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Glasgow City Health Improvement have developed a range of Gender Based Violence resources for School and Youth/Community setting use.

Gender Based Violence – Keeping Mum Film and Primary School Teaching Resource

Keeping Mum

An educational film aimed at children in Primary 5-7 and the professionals who work with them on the impact of domestic abuse. Based on the play, Gold Stars and Dragon Marks (developed in 2008 by Baldy Bane Theatre with Scottish Government funding), the film was produced in 2018 with NHS Endowment funding. Keeping Mum, by Soundsmove Production, stars Still Game’s Mark Cox and Jane McCarry. It follows three children as they learn secrets about each other’s lives and negotiate the consequences of telling and not telling. It also looks at appropriate responses from parents/carers and professionals. The Keeping Mum video is complimented by a teacher support pack which includes a lesson for pupils to accompany the film and further supporting resources and information.  Teacher twilight training on the resource is offered by Health Improvement.

Teacher Support Pack

Glasgow City Health Improvement and the Glasgow Violence Against Women Partnership have developed teacher support pack for use with the Keeping Mum film. The packs contain background information to the films; links to Curriculum for Excellence, RSHP and God’s Loving Plan/Called To Love; useful tools; a lesson plan for use with pupils and links to support agencies.

Glasgow Primary Schools – Healthy Relationships – Keeping Mum Teacher Support Pack

Keeping Mum Video – BSL Version NHSGGC – Keeping Mum BSL – YouTube

Keeping Mum Video –  Audio description NHSGGC – Keeping Mum – YouTube

Keeping Mum Video NHSGGC – Keeping Mum – YouTube

Gender Based Violence – Crush Film and Secondary School Teaching Resource

Crush

An educational film aimed at S3 young people, addressing relationship abuse and exploitation. 

When does care become control? Based on the stage play, Crush, which was developed in 2008 with Scottish Government funding, the film features four young people. It follows the development of an abusive relationship, looking at early warning signs, the role of bystanders and the impact. The Crush video is complimented by a teacher support pack which includes a lesson for pupils to accompany the film and further supporting resources and information. Teacher twilight training on the resource is offered by Health Improvement.

Teacher Support Pack

Glasgow City Health Improvement and the Glasgow Violence Against Women Partnership have developed teacher support pack for use with the Crush film. The packs contain background information to the films; links to Curriculum for Excellence, RSHP and God’s Loving Plan/Called To Love; useful tools; a lesson plan for use with pupils and links to support agencies.

Glasgow Secondary Schools – Healthy Relationships – Crush Teacher Support Pack
Guidelines for Responding to Gender Based Violence in a Youth Setting

The Glasgow Violence against Women Partnership in collaboration with Health Improvement has developed Guidelines for responding to Gender Based Violence in a Youth Setting.

The Guidelines are supported by Equally Safe Young People (ESYP) training, delivered by Health Improvement.  The guideline and training supports youth workers to understand gender based violence, to be able to address the underlying causes and to respond to disclosures from young people.

Guidelines for Responding to Gender Based Violence in Youth Work Settings

For Equally Safe Young People training dates, please see our Glasgow City Health Improvement Training Calendar.

An Evaluation of ESYP Training can be found HERE

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Please note: resources must be collected and returned to our office in West House, Gartnaval Hospital. We will be in touch to arrange suitable times for this.

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Healthier, Wealthier Children(HWC) aims to contribute to reducing child poverty by  helping families with money worries. The project is working closely with antenatal and community child health services to target pregnant women and families with young children experiencing, or at risk of, child poverty, as costs increase and employment patterns change around the birth of a child.

The project offers income maximisation advice for families experiencing child poverty and will aim to prevent families from falling into child poverty by working with health and early years services to identify families at risk at an early stage. Consequently the main service groups targeted for providing referrals to Healthier, Wealthier Children income maximisation services will be, in the first instance, midwives and other antenatal service staff, health visitors, oral health and breastfeeding advisers, parenting support workers, and early education staff.The initiative has been running since October 2010. As of August 2020, financial gain is estimated at £36,462,342 from 26,687 referrals. Healthier Wealthier Children models are cited as a requirement of Scotland’s Child Poverty action plan and similar models have been developed in Australia, Sweden and Newham in East London

The principles of the initiative are being rolled out nationally. NHSGGC staff are linking with Health Scotland on this.

The initiative is cited in:

  • Equally Well Annual Reports
  • National Child Poverty Strategy
  • National Early Years Collaborative
Project Structure

Healthier Wealthier Children is a collaboration between NHS Greater Glasgow and Clyde, Local Authorities, Glasgow Centre for Population Health and Voluntary Sector Money Advice Services.

Almost half of the children in Greater Glasgow and Clyde live in low income households, ranging from 25% in East Renfrewshire to 69% in East Glasgow [1]. Addressing child poverty is a key Scottish Government strategy for improving children’s health and well-being and is supported by the strategies, Equally Well, Achieving Our Potential and the Early Years Framework. Maximising families’ income is one element of addressing child poverty and a practical action that health and social care service providers can offer with the right support. A collaboration between NHS Greater Glasgow and Clyde (NHSGGC), Glasgow City Council (GCC) and Glasgow Centre for Population Health (GCPH) with additional support from other council partners has been successful in attracting funding from the Scottish Government Social Inclusion Division for a Child Poverty and Financial Inclusion Project.

The funding of £1,058,375 was secured for 15 months from January 2010 to provide income maximisers and development officers for all Community Health (and Care) Partnerships across NHSGGC. It builds on actions taken by NHSGGC to meet the objectives outlined in the Scottish Government Health Directorates Chief Executive Letter (CEL) 36 for improving nutrition for families living in disadvantage. CEL 36 implementation included work to improve uptake of the UK-wide Healthy Start programme and through this identified a gap in financial service provision for families attending antenatal and postnatal health services.

Building on the Healthy Start work, the Project supports the development of expertise within financial inclusion services and health structures for addressing child poverty by targeting income maximisation advice to pregnant women and families with infants and young children. The main aims of the Project are to:

  •  Test out a partnership model of providing income maximisation advice at a local level; and
  •  Develop a strategic approach to linking this service provision with health and other services in the longer term.

The Project is implemented through all HSCPs across Greater Glasgow and Clyde. Income maximisers in HSCPs and development officers will be employed across the whole of NHSGGC to establish referral and information pathways between health and financial inclusion service structures. The Project targets families with children under 5 attending health and early years services although some exceptions will be allowed. For example, particular attention is paid to picking up families who face additional barriers to maximising their incomes such as in the case of kinship carers, or where affordable childcare is unavailable.

NHSGGC has a Financial Inclusion Group, which reports to NHSGGC Corporate Management Team. The Healthier Wealthier Children Project Steering Group reports to the NHSGGC Financial Inclusion group[1] Low income households are defined here as being in receipt of any benefits, out of work or in work (2006 data, GCPH analysis, 2009)

Definitions and Standards

What is financial inclusion?

Financial inclusion means that individuals have access to appropriate financial products and services. This includes people having the skills, knowledge and confidence to use these products and services

Financial Inclusion Guidance for staff

NHSGGC has developed Guidance for staff on money worries. This guidance includes working with patients and sources of support for staff who have money worries.

Health benefits of financial inclusion

Summary Report: The Health Benefits of Financial Inclusion

Addressing financial exclusion is a priority for health service providers because it has the potential to reduce health inequalities and tackle the social determinants of ill-health. People living with long term ill-health or disability are more likely to be living in poverty, a key factor in poorer health outcomes. The NHS has contact with people as part of their rehabilitation and self care pathway and therefore an opportunity to support people’s wider social needs.

To develop an inequalities sensitive health service NHSGGC wishes to skill health practitioners to understand the social issues and structural inequalities facing their patients, support patients with these and have the capacity to refer them to appropriate services. Current evidence shows that the health inequality gap is widening and the current economic downturn is likely to worsen the situation for our most deprived communities and excluded groups; including women, black and minority ethnic people, disabled people, homeless people, refugees and asylum seekers. Financial exclusion is a growing concern in this context and so more needs to be known about the role of financial inclusion interventions in improving health.

