Family, French Hens and Friendships

Last week was a difficult one and I was really glad to get to Thursday, where at the close of play I decided ‘that was it’ for the 2011 academic session. It wasn’t and I spent many hours on the 23rd sorting out problems and it was late on in the evening that my Christmas break started. Yesterday was Christmas Eve, and it was a day that started dull and cloudy. I went up to High Rid with Cello, and unlike last year there was no snow, and spookily, no people.

Later on, Christmas Eve was to be transformed into Christmas Day as some of my children came to celebrate their Christmas. By 14.00 there were ten of us sitting around eating a wonderful Mushroom, and Cashew Nut and /or Turkey Roast meal – and yes the sprouts were cooked to perfection, the roasted vegetables were heads held high in a rosemary herb sauce and the mash was horseradish infused. There were no prisoners and no leftovers for the chickens to enjoy.

Today is to be a repeat performance, but with a completely different set of members of the extended family– this time with eight people sitting around the table. However, a relaxed day is envisioned as we are not planning to eat until 16.00 hours. There is a chance for Cello and I to go for a walk, and put the world to rights as we do.

And today is the first day of Christmas. I am always reminded of the song the Twelve days of Christmas on Christmas Day. January 6th is the Twelfth Day, and the Twelfth Night is defined by the Oxford English Dictionary as ‘the evening of the fifth of January, preceding Twelfth Day, the eve of the Epiphany, formerly the last day of the Christmas festivities and observed as a time of merrymaking’

Of course (well maybe) it is the Third day of Christmas that interests me the most. This is the day that ‘my true love’ gives three French Hens which, in a biblical sense refers to Faith, Hope and Charity. Given the high degree of uncertainty there is for many people in the world at the moment, these are virtues that we are going to have to draw upon again and again over the next 12 months.

Yesterday, thanks to Mr I Pad (and don’t say anything to my little Brother Mark because he will become impossible in a I told you sort of way) I was able to speak to family and friends from around the world. Amazingly clear images and conversations all of which were achieved at a press of the button. I will speak to my little sister in Australia later on this morning but she did send me a photo of her outside Christmas tree decoration.

 

This is my first blog at Christmas that is actually written on Christmas Day - so it only remains to say a Merry Christmas to all my many French Hens, Family and Friends, and whereever you are and whatever you are doing, I hope it’s really good for you.

Another Six Hours Travel, but its Plymouth and not Dubai before its Red Shoe Time and an End of Week Surprise

Last week I spent an extraordinary amount of time sitting in railway carriages, waiting at train stations, searching pockets for wayward tickets, but also meeting some amazing and at times, unusual people. I am coming to the end of the Christmas Party season, and I have found it’s much easier and safer to imbibe the occasional tipple and then travel by train rather than get in a car and drive home. However, in the middle of the week I travelled down to Plymouth to take part in a PhD examination.

On the morning of this journey BBC News 24 hours started their broadcast from Plymouth Hoe. The report was about the storms and the winter weather that had engulfed the UK. We were due to have our first snow of the winter. Of course with the storms came the usual disruption of everyday life. The journey down to Plymouth took some 7 hours. The Hoe was just a collection of some distant unconnected lights seen from my hotel window. In the morning it was just possible to view the Plymouth Hoe through the buildings.

The students study was on how service users might best contribute to the acquisition and development of interpersonal skills in student mental health nurses. I was privileged to sit with another external examiner who had Hildegard Peplau as her own PhD supervisor. Peplau was possibly the first nurse theorist after Florence Nightingale and her life’s work was devoted to exploring the importance of the nurse - patient relationship and its primary importance to nursing practice. Unsurprisingly perhaps, her area of focus was on mental health care.

The journey back to Manchester was another 7 hours of disrupted travel. I will be happy if I don’t see Birmingham New Street Station for a long time to come. The last time I traveled 6-7 hours to and from Manchester the destination was Dubai – and Plymouth, as attractive as it may be, wasn't Dubai. Thursday was a second PhD viva – strange, like waiting for trains at BNS, nothing arrives for a while and then two come together.

