Listen to our NTH Voices podcasts.
Each episode brings an insightful conversation with North Tees and Hartlepool NHS Foundation Trust staff about careers in the NHS, the wellbeing of our staff and the future of healthcare.
Listen on Spotify
All episodes
Episode 10 – Giving back to our communities this Christmas
Each year we organise a food and toy drive to give back to our community over Christmas.
In this episode of NTH Voices, communications, engagement and marketing manager Mark Malik talks about why this is so important to our Trust and how staff can get involved if they would like.
Episode 10 – Giving back to our communities this Christmas
Intro: Welcome to North Tees and Hartlepool voices, telling the stories of our people and community in our Trust.
Elliot: Hello, my name is Elliot Kennedy. With me in studio this morning we have Mark Malik from communications, engagement and marketing team. Good morning, Mark.
Mark: Morning, thanks for having me today.
Elliot: Today we’re talking about giving for Christmas.
Mark: Yes, absolutely.
Elliot: Who will we collecting for?
Mark: Well basically we’re asking staff, if they’re able to do so, to collect food, toys, gifts and wrapping paper for some of our local partners.
So the food will be going to the food banks in Stockton and Hartlepool which will be supporting some people with extra food and treats over the Christmas period. And toys, gifts and wrapping paper going to our partners over at the Salvation Army in Stockton and Hartlepool as well to help some people enjoy Christmas a little bit more.
Elliot: And why are we collecting these items?
Mark: Well basically, it’s a sad fact that our region experiences some of the worst poverty and financial disadvantage in the entire country. So this collection is about some of our local families, some of whom are in you know very, very dire financial situations, to just have a nice Christmas and enjoy themselves a little bit more, try and ease a little bit of that pressure.
Elliot: It’s a nice idea but some of our own staff may also be finding a hard times this year.
Mark: Absolutely. We wouldn’t want anyone to feel pressured into donating. What we ask is only to donate anything if you can afford to do so. But, you know, every penny counts so even if a couple of colleagues could club together and get something small, that would be appreciated too.
Most supermarkets have, you know, very reasonably priced own brand goods – tins of peas, sweetcorn, things like that that can go on their meal. Or even gifts that start from just a couple of pounds.
But, again, absolutely only if you can afford it.
Elliot: Are we appealing to members of the public as well?
Mark: Not really, no. This is a staff only appeal but if you’ve got a family member who wants to join in they can give you something to bring in yourself or give you some money. My dad always gives me a few quid and he’s quite surprised how far we can stretch it.
So what we’re looking for is tins of vegetables, gravy granules, packets of stuffing mix, store bought Christmas cakes, Christmas puddings, toys, games, things for older teenagers – they often struggle with older gifts for them. Men’s toiletry sets – Salvation Army struggles with that. Lots of people don’t think that men require things like that as well so anything that people can give would be great and if families want to join in and help as well that’s absolutely fantastic too.
Elliot: Now, more importantly, where can staff drop these items off?
Mark: Best thing to do would be for staff to check their emails where we have sent messages around.
But if I can quickly recap them, up in Hartlepool we’ve got ward two on the first floor, the specialist services admin hub, the outpatient staff room, Amanda McNeany on the fourth floor kindly uses her office as a dropoff base, and the chemotherapy ward as well.
And over at North Tees, Tatchell Centre reception, the pathology staff room, the third floor of the tower block, the fifth floor of the tower block and the seventh floor of the tower block – that’s the directorate offices. They will all take gifts and donations there. The main office of the X-ray service, the undergraduate department in the south wing, NTH Solutions office which is near the Tees Restaurant entrance and our own office communications, engagement marketing office on the fourth floor of the north wing.
So we’re spread about the Trust. Wherever people are, they’re not too far from a drop off point. And then our brilliant volunteers collect them once a week, gather them all together and take them off to the food banks and Salvation Army.
I know the stuff that me and my dad have done has already gone so it’s already on its way, it’s already moving well.
Elliot: Well thank you, Mark.
Mark: Thank you very much.
Outro: Thank you for joining us. Until next time. You’ve been listening to NTH Voices.
Episode 9 – Introducing InPhase
Over the coming weeks and months, we are introducing InPhase into our Trust – a new hospital events reporting system which will replace Datix.
In the latest episode of NTH Voices, chief nurse Lindsey Robertson gives an overview of how we are rolling this out with staff, how to get involved and what you can expect.
Episode 9 – Introducing InPhase
Intro: Welcome to North Tees and Hartlepool voices, telling the stories of our people and community in our Trust.
Elliot: My name’s Elliot Kennedy and today we go behind the scenes with…
Lindsey: Lindsey Robertson, chief nurse, hello.
Elliot: Hello there. Why are we moving away from Datix?
Lindsey: We’re moving to a more flexible system so that’s the first thing. Datix has stayed fairly static and it hasn’t really kept up with the national direction of travel.
The bigger context of this really is how we capture events that happen across the organisation. So we used to call them incidents but now we call them events and it’s all in line with the national patient safety strategy.
So we want to make it really, really easy for all of our staff to capture events where things might go well and things might not go so well so that we ensure that we learn and we improve. And that’s really the basis of why we’re changing our system.
InPhase is really flexible. Most young people or most people across the organisation now have apps on their phone, we we’re used to that, so this is an app based system that sits in the cloud, uh wherever that is, and they can access those apps on any device that they’ve got. So they’re not restricted to any of the computers that we’ve had previously.
So it’s much more flexible and easier so when staff feel that there’s something they want to share with us from a patient safety perspective or improving quality then they can do it really easily.
Elliot: So how long will it take to learn and embed?
Lindsey: So we’ve been learning for a little while. So there’s a core team of us that have been doing this and driving it forward. There’s quite a number of staff already being trained but, with anything, I think it’s once we start to roll it out and we use it and we test it and it’ll evolve.
So certainly the first phase of roll out will be for our events which our staff will understand as Datix incidents, how they report, so we’ll call them events and that’ll be the first app to roll out in December. So there’s lots of training around that and then we’ll follow on with complaints and compliments and risk. So we’re moving that as a rolling programme.
Elliot: So what’s the main advantages of implementation of InPhase?
Lindsey: I think I’ve probably said a bit of that in a very hurried way.
So I think the main advantage is that it is really accessible. I think previously there’s only been one system, people have to sit down, they have to get to a desktop computer. This means that they can do it from their phone. It’s really easy like anything, like if you were buying something on your phone.
It’s very easy to access as it’s a cloud-based system so any piece of technology they can do and if people can’t get to the technology can support them with some paper if they need to do that.
Elliot: We have clear points and contact support and training and advice?
Lindsey: Yeah, we’ve got what we would call super users. We’re going to have those across all the departments, we’re going to make it really easy for those staff who are front line so they can go and get some support from the teams understanding it and rolling it out, but not just around training that they have to access online but we’ll be there walking the walk with them so that we can really get underneath it and support any of those things that we probably haven’t predicted but we can do it the time.
Elliot: So the roll out plan will be phased?
Lindsey: Yeah.
Elliot: How do you plan for that?
Lindsey: We’ve already got that happening so we’ve done quite a lot of training now. I think there’s been circa 130 people trained on some of the app based stuff, already got a dedicated team.
We’re going to have computers and any technology set up in the back of the restaurant but we’ll be walking the floor so when we roll it out we’ll go to the areas where people are using it and we’ll be with them on site.
Elliot: And the planned roll out is to end in March? Yeah. This year Datix will go at the end of December so we’re on a tight deadline. People have been working really hard to make sure that we get those first apps in use and then we’ll have it all in place by the end of March.
Elliot: Okay, thank you.
Lindsey: Thank you.
Outro: Thank you for joining us. Until next time. You’ve been listening to NTH Voices.
Episode 8 – Relaunching our communications, engagement and marketing service
Our communications, engagement and marketing team support services right across our hospitals and community bases.
In the latest episode of NTH Voices, Ruth Dalton, deputy director of communications, engagement and marketing, discusses how the team works with NHS staff and journalists, and how they’re evolving support based on staff feedback.
To get in touch with the team, email [email protected]
Episode 8 – Relaunching our communications, engagement and marketing service
Intro: Welcome to North Tees and Hartlepool voices, telling the stories of our people and community in our Trust.
Elliot: I’m Elliot Kennedy and today we go behind the scenes with Ruth Dalton, deputy director of communications, engagement and marketing. Why are you doing a relaunch of communications, engagement and marketing?
