Healthcare Improvement Scotland – The NEN

Volunteering helps Safia find the perfect work and life balance

As a girl who began watching ballet at the age of 10, little did Safia Qureshi realise that one day her interest in dance would lead to a career in helping to improve people’s health and wellbeing.

Safia is currently Director of Evidence and Digital at Healthcare Improvement Scotland, the national improvement agency for health and care in Scotland, whilst also being a volunteer with Scottish Ballet. She is involved with them as part of a ground-breaking initiative that uses dance as an alternative to medication.

Safia, from Penicuik, is one of 3485 NHS volunteers each month, who give up their time to help others. In total, NHS volunteers donated 584,000 hours in 2023-24 – the equivalent of 24,333 days.

She is encouraging others to do their bit and give up some of their spare time, as part of Volunteers Week, which runs from Monday, 3 June until Sunday 9.

Safia said: “I grew up loving ballet. I went to see it with my mum when I was a little, so I’ve always gone to see it when I can.

“I was doing a leadership development course run by the Scottish Government called Project Lift when I first came into contact with Scottish Ballet in a work setting. and they had this idea which they called Colliding Perspectives.

“I was involved in an initiative where small groups of people who were on the course came together with folk from different industries, and one of the companies involved was Scottish Ballet.

“They were looking for help with developing their Dance Health programme so I was straight at the front for that one, saying ‘Let me help!’

“Some colleagues and I were invited for a visit, to meet them and talk about what they were looking for.

“When I was there, I wondered if Healthcare Improvement Scotland might be able to help them, because one of their challenges was persuading healthcare professionals that dance could be used as an alternative to medication.”

Safia initially volunteered with a programme which helped people with Parkinson’s Disease.

She explained: “Having heard about their dance health programme at a high level, I got the opportunity to volunteer with the Dance for Parkinson’s programme that Scottish Ballet was running in Peebles, so I volunteered with them, probably on and off for maybe a year-and-a-half, and that was what really did it for me.

“It was just the most amazing experience, as the classes were run by professional dancers and they treated everyone who was in the room as a dancer. It was all really respectful and the programmes are based on whatever Scottish Ballet are working on, so there’s always a connection back to the company.

“The class became this real community, where people with Parkinson’s and a friend or a partner would come, and we’d all do the class together. It was great for helping people to relax and unwind.

“There were times when I would be blinking back tears at the positivity and community in the room. There’s something really special about the way that dance helped and united us all. I got such a lot from it personally, and it made me more determined that we need to show other people this is something that is amazing.”

With her knowledge as a health and care professional, Safia has been delighted to bring her professional expertise, her contacts within the world of healthcare professionals, plus her love of ballet together, and in turn has made many friends.

She said: “I helped Scottish Ballet set up their research committee and bringing in clinical experts.

“Having been a volunteer for a while, I was thinking some of the exercises that Scottish Ballet do might benefit people with Long COVID.

“We asked some of the patient representatives who’d supported us develop a clinical guideline for people with Long COVID guideline if they would meet with Scottish Ballet and talk them through what might be useful. They then introduced Scottish Ballet to more people in the Long COVID community. There was a real example of thinking differently, and using what you do in a different way to help people.”

Safia added: “When I was 10 years old and going to the ballet with my mum, I wouldn’t have believed this was all possible and that one day, I’d be working with Scottish Ballet. It still catches me every time I go.

“Through volunteering, you meet fascinating people who you would never otherwise have met and you also get to learn about yourself as you broaden your horizons. It’s very rewarding.

“Volunteering makes you feel good in lots of different ways, by doing something that takes you out of your day-to-day routine. I’ve been part of a community I never knew existed, which is lovely and I couldn’t recommend it highly enough.”

Hospital at Home for Older People

£3.6 million investment as capacity increases by 57% to exceed targets

The Scottish Government is continuing to invest in Hospital at Home for Older People with £3.6 million allocated for 2024/25, bringing total funding allocation for the initiative to over £15 million since 2020.

