The Loop | Issue 6 | July-September 2022

Language and Stigma

Positive Impact of COVID

ISSUE

6

JULY - SEPTEMBER 2022

The Loop

IHSCM Quarterly E-magazine

People Plan for Social Care

Contents

ISSUE

6

4.

Editorial

6.

The People Plan for Social Care

10.

How will genomics change our approach to holistic care and population health?

14.

How can we keep active in our new virtual world of work?

18.

The positive impact of COVID and what can we learn from it

20.

PhD... Should I, shouldn’t I?

24.

Innovation in Social Care, is it achievable?

26.

Language and stigma

30.

General Anxiety Disorder

34.

Staff retention in the care industry

36.

The merit of lifelong learning

40.

How to Speak Up Safely - A new IHSCM Short Course

CEO: Jon Wilks, Chairman: Roy Lilley, Strategic Advisor: Shane Tickell, Director of Social Care: Adam Purnell, Membership Manager: Emma Caton, Operations Manager: Jade Maloney, Social Media Administrator: Rachel Jury, Operations Administrator: Michaela Shannon, Digital Content Consultant: Luke Farmer

EDITORIAL

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Welcome to the new edition of our IHSCM members quarterly e-magazine All of you managing and leading teams and organisations across health & social care currently face an extraordinary challenge. The combination punches thrown at you by waitlists, money, Covid, workforce, inspections and inflation are deeply threatening and troubling for all of you, I know. Whether you are a student on the first rung of acquiring skills to equip you in the world of health and social care or you a senior manager wondering how to react to the latest challenge, you share common anxieties generated by any of those punches cast at you.

Boosting your personal resilience is therefore right up there when I am considering how the IHSCM can support and encourage you. There are any number of forces arranged against you and seeking to undermine, find fault, drain confidence or reduce your ability to lead, so how you

prepare and protect yourself is important.

Any new entrant to the world of boxing will quickly realise that she or he is not going to start by being asked to spar in a ring with a seasoned and experienced campaigner. Instead, you’ll first be shown how to build yourself into great physical fitness shape, before then developing an understanding of the techniques for protection and evasion. Finally they will start showing you how to punch with power and precision and react to an opponent’s aggression.

I don’t think it does us any harm to draw parallels from this for ourselves as we seek to build our resilience in a threatening work environment.

Firstly then, my advice

Chief Executive

JON WILKS is to give yourself a thorough and honest appraisal of your fitness to lead. What are your acknowledged strengths? How do you know them?

Why do they matter? Ditto for your challenges. Then set about creating a plan for yourself that helps you to further develop your strengths and address your challenges positively. Maybe enrol on one of the IHSCM short course masterclasses, attend some of our workshops, PowerHours or Round Tables, join a special interest group meeting. Meet other people like you. Discuss your successes and issues.

To be clear, you have done an incredible job during the covid pandemic and it is unfair for you to be too tough on yourself – so don’t be aiming for a personality transplant or wildly ambitious skills acquisition. To paraphrase the immortal words of Gloria Gaynor, ‘you are what you are’. This is more about developing some selfawareness as well as recognition of your value and opportunities for improvement.

Secondly, my view is that the now rather hackneyed expression of ‘control the controllables’ still rings true. I know that it sounds trite and even ridiculous when you are faced with what appears to be an

impossible situation, but you need to remind yourself of it before you allow any perceived impossibility to overwhelm you. Identify the elements that you can positively affect or remove. Put whatever remains on the mental pile of ‘its awful but I can’t do anything about it’. At least you have focused on making some positive impact and whatever you have done will have improved matters.

Thirdly, be prepared to seek support.

The IHSCM is vibrant and growing, with thousands of members just like you who would be delighted to give you some reassuring words, advice or guidance. There is immense strength in our numbers and huge reserves of expertise and experience. Come along to any event and, if you can’t find the courage to speak, just put whatever is troubling you in the virtual chat. I have watched with immense admiration as people instantly come forward to help.

Within moments you’ll have an idea for solving your issue and a new network of support contacts. And all because you were prepared to say ‘help’.

Stay safe, stay strong and thank you for the brilliant work you are all doing.

Jon Wilks CEO

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The People Pl for Social Car It would be difficult to have made it to July of 2022 without at least hearing about the People Plan report published by the IHSCM Social Care Innovators.

Published in December 2021 and launched at the House of Lords in March 2022, the report lays out a foundation for social care reform.

We know, we know, a plan that looks to reform social care, hasn’t that already been done? Isn’t this just the same old, same old?

I’d be lying if there wasn’t some truth to that. Sure, a lot of the findings within the report will likely be familiar to you, but it’s the way we created the report, the structure and language of the report, and what we’ve done and continue to do post publishing that makes the people plan stand out from the crowd.