About the Review

To date, NHSGGC has piloted a number of financial inclusion initiatives. A Financial Inclusion Group has been established to draw lessons from current practice and mainstream good practice in a sustainable way. It has developed an action plan, which it reviews regularly. To inform the work of the Financial Inclusion Group, the Scottish Poverty Information Unit (Glasgow Caledonian University) was commissioned to conduct a literature review. The broad aim of the review was to summarise the health benefits of financial inclusion identified in existing research and involved:

  •  A review of evidence of the health and quality of life impacts of financial inclusion initiatives, with particular reference to collating evidence of NHS-based interventions & the health benefits of these
  •  Exploring models of practice and learning to improve practice and identify evidence of the tools and barriers that exist
  •  Reviewing research methods used in existing studies
  •  Development of recommendations about future policy, practice and research

The research team undertook a Rapid Evidence Assessment (REA). REAs provide a balanced assessment of what is already known about a policy or practice issue. The method is appropriate for this review because the policy area is relatively new and there are few existing studies. It focused on English language sources and data, and on reports published in the last 10 years, with an emphasis on UK studies.

Key Findings

This review identified 16 key studies or journal articles which have reported health and social outcomes of financial inclusion interventions. It is clear that NHS has long recognised the value of improving access to welfare benefits and income maximisation in tackling health inequalities. Initiatives that tackle the broader issues relating to financial exclusion, such as financial awareness or financial capability are relatively recent. Many of these new initiatives remain at the early stages and few have been evaluated, particularly for their impact on health. This presents opportunities for future evaluation and research to explore the health impacts of these approaches.

All 16 of the studies identified discuss heath impacts of advice provision. Only two evaluated additional approaches including financial exclusion awareness raising sessions, money management guidance, or development activities. The studies generally focused on the provision of welfare benefits advice including income maximisation work. However, Citizens Advice Bureaux (CAB) and many other advice services advise clients on a range of social, legal and welfare rights issues (including, for example, housing, employment, taxation and debt) and several studies highlight the wide range of issues addressed and the fact that individual clients may raise more than one problem.

The main message from across the studies is that both qualitative and quantitative methods identify benefits from advice in terms of improved mental health, reduced stress or anxiety and better quality of life, but there is less evidence of improvements to physical health. Relatively short follow-on study periods and other methodological issues are suggested to have contributed to modest results in some studies.

Targeting services

Where projects have involved targeting vulnerable groups there is limited evidence of analysis of the different situations or the impacts for groups within target populations, for example, on the basis of gender, age, ethnic origin, disability or learning difficulties. Strategies that work for one group or situation can inform work with other groups but may not always be effective. Research and evaluation need to go beyond recording the characteristics of service users and explore different needs, impacts and outcomes of advice. However, this work should also be informed by a growing body of research on effective practice in financial inclusion work.

Benefits for Health and wellbeing

One assessment of work to date is that there is little need to conduct additional work to determine whether welfare rights advice has a financial effect but the potential benefits for health and wellbeing remain largely theoretical. Both qualitative and quantitative research has however identified that financial inclusion interventions can impact positively on people’s mental health and well-being. The importance and value of this has been under-played in the literature. The relationship between debt and mental health and the wider effects of addressing the stress and anxiety of debt and low income is a clear area for future research.

The review has also identified opportunities to further develop existing approaches to tackling financial exclusion. For example, in addition to welfare rights and debt advice, other linked areas of policy and practice have the potential to be considered in integrated approaches to financial inclusion because they are strongly linked to the issues of poverty and ill-health. Addressing fuel poverty is one area that has been highlighted. Prevention of homelessness and eviction and re-housing of homeless individuals is another area in which the right advice and support is essential to addressing the situation of people who are likely to have health and/ or addiction issues.

These wider issues also serve to highlight the need for a broader agenda in research that takes more account of the complexities of people’s lives. The review raised questions about whether enough account has been taken of the effects for different groups of people and different health circumstances (for example acute and chronic health conditions, mental health problems).

Evidence of effective practice exists, but this would benefit from further development. In particular advice needs, like health needs, are often not static and some flexibility in service design may be needed to respond to changing needs. For example, someone diagnosed with a condition involving long-term management or a long period of recovery may have particular and different advice needs at the point of diagnosis, when entering or leaving hospital as an in-patient and during periods of recovery or deteriorating health. Such an approach would be consistent with the aim of holistic provision and the aims of providing seamless services and the use of the pathways approach. Training and information sharing are necessary components for ensuring that health and financial inclusion professionals have the right levels of awareness and expertise for the work they do.

Financial inclusion is an area of mutual concern for local government and health services. It has much potential to contribute to better understanding of how services can help to reduce health inequalities and address any unintended consequences of the way services currently work.

Recommendations for Research

There is considerable potential for financial inclusion initiatives to contribute to an agenda for improving health. To gain a better understanding of the impact on health the following approaches to research are recommended:

  • More research is needed to broaden understanding of the importance of factors such as gender, family circumstances, age, ethnicity or disability for different groups within target populations to improving health, wellbeing and quality of life through financial inclusion work
  • For its contribution to be understood better and the social impacts of financial inclusion taken into account more fully, there is a need for multi-disciplinary research involving people with expertise in both health and financial inclusion
  • More mixed-method and holistic, qualitative approaches should be adopted and more sensitive research tools developed for assessing the impact of financial inclusion and that is relevant for target groups
  • Longitudinal studies are required, lasting beyond the one year duration of most studies in the past, particularly to understand more about the impacts on physical health and the potential for financial inclusion to contribute to reducing the physical health risks associated with poor mental health.

Recommendations for Practice

Recommendations for practical approaches to take forward financial inclusion work within NHSGGS include the following:

  • Project and service monitoring should reflect both project and wider policy priorities, for example, monitoring for family situation / relationships, dependents and caring roles
  • Financial inclusion development and evaluation should take account of the reach to different groups, including within target populations
  • Existing research and practical guidance can inform this area of work, including adaptation of existing effective practice to reach new groups
  • Consistent with holistic service provision and the pathway of care approach, projects and services should be developed in a way that recognises the importance of responding to changing needs over time
  • NHSGGC should consider how addressing fuel poverty can be incorporated within its approach to financial inclusion and the linked issues of housing circumstances, including the risk of or actual homelessness, that are potentially important areas for advice and support
  • There may be a need for wider links, for example with services addressing advice on homelessness and benefits, including CABs and Shelter, in a broad agenda to tackle financial exclusion
  • Partnership working should involve health and financial service providers, but also service users and carers and the services that support them, for example, key workers. Consideration should be given to involving other service providers such as in housing and domestic fuel supply.
  • Training, awareness raising and capacity building are needed for staff, not to become experts in new areas, but to refer effectively, for example: training for staff in financial inclusion work on issues such as health needs, or mental health first aid; for health service staff on the breadth of rights and entitlements, sources of help and when and how to refer; and for all groups, equality and diversity training may be important, particularly in projects involving screening of potential clients for financial inclusion interventions.
  •  

The full report is available to download at the Scottish Poverty Information Unit website:

Health Benefits of Financial Inclusion: A Literature Review (pdf)

Case Studies
Case Study 1- Mum with two children under seven, one with learning difficulties
  • Mum with 2 children under 7. Son suffering from learning difficulties and bowel problems. Mum required replacement bed and bedding, washing machine and clothes. Community Care grant of £373 awarded after initial rejection. Only successful because money advice service persisted given patient under severe emotional and financial pressure.
  • Disability Living Allowance applied for. Son awarded high rate care for 2 years on 5th April but the award was backdated to 11th March. Mum did not wish to appeal the fact that no mobility component was awarded.
  • As there was an award of high rate care this led onto the client being eligible for Carer’s Allowance. Third appointment made to complete forms and benefit awarded. A backdate had been requested and granted to the 11th March when the DLA was awarded.
  • his then led to a review of patient’s Income Support so that all relevant premiums could be added and recalculated.
  • Patient went from receiving £255.00 per week to now receiving £451.71 per week for all benefits.
  • All backdated money received as lump sum was £2,360

Client says: “I have found the service really beneficial and was shocked at how much I was actually entitled to after the Job Centre initially rejected my case. If only there were a million X [Income Maximisers] out there.”

