Sunday, 29 December 2013

Last Words as 2013 changes into 2014

I'm on my Christmas holidays. Christmas Day was spent with family. Christmas dinner was a Cashew and Mushroom Layered Loaf (there was turkey for those that just had to have it). Then Boxing Day it was up to the House in Scotland. It was a nightmare journey; ice on the roads and that winter sunshine that is just too low in the sky as you drive. The further North I got the stronger the wind became and then the rain started to pour.

Driving down the hill that leads into the village I was surprised to see there wasn't a space to be had in the Village Hall car park, or a table at the Anchor Hotel bar. Despite the gale force winds and driving rain, the whole place was busy with families, groups of friends and there were dogs everywhere.  Someone had even parked their car in front of Mary’s cottage, strictly verboten in the unwritten but usually carefully adhered to village rules.

On the day after Boxing Day, Friday, there wasn't a soul to be seen. The road, beaches, woods and by ways were completely deserted. I twice walked Cello and didn't see a single person. The village had returned to its quietness and the simple twice daily movement of the tide coming in and the tide going out again. As 2013 draws to a close it’s a time for reflection, and for me this is a wonderful place to be, and to be able to sit and contemplate the passing year and to think about ambitions for the future.

However I know that others were finding themselves in very different places – much of the South of England has been battered by damaging storms, and many families still have no power or heat, a situation they have been in since Christmas Day. Here in Scotland, like in many other parts of the UK, over 2000 food parcels were handed out over the Christmas period, 1200 meals prepared for people in homeless shelters, and just under 200 people sought help over a 4 hour period at a winter destitution ‘surgery’ held by the Glasgow based charity, Positive Action in Housing last week. They wanted help with crisis payments, clothing, food and bus passes to get them through the Christmas period. As the Christmas snows fall in war torn Syria, an estimated 3.1 million children have little food or shelter, and more than 1 million children are now living in refugee camps. Oppression of peoples basic human rights continues in many parts of the world. I had an email from a colleague in China yesterday. She can read the VCs Blog, but not this one.The China Government have banned access to it!

Seeing or hearing of other peoples suffering often causes emotional pain and can give rise to empathy, an element of caring and compassion that is sometimes clouded by unconscious notions of guilt when there is nothing that we can seemingly do to help or relieve the suffering of others. 2014 will be my 7th year as Head of School. I once had a clear 10 year plan for the School which was about more effectively preparing nurses so they could better able to help others help themselves. Over the years this plan has been renewed and re-constructed as the School has grown and the challenges have changed. My Christmas contemplations will include how as a School we can continue to help others to more effectively help themselves. Many thanks to all of you have supported me by continuing to read this blog over the past year. I wish  you and yours the very best for 2014.

Sunday, 22 December 2013

Some Things that Matter to Me on the Sunday before Christmas

Last week was full on with everyone trying to get themselves sorted before leaving for their Christmas break. I had back to back meetings from start to finish almost every day. There was often little time to stop and think, and that mattered to me. In fact, last week there was quite a lot that mattered to me.

Hearing that my long term friend from Finland was working his last week, and retired on Friday – and that he had finally done so and with happiness in his heart mattered to me. Hearing that my friend from Holland had her hip operation postponed again and thus leaving her in pain and lacking mobility, mattered. Enjoying catch up meals and or a glass of wine with friends here in the North West, and hearing all their news, sharing time together, exchanging gifts, good and bad news, smiles and laughter, all mattered to me.

Being able to sort out student bursary problems, lost exam papers, and a chance to re-submit failed work before students settled down for their Christmases, mattered, to them and to me. Seeing the smile of relief on the young man sitting opposite me on the late night train from Manchester, his relief was a consequence of  knowing he was finally on the right train and going home, mattered. 

Hearing favourite Christmas carols and songs in the shops, bars and radio, seeing the twinkling lights, smelling hot chestnuts roasting on the street stalls, smelling cinnamon candles burning in the house, tasting the mid-morning mince pie, seeing the smiles on colleagues faces at the School Christmas do, all of which mattered to me.

