Sunday, 26 February 2012

Professor Ponytail Returns to the House atop Quarry Hill and Eats Out

Last week I returned to Quarry House, home to the Department of Health (DH). The last time I was there was some 5 years ago, and since then it seemed nothing much had changed with the building, although much has changed in the NHS. Way back in 1990 the DH occupied 23 buildings in London. In an attempt to rationalise and reduce costs, the then Conservative Government decided to relocate a large number of the staff employed by the DH to purpose built accommodation located outside of London and the South East. Originally, the move to the North West involved consideration of both the cities of Leeds and Manchester as possible locations. However, those affected by the move voted overwhelmingly on Leeds as the preferred choice.

The site chosen was Quarry Hill. For some 40 years, until its demolition Quarry Hill, was the largest social housing complex in the UK. It was a development noted for such radical and modern features as solid fuel ranges, electric lighting, a state-of-the-art refuse disposal system and communal facilities. The whole complex was demolished in 1978 because of its social problems and poor construction methods.

On the same site, in 1990, the construction of Quarry House started. It was completed, on time in 1993. Eventually some 2070 posts were relocated to Quarry House (which also provides accommodation for what is now called the Department of Work and Pensions (formally the Benefits Agency). 1630 people came from London to these posts and the remaining 440 from Southampton, Lytham- St Annes and Preston. The building cost £79.7m (1993 prices) and within this budget was some £543,000 which was spent on ensuring the building made a contribution to the arts. The money was spent on designing and creating inner courtyard gardens flanked by the buildings wrap around design. Although I was not permitted to take photos, the gardens still looked in good condition and it was possible to see where the money had been spent.

I was there with colleagues from the School of the Built Environment, to discuss the development of a research project that would seek to look at the health and well being benefits of new approaches to the provision of buildings designed for health services. The group we met with was headed by Peter Sellars, Deputy Director of Estates & Facilities Division at the DH. His team is responsible for ProCure21+ a National Framework which delivers faster, more streamlined procurement, design, planning, and construction, of publicly-funded healthcare schemes for the NHS. Its predecessor, ProCure21, successfully delivered over 420 community hospitals, primary care centres, mental health units and other acute services such as cardiac care and out-patient units. ProCure21+ continues to build upon this well deserved reputation within both the construction industry as well as the wider NHS for bringing about improvements in health outcomes through well designed buildings and services, but they lack the evidence to demonstrate the relationship between the two. We had a good meeting, and agreed a way forward in developing the basis for a possible project – it’s a case of watch this space.

Although I didn’t get to eat at Quarry House, it has been a busy week for eating out. Regular readers of this blog will know that I can be fussy about where I eat out, and why restaurants appeal or don’t. I was at the Twisted Med this week – didn’t appeal, other than the Eaton Mess meringue, which was feather light. And at one dinner this week, a friend remarked that her sister’s son, who I had met briefly at a recent 50th birthday celebration, is now studying at the University. Although not a student in our School he apparently reports seeing me quite often and he and his student group refer to me as Professor Ponytail. Unlike the optician who tested my eyes yesterday. He was convinced I was a musician. After hearing his life story and the bit where his wife, a Professor in European Politics had just divorced him, I didn’t have the heart to disabuse him of this thought, although he confessed that he hadn’t heard of the blues group the Silver Ponytails.

And last night, I was at a family 21st birthday party, which was made all the more enjoyable for the company of three charming young ladies, Charlotte, Amy and Sophie, who I said I would mention in today's blog. Happy Dancing!

Sunday, 19 February 2012

Symmetry, Slovakia, and the Impact Factor of Snowdrops

This week I was pleased to be able to write an Editorial for a new nursing journal, the Journal of Nursing: theory, research, education which is published by a group of my colleagues working for the, Jessenius Medical Faculty located in Martin, Slovakia. This is part of the Comenius University of Bratislava. The Editorial was for the 2nd edition of the journal, due out in March this year.

I have been part of the group that developed the idea of a journal for Slovakian nurses and was delighted to be asked to become a member of the Editorial Board. For me, it is a real privilege to be part of what I believe will be a contributing force for change in the way research can be used to improve nursing care for patients, their families and the communities they come from.