 Friday was the last School Development Day of 2011. Traditionally, (in my 5th year as Head of School) it is when the Red Clogs come out. These are my Christmas Clogs, worn only from the School Development Day to Boxing Day – then they go back into storage. As those readers who have met me know that black is absolutely the colour of the day. I got my Red Clog inspiration not from my friend, colleague and Professor of Mental Health Nursing, Phil Barker (who habitually wears red clogs, and once claimed that Hildegard Peplau would be one of the six people he would include in his personal life boat) but rather from the 1948 film the Red Shoes. This is a film of a ballet dancer (Vicky) and the dilemmas she faces in choosing between love and a career. There is a wonderful conversation between the ruthless but charismatic impresario of the ballet Lermontov, who questions Vicky at a critical point in her career:

Lermontov: Why do you want to dance?

Vicky: Why do you want to live?

Lermontov: Well, I don't know exactly why, but... I must.

Vicky: That's my answer too

Of course the film is loosely based on the Hans Christian Anderson fairy tale in which a young woman sees a pair of red shoes in a shop window, and which are offered to her by a demonic shoemaker – of course after she accepts the shoes her life is cursed as wherever she goes and whatever she does the shoes refuse to stop dancing and the young women eventually dies from dancing exhaustion.

Dancing exhaustion is a state of being that I do understand. Unexpectedly I found myself at the MEN in Manchester on Friday night dancing to a band called Duran Duran. How I got there is a tale almost as complicated as the ballerinas and the shoe makers. Duran Duran is a British band, formed in 1978. At which time I had two children, and despite my other three children still being just a twinkle in my eye, this was a band that didn't feature on my musical radar even though the band initially were part of the New Romantic scene.

The band became popular for their music and some fairly controversial videos, which featured partial nudity and suggestions of sexuality. In the early 1980s these were shown on what was then a new music video channel on the television called MTV. However, it was another film from the mid 1940s that was the start of this revolution. Brief Encounter (1943) tells the story of housewife Laura who meets a doctor called Alec at a train station. Although she is already married, they gradually fall in love with each other. They continue to meet every Thursday in the small café at the station. This passionate pair, who don't ever exchange a kiss during the film, eventually decide to part. When Alec puts his hand on Laura's shoulder at their final meeting in the station café, it's as erotic and far more touching than just about every sex scene you'll ever see in a Duran Duran video .

But enough of such musings, Cello, who has loved the snow of the past week, is awaiting his first walk of the day and its time for me to get up and make a start. As I appear to have acquired a cold from somewhere, I can only think that walking is definitely better for my health than train travel. 

Enduring Migration, Some Information, and Christmas Beckons.

Those of you who are regular readers of this Blog will have noticed that today’s blog was posted some three hours later than normal. I have been temporarily forced into a new Sunday morning regimen through something called Migration – and I have to say I am not a happy bunny!

Migration in the context of IT is the movement from one system to another. Strangely in a world that I assumed to be constructed around certainties and formula based approaches, it is unsettling to be told that the people managing this migration cannot tell me when I will be migrated. So until I am migrated, I have to turn off my computer at 18.00 and not turn it on again until 07.00 the following morning. This procedure has to be adhered to for the next seven days – so it will make for an interesting time I think. Still it could be worse. Our IT systems migration and hopefully improvements might have been undertaken by the same people as those involved in the failed NHS IT system.

According to the Times this week Margaret Hodge (a Labour MP), and chair of the Public Accounts Committee, described the American firm in charge of the failing NHS IT project as ‘cowboys’ who should be ‘run out of town’. Incredibly it seems that Computer Sciences Corporation was looking to increase its contract by a further £2bn even after it failed to deliver any fully functional software to the 166 NHS trusts in England. Margaret’s outrage is interesting given that way back in 2008 it was known that Labours £12bn NHS It project had run into serious trouble. Launched in 2002, the Labour Government NHS IT project was supposed to revolutionise the health service. A report published by the Public Accounts Committee last week reported that the scheme has fallen behind schedule and costs have escalated.