On Friday I met with colleagues from the Salford Clinical Commissioning Group (CCG). The CCG was one of the 200 organisations that are responsible for commissioning almost £70 billion worth of health care services, provided in both hospital and the community. I was there to discuss how the University could help them with their work in transforming health and social care for the people of Salford. 

They were person centred in everything they did and thought. Their approach to providing health and social care was predicated on a very simple, but what I thought was a very special thought: moving their approach from concentrating on ‘what’s the matter with you’ to better understanding ‘what matters to you’. They were people after my own heart.

And I hope that you all have a very merry and relaxing Christmas! 

Sunday, 15 December 2013

Challenging Conventional Wisdom while Enjoying a Cheese and Opinion Pie!

Last week had a slightly ‘Ground Hog Day’ feel to it. One recurring theme was the National Student Survey (NSS). In the company of others I spent time looking back at last year’s results and forward to the next NSS, due to start in January 2014. Every year since 2005, Ipsos MORI conducts the NSS. The survey provides an opportunity for students to feedback on their experiences of study at their University. The results are important as these are published and used by students (and possibly their parents) in selecting a University to study at.

The results are also important as they contribute to where each University is located on the various national and international league tables that describe the quality of research, education and employment prospects of graduates. High performing institutions will attract both high performing students and academics. Interestingly in a study published last week by the London School of Economics, they noted the benefit of individuals who were high performing, rather than the institutions they studied at.

The LSE study was looking at primary children and not University students however. Their study involved 2 million children, and was conducted across all types of primary schools. The study found that being seen as a high flyer in a primary school, regardless of the child’s actual ability was a strong motivator for their performance in secondary school. Boys were 4 times more affected by being top of the class than girls. The suggestion that pupils benefited from being top of a weak class, rather than being middle ranking in a class of high-performing children really does challenge the conventional wisdom that children will do better if pushed into a higher performing peer group.

And in a week where I was being asked to report on the number of 3* and 4* quality publications each of my colleagues had published in the last quarter, I was interested to read of someone who was also challenging conventional wisdom. This was the Nobel Prize Winner Randy Schekman, who last week claimed that leading academic journals are distorting the process of science and represent a ‘tyranny’ which must be broken. He has declared a boycott on such publications. Schekman, a US biologist who was presented with the Nobel prize in physiology or medicine last Tuesday said his laboratory would no longer send research papers to the top-tier journals, Nature, Cell and Science.

He also attacked the widespread metric called an ‘impact factor’ used by many top-tier journals. A journals impact factor is a measure of how often its papers are cited, and is used as proxy for quality. Schekman said the 'impact factor' was a toxic influence on science and introduced a distortion – a paper can become highly cited because it is eye catching, provocative or wrong.

I went out last week to one of my favourite restaurants (Albert’s Shed) for what I had hoped was going to be a meal with a high impact factor, a meal I thought was both eye catching and provocative. However, I was wrong. My favourite starter, asparagus, with a poached egg covered in bread crumbs, was off the menu. My favourite main course, a cheese and onion pie, was on, but to be frank, it simply wasn't that good. I was disappointed. Telling a friend the next day, I mistakenly wrote ‘cheese and opinion’ pie, which more closely described the second cheese and onion pie I had later on in the week at Chancellors.

I was there with other Heads of School and Deans from the North West, and we were meeting with Laura Roberts, the Managing Director of Health Education North West. This is the organisation responsible for spending over £700,000 million a year on educating and training health care professionals in the North West. It was an interesting conversation, made so by colleague’s willingness to offer and debate their thoughts on the challenges facing health care educators. I also found out that Laura and I once had the same mentor and ‘rabbi’, the wise Bill Sang, someone not shy of challenging me or conventional wisdom. And the cheese and onion pie, well it was just exquisite.

Sunday, 8 December 2013

Moved by Memories of South Africa

I was half thinking about focusing today's blog on the news released last week about the performance of many of our ambulance services. The headline news was that ambulances are taking longer to get to the scene than they did in the previous 2 years. The rise in time taken was worse in the East of England where it was taking 90 seconds longer than this time last year. The national target is to be on site within 8 minutes. It seemed really important, and it is in the context of our lives in the UK.

