk/documents/college-artslaw/law/research/adult-social-care-provision-under-pressure-lessons-from-the-pandemicnovember-2021.pdf 4. https://www.legislation.gov.uk/ukpga/2014/23/contents/enacted 5. https://www.gov.uk/government/publications/coronavirus-covid-19-changes-to-the-care-act-2014/care-act-easements-guidance-for-local-authorities 6. https://www.theguardian.com/society/2020/may/07/stop-using-coronavirus-powers-to-neglect-care-duties-uk-councils-told 7. https://www.libertyhumanrights.org.uk/issue/liberty-and-disability-charities-warn-councils-not-to-weaken-social-care-during-coronavirus-pandemic/ 8. https://www.inclusionlondon.org.uk/disability-in-london/coronavirus-updates-and-information/campaigns-news-during-coronavirus-crisis/restoring-8. disabled-peoples-rights-scrap-the-coronavirus-act-easements/ 9. https://www.disabilityrightsuk.org/news/2020/september/baroness-campbell-calls-human-rights-busting-coronavirus-powers-be-switched 10. https://www.cqc.org.uk/guidance-providers/adult-social-care/care-act-easements-it 11. https://www.adass.org.uk/media/8265/themes-and-learning-from-adass-members-on-the-local-response-to-covid-19-in-spring-and-earlysummer-2020-041120.pdf 12. https://www.theguardian.com/society/2022/jan/15/vulnerable-adults-left-without-care-in-england-as-staff-crisis-worsens 13. https://www.adass.org.uk/adass-press-release-a-national-emergency-for-social-care

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Securing the Supply Chain A supply chain attack happens when someone attempts to cause damage to an organisation by targeting less secure links in its supply chain, such as a partner or a service provider. In recent years, supply chain attacks such as Stuxnet, NotPetya and SolarWinds have had devastating effects on organisations around the world. Article | National Cyber Security Centre (NCSC)

ith attacks on the increase and the health and care sector continuing to be targeted by cyber criminals, it’s as important as ever to be vigilant. The following guidance from the National Cyber Security Centre (NCSC) explains how you can keep your organisation safe by securing your supply chain. Collaborate With Your Suppliers and Partners

Most organisations rely upon suppliers to deliver products, systems and services. Therefore an attack on your suppliers can be just as damaging to you as one that directly targets your own organisation. Supply chains are often large and complex, and effectively securing the supply chain can be hard because vulnerabilities can be inherent, introduced or exploited at any point within it. The first step is to understand your supply chain, including commodity suppliers such as cloud service providers and those suppliers you hold a bespoke contract with.

“

Exercising influence where you can, and encouraging continuous improvement, will also help improve security across your supply chain.

Until you have a clear picture of your existing supply chain, it will be very hard to establish where you can have any meaningful control over it. Continued on Page 12

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Continued from Page 11

What Are the Benefits?

• Managing risk to your business that manifests in the supply chain. • More effective relationships with your suppliers and partners and better understanding of each other’s needs. 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.

• Better visibility and early warning signs of incidents that might affect your organisation. • Identifying any over-reliance on single suppliers. • Demonstrating good cyber security can help you win supplier contracts, particularly those from government where good practice is already required. What Should You Do? 1. Understand Your Supply Chain

Until you have a clear picture of your existing supply chain, it will be very hard to establish where you can

have any meaningful control over it. Ensure you have a list of all your suppliers and partners, and identify which ones are highest priority (in terms of risk) to concentrate your efforts on. Where possible include subcontractors, beginning with your highest priority direct suppliers. Look for information published by your existing commodity suppliers that helps you understand the security of their service. Ensure you understand the terms and conditions in your contract or licensing agreement and what parts of security each is responsible for. Work with the suppliers you have a bespoke contract with to understand their current security posture. How does that compare with what you’ve asked of them (if anything), and what they’ve asked of their subcontractors (focusing on the parts of their organisation that handle

your contract)? Understanding your supply chain and the risks posed to it will help identify any suppliers who consistently fail to meet expectations. Develop a common understanding with your suppliers of each party’s security responsibilities, and what subcontracting decisions you are happy to delegate to them. 2. Embed Security Within Your Contracting Process

Build security considerations into your contracting decisions, and where appropriate require your suppliers do the same. Establish supply chain security awareness and education for appropriate staff, and work with them to ensure the process is fit for purpose. When making decisions about commodity suppliers like cloud service providers, look for published information on their website that might help you understand whether they adequately meet your security requirements. You are likely to have standard terms and conditions in your contract or licensing agreement, so ensure you are aware of what parts of security you are responsible for and what they will do for you. Refer to the NCSC’s Cloud Security Guidance for more information on how to determine how confident you can be that a cloud service is secure enough to handle your data. Prospective suppliers should provide evidence of their approach to security, and their ability to meet the minimum security requirements you have set at different stages of the contract competition. Minimum security requirements (like ISO 27001 or Cyber Essentials for mitigating commodity attacks against enterprise technology) should be proportionate to the risk for each supplier. Ensure standards are justified and achievable and won’t unnecessarily put off suppliers looking to compete for contracts with you.

Continued on Page 14

Did You Know?

Blue Stream Academy are proud to have been awarded an ISO27001 accreditation. We are audited by BSI, the most respected body to award certification in the UK. Ensure your data is secure - choose an ISO2700-accredited organisation.

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Continued from Page 13

Avoid creating unnecessary barriers and acknowledge and be prepared to recognise any existing security practices or certifications they might have that could demonstrate how they meet your minimum security requirements. Ensure you provide supporting guidance, tools and processes to suppliers to enable them to effectively manage supply chain risk to your requirements. If you are a supplier, make sure you meet the security requirements of your customers, including challenging customers and partners for guidance when it’s not provided. Consider what support you will need from suppliers to maintain their products and services; likewise, use vendor or community-supported software where available. Ensure that contracts clearly set out specific requirements for the return and deletion of your information and assets by a supplier on termination or transfer of that contract.

Listen to and act on any concerns highlighted through performance monitoring, incidents, or upward reporting from suppliers that may suggest that current approaches are not working as effectively as planned. Seek to build trust and strategic partnerships with key suppliers, sharing issues with them, and encourage and use their input to improve your collective security. Include important partners in your cyber incident response exercising where appropriate Learn More

For more guidance from the NCSC, visit the links below: Supply Chain Security Guidance www.ncsc.gov.uk/collection/supply-chain-security Supplier Assurance Questions

www.ncsc.gov.uk/guidance/supplier-assurancequestions Cloud Security Guidance www.ncsc.gov.uk/collection/cloud-security/ implementing-the-cloud-security-principles

3. Support Organisations in Your Supply Chain to Improve

Be prepared to provide assistance when necessary where security incidents in your supply chain have the potential to affect your business or the wider supply chain. Your contract should include requirements for managing and reporting security incidents.