The cost of the electronic record element of the NHS IT project is estimated at around £7bn. To date, the Department of Health has spent £2.7bn on it. Last week the Government announced they were cutting their losses and intend to spend the remaining £4.3bn on better systems that have been proved to work and offer more value for money. However, not everything is to be lost. Spine, which stores patients' care records, the N3 Network offering a broadband network to health workers; NHSmail a unified, secure email system for the whole service, and the Choose and Book system, an appointment booking service are to be retained and developed further. The NHS has partnered up with Intellect and the Technology Trade Association to take the NHS IT improvement forward. These organisations mainly work with small to medium size companies and for me it’s great to see an antidote to one-size-fits- all approach in action.

And talking of which, this weekend the Christmas Branch went up. Now over the years this alternative (Rainbow Warrior style) approach to cutting down Christmas trees has been both ridiculed and loved. A long time ago, I would supplement my income by working in the Welsh plantations cutting down and dragging hundreds of Christmas trees out of the woods for this once a year extravaganza. I earned pence for each tree, and I knew back then that one day I would not cut any more trees down. I don’t do artificial Christmas trees, so the alternative for me at Christmas has been a Christmas Branch. In my current home I am fortunate to have a number of big mature Beech trees in the gardens, and every October I select a branch and cut and store in the garage until this weekend. Then in it comes to the house and accompanied by Sherry and Mince Pies, the branch is dressed.

In compensation for my personal and perhaps reckless deforestation of Wales, every year I also buy a ‘Christmas’ tree with roots and plant this outside, sometimes in my gardens but sometimes on the hills that surround the house.

And wandering around my garden yesterday looking for somewhere to plant this tree I couldn’t help but notice just how well Mother Nature does in dressing her own trees. For example, both a Crab Apple tree with its miniature bauble like fruit and a Silver Birch with its funky fungi looking splendid in the autumn air.

Information Bubbles and the Search for the Perfect Red Wine Continues

Last week I came face to face with someone who in the words of Eli Pariser, described the way in which at any particular time, we create, enter and inhabit a bubble that allows us to make sense of the incomprehensible, the inexplicable, the exciting but unknown aspects of the world we live in and in doing so, we are able to retain some sense of ontological security. OK Eli doesn’t say all of that, it is of course my interpretation of his work. In his book The Filter Bubble, Eli argues that why we might all live in the era of personalization, our world views are being distorted by the change in the way media is being consumed by internet users.

In a week where I explored with a group of new Masters students the impact of what I call a Focauldian governance of the UK Public Sector, I find Eli to be an intriguing online organiser and disorganiser. He has been a long term critic of the way in which in the new information age algorithms, code and robots curate search engine result – amid as such, can we ever be sure were seeing the whole picture? Some would answer yes, resoundingly.

Last week I dealt with two Academic Misconduct cases, where through Turnitin, colleagues were able to say, and say categorically, that students involved had extensively copied from other peoples work and presented it as their own. I also waited with two colleagues for life changing information to filter through and reach us. And when it did, the information in itself did not help make sense of what, up to that point might have seemed a perfectly rationale world.

Importantly, for me and perhaps all of us, (with the possible exception of those asleep on the train to Preston) is the growing need to get to grips with the way in which the so called information age is changing human life profoundly. Arguably an almost unfettered access to information is changing culture, language, and it has even changed the thought process – legitimisation by Wikipedia rules OK.

This week the UK Secretary of State for Health, Andrew Lansley observed that many patients will benefit directly from Governmental efforts to make health data transparent and easy to use by the medical research community. Allegedly such free access will fuel advances in treatment, as well as positioning the UK as a centre of excellence for research. Of course this access to personal data is a good thing, but I wonder where all this information has come from, where it is stored and who is using it for what other purposes. Whether any of this prolific collection of data and information will make a difference to patient care or patient choice remains to be seen.