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The People Plan is a comprehensive report that has 5 focus areas; Public Image, Recruitment, Retention and Staff Wellbeing, Training and Pay and Conditions. Each focus area examines the current situation, current examples of outstanding practice, and then each section makes a series of recommendations (59 in total) for central/Local Government and care providers including free DBS’s, transferable training passports and improved wellbeing services for managers.

lan re The plan is an active approach to bringing real change and reform to social care by listening to everyone involved in social care, ensuring that it is a report by the people for the people.

The plan has received wide praise from industry leaders, local authorities, and other decision makers and commissioners, with many committing to work to trial some of the recommendations the plan proposes.

This has led to us building up a list of supporters and endorsers of the people plan that includes Lord Philip Hunt, Baroness Wheeler, Care England, NCF, Care Tech Foundation, National Care Association and many more.

As the current People Plan continues to gain momentum, we have now begun the consultation phase for the next publication of the report. This new version of the report will retain the 5 focus areas of the current report but will also introduce:

Adam Purnell, Director of Social Care, IHSCM

• • • • •

Greener Care Access to Care Equality Diversity and Inclusion Policies, Regulations and Guidance Mental Health of those using Care Services

The consultation was launched at the Health plus Care Show during a keynote presentation of the plan with the creators and chairs, Palvi Dodhia, Jasmeet Rai and Joan Bothma and is designed to be as accessible as possible. Contributing to the consultation can be done via the survey, video discussion forums, email, webform, phone, and contributors will be in with a chance of winning a £100 voucher.

There is a movement happening in social care and it is the responsibility of everyone to keep the pace. Be part of the future of social care and contribute your views to the people plan consultation.

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You can view the current People Plan and access the consultation here.

Or you can go direct to the survey consultation here.

If you wish to lend your endorsement to the IHSCM People Plan for Social Care, please email Adam Purnell at apurnell@ihm.org.uk with the following For Individual Endorsement Full Name A short sentence of why you endorse it Relation to social care (e.g. care user) or Position For company Endorsement Company Name Logo A short sentence of why you endorse it

People Plan Dates for your Diary July 14th 13:30-14:30 Retention – A people Plan Roundtable August 22nd 12:00-13:00 Pay and Conditions – A People Plan Roundtable

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How will genomics change our approach to holistic care and population health?

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Charlotte Douglas, Genomics Project Manager

The NHS is moving towards an Integrated Care model with holistic, whole-person healthcare approaches.

Genomics has the potential to enhance how we implement personalised and preventative medicine.

Simply put, genomics aims to diagnose and treat patients with severe illnesses, such as childhood cancers or rare conditions, by sequencing and analysing an individual's entire DNA sequence.

Firstly, it reduces the time spent in a ‘diagnosis odyssey’, the term used for chronically unwell patients who can spend years without a diagnosis.

Secondly, it enables finding a therapy targeted to the individual, thereby improving their quality of life. These aspects of genomics speak to personalised medicine.

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An equally important benefit of genomics is its potential for use in preventative medicine, or Population Health Management (PHM). PHM is a proactive care approach. It integrates information not just on an individual’s health status, but also takes into account the socio-economic, behavioural and social determinants of health; a holistic approach to healthcare.

Genomic data could be an essential puzzle piece to the whole-person jigsaw of integrated whole-person care.

The provision of genomic information may empower people to take a more proactive role in managing their own health. This could be done by equipping individuals with essential information about their health options and how to reduce the chances of preventable conditions occurring. It enables health and social care providers to co-develop health interventions and strategies with individuals before they could potentially deteriorate. Genomic information becomes a powerful tool for people that are currently healthy.

An example of this is Familial Hypercholesterolemia (FH). FH is a genetically inherited condition, where a person has increased susceptibility to high cholesterol. If poorly managed, high cholesterol can lead to hypertension, heart attacks or strokes. By testing for FH using genomic sequencing, clinicians and patients can take a PHM approach. A joint decision can be made on preventative interventions required to manage their cholesterol and understand the patient’s risk factors.

Ultimately, using genomic information, individuals can support themselves to stay healthier, for longer.

However the use of genomic data should be carefully considered. For some individuals, the understanding of how to manage their health may be empowering. Similarly, the diagnosis of a condition after many years (the aforementioned diagnosis odyssey) may well bring relief to patients, potentially improving their mental health and wellbeing. For others, knowing they have a genetic predisposition to a condition could be deeply upsetting.

In 2019 the headline Genomic Medicine Service and the Core20Plus5 policies were launched as part of the NHS Long Term Plan.

