Using to improve maternity services

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Value your staff and motivate them to deliver the best care? Promote person-centred ... writing / hosting the “in my s
Using

to improve maternity services

Are you looking to... Engage with users and the local community to improve your services? Value your staff and motivate them to deliver the best care? Promote person-centred practice, independence and choice? Get people to 'think outside the box' and work across boundaries? Challenge attitudes and assumptions? Explore difficult or sensitive topics? Explore ways to improve quality AND save money? Continually improve your practice?

The Whose Shoes? approach Whose Shoes? is a values-led, bespoke approach to change management, in the form of an engaging board game, developed by Nutshell Communications Ltd. It is being used successfully by a wide range of health and social care organisations, universities and other interested parties to support their transformation to a more person-centred, integrated culture of care and support. Good communication is central to this. In particular it is being used to challenge attitudes and assumptions, reduce stigma and encourage a more holistic approach, rather than just seeing people as ‘a health condition’. Sessions are highly interactive and inclusive, using lively facilitators, a ‘light touch’ approach to facilitation and engaging, attractive tools. Participants enjoy in-depth discussions in a relaxed, non-threatening environment. It is thought-provoking and freeflowing, challenging but fun. People quickly identify and discuss the topics and issues that are really important to them and work together to share good practice and find local solutions. Person-centred approaches are embedded into the tools and people can be inspired to change their practice in many ways – re-thinking how they engage with others, specifically patients and their families. Care professionals often say their training is too focused on medical learning and they benefit hugely from this more rounded approach. It is always hard to predict exactly what will come out of a Whose Shoes? session – but to date, with the right environment, there is always a significant impact. There needs to be real

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clarity about the outcomes the organisation is wanting to achieve. Our bigger projects involve considerable preparation time in teasing through the key issues and working out the best ways to bring the right people on board and trigger the necessary actions for service improvement.

Whose Shoes? - Improving Maternity Experience The maternity version of Whose Shoes? has been developed in partnership with the London Strategic Clinical Network, led by consultant obstetrician Florence Wilcock at Kingston Hospital, with support from Kath Evans, Patient Experience Lead at NHS England. The scenarios have been co-produced using the real voices of people using maternity services, clinicians, policy makers, commissioners, independent providers and others associated with pregnancy, childbirth and early parenthood. A series of five pilot workshops are underway across London and these have been used to refine the tool and produce a leadership and facilitation pack to support the toolkit.

Introducing Gill Phillips, creator of Whose Shoes? Listed in 2014 in both the HSJ ‘Top 50 Inspirational Women’ and HSJ ‘Top 50 Innovators’. Gill Phillips is the creator of the award-winning Whose Shoes? concept and tools and the lead facilitator for the Whose Shoes? team. Other team members are carefully selected who demonstrate the same values and enabling approach. Gill is known for gently but firmly pushing the boundaries, challenging stereotypes, stigma and silo thinking. Her workshops are lively, inclusive and relaxed – encouraging everyone to discuss the real issues as equals, regardless of roles or organisations, and to build local networks and collaborations. She is highly influential on social media, tweeting as @WhoseShoes and writing / hosting the “in my shoes” blog series. She is an international speaker and is a champion of the full involvement of experts by experience.

Using social media to engage more widely Social media (particularly Twitter) has played a big part in the project. Gill Phillips devised the hashtag #MatExp and, as it gained traction, registered it as an ‘official’ health and care hashtag with Symplur. #MatExp is creating a lot of energy across the country, encouraging users to play a lead role in driving improvement. There have been 20 million ‘impressions’ so far, with @WhoseShoes leading the social media movement and putting considerable time and effort into building and engaging with the community, also writing blogs and setting up a bespoke, crowd-sourced Pinterest board. We are delighted that #MatExp has been accepted as a ‘grassroots’ NHS Change Day campaign, 2015. We are happy to tell anybody more about these developments and how they as individuals or their organisations can get involved.

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Over 20 million impressions of #MatExp so far...

Whose Shoes? 14.6 million of them!

The first Whose Shoes? #MatExp pilot at Kingston Hospital, 17 October, 2014 - with Florence Wilcock tweeting in the corner!

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How can I get Involved? Become a Whose Shoes? Hospital and Subject champion

Creating the right environment The Whose Shoes? toolkit is designed, as far as possible, as a stand-alone resource but its success will depend significantly on creating the right environment, providing 'light touch', enabling facilitation and a determination to bring about real actions as a result of a session and follow them through to fruition. It is usually advised that this includes a workshop facilitated by people who have been involved in the original project, whether the Nutshell Whose Shoes? team or NHS partners. We are encouraging users to get involved in not only attending but actually leading events – but the logistics of this are still being sorted out - and sometimes this is difficult with a young family!

Collaborating for success The ideal model is to have a hospital champion, building a close relationship with Nutshell, so that there is mutual understanding of how the tool works and what it can achieve in a conducive environment. This person may also be the ‘subject champion’ – i.e if maternity is the first topic to be introduced into the hospital, but it is envisaged that, as time goes by and more material is available, each specialism within the hospital will have its own champion. We are hoping that people coming to the Train the Facilitator event will want to get involved in rolling the project out to other London hospitals and other regions of the UK. Whose Shoes? is very different from traditional 'top-down' improvement approaches. Coupled with a strong and genuinely ‘listening’ social media presence, it has the potential to grow a grass roots style social movement, driven by real passion for positive and inclusive change. The people delivering sessions must understand this concept and be personally committed to taking an enabling leadership role, not under instruction from on high!

