Alexa, what do you think of this week’s blog? (Sorry I don’t understand…)

A couple of years ago I joined Amazon Prime. I joined not because I wanted access to films or music (although that was a bonus), no, the reason for signing up was the fantastic on-line ordering and delivery service that Amazon have developed. As a Prime member I can order something today and it will be delivered tomorrow. I increasingly use this service as it is so reliable and you can order 24 hours a day. More people are Amazon Prime members than any other similar membership group, with some 100,000,000 members, although the number of active Amazon users is over 310,000,000. Amazon was once simply a way to buy a book online. These days it has more products for sale (562,382,292) than the entire US population (324,459,463). It has come a long way since its humble beginnings in 1999. 

As a company, they are beginning to change the way we shop, entertain ourselves and others, and in many other areas are changing the way we live. To my mind one of the best things they developed was Alexa. This device, which is no bigger than a tin of beans, is phenomenal. I have no idea how it works, but it changed my life. Overnight all my CDs, (younger readers ask your parents what a CD is) became redundant, and there were 100s of them. Even my iPod was condemned to that bedside cabinet draw that has lots of other useless stuff that you can’t just throw away just yet. These days I can get access to 40 million songs, simply by asking Alexa to play them. 

I can ask her what the news is, the weather, if there are any travel issues on the roads, and so much more. Sometimes she gets things wrong, and sometimes she appears to have a mind of her own and will suddenly say something or respond to something heard on the TV, but usually she sits there on the piano and waits to be asked a question or to be given a command. However, I was surprised last week that the new Secretary of State for Health and Social  Care, Matt Hancock (or Gadget Man as some commentators are starting to call him) suggested that we (patients) will soon be able to ask Alexa for a diagnosis and treatment plan, using information available on the NHS Choices website. 

As part of a commitment of to invest some £487 million in hospital technology, he announced a partnership between the NHS and Amazon. This may sound a lot of money, but in the context of Amazon’s 2017 earnings of over £69 billion, it’s small change. Not so though for all those nurses who were expecting to get their pay rise in July’s pay packet. Despite voting for the recent 3% pay deal announced by Mr Hancock’s predecessor, it was revealed last week that nurses will only get 1.5%, and have to wait for next year’s incremental point to get the full pay rise. There is much anger being directed at Janet Davies, the Chief Executive of the Royal College of Nurses (RCN), who it appears miscommunicated information to their 435,000 members over the detail of the proposed pay deal. In fairness, all health unions apart from GMB voted to accept the pay deal. Maybe the GMB asked Alexa what she thought?

Perhaps, Gadget Man should have asked Alexa what she thought the reaction would be to his first speech as Health Secretary, where in a week of rising upset over pay, he announced that technology, prevention and the health and social care workforce were his three top priorities. He believes that the technology investment will make the NHS the most advanced health care system in the world. I think we probably have a little bit of catching up to do however – see here and here. Gadget Man hopes that patients being able to ask Alexa for health advice will take the pressure off the NHS by keeping people with minor illness out of GP surgeries and Accident and Emergency departments. He is a patient of Babylon’s controversial GP at Hand app.   

There are over 50 million GP consultations each year for minor complaints, all of which do not require a trip to the doctor to sort out. Such appointments cost the NHS billions of pounds. However, there are many GPs who are suspicious that asking Alexa will reduce the number of such consultations. Based on previous experience of such interventions as NHS 111, NHS Choices, Pharmacist services, even the latest health scare, it’s often a case of ‘see your  doctor’. My experience suggests that unlike the demise of my CD collection, health technology will be a slow burn if it is going to change people’s health and wellbeing or reduce the demand for NHS services. It will be changes to organisational systems and ways of working, a developing workforce, health promotion and prevention strategies, community based social care and carer support that will really make a difference. Technology is an enabler of all these elements, not an outcome in itself. But just to be sure, I’m going to ask Alexa.   

