BSA
Today Blue Stream Academy’s Healthcare & Lifestyle Magazine Summer 2022 | Issue 14
Look Who’s Talking:
Suntan Risks — More Than Skin Deep Dr Roger Henderson
We’re Celebrating 10 Years of Blue Stream Academy! A Spotlight On:
Reducing Costs and Saving Energy
BSA Today Issue 14 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, 15 & 16 Riverside Business Centre Foundry Lane Milford Derbyshire DE56 0RN 01773 822549 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
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In this issue BSA Today | Issue 14
From the Editor's Desk...
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ummer is finally here, and we couldn’t be happier at Blue Stream HQ – it’s such a positive time of year, with the bright days, the warm weather and the smell of sun cream; it’s just blissful. That being said, health and social care never rests, so it’s business as usual for BSA Today. They say that the only time you should ever look back is to see how far you’ve come – well, we’ve certainly come a long way. In April this year, we celebrated 10 years of Blue Stream Academy – it was an awesome celebration powered by nostalgia and optimism in equal measures.
As with our training, every aspect of BSA Today is important to us as we continue to forge stronger links with respected professionals and organisations nationwide – covering important topics in our own
unique format. Our content has continued to receive praise from readers who appreciate the knowledge, passion and enthusiasm of our contributors, echoing our message of giving health and social care a voice. On behalf of the team, we hope you enjoy reading our summer selection of exclusive content.
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 Marie Anne Essam Clinical Lead and Ambassador for Social Prescribing
Brady Braddock | Editor Sian Ratcliffe | HR
Lewis Cowlishaw | Content Development Stuart Walsh | Information Security ART & DESIGN
Dr Roger Henderson Senior GP, Media Advisor, and Health Writer
Bethany Cooper Health Sciences/Medical Writer and Emergency Nurse www.bluestreamacademy.com
Courteney Barlow-Ferguson | Graphic Designer Craig Goodall | Creative Services COMMUNICATIONS
Abi Bowler | Marketing & Media
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Cover Stories
We’re celebrating 10 Years of Blue Stream Academy Thank you for your support!
A Spotlight On... Reducing Costs and Saving Energy
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We look at progress the NHS is making towards achieving net zero, shining the spotlight on how one hospital trust has cut carbon emissions while improving experiences for patients.
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We’re Celebrating 10 Years of Blue Stream Academy!
All Things Blue Stream 06
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.
Over a quarter of a million trainees now use Blue Stream Academy’s training and management solutions nationwide. Join us on a trip down memory lane to see how it all began, as we look at some of our key milestones over the past 10 years.
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Eye on Healthcare
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Data Watch: What to Do When the Cyber Threat is Heightened
Following Russia’s invasion of Ukraine, the National Cyber Security Centre (NCSC) is calling on UK organisations to strengthen their online defences. Here, we look at the NCSC’s guidance on steps your organisation should take.
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@BlueStreamNews
With 2022 now in full swing, we recap the last few months at Blue Stream Academy and talk news and events with Team BSA. Plus, we have some key dates for your diary.
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LiveChat Lounge
Check in with Blue Stream Academy’s friendly support team to hear what our customers have to say about our suite of interactive eLearning modules and Management of Information System (MIS).
Data Watch: Glossary
Some of the terms in Data Watch might not be familiar if you don’t work in data security. If you’re curious about what they mean, check out our glossary. 04
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Lifestyle & Wellness 29 Caring for Carers
A firm favourite with our readers, Dr Marie Anne Essam shares a passionate and personal article exclusively with BSA Today. Using her insight as a GP, Dr Essam talks about the need to recognise the pivotal role that carers play in patient wellbeing.
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The Importance of Hydration
With the summer heat comes an endless thirst to quench, and it’s no secret that the human body depends on water to survive. Here, medical writer and emergency nurse Bethany Cooper explains why good hydration is one of the most important aspects of our diet.
38 Great Food with Two Greedy Gals
www.bluestreamacademy.com
Look Who’s Talking
Suntan Risks — More Than Skin Deep
We’re proud to introduce senior GP, media advisor and health writer Dr Roger Henderson as our latest Look Who’s Talking author.
R e a d o n Pa
ge
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Instagram’s Two Greedy Gals are back with some sensational summertime treats that they’ve created exclusively for BSA Today. Check out their green pesto pasta salad, big green sandwich and refreshing peach and raspberry iced tea – delicious!
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As summer begins, Dr Henderson talks about the dangers of tanning pills and injections and debunks the myth that sun-free ways of tanning are risk-free. 05
Thirty Minutes’ Exercise Won’t Counteract Sitting All Day, But Adding Light Movement Can Help – New Research
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t’s recommended we do at least 30 minutes of exercise a day – or 150 minutes a week – to stay healthy.[1] But 30 minutes accounts for just 2% of the day. And many of us spend most of the rest of the time sitting. Research shows that sitting can be bad for our health in many ways
– with some even suggesting it’s as bad for us as smoking.[2] And our new study[3] has revealed that 30 minutes of daily exercise is not enough to overcome the health risks of sitting too much. But we also revealed that with the right balance of time spent exercising and moving, it may be possible to counteract the negatives of sitting.
We combined data from six different studies from the UK, US and Sweden, looking at a total of over 130,000 adults. Each of the studies used a physical activity monitor (like a Fitbit) to measure a person’s movements and sitting time throughout the day. Each study then followed the participants for an average of 4 to 14 years to track whether any participants died. As expected, we found that 30 minutes of daily exercise decreased the risk of early death by up to 80% for those who also spent less than 7 hours a day sitting. But it didn’t have the same effect for people who spent between 11 and 12 hours a day sitting. In other words, it’s not as simple as checking off the exercise box on the to-do list. A healthy lifestyle requires more than 30 minutes of exercise if you spend a lot of time sitting.
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For those who sat a lot, 30 minutes of daily exercise would only lower risk of early death by 30% if combined with 4 to 5 hours of light movement a day (such as shopping, cooking or yard work) – spending less than 11 hours sitting in total. We can think of this mixture of light activity, exercise and sitting as a ‘cocktail’. And when it comes to living an active lifestyle, there are different recipes you can choose to to get the same benefits. For example, one person might exercise daily for 30 minutes, move throughout the day for about 6 hours doing activities like housework or walking to work, but spend around 10 hours a day sitting. They would have the same risk of death as someone who exercised 55 minutes daily, moved throughout the day for about 4 hours, and sat for about 11 hours. In other words, different combinations of exercise and movement can be used to offset the harms of sitting.
Personalised Recommendations
Our findings provide new insights on what constitutes a healthy and active lifestyle. For decades, scientists have studied the health benefits of exercise – but this research has largely ignored the fact that how you spend the rest of the day also matters. Instead of the recommendation that everyone should strive to achieve 30 minutes of daily exercise, our results show physical activity recommendations can be more personalised. People can adopt a mixture of activity that works best for them.
Authors Sebastien Chastin Professor Health Behaviour Dynamics of People, Places and Systems, Glasgow Caledonian University Keith Diaz Assistant Professor of Behavioral Medicine, Columbia University The original article can be found at: https://theconversation.com/ thirty-minutes-exercise-wontcounteract-sitting-all-day-but-addinglight-movement-can-help-newresearch-160577
For many of us, our jobs require us to sit for 8 hours or more a day. But when you get home, exercising for 1 hour and doing light activities for a few hours in the evening (such as housework or yard work) could still yield health benefits. Continued on Page 08
The more you sit, the more movement you need. www.bluestreamacademy.com
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Gardening and yard work are easy ways to get more light activity into your day. Continued from Page 07
If you’re a stay-at-home parent who’s typically too busy to get to the gym, moving around throughout the day while doing essential tasks (such as playing with the kids or putting away groceries) can also improve your health. The caveat, however, is that our study found that 6 minutes of light activity was equivalent to 1 minute of moderate to intense exercise. So you would need to do 3 hours of light activity to yield the same benefit as 30 minutes of exercise. While our study adds important new insights about the ideal balance of movement, we are missing one ingredient: sleep. It’s unclear if the health benefits of exercise and movement are the same if you don’t get enough sleep. As well, key questions on how to spend your day – like whether you should wake up 30 minutes earlier to exercise – still need to be studied.