This information is licensed under the Open Government Licence v3.0. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence. © National Cyber Security Centre 2022

A Spotlight On... Parkinson’s Awareness Parkinson’s disease is the fastest-growing neurological condition in the world today, with 1 in 37 of us likely to be diagnosed with the disease in our lifetime.[1]

I Lewis Cowlishaw Content Development Manager at Blue Stream Academy Lewis oversees the research, writing and development of our eLearning content while coordinating with subject matter experts from across the UK. “Our enthusiastic in-house development team ensures that we stay on top of the latest developments,” says Lewis. “The key to success at BSA is about being on the pulse of the health and social care sector and having a devoted following of passionate users certainly helps too.”

t tends to affect adults over 50, and in the early stages the most recognisable symptoms affect movement. They often include a tremor that gets worse when the person is resting, bradykinesia (slowness of movement), rigidity and problems with posture. With our brand-new Parkinson’s Awareness module now LIVE for all Blue Stream Academy customers, this article takes a look at the origins of the condition, highlights how knowledge has developed and describes how recent technology has helped to alleviate the symptoms for millions of people. The Origins of Parkinson’s

In 1817, the British physician James Parkinson wrote an essay on a condition generally referred to as “the shaking palsy”.

“Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported; with a propensity to

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bend the trunk forwards, and to pass from a walking to a running pace” – James Parkinson, ‘An Essay on the Shaking Palsy’, 1817[1].

The term ‘Parkinson’s disease’ was coined 55 years later by a French neurologist named Jean-Martin Charcot. Continued on Page 16

Continued fromn Page 15

Parkinson devoted a chapter of his monograph to “considerations respecting the means of cure”.[1] In humility, and with a vision that anticipated current concepts of neuroprotection, he expressed the hope that a treatment would be identified by which “the progress of the disease may be stopped”.[1] Early Experiments

In line with the prevailing therapeutic approaches of the early nineteenth century, Parkinson recommended venesection – specifically, bloodletting from the neck – followed by vesicatories to induce blistering and inflammation of the skin. Small pieces of cork were purposefully inserted into the blisters to cause a “sufficient quantity” of purulent discharge.[2] The intention was to divert blood and inflammatory pressure away from the brain and spinal cord, and, in this way, decompress the medulla that Parkinson considered to be the seat of neurological dysfunction. A more unusual and hazardous early treatment of Parkinson’s disease involved using a suspension apparatus to stretch the spinal cord. Developed in 1883 in Russia, the apparatus became famous when its safety and efficacy were examined in the context of a variety of disorders, including Parkinson’s. Using gravity and the patient’s weight to put excessive vertical traction on the spinal cord and nerves, the therapist suspended the patient in mid-air by using a pulley and a harness that slipped under the chin.

This early experiment helped to ease rigidness and some sensory symptoms for patients with Parkinson’s, but it had no effect on tremors. When this treatment was introduced in France, it was soon abandoned because of the serious side effects and stress it caused for patients.[2] Modern Treatments and Advancements

People who are diagnosed with Parkinson’s have low levels of the neurotransmitter dopamine in the basal ganglia – a group of structures involved with movement and some other functions. The dopamine levels reduce when dopamine neurons die in a region of the basal ganglia. This region – the substantia nigra – has high numbers of dopamine neurons, but a person who has reached the end stage of Parkinson’s will have lost more than 50% of the dopamine neurons in this region.[3]

The most common treatment for Parkinson’s is designed to restore dopamine levels in the brain. Dopamine does not cross the blood-brain barrier, so it can’t be administered directly. Instead, a precursor to dopamine called L-DOPA is used orally, which is synthesised into dopamine in the brain. Although L-DOPA can lead to improvements in the movementrelated symptoms of Parkinson’s, it does nothing to halt the neurodegeneration caused by the disease.[4] One of the most important advancements in treating Parkinson’s is the development of deep brain stimulation. Deep brain stimulation is a neurosurgical procedure that is used to treat problems with movement since 2002. A medical device is placed into the patient’s head and is used to send electrical impulses, through implanted electrodes, to specific targets in the brain. For most people, these electrical impulses lead to significant improvements in many motor symptoms. Often, people who have received this treatment find that they can reduce their daily doses of medication by as much as 30–50%.[5] Despite these benefits, deep brain stimulation is not recommended for all people who have Parkinson’s, and patients must meet a strict set of criteria to be able to receive it. In a small number of cases, the surgery can be associated with complications such as seizures, bleeding or infection. Other issues can include the device malfunctioning down the line. Despite some tremendous advances in this field, the prevalence of Parkinson’s is increasing. Although no definitive cause has been identified, research is ongoing to identify potential causes and it is believed that a combination of genetics and environmental factors are responsible 1. 2. 3. 4. 5.

Parkinson J. (1817). An Essay on the Shaking Palsy. (Last accessed February 2022) The History of Parkinson’s Disease: Early Clinical Descriptions and Neurological Therapies https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3234454/ (Last accessed February 2022) Clinical Progression in Parkinson’s Disease and the Neurobiology of Axons. https://www.ncbi.nlm. nih.gov/pmc/articles/PMC2918373/ (Last accessed February 2022) Levodopa and the Progression of Parkinson’s Disease https://www.nejm.org/doi/pdf/10.1056/ NEJMoa033447 (Last accessed February 2022) Medication Reduction After DBS Placement in Parkinson’s Disease. https://n.neurology.org/ content/86/16_Supplement/P6.383 (Last accessed February 2022)

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Want to Find Out More?

Our Parkinson’s Awareness module is now LIVE on the system and is available to all current customers at no additional cost. Our comprehensive module covers the signs, symptoms and information for supporting people with Parkinson’s as well as the importance of person-centred care. For more information on Blue Stream Academy or a FREE TRIAL of the suite, get in touch with the team at info@bluestreamacademy.com or call 01773 822549.