Also this week I have been involved in looking at the work of colleagues in the College and the wider University in relation to the forthcoming Research Excellence Framework (REF). It was good to see that in the main we are already in a good position. As I have noted before, UK research papers attract 11% of the world’s citations and make up 14% of the world’s highly cited output, including 17% of the world’s research papers with more than 500 citations and 20% of those with more than 1000 citations. The average research impact of UK publications now surpasses that of the US and we manage all of this on very limited State support. The UK spends 4% of the world’s Gross Expenditure on research, and the UK boast 6% of the world’s researchers who are authors on 8% of the world’s research articles and reviews published in internationally influential journals.

And as my research mentor enters his last couple of weeks with us the search for the Perfect Red Wine continues afoot. Finding and drinking the right amount of red wine is of course, as the research evidence suggests, crucial to our health and well being. This week in an attempt to contribute to this knowledge base, I have imbued some very indifferent Italian, some superlative Australian, and some excellent, if somewhat overpriced Chillan red wine. The wine from Chile was a Syrah Mouvedre from the Maipo Valley. The taste was of elegant aromas of dark fruits such as black cherries and redcurrants with rich chocolaty notes, with hints of toffee and nutmeg. So far the Chillan is winning – although of course, a little more empirical research is required.

And for all those Rainbow Warriors out there - sorry but yesterday I had to ditch the solar powered Christmas Tree lights on my Weeping Birch tree. They never got past 7.5 minutes of feeble illumination. So I rejoined the National Grid and now enjoy warm whitel lights glowing brightly in the darkness. However, unlike my neighbour with his unattractive grey plastic junction box, I utlised a blue tit nesting box to bring the wires, transformers and so on together in a totally eco friendly way.

Pipelines, but a very Different Landscape to Basra, Opening Minds in Openshaw, and a Birthing Centre in Bolton, and Cello loses his Ginger

In what felt like a very packed week it was still possible to find the odd oasis of amusement and fun. Waiting for me on Monday was a copy of a letter from Ian Dalton, Senior Responsible Officer, FT Pipe Line (what a job title!). In this letter Ian sets out the NHS plans for an all Foundation Trust Provider Landscape by 2014. The letter is a delight of metaphorical ambitions, there is much talk of tough journeys, challenging journeys, the amount of the work the journey will entail, next steps, steps to be taken as organisations start off on their journey – a journey to establish a FT pipeline across the English Landscape. It’s wonderful stuff and the letter is a delight to anyone remotely interested in doing some content analysis.

It was on the 3rd October 2011, that the NHS North East, NHS North West and NHS Yorkshire and the Humber - the three strategic health authorities in the North of England - were placed under a single management framework now known as NHS North of England. And Ian is, of course also the Chief Executive of the NHS North Strategic Health Authority. What some people might not know is that while working for the Department of Health, Ian was seconded to the Foreign Office and posted to Basra. There he oversaw the reconstruction of health services following the Iraq war.

Tuesday night involved a Silver Service Dinner at the Bistro East, at the Manchester College, Openshaw. The meal was a celebration of some early successes with the Single Ticket project. The Single Ticket programme was developed by Manchester College, and a number of high profile partners from health and social care, inckuding our School. It aims to give the residents of Manchester and Salford an opportunity to gain experience of working in health care and gain a BTEC Health and Social Care qualification. The students on the programme gain experience in mental, adult and children’s health care through varied work placements. The first of the successful students to gain jobs were guests and hearing their stories was a real privilege.

Colleagues from Solleftea in Sweden were also guests and dinner provided the opportunity to hear of their experiences in delivering similar projects and to explore where we might work together in the future. The food was prepared and served by the College’s catering students. Whilst the food wasn’t entirely my taste the presentation was absolutely awesome and there were some fantastic food creations.

Last week saw the closure of the traditional maternity services in Salford. And on Wednesday evening I attended the opening of a new Birthing Centre in Bolton. Champagne and canapés were the order of the night. This was a private birthing centre offering a range of services from fertility advice through to birth. The opening of the centre coincided with the first reports of the Birthplace in England research programme. Birthplace is an integrated programme of research and is made up of several interrelated studies designed to provide evidence about important childbirth outcomes for women, their partners, and health professionals. This information will help all those involved take informed decisions over chosing where baby might be born. The research outcomes will also help policy makers and service providers to provide the highest quality and most cost-effective maternity care services.