Ruth: Okay, it’s a really good question. The communication service within our Trust has been here for a number of years now. People across the organisation will link it with Anthem and newsletter as well as messages about updates and events.
But back in 2018 there was a directive to change how we deliver our service and what it should look like moving forward. And after a lot of reshaping and restructuring – some bad, some terrible in fact and some good – we’ve arrived where we are today and we want to talk about how we now work and what you can expect from us in terms of support.
Elliot: So what can we expect to see and how we got to this point?
Ruth: Well hopefully most people across the organisation will have had some link at some point with our team. That might be reading a health and wellbeing magazine, following us on social media or you might have shared a good news story or two for our website.
But we deliver a lot more than that and we wanted to test if we were getting it right or completely missing the mark. So back in October, we issued a brief survey and invited staff to respectfully give their thoughts on our service. It’s all subjective of course and working in PR and communications you become exceptionally thick skinned.
The feedback leaned the majority of the way to a positive view of the service. Staff suggested that there were lots of platforms and channels for them to receive Trust news but they also gave us some really candid feedback about what else they wanted. They want more face-to-face communications, our community staff want more involvement and inclusion and boy do they love a screen saver.
Our job now is to translate that feedback into a service befitting of the Trust and in shaping that we want to talk a little bit more about some of the other work that we deliver.
Elliot: So beyond the bulletins and the newsletters what else is the team going to do?
Ruth: Well we look after our website – we built our new version earlier this year. We work with our external stakeholders to ensure that they know what’s happening in the Trust and how they can use their voices to help us – our political partners and our local authorities, for example.
We work with the local regional or national media, we try exceptionally hard to ensure that we get as much positive coverage as possible, and we’re really proud of that, but we also work to support maintaining a good reputation for this organisation, our group and the wider NHS. That’s some of the more challenging aspects of our work really.
Most of our media partners are great, they’re not all journalist of days gone by but some are still looking for sensationalist headlines and a scoop if you will. And if you sit within earshot of my office, you’ll hear the rows and challenges made of some of our colleagues on a day-to-day basis.
I’ll give you one little snippet insight to something that happened during the pandemic. One of our local newspapers printed a headline without any consultation with us about how Covid had hit the University Hospital of Hartlepool. People remember at that time that that wasn’t the situation, that Hartlepool was kept for our elective work and making sure that it was a green site essentially. There were a lot of rows that day with the local editor of that newspaper to pull the headline, which happened.
So there’s a lot of that negotiation goes on behind the scenes, some stuff that doesn’t get to press perhaps where it would have if our team weren’t in place often happens. So we deal all sorts with all sorts of crisis communication, celebratory communications, sometimes straightforward fact giving communications.
We also now look after engagement and that’s a learning curve. Pleasing 6,000 staff is no easy task but we keep going.
Elliot:
Ruth: So what’s happening next? So next we’re looking to share more of our ambitions and our service into the teams that feel they might benefit from our work. So if you’ve got something you want to share, get in touch, we can give you platforms internally and externally. If you need support with a challenging media issue give us a call.
We look after identity and voice – ensuring that we make North Tees and Hartlepool stories heard. We deliver difficult messages at times and they can be really hard to land but we try to do it with respect. We’ll be sharing more of our plans in the coming days and weeks and we would love colleagues from the Trust to get involved.
Elliot: Thank you Ruth.
Ruth: Thank you Elliot.
Elliot: Bye bye.
Outro: Thank you for joining us. Until next time. You’ve been listening to NTH Voices.
Episode 7 – Welcome to our financial health and wellbeing events
This year we are once again welcoming in local public sector and private companies to offer staff money saving advice and exclusive offers as our financial health and wellbeing marketplace event returns.
In this episode of NTH Voices, chief people officer Susy Cook and deputy director of communications, engagement and marketing discuss our reasons for putting on this event and what our staff will be able to find on the days.
Episode 7 – Welcome to our financial health and wellbeing events
Intro: Welcome to North Tees and Hartlepool voices, telling the stories of our people and community in our Trust.
Elliot: You’re listening to Radio Stitch, serving the patients, staff and visitors at the university hospitals in the North East. Today we have Ruth Dalton and Susy Cook.
Ruth: Good morning.
Susy: Good morning, Elliot.
Elliot: Good morning. What are these events and financial health and wellbeing and how do they come about?
Susy: So the events are really exciting events with the help of Ruth, our communications and engagement lead. They came about because when we started to really understand what people meant by health and wellbeing.
We decided to run a survey with the support of Ruth and her team to understand what people really wanted to help them around health and wellbeing. So we ran a reward and recognition survey to understand, in the guise of reward and recognition, what people wanted to know more about, where they wanted help, what would really help them in their work and daily living.
And one of the things that came out was support around financial health and wellbeing and therefore that was the start of these events.
Elliot: Why should staff attend and what can they expect to experience?
Ruth: Okay, so Elliot, this is the second year we’ve run these events so hopefully staff will remember their success last year. So we work with a number of internal departments as well as lots of external partners as well.
So we’ve got people from the welfare team at Stockton Borough Council, and Hartlepool Carers who can support families who need support there. We’ve got commercial enterprises coming in, Kwik Fit onsite on the day offering free winter checks for our staff so make sure you register for that.
It’s a real host of different organisations and departments that can offer different levels of support, advice and guidance.
Elliot: And what type of organisations will be there?
Ruth: So, as I said, we’ve got Stockton Borough Council health and welfare, we’ve got education teams. We’ve got the ARC in Stockton so if staff already don’t know this we get a 10% discount on all of their gig tickets, we work really closely with those guys.
We’ve got some health and beauty people coming along, we have food banks coming along in respect of can we work to support those guys as well, we know we work really actively with those guys.
Lots of different organisations internally. We’ve got our smoking cessation team coming along who I am assured are bringing along some really exciting new vapes for people to look at.
So lots of different ways that people can look at different aspects of their life to address any kind of financial health and wellbeing imbalances really.
Elliot: Are these events part of a wider ambition for health and wellbeing for the Trust?
Susy: They absolutely are. So we’ve done a full review of our health and wellbeing offer for the organisation and really focused on what can we do to provide a service that helps people on a number of levels.
So we’ve reviewed our occupational health team we’ve got Helen Waller now. A big plug for Helen, our health and wellbeing care coordinator, who’s out there on a regular basis linking in with our staff and supporting.
We’ve got the health and wellbeing magazine that Ruth here supports us with that promotes and shares ideas and information around health and wellbeing. We’ve got our occupational health team, who are fantastic, that support our staff out there around all things health.
We’ve also got, remember, for everybody the flu vaccination. Please get your flu jabs and the Covid vaccination because, you know, it’s really important not only to protect yourselves but to protect our patients.
So yes, whilst the festival of financial health and wellbeing is really important in terms of finance support, we do have a bigger ambition for health and wellbeing and we will continue to review our health and wellbeing offer.
Elliot: Now, what are the dates for these events?
Ruth: They are happening on the 29th and 30th of November at Hartlepool and Stockton respectively.
Elliot: And what time are they? All day?
Ruth: They are running from half 11 until 1. So when we worked with colleagues last year, these were the best times for people to drop in and out as they’re grabbing sandwiches or having their lunch. And happy to sort of feedback from staff after that as well.
Elliot: And it’s an open door?
Ruth: Open door. So at North Tees it will be in the back of the restaurant, literally in the back of the restaurant not the Tees meeting room on the outside. And Hartlepool in the main foyer there so you won’t be able to miss us.
Elliot: Ruth, Susy, thank you.
Ruth: Thank you.
Susy: Thank you, Elliot.
Outro: Thank you for joining us. Until next time. You’ve been listening to NTH Voices.
Episode 6 – Developing our group model
James Bromiley, associate director of group development, works across both North Tees and Hartlepool NHS Foundation Trust and South Tees Hospitals NHS Foundation Trust. He leads on collaboration between the two NHS trusts.
Here he discusses recent developments and how our working group model this will look in the future.
Episode 6 – Developing our group model
Intro: Welcome to North Tees and Hartlepool voices, telling the stories of our people and community in our Trust.
Elliot: I’m Elliot Kennedy and I’m going behind the scenes. Today we have James Bromiley. Good morning James.
James: Good morning, Elliot.
Elliot: What’s your role?
James: So my role, Elliot, I’m the associate director of group development and I work across North Tees and Hartlepool and South Tees trusts on group development which is the way in which the two trusts work together collaboratively across the range of services.
