Breast Feeding Awareness Week Coffee Morning

A Coffee morning has been arranged by the Tranent and Ormiston HV’s to be held at the Early Years Centre, Sandersons Wynd, Tranent. On Wednesday 13th May from 11am – 12 noon. We are advertising it on the radio, in the local press and on posters so hopefully there will be a good response. There will be no charge for the refreshments provided.

Civic Conversation

 In partnership with Queen Margaret University we have taken the opportunity to host a one woman play about alcohol and the role it play in the lives of many young women.

The play called Acceptance is written and performed by Liz Nicoll and a short extract can be viewed at


This is a play that touches upon many of the issues that affect women like Scarlet today and conveys in a genuine and meaningful way the emotional and social dilemmas and the pressure people in today’s society face to fit in.” David Shaw – Glasgow Council on Alcohol

“….. a clever piece of writing and a heart-tugging story consummately performed; it’s everything one-woman theatre can, and should be.”    Three Weeks Publication Edinburgh Festival 2008.

 Venue:         Tranent Town Hall, May 14th  2009, 1.30pm – 3pm

Venue:            Brunton Hall, May 20th 1.30pm – 3pm

 Refreshments and an opportunity for discussion will follow the performance.

Crèche available but must be booked in advance

This performance is free of charge

To book a place tel. 01620 827509 email

For a flyer click here Acceptance

 The civic conversation is the community engagement strategy fro Support from the Start – see previous posts for more discussion

Conference feedback

Almost 180 people attended a one day conference which launched East Lothian’s Equally Well test site – Support from the Start.

The day was started off with Dr Sue Ross Executive Director of Community Services for East Lothian Council welcoming participants and setting the scene for the day with a description what the test site hopes to achieve. 

The keynote speaker for the morning was Dr Harry Burns – Chief Medical Officer for Scotland – who spoke about the ‘Need for action’ to tackle inequality in health. He explained the latest research on the causes of health inequality and emphasised the importance of intervention in the early years of life if Scotland is to redress inequality in health outcomes. Dr Burns presentation made it very clear that the environment that children are brought up in has a clear and direct influence on physical and mental development in a way that can continue to influence responses to social and environmental stimuli in later life. His central thesis, from a variety of research sources, was that environmental, social and psychological influences that produce an inconsistent parenting environment creates a physically evident stress response in children. In turn this stress response prompts maladaptive responses in the way that children respond to the physical, social and psychological environment they inhabit and this produces health and social problems both in childhood and later life. 

Participants in the conference were invited to discuss what they had heard from Dr Ross & Dr Burns in the light of their own concerns for health and well being in their service areas. Having identified their concerns for trends in health they looked at the consequences of these concerns / trends if nothing was done to address them. Finally they were asked to think what could be done to address the consequences they had identified and in particular to complete the statement  – We will tackle inequality in health by……  A summary of the output from the discussion can be found here. These statements will contribute towards an action plan for Support from the Start

The morning session was closed by Don Ledingham Acting Executive Director for Education and Children’s Services for East Lothian Council with a presentation on the theme of – ‘A call to Action’. Don Ledingham’s presentation focused on the need for a sense of ‘belonging’ in children and communities as an essential part of what is required to create the circumstances for god health. He emphasised that services had a responsibility to generate that sense of belonging in all children, and that unconditional positive regard (or in old money – love)  was essential to achieve this. He also pointed to free school entitlement as a marker for many of poor social, educational and health outcomes that Support from the Start seeks to address and suggested that this would be one way of making sure that the right suppport is reaching the right people.

The them of the afternoon session was creating a ‘conversation’ about health and inequality that actively engages communities and families. The session was opended by East Lothian’s Depute Provost, Councillor Roger Knox who spoke about the importance of making connections, and reaching different parts of the community with support and information.

The keynote speaker for the afternoon session was Andrew Lyon of the Intrnational Futures Forum. Andrew’s presentation focused on how we think about the future, and critically that our individual and collective futures are created by what we do in the present. He talked about the role a ‘civic conversation’ can have in shaping our understanding of the present and future, by bringing together the many different perspectives that exist about the same issues to create a shared understanding of what is needed and what is possible.

Th table discsussions in the aftenoon focused on what communities could do to create a conversation about health and inequality. Folowing the same process as the morning the participants genrated – We will ….. ‘ statements and these will aslo be usedto form the action plan for Support from the Start.

