Can you make a difference to people’s lives?

Thomas Monaghan, Portfolio Lead for Living Well in Communities

15 June 2015. That’s the day I became part of Healthcare Improvement Scotland.

What attracted me to work in Healthcare Improvement Scotland? I wanted to help people have better lives. People like my late sister, who due to her long list of mental and physical conditions spent the last few years of her life ping-ponging between hospital and home. She could barely live her life because the services that supported her, my family and I were so busy trying to keep her safe that we effectively stopped her from living. I don’t want anyone else to experience that. I want everyone, no matter their background, to have the same opportunity to have a better life. And that’s why I’m part of Healthcare Improvement Scotland, because I’m helping people have a better life.

As my third work anniversary approached I started reflecting about the roles I’ve had in the past, from teaching undergraduates during my biomedical studies to service improvement in a large social housing and care group. And I realised that working in Healthcare Improvement Scotland combines the best parts of all my previous roles. I have the methods and thought-provoking challenges of scientific research. The buzz from helping people put new skills into practice. And the heart-felt satisfaction of helping people have better lives. And that’s with the pleasure of working with like-minded people.

My work

I started out at Healthcare Improvement Scotland as an Improvement Advisor. With the help and support of the team at Healthcare Improvement Scotland I developed my own skills and knowledge, growing my experience and confidence to enable me to develop with the organisation to become the team lead of Living Well in Communities. The team delivers a wide range of improvement programmes that work with health and social care organisations to help people have a better life at home, wherever that’s their family home or a care home.

There are many aspects to having a better life. One of them is avoiding time in hospital. Hospitals are great places to be when you need them, but many people have a similar experience to my late sister and have episodes where their lives are put on hold as they ping-pong in and out of hospital. But it’s not inevitable.

Helping people to live well in their community

The Living Well in Communities team have been working with services in over 20 health and social care partnerships (HSCPs) to find ways to improve support for people in the key population groups below to help them live well at home for longer.

We have been doing this by:

  • testing ways to identify people in these groups before a crisis occurs leading to repeat hospital admissions,
  • developing tools and approaches to help practitioners have a conversation with people at risk of crisis about what they want for their future, and
  • implementing preventative models of care to support people live well in their community for longer.


Scaling up change across Scotland

Much of our early testing work, particularly around frailty, is now complete and we are about to offer all HSCPs support to change their local systems to help people to live well in their communities for longer. We have already started working with the ten HSCPs in the north of Scotland and we will soon be able to support the HSCPs in the east of Scotland.

To further enhance our work, we are seeking to appoint a new Improvement Advisor to join our dynamic and driven team of liked-minded individuals to offer support to the HSCPs in the west of Scotland.

Could that be you?

Join us and help change lives

You would be joining a great team with a mix of people from various sectors. Some of the team have traditional health backgrounds, but others have joined us from local authorities, the Mental Welfare Commission, third sector providers and even a national sports association. I value that diversity and we’d like to continue to invite applications from a wide range of backgrounds.

There are some essentials for joining the team. You need practical improvement skills that you have used to help professionals change the way they work by using structured methods to systematically drive improvement. Methods such as the IHI Model for Improvement, system thinking methods such as Lean, experience based co-design or even RADAR from the EFQM Excellence Model. Data skills are also incredibly useful, not just traditional quantitative data for run charts, but also using qualitative data to drive improvement.

Key to the success of this role is the ability to establish and maintain good relationships. You will need to form and manage excellent working relationships with the Health and Social Care services you serve throughout the west of Scotland. You will also need to work closely with the rest of the Living Well in Communities team, especially the National Clinical Leads, National Professional Leads and national partners who bring substantial health and social care subject matter expertise to our work.

As you will be leading regional improvement support, it is important that you have some practical experience managing large projects or programmes. Our regional work is more responsive to local needs than traditional national programmes, which means you need to be comfortable managing programmes that will change with local needs and often start with a lot of ambiguity.

And finally, what we need is a passionate leader. Someone who truly cares about helping people have better lives and can use that passion to inspire others to change. We need someone who can persuade others to break old habits and try something different. We need someone who is self-aware and is driven to continuously develop their own skills, experience and behaviours as they strive to improve the support they provide to HSCPs.