However, as I drove to work last Thursday the headline news was of Nelson Mandela’s death. I have been to South Africa a few times.The news of his death prompted a number of memories and thoughts. One thought was what on earth people living in the Soweto Townships for example might think about my focus on ambulance response times.

In 2004, I was invited to present a paper at the 1st Regional Congress of Social Psychiatry, hosted by the World Association for Social Psychiatry. The conference was held in Johannesburg. It was an interesting experience. I was there with 2 colleagues from the University of Leeds and 1 colleague from the University of Newcastle (Australia). The conference was located in a hotel complex very close to the airport. In fact I could see, feel and hear the planes taxiing to the end of the runway from my bedroom.

The hotel, once you got inside, was a completely artificial environment akin to the hotels in Las Vegas. The roof was painted with clouds, there were cafes with outside seating areas, that were really still inside, and lots of casinos, all of which had a sign at the entrance asking customers to deposit their guns at reception! It was quite a place. While there we were able to visit the surrounding area, which was full of signs of the past.

The Sowato (SOuth WEstern TOwnship) township was still there. This township was the scene of the Soweto Uprising in 1976, when there were mass protests over the South African governments policy to enforce education in Afrikaans rather than English. The police response was to fire on the protesting students and some 23 people died on the first day of protest. Those killed included Hector Pieterson, a 13 year old school boy. The picture of the dying Hector being carried away from  the riot became the iconic image of these protests, which finally moved the international community to introduce economic and cultural sanctions.

I was also able to visit Nelson Mandela’s house, which is now a national museum. It felt very much like a privileged experience. I did get to sit on his bed, which felt rather like sitting on Freud’s couch (which I was forbidden to do when I visited Freud’s house in London). Nelson Mandela was an anti-apartheid revolutionary, and politician who spent 27 years in prison after being sentenced to life imprisonment in 1962 for conspiring to overthrow the government. An international campaign eventually secured his release in 1990.

In 1994, he became the first black president of South Africa. During his 5 year term of office as president, his government successfully started the process of tackling institutionalised racism, poverty and inequality, and promoting racial reconciliation. He reminded us all that: ‘what counts in life is not the mere fact that we have lived.  It is the difference we have made to the lives of others that will determine the significance of the life we lead’. He really did make a difference to so many people, and not just those living in South Africa.

And if you do happen to live in South Africa, you might be pleased to know whilst there are no official ‘responses times’ in the South African Ambulance system, a response time of 15 minutes is usually achieved and seen as being acceptable. 

Sunday, 1 December 2013

Plain speaking (not wrappers) needed if we are to become a Non Smoking University

This week I attended my first Trust Board meeting as a Non Executive Director, at Wigan Wrightington and Leigh NHS Foundation Trust. It was an interesting and illuminating experience for me. The meeting is split into two parts, a public section and a private section. The first section was by far the longest, and the issues and reports presented varied and often complex. It occurred to me while reading the papers in preparation for the meeting, and there was plenty to read, just how complex balancing out the provision of health care services is with the promotion of healthier life styles.

One of the reports I read, noted the successes and challenges arising from the WWL decision to support the Public Health England Stopober 2013 Challenge which was aimed at helping patients and staff to stop smoking. A variety of supportive approaches were available to staff and patients who wanted to give up, and there was also a drive to challenge people seen smoking in the grounds. The latter is a difficult thing to do. And nurses in particular, are not that good at either setting an example or helping others to make better life choices around smoking (see Warne T., and McAndrew S., Health promotion and the role and function of the nurse. In: D. Whitehead and F. Irvine (eds) 2009Health Promotion and Health Education in Nursing: A framework for Practice, Palgrave, London).

This is a situation that has not changed since I wrote that book chapter. Indeed, in 2012, some 14% of adults in managerial and professional occupations in the UK (such as medicine and nursing) smoked. Smoking is the biggest cause of cancer in the world. Around 50% of the 10 million people who smoke in the UK will die of a smoking related illness if they continue to smoke. Sadly, despite it being illegal to sell cigarettes to anyone under the age of 18 in the UK, every year more than 200,000 children aged 11 – 15 start smoking.