However, some of us don’t have any choice over certain aspects of our lives. Despite the colder weather arriving, this week Cello was taken for what I am sure he hopes will be his last hair cut of 2011. His coat had become long, curly, slightly unruly and absolutely ginger in colour. After having a Christmas Trim, he does look smarter, can run and swim further, and his coat has returned to his original and lovely chocolate brown colour. However as I write this post there is a gale blowing outside and the rain is lashing against the windows. I can see it might be difficult to get him out of his bed for a walk this morning!

Conversations, Journeys, Susan Sontag, and French Wine!

Whilst the previous three or four weeks have, for me, been characterised in part by travel and meeting some very intresting and exciting people along the way, last week was different. The closest I got to travelling was to say goodbye to a friend on Platform 13, Piccadilly Station. However, this week I have found myself in conversation with a number of other people, who in lots of different ways, were starting life changing journeys of their own.

Some of these journeys were the result of choices they had made, others were not. For some the journey will involve them having to deal with potentially life threatening illnesses. Reflecting on the conversations, some of which I felt were undoubtedly difficult, I recalled the words of one of my favorite writers, Susan Sontag. She said ‘silence remains, inescapably, a form of speech’. Silence has been something, in a therapeutic context I have been very comfortable with. However, in other kinds of conversations, it is equally important to sit and listen, in order that others have the space within which they can speak.

Susan Sontag, was a writer, critic, feminist and gave a voice to a generation of diverse academics that lives on way after her death, she sadly died in December 2004 from uterine cancer. Two powerful works, Illness as Metaphor, (1978) and later, AIDS and its Metaphors (1989) were written while she was being treated for metastatic breast cancer. I used some of her work in my PhD, drawing upon her explication of the use of metaphor in professional and personal accounts of illness and treatment, and what the concept of truth in the transactional aspects of relationships might involve: 'The truth is always something that is told, not something that is known. If there were no speaking or writing, there would be no truth about anything. There would only be what is'.

And ‘what is’ featured in other conversations about relationships last week. Some of these conversations were about professional relationships. I met with all the School Directors to talk about the outcomes of conversations that were held the previous week. As a consequence of those conversations I asked some of the Schools Directors to take responsibility for areas of the Schools business that they might consider took them out of their comfort zones. However, ‘the truth’ is that they all have shown great skill and application over the last two years in ensuring the School has continued to make progress towards its strategic ambitions. I believe that in the taking the work of the 'new School' forward, these talents needed to be refocused to fully take advantage of the opportunities open to us.

Opportunities lost and promised, featured in other conversations. An evening meal with a friend where the conversation included how difficult it can be to witness the relationships of others (dearly loved) sadly coming to an end. But I also had a delightful lunch (in a very noisy Café) with a good friend on the cusp of great things, who I hope will continue to believe in themselves. And Thursday evening’s conversation surprisingly involved French wine with something to eat and good company (surprising only given my love of Australian wines).

And I am starting on my own little journey, and one that involves an Apple. After years of steadfastly refusing to entertain the notion of buying an I-this or an I-that, I succumbed and purchased one of those new fangled I-Pads yesterday (it’s still in its shiny box). I will see how I get on with this particular journey. The I-Pad, I am told, will replace my book and CD library and allow me access to information anywhere. Susan Sontag described books as being 'funny little portable pieces of thought' – I wonder what she would have thought about the I-Pad.

Tracey meets Liz, Outrage in Amsterdam and Chicken Pox Lollipops

Eccentricity, difference and even a little quirkiness have been on my mind this week. As those readers familiar with my published work will know, the drive towards universality, homogeneity and coercive specification is an anathema to me. Unfortunately, it is often these approaches that organisations seek to impose in a countervailing attempt to address organisational adversity. Such adversity usually arises from changes to an organisations economic, political and or professional wellbeing. However, as I have said many times before ‘the more precisely you specify a professional performance, the easier it is to measure and the harder it becomes to motivate’. For whatever reason, this week I have been more than usually aware of such approaches. It may well be that I have been playing catch up with emails and the concentrated reading of these might well have resulted in a heightened perception on my part.

