Sunday, 25 December 2016

My Christmas Day Blog 2016

I started writing my blog in 2009. Early every Sunday morning  I 'post' my blog for the week. Today is Christmas Day, and rather like the Queen, I feel a need to post a brief Christmas message. Since 2009, Christmas Day has only fallen on a Sunday on 1 other occasion and that was in 2011. After today it won’t happen again until 2022. I wonder if I will still be writing my blog then. Confusingly for some, in Western Christianity, the first Sunday after Christmas is actually called 'the First Sunday of Christmas', which this year will also be the first Sunday of brand spanking New Year of 2017! So this is the last blog posting for this year. Many thanks to all of you who choose to read it each week.

A couple of things came to mind when I stopped and thought about what I could write for this blog. I wanted to include a carol, and given I am a long-time fan of the late great Leonard Cohen and thought I might bring you some of his Christmas music, but he never recorded a Christmas album. The only song he ever recorded is 'Silent Night', which he sang with Jennifer Warnes way back in December 1979 – which you can hear here. In case you are wondering, Christmas Day in 1979, fell on a Tuesday. The Leonard Cohen version is not the best one available, but it is better than mine. 

When I was very much younger and lived with my parents in North London, we had a harmonium in one corner of our dining room. It was a magnificent beastie. Black wood, ivory coloured keys, lots of pull out levers, 2 wooden paddles that you operated with your knees to make the sound louder or softer and all worked by 2 foot pedals which you had to pump. I am not aware that any of us 7 children could play, and I am almost certain my parents didn’t either. But as a child it was great fun to play with. The only recognisable tune I could ever get out of it was a one handed version of 'Silent Night'. One of my brothers went on to play the piano in later life, but as I had dreams of becoming a rock star it had to be the guitar for me. I can play 'Silent Night' and other assorted Christmas carols on the guitar and for a small fee I am available to play at a Christmas party near you.

The other thought that came to me was of all those people who will be working over the holiday to keep us safe, warm, healthy, keeping the lights on, the roads moving, the food on our tables, and for all of those giving up their time and energy in 'being there' for others in shelters, on the streets or at the end of a telephone line. Many thanks to you all, and for all that you do for the rest of us. 

And wherever and however you are celebrating Christmas this year I hope you are able to find time to enjoy, laugh, relax and if so moved, sing the odd Christmas carol or song in the company of friends and family. W and me, well as soon as I press 'post' we are off to spend Christmas Day (and the next 8 days) up in the House in Scotland 

Best wishes for Christmas 2016!

Sunday, 18 December 2016

All I want for Christmas is some happiness and wellbeing for everyone

This time next week it will be Christmas Day. For many it will mean excitement, laughter and an opportunity to renew friendships and family bonds over a shared meal and the exchange of presents. For many others however, Christmas Day may not hold the same appeal. For example, the Department for Communities and Local Government published a study earlier in the year which reported that during 2015 there will be 3,569 people sleeping rough in England on any one night. In 2015 there were 68,560 households living in temporary accommodation, of which, 78% (53,480) were families containing children and or a pregnant woman.

The Joseph Rowntree Foundation reports that in 2015, there were 13.5 million people living in poverty, some 21% of the UK population. Whilst over 45% of those in poverty don’t live in a working family, there are 3.8m people who have a job yet are still living in poverty. 1.4m children live in long-term workless households, and 69% of the poorest in society have no savings whatsoever. The only group I could see where there were improving data was for those aged 65 or over. Despite there being a rise of 1.7m more people in this age group over the last decade, there are 400,00 fewer pensioners living in poverty.

These are depressing statistics, and although there is no data available for 2016 it is unlikely the picture will be much improved. The impact on individuals, their families and the wider community such difficulties bring cannot be overstated. For many people, it will mean living with daily unrelenting misery and unhappiness, despair and fear. The London School of Economics published an challenging report last week that looked at factors which impact on people’s happiness and wellbeing. One of the reports authors, Prof Richard Layard, noted that the evidence from their study showed that the things that matter most in terms of our happiness and wellbeing were our social relationships and our mental and physical health.

Whilst acknowledging that poverty, unemployment and homelessness inevitably will have a negative impact on individual’s sense of wellbeing, just simply having more money didn't improve people’s sense of wellbeing and happiness. Having a partner, and someone to share life with was seen to be more valuable than even doubling an individual’s income in the context of raising people's sense of wellbeing and happiness. In acknowledging that experiencing depression and anxiety would have the most negative impact on an individual's wellbeing, the study posed the question as to whether it would be better for the role of the State needing to shift from 'wealth creation' to something they called 'wellbeing creation'.  

