Mental Health Don’t walk the line Labels for less We take an in-depth Pulse meets a Enter our staff competition look at how everyone Johnny Cash fan for the chance to win should be alert to signs who’s using texts to a £150 voucher for of mental ill-health manage his illness GetTheLabel p18

September / October 2015 www.thepulse.scot.nhs.uk thepulse

As we prepare for the opening of the Lanarkshire Beatson, Ann Muir, Public HAT’LL BE Partnership Forum describes the satellite centre as ‘incredible’. INCREDIBLE! Page 04 Partnership working has delivered important cancer facility 02 NEWS thepulse Contents SAFETY FIRST News 2-5 - RAJ’S AIM Stroke Awareness 6-7 Health improvements 8-9 Four-day training course Dental Services Update 10-11 teaches basic to advanced skills Cardiac Alerts 12-15 Dr Raj Padmanabhan takes great providing training and education pride in sharing his work with throughout the NHS. Staff Benefits 16-17 his colleagues and trainees .The Dr Padmanabhan has also Retirals 19 consultant anaesthetist at published a practical guide for the General Hospital is passing on use of Aintree Intubation Catheter Staff News 20 cutting-edge techniques to – a guide originally intended for trainees to improve patient care local use, which has since been

10 MENTAL HEALTH FOCUS 11 and safety. Life is good and you’re recognised on a national level and not alone, says Len Speaking about his work Raj is in use in many hospitals across said: “I am absolutely committed the UK. Raj has established LEAT Len Northfield values the help he’s had to manage his depression When Len Northfield was 28, services to help them. he awoke on a hospital trolley Len continued: “I’ve suffered receiving emergency treatment. depression all my life and Len’s last thought prior to that reached those points where moment was to bid the world you find yourself in this hateful, goodbye as he attempted to take desolate place where you are his own life. the only inhabitant. However, to teaching and training the I want to help people see that (Lanarkshire Endoscopic Airway Len said: “I still remember coming to and being surrounded they are not alone and that it’s by medics intent on saving my possible to learn to identify the life and being angry with them signs that often proceed a bout Participants for succeeding. I also remember of depression, manage them and with a colourful spending the night hooked up lead a relatively normal life. declaration to a heart monitor with a nurse “I take medication every day of support for watching over me.” and will probably take it for the ‘Growing a However, more than 25 years on, rest of my life. But I also use a anaesthetists of tomorrow Movement Len has learned how to manage variety of other tools to help me Training) and ETAC (end-tidal for Change’ the depression which drove this such as Mindfulness and use the and is now a trained counsellor Wellness Recovery Action Plan who, as a peer support worker, (MyRap) tool which is based on uses his lived experience to help the principle of playing to your people in the acute psychiatric strengths.” admissions ward in Wishaw Reflecting on the distance Len General Hospital on their has come, he added: “Life is good POSITIVE MOVES TO recovery. and I owe a lot to the individuals particularly regarding aspects of The Strathaven man shared and services who helped me and anesthetic concentration) – two his story to remind those who I want to help those who have have a mental health problem reached the bottom to find the LESSEN SUICIDE TOLL that there are people and first step on the ladder out.” September and October are busy According to the World Health and wellbeing development everything we’re trying to achieve. times of the year in Lanarkshire’s Organisation (WHO), over 800,000 manager and chair of the We want to create an environment people take their own life every Lanarkshire Recovery Network, where all of us recognise mental Paula is new head mental health calendar. Suicide year. explained the thinking behind a health, understand it, value it, know Paula Macleod has been appointed for Rutherglen and Cambuslang airway management.” Prevention Day falls on 10 September Here in Lanarkshire there is a ‘Growing a Movement for Change’. how to look after it and support interim head of the mental health before becoming service manager innovative and successful NHS and World Mental Health Day is 10 ‘Movement for Change’ to He said: “We’ve done some others and know what supports and learning disability service for the South West Unit. are available. replacing Jim Wright who retired October. The Scottish Mental Health challenge the stigma and fantastic work in Lanarkshire down Paula said: “I’m really looking discrimination associated with the years in relation to mental “Let’s be clear, stigma and in June. forward to supporting staff to Arts and Film Festival also takes place mental health. An event was health, but we deliberately choose discrimination stops people asking Paula has worked in mental health provide effective, efficient and from 10-31 October. held earlier this year to bring the term ‘growing’ as we realise for help, hinders recovery and for over 30 years since starting her safe services for all our users and partners together from a host of there’s much to build on and still removes opportunity. Stigma hurts, career in Glasgow’s Leverndale carers. organisations to allow them to much to do. support helps and we all have an Hospital in 1984. I also want to help our staff feel The Pulse takes a look at mental share resources and experiences important part to play. “For me, ‘Growing a Movement for She moved to Lanarkshire in valued and aim to support and health and how we can help reduce to address this issue. Change’, is a natural title for this “If not you, who? If not now, Paula MacLeod 2005 becoming service manager promote their professionalism.” Lanarkshire based national skill the stigma. Kevin O’Neill, public mental health continuing work as it encompasses when?” Raj has established the first ever structured manikin-based airway courses.