The conference was closed by Alan Blackie, Chief Executive of East Lothian Council. His presentation was on the theme of ‘Keeping the conversaton going’. he emphasised that Support from the Start was not a short life project but a focus within mainstream services on tackling the kind of inequality in health that can be passed from generaton to generation if action wasnt taken to break the cycle. He made it clear that this could not be achieved without the active engageent of families and communites and that a consistent and creative dialogue had to be  developed with communities on this issue. This dialogue or conversation was not the purpose but a means to ensuring that services were doing all that could be done to redress inequality in health and improve life chances for children in East Lothian.

Copies of the presentation and a summary of the ‘We will statement will be posted here shortly.

Dr Harry Burns presentation slides dr-harry-burns-part-1 dr-harry-burns-part-2 

 Andrew Lyons International futures forum Andrew Lyons presntation equally-well-east-lothian-march-09


Steven Wray

Bump to bairn

The Tranent health and Well Being Group worked with the East Lothian Young people and Food Group to run an event for local parents at the Loch Centre in Tranent. Parents could find out about health topics such as weaning and oral health or other aspects of life such as financial issues or childcare from a range of local and East Lothian services.  We estimate that at least 30 parents came along and the event had a positive and lively atmosphere.  We will be asking stall holders for their views so we can judge if this is something we should do again.

Parents were asked to give us their views on how it feels being a parent or carer in Tranent.  I thought others might be interested to see what they said – see below:

What’s not so good about being a parent or carer in Tranent? 


  • Stigma if a young parent.
  • Early Daze- 2nd baby mums not always able to attend
  • You can’t get buggies on most of the buses.
  • ‘Policeman’s Close’ – need to go on the road with buggies.
  • Lack of support from Council-funding not being allocated to our worker to keep our young parents group going.
  • Some shops not accessible to parents with buggies.
  • Lack of funding for groups



What’s good about being a parent or carer in Tranent?


  • Able to go to local parent and toddler groups
  • Early Daze 0-6months group with Health Visitors- really good for mums mixing and to access advice.
  • Local support groups.
  • Good health visitors
  • Good mums
  • Good midwives.
  • Social life with other mums.
  • Information given from midwives and health visitors.
  • Everything on the ‘door- step’ for a parent i.e. shops, banks etc.
  • Early Daze – provides advice, and a social aspect allowing friendships to be forged.
  • Good groups and support networks.
  • Having the support of local workers


How easy is it to be a parent or carer in Tranent?

(Individuals were asked to indicate on a scale between 1 and 10)


  • 2 parents indicated 5
  • 1 parent indicated 7


What needs to change?


  • More childcare.
  • More jobs for mums
  • Better parks and cafes.
  • Less stigma
  • Fill the gap with a local playgroup.
  • More private nurseries.
  • Better parks
  • More jobs for mums.
  • Better facilities for all ages 0-15yrs
  • More jobs aimed at single parents
  • Funding continuum for groups.



What’s not so good about Tranent?


  • The high street pavements aren’t buggy friendly.
  • Dated facilitied
  • Doctors’ surgery too small for size of population in Tranent.
  • Lack of cafes and meeting places.
  • No cafes or restaurants for families.



What’s good about Tranent?


Friendly mums.

Good choice of school for the size of Tranent.

Anti-natal classes and follow-up visits.

Plenty of groups for parents and children to meet.

Good support for breast feeding.

Quite child friendly.

Can access most shops with pram.

If improvements to Polson Park go ahead will make a big difference.

Helpful information from


How child friendly is Tranent?

(Individuals were asked to indicate on a scale between 1 and 10)


  • 1 parent  indicated 6




What needs to change?


  • More child friendly shops.
  • Better transport from surrounding villages.
  • Too many ‘bookies’ and off licences.



Bugs, Boats and Obesity

Busy BugsThe East Lothian Physical Activity & Health Partnership hosted a meeting on promoting physical activity in the early years on 2nd March. The positive effects of moderate physical activity on all aspects of health and well being in all age groups are clear from research.

The meeting was led off with an informal presentation by Caroline from the Active School team who spoke about her work rolling out the Busy Bugs programme in East Lothian, as well as other programmes such as Basic Moves and Kickstart.

“Busy Bugs/Top Tots helps to introduce and sustain play and physical activity as part of a daily routine for children aged two to three-and-a-half years. The programme provides new ways to keep children active at nursery and at home, through play, movement to music, basic moves and games, with a focus on enjoyment and fun! The course covers programme planning, content and management, lesson plans, resources and the evaluation and review process. It is ideal for parents, nursery, playgroup workers and anyone else working with this pre-five age group.”