These policies emphasise equitable access to health care, including genomic services, and informed consent in communities. The Covid-19 pandemic has exacerbated preexisting inequalities in access to health and social care and this was recognised within these initiatives.

The whole-person must be considered when delivering interventions to improve community health, and genomics is not a ‘catchall’. However, genomics could have the power of providing insights where nothing else can.

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How can we keep active in our new virtual world of work?

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The COVID-19 pandem us re-evaluate the wa particular, it has chang we conduct meetings majority of meetings n place via a virtual plat

This seismic shift to virtual working has saved the NHS thousands of hours compared to holding in-person meetings. It has been reported that the NHS holds on average 1.3m virtual meetings per week, freeing up more than 2.9m hours for NHS workers across the country in a six month period1 .

These figures make great reading in terms of efficiency and convenience, but the downside is we are less active. Sitting at our desks taking part in virtual meetings is now ubiquitous across the NHS workforce, which means we move much less than we used to.

Physical inactivity has been identified as the fourth leading risk

Dr Ros Leslie, Non-Medical Research Lead and Chief AHP

mic has made ay we work, in ged the way s, with the vast now taking tform.

factor for global mortality2, suggesting sedentary lifestyles are a risk factor for cardiometabolic morbidity and allcause mortality3 .

Thus, it has been reported that ‘sitting is the new smoking’3 .

Alongside physical effects of virtual meetings, there are also other effects including burnout, isolation, disconnect, and decreased concentration. However, just 15–30 minutes a day of brisk walking can provide significant health benefits4,5 .

Walking also improves cognition, creativity, and the generation of novel ideas6 and increases the level of engagement and breaks down barriers between co-workers by creating a peer to peer ethos as opposed to a hierarchy.

Dr Nicky Eddison, Associate Professor and AHP Research Lead

All of which increase job satisfaction7.

Research has suggested that where there is a need to generate new ideas in the workday, walks should be incorporated into the working day6.

Walking meetings A walking meeting is simply a meeting that takes place during a walk instead of in an office.

Walking meetings have emerged as both a productive and healthy solution to combat the challenges facing workers who spend long hours at their desks in virtual meetings.

It is suggested that the format works best in smaller groups of between 2-4 people.

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Top tips include • • • • •

Have a set destination in mind to give the meeting a direction.

Ensure everyone is able to participate, a walking meeting shouldn’t be mandatory and should always be inclusive.

Ensure the purpose of the meeting is appropriate for a walking meeting, one that doesn’t require a lot of note taking.

Always agree on a walking meeting beforehand so people are informed and prepared Enjoy the experience of combining work with a bit of exercise and fresh air.

As Friedrich Nietzsche wrote “All truly great thoughts are conceived while walking”, so it’s time to get our walking shoes on!

References 1. NHS Digital. 2.9m hours saved by NHS colleagues using Teams. Accessed April 29, 2022. https://digital.nhs.uk/news/2021/2.9mhours-saved-by-nhs-colleagues-using-teams 2. World Health Organization. Global Recommendations on Physical Activity for Health. Geneva: 3. Baddeley B, Sornalingam S, Cooper M. Sitting is the new smoking: where do we stand? Br J Gen Pract. 2016;66(646):258-258. doi:10.3399/BJGP16X685009 4. Wen CP, Wai JPM, Tsai MK, et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet (London, England). 2011;378(9798):1244-1253. doi:10.1016/S0140-6736(11)60749-6 5. Lee IM, Shiroma EJ, Lobelo F, et al. Impact of Physical Inactivity on the World’s Major Non-Communicable Diseases. Lancet.

2012;380(9838):219. doi:10.1016/S0140-6736(12)61031-9 6. Oppezzo M, Schwartz DL. Give Your Ideas Some Legs: The Positive Effect of Walking on Creative Thinking. J Exp Psychol Learn Mem Cogn. 2014;40(4):1142–1152. doi:10.1037/a0036577 7. Clayton R, Thomas C, Smothers J. How to Do Walking Meetings Right. Harv Bus Rev. 2015;August:6-11. https://hbr.org/2015/08/howto-do-walking-meetings-right

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The positive im COVID and wha we learn from i In years to come we may be donning T-Shirts with slogans such as “I survived 2020” and be remembering the measures to keep the nation safe and the negative effects of these.

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The impact across Health and Social Care services remains present and shall be for some time to come.

However, it is worth considering the positives from the shared experiences we had. The lack of social opportunities and the restrictions on mixing and meeting people led to some creative work across health and social care which we should continue to support and ensure the many positive effects are still felt by the many people who receive and indeed work in services.

People used technology, previously considered as not appropriate, to connect with others and showed us all not to limit our expectations of what people can achieve by using and benefiting from technology.

