With the consultation period for the “Scientific consultation: draft SACN Carbohydrates and Health report – June 2014″ now open (http://bit.ly/1lYw4BC) and the launch of Public Health England’s discussion paper “Sugar reduction: responding to the challenge.” we thought we’d give a little more food for thought by giving you a second chance to view a blog from earlier this year. Please feel free to comment and join the discussion.
Originally posted on AHPScot Blog --->AHPs Sharing Information:
AHP leadership in the fight against obesity
Linda Hindle, Chair of DOM UK [Dietitians in Obesity Management]
The obesity epidemic is a societal problem which will only be solved by simultaneous action at many levels and by a wide range of partners. AHPs are rising to this challenge but we need to do more and faster if we are to tackle this ‘ever-growing’ problem. Not surprisingly, dietitians, with their focus on food, are at the forefront of the fight against the nation’s obesity epidemic. DOM UK is a specialist group of the British Dietetic Association dedicated to supporting health professionals to prevent and treat obesity. Members of DOM UK are leading multi-agency strategies to tackle adult and childhood obesity, providing expert specialist input to bariatric surgery teams, informing national guidance and policies, supporting the provision of clear evidence based information to the public plus a range of local innovative…
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Launch of the Personal Footcare Guidance and Resources
The Personal Footcare Guidance and resources were launched in September 2013. Delegates were asked two questions about the guidance
- What is the best thing about the guidance
- What is your take home message from the launch
Here is what they had to say……
With thanks to
- Jenny Ackland, National AHP Lead for Personal Footcare
- John McConway, Podiatry Manager, NHS Ayrshire & Arran
- Karen Utting from the Society of Podiatrists and Chiropodists
- Tracy MacInnes, AHP Officer, Scottish Government
- Allister Kelly, Podiatry Manager, NHS Dumfries & Galloway
- Pauline Johnston, Practice Development Podiatrist, NHS Greater Glasgow & Clyde
- Jacqui Lunday-Johnstone, Chief Health Professions Officer, Scottish Government
By Prof Annie S. Anderson BSc PhD RD FRCP (Edin)
Professor of Public Health Nutrition,
Centre for Public Health Nutrition Research
Centre for Research into Cancer Prevention and Screening
It is almost 7 years since the World Cancer Research Fund produced their comprehensive review on Food, Nutrition, Physical activity and the prevention of cancer, and about a month since the last update (ovarian cancer) was published. The totality of evidence shows that around 43% of breast and 47% of bowel cancer can be prevented and yet these messages remain largely unacted. After tobacco use, excess body weight is the biggest modifiable risk factor but obesity and its association with breast cancer remains the major elephant in the room. I do wonder why we spend so much on research if this cannot be translated into practice and policy.
Everyone has such fab excuses…. its fate, its in the genes, it’s what you ate as a child that counts, its alcohol bingeing as a teenager, Uncle johhny is still alive at 90 despite no green ever passing his lips.
Despite a burgeoning evidence base on the importance of weight management in cancer survivors, both in terms of cancer outcomes, management of treatment side effects and well being the nutritional focus is dominated by malnutrition. Last week, our colorectal clinical nurse specialists sought reassurance that the obese patients shouldn’t really be encouraged to consume creamy drinks, pies and pastries, highlighting a local patient guide that implied otherwise.
More disappointing is talking to clinicians, where a set of reasons for not talking about diet and obesity including “the evidence doesn’t come from randomised control trials” (neither does smoking evidence!), not enough time, not trained, personally overweight, don’t want to spoil professional relationships, talking about obesity is ineffective…… and for more just see our paper on colorectal clinicians (Anderson et al, Colorectal Dis 2013, 15(8) 949-57).
We have conquered so much in terms of treatments and length of survival we really are overdue the focus on quality of years, the well being associated with weight management, the refreshing effect of a brisk walk, the taste of fresh fruit but major advocacy efforts are needed!
The Scottish Cancer Prevention Network (SCPN) was established 4 years ago to engage a range of stakeholders to work together to promote cancer risk reduction behaviours relevant for primary prevention and for cancer patients. SCPN gets funded through the Scottish Cancer Foundation and has grown a lot in these years, from a core of 80 people to over 800 signing up for our newsletter with cascades out to around 24,000 (including 4 health boards who flag the issues to all NHS staff). Patients are starting to say it is a duty of care to be informed about evidence on cancer prevention for them as survivors and for their families. The tide is starting to turn. Our annual conference has been a sell out for the last two years as the cancer charities get behind the idea that prevention must be a feature of their work and even CRUK have finally decided to invest in cancer prevention research. The health promoting health service initiative is a perfect opportunity to promote healthy lifestyle. One day we might even see some universal work around obesity with approaches that remove guilt and stigma and really flag opportunities for reducing cancer risk (as well as diabetes and cardiovascular disease).
