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.