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?