Also sadly, some 63 years after Richard Doll first showed that there was a direct link between smoking and lung cancer, the UK Government is only now considering selling cigarettes in plain packing. In an announcement last week, the current UK Coalition Government pledged to bring forward legislation that would see all cigarettes being sold in plain white packaging or in packs bearing challenging health warnings by May 2015.

Come on, more than 34 million working days are lost each year because of smoking related sick leave and over 100,000 people a year in the UK die each year due to smoking. To put it another way that is 275 people a day that die from smoking related illnesses. Today is the 1st of December. Christmas day is now 25 day away or 6875 smoking related deaths away. Indeed by the time you read and get to the end of this blog, 5-6 people will have died from a smoking related illness. The situation is even more of a worry depending on where you happen to live in England.

I am writing this blog posting as an ex-smoker. I've not smoked for years now, and feel much better for giving up, have more money in my pocket and now have an almost evangelical zeal to help others to stop. My NHS pledge is to try and make the University of Salford the first non-smoking university in the UK before I retire - and the clock is ticking.

Sunday, 24 November 2013

The Royal Road to Coincidence: or going to London to see the Queen

My young grandson Jack likes to know where people are and what they are doing. So every day he asks if I am going to work, and will I be travelling by car, train or plane. I don’t have a private Lear Jet, but he is fascinated by the planes he sees flying in the sky. He knows that occasionally I am up there in one, on my way to a different country on behalf of the University. On Tuesday I was due to travel down to London for a Council of Deans Health Executive meeting.

I'm not normally mischievous but when little Jack asked what I was doing I said I was catching a train to London, 'why?' he said, 'to see the Queen' I replied. He seemed satisfied with this and apparently told everyone else he met during the day that I was on a train to see the Queen. I am not sure he really understands who the Queen might be, I strongly suspect in his mind the Queen is akin to the Man who Lives in the Moon, someone Jack also talks a lot about. For him it was enough to know I was travelling on a Royal Road.

I found the Council of Deans of Health meeting interesting and very enlightening. One of the policy advisor's to join us during the day was Andrew Boggs, from the Higher Education Regulation Group. In his softly spoken Canadian accent he carefully took us through the new regulatory landscape for UK University's. This might, to many people, seem a very uninteresting subject, but actually, Andrew brought it to life in a way that was completely the opposite. He also introduced into my lexicon the notion of a Rosetta Stone.

I didn't know what a Rosetta Stone might be, a quick Google later I had one of those 'Ah ha' moments. The Rosetta Stone is an ancient Egyptian granodirite stele inscribed with a decree issued in 196 BC on behalf of King Ptolemy V. In this case, the stele was a donation stele, which granted a tax emption to the resident priesthood. Securing the favour of the priesthood in this way was essential for the Ptolemaic kings to retain and effective rule over the people. You might want to come to your own decision about what Andrew was hinting at.

For me, the conversations started a memory train that went back to 2007, when I and a colleague published a paper entitled 'Passive patient or engaged expert? Using a Ptolemaic approach to enhance mental health nurse education and practice' - the paper explored the need to reclaim a patient centred approach to providing mental health nursing care - yes we were possibly ahead of our time. 

And in a strange kind of way, hearing Andrews words, I was also drawn once more to think about the Ptolemaic Dynasty. Ptolemy V personally sponsored the work of the great mathematician Euclid. However like me, he found Euclids seminal work the 'Elements' difficult to understand. Allegedly it's said the Euclid responded to Ptolemy asking him whether there was an easier way to master Euclid's work with: 'Sire there is no Royal Road to Geometry'.

A second 'Ah ha' moment - it was Freud, who described dreams as being the Royal Road to the Unconscious - Freud's work has been very influential in the development of my view of the world. The interpretation of Freud's work by other people has also often captured my imagination. For example, Simon Morris and 78 of his students cut out every word from Freud's 736 page book 'The Interpretation of Dreams' (which including the index ran to some 333,960 words). They scattered all the cut out words from a car travelling at 90 mph and then recorded the subsequent array of words. The resulting analysis, does, in my opinion,  describes a world reminiscent of 'the Man on the Moon, meets the Queen, while driving on the road to London'. 

