Sunday, 27 December 2015

Three little boys travelling to infinity and beyond!

Boxing Day has never been a particularly good day for me when it comes to travelling up to the House in Scotland. I have driven in icy conditions with cars slipping and sliding off the road in front of me, and on one occasion, due to traffic congestion, it took nearly 5 hours to do a journey that should take half that time. Yesterday was no exception. The weather was atrocious. Early morning torrential rain meant that I was soaked just taking Cello out for his early morning walk. By the time the car was loaded I was soaked for the second time. The motorway was awash with water, and the journey was a difficult one. It was so unlike Christmas Eve.

Christmas Eve was blue skies, the kind of skies that seductively make you want be outside, to walk to skip and just enjoy being in the fresh air. The fact it was the end of a December was a special bonus. Part way through the day I realised that I didn't have any fresh orange in the fridge. Orange juice, that is, to make a Christmas Day morning Bucks Fizz. I had 2 boys aged 4 years and 18 months old, both in need of some exercise. As we had been cooped up inside because of the rain, which had finally stopped, I thought it might be a good idea to get out for a walk. So with my youngest daughters warnings of ‘keeping the boys clean’ ringing in my ears, off we set.

Rather than walk to the local supermarket, a good 20 mins brisk walk away, I thought we would walk up the road to the local corner shop, a mere couple of hundred yards away. Now I don’t know what it is about small boys, dressed in their best ‘bib and tucker’ and puddles, but both Jack and Harry seemed magnetically attracted to every puddle along the way. We had only been going for a few minutes when Harry resembled the Dr Foster of the children’s rhyme, sitting in a puddle right up to his middle.

Now the one good thing about being a grandparent is that you never really get into serious trouble as far as the grandchildren are concerned. Whatever happens it all eventually comes down to the slightly exasperated exclamation of ‘Granddad!’ And so it was on Christmas Eve, when the 3 of us got back to the house, orange juice safely in hand but looking rather wet and dishevelled. There was a slightly forced smile, a cry of  ‘Grandad!’ as the boys were whisked away to be dried off and changed. 

It was ironic really. In the last few weeks, here in the North of England, it’s been, as Samuel Coleridge wrote in his epic poem of the Ancient Mariner ‘water, water everywhere, nor any drop to drink’. The journey up to the House in Scotland was punctuated by news reports of how folks Lancashire were being affected by the non-stop torrential rain. Floods were wide spread, and as I sped up the motorway towards Scotland the evidence was plain to see. 

My heart went out to all the people whose lives would be impacted by the rain and floods, as it did to all those people where water is not freely accessible on a daily basis. It was a humbling couple of days. The contrast of the boys splashing in a carefree way through puddles, me turning a tap and enjoying a piping hot shower, and later, pouring a little water into my evening whiskey, with those without water or those experiencing too much water, was stark. 

The next time I write my blog will be 2016 – and I'm hoping next year, whatever the weather brings, will see me working for a fairer more less unjust world. This is me signing off for 2015 – and wishing you and yours well for the next 12 months, and to infinity and beyond! 

Sunday, 20 December 2015

Time for today’s prize winners, but thinking about tomorrow's winners too

One of the things I really enjoyed last week was being part of our School Prize Winners Celebration. Friday morning saw nearly 90 people assemble to celebrate the extraordinary achievements of students from across the School’s range of programmes. All students who graduate from the University have achieved something special, and something to be proud of. This was a group of students, who for a variety of reasons were ‘best in their class’. It was wonderful to see both my colleagues, the students, and their families shared pride and enjoyment in celebrating their success.

In introducing the event I talked about the wider successes the School has enjoyed over the past year. Our research income, the awards students and colleagues had been given for their contribution to services and/or the professions. I also talked about the changing world many of our graduates will now find themselves in. For example, colleagues from the School make a major contribution to the work of our Institute of Dementia, working at developing news ways to help people to live well with dementia. The nature of health and social care services is changing in terms of how, where and by whom they are provided. Preparing our students to shine in such a turbulent environment is something my colleagues are very, very good at doing.