Layard, who is an international renowned economist, has long campaigned for greater investment in mental health services in the UK. His work has demonstrated that eliminating depression and anxiety would reduce misery by 20% compared to the 5% reduction that would be achieved if the focus was on eliminating poverty. Extra spending on reducing mental illness would be self-financing, as costs would be recovered through higher employment (and increased tax receipts) and a reduction in NHS costs from fewer visits to GPs, in-patient mental health services and hospital A+E departments. Whilst the State has a responsibility for ensuring the availability of appropriate mental health services, families and friends will continue to have a huge role to play in reducing the impact of those experiencing mental health problems. And if you want to know more about dealing with practical issues, this is a great site for help and advice. 

I am part of very large family, and today many of our children and grandchildren will be coming for turkey and all the trimmings, present giving (and opening) and hopefully lots of fun to be had together. This is the start of a number of family celebrations which will end this year with a family party on Christmas Eve. However, this time next week, W and I will be up in Scotland to spend a quiet Christmas Day together with just Cello the dog and Billy the parrot for company. It's the first time we have done this, and surprisingly, I'm quite looking forward to it! 

Sunday, 11 December 2016

A new ‘toke’ on the older persons Great British Bake Off?

Hmm, well in a week where I got to see Sir Rod Stewart, who at 71, gave the Manchester audience a fantastic show, and Sir Mick Jagger, now 73, celebrating the birth of his 8th child, all I managed was to catch a cold. Actually it wasn't even a full blown affair. I had those horrible symptoms that lurked just outside of being a streaming cold, but were sufficient to give rise to a headache, sneezing, sore itchy throat, a tickly cough and general fatigue. LemSip, and Whisky (but not in the same glass!) were the order of the day, and as I write this blog the cold has been kept at bay. I have always been an advocate of self-medication, and I know that many minor ailments are self-limiting, so I’ve not had a problem. It appears I’m not alone.

Many older people have to deal with a multitude of different chronic illnesses. Its been reported that for some people living with conditions such as cancer, glaucoma, multiple sclerosis, arthritic pain and even Alzheimer's taking cannabis has helped them. Allegedly, it is said that one joint can do the same job as a cupboard full of different medications. Recent research in the US has revealed that over the last 10 years there has been a 71% increase in cannabis use by people aged 50 years and older. Although the use tails off in those aged 65 or over, there has still been a rise in cannabis use amongst this group as well.

Over 50% of all States across the US have now legalised medicinal cannabis use, and 8% have gone further and legalised the recreational use of cannabis. It may well be that in the US purchasing cannabis is a cheaper and easier option than buying prescription medication. Here in the UK more than 15m people admit to having taken illegal drugs; 3m continue to do so. Whilst the biggest users of drugs are in the age group 35 - 44, like the US, there has been an increase in those over the age of 50 using illegal drugs. The middle classes and those who live in Scotland (not necessarily the same thing) show the greatest use, and cannabis remains the most popular drug.

Interestingly, the studies show that only a tiny number of people (4%) started to use cannabis after the age of 35. One consequence is that older users are probably more experienced and have a lower risk of harming themselves or others after use – although a particular concern appears to be the increased risk of falls. Prof Dame Sally Davies, once named as the sixth most powerful woman in Britain, and now holds the post of the UKs most Senior Medical Advisor was one of those who once tried cannabis. She has never smoked but baked it in cookies while she studied medicine at that other Manchester university in the 1970s.

Now aged 67 years old, last week she was offering advice on how the baby boomer generation (those born between 1946-64) could stay healthy. Cannabis didn't feature. However she recommended as we got older we stayed working or once we retired we took up some kind of volunteering work. 30% of British workers will be over 50 by 2020, and 12% of this group are older than the current pension age.

It would seem that many people are living much longer than ever before. Of concern to these people is the fact that there are changes on the horizon as to what the future pension age might be. You can find out here when you might be able to draw your pension. Interestingly my state pension age is the same (May 2021), in both England and Scotland. I was able however, and if I had so desired, to get a free Bus Pass in Scotland back in May 2015, although, I would only be able to use it on buses in Scotland.

