Posted by: ayrshirehealth | December 17, 2014

iPledge by @dtbarron


Make a differenceDuring this year, here in NHS Ayrshire & Arran, we have had the privilege of walking with Tommy Whitelaw on his #makeadifference campaign. Dementia carerTommy is the Project Lead at Dementia Carer Voices at the Alliance Scotland. Over 500 of our staff attended the ten talks he held with us during May to August.

We were fortunate that a Tommy agreed to add on two additional talks to the original eight, as we had a lot of staff who could make the first series of talks.

‘I pledge’ to do one thing

Pledge tree 1Pledge tree 2Many of you reading this blog will have attended one of of his sessions and made a pledge, just one thing you’ll do differently when you’re interacting with someone who has dementia, or dealing with their carers.

Thank for attending, and thank you to the 270+ staff who completed a pledge leaf and now has it posted on one of our Pledge trees.

But what’s it all about, we already have good dementia services, it (dementia) has been a focus for us for years; what extra does this ‘tour’ bring?  We have good older adult services, we’ve invested, via the Change the Fund’ on older adult services, we have older adult mental health services, we even have Frailty and Delirium focused teams.

And of course there’s also the question I’ve been asked – how will we know we’ve ‘made a difference’?

Added value

Tommy’s talks challenge the system, he asked difficult questions about our processes, not by shouting and protesting, tying himself to railings etc, but simply by sharing real stories.  Tommy n TourThese stories are about his mum, Joan, real stories about the thousands of people who wrote and shared their love stories with him, personal stories of how he struggled with each ‘forever change’ i.e. a change in Joan’s health that never reversed.

All that he asked was for us to reflect on how our daily interactions impacted on people living with dementia and their carers – were they really at the centre of what we were doing, or did we simply follow our processes?

Incontinence padsWhen the incontinence arrived (with Joan), it arrived forever, it diminished dignity, it impacted on ever aspect of life – waking up soiled, unable to go out, the constant need for clothes and bedding to be washed – this just touch on the surface of the emotional and psychological impact it had.

However when it’s not your family, your mum or dad, or your partner and we’ve got a protocol to follow, it’s easy to miss the devastating impact this can have on a persons physical, mental and social health.

Would this happen in Ayrshire?

My wife told me last week, when trying to organise for an incontinence assessment for three of her patients (not in Ayrshire), she was told it would be the end of January before the assessment would take place!  Time bundleIndividual people did make a difference in these cases, only because my wife knows who else to ask, people who will actually put the person at the centre of care and bend a little; it certainly feels the system doesn’t!

Would this happen in Ayrshire?

Would you know who to ask if you wanted a personcentred approach?

Will people avoid asking you, because you’re the person that quotes chapter and verse of the protocol and can explain all the reasons why something can’t happen?

It was therefore easy to say yes when the opportunity to invite Tommy to speak to our staff in Ayrshire arose.  I was going to meet someone I’d admired, someone I’d listened to, that I’d shared ideas with.  His tenacity, his belief that the #makeadifference campaign could make things better for others is wonderful to see, indeed to hear.

Our Story

screen-capture-6And so to our story, and three ‘stand outs’ regarding the Ayrshire leg of Tommy’s tour – Senior Charge Nurse Lynn McLaughlin, Clinical Improvement Advisor Amanda Johnston (now with the a Scottish Govt) and our Alzheimer Scotland Dementia Nurse Consultant Janice McAlister.  The three musketeers were assisted greatly by Wendy Rae (Medical Photography Dept) who hand cut every leaf (see our pledge trees above), in making it all happen.

Tommy has given a ‘talk’ to the NHS Board (31.03.14) and and further ten eight open talks at Ayr & Crosshouse Hospitals, during June to August 2014.

We have collected pledges from each of these talks and added them to our ‘Pledge Trees’.

The film [CLICK HERE] captures the overarching story of what we’ve done and why.

Not everything that counts can be counted

Of course, if I’d taken a ‘proper’ improvement methodology approach to what is after all an improvement project, we should have created a baseline of information (knowledge/experience) and then gone back to see if it has changed, either staff or patient or relatives experience.  I don’t know about you, but I’m almost sleeping writing about the proposal!

Just do itThe approach therefore was one of ‘just do it’, all pledges were given anonymously.

Individual, personal responsibility lay with those attending – the action they pledged to undertake was theirs and theirs alone, it not the organisation asking it’s Tommy, it’s personal.  It’s a personal ownership approach rather than corporate ‘expectation’.

530 staff have attended 10 sessions (nurses, allied health professionals, medical, management, administration and support staff, social work, Fire & Rescue and Police) – over 270 staff have made and recorded pledges.  Tommy and Janice then took the ‘talks’ out to local authorities and to student nurses at University of the West of Scotland.

Further information is available to staff who have access to our intranet site AthenA, by clicking HERE.

Next steps

In January we will go back out to our staff asking them (again anonymously via SurveyMonkey) what they have done with their pledge, have they fulfilled it, if not what has been the barrier, what can we (the organisation) do to support them delivering on their pledge.

@tommyntourI’m thrilled to have been a part of this work, to walk alongside Tommy, to see and read the enthusiasm of our staff.  It’s not too late, if you want to add your pledge to the comments section on blog, or you can email me, or tweet Tommy (@tommyntour) – it’s never too late to ‘make a difference’.

I’m 100% we can! we have and we will continue to make a difference here in Ayrshire & Arran – our journey is far from over, but we’ve most certainly started on the right road.

Thank you to all of you who do #makeadifference every day.

This week’s blog was by @dtbarron (Derek T Barron), Associate Nurse Director, Mental Health Services, NHS Ayrshire & Arran | Lead Nurse, North Ayrshire Health & Social Care Partnership | Visiting Senior Lecturer, University of Abertay.




  1. I am pleased to see that Tommy is making a difference and that his past career of being a tour promoter is helping with this.

    Regarding your comment Derek: “not by shouting and protesting, tying himself to railings” I have to come in here and say that sometimes it requires active resistance for cultures to shift and radically change. I am thinking of suffragettes and civil rights movements, without which the world would be a poorer place, in my opinion.

    As an unpaid carer I support two sons who are disabled because of mental health difficulties, one of whom lives with me. I get £61/week for the privilege. I also voluntarily write and campaign for improvements to mental health and psychiatric services, and sometimes this does involve a protest, speaking out, although up to this point I haven’t had to tie myself to railings. But I would be prepared to if it made a difference.

  2. […] comment on today’s @Ayrshirehealth post – iPledge by @dtbarron […]

  3. Great stuff and a very honest reflection of on services in Ayrshire. It’s interesting to follow the way that you’ve chosen to evaluate things and by not going down the formal target route. Fascinating stuff to read, and hope the survey uncovers some success stories!


    • Thanks for your thoughts – I think, at times, we obsess about counting everything, and while I think counting can be important it isn’t always important.

      In this occasion I felt it more important to give responsibility to those that made pledges, we can support them, but we aren’t taking on their ownership for them.

      I’m looking forward to the survey in January as another way for us to learn.



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