Many of my colleagues will be familiar with the ‘Devo Manc’ and ‘Northern Powerhouse’ devolution initiatives here in Greater Manchester. But like me, I guess many will have been surprised at the announcement made last week at the Great Ormond Street Hospital, of a devolution deal for London. In Manchester the proposition is to work towards a £6bn budget for the provision of integrated health and social care across the region. Plans for London also look to integrate primary and secondary care, but will do so through the establishment of 5 pilots across the capital. Watch this space…

Change is definitely in the air, and strangely some of these changes have a rather familiar feel to them. Last week I spent some time finishing off our School Operational Plan for 2016/17. One of the initiatives we are planning for September is the development of an Associate Nurse programme. Amazingly, before the ink had barely dried on the page, up steps Health Minister Ben Gummer to announce the introduction of a new nursing associate role. The ambition is that 1000 nurse associates will start their training in 2016.

Was I spitting feathers at this apparent hijacking of my ideas? – Not at all. I have been developing this idea for a while and wrote about the need to develop the Associate Nurse role in one of my blog posts back in September. I was also privileged to take part in a thought leadership round table event in October with colleagues from around the 4 countries of the UK, the NMC and with Lord Willis. I was able to share my thinking over the development of Nurse Associate role. Already there is much debate as to whether we are diluting the role and achievements of our graduate nurses, and are we returning to the two tier system of Enrolled and Registered Nurses. I refute both contentions and absolutely see this role as a new, necessary and important new entrant to the health and social care workforce. However, as I noted in regard to the plans for London devolution, we will have to watch this space. 

This is my last blog posting before Christmas 2015. Whatever your plans might entail, I hope all readers of this blog get to spend a peaceful and joyous time with their families, friends, colleagues and those you want to with. 

Best wishes for a happy and merry Christmas to you all. 

Sunday, 13 December 2015

Futures, Past and Present: the Healthy University and Communities of Care

Two hours ago I landed in Dubai. Tomorrow is my last Board Meeting of the year at the Abu Dhabi Police project. It has been a long year, full of change and challenge. But as the year draws to a close, it’s good to know that the 'train the trainer' stage of the project has almost reached its successful conclusion. I am confident that we have developed a partnership that will see the ambitions of the Abu Dhabi Police in establishing a future world class juvenile justice services being delivered.

And for one brief moment last week, I took the entire VC Executive Team and University Management Team through a possible future scenario which saw the University of Salford becoming completely focused upon Health. In my imaginary world, every programme we ran was health orientated; we operated a healthy campus where good food was available at a reasonable cost; where smoking was banned and where lifts were only to be used by those with mobility issues. This imagined future occurred as part of a workshop aimed at exploring possible futures for our university following the recent comprehensive spending review.

Whilst it might have been a humorous interlude in an otherwise frustrating workshop, for me at least, it was a fleeting glimpse into a possible future world that I probably won’t see. More prosaically, last week, my world was also grounded in a reality that was difficult to ignore. Last Monday I attended the funeral of my next-door neighbour in Scotland. Kevin had died the previous week having lived with Motor Neurone Disease (MND) for the past year. Whichever way you look at it, MND is a vicious and cruel disease. Kevin was a doctor, specialising in micro-biology. He worked at the same health care service as my eldest daughter. He was a brilliant doctor and knew absolutely what a diagnosis of MND would entail. His courage in dealing with his disease was both inspirational and humbling. My thoughts are with Kevin’s wife and daughter as they work their way through this sad time and their loss.

5 people a day die from MND. This cold statistic of course masks the huge distress families living with MND can experience, and experience from diagnosis to death. Death featured in other ways last week. I was surprised to read a report last week, published by the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK), a research unit at Oxford University. Their report suggested that suicide is among the leading causes of death for pregnant women or women who have recently given birth.

Many of the women involved had pre-existing conditions of health concerns prior to their pregnancy, but conditions they were not asked about, and often the women and their families downplayed their problems. BRRACE report recommended that health care services need to create a safe space for women to discuss these issues. This was a theme similar to one I talked about last Thursday when I was interviewed on Quay TV. The brief interview was focused on young people who use self-harming behaviour and what their families can do to help them. If you are in this situation, then I recommend this very helpful and useful guide to living with someone who is self-harming - and many thanks to my colleague Gaynor for bringing it to my attention – the power of Twitter strikes again. 

And finally, audit also played a different role in my world last week. On Wednesday I was interviewed by members of the inspection team from the Care Quality Commission. I am Chair of the Quality and Safety Committee a sub-committee of the Wrightington, Wigan and Leigh (WWL) NHS FT Trust Board. It was an intense and interesting experience. It will be some time before the outcome of the inspection is known in detail, but the initial feedback was very positive – a great credit to all those involved in providing services and the community of care that is WWL.

