Sunday, 27 May 2012

CSC tells it like It Is, HEE is no Laughing Matter, the RCNs PC isn’t, the NMC comes to its senses, but Where were my Inclusive Vegetarian Sausages?

If this week’s blog has a title nearly as long as the blog itself, it’s down to the busy, busy week I was involved in last week and the range of issues grappled with. Last week, of course saw the publication of the Commons Select Committee (Health) report on the UK Governments plans to reform the education, training and workforce planning in the NHS. They didn't mince their words in giving their verdict on current plans to handle the £5billion annual budget – the CSC said the plans were unclear and lacked detail. Now there’s a surprise.

They welcomed the creation of Health Education England, and the Local Education and Training Boards (both new organisations aimed at reforming and improving how education and training of the health workforce). What they felt was missing was the detail of just how these organisational entities might work. I am sure there will be others like me who are concerned that these reforms are ‘provider’ organisations driven – NHS Foundation Trusts - and the voice of the patient appears lost in the administrative fiat being performed inthrough their creation. It was something hotly debated last week at the Council of Deans (Health) Summit held at Crewe Hall – a place well worth a visit if you get the chance.

One of the workshops at this event was aimed at exploring HEE and the new system architecture in England – a work shop led by Nicki Latham from the DH. The session was structured around the usual DH rhetoric and somewhat rose tinted view of the world. Unfortunately sitting in the room with Nicki were some formidable, long serving and experienced educationalists. All of whom were happy to help Nicki see a different view of the world. The overall message was a sobering one for all those concerned with providing education and training for the future health care work force. Those taking part in the workshop were people who teacher others about care. They also care for others themselves, and a gentle humour was injected into debate to protect the innocent, but the session was no laughing matter.

Neither was the debate about how the CoD should respond to the RCNs commission’ into nurse education and training. Every University in the 4 countries of the UK was represented at the meeting. Almost universally there was little appetite to engage in the work of the RCN and this self appointed commission. Some members had tried and failed to get Peter Carter to address the so called issues facing the nursing profession from an evidenced based perspective instead of what appears to be a reliance on largely anecdotal based views of the current state of development of the nursing profession. 

So it was good to hear from Judith Ellis at the Summit. She is the Interim Chair for the NMC and presented a completely grounded assessment of the issues facing the NMC and the nursing profession. Importantly they were clear about their remit and what to focus upon the immediate and long term. Some of the data she used to construct her argument about what needs to be done were compelling. For example, the NMC holds a register of some 680,000 nurse (the largest regulatory body in the world).

Currently the NMC has 82 Approved Educational Institutions (our School is one of these), and some 1034 nurse education programmes approved. It spends some £43million of its annual registration fee income of £52million on Fitness for Practice cases (but only 0.06% of nurses are involved in these processes) And of the 50 – 70 referrals the NMC receive a week, some 40% are referred back to NHS Foundation Trusts to resolve, being organisational issues rather than professional issues. Interestingly the NMC were not informed about the RCN ‘commission’. However, Peter Carter had a lot to say about the NMC current consultation on raising its annual registration fee from  £76 (no change since 2007) to £120. He said “it was staggering proposal at a time when nurses are under huge finical pressure and it is deeply unfair that the NMC should propose a near 60% increase in fees” – this is from a man who heads up an organisation that charges an £194 annual membership fee. Payment of the RCN subscription will not entitle a single nurse to practice or help protect the public from poor practice.

And last week at Fridays Deputy Vice Chancellors Breakfast Meeting I was told that there was no food for vegetarians as no one had asked for it and they always make bacon rolls and sausage sandwiches’. Now some 11% of the UK adult population are vegetarian (some 4milion people) and there are twice as many women who are vegetarian than men. Despite someone going out to find some non meat sausage (many thanks) the experience provides an interesting insight into how our inclusive approaches to valuing our people have some way to go before they are truly embedded in everything we do!

Now need to get up and start the cooking preparations for later when  35 people are expected for Pimms and canapes on the lawn to celebrate my youngest daughters 30th birthday.

Sunday, 20 May 2012

Ferreting Around, Crowdsourcing, Smart Guides, Raiders of the Chicken Ark and 24 is the Answer

Last week was almost unbelievable in terms of animal encounters, which have included meeting a squirrel sitting by the side of the drive eating a slice of toast, and on Monday, when I was driving into the University, there in front of me was a large yellow and black ferret. It seemed quite happy just, well ferreting around. I was able to get my phone out and take shot. Seeing him was a wonderful start to the day.