The expectations to ensure each day included a “meaningful activity” changed and we learned from the people we support what really is a meaningful activity for them. This may

mpact of at can it be completing a jigsaw, always with that one missing piece, or having a real conversation with a neighbour, when previously a polite nod was all that took place and we began to learn about life from the people we support.

Zoom parties, virtual scavenger hunts and bingo all provided opportunities to “meet” people and really learn about each other more often than not when the support staff were fumbling with technology and the “rules” of the game to try to do it “right” .

Our understanding of behaviours of distress changed and developed.

Previously we focused on levels of engagement, skills development, stimulus change and other formal approaches. These continue to be important but what we learned from just being with a person, reducing the expectations and really learning from and about the person without the distractions of trying to complete

Heather Simpson, Support and Care Manager Kingdom Support and Care

tasks, aiming to be at a place by a certain time, ensuring predictable routines were in place and followed to the letter, is immeasurable. We learned their preferences, ways of learning and subtle signs that all had importance to each person.

We shared fun, laughs and often had silly times which may not tick a box or provide evidence of quality service provision but is just as important.

This learning should be utilised and remembered when services are commissioned, designed, delivered and assessed as these are things which are important to people. If someone wants to spend their day learning the words to “Let it go” from Frozen then respect that, support it and bring back some of the magic and joy to the lives of people we support and have fun with them along the way.

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PhD….

Should I, shouldn’t I? Organisations that are research active are reported to have a lower riskadjusted mortality rate, improved patient experience, and better staff recruitment and retention compared to those with a lower research profile1.

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The recent publication of the Allied Health Professions (AHPs) research and innovations strategy2 has provided a platform for AHPs to engage in research. Although it has been reported that AHPs are more likely than nursing colleagues to progress post Master’s degree3 , fewer than 0.1% of the UK AHP workforce are employed in clinical academic roles. This may be due to the difficulty in navigating the routes to a PhD qualification or balancing the demands of work and PhD level study.

I (Nicky) chose a traditional route to a PhD, studying part-time for 6 years whilst working full time as an orthotist. This level of commitment often puts people off from pursuing a PhD.

Dr Nicky Eddison, Associate Professor and AHP Research Lead

Samantha Cook, Clinical Specialist Physiotherapist

However, there are other options available.

Sam’s journey As a physiotherapist in a senior role, I was keen to expand my research skills.

Following completion of two advanced clinical practice modules and two research modules, I found myself contemplating my next move. My ultimate goal is to continue a clinical career and have the skills and confidence to lead research in my area of expertise, but I was unsure how best to achieve this.

The routes to a PhD The most traditional route to achieve my goal would be completing a BSc, followed by an MSc and then a PhD. After completing the advanced clinical practice modules I reflected on completing a full

MSc and concluded that I would be spending 1-2 years studying a topic that would not progress me closer to my goal, and I would return to work in the same role.

Having completed the two research modules as part of the National Institute for Health Research (NIHR) and Health Education England (HEE) pathway I investigated a full research methods MSc. Decisions I contemplated a full research MSc, 2 years of studying research which would bring me closer to my goal.

However, I found that in my current position I was able to collaborate with research leaders on projects and get hands-on research experience which

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would be limited if I chose to complete a full MSc. So I parked the MSc idea and explored the NIHR/HEE pathway more intimately.

The pre-doctoral clinical academic fellowship (PCAF) is a two-year programme to help prepare for a competitive PhD application and allows dedicated time for developing your doctoral idea.

When making my decision I needed to consider my current position, completing the PCAF at this stage also meant I couldn’t progress clinically into a clinical specialist post, wanting to develop clinically and academically was important to me, and allowing one to pause while the other progresses is possible, but why couldn’t they simultaneously evolve?

The PCAF idea was also parked for now as I applied for a clinical specialist role in the area of my expertise. This meant a life change for me, leaving London and moving to the West Midlands. Once settled into my new role, I sought out opportunities to develop my clinical academic career once again.

With the MSc and PCAF remaining parked, I discovered the West Midlands Pre-doctoral bridging programme, for people who can demonstrate learning at MSc level looking to progress to a PhD application, with support and dedicated research time.

and await the outcome to hopefully start in September 2022.

Final thoughts In summary, there are more than just the traditional routes to reaching the goal of becoming a clinical academic and finding the right one for you is a journey in itself. The key learning points I took from this are to explore all your options and spend time with people who have taken traditional and non-traditional routes.

I have generally found the research community to be incredibly humble and helpful. Networking is incredibly important, since expressing my interest in research I have connected with leaders in research and continued to engage in projects whilst deciding my route.