RESTORE2mini

eLearning Module Free Access for Every Carer Supported by the Devon Training Hub

Blue Stream Academy is pleased to announce the release of a new RESTORE2mini eLearning module, created and developed alongside experts from the South West Academic Health Science Network (South West AHSN). This module has been developed with the support of the Devon Training Hub. Developed and co-produced by NHS West Hampshire Clinical Commissioning Group, now part of the Hampshire and Isle of Wight Integrated Care System, and the Wessex Academic Health Science Network, RESTORE2mini has grown from nationally recognised deterioration methodologies such as the National Early Warning System (NEWS2), early recognition (Soft Signs) and structured communications (SBARD). With Blue Stream’s RESTORE2mini eLearning module you can join over a quarter of a million enthusiastic trainees, learning new skills to provide better care across all health and care environments. As the market leader in health and care eLearning, we recognised the great importance of RESTORE2mini to empower carers with improved knowledge and understanding of the people for whom they care. This is why we’ve made this module complimentary for every carer in the UK and, with the help of South West AHSN, we feel this is a number 1 resource for all carers. This eLearning module is available free of charge for every carer throughout the UK - whether caring for residents in a care home, or in their own home. To register for free access, please contact us at: nch@bluestreamacademy.com 01773 822549

www.bluestreamacademy.com/enquiry/index

Your Training.

Your Way.

BlueStreamAcademy BlueStreamAcademy @BlueStreamNews

Look Who’s Talking:

Cervical Screening Around 3,200 women are diagnosed with cervical cancer every year in the UK. The peak age group at diagnosis is 30–34, but 9% of cases are diagnosed in women aged 75 and over, so it is important not to think of cervical cancer as purely a “young person’s disease”.[1]

here has been a 25% decline in incidence of cervical cancer since the early 1990s, a trend which is expected to continue due to the success of the human papilloma virus (HPV) vaccination programme.[2]

Dr Toni Hazell GP, freelance medical writer, blogger and editor Toni is a GP in North London and works for the Royal College of General Practitioners (RCGP) as an eLearning fellow, writing and editing eLearning. She also does similar work for a variety of other organisations and is a regular presenter and chair at GP educational events. She is a GP appraiser and sits on her local individual funding review panel. Her blog can be found online at www.tonihazell.co.uk

Cervical cancer is largely caused by high-risk strains of HPV, which can be detected in 99.7% of cervical cancers. HPV is sexually transmitted and has a very high prevalence – on average, a sexually active woman has a 50–79% risk of being infected with HPV during their lifetime, and almost 40% of women are infected within two years of their first sexual activity.[3] There are over 130 strains of HPV, some of which cause cancer and others that are lower risk, causing genital warts. This knowledge of the links between HPV and cervical cancer has revolutionised the cervical smear programme in the UK. The National Health Service Cervical Screening Programme (NHSCSP) was set up in 1988. Cervical screening started in the UK in 1964, but implementation was patchy, with smears being

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done opportunistically and no organised follow-up. The NHSCSP introduced a central policy about who to screen and treat and also started the process of computerised call and recall systems, operated by district health authorities rather than by the individual GP.[4] Coverage rose steadily from around 40% in the 1980s to 72.2% in 2019/2020.[5] Cervical screening tests (colloquially known as smear tests) do not usually find cancer. When the cells are examined under the microscope, what is seen is dyskaryosis: cell changes which, if left untreated over time, may regress back to normal or may develop into cancer.[6] Dyskaryosis can be defined as mild, moderate or severe; regression back to normal is more common with mild dyskaryosis, with progression being more of a concern for the moderate or severe types, although progression to cancer is still likely to take years. Continued on Page 20

Continued from Page 19

A smear test that is examined under the microscope can therefore have five possible results – normal, dyskaryosis (mild, moderate or severe), or inadequate, where there are not enough cells to make a report. The fifth group has become much less common since the advent of liquid-based cytology, introduced in 2004, which means the cells are suspended in liquid when taken, rather than being smeared directly onto a slide.[7], [8] A woman who has dyskaryosis on her smear test will be sent for a colposcopy, where the cervix is examined under the microscope and a biopsy is taken. The outcome may be a normal result, or abnormal cells referred to as cervical intra-epithelial neoplasia (CIN) or cervical glandular intra-epithelial neoplasia (CGIN). CIN is graded from 1 to 3, with a higher number meaning more likelihood of progression to cancer; CGIN has a high chance of progression to cancer and is managed in the same way as CIN3,[9] with removal of the abnormal cells. The most recent significant change to the NHSCSP has been the advent of primary HPV testing to replace cytology (looking at the slide under a microscope). This was first piloted in 2013, when six laboratories began looking for HPV in a subset of smear tests, before the samples were examined under the microscope.[10], [11] Another group of smear tests was managed in the normal way, with cytology as the first test. HPV screening increased the detection rates of CIN3 and 20

cervical cancer. In 2019, primary HPV screening was rolled out across the whole of England, meaning that samples are now tested for HPV – if the result is negative, the sample is discarded (with no cytology) and the woman is recalled for another test at the usual screening interval (3–5 years, depending on the area of the UK and the woman’s age). If the HPV test is positive, then cytology is carried out. Negative cytology with a positive HPV screen means that the woman is invited for a repeat smear in 1 year. Women with dyskaryosis on cytology are sent for a colposcopy appointment. This is summed up in the algorithm to the right.[12] The abbreviation HR-HPV stands for high-risk HPV, as it is the high-risk strains of the virus which are tested. At the time of writing, Northern Ireland is the only part of the UK that is not using primary HPV screening for smears. We have already seen that cervical cancer is largely caused by HPV. Other risk factors include smoking, a higher number of sexual partners, lack of condom use, and first intercourse at a younger age.[3] The HPV vaccine was introduced in 2008 for girls, and it was first offered to boys in 2018.[13]

Notes

1. Inadequate tests at any screening episode in the pathway will be repeated in 3 months. Three inadequate tests in a row will lead to a colposcopy referral. 2. Women entering the pilot under follow up for treatment for CIN will be given a 3 year recall if HR-HPV -ve and will be referred to colposcopy if HR-HPV +ve/any grade of cytology.

3. Women entering the pilot under follow up for CGIN or SMILE (complete excision margins) will follow the protocol for CGIN at their next two tests as dtailed in the HPV Primary Screening Pilot Colposcopy Management Recommendations Algorithm.