Recent statistics released by Healthcare Improvement Scotland (HIS) show that last year the Hospital at Home service for Older People, which provides a safe, alternative to being admitted to an acute hospital, exceeded targets in several key areas between April 2023 and March 2024, including:

total bed numbers have increased by over 57%, ahead of the Scottish Government’s 50% target
14,467 patients used Hospital at Home, up from 11,686 in the previous 12-month period
the Hospital at Home service is now the eighth biggest “hospital” for older people emergency inpatients, alongside Forth Valley Royal Hospital in Stirling.

Health Secretary Neil Gray said: “These figures from HIS show that Hospital at Home is becoming an increasingly popular care alternative for elderly patients to receive acute treatment in a place they feel comfortable and familiar with.

“There are more Hospital at Home beds available and an increasing number of patients choosing to use the service.

“Hospital at Home gives people greater independence during their recovery process. Evidence shows that those benefitting from the service are more likely to avoid hospital or care home stays for up to six months after an acute illness.

“It is also one of a range of measures that we have put in place to tackle delayed discharge numbers and free up beds within our hospitals.”

Belinda Robertson, Associate Director of Improvement, Healthcare Improvement Scotland said: “This announcement of additional funding will continue to improve access to Hospital at Home services and make them more sustainable to the benefit of patients across Scotland.

“It’s heartening to see that Hospital at Home services prevented over 14,400 people spending time in hospital over the past year.

“Moreover, with our support we’ve witnessed more NHS boards and Health and Social Care Partnerships embracing Hospital at Home by establishing and developing services.

“We look forward to continuing to help services develop and share learning in the year ahead.”

Expert warns of the dangers of using old antibiotics

A health expert has issued a warning to people not to save unused antibiotics at home to take later at their own discretion – as this risks more harm than good.

As concerns over antibiotic resistant infections grow, an expert from Healthcare Improvement Scotland has urged people to avoid using antibiotics they may have saved up at home, as their overuse presents a serious threat to the future of healthcare.

Professor Andrew Seaton, Chair of the Scottish Antimicrobial Prescribing Group (SAPG), part of Healthcare Improvement Scotland, said: “We know that many people have antibiotics at home which they or another family member have been previously prescribed and there can be a temptation, when feeling unwell, to use them.

“However, it’s quite likely, at times when chest and throat infections are common, that infection will be caused by one of the many circulating viruses rather than by an infection that requires an antibiotic.

“Antibiotics will not speed up recovery from a viral illness and they may cause unwanted effects including stomach upset. Critically, future infections may be more difficult to treat because overuse of antibiotics drives the development of antibiotic resistance.”

Using antibiotics that have been lying around the house for a while means they may also have expired. Once the expiration date of a medicine has passed there’s no guarantee that it will be either safe or effective.

A survey of 2000 people in 2022 found that one in three people said they had taken expired medicines and almost a third of these said they had taken medicines that were not meant for them.

The most common reason for an antibiotic prescription is for respiratory tract infections eg infections of the throat, ear or chest.

Professor Seaton, an infectious diseases consultant in NHS Greater Glasgow and Clyde, explained: “Although we are making progress in getting across the importance of not overusing antibiotics, we know that the pandemic has had a significant impact on our healthcare system including the way in which people access healthcare advice.

“We think this has at least contributed to an increase in the use of antibiotics. Work is still needed to protect our population from the very real threat of antibiotic resistant infections and to help preserve our precious antibiotics for future generations as well as for those who need them most now.”

Professor Seaton has also highlighted the importance of safe disposal of unused medicines. He said: “Antibiotics don’t only act on germs inside of us, but also act on the many germs living in soil and water and we know that antibiotic resistance in the environment has important consequences for plant, animal and human health.

“It’s essential therefore that we avoid environmental contamination by not disposing of antibiotics in household waste for landfill or flush them down the toilet. Safe disposal of unused antibiotics will reduce the environmental impact and help protect our planet.”

Global analysis of more than 200 countries in 2019, before the COVID-19 pandemic, estimated that infections due to antibiotic resistance are now a leading cause of death worldwide, higher even than HIV/AIDS or malaria.

More than one million deaths are estimated to occur annually as a direct result of antibiotic resistant infections due to common, previously treatable infections such as pneumonia and bloodstream infections.

In a bid to encourage people to safely dispose of unused antibiotics, pharmacies throughout Scotland are offering an ‘amnesty’ where people can return medicines to them to be safely disposed of.