Research (and teaching) are my key missions from my University overlords but in reality writing another paper to be read by 20 or so people versus a newsletter article that reaches thousands seems to me a better route to helping to change ways of life. It would be fab if more dietitians could be involved (sign-up for the newsletter by e-mailing firstname.lastname@example.org, follow on twitter @thescpn or e-mail us if you want to submit some content) and show professional solidarity for cancer risk reduction!
Dietetic Consultant in Public Health Nutrition
I can appreciate that you may well be thinking you are about to read something on dysphagia which is undoubtedly a very important clinical issue. But no that’s not today’s topic. Instead I want to draw your attention to an increasing irony which stems from the highly successful food and drinks industry. Whilst the industry seemingly counts on people’s ignorance to actively push waistline-busting, high fat, high sugar and nutrient poor drinks and snacks on them, what is getting harder to swallow is our own ‘do as I say not as I do’ approach!
But before you raise your hackles and fast forward to the ‘reply’ button (and please do because I really want to know what you think) let me expand on this seemingly contentious statement and centre on the fact that the majority of registered AHPs work for public sector organisations.
It remains shocking but not necessarily newsworthy anymore that the majority of the UK population is overweight or obese – six out of ten of us by the way – and the prevalence of nutrition-related disease such as cardiovascular disease, type 2 diabetes, and some cancers, remains high and potentially preventable. But being able to make appropriate lifestyle choices (I am talking about what we eat and drink and, how active or sedentary we choose to be), is definitely not easy in today’s obesogenic environment. And whilst we may quibble about whether or not the NHS is the best place to tackle obesity, what is certain is that solutions to the problem must go beyond blaming the individuals struggling with this condition. So in this blog I am focusing on the AHP work place.
We know that the work place has great potential as a setting for improving the health of the population. For many AHPs the work place is an NHS setting such as a hospital. In the context of retail facilities within the NHS, there is a great opportunity to influence the behaviours of staff, patients and the public because of the ease of constant access to a large number of people, many of whom already suffer from overweight or obesity and long term nutrition-related diseases or, are at risk for such adverse health effects. This can be positive or negative. Unfortunately the current business model appears to be the latter. It is aimed at achieving maximum profit and the reality is that we see an excess of undesirable high fat, high sugar items which are heavily marketed to vulnerable patients, visitors and staff. I fear that there are many examples throughout the UK to illustrate the point where fast food, coffee shop and confectionery chain outlets are located on NHS premises, along with their aggressive sales tactics pushing less healthy products down our throats. But perhaps there are also examples to the contrary where healthier choices are actively marketed and high fat, high sugar items are not marketed. Please let me know either way. Are there other business models that might be operating? Are there examples of good practice in retailing and specifically examples of what happens in other countries? Is there a social enterprise retail model that might be an exemplar for use in the NHS? Has anyone made a case about vulnerability and excess diet-related health in more disadvantaged groups in NHS premises? And on a wider lens how can the synergies between nutritional adequacy, environmental sustainability and economic goals balance within this context?
And what about our own professional practice within the work place? It is widely recognised that our health and social care systems are unsustainable without radical transformation and that we must work more upstream to prevent problems arising rather than concentrating solely on trying to fix them. Linda Hindle, Lead AHP at Public Health England said that AHPs ‘must take every opportunity to create the environment, conditions, information and support to help individuals and communities change their behaviour to enjoy better health and wellbeing’. Yup – as registered healthcare professionals, AHPs can help achieve this transformation! But there is no silver bullet solution and it’s a combination of actions that are needed. For example AHPs can make every patient contact count by being able to:
- Raise the issue of lifestyle.
- Share some practical key messages about food, nutrition and physical activity.
- Sign post to different support services such as weight management and physical activity opportunities.
Plus, we’ve all heard the old adage ‘do as I say and not as I do’. AHPs are often viewed by the general public as role models for health and promoting healthy lifestyles should play a key role in our own professional practice ………but we don’t always practice what we preach do we? For example have a think about the following suggestions:
- Meetings and hospitalities – include fruit and not just biscuits (better still do without the biscuits!)
- Working lunches – arrange for ‘healthier options’ such as pulse based soups, sandwiches with low fat fillings and fruit, and avoid the fatty sausage rolls and ‘deep fried’ nibbles.
- Conferences & training sessions – ask for the above (there is usually a dietary needs box which you can use) and provide feedback on the food and drinks provision (positive or otherwise) on the evaluation.
- Celebrations and gifts for teams – a fruit basket is much better that than tins of chocolate sweeties!