Case Study 2- Working mum on maternity leave
  • Working mum on maternity leave, still living with parents, had never accessed the benefits system before. On the 36th week of pregnancy, the patient was referred to the money advice service by her midwife, allowing money advice service to begin a full assessment of her needs.
  • After explaining what statutory pay entitlements the mum would get, a benefit check revealed that she would only be eligible for benefits after the birth of the baby.
  •  Mum agreed to come back for a second appointment to help her to apply for the relevant benefits, including Child Tax Credits, Sure Start Maternity Grant and Child Benefit.
  • The Sure Start Maternity Grant would only be applicable after the qualifying benefit of Child Tax Credits was awarded. At the third appointment, this was applied for after the good news came through about the Child Tax Credits. 
  • All in all, the mum will receive a net gain in benefits awarded of just under £4,890 for the year
Case Study 3 – Young couple with three children, two with disabilities

A young couple with 3 children, the youngest 2 are under 5 and each has a disability. Dad works full time in fairly low paid employment with mum at home full time caring for the children. The couple are owner occupiers. Mum finds it very difficult to go out with the children as she is unable to use public transport and taxis are too expensive. Due to the children’s mobility difficulties, Mum and the children spend most of their time at home which means heating the home for most of the day and night. Due to the children’s disabilities mum has to do lots of laundry. These factors are having a big impact on the family’s energy bills. Debt has been accrued with Brighthouse, a high street weekly payment household goods store, totalling £6000 for a suite and a tv. Weekly payments to Brighthouse are £33 with 2 payments remaining on the suite.  The family Health Visitor suggested a referral to HWC following a diagnosis of significant disability of youngest child. Mum commented she did not think that a child of 2 and half years would be entitled to DLA but was happy for the referrals to be made.

Following referral to HWC the Income Maximiser assisted the family in applying for additional benefits. The family were awarded Middle Rate Disability Living Allowance (DLA) and disabled child element of tax credits. This amounted to an additional £47.80 and £52.21 extra per week respectively. Mum stated that the extra money will help with taxi costs, she can now afford hackney style taxis to get out and about to hospital appointments; this had been a problem in the past with the larger style pram. Mum can also afford taxis to go to clubs and support groups in her area. The extra money will also go towards utilities bills and mum will not have to worry as much about times when she has to heat the house for days at a time, i.e. winter 10/11 was a very worrying time. A benefit check also revealed that the couple were entitled to Council Tax Benefit, they assumed they wouldn’t be as they were owner occupiers, this saved the family £943.44 per year.

The couple were also supported to apply for a mentored loan of £500 from their local credit union and Money Matters, the income maximiser also negotiated the return of the tv to Brighthouse. A tv was purchased from a local supermarket for under £500 with repayments on the mentored loan £12 per week, £2 of which is savings with the credit union.

Engagement with the service has clearly brought about significant improvement for this couple and while this may not be the case for everyone it highlights the potential contribution Health Visitors and other key health staff groups can make to reducing child poverty

Case Study 4 – Client with two children recently separated from partner

Client referred by family support worker. Client recently separated from partner very stressed.

  • Young women with two children one under 5 with long term illness.
  •  Child has had various operations but has not been diagnosed.
  • Income Max got support to complete D.L.A application for child
  • Client has a lot of Debt to Brighthouse to a sum of £6,000 for a suite and television and a small amount to Provident, client paying off debt at £33.00 a week.
  • Client only had 2 payments to go to finish of paying for suite but had just got the television.
  • Outcomes
  • Income Max got client a mentored loan through Credit union and Money Matters for £500.
  • Money Matters negotiated with Brighthouse for client to return television.
  • With the £500 loan the client bought a new television from Tesco.
  • Client now only paying £12 per week back for mentored Loan of which £2.00 is being put into her credit union, by the time client has paid off loan she have savings for the first time.
  • Money Matters got her re-payments to Provident down to a £1 per week and changed clients energy over to the social tariff saving her another £7.00 per week.
  • Client was unsuccessful on the first application for D.L.A – Welfare Rights Officer appealed was given D.L.A and higher rate tax credit and carers allowance which has given the family an additional £130 per week.

Taken nearly 5 months work to get final outcomes

Case Study 5 – Single mum with young baby

Client a young single mum with young baby who is concerned about debt

  • Client has been given a £50 fine for dropping a crisp bag in the street on her estate by community warden. 
  • Client not able to pay fine.
  • Income Max telephoned Community Warden Team to appeal as mother said she didn’t mean to drop it; it fell out of the pram.
  • Community Warden team said “you can appeal for fines for dog pooh or cigarettes but not litter”.
  • Income max explained client’s situation – Community Warden gave client extension of 4 weeks to pay.
  • Client still not able to get the money together in time.
  • Income Max telephoned again to see if she could pay it back so much a week.
  • Case now has been sent to Sheriff court and the fine had gone up to £75.00 for non payment.
  • Income Max eventually managed to get the court to agree that client to pay £5.00 each week which would be taken of her benefits to pay the fine.
  • Court would not waiver the additional £25.00 interest added due to late payment.
  • Have taken this case to Council representative and suggested that maybe instead of a fine that in some cases individuals could be told to attend a two hour awareness session on the environment which might be more appropriate. Instead of increasing peoples debt.
Case Study 6 – Mother not receiving Healthy Start vouchers

Referral from Social work support worker- Mother not receiving Healthy Start vouchers.

  • Client had put in 4 applications for Healthy Start Vouchers never received anything.
  • Income Max contacted Healthy Start Helpline and was told that client must have moved address and not informed Healthy Start therefore 1st application not valid
  • 2nd application midwife wrote the wrong estimated delivery date on the application again void (no letter ever sent to client)
  • 3rd application H/V did not put her postcode of work base therefore application void. (even although H/V tel on the form)
  • Income Max appealed against decision and asked if vouchers payment could be backdated is it was not client’s fault.
  • Healthy Start at first said no and every time Income Max telephoned they would give a different reason why client was not entitled to backdated money. No consistency at all with the helpline staff.
  • When Income Max quoted something from the Healthy Start booklet in defence of client helpline staff stated that the booklet was wrong.
  •  Income Max e-mailed Rights adviser who she had met the week before at a training event and told her the story. The Rights adviser advised Income Max that the booklet was correct.
  •  Income Max eventually got clients claim backdated and client received £269.00 for backdated money alone
Case Study 7- Family with disabled child

Due to the intervention of an Income Maximiser, a family where one of the parents was working, discovered that they were entitled to extra weekly benefits totalling £140.

This was because the youngest of their three children have disabilities and have now been awarded Middle Rate Disability Allowance of £47.80 and the disabled child element of tax credits, equal to £52.21.

The additional cash is easing the financial burden because the mum is unable to work, staying at home to look after the younger children.

Because of the children’s mobility problems they were unable to use public transport and since taxis are expensive, a lot of time was spent at home.

And the children’s disabilities means that mum has a lot of laundry to do, adding to the energy bills.

Now the family can afford taxis to attend hospital appointments, clubs and support groups in their area and have more money to put towards utility bills.

Case Study 8- Family with one parent in full-time low paid employment

A home owning family involved mum working full-time in a low paid job, with dad looking after their three young children.

They spoke to a Health Visitor Support Worker about their financial concerns and stress and anxiety this was causing, but thought that they were receiving all of the benefits they could apply for.

 An appointment with an Income Maximiser led to a benefit check being carried out which revealed that they were entitled to Council Tax Benefit, saving them £943.44 annually.

The parents reported that this extra help is reducing their financial pressures and stress and mum now felt able to look for a better paid job.

Also the family are now in a position to set aside money for any emergencies, such as replacing their washing machine and also buy the children new toys which they hadn’t been able to do for sometime.

Case Study 9 – Single parent with disabled child

A single parent was working part-time (on national minimum wage) and struggling to cope due to the needs of her only child who had been unwell for some time and was exhibiting behaviour and learning difficulties: the child had been undergoing investigation for strange seizures and was not adjusting well at school. When referred, the mother could no longer work due to stress and anxiety and was on sick leave: however, the employer was not paying SSP and the DWP would not award ESA because of the employer’s responsibility.

Fortunately, there occurred at this time a definitive diagnosis of absence epilepsy – a rare condition – which enabled a straight-forward claim for Disability Living Allowance: since the child was awarded high-rate care and low-rate mobility there was also a significant increase in the Child Tax Credits award. It was not really feasible for the parent to return to work due to the time and effort involved in caring for her child hence this meant applying for Income Support and Carer’s Allowance (including the carer’s premium on the I.S.)

In total, including back-dated payments, household income is now £337 per week or £17,524 over the course of the next year. This means that the parent can now focus solely on the support and development of her child and provide properly for additional needs.

Resources for Staff

Healthier Wealthier Children has developed a number of guidance tools for health and money advice services staff. These have been developed, by Healthier Wealthier Children workers, as a result of needs identified by frontline staff.

Guidance – Health staff

A Quick Guide to welfare benefits for families with children (pdf) has been used extensively in the project. It fits into staff diaries and is a good reference aid for staff when working with clients.