16 HEART DISEASE 17 management training programme Did you His leading work, in conjunction know? Angina is chest pain that occurs when Alert for the blood supply to the muscles of the heart is restricted. It usually happens the signs of because the arteries for anaesthetic trainees across supplying the heart with colleagues at a local and become hardened and narrowed. The most common cardiac arrest symptom of angina is a feeling of pain or A new project’s helping to in the same way. If everyone discomfort in your reduce the number of people carries out checks in the chest. The pain can who suffer a cardiac arrest on same way, we can detect Wishaw General’s cardiology more subtle deterioration in feel tight, dull or NHS Lanarkshire. ward. patients.” heavy. national level, has ensured that The pain can spread The pilot project, which is The team have also introduced from your chest being carried out in Ward 4, new ways to flag up subtle to your left arm, has seen a number of new changes in a patient’s neck, jaw and back. procedures being introduced condition to nursing and In some cases, the in a bid to halt a cardiac arrest medical colleagues. pain is similar to in its tracks. The ward aims to Gary added: “When nurses The ward indigestion. reduce the number of cardiac are doing their observations aims to arrests by 50% by June 2016. and detect deterioration reduce the Gary Boyle, senior charge in the patient’s condition, number NHS Lanarkshire has been a nurse, said: “Before someone they take one of our new of cardiac has a major deterioration, Dr Raj Padmanabhan said: sticker alerts and place it in arrests by there are very subtle changes the patient’s medical notes. in their overall condition. They accompany this with If you can identify these a narrative saying why they 50% changes and respond to them have placed the alert, what by June as they happen, you can often they observed and whether 2016 prevent a major deterioration the patient requires a medical ANDREW’S CLIMBING from happening. review. “We have introduced “Every time there is a change proactive leader in implementing new ways to recognise a in the patient’s condition, a “Anaesthetics is a specialty deteriorating symptom. For new alert is placed in their example, we introduced record. The result is that TO BEAT CHEST PAIN monitoring every patient’s there is a clear mapping pulse manually instead of of any deterioration and Eight-week cardio rehab class helped Andrew’s health relying on machines. We’ve allows doctors to review When Andrew Jamieson was diagnosed Andrew was referred to the rapid access Ann Marie Blaney, chest pain nurse also introduced a standard their treatment much earlier with angina, Wishaw General’s cardiac chest pain clinic at Wishaw General Hospital. specialist, said: “Patients who are diagnosed observation procedure so that than they would have been rehabilitation nurses helped him get back on “I was diagnosed with angina and put on with angina are reviewed at the nurse led all staff check every patient previously.” his feet. medication. The nurse suggested that I clinic. When a patient’s condition is stable, Wishaw General is one of the first hospitals attend an eight-week cardio rehab class in we offer them a place on our eight-week many national patient safety in Scotland to fully integrated angina service, the hospital’s physiotherapy department.” exercise clinic. The classes are tailored to where airway management is a each patient’s needs and can be either high which cares for patients from diagnosis After the eigh-week exercise programme, Did you know? through to follow up care and lifestyle advice. patients who are able are invited to attend a intensity or low intensity. The nurse-led service sees patients with A heart attack is a serious medical emergency in which the supply similar 10-session course at their local gym. “NHS Lanarkshire is one of the first health angina being diagnosed and treated before of blood to the organ is suddenly blocked, usually by a blood clot. This course is facilitated by trained staff. boards to introduce this type of service for receiving a further assessment where angina patients. After a diagnosis, each Lack of blood to the heart can seriously damage the heart muscle they are referred to the hospital’s Andrew added: “Because my job is quite physical, I said to the instructor patient is reviewed again before being cardiac rehabilitation exercise class. referred to the exercise and education Symptoms can include: that his challenge, if he chose to Andrew, from Motherwell, said: “A accept it, was to get me to climb an programme. recommendations pertaining to • chest pain – the chest can feel like it is being presses or squeezed few years ago, I had been feeling a 80-metre ladder in the wind turbines “We see their health improving and they see fundamental skill. The course sees by a heavy object, and pain can radiate from the chest to the jaw, bit breathless and felt some tightness at work. He said there was no reason the difference. Hopefully they keep it up in my chest. My father had coronary neck, arms and back why I shouldn’t be able to do that.” and change their lifestyle for the better. “ heart disease and died in his forties. • shortness of breath Being in my late fifties, I Wishaw General’s cardiac “NHS Lanarkshire is one of the first health boards to • feeling weak and/or lightheaded decided I needed to do rehabilitation nurses are something, so I made an introduce this type of service for angina patients.” • overwhelming feeling of anxiety working hard to help appointment with my GP.” patients return to health trainees spend four days learning a structure and standardisation of range of techniques in a structured airway equipment. setting and ranges from basic to Raj said: “Without the motivating advanced.” thought that eventually our The course has now expanded patients will benefit, many of Got a story? to involve NHS Dumfries and these innovations would not have Galloway, NHS Ayrshire and NHS happened. I acknowledge the If you have any ideas, stories Forth Valley, making it the first ever encouragement, help and support or features you would like to joint anaesthetic venture between rendered by many of my clinical see included, or would just like ‘non-teaching’ Scottish health and non-clinical colleagues to tell us what you think of the boards and demonstrates the through this patient centred Pulse, please get in touch... critical role that consultants play in journey to date”. Fiona O’Dowd Tel: 01698 858 108 “I am absolutely committed to teaching and fiona.o’[email protected] training the anaesthetists of tomorrow particularly the deadline for contributions regarding aspects of Airway Management.” to the next issue of the Pulse is 2 October. Structured improvements Editorial policy The organisation of formal airway NHS Lanarkshire worked together to As the staff newspaper of NHS training has been the topic of much design and implement a structured Lanarkshire,the Pulse aims to celebrate the work and achievements of staff discussion in anaesthetic literature and programme of airway teaching for and services. It also shares information its importance has been heightened their trainees. The aim is to optimise about the changes and issues that affect by the restriction in theatre hours non-clinical learning opportunities staff at work. We would like to hear your thoughts and suggestions about the imposed by the European Working within the framework of departmental kind of stories you would like to see in Time Directive.Recognising this, the and national Difficult Airway Society the Pulse. Contact Fiona (above) with three anaesthetic departments within guidelines. your stories, comments and ideas. 03

Arun pioneers ear surgery technique Traditionally, ear surgery is carried out with a skin incision either in the front or the back of the ear – resulting in slow healing, pain for patients and scarring. But, Mr Arun Iyer, a consultant ear, nose and throat surgeon at Monklands Hospital, has introduced the use of endoscopic ear surgery in Scotland. This pioneering approach allows Arun to see where he’s operating by inserting an endoscope into the ear canal. Arun said: “I was so impressed by the procedure that I decided to start a cadaveric course with the help of The Royal College of Physicians & Surgeons of Glasgow.

Arun: better care is outcome “The first course in October 2014 was a huge success and we had renowned international faculty and delegates from as far as Israel.” He continued: “There are lots of benefits to this technique, it improves the experience for the patient as they have less discomfort and they recover a lot quicker. It is particularly useful for treating children as it can be done with very minimal pain and without the need for admission.”

