All Change at Crewe, and Play it Again Sam

Last week was a busy one. Monday and Tuesday were full on days at the University. Academic Council on Tuesday was devoted to rethinking the University Research, Enterprise and Innovation Strategy. The debate was honest and focused and reflected very much the recent developments in the School in terms of getting to where we want to be research wise. And then early Wednesday morning it was off to Crewe and the Council of Deans 2013 Summit.

Now the Council of Deans (Health) are a membership organisation, influential  and powerful in  representing the voice of the Deans and Heads of the 85 UK University faculties across the UK who deliver health professional education and research for nursing, midwifery and the allied health professions. Strategic direction and operational management of the Council is delivered through an Executive Team made up of representatives elected by the membership and who represent either the 4 nations of the UK or particular professional groups. On Tuesday, following a membership ballot, I was elected to the Executive Team to represent nursing and midwifery education.

The summit was a great success, with speakers such as Ian Cumming, Alistair Burns, Emma Westcott, Belinda Dewar and Pauline Watts presenting well thought through challenges to the future health professions education agenda, regulation, dementia awareness and relationship centred approaches to health care. The latter challenge is something very close to my own heart. It was then a fast forward to Friday, a hectic day playing catch up, but with a long weekend to look forward to.

Saturday was the start of Scotland’s premier Art and Craft Open Studios Event. This is the Spring Fling where just under a 100 artists across the Dumfries and Galloway area open their homes and studios to the public. First stop was to Urpu Sellar, my favourite artist and creator of quirky sculpture. It was wonderful to be able to see where she creates her works and enjoy a whistle stop tour through her home. It was very Finnish, even though she has lived in Scotland for 32 years.

Whistle stop tour to the Wicker Man creator, Trevor Leat – fantastic works created entirely in Willow. Then on to Adam Booth, an exceptional Blacksmith Artist! A pulsating 45 minutes were spent looking at his creations (truly amazing), and watching him use his forge, before buying a flock of seagulls for the garden. However, yesterdays stay in the mind experience was becoming Humphrey Bogart in Castle Douglas. 

Kim Ayers, photographer with big idea, is creating a 100 portrait installation of Humphrey Bogart’s – all of which are members of the public, who dressed in the same trench coat and trilby, have a black and white photo taken and placed on a Humphrey Bogart wall. This wall when assembled will be photographed as a single image and posted on the internet as an image of Humphrey Bogart made up of these individual photos. I cannot show my photo here as its work in progress, but I will post once published. Today its garden visiting, which feels a long way away from NHS Commissioning Boards – but I guess both are equally important. 

Grumpy Old Man Blues

I woke up this morning feeling just a little grumpy. I am not sure why, although there have been plenty of things to set me off. For example, I was just a little annoyed to see how the BBC chose to report the news of the forthcoming publication 5^th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). They claim it was known as the bible of psychiatry. Now come on, apart from upsetting my Mother who considers the Bible sacred (as do many other believers in Judaism and/or Christianity), just who are these people?

Mainly it seems the American Psychiatric Association, a powerful group who seem to rely more upon consensus rather than the evidence base in diagnosing mental illness. Although mainly used in the US, the DSM-5 is influential in other parts of the world. Peter Kinderman, Head of the Institute of Psychology at the University of Liverpool speaks for many of us when he notes that the DSM – 5 lowers many diagnostic thresholds and increases the number of people in the general population seen as having a 'mental illness'.

I noted in my blog late last year that the additions planned for this new edition of the DSM – 5 will turn normal everyday behaviours and reactions into a mental illness. In the UK and elsewhere in the world the International Classification of Diseases (ICD - 10) is used as the standard diagnostic tool. ICD – 10 has been used since 1994, the 11^th edition is due out in 2015. Unlike the consensus approach of the DSM, the ICD is fully endorsed by the World Health Organisation. Given this, I’m not sure why we need the DSM.

Consensus and endorsement by the medical profession could also be found in the letters page of yesterday’s Times. 12 former Presidents of Medical Royal Colleges (including Royal College of Psychiatry) wrote in support of the Assisted Dying Bill tabled by Lord Falconer in the Lords last week. A clever letter, which both said it wasn’t up to the medical profession to create the legislation, but it would need 2 doctors to work independently to ensure the patient’s wishes were met when choosing the time and circumstance of their death.  It would be just my luck to get one doctor using the DSM and the other the ICD to aid their decision making.

I was also grumpy last week about the Angelina Jolie story. Raising the public perception of the issues involved is great, but this appeared to be another tale of what evidence should/could be used by women in making life changing decisions. Myriad Genetics are facing a Court Case over their patent of the BRCA1 and BRCA2 genes, the genes that when present indicate the risk of breast cancer. These genes were patented in the mid 1990s and since that time a million women have had the test at a cost of £1970 each test. It’s estimated that over the past 20 years at least 41% of our genes have become the intellectual property of corporations. Its good to know that genetic testing can be carried out on the NHS if there is a strong family history of breast cancer.

In a couple of hours I’m off to do a 23 mile charity walk – over (or rather up and down) the hills of Lancashire. No decisions to make, other than what to put into my sandwiches: Cheese, cheese and tomato, cheese, tomato and mayonnaise, cheese, tomato, mayonnaise, and fresh spinach – Oh forget it, peanut butter and Marmite will do. The Blues, well last week I finally got around to buying Seasick Steve’s Hubcap Music, another grumpy old man, but his music is great to walk to. 