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Ultimately, our findings show that a healthy and active lifestyle is more than just exercising for 30 minutes, and that there are many different ways of achieving better health and longevity. While exercise still provides the best ‘bang for your buck’ in terms of the amount of time required, our findings are still good news for people who may not have the time, ability or desire to exercise. The road to an active lifestyle is more accessible and achievable than we thought – and is not just for gym regulars
1. 2. 3.
Bull FC, Al-Ansari SS, Biddle S et al. World Health Organization 2020 Guidelines on Physical Activity and Sedentary Behaviour. Br J Sports Med 2020; 54(24):1451–62. http://dx.doi.org/10.1136/bjsports-2020-102955 Beck AM, Eyler AE. Is Sitting Really the New Smoking? Am J Public Health 2019(August):e11. https://ajph.aphapublications.org/doi/10.2105/AJPH.2019.305183 (Last accessed May 2022) Chastin S, McGregor D, Palarea-Albaladejo JP et al. Joint Association Between Accelerometry-measured Daily Combination of Time Spent in Physical Activity, Sedentary Behaviour and Sleep and All-cause Mortality: A Pooled Analysis of Six Prospective Cohorts Using Compositional Analysis. Br J Sports Med 2020; 55(22):1277–85. http://dx.doi.org/10.1136/bjsports-2020-102345
We’re Celebrating 10 Years of Blue Stream Academy! Established in 2012 with the innovative idea to standardise healthcare training to ensure the consistent delivery of quality care through better staff education and development, Blue Stream Academy has progressed to develop the market-leading platform that we offer today. Over the past 10 years, more than 5000 healthcare providers have unlocked the benefits of the Blue Stream system, supporting over a quarter of a million trainees with a library of high-quality and up-to-date eLearning resources. That’s not all! To provide a complete business solution suitable for any health or social care provider, we’ve developed and integrated the following key system features: • Management of Information System (MIS) • Blue People HR System • Care Certificate Solution • Blue Voice Discussion Forum • Blue Connect Diary and Video-Conferencing System • Blue Check DBS Checking System • Blue Recruit Recruitment System Our mission has always been, and always will be, to assist with the delivery of the highest quality patient care through better staff education, experience and development. So, with a decade to reflect on, we thought it was only right to look back on what we’ve achieved. Continued on Page 10
www.bluestreamacademy.com
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Continued from Page 09
The Blue Stream Academy journey has been an amazing one so far. We decided from the beginning that we would listen to the needs of those using our system in our quest for excellence. We believe, and feedback confirms this, that we have developed a comprehensive and informative learning experience. We continue to develop new and exciting features to further enhance our suites and we are always eager to receive any suggestions or requirements from our customers. Shelley McCart CEO at Blue Stream Academy 10
“Congratulations on the 10 years – how quickly they’ve flown. From year 0, Team BSA has gone from strength to strength and has provided a brilliant training platform for practices, which has been very much appreciated. I’m that old that I remember the very start and I’m very proud to have been with BSA from the beginning and wouldn’t be without this excellent training service provision. Thank you so, so much for the surprise gift which I received yesterday – it made my day! Here’s to the next decade and beyond!” Vera Practice Manager, Bolton
Scan me !
Scan the QR code above to view the story so far! www.bluestreamacademy.com
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Presenting Our Blue StreamNet Platform Training & Management Solutions at Your Fingertips
Over the years, as the healthcare landscape has changed and organisations have needed to adapt, many new challenges have arisen for managers, their organisations and the staff who power them. At Blue Stream Academy, we have listened carefully to our customers to ensure that the system we provide contains the features that are needed. Our aim has always been to improve user experience, reduce wasted time and be as economic as possible. We have now developed Blue StreamNet to help streamline an organisation’s business needs into one easy-to-use platform. It couldn’t be easier!
Blue Stream eLearning
Blue Check
DBS Checking System
Blue Hub MIS
Blue Connect
Video Conferencing
Blue People HR System
Blue Voice
Discussion Forum
Blue Recruit
Recruitment System
Care Certificate
Paperless Care Certificate
Our team is on hand to discuss the different ways that we can support your organisation and transform your daily processes. Please get in touch by emailing info@bluestreamacademy.com to find out more about our effective, efficient and easy-to-use platform.
Look Who’s Talking:
Suntan Risks — More Than Skin Deep As the summer months arrive, more and more people are jetting off for their first overseas holiday since the start of the COVID-19 pandemic. Many of them will say they are looking forward to a well-earned break or to ‘get some sun’, and they might have tried to get a suntan in advance by using a tanning booth.
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art of this taps into one of the biggest health myths around, which is that a bronzed and tanned appearance is linked to good health and wellbeing.
Dr Roger Henderson Senior GP, Media Advisor and Health Writer Dr Roger Henderson has worked in the NHS for almost 40 years and has been a GP since 1990. He is a health broadcaster, conference speaker and columnist for many national newspapers and magazines, including the Times and Spectator. He is the consultant clinical writer for the Healthily website and a judge for the annual national GP awards. His spare time is spent wondering what it would be like to have some spare time. His website is www.drhenderson.co.uk.
www.bluestreamacademy.com
The use of tanning salons in the UK is continuing to increase. A major motivating factor in people wanting to get a suntan is to enhance their general appearance to others[1] and make them more attractive to potential partners if they are looking for a relationship. In adolescent women, the desire to tan is driven by appearance and mood enhancement;[2] young men who are bullied, are overweight or have low selfesteem are also more likely to tan.[3] Ninety per cent of women perceive tanned skin as more attractive than pale skin.[4]
this is actually evidence of visible DNA injury to your skin, damaging your skin cells and speeding up the visible signs of ageing. Worse than this, tanning significantly increases your risk of all skin cancers, such as basal and squamous cell cancer and melanoma. This damage starts with your very first tan and every time you subsequently expose your skin to UV rays the damage increases, creating more genetic mutations and greater risk. Continued on Page 14
There is – of course – a gaping hole in this narrative: there’s no such thing as a safe or healthy tan. In fact, it’s the complete opposite. When your skin reacts to ultraviolet (UV) radiation from the sun or a tanning bed, 13
Continued from Page 13
One study that looked at women diagnosed with melanoma before the age of 30 found that 97% of them had used tanning beds.[5] The risk of melanoma is also increased by up to 20% for those who have ever used indoor tanning devices.[6] Worldwide, there are more skin cancer cases due to indoor tanning than there are lung cancer cases due to smoking[7] – a truly remarkable statistic – and in the UK, numbers of melanoma cases have rapidly risen to the point where it is now the fifth most common cancer overall.[8] A tan starts when the skin is exposed to UV radiation and genetic damage is triggered to cells on its outermost layer. To try to prevent further damage, the skin produces the pigment melanin, which darkens the skin and so causes what we know as a tan. Different types of skin are at greater risk of sun damage, although all types of skin are susceptible to it. The paler your skin, the greater your risk of sun damage and skin cancer.