Skills enhancement Dr Tammar Al-Ani, a third year trainee anaesthetist, has under taken the airway management training programme. Tammar said: “It was excellent and has given me additional skills that I can use to provide the safest level of care to our patients. As it is a relatively new course, I have also had the chance to share these skills with my more established anaesthetist colleagues and pass on what I’ve learned.” Dr Tammar Al-Ani 04 NHS NEWS

New health and council centre opens in Wishaw Patients and staff have given the new Houldsworth Centre the thumbs up. The new joint health and council community facility in the heart of Wishaw is a physical example of integrated working. Coltness woman, Elaine Isaac, said: “The new centre is fantastic. It looks great from News in Brief the outside but it is even better inside and, with a range of services all under one roof, The Houldsworth Centre is the third new it is very handy. community health centre “It is a real community hub and I am sure which NHS Lanarkshire local people will appreciate the amount of has opened in 2015, thought the council and NHS have put in to Elaine Isaac and Heather Hutchison along with Hunter create this wonderful facility.” Community Health The new 7800 square metre facility hosts impressed they are too.” Centre in East Kilbride a range of health services including GP The former health centre building will be and Community and dental practices as well as the North demolished to make space for a two-storey Health Centre. Lanarkshire Council library, First-Stop-Shop car park with 190 spaces. The three facilities, and housing service. Colin Sloey, NHS Lanarkshire director of with a total value of Centre administrator, Heather Hutchison, strategic planning and performance, said: £43million, are the result said: “I worked at Wishaw Health Centre “The Houldsworth Centre is a tremendous of a partnership between for 26 years so I was quite sad to be leaving addition to the town centre allowing people NHS Lanarkshire and those premises. However my sadness quickly to access a wide range of health and council hub South West Scotland disappeared once we opened the doors to services in one convenient location. Limited. patients at the Houldsworth Centre. “This represents a significant investment “I am really impressed with the size of the by NHS Lanarkshire in local health care building and how bright and airy it feels. You and shows our commitment to integrated can tell by the looking at the patients when working and to playing our part in the they enter the building for the first time how regeneration of the local area.” ‘At’ll be incredible from page 01 The design reflects this is through the entrance to the new building - a The Lanarkshire Beatson will open two-storey atrium, designed to feel at the end of November and everyone welcoming rather than intimidating. involved with its development and It’s described as more like a hotel build is excited to see the progress lobby than a hospital. of the satellite site at Monklands Hospital. The new centre will include two state- of-the-art linear accelerators. This will Since Monklands Hospital is already enable around 80 patient treatments a our identified cancer centre, hosting day, predominantly from Lanarkshire, a number of cancer services, this who require radiotherapy for lung, new facility expands the work of the breast, prostate and rectal cancers to renowned Beatson centre, based be treated. in Glasgow. The £22m satellite radiotherapy site is being developed The centre will use the same CO-OPERATION PAYS OFF within this major working hospital, equipment, clinical protocols and A new core laboratory at Monklands with the centre’s footprint occupying management structure as the Beatson Hospital is streamlining work-flow and nearly all available space. West of Scotland Cancer Centre, and improving efficiency. section staff will spend a proportion of Access has had to take account of an their worktime on site in Lanarkshire. The new layout makes better use of outpatients department, a day surgery space and helps the laboratory to run Ann Muir, North Lanarkshire Public unit and the ‘blue-light’ ambulance more smoothly. route to A&E. However, the whole Partnership Forum, said: “The services project is about bringing positive provided in by the Beatson in Glasgow Louise Brown, senior biomedical change to healthcare in the West of are world-class so to have a satellite scientist, said: “The new core laboratory Scotland. So patient experience and centre in Lanarkshire is incredible.” is the result of a great deal of hard work delivering high standards of care are The new Lanarkshire Maggie’s Centre and cooperation from our staff. The no less important. is also located on the site. creation of the new facility happened 05 ‘Fantastic’ and ‘spacious’ Lincluden Centre opens Lincluden Medical Centre in Uddingston has opened the doors on a brand new surgery. The new building, which has been funded by NHS Lanarkshire, was open to patients on 16 July and officially opened by NHS Lanarkshire Chair Neena Mahal on 20 August. Former Practice manager Neil Doherty said: “The whole process has been a number of years in the making, and we’re delighted that it has finally reached a conclusion. The new premises will allow us to provide a better service to our 7,800 patients in the local area. It looks fantastic and is more spacious.”

(l-r) Senior partner Dr Bruce Thomson, Neena Mahal, Katherine Phipps, new practice manager; Neil Doherty and Rena Hall, assistant practice manager The new surgery significantly increases the space available to develop specialised clinics and increase appointment times to improve access for patients in a way that was not possible at the old surgery in 53 Road. It also allows the surgery to meet the needs of its growing list size and future population growth in Uddingston. Creating a good workflow - the Seven GPs, four nurses and ten support new core laboratory at Monklands staff are based at the new centre. The is part of the Lanarkshire-wide telephone number remains the same: laboratory investment 01698 813873 CO-OPERATION PAYS OFF Single pathology department for NHS Lanarkshire in a number of phases. The team were and urine.” for pathology, said: “The new really patient and supportive throughout The core laboratory at Monklands is pathology department will house all the whole process and we are now part of the Lanarkshire-wide laboratory histopathology and cytopathology seeing the benefits of the new set-up.” investment work which will also see services for NHS Lanarkshire and “The core blood sciences laboratory is a new £1.8m pathology laboratory in create a single, modern pathology staffed by a team of clinical scientists, the building previously occupied by department. biomedical scientists, medical laboratory corporate services on the Monklands All tissue samples from across assistants and clerical staff. They carry site. Lanarkshire will be processed and out analysis on fluids such as blood Allan Wilson, lead biomedical scientist reported from the new laboratory.” 06 STROKES FOCUS OUR STROKE CARE EXCEEDS AVERAGE Every year over 1,000 people in Lanarkshire have a stroke Figures released by the Scottish occur in the under-65s. Stroke Care Audit (SSCA) National “It’s essential people recognise Report show NHS Lanarkshire is a stroke when it’s happening one of the best performing health and take prompt action. Delay boards for stroke services. increases the risk of death or Katrina Brennan, stroke managed major long-term disabilities, such clinical network (MCN) manager, as paralysis and communication said: “The most important problems. It is vital that the indicator of the performance symptoms are not just ignored.” of stroke services is the Picture caption (left to right): performance against the Stroke Katrina Brennan, Campbell Care Bundle. The Scottish average Chalmers, NHS Lanarkshire stroke for individuals receiving the nurse consultant and Dr Mark appropriate bundle is 65% while in Barber, hosted an event to inform Lanarkshire we are achieving 83%. health professionals and members “This is a fantastic achievement of the public about the work of the and a testimony to the hard work NHS Lanarkshire Stroke MCN. of all the staff involved which ultimately benefits patients on the stroke care pathway.” Act FAST with signs of stroke NHS Lanarkshire stroke services is It is essential people recognise a stroke when it’s happening already exceeding their target for and take prompt action. improvement to be achieved by end of March 2015. FAST – which stands for Face, Arm, Speech and Time to call 999 – aims to make people aware of the signs of stroke. Dr Mark Barber, stroke MCN clinical lead, said: “Every year, Campbell Chalmers, stroke nurse consultant, said: “The FAST over 1000 people in Lanarkshire campaign is designed to make members of the public react as have a stroke and, contrary to quickly as possible. popular belief, a stroke is not “Rapid treatment can make a huge difference to the odds of something that only happens to surviving or being left with a long term disability.” older people as about a quarter After two transplants, Mary and family so grateful to donors Mary Moffat’s life was turned upside young and my mother-in-law saw the same After tests, Mary and her husband down when she was told that two of her symptoms in Rachael as she had seen in were told some serious news. Their young children needed life-saving heart my husband.” consultant told them that both children transplants. Mary took Rachael to the paediatrician at had a condition called Restrictive Cardiomyopathy. The midwife, who works at Wishaw Wishaw Health Centre, who referred her to General Hospital, now wants to encourage Yorkhill Children’s Hospital. “When you are told something like that, local residents to join the organ donor Mary added: “Around the same time, my you can’t take it in. I was really upset and register, in a bid to save more lives like her husband called me at work to say that you try to think that it must be someone children’s. 10-year-old Stephen had collapsed. else’s children that they are talking about.” Mary, from Motherwell, said: “In the year There was no lead up to it. He was very Mary and her husband were also given that Rachael started school, she was really active and had wanted to be a professional tests, which resulted in him also being tired all the time. I would come home from footballer. When Stephen collapsed for diagnosed with the condition. work every day and find her sleeping. My a second time, he was also referred to Both children were quickly added to the husband had a blocked aorta when he was Yorkhill. organ donor register. 07

