This month the NHS turns 75. Marilyn Hinks from Powys was born just a couple of weeks after the service started and has grown up with the NHS. She tell us what it's been like to grow up with the NHS.
Can you tell us more about being one of the first NHS babies?
I was born 10 days late on 28th July 1948 at home, in Birmingham
What role did the NHS play for you as a child growing up with the NHS?
It meant I was able to have all the injections against some awful diseases, such as polio. I saw children at school who had permanent disabilities from polio and, as an adult, can understand the relief my parents felt when the vaccine became available. We had every injection as soon as we could.
I had to go into hospital to have my tonsils removed and for suspected appendicitis, scary but,again, must have been such an amazing thing for parents to have this care there, free of charge.
What do you think the benefits of the NHS are?
So many. We have grown up with the NHS and can’t imagine how different our lives would have been without it. It helps remove the fear of being ill, while receiving world class care. It means that, whatever your financial situation, you are assured of healthcare. Over 75 years, the benefits to us all must be impossible to calculate but each person has a story of how they have been helped and supported.
The research into diseases continues to help cure people who go on to live happy, successful lives. A benefit to the whole of our society.
Why is the NHS important to you?
Like many of my friends I am reaching a time in life where I may need help from the NHS. It is so reassuring to know that health care is available without the worry of having to have health insurance. On an emotional level it means so much , as seen by the support for the NHS during Covid. It truly is something of which we can all be proud, giving care from”the cradle to the grave”.
Do you have any memorable experiences of being supported by the NHS?
I spent several weeks in hospital prior to the birth of our first baby. I remember sitting watching the second moon landing with the staff before going into theatre. Over the weeks the staff had got to know us all and we felt very blessed to be cared for in a brand new hospital. With their care I gave birth to a healthy baby.
I have been fortunate to have only had emergency treatment once. The staff were ready for me when I arrived and immediately started to treat me, avoiding my becoming seriously ill. So grateful.
My beautiful great grandson was critically ill when he was a toddler. The care and support given to him and the family was truly awe inspiring. We now have a happy, fit and active 6 years old thanks to the NHS.
Are there any aspects of the NHS that you feel are invaluable?
What makes the NHS so special is the availability of care. No one asks for your credit card when you arrive at A&E.
The level of care given to those who need help is second to none and,despite the present issues, the trust that we have in this remarkable service is based on years of own experiences and those of others. The NHS has changed the health of the country and saved an unknown number from pain and permanent disability.
What challenges do you think face the NHS at the moment?
Undoubtedly, the NHS has many challenges, partly because,as a result of the wonderful care we receive, we have an ageing population that will continue to grow. We have come to expect a high level of care and expectations may have to become more realistic.
The numbers of trained staff will need to be addressed along with the stress levels they experience.
Finance,as always, is an issue and we may have to accept that better care has to be paid for by us all.
Can you imagine what life would be like without the NHS?
Like many countries we would probably have an insurance system, providing excellent services to those who can afford it. This would lead to inequality of healthcare and mean poor care for those who could not afford to pay. Without the last 75 years of the NHS more people would be living with much poorer health, leading to a much less secure way of life. We have come to expect that every child is protected from life-threatening diseases and that help is available when needed. The NHS has enriched all our lives and without it we would be a much poorer country both financially and economically.
If you could wave a magic wand what would you give to the NHS?
So much. More money to improve services and shorten waiting lists. Also, money to develop more preventative care so we can all try to stay healthy and not need to use the health service so much.
I would give the respect and thanks it received during covid as a permanent way of thinking about this amazing service.
I would encourage development of research to prevent and treat illnesses that are not curable at the moment.
I would give the NHS a great big “Thank you” for being there all my life, caring for us all including my family and friends and say,”Please keep doing what you do best, caring for us all”.
This conference was organised and hosted by Powys Teaching Health Board at the Metropole Hotel in Llandrindod Wells on the 16th May and was attended by approximately 100 people. Our PAVO Health & Wellbeing Engagement officer Sue Newham attended the event and tells us more about it below.
Kirsty Williams, Chair of the Regional Partnership Board, opened the conference by saying that an ageing population was a reality for Powys now. She asked who was going to do the caring if working age people continue to leave for work elsewhere. Kirsty said that services in Powys couldn’t manage without the vibrant third sector that exists in the county.
