Sunday, 14 December 2014

I Heard the News Today and Oh Boy, The World Is Changing!

I've not read a newspaper in many a year – well I've not held a newspaper in my hands, one of the old fashioned sort, made of wood pulp and recycled materials. I guess its people like me that have contributed to the demise of the printed word, especially in the form of a daily newspaper. These days, like many other people I hear the news on the radio, or read on-line versions of newspapers and/or TV news programmes. I often hear the genesis of a breaking news story on my way into work and then hear how the story has developed during the day on my return journey.

One newspaper that has successfully made the transition from pulped wood to digital is the Guardian. Although this is not a newspaper I would particularly want to read, the Guardian is one of the most read English language news websites in the world, with 111.5m unique browsers accessing this web site each month. The fact that it doesn't make a profit (£31m loss this year, £33m the year before) doesn't seem to matter.

Last week saw the announcement that the Guardians Editor of 20 years, Alan Rusbridger (whose annual salary is £491,000) is to retire next summer. Under his editorship, the Guardian was awarded the Pulitzer Prize for public service (following the exposure of the surveillance activities of various US governmental security organisations). It was the Guardian that first broke the News of World phoning hacking story, which eventually led to the Leveson enquiry into press standards.

All good stuff and I wish Alan a long and happy retirement. However, it was a story in another newspaper that caught my eye at the start of last week. I had heard the radio announcer say they were to do a piece later on in the news bulletin about how digital technology is being used to help blind people see. Due to finishing my journey I missed the story and searched on line for it. Alas, to no avail. What I did find was a story published by the Telegraph newspaper (one I would be inclined to read) from way back in April this year. Reading it made me stop and think.

It was a story drawn from a research report published by the Royal National Institute of Blind People (RNIB) about the dwindling numbers of Eye Clinic Liaison Officers (ECLO) to be found in specialist eye hospitals. The report (can be found here) notes that often these clinics are so busy that doctors and nurses have little time to discuss with patients how they might deal with the loss of their sight. Only 218 of more than 400 eye clinics and hospitals have support staff, trained and skilled to provide advice on practical issues or to offer emotional support when people are told their sight cannot be saved. Having spent 2 weeks trying to get my glasses sorted (yes I know I should have gone to S********s) and struggled to read my computer screen, mobile, and the many requests for money that pass over my desk every day, and feeling very sorry for myself in the process I cannot begin to imagine what it must be like to be told you are losing your sight and there being no one there to help.

There was a group of health care professionals who were up in arms at the end of last week because they believed they would lose the opportunity to help and practice as specialists. This group were the Mental Health Academics UK (MHAcUK). Lord Willis (who is the independent chair of the Shape of Care review into the future nursing workforce) gave an interview to a journalist last week. In it he was said to advocate a more generic approach to the early part of nurse education, with specialist knowledge and skills being a feature of the later part of the educational programme (perhaps even into the first year of practice as a newly qualified nurse). Whether he said these things or not, the MHAcUK group appeared to feel the role of the mental health nurse was doomed.

One consequence was that last Thursday and Friday my in-box was filled with emails from mental health (academic) nurses intent on marching to the House of Lords and demanding full recognition for the skills and knowledge mental health nurses have as a profession. I am a mental health nurse by professional background, and I disagreed with the stance taken by MHAcUK and told them so. I thought they were missing the point of the review. Indeed mental health nurses only deal with a very small part of the population who experience mental health problems. 

I do recognise that often they work with people who mental health needs are complex and challenging. But the world is changing – as with newspapers, digital technology is challenging traditional service delivery and facilitating greater service user involvement and determination of service provision. Likewise, who actually provides services these days is changing. As my colleague Professor Davie Richards so eloquently noted last week ‘In the 1970s and 80s, mental health nurses were the obvious professional group suitable for training as psychological therapists. In the 21st century, newly qualified mental health nurses do not have the skills and knowledge to care for and treat the most prevalent and epidemiologically burdensome mental health conditions, requiring the English NHS to invest £700m over the last 6 years establishing and training a totally new workforce to do the job. The two most prevalent and burdensome mental health conditions – depression and dementia – are currently, and will in the future be even more so, the business of non-mental health professionals. People with dementia receive their care overwhelmingly from professionals, informal carers and para-professionals, not mental health nurses’

Mental health nurse academics like newspaper editors and owners perhaps need to change their view of the world. In this case, to consider once again, what they should be thinking about in terms of providing the best and most appropriate educational preparation for our mental health nurses of the future.