Sunday, 17 November 2013

Getting to the heart of the matter: Compassion in Cardiac Care

Yesterday was a long day. At 07.00 I caught the first plane out from Zagreb in Croatia, to Frankfurt, and then onto Manchester Airport. I had a quick shower and change of clothes at the Bolton House. Then it was driving up the road to the quintessential English Village of Hornsby for afternoon tea, and wedding planning with youngest son and future daughter-in-law and her parents. A few hours later it was up to the House in Scotland for a house warming with friends who have just moved into their home in the village.

I was in Croatia at the invitation of the Croatian Cardiac Nurses Congress, a member of the European Society of Cardiology. I was to speak at their conference – my paper explored what ensuring compassionate cardiac nursing care might involve – which I think involves bringing together the theoretical and practice based knowledge nurses have, with patient experience knowledge and valuing these equally in our relationships with patients, carers and our colleagues. A lively and collegiate discussion followed the presentation. It felt good to be in the company of such committed and passionate colleagues.

I was also able to meet with the President of the Croatian Nursing Council, Dragica Simunec, who has written much about the development of nursing in Croatia. She was someone whose ambitions for the future development of nursing were matched by her actions. I hope both our Schools will be able to work towards achieving a better future for nurses in both countries.

The final meeting of the trip was with Professor Davor Milicic, Dean of the Medical School at the University of Zagreb. The University which was founded in 1669, is one of the oldest University’s in the world, and has over 52000 students studying programmes in 31 different faculties. The Medical School was founded in 1917, and amongst other programmes has a full medical education programme which is taught entirely in English. The medical school is consistently in the top 10 medical schools world wide.

It was a wonderful experience from the moment I arrived at Zagreb (which was much later than planned due to the world renowned efficiency of Lufthansa Airlines) and entered my hotel room to find a magnificent array of welcoming gifts, to the kindness of the night porter who at 04.30 yesterday morning (03.30 GMT) sorted out a cup of tea for me while I waited for the taxi. Thanks too, to the patient who agreed I could watch her coronary angioplasty - a first time experience for me, and a profound one too. I am very much looking forward to going back there, but right now I am looking forward to turning my computer off and enjoying a long luxurious lay in this morning! 

Sunday, 10 November 2013

The Nurse who Came In With a Cold: recharging the batteries

Last week was a study in human endurance. OK, OK, that’s possibly a slight exaggeration. Those who read last week’s blog might remember that I was suffering with a bad cold (not flu). Well said cold went straight to my chest. Like a REF Impact Case Study, there was a direct line of connection between my bad cold and near bronchitis. By the Monday I was coughing and spluttering and totally incapable of doing anything that required sustained effort. Cello was not impressed with his shorter than normal daily walks!

This, as it turned out, was a good thing. I was on week’s holiday at the house in Scotland. Had I not been feeling so rough, I am sure that despite being on holiday I would have looked at emails, tweeted on Twitter, and over used my smart phone and in so doing wrecked any chance of enjoying any down time. I have always admired those folk who can go off for a fortnight’s holiday somewhere, leaving work way behind.

So instead of moving my office to Scotland I left the lap-top in its case, the iPad unopened and turned the sound off on my phone. And strange as it might sound, in-between the running nose, pounding headache, hacking cough, shivers and generally feeling miserable about everything and everyone, I actually started to feel better in myself. 

As I said, I couldn't face long walks, but loved walking along the shore and through the woods with Cello. On one afternoon I was fortunate enough to see an otter playing, swimming, fishing and eating along the front as the tides turned. On another morning I went along to the local Ladies Guild Christmas Fair at the local Village Hall. Over indulged with the most delicious home made scones, cream and strawberry jam, and got brought up to date with the village gossip (shades of vanilla rather than grey!). I didn't win a raffle prize though.

Tuesday night I was able to watch the local firework display from the comfort of my lounge. Although the village firework show wasn't as ostentatious as the Sydney Harbour displays we have come to marvel at, it was as little Jack my 2 year old grandson said, ‘awesome’ nevertheless.