What more can AHPs do to change the reality under our work place noses of, an excess of undesirable high fat, high sugar items being heavily marketed, promoted and/or offered to vulnerable patients, visitors and staff? Answers on a postcard please.
By Emma Carder (Freelance Dietitian Liverpool and Glasgow)
Professional training days and health conferences not only raise important issues for NHS departments in terms of staffing resources but they can also have a significant impact on budgets as well. Since leaving the NHS in 2010 to become a full time freelance dietitian I have a much better appreciation of accounting and book balancing! With this in mind I have had to become pretty apt at seeking out free professional development opportunities. My steepest learning curve from the past four years has undoubtedly been in my professional use of social media. I’ve discovered that social networking sites, particularly Twitter and LinkedIn, offer health professionals an incredible variety of free CPD opportunities. Having just read a Nursing Times tweet about the newly published #socialpioneer awards I’m pleased to say my social media enthusiasm is clearly shared by many others too!
Sadly, as we all too often notice, there are also a significant number of unscrupulous voices on social media who also enjoy engaging in health related information. With their clever marketing strategies and way with words it can be extremely difficult for the public to distinguish fact from fiction. With this in mind positive social media engagement by AHPs helps to ensure that we are the trusted & recognised key options leaders. AHP’s can engage on many levels within social media e.g. we can; share examples of outstanding practice, disseminate current research findings, contribute to topical debate and challenge the latest media headlines. Not only does such engagement help us to establish a positive online profile it also serves to enhance our professional development and strengthens public confidence within our profession.
It’s great to be given this opportunity to share my opinion on how social media can not only be used as a networking tool but also as a significant platform for promoting the work and worth of Allied Health Professionals. My top three tips for social media engagement are; Twitter chats, virtual health conferences and LinkedIn membership.
There are a multitude of high quality Twitter health conversations and debates going on in which you can participate in or simply eaves drop on. Participants can print off the chat from its archive and use alongside a short reflection as evidence towards their ongoing CPD. This link is a great starting place for finding health related chats that interest you: http://bit.ly/twittertweetchats Simply enter your area of interest and time zone. I’ve just had a little look at what UK chats are running tonight and tomorrow and as you can see, in two days alone, there is a huge diversity of health related information all ready and waiting to be tapped into!
One of the chats highlighted in the table is RDUK.
RDUK stands for Registered Dietitians UK and it’s a monthly moderated Twitter chat that covers a wide variety of nutrition topics. RDUK was established in 2011 by three dietitians; Sasha Watkins RD, Azmina Govindji RD and myself. The overall aim of the chats is to provide a credible and accessible platform for sharing evidence based nutritional information. To date we have organised & led over 25 UK nutrition related chats. Over the past three years the chats have grown from strength to strength and now average ~60 participants including; dietitians, registered nutritionists; allied healthcare professionals, medical& nursing staff, health journalists, food bloggers, health charities and the general public. The February 2014 chat on ‘Sugar’ reached over 1.6 million people and involved 85 participants including Diabetes UK. Chats are supported by the British Dietetic Association and during Dietitian’s Week (9th-13th June) RDUK will be hosting 3 special twitter chats; Meat Free Monday, The Big Fat Debate and Nutrition Truths. RDUK has recently been short listed for a 2014 Clinical Nutrition (CN) Award in the ‘Nutritional Resource of the Year’ category. To find out more on how to participate in any future chats or to view the archived chats simply click the link http://bit.ly/rdukchat
Virtual Health Conferences
Social media now offers the possibility of listening in and even participating in key national and global health conferences. Over the past two weeks alone I have listened in to two major health conferences; Primary Care 2014 in Birmingham and The European Congress on Obesity in Bulgaria. Using #PrimaryCare14 I was able to catch up on the presentations of three fellow dietitians, Dr David Johns, Azmina Govindji and Zoe Connor, who were presenting their work within their respective specialities; teenage obesity, the glycaemic index and autism. Using #ECO2014 I was able to read tweets & interact with eminent speakers in the world of obesity research. This week there are a couple of NHS Conferences taking place and I’ll be keeping a close eye on them via #Confed2014 and #NHSScot14. If you are keen to follow a health conference then the following link is a great place to find out what’s coming up in the future. http://bit.ly/twitterconferences
LinkedIn is equivalent to a business version of Facebook. Despite being more formal than both Facebook and Twitter it still offers plenty of learning & networking opportunities. An easy way to maximise your CPD on LinkedIn is to search for public and private member groups that relate to your particular qualifications. At the moment I’m a member of 5 different private member groups which range from the British Dietetic Association to the Kings College Low Fodmap Dietitians Group. Being a group member allows you to interact with fellow colleagues by ‘liking’, ‘commenting’ or simply following their discussions. You can also keep right in the loop with group goings on by adjusting the group settings to ensure you are sent a weekly summary of key discussions.
