Humanising Healthcare – Hope for a System under Strain

Group reflects on Humanising Healthcare

SDHI in collaboration with NHS Fife, the Scottish Improvement Science Collaborating Centre (SISCC) and the International Futures Forum (IFF) hosted an interprofessional and interdisciplinary seminar and workshop with 20 participants to envision the future  of  a  healthcare system currently under strain. Dr Margaret Hannah, Consultant and Deputy Director of Public Health in the NHS Fife and author of ‘Humanising Healthcare: Patterns of Hope for a System under Strain’ and Graham Leicester, Director of the International Futures Forum (IFF) facilitated the afternoon with SDHI Co-Director Thilo Kroll.

Healthcare systems are under ever increasing performance pressures and exposed to massive rises in expenditures. At the same time criticism of the way we deliver health care grows highlighting the lack of compassion and a detachment of people’s life priorities and choices. Inequalities in health care access, treatment use and outcomes are not being tackled adequately. The research that supposedly generates the evidence base for effective therapies and interventions is selective, exclusionary, de-contextualised and for many long-term conditions flawed. Faced with a growing number of people who manage not one but multiple long-term conditions outside institutions in diverse community settings health care systems lack co-ordinated, integrated quality practice models that are centred around people’s lives and not primary their health conditions.

So, what are the alternatives to the status quo? What can we learn from the past? Perhaps, very timely 2015 saw a re-publication of the book ‘A Fortunate Man: The Story of a Country Doctor’ by John Berger and Jean Mohr. The book had originally been written in 1967 and was based on the sensitive portrait of John Sassall, a GP in the Forest of Dean. It illustrates his relationships with the diverse residents of this rural community and his approach to understanding the delivery of health care in the context of the social and environmental fabric of rural living. A quote from the book illustrates this very well

“Landscapes can be deceptive. Sometimes a landscape seems to be less a setting for the life of its inhabitants than a curtain behind which their struggles, achievements and accidents take place. For those who, with the inhabitants, are behind the curtain, landmarks are no longer only geographic but also biographical and personal.” (pp 18-21)

Margaret Hannah describes in her book the way our current healthcare arrangements are costly, guideline driven and dis-ease and disorder focused. Hope lies in adopting a salutogenic, asset-based approach that works with (not for) individuals and communities as co-creators of health. The workshop identified opportunities for transformational change in the way we deliver healthcare through  co-creation approaches and participatory action research. It also requires the collaboration with non-traditional partners in health, i.e. community organisations, local authorities.

We  are  currently working on a briefing paper based on the  workshop, which we will make available for reflection and discussion shortly.

Graham Leicester capturing ideas from the discussion


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New Scottish Improvement Science Collaborating Centre

SDHI is pleased to be a core partner of the The Scottish Improvement Science Collaborating Centre – a Scotland-wide initiative to improve quality of patient care and ensure that world-leading research leads to impact across society. The multidisciplinary initiative has been received £3.25 million of funding for 5 years from the Scottish Funding Council, the Chief Scientist Office, The Health Foundation, and NHS Education for Scotland (NES). The Centre will be based at the University of Dundee but it will be a large-scale collaboration involving universities, health boards, local authorities, patients, carers, communities and advocacy groups. It will be led by the University’s Professor Mary Renfrew and Professor Dilip Nathwani from NHS Tayside.

Several SDHI team members will contribute to this effort, including Co-Directors Davies and Kroll and Dr Jacqui Morris.

The Centre’s partners include:

Universities – Dundee, Stirling, St Andrews, Aberdeen, Edinburgh Napier, Strathclyde, West of Scotland, Glasgow Caledonian, with support from Coventry, University College London and Ottawa.

NHS Boards – Tayside, Fife, Greater Glasgow and Clyde, Lanarkshire, Highland, Lothian, Borders, Dumfries and Galloway, Ayrshire and Arran

Third sector, patient, carer and community perspective – Health and Social Care Alliance Scotland, Alzheimer Scotland, Ardgowan Hospice

National NHS – NHS Education Scotland, Healthcare Improvement Scotland, Scottish Health Council, NHS National Service Scotland, Scottish Ambulance Service, NHS 24, QI Hub

Local authorities – Perth and Kinross Council, South Lanarkshire Council

Scottish Government – Quality Unit

Private sector – Scottish Care

International improvement science partners – Institute for Healthcare Improvement, Boston, USA, Qulturum Center for Learning and Innovation in Healthcare, Jönköping, Sweden

The Scottish Funding Council (SFC) SFC is responsible for allocating public funds to colleges and universities in support of Scottish Government priorities. SFC’s funding contributes towards the costs of learning and teaching, skills development, research, innovation and other costs such as staff, buildings and equipment in Scotland’s 19 universities and 25 colleges

The Chief Scientist Office (CSO) is part of the Scottish Government Health and Social Care Directorates. It supports and promotes high quality research aimed at improving the quality and cost-effectiveness of services offered by NHSScotland and securing lasting improvements to the health of the people of Scotland

NHS Education for Scotland (NES) is NHSScotland’s national education and training Board. They are responsible for supporting NHS services to the people of Scotland through the development and delivery of education and training for all those who work in NHSScotland. They also work closely with a range of partners to deliver its vision of Quality Education for a Healthier Scotland

The Health Foundation is an independent charity working to improve the quality of healthcare in the UK. It wants the UK to have a healthcare system of the highest possible quality – safe, effective, person-centred, timely, efficient and equitable. The Health Foundation believes that in order to achieve this health services need to continually improve the way they work. They inspire and create the space for people to make lasting improvements to health services. They also conduct research and evaluation, put ideas into practice through a range of improvement programmes, and develop leaders and share evidence to drive wider change

In the following months, we will bring you regular updates of the new Centre’s work.