Elliot: And tell us about the group and what’s the model that North Tees and South Tees are going to use?
James: Yeah, so it’s clearly not new for North Tees and South Tees to work together. That’s been going on for years and years across a range of services. The group model is really a description for how we take this forward with more pace and across a greater range of services over the next few years.
The trusts stay as autonomous trusts. North Tees and Hartlepool and South Tees remain as organisations but it’s an equal partnership.
It’s describing how we work collaboratively for the benefit of patients, for the benefit of staff, for the benefit of the population really, to make the strategic decisions at a group level.
The idea of group model really is something that’s going to be more common across the country. So there are group models for example in Barts, in London, in Manchester, in Northamptonshire, and what we’re trying to do is to take the benefits of those group models which already exist but then put them into a way in which really works for our own circumstances and our own population.
Elliot: And what does that mean for staff and others within the trusts?
James: The benefit of the group model is we get the scale of working together across the two trusts but we keep that local identity and we keep that those local links and access to services.
So I think for patients, you can see benefits in terms of making sure that we get exactly the same level of care across the two trusts. For example, if you have to go from one hospital to another through your period of care that should be made much more easy for you.
I think, for staff there are huge benefits as well so you could form a career path much more easily across North Tees and South Tees.
And for clinicians working across the two sites through for example having the same digital platform or a digital platform which at least talks to each other will be much more straightforward. So for staff it’ll be much more easy.
And then the third thing really is around the voice that we’ll be a much bigger group than two individual organisations and so we’ll have a stronger voice. We’ll be able to respond much more clearly to the needs of the population and we’ll have a stronger voice regionally and nationally in terms of how we argue for our population’s needs.
Elliot: And I understand there’s going to be a partnership agreement?
James: Yeah, the partnership agreement is really something I’ve been living and breathing, Elliot, since I’ve been in this role at the start of August. What it is it’s a formal agreement for how this group model will work across North Tees and Hartlepool and South Tees. And also the ICB, the NHS for North East and North Cumbria, will also be a signatory to this.
What it does is it sets out how this group model is going to operate so it sets out the context, the population needs that we’re trying to meet and the benefits of working collaboratively. It sets out governance, how we’re going to take joint decisions and how we’re going to have a joint leadership structure. It sets out a road map for how we’re going to get there.
The most important part of the partnership agreement is describing how we’re going to change things and migrate things clinically to join those clinical services together. And to set a series of priorities which will be really the heart of what this collaboration will be to enable those services to really serve the population much more effectively than they currently do by working collaboratively.
And clearly clinicians have been at the very forefront of designing what those should be and it also sets out what we’re calling the enabling strategies but that’s really the support – so how do we support that clinical change in terms of digital strategy, in terms of HR strategy, in terms of finance strategy as well.
Elliot: And the aim is to achieve this by when?
James: Well it’s going to take a long time to do this really properly but we’re making this change now through the partnership agreement to really accelerate the collaboration that we’re doing.
The aim will be to have the group set up and running by quarter one of 24/25. so in that April to June period. But that won’t be the finished article. The partnership agreement is very much a live document. It’s a living document and the group model will be a living entity. It’s going to change and migrate and evolve as we come across new things and new opportunities.
So I don’t think there is a finishing point to be honest.
I think it’s really important that we indicate that we’re doing this at pace, but of course we’ve also got to make sure that we maintain the stability of services in both of the trusts. What we don’t want to do is create change which is destabilising. It’s about the balance between clear step change but also making sure that we maintain that stability of services.
And I have to say, and this gets very boring for people who talk to me, but I really love this role. I think it’s fantastic. I feel like this is the opportunity to make this work after lots of attempts at collaboration over the previous years.
This is the opportunity that we’ve got to make things really work for our staff our patients and the population of the Tees Valley and beyond.
Elliot: Thank you James.
James: Thank you, take care.
Elliot: That was James Bromiley, the associate director of group development here within North Tees.
Outro: Thank you for joining us. Until next time. You’ve been listening to NTH Voices.
Episode 5 – Launching our faculty of leadership, learning and improvement
This episode of NTH Voices sees conversation around the launch of our new faculty of leadership, learning and improvement.
Chief people officer Susy Cook and joint chair Derek Bell discuss what the faculty is, how it will support our current and future workforce, and how everyone can get involved.
NTH Voices episode 5
Intro: Welcome to North Tees and Hartlepool voices, telling the stories of our people and community in our Trust.
Elliot: You’re listening to Radio Stitch serving the patients, staff and visitors of the University Hospitals in the North East and today we’re behind the scenes with Susy Cook and Derek Bell, hello.
Susy: Hi, I’m Susy Cook, chief people officer and director of corporate affairs here at North Tees and Hartlepool hospitals.
Derek: And I’m Derek Bell, the joint chair of North Tees and Hartlepool hospitals and South Tees Hospitals Foundation trusts.
Elliot: Well we know what your roles are but what are we here to talk about today?
Susy: So we’re here today to talk about the faculty of leadership, learning and improvement. The aim of the faculty is to take us one step further in bringing together our leadership and learning offer for the organisation and to support our staff in their development which is really crucial as they move on their journey.
We also want to think more widely about how we attract people who may not have even thought about coming to the organisation and having a career in the NHS and it will be an enabler to drive transformation forward and use some of our improvement methodologies as we move towards our group model.
Derek: And just picking up on what Susy was saying there, it’s important that the faculty itself will align with colleagues at South Tees through STRIVE which is achieving similar things in recent months and that will help both organisations work together for the benefits of the local population and also the staff in terms of their learning.
Elliot: What has the faculty already achieved and what are the future ambitions for it?
Susy: So the faculty’s already achieved significant things. We had the NTH100 programme that’s ran, we’ve got our medical education offer, our apprenticeships offer.
But in recent months we’ve reviewed all our leadership offer, creating a new suite of programmes to support all staff at all levels, including the very first programme which is ‘It All Starts with Me’ which is a leadership development programme for everybody within the organisation. And our online learning support for staff to allow them to start to understand and work in terms of leadership training and leadership development.
We’re currently working with our medical colleagues in reviewing leadership development and how we support them and we’ve also reviewed our improvement delivery model which is supported by our medical lead Gill Davidson who does significant training around the QSIR initiative which is an improvement method to help everybody improve their day-to-day working.
Derek: We’re also at an important point in time with the launch of our Health and Social Care Academy. This is supported by Hartlepool Council and Hartlepool College of Further Education working with the Trust through the towns deal. This is to create a new environment to attract people to learn and work with us at all levels of the organisation and create opportunities for the future for all staff and for the population.
The academy will actually importantly include a state-of-the-art simulation facility based at the University Hospital of Hartlepool, offering our local partners and organisations access to these state-of-the-art facilities.
Elliot: Do you have any events arranged where staff can find out more about this?
Susy: We certainly do. We’ve just ran a really successful event at Hartlepool Hospital a week ago which allowed everybody to turn up and get a sample of some of the facilities that we’re going to have and have a taster of some of the development opportunities and this Thursday we have another event here at North Tees Hospital.
It will be back of the staff restaurant for people to come along in a very non-formal environment and have a taste of what’s available to them within the faculty – no matter what their role is, no matter where they are within the organisation – and allow them to have some open and honest conversations about what they’d like to do with their future careers.
Derek: I, along with the other non-executive directors, will be attending. We’re very keen to support this exciting agenda and we’re looking forward to meeting staff and seeing them on the day.
Elliot: Now any last messages for the staff?
Susy: Yes. To all the staff members out there, please do come along to the event if you can. If you can’t, ask your colleagues to come.
Keep your eyes on the development of the faculty as we move forward. And as Derek rightly says there the launch of the academy and the simulation suite – there’s some exciting times ahead. We’re going to be running a suite of programmes where we have speakers join us from external organisations.
There’s some exciting news to come.
Derek: I mean, this is importantly about how we value staff and if we want to encourage people at all levels in the organisation to come along and take the time to learn and work with us with these development opportunities so we’re looking forward to a very exciting day but importantly continuing that relationship in future months and years.
Elliot: Susy, Derek, thank you.
Susy and Derek: Thank you.
Outro: Thank you for joining us. Until next time. You’ve been listening to NTH Voices.
Episode 4 – The mortuary is not how you see it on TV
In this episode of NTH Voices, we go behind the scenes of our mortuary where our patients are cared for after death.
Mortuary assistant Sara Hutchinson talks through what her role involves, how the team after patients at their most vulnerable and what they do to support their loved ones throughout the process.