Finally, if you have an interest in research and are still undecided if a PhD is for you, connect with your local research lead or department and think about service development and smaller research projects first.

Research can be incredibly exciting but it can also be very challenging, gaining experience will set you in a good position to make decisions regarding the future.

References

This programme is for one year only, one day a week protected research time which facilitates networking opportunities within the West Midlands area and provides training and support for a PhD application. I have since applied for the bridging scheme 0022

1. Cordrey T, King E, Pilkington E, Gore K, Gustafson O. Exploring research capacity and culture of allied health professionals: a mixed methods evaluation. BMC Health Serv Res. 2022;22(1):1-10. doi:10.1186/s12913022-07480-x 2. Health Education England. Allied Health Professions ’ Research and Innovation Strategy for England.; 2022. https://www.hee.nhs.uk/ our-work/allied-health-professions/enable-workforce/allied-healthprofessions’-research-innovation-strategy-england 3. Trusson D, Rowley E, Bramley L. A mixed-methods study of challenges and benefits of clinical academic careers for nurses, midwives and allied health professionals. BMJ Open. 2019;9(10):1-9. doi:10.1136/ bmjopen-2019-030595

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Innovation in Social Care is it achievabl Innovation for me is more about adjusting a mindset to embrace the possibility of a different perspective.

Having come from a sales and marketing background in the telecoms industry I don’t have some of the deep rooted perspectives or thoughts about what a care home should be like or how it should be managed.

Care isn’t about the company it’s about the people cared for. Forever mindful of this I wanted to create a care journey for individuals that I myself would be happy to consider.

We really struggled during covid, as many care operators did. It wasn’t just the strain on the business it was the desperate feeling of being helpless, not being able to fix it, seeing 0024

colleagues emotionally at their worst and good friends we care for unable to see their families. We were on emergency autopilot like pandemic zombies.

One thing we didn’t do during the pandemic was panic or make kneejerk business decisions. We didn’t consolidate the business or pare back operations; we kept all our staff, and maintained a ‘business as usual’ approach knowing that one day it would all be over.

More important, I handed responsibility over to the experts.

If there is one thing I have learnt, always get an expert to do an expert job rather than trying to do it yourself, it really pays dividends in the end.

Adam Hutchison, Managing Director, Belmont Healthcare

e, le?

Innovation in social care seems to offer loads of clichés but nothing tangible, rather a buzzword for re-inventing the wheel.

I made critical appointments in three main functions, finance, operations and marketing. Having experts in these roles has helped me to deliver and build on my vision of developing our care journey.

My whole ethos about developing the Belmont Healthcare care journey is purely to develop choice for people. I don’t want to create ‘vanilla’ care homes I want to develop a multi-facetted care journey in its truest form where care isn’t a last resort.

I want someone with capacity to say to themselves ‘I want that’, to manage life as best as possible in their own home, perhaps with our help, until they are ready to move into residential care.

Until we get people to think differently about care and care homes we will never get to where we want to as a sector. It really is all about getting people to engage with care services in a different way.

I have always focused on the longterm vision. Even when it seemed foolhardy I always believed we would get to that next point.

The pandemic may have stalled business development but it also enabled me to reassess.

We now have a really solid foundation to grow and develop our care journey and we are all really looking forward to it

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Languag Stigma Labels and terms change over time, especially those used within the health and social care fields of professional practice and especially assessment. The language used is important and needs a different approach to that used elsewhere. Its all about what we say, as much as what we do.

Dr Mervyn Eastman,

George Coxon,

Co-Founder, Change AGEnts &

Collaborative Director,

Co-Founder, Member of Later Life Audio &

Devon Care Home

Radio Co-operative 0026

ge and Labels and terms change over time, especially those used within the health and social care fields of professional practice and especially assessment. The language used is important and needs a different approach to that used elsewhere. Its all about what we say, as much as what we do.

The time has come to consider that the term Frail or Frailty be added to the list of obsolete terms and labels.

Frailty is classified as the medical condition of reduced function and health in older adults and hence patients are classified as frail. Inactivity, poor nutrition, social isolation (loneliness) and multiple medications are among the predisposing factors and the

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symptoms that are deemed to warrant the term are: • • • • •

Falls Immobility Delirium Incontinence Side effects of medication

Not disputing the existence of the "conditions" that lead to the concept and labelling of Frail or Frailty applied to individuals or a whole section of an older demographic, but the term Frail and Frailty need to reflect and be underpinned by the notion of preciousness – the determinants of those conditions that constitute the label and thus the social conditions / environment and political systems which increase vulnerability.

It fails to acknowledge the moral imperative and ethical position with regard to care and later life. It fails to respond to and confront social justice.