So imagine my dismay on learning that the bad girl of art, Tracey Emin had met the Queen for a cosy chat last week. Dressed in a Vivienne Westwood suit (but it was highly tailored and grey !?!) Tracey met the Queen at an art gallery in deepest Margate, Tracey’s birthplace. The gallery was exhibiting a diverse collection of works depicting youth. Tracey, whose work includes installations that feature amongst other things used condoms and blood, even gave the Queen a curtsy upon meeting her. It seems the once somewhat eccentric, angry and outrageous Tracey has finally become part of the establishment.

I was in one of my favourite cities on Thursday. I first went to Amsterdam some 40 years ago, and for me it has retained an almost magical quality and appeal. I was there for a meeting with colleagues to plan another European project aimed at finding ways of improving the preparation of nurses for professional practice. Although the schedule was busy there was time to also walk around the city and to see how it had changed. The magnificent central train station had been cleaned up and was a fantastic testament to Dutch architecture, faith in the future, and economic prosperity.

In the city centre was a large anti capitalism protest camp against. These camps are becoming an almost ubiquitous feature of many cities. They have grown in number over the last couple of years and are to be found all over the world. The protest camps have as their inspiration the work of Stephane Hessel and in particular his essay, published in 2010, entitled Time for Outrage. Indeed the early protest camps (in Spain) were named the Outraged. Hessle’s concern has been on the increasing gap between the rich and poor in society, particularly where this impacts upon the provision of health, social and welfare services in society.

For me the most bizarre manifestation of this gap was the story last week of the so called Lollipox. These are the products of an online business in the US that sells second-hand licking lollipops from children who have recently had Chickenpox. The lollipops are sold through Facebook. Anyone who knows anything about Chickenpox knows that buying these lollipops is a complete waste of money. Chickenpox is caused by the Varicella zoster virus and is usually spread through the air and/or through direct contact with the fluid from blisters.

And blisters are where I end this week’s blog. Yesterday I spent a couple of hours blowing the leaves off the drive. Despite having a big boy’s toy of a blower, the task involved muscles not used for a while, and gave rise to blisters to both hands.

Another Sunday Morning in Dubai – But it was a Great Busman’s Holiday

This time last week I was sending my blog from the Business Lounge at Dubai Airport. One week later, and I am once again sending my blog from the Business Lounge. In between I have been to Adelaide on a bit of a busman’s holiday. And it has been a wonderful week. I was hosted by the School of Nursing and Midwifery at the University of South Australia. They looked after me as if I was royalty.

The Qantas problem was overcome with a stopover in Melbourne – lovely to step out into the city and have lunch by the river – it brought back fond memories of previous visits. The evening was spent with a group of trainee Air Hostess. They were the most competitive group of people I have come across in many a year. I was appointed official judge for the best doughnut hair style. I have to say I was fascinated by the way those who knew how to do it did it – and did so effortlessly. I didn’t realize there was an actual material doughnut involved.

One day later than I planned I arrived at Adelaide. Two hours after landing I was having lunch at a Rundle Street pavement restaurant. Lunch proved to be a great opportunity to start the process of finding out what similarities there might be between the School of Nursing and Midwifery at UniSA and the School of Nursing, Midwifery & Social Work at UoS. And there are many. Although the School at UniSA only taught nurse and Midwifery programmes, the numbers of students for these programmes were comparable to the UoS School. Amazingly from a UK context, each student has to make a contribution of up to 5000AUD toward the cost of their education and training – and some 90% of applicants to the School had UniSA as their first choice.

The next day I had an escorted tour of the city which touched each of the four quarters of Adelaide – so it was possible to experience the inner city, with its fantastic mixture of old and new architecture, and its bustle – epitomized for me in taking a coffee in the Central Market – the hill district, which of course had to include a visit to a small boutique winery, and then the old part of Adelaide with its fine old buildings set in huge plots, before going to the coast. When I first came to Adelaide in 2001 it was to a service led mental health conference. The coast with its sandy beaches and shallow warm water were the memories I have kept in mind ever since.