4. Women in follow up for cervical cancer (who still have a cervix) and CGIN/SMILE (without complete excision margins) at a pilot site will be given annual HPV testing (instead of cytology) for 10 years. #HPV16/18 recorded where available. Women testing HPV 16 or 18 positive/cytology normal at baseline and again at their first 12 month follow up test can be referred to colposcopy without further repeat tests. Continued on Page 22 www.bluestreamacademy.com

Stages of HPV

Normal

Early Stage

Continued from Page 21

It is estimated that the current cohort, who are aged 12–13, will have an 87% risk reduction in cervical cancer, compared to a similar cohort who are unvaccinated, with a reduction in CIN3 of 97%.[14] This raises the enticing possibility that we could eliminate cervical cancer in the NHS,[15] but it comes with the caveat that women are now receiving letters telling them that they are positive for HPV. This can cause a lot of anxiety, and GPs are fielding an increasing number of calls from women who are concerned about passing HPV on to their partner, and whether it should be treated. For other sexually transmitted infections, such as chlamydia, we would treat the infection with antibiotics and make attempts to do contact tracing so that the patient’s partners are treated. HPV is managed differently – there is no treatment (though some people will spontaneously clear the virus), and its nearubiquitous prevalence in the sexually active population means that there is no need to do contact tracing or advise people to use condoms if they are not already doing so. Women phoning up after a positive HPV on a smear test can therefore be reassured that they need do nothing apart from attend their next smear test in a year’s time; their partner need not be tested (if he is male); for women with a female partner, the partner will be tested at her next smear test but does not need to bring this forward. There are various patient information resources available to back up this information.[16], [17] As the number of people vaccinated against HPV in their teens increases, we might wonder whether the day will come when smear tests will no longer be needed.

Mid Stage

This doesn’t seem likely any time soon, but primary HPV testing raises the possibility of longer smear intervals for those who are persistently HPV negative; this has been recommended for the whole of the UK, but it has only been implemented in Wales and Scotland so far,[18], [19] where HPV-negative women will now be screened every 5 years from the age of 25, instead of every 3 years. There was a predictable social media outcry, but this change is based on solid science; it takes years from infection with HPV to develop dyskaryosis, and years from the development of dyskaryosis to develop cancer, so an HPV-negative woman does not need to have a smear every 3 years. Other pilot projects are looking at women being able to self-swab for HPV, only needing a formal smear test if the HPV test is positive. This may allow for some sort of screening to become accessible to women who find it difficult to attend a smear test. Cervical screening has been around in an organised form in the UK for over 30 years. With our increasing knowledge of HPV, and another cohort being vaccinated each year, the prospect of further reductions in cervical cancer is exciting. All healthcare professionals need to understand the link between HPV and cervical cancer so that we can explain current screening, and any future changes, to our patients 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19.

Late Stage

Cancer Research UK. Cervical Cancer Incidence. www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervicalcancer#heading-Zero (Last accessed December 2021) Cancer Research UK. Cervical Cancer Incidence Statistics. www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/ cervical-cancer/incidence (Last accessed December 2021) National Institute for Health and Care Excellence. (2021) Cervical Cancer and HPV. https://cks.nice.org.uk/topics/cervical-cancer-hpv (Last accessed December 2021) Albrow R, Kitchener H, Gupta N. Cervical screening in England: the past, present and future. Cancer Cytopathol 2012; 120(2):87–96. NHS Digital. (2020). Cervical Screening Programme, England – 2019–20 [NS]. https://digital.nhs.uk/data-and-information/publications/statistical/cervicalscreening-annual/england---2019-20 (Last accessed December 2021) Department of Health. (2012). Cervical Screening: What Your Abnormal Result Means. www.unidocs.co.uk/docs/cx/abnormal/english.pdf (Last accessed December 2021) Public Health England. (2020). Topic 1: The NHS Cervical Screening Programme (NHSCSP). www.gov.uk/government/publications/cervical-screeningcervical-sample-taker-training/topic-1-the-nhs-cervical-screening-programme-nhs-csp (Last accessed December 2021) The British Society for Colposcopy and Cervical Pathology. About Cervical Screening. www.bsccp.org.uk/women/frequently-asked-questions (Last accessed December 2021) NHS. (2019). Results: Colposcopy. www.nhs.uk/conditions/colposcopy/results (Last accessed December 2021) Gov.UK. (2019). HPV Primary Cervical Screening Pilot Report Published in BMJ. https://phescreening.blog.gov.uk/2019/02/12/hpv-primary-cervicalscreening-pilot-report-published-in-bmj (Last accessed December 2021) Rebolj M, Rimmer J, Denton K, et al. Primary Cervical Screening With High Risk Human Papillomavirus Testing: Observational Study. BMJ 2019; 364:l240. Public Health England (2016). HPV Primary Screening Pilot Protocol Algorithm. https://assets.publishing.service.gov.uk/government/uploads/system/ uploads/attachment_data/file/529496/HPVPSFlowchart-Version3_Jan16.CURRENTppt.pdf (Last accessed December 2021) NHS. (2019). HPV Vaccine Overview. www.nhs.uk/conditions/vaccinations/hpv-human-papillomavirus-vaccine (Last accessed December 2021) Falcaro M, Castañon A, Ndlela B. The Effects of the National HPV Vaccination Programme in England, UK, on Cervical Cancer and Grade 3 Cervical Intraepithelial Neoplasia Incidence: A Register-based Observational Study. Lancet 2021; 398(10316):2084–2092. NHS England. (2020). “Potential to Eliminate” Cervical Cancer in England Thanks to NHS Long Term Plan. www.england.nhs.uk/2020/01/potential-toeliminate-cervical-cancer-in-england-thanks-to-nhs-long-term-plan (Last accessed December 2021) NHS. (2019). Human Papillomavirus (HPV). www.nhs.uk/conditions/human-papilloma-virus-hpv (Last accessed December 2021) Jo’s Cervical Cancer Trust. Human Papillomavirus (HPV). www.jostrust.org.uk/information/hpv (Last accessed December 2021) Welsh Government. (2022). Written Statement: Change to Cervical Screening Interval. https://gov.wales/written-statement-change-cervical-screeninginterval (Last accessed January 2022) UK National Screening Committee. Consultation on Modifying the NHS Cervical Screening Programmes in the Four UK Nations. [PDF] https://viewhealth-screening-recommendations.service.gov.uk/document/320/download (Last accessed December 2021)

BSA LiveChat:

We’re Here to Help! Here at Blue Stream Academy HQ, we pride ourselves on exceptional customer support that is hosted in-house by our friendly team of system specialists. Each year, our LiveChat team handles around 25,000 queries, resolving 95% of these within 24 hours. Throughout the year, members of the team have gone above and beyond to support health and social care professionals across the UK. We understand that any issues need to be sorted quickly and easily, and sometimes you might not want to call us at the office. So, if you ever get stuck, be sure to visit our website and speak with one of our team, who will be more than happy to assist. Below are just a few of the kind comments left by people who used our LiveChat service.

From all at Team BSA, thank you to all of the health and social care professionals who have been working so hard, day and night, over the past 12 months!

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Brilliant, so good to get a real person responding and so quick too.

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Sorted perfectly with zero fuss!

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Supportive and amazing! It was very quick and was a simple solution.

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As always issue solved in no time. Many thanks!