A stroke can strike at any age From a sore head one Sunday morning, 40-year-old Temi learned he had actually suffered a stroke. Temi, from Cumbernauld said: “It really shocked me. I now struggle to speak as I have a condition called aphasia. It all started with a sore head one Sunday morning. I didn’t feel quite right, I struggled to speak, and I just thought I needed to go to sleep.” His wife, Alison, also noticed small changes in his behaviour that morning too. “Temi couldn’t open the door, he struggled to get words out and, while trying to make a cup of tea, he made a real mess of the kitchen. You couldn’t recreate this if you tried and it was totally out of character. It may have sounded trivial but I decided to call NHS 24,” she said.

One year on, Temi is making good progress with his stroke recovery “I didn’t feel quite right, I struggled to speak, and I just thought I needed to go to sleep.”

From there Temi, who has two young children, was taken by ambulance to Monklands Hospital for tests. Due to his age and because he’s a fit person, Alison thought her husband would be fine the next day. However, the couple were to After two transplants, Mary and family so grateful to donors receive unexpected news. Following a thorough assessment, it was confirmed Mary said: “They both received their that Temi had suffered a stroke, so he was transplants within a year of being admitted to a stoke ward where he stayed diagnosed, which is extremely quick. for two weeks. They have kept really well since. Temi said: “The hospital staff were fantastic, “To donate an organ is the biggest gift they knew what I needed to get better and you can ever give. I would like to thank I was referred to the CARS (Community the two families who donated their Assessment and Rehabilitation Service) loved ones hearts so that my children team. We went through a whole range of could live.” activities that were all set around what I wanted to achieve. To find out more about organ “With their help I made improvements donation and to join the NHS every day. I am slowly getting better and, Organ Donor Register, visit Mary with Stephen and Rachael – now one year on, I am making a phased return www.organdonationscotland.org both doing well after their transplants back to work.” 08 LUNG DISEASE

DON’T WALK THE LINE, JUST TEXT, SAYS JOHN Modern technology is helping out with healthcare in many innovative ways. The Pulse meets one patient who’s taking advantage…

LANARKSHIRE’S answer to Johnny John had to retire from his job, Cash has revealed how the power but ongoing medical support, of text has kept his life in harmony including an innovative new during ill health. text message system – which John Stalker (54), from Hamilton, links patients directly to NHS was a long distance driver who – Lanarkshire respiratory nurses to inspired by the Man in Black – sang help manage their condition – has and played guitar around local given him a crucial boost. music halls and clubs in his spare “When something like this time. However, life as he knew it happens it affects your confidence was changed forever when, after profoundly – especially when bouts of increasing breathlessness you’re used to performing. The and a persistent cough, John was text message system, however, diagnosed with chronic obstructive has given me an extra layer pulmonary disease (COPD) in 2011. of reassurance and a sense of regaining control. Help and advice “The text message is only a text away.” The system is known as Florence system, however, has and is free for the patient to use. given me an extra COPD patients, who can be layer of reassurance of any age over 16 years, text details such pulse and oxygen and a sense of levels and receive texts back with regaining control” advice and reminders, all based on the latest readings and their individual care. COPD is the name for a collection If the symptoms worsen an alert of lung diseases including chronic is also sent to the specialist nurse bronchitis, emphysema and allowing them to respond by chronic asthma. phone, text or visit as required.

The innovative telehealth scheme is part of the European-wide initiative United4Health, which is geared to using new technology to improve healthcare. NHS Lanarkshire along with North and Council are partners. John had 11 hospital admissions last year due to his condition. Since starting using the text message system in January he’s only been admitted once as he was able to initiate treatment and specialist support earlier from his own home.