I first went to Slovakia in 1996 to present a paper at what was the 2nd International Conference on Education in Nursing, This was the first paper I had ever presented. I have been going back to Slovakia every other year since then! My first paper was entitled The changing nature of the UK nurse education system: concerns and challenges and explored the impact on UK nurse education of the internal market system in the NHS. And last year, at the 9th conference, I presented two key note papers: Thoughts in Search of an Evidence Based Thinker, and Bricolage: The importance of context to nursing research and practice.

Whilst the conference is a modest affair, no more than a hundred delegates, I really enjoy being a part of these events. They provide a much needed showcase for research and other scholarly activity that has been undertaken by academics, practitioners, those responsible for managing services and for those involved in developing health care policy in Slovakia (and the neighbouring countries). The presentation of nursing work is well received and for some, the congress provides a first opportunity to share their work with a wider audience of peers. Unfortunately my knowledge of the Slovak language is still limited, but many of the presentations use English and there is always expert simultaneous translation available. From the first time I went there, I have been made to feel very welcome my Slovakian colleagues.

Martin was, and to some extent remains, a tortuously difficult place to get to. On that first occasion, I had to fly to Prague, and then take an overnight train to Slovakia. This was at a time when passports were checked at every border and the train journey was punctuated by border guard and police checks every few hours. It was a very interesting experience. When I arrived (at 06.30) in the morning, I was offered breakfast by my very hospitable hosts. It was at this point that I discovered Slovakia didn’t quite know how to deal with vegetarians. The plate, piled high with fatty bacon and sausages was gently declined, and after much discussion the bacon and sausages was unceremoniously removed, and more eggs and mushrooms added. This seemed to be the solution at all those early meals, remove the meat, and double the potatoes and cabbage – thankfully, things have got a lot better these days and most restaurants offer a few vegetarian options on thier menus. Sadly, the large tumblers full of very fine Slovakian apple cognac served with each meal (even breakfast) have largely disappeared.

That the conference has spawned a new journal is brilliant. The journal provides a place for both empirically based research papers and for papers that present the changes made in practice around treatments, interventions, the organisation of services and the care that can be provided. Importantly for me the journal welcomes papers that present new ideas on how nurses can be prepared for practice or how they can improve their knowledge and skills. There are now some 35,000 nurses working in Slovakia, and the number of graduate nurses has risen by some 1500% since 2000 whereas the numbers of every other health profession has remained static. In Slovakia, and elsewhere, this change in educational achievement should give an increasingly powerful voice to nurses. As the provision of health care is affected by the wider international economic problems facing nations, using this voice to ensure that new ways of working (often with less resources) does not impact negatively on the provision of high quality nursing care and treatment becomes increasingly important. I am committed to making sure the work of the journal helps in this regard.

Back at the ranch, I am embroiled with discussions about the Research Excellence Framework (REF), journal papers and the importance (or not) of impact factors. The impact factor was devised by the founder of the Institute for Scientific Information, Eugene Garfeild. It is a measure that reflects the number of citations that papers published in academic journals achieve. As such the impact factor is used to note the relative importance of a particular journal in relation to another. Journals with higher impact factors are deemed to be more important than those with lower ones. The Journal or Nursing: theory, research, education is unlikely to attract an impact factor for a number of years if ever – but does it mean that as academics we should avoid trying to get our work published in this journal. I think not!

Interestingly, and contrary to many popular beliefs the current REF exercise (a process that adjudges the quality and power of recent research on a national and international level) which is predominately concerned with the published outputs of academics, will not take into account the impact factor of the journals within which papers are published. This is a long overdue stance that perhaps recognises that the impact of published work does not rely entirely on how often a particular piece of work is cited in the work of others. I am passionate about getting my ideas and those of my colleagues, published. Since that first conference paper presentation in 1996, I have published my PhD, 83 peer reviewed papers, book chapters and research reports, 96 conference papers, 26 non- peer reviewed papers and 133 blog postings. In all of this time I have only published 2 single authored papers, preferring instead to write with others.

And driving home on Friday night, after enoying an evening of wonderful conversation and friendship, I turned onto my drive, and my headlights picked up the naturally seeded drifts of snow drops lining the drive. These tiny white flowers standing tall and proud in the cold night air were perfect reminders that whatever we do Mother Nature will always find a way of providing the impact we need to remind us of what is really important.  

