It was a mistake, you said. But the cruel thing was, it felt like the mistake was mine, for trusting you

After over 10 years of posting a blog every Sunday morning, I'm still enjoying the writing and opportunity to share my thoughts, ideas and observations. However, one of the down sides to writing a weekly blog is that other bloggers can scoop the breaking news and post before you have a chance to do so. Thinking about this week’s blog I was originally drawn to writing about Health Education England (HEE), prompted in part by the news that its chief executive was to step down in March 2020.

Safe to say, over time I had become steadily disenchanted with HEE. Back in 2012 it felt like one of Andrew Lansley’s better ideas on how to improve the NHS, and to be frank, there weren’t that many. I was Dean of a School for some 5 years before HEE was formed and had enjoyed a fairly privileged position in the university as our student numbers were almost guaranteed, students got bursaries and I enjoyed a great relationship with the folk at the Strategic Health Authority. In fact, thanks to a block contract type of approach, I think on occasions we even got paid for the student tuition fees even if they dropped out. It was a good time. However, it wasn’t always a good use of tax payer’s money!

That all changed when HEE came along – and the world became a great deal more competitive. Our University was one of 11 in the region who provided nurse and other health professions education. Up to the arrival of HEE, there was room for everyone, and each university played to its geographical strengths and their different reputations. Post HEE, came a period of uneasy alliance, as contracts were signed and student commissions became a great deal more managed. The alliance across the 11 universities was held together by a trust that grew out a mistrust of HEE and what appeared to be politically motivated changes. However, this trust was completely abandoned when Bolton University declared an educational UDI and started its own nurse training scheme in partnership with a local NHS Trust. In effect providing a privately funded autonomous opportunity for folk to become a nurse. HEE did nothing to intervene, and the private market flood gates were well and truly opened. It was not a good time for those loyal to the HEE commissioning model.

Anyway, that was my original intention, write about my experiences, good and bad, of working with HEE. And then that other great blogger, Roy Lilley got there first and posted a blog last Friday about HEE – see it here – it’s written in a slightly more acerbic style than myself but we both share some of the same misgivings over the way HEE’s approach has resulted in such a workforce crisis in the NHS.

So not wanting to give you a different version of the same story I decided to take this blog off in a slightly different direction. However, the notion of trust and what might grow and sustain it, features in what I turned to in this post instead. The subject that percolated up came from a meeting I attended last Friday, the regular Wrightington, Wigan and Leigh (WWL) NHS Trust Safeguarding Committee. I attend wearing my Non Executive Director special interest hat, although abuse in all forms has been something that has featured in my research and publications.  

The meeting only happens every six weeks and has an extraordinary long agenda. Being held on a Friday afternoon means there can sometimes be a limited attendance, which is a shame as there are lots of good reports presented of some exemplary work. Of course, another reason for people to attend is that safeguarding everyone’s responsibility, not just those who have safeguarding in their job title. It was also National Safeguarding Adults Week last week. Organised by the Ann Craft Trust, The University of Nottingham and the Safe Guarding Adult Board Manager Network, the campaign took a different focus each day. Each focus was on the difference issues facing adults at risk and included: Self-Neglect, Modern Slavery, Safeguarding adults in sports, Transforming Care and Domestic Abuse.  

According to the latest figures available, (2018) it is estimated that nearly 2 million adults (aged 16 – 59 years) experienced domestic abuse. That’s 6 in every 100 adults. Women are almost twice as likely to experience domestic abuse than men. In in England, 1.3 million women were victims, compared to 695,000 men. For reasons not known to me, Wigan has a higher number of men reporting domestic abuse than in other parts of England, and overall, the rate of domestic abuse in Wigan is four times that to be found nationally.

These statistics don’t shed any light on the context and impact of domestic abuse. For example, if coercive and controlling behaviour is take into account the difference between the experiences of women compared to men becomes more apparent. It is estimated that more than 750,000 children in the UK witness domestic abuse each year. So the effects of domestic abuse clearly doesn't just impact on just the victim, in many cases the whole household can suffer. Seeking help is often really difficult. So it was wonderful to hear of the work of the award winning WWL Independent Domestic Violence Adviser and Sexual Violence Adviser (IDSVA) service. With Wigan Borough Council, WWL funded an independent domestic violence adviser service pilot scheme, developing an adapted model of working tailored to the hospital environment to offer swift intervention and support.

Its been a success. In the first nine months 300 people (including some WWL staff) accessed the service. 16% of whom were male. Interestingly, none of those who accessed the service have re-presented to the hospital. The service is due to be officially launched in November within the forthcoming 16 days of action, have a look here. My sense of why it has been successful is that those involved have created a place where trust can be tested and found to be reliable – hearing about this work filled me with immense gratitude that there are those who are prepared to really make a difference to people who have no where else to turn to.  

Thank you to David Levithan, The Lovers Dictionary for this weeks post title.