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Having a tan doesn’t increase your protection from sun damage – it’s your skin type, as determined by your genes, that matters. Despite all these salutary facts, having a ‘healthy’ tan appears to be embedded in the mindset of many people – especially younger adults – and this has led to the rise in demand for so-called tanning pills and tanning injections as a ‘sun-free’ way of getting that desirable healthy glow. Easily obtained online, such products are promoted on social media, often without any balanced understanding of their health risks that would help consumers weigh up whether they are safe. Tanning pills are non-prescription formulations with variable levels of different ingredients in them. The three usual constituents are canthaxanthin, betacarotene and tyrosine.[4] • Canthaxanthin is a carotenoid, which is a group of yellow, orange or red pigments. It occurs in mushrooms and crustaceans and is used as food colouring. When ingested, it is deposited in the fat under the skin, creating an orange-brown appearance. Tanning pills containing canthaxanthin have been banned by the American Food and Drug Administration because of side effects including hepatitis, retinopathy (yellow deposits on the retina) and aplastic anaemia,[4] a condition that stops your body producing enough blood cells and can cause death.
All these ingredients also have the potential to be toxic to an unborn baby. Tanning pills are banned in the UK, so they shouldn’t be used by anyone.[9]
TYPES OF MOLES
TO CHECK FOR
• Beta-carotene is a different type of carotenoid, usually obtained through eating fresh fruit and vegetables, which can cause a yellow pigmentation in the skin. High doses are associated with an increased risk of lung cancer in smokers.[4] • Tyrosine is a precursor to the production of melanin. Users claim that by boosting the level of tyrosine in the body, more melanin is produced. However, there is no evidence to support this claim and tyrosine pills haven’t been shown to work.[4]
Tanning injections – commonly known by the name ‘melanotan’ – have become increasingly popular despite multiple national health organisations warning against their use and the UK government making it illegal to sell unlicensed melanotan injections. The majority of people who use melanotan injections do so to try to achieve a tanned look. However, it is also claimed that these injections assist with weight loss and improve sexual performance, which has given them the nickname ‘the Barbie drug’.[10] Usually purchased from the internet or through gyms, spas and tanning salons, melanotan injections carry the usual risks of any self-administered agent (such as anabolic steroids) associated with sterility, chemical composition and dosage. There is also the risk of viral infections (such as hepatitis C or HIV) from needle-sharing. Melanotan is also available to purchase online in the form of a nasal spray, but injections and sprays alike carry the risk of multiple side effects, including nausea, dizziness, kidney dysfunction and rhabdomyolysis (muscle wastage).[10] Many online stores promote melanotan as a quick and easy way to get a tan, making unsubstantiated claims about its safety and effectiveness, but health bodies in multiple countries have issued warnings to the public about their safety. If you are someone who feels they need tanned skin to look and feel good, there’s no way of getting around one simple hard fact – the best way to protect your skin is to avoid tanning entirely, including from sunbeds, tanning pills and injections.
Continued on Page 16
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Cafri G, Thompson JK, Roehrig M et al. An Investigation of Appearance Motives for Tanning: The Development and Evaluation of the Physical Appearance Reasons For Tanning Scale (PARTS) and its Relation to Sunbathing and Indoor Tanning Intentions. Body Image 2006; 3(3):199–209. Lewandowski GW Jr. (2020). Will a Tan Make You More Attractive? What Research Tells Us About Tanning and Attractiveness. Psychology Today [blog], 17 July. www.psychologytoday.com/gb/blog/the-psychology-relationships/202007/will-tan-make-you-more-attractive (Last accessed April 2022) 3. Blashill AJ, Traeger L. Indoor Tanning Use Among Adolescent Males: The Role of Perceived Weight and Bullying. Ann Behav Med 2013; 46(2):232–6. 4. Garone MG Jr, Howard J, Fabrikant J. A Review of Common Tanning Methods. J Clin Aesthet Dermatol 2015; 8(2):43–7. 5. Skin Cancer Foundation. (2021). Risk Factors: Tanning. www.skincancer.org/risk-factors/tanning (Last accessed April 2022) 6. Boniol M, Autier P, Boyle P, Gandini S. Cutaneous Melanoma Attributable to Sunbed Use: Systematic Review and Meta-analysis. BMJ 2012; 345:e4757. https://doi.org/10.1136/bmj.e4757 7. Wehner MR, Chren M-M, Nameth D et al. International Prevalence of Indoor Tanning A Systematic Review and Meta-analysis. JAMA Dermatol 2004; 150(4):390–400. 8. Cancer Research UK. (2020). What is Melanoma? www.cancerresearchuk.org/about-cancer/melanoma/about (Last accessed April 2022) 9. NHS. (2021). Is it Safe to Use Fake Tan During Pregnancy? www.nhs.uk/common-health-questions/pregnancy/is-it-safe-to-use-fake-tan-during-pregnancy (Last accessed April 2022) 10. Habbema L, Halk AB, Neumann M, Bergman W. Risks of Unregulated Use of Alpha‐melanocyte‐stimulating Hormone Analogues: A Review. Int J Dermatol 2017; 56(10):975–80. https://doi.org/10.1111/ijd.13585
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To keep your skin as protected as possible:
Spend time in the Never allow your skin shade when the to burn. sun is strongest and when your shadow is shorter than you are (typically between 11am and 3pm).
Cover up with loose clothing and sunglasses.
Always use a sunscreen of at least factor 30 when in the sun and apply it regularly. Make sure it’s not past its expiry date: most sunscreens have a shelf life of 2 to 3 years.
Wear a largebrimmed hat.
If in doubt, it’s always worth remembering one thing: beauty may be skin deep, but skin cancer isn’t. 16
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, 09:00 - 17:30pm www.bluestreamacademy.com www.bluestreamacademy.com
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A Spotlight On... Reducing Costs and Saving Energy We all have a vital role to play in reducing our carbon footprint to help tackle climate change, and the NHS was the first health service in the world to commit to reaching carbon net zero.[1]
O Lewis Cowlishaw Content Development Manager at Blue Stream Academy Lewis Cowlishaw 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 care sector, and having a devoted following of passionate users certainly helps too.”
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ne year on from making that commitment, the NHS has already reduced its emissions by the equivalent of powering 1.1 million homes a year.[1] The Delivering a Net Zero NHS report demonstrated that the NHS has exceeded the 2020 targets outlined in the Climate Change Act. But to meet the organisation’s commitment to net zero, every part of the NHS needs to work together.[2]
Over 1.3 million people work in the English NHS alone.[3] If we consider the millions of people who work in social care, as well as the organisations that support the sector by providing goods and services, the figure will be much higher. All of us can play a significant role in reducing the sector’s carbon footprint, limiting our impact on the environment while making a significant difference to public health.
We’re already making many positive changes, at home and at work, as more of us choose to reduce our negative impact on the environment. There’s plenty we can do – from saving energy, recycling more packaging and using less plastic, to reducing emissions from travel, creating more green spaces and improving logistics.
It’s encouraging that often, simple changes can be highly effective:[3] • Using a refillable bottle for a year saves 64kg of CO2 compared with single-use plastic bottles. • Turning off equipment and lights and controlling temperatures can lead to great savings: a pilot project at Barts Health managed to save 2,200 tonnes of carbon a year across six sites. • Saving one car journey a week of 16.7 miles (the average daily commute) reduces the equivalent of 230kg of CO2 per person over a year. • Using the right bin saves the amount of waste sent to landfill: In 2017, the NHS sent 15% of its waste to landfill, a total of 47,000 tonnes, a weight equal to 650 times the Space Shuttle. A Case Study: Oxford University Hospitals NHS Trust
Healthcare organisations around the country are coming up with inspiring ways to help reach the goal of net zero. One of these is Oxford University Hospitals NHS Foundation Trust (OUH), which found an innovative way of reducing its carbon footprint while delivering life-saving drugs to patients.[4] The Issue
Around 4% (9.5 billion miles) of all road travel in England relates to the NHS, contributing around 14% of the system’s total emissions. Traffic in and around Oxford is often congested which causes delays for vans delivering critical and patient-specific medical supplies, such as chemotherapy drugs, antibiotics and intravenous nutrition products to OUH sites.
www.bluestreamacademy.com
This unpredictability has put pressure on NHS staff to deliver treatment in a timely manner and has negatively affected patient experience. The Trust needed to find a more efficient way of getting key medical products to hospital sites and patients, that also benefited the environment. Continued on Page 20
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Continued from Page 19
The Solution
A pharmacist at OUH initiated discussions with their local supplier (Baxter and bike-courier firm Pedal and Post) to set up an alternative transport solution for chemotherapy drugs. Life-saving products are now delivered by cycle couriers to wards, day treatment areas and pharmacies at two sites in Oxford, saving time, money and generating cleaner air. Using cycle couriers has reduced the impact of external factors such as peak hour traffic and roadworks on delivery times.