A Quick Guide to benefits for children with additional needs  (pdf) is being piloted with Health Visitors within short awareness sessions about Child Disability Living Allowance . The project found many misperceptions about what children are eligible for DLA and application processes.

Guidance – Money Advice Services Staff

A non-engagement protocol (pdf) has been developed with the aim of providing a standard approach for managing Healthier Wealthier Children referrals across NHS Greater Glasgow and Clyde and increasing efficiency of services to respond to referrals. It is considered an example of good practice on managing referralas by NHSGGC’s Strategic Financial Inclusion Group.

Guidance on dealing with sensitive patient issues (pdf). This outlines what is expected and not expected of Money Advice Services staff when dealing with NHS clients, who may disclose complex health issues. 

Good Practice Reports

There have been a number of reports collated on innovative work in Healthier Wealthier Children.

Healthy Start Antenatal Cooking Classes in North West Sector Glasgow City CHP Report (pdf)

In Inverlcyde, Barnardos provide a groupwork programme for pregnant women with complex needs.  Healthier Wealthier Children was integrated into this approach which resulted in increased patient engagement with Money Advice Services. 

Healthier Wealthier Children partnership work with Barnardo’s Inverclyde (pdf) 

In South East Glasgow, engagement and training for nurseries resulted in better partnership working between health visitors, nurseries and Healthier Wealthier Children and improved care pathways for patients.

Healthier Wealthier Children partnership working with nurseries in Soutn East Glasgow (pdf)

An Equality Impact Assessment (EQIA) was carried out for the project overall with some local areas also carrying out EQIAs.

The project has been innovative in providing a service in 48 locations across NHSGGC.  This has been mapped against deprivation levels to inform service planning post project.

Development Workers across NHSGGC collated good practice and challenges with Healthy Start implementation.

Money worries and budgeting were integrated into a pilot project on antenatal cookery classes in North West Glasgow. This pilot was targeted for pregnant women who have complex needs. Budgeting with Healthy Start vouchers and use of Healthy Start vitamins were covered in the pilot.

Healthy Start Antenatal Cookery session Report (pdf) 

HWC Training

Development Workers and, at times, Income Maximisers have carried out a wide range of awareness sessions and training to health and other staff. It has also included innovative work in, for example, nurseries and weaning fairs of referral options for parents and training for Health Visitors on the links between employability and financial inclusion. 

Two standard presentations (shorter and longer versions) were developed on child poverty for frontline staff.

Child Poverty Presentation (short version)

Child Poverty Presentation (long version)

In addition, Development Workers and Income Maximisers themselves have shown a high commitment to learning. HWC provided induction training and an induction pack (pdf)  on welfare reform and welfare benefits for children and families and equalities monitoring. Poverty Alliance Scotland have provided Poverty Awareness Training and Training for Trainers. Child Poverty Action Group provided training on specific issues for children including Child Disability Living Allowance. 

Summary Evaluation report on Poverty Awareness Training delivered to NHS Greater Glasgow and Clyde (pdf)

National Consultations

The good practice within Healthier Children was also recognised in the Equally Well Review  and  in NHSGGC’s response to Scotland’s Child Povery Strategy:

Passported Benifits – Consultation Response (pdf)

Child Poverty Strategy – NHSGGC Final Consultation Response (pdf)

Video Resource for staff

Healthier Wealthier Children, in collaboration with NHS Education for Scotland and IRISS, have produced a video that highlights the challenges and opportunities in raising the issue of money worries with clients. 

Money Worries – A case study of how professionals in health and social care services ask and respond to client’s money worries. Rose Sloan, a special needs in pregnancy service midwife at Inverclyde Royal Hospital, talks about the importance of raising the issue of money worries with clientshttps://player.vimeo.com/video/50375916?color=ffffff&title=0&byline=0&portrait=0

Healthier Wealthier Children: Responding To Money Worries from Mindreel.

Documents and Publications

Articles/Publications/Reports/Documents: 

Media Exposure

Press release in News Medical Online, following this publication entitled “Study evaluates role of midwives, health visitors in tackling child poverty” (2013) Press release by RCN Publishing Company in www.alphagalileo.org entitled “Nurses help fight child poverty in Scotland” (11th June 2013) The Herald 6th March 2011 “Child poverty project which makes a real difference” Evening Times 17th Oct 2013 “£4.5m boost for families in poverty battle” Featured in Evening Times 7th Nov 2014 “Advisors deliver £20 million health boost” and Kirkintilloch Herald 5 Nov “Income advice scheme saves £20 million” Features in Glasgow Advice and Information Network newsletter – Jan 2011; Nov 2011; Aug 2012; NHSGGC Health News – April 2011, Sept/Oct 2011; October 2014; Clydebank Post – June 2011; Herald Features Article (Stephen Naismith) – July 2012; Paisley Daily Express – Jan 2012; Children in Scotland Newsletter – Jan 2012; Herald parenting supplement – Sept 2012

Related Links

Websites:

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Acute Hospitals and Community Health Care

The designed environment, health facilities, the surrounding areas and communities offer a broad context where the arts can be integrated through co-designed processes that contribute to the improved health and wellbeing of a place and community.

Find out more about our hospitals, community health centres and specialist services.

Hospitals

Therapeutic Design and Art Strategies have been successfully delivered in new Acute Hospitals developments at:

New Stobhill Hospital

New Stobhill Ward Block including waiting room in the park, the New Neo Natal and Maternity Extension)

GROVE

The New Stobhill Hospital provides an attractive and welcoming environment for patients and visitors with light, airy public spaces, comfortable waiting areas and fresh, modern consulting rooms. It is located on the north side of the city, adjacent to Springburn Park.

Patients will not only benefit from modern new facilities. The way care is provided from the hospital has also changed for the better. Services have been redesigned around the needs of the patient to enhance the quality of care and speed up diagnosis and treatment.

The hospital will treat about 400,000 patients every year.

In addition to outpatient clinics, day surgery and diagnostic services, the hospital provides a number of specialist services such as cardiology, renal dialysis and gynaecology.

Concept

It is our understanding that art in a hospital should contribute to a healing environment.

The new hospital is set within an apparently random planting of silver birch trees. Open courtyards are planted with larch trees and surfaced with natural larch boarding. The theme of woodland light and shade is continued within the building by means of installed painting, video and poetic texts.

It is a grove of larch in a forest of birch.

The New Stobhill Hospital GROVE project has resulted in the installation of groups of works by five artists across the Hospital.
 
Thomas A Clark, poet and artist, working closely with Reiach & Hall Architects, wrote a number of short poems which have been installed throughout the Hospital.  In response to these poems four visual artists have created artworks. 

Kenneth Dingwall painted a series of abstract designs in the corners in surgical and endoscopy waiting areas, and placed a sequence of shapes above eye level in the Imaging Waiting Area. 

Olwen Shone, Andreas Karl Schulze and Thomas A Clark created a series of works within the main clinic waiting areas comprising 14 films of natural scenes installed on monitors and projectors and 130 small abstract compositions, juxtaposed with Clark’s poems. 

Donald Urquhart and Clark created a series of works entitled Six Landscapes in specialist clinic waiting areas.  Urquhart also created Alphabet, a series of drawings of indigenous trees which are also keys to the ancient Gaelic alphabet.  Urquhart worked with Reiach and Hall, Clark and Schulze to create the Sanctuary.  Urquhart had previously developed the award winning Sanctuary at Edinburgh Royal Infirmary

In parallel, and as a direct result of the work in the New Stobhill Hospital, a public art scheme has been developed for the adjacent entrance to Springburn Park.  Developed by Alec Finlay from work with staff and patients in the Hospital as well as with users of the Park, this extends the ideas embedded in the Hospital.

The aim has been to create another Waiting Area in the Park, encouraging walking (even short distances) as well as connecting the natural themes of the artworks in the hospital to the natural environment of the Park.

It has been implemented through a partnership between Glasgow City Council Land Services, Culture & Sport Glasgow and NHSGGC Endowments.

Team

Architects: Reiach & Hall Architects
Curator and Lead Artist: Thomas A Clark

Artists (some web sites are indicative rather than personal sites):
Kenneth Dingwall
Andreas Karl Schulze
Olwen Shone
Donald Urquhart

Project Manager: Chris Fremantle

Funders

Scottish Arts Council, NHSGGC Staff Lottery, NHSGGC Endowments, many Glasgow Faith Groups.

