Sunday, 22 February 2015

Money, money, money - is it easy to forget that it’s always sunny in a rich man’s world?

On the 1st November 1976, the Swedish pop group Abba released their song Money, Money, Money. The song was a No 1 hit in Australia, Belgium, France, West Germany, Holland, New Zealand and Mexico. It only reached the number 3 spot in the UK.  The post 40 year old generation possibly will only know the song from the 2008 film, Mama Mia. I heard the song being played as background to a piece on the radio dealing with tax avoidance. The chorus of: 'money, money, money; must be funny in the rich man’s world' being used to introduce and accompany the piece.

But actually the song tells a rather sad, some might even say poignant story of a woman who, despite her hard work, is barely able to earn enough to keep the wolf from the door, and sees the solution as finding a wealthy man to share her life. Most people don’t realise this is what the song is about. It has a catchy tune, easy to follow along chorus line and its one of those songs that when you hear it, it sticks in your mind for hours!

Money and memory featured in many ways last week. It was great to hear yesterday that the UK government announcement to make £300m available for research into dementia. Memory problems are just one of the problems people living with dementia face. Understanding how this effects people will feature as part of the drive to ensure that all staff working in the NHS gain a better understanding of those living with dementia. This new money comes on top of a multi-million pound fund to be established aimed at creating an international research fund for the development of new drugs to slow down the onset of dementia or even deliver a cure by 2025. Mr Cameron (the UK Prime Minster) may well have forgotten that it can take between 15-25 years to develop, test and licence a new drug.

Possibly less positive news last week was the report about the Dementia Identification Scheme, an enhanced service, that was launched in October 2014. As part of the enhanced service, GP practices are expected to offer 'at risk' patients a dementia assessment. 'At risk' patients are those over 60 years old living with long term conditions, such as cardiovascular disease, obesity or diabetes, patients over 40 years old with Down’s syndrome, and patients over 50 with learning disabilities. The scheme means that GP's earn an extra £55 for every extra patient they diagnose with dementia. This somewhat controversial enhanced service was criticised by many care givers and health care professionals as they felt the scheme would divert resources away from those patients who had already received a diagnosis.

The pay of GP's is very difficult to ascertain. Salaried GP's, can earn up to £80k a year, whereas partner GP salaries for those that actually own the practice, can be much higher, with nearly 20% of GP's earning more than £200k a year. I couldn't find out this morning what the favourite car of the GP is, but its likely that you will find a handsome collection of top end cars parked in the 'reserved for the doctor' slots at your local surgery. And before anyone cries hypocrite in my direction, I am happy to admit I love driving my 6 month old Jaguar XF Sport.

I mention cars because interestingly, and for the second year running, GP's and consultant hospital doctors are once again in the top two places for being the worst ever drivers. GP's are 100 times more likely to cause an 'at fault' accident than a building society clerk. Annually, 333 GP's in every 1000 make an ‘at fault’ claim. The top ten worst drivers are all healthcare professionals. Number 3 in the top ten last year were Clinical Psychologists, who as a group seem to have improved their driving as this year they were listed at number 10. Now don’t get me wrong, I wouldn't want to suggest there’s any kind of connection between the expense of driving (and sometimes crashing) top end cars and GP's finding new ways to increase their income, but as Benny and Björn might have said, money money, money, [its] always sunny, in a rich man’s world. 

Sunday, 15 February 2015

No Shades of Grey in Whipping up Enthusiasm for a New Approach to Public Health

Yesterday was a Red Letter Day, well, possibly like me you received lots of cards largely red cards sent in red envelopes, perhaps accompanied by red flowers, red wrapped heart shaped chocolates and rosé wine (don’t know why its rosé and not red). Yes it was Valentine’s Day 2015. Valentines cards have been sent since 1477, but it’s a day whose origins are earlier, and most likely comes from the ancient annual Roman festival known as Lupercalia. During this festival, men would strip naked and run through the streets swatting young maidens with dog or goat skins whips – apparently this was said to increase the young ladies fertility.

It all sounds like the inspiration for the story line in the best selling book Fifty Shades of Grey. The film adaptation of the book was released yesterday (see the official trailer here) and has sparked mixed reactions. The Forbes review appeared to some up a fairly representative view – ‘for a film that’s supposed to be about the collision between deep emotional need and raw human sexuality, it is cold and clinical to the point of feeling sterile in everything from aesthetics to characterisation’ – not the most encouraging endorsement.