Webinar recording on Human Rights, Violence, Spinal Cord Injury and Rehabilitation in Haiti Now Available

Fiona Stephenson, Clinical Nurse Specialist and founding member of the Haiti Spinal Cord Injury Working Group and Co-ordinator of the Haiti Spinal Cord Injury (SCI) Database presented an inspiring and insightful webinar on the context of violence as the leading cause of spinal cord injuries in Haiti. Fiona, who is also a Co-Founder of the International Network of Spinal Cord Injury Nurses and the International Spinal Cord Society (ISCoS), discussed in her webinar the challenges to providing basic life sustaining care and rehabilitation for gunshot injury survivors in a resource poor environment. Mortality and medical complications are extremely high, skill and extensive despite the great skill, creative mindsets and phenomenal willpower of the health care teams on the ground. The earthquake that shattered Haiti in 2010 has taken a further toll on a very rudimentary health care infrastructure. Gun violence is not abating. Despite much innovation and legislative changes, people who live with the disabling consequences of violence still find it difficult to find support, accessible environments and opportunities for full societal participation and inclusion. Many promising facilities are threatened by closure due to a lack of funding. But despite all adversity, there were many stories of hope, human spirit and resilience, of people pulling together and becoming advocates for their own life, against gun violence and for better support services and health care.

Fiona’s webinar presentation can be viewed here.  We will add an audiopodcast shortly.

Dr Damien Williams, School of Medicine, University of St Andrews gave a very nuanced and greatly reflective response to Fiona Stephenson’s presentation. 

If you would like to learn more about gun violence in Haiti and its disabling consequences, we recommend to purchase the book ‘Gun Violence, Disability and Recovery’, edited by Cate Buchanan, Director of the Surviving Gun Violence Project. The book is available as an ebook or paperback on the organisation’s website

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Phil Hanlon presents ‘Afternow’ Project

The Centre for Environmental Change and Human Resilience (CECHR) team host a seminar with Professor Phil Hanlon, Public Health at the University of Glasgow on his ‘Afternow‘ project on Thursday the 13th of February 2014 at 4pm in the Dalhousie Building (3G02 LT1).  More information can be found on the website

Please register at for the event

Strong SDHI representation at the American Public Health Association Annual Meeting and Expo in Boston

Like in the previous year, SDHI affiliated researchers had a substantial presence at this years largest academic and professional public health conference with an estimated 13000 delegates. SDHI Associate Director Professor Peter Donnelly (St Andrews) hosted a special session on the recent Sandy Hook School Shooting in Boston, which brought together different perspectives ranging from parents, criminologists to policy makers.

Damien Williams presented posters on the relationship between community and domestic violence and football matches in Glasgow as well as on alcohol use quantities and patterns among university students at St Andrews.  Thilo Kroll contributed to a special session organised by the Disability Chairs Forum of the APHA Disability Section on ‘The a Construction of Disability and Health: The Role of Spaces and Places’, a discussion which continues on Facebook, and to a presentation entitled ‘Addressing the psychosocial support needs of cancer co-survivors in low income communities’ as part of a session on ‘Social Determinants of Behavioral Health: Addressing Root Causes through Public Policy and Community Practice’ . The latter also introduced SDHI’s sister platform, FRED (family focused research, education and development), which aims to bring together researchers, practitioners and families globally to examine and tackle social deprivation and marginalisation issues related to health. At present researchers from the Unites States, Finland and the UK are engaged in this effort. Thilo also presented three posters relating to a recently completed study on outcome measurement after stroke. The posters focused on rehabilitation professionals’ attitudes to outcome measure use, rationale for selecting outcome measures, and engagement of stroke survivors with aphasia in the discussion about what matters after stroke.  Shiraz Sheriff, PhD student who is supported by SDHI team directors Ed Hall and Thilo Kroll presented his poster, entitled ‘Asthma, deprivation and the urban environment in Scotland: Evidences, challenges and directions‘. For the first time SDHI was also involved in the APHA Film Festival where Lisa Nicoll’s film ‘Wasteland’ was shown. A productive evening session with PhD students has further linked SDHI’s research portfolio and support for postgraduate researchers to a wider international group, which is part of the internationalisation ambitions of SDHI. The presence of SDHI at APHA was particularly poignant this year as the motto of the conference was ‘Think global, act local: Best practices around the world’.

SDHI at the American Public Health Association (APHA) Annual Conference and Expo in San Francisco

Several SDHI researchers from Dundee and St Andrews will be heading to San Franciso shortly to present research findings at this year’s Annual Meeting and Expo of the American Public Health Association. It is the largest global gathering of public health experts, researchers, practitioners and advocates with an expected 13,000 delegates. It is not only a fantastic opportunity to showcase state-of-the science research but also a venue for networking and development of research collaborations. ;

SDHI will be reporting from the event via Twitter using #APHA and #SDHIAPHA and on this blog. So, stay tuned for more.

Introduction to Spatial Analysis in Public Health and Healthcare

This one day workshop presented by Sanjeev Sridharan, Associate Professor, University of Toronto will be held on Wednesday 19th September in IT Suite 2, Dalhousie Building, University of Dundee

For further details please see Spatial Analysis Training Course flyer