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Very helpful and sorted out my query in double quick time, allowing me to get back to eLearning.

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Simple, quick and straight to the point!

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Brilliant. I’ll use it again if I need to because it was really easy to do, and the person I spoke to was so helpful.

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Brilliant service 10 out of 10.

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Really helpful and able to answer all my queries with very quick responses.

Our LiveChat service is available Monday Friday between 9:00 - 17:30 www.bluestreamacademy.com

Wellbeing for All: A Trauma-Sensitive Perspective The World Health Organization officially recognised burnout as an “occupational phenomenon” in 2019.[1] With excessive and intensive workloads, rising vacancies, overburdened systems and rigid working cultures as the norm in the UK’s health and social care sector, those working within the profession are more susceptible to burnout than most.

T Alison Carter Healthcare Editor & Writer Alison is a trained journalist and an experienced healthcare editor and writer, having spent a decade writing across the health, care and education sectors about occupational wellbeing and holistic development. She is also a certified traumasensitive yoga and Pilates teacher, and has worked with children and adults around the world to support those dealing with injuries, stress, anxiety, trauma and pain. For more information head to returningtoyouyoga.com 24

he past two years, comprising the COVID-19 pandemic, on-and-off lockdowns, a plethora of restrictions and the impact of Brexit, have had an insurmountable impact on those working hard in health and social care, and this has understandably affected those at the heart of the service. A survey by the NHS of their workforce in England[2] showed a 10% increase in those feeling unwell due to work-related stress in 2020, compared with the previous year. A staggering proportion – almost half – of those surveyed reported feeling unwell because of the pressure placed upon them during the pandemic. The NHS’s surveys of workplace stress have also shown a steady increase in health and care professionals reporting illness induced by work-related stress since 2016.

A report from the Society of Occupational Medicine[3] also detailed how work-related stress, anxiety, and depression are more prevalent among health and social care professionals than those working in most other sectors. Occupational Hazards – Getting Stuck on ‘On’

Recent reviews of UK-based health and social care professionals[3] have found that ongoing pressure in places of work has led to psychological distress, compassion fatigue, burnout, post-traumatic stress disorder (PTSD), and even suicide. It wasn’t until I had completed my trauma-sensitive teacher training that I fully comprehended the impact stress can have on the nervous system, the debilitating effect it can have on an individual’s capacity to function, and the long-term

health implications. When an individual experiences something stressful or traumatic, which for healthcare professionals may happen every day, the body is flooded with the stress hormones cortisol and adrenaline, and the system becomes primed to react to the threat the person is faced with. From a healthcare perspective, this primed state is initially useful, as it allows workers to focus, tune in and react immediately to administering the required treatment to their patient.

This is a physical response that discharges its body of the fear, stress and anxiety coursing through its veins. With the dissipation of the threat and the following ‘twitch and shake’ routine, the animal rids itself of the tension the traumatic incident has manifested in its body. The nervous system then returns to its normal, or parasympathetic, resting state and the animal can carry on with life as usual.

Continued on Page 26

The system is now in ‘fight or flight’ mode. The sympathetic nervous system is activated, and the body understands that it is in a state of emergency. All non-essential body functions are switched off, and the individual is switched ‘on’. All this is happening without the individual realising; it is a situational and physiological reflex, which happens automatically. The issues listed above – of fatigue, stress, PTSD and burnout – occur when an individual is stuck on ‘on’ for a prolonged period. It’s useful to mention here how animals deal with heightened levels of stress, to illustrate the ‘on’ and ‘off’ switch within our nervous system. When a zebra escapes the jaws of death after being chased by a predator, it shakes, twitches, trembles and tremors. www.bluestreamacademy.com

Continued from Page 25

Humans, however, once a traumatic experience has ended, often do not implement this ‘shake it off’ practice (unless working with a trauma-informed practitioner who can guide them) and therefore do not rid the body of the tension created. The stress hormones remain active and the body primed for threat even when it no longer exists. This pushes the nervous system beyond its ability to regulate, so it stays overstimulated for long periods, resulting in anxiety, panic, anger, hyperactivity, PTSD, burnout and general overwhelm. Nurses, carers and doctors are in high-stress environments, witnessing and dealing with life-and-death situations at first hand every day. This, of course, impacts the nervous system as described above and results in long periods of fight or flight. This takes its toll and explains the shocking statistics surrounding burnout. Recognising the Signs

People working in health and social care are providing a valuable service that benefits the individuals and communities they interact with. This is important: without these services, and the people within them, our society would suffer. However, the health and wellbeing of the professionals themselves also matters! Their health is just as fundamental as the health of the patients they care for. From this perspective, those working in health and social care should take the time to recognise the warning signs of an unregulated nervous system so that they can take action to reset. If headaches, anxiety, fatigue, low mood, insomnia, confusion, flashbacks and restlessness have become the norm then the risk of burnout is very real. After recognising the symptoms, taking time to implement self-care and speaking up at work are the next vital steps. The Health and Social Care Committee report[2] into burnout across health and social care services describes how staff often felt unable to speak up about their safety and wellbeing due to the pandemic and the resulting strain on the system.

The report emphasises the “importance of creating a culture across the health and social care sectors where staff feel supported to speak up”, and references the National Guardian’s Office, which has established a forum for staff and appointed Freedom to Speak Up Guardians in a bid to remedy this issue. Ultimately, the change starts with the individual. Taking personal accountability and responsibility for your health is vital if you work in health or social care. Recognising the signs is the first step; from there, it’s important to communicate with your line manager about the support you require and the steps you will be taking to implement self-care. Recognising yourself as your own patient is important in order to take preventative, or reactive, steps to protect your own health and wellbeing.

www.bluestreamacademy.com

It sounds intuitive and simple enough, but taking the time to check in with yourself, whether through meditation, yoga or a prolonged period of rest, is often what is needed to reset the nervous system. Small regular practices every morning and night can bring you back to neutral, activate the resting nervous system and allow you to relax. Checking in, speaking up and taking action can make the difference between self-maintenance for health and social care professionals, or reaching the point of burnout. Health and wellness are for everyone, especially those working in health and social care 1. 2. 3.