Kim, a carer for her husband, gave a moving account of life with someone with Frontal Temporal Dementia. She explained that there are around 80,000 people with rare forms of dementia alive in the UK today.
Frances, who has been living with dementia for a number of years said that it felt like being a statue under the chisel of a sculptor, where bits kept getting knocked off. Frances shared some of the things she is no longer able to do, but also displayed a joyful sense of humour, which had people laughing. This picture shows her “testing” an electronic cat used as therapy on dementia wards. She said, “We’ve been expecting you, Mr Bond!”
Frances Isaacs - expecting Mr Bond.
Round table discussions enabled all participants to discuss the Dementia Friendly Hospital Charter, with discussions around what families need to know when their loved one is in hospital. The next discussion was around what is available for those living with dementia in the community, and what should be available. The final discussion was about the Memory Assessment Service and what support families need/ should receive when people are going through the assessment and diagnosis process. Information, awareness raising and education featured in all the discussion topics. Findings will be collated and shared at a later date.
Over the lunch period, people were able to visit some of the stands provided by third sector organisations in the side room. Dementia Matters in Powys were cycling the length of Wales as part of a Cyclathon to link with Dementia Awareness Week. At the end of the week 90 miles had been completed by members, carers, volunteers, DMiP staff and supporters! Connecting the equivalent distance from Welshpool, Newtown, Llandrindod Wells and Ystradgynlais in Powys.
Sue Newham - PAVO Health & Wellbeing.
Sue Newham, PAVO, said, “The conference was really well organised and very informative. So many people and organisations are working to improve life for those living with dementia, and their carers, that it’s hard to keep up with all the developments. As a carer for my mother who lived with dementia until her death last year, I am very aware of the sadness and practical difficulties that a dementia diagnosis can bring. I am glad that there is a real focus on coordinating care and improving the diagnosis process for patients.”
A notable part of the conference was a speech of thanks to Mel Sillett, who has worked closely with Powys Teaching Health Board to implement the All Wales Dementia Standards of Care. Mel has recently moved on to a similar role in Denbighshire. We wish her every success in her new role.
Mel Sillet - Moving to Denbighshire.
Other speakers included:
Duane Stannard from the Dementia Home Treatment team
Deborah Gerrard from Dementia Matters in Powys, talking about the Wales Dementia Standards work and the Powys task groups.
Staff from Welshpool Hospital talking about the changes they had made to caring for patients living with dementia, as part of The Butterfly Scheme
Louisa Kerr from Powys Teaching Health Board covered the Memory Assessment Service in Powys and reported a rise in diagnosis rates in Powys as a result of more consistent use of read codes. She also explained the DiaDem Cymru programme for diagnosing dementia in care home patients
Debbie O’Shea explained the pathway for dementia assessment for people with learning disabilities
Ian Dovaston from the NHS Executive talked about three initiatives aiming to improve dementia care in residential settings. Care Fit for VIPs is a free, online toolkit to help care homes improve the quality of their dementia care. Dementia Care mapping is a method of staff observation in care settings which follows a formal process. It's a way to measure the experience of people with dementia.He also talked about the Inpatient Practitioners’ Network.
Linzi Shone, Head of Nursing for PTHB, updated attendees on the Dementia Friendly Hospital Charter.
PCSO Aileen Stewart reminded people about the Herbert Protocol, which provides the police with important information about that person, should they go missing.
Anybody interested in finding out more about dementia support in Powys is welcome to join us for our next Powys Dementia Network, scheduled for September in Brecon, date and venue to be confirmed.
When we think about domestic abuse, we rarely think about
older people. In reality older women and men can experience the same forms of
abuse as younger people but it may go unrecognised. Older people can experience domestic abuse
from an intimate partner or a family member, they may face additional barriers
to seeking help and support. This may be due to ill health 0r are receiving
care from, or providing care for, the person who is causing them harm. They may
feel there is a lack of support or not know where to go for support. Some older
people have lived with domestic abuse for many years in their relationship,
whilst for others the abuse may have started later in life. It can be triggered
by a traumatic event or ill health. Some older people don’t think that domestic
abuse services are there for them and the services are for young people. In
fact the services are there for everybody regardless of age, gender or
sexuality. Services have identified that there are issues around the language
that is used within information sources and are looking at addressing this by
reaching out to older peoples support and community groups. This will help
raise awareness of domestic abuse whilst also encouraging older people to
inform the language of future material, as well as identifying where older
people are more likely to access informative quality material.