To find out more e mail Morag Hearty on United4.HealthProject@ lanarkshire.scot.nhs.uk

John Stalker with NHS Lanarkshire respiratory nurse Pamela Mcatamney 09 Lung cancer spotlight Car crash revealed cancer for Peter When Peter Doyle was in a bad car crash, he expected to be diagnosed with whiplash. However, in a shock turn of events, he was told he had lung cancer. Lung cancer is the most common cancer in Scotland with around 5,000 new cases diagnosed every appointments for myself. The year. stress was one of the worst The grandfather of three bits of it. My head was in said: “In May last year, we turmoil and I didn’t know if I were driving when this was coming or going. I was boy came out of nowhere absolutely stunned. and flew into us. The car “When you are told that you was mangled and the have cancer, everything goes fire brigade told us that through your mind. I even they didn’t know how we planned my funeral and managed to get out alive. told my wife exactly what We were both in a bad way, I wanted and what I didn’t but my wife got she worst want to happen on the day. of it. She ended up having “After my final round of to stay in hospital for three chemotherapy, they told me weeks. Integration that the cancer had reacted “I was in a lot of pain in to the chemotherapy and newsletters my ribs. I was in agony it had shrunk. This enabled whenever I coughed or them to take a section of my now available sneezed, so I was sent for lung away instead of the full The latest newsletters on the some x-rays.” thing.” integration of health and Peter was contacted to say Peter said: “I feel good now. social care have now been that medical staff had seen We were unlucky having the published. a shadow in his lung, which crash, but it ended up being As well as the latest was later diagnosed as lucky for us. It was due to the developments, the cancer. crash that I was diagnosed. respective third editions for Peter said: “I was running “Cancer doesn’t hide from North and South Lanarkshire about daft visiting my wife anyone. It affects all people at map out the next key phase of in hospital in between all stages of life.” integration. Integration is focused on person-centred care, health, Lung cancer – planning and delivery so people get the right advice the symptoms and support in the right place Symptoms of lung cancer include: a cough you have had and at the right time. for three weeks or more, a cough that you have had for a Partners including unpaid long time that changes, feeling breathless, a chest infection carers, the third (voluntary) that doesn’t clear up, coughing blood, unexplained weight sector, the independent loss, chest or shoulder pain, unexplained tiredness or a sector are working closely hoarse voice. with the respective local Having one or more of these doesn’t mean you have lung authorities and NHS cancer. However, if you’ve had them for more than three Lanarkshire as the integration weeks you shouldn’t ignore them – just visit your GP to journey progresses. be on the safe side.

You can read more To make an appointment at the travel clinic, now by visiting call 01236 712241. http://goo.gl/9QR8po 10 MENTAL HEALTH FOCUS

Participants with a colourful declaration of support for ‘Growing a Movement for Change’ POSITIVE MOVES TO LESSEN SUICIDE TOLL September and October are busy According to the World Health and wellbeing development times of the year in Lanarkshire’s Organisation (WHO), over 800,000 manager and chair of the people take their own life every Lanarkshire Recovery Network, mental health calendar. Suicide year. explained the thinking behind a Prevention Day falls on 10 September Here in Lanarkshire there is a ‘Growing a Movement for Change’. and World Mental Health Day is 10 ‘Movement for Change’ to He said: “We’ve done some October. The Scottish Mental Health challenge the stigma and fantastic work in Lanarkshire down discrimination associated with the years in relation to mental Arts and Film Festival also takes place mental health. An event was health, but we deliberately choose from 10-31 October. held earlier this year to bring the term ‘growing’ as we realise partners together from a host of there’s much to build on and still organisations to allow them to much to do. The Pulse takes a look at mental share resources and experiences “For me, ‘Growing a Movement for health and how we can help reduce to address this issue. Change’, is a natural title for this the stigma. Kevin O’Neill, public mental health continuing work as it encompasses 11 Life is good and you’re not alone, says Len

Len Northfield values the help he’s had to manage his depression When Len Northfield was 28, services to help them. he awoke on a hospital trolley Len continued: “I’ve suffered receiving emergency treatment. depression all my life and Len’s last thought prior to that reached those points where moment was to bid the world you find yourself in this hateful, goodbye as he attempted to take desolate place where you are his own life. the only inhabitant. However, Len said: “I still remember I want to help people see that coming to and being surrounded they are not alone and that it’s by medics intent on saving my possible to learn to identify the life and being angry with them signs that often proceed a bout for succeeding. I also remember of depression, manage them and spending the night hooked up lead a relatively normal life. to a heart monitor with a nurse “I take medication every day watching over me.” and will probably take it for the However, more than 25 years on, rest of my life. But I also use a Len has learned how to manage variety of other tools to help me the depression which drove this such as Mindfulness and use the and is now a trained counsellor Wellness Recovery Action Plan who, as a peer support worker, (MyRap) tool which is based on uses his lived experience to help the principle of playing to your people in the acute psychiatric strengths.” admissions ward in Wishaw Reflecting on the distance Len General Hospital on their has come, he added: “Life is good POSITIVE MOVES TO recovery. and I owe a lot to the individuals The Strathaven man shared and services who helped me and his story to remind those who I want to help those who have have a mental health problem reached the bottom to find the LESSEN SUICIDE TOLL that there are people and first step on the ladder out.” everything we’re trying to achieve. We want to create an environment where all of us recognise mental Paula is new head health, understand it, value it, know Paula Macleod has been appointed for Rutherglen and Cambuslang how to look after it and support interim head of the mental health before becoming service manager others and know what supports and learning disability service for the South West Unit. are available. replacing Jim Wright who retired Paula said: “I’m really looking “Let’s be clear, stigma and in June. forward to supporting staff to discrimination stops people asking Paula has worked in mental health provide effective, efficient and for help, hinders recovery and for over 30 years since starting her safe services for all our users and removes opportunity. Stigma hurts, career in Glasgow’s Leverndale carers. support helps and we all have an Hospital in 1984. I also want to help our staff feel important part to play. She moved to Lanarkshire in valued and aim to support and “If not you, who? If not now, Paula MacLeod 2005 becoming service manager promote their professionalism.” when?” 12 MENTAL HEALTH FOCUS ESSENTIAL INFORMATION Your intervention can help prevent suicide Working for the NHS means we are more likely to be in contact with someone who’s experiencing Around emotional distress or at risk of suicidal ideas. The signs can be ambiguous in nature which 2 can make it difficult to see them and staff have a very important part to play in ‘reading between people die the lines’ and act on the warning signs. everyday in Scotland as a result of Be ALERT suicide • Ask someone if they have thought about suicide. Talking does not make it worse – it helps • Listen and show you care • Encourage them to get help right now • Tell someone. You can’t do it alone.