Key Dates

Project Completed Spring 2009

Awards

Prime Minister’s Better Public Building Award 2010
RIBA Stirling Prize 2010 Midlisted
Design & Health International Academy Awards Best International Project under 40,000 sqm 2010
RIBA Award 2010
Scottish Design Awards Best Public Building 2010 Commendation
Public Private Finance Awards Best Designed Project 2010
Civic Trust Awards 2010 Commendation
Glasgow Institute of Architects Awards Best Healthcare Building 2009
Building Better Healthcare Awards Best Designed Hospital 2009
Roses Design Awards Best of the Best 2009
Grand Prix Roses Design Awards Best Public Building 2009 Gold
RIAS Andrew Doolan Best Building in Scotland 2009 Finalist
Building Design Healthcare Architect of the Year 2009 Finalist

Links

Architecture & Design Scotland – Case Study 

New Victoria Hospital

The Hospital and the Park

The New Victoria Hospital is located on the Southside of Glasgow, near Queens Park.  It provides an attractive and welcoming environment for patients and visitors with light, airy public spaces, comfortable waiting areas and modern consulting rooms.

Patients will not only benefit from modern new facilities. The way care is provided from the hospital has also changed for the better.  Services have been redesigned around the needs of the patient to enhance the quality of care and speed up diagnosis and treatment. About 400,000 patients attend the hospital every year.

In addition to outpatient clinics, day surgery and diagnostic services, the hospital provides a number of specialist services such as cardiology and gynaecology.  There is also a new Minor Injuries Unit with its own dedicated entrance for rapid access to a highly skilled clinical team.

And for the first time, patients from south-east Glasgow, Rutherglen and Cambuslang requiring an MRI scan, renal dialysis or chemotherapy are able to get this locally at the New Victoria Hospital.

Concept

The New Victoria Art & Environment project has delivered permanently installed artworks by five artists, and an initial programme of residencies and projects within the Hospital.  The curatorial concept for the project focused on The Hospital and the Park, linking the new hospital with Queens Park.

Ally Wallace was appointed as Lead Artist.  He developed an integrated coloured glazing scheme working closely with HLM Architects, and also developed a number of wall paintings for the basement car parking area.

Ronnie Heeps worked closely with the Spiritual Care Committee to develop the Sanctuary in the New Victoria Hospital, drawing on the concept of ‘Squaring the Circle’.  The Friends of the Victoria worked with Glasgow Metropolitan College to commission furniture for the space.

A key part of the New Victoria Art & Environment project focused on Waiting Areas where Jacki Parry and Hanneline Visnes created works permanently installed in five locations.  Calum Stirling was commissioned to create the work, Sculpture Park, adjacent to the Hospital.

In addition HLM Architects developed the concept of a multimedia projector in the Atrium showing a range of artists’ film and video.  An initial work drawing on the New Victoria, the Victoria Infirmary, Queens Park and the local area has been created by Ronnie Heeps.

Team

Architects: HLM Architects
Curator: PACE
Lead Artist: Ally Wallace

Artists

Ronnie Heeps
Jacki Parry 
Calum Stirling
Hanneline Visnes

Project Manager: Chris Fremantle

Funders

Scottish Arts Council, NHSGGC Staff Lottery, NHSGGC Endowments, many Glasgow Faith Groups.

Key Dates

Completed: Spring 2009

Queen Elizabeth University Hospital Campus
Art on the QEUH Campus
Community Health Centres

Therapeutic Design and Art Strategies have been successfully delivered within new Community Health and Social Care Centres at:

Barrhead Health and Care Centre

The overarching vision demonstrated in the Barrhead Health and Care Centre Art Strategy recognises the benefits of art and creativity in the healthcare environment. As a result, the strategy delivers high quality artwork in parallel with a positive model of participation, creating opportunities for the local community to engage with the artists, impacting on the artist’s research and the final artwork for the centre.

Barrhead Health and Care Centre

Patricia Fleming Projects are delighted to announce: Barrhead Health and Care Centre wins Public Building of the Year 2012 at the Scottish Design Awards.

We would like to take this opportunity to congratulate Avanti Architects, Artists Iain Kettles, Susie Hunter, David Zérah, our clients NHS Greater Glasgow and Clyde, and East Renfrewshire Community Health and Care Partnership (CHCP).

We are very proud of the thought-provoking, sensitive and beautifully executed artwork created specifically for the Barrhead Health and Care Centre. The art in the centre acts as a conduit between people and ideas. It raises questions about the importance of wellbeing, design and location. External (above) and internal permanent sculpture by Iain Kettles and Susie Hunter create not only a marker for new public space in a busy main street, but also begins a dialogue about art and health out into the wider community. The photography of French artist David Zérah can be seen throughout the building. Thirty works were selected from thousands taken during a residency in the area. Based in Barrhead the series instigates an on-going conversation with the community, patients and staff about the space we share. As part of the art strategy a new collection of artworks was started which we hope will continue to grow. Works by leading Scottish contemporary artists Jacqueline Donachie, Katy Dove and new talents Mary Wintour and Lisa Ure.  Residents from across Barrhead and Neilston took part in a series of workshops exploring the project themes with Glasgow-based designer Anna Sheard.

The overarching vision demonstrated in the Barrhead Health and Care Centre Art Strategy recognises the benefits of art and creativity in the healthcare environment. As a result, the strategy delivers high quality artwork in parallel with a positive model of participation, creating opportunities for the local community to engage with the artists, impacting on the artist’s research and the final artwork for the centre.

The arts strategy was created with support from the Barrhead Arts Team. The aim is to put the new centre, health and wellbeing at the heart of the community and promote the imaginative role that artists can play in the creation of inspiring places.

http://www.scottishdesignawards.com/

Credits:

Barrhead Health and Care Centre Project Manager: NHS Greater Glasgow & Clyde
Architect: Avanti Architects Ltd
Main Contractor: Graham Construction
Civil & Structural and Mechanical & Electrical Engineer: Cundall
CDM Coordinator: Turner & Townsend
Quantity Surveyor: Cyril Sweett
Curator: Patricia Fleming Projects
Artists: Iain Kettles, Susie Hunter, David Zerah
Artwork Fabricator: Scott Associates
Landscape Consultant: Fiona Robertson

For images of the artworks, artists cv’s or further info contact

ruth@patriciaflemingprojects.co.uk

The West Centre

The West Centre is a new purpose built Centre for Children’s Community Health and Care.

The Centre offers a ‘one stop shop’ combination of services for children, young people and their families who are affected by a wide range of difficulties such as developmental, emotional, behavioural and mental health problems, communication difficulties, Autistic Spectrum Disorders, Physical Disabilities and Neurological Disabilities.

The Centre supports a whole new way of integrated working for those providing services with social workers, community child health staff, educational psychologists, mental health professionals and more, all having bases within the building and working together.

The Centre also provides services to patients and clients not only from West Glasgow but also East Dunbartonshire and West Dunbartonshire. The Centre also features integrated art and design features throughout the building, both inside and out.

The West Centre by Anderson Bell Christie

Concept

The integral art and architecture programme was introduced into the final design process, and developed in collaboration between a Lead Artist, Architect and an arts support team drawn from Centre staff.

The final programme was designed to offer an aesthetic logic running throughout the building, respecting and engaging its users. The aim was for a definite sense of uniqueness and place, with a light touch, but rewarding repeated visits with layered meanings and discoveries: more elements to search out and find familiar details to return to.

The artworks tread a delicate path with care and respect, aiming to reconcile a high standard of professionalism with the often conflicting demands of different ages and abilities of children and adults. The outcomes offer a sense of childlike wonder and engagement without ever being patronising or childish.

Funders

The artworks programme was made possible with a grant of £250,000 from the Yorkhill Children’s Foundation

Awards

The West Centre has picked up the Glasgow Institute of Architects Design Award (Healthcare), and was also short listed for the highly prestigious Royal Incorporation of Architects in Scotland – Doolan Award.

Key Dates

July 2008 – appointment of Lead Artist
November 2008 – start of building work on site
June 2010 – completion of building and artworks programme

Team

Linda Mallett, lead artist and curator
Tassy Thompson, external artworks
Tim Taylor, internal niche artworks
Graven Images, design and graphics
Anderson Bell Christie, architects

Links

Architecture & Design Scotland – Case Study
Atrium Screen by Graven Images
Cloud by Tim Taylor
Fence by Tassy Thompson
Floor niche by Tim Taylor
Flying Saucers by Tim Taylor
Harp by Tim Taylor
Interactive Ship niche by Tim Taylor
Peephole view by Tim Taylor
Reception desk by Tim Taylor
Totem by Tim Taylor

The Vale Centre for Health and Care

Location

The site is located on the A82, the main road from Glasgow to Loch Lomond and is adjacent to the Vale of Leven Hospital.