By the end of last week I was feeling much better physically, emotionally and more relaxed and refreshed. I know that later on today I shall have to open that in-box and tackle the emails and possibly by the middle of the working week my recharging week in Scotland will seem like far distant dream. However, I will remember in future to leave my computer and desire to stay in touch with work at home the next time I have a holiday. Roll on Christmas! If you want to create a better life for yourself and perhaps are thinking where in the world might you find this, try this wonderful guide – you might be pleasantly surprised

Sunday, 3 November 2013

Ones Flu over the Chickens Nest, and a Vision in Blue

As last week drew to a close, I felt increasingly unwell. My grandson Jack had been suffering with a cold all week, and I guess I had caught it from him. While he is getting better, I found myself spending the first 48 hours of my holiday with a pounding headache, dry persistent cough, and sucking pastilles for a raging sore throat, and generally feeling very miserable. But thankfully, I am sure it’s just a cold (a bad one mind you) and not flu.

The national flu vaccination campaign is in full flood, with ever increasing numbers taking this up. All children between the ages of 2 years and 16 years old should receive it every year. The injected flu vaccine contains inactivated strains of flu virus and doesn't cause flu. The flu vaccine is often grown in fertilised hens eggs, although egg free vaccines are available for those with an egg allergy.

Scariest hen and flu story this week was definitely that published in the Lancet regarding poultry markets in China. The story showed that these live poultry markets created a huge flu reservoir  and that following closure of some 800 such markets across Shanghai, Huzhou, Hangzhour and Najing, the number of new H7N9 bird flu cases dropped by 97%. There have been 137 cases of H7N9 bird flu deaths according to the WHO, and most of which were in the months immediately after the virus was found to be moving away from infecting animals to infecting people. 

My chickens live in the back garden. They have never been to China, and I have never heard them as much as have a sneeze. Chickens are good for the garden, and the older one becomes, gardens, so it seems are good for us.  A Swedish study published  in the British Journal of Sports Medicine last week showed that for people over the age of 60 fixing the car, doing home repairs, cutting the lawn, blackberry  picking or going hunting could reduce the risk of a heart attack or a stroke by 27% and death from any cause by 30%. 

I do like gardening and like seeing my hens pottering about. And in a week where I joined other colleagues to test out our University Vision I was struck by the near Wittgenstein like thought (‘roughly speaking; objects are colourless’ Tractatus Logico-Philosophicus) contained in a Tweet sent last Friday which posed the question as to how people who are blind pick their socks. Its a serious and fascinating question where it seems technology is coming to the rescue, well at least in part. Technology can tell us it’s a pair of red socks, but how do we know what red means either physically or emotionally? Me, well I know right now my cold is making me feel very blue! And at 05.00, do I take the night nurse or day nurse tablets?

Sunday, 27 October 2013

Finland Bound: [Going] Back to the Future

Yesterday morning I flew into a grey, wet and windy Manchester. I was amazed that it took just 10 minutes, as we came into land to go from sunshine so bright it makes your eyes hurt to the greyness of the wettest day imaginable. Not that my spirits were dampened on this occasion. I had just spent a couple of days with some incredibly creative and welcoming people, and had a visit from my youngest grandchildren to look forward to later on in the day.

The people I had spent the last couple of days with were from Saimaa University of Applied Sciences, located in Lappeenranta, the 13th largest city in Finland. This was not a trip I had planned. My boss was due to go there and arrangements had been in place for some time. However, she was unfortunately taken ill, and on Tuesday it became clear she would not be able to travel. After a conversation with my VC it was decided that I would go in her place and travel out the following day.

However, Wednesday proved to be a long day. I had a great meeting with colleagues from the pre-registration nurse teams. It was an opportunity to re-affirm my personal pledge to regularly experience every aspect of our Schools activity, from being in a classroom, to practice, and all things student focused. There were also some positive and constructive HR meetings aimed at working towards changes in the School. The last meeting of the day was an extraordinary meeting of the University Senate. This meeting provided an opportunity to discuss our new University Strategy.

Then it was a dash to Manchester Airport to take the 18.30 flight to Helsinki. The flight takes only 2 hours, but as Finland is 2 hours in front of the UK it meant I arrived at 22.30, tired and wanting only to climb into bed and sleep. However, it was a single room with a single bed. I can’t remember the last time I slept in a single bed, and it certainly wasn't last Wednesday!