Sunday, 12 February 2012

The Art [Deco] of Figure Skating in Morecambe, the NHS and Beyond

Last week was dominated by finance, numbers and the exploration of consequences. Following some considerable preparation work, I found myself once more on the way to the seaside town of Morecambe for this year’s University Financial Planning Conference. However, getting to the venue was a trial on its own. Early morning rain falling on frozen roads created sheet ice and led to hazardous roads and pavements. Cumbria and Lancashire police forces reported more than 100 road accidents between the hours of 05.00 and 09.00 am, in and around the M6.

The venue for the conference was the Midland Hotel, a renovated Art Deco style hotel, well past its once glorious heritage. I didn’t like it last year when we went there, and my desire for being there again hadn’t grown over the intervening 12 months. My deep joy reached a new low when I got out of my car and slipped on the icy surface. But at least this year I was aware of the toilet hidden in the bedroom cupboard (I kid you not) and I got a double bed (complete with an explicable cuddly toy) and a view that was handy for keeping an eye, overnight, on my car in the car park.

However, my comfort, well being and sense of the atheistic were not the reason I was there. The Senior University Leadership Team were gathered together to address the severe economic and financial situation impacting upon our future as a University. This situation is caused by a number of interrelated issues. Overall, there has been a 2.5% reduction in the Higher Education Funding Council England (HEFCE) grant made available to universities which is down to some £6,507bn. A new fee system has been introduced, and students starting in September 2012 will be impacted by this, with fees for programmes rising to some £9000 per year in some Universities. Student applications are down by some 30% on this time last year, and changes brought in by the UK Boarder Agency for overseas students has dramatically reduced the number of overseas student coming to the UK.

In addition recurrent research funding has decreased by 1.1% and HEFCE have reduced the weighting given to the quality-related research funding away from activity rated 2* with only that research rated at 3* and 4* receiving any quality related payment. It is these payments that in part, allow for the development of high quality research, and research capability at a School and College level.

These overall funding reductions have resulted in a challenging situation for many Universities, and for many Universities, (Salford included) there is a growing need to find ways of increasing income and reducing costs to deal with this situation. Some Universities seem to have come up with imaginative approaches. The Guardian last week published the Top Ten Universities raising the most in library fines:

University of Leeds£1,869,340

University of Manchester£1,299,342

University of Wolverhampton£1,252,253

King's College London£1,197,715

University of Hertfordshire£1,147,238

University of Birmingham£1,114,863

University of Plymouth£1,058,777

University of Nottingham£1,025,560

Kingston University£1,020,753

University of Durham£1,005,426

Thankfully, our University does not feature in this ‘top ten’ list and our Financial Planning Conference took a different approach to what could be done at School, College and University level in addressing increasing income and reducing costs. In terms of increasing income, we discussed the development of new integrated interdisciplinary programmes focused on emerging markets, how to substantially shift the strategic focus and quality level of delivery for our CPD portfolio, and further leveraging the Media City advantage. These proposals are in the processes of being translated into financially relevant targets and commitments. Reduction in costs included continuing the work on reducing the non-staffing budgets, but also we considered the need to address the skill mix and size of the current workforce. Again these discussions are to be given a financial, temporal and spatial framework over the next few weeks.

As a School I believe we are well placed to maximize the opportunities that arise from changes in our operating environment. Last week the Department of Health announced the predicted funding for the NHS£65bn will be available for local doctors, nurses and other health professionals to to spend in the development and provision of local health services. In addition, around £5.2bn is to be spent on Public Health Services. Of this, at least £2.2bn will go direct to Local Authorities to help local communities stay as healthy as possible and to reduce health inequalities. These figures were developed by mapping PCT spending in 2010/11 on to the future structure, subject to the passage of the Health and Social Care Bill, and uplifting these to 2012/13 levels. And whilst it is not yet possible to find the funding allocation for Adult Social Services, (some £16.1bn was spent in 2009 – latest figures available), it is likely to be around £25bn.

The size of these investments in health and social care, alongside the re-organisation of service providers, new technologies and a changing workforce provide the School with enormous opportunities to change and further develop our educational, research and service development portfolio.

And it would be good to do so. In my own field this week, the launch of a National Survey of Investment in Mental Health Services in England was announced. This is the tenth national survey and aims to provide detailed analysis on spending for mental health services which will help the Department of Health and Local Authorities in formulating policy for the provision of mental health services.