World Health Organization. (2019). Burn-out an “Occupational Phenomenon”: International Classification of Diseases. www.who.int/news/item/28-052019-burn-out-an-occupational-phenomenon-international-classification-of-diseases (Last accessed February 2022) House of Commons Health and Social Care Committee. (2021). Workforce Burnout and Resilience in the NHS and Social Care. https://committees. parliament.uk/publications/6158/documents/68766/default/ (Last accessed February 2022) Kinman G. (2021). Managing Stress, Burnout and Fatigue in Health and Social Care. The Society of Occupational Medicine. https://www.som.org.uk/ Managing_stress_burnout_and_fatigue_in_health_and_social_care.pdf (Last accessed February 2022)

Little Tasks, Big Rewards! Article | Brady Braddock, BSA Today Editor

Mental illness is no joke – it affects people from all walks of life and often comes without warning. Overwhelming depression and anxiety can make even the smallest of tasks feel like an uphill struggle. Please remember that mental illness is often invisible, and a smile can hide a lot. That happy-go-lucky colleague who makes your day that much brighter might be fighting an inner battle that you know nothing about. Talk to people, ask them if they’re actually OK – and if you’re going through tough times, please reach out to someone, however difficult that may be, as help is at hand! Mental Health Crisis Helplines Here’s a little ditty from our Editor...

Little tasks give huge rewards,

No achievement is ever too small.

When you get up – first, make your bed. This little task puts you one step ahead. Switch on the shower and step inside.

Don’t think for a minute, lose track of time. Brush your teeth and comb your hair.

Open your wardrobe, decide what to wear. Go to the kitchen, choose something to eat.

Next, put on your coat, slip shoes on your feet.

Lock the front door, wave your loved ones goodbye. You don’t have to smile, as long as you try. Get into work, set tasks for the day.

Try not to worry if things don’t go your way.

If your day’s super hectic as your workload rolls in. Just remember, little tasks help you win!

If you’re in crisis and need to talk right now, there are many helplines staffed by trained people ready to listen. They won’t judge you, and could help you make sense of what you’re feeling. Samaritans To talk about anything that is upsetting you, you can contact Samaritans 24 hours a day, 365 days a year. You can call 116 123 (free from any phone), email jo@samaritans.org or visit some branches in person. You can also call the Samaritans Welsh Language Line on 0808 164 0123 (7pm–11pm every day). SANEline If you’re experiencing a mental health problem or supporting someone else, you can call SANEline on 0300 304 7000 (4.30pm–10.30pm every day). National Suicide Prevention Helpline UK Offers a supportive listening service to anyone with thoughts of suicide. You can call the National Suicide Prevention Helpline UK on 0800 689 5652 (open 24/7). CALM (Campaign Against Living Miserably) You can call the CALM on 0800 58 58 58 (5pm–midnight every day) if you are struggling and need to talk. Or if you prefer not to speak on the phone, you could try the CALM webchat service. The Mix If you’re under 25, you can call The Mix on 0808 808 4994 (3pm–midnight every day), request support by email using the ‘Email us’ form on The Mix website or use their crisis text messenger service.

Key Awareness Days Papyrus HOPELINEUK If you’re under 35 and struggling with suicidal feelings, or concerned about a young person who might be struggling, you can call Papyrus HOPELINEUK on 0800 068 4141 (weekdays 10am-10pm, weekends 2pm-10pm and bank holidays 2pm–10pm), email pat@papyrus-uk.org or text 07786 209 697. Nightline If you’re a student, you can look on the Nightline website to see if your university or college offers a night-time listening service. Nightline phone operators are all students too. Switchboard If you identify as gay, lesbian, bisexual or transgender, you can call Switchboard on 0300 330 0630 (10am–10pm every day), email chris@switchboard.lgbt or use their webchat service. Phone operators all identify as LGBT+. C.A.L.L. If you live in Wales, you can call the Community Advice and Listening Line (C.A.L.L.) on 0800 132 737 (open 24/7) or you can text ‘help’ followed by a question to 81066.

Ovarian Cancer Awareness Month 1 - 31 March

www.targetovariancancer.org.uk

Ovarian Cancer Awareness Month highlights the inequalities faced by thousands of women with ovarian cancer, with the aim of ensuring that women receive the best care regardless of their age, location or ethnicity.

World Kidney Day 10 March

www.worldkidneyday.org

World Kidney Day is an annual campaign to help raise awareness of how our kidneys work and the suffering caused when they don’t work properly. It aims to educate people on what kidneys do and how to improve kidney health.

Stress Awareness Month 1 - 30 April

www.stress.org.uk/national-stress-awareness-month

Stress Awareness Month aims to raise awareness of the causes of – and cures for – our modern stress epidemic. Millions in the UK are experiencing high stress levels, damaging their health, and this challenge needs to be taken as seriously as physical health concerns.

Helplines Partnership For more options, visit the Helplines Partnership website for a directory of UK helplines. Mind’s Infoline can also help you find services that can support you. If you’re outside the UK, the Befrienders Worldwide website has a tool to search by country for emotional support helplines around the world

Mental Health Awareness Week

www.mentalhealth.org.uk/campaigns/mentalhealth-awareness-week

9 - 15 May

Mental Health Awareness Week is an annual event that provides an opportunity for the whole of the UK to focus on achieving good mental health. Each year, the Mental Health Foundation continues to set the theme, organise and host the week. This year’s topic is loneliness.

International Nurses Day 12 May

www.icn.ch/what-we-do/campaigns/internationalnurses-day

www.bluestreamacademy.com

International Nurses Day is celebrated worldwide on 12 May, the anniversary of Florence Nightingale’s birth. It’s an annual celebration of nurses and an opportunity to showcase key stories from the nursing workforce in your organisation.

The Power of Positive Psychology Step away from your bathroom mirror and put that meditation cushion to one side! Positive psychology isn’t all about repeating mantras and practising mudras.

ou’ve probably heard lots about how having a positive mindset can make a difference to your life, but when you have anxiety it can be difficult to get yourself out of a cycle of worry. A study by Barts Charity[1] found that rates of anxiety in healthcare professionals increased significantly during the pandemic, as many staff worried about taking a potentially deadly disease back to their family or to vulnerable service users. The report suggested that 8 in 10 healthcare workers suffered with anxiety during the first wave. With COVID-19 continuing to pose a threat to the weakest members of society as restrictions ease, that feeling of concern is unlikely to improve any time soon. Thinking Positive For a long time, therapists have focused on helping their clients find a ‘normal’ level of satisfaction by looking at what has made them unwell. Positive psychology goes beyond this by helping anxiety sufferers focus on the good things in their life instead, so that they feel better than ever before. Positive psychology is the scientific study of what makes life worth living.[2] By shifting your focus to your strengths and attributes, you can improve your wellbeing and mental health. Here are some ways to practise positive psychology. 1. Gratitude Practice As human beings, we find it much easier to count the things that go wrong for us, rather than the good things that happen. But if you can foster a regular gratitude practice, you’ll soon start to focus on the positive by default. A great time to do this is right before bed. Think of three good things that have occurred in your day. Then, recognise your role in those things. For example, you might be grateful that a stranger held a door open for you on your way in to work. They did this simply because you were behind them on your way out of the same door. It might be a small thing, but it 30