How do I become a Whose Shoes? champion? Anyone who attends the Train the Facilitator session (or equivalent at a later date) may purchase a licence to the Whose Shoes? 'Feel the Buzz' Starter Pack if they will personally lead the project (as a Whose Shoes? maternity champion) in their own hospital. We will discuss at the Train the Facilitator event how informal NHS support might be provided, including people buddying with each other and possibly having teleconferences with other champions. This can be a great staff development opportunity, mentoring colleagues perhaps from a neighbouring hospital, learning about the experience and impact elsewhere and building good practice networks. Success here will clearly depend on the time, energy and commitment of the staff involved. Normally, however, it is recommended that external support is provided, particularly for an initial workshop. This could either be in the form of paid consultancy from Nutshell or through the NHS network that we are growing through the project.

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Nutshell facilitators Whose Shoes? is a vibrant approach to transformational change and it is really important to find the right people to support hospitals wanting to invest in our toolkit. The best Nutshell facilitators tend to come forward from the workshops themselves and this is already happening with #MatExp, discovering networks of people who can work with hospital champions to deliver high quality workshops. The Train the Facilitator event will be an important opportunity to find out what will be the most helpful support package options for organisations utilising the new maternity resources. It is envisaged that early adopters will be people who are 'already there' in terms of understanding the need for transformational change but requiring different levels of support to move forward.

Identifying funding Ideas will be explored at the ‘Train the Facilitators’ session to help hospitals identify funding, if appropriate. These could include charitable funds, fund-raising or application for grants around improving patient experience or other related topics.

Looking ahead The pilot project has been very exciting and has generated a lot of energy for positive change which is spreading nationally, linking to and helping to build strong networks in different parts of the country. We are hoping to run regional events, in partnership with the Patient Experience team at NHS England and sharing the learning from the London project, so please get in touch if you are interested in being part of this.

Whose Shoes? - other topics It will also be possible to get involved in further bespoke work, by negotiation with Nutshell. This could be to explore and develop new material around specific aspects of maternity in more detail or for other topics where it is felt people’s experience of healthcare services could be improved. Some of this work is underway already (for example, dementia care) so please speak to Gill Phillips at Nutshell for further information: [email protected] www.nutshellcomms.co.uk Special status, and suitable acknowledgement, will be granted to organisations co-producing bespoke material.

Intellectual Property 

All Intellectual Property for Whose Shoes? toolkits and all components belongs to Nutshell Communications Ltd



No part of the toolkit may be reproduced or amended in any way without express permission from Nutshell.

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Options for a hospital to invest in the Whose Shoes? approach to transformational change Whose Shoes? 'Feel the Buzz': Starter Pack - Just do it! Includes 5 x Whose Shoes? Maternity Leadership toolkits. Each toolkit contains:  Whose Shoes? board game including all components  One set of maternity cards and poems  Leadership pack  Facilitation pack PLUS one-to-one support to get you going: 

2 x 1.5 hr support calls (Skype / telephone) with a Whose Shoes? facilitator before and following your Whose Shoes? event. Enables you to tailor and facilitate your own event.

With this selection, you have the additional option of buddying with a Whose Shoes? Champion in a local Trust or another hospital as an additional 'guide'. £2,975 + VAT

Whose Shoes? 'Feel the Buzz’: Partnership package Let’s do it together! Includes 5 x Whose Shoes? Maternity Leadership toolkits. Each toolkit contains:    

Whose Shoes? board game including all components One set of maternity cards and poems Leadership pack Facilitation pack

PLUS your very own dedicated Whose Shoes? facilitator!     

This person will co-produce your workshop with you and help you get the most from it. On the day, they’ll help you set up, co-facilitate the session, support you in your change leadership role and engage in immediate strategic conversations at the end of the day Proactive Whose Shoes? social media event promotion and network engagement, sharing and raising the profile of your organisation Unlimited support calls before your event Debriefing session following your event.

With this selection, you have the additional option of buddying with a Whose Shoes? champion in a local Trust or another hospital as an additional 'guide'. £4,495 (plus direct expenses) + VAT

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Designing a Whose Shoes? event in a new subject area Price on application, through discussion about the nature of your idea, feasibility, desired outcomes and co-production opportunities. Including for example:           

Co-design of the project Meetings / Skype / email and telephone support throughout the project Research, including visits and networking to add new insights and perspectives Focus groups / interviews Support with programmes and flyers Bespoke slide presentations Co-produce new scenarios, from multi-perspectives, reflecting your identified priorities (including poems) Design, print and supply new material Facilitate workshop(s) Full social media support Whose Shoes? bunting and key-rings for participants

Whose Shoes? change project Price on application, through discussion about the nature and scale of your change leadership project; ultimately this could be working towards whole system change. What if you are already aware that your priority this year is innovation or change? You also know that the most effective way to reduce costs is to enable staff to work their magic with 'small change, big impact' projects from the 'ground' up. Our facilitators work with you to tailor bespoke change projects, tapping into the creativity and energy of your people. We will meet you where you are at. Bespoke consultancy support to the project, with a dedicated Whose Shoes? consultant working with your Whose Shoes? hospital champion(s).

All licences are per hospital, in perpetuity, for use within the specific hospital, including partnership events that they host and for the agreed topic(s) – eg maternity. The administration for all events, invitations, bookings, follow up pledge postcards etc is handled entirely by your (hospital) team.

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