About domestic abuse services.
Above all the need for support to explain your options and
to access safety and protection is paramount.
This can happen by accessing safe secure accommodation like a refuge,
your local authority or the police. Whether you are supported in refuge or
within the community there is something to help everyone. Talking to someone is
the first step to accessing the help and support you need, which may be
emotional but also practical such as help with housing support, legal advice,
benefit entitlement, group support or courses such as the freedom program or
even referrals to other specialist support services.
If you are a victim or know someone who is a victim of
•Physical abuse
•Emotional abuse
•Economic/Financial abuse
•Sexual abuse
•Coercive or controlling behaviour
Then you are advised to seek advice or support.
Wherever you live in Wales there are services for everyone
even if you live in rural areas. The Live Fear Free helpline for Wales is an
amazing source of information and support. You can speak to them in confidence.
They can tell you what your closest domestic abuse service is and help you find
refuge space should you need it. It is a 24 hour service and you can contact
them on 0808 80 10 800 or visit their website www.livefearfree.gov.wales
You can also find useful information and support through the
older peoples commissioner website
Reporting the problem
All Wales Police Domestic Abuse Data – Older people aged 60+
•2013/14: 656 incidents reported to police
•2018/19: 3771 incidents reported to police
The number of reported cases of domestic abuse in older
people is rising this is not because there was more domestic abuse in 2018/19
than there was in 2013/14 but because advice has started filtering through;
this could be directly to the victim, through a friend, neighbour or family member.
THERE IS LIFE AFTER DOMESTIC ABUSE AT ANY AGE
Outcomes
Mid and West Wales safeguarding violence against women,
domestic abuse, sexual violence safeguarding board aim to not only raise awareness
but recruit or gather the opinions of older people. This will
•Empower
•Aid Prevention
•Protect
•Give a voice
•Make sure support is appropriate
If you would like us to hold an information event at your
community group then please contact info@camau.org.uk
If you are over 55 and would like to participate in an
interview or be part of a panel then please contact
mww.survivor.panel@gmail.com
Around 1000 Powys residents are
diagnosed with cancer each year in Powys.
A programme funded by Macmillan
Cancer Support called Improving
the Cancer Journey in Powysis working in partnership with the council,
health board and delivery partners like the Bracken Trust, Credu and ourselves
to ensure that support is available closer to home for both the person and
their wider family following a cancer diagnosis.
We thought it’d be a good idea to
find out more about how the programme came about, how it works, who’s involved
and introduce Penny Tanner who has recently joined
us as the ICJ Community Connector. Penny has a clear vision for her role and told us “My aim for this role would be to enable people in Powys to access support closer to home, by linking them in with their local community assets and organisations, raising awareness of activities/support groups that they may like to engage in, improving their Cancer journey and addressing what matters most to them.”
Penny Tanner - ICJ Community Connector
Penny will be on hand to ensure
that every Powys resident with a cancer diagnosis who are referred to PAVO, is offered a personalised ‘what matters to me’ supportive
conversation. The first step is for
people to complete a simple concerns checklist either online or on paper. This checklist helps the person to consider
how they are feeling and what concerns they may have. Once submitted, Penny will then have a
conversation to explore the person’s holistic needs and produce a tailored care
plan. This plan sets out the concerns
and how and what support is available to address them whether it’s an information
sheet on diet or a referral to the Bracken Trust for complementary therapy or
to join their yoga class.
What do we mean by people
living with cancer?
When we refer to ‘People Living
with Cancer’, we mean people with a cancer diagnosis, their unpaid carers,
their families and those important to them. We also include people who have
been referred with a possible cancer diagnosis and are awaiting the results of
that referral.
We also abbreviate to the acronym
PLWC.
How did the ICJ in Powys
programme come about?
Conversations first began
with Powys Teaching Health Board back in 2016 following two things
·a successful project launched in 2014 in Glasgow
led by the local authority called Improving the Cancer Journey, Glasgow.You can read the final evaluation
report published in September 2020.
·results from Macmillan’s Patient Experience
Survey where it was clear that Powys patients were feeling more isolated and
less supported than residents in other parts of Wales.
