Last Words as 2013 changes into 2014

I'm on my Christmas holidays. Christmas Day was spent with family. Christmas dinner was a Cashew and Mushroom Layered Loaf (there was turkey for those that just had to have it). Then Boxing Day it was up to the House in Scotland. It was a nightmare journey; ice on the roads and that winter sunshine that is just too low in the sky as you drive. The further North I got the stronger the wind became and then the rain started to pour.

Driving down the hill that leads into the village I was surprised to see there wasn't a space to be had in the Village Hall car park, or a table at the Anchor Hotel bar. Despite the gale force winds and driving rain, the whole place was busy with families, groups of friends and there were dogs everywhere.  Someone had even parked their car in front of Mary’s cottage, strictly verboten in the unwritten but usually carefully adhered to village rules.

On the day after Boxing Day, Friday, there wasn't a soul to be seen. The road, beaches, woods and by ways were completely deserted. I twice walked Cello and didn't see a single person. The village had returned to its quietness and the simple twice daily movement of the tide coming in and the tide going out again. As 2013 draws to a close it’s a time for reflection, and for me this is a wonderful place to be, and to be able to sit and contemplate the passing year and to think about ambitions for the future.

However I know that others were finding themselves in very different places – much of the South of England has been battered by damaging storms, and many families still have no power or heat, a situation they have been in since Christmas Day. Here in Scotland, like in many other parts of the UK, over 2000 food parcels were handed out over the Christmas period, 1200 meals prepared for people in homeless shelters, and just under 200 people sought help over a 4 hour period at a winter destitution ‘surgery’ held by the Glasgow based charity, Positive Action in Housing last week. They wanted help with crisis payments, clothing, food and bus passes to get them through the Christmas period. As the Christmas snows fall in war torn Syria, an estimated 3.1 million children have little food or shelter, and more than 1 million children are now living in refugee camps. Oppression of peoples basic human rights continues in many parts of the world. I had an email from a colleague in China yesterday. She can read the VCs Blog, but not this one.The China Government have banned access to it!

Seeing or hearing of other peoples suffering often causes emotional pain and can give rise to empathy, an element of caring and compassion that is sometimes clouded by unconscious notions of guilt when there is nothing that we can seemingly do to help or relieve the suffering of others. 2014 will be my 7th year as Head of School. I once had a clear 10 year plan for the School which was about more effectively preparing nurses so they could better able to help others help themselves. Over the years this plan has been renewed and re-constructed as the School has grown and the challenges have changed. My Christmas contemplations will include how as a School we can continue to help others to more effectively help themselves. Many thanks to all of you have supported me by continuing to read this blog over the past year. I wish  you and yours the very best for 2014.

Some Things that Matter to Me on the Sunday before Christmas

Last week was full on with everyone trying to get themselves sorted before leaving for their Christmas break. I had back to back meetings from start to finish almost every day. There was often little time to stop and think, and that mattered to me. In fact, last week there was quite a lot that mattered to me.

Hearing that my long term friend from Finland was working his last week, and retired on Friday – and that he had finally done so and with happiness in his heart mattered to me. Hearing that my friend from Holland had her hip operation postponed again and thus leaving her in pain and lacking mobility, mattered. Enjoying catch up meals and or a glass of wine with friends here in the North West, and hearing all their news, sharing time together, exchanging gifts, good and bad news, smiles and laughter, all mattered to me.

Being able to sort out student bursary problems, lost exam papers, and a chance to re-submit failed work before students settled down for their Christmases, mattered, to them and to me. Seeing the smile of relief on the young man sitting opposite me on the late night train from Manchester, his relief was a consequence of  knowing he was finally on the right train and going home, mattered. 

Hearing favourite Christmas carols and songs in the shops, bars and radio, seeing the twinkling lights, smelling hot chestnuts roasting on the street stalls, smelling cinnamon candles burning in the house, tasting the mid-morning mince pie, seeing the smiles on colleagues faces at the School Christmas do, all of which mattered to me.

On Friday I met with colleagues from the Salford Clinical Commissioning Group (CCG). The CCG was one of the 200 organisations that are responsible for commissioning almost £70 billion worth of health care services, provided in both hospital and the community. I was there to discuss how the University could help them with their work in transforming health and social care for the people of Salford. 

They were person centred in everything they did and thought. Their approach to providing health and social care was predicated on a very simple, but what I thought was a very special thought: moving their approach from concentrating on ‘what’s the matter with you’ to better understanding ‘what matters to you’. They were people after my own heart.