It’s important to remember that you don’t need build confidence and effectiveness to be an expert to help someone. However in suicide intervention. Where to get help there are a range of training courses available Visit the training section of elament For more information – ranging from one hour to two days – to help (www.elament.org.uk) for more details. about mental ill-health and stigma visit: Help yourself Help others www.seemescotland.org or www.elament.org.uk Some tricks to help you Savour the moment, whether Everyone needs help and protect and improve your you are walking to work, support at times, never more so mental health: eating lunch or talking to when stressed or down. Stigma friends. 1. Connect with the people and discrimination can add to around you, family, friends, 4. Keep learning. Try this. To help someone: colleagues and neighbours. something new. Rediscover 1. Stay connected – don’t let Think of these as the an old interest. links drop just because the cornerstones of your life and Take on a different other person isn’t feeling up For urgent help and advice, invest time in them. responsibility at work. Learning to socialising, going out, or contact your GP, NHS 24 2. Be active. Go for a walk or new things will chatting much. on 111 the Samaritans on run. Step outside. Cycle. Play make you more confident as It might seem like they don’t 08457 90 90 90, Breathing a game. Garden. Discover well as being fun. need you, but they do. Space on 0800 83 85 87 or Childline on 0800 1111. something you enjoy and that 5. Give. Do something nice 2. Be yourself - you don’t have suits your level of fitness. for a friend, or a stranger. to be an expert to be a good Well Connected is an award winning Lanarkshire 3. Take notice. Be curious. Thank someone. Smile. friend to someone with mental programme designed to Catch sight of the beautiful. Volunteer your time. Look ill-health. Just be there, listen, help people. out, as well as in. Create and show that you care. connections with the people 3. Remember, that the person around you. who is ill might not feel or For further information seem like themselves at the visit the self-help section minute, but they are still the of elament or call 800 073 friend, colleague or family 0918 for North Lanarkshire member they were before. and 0330 3000 133 for South Lanarkshire. 13

Arts festival challenges mental health The ninth Scottish Mental Health Arts and Film Festival will take place from 10-31 October. It’s one of Scotland’s most diverse cultural events and aims to challenge preconceived ideas about mental health. Overseeing the festival in Lanarkshire is senior health improvement officer Susan McMorrin. Susan said: “Sadly, despite the fact most people will have some personal experience of mental ill-health, there is still too much stigma, discrimination and inequality associated with it and experienced by too many people both young and old.

Men are “This festival gives us a platform to challenge these problems and 3 engage and explore the issues and themes around mental health.” times more likely to die The festival aims to remind everyone about the importance of by suicide than good mental health and why it is females but important to value your own and less likely to other people’s mental health. ask for help Susan added: “Being, involved, creative, connected, learning new things are very important to our mental health and therefore the festival is for all of us.” For a full programme of the events taking place in Lanarkshire visit: http://www.mhfestival.com/

For more information contact: susan.mcmorrin@lanarkshire. scot.nhs.uk 14 DENTAL SERVICES

Dr Albert Yeung collected the NOHPG Patron’s Prize on behalf of NHS Lanarkshire and ASCS Dental support pack for kids wins prize A dental project carried out in NHS Lanarkshire has won a national award and was shortlisted for an international one after working to improve the oral health of children with physical disabilities and/or sensory or learning impairments. The Special Smiles Dental Project, a collaboration between NHS Lanarkshire and Action for Sick Children Scotland (ASCS), won the National Oral Health Promotion Group (NOHPG) Patron’s Prize and was one of four finalists at the Bright Smiles- Bright Futures Award. The project’s specially developed resource pack is used in schools which teach children with SMILES BETTER additional and complex support needs to help reduce these children’s anxieties about the dentist and improve their oral health through preventative WITH OUTREACH measures.

Lanarkshire residents have been Why a smile is important: full of praise for student dentists Over 2000 patients have used the service and nurses who put smiles back • It takes 43 muscles to frown but only 17 on their faces. treatment from the student decided to find out more. It’s to smile dentists and dental hygienists/ the best thing I’ve done because They have been beneficiaries • When seeking a new partner, a smile therapists in their final year of it’s given me the confidence to of a unique initiative at NHS is top of the most sought after physical training. smile for the first time in years.” Lanarkshire’s Dental Outreach attributes, beating body shape, dress Centre in the Buchanan Centre, Arthur McLaughlin, 71, from Alison Murdoch, 41, from sense and eyes , which gives people Coatbridge said: “I needed new Wishaw, said: “I saw a poster for • Teeth/Smiles are rated the second not registered with a dentist the teeth so when I heard about the outreach centre in my GP most important attraction feature, after chance to get a course of dental this opportunity it was a no surgery and got in touch. It was personality, and the most important treatment absolutely free. brainer for me. It’s made such fantastic and I can only say the body feature surveyed (including body a huge difference to my smile dentist had healing hands as Since it launched five years ago, shape, height, hair, face and eyes) and makes me feel a lot better they gave me my smile back.” over 2000 people have received • On a night out, 80% of us would be as well.” free treatment, and the centre is One of the senior dentists at the more likely to talk to somebody we now appealing for new patients Elizabeth Jorgensen, 70, from Outreach Centre, Paul Hazlett, didn’t know if they smiled at us. to come forward. Those eligible Coatbridge, said: “When my said: “As it’s final year students get a free course of supervised daughter told me about this, I who carry out treatment, 15

Alison Murdoch (in dental chair) with Paul Hazlett and student dental nurses Robbie has challenge (l-r) Laura McGuire, Collette Some oral McCann and dental nurse Lauren Gormley health to get his teeth into An East Kilbride dentist has Robbie has been involved in the been named the President of teaching and training of young facts and the West of Scotland Branch of dentists, both at Glasgow the British Dental Association. Dental School and figures Robbie Thomson, a GDP and in general practice. practice owner of the Grey After 32 years treating patients • A third of all children Gables dental practice in the at Grey Gables, he says that the starting school have tooth Village in East Kilbride, said he day-to-day interaction with decay was delighted to be chosen. his patients is what he really A dentist for 34 years, he said: enjoys. • Around 25 per cent of all “It’s a real honour when you’re adults say they have not He continued: “I’ve looked chosen for such a prestigious after so many patients – often visited a dentist in the past position like this by your peers. two years different generations of the I’m really looking forward to the same families – and it means • One in four adults don’t challenge this office will bring a great deal that so many have brush twice a day, including over the next year.” trusted the practice with their a third of men For the past two decades dental care over the decades.” • One in 10 admit they regularly forget to brush Orthodontic care improves their teeth • 21 per cent of adults use with professional qualifications dental floss regularly while one in three have never flossed their teeth • Around 2 per cent of the population have never visited a dentist • One in every seven adults who had ever been to a dentist suffers from extreme dental anxiety. Fun facts