And then first thing on Wednesday, while walking Cello (who is making a good recovery), there in the orchard was yet another ferret – this one almost golden coloured all over. Now a ferret at work is one thing, but a ferret being so close to the chickens at home is something else. They do not make good bedfellows. The coincidence of seeing 2 ferrets in the same week was a rum business or fesnyng as some people would say.

And the NHS has come up with a new way of getting lots of people to say something. The 15th of May (a red letter Day if ever there was one) saw the launch of a new web site as part of the NHS Patient Feedback Challenge. Backed by a £1 million pot against which NHS staff can bid, the PFC aims to spread best practice and ideas across the NHS. The web site will be used to collect ideas and support the development of bids for projects. Gathering ideas in this way has been described as crowdsourcing, and this crowdsourcing is a fundamental part of the bidding process. It allows organisations the chance to share ideas, convince other of the ideas value, get feedback to improve the ideas and build partnership links that will enable the spread of ideas more effectively.

So my hope is that someone comes up with an idea that makes it easier to get an appointment with a GPs. And a way that doesn’t rely upon us either being dead (or near dead) or well (or at least well on the road to recovery) before we are granted an appointment for our 7 minute consultation. It’s inexplicable to me that this year we have the prospect of 1000 graduate junior doctors facing unemployment as there are too few foundation posts available to allow them to complete their final training. It cost the taxpayer £260,000 to put each of these medical students through university. Most will leave the profession, adding to the problem of anyone getting to see a GP in a timely fashion.

It’s probably just as well that last week saw the publication of 3 more Smart Guides to Engagement. These guides are aimed at everyone working in or with clinical commissioning groups. The guides have been written by experts to provide straightforward advice on all aspects of patient and public engagement in an easily digested format and are great fun to read (well if you like acronyms that is, I have never seen so many in all my life!). You can down load copies from the NHS Institute for Innovation and Improvement website. The one I liked best was entitled Listening, Learning and Responding, and was written by Dr Brian Fisher, who is both a GP and the patient and public involvement lead for the NHS Alliance. I have sent a copy the Smart Guide to my GP.

One other Smart Guide published this week was called Working with LINks (told you they like their acronyms) and Local HealthWatch, which given the news from Berkshire last week could perhaps have been re-titled Working with your Local Hen Watch. Apparently the new big crime wave is chicken theft, particularly from urban back gardens. Said to be a consequence of the recent EU ban on Battery Hen Farms, which has resulted in an exponential rise in the price of a half-a-dozen eggs. Somewhat ironically, the 9 stolen hens that were the feature of the report had all been rescued from the local battery hen farm.

Now as a result of my own personal crowdsourcing survey, I think raising the height of the chicken run fence is not the answer. The answer according to best practice is to locate the chicken house in a place where neither ferrets nor chicken thieves can get to. Inspiration for this is the newly opened swimming pool at the Holiday Inn in Shanghai. This cantilevered swimming pool provides guests with the feeling they’re swimming over the air. The one-of-a-kind swimming pool is located on the 24th floor of the hotel with nothing but a pane of toughened glass and long drop beneath them. For those who are interested the hotel also boasts an 24 hour on call medical care service.

Sunday, 13 May 2012

MBAs, Foucault’s Pendulum, the Price of a Dewclaw, and the Best School!

One of the really good things about working in a University is that among other things, one gets paid to read. Last week I was preparing my profile for our new School web page and in doing this I sat and read my CV recalling that I first went to University in 1992 to study on a part time MBA programme. I graduated in 1995. I recall those three years with great fondness – it was the closest I have ever come to being a university student. And it was Harvard University who in 1908 offered the world’s first MBA programme. Almost 50 years later, the MBA became a recognised award in Europe, with the Institut Européen d’Administration des Affaires offering the first MBA degree, although it took a further 8 years before the Manchester Business School offered the first UK MBA in 1965.

And last week I was reading about the properties of pendulums. Now you might find that strange, but for what can only be described as serendipitous reasons, the concept of the pendulum has featured in many of my communications last week. For example, I was looking at the somewhat polemic papers I had written during those MBA years that explored the notion of countervailing process of power as health care policy gets translated into health care practice. In terms of pendulums, most people will be familiar with Galileos attraction of the shimmering swinging chandelier in the Pisa Cathedral that sparked his work on how the pendulum operated and which became crucial to our notion of how we might measure time.