Professor Meghana Pandit, Chief Medical Officer at the Trust, said: “Having a more effective and timeefficient delivery system in place helps us support our hardworking staff and deliver the best care possible to our patients.” This case study is available on the Greener NHS website. Visit the site to read other inspiring examples of how NHS organisations are reducing emissions, or to share your own success stories! Want to Find Out More?
Bhulesh Vadher, Chief Pharmacist at the Trust, said “The new bike courier service has taken away unnecessary extra pressure on NHS staff and has considerably reduced the delivery time. Using bikes instead of cars or vans is also better for the environment and the Oxfordshire community.”
If you’d like to understand more about carbon and how to save energy at your organisation, our training module Reducing Costs and Saving Energy is available to all our customers. The module explains why carbon management is important, outlines the principles of good carbon housekeeping, and looks at an organisational carbon-management plan.
The Impact
Up to the end of August 2021, over 51,000 products had been transported using the bikes since the first delivery was made at the start of August 2020. Delivery time to the two sites has halved, leading to improved services for patients. The eco-friendly improvements deliver an estimated saving of up to 10 tonnes of carbon emissions per year, as well as improving air quality by eliminating pollution produced from diesel engines.
To find out more, please phone us on 01773 822549 or visit our websites LiveChat feature at bluestreamacademy.com. This article contains public sector information licensed under the Open Government Licence v3.0. 1. 2. 3. 4.
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NHS. Greener NHS. www.england.nhs.uk/greenernhs (Last accessed May 2022) NHS. System Progress. www.england.nhs.uk/greenernhs/whats-already-happening (Last accessed May 2022) NHS. Take Action. www.england.nhs.uk/greenernhs/get-involved (Last accessed May 2022) NHS. Green Transport Delivers Life-saving Drugs and Improves Patient Experience. www.england.nhs.uk/greenernhs/whats-already-happening/green-transport-delivers-life-saving-drugs-and-improves-patient-experience (Last accessed May 2022)
Actions to Take When the Cyber Threat is Heightened In this issue, Stuart curates guidance from the National Cyber Security Centre to help BSA Today readers improve their information security practices and reduce the cyber threat for all health and social care organisations.
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n response to Russia’s invasion of Ukraine, the National Cyber Security Centre (NCSC) has called on UK organisations to strengthen their online defences.
“While we are unaware of any specific cyber threats to UK organisations in relation to events in Ukraine, we are monitoring the situation closely and it is vital that organisations follow the guidance to ensure they are resilient,” explains Paul Chichester, the NCSC’s Director of Operations, in a statement published alongside the latest guidance.[1] With this in mind, we’re strongly encouraging health and social care organisations to reduce their risk of becoming victims of an attack. The following guidance from the NCSC explains in what circumstances the cyber threat might change and outlines the steps that organisations can take in response to a heightened cyber threat. If you’re curious about what any of the technical terms in this article mean or you want to know what your data security team are talking about, turn to the Glossary on page 26. Balancing Cyber Risk and Defence
The threat an organisation faces may vary over time. At any point, there is a need to strike a balance between the current threat, the measures needed to defend against it, the implications and cost of those defences and the overall risk this presents to the organisation. There may be times when the cyber threat to an organisation is greater than usual. Moving to heightened alert can: • Help prioritise necessary cyber security work. • Offer a temporary boost to defences. • Give organisations the best chance of preventing a cyber attack when it may be more likely, and recovering quickly if it happens.
Continued on Page 22
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Actions to Take
The most important thing for organisations of all sizes is to make sure that the fundamentals of cyber security are in place to protect their devices, networks and systems. The actions below are about ensuring that basic cyber hygiene controls are in place and functioning correctly. This is important under all circumstances but critical during periods of heightened cyber threat.
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Factors Affecting an Organisation’s Cyber Risk
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.
An organisation’s view of its cyber risk might change if new information emerges that the threat has heightened. This might be because of a temporary uplift in adversary capability, if for example there is a zero-day vulnerability in a widely used service that capable threat actors are actively exploiting. Or it could be more specific to a particular organisation, sector or even country, resulting from hacktivism or geopolitical tensions. These diverse factors mean that organisations of all sizes must take steps to ensure they can respond to these events. It is rare for an organisation to be able to influence the threat level, so actions usually focus on reducing your vulnerability to attack in the first place and reducing the impact of a successful attack. Even the most sophisticated and determined attacker will use known vulnerabilities, misconfigurations or credential attacks (such as password spraying, attempting use of breached passwords or authentication token reuse) if they can. Removing their ability to use these techniques can reduce the cyber risk to your organisation.
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An organisation is unlikely to be able to make widespread system changes quickly in response to a change in threat, but organisations should make every effort to implement these actions as a priority. Check Your System Patching
• Ensure your users’ desktops, laptops and mobile devices are all patched, including third party software such as browsers and office productivity suites. If possible, turn on automatic updates. • Check to make sure firmware on your organisation’s devices is also patched. Sometimes this is implemented in a different way to updating software. See the NCSC’s Device Security Guidance. • Ensure your internet-facing services are patched for known security vulnerabilities. Internetfacing services with unpatched security vulnerabilities are an unmanageable risk. • Ensure, where possible, that your key business systems are all patched. Where there are unpatched vulnerabilities, ensure that other mitigations are in place. See the NCSC’s guidance on Vulnerability Management. • Also review existing business cases for known unpatched systems in view of the heightened threat.
Verify Access Controls
• Ask staff to ensure that their passwords are unique to your business systems and are not shared across other, non-business systems. Make sure passwords for your systems are strong and unique, and that any which are not are changed immediately. See the NCSC’s password guidance: Three Random Words. • Review user accounts and remove any old or unused accounts. If you have multi-factor authentication (MFA) enabled, check it is properly configured. Make sure it is enabled on systems and user accounts according to your policies. • Carefully review any accounts that have privileged or administrative access and remove old, unused or unrecognised accounts. Ensure that accounts that have privileged access or other rights are carefully managed and, where possible, use MFA. Privilege can refer to system administration, but also to access to sensitive resources or information, so ensure resources are also adequately protected. • Consider your overall system administration architecture to better understand your risk in this area. See the NCSC’s guidance: Secure System Administration. Ensure Defences are Working
• Ensure antivirus software is installed and regularly confirm that it is active on all systems and that signatures are updating correctly. • Check your firewall rules are as expected – specifically check for temporary rules that may have been left in place beyond their expected lifetime. • The NCSC’s Device Security Guidance can help with secure configuration of common desktops, laptops and mobile devices. Logging and Monitoring
• Check that there is an offline copy of your backup – and that it is always recent enough to be useful if an attack results in loss of data or system configuration. • Ensure machine state and any critical external credentials (such as private keys, access tokens) are also backed up, not just data. Incident Plan
• Check your incident response plan is up to date. See the NCSC’s guidance on Incident Management. • Confirm that escalation routes and contact details are all up to date. • Ensure that the incident response plan contains clarity on who has the authority to make key decisions, especially out of normal office hours. • Ensure your incident response plan and the communication mechanisms it uses will be available, even if your business systems are not. Check Your Internet Footprint
• Check that records of your external internet-facing footprint are correct and up to date. This includes things like which IP addresses your systems use on the internet or which domain names belong to your organisation. Ensure that domain registration data is held securely (check your password on your registry account, for example) and that any delegations are as expected. • Perform an external vulnerability scan of your whole internet footprint and check that everything you need to patch has been patched. Internet-connected services with unpatched security vulnerabilities are an unmanageable risk. Continued on Page 24
• Understand what logging you have in place, where logs are stored and for how long logs are retained. Monitor key logs and at a minimum monitor antivirus logs. If possible, ensure that your logs are kept for at least 1 month. Review Your Backups
• Confirm that your backups are running correctly. Perform test restorations from your backups to ensure that the restoration process is understood and familiar.