Episode 4 – The mortuary is not how you see it on TV
Intro: Welcome to North Tees and Hartlepool voices, telling the stories of our people and community in our Trust.
Elliot: I’m Elliot Kennedy and we go behind the scenes today with Sara Hutchinson.
Sara: Hi.
Elliot: Hello, Sarah, what’s your job?
Sara: I am a mortuary assistant. I’m one of a small team of people who work within our mortuaries taking care of deceased patients just like the live ones. We maintain patient dignity and respect at all times, check identification, property, ensure patient paperwork is completed and just make sure the patient remains safe and cared for whilst they’re in our care.
Elliot: And what does a typical day look like? First thing on a morning when we arrive at work, we check our patients that have been admitted overnight and then we admit them onto our electronic mortuary register. We obviously check their identification, any property, clothing record any implanted devices like pacemakers.
We then change sheets and clothing if they become soiled for any reason. We then liaise with our bereavement services to ensure they are aware of our new admissions.
Most of the rest of our day’s split between cleaning the mortuary, assisting the funeral directors when they come to collect their patients and just helping families who come to visit their loved ones throughout the day.
Elliot: And do you deal with all patients that come down?
Sara: Yes, we deal with children, babies and adults, early pregnancies all the way through to a patient aged of 102 is actually the eldest that I can remember we’ve dealt with.
Myself and the team, along with bereavement services, do support mums and families and they’re able to come in and visit and hold their babies in our care. With baby loss awareness week recently I think it’s really important to speak about baby loss and make people aware that we have facilities to help support the bereavement process.
We can also help with funeral advice. While we always remain professional, we are that empathetic ear and at times that shoulder to cry on.
Elliot: And what’s your favourite part of your job?
Sara: My favourite part of the job is helping with the families. Quite often people have misconceptions of how their loved ones will look or how the mortuary will look. It’s very rewarding when someone comes to visit at the mortuary and they thank us for making their loved ones look so well and just showing how nice a place their loved one is staying.
We always treat our patients as if they are our own family and I think how we would like our loved ones to be treated. Some staff have had family come through our mortuary and it’s nice to know that they’ve been given the best possible care.
I also like when families share stories of their loved ones. Sometimes it just describes how they used to be. It helps us to feel connected to our patients as human beings and know that they were loved and cared for.
Elliot: What advice would you give or something you would like the living to know about the mortuary?
Sara: Just that the mortuary is not how you see it on TV. It’s a professional environment, it’s just like a ward for the deceased really.
If someone has any concerns, needs advice or assistance in regards to death of a loved one or patient just contact us as the bereavement team are very knowledgeable and experienced and can help advise, guide or signpost you to the information you require.
Elliot: And lastly, what would you say to someone who was wanting to work with the deceased?
Sara: Why not? It’s very rewarding. You get to look after families and deceased patients when they’re at their most vulnerable. I enjoy it and I get to work with some amazing people in the team.
If you like to deliver excellent patient care then the mortuary is the place for you.
Elliot: Well thank you, Sara. That’s Sara Hutchinson who’s a mortuary assistant.
Outro: Thank you for joining us. Until next time. You’ve been listening to NTH Voices.
Episode 3 – Making every contact count
Making Every Contact Count (MECC) is an approach to behaviour change that uses the day-to-day interactions that health and social care staff have with people to support them in making positive changes to their physical and mental health and wellbeing.
In this episode of NTH Voices, MECC lead Kath Tarn talks through how it can improve health and wellbeing, what patients can expect from these conversations and how our staff can support.
Episode 3 – Making every contact count
Intro: Welcome to North Tees and Hartlepool voices, telling the stories of our people and community in our Trust.
Andrew: Hi welcome to radio stitch. In the studios today I’ve got Kath from make every contact count and she’s going to tell us and give us some awareness of what it actually means. Hi Kath.
Kath: Hi Andrew. Hi I’m Kath Tarn, I lead on making every contact count here at North Tees and Hartlepool NHS Foundation Trust.
Andrew: Hi Kath, so tell us what is make every contact count?
Kath: So making every contact count is an approach to behaviour change. So it’s about using the interactions that we have with people every day in healthcare and communities and with our families as well to have a conversation that will make a difference and influence someone to choose a healthier behaviour.
Andrew: So is that like, I don’t know, say a patient that comes in and they don’t know what the options are and they don’t know who to contact is that where you say make every contact counts does that.
Sort of say right, okay, then we can point you in the right direction. These are the people that can help you and then obviously you’ll send them there or whatever, point them there and if they make that contact that’s basically what it’s saying isn’t it? Make that contact which is going to make your life a lot easier and better in the future.
Kath: Yeah, so our ask of patients is to expect a conversation about health and wellbeing. Then when they come to our hospitals we want to know about your health and wellbeing. We are interested and we want to signpost you to be able to change behaviours that are important to you.
So to support us to help do that we’ve got a MECC gateway which is a a website which has all the services that are available in our region. So for our Hartlepool patients. Stockton patients, Peterlee patients. And patients can access this website for different parts of wellbeing.
So the core elements of MECC, to name just a few, are to improve physical activity, to support with mental health, to reduce smoking, to promote healthy weight, reduce alcohol but there’s many many other options on there where I’m making every contact count.
Andrew: What’s the website address?
Kath: The website address is www.meccgateway.co.uk/nenc
Andrew: So anybody who wants to look at that can actually join onto it and look on the website and they can actually access all those positions that you’ve just mentioned and everything else rather, smoking or and give contact to yourselves? Would a member of the team actually contact them after that or?
Kath: The gateway works as a resource so that there’s contact information on each page that might be relevant to that person. So if the person wants to stop smoking, the website has information on there that helps someone to do that, whether that’s a national initiative or something local to us. And we’ll have contact information on there.
The gateway is what it says, it’s a gateway to other services.
Andrew: Yeah, so basically you’re just opening the gate and it’s widening your world as such?
Kath: Yeah.
Andrew: Especially on the worldwide web as they say, which is great and like I said moving forward with MECC and things like that where do you see that the future is with it? How do you think it’s going to progress and get bigger and bigger? Is that only with the interaction of other people and staff and obviously patients that are out there?
Kath: Yes, so MECC is for everybody and we recognise that our population, particularly in Hartlepool and Stockton, we have higher prevalence of people who smoke, who have obesity, we have higher prevalence of physical inactivity and alcohol admissions to hospital.
Andrew: Yeah, I remember talking to other members of staff and especially the alcohol awareness team and things like that. Covid had a lot to do with it because obviously people were stuck at home and it was just easy to go around the off license or the supermarket and get 24 cans of lager or these shops that are open 24 hours.
And obviously when you’re bored and people who were smoking smoke more as well because they just sat at home so yes, and eating more. So yeah, you’re covering every boundary as such and hopefully obviously making people more aware of this and making them healthy as well while doing it which is great.
Kath: So MECC is one of our key priorities as a Trust as part of our health and wellbeing strategy. And we’re on a journey to challenge culture through a change programme to become a healthy hospital.
So we have support from the regional team across North East and North Cumbria and North Tees and Hartlepool are a leading Trust in the implementation of MECC across the region so we have support from staff to act as role models to have healthy conversations with each other and with family and to have healthy conversations with patients where the possibilities lie.
MECC isn’t about taking up clinical time that should be invested in a clinical decision, it’s about taking an opportunity for a brief or very brief intervention that could signpost someone to a better life.
Andrew: So basically a member of staff who’s got a member of their own family or anything like that can just sort of say look have a go, get on to that website, it’ll open your eyes to a lot of things and where to go to gain help for the wellbeing of themselves basically?
Kath: Yeah and it doesn’t just stop with the website, it also is about who you know and what you know. So if you know that there’s somebody who’s managed to have a successful behaviour change in their life, do you think they could influence somebody? Then someone to have a conversation with that person might be useful.
And it’s also about knowing what’s available in the community outside of the gateway as well and acting as community connectors to influence our population.
Andrew: Yeah the way I see it, it’s a lot to do with support as well and that’s what’s needed, it’s good having that contact, it’s having the support with it and having a team like yourselves that’s there willing to give that support to staff, patients, anybody that’s out there – friends, neighbours, whatever.
They always say if you know somebody who’s lonely just give them a call, it will boost them up and that’s having that contact, it’s knowing somebody that’s out there and knowing somebody. Okay, Audrey next door, I’ll give her a knock and go in and have a cup of tea or whatever else. Again it’s all contact isn’t it? Yeah. And that’s what you are doing, which is great.