The following morning it was on a train to Lappeenranta. I travelled with 3 colleagues from Saimaa University. They had been at a meeting in Helsinki. The 2 hour journey passed so quickly and the discussions were rich in content, humour and focus. Once in Lappeenranta it was a quick change before taking a tour of the facilities at the Skinnarila Campus. This is a new purpose built campus, just 2 years old and located right at the shore of Lake Saimaa. It was a fantastic setting, and the facilities were first class.

Dinner that night was an opportunity to discuss potential collaborations between our Universities and in particular, inter-disciplinary teaching and research. We ate at the Restaurant Wanha Makasiini, a great venue, perhaps a tad short of vegetarian options on the menu, but with a wine list that more than compensated this. Later, I spent an hour playing catch up with emails and Twitter conversations, many of which involved colleagues from across the University of Salford interested in being part of any future collaborations.

Friday morning was spent meeting a range of practitioners engaged in putting concepts of integrative care into practice. They had been across to Salford Royal Hospitals to find out how they were doing it. I was impressed with the way they were taking forward integrated health and social care services, particularly in the rural and remote areas of Eastern Finland. I was also treated to a whistle-stop tour of the South Karelia Emergency Health Care service – a different scale to many UK services with just 50,000 attendances a year compared to just fewer than 100,000 patients a year in somewhere like Wigan, Wrighington and Leigh NHS Trust.

The reminder of Friday I was engaged with a series of meetings looking at potential research focused links and opportunities for future collaboration. And by late Friday evening I was back in Helsinki reflecting on what had been a very hectic, but rewarding 2 days. I have been visiting Finland for at least the last 15 years, and I have to say this was one of the best visits ever. I am really looking to going back in the future and developing our relationship with colleagues in Saimaa. 

Sunday, 20 October 2013

A TV Snip, Sunrise, Sleep, and a Letter to Father Christmas

Last week was an amazing week, or rather a week of amazing experiences and encounters. Some of which I witnessed from afar. For example, watching Dr Doug Stein perform the first vasectomy live on Australian TV to launch the inaugural World Vasectomy Day. This was said to be the world’s first vasectomy-athon with 184 doctors across 25 countries signed up to perform 1000 vasectomies over a 24 hour period.It was organised as part of a global campaign to address population, freedom of choice, family planning and sustainability of the planet.

Other experiences were a multi-sensory delight. There was the Birthday Cakes in the shape of ice cream cornets baked by a friend for Jacks 2nd birthday, delicious to look at and eat. That sun rise on Wednesday. I was stuck on the M62 on my way to Liverpool and a Council of Deans of Health meeting. I was stuck in traffic feeling fairly miserable when the sky was lit up by the deepest red you had ever seen. Over the next 20 minutes the sky line was transformed into a glorious riot of reds, oranges, and yellows. I tried taking a photo but failed completely to capture the experience.  

Possibly I was feeling a little miserable on that morning, because I had enjoyed sufficient sleep to be completely brain washed. Nancy Schimelpfening (what a delightful name) reported in last Tuesdays Las Vegas Guardian, (to my mind a more interesting paper than the British version) on the paper published in the journal Science on the work of Dr Maiken Nedergaad. He, is the co-Director of the Centre for Translational Neuromedicine, in the US. His study looked at the glymphatic system in the brain which he has discovered, cleanses the brain of toxic molecules while we sleep. The results of the study could have implications for the treatment and prevention of several neurological disorders including some of the dementias.

However, I was probably feeling miserable because I was sitting in my car travelling at a snail’s pace rather than at the speed of light, and such inactivity doesn't suit me. Actually inactivity of any sort is not a good thing for us. Physical inactivity has shown to be the principle cause of a number of health conditions including 13% of Type 2 diabetes, 18% of colon cancer and 17% of breast cancers. Doing something as simple as taking a daily walk could prevent 36,815 people dying prematurely from such diseases. Life changing steps to be taken indeed.