I hope this post gives you a flavour of some of the exciting opportunities that are out there for AHP’s and I look forward to engaging with you soon!
By Anna Julian (@AnnaJulianRD)
Chairperson of the West of Scotland Branch of the BDA
This week is Dietitians week. Five fabulous days of our very own, to flex our AHP muscle and highlight the work and worth of dietitians across the UK.
Dietitians week, as part of the British Dietetic Association’s Trust a Dietitian campaign, aims to promote the role of the dietitian as the only qualified health professionals to assess and treat nutritional issues at the public health level.
As we all know, with AHP power comes great responsibility, and we recognise the benefit of continuing professional development (CPD) both on our day-to-day practice and to ourselves as individuals. With a rapidly changing environment it is fundamental to keep up with the latest research and guidance, appraising evidence and integrating new strategies to keep our clients at the centre. We also recognise the need to maintain our motivation; to meet inspiring people who get us buzzing about our chosen vocation and to learn new facts about food that we never even knew we were missing. We spend 525,600 hours of our lives as health professionals (based on entering the profession at 21 and continuing until the end of our lives. Being an AHP is not just for Christmas) so we need to maintain our passion, keep looking for challenges and setting goals.
So, as we at the West of Scotland branch look forward to celebrating and sharing practice with other branches, groups and individuals around Britain over the next few days, we thought it the perfect time to introduce ourselves.
So who are we?
Established in 1952, the West of Scotland branch of the British Dietetic Association has been helping to quench members’ knowledge for decades, providing a local forum for BDA members to exchange ideas and network. Although the way we communicate has changed significantly over the years, the purpose of the branch remains very similar today.
We aim to:
- Provide opportunities for networking with a variety of members from different disciplines and organisations: We have members practising within all areas of dietetics, across different sites and within all sorts of settings.
- Offer educational updates and discussion forums on clinical/professional issues of general interest. Past meetings have included: Clinical speed-updating – a quick fire update session with speakers on a range of nutritional topics; AHPs as agents of change in health and social care – The National Delivery Plan for the Allied Health Professions in Scotland; Social Media in Professional Practice and ‘Food for thought’ – setting up as a freelance dietitian.
- Facilitate cross-departmental collaboration on local and regional projects.
- Provide two-way communication between the BDA and members within that region.
- Supply links with regional specialist subgroups.
There are 13 branches of the BDA, all of which are run by a committee made up of at least three core members; Chair, Treasurer and Secretary. Our branch also includes a PR officer, Meetings organiser, Ordinary member and Student member making us seven in total. At present, we are six dietitians working across Glasgow and Lanarkshire, plus a student member from Glasgow Caledonian University. Taking on a committee position is a fantastic HCPC-friendly CPD opportunity, with the chance to develop leadership, organisation and communication skills, in addition to influencing the direction of the branch (and the odd free lunch and trip down to HQ in Birmingham).
How do we achieve our aims?
The branch hosts four meetings per year, presenting a mix of clinical and professional topics in a variety of formats. In addition we fund an annual student prize to promote academic excellence and support members involved in research. In 2013 we also supported members from the Glasgow and Clyde Weight Management service to present at the ECO conference in Liverpool.
Our biggest project is the annual study day, which takes up the majority of our time and creativity. Last year we teamed up with the BDA East of Scotland branch and the Royal College of Speech and Language Therapists Scottish Special Interest Group for a day of dysphagia management in Stirling. Held on a Saturday and midway between East and West territory, we tried to make it as easy as possible for our members to attend. The day was a brilliant opportunity to meet our AHP colleagues, share in lively discussion and listen to excellent speakers.
We are really keen that the branch is not just a CPD opportunity, but a chance to meet like-minded AHPs, motivate and stimulate. Through the branch we can raise the profile of local AHP activity and show the public, other health professionals and the government why they should #TrustADietitian.
Join us for Dietitians Week and our next meeting; Wednesday the 11th June 6-8pm with Rin Cobb (@pndconsulting), Sports Performance Dietitian and our annual AGM – https://www.eventbrite.co.uk/e/playing-with-your-food-sports-dietetics-with-rin-cobb-tickets-10037184489 Plus, listen out for details of our next study day in Perth on November 1st 2014 (Save the date!). Organised jointly with the East of Scotland branch, ‘Showcasing the skills of the dietitian’ hopes to demonstrate our extended role with speakers from the worlds of media, academia and clinical dietetics.
Log on to http://www.trustadietitian.co.uk/dietitians-week/Events/ to keep up with all the events of dietitians week and join the twitter chat at #RDUK
Get involved! We would love to collaborate with other AHP groups in the future. If you are interested in linking up for an event please contact Anna Julian, branch chair at email@example.com.