Sunday, 6 December 2015

Winter Graduation 2015: Not quite a New York stage, but a good show anyway

It was 1994 when I first went to New York. W and I were going there for a romantic Valentine’s Day celebration. It was a trip that left me with some great memories. I remember it being a warm Spring, and it was possible to eat ice cream in Central Park. The sunshine made sightseeing more enjoyable. One of the many things I had on my sightseeing ‘bucket list’ was visiting the Statue of Liberty. Having flown around it in a helicopter I had found out it was possible to go inside the statue and climb the 354 steps to the top and view New York through a window set in the crown.

These days tourists visiting the crown do so via a central stair-well constructed and opened to the public in 2009. However, back in 1994 tourists climbed up the inside using one way stairs which wound their way around the inside. I recall being behind someone who became increasingly claustrophobic and wanting to go back the way she had come – an impossible task. Once the small platform in the crown was reached it was only possible to stand and look at the view through an incredibly scratched and dirty window for just a few seconds, before you were hurried on to start your descent.  

Despite returning to New York on many occasions since then, I have never revisited the Statue of Liberty after that first visit. Its possible that these days the experience is much better, but for me, as one of my ‘bucket list’ experiences, it wasn't a good one! It was the triumph of experience over expectation. 

I’m not sure why this particular New York memory came to mind other than last week I found our Winter Graduation ceremonies rather more a triumph of hope over my experience. The University re-introduced a Winter Graduation last year after only having a Summer Graduation for a large number of years. I wasn't a fan of the idea, but of course once the decision was taken, I was more than happy to do my bit in making it a celebration. However as hard as I try, it’s difficult not compare the 2 Graduation ceremonies.

The Summer Graduation is held at the contemporary Lowry Theatre located at Salford Quays, next door to Media City. This is a grand venue and one set up and well used to facilitating such an event. In contrast, Maxwell Hall (located on the main campus site and built in 1960) is well past is former glory. In the mid 1980s it was used as a concert venue for groups such as the Smiths, the Fall, Icicle Works and New Order. The Maxwell Hall stage is tiny in comparison to the one at Lowry which often accommodates 90+ of my colleagues at each Summer graduation ceremony, and most years we have at least 2 ceremonies.

The attendance of my colleagues at each ceremony is important for many different reasons. They will have worked with the students for 2 or 3 years, offering them opportunities to learn and grow. I think that being able to share and celebrate each student’s success is both a form of closure and a symbolic act of acknowledgment in witnessing what might be called a rite of passage from ‘graduand to graduate’. Of course my academic colleagues are only part of the celebration. Parents, husband, wives, partners, children and friends have their part to play as well in creating the atmosphere of a special occasion. Did this happen last Tuesday? I hope so. 

Our School took part in the first ceremony, but it was only a brief encounter. Ceremony 2 was all ours. We processed in all our fine robes, to triumphal music. Maxwell Hall was literally full to the brim. Our Chancellor, Jackie Kay warmed the congregation up with her humorous stories and sheer joyful presence. As the students were presented for their various awards there were whoops, cheers, and much laughter and clapping. I even got through the names without too much trouble.  Nobody fell off the stage or tripped up or down the stairs. Everyone who should have been there was there, well with the exception of many of my colleagues who couldn't  get a seat on the stage that is.  So I am not sure why, after the ceremonies I was left feeling like I did on that first visit to the Statue of Liberty.

Maybe I am just slowly turning into a grumpy old man (W might say not so slowly) – or maybe it’s because my ‘pleasure’ gene is starting to fade. The pleasure gene, often referred to a Taq1A plays a role in processing dopamine, which is the hormone in the brain associated with pleasure and reward. It is a hormone that is released when people smoke. In research undertaken in Zhejiang University, China and published last week, it was reported that people (smokers) will have with slight variations of this gene. These variations will either make it easy to give up smoking or next to impossible to do so. So once started, they are likely to remain as lifelong smokers, with all that might entail. I gave up smoking a long time ago, so its probably just that I am turning into a grumpy old man. Still, even if this is the case, I still look forward to going back to New York at some stage and to attending the next graduation ceremony, which fortunately for me, will be in the Summer and at the Lowry!