The Active School Teams approach is to train people – staff and community members – to deliver these programmes, and then to provide backup and support for these staff. They have found that support is needed especially until the trainees get some experience of delivering the programmes for children under their belts. Busy Bugs has been particularly popular with nursery staff, both local authority and private sector. A gap, discussed at the meeting, has been links to communities. A positive outcome from the meeting was a connection being made with the community development service that may help with this. There is also a need to develop a train the trainers package to help disseminate Busy Bugs and other programmes further than is possible within the resources of the Active Schools team. The teams vision is that this programme becomes a part of mainstream early years provision with back up and quality assurance provided by themselves. Hence, the Active schools team would train the trainers for school, nurseries and community settings who would then train staff to deliver the programmes in the different settings.

The meeting also heard about dance initiatives for this age group, and the provision of outdoor play in the form of play parks and outdoor areas of nurseries and infant schools.  It was clear that a lot of high quality work is going on in East Lothian to promote physical activity for this age group.

The issue of obesogenic environments was also touched upon as an explanation of why children (and adults) seem to be becoming more overweight despite such excellent work taking place in schools and nurseries. Basically an obesogenic environment is one in which it is easy to access lots of calorie dense food, and difficult to burn off those calories in physical activity. Such an environment makes it very easy to  gain weight particularly if you are genetically disposed.  In terms of weight gain it can be said that ‘Genes load the gun, but the environment pulls the trigger’.

Are East Lothian communities obesogenic – and if so are we asking all the dedicated staff who provide programmes like Busy Bugs to bail out a leaky boat?

Whats on?

Here are some Support from the Start related activities planned for the next few months

February 19th

Induction session for the staff members that have been nominated as service champions. Another session will follow for those that can’t make that date or are still to be nominated.

March 2nd

The East Lothian Physical Activity Partnership – will be asking the question – Early years & physical activity, what are we doing and can we do it better?

Venue: Early Years Centre Sanderson Wynd  9.30am – 11am

Contact Helen Bruce for further information

March 16th

Support from the Start – A conference on health inequality in East Lothian for parents/ carers and service providers

Venue: Brunton Hall, Musselburgh 9.30am – 4pm

Guest Speakers – Harry Burns, Chief medical officer for Scotland & Andrew Lyon of the International Futures Foundation

To book a place contact

March 24th

Bump to Bairn

An Informal and fun session for parents and children. Drop in and meet a range of services and professionals who support parents to be and parents of pre fives, and a range of other services for healthy living 

Venue: Loch Centre Tranent 12.30 – 2.30pm

For more information contact

April 1st

Inaugural meeting of the East Lothian Active Outdoor’s Network

Guest Speaker Juliet Robertson  ‘Active Outdoors in Early years Settings’

Venue: To be confirmed 2pm- 4pm

To book a place or for more information contact


Supporting The Best Possible Start For Children In Scotland

NSS Seminar Tuesday 3rd March 2009

In this my first trial post…

Can I draw your attention to a forthcoming National Services Scotland (NSS) seminar entitled ‘NSS – Supporting The Best Possible Start For Children In Scotland’, to be held on Tuesday 3rd March 2009 at the Teacher Building, St Enoch’s Square Glasgow. The seminar runs from 10am to 3.45pm.

The seminar will feature:



Recent developments in pregnancy / new born screening policy

Dr Ros Skinner

Child health inequalities

Dr Jim Chalmers

Child vaccination / immunisation schedule update

Dr Claire Cameron





The Care of Critically ill Children in Remote and Rural Areas

Dr Andrew McIntyre

Audit of High Dependency Care for Children & Young People in Scotland:  Supporting Scotland‘s Healthcare Planning

Ms Julie Adams

Implications of recently published SGHD report on Early years, early intervention


Clinical quality and outcome indicators for children’s specialist services

Clare Clark & Alastair Philp

To register for a place, simply complete the registration form on the following link and click the send button.

Completed forms should be returned no later than Tuesday 24th February.

Please feel free to pass these details on to any colleagues who may be interested in attending. Further seminars will be organised during 2009/2010, details of which will be circulated later in the year.

If you have any queries or require any further information, please contact Bill Dunn in the ISD Customer Relations Group on 0131 275 6234 or by e-mail at








Logic Modelling

In preparing for battle I have always found that plans are useless, but planning is indispensable.
–  Dwight D. Eisenhower

Having spent a good bit of time in the last few weeks working on logic modelsrelated to health outcomes I can agree with this sentiment. I have never been good at absorbing information that is presented in boxes.  For people like me at least the product of the logic modelling process is not very useful as a communication tool about the plan that it describes, particularly if I haven’t been involved in developing it.  However, the process of developing the logic model really does help with thinking through the linkages between Outcomes ( the impacts we want), the Outputs (the tasks we perform) and Inputs (what we invest) in a complex and dynamic environments such as health and well being.