happened just because you were there. Just because you were being you. This practice has several benefits. Firstly, it forces you to look at the good things that have happened in your day, cultivating a habit of positivity that can’t help but make you feel good about yourself. Secondly, when you place yourself in the role of the gratitude-receiver (the person who is collecting reasons to be grateful), you also anchor yourself in the positive event. You are responsible for bringing good things to yourself. That might happen with intention or without intention; but it will happen. Top tip: Writing these positive thoughts down brings an extra layer of satisfaction. If you can get those thoughts out of your head and on to paper, it gives you a whole new perspective. Your thoughts suddenly become something you can touch and look at. They become something you have created, giving you a boost before bed. When you regularly practise gratitude, you will find that you sleep better and feel more contented. It is unlikely that you will feel much difference after one attempt, but over time these small positive changes will build up to help pull you out of anxiety. Research by Martin Seligman and Tracy A Steen from the University of Pennsylvania in 2005[3] shows that this practice can have longlasting benefits.

2. The Best Version of You This positive practice encourages you to think about the very best version of your life and how that might look in the future. Imagine you have the power to create your dream life. What would that look like? Aim to do this practice for 10 minutes every day over three days. You can simply think about this or write it down, but it’s the mental image that will give you the most pleasure. Again, there are many benefits to this, aside from the fleeting feeling of aspiration that you will experience. Research by Laura King from the University of Missouri[4] has shown that this practice helps build optimism, resilience and self-efficacy. The ability to think beyond the present in a positive way is a powerful tool against anxiety. More than that, practising visualisation helps us to wish things into being. Once that goal has taken shape in your head, with regular reinforcement it can go from being an affirmation to being a self-fulfilling prophecy. If you imagine your future self in your ideal situation and keep affirming that in your mind, who knows what you will be capable of? With that kind of focus and motivation, it is difficult to feel anxious about the future.

Suzanna Hayes-Goldfinch Freelance Writer Suzanna is a freelance writer for magazines and websites with over 15 years of copywriting and editing experience. She has worked on many publications, including New Food magazine, Cycling World and InsideKent. She now writes from her home in Kent on a wide variety of projects, including website content, blog posts and marketing materials. You can find her website at www.essencecontent.co.uk.

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3. Learned Optimism If you have ever experienced cognitive behavioural therapy, you will probably have encountered learned optimism. This is a way of challenging your negative thoughts so that they become something more positive. It takes some practice, but over time it can be a very successful approach. A typical symptom of anxiety is cyclical thinking – a pattern of unhelpful thoughts that are not necessarily true but can hold you back from living your life in a healthy way. In a current health or social care setting, for example, this pattern might be feelings about COVID-19 and the worry that we will always be living in fear. The practice of learned optimism encourages you to acknowledge your feelings. Notice that they are there and then decide how true they are. You have no way of knowing that you will always be living in fear of COVID-19, so this is not a feeling based on fact. You can also acknowledge that you don’t have control over COVID-19. You do have control over your feelings. Your next step would be to change something about your feelings. For example, if you notice the thought, “I worry that we will always be living in fear,” you could adapt this to, “I acknowledge that COVID-19 is around and I will be careful, but I look forward to the day when it is no longer a concern.”

Repeat this to yourself every time you feel that niggle of doubt and watch how your train of thought changes. Say it enough, and you’ll notice that you start to believe it. 4. Be Kind to Yourself Self-doubt is normal, but it’s useful to assess the way you talk to yourself. As with learned optimism, you need to notice negative thoughts about yourself when they arise. Once you have identified them, you can reframe them as something positive. For example, “I hate that I worry all the time,” can become, “I worry because I am caring and kind.” Aim to do this every single day, so that you begin to find it easier to think positive things about yourself. Soon, you will find it becomes a habit, and your anxiety will ease. In fact, you can start right now. If you’ve read this article and thought, “That’ll never work for me” – reframe that thought! Change it to, “I could try these tips and see if they work.” All four of these techniques will help to ease anxiety and take small steps towards a happier, more positive lifestyle

1. 2. 3. 4.

Barts Charity. (2020). More Than 1 in 4 Healthcare Workers Seek Mental Health Support During COVID. www.bartscharity.org.uk/our_news/morethan-1-in-4-hospital-staff-seek-mental-health-support-during-covid (Last accessed February 2022) https://www.psychologytoday.com/gb/blog/the-good-life/200805/what-is-positive-psychology-and-what-is-it-not Seligman MEP and Steen TA. Positive Psychology Progress: Empirical Validation of Interventions. Am Psychol 2005; 60(5):410–21. https://doi. org/10.1037/0003-066X.60.5.410 King LA. The Health Benefits of Writing About Life Goals. Pers Soc Psychol B 2001; 27(7):798–807. https://doi.org/10.1177/0146167201277003

Great Food with

TWO GREEDY GALS Our local Instagram foodies, Two Greedy Gals, have created some delicious springtime treats for you to share with your family and friends. We hope you enjoy these tasty recipes – bon appétit!

HEAVENLY HUMMUS Serves 4

Time 10 mins

Directions 1. Rinse the chickpeas thoroughly under cold water. Transfer to a food processor (saving a few for topping), add 50ml of good-quality olive oil, and blitz until smooth. 2. Peel and crush your garlic cloves and add to the food processor. 3. Juice and zest both lemons, then add the juice and half of the zest to the mix, along with the tahini, cumin and water. Blitz for several minutes until the mixture becomes silky in texture – if it still looks a little too thick, slowly add more water until your desired texture is achieved. Then, season to taste. 4. To finish up, add your delicious hummus to a serving bowl and drizzle with some extra olive oil, some chickpeas and a dusting of paprika.

Ingredients • 1 can chickpeas (240g when drained) • 50ml olive oil (plus extra for serving) • 2 garlic cloves • 2 small lemons

• • • • •

45g tahini ½ tsp dried cumin 30ml water Salt to taste Paprika (for serving)

Nutritional Values Per Serving

www.bluestreamacademy.com

SUPER SIMPLE OLIVE FLATBREAD Makes 6

Time 35 mins

Directions 1. Grab a large mixing bowl, add in all your ingredients and mix until everything is combined as one. Dust a clean surface with your extra flour and pour out your mixture ready for kneading. 2. Knead the mixture for a couple of minutes until it forms a nice dough. Then place it into a floured bowl, cover with a tea towel and leave for around 20 minutes. 3. After 20 minutes, dust your work surface with flour again, take the rested dough, roll it out with a rolling pin and divide it into 6 equal pieces. Flatten and round the pieces so they are around ¼ inch thick.