Kath: And I think at that level as well, Andrew, there’s also great importance on partnership working because we know there’s health inequalities in our communities, we know that people don’t have the same opportunities and it’s not just as easy as asking somebody to be more physically active.
There might be other reasons why they aren’t and we want to adopt a personalised care approach to our interactions and our interventions so that we find out what matters most to people.
We work at a system level to understand our population, understand what the barriers are to achieving health and healthy lifestyle and we are able to provide opportunities, work with local authorities, work with our voluntary sector to provide opportunities that mean something to the people of Hartlepool and Stockton.
Andrew: That is absolutely fantastic and I’d like to thank you for coming into the studios today to have a chat with us and things like that and hopefully we can progress this and give you some awareness, like I said Radio Stitch is out there broadcasting throughout North Tees and Hartlepool we’re even on the TVs and hopefully going over with James Cook very shortly.
Thank you very much, Kath, for coming down and seeing us and if we can help you in any way in the future please do. Just give us a refresh on the website and how people can get in with you.
Kath: Yes so making every contact count – the website is www.meccgateway.co.uk/nenc
And my final ask of Andrew today is what opportunity do you have, Andrew, to make every contact count today?
Andrew: Well in the Radio Stitch network, we have a lot of contacts out there in the communities. Like I said now we’re reaching out to other hospitals, other community sectors like Peterlee, Lawson Street and things like that.
Plus I have a lot of contacts from my industry over the last 30 years of being in the hospitality trade and things like that. And again now I have the time to sit down and think about people, I will definitely be making that contact count. So yeah we’ll push forward and we’ll give you some backing and we’ll get you some awareness out there and hopefully we can grow this for you.
Thank you very much for coming in, Kath, and don’t forget make every contact count.
Kath: Thank you, Andrew.
Outro: Thank you for joining us. Until next time. You’ve been listening to NTH Voices.
Episode 2 – Meet our alcohol care team
One year on since our alcohol care team was formed, we chat with alcohol lead nurse Hayley Douglas about how the team support our patients and their ambitions going forward.
Episode 2 – Meet our alcohol care team
Intro: Welcome to North Tees and Hartlepool Voices, telling the stories of our people and community in our Trust.
John: So hi and welcome to NTH voices, our new podcast. I’m John Hugill from the communications and marketing team. I’m joined by Hayley Douglas, our alcohol lead nurse.
Hayley: Hi.
John: How you doing today?
Hayley: Good, yeah, are you?
John: Excellent, yes, very well thanks. So I’ve just got a few questions to ask you so can you tell me first of all a bit about your role and the role of the wider alcohol care team?
Hayley: Yes so the alcohol care team is made up of myself and another registered nurse. We have three band four associate practitioners. We see patients all across the hospital from A&E to patients that are waiting for operations if they need any support with their alcohol withdrawal management when they’re in hospital.
We’ve been around since July. I’ve been around since April last year but we’ve actually only been live since July and the team’s just been coming in slowly throughout the year. We’re fully staffed now and we’re fully operational so we do Monday and Friday 8 till 6. And weekend and bank holidays we do 8 till 4.
John: So like you say the team was set up in in July, so it’s nearly coming up to a year now. So what would you say have been the main challenges and achievements over that time?
Hayley: I think we’re still embedding in the Trust really. I think not all the staff know that we’re here so hopefully doing this will help. So yeah we’re not getting a true picture of how many of our patients are coming through the hospital doors who actually have an issue with alcohol.
The government recommends that you don’t drink any more than 14 units a week so everybody really should be screened for that when they’re coming into hospital and patients aren’t. So it’s kind of our job to embed that into the Trust but that’s an ongoing piece of work really. So yeah we’re catching as many patients as we can but there is still quite a lot of patients that we aren’t getting hold of.
John: So as we know Teesside has some of the highest rates of alcohol related deaths in the country, with Hartlepool being the third highest I believe. Why do you think this is and what challenges does this represent to the team and to those people affected?
Hayley: I think the pandemic has got a lot to answer for. We are still not seeing the full aftermath of that, like the sales of spirits and wine was up by millions. So I think all these patients are now starting to filter through.
We’re even seeing patients that have never been to a GP for 10 plus years and they’re coming into the hospital with like end stage liver disease and I think the fact that they have been in their house for years and done nothing but drink alcohol has massively impacted on that like on the whole population really.
And then, in turn, is loneliness which leads to mental health problems.
John: Quite a multi-layered thing, lots of different reasons I suppose why someone might get to the point where they come into hospital with an alcohol problem.
Hayley: Yeah, I mean like even falls. You know if you’re at home, you have you’ve had too much to drink and you have a fall and then they’ve had a long lie we’re seeing lots of those patients. A lot of our patients come in with chest pain as well in regards to what’s going on like with the community and how we’re working.
So Stockton and Hartlepool have both just – both councils have just written a report on their drug and alcohol needs assessments which we are being part of as well in regards to writing out the recommendations for that.
It’s quite interesting actually when you look at the map on Hartlepool, there’s like specific areas where the hot spots are. And those hot spots tend to be the more deprived areas. They tend to be the areas that have more, you know, your 24 hour places where you can get alcohol 24 hours a day basically. So they’re going to look at things like not being able to get more licensing in them areas.
John: So how do you think that will help then with licensing?
Hayley: If we do make those changes and find those patterns where in those areas – interestingly Scotland actually have done something very similar to what we’re proposing in our area. They’ve even put, you know, on your bus stops and things like that the posters about like not drinking too much. I’m sure a lot of the places in Glasgow they stop selling alcohol at 10 and they’ve seen a massive reduction in their alcohol related hospital admissions.
So that would be amazing if we could do something similar in our area. It’s getting all that pushed through though but that’s working with our community partners to do that. It sounds like very interesting work and I’ll hear more about it over the next few months.
John: So just finally, have you got any new developments and events planned over the next few months and any key messages for our listeners?
Hayley: Yes so we have put on another clinic for our fibro scans – that’s on a Thursday morning over in Hartlepool. We continue to do the Friday morning ones here at North Tees.
Our AA meetings obviously in the chapel every Tuesday 4 to 5. All are welcome to that so that’s like family members, patients and staff.
We are doing a one-year run event in July which is open for all staff, that’s going to be in the lecture theatre so keep your eyes peeled for an email about that and register your place. On the agenda will be people from AA, our liver disease training.
John: Just for our listeners what is fibro scanning – what’s that?
Hayley: So fibro scanning is not an ultrasound but what it does is it’s a scan but it kind of like sends vibrations to your liver and it measures the stiffness of your liver.
So if your liver is a little bit stiff that would probably indicate that you’ve got a fatty liver. If it is really quite stiff you would be looking at more of an aerosis of the liver which would need ongoing management really. But your fatty livers can be turned around and they’re the patients that we want to be seeing and getting really so that we can put some support in place for them around their drinking, exercise and diet.
John: Is this a brand new development for a lot of NHS trusts? Is this is just quite a new thing?
Hayley: For the alcohol care teams across the country it is yeah. A lot of the alcohol care teams nationally are doing the fibro scan clinics and we’re lucky to have two clinics on. So yeah it’s all about early detection and prevention, I suppose it’s just picking those things up as early as you can and it doesn’t even have to be I suppose a patient who necessarily has that issue who comes in. We’re just picking something up.
hey might be in for something else and we’re picking that up when they’re in yeah. And the attendance is quite good on the clinics to be honest.
We had some figures back the other day from how many have attended and how many have DNA-ed and how many we’ve referred on for like a consultant gastroenterologist to pick them up and it’s a third which is quite scary really. But these are the patients that we haven’t picked up prior to us being in the hospital.
John: It sounds like there’s lots going on and lots to be excited about over the next few months so hopefully we can get you back on the podcast in a few months time and find out lots of new developments because it all sounds like it is changing very quickly so.
Hayley: Yeah thank you a lot.
John: Thank you very much, we’ll see you soon
Outro: Thank you for joining us. Until next time. You’ve been listening
Episode 1 – The mental impact of stroke
Welcome to our new podcast, NTH Voices.
In our very first episode, we chat with David and Laura, two of our psychologists working in our stroke service. The pair share insights into the impact a stroke can have on mental wellbeing, the questions our patients have, and how their service can support patients in hospital and in the community for up to two years post-stroke.
Episode 1 – The mental impact of stroke
Intro: Welcome to North Tees and Hartlepool voices, telling the stories of our people and community in our Trust.