The London Fire Brigade response was a great deal more pragmatic. They have reported a steady increase in people getting stuck in handcuffs since the book was published and are worried that the release of the film yesterday might lead to more people getting into equally tricky situations. They have started a campaign called Fifty Shades of Red aimed at ensuring people don’t get into compromising situations when trying to emulate scenes from the film. It’s certainly a public health message with a difference.  

During Wednesday and Thursday last week I also got to hear of a different public health message from a group of people whose energy and creativity truly inspired me. I was at the Village Hotel, Bury, (which didn't inspire me at all) with 150 people, drawn from Executive Teams and Non-Executive Teams of NHS Hospitals, Community Trusts, and Clinical Commissioning Groups from across the North West all intent on learning how to make Safety Visible. This was the first action learning event in a year long initiative paid for by the Health Foundation.

The Health Foundation is an independent charity whose work aims to improve the quality of health care in the UK. Every year they give up to £18m to fund health care research, fellowships and improvement projects across the UK – all which are focused upon improving healthcare quality. They are funded through an endowment fund (currently valued at £820m) which came from a one off chartable donation of £560m from the sale of the PPP Health Care Group in 1998. It has been said this was one of the largest single charitable donations in UK history.

The event was organised by Haelo. Haelo is an innovation and improvement centre which host experts, clinicians and improvement fellows. It’s supported by Salford Royal NHS Foundation Trust, Salford Clinical Commissioning Group and Salford City Council. I have been involved with it since its inception and along with other colleagues from the University of Salford it’s been great to be part of an initiative aiming to improve the population health and health care for the people of Salford

For me the Making Safety Visible event was very interesting because of the journey of change we appeared to take. Day One, harm (patient harm) was conceptualised mainly by such things as pressure ulcers, hospital acquired infections, avoidable deaths and so on. By the end of the two days harm was also being thought of in terms of population health (obesity, smoking cessation, promoting good mental health and well being and so on). And in organisations that often are confrontational in their relationships with each other, there was a change in perception over the positive nature of what could be achieved by working together. We seemed to reach a slightly more equal relationship than that perhaps portrayed in Fifty Shades of Grey. However, like Valentine Day, time will tell if these changes survive or not. 

Sunday, 8 February 2015

People Watching, Alex and Alexis and Please Don’t Eat the Daffodils!

One of the things I love to do above all else is to people watch. I was 22 when I bought my copy of Manwatching: A Field Guide to Human Behaviour, a book written by Desmond Morris. Although you can still get old copies on Amazon (where else?) the re-released publication is now entitled People Watching! I am not a psychologist, but I am fascinated by human behaviour. My PhD drew upon social anthropology – the study of people, what they make, do, think, and how their relationships are organised.

There were a number of experiences last week that sparked the anthropologist in me. For example, I have recently been selected to serve as the Academic Member on the University Council. Last week saw me attending my first Council meeting. The Council table was laid out in a square and somewhat surprisingly, there were name plates already arranged around the table. Sitting there in the pre-meeting small talk moments I looked at the people already sitting down. Smart business wear was clearly the fashion prerequisite. Women and men were in suits, dark colours di rigueur. And then there were the ties.

Every man in the room was sporting a tie - except for me. I wear Thomas Sabo silver feathers (there are other fine jewellers) I don’t wear ties. Back when I was reading Desmond Morris, I was also watching a snooker genus weave his magic. Alex ’Hurricane’ Higgins. He revolutionised snooker, and was possibly responsible for bringing the game to millions and certainly he was the grandfather of the modern game. But he was at times a troubled soul.

He had a somewhat volatile personality, often getting into fights and arguments both at the snooker table and in his private life. He drank alcohol and smoked during his matches. For most of his life he smoked 60 cigarettes a day. His life style choice caught up with him. He had cancerous growths removed from his mouth in 1994 and 96, and unfortunately, in 1998, he was diagnosed with throat cancer. He earned and lost £4m in his life. Alex Higgins was found dead in his bed, in a sheltered housing project in Belfast in 2010. He weighed just six stone, having ‘lived’ on a liquid diet for a couple of years due to losing all his teeth after intensive radiotherapy. Cathal McNaughton’s photo of him taken just before he died is immensely haunting.  

Alex Higgins also didn't wear a tie. In a time when the governing body for snooker prescribed what the players should wear, Alex was a rebel and refused to conform. He was his own man and did his own thing, and did it well and in a way that entertained many, many people for a large number of years. His experience was slightly different to that of Alexis Tsipras, the recently elected Greek Prime Minster. He was on a European tour last week, trying to assuage the anxiety of other European heads of state over the anti-austerity stance of his Syriza party.