Sunday, 29 November 2015

I read the news today oh boy: it was all about changes to nurse education, Oh Boy!

Well the news we had all been expecting to hear finally arrived last Wednesday. The UK Chancellor of the Exchequer presented the outcomes of his Comprehensive Spending Review. The changes to the current arrangements which support the education and training of nurses in the UK had been long expected. The proposition to replace the current system where student nurse fees were paid for by the NHS with a student loan based approach, something all other students endure, was always on the cards. Many of us acknowledged that this was a possibility over a year ago when no agreement could be reached on the current so called ‘bench mark price’ system that pays universities the tuition fees for NHS commissioned students.

A year ago a no change moratorium was agreed between all the parties, which is due to end in September 2016. This was a sticking plaster solution that benefited none of those involved. Much work has gone on behind the scenes to try and ensure progress in resolving the increasingly difficult problem of paying for the preparation of the nurses we need in our health services. Last Thursday I joined my colleagues at the Council of Dean Health (CoDH) Executive to discuss the possible implications of the changes announced by the Chancellor. The CoDH is an organisation which represents the 84 universities providing NHS commissioned programmes. Without doubt, the CoDH has been the leading party in trying to negotiate an affordable solution with the Treasury.

The change to student nurses taking out student loans like all other students studying at university was always going to be controversial and spark high expressed emotion. There will be many who see this solution, which will be introduced in the 2017/18 academic year, as adding to the problem of a the growing nursing shortage in the UK. There is some merit in this claim. However, time will tell the extent of the impact on student numbers,. We currently attract nearly 5000 applicants a year, all trying to get one of the 700 student nurse places we are commissioned to provide each year. We are engaged in recruitment processes and selection activities every week of the year.

This is very different to when I started my nurse education. Back then there were only 14 students in my cohort, and we were taught by a Clinical Tutor, a Lecturer and a Head of School. I was 20 years old when I started. Today 60% of nursing students are over the age of 25, with the overall average age of student nurses being some 28 years old. Clearly this is a different demographic when compared with many of the students studying other programmes. Taking out a student loan aged 28 might be too difficult for some prospective nursing students to consider in the future. 

Thinking about these changes did make me recall what the world was like when I trained way back in 1975. Nursing programmes weren't taught in the University, but in Schools of Nursing located in hospitals.  I was paid £23 a week, and was given 2 free suits and 6 white coats to wear while at work (those were the days when it was thought that mental health nursing care was better provided with staff wearing white coats). £23 a week in 1975 is the equivalent to £158 today in 2015. I worked full time, and was on the rota and worked 12 hour shifts. Whenever I could, I worked overtime on nights most weekends.. 

During the 3 years of my training I bought my first house for some £6000, 2 of my 5 children were born, and I started a folk club. Two years in, I sold my first house and bought a smallholding in West Wales. Consequently, for the last 12 months of my training, I had a daily round trip of 80 miles, a journey I undertook in my trusty Citroen 2CV6. This magnificent little car could also carry goats, hay bales, as well as a growing number of children. However, back then there were no mobile phones, blogs didn't start to appear until the 1990s and the only texts to be found were those in churches. There were no smart motorways, indeed the start of the Welsh end of the M4 motorway was only opened in 1977. I remember the sheer joy of driving on it for the first time during that last year of my nurse training. So it really was a very different world. I know and accept that of course I am possibly guilty of looking at the past through slightly rose tinted glasses. 

We need to look forward to what the world expects of health and social care services. I am confident in the work of my colleagues who are developing new educational programmes. Such preparation will help ensure that nurses in the future will be fit for purpose as confident co-creators of their future alongside other professionals and service users. In a strange coincidence, one of my two children born during that time was also in the news last week. Sally is the General Manager of the Art Deco Trust, based in Napier, New Zealand. She had been working with the University of Auckland to assess the earthquake strength of Napier’s world renowned post 1931 heritage buildings. Apparently, according to a report in Te Waha Nui published last week, everything is looking good; the future of the many fine buildings is assured. Let’s hope UK nurse education enjoys the same future.

Sunday, 22 November 2015

Are Men really from Mars when Sisters are still Doin’ it for Themselves

Driving up to the House in Scotland last Friday I listened to Desert Island Discs. The guest was First Minister for Scotland, Nicola Sturgeon. Her penultimate choice of songs was the Eurythmics and Aretha Franklin version of ‘Sisters are Doin’ it for Themselves’. It was good to hear the song again and interestingly for me at least, it was a song that resonated well with my week.

