Realising Realistic Medicine: Chief Medical Officer for Scotland annual report 2015-2016 appendix

NHS Greater Glasgow and Clyde

Initial thoughts

There are many individual projects going on in GG&C which embody the principles of Realistic Medicine. Realistic medicine has been embraced across a range of specialties and settings - from the community to tertiary hospital environments. Further to the Inspire project discussed earlier, work is ongoing with people with dementia: diverse populations but with the same needs for person-centred and holistic care.

What have we done so far?

As well as the InSPIRE project, Realistic Medicine is also being taken forward in the area of dementia care. While the Getting to Know Me initiative is a nationwide initiative developed by Alzheimer's Scotland, NHS GG&C is currently the only Health Board with an Allied Health Professional consultant for dementia.

Additionally, education is delivered for a wide variety of professionals on how to use the Getting to Know Me document - highlighting that although it is intended for use in dementia this is not its only function and that it could be used in other environments such as those with sensory impairments. Getting to Know Me is used as a key part of post-diagnosis support for dementia.

Therapeutic Gardens are also in use, aiming to provide a more holistic and person-centred environment. Four gardens were set up across Glasgow with the aim of providing open access to a safe outdoor space which could be used in a therapeutic way. An example is the use of specific garden activities such as hanging laundry to assist physiotherapists and occupational therapists in assessing functioning.

Environments such as a mini-golf area allow people to re-engage with their families in a naturalistic way.

What next?

Research is now being undertaken locally in relation to InSPIRE in the form of a randomised control trial as well as a historical control group analysis using self-efficacy as an outcome measure ("How in control of their health do people feel?"). The aim is to provide evidence for future innovation. Work is also being undertaken with the University of Aberdeen on an external evaluation investigating the process involved in scaling up the innovation.

Educational sessions around Getting to Know Me are ongoing, with the aim of providing more of these within acute care as well as developing work on one-to-one care. There is a need to link this work with anticipatory care planning and it is recognised that education for carers is also important.

Final thoughts

Realistic Medicine has been happening for some time now - in various pockets around the city and country. Recognition of this work as being closely allied with the Realistic Medicine philosophy will help engage professionals in future.

Therapeutic Garden in NHS GG&C - putting green, planting, gazebo and laundry area all used by various health professionals, patients and visitors.