SMILES BETTER • Half of us brush our tongue Sitting on dental stool Lesley Sheridan based in Hairmyres, with l to r when we brush our teeth Margaret Lynch (Monklands), Nicola Jamieson who works between all • Earrings, business cards, three sites, Stacey Panton (Monklands), Mandy Taylor (Wishaw), Suzanne Brock (Hairmyres) and on the dental chair is Sarah Forbes from Wishaw keys, matchsticks and screwdrivers are just some A magnificent seven and a further two case studies WITH OUTREACH of the objects we admit to orthodontic nurses in had to be combined with using to get food particles Lanarkshire now have a post orthodontic and surgical from our teeth qualification certificate in intervention.” Orthodontic Dental Nursing. Over 2000 patients have used the service • More than half of us The seven nurses are based in wouldn’t tell a friend or It now means that all NHS the three acute sites with two appointment times take colleague if they had bad Lanarkshire orthodontic each in Hairmyres, Monklands slightly longer than normal and breath in fear of risking a nurses have completed the and Wishaw and one who patients may not have as much friendship qualification which will allow works between all three. treatment as they may expect in them to give better oral health Frances continued: “This • One in five cannot a general dental practice. advice to patients. qualification allows the remember when we last Frances Queen, senior dental nurses to more effectively “However, the treatment is changed our toothbrush carried out to a high standard nurse for orthodontics, said: and efficiently support the as experienced dentists will be • A toothbrush came top of “This is no mean feat as this delivery of the consultant-led supervising all the work.” the list of things we couldn’t was a six-month course which Lanarkshire-wide orthodontic do without when we go on required the nurses to travel service. This can only be holiday to Dundee and produce a good for patients and we are To be eligible you must be portfolio involving 50 case delighted that seven dental over 16-years-old and not be • If we only had five minutes studies. Two of the case nurses have shown the level registered with a dentist. to get ready in the morning, studies also had to document of commitment required to For more information call one in 20 would skip the treatment they gave from successfully complete this 01236 703460. brushing our teeth. when it started to it finishing course.” 16 HEART DISEASE

Alert for the signs of cardiac arrest A new project’s helping to in the same way. If everyone reduce the number of people carries out checks in the who suffer a cardiac arrest on same way, we can detect Wishaw General’s cardiology more subtle deterioration in ward. patients.” The pilot project, which is The team have also introduced being carried out in Ward 4, new ways to flag up subtle has seen a number of new changes in a patient’s procedures being introduced condition to nursing and Simple sticker system provides at-a-glance updates in a bid to halt a cardiac arrest medical colleagues. in its tracks. The ward aims to Gary added: “When nurses The ward reduce the number of cardiac are doing their observations aims to arrests by 50% by June 2016. and detect deterioration reduce the Gary Boyle, senior charge in the patient’s condition, number nurse, said: “Before someone they take one of our new of cardiac has a major deterioration, sticker alerts and place it in arrests by there are very subtle changes the patient’s medical notes. in their overall condition. They accompany this with If you can identify these a narrative saying why they 50% changes and respond to them have placed the alert, what by June as they happen, you can often they observed and whether 2016 prevent a major deterioration the patient requires a medical from happening. review. “We have introduced “Every time there is a change new ways to recognise a in the patient’s condition, a deteriorating symptom. For new alert is placed in their example, we introduced record. The result is that monitoring every patient’s there is a clear mapping pulse manually instead of of any deterioration and relying on machines. We’ve allows doctors to review also introduced a standard their treatment much earlier observation procedure so that than they would have been all staff check every patient previously.”

Did you know? A heart attack is a serious medical emergency in which the supply of blood to the organ is suddenly blocked, usually by a blood clot. Lack of blood to the heart can seriously damage the heart muscle

Symptoms can include: • chest pain – the chest can feel like it is being presses or squeezed by a heavy object, and pain can radiate from the chest to the jaw, neck, arms and back • shortness of breath Wishaw General’s cardiac • feeling weak and/or lightheaded rehabilitation nurses are • overwhelming feeling of anxiety working hard to help patients return to health 17

Did you know? Angina is chest pain that occurs when the blood supply to the muscles of the heart is restricted. It usually happens because the arteries supplying the heart become hardened and narrowed. The most common symptom of angina is a feeling of pain or discomfort in your chest. The pain can feel tight, dull or heavy. The pain can spread from your chest to your left arm, neck, jaw and back. In some cases, the pain is similar to indigestion.

ANDREW’S CLIMBING TO BEAT CHEST PAIN Eight-week cardio rehab class helped Andrew’s health When Andrew Jamieson was diagnosed Andrew was referred to the rapid access Ann Marie Blaney, chest pain nurse with angina, Wishaw General’s cardiac chest pain clinic at Wishaw General Hospital. specialist, said: “Patients who are diagnosed rehabilitation nurses helped him get back on “I was diagnosed with angina and put on with angina are reviewed at the nurse led his feet. medication. The nurse suggested that I clinic. When a patient’s condition is stable, Wishaw General is one of the first hospitals attend an eight-week cardio rehab class in we offer them a place on our eight-week in Scotland to fully integrated angina service, the hospital’s physiotherapy department.” exercise clinic. The classes are tailored to each patient’s needs and can be either high which cares for patients from diagnosis After the eigh-week exercise programme, through to follow up care and lifestyle advice. patients who are able are invited to attend a intensity or low intensity. The nurse-led service sees patients with similar 10-session course at their local gym. “NHS Lanarkshire is one of the first health angina being diagnosed and treated before This course is facilitated by trained staff. boards to introduce this type of service for receiving a further assessment where Andrew added: “Because my job is angina patients. After a diagnosis, each they are referred to the hospital’s patient is reviewed again before being cardiac rehabilitation exercise class. quite physical, I said to the instructor that his challenge, if he chose to referred to the exercise and education Andrew, from Motherwell, said: “A accept it, was to get me to climb an programme. few years ago, I had been feeling a 80-metre ladder in the wind turbines “We see their health improving and they see bit breathless and felt some tightness at work. He said there was no reason the difference. Hopefully they keep it up in my chest. My father had coronary why I shouldn’t be able to do that.” and change their lifestyle for the better. “ heart disease and died in his forties. Being in my late fifties, I “NHS Lanarkshire is one of the first health boards to decided I needed to do something, so I made an introduce this type of service for angina patients.” appointment with my GP.” 18 STAFF BENEFITS