Last week saw the completion of the final draft of our University application to gain the Athena Swan Charter Bronze award.  Many universities already have this award, an award which recognises the commitment of organisations to advancing the careers of women in science, technology, engineering, maths and medicine, the so called STEMM subjects, in higher education and research. The Charter was established in 2005, and was expanded this year to also recognise the work undertaken in the arts, humanities, social sciences, business and law.

The Athena SWAN Charter is based upon 10 key principles that reflect an acknowledgement that academia cannot reach its full potential unless opportunities are created to benefit from the talents of all its members. Organisations who gain this award do so as they are able to demonstrate their commitment to advancing gender equality in academia, but in particular address the problems many women experience in developing their academic careers and being equally represented within all levels of academic endeavor.

Providing evidence of such 'commitment in action' is difficult and I think it’s a great testament to the work of colleagues in many parts of the University community that it has been possible to develop what I think is a strong application. The School is committed to gaining the Charter Award for itself by September 2017. We have an action plan that addresses where we need to improve our approach and actions. The email with the final draft application landed in my email in-box last Thursday morning. Last Thursday was also International Mens Day (IMD).

I struggled to find out how as an organisation, we were marking IMD. The simple answer appeared to be that we weren't. I am not even sure as to whether we were planning to do anything or whether like York University, the planned events had to be cancelled. Protests from various fractions eventually made it impossible for York university to mark IMD in any way. I can absolutely understand the protests, which in the main objected to claims that men are subject to the same stigma, prejudices and career and life restricting experiences as many women routinely face. Such claims border on the ridiculous, which is why I think the Athena SWAN Charter is so important.

However, one of the prompts to my thinking about this week’s post was a YouGov survey undertaken by the Movember Foundation. The foundation raises funds and commissions research into male cancers, but also is increasingly trying to raise awareness of male mental health issues. The study published last week reported that 2.5 million British men have no friends they could turn to for help or advice in a crisis. The study showed men’s chances of friendlessness almost treble between their early 20s and late middle age. It’s even worse for married men who are also significantly less like to have friends to turn to than their single counterparts.

The Movember Foundation study adds to the existing evidence base that men are still dying sooner than women (4 years on average); 12 men will take their own life each day; 90% of rough sleepers are men; 95% of the prison population are men; 70% of murder victims are male; 96% of people who die at work are male and men account for 84% of suicides linked to the recession. There are of course very complex factors behind these sad statistics, factors I can’t deal with in this post, but the degree of friendlessness of so many men will contribute of course. 

I was saddened that as an organisation we chose or perhaps omitted to mark IMD this year. Ironically, last Thursday as I was musing on this thought, my email pinged, and into my in-box popped a new email. It was from Donna, one of my Social Worker colleagues who was asking colleagues across the School if they were interested in thinking about next year’s International Women’s Day (8th March). This year (2015) the University joined forces with the British Psychological Society to facilitate the very successful conference ‘Social Media and Feminism’. It was an event that celebrated the social contribution of women. During the day my email inbox was flooded with enthusiastic and positive response’s to Donna's question as many of my female colleagues came up with ideas or said they wanted to be involved in some way. Clearly women are still doin' it for themselves.

Sunday, 15 November 2015

Deux vendredis soirs différents: Determined to Dream and Imagine...

This morning my thoughts are with all those who suffered a loss of a loved one in the despicable, cowardly attack by terrorists in Paris last Friday night. As I write this post, its being reported that 129 people have died, and 352 were injured, 99 of whom are in a critical condition.There will be many others who will have been touched by these attacks. The senseless atrocity occurred during a week that marks Armistice Day. Armistice Day is commemorated every year in memory of the ending of hostilities that was World War 1 - 'the eleventh hour of the eleventh day of the eleventh month'. This year I was proud to pause the meeting I was chairing and stand in respectful silence to acknowledge the sacrifices made by so many on our behalf during this and other wars.

My Friday night couldn't have been more different to the one being experienced as the tragic events in Paris were unfolding. At 18.30, I was sitting in my car, in the dark, being rocked by the gale force wind, watching the sleet hit the windscreen. I was getting ready to go into the warmth of the DW Stadium in Wigan to help celebrate this year’s Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust 'Recognising Excellence Awards' ceremony. It is one of my favourite nights of the year!