The VHCC, currently under construction is designed to be a state-of-the-art community health and care facility within which will be based a variety of key services including General Practices; General Dental Practice; Dietetics; Podiatry; Speech and Language Therapy; Primary Care Mental Health; Physiotherapy and Community Dental Services. It will also provide a local base for district nursing, health visiting, prescribing support as well as teaching and studying facilities.

VHCC users will be from a wide catchment area, encompassing both urban and rural communities.

Framework

Two workshops were held, bringing together four creative thinkers with members of the VHCC Art and Design Strategy Group, as part of the initial research. The following concepts were investigated and will inform each of the therapeutic art and design commissions:

The journey;

Thresholds, welcome and departure;
Interaction in public spaces;
Relationships between the built environment and the rural environment.
The aim for each commission is to deliver specified projects to support the patient experience and the working day for staff through reference to the local natural environment by bringing the outside into the Centre and by leading the gaze beyond the walls of the building into the wider landscape.

Therapeutic Art and Design at the Vale of Leven Centre for Health and Care

Unique artworks made by four of Scotland’s leading artists commissioned to reflect the local natural environment are permanently installed in the building and grounds of an inspirational new health and care centre for the Vale of Leven West Dunbartonshire

By focusing on the surrounding locality each artist tells a different story about people and place through a range of media including textiles, painting, photography and wood.

Working with staff and the community, each artist has produced integrated artworks designed to support orientation, to bring the outside into the building and to promote a sense of wellbeing for patients, visitors and staff.

Artist Jephson Robb was tasked to create seating from the trees felled on site during the building process, to be situated in the atrium and at the two approaches to the building. Five sculptural benches are now permanently in place offering both resting points and beautiful objects to enjoy which work in harmony with the design of the new building itself.

Scotland’s foremost environmental artists Dalziel and Scullion have made four beautiful light emitting artworks which explore the wild and cultivated plants growing on allotments in the patient catchment area, bringing a sense of the domestic into the healthcare environment.

Donald Urquhart developed two works which focused on the near and far. The first piece was influenced by the pot shards found on the site during the excavation process for the new building. Dating back to the Bronze Age their beautiful geometric markings informed the design for the manifestation for the gym window, offering privacy for staff and patients in the gym yet allowing views out whilst letting plenty of light in.
The second work was inspired by the stunning mountain scenery so close to the Vale of Leven and designed to integrate seamlessly into the new building. Painted as a modernist pixilated frieze around the first floor of the atrium are colours capturing the soft autumn and winter beauty of the Loch Lomond and the Trossacks, offering a contrast to the close up detail of the allotment images by Dalziel and Scullion.

Textile artist Deirdre Nelson worked with pupils at the Vale of Leven academy to research the history of the area within living memory and create artworks from the gathered stories which were incorporated into a design printed onto healthcare curtains for the couches in the GP consulting rooms.

The design and build of the Centre was commissioned by West Dumbartonshire Community Health and Care Partnership and managed by NHS Greater Clyde and Glasgow. The Therapeutic Art and Design strategy was managed and delivered by Wide Open.

West Dumbartonshire Community Health and Care Partnership would like to thank the dedicated involvement of the staff and pupils at the Vale of Leven Academy, the patient focus groups and NHS staff, without whom his project would not have been possible.

Specialist Services

Therapeutic Design and Art Strategies have been successfully delivered within Specialist Services at:

New Neo Natal Unit Care and Maternity Unit

A programme of commissions in public areas commencing with the maternity hospital front entrance, into waiting areas and the establishment of a gallery space with Glasgow Open Museum Service. Supported by: Glasgow Children’s Hospital Charity, Women and Children’s Endowment Fund, Glasgow Open Museum Service

“Spinning Gold” is an innovative programme for art integrated into the Maternity unit and new Neonatal extension of the Southern General Hospital Glasgow. Lead Artist partnership Koan 3 identified the first phase of opportunities for contemporary artists to contribute to the creation of the therapeutic environment within the building which was designed to improve the overall experience for patients, visitors and staff. The range of commissions was open to artists working in a variety of media within the public realm. The initiative signaled an ongoing commitment by NHS Greater Glasgow and Clyde to integrating art and creativity within the design of health care environments.

New Neo Natal and Maternity Unit Lead Artists: Koan 3, Hypostyle Architects, Artists Linda Schwab, Tony Stallard, Nicola Gear, and Glasgow Open Museums.

West Centre Child and Family Therapy Centre, Drumchapel

Integrated art and architecture approach. Lead Artist Linda Mallet and ABC Architects. Artists: Tim Taylor, Tassy Thompson, Graven Images. Core funded with additional support from Glasgow Children’s Hospital Charity.

https://www.nhsggc.org.uk/your-health/public-health/health-improvement/arts-and-health/14-health-by-design-acute-hospitals-and-community-health-care/142-community-health-centres/1422-the-west-centre

The West Centre integral art and architecture programme was introduced into the final design process, and developed in collaboration between a Lead Artist, Architect and an arts support team drawn from Centre staff. The aim was for a sense of place and uniqueness, with a light touch, but rewarding repeated visits with layered meanings and discoveries: more elements to search out and find familiar details to return to. The artworks tread a delicate path with care and respect, aiming to reconcile a high standard of professionalism with the often-conflicting demands of different ages and abilities of children and adults. The outcomes offer a sense of childlike wonder and engagement without being patronising or childish. The West Centre was awarded the Glasgow Institute of Architects Design Award (Healthcare), and was also short-listed for the prestigious Royal Incorporation of Architects in Scotland – Doolan Award.

http://www.andersonbellchristie.com/project/the-west-centre

New Inverclyde in Patent Care Unit Orchard Grove

A Dementia Friendly patient activity and environmental design strategy. Concept: Hearts, Hands and Minds.

Funding: Core programme, Inverclyde Mental Health Service, Creative Scotland additional funding sourced by the curator and Art and Environment strategy group

Strategy Curator: Jane McArthur, Wide Open. Project Manager (delivery) David McDonald. Funding: Core programme, Mental Health Service, additional funding pots source by the curator and local art and environment strategy group, Creative Scotland

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Planning treatment in a European Country   

If you are thinking about any sort of planned medical or dental treatment outside the UK, please discuss this fully with your GP, hospital consultant or dentist. Make sure you are fully informed as it is important to have the information you need to make the right choices. You will need to be fully informed about your European healthcare provider and the details of the treatment you are planning to have. You may also need to consider:

  • when you will be able to travel
  • how your medical notes will be exchanged between teams
  • arrangements for after-care or follow-up treatment either abroad or at home
  • how you would deal with any complaint or problem should something go wrong following your treatment abroad
S2 Scheme

All treatment under the S2 scheme requires Health Board approval before treatment can commence. Please click on the linked heading above for more information. 

EU Cross Border Healthcare Directive

The arrangements for reimbursing health care costs to people who live in Scotland and receive treatment in EEA states stopped on 31 December 2020 (EU Exit Implementation Period completion day). Click on link above for more information

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Why pharmacists should be involved

The community pharmacist is a trusted source of information and advice for their patients and about 90% of the adult population visit a community pharmacy at least once a year. This presents an important opportunity for pharmacists and their staff to motivate and empower their customers to improve their health.

Health Improvement covers a wide range of topics some examples are discussed below and the topics boxes give a little more detail.

Health Improvement targets for Scotland can be found by linking into the Scottish Executive’s website

For further information for pharmacy staff in NHSGGC click here

Stopping smoking

Stopping smoking is one of the most important health improvement interventions. Community pharmacy can supply nicotine replacement therapy or varenicline with behavioural support to help patients stop smoking.

Advice on healthy living

Pharmacists can provide the right advice on healthy living and signpost patients to the best resources to achieve their health improvement goals.

Reduce health inequalities

Community pharmacy offers the Pharmacy First Service (PFS) which encourages people to go to their local pharmacy for support with minor and acute health conditions. Pharmacies undertake a NHS PFS consultation and provide advice, treatment or referral to another healthcare professional if appropriate. 