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Continued from Page 23
Phishing Response • Ensure that staff know how to report phishing emails. Ensure you have a process in place to deal with any reported phishing emails. Third Party Access
• If third party organisations have access to your IT networks or estate, make sure you have a comprehensive understanding of what level of privilege is extended into your systems, and to whom. Remove any access that is no longer required. Ensure you understand the security practices of your third parties. NCSC Services
• Check your Cyber Security Information Sharing Partnership (CiSP) account works so you can access and share information about the threat with other organisations and see updates from the NCSC. • Register for the Early Warning service so that the NCSC can quickly inform you of any malicious activity reported to them regarding your systems. Brief Your Wider Organisation
• Ensure that other teams understand the situation and the heightened threat. Getting buy-in from the rest of the business is crucial in being able to complete the actions described here. • Ensure colleagues in other areas understand the possible impact on their teams’ workloads and tasking. Make sure everyone knows how to report suspected security events and why reporting during a period of heightened threat is so important. Advanced Actions
Large organisations should carry out all the actions outlined above, to ensure that the most fundamental security measures are in place. Organisations and sector regulators using the Cyber Assessment Framework (CAF) to help them understand cyber risk should note that the CAF contains guidance on all the areas included in the actions above. If your organisation has deprioritised these areas of the CAF, you are advised to revisit those decisions immediately when the threat is heightened.
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In addition, those organisations with more resources available should also consider the following steps: • If your organisation has plans in place to make cyber security improvements over time, you should review whether to accelerate the implementation of key mitigating measures, accepting that this will likely require reprioritisation of resources or investment. • No technology service or system is entirely risk free, and mature organisations take balanced and informed risk-based decisions. When the threat is heightened, organisations should revisit key riskbased decisions and validate whether the organisation is willing to continue to tolerate those risks or whether it is better to invest in remediation or accept a capability reduction.
• Some system functions, such as rich data exchange from untrusted networks, may inherently bring a greater level of cyber risk. Large organisations should assess whether it is appropriate to accept a temporary reduction in functionality to reduce the threat exposure. • Larger organisations will have mechanisms for assessing, testing and applying software patches at scale. When the threat is heightened, your organisations may wish to take a more aggressive approach to patching security vulnerabilities, accepting that this may have a service impact itself. • During this time, large organisations should consider delaying any significant system changes that are not security related. • If you have an operational security team or a Security Operations Centre (SOC) it may be helpful to consider arrangements for extended operational hours or to put in place contingency plans to scale up operations quickly if a cyber incident occurs. • If you have systems in place that can take automated action or notifications based on threat intelligence, you might also consider procuring threat feeds that may give you information relevant to the period of heightened threat
If you’re curious about what any of the technical terms in this article mean or you want to know what your data security team are talking about, turn to the Glossary on the next page. www.bluestreamacademy.com
1.
https://www.ncsc.gov.uk/guidance/actions-to-take-when-the-cyber-threat-is-heightened
This information is licensed under the Open Government Licence v3.0. To view this licence, visit www.nationalarchives.gov.uk/doc/open-governmentlicence © National Cyber Security Centre 2022
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Glossary Our ever-popular Data Watch feature includes a few technical terms that most of us don’t encounter too often. If you’re curious to learn more, here is our glossary of terms and definitions! Article | Stuart Walsh, CISO at Blue Stream Academy
Firewall
In computing, a firewall is a security system that monitors and controls data moving in and out of a network of computers. A firewall is like a barrier that separates a trusted network (such as computers in an office) and an untrusted network (such as the internet).[1],[2]
Internet Footprint
Your internet footprint (also known as a digital footprint or digital shadow) is the unique set of digital activities, actions, contributions and communications that can be traced to you on the internet or digital devices. Digital footprints can be passive or active. Your passive digital footprint is your web-browsing activity and information stored as cookies.
Hacktivism
Hacktivism or hactivism (a portmanteau of hack and activism) is the use of computer-based techniques (such as hacking) as a form of civil disobedience to promote a political agenda or social change. It is often related to free speech, human rights, or freedom of information movements.[3]
Your active digital footprint is mostly information that you choose to share on websites or social media. A digital footprint can be left by a person, a business or an organisation.[4]
Phishing
Phishing is when attackers attempt to trick you into doing ‘the wrong thing’, such as clicking a bad link that will download malware (such as ransomware) or direct you to a malicious website. Phishing can be done by text message, social media or phone, but it is mainly used to describe attacks that arrive by email. Phishing emails can reach millions of users directly, and hide among the huge number of benign emails that busy users receive. Attacks can install malware, sabotage systems or steal intellectual property and money.[7] 26
Threat Actors
A threat actor (or malicious actor) is a person or group of people who take part in an action that is intended to cause harm to computers, devices, systems or networks. Threat actors perform malicious acts against a person or an organisation by exploiting ‘open vulnerabilities’ and disrupting operations. Different threat actors have different educational backgrounds, skills and resources; their background influences who they target, how they attack and what information they seek. They include cyber criminals, nation-state actors, ideologues, thrill seekers/trolls, insiders and competitors – all with distinct motivations, techniques, targets and uses of stolen data.[8]
Password Spraying
Password spraying is a type of ‘brute force’ attack. The attacker tries to force their way in by using a list of usernames and default passwords on an application. For example, the attacker will use one password (say, Secure@123) to try to access many different accounts on the application. This avoids the account lockouts that would normally occur when trying to access a single account with many passwords.[6] This attack is common when an application or administrator sets a default password for new users.
Multi-Factor Authentication (MFA)
Multi-factor authentication (MFA) is an electronic authentication method in which you are granted access to a website or application only after successfully presenting two or more pieces of evidence (or factors) to an authentication mechanism: knowledge (something only you know), possession (something only you have) and inherence (something only you are). MFA protects your data (which may include financial assets or information that could be used to identify you) from being accessed by an unauthorised person who has been able to discover, for example, a single password.[5]
Zero-Day Vulnerability
A vulnerability is a weakness or error in a system or device’s code that, when exploited, could allow someone to access data or systems when they don’t have permission to do so.[9] A zero-day vulnerability is a vulnerability that has been identified but has not yet been fixed (patched). This makes them a higher risk to users.[10]
1. https://techterms.com/definition/firewall (Last accessed May 2022) 2. https://www.techopedia.com/definition/29917/network-traffic (Last accessed May 2022) 3. https://www.techopedia.com/definition/2410/hacktivism (Last accessed May 2022) 4. https://techterms.com/definition/digital_footprint (Last accessed May 2022) 5. https://www.techopedia.com/definition/13657/multi-factor-authentication-mfa (Last accessed May 2022) 6. Ranjan R. Password Spraying Attack. OWASP. https://owasp.org/www-community/attacks/Password_Spraying_Attack (Last accessed May 2022) 7. National Cyber Security Centre. What is Phishing? www.ncsc.gov.uk/guidance/phishing#section_2 (Last accessed May 2022) 8. https://www.cisecurity.org/insights/spotlight/cybersecurity-spotlight-cyber-threat-actors (Last accessed May 2022) 9. Trend Micro. Vulnerability. www.trendmicro.com/vinfo/us/security/definition/vulnerability (Last accessed May 2022) 10. Trend Micro. Zero-day Vulnerability. www.trendmicro.com/vinfo/us/security/definition/zero-day-vulnerability (Last accessed May 2022)
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Blue Stream Academy
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Mark Thompson 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. Beth Reeve Ascot Care
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.