There was much to celebrate, with many nominations from across the WWLs 4500 colleagues being made for this year’s awards. These awards recognised contributions made for service transformation, improving safety, team working, supporting others, and improvements to the quality of care provided. The sheer range of people and achievements nominated showed the enormous commitment there is to service improvement across WWL. It was great to see Lesley Cuncliffe and the inspirational Domestic Team win the Team Working prize, their work has ensured that WWL is the cleanest hospital in the NHS for the second year running!

For me, last Friday started with a 06.00 meeting with colleagues to discuss the development of Industry Collaborative Zones. Then it was down to The Lowry theatre for a HAELO Board Meeting.  09.00 saw me in the compass auditorium for day 2 of the 2015 HAELO Hosts, which this year took as its theme, Underground Improvements. HAELO is an innovation and improvement science centre which is based in Salford and is made up of 4 strategic partners: Salford Clinical Commissioning Group; Salford City Council; Salford University; and Salford Royal Hospital NHS Foundation Trust.

HAELO's mission is to positively influence the delivery of high quality public services, restore hope and become a powerful agent for change by adding to the growing knowledge of how improvement works in theory and in practice. Over the 2 days there were many examples presented of how such ambitions were being achieved. For me day 2 provided one of the most poignant and exciting of these. It was the 'soft launch' of the dementia united initiative. You can read more about this initiative here.

It was poignant because of the telling by Ann Johnson of her journey in living with dementia for the past 10 years. Ann was diagnosed with dementia when she was just 52 years old. A former nurse and nurse teacher, her faith and her friends are important to her, and in particular in her message, that we each have one life, and we should try and live it well. She is truly inspirational.

And I was privileged on last Thursday to open up our Politics of Location Conference. It was a conference that was the idea and passion of one of our social work colleagues, Gabbi Hesk. Through her hard work and fantastic leadership she was able to bring together a great team of colleagues and organise a truly powerful event jammed packed with a cast of inspirational speakers from around the world. One of these was our very own Chancellor, Jackie Kay, someone I was really proud to share the stage with! You can share the experience here

It has been a bitter-sweet week. For much of last week I have been able to share the wonderful stories of achievements of so many people who have chosen to care for and work with others. For so many people in France and beyond, last week was very different. My thoughts this morning are with all those whose lives have been so brutally torn apart by a minority who chose fear rather than freedom, and death rather than life. I hope that all those who so innocently lost their lives will rest in peace.

...Imagine there's no countries
It isn't hard to do
Nothing to kill or die for
And no religion too
Imagine all the people
Living life in peace... may say I'm a dreamer

But I'm not the only one
I hope someday you'll join us
And the world will be as one

Sunday, 8 November 2015

A week of fireworks, advocates for mental health equality and a good Samaritan taxi driver

The House in Horwich sits in a small community of just 6 houses. Last night it was our community bonfire celebration. It’s an evening I don’t like to miss if at all possible. I really enjoy spending the afternoon helping our neighbours children (and young people these days), and some of my grandchildren, building the bonfire, erecting the shelters in the orchard and generally getting excited about the evening. This year, we were a little short of wood, but as it turned out, it was a good fire anyway. As darkness arrives, the fire is lit, our neighbour Simon, a professional chef, starts cooking, the wine is opened and later, the fireworks are set off. It was a wonderful evening, with good company, food, conversation and friendship. 

The House in Scotland bonfire celebrations were last Thursday. I missed those as I was travelling to Birmingham on Thursday evening. The train journey was however, literally illuminated by fireworks being set off all along the route. My good feeling was shattered when on arrival at the renovated Birmingham New Street station I found that the taxi drivers were on strike. Unbelievably, just as despair was beginning set in, Ahmed, complete with Black Cab, arrived and asked if could help.

We set off towards the hotel, which was located right in the middle of the University campus, and Ahmed kept up a steady narrative about the history of Birmingham, and when he found out I was a nurse, explained what the 6 Cs was really about – he loved the notion of a compassionate nurse. Our engaging conversation was brought to a halt as we turned into Edgbaston Road to find it filled with thousands of students all intent on getting to the University bonfire celebrations. The delay caused by the sheer number of people doubled the cost of the taxi fare! But I got there, albeit some 4 hours after leaving Manchester – many, many thanks for your help Ahmed!