After a fine lunch at Lofty Peak, a lunch taken with a panoramic view of the city, it was back to the University to see the practice simulation laboratories. These were superb. Every clinical context was catered for and they were ‘staffed’ by colleagues from practice. It was an impressive set up that brought together new technology, the best from contemporary clinical practice and an approach to skills acquisition that was comprehensive and realistic. And it didn’t stop there as some of these facilities were so realistic and well equipped that the plan is to run real life clinics from them.

The following couple of days were a mixture of great conversations with some interesting and enthusiastic colleagues. I had a breakfast meeting with Nicholas Proctor and was able to identify a range of shared mental health research interests that I will follow up on. And by a strange twist of fate, this week I have also been attending a week long virtual Editorial Board meeting for the International Journal of Mental Health Nursing – many of the Board, including the Editor, are resident in Australia. But Australia is a big place and trying to get everyone together for a meeting is next to impossible. This week I was able to contribute in real time and not as is normally the case, some 10 hours behind the conversation.

So many thanks to Alun, Alan, Kelly, Roger, Mary, Nicholas, Peter, Carol, Joanne, Geri the driver (who had an encyclopedic knowledge of Adelaide’s history) and especially Michelle whose unremitting attention to detail made the whole trip a very successful one. Qantas got its act together and delivered me to Sydney airport, where Emirates once again took over That A380 is a great plane - but you have to travel on the upper deck to understand why.

After travelling for the best part of 17 hours already I am just 7 hours away from Manchester – I wonder how the little Arctic Tern manages the same journey on just an occasional swoop down for the odd fish along the way. And just how does he know whether to turn left or right?

Back to Marmot, a Foot in the Door, and Dubai Airport at 03.45am

It was Lord Marmot who in his publication Marmot: A strategic review of health inequalities in England post-2010 set out the six main policy areas that required action to be taken if health inequalities were to be reduced. These policy areas: (1) Give every child the best start in life (2) Enable all children young people and adults to maximise their capabilities and have control over their lives (3) Create fair employment and good work for all (4) Ensure healthy standard of living for all (5) Create and develop healthy and sustainable places and communities (6) Strengthen the role and impact of ill health prevention provide the strategic framework for developing a fully integrated public health policy for England.

The UK Government’s Health and Social Care Bill 2011 introduced the new Health and Wellbeing Board which is charged with improving local health and social care, and reducing health inequalities. It sits within the local authority, although responsibilities for delivering many of the Boards functions will have to be shared between agencies. The Health and Wellbeing Board have a statutory responsibility for the delivery of a local Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy in order ensure joined up commissioning across health, public health, social care is achieved. What’s exciting about these changes is that the Board will need to think more creatively for innovative solutions and draw upon wider services in order to more effectively promote health and wellbeing, and for delivering value for money.

So I was pleased this week to read the publication from the Northern Housing Consortium entitled A Foot in the Door. This publication is both very informative (in terms of describing the emergent health and care structures and organisations) and a useful and useable ‘tool kit’ for those working in the housing sector to use when looking at developing more collaborative relationships with health and well being commissioners and providers.

The NHC Chief Executive, Jo Boaden is enthusiastic about tackling some of the complex issues that result in such persistent health inequalities. The toolkit reminds the housing sector that they already have an invitation to get involved and that the agenda for change is clear. Poor housing conditions are implicated in up to 50,000 deaths in the UK; cause 0.5 million injuries and illnesses that require medical attention; and contribute to increased risk of cardiovascular diseases, respiratory diseases and depression and anxiety.

There are huge economic issues associated the provision of poor housing. The estimated costs to the NHS in England each year is around £600m to provide treatment for health problems arising from poor housing. In 2010 the average cost of a fractured hip is £29665; five times the cost of an average adaptation and 100 times the cost of fitting hand and grab rails for older people. Research shows that investment of £1.6bn in housing related support generated savings of £3.41bn to the public purse including £315m of savings to health service in a year. The NHC note that investment in specialist housing could result in savings to the public purse of £639m each year, including an estimated saving of £11751 per person to the NHS for those experiencing a mental health problems.