Josie Bades Bury Hospice
For28 more information, get in touch with us on 01773 822549 or at info@bluestreamacademy.com
Caring for Carers What is a ‘Carer’?
Dr Marie Anne Essam Clinical Lead and Ambassador for Social Prescribing Dr Marie Anne Essam is a GP in Hertfordshire and works widely to develop and support social prescribing with regional, national and international development of the link worker role. Contact her on info@equiptoempower.co.uk and be sure to follow her on Twitter: @marieannedoc. www.bluestreamacademy.com
Informal carers – often family members, sometimes friends and neighbours – are the backbone of support for many vulnerable adults and young people. Some of these people will be officially recognised by social and medical services, their names recorded as a ‘go to’ in the event of a crisis; many just get on with it, and don’t even see themselves as providing mission-critical compassion, company and assistance for the person in question. A badge they sometimes prefer to wear is quite simply, “I look after someone”. Caring Affects Health
Caring is now recognised as a ‘social determinant of health’ by Public Health England.[1] This means there is evidence to show that what anyone who cares, and anyone who cares for carers, will tell you is true: caring can detrimentally affect your health.
Pouring yourself out on behalf of another, having your phone handy 24/7 in case you’re needed, and making sure not only your own affairs but also those of another are attended to can be wearing. Musculoskeletal aches and pains can result from lifting and manoeuvring. Lack of sleep undermines many aspects of our health. Worry, stress and social isolation affect our mental wellbeing. There are joys and privileges associated with the trusted role of carer, and I do not mean to take away from that. This article aims to draw attention to the immense personal effort and cost that caring can involve, and to be a reminder to all of us, in any public arena, to look out for carers as well as the people they bring to appointments. Continued on Page 30
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A True Story
I remember well a gentleman I met in the practice, who brought his disabled wife, in her wheelchair, to see me. I tried to engage him in a conversation about his own health, as he looked incredibly exhausted. “I’m just the pusher,” he replied. It took three visits for him to give in and let me take an interest in him too. And the result was transformational.
He accepted a Social Prescribing referral (read more about this in my previous articles for BSA Today) and the link worker not only supported his wife, but also gave him the time he needed to reprioritise his own health. He gave up smoking, he asked me to refer him for pulmonary rehabilitation for his chronic obstructive pulmonary disease, and he welcomed the help of a local charity that provided a volunteer to come and sit with his wife so he could have some time off. The outcome was amazing. He stood up tall, smiled, joked and developed an admirable resilience, which proved essential as his lovely wife grew sicker and sadly passed away.
When I spoke to their daughter a couple of years later, after ‘my’ gent also died, she reflected that her dad had come back to life when he’d received care as a carer for her mum, and they’d enjoyed better quality time together despite the challenges. A Call to Action
What can you do? Lots of things! • As a Carer Take a moment here to know you are appreciated. Thank you for your incredible, selfless, intuitive, compassionate, multi-tasking efforts on behalf of another. And do let your boss, your GP, your local social services, your Jobcentre and your local voluntary groups know that you are one of our very special people.
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• All of Us Ask if people care, and if they do pop an easily spotted alert on their record. Refer or signpost them to local or national carers’ charities. For more information, see the Help and Advice section of the Carers UK website.[2] • As an Employer Know who has caring responsibilities, even occasionally, and be flexible and supportive as needed. • As a Service Provider Know who your carers are and be adaptable about appointments for both the carer and the person for whom they care. Life can be a juggling act and your understanding can make all the difference. • In Health Services Consider carers’ health checks and give them first refusal on flu jabs and so on.
• As a Business Invest in groups and initiatives in your local community that support the very people for whom your employees and customers care. The fact that you recognise that employees have family and friends whose lives matter goes a long way in establishing a corporate social responsibility brand which sets you above your competitors.
• As a Professional Give carers the space to tell you how they are and be aware that, just occasionally, you will be the one to pick up on a possible adult or children’s safeguarding situation, because these tough human relationships don’t always go right. Watch for carer stress syndrome: burnout.
It has surprised me how extreme that can be, when someone has given away so much of themselves that they are at risk of being very emotionally unwell. Continued on Page 32
• As an Observer Look out for opportunities to recognise and applaud a carer. The mum of a child with significant invisible diagnoses who is embarrassing her in a supermarket queue will be blessed by your quiet “Well done” and warm smile when she’s used to receiving disapproving looks. Help a shopper who is pushing a wheelchair with their bags to the car. Give up your place in the line for the loo, or a seat in a café. www.bluestreamacademy.com
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Caring Through COVID
In Hertfordshire, I’ve been privileged to participate in carers’ forums, when we asked carers how we were doing as professionals (health, social, mental health and voluntary sector) caring for them. We had three groups: adults who care for adults, parents who care for children with special educational needs, and young carers who have in their home a parent or sibling with additional needs. It was humbling to hear how tough the pandemic had been for them. Some explained that they’d had a contingency plan for everything – except a pandemic. Some parents felt relieved they did not have to navigate public transport to specialist appointments for their child, although they did wonder how much was lost in a ‘telephone review’. Many carers were frightened – about infection, about supplies, about public services unable to provide the previous level of input for their loved ones. Relatives of those with worsening long-term conditions, dementia or mental health were phenomenally overstretched.
A Little Bit About a Lot of Help Available
Local branches of Carers UK provide advice, counselling, mentoring and advocacy for carers. There are groups for carers of every kind, including young carers, who are encouraged to connect with each other and enjoy some recreational time together. These young people are mature beyond their years, and they’re a great treasure to their families and the society in which they grow up. Their schools and colleges need to understand and make allowances for them so they can fulfil their potential as well as caring. Emergency breaks for carers are available in some areas, as are befriending and ‘sitting’ services. Many areas have a ‘carers’ passport’, which gives carers priority access, discounts and so on. It’s also a simple way of showing strangers and officials when you are in fact ‘on duty’. In Closing
In my work as a GP, and as a clinical lead for social prescribing and carers with my local clinical commissioning group, it never ceases to amaze me how much we rely on the goodwill and commitment of carers. We need to do everything in our power to recognise them and support them. Thanks to you all for reading this, and for the difference you make
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1.
Public Health England. (2019). Caring as a Social Determinant of Health: Review of Evidence. www.gov.uk/government/publications/caring-as-a-socialdeterminant-of-health-review-of-evidence (Last accessed April 2022)
2.
Carers UK. Help and Advice. www.carersuk.org/help-and-advice (Last accessed April 2022)
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The Importance of Hydration It’s widely known that health experts recommend drinking eight 8-ounce glasses of water every day, which equates to about 2 litres. According to guidance from the Institute of Medicine, the recommendation for actual fluid intake is 3 litres for men and 2.2 litres for women.[1]
N
ow, if you’re the sort of person who regularly drinks eight glasses of water a day, well done to you. As a nurse working in a busy A&E department, I would often go home after a long 13-hour shift and realise I hadn’t drunk enough water throughout the day, and my kidneys would ache as a physical reminder of this. Research suggests that I’m not the only one, as many of us fall short of the recommended eight cups a day.[2],[3] We’ve all seen the recent memes: how can we possibly be expected to juggle a career, have a social life, study, have a hobby, keep up with household chores, eat five portions of fruit and veg a day, exercise, practise self-care and drink eight glasses of water a day while navigating a global pandemic? It’s so easy to reach for a hot cup of coffee when we’re overstretched and running low on steam, but today I want to shine a light on the advantages of prioritising water throughout the day – because the benefits to our body are more important than we may think. How much of the human body is made up of water varies by age and gender; it can also be affected by body size and shape, and the balance of muscle and fat.[4] We can maintain this balance of water by drinking fluids throughout the day. But why is this so important? Well, ensuring adequate hydration has numerous benefits for the human body, not only physically but also mentally. Physical Benefits
Regulating the balance of water in the body is essential for maintaining health and life.