Macmillan was keen to test out
how a model of care could be put in place in a more rural county and Powys was
chosen as the first Welsh project.
Cancer is also classed as one of
the Big 4 Diseases within the Powys Health and Care Strategy - a joint strategy produced by Powys Teaching
Health Board and Powys County Council - both partners in the programme. Together the three key strategic partners launched
the programme in late 2019 and appointed a Programme Lead and a Project
Manager. A Communications and Engagement
Officer was appointed in early March 2020.
What’s the key aim of the
programme?
The key aim is to bring quality
personalised support closer to people’s homes following a cancer
diagnosis. With no district general
hospital in the county, the vast majority of residents have to leave the county
for tests and treatment. When residents are
in between treatment or check-ups, or discharged from the hospital setting, they
can often feel alone and not know where to turn for advice, information, or
support.
The ICJ in Powys programme aims
to fill that gap and give support at a local level to improve the person’s
well-being and quality of life in whatever way matters to them.
Support can be
emotional,
practical,
physical,
financial,
social, or
spiritual.
Support tends to focus on the non-medical
things that affect people like needing help to collect prescriptions or do some
shopping, someone to come in and tidy the house or do some gardening or
cleaning. People may be worried about their work situation and need help with
financial matters from accessing benefits, considering their pension, or applying
for a blue badge. Unsurprisingly, transport and getting to hospital
appointments is another key factor that impacts both people’s health and
wallet.
One of the key successes already
has been the daily screening meetings which take place in
the council. The Assist service take
calls every day about care and support needs and these are discussed in detail
the next morning so help can be identified.
PAVO and Credu both current attend these screening meetings and all
residents presenting with a cancer diagnosis are signposted to PAVO for a
holistic needs assessment. Carers are
signposted to Credu
The peer support group meetings
take place every six weeks allowing all outreach workers, community connectors
and the lead nurse from the Bracken Trust and the Lead Cancer nurse from the
health board to come together and share any good practice, any barriers and to
discuss options to improve the offer of a supportive conversation to Powys
residents who have a cancer diagnosis.
What are we doing well?
The Assist screening meetings are
working well and have seen an increase in referrals not just for people living
with cancer.
The council’s Money Advice team
have expert knowledge about benefits and support to help someone who is facing
increased costs re- travel, heating etc…
All delivery partners are working
hard to offer people living with cancer the support they want about the things
that matter to them. This results in a
tailored package of care not an off the shelf solution.
Together we are raising awareness of the programme both locally, regionally, and nationally. Sue Ling, ICJ Communications and Engagement Lead and Sharon Healey, PAVO Senior Officer Health and Wellbeing, both attended the Macmillan conference in London in early November. Sharon took part in a panel debate and spoke about the role the third sector are playing in Powys to support people living with cancer.
left to right: Sharon with fellow panel colleagues – Sheila Small and Emmily Ochieng from the Hillingdon NHS Trust and Sian Webb from NHS Kent and Medway.
How are people living with
cancer involved?
The programme set up a
stakeholder reference group in September 2020 which became the Journeying
Together Forum comprising of ten people with lived experience either as someone
living with cancer or as an unpaid carer. The forum meeting bi-monthly and discuss
barriers, coproduce publicity materials, complete surveys, contribute ideas and
hold the programme to account with representatives attending both the Operational
Board and Strategic Programme Board meetings.
How does someone access
support?
If you are supporting
someone living with cancer and they’d like some additional support then please
do refer them to Penny who is contactable on 01597 828649 / penny.tanner@pavo.org.uk
How do I find out more about
the broader ICJ programme?
The ICJ webpage hosts a lot of
information about the programme including both video’s and a compendium of
patient stories that is worth viewing.
It also has various reports and copies of all press release issued by
the programme. Here Dr Ruth Corbally talks about the what matters to you / eHNA conversation that is on offer to anyone living with cancer in our county.
What Other Resources are
available?
Books About Cancer resource.
In late 2020 a grant was sought
to purchase four sets of Macmillan recommended books. These books are available
for loan from Powys libraries. You can order online using the library
catalogue.
Support Closer to Home
leaflet.
CNSs in hospitals across Wales
and England are often praised for their empathetic approach to patients. They
are kind and knowledgeable and many offer Powys patients a holistic needs
assessment in the hospital setting. However, we know that sometimes that isn’t
necessarily the right time for the person who has just recently received a
cancer diagnosis to take this on board.