Speaking specifically about other language used in social care land, people need to speak up loud and proud about what makes our work attractive – to create a new narrative with a specific glossary of terms that that deviates from us being seen as a lesser part of the health care world.

In practice what this means is, for example, outlawing language such as ‘challenging’ behaviour, or ‘doing’ things to people, like feeding, toileting, dressing, and changing them, etc.

As to being ‘aggressive’ – Aggression requires premeditated malicious intent, and a person living with a 0028

dementia, who may be resisting care for example, is simply feeling under threat and not understanding what the helper is trying to do.

Even the use of the word ‘admission’ when someone is moving into a care home. Care homes are not a hospital: we have ‘arrivals’ not ‘admissions’, and we are promoting homely life, not life in a clinical treatment setting.

It’s time we start to think and call out medical jargon, labelling and words that could alienate and disempower people, by not being entirely consumed by what the matter is with those we look after, but more so, what matters to them. Embedding a more ‘relational care’ ethos as much as a ‘person centred one’.

Here at The Institute, we have a range of different Special Interest Groups.

One of the groups we have is a ‘Frail Older Care and Dementia’ group, which focuses on covering wider issues and supporting innovation in all matters relating to older care. We would like to rename this group, emphasising the importance of language and stigma, and we would like to encourage IHSCM Members and Non-Members to participate actively in the process.

If you have any proposals for a new name, please send them to mshannon@ihm.org.uk

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General Anxiety D Jainaba Jum , Health and Social Care student at the University of Wales Trinity Saint David, CEO of Queen holistic initiative.

In this report a critical examination of the classification, diagnosis, treatment of mental health disorder of (GAD) General Anxiety Disorder from the ICD10 will be provided.

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General Anxiety Disorder, according to the NHS (2021). IS defined as a constant feeling of stress, extreme panic and fear which can have a serious detrimental impact on an individual’s everyday life, affecting physical and mental health and wellbeing.

GAD is classified within F40F48 Neurotic, stress-related and somatoforms disorder. GAD is under F41.l. Causes of anxiety, (Aetiology), signs and symptoms. When anxiety can be diagnosed.

The symptoms of (GAD), General Anxiety Disorder, can cause both psychological (mental and physical symptoms). These vary from person to person, but can include; 1. Feeling restless or worried.

2. Having trouble concentrating or sleeping.

3. Dizziness or heart palpation.

4. Being easily fatigued.

5. Having headaches, muscle aches, stomach-aches, or unexpected pains.

6. Being irritable.

These are some of the symptoms. .

You are most likely to be diagnosed with GAD if you had symptoms for 6 months or more. Funding it difficult to manage your feelings of anxiety, is also an indication that you may have the condition. To help with the diagnosed, the GP may carry out a physical examination or blood test to rule out other conditions that may be causing the symptoms such as: anaemia (a deficiency in iron or vitamin B12 and folate), or an overactive thyroid gland hyperthyroidism).

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Questionnaire can be completed by the patient.

Current treatment (give an evaluation = positive and negative). Divide the treatments according to the severity.

Measurements of rehabilitation.

These are all the tools to chart progress/treatments and to check the effectiveness of treatments provided. In order to assess the effectiveness of the treatment, it is important to know the Measurements of rehabilitation. This is because if the treatment is not effective, it should be changed.... One of the rehabilitations in GAD is the General Anxiety Disorder QUESTIONNAIRE. (GAD-7). This questionnaire is a tool to measure the level of anxiety over a period of two weeks.

Recommendations for improvement of anxiety (Complementary Therapies).

Use of complementary therapies.

For example, students such as Shohani et al. (2018), demonstrated the effectiveness of yoga in reducing anxiety in women. This will have a positive impact as it will reduce the use of drugs and their side effects.

(NICE).

Although at times the anxiety that all people experience can be somewhat severe, a characteristic of GAD is that this anxiety is usually more intense and long-lasting. If you have more severe anxiety than most people you know, then it may be more than “normal “ anxiety.

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Arden University offers you the opportunity to study online around your current job MASTER OF PUBLIC HEALTH Aligned to APHEA European Public Health competencies, this programme will prepare you for a career in the public health sector with particular focus on the latest digital and analytical skills sought by employers.

MSc GLOBAL HEALTH MANAGEMENT Designed in collaboration with leading employers , this course focuses on issues that impact health but transcend national boundaries.

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For more information or to apply please visit arden.ac.uk

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Staff Retention in the Care Industry Staff retention is a significant challenge in the care sector – making it even harder for the existing workforce to keep up with the evergrowing demand.