And I hope that you all have a very merry and relaxing Christmas! 

Challenging Conventional Wisdom while Enjoying a Cheese and Opinion Pie!

Last week had a slightly ‘Ground Hog Day’ feel to it. One recurring theme was the National Student Survey (NSS). In the company of others I spent time looking back at last year’s results and forward to the next NSS, due to start in January 2014. Every year since 2005, Ipsos MORI conducts the NSS. The survey provides an opportunity for students to feedback on their experiences of study at their University. The results are important as these are published and used by students (and possibly their parents) in selecting a University to study at.

The results are also important as they contribute to where each University is located on the various national and international league tables that describe the quality of research, education and employment prospects of graduates. High performing institutions will attract both high performing students and academics. Interestingly in a study published last week by the London School of Economics, they noted the benefit of individuals who were high performing, rather than the institutions they studied at.

The LSE study was looking at primary children and not University students however. Their study involved 2 million children, and was conducted across all types of primary schools. The study found that being seen as a high flyer in a primary school, regardless of the child’s actual ability was a strong motivator for their performance in secondary school. Boys were 4 times more affected by being top of the class than girls. The suggestion that pupils benefited from being top of a weak class, rather than being middle ranking in a class of high-performing children really does challenge the conventional wisdom that children will do better if pushed into a higher performing peer group.

And in a week where I was being asked to report on the number of 3* and 4* quality publications each of my colleagues had published in the last quarter, I was interested to read of someone who was also challenging conventional wisdom. This was the Nobel Prize Winner Randy Schekman, who last week claimed that leading academic journals are distorting the process of science and represent a ‘tyranny’ which must be broken. He has declared a boycott on such publications. Schekman, a US biologist who was presented with the Nobel prize in physiology or medicine last Tuesday said his laboratory would no longer send research papers to the top-tier journals, Nature, Cell and Science.

He also attacked the widespread metric called an ‘impact factor’ used by many top-tier journals. A journals impact factor is a measure of how often its papers are cited, and is used as proxy for quality. Schekman said the 'impact factor' was a toxic influence on science and introduced a distortion – a paper can become highly cited because it is eye catching, provocative or wrong.

I went out last week to one of my favourite restaurants (Albert’s Shed) for what I had hoped was going to be a meal with a high impact factor, a meal I thought was both eye catching and provocative. However, I was wrong. My favourite starter, asparagus, with a poached egg covered in bread crumbs, was off the menu. My favourite main course, a cheese and onion pie, was on, but to be frank, it simply wasn't that good. I was disappointed. Telling a friend the next day, I mistakenly wrote ‘cheese and opinion’ pie, which more closely described the second cheese and onion pie I had later on in the week at Chancellors.

I was there with other Heads of School and Deans from the North West, and we were meeting with Laura Roberts, the Managing Director of Health Education North West. This is the organisation responsible for spending over £700,000 million a year on educating and training health care professionals in the North West. It was an interesting conversation, made so by colleague’s willingness to offer and debate their thoughts on the challenges facing health care educators. I also found out that Laura and I once had the same mentor and ‘rabbi’, the wise Bill Sang, someone not shy of challenging me or conventional wisdom. And the cheese and onion pie, well it was just exquisite.

Moved by Memories of South Africa

I was half thinking about focusing today's blog on the news released last week about the performance of many of our ambulance services. The headline news was that ambulances are taking longer to get to the scene than they did in the previous 2 years. The rise in time taken was worse in the East of England where it was taking 90 seconds longer than this time last year. The national target is to be on site within 8 minutes. It seemed really important, and it is in the context of our lives in the UK.

However, as I drove to work last Thursday the headline news was of Nelson Mandela’s death. I have been to South Africa a few times.The news of his death prompted a number of memories and thoughts. One thought was what on earth people living in the Soweto Townships for example might think about my focus on ambulance response times.

In 2004, I was invited to present a paper at the 1^st Regional Congress of Social Psychiatry, hosted by the World Association for Social Psychiatry. The conference was held in Johannesburg. It was an interesting experience. I was there with 2 colleagues from the University of Leeds and 1 colleague from the University of Newcastle (Australia). The conference was located in a hotel complex very close to the airport. In fact I could see, feel and hear the planes taxiing to the end of the runway from my bedroom.