So, the forum suggested a simple A5 leaflet be produced which CNSs could
hand out to Powys patients. This signposts them to the key delivery partners
and explains what type of support can be given closer to home from collection
of prescriptions to dog walking to benefits advice. 10,000 leaflets were printed. and distributed
during the summer.
Support Closer to Home - Leaflet
A chance to join in Powys ParkWalk/ParkRun.
Although known as parkrun, lots
of people walk the route and in October the ICJ programme joined forces with
parkrun to promote and encourage people living with cancer to join in. If
someone you are supporting might be interested they just need to register and download their bar
code. It’s a simple as that. There are
two parkruns in the county currently – one in Builth Wells and one in Newtown.
Both start at 9am on a Saturday morning.
Powys Park Walk / Park Run.
Listening to Patient Stories - Key Themes.
In 2021 people living with cancer
were asked to share their experiences with the programme.
In listening to and then
analysing the stories captured, ten key themes emerged which seemed to be
common for the majority of Powys residents.
Listening to Patient Stories.
Pre-diagnosis,
diagnosis and prognosis.
Co-ordination
of care.
Emotional
support and care.
Patient voice
and choice.
Carers rights
and voice.
Practical
support offered in the county.
Relationships
and communication.
Transport and
travel.
Education and
information.
Advance Care
planning.
Understanding these key themes
will help the programme consider gaps and improve awareness, connections and
relationships with acute sites, health care professionals and all involved in
caring for someone with a diagnosis.
Mudiad Meithrin was born during the 1971 Bangor National Eisteddfod, as the Cymdeithas Ysgolion Meithrin Cymraeg (Society of Welsh medium Nursery Schools). Our aim is to ensure that every child in Wales has the opportunity to benefit from Welsh-medium early years experiences.
Over the past 50 years, Mudiad Meithrin has firmly established itself in the national consciousness as the Welsh-medium early years specialist. Today, it supports a national network of Cymraeg i Blant (Cymraeg for Kids) groups and Clwb Cwtsh informal Welsh language classes, alongside its traditional Cylchoedd Ti a Fi (Welsh-medium Stay and Play groups), Cylchoedd Meithrin (Welsh-medium playgroups/nurseries) and dedicated Welsh-medium training through Academi for the sector from initial qualifications through to innovative CPD short courses and accredited childcare qualifications.
In your opinion, what is the most beneficial aspect of Mudiad Meithrin’s work?
Mudiad Meithrin provides accessible, local Welsh-medium activities for families across Wales from birth to school age. As well as providing affordable, community-based Welsh-language childcare options for parents across Wales, Mudiad Meithrin also helps to build community networks through participation in and with the local groups. The friendships made and developed by both the children and their carers builds support networks across our communities, both rural and urban.
Research has shown that children raised bilingually benefit in many ways, do you have any tips for parents wanting to support their children bilingually?
The best advice is for parents to make it fun and try not to force your child to use a particular language at any time. Going to the local Cylch Ti a Fi or Cylch Meithrin is a big help … as you and your children will be able to socialise with other families who also want to raise their children bilingually. The more opportunities you have to hear and practice speaking both (all) languages the more the children will naturally want to use them.
There are a huge range of books, TV programmes and Apps available to help support the use of Welsh in the home. Choosing a few favourites to start will encourage you to use them and over time you will find yourself looking for more to add to your collection.
If you want to learn Welsh or just develop your confidence a bit more, then there a range of courses available, both online and in-person. Clwb Cwtsh is a great way to start if you have young children, and courses are available across Wales.
If someone was new to the area how would they find their local group and sign up?
The best way to find your local Ti a Fi group (Cylch Ti a Fi / Stay and Play group) or Cylch Meithrin (Welsh-medium playgroup) is to use the ‘Find a Cylch’ function on our website here: Search for a Cylch - Meithrin . Once you’ve found your local Cylch, you can contact them directly to sign up or for more information. Many Cylchoedd also have their own social media pages. Once you have found your local group, following their social media pages can be a good way of making that first leap and then keeping in touch once you’ve been.
Why is play important for children and how do you think the pandemic has impacted children’s play?