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Chloe Weatherhead, Head of Customer Success, Radar Healthcare

Skills for Care predicted that by 2035 the care workforce will need to increase by a minimum of a third, to keep up with the ageing population and demand for new carers. In the same report, it was estimated that staff turnover within social care is 30.4%. To put this into perspective, approximately 23% of independent sector workers have a turnover rate of less than 10%.

This prominent level of shift indicates that organisations within the care sector are struggling to find and retain suitable candidates. Working in care comes with many challenges, and an insufficient number of workers within the industry creates problems for both service users, workers, and organisations.

Ongoing issues within the sector have meant that care providers have needed to adopt a range of new strategies to support and retain their employees. Technology, especially over the COVID-19 outbreak, has proven to be extremely successful within the healthcare industry. It has shown how embracing paperless methods can improve organisation, boost work ethics and morals, encourage communication, and reduce the number of hours completing admin.

The Impact of Staff Turnover High staff turnover can be incremental to an organisation’s service and reputation. It can lead to lower levels of patient satisfaction, increase the number of risks to both employees and service users, and make meeting CQC (Care Quality Commission) and Care Inspectorate standards even more challenging.

The care industry is extremely valuable to our economy, contributing over £50 bn to the UK economy and equating to 5% of all

employment. It is vital for the wellbeing of our ever-growing and ageing population that the high turnover rate is minimised.

In addition, a high staff turnover means there needs to be a larger investment in recruiting, training, and retaining quality employees.

But how can technology help take some of the pressures off both providers and employees?

How can technology assist?

Useful technology, like Radar Healthcare can assist staff turnover issues by increasing efficiency and boosting morale.

Radar Healthcare partner, ECL said: ‘By streamlining the compliments logging process, the number of compliments logged rose from 9 per year to 1,500 per year! Being able to communicate this level of engagement from our service users has had a hugely positive effect on morale and encouraged our team to always strive for better performance.’

Maintaining and tracking records of employees’ training, appraisals, supervisions, and compliance requirements shows that an organisation values their individual workers and is invested in supporting and retaining them. Technology can also significantly alleviate the daily administrative pressures faced by those working in the care sector, as one partner of Radar Healthcare said: ‘Our evolution of health and safety and quality wouldn’t have happened without Radar Healthcare. We haven’t grown our team, yet we’re doing about 60% more than we’ve ever done before thanks to the software.’ www.radarhealthcare.com

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The merit of lifelong learning Lifelong learning can be defined as “development after formal education: the continuing development of knowledge and skills that people experience after formal education and throughout their lives”1 .

The premise being it is not possible to gain all the knowledge and skills required via formal education, these must be updated and enhanced throughout our lifetimes. Which requires a combination of resilience, resourcefulness, and reflectiveness, a gamut of learning strategies including immersion in experiences2. It has been suggested that a sign of intelligence isn’t the mere accumulation of knowledge but how often you change your mind when confronted with new knowledge, the ability to rethink and unlearn. Being open-minded to change, including changing your opinion is a huge strength. Recent 0036

events have demonstrated how the world changed overnight due to the COVID-19 pandemic, the ways we worked changed, and the rule book was thrown away.

Being open-minded to new experiences, new knowledge and views enriches life for the better. We shouldn’t limit our time of education to our younger years. Change is constant and inevitable3 . nothing remains the same, however, growth is optional. Learning should be lifelong; we must remain curious.

People like to learn different things and in different ways. No matter how much you learn you’ll still only ever know a tiny fraction of what there is to know, so choose things that are important to you, that keep you curious and make you feel fulfilled.

Learning at Work Week 2022 took place from 16th to 22nd May 2022.

The theme was ‘learning uncovered’ which delved into the merit of lifelong learning.

Ros Leslie – Chief AHP From a very early age, my dad used to read words from the dictionary with me. I have been blessed with having a continuous learning mindset. Lifelong learning for me has always been self-motivated based on a need for self-fulfilment, and I have always strongly believed that education does not end at graduation; indeed, graduation is only the beginning.

Reading is important for learning, although, for me, there is nothing better than learning through experience. Whether that is a clinical experience, something that has happened outside the workplace or simply a conversation.

Every experience in life – including mistakes as well as successes - can be a learning experience, but only if you take the time to reflect. It is important to reflect on how we felt and how we and others behaved to give context to what we have learned, this process of reflection will make our experiences more tangible.

As I continue to learn something new every day, this knowledge acquired over the years will make a huge difference in my life, giving me a true sense of purpose and achievement.

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Gail Parry – Organisation Development Lead Learning to me means having a gateway to being the best I can be.

‘Knowledge is Power’ has been said so many times, and having access to information, books, research, blogs and now podcasts, have all been part of my learning experience. I was taken to the library when I was a child, and my love of books and information was passed to me by my parents.