Logic Modelling is never going to be a favourite task for me, but at least I can understand why it is necessary.

I am still an edubuzz novice and havent mastered the art of inserting images but hopefully clicking below will reveal a draft logic model for  Support from the Start


Starting a conversation

‘Support from the Start’ aims to improve health in areas of East Lothian that have the poorest health outcomes by focusing on early years and parenting. Engaging service providers and members of the community is key to its success. 

But what does ‘enagement’actually mean and how can it be achieved?

Communties scotland has developed standards for community engagement, and the guidelines for the standards gives the following definition :-


 Developing and sustaining a working relationship between one or more public body and one or more community group, to help them both to understand and act on the needs or issues that the community experiences

So in this case community engagement means :

Developing and sustaining a working relationship betweent council, health and voluntary sector services that provide or support services to parents and children between 0 and eight, and the communities of Tranent, Wallyford, Whitecraig, Prestonpans and Musselburgh East to help them both understand and act on the issue of health inequality.

How can this ‘working relationship’ be developed and sustained?

In my experience good working relationships are like good conversations created from a mutual interest, and a mutual acceptance that the other person has something valid and important to offer / say. Crucially both sides need to demonstrate that they are listening to maintain the interest and involvement of the other partner.

At a national conference on Equally Well I heard a speaker from the International Futures forum talk about a ‘civic conversation’ as method of community engagement. The idea of a ‘civic conversaton’  was first put forward by philospher Anthony Grayling and has since been developed as a methodology for  trying to find out what people and services thought was important for the future of Glasgow, and to develop an understanding between services and community about the desired future.

 If we have health as part of the ethos of the city, then what policies and actions ought we develop to make this apparent and explicit. A civic conversation explores aspirations and possibilities for worthwhile action to ensure that both Glasgow and Glaswegians flourish. The basic premise underlying the civic conversation is that the way a community talks to itself, how it forms its values, beliefs and policies ultimately influences how it behaves. 

On the 16th March Scotland’s Chief Medical Officer is coming to a conference in East Lothian to help us start a ‘civic conversation’ about health inequality. He will  tell us why acting on health inequality is so important to East Lothian’s and Scotland’s future, and why the early years of life are crucial to improving health and preventing illness. Having intiated this ‘civic conversation’ we will need to be able to develop and sustain it, and the afternoon session of the conference will look at how we can take this conversation into the target communities. However, the end of the conference will not be the end of the conversation only the end of its beginning. We hope the community members and service providers that attend will go away with ideas about how to continue a ‘civic conversation’, and that the result of the many conversations that take place will be brought together in the following year at an event that will focus on developing and deepeing the conversation by showing how services and communities have listened to each other on the issue of health inequality.

Supporting research and evaluation


Learning is intended as one of the key tools for ‘Support from the Start’. The following describes how we will be supporting the learning process around ‘Support from the Start’.

We start from the premise that tackling health inequality is not something that is completely understood – there are no off the peg solutions.

However, we will not be ignoring what is already known, and part of the learning process will be disseminating information about what has been shown to work in the rest of Scotland and internationally. The Health & Early Years Learning Network will have a key role to play in this work. This network will be chaired by Ann Hume, East Lothian Council’s Early Years and Childcare Officer, and will promote and organise events and training session for ‘Support form the Start’. The first of these will be on the 16th March, and we are delighted to announce that the Guest Speaker will be Harry Burns, Scotland’s Chief Medical Officer. More information on this event will be the subject of another post – however you can reserve a place by emailing your contact details to:

To support services and communities that want to undertake evaluation and research in relation to ‘Support from the Start’, we are establishing a Research and Evaluation group which will be chaired by Queen Margaret University. This group will bring together people and organisations with expertise to act as an information and support for ‘Support form the Start’ research and evaluation activity. Anybody that has a research idea connected to the health of children in the early years will be able to submit it to this group and receive feedback on how they might be able to turn into a practical research / evaluation proposal. The group will also be tasked with maintaining an overview of research and evaluation taking place in respect of ‘Support from the Start’, and liaising with national groups and resources for research.  

Another way learning will be supported is through ‘Action Learning Sets’. The Set members will be those individuals that have been identified as champions for ‘Support from the Start’. The Sets will allow the champions to meet on a regular basis and discuss problems and issues associated with tackling health inequality in their service areas.

Finally, this blog aspires to be a place where people can not only learn about East Lothian’s Equally Well Test Site, but also debate issues in relation to tackling inequalities in health.

Happy New Year

Steven Wray