I lay in bed the following morning and listened to 'Old Joe' ring out the time. The clock tower is 100 meters tall and over 100 years old. Its truly a magnificent centre piece to the University campus. I was there to do an early morning PhD Viva - early morning as the other External Examiner was in Australia and participating via Skype. The time difference was 11 hours – our morning, his evening. The candidate was someone I had met on a plane in 2014, we were both on our way back from a mental health nursing conference, held in Tallinn.

He made a great defence of his thesis and the recommendation was that he be awarded his PhD. My colleague from Australia and I wished him well. Although his study focused on peoples engagement with mental health services, his work absolutely resonated with the emergent themes from the recently published 5 Year Forward View Mental Health Review Taskforce. These themes were: prevention (and stigma); access (and choice); quality (and experience); with an overriding lack of parity between the way physical and mental health care services are funded and provided. 

These were themes I had explored in presenting a paper at the Future of Mental Health Services conference held at our University last Tuesday. I was very pleased to be able to share the stage with Norman Lamb MP, the Liberal Party spokesperson for Health. He told a very powerful story that drew both on his own experience of being in a family with a member who lived with mental health challenges, and his work as member of the previous UK coalition government. Last week he joined 200 other high profile public figures in leading a campaign, ahead of the Comprehensive Spending Review, for equality of resources for the provision of mental health care services. If you want to also support the campaign, you can through this link. As this year’s Guy Fawkes celebrations come to an end, remember, signing the petition is always going to be better than blowing up the Houses of Parliament. 

Sunday, 1 November 2015

Training Nurses and Social Workers and the Case for Avoiding Smoking & Sausages

I want to start this week’s blog with a big thank you to all of you who took the time to read last week’s blog and then took more time to let me know what you thought – almost overwhelmingly, the tweets and emails were very positive and many people shared my excitement over what looks to be a great opportunity to shape future nurse education and practice. I will pass on these comments to Jackie Smith at the NMC

The view regarding future Social Worker training was however, less positive this week. The announcement that the controversial social work training programme Frontline, was being launched for the first time in the North East was greeted with very mixed responses. This 2 year programme, which costs a staggering £19000 a year, provides a fast track route into social work. Individuals gain a social work qualification in a year and a Masters qualification in year 2.

The programme, which was launched in summer 2014, evoked great ill-feeling and disquiet from those providing a more traditional model of university based, generic training for social work. Sam Baron chair of the Joint University Council’s Social Work Education Committee comments last week will be shared by many: ‘They [Frontline] is training people to do a job, we are educating for a profession’. She also noted that tenders are currently being issued for further Frontline programme provision and this before the existing programme has been evaluated. Watch this space, it’s a debate that has some way to run yet. 

There was another debate last week that made me smile (and be thankful that I have been a long time vegetarian). It was of course, the World Health Organisation (WHO) announcement that bacon, ham and sausages rank alongside cigarettes as a major cause of cancer. It was the WHO’s International Agency for Research on Cancer (IARC) that reported there was now enough evidence to rank processed meats as a Class 1 carcinogen alongside alcohol and cigarettes which are also classified as being a Class 1 carcinogen. Of some 940 agents reviewed by the IARC, only one substance found in yoga pants, didn't cause cancer. 

Last Monday’s Guardian newspaper coverage of the story included a wonderful observation by Betsy Booren, from the North American Meat Institute in response to this study and in particular that red meat was a Class 2A carcinogen. She is quoted as saying ‘the IARC says you can enjoy your yoga class, but don’t breathe in the air (Class 1 carcinogen), sit near a sun-filled window (Class 1), apply aloe vera (Class 2B) if you get sunburn, drink wine or coffee (Class 1 and 2B),or eat grilled food (Class 2A). And if you are a hairdresser or do shift work (both Class 2A), you should seek a new career’

More seriously, as we get to the end of October and this years ‘Stopober’ it was good to read the report from Public Health England who note that this year, 215,000 people signed up to stop smoking. This commitment reflects the substantial reductions seen in the numbers of people smoking over the last 30 years. Whilst there are still approximately 8 million smokers in England, there are now 37% fewer smokers than 30 years ago. Only 21% of all households now include a smoker – but nearly 80,000 deaths a year are caused by smoking and treating smoking related diseases costs the NHS an estimated £2 billion a year. So remember, while a eating a ham sandwich might be bad for you, it’s still not as risky as 20-a-day smoking habit. 