I have always had an interest in ‘Learning stuff!’ I am fascinated by words and their meaning, and that came from wanting to understand and apply that knowledge in practice. During the pandemic, I could never have imagined working from home, and working remotely. It was a wonderful opportunity to upskill how I was learning from a virtual platform, and equally, how I could facilitate others in that space. Having to pick up nuances and body language and draw on other skills, really improved my listening and observation skills. In 2019 I was trained in the virtual space not seeing anybody but listening and utilising listening skills, and learning how to have meaningful mentoring sessions.

It was my first experience of learning in a truly virtual way. And who knew that this was going to be one of the most useful tools for me that I took forward into 2020 just as the pandemic happened. It served me well as I now coach, train and facilitate in this way. I am eternally grateful to Google, having instant access to the world of knowledge amazes me. An improvement from the days when I reached for my dad’s encyclopaedia when I wanted to know something. All of this has enabled me to learn new things and to feel credible, a little gift of knowledge to myself.

Thus, lifelong learning can help to improve your confidence, keeps you curious, provides purpose and enhances your skills. It can bring joy, connection and understanding of the world, and can play a huge part in enhancing your wellbeing. By learning, we can achieve personal aspirations and organisational goals.

“The larger the island of knowledge, the longer the shoreline of wonder” - Ralph W. Sockman

References 1. London M. The Oxford Handbook of Lifelong Learning (1 Ed.). Lifelong Learning: Introduction.; 2011. doi:10.1093/ oxfordhb/9780195390483.013.0013 2. Claxton G. Wise up : The Challenge of Lifelong Learning. Bloomsbury; 1999.

3. Disraeli B. Speech on Reform Bill of 1867, Edinburgh, Scotland, October 29, 1867.—Selected Speeches of the Late Right Honourable the Earl of Beaconsfield, ed. T. E. Kebbel, vol. 2, part 4, p. 487 (1882).

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Cheryl White Apollo Care, Liverpool 0039

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How to Speak Up Safely A new IHSCM Short Course I was absolutely delighted when the IHSCM approached me to help them develop an online masterclass to help members speak up safely in health and care settings.

My mum was a Matron, my gran was a Matron, my aunty was a community nurse and health visitor, I spent five years in middle management in the NHS and five years as the volunteer Chair of Eden Carers, here in the Eden Valley in Cumbria where I have lived nearly all my life.

The topic of patient safety and how to create safe cultures of openness has dominated discussion in the world of health and care for as long 0040

as I can remember. And it continues to do so.

My name is Tom Bell, I am a business consultant and former NHS Manager turned Whistleblower with lived experience and specific expertise in wilful blindness and ethical fading in public services.

I am the author of Lions, Liars, Donkeys and Penguins - The Killing of Alison, the book tells the true story of the events leading to and following the suicide of my sister after a period of abuse in an NHS mental health hospital.

It is now over thirty years since Alison took her own life, my family

Tom Bell, Director and Lead Consultant, Cormetis Consulting

and I are presently awaiting a decision from the Attorney Generals Office as to whether we will be allowed to have a fresh inquest into the events leading to her death.

I’m nothing if not persistent! And while it would be entirely fair to say Alison died because people did not speak up, it would also be fair to note that when people did, nobody listened, and if they did, they felt unable to deal with what they were hearing and act upon it.

The damage that a dysfunctional culture of silence inflicted on my family and the price my sister ultimately paid remains beyond measure. But despite what has happened I understand the reasons people do not speak up, and often feel unable to speak up safely.

They are multi-faceted, more complex than many would have us believe.

Closed cultures, cultures of silence and complicity, are not simply down to bad management, the absence of courage, or the presence of malice, in fact I believe few instances of harm can be tied to either of these simplistic trains of thought.

The truth is that our behaviours, responses, and actions are creatures with incredibly deep roots. Our need to belong, not to upset those we see as being in charge, was once essential to ensure our own survival when exclusion from the group was a death sentence by predation or starvation for our ancestors.

In the course I have created on speaking up safely in health and care, I talk about a concept called wilful blindness, and I explain that for people to speak up safely, they must first be willing to recognise what happens around them.

The reason many people don’t speak up is because we are not naturally predisposed to acknowledge the things occurring around us that we might not be entirely comfortable with.

We have learned to compartmentalise our lives and our actions and fail to acknowledge the humanity that ultimately binds us all together. I believe you’ll not only enjoy the course that’s been created for you, I think you will find it fascinating, insightful, and incredibly useful. I look forward to seeing you there.

IHSCM Members can now enrol on our BRAND NEW short course masterclass ‘How to Speak Up Safely in Health and Social Care’ Watch the course promotional trailer.

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