Ingredients • 175g self-raising flour (plus extra for dusting) • ½ teaspoon baking powder

• 175g natural yoghurt

• Handful of green olives, (finely chopped) • Olive oil for cooking

4. When you’re ready to cook your flatbreads, lightly oil and heat a griddle pan. Once very hot, place a flatbread in the pan and cook for a couple of minutes until it starts to brown, then flip and cook the other side until it’s nice and golden. These are the perfect addition to our heavenly hummus, or why not try topping with sun-dried tomatoes, feta and olive oil for a quick and easy lunch?

Nutritional Values Per Serving

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SMOOTHIE BOWLS Directions

Makes 1

Time 10 mins

1. Add the frozen banana and almond milk to a blender and blend until smooth (if needed, add a splash more almond milk). Ingredients

Topping Suggestions

• 1 large banana (frozen and chopped)

• Sliced kiwi

• 2 tbsp almond milk (plus extra if needed) • 70g frozen berries

• Sliced strawberry • Blueberries

• Frozen raspberries • Chia seeds • Granola

2. Add your frozen berries of choice and blitz – you should end up with a consistency like ice cream or sorbet. 3. Spoon your smoothie mixture into a bowl and get creative with your toppings! We love adding a mix of fresh and frozen fruit, granola and cashew butter – yum!

• Coconut flakes Nutritional Values Per Serving

www.bluestreamacademy.com

HOMEMADE LEMONADE Serves 4

Time 20 mins

Directions 1. Zest the lemons using a fine grater, and then juice them into a watertight container or jug. 2. Add the lemon zest, sugar, and still water to a pan. Slowly bring to the boil, stirring gradually while the sugar dissolves. 3. Once the liquid has turned to a boiling syrup, add the lemon juice and remove straight from the heat. Leave to cool, and then strain into your chosen jug. 4. Add the chilled sparkling water and ice to serve.

Ingredients • 4 lemons

• 84g granulated sugar

• 700ml sparkling water (chilled)

• 300ml still water

Nutritional Values Per Serving

Blue Stream Academy

DO IT ALL FOR YOU! Are you getting the best possible training experience for your money? Want to move training provider, but don’t have the time to switch? Why not let Blue Stream Academy do it all for you?

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SEND OVER YOUR DOCUMENTS

WE’LL UPLOAD THEM FOR YOU

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Don’t just take our word for it, take a read through our customer feedback below!

“

The Blue Stream team have been a delight to work with, with quick responses to any queries. The direct support provided to Gloucestershire Locums for their training has really relieved pressure on Gloucestershire Primary Care Training Hub and been invaluable. Nothing is too much trouble, and the whole team is professional, friendly and highly responsive.

Mark Thompson Development Support Manager Gloucestershire Primary Care Training Hub

“

As a business of 6 care homes and a domiciliary care service, it has been essential for us to ensure our staﬀ teams are fully trained – particularly during the challenges that have arisen alongside the pandemic. The team at Blue Stream Academy have been there to support us at every turn; they are incredibly friendly, always respond in a short period of time and will answer any query we throw at them. The platform itself is outstanding in the services and reporting tools it oﬀers, but the customer service is what makes me recommend Blue Stream to others in the care sector; in my experience it is unmatched. From Ascot Care: thank you to Blue Stream, for your endless support.

As an organisation we are really impressed with the user friendly nature of the online training modules, and the platform is now thoroughly embedded across our organisation. The management system oﬀers a quick and easy way for training records to be regularly monitored across departments and the organisation as a whole to ensure continued compliance. The set-up process was smooth and eﬃcient and any support that we have needed from Blue Stream along the way has always been provided promptly.

Beth Reeve Ascot Care

Josie Bades Bury Hospice

For more information, get in touch with us on 01773 822549 or at info@bluestreamacademy.com

@BlueStreamNews As the brighter nights approach and winter draws to a close, Team BSA thought it would be the perfect time to let you know what we’ve been up to. Over the festive period, our team prepared and delivered more than 40 personalised presents to a care home in our local community as part of the Christmas Shoebox Appeal. The residents were delighted with their gifts, with one lady telling us that the experience had made her Christmas!

Events Calendar

11 12

MAR

05 Pulse PCN London APRIL Novotel London West International Ctre, Shortlands, London, W6 8DE 10

Care Roadshow Aintree Racecourse Ormskirk Rd, Aintree, Liverpool, L9 5AS

18 19

Residential Home Care Show ExCel London Royal Victoria Dock, 1 Western Gateway, London, E16 1XL

Care Roadshow Birmingham Villa Park Stadium Villa Park, Trinity Road, Birmingham, B6 6HE

MAY

We were also proud to launch the first competition on our discussion forum, Blue Voice. Blue Voice is the latest feature on Blue StreamNet, and it enables users all over the UK to connect with likeminded trainees, take part in competitions and network with professionals in their sector, all from their BSA dashboard. Have you checked out the latest Blue Voice competition?

Ace 2022 Event Business Design Centre 52 Upper Street, Islington, London, N1 0QH

CMM Insight Care Conference JUNE Leeds Oulton Hall Rothwell Lane, Oulton, Leeds, LS26 8HN

Come and say hi !

Team BSA are also busy preparing for an exciting few months, as we’ll be attending exhibitions and events across the country. Check out our events calendar to see where we’ll be, and come and say hi to our team! 38

LiveChat Lounge We checked in with our enthusiastic support team to see what questions they’ve been answering in our LiveChat feature. Here’s one they shared with us for this edition:

Hi there,

We have just implemented the Blue People HR system and it looks like we will be going through a period of increased recruitment over the next few months, as we will be creating a lot of new positions within the home. Do you have anything on the management system which would allow us to externally advertise our vacancies and help with hiring? Dawn, HR Assistant, Care Home, Cumbria

www.bluestreamacademy.com

Hi Dawn,

Thank you for your query. I’m pleased to confirm that a feature called Blue Recruit is already available on our management system. This feature allows organisations to post job vacancies on the live Blue Recruit website, at no extra cost. To activate this feature on your account, you will just need to assign a recruitment administrator at your organisation. To do this, head to Management > Staff > Staff List > Edit and then tick ‘is Recruitment Administrator’ and save those changes. When they next log in, they’ll see a new Recruitment tab on their dashboard. In here, they can create a vacancy, post the job, and review, rate and shortlist applicants. I hope this helps, and if you would like any further information, please contact our support team via email, LiveChat or telephone. Many thanks, Team BSA