The hotel, once you got inside, was a completely artificial environment akin to the hotels in Las Vegas. The roof was painted with clouds, there were cafes with outside seating areas, that were really still inside, and lots of casinos, all of which had a sign at the entrance asking customers to deposit their guns at reception! It was quite a place. While there we were able to visit the surrounding area, which was full of signs of the past.

The Sowato (SOuth WEstern TOwnship) township was still there. This township was the scene of the Soweto Uprising in 1976, when there were mass protests over the South African governments policy to enforce education in Afrikaans rather than English. The police response was to fire on the protesting students and some 23 people died on the first day of protest. Those killed included Hector Pieterson, a 13 year old school boy. The picture of the dying Hector being carried away from  the riot became the iconic image of these protests, which finally moved the international community to introduce economic and cultural sanctions.

I was also able to visit Nelson Mandela’s house, which is now a national museum. It felt very much like a privileged experience. I did get to sit on his bed, which felt rather like sitting on Freud’s couch (which I was forbidden to do when I visited Freud’s house in London). Nelson Mandela was an anti-apartheid revolutionary, and politician who spent 27 years in prison after being sentenced to life imprisonment in 1962 for conspiring to overthrow the government. An international campaign eventually secured his release in 1990.

In 1994, he became the first black president of South Africa. During his 5 year term of office as president, his government successfully started the process of tackling institutionalised racism, poverty and inequality, and promoting racial reconciliation. He reminded us all that: ‘what counts in life is not the mere fact that we have lived.  It is the difference we have made to the lives of others that will determine the significance of the life we lead’. He really did make a difference to so many people, and not just those living in South Africa.

And if you do happen to live in South Africa, you might be pleased to know whilst there are no official ‘responses times’ in the South African Ambulance system, a response time of 15 minutes is usually achieved and seen as being acceptable. 

Plain speaking (not wrappers) needed if we are to become a Non Smoking University

This week I attended my first Trust Board meeting as a Non Executive Director, at Wigan Wrightington and Leigh NHS Foundation Trust. It was an interesting and illuminating experience for me. The meeting is split into two parts, a public section and a private section. The first section was by far the longest, and the issues and reports presented varied and often complex. It occurred to me while reading the papers in preparation for the meeting, and there was plenty to read, just how complex balancing out the provision of health care services is with the promotion of healthier life styles.

One of the reports I read, noted the successes and challenges arising from the WWL decision to support the Public Health England Stopober 2013 Challenge which was aimed at helping patients and staff to stop smoking. A variety of supportive approaches were available to staff and patients who wanted to give up, and there was also a drive to challenge people seen smoking in the grounds. The latter is a difficult thing to do. And nurses in particular, are not that good at either setting an example or helping others to make better life choices around smoking (see Warne T., and McAndrew S., Health promotion and the role and function of the nurse. In: D. Whitehead and F. Irvine (eds) 2009Health Promotion and Health Education in Nursing: A framework for Practice, Palgrave, London).

This is a situation that has not changed since I wrote that book chapter. Indeed, in 2012, some 14% of adults in managerial and professional occupations in the UK (such as medicine and nursing) smoked. Smoking is the biggest cause of cancer in the world. Around 50% of the 10 million people who smoke in the UK will die of a smoking related illness if they continue to smoke. Sadly, despite it being illegal to sell cigarettes to anyone under the age of 18 in the UK, every year more than 200,000 children aged 11 – 15 start smoking.

Also sadly, some 63 years after Richard Doll first showed that there was a direct link between smoking and lung cancer, the UK Government is only now considering selling cigarettes in plain packing. In an announcement last week, the current UK Coalition Government pledged to bring forward legislation that would see all cigarettes being sold in plain white packaging or in packs bearing challenging health warnings by May 2015.

Come on, more than 34 million working days are lost each year because of smoking related sick leave and over 100,000 people a year in the UK die each year due to smoking. To put it another way that is 275 people a day that die from smoking related illnesses. Today is the 1st of December. Christmas day is now 25 day away or 6875 smoking related deaths away. Indeed by the time you read and get to the end of this blog, 5-6 people will have died from a smoking related illness. The situation is even more of a worry depending on where you happen to live in England.

I am writing this blog posting as an ex-smoker. I've not smoked for years now, and feel much better for giving up, have more money in my pocket and now have an almost evangelical zeal to help others to stop. My NHS pledge is to try and make the University of Salford the first non-smoking university in the UK before I retire - and the clock is ticking.