Time for a quick recap – I am happy to self-medicate when I am ill. I am soon to retire from my job in England, to live in Scotland. I don't smoke, but I enjoy baking. I won't receive a state pension until 3 years after I retire so will be poor. But I get free public transport on buses to anywhere in Scotland. I enjoy meeting people and I am quite good at sales, and the Chief Medical Officer says I need to keep active to stay healthy – methinks there might be a niche market opportunity somewhere in all this. 

I am pleased to report that the week ended on a different kind of high. I traveled down to Cardiff to see my Mother and Father, both of whom are from the generation that preceded the baby-boomers. They both look amazingly fit and well, and it was a lovely day. As far as I know they don't use cannabis, but interestingly my Mother had a baked some good looking cakes that had us all smiling for hours after we ate them. And just before anyone rushes to complain about this week’s blog subject – please accept that the blog was written slightly tongue in cheek, and of course I would not and do not want to advocate any use of illegal drugs!

Sunday, 4 December 2016

If you’re really smart, you won’t bother trying to get an appointment with your GP

Despite there being 33m landlines in use in the UK, a growing number of the population, around 14%, live in a mobile only home. OfCom 2016 research report noted that mobile phones are the media device most adults would miss the most. In 2014 it was their TV (and it still is for those aged 55 and above). So perhaps it shouldn't have been too much of a surprise to sit in a meeting the other day and watch a colleague endlessly switch from looking at (and using) the 2 mobile phones she had. There was almost something rhythmic to what she was doing in her constant scanning and responding to her emails. Amazingly, she also appeared able to actively participate in the discussions.

One phone is more than enough for me – but there must be lots of folk in the UK who routinely have and use more than one mobile. Indeed worldwide there are over 7bn mobile phones in use. The UK has a population of just over 64m. However, and interestingly there are currently 83m mobile phones in use and over 91m active mobile subscriptions. 93% of the UK population personally own or use a mobile phone, although only 71% of these users have a smart phone.  

It seems that the smart phone is becoming the preferred device to use for 60% of our on-line activities. There is a 10% increase each year in the numbers of people who only use smartphones or tablets to go on line rather than a PC or laptop. Most of us (87%) use the internet however, and the only group where this is not true are those aged 75 years and older In this group most (65%) don't use it at all. However there is one area of use where on-line access is still not generally fully developed - the NHS. The Nuffield Trust recently published report - The Digital Patient: transforming primary care? builds on previous work in this area. For example it acknowledges the way in which digital tools are already changing how many people manage chronic health conditions such as diabetes or asthma.

But equally many of the 165,000 health apps available today have not been properly assessed. And of those that have been assessed, many have been found to be inaccurate or ineffective. This is slightly worrying when its known that 51% of people using search engines cannot correctly identify what might be an advert or sponsored link. 62% of users accept that some websites will be accurate and unbiased, and some won't. However, 18% of users, and predominately people aged between 18–34, think that if a website has been listed by a search engine it must be accurate and unbiased!

The Nuffield report focused upon a number of digitally based services. For example, online triage programmes; symptom checkers; wearable technology; on-line appointment systems; and video consultations. One of its conclusions, was that the evidence around the effectiveness of health apps also applies to some of these other digital services. Leaving such quality issues aside (I'm sure someone somewhere will find a way to address these concerns) there is still the issue of the modern day equivalent of Horse, Trough, Water and Drinking going on here. Patients will not make use of the emergent digital services if they are not shown how they might benefit from doing so, and some people will simply not be interested in finding ways of increasing self-care.

In the UK, it is the NHS England's strategic aim to get at least 10% of patients to use one or more [official] on-line service by this year and 20% by 2017/18. The GP Forward View aims to ensure every GP practice is able and equipped to gain the benefit of high quality wi fi services and as such can make better use of technology in enhancing our experience of contact with health care services. A quick recap – we all use mobile phones, more of us own and use smart phones to access a wider range of services. The NHS is playing catch up but getting there. GP practices are to be equipped to ensure we start to access health care services in the same easy way we buy a take away, order a taxi, fill in our tax returns and find our way when lost. 

That might have been the end of this week's blog – and a good place to end it would have been. That was until I read about those good folk at NHS Somerset Clinical Commissioning Group (CCG). They have joined a growing group of CCGs who have started to ban GPs from prescribing a range of 25 items that are considered suitable for 'minor ailments'. It is one way to get people to think more about 'self-care' I guess, but some might think about it as another example of care rationing. If this is the case for you and you are already reaching for your smart phone to look for someone to complain to – I have saved you the effort – you can click on the hyperlink here.