Laura: Hi guys, we’re just here today to speak a bit about our role on the ward 41, the stroke ward. My name’s Laura.
David: And my name is David.
Laura: And we’re both psychologists that work into the stroke service.
So today we’re just going to have a bit of a general conversation from our experience of seeing and supporting patients on the ward following having a stroke and just thinking about how difficult that can be for patients. And also just to bring in awareness really to the mental health aspects of having physical illness, and in particular having a stroke.
So I don’t know if you want to start, David, but what kind of comes to your mind do you think when you’ve seen patients on the ward who’ve just recently had a stroke?
David: I think what comes to mind initially is that there’s a process of shock and it’s really hard I think for people to sometimes accept what has happened to them. And it brings with it a lot of feelings of loss of independence, questions about stroke, questions about when they’ll be able to go home and it is a process of adjustment.
Laura: Yeah I think you’re right. I think for a lot of people and some people will do well just naturally over time. I think when someone’s first had a stroke, it just comes as a massive surprise I think.
That’s what a lot of people have told me. They’ve said to me ‘you know what I never thought I’d have a stroke, I didn’t think it would happen to me’. Some people have said ‘I didn’t even realise I was having a stroke when I was having a stroke so maybe I deferred getting help and treatment’ and then to turn up in hospital there’s I guess quite a lot of just shock and surprise really about ‘I’ve had a stroke’ and what a stroke means.
I think that’s one of the things that’s really difficult about being on the ward. I think some people on the ward are very unwell when they’ve had a stroke and they’ve got everything that people might think about when someone’s had a stroke. They might not be able to move, they might not be able to speak and might not be able to function very well. And I think on the whole in society that’s the image that we have of people that have had a stroke, that it’s older people that become very frail and they can’t do a right lot. And I think actually that’s not the reality I think when people have a stroke.
There’s so many people on the ward that are working age adults. that are young. They have some difficulties from having a stroke so they might have some difficulty with their speech, with their vision, with their balance. They might have some weakness in one of the arms and legs. Some people might not be able to move, some people might be able to move but actually they’re pretty well functioning after having a stroke and that comes as quite a surprise to people then being this young person that they’ve had a stroke. Or maybe they don’t have some of the obvious complications with having a stroke after.
I don’t know what your thoughts on that are David?
David: I agree with that, Laura. I think, you know in my experience, over the last six months we’ve seen people across the lifespan. You know I’ve seen people in their 20s, 30s up to the 90s so it isn’t limited and I agree with what you were saying about we have this image, this idea as a society that stroke only affects people of old age and that is, you know, patently untrue and I think sometimes that can be really difficult when you’re a younger person or a working age adult person on the ward.
And I think it goes to what you were saying earlier – you see the full spectrum of stroke on the ward as well which can be quite distressing. So you might, you know, depending on what type of stroke you’ve had you might see someone who’s been really affected by it. And I guess one of the things that I talk about with patients is to not make those comparisons. Sometimes it can be unhelpful to make comparisons between the stroke that you’ve had and the stroke that someone else has had.
Laura: Yeah, I think you’re right. I think sometimes the patients can get into that state can’t they? Comparing themselves to others with that comes anxiety and concern about ‘well, why am I okay?’ ‘why are they not okay?’ ‘will that be me?’ ‘will I have another stroke?’ and end up like that and you get a lot of worry don’t you about what that means. Will they have more strokes.
But I think there’s also the other side of that where they really start to worry and then almost feel guilty that they’re not that impaired and that can impact on people. I guess that’s a theme that we’ve seen maybe more towards the community when people are going home.
David: Yes.
Laura: That they’re saying you know ‘am I a fraud?’ ‘did I have a stroke?’ They almost question themselves because they’re not how they think they should be or they’re more functional than they should be. And then it’s like, ‘well do I deserve support?’ Is it okay for me to have difficulties with my mental health because I’m not really impaired? I just can’t speak very well.’ Or ‘I still don’t have the function in one of my left hands’.
And we always say, don’t we, that actually everyone that has a stroke goes through a process of being scared, being anxious, of being worried, of being in shock, having to adjust and process what’s happened to them, coming to terms with maybe physical difficulties as a result of having a stroke, potentially difficulties within their family but also with their mood and mental health. Because I think even if you’re doing okay after you have a stroke, there’s still that worry and anxiety about having another one.
David: Yeah, it’s a big worry isn’t it for a lot of people?
Laura: Yeah, it’s a massive worry for a lot of people. In fact a lot of the people that we see – that’s one of their questions isn’t it? ‘Do I know if I’ll have another stroke?’ and I guess what we say about that is we don’t know but we do know that no one asks to have a stroke. We don’t know if anyone’s going to have another stroke in the future.
But if we spend a lot of time I guess getting caught up in that worries, that can be really negative for our mental health. And it’s really difficult and it’s a process of adjustment but it’s trying to really take things one step at a time, one day at a time and trying to think about getting better and focusing on your rehab at that moment in time. But it’s tough isn’t it? Those comparisons.
David: And I think that’s so important just to pick up on what you said there, Laura, about taking it one day at a time and that it’s temporary, you know?
I think when people come into hospital if they’ve not been in hospital before that in itself is different, they’re in a different environment you know they might be missing their family they might have a lot of certainty around, you know, like you were saying ‘will this happen again?’ and questions around ‘why did this happen?’
And I think as people we like certainty, we want certainty and that question that you mentioned there – ‘will I have another stroke?’ – we hear that a lot don’t we? We hear that on the ward, we hear that in the community, in our group work that we do. And there’s something about wanting that absolute certainty. And I think people can buy into that worry of ‘am I going to have another stroke?’ And it can have a really detrimental impact on their wellbeing.
Laura: It really can. But it’s all an effort isn’t it to try and feel safe, try and prevent something else from happening? And it’s hard to accept that some of the time we don’t have control over these things.
But I guess what you picked up on there as well, David, is that sometimes people can get into this state of blaming themselves for having a stroke as well. And sometimes you have to work with that and say ‘you know what, we don’t always know 100% why people have strokes’. There are certain risk factors, there might be certain things about your diet and exercise that might have increased it, but we don’t know because everyone’s different.
So some people might smoke and drink and never have a stroke and someone might never drink anything in their life and yet have a stroke. So I guess it’s all about interactions, isn’t it, with your body. And we try to move away, don’t we, from kind of working out why someone’s had a stroke because no one asks for it. To just think about what can we do now to look after you.
David: I think that mirrors a lot of my experience on the ward, Laura, as well sometimes when I’ve met people, the question of ‘why have I had a stroke?’ They can be very self-blaming, you know. They can say I’ve smoked or I’ve drank or it’s because of my weight or it’s because I’ve been stressed and they internalise that problem and they attribute it to something that they’ve done.
And I think it’s really important to try and step away from that mindset because the blame, you know, like you were saying it’s not clear what necessarily the causes are. And individual differences will always be present, as it is with any condition, and I think it goes to that process of adjustment as well doesn’t it? Of wanting the certainty of why has this happened to me?
Laura: And I think that’s a natural process for everyone to go through. And that’s what I say to everyone that I meet on the ward is that it’s a process of adjustment and in fact a lot of the patients that I do see will tell me that they’ve started to adjust themselves.
So I think often we will see someone maybe a week after the referral has gone in and what I will get told is they were feeling really low. They were really upset, they were feeling quite anxious when they were initially on the ward.
But now they’ve been on the ward a week, you know what, they’re feeling better and they’re telling me that they’re feeling better because they’re seeing their family, they’re coming to visit, they’re starting to understand what’s happened to them. They’ve started to engage in physio and speech therapy, they’re starting to see progress and so actually that initial shock, that initial distress is starting to lift and for a lot of people this happens naturally, doesn’t it David?
Quite often the people on the ward don’t need a lot of input from us, it’s just about helping them to understand that it’s okay to feel distressed and anxious after a stroke.
Something big has happened to you, something scary has happened to you. Of course you’re going to feel upset, anxious and worried.
David: It goes to what we were saying earlier, doesn’t it, about normalising distress. That it is normal and I think, you know, there’s a tendency I wonder sometimes about pathologising distress and seeing it as being something that needs specialist input.
To pick up on what you were saying, Laura, sometimes we do see people a week after the referrals come in and, you know, once I’ve seen them they’ve said like ‘actually yeah, a week ago when I was speaking with a consultant, I was really distressed but actually I’ve talked about a plan, I’ve got a plan for going home and the physios have already noticed an improvement in my mobility or my speech is getting better’.