  

Raising our hats (and a glass or two) to all the students who graduated last week

Last Thursday, at 10.30 in the morning, I got a telephone call. Nothing unusual with that you might be saying, but I was asleep at the time. Sound asleep some five hours after I normally wake up. On the Wednesday, I had been to the graduation ceremonies of students from my former School at the University. It was wonderful to see the joy, happiness and pride on the faces of the students, their families and friends. I was allocated a seat on the back row of the stage, which felt somewhat strange. However, I was also proud to see the new guard present the students and I was also glad to see two of my PhD students collect their doctorates. 

It was a beautiful day weatherwise and after the last ceremony, I joined my former colleagues and friends for a celebratory drink. It was great to catch up, share stories and have fun. But it turned out to be a very long evening that stretched into the early hours of the morning. Hence the non-attendance that morning at the #earlyrisersclub.

The following morning I felt every year of my age as I cautiously made my way through the day, and had just about recovered when it was time to attend for us to attend the University Graduation Dinner. It was like Groundhog Day, with celebrations again going on into the early hours of the morning. Friday’s morning roll call for the #earlyrisersclub came and went as I lay fast asleep for the second day running. Although it wasn’t such a late start to my day, I once more struggled somewhat to get through the day. 

Of course you may be thinking that my pain was self-inflicted, and to some extent I couldn’t argue with you. I’m in the generation that should know better!  Men between the ages of 45 – 64 continue to be the largest group who tend to drink more than eight units of alcohol in one sitting. Whilst there is a trend for many younger people to eschew alcohol in favour of healthier options, women aged between 16 – 24 are more likely to consume the same level of alcohol in one sitting. Young men are more likely to drink beer, lager or cider whilst young women are more likely to drink spirits, alcopops or wine. 

The commonest reason given for why young people (particularly those still at school) drink alcohol was that it made them look cool in front of their friends. However, and encouragingly, since 2003 secondary school pupils’ attitudes towards someone of their own age drinking or getting drunk have become less tolerant. I say this trend is encouraging as alcohol-related health issues continue to give rise for concern. The latest figure available (2017) show there are nearly 400,000 admissions related to alcohol consumption. 61% of which are men. Blackpool had the highest rate with 1,160 per 100,000 population. My younger brother Mark will be pleased to find out that Kingston-upon-Thames had the lowest rate at just 390.  

If one includes all admissions that involve some link to alcohol consumption the figure jumps to 1.1 million admission a year. This represents 7% of all hospital admissions, and consumes much in the way of time and resources. 85,000 people were treated for problematic drinking alone. Sadly it’s estimated that there are nearly 7,000 deaths directly related to alcohol consumption each year. The Sheffield University’s influential Alcohol Research Group predicts that this is likely to rise. Their research predicts that alcohol misuse will lead to 63,000 deaths over the next five years, with the NHS having to find some £16 billion in treatment costs. They also predict that 32,000 of these deaths (the equivalent of 35 deaths a day) will be the result of liver cancer and another 23,000 from alcoholic liver disease. Please excuse my pun, but these predictions are very sobering indeed. 

Now my two missing mornings were entirely due to my own over indulgent behaviour. Thank goodness graduation comes just once a year. Hopefully there will be no lasting damage done. I have taken to drinking alcohol-free wine these days, and I ‘try’ and only indulge in real alcohol at the weekends. As well as thinking about my health (and my wallet), I have another incentive for keeping a clear head just now. Grandchild number 11 is due towards the end of July and J and I are first on call to drive across and babysit Carys, who is grandchild number 10. And yes, I do have a bottle of fizz ready to wet the baby’s head with – but all things in moderation from now on!

My favourite story from Graduation 2018 involved JD, an Associate Dean from the Business School. He appeared at our first ceremony. I was surprised to see him and asked what he was doing there. It's simple he said. Earlier in the year he had major life saving heart surgery. The first person he met when he regained consciousness was a student nurse from the School. She cared him for the first days of his recovery and during that time she told him she was due to graduate this July. He promised her that should he survive, he would come to the ceremony and applaud her with as much vim and vigour as he could muster. He survived, and he came as promised. JD didn't smoke, never drank alcohol, ate well and was a keep fit fanatic.