Labels for less - £150 on offer! WE HAVE teamed up with NHS Staff Benefits and GetTheLabel.com to offer one lucky reader a £150 Staff benefits gift voucher to spend on the online store. All NHS Lanarkshire staff can benefit from exclusive GetTheLabel.com is an online clothing and discounts on everything footwear retailer. They help customers to save from restaurants to High money on popular labels and big brand names. Street stores, holidays and home improvements. GetTheLabel.com offer shoppers iconic brands with unbelievable discounts. You can now quickly and easily access the full range With over 6,000 items online and up to 75% off, of discounts on the NHS GetTheLabel.com has it all, from sportswear to Staff Benefits website. fashion for all occasions. Register free to have full access to all the fantastic The website has items from brands including offers available in your Nike, Adidas, Timberland and Lipsy. areas. All Pulse readers are also entitled to All the companies on the a 10% discount. To find out more, visit: website offer discounts to www.nhsstaffbenefits.co.uk. staff and there are many more offering great deals. On the home page, you will find the Monthly Megadeal link, where How to enter you’ll find extra special To enter the competition, just answer the offers available for a following simple question: limited time only. Make sure you don’t miss How much discount do Pulse readers get out – check the Monthly Megadeal now. at GetTheLabel.com? Please send your competition answers – including your name, location and contact number to – For information on the staff lottery mortgage, Alison McCutcheon, Communications, NHS financial advice, online Lanarkshire Headquarters, , loyalty shopping, of course Fallside Road, , G71 8BB. all the fantastic local discounts available, visit Or email your answer to www.nhsstaffbenefits.co.uk [email protected] with ‘GetTheLabel’ in the subject line. The deadline for entries is Friday 2 October 2015.

Last months winner! In the last competition, senior healthcare support worker Fiona Lovatt and Smoking Cessation Nurse Specialist Lesley Allan both won a great day out with Escape Glasgow. Each prize is worth £66 and can be used for a team of up to five people. The challenge will see Fiona and Lesley being locked up in a mysterious room, with exactly 60 minutes to get out. To find out more about Escape Glasgow, visit www.escape-glasgow.co.uk. RETIRALS 19 SO LONG & ENJOY YOUR Saying goodbye to Elaine Allison Staff benefits WELL-DESERVED RETIREMENT We’ve said goodbye to many weel-kent faces recently

Treatment room nurse Anne Bartie, After 41 years service, advanced specialist Josie Davidson retires after 41 years Strathaven Health Centre, 18 years. midwife risk manager Josie Davidson, Congratulations go to Elaine Allison, Wishaw General Hospital maternity unit health visitor at Alison Lea Medical After a remarkable 43 years, Martha Centre, East Kilbride who retired in May McMaster, deputy charge nurse, after 36 years service. emergency room, Wishaw General Elspeth Moffat, administration assistant, Hospital. Property and Support Service Division Unison representative and Branch (PSSD), Law House, 32 years. secretary Mary Samson, human Janette Tiernan, secretary, diabetic resources department, Law House, service, Monklands Hospital, 38 years. 22 years. Wishing Elspeth Moffat well as she retires

43 years! Enjoy your retirement Martha Anne Bartie’s retiring after 18 years Farewell Mary - enjoy your retirement

Where did those 38 years go? Everyone wishes Janette Tiernan a happy retirement 20 SPOTLIGHT STAFF SURVEY NOW OPEN - Have you ever wished that the work your colleague does could be recognised in some way? HAVE YOUR SAY NHS Lanarkshire has made that WHEN ASKED, 36% of NHS Lanarkshire staff wish come true by launching said they had experienced emotional/verbal our own Staff Awards. They abuse from patients/service users or other launch on 1 December when members of the public. What about you? staff, patients and visitors will nominate staff and volunteers The national staff survey runs until 21 across the organisation for the September. Fill in the survey to let us know care that they provide. what you think about working for NHS Susan Dunne, head of Lanarkshire and have the chance to win an organisational development, said: iPad mini courtesy of Lets Connect Home “We have a lot of hard working Computing Scheme. staff throughout Lanarkshire, Questions cover a range of key staff issues who provide an exceptional such as verbal and physical abuse, bullying, standard of care and services to discrimination, equality, communication their patients and colleagues on with your manager and safety. a daily basis. The Staff Awards Lilian Macer, employee director, NHS is an excellent opportunity to Lanarkshire, said: “The staff survey is a recognise our dedicated staff and great opportunity for staff to share their volunteers. experiences of working in NHS Lanarkshire “The award categories pay special in a way that can drive improvements. We attention to those who are want to ensure NHS Lanarkshire is the best unsung heroes, those who go the possible employer and the survey is an extra mile to deliver outstanding important tool for identifying the key issues Paper copies of the survey will be made services and those who provide for staff and prioritising positive actions. available for anyone who does not have exceptional person centred care.” access to email. If you would prefer to “To do that effectively, we need as many She added that the awards also complete the survey over the telephone, staff as possible to complete the survey so it recognise teams or individuals you can call FREEPHONE 0800 587 3115, gives an accurate picture.” who are innovative and those Monday to Friday between 08:30 and 17:00. The survey is anonymous. Your responses who continuously improve Once you have completed the survey, let are confidential and will not be accessible by services. us know by leaving a comment on the staff NHS Lanarkshire. “And there’s also a category to survey story on Pulse online: www.thepulse. recognise volunteers who excel Everyone should have received an email scot.nhs.uk/staffsurvey2015. All members in their commitment to support with a password to allow them to access of staff who comment will be entered into the health and care needs of the and complete the survey. If you have still a prize draw with the chance to win an people of Lanarkshire,” Susan not received this, contact geraldine.reilly@ iPad mini courtesy of Lets Connect Home concluded. lanarkshire.scot.nhs.uk . Computing Scheme. The award categories are: • Outstanding individual • Outstanding team

It’s a mugs game... • Outstanding care • Outstanding volunteer Do you have a colleague who has gone the extra mile to help you out? Do they deserve some recognition? • Innovation in practice You can now say thanks by nominating your colleague to win one of our ‘golden mugs’. • Service improvement In each edition of The Pulse, we will award a mug to one member of staff who represents ‘team spirit’. Nominations can be completed To nominate your colleague, email The Pulse with your colleague’s name, location of online at www.nhslanarkshire. work and the reason why you are nominating them. org.uk, by telephone on 01698 377790 or by post. Nominations for the next edition should be sent to Fiona.o’[email protected], no later than Friday 2 October 2015. Freepost nomination forms will be distributed to sites across the NHS Lanarkshire area.