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Because of its role in every function of the human body – it’s essential for every cell, tissue and organ to work effectively – water has long been considered the body’s most important nutrient.[5] This is a sweeping statement, so I’m going to break it down for you. • Drinking water contains several electrolytes (including calcium, chloride, fluoride, magnesium, potassium and sodium), all of which play an important part in our bodily functions. • The water we drink is absorbed by the intestines and then circulated around the body in the form of fluids, such as blood. When we drink, this process can happen in as few as 5 minutes. • Water is vital for moving oxygen, nutrients and waste products into and out of the body’s cells. It is needed for all digestion and absorption functions. • Water helps to regulate body temperature and serves as a cushioning component between joints, in the spinal cord and in the brain.
Drinking more water not only improves our internal bodily functions but also has a positive effect on our appearance. Although on a cellular level, water is not absorbed directly into the skin, there has long been an argument that increased water consumption helps to maintain your skin’s elasticity and complexion. Research suggests that higher water input has a positive effect on skin physiology.[6] And there is a compelling argument that drinking water can improve the body’s ability to lose weight via two mechanisms: appetite suppression and increased metabolism.[7] Continued on Page 36
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Bethany Cooper Health Sciences/Medical Writer and Emergency Nurse Bethany completed a master’s degree in Trauma Science in 2019, research from which has recently been accepted for publication in a medical journal. Over the past year Bethany has been working as a health sciences and medical writer. She is passionate about health, encouraging health literacy, and patient engagement. 35
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Mental Benefits
Alongside the many physical benefits of drinking enough water every day, there are numerous mental benefits. Multiple studies point to a link between dehydration and a higher risk of anxiety. In one 2018 study, researchers found that people who drank more water had a lower risk of anxiety and depression than those who drank less water.[8] Likewise, researchers in a 2015 study found that drinking less water was associated with greater tension, depression and confusion.[9] When people begin to feel thirsty, they have already lost around 2–3% of the water in their body. That might not sound like much, but dehydration by just 2% significantly impairs performance in mental tasks and physical coordination.[10] In a recent study, drinking a glass of water was found to positively enhance working memory.[11] Water is the medium for most chemical reactions in the body, especially those metabolic reactions involved in producing energy. So, when we reach for that cup of coffee to keep our mind in check during a stressful day, in reality a glass of water would prove significantly more beneficial for our mental capacity and cognitive function. 1.
Other mental benefits from increased water consumption come from improvements in sleep quality. Dehydration can disrupt our sleep in a number of ways, while drinking more water during the day can improve the quality of our sleep.[12] In turn, a better quality of sleep has numerous benefits for our mental wellbeing. Future Health
I’ve discussed how drinking enough water can significantly help to protect your current health, but it can also play a huge part in protecting your future health by flushing out toxins so your body is in the best possible shape to fight inflammation. There is increasing evidence that a low water intake or mild dehydration may be linked with the risk of chronic diseases,[13] including type 2 diabetes, obesity, coronary heart disease, hypertension, urinary tract infections, blood clots and stroke.
Institute of Medicine. (2004). Executive Summary: Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. National Academy of Sciences, Food and Nutrition Board. Washington, DC: National Academy Press. Oakley PA, Baird ML. Do Patients Drink Enough Water? Actual Pure Water Intake Compared to the Theoretical Daily Rules of Drinking Eight 8-Ounce Glasses and Drinking Half Your Body Weight in Ounces. JWARP 2015; 7(11):883–7. http://doi.org/10.4236/jwarp.2015.711072 3. Stookey JD. High Prevalence of Plasma Hypertonicity Among Community-dwelling Older Adults: Results from NHANES III. J Am Diet Assoc 2005;105(8):1231–9. https://doi.org/10.1016/j.jada.2005.05.003 4. Yashushi O, Sakai K, Hase H, Joki, N. Dry Weight Targeting: The Art and Science of Conventional Hemodialysis. Semin Dialysis 2018: 31(6); 551–6. https://doi.org/10.1111/sdi.12721 5. Jéquier E, Constant F. Water as an Essential Nutrient: The Physiological Basis of Hydration. Eur J Clin Nutr 2010; 64:115–23. https://doi.org/10.1038/ejcn.2009.111 6. Palma L, Marques LT, Bujan J, Rodrigues LM. Dietary Water Affects Human Skin Hydration and Biomechanics. Clin Cosmet Investig Dermatology 2015; 8:413–21. https://doi.org/10.2147/CCID.S86822 7. Thornton SN. Increased Hydration Can Be Associated with Weight Loss. Front Nutr 2016; 3:18. https://doi.org/10.3389/fnut.2016.00018 8. Haghighatdoost F, Feizi A, Esmaillzadeh A et al. Drinking Plain Water is Associated with Decreased Risk of Depression and Anxiety in Adults: Results from a Large Cross-sectional Study. World J Psychiatr 2018; 8(3):88–96. https://doi.org/10.5498/wjp.v8.i3.88 9. Muñoz CX, Johnson EC, McKenzie AL, et al. Habitual Total Water Intake and Dimensions of Mood in Healthy Young Women. Appetite 2015; 92:81–6. https://doi.org/10.1016/j.appet.2015.05.002 10. Adan A. (2015) Cognitive Performance and Dehydration. J Am Coll Nutr 2015; 31(2):71–8. https://doi.org/10.1080/07315724.2012.10720011 11. Edmonds CJ, Beeley J, Rizzo I. Drinking Water Enhances Cognitive Performance: Positive Effects on Working Memory But Not Long-Term Memory. J Cogn Enhanc 2022; 6:67–73. https://doi.org/10.1007/s41465-021-00225-4 12. Zwawy M, Al-Husayni F, Alamri S, et al. Association Between Amount of Water Intake and Quality of Sleep in Adults: Jeddah, Saudi Arabia. Int J Adv Res 2018; 6:2320–5407. 13. Manz F, Wentz A. The Importance of Good Hydration for the Prevention of Chronic Diseases. Nutr Rev 2005; 63(6 Pt 2):S2–5. https://doi.org/10.1111/j.1753-4887.2005.tb00150.x 2.
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Key Awareness Days So, whatever your daily life looks like – whether you’re working from home, working in an office, looking after your children or working as a busy healthcare professional – you need to make time to hydrate throughout the day. Prioritise your water intake and prioritise your health. Admittedly, while writing this article I’ve gone to fill up my water bottle more often than normal; my only hope is that you will do the same
Pride Month 1 - 30 June
Pride Month is held in June each year to celebrate LGBTQ+ communities, and is commonly marked by parades, parties, and historic awareness activities around the world.
Good Care Month 1 - 31 July
www.hcpa.info/good-care-campaign/
The Good Care campaign has been created to celebrate the incredible work that carers undertake each day whilst tackling an ageing population and increased complex need requirements that need additional care support.
Talk to Us 2022 Month 1 - 31 July
www.samaritans.org/support-us/campaign/talk-us/
‘Talk to Us’ is an annual awareness campaign from the Samaritans, aiming to encourage the UK to become better listeners. By becoming a better listener through listening without interruption or distraction, we can support our loved ones in opening up and talking about their feelings and any challenges they may be facing.
The NHS’s 74th Birthday 5 July
www.england.nhs.uk/nhsbirthday/
As the NHS celebrates its 74th birthday, join us in reflecting on the innovations and adaptations achieved throughout the years. Join the nation and host an NHS Big Tea party, raising funds to support NHS staff, patients and volunteers throughout the UK.