Professor Seaton said: “For the majority of people who are feeling unwell with a cough, cold or sore throat, symptoms will settle with simple measures including rest, increasing fluid intake and careful use of pain killers like paracetamol.“

There is a useful check list which people can go through on the NHS 24 website to decide if further advice is needed Cough | NHS 24 .

Professor Seaton added: “For people with known serious underlying health conditions or for those where symptoms are not settling within a few days or are worsening it is advisable to take advice from NHS 24, their pharmacist or GP.”

Inspection report for Royal Infirmary of Edinburgh, NHS Lothian

Healthcare Improvement Scotland has published a report relating to an unannounced follow-up inspection visit to the Royal Infirmary of Edinburgh, NHS Lothian. The inspection took place in September 2023.

The purpose of the follow-up inspection was to assess progress and provide assurance on NHS Lothian’s improvement actions in response to serious patient safety concerns that were identified and escalated during a previous inspection of the hospital in February 2023.

To provide assurance of improvement following the concerns previously identified, the main focus of the follow-up inspection was the emergency department. Inspectors also visited a number of wards and the medical assessment unit.

Donna Maclean, Chief Inspector, Healthcare Improvement Scotland, said: ““Serious concerns raised in our previous inspection related specifically to the safe delivery of care and to potential patient safety risks. During this follow-up inspection we observed that considerable progress has been made in responding to these concerns.

“The delivery of fundamental care has improved with the addition of care and mealtime coordinators in the emergency department. Improvements have also been achieved in supporting patient care, dignity and leadership and in the coordination of care within the department.

“Implementation of a new continuous flow model has improved the flow of patients through the hospital during weekdays. However, further work is needed to support the timely flow of patients from the emergency department to an appropriate care area out of hours and at weekends.”

Six of the previous 13 requirements have now been met and progress has been made with four requirements, with further work to be undertaken.

Three requirements have not been met. These include hand hygiene, the use of personal protective equipment and the management of intravenous fluids.

One new additional requirement has been added with regard to the safe management of cleaning products. One new recommendation has been added in relation to the timeframes for the completion of significant adverse event reviews.

An improvement action plan has been developed by NHS Lothian in order to meet the requirements.

The full inspection report is available to view at:

Royal Infirmary of Edinburgh (healthcareimprovementscotland.org)

Scots want to see more done to limit tobacco sales and use

A report published yesterday by Healthcare Improvement Scotland finds that people want more to be done to limit the sales of tobacco products.

The survey, commissioned by the Scottish Government, asked questions which will form part of a refreshed plan to be published this autumn, to support a tobacco-free Scotland.

The Citizens’ Panel survey, which ran between November 2022 and February 2023, found that of the 667 people who responded to the survey, 75% want more action to be taken to further limit who can sell tobacco products, and while 63% agreed the legal age to buy them should be raised from 18 to 21, 25% were opposed.

Some 65% agreed that Scotland should increase the legal age of the sale of nicotine vaping products from 18 to 21 years.

In addition, the survey found that 80% of respondents said that they either strongly agreed or agreed that action should be taken to further limit who can sell nicotine vaping products. Just 9% either disagreed or strongly disagreed.

In addition, 67% felt packaging, in pack information and the appearance of cigarettes should be made more unappealing. Some 64% agreed that taxes on tobacco and vaping products should be raised, but nearly a quarter of respondents (23%) disagreed with this.

There was also wide agreement that the smoking ban should be widened to create more smoke-free areas where children congregate, such as outside schools and play parks, with almost nine in ten respondents (86%) in agreement. Just 8% disagreed.

The report recommends that the Scottish Government considers including all the measures that have the strongest public support in its Tobacco Action Plan 2023.

It adds that the Scottish Government should then consider further around more punitive measures, such as raising the age of purchase and raising taxation on tobacco and vaping products. After assessing the impact of these measures, these could also be implemented following a staged approach.

Clare Morrison, Director of Community Engagement at Healthcare Improvement Scotland said: “As Scotland looks to become tobacco-free in the near future, this shows that the majority of people believe more should be done to limit access for younger people to tobacco and vaping.”

Visit our Community Engagement website to access the full report.

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