And once they can see those incremental increases, those gains on a day-by-day basis or somebody feeding back to them, you know, ‘I can see that you’ve made this improvement’, I think it has a huge impact on their wellbeing. I think that period of time to just make sense of and process what has happened to them is so important.
Laura: Oh, definitely. And I think getting that feedback and getting that improvement in physio and therapy really motivates them as well to continue to do well.
I think the only downside sometimes – one of the difficulties though is that if there then becomes any delay or I guess people aren’t making as good a progress in physiotherapy and speech therapy as they would like, so I think then when maybe they initially started to make progress on the ward, and then they’re starting to struggle, they can get quite frustrated. Because they start to worry about what my life might be going forward, they might start to then blame themselves as well.
So I think one of the things that I’ve noticed when I have met patients on the ward and they’ve not kind of made that natural adjustment or they made that natural adjustment to feeling a bit brighter and they’re starting to struggle again is when they’re getting frustrated with themselves.
And I think when people have had a stroke as well, what’s really difficult is sometimes obviously you can see some of the physical impact when you can’t move and you’re having difficulty with your speech.
But you forget that it’s your brain that’s hurt because you can’t see your brain. Everyone’s used to their brain kind of doing what they want when they want, so thinking for them – making sure they’re breathing, walking, talking, all the rest of it. But then when their brain’s not allowing them to do something because it’s damaged, they start to blame themselves.
So quite often I spend a lot of time with patients and really reinforcing the fact you’ve had a stroke, your brain is hurt, you have a hurt brain, it’s not you that’s struggling because they start to feel like a failure. It’s the fact that your brain’s hurt.
And we then try to compare it and think about, well if you had a broken leg and could see that your leg was broken, would you get angry and frustrated with yourself if you couldn’t walk, if you couldn’t get yourself out of bed? Probably not. You’d probably be much more kind to yourself and understanding, you might be more likely to ask for help.
And it’s the same thing but because you can’t see that your brain’s hurt, particularly if the rest of you is quite well functioning, and maybe you can do everything else that you want to do but your brain’s not letting your think straight or getting your words jumbled, you can get really frustrated. And it’s just reminding yourself when you’re on the ward I think.
I don’t know if this is same when you see patients – ‘you know what, it’s not you, you’ve got a hurt brain, be kind to yourself.
David: And I’ve used that exact terminology, Laura. That if you’ve got a visible difficulty like, you know, a broken leg, it’s visible, it’s easily observable and you wouldn’t expect to climb a ladder, you wouldn’t expect to run a marathon.
But we can’t see the damage to our brain so if you’ve got difficulty with your speech or difficulty with mobility or difficulty with coordination, it’s not easy to observe where that’s coming from or why that is. So it builds a lot of frustration and I think sometimes people can be very self-critical.
And I think that’s sometimes one of the things that I see in people that’ve been on the ward, and I wonder if that’s your experience as well, Laura? They can be really critical about and I think it comes back as well to what you were saying earlier Laura about the idea of feeling like a fraud, you know, that my stroke isn’t as bad as other people.
And, again, being on the ward you see the full spectrum of stroke so it does invite that comparison. And I think it’s really important to remember that, what we were saying, that every stroke is different, that you can’t make those comparisons because we have strokes at different ages, different types of stroke, whether it’s ischemic or hemorrhagic, and also how physically fit the person was before the stroke is a factor as well. Do they have other physical health problems, do they have previous mental health problems?
I wonder, Lauren, in your experience – in mine when I’ve seen people on the ward who’ve struggled with adjustment sometimes it’s because they’ve had previous mental health problems and I think that can make it more difficult to adjust as well.
Laura: Yeah I would say so. I think for some people their life experiences may have been difficult way before the stroke happened and they might have lots of other things going on for them. They might find that they don’t always have strategies to manage their emotions, historically, based on their upbringing or different life events.
And then when you’ve had a stroke, obviously you need ways of managing your emotions and managing difficulties in life. And I think if they don’t have that already, then they’re more likely to find it harder to them to adapt to having a stroke. I think that’s what I would say. I think most people that I’ve seen that maybe don’t have a history of mental health difficulties, haven’t been in kind of secondary mental health services, have adapted quite well while they’ve been on the ward.
I think one of the things that we notice on the ward as well is that actually sometimes the biggest distress about being on the ward isn’t necessarily about having the stroke, but it’s being about being away from family.
David: Yes.
Laura: because being on the ward anyway is tough, you’re in an unfamiliar environment, you’re not in your own safe space where you’re in control, where you have family members around you that you feel supported by and comfortable with.
I think people are different aren’t they and I think some people can adapt to getting support and help from people they don’t know. Other people just don’t like that, it’s not what they’re used to, it’s unfamiliar, particularly if someone’s really independent.
So I think sometimes actually some of the distress about being on the ward isn’t necessarily about the stroke specifically but it’s about that loss of independence and having to rely on people that they don’t know and being away from the family that they would much rather be with.
David: Yeah.
Laura: nd the home environment that makes them feel safe and it’s that breaking relationships that then impacts their mood. But what we often find with those individuals is when they do get home, when they’re thinking about home or when patients’ family members are coming in to see them, that they get brighter, they’re feeling better in themselves. That’s what’s helpful.
And for those individuals, we know lots of people on the ward don’t we, we talk about bringing things in from home that might help them to adjust or to manage while they’re on the ward, particularly if they’re in here for a long time. Things that remind them of family members things that remind them of the comforts and support and love that they’ve got outside of hospital because hospital’s tough isn’t it?
It’s a tough place to be if you’ve got any other physical health difficulties going on, if you’ve got negative experiences of being in hospital or your loved ones of being in hospital, if you’ve had bereavements recently hospitals are even harder.
David: Yeah, completely agree Laura, with everything you said there. And I also think, you know, going back to what you’re saying, a lot of the people that we see on the ward for initial assessments, we often don’t see again once they’re released, post discharge.
And I think it goes to what we’ve been saying today about the normal process of adjustment. Once they’re home, they’re back in their normal environment, they’re with family, they’re being cared for, they’ve had time to process what’s happened to them, the distress reduces significantly and they no longer need or want psychological support in many cases.
Laura: No, I think you’re right. I think that’s the thing, isn’t it? And that’s what amazes me. I think humans always amaze me, just how resilient and adaptive we are really as a species and people do remarkably well without our support.
It is just the odd case, isn’t it, where something where they’ve maybe got a delay in physio on the ward, things haven’t gone quite to plan, they maybe have underlying kind of mental health difficulties where we’ve had to do more with them while they’ve been in hospital.
And I think when people get discharged home, quite often people do really well for a period of time. I think sometimes that changes if maybe, as I said earlier, things aren’t quite going to plan, they’re not getting back to have their previous level of functioning and I think that’s when I guess that loss comes in and I think people forget this quite a lot.
So we often think about loss and grief to do with death and people dying but actually it’s just to do with loss in general. And when someone’s had a stroke if they’ve lost part of what they’re able to do, if they’ve lost where they’re functioning, if they can’t go back to work, they might not feel like themselves. And I think sometimes it’s that grieving process for who they used to be and I think sometimes then people can really strive to be the person that they were before and spend a lot of energy and effort into being that person to no avail.
So I think quite often they’ll try to do things exactly how they used to, not be able to, feel frustrated in themselves but still want to get back to that person so then continue trying to do it. And then it’s about working with people to process that that loss and those kind of feelings of grief but then thinking about, well how can you be the person you are now? Because he still you, it’s just maybe a different version of you going forward so how can we help you to adjust to your life to still do the things that are important to you?
David: Yeah, it’s interesting isn’t it? The idea of, we talked a little bit about normal and I think there’s something really powerful about wanting to get back to normal and we hear this a lot, we hear this on the ward. We hear this also in the community, in our groups and our one-to-one work.
There’s something really strong, I think, about ‘I want to get back to normal’. And I think in some of the people that I’ve met and worked with there’s kind of like a grace period where they’ll allow themselves say a period of time, say six months, and they notice that they’re making progress but once they get to that six-month point sometimes there can be a dip in mental health when people feel that I’m not back to where I thought I was going to be or at this point in time. I thought I would be, in air quotes, ‘back to normal’.
And once there’s a realisation that sets in, I think that there’s a new ‘normal’ and there’s going to be a new sort of equilibrium. I think that is where sometimes people can struggle with their mental health.