The challenges for the School in responding to these opportunities are fantastic. Developments such as these in the Schools operating environment present us with a much wider range of opportunities to bring our combined expertise to bear in developing new programmes of education, research and engagement. However, I will have to leave such thinking until later. Instead of sitting in my bed with a cup of tea at 05.00 am on Sunday morning writing this blog, I am in the Business lounge at Dubai airport on my way to Australia and its 07.45 am 03.45 UK time, some 7 hours after leaving Manchester last night. And I’m just a little tired to be thinking about anything other than the next 14 hour flight to Melbourne. The really good news is that Qantas (the internal carrier for Emirates) have gone on strike. I am not sure how I get to my final destination, Adelaide!

Three Weeks Early and One Week Later.

Two hours after writing my blog last week, grandchild number six was born. Heavily pregnant Rebecka was staying over to meet older sister Jennifer who was visiting on the Sunday. Just as I finished my blog Rebecka announced that her waters had broken and it was all action stations. At 06.50 little Jack was born – three weeks early. Conceivably [sic] the midwife who delivered Jack would have been trained and educated at our School, more of which later.

As Rebecka has yet to return to her own home, preferring to stay here all week, it has been a somewhat busy week. It’s been more late nights and early, early mornings. The West Wing resembles a maternity unit, and the number of visitors arriving during the week has made Amsterdam Airport on a busy Bank Holiday weekend look completely tame. Yesterday it was the Lincoln contingents turn. Now Saturdays are meant for doing the chores and starting the relaxation promised by a weekend away from work. Yesterday turned out different. I got to understand where the ninth century Bishop Aethelwold of Litchfield was coming from when he commissioned the manuscript The Book of Cerne. The work is famous for its inclusion of the Harrowing of Hell, possibly the earliest surviving Christian drama script. This play describes Christ’s decent into hell. Spookily the story is depicted in a wonderful stone frieze high up on the walls of Lincoln Cathedral.

Tuesday was an interesting day. The morning was about dealing with what turned out to be in-appropriate behaviour by a student towards other students and staff in the School. A difficult meeting to have and unfortunately it was a meeting with a very sad outcome. Unlike the afternoon which involved a PhD viva. As regular readers will know, I think that taking part in PhD viva is a huge privilege. I tend to treat each viva as a chance to have a conversation rather than simply facilitating an examination. And so it was on Tuesday - it was a great conversation and the outcome was a good one.

Thursday was slightly stranger day. I was lucky enough to be part of a group visiting Keele University to explore partnership opportunities. So 08.30 saw me sitting in a mini-bus travelling down the M6 motorway alongside the VC and other assorted colleagues from across the University. My day at Keele was hosted by Professor Andy Garner, an internationally renowned academic and practitioner from the field of Pharmacology. He is the Dean of Health and Pro-Vice Chancellor at Keele University, and introduced me to the first virtual ward I have ever seen.

Imagine walking onto a ward that is there, but as you try to touch anything, a bed, a patient and so on, it’s not there. Yet you can pick up the patients notes, flip the pages, and read everything that has been written. You can talk to the patients and be with them while they vomit (yes into a bowl that you can see, but can’t touch or smell), and you can intervene and provide treatment – if it happens to be wrong it might kill the virtual patient, which of course is much better than doing so in real life. The experience showed me what might be possible at Media City, and possibly what it is I don’t yet know about what it is I don’t know in terms of using such technology.

And as we enjoy a slightly warmer and brighter weekend than at first thought possible I am sending envious glances to those colleagues who this weekend are able to walk in the hills or on beaches, but I am also sparing a thought for those colleagues who might be busy preparing for their viva on Tuesday, or making a start with sorting out their expressions of interests for the new Director roles.

And those midwives – an interesting experience. Clearly they are very good at doing what they do, but I found the juggling between what is offered as official advice and guidance and that gleaned from practical experience an interesting cultural manifestation of what appears to be contemporary midwifery practice. I won’t say anything about the quality of the written comments the midwives make when reporting on what they have encountered at each visit, but I do intend to write a paper about the obscurity of succinctness in such records.