Managing long term conditions


Many long term conditions require health improvement interventions in addition to medicines which might be prescribed.

Mental health

Good mental health is of key importance to maintaining good general health. Pharmacists should know where to signpost patients for appropriate support as they may need more assistance in managing their daily living requirements. Also patients suffering from poor mental health may need more support to make important lifestyle changes.

For any enquiries regarding Pharmacy Public Health Improvement please contact ggc.pharmacyhit@nhs.scot

Alcohol Awareness

Approximately 1 in 8 men and 1 in 24 women have some degree of alcohol dependence. Excess drinking puts long term health at significant risk. Excessive alcohol consumption is associated with an increased risk of a range of illnesses that collectively contribute to a massive impact on morbidity and mortality.  Please see Alcohol Consumption Questions and the Fast Alcohol Screening Test (FAST) 

For more information visit

  • Drinkaware A Charity promoting responsible drinking.
  • Alcohol Focus Scotland – is the national charity working to reduce alcohol harm.
  • DrinkSmarter  A Scottish Government practical website with many handy tools, supporting healthier drinking habits. 
  • Glasgow Council on Alcohol (GCA) Providing support, counselling, advice, information, group work and training for those affected by alcohol misuse. 
  • Alcohol Change UK :  A charity campaigning for effective alcohol policy and improved services for people whose lives are affected by alcohol-related problems. 
  • Al-Anon Family Groups provide support to anyone whose life is, or has been, affected by someone else’s drinking, regardless of whether that person is still drinking or not.

 Key points for community pharmacy

  • Offer advice on sensible drinking
  • Give advice on prescription and Over the Counter (OTC) medicines about interactions with alcohol.
  • Signpost patients to local services offering support
  • Further Information, Resources and Support (including “Alcohol Before, During and After Leaflet) Alcohol and Pregnancy Leaflet 

Some pharmacies may

  • Offer alcohol brief interventions using a FAST tool
Cancer

It is estimated that 1 in 3 people in Scotland will develop some form of cancer during their lifetime.

This is a wide ranging topic and there are many different types of cancer. Some are more likely to occur in females e.g. cervical and breast cancer while others in men e.g. prostate cancer.

Many forms of cancer can now be successfully treated if they are identified in their early stages and we now have screening for the commonly occurring breast, bowel and cervical cancers.

Some cancers such as melanoma (skin cancer) may be prevented by health protection measures such as avoiding the sun and using sunscreens. Smoking cessation remains one of the most important health improvement measures to avoid developing cancer.

For more information visit

  • Scottish Cancer Index provides links to cancer related websites specific to Scotland.  
  • Cancer Research UK  Helpline 0808 800 4040  Mon – Fri 9-5pm
  • Bowel cancer UK providing support and advice. Telephone: 020 7940 1760
  • Bowel screening in Scotland | NHS inform information at this website
  • Breast Cancer Care providing information and assistance for those affected by breast cancer. Freephone Helpline 0808 800 6000.  
  • Sun Smart   This Cancer Research UK website provides a wealth of information including, information on skin cancer, sunburn and how it damages your skin, advice on protective measures to take – applying sunscreen, staying in the shade, wearing protective clothing and sunglasses, and advice on protecting children from the sun.    
  • Asthma + Lung UK provides advice on all diseases affecting the lungs including lung cancer. 
  • Leukaemia Care provides support for people with leukaemia, lymphomas and related disorders. Tel: Helpline: 08088 010 444 or chat via WhatsApp on 07500068065
  • Lymphoma Action provides support for those affected by Hodgkin’s disease and non-Hodgkin’s lymphoma. Tel. Helpline no: 0808 808 5555
  • Macmillan Cancer Support is a national charity providing expert care and support for people living with cancer. Tel. Helpline: 0808 808 0000
  • Maggies Centre provides support organisation for those affected by cancer. One of the centres is in Glasgow.   
  • Marie Curie Cancer Care. Dedicated to the cure of people affected by cancer and the enhancement of their quality of life through its caring services, research and education.  Telephone Support Line: 0800 090 2309
  • Oesophageal Patients Association Telephone: 0121 704 9860 (Mon – Fri 9am – 5pm)
  • Orchid: Fighting Male Cancer  Good range of leaflets on testicular and prostate cancer.  National male cancer helpline: 0808 802 0010
  • Prostate Cancer UK Telephone:  Helpline: 0800 0748383 

 Key points for community pharmacy

  • Signpost patients to appropriate support organisations.
  • Many quality, free resources can be ordered to support Community Pharmacy through the patient resources link http://quick-guide-for-patient-resources-v62-jul-23.pdf (scot.nhs.uk)
  • Be alert to red flag symptoms such as a persistent cough which might suggest a patient should be referred to their GP for investigation.
  • Encourage patient’s participation in national screening programmes e.g. cervical screening whenever possible.
  • Only sell a minimum of SPF 15 sun protection products. 
Healthy Lifestyle… at any age

Many factors go together to improve an individual’s health. Their health needs change through life as they get older and different issues might impact on men’s and women’s health. However, a healthy lifestyle is important at any stage of an individual’s life.

Diet and nutrition, exercise, smoking cessation and managing alcohol intake are modifiable lifestyle factors that can be addressed to improve health.

Other factors may not be readily addressed by individuals but rely upon society working together to promote healthy living and working environments.

Health inequalities arise when individuals or communities are not empowered to make healthy lifestyle choices.

For more information visit

 Child Health

 Health in older age

 Healthy Living 

Community Pharmacy – Signpost patients to appropriate support organisations.

Beware of your patients particular needs. Check out your locality’s health profile.

Long Term Health Conditions

The effective management of long term health conditions (LTHC) can greatly improve a patient’s health and wellbeing. Examples of these conditions include epilepsy, cardiovascular disease, diabetes asthma and chronic obstructive pulmonary disease (COPD).

In addition to taking appropriate medication LTHC patients are often asked to make lifestyle changes such as smoking cessation or alcohol reduction. But at the same time they may be struggling with psychological issues caused by the impact of their diagnosis.

So in addition to understanding the clinical management of patients and the guidelines that are in place for these it is important to consider the patient as a whole and understand their attitudes to their condition and its management.  

For more information visit

Key points for community pharmacy

  • Signpost patients to appropriate support organisations.
  • Know when to call for medical assistance in the event of a heart attack and how to deliver basic resuscitation (CPR) for patients who have collapsed. Details of suitable courses may be found at St Andrews Ambulance Brigade
  • Advise on use of inhaler devices for asthma and COPD patients

 Some pharmacies may

  • Offer health screening such as blood pressure or glucose monitoring
Mental Health

Mental health is a complex topic affecting a significant percentage of people in the UK at any one time. Issues might include depression (including postnatal depression) bipolar affective disorders, stress, anxiety disorders, phobias, eating disorders, schizophrenia and others. Some individuals may suffer from a combination of symptoms.

The management of patients suffering mental health problems may range from self help approaches to in patient care at a psychiatric specialist hospital or facility.

Regardless of how patients are managed, good mental health is underpinned by a healthy lifestyle. Good diet, smoking cessation, exercise, sleep hygeine and alcohol management will not necessarily cure a patient but they will significantly contribute to their recovery.

For more information visit


Key points for community pharmacy

Palliative Care Services

This service is provided by a network of 70 pharmacies across the NHS Greater Glasgow & Clyde area. These pharmacies maintain

  • a stock of specific core medicines
  • provision of advice and useful contact numbers for specialist palliative care advice
  • a support network to other pharmacies within their localities. 

Some participating pharmacies are available to dispense out-of-hours urgent prescriptions. This can be arranged through NHS 24. A courier service protocol is available to ensure timely supplies of medicines to palliative care patients in emergencies. The aim is for the first pharmacy contacted (regardless of being a part of the Palliative Care network or not) to ascertain the urgency of the prescription and resolve any supply issues, in order to avoid patients, carers, or nurses needing to phone or visit multiple pharmacies. All community pharmacies are provided with a list of the network pharmacies for this purpose and the specific core medicines list. For more details on the Palliative Care Service, click here  or contact: Palliative Care Specialist Pharmacists on the below telephone numbers: 07876 478140 or 07880 786659 or 07775 012560

Quit Your Way

NHSGGC are responsible for a wide range of tobacco projects including the “Quit Your Way” Pharmacy Service.

Suitable pharmacotherapy (Nicotine Replacement Therapy [NRT] or varenicline) together with personalised advice and support is provided from the community pharmacy for usually up to 12 weeks.