This might also be a good thing, as last week it seemed that a lot more people might be at risk of being labelled mentally ill due to behaviour most people would consider normal. But not necessarily what American psychiatrists and psychologists might consider normal judging by what is proposed to be included in forthcoming Diagnostic and Statistical Manual (DSM-5). Thankfully powerful voices in mental health care in the UK are speaking out against the publishing of DSM-5, an updated version of the ‘psychiatrists bible’ that attempts to categorise every type of mental disorder, including some that are clearly difficult to accept as disorders. For example, among the anxieties to be labelled mental disorders in DSM-5 are shyness in children and uncertainty over gender. Loneliness could attract a diagnosis of chronic depressive disorder, and so could unhappiness following bereavement. A serial rapist could be classified as mentally ill, and given a diagnosis of paraphilic coercive disorder. Under the DSM-4, last revised 12 years ago, children who argue and refuse to obey parents can be classified as having oppositional defiant disorder.

Thankfully I didn’t get to the page that described the diagnosis of middle aged men who have an acute dislike of visiting art deco hotels, where toilets are hidden in cupboards; lunch largely consists of bowls of severely charred chicken pieces and to be asked do so during the cold British winter – but I bet the page is there.

Sunday, 5 February 2012

[M]ice at the V+A, 30 something’s for the over 50s, Me and My Mate Billy, and Wit[tering] on about Sircumcision

Last week not only were the NMC back, but I was back in the V+A. The NMC were back to assess the quality of our mentorship programmes (Nurse and Midwives). The review team approved the programmes and commended the team on their relationship with practice colleagues evidenced by the high quality of the mentorship provided to students, and the shared understanding of the learning outcomes and NMC standards by colleagues in practice and the School.

I was at the V+A for a College Planning Meeting. Now as regular readers will know, the V+A is not my favourite place in the world to stay. And whilst I do have some good memories of past stays there, it would not be my first choice of an overnight venue. I was there with my colleagues to develop the College response to the changing HEI environment and in particular to consider the fitness for purpose of our strategic plans in meeting the new economic realities facing all Universities.

After a long days work it was good for the team to enjoy a meal together, and catch up on non-work issues. The chef had been told I was dining (the food is one of the reasons I don’t like staying there) and he came out and I was able to negotiate an off menu meal that was surprisingly good. So in mellow mood I even considered whether I might have been a little harsh in my criticism of the place when much to the surprise of our table, we were joined in the dining room by a tiny little mouse.

The mouse ran around for a bit and perhaps like me had issues with the menu, turned and dissappeared. Now where there is one mouse there are likely to be many others. Mice become sexually mature in 8 to 10 weeks and a pair can produce 8 litters each of 16 young, in a year, so you are never likely to be far from a mouse or two!

The following morning I took a short walk around a cold and crisp white early morning Manchester. The canal that runs into the River Irwell was completely frozen over and yet the river just the other side of the lock gates ran freely. And it seems my gentle walk around the grounds of the V+A was typical of people my age. A recent GlaxoSmithKline (GSK) study revealed that people over the age of 55 do 30 minutes more exercise per week than people aged 18-25.

GSK in association with NHS London and supported by the Royal College of General Practitioners, the Royal College of Nursing, the Chartered Society of Physiotherapy and 7 patient groups across the UK launched the Your Personal Best initiative last week. This initiative aims to promote lifestyle changes among the 7.8 million Britons in the 50+ age group who have long-term health problems. Inspired by the London 2012 Olympics, it encourages people to undertake regular light physical activity, such as gardening or walking the dog. The scheme highlights the role played by nurses, GPs, physiotherapists and other health workers in promoting a healthy lifestyle among patients.

Being a keen gardener, a daily walker of Cello my Australian Labradoodle, and a Nurse, I thought the YPB initiative ticked a lot of boxes for me. This week however, I won’t be out walking with Cello every day. Cello is currently on holiday in Scotland and there is just Billy the Parrot and me rattling around in Ch√Ęteau Warne. Which is a bit of a shame as the snow came yesterday and the ground is covered in about 4 inches of the stuff and despite trading the Tractor for other more manual and eco friendly snow clearing equipment, Billy is not that handy with a shovel.

And my thanks go to Sarah and James who with great cutting wit made me smile in what I thought was the defining comment following the news regarding Fred Goodwin last week:

@sarahtaylor: @mrjamesob - Sircumcision = having your knighthood removed.

And yes, I survived my alcohol free week, and that glass of heart protecting red wine tasted so good on Friday!