Sunday, 25 October 2015

Raising the Bar in the Brave New World of Nurse Education

For the first time in 4 weeks I am writing this week's blog from the sanctuary of the House in Scotland. The last 4 weeks have been very busy and have left me emotionally and physically exhausted by all I've been involved with. The cough/cold I acquired on my recent flights to and from Australia settled firmly in my chest leaving me with a chest infection and a painful bout of sinusitis. However before leaving for Scotland I managed to get an appointment at the local GP practice and came away equipped with the very best that the pharmaceutical industry can be provide.

I didn't see a GP, but one of the nurses. She was an Advanced Practitioner, highly skilled, knowledgeable and possessed great interpersonal skills. She was able to make a diagnosis, sort out the poly-pharmaceutical complexities in prescribing, empathised over the pain in my face, ear and neck and provided advice to avoid any further fainting episodes. I was impressed. For me, she also epitomised what the qualified nurse of the future might look like, someone who I believe is also likely to be able to work in this way.

Last week I had the opportunity to join 9 other professors (or thought leaders as we were referred to) in meeting with Lord Willis (Phil to his friends), Dame Jill MacLeod Clarke, Jackie Smith (CEO and Registrar of NMC) to explore what we might expect from newly qualified nurses 5 or 10 years in the future. All 4 nations of the UK were represented, as were all fields of nursing practice. Most of us were also Deans of Schools of Nursing and Allied Health Professionals. We all agreed to abide by Chatham House Rules, so I am not able to share the detail of our discussions but can provide some key headlines.

The first headline is that the NMC as a body were very open to change. It was acknowledged that the current standards used to construct and approve pre-registration nursing programmes were in need of a review. However, it was also acknowledged that perhaps we could learn from the work of others in undertaking such a review – and one such example we had been asked to look at in preparation for the meeting was the standards and outcome documents published in July this year relating to the ‘Tomorrows Doctors’ initiative. These documents make good reading for educators! You can see for yourself here (standards; and outcomes).

The second headline was that the group shouldn't concern itself with process (how future programmes might be delivered is open to all suggestions), or the current limitations arising from developing an overcrowded curriculum around four fields of socially constructed professional practice. Arguably  these fields of practice have increasingly little relevance to the exponential pace of change seen in the way health care services are being delivered. The focus for the group was firmly on the outcomes of educational programmes aimed at delivering the nurse of the future.

The discussions around what we expect that nurse to be like and what they should be able to do, form the basis of my third set of headlines. Collectively, we anticipated the nurse of the future, at the point of qualification would be: knowledgeable, and a knowledge broker, confident at working in the space called not knowing and uncertainty; a confident care navigator, able to signpost patients, carers and families to specialist service providers; digitally literate and able to effectively use new technology in providing care; a health promoter and health educationalist, personally role modelling how to maintain good health and well-being; a co-creator with patients and their families in the production and delivery of care; a team leader, working within teams made up of new entrants to the health care work force perhaps along the lines of the Nurse Associate concept. 

Of course there was much more, but you will have to wait until the report presents this and other consultation discussions to see the full picture.  From an educators perspective there were also some thoughts to ponder on. One that resonated was that we should perhaps stop treating our students as if they were our patients, failing to fail is not a helpful approach, but addressing this phenomena needs to be matched by a review of the payment by attendance and progression system we have in England (not the case in Northern Ireland). Likewise while the bio-science elements of future programmes needs to be reviewed this should be with the aim to make the nurses knowledge deeper not broader. 

It was a very interesting conversation to be part of, and I am to continue being part of the discussion.  For me it feels like a once in a life time opportunity to do something different for nurse education and the nursing profession, something different that will more effectively help prevent disease, promote health and well-being and provide high quality care when its required. And for all of you busy working on seeking NMC re-approval for your programmes in 2016, don’t worry, if you are not ready to embrace this brave new world just yet, you perhaps don’t need to. But if on the other hand you want to be big, bold and bad in terms of your programme development, well I think you will increasingly find some very receptive like minded folk to work with. Well done Phil, Jill, Jackie and all at the NMC for raising the bar in this crucial discussion over the future of nursing.