World Breastfeeding Week 1 - 7 August
worldbreastfeedingweek.org
World Breastfeeding Week 2022 (#WBW2022) aims to increase awareness surrounding restoring breastfeeding support systems to pre-pandemic levels, alongside increased awareness surrounding the nutritional benefits of breastfeeding. www.bluestreamacademy.com
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Great Food with
TWO GREEDY GALS Our local Instagram foodies, Two Greedy Gals, have created some delicious summertime treats for you to share with family and friends. We hope you enjoy these tasty recipes – bon appétit!
RED CABBAGE COLESLAW Serves 12
Time 15 mins
Directions 1. Thinly slice the red and green cabbage, carrots and red onion and then combine in a large bowl. 2 . In a separate bowl, mix together the yoghurt, lemon juice, cider vinegar, celery salt and chives. 3 . Pour the yoghurt mixture over the sliced vegetables and mix. Add salt and pepper to taste. Refrigerate until ready to serve – done!
Ingredients • • • • •
400g red cabbage 400g green cabbage 2 large carrots 1 red onion (optional) 200g Greek yoghurt
• • • • •
½ lemon ( juice only) 2 tsp cider vinegar 1 tsp celery salt 3 tbsp fresh chives Salt and pepper
Nutritional Values per Serving
Like what you see? Be sure to follow
@TWOGREEDYGALS on Instagram!
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THE BIG GREEN SANDWICH Serves 2
Time 30 mins
Directions 1. Preheat your oven to 200C/gas mark 6. Grab your chicken breasts and, using a rolling pin or a meat mallet, lightly pound until they are the same thickness throughout. 2 . Place the chicken breasts on a lined oven tray, drizzle with olive oil and season with salt, pepper and paprika (you can season however you’d like at this step – get creative!). Leave to cook for 20–25 minutes, until they’re nice and juicy. Cut into slices. 3 . Lay out the bread, ready to make two sandwiches. Smash the avocado and divide it between two slices of bread, then season to taste. Then, layer these slices with the chicken, mozzarella, cucumber and lettuce leaves. Coat the other two slices of bread with the green pesto. 4 . Once you’ve assembled the sandwich, wrap it in greaseproof paper and cut it down the middle. This is the perfect sandwich for your lunchbox or a picnic! Ingredients • • • • •
2 chicken breasts 1 tsp olive oil Salt and pepper 1 tbsp paprika 4 slices of bread of your choice (we like a classic crusty loaf) • 1 large avocado
• 1 fresh mozzarella (sliced) • 1/3 cucumber (sliced) • 4 butterhead lettuce leaves • 2 tbsp green pesto (see the Green Pesto Pasta Salad recipe)
Nutritional Values per Serving
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GREEN PESTO PASTA SALAD Serves 8
Time 35 mins
Directions First, make the pesto. You can do this ahead of time for a quick and easy pasta dish! 1. Start by peeling and crushing the garlic cloves and roughly chopping the basil leaves. 2 . Place the basil, garlic, parmesan and pine nuts into a food processer and lightly pulse. 3 . Slowly add in the olive oil while whizzing until you have a smooth texture. 4 . Add the lemon juice and season with salt and pepper to taste. Then make the salad. 1. Preheat the oven to 200C/gas mark 6. 2 . Place the cherry tomatoes (on the vine) on an oven tray, drizzle over the olive oil and season with salt and pepper. Bake for 12–14 minutes. Ingredients For the pesto • 3 garlic cloves • 50g fresh basil leaves • 50g parmesan • 55g pine nuts (toast lightly, if preferred) • 150ml good quality extra virgin olive oil • Juice of ½ lemon (optional) • Salt and pepper Nutritional Values per Serving
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For the salad • 250g cherry vine tomatoes • 1 tbsp olive oil • 500g dried pasta • Salt and pepper • 200g feta
3 . While the tomatoes are roasting, boil a pan of salted water, and cook the pasta for the time shown on the packet. Chop the feta into small cubes. 4 . Once cooked, place the pasta into a large serving bowl and mix in 4–5 tablespoons of pesto (add more for a more intense pesto flavour) as well as the tomatoes and the feta. This dish can be served hot or cold – perfect for sharing. Enjoy!
PEACH AND RASPBERRY ICED TEA Serves 10
Time 1 hour 20 mins
Directions 1. Add the sugar and water to a pan and bring to the boil slowly. 2 . Once the sugar has completely dissolved, add the chopped peaches and raspberries, cooking until soft. 3 . Once cooked, remove from the heat and mash the fruit. Leave this to infuse for around an hour. 4 . Run the mixture through a fine sieve into a jug, getting as much juice from the fruit as possible. Set the syrup aside. 5. Place the teabags in a separate, large jug and pour in around 2 litres of boiling water, leaving to steep for 5 minutes. Remove the teabags and leave the tea to cool. Ingredients • 200g granulated sugar • 5 ripe peaches (4 chopped, 1 sliced to serve) • 200g raspberries (save a small handful to serve)
• 4 teabags (we like to use Earl Grey) • Ice • 250ml water
6. Once cooled, stir in the peach and raspberry syrup, ice, and remaining fruit.
Nutritional Values per Serving
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@BlueStreamNews The first half of 2022 has been filled with celebration, fundraising and all-round team passion. It was a sociable start to spring, as the team met up with a range of health and care professionals at the ACE Aesthetics event, the Hampshire Care Association Spring Breakfast and the Pulse PCN conference. Are you attending an event over the next few months? Check out our events calendar to see where you can meet #TeamBSA as we exhibit throughout the UK this year!
Events Calendar
29 MediWales Connect JUNE Mercure Cardiff Holland House Hotel & Spa 24 26 Newport Road, Cardiff, CF24 0DD 30
JUNE
7
JULY
Care Management Matters Leeds Conference
Oulton Hall Hotel Rothwell Lane, Oulton, Leeds LS26 8HN Management in Practice Liverpool ACC Liverpool Kings Dock Street, Liverpool, L3 4FP
Come and say hi ! Following the deeply saddening news of the conflict in Ukraine, the team at Blue Stream HQ wanted to help in any way they could. On Sunday 17 April, we hosted a fundraising evening and donated all the profits generated to the British Red Cross’s Ukraine Crisis Appeal (Charity Number: 220949). With help from local businesses throughout Derbyshire, #TeamBSA hosted a charity auction, raffle and fundraising event, raising well over £3000 so far!
In April, we celebrated 10 years of Blue Stream Academy with everything from gifts to our customers to a birthday bash – obviously, BSA Bob had to join us for that! As well as celebrating our progress so far, we’re looking ahead to the next 10 years of Blue Stream Academy and we can’t wait to announce all the upcoming system features and exciting new modules set to be released soon. Check out the article on page 10 to read about our journey. 42
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 issue:
Q
Hi Blue Stream,
After seeing some of the new modules released on Blue Stream, we are wanting to amend our staff training profiles and get these added on. Can you let me know how best to do this? Also, could you confirm what level your Prevent training is please? Many thanks, System Administrator, Essex.
A
Hi there,
Of course! When you log in, head to Management > Staff > Manage Profiles. In this section, you’ll see each of the job roles you’ve set up at your organisation. Click ‘Edit’ on the job role you wish to update, and a box will appear to the right of the screen. In here, you can add or remove the modules you want to assign to this job role and amend the list of users who are attached to the role. Once you’re happy with your changes, select ‘Save’ and your changes will be updated right away. Our Prevent module covers Basic Prevent Awareness, which is the same target group for Safeguarding Children and Adults Level 1 and Level 2 in line with the Core Skills Training Framework. We hope this helps. If you need any further assistance, you can contact us by email, LiveChat or phone. Team BSA
www.bluestreamacademy.com
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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