Alexis Tsipras, aged 40, is the youngest Prime Minister in Greece for 150 years, and hasn't worn a tie for years. He didn't wear one during his campaign, nor for his formal swearing in, or when he met with the various heads of state across Europe. Whilst fashion has always been a major influence in both organisational and world politics, it has never been more the case than with ties, one of the most visible pieces in a man’s wardrobe. The tie has been a colour-coded communications tool. Precisely what Alexis is communicating is down to political commentators, psychologists and anthropologists alike to analyse and de-construct for meaning. 

And talking about meanings, what possessed Tesco and Public Health England to take the decisions they took last week. Tesco staff in Plymouth were asking customers for proof of age when they were buying fruit. As everyone knows, fruit can ferment and turn into alcohol, which as we also know cannot be sold to those under the age of 18. Tesco’s were being uber cautious I guess. Just as cautious and intent on protecting us from ourselves, was Public Health England. They issued a poisoning warning, asking supermarkets not to place their daffodil bulbs in the fruit and vegetable section of the store as people were mistaking them for Chinese vegetables, cooking them and becoming seriously ill. Not wearing a tie to the Council meeting feels quite tame in comparison to shopping in my local supermarket.

Sunday, 1 February 2015

Only the lonely, but here’s an answer to the ‘which came first the chicken or the egg question’

It was a real hurly burly of a week last week. Apart from admiring the grandchildren's snowmen (its a new way to get the drive cleared of snow) there was a lot going on with a great deal of travelling, tight deadlines to meet and much discussion to engage in. Despite seldom being alone, for some reason I found this busy-ness gave rise to a strange sense of loneliness. Thankfully when I checked the degree of loneliness I was actually experiencing using the loneliness test devised by psychologist Daniel Russell, I found I was in the 'normal loneliness' range. Interestingly, most university students, school teachers and nurses are the groups most likely to be placed within this range. However, loneliness is a killer. The pain of loneliness is akin to the experience of physical pain

You can try the loneliness test for yourself here – but beware for some reason there are also invitations for lonely people to meet lovely Russian ladies. The test is featured in John Cacioppo's book 'Loneliness' Written with his colleague William Patrick, a book that explores the health and social consequences of loneliness. Although some people are happy to be alone, most of us thrive in situations that provide opportunities for mutual support. Most people prefer companionship, and healthy relationships are built around having someone in your life who affirms who you are. Feeling that you are part of a group or collective beyond you own existence is also another important factor.

I belong to a number of such groups. For example, last Monday, I spent the morning in the company of the Wrightington, Wigan, and Leigh Foundation Trust Board on a strategic planning day, before travelling to Belfast to be part of the Council of Deans (Health) AGM. Both these groups, healthcare professionals and health care professionals educators provide an opportunity for active participation, re-affirmation of self and to be able to make a contribution that might influence others.

And Wednesday evening saw me at the DW Stadium attending a Council of Governors meeting. It’s not a particularly big stadium, (seats 25000) and is home to both a football team and a rugby league team – collectives that hold no appeal for me at all. It was a wintry evening and the stadium was empty and riding up in the lift alone, it felt like I was the only person there.The first part was given over to Dementia Friends training. It was the third time I have attended such a training session in different organisations, and as always, it was great to see the raising of people’s awareness of those living with dementia.

Whilst not all those living with dementia are old, as a group, older people are far more likely to experience health problems as a consequence of loneliness. Evidence from population studies undertaken in 2012 found that 20% of older people (over the age of 50) felt lonely all the time and 25% felt they have become lonelier over the previous 5 years. 50% felt their loneliness more at the weekends and 75% reported night time being the worse. This and other studies have linked loneliness to many health problems, from high blood pressure, depression, and a raised risk of suffering a heart attack or stroke. The 2012 study found that the loneliest were nearly twice as likely to die as the least lonely. 

Of course there are some people who are very happy living a life of solitude. Others might still experience loneliness even amidst family and friends. It’s about feeling involved, needed and valued by the individuals and groups near to us. I ended the week in a good place. I spent the morning with our School Executive developing our response to the first review by the University Executive of our Operational Plan. It was a good meeting, and I hope others, like me felt valued by the group and the work we were doing. I also ended the working week with a smile on my face as finally I was presented with the answer to the question as to which came first, the chicken or the egg? Simon Steer, from Devon, started frying an egg, which then strangely appeared to take the shape of a chicken as it cooked. For me it was the picture of the week.