Laura: There’s a real sense, isn’t there, of people wanting to be who they were before and I think that always comes through with everyone that we see. And I think, for me, it’s those two themes of ‘I want to be certain that nothing bad’s going to happen to me again’ and ‘what can I do to prevent another stroke happening to me?’ and ‘I just want to be who I was before’.
And it’s tough because I think one of the hardest things about having a stroke is we don’t know if that’s going to be the case and for some people we do know that they will never be who they were before. But other people, we don’t know that.
And it is then a process of adjustment and grief. Kind of coming to some acceptance that you are still you, but things are going to be different and you have to be ready to take that journey and then to engage in therapy around that as well.
David: And engagement is so important isn’t it? We have that conversation a lot in our group work, in our one-to-one, that it has to be right, that we can’t fix people, we can’t fix their mental health and it’s collaborative.
It’s a shared process of psychologists trying to make sense of what it is that they’re struggling with at that time and also thinking about what are the barriers? So where is it that they’re stuck? And I think the biggest, the common pitfalls, and I think you’ve commented on some of them Laura already, are among things like wanting to get back to normal.
I think change in identity, which I think we’ve touched on, is such a huge thing isn’t it? Especially if you’re a working age adult because our job is part of our identity, whether or not we’re a mother, father, son, daughter, friend, partner. We all have different social roles and sometimes a stroke can challenge or change those roles if you’re not able to work, if you’re not able to adapt.
In my experience, Laura, and I’m curious about yours, sometimes the people who struggle to accept the care and the support are the ones who are themselves carers. So if they’ve been a parent and they’ve been used to caring or if they’ve been in a job where they’re used to caring for people professionally, it can sometimes be harder I think for them to accept that support themselves. What’s your experience?
Laura: I think that’s bang on, David. I think that’s my experience and I think it comes from a place of it just feeling really uncomfortable and I think, therefore, sometimes frightening and scary to give up that role.
And I think that might come back to not feeling in control and I think there also comes a doubt of ‘will people be there for me?’ because I think their dynamic within relationships has always been ‘oh, I’ve always looked after other people, will people really do that for me?’ Because this is how I know to get my needs met, this is how I know to make sure that I have those relationships and maintain those relationships. And I think people then become quite frightened of doing things differently.
And I think we often try and say to people to think about things from a compassionate perspective. So to think about actually, what do you think your daughter or friend would say when you said that you didn’t want people to help you or you’d be worried that they wouldn’t want to help you? And quite often they go ‘well, I think they’d be fine with it, like I think they’d want to help me’. But I think they don’t often come to that conclusion themselves, they just become worried because they don’t want to burden other people.
And I think their life has always been about not being a burden but being helpful. So then to not be helpful automatically makes them feel like they’re going to be a burden.
David: And that can have such an impact on recovery, can’t it? Because it comes with all those feelings of guilt and feelings of grief again, and I think what’s underpinning it is difficulty of accepting it.
And we talk a lot in our work about acceptance.
Laura: Yeah and I think it is, isn’t it? We do use acceptance and commitment therapy in a lot of the work we do with patients. And ultimately in that, it talks about how life is really tough, there are difficulties to life. Having a stroke is tough. It’s difficult physically, it’s difficult emotionally and that’s what we’re saying really, just to accept that there are difficulties, there are emotions.
It’s going to be tough but let’s do it together and I think that’s how we work therapeutically, isn’t it? We work with people and sit beside them in their difficulties to see what sense we can make of it together and how we might be able to make it feel less overwhelming.
But it is, it’s about acceptance ultimately when you’ve had a stroke. And I think that’s what’s hard because there’s no other way around it.
David: And I think it’s important to add on the back of that, Laura, as well is that we see people who make enormous improvements in their mental health, people who do move to that place of a new normal for them, people who are able to connect with the things that they value and we do see really positive therapeutic gains.
I think motivation is important, I think engagement. I think one of the things we spend a lot of time talking about doing, especially in our group work, is about tolerating distress and it’s not something to fight. That we all experience negative emotions, we all have difficult thoughts, we all have difficult feelings and these are not abnormal. They’re not bad. Sometimes though we spend a lot of time trying to fight those thoughts and push them away and it’s kind of like adding fuel to the fire, it just exacerbates the distress that’s already there.
And sometimes people spend a lot of time fighting their suffering rather than actually turning towards it and thinking ‘I’m going to embrace what I can do in the moment’.
Laura: Yeah, I think a lot of people don’t really spend so much time trying to be who they were before and to get away from any of the suffering or any of the difficulties that they might now have, that they don’t acknowledge what time they’ve got or what are the positives in their life right now and how they could be spending their time a different way.
David: And people, this is experience on the ward and in the community, some people spend a lot of time hiding that they’ve had a stroke, not wanting other people to know they’ve had a stroke and they might go to great lengths.
So, for example, they might go they might do their shopping in a different town so they don’t bump into people who know them and I think underpinning it is the lack of acceptance of what’s happened and wanting to be seen as ‘normal’. And if somebody I see who knows me knows I’ve had a stroke then it’s like.
Laura: And we speak don’t we to them often about, well what impact does that have on your life? Like how can you still see your friends, how can you still see family members, how can you still do the things that are important to you if you’re not willing to acknowledge that you’ve had a stroke and you’re hiding? Because it’s taken away from you everything that’s important in your life and everything that you enjoy.
And quite often people, when they think about it like that, start to come around to accepting it and actually by preventing others knowing that I’ve had a stroke, it’s stopping me from doing the other things I enjoy in life. Because I don’t want my friend to know, I don’t see her anymore. Or because I don’t want another friend or family member to know or my work to know, I don’t do this anymore or they might not engage in hobbies that they like. And it’s so important, isn’t it, that acceptance really to be able to move forward?
David: And there’s something about being in the now that I think people spend a lot of time imagining a future that they haven’t lived and also living in a past that they have lived, but there’s very little time sometimes spent in the present moment.
And we talk a lot about mindfulness and being present in the here and now, because ultimately this is all we have. We only have now, we don’t have the past because it’s gone, we don’t have a future because we haven’t lived it yet. All we have is here and now.
And we all do this, whether we’ve had a stroke or not, we spend a lot of time ruminating about what’s happened or what we think is going to happen and we get caught up in these really difficult cycles don’t we?
Laura: Oh, so easily. So easily we get really caught up in just thinking and thinking and thinking about things don’t we? And it’s because we want to prevent bad things happening to us and we don’t want to sit with discomfort, we don’t want to be in in pain.
But I think, David, what’s really important to emphasise is so many people that we see do really well following a stroke with their mental health. So many people that then come to see us in the community make huge improvements in their mental health and go on to live really meaningful lives. And it’s a journey for everyone. Everyone’s different.
I guess one of the things that might be important to mention on the podcast is if you’re on the ward and you feel like you might need support or you would like to speak to myself or David, speak to the staff on the ward. We can arrange to come and see you.
But also if you’re listening to this now in the community and you think you might need support in the community, you can always get referred back into us. So we’re here to offer a service for anyone that’s had a stroke for up to two years post-stroke.
One of the main things that we offer as a service is a group therapy which has had just amazing feedback. People get to meet other people that have had a stroke, people that they say are like them and it really normalises some of these difficulties. They learn from each other, they grow together, they learn strategies for me and David to think about things differently and it’s just one of the best groups I’ve ever run really.
David: Yeah.
Laura: So please, if you think you need any kind of support with your mental health. We know that some people are just okay but others, they do want that support and that’s okay too, it’s valid to need that support.
Please just kind of let someone know or get in touch with us directly.
David: Yeah, I would echo that 100%, Laura, yeah.
Laura: Is there anything else that you think might be important for them to know? I think they’ve probably got a whistle stop tour of everything we’ve ever done in stroke psychology.
I think, for me, it’s just remembering that yes, a stroke is a physical illness but it might have an impact on your mental health, it might have an impact on your relationships and I guess the one thing we’ve not mentioned, it can also have an impact on your cognition. So what people don’t always think about is when your brain’s hurt, that impacts your memory and your attention and your understanding and how quickly your brain can think things through.
David: And that’s another thing we offer in the community – we offer neuropsychological assessment to assess in more detail some of the memory or cognitive difficulties you might be experiencing. So if that’s something that you’re concerned about, we would happily accept your referral for that as well.
Laura: So I hope all of you listening are continuing to do well in your journeys post-stroke and potentially me or David will see you on the ward in the future.
Outro: Thank you for joining us. Until next time. You’ve been listening to NTH Voices.