However, last week I was drawn more to ideas as espoused by Foucault about his concnern over the oscillation properties of a pendulum. Now this Foucault is one Jean Barnard Léon Foucault and not my favourite philosopher, Michael Foucault. Jean showed that the plane of oscillation of a pendulum, like a gyroscope tends to stay constant regardless of the motion of the pivot – his example was the Earths rotation. Being someone who adores and embraces metaphor, I wondered how others might see my oscillations, whether these be in relationship terms or in decision making contexts, and if despite such oscillations (however challenging these might be for others to experience), my self could ever be seen to remain constant.

In these musings I can of course rely upon my four legged companion Cello for an un ashamedly neutral view. Unfortunately, last week Cello had problems with an errant dewclaw (sometimes referred to as a Dogs Thumb). Uncomplaining as ever, it only became apparent that there were problem when Cello cried at being groomed and the brush touched his inner leg. A quick visit to the vet for a consultation (£75) later, revealed a rogue Dewclaw needing treatment. Treatment given (£250) and one seriously fed up little dog later, I was left wondering what it was I had paid for. The Dewclaw, even when removed, can and will grow back! Good business if you can get it.

The best conversation of the week has to be the one I had with colleagues from Libya.

And the 2012 Best School in the University – as voted by the University of Salford Student Union members was...

...School of Nursing, Midwifery & Social Work...

...enough said!

Sunday, 6 May 2012

You’re a Frog! - Not French but German Competiveness, Full Circle with Profits

The College Executive went back to the V+A last week for the first of this year’s regular planning and review meetings. While the sun shone outside we were locked in an airless room for two days working our way through our strategic, operational and academic plans, all of which came with the impossible to read on screen and too big to print off financial spreadsheets. Good progress was made on both days.

At the end of day one, while sipping a fresh lemonade before dinner, (and thankfully the V+A now has a new menu) in walked Nick Hewer of Apprentice fame. The Apprentice is a reality television show in which young business men and women undertake a series of business challenges in a competition where the prize is a £100k job with Lord Sugar in one of his companies.

Nick Hewers role in the programme is to observe one of the teams as they undertake the tasks and then report back on the efforts of the various participants. He is famous for his droll comments, and facial expressions that convey his incredulity, and amazement at the antics of the contestants. But I had thought him to be a good egg despite this make believe facade – after all despite having a house in France, he  also spends a lot of his time living in his native England.

So it was with some surprise that when our eyes met across the room, and I raised my glass in salute he spurned the friendly gesture with a characteristic grimace. I was well and truly snubbed. Interesting to note, none of the 7 winners he helped select over the years, still works for Alan Sugar. I think the makers of the BBC impression programme Dead Ringers probably had it right when they had Sir Alan saying ‘you’re a frog’ rather than the more familiar ‘you’re fired’.

And this week I also met someone who in his time has both fired a number of people, but who has also been passionate about the concept of apprenticeships as an example of how Britain might grow it’s manufacturing base and maintain its competiveness on the world stage. Michael Ray Dibdin Heseltine (Lord Heseltine) delivered this month’s VC Lecture. He was a major force in British politics for a considerable number of years. Now retired, and not looking anything like his 78 years of age, he is a self made millionaire, a keen gardener and passionate arboriculturist as well as still contributing to British political life.

He was impressive, and delivered a captivating paper on how Britain might regain its competitive edge. Interestingly, he cited the German experience as something we might want to consider. In Germany, there are proportionally fewer Universities per head of population than in the UK. What they do have are a much greater number of technical colleges (Fachhochschulen) that produce legions of well educated workers able to meet the German manufacturing industry needs for a skilled workforce.

It these institutions that provide the educational underpinning to many German apprenticeships and these days the Fachhochschulen also undertake research projects which are usually sponsored by industry. Lord Heseltine wondered whether the British Higher Education system might better serve the needs of industry by developing stronger partnerships between the private and public sector, and producing graduates able to more effectively deliver a workforce capable of increasing the UKs competiveness.

I remained open minded about this, and in any event it’s probably important to be keep at least one wary eye open around such developments. This week it was announced that the UK Government is to allow Circle to keep the first £2m of its ‘profits’ from running Hinchingbrooke Hospital in Cambridgeshire. In Febuary 2012, Circle became the first private firm to be enabled to run a NHS hospital, a hospital that currently has £40m worth of debts. Its nice business if you can get it.