Glad to be Celebrating Nurses Day!

Last week was a difficult one for many reasons. One reason was the fact I was both under the weather and concurrently under the cosh to produce a major piece of work for the University by last Friday. My throat seemed to be the focal point for my ailments and at one point I was spraying, sucking, drinking, rubbing and inhaling so many different chemical and medicinal ingredients I was in danger of glowing after dark. The self-prescribed cocktail of popular cures seems to have worked as I can now once again speak, swallow and eat and drink. When my children and grandchildren ask how I know what to do when ill – I smile and say 'that’s because I’m a nurse'.

Since 1965 nurses all over the world have, once a year celebrated International Nurses Day. In 1974 today, the 12^th May was chosen to celebrate the day as the 12^th May is the anniversary of the birth of Florence Nightingale in 1820. And so it’s been ever since. The UK public sector union Unison tried, in 1999, to persuade the International Council of Nursing to transfer Nurses Day to another date saying Florence Nightingale didn't represent modern nursing. Thankfully, Unisons efforts failed, as did the misguided attempt by the UK Education Secretary, Michael Grove to remove all traces of Mary Seacole, from the national curriculum so as to make room for a greater educational focus on people like Winston Churchill, and Oliver Cromwell.

Our School has its base in the Mary Seacole Building at the University of Salford, and we are proud that the building in which over 700 students start their nursing career each year bears the name of someone as famous as Florence Nightingale was for demonstrating what care can actually mean to others.

Despite recent uninformed and negative media suggesting that today’s nurses are to educated to care – often heuristically presented as being ‘to posh to wash’ modern nurses are skilled, knowledgeable and responsible for making sure patients receive the most appropriate care, in evidence based ways. Many senior and specialist nurses are highly qualified and have highly developed clinical skills enabling them to diagnose, prescribe treatment including medication, and lead inter-professional health care teams.

Our pre-qualifying nursing programmes attract men and women with diverse backgrounds, skills and qualities. We have applicants of all ages, and we adopt a values based approach to our recruitment processes and decision making. We were doing this before the UK governments recent announcement of its vision of compassionate nursing called the 6Cs – care, compassion, competence; communication; courage; commitment.

As a School, we are marking the day through a Nurses Day Conference on the 14^th May. The conference provides an opportunity to celebrate nursing, recognise and appreciate the professions history, where it is today and what nurses in different fields of practice and clinical situations are engaged in in terms of the future nursing profession. It promises to be a great day. And best of all, I will now be able to do the welcome address!

Children, Bubbles, and Grandchildren, Beware

I had a monetary lapse of reason last week when I stumbled upon the Commissioning a Good Child Health Service published on Tuesday. My immediate thought was what a stroke of genius. Good children will eat their five a day fruit and veg, take plenty of exercise, be mentally stimulated and model pupils, never argue with their parents and always go to bed on time. I imagined at the GPs there would be a streaming out process based upon a good behaviour guide that I am sure if not already invented, a psychologist somewhere will be working on one. Good children take the door to the left, bad children, the door on the right.

In reality, Commissioning a Good Child Health Service comes out of work undertaken by the Royal Colleges of General Practitioners; Nurses; Paediatrics and Child Health, with a sprinkling of fairy dust provided by the Department of Health. This working party developed the guidance for commissioners of services to help local service providers address problems of in-appropriate Emergency Care services attendances, prenatal and adolescent mental health issues, children with long term and chronic illnesses, safeguarding and the needs of looked after children.

Around 25% of a GPs patients are under the age of 19, and this group represent more than 20% of the UK population, which according to the 2011 census, was around 63 million. The population is the 3rd largest in Europe (behind Germany and France) and the 22nd largest in the world. Apart from where I am currently writing my blog (Kippford in Scotland), the UK Population Density is also one of the highest in the world at 674 people per square mile.

Up here in Scotland, it’s not so crowded, (indeed last night in the Anchor Pub, the landlady was wondering out aloud as to what had happened to the usual Bank Holiday visitors). However, there are some remarkable statistics regarding children, particularly around birth-rates. 6% of babies born in Scotland during 2010 were to mothers under 20 years old, the largest group were mothers aged 20 – 35 years old, who gave birth to 71% of the babies born. In 2012, 51% of all babies born in Scotland were born to unmarried mothers. The the good children guidance recognises that across the UK there are significant numbers of children who are living in poverty, and experience poor access to health care.

Yesterday, I also had a chance to meet with my favourite artist Urpu Sellar. She makes the most wonderful sculptures that delightfully capture the idiosyncrasies of the English Language. We were both at an art show at my favourite gallery in Kirkcudbright, The White House. Rosie, the owner had provided folk with pink champagne and mouth wateringly good chocolates to help with the viewing (and purchasing). I didnt buy anything from Urpu’s collection this time as I am visiting her gallery and workshop as part of the forthcoming Spring Fling Arts Festival later on in May. However, I couldn’t resist buying a beautiful felt door stop made from the wool of Blue Faced Leicester Sheep and dyed Marino Sheep wool. The piece was created by Rachel Morley.

And grandchildren beware – you can only touch it if you are ‘good’.