For further details, please contact any participating pharmacy or the Quit Your Way Pharmacy Team (T:0141 201 4945 or e: ggc.pharmacyhit@nhs.scot)

Resources

View and order resources

Public Health Resources Directory

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This aspect of Pharmacy Public Health deals with the planning for, and managed introduction of new medicines. The Scottish Medicines Consortium  is responsible for providing advice on the clinical and cost-effectiveness of all new medicines and important new indications for existing medicines.

The NHS GGC prescribing website provides useful links to the local Medicines Formulary, medicines policies and associated resources.  

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Why pharmacists should be involved

The community pharmacist is a trusted source of information and advice for their patients. This is particularly important for those issues which can have high media attention e.g. introduction of a new vaccine or an outbreak of an infectious disease.

Further information and advice can be found in the Health Protection Topics section of this website.  Examples of topics included are:-

Infection Control

Knowledge of infection control principles is important to protect yourself and your patients.

And

Immunisation and Storage of Vaccines

Advice on safe storage of vaccines which must be stored in the ‘cold chain’ between  2oC and 8oC at all times.

Communicable Disease, Outbreak Control and  Emergency Planning

Pharmacists can recognise symptoms of a notifiable disease in order to appropriately refer patients

Understand how an outbreak is being managed to be able to offer appropriate advice and reassurance to the public.

Maintain Business Continuity Plans to ensure minimal impact on the delivery of patient care in the event of an emergency situation.

Screening for Health Protection  

Pharmacists can encourage uptake of screening programmes against several cancers e.g. cervical, breast cancer and  bowel. More information may be found on the Screening – Health topics – Public Health Scotland website.   

For any enquiries regarding health protection please contact:

mailto:ggc.pharmacypublichealth@nhs.scot

Blood Borne Virus

Three blood borne viruses are the main cause for concern in Scotland, Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C.

There is an effective vaccine only for Hepatitis B.  However, there are few effective treatments for Hepatitis C and HIV.  

More information

Key points for community pharmacy

 Some pharmacies may

  • Offer support for dried blood spot testing for Hepatitis C and HIV.
  • Dispense antiviral medicines for Hepatitis C.
  • Provide ‘Injecting Equipment’ to prevent spread of disease.
Communicable Disease

Public Health Protection Unit – NHSGGC in NHSGGC has a key role in monitoring and responding to the incidence of notifiable diseases e.g. meningitis.

For more information visit

 Key points for community pharmacy

  • Recognise and refer patients with symptoms suggesting a serious or notifiable disease to the GP or acute services as necessary.
  • Compliance with prophylactic therapy e.g. tuberculosi
Community Pharmacy & Infection Control

The NHS GGC Community Pharmacy Infection Control Guidelines  provide basic advice.

To reduce the incidence of infection due to antimicrobial resistance in the population, NHSGGC has launched https://handbook.ggc.medicines.org.uk/guidelines/infections/mrsa-eradication-policy/ to be followed in primary care and the prescribing support team has developed a non-prescription pad to encourage patients to seek non antibiotic remedies for viral infections.

More Information

 Key points for community pharmacy

  • Provide antibiotic stewardship.
  • Offer advice to patients on appropriate infection control techniques to reduce spread of disease such as norovirus or influenza.
Health Screening

The NHS GGC Public Health Screening is responsible for a range of health screening programmes.

  Key points for community pharmacy

  • Encourage patients to participate in screening programmes.
Immunisation Programmes

Immunisation is one of the most effective health interventions.

There are several formal immunisation progammes in the UK. They are Childhood, Adult and Seasonal Influenza.

More Information

  • NHSGGC and vaccination schedule | NHS inform
  • NaTHNaC – a comprehensive guide to required travel vaccination and other travel health protection issues.
  • ‘Immunisation against Infectious Disease’ (‘The Green Book’) – provides detailed information on UK vaccination.
  • ‘Promoting Effective Immunisation Practice’ – training available via Turas Immunisation | Turas | Learn

 Key points for community pharmacy

  • Encourage patients to engage with national and childhood programmes.  

 Some pharmacies may

  • Offer travel and influenza vaccination clinics.
Outbreak Control

Public Health Specialists from NHS GGC Public Health Protection Unit – NHSGGC are involved in identifying and managing outbreaks of disease. They will liaise with infection control teams for example in the case of a norovirus outbreak in an institution or with local authorities if an outbreak is linked to a food supplier in an E. coli outbreak. 

Chemical Biological Radiological and Nuclear (CBRN) outbreaks

Local authorities and health boards are required to have plans in place to manage accidental events such as major oil or chemical spills or deliberate terrorist acts. For further detail see: Chemical, biological, radiological and nuclear incidents: recognise and respond – GOV.UK

  Key points for community pharmacy

  • Provide reassurance to patients.
  • Keep Business Continuity Plans up to date.
Patient Group Directions (PGDs)

Patient Group Directions (PGDs) are legal documents that enable suitably qualified healthcare professionals to administer and supply medicines (P or POM) in a defined clinical situation where the patient may not be individually identified before presenting for treatment. The individual using the PGD must have signed and been authorised to use the PGD prior to administering or supplying any medicines named in the document.

NHS GGC uses PGDs to allow nursing staff and Health Visitors to administer vaccines for the routine child immunisation programme and travel in specialist clinics. 

More Information

 Key points for community pharmacy

Seasonal Influenza

Individuals are most likely to catch influenza in the winter months. The season runs from October to the end of February occasionally into March, peaking in December/January.

Seasonal influenza can affect anyone. It is an acute viral infection of the respiratory tract. There are three types of influenza virus: A, B and C. Influenza A and influenza B are responsible for most clinical illness.

It is difficult for an individual to develop long term immunity to influenza as the make up of the viral strains change slightly on a regular basis. So vaccination against seasonal influenza has to be undertaken annually.

More Information

The government resource Immunisation against infectious disease – ‘The Green Book’

In the United Kingdom immunisation for influenza for certain groups including ‘at risk’ patients is provided on the NHS and in Scotland the Chief Medical Officer (CMO) will send a letter detailing which groups are eligible for vaccination. Letters from the CMO are available here. 

Egg allergy isn’t always an absolute contraindication for receiving flu vaccine. The British Society for Allergy and Clinical Immunology website advises on managing individuals with egg allergy

An e learning course for healthcare professionals undertaking immunisation is available. Registration is required to undertake this course.

NHS Inform has key patient information on all types of immunisation

NHS GGC: Immunisation – NHSGGC

 Key points for community pharmacy

  • Encourage at risk patients to attend for vaccination
  • Advise on management of symptoms
  • Some pharmacies offer private flu vaccination clinics
Sexual Health

Sandyford co-ordinates a wide range of sexual health services in NHS GGC.

The Free Condoms web-site provides, support for practitioners involved in condom distribution, information on how to sign up as a distribution point, where to find condom distribution points and general advice on condom use and products offered

It is important that pharmacists and their staff understand what they should do if they have any concerns about a child and sexual health issues. Access information at NHS GGC Child Protection Unit’s website 

More Information

  Key points for community pharmacy

  • Be able to recognise and differentiate between symptoms of sexually transmitted diseases.
  • Refer all men consulting with symptoms of discharge or thrush infections to Sandyford or their GP.
  • Be aware that there is no charge for vaccine supplied by a Sandyford Clinic.
  • Supply of emergency hormonal contraception or bridging contraception under PGD.
Substance Misuse

Pharmacists play an important part in providing information and advice about substances liable to misuse controlling the availability of medicines, and the associated risks and in providing harm reduction programmes e.g. methadone and the supply of injection equipment.  

More Information

 Key points for community pharmacy

  • Give advice on wound care and management, safer injecting practices and remind clients of the importance of safe disposal of syringes.
  • Know which pharmacies are ‘Injecting Equipment Providers’
  • Be able to sign post clients to other services as necessary.
  • Know how to deal with needle stick injuries
Travel

NaTHNaC gives the most up to date information for both public and professional use.

Key points for community pharmacy

  • Provide patients with pre-travel advice.
  • Encourage the use of sunscreen with a minimum SPF15. 
  • Advise on the carriage and storage of medicines abroad e.g. insulin. 
Vaccine Storage

NHS GGC Guidelines on Vaccine Storage and Handling are available in the NHSGGC Guidelines Repository

More Information

 Key points for community pharmacy

  • Remind patients collecting travel vaccine of the storage requirements. It is preferable that they collect vaccine immediately before their appointment for administration.

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