Not taking enough exercise, could be one reason why like me, some people have difficulty getting enough sleep. Other reasons might also include drinking too much alcohol (not one that applies to me), disrupted circadian rhythms, stress and of course, an uncomfortable bed. The most comfortable bed I've ever had was a water bed. As these were all the rage in the late 1960s and early 70’s younger reader may not know what these were. Essentially the bed was one giant mattress filled with heated water that fitted into a wooden frame.

I think they went out of fashion very quickly, but now I have found the modem day version of the ubiquitous water bed. It’s called the Exbury Egg (look here) Exbury Egg, and I so want one for Christmas. There are only 65 days left until Christmas Day. So yesterday I got out pen and paper and wrote my letter to Father Christmas. I told him I had been good all year, and after all, I did stop contributing to the gene pool some 30 odd years ago. 

Sunday, 13 October 2013

An Alphabetti type Week spent in almost Parallel Universes

My Outlook Calendar regularly becomes littered with acronyms and abbreviations describing what it is I am to do. For example, the week started with an OMG (Operational Management Group) meeting with the Schools Directors, quickly followed by a EMB (Executive Management Board) strategic planning day. Late afternoon it was agreeing the CRaIC College Research and Innovation agenda, and that was Monday. Tuesday, it was a day of back to back meetings, including  preparing for a FfPP (Fitness for Professional Practice) Appeal and a FfPP Panel hearing to be heard later in the week.

Wednesday I had to make my apologies to the GMW (Greater Manchester West NHS Mental Health Trust) Members meeting as the HCPC (Health and Care Professional Council) and TCSW (The College of Social Work) were starting the first of a 2 day approval visit for what was to be the third SU3 (Step Up – Social Work 3) programme. By Thursday we learnt we were going to be recommended for approval by the HCPC and endorsed by TCSW and we were going to do so on the back of such good feedback from students on their experience, and employers because of the high quality newly qualified Social Workers they were able to employ.

Friday and we had the HENW (Health Education North West) ARM (Annual Review Meeting). The ARM is an occasion to see if the School had met the quality assurance targets set by the HENW for our NHS (National Health Service) commissions - and we had! Again it was wonderful to see and hear the reports from our students who found their lecturers inspirational, motivating, and supportive.

So things were going well. And then I came across the news from the former NHS CMO (Chief Medical Officer - Sir Liam Donaldson) that doctors over the age of 55 are 6 times more likely to give rise to major performance concerns. In fact 6179 doctors had caused concern over the last 10 years according to Donaldson. Male doctors were twice as likely as female doctors, particularly those working obstetrics, gynaecology, and psychiatry, to be referred to the NCAS (National Clinical Assessment Service).

Now I was totally confused. I thought the report was about the recently formed NCA (National Crime Agency) - the British equivalent of the FBI (Federal Bureau of Investigation). I wondered what on earth they were doing getting involved with the performance of doctors? Well I guess that one explanation might be that as far back as 2000, Dr Richard Smith, the then Editor of the BMJ (British Medical Journal) reported that up to 30,000 people a year in Britain die of medical errors with many more people being injured and suffer other consequences.

The president of the GMC (General Medical Council) at the time, Sir Donald Irvine said it was a complete fallacy to think that doctors should be expected never to make mistakes – and that as medicine is a judgement based discipline, it is inevitable that mistakes will happen. Of course, on this occasion the mistake I made was confusing the NCAS with the NCA (and what is an S between friends?) – however it’s possible to see how such tiny differences in understanding, perception or experience, can lead to at best confusion, and at worse, utter destructiveness.

Last week, in a parallel universe that is my world as Head of School, I experienced a little of this. It wasn't a good place to be. However, taking a step back, I was reminded of my long term desire to show unconditional regard to others by recalling the words of one of my all-time favourite poets T S Eliot – in his book the Cocktail Party, he noted that: ‘half the harm that is done in this world is due to people who want to feel important. They don’t mean to do harm; but the harm does not interest them. Or they do not see it, or they justify it because that are absorbed in the endless struggle to think well of themselves’.  Today, thankfully, marks the start of a new week. And a big thank you to all of you who chose to read my Empathy blog - you have truly helped spread the word in such a magnificent way.