If you have these skills, the energy and drive to be part of the Living Well in Communities team, then we would love to hear from you.

Apply now at our website. If you’d like have an informal chat to a current Improvement Advisor about their experience in the role, then please email Nathan at You can also find more information about us on our website and on our blog.

If you join the team we’ll put your skills to good use to work with health and social care services to shape the care experience of tens of thousands of people. That won’t reverse my late sister’s experience, but it will help thousands of others to have better lives.


Palliative and End of Life Care: Focus on Identification

Michelle Church, Improvement Advisor, reflects on our recent learning event, which explored ways of identifying people who could benefit from a palliative approach to their care.

On 31st May 2018, test site participants from six health and social care partnerships (HSCPs) and key delivery partners across Scotland joined the Living Well in Communities team to learn and share knowledge about tools that can support identification of people who could benefit from a palliative approach to their care.

Making the case for early identification

Kirsty Boyd, consultant and lecturer in Palliative Medicine, talked about the many benefits of earlier identification:

  • Helps people say what matters to them.
  • Increases the opportunity for people to participate in decision-making.
  • Reduces the risk of later regrets and poor outcomes.
  • Gives people time for planning ahead, resulting in fewer crises.
  • Reduces unplanned admissions of low benefit.
  • Encourages medication review and treatment planning.
  • Improves continuity and coordination of care by sharing information.

 How can we do earlier identification?

Our national clinical leads, Dr Paul Baughan and Sandra Campbell, gave an overview of the visual resource the LWiC team have developed to help compare different identification tools that are currently used in Scotland. Sandra did a before and after survey of how aware and confident participants were about the variety of tools.

How did we mobilise knowledge?

Experts from across the UK shared their tools, knowledge and experience of doing identification. People got the chance to participate in interactive workshops looking at the tools that a number of palliative care test sites. Some insights from the sessions are included below:

Anticipal and eFI electronic tools

FAST and PPP tools

PPS and SPAR Tools

SPICT4ALL and carers identification

What did people think of the event?

People felt that they had learnt about why, when and how to use different tools to support identification and inform practice. People really liked that they had the chance to network with experts and colleagues.

Overwhelmingly, the take home message was that earlier identification and communication is key to supporting those who would benefit from a palliative approach to their care.

What did you likeTake home message

What next?

HSCP palliative care test sites are now using the comparator to consider what tools will benefit local people and services and how people identified can be supported. This work will contribute to the vision that by 2021 everyone who could benefit from palliative care will have access to it and will support the Realistic Medicine ambition of shared decision-making and a personalised approach to care.

Meet Gemma Stewart!

Gemma Stewart b&wI would like to introduce myself as a new project officer for the Living Well in Communities team.

I will initially be assisting with establishing a programme of work LWiC are undertaking to support the health and social care partnerships in the North of Scotland.

This is an exciting new role for me in an established team, where I know I will be given the opportunity to learn lots and hopefully make a difference at the same time.

I have quite a varied work history, but one I think that has given me good experience and learning which I can bring to this role. I initially trained as a Physiotherapist and worked for a few years in NHS England in both acute and outpatient settings. This has given me a great insight into the challenges services and clinicians face on a day-to-day basis to support patients, their families and carers.

Having taken a break to explore the travel bug, I settled in Scotland where I have held office roles in both the private and third sector. For the last two and a half years I have been working in Healthcare Improvement Scotland’s ihub, initially as an administrative officer and then project officer for the Tailored and Responsive Improvement Support team. Here I have been largely responsible for managing the ihub associates framework agreement, and more recently working on the 90-day innovation cycle to explore quality management systems in health and social care in Scotland. I hope to be able to bring the valuable skills I have developed in these roles to my new position.

In the short time that I have been a member of the LWiC team, I have been struck by the enthusiasm and drive of the whole team, who have a multitude of varied skills and experiences behind them. There is a real passion for the work they undertake and an awareness that although there may be challenges ahead, by working together with our partners and communicating clearly these can be overcome.

I am incredibly excited to be a part of this team and to have the opportunity to make a difference and support people to live well for longer at home or in a homely setting.

If you have any questions please do get in touch.