Children learn through play, and young children don’t differentiate between playing and learning. Different kinds of play help children develop different types of skills. Collaborative play helps them develop their social and emotional skills as well as understanding how turn-taking works in different situations. Structured play opportunities help them develop their fine and gross motor skills. Putting things in and out of containers might be frustrating for us adults, but it helps children to develop skills they need for later formal learning. Just moving and using their muscles helps them to learn how their body moves and improves their coordination … squidging their peas with their fingers actually helps them to hold a pen or fork when they’re older!
Many of our children have seen their opportunities for unstructured, free play restricted over the past few years. As families were encouraged not to meet and socialise, children of all ages missed out on opportunities to make and nurture friendships with minimal adult intervention.
For those children born during the pandemic, especially in early 2020, the pandemic heavily impacted their early experiences of play. With Stay and Play groups not able to meet in person, many only interacted with other members of their immediate family for a considerable length of time. With playgrounds also kept closed in those early days, access to outdoor public play spaces was limited. A factor which impacted families living in homes with no private outdoor space considerably … without a garden you can’t easily play ‘tag’, kick a ball, or just sit crunching the leaves from the trees.
What is the most valuable thing you have learned about the positive impact of play for children?
That free play is important … it’s both free (in terms of cost) and unstructured (the children get to decide the rules). Two things that are essential for our children to develop the skills that they need as they grow. Encouraging our children to be creative and use what’s available instead of feeling pressured into buying new toys and gadgets all the time. Free play feeds their imaginations … pillowcases can be superhero capes one day, a magic carpet the next. Cushions can be buses, castles or a pirate island as required.
Mostly though, the positive impact of play is that it helps to connect our children with those around them. The time spent playing, laughing, babbling and generally having fun together helps us all to enjoy that time and build the bonds that last a lifetime.
If you could change one thing about play provision for children, what would it be?
Increase unstructured outdoor play opportunities and spaces for children. For many families, homes are comparatively smaller than for previous generations, with outside play space at a premium. The increase in car use and traffic generally means playing football down the middle of the street isn’t an option for most of today’s children, and many homes have ‘lost’ some of the play potential of their outdoor spaces as the need for parking spaces increased. Our children also spend more time than previous generations in formal childcare outside the home, so opportunities for child-regulated outdoor play experiences can be limited. We need more playgrounds, more parks, more open spaces where children (and their families) can run around, build a den and play imagination driven community games. Places where families can enjoy the outdoors and encourage free play and creativity, whatever the weather throws at them.
Where did the idea for ‘Forest Cylch,’ come from?
Some Cylchoedd Meithrin operate fully (or almost fully) as outdoor settings and this has inspired us as a Cylch Meithrin to think about increasing our outdoor practice. The ‘Forest Cylch’ ethos is based on the ‘Forest School’ concept and we have depended heavily on improving our learning with an accredited trainer running sessions with us in Llanerfyl. We think that children learn better through play and that playing outdoors provides physical and cognitive benefits.
What inspired you to train as a forest school leader?
Mirain, our Cylch leader, is undertaking a Level 5 qualification (in childcare) and has chosen this as her end-of-qualification project. So although Mirain won’t be a fully accredited ‘Forest School’ practitioner, she will embed much of her learning in the way she plans everyday activities incorporating the expectations of the new curriculum.
What are the benefits of forest school?
They say that there isn’t such thing as bad weather only the wrong type of clothes! That is true most of the time although no-one would want to be outside in torrential, cold rain! Most of the time, however, we recognise that children enjoy learning through play outdoors and enjoying being immersed in nature. We have seen first hand how they develop their play using natural resources (tree stumps, leaves, pinecones) and how they love roasting marshmallows on an open fire under supervision! We have invested in warm, insulated coats for staff and in dry suits for the children so that (inappropriate) clothing is never an excuse or reason for not going out!
How do you plan to embed the forest school principles into your practice?
Embedding these principles will be easier as we move our setting location to Ysgol Cwm Banwy with its access to expensive green fields and a sensory garden. We will of course have our designated outdoor play area where the children will be inspired to learn and create using all that nature has to offer!
If you had one top tip, or piece of advice about children’s wellbeing what would it be?
Appreciating the positive impact of play in that it helps to connect our children with those around them. The time spent playing, laughing, babbling and generally having fun together helps us all to enjoy that time and build the bonds that last a lifetime.
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