A big Boxing Day THANK YOU

It’s Boxing Day, and the year is rapidly coming to a close. In the nearly 12 years I have been writing and posting my blog on a Sunday, Boxing Day has only ever fallen on a Sunday once before, and that was in 2010. Strange. And yesterday was, of course, Christmas Day. I wonder what you did with the day. Some of you will have been working, looking after others, keeping us safe, keeping us warm, and for some, keeping us fed. If you were one of those folk, I want to say a big THANK YOU for being there for others in so many different ways. For J and I it was a quiet day, spent together, with Facetime and Zoom replacing family sitting around our Christmas table. For the second year running, Christmas plans have been disrupted, dreams left unfulfilled and people missed. As a consequence of the pandemic, some of those people will be missed forever. It has been a tough year once again for so many people.

This time last year I wrote in my blog that I hoped we could get the vaccination programme up and running asap. That hope came true and what a success the vaccination programme has been, in so many ways. A short while ago, I was privileged to go out with our School Nurses as they were vaccinating  12-15 year old children and young people. As I said at the time, it was compassionate care at its best. I was able to get both my initial jabs early on in the first wave of vaccinations and got my booster in early October. On a personal level it was a huge relief and I have become increasingly evangelical about encouraging others to get themselves vaccinated.   

I think we will be on a repeat vaccination programme for a few years to come – rather like the annual flu vaccination programme. Indeed, Israel and Germany have both approved a 4th ‘offensive booster’, to be given some 4 months after the original booster jab. The UK is still considering the data, or prevaricating as I prefer to think of it.

The present system of robbing Peter to pay Paul to carry out the vaccinations is not sustainable in the longer term, however. We need to develop an independent vaccination professional. A group of people ready and able to vaccinate on a rolling basis. That said, here is another big THANK YOU to all the current health and social care professionals, the army of volunteers, and the armed forces too, who have made it possible to get so many of us vaccinated. It is not the politicians we should thank for getting us this far, but folk like many of my readers who have gone above and beyond their normal work to get us vaccinated. And I’m willing to bet that many had to forgo the cheese and wine at the end of what would have been many a gruelling day.

Yesterday afternoon, after spending what was a non-gruelling Christmas Day, as J and I were nibbling away at the cheese, and sipping mulled wine, she asked me what my New Year’s resolutions were going to be. I didn’t really have an answer, so I looked back at my ‘end of year blog’ in 2020. 

There I found, not resolutions, but four ambitions for the year. I wanted to: (1) help improve the health and health outcomes for our communities (2) find ways to help reduce health inequalities (3) enhance the productivity of our health and care organisations (4) develop a stronger and more coherent partnership placed-based approach to how care is delivered.

When I wrote those words, I was a Non-Executive Director at Blackpool Teaching Hospitals, and Vice-Chair at Wrightington, Wigan and Leigh Teaching Hospitals. In both communities, I had lots to go at. Little did I know then that I would have a different opportunity to take these ambitions forward. Very unpredictably, I was approached by a head-hunter company to see if I might be interested in a Chair’s position at Stockport NHS Foundation Trust. The hospital is 60 miles away, or a 90-minute car journey. It wasn’t something I had thought about, but I was intrigued to find out more. Long story short, I put my hat in the ring and was really pleasantly surprised to be offered the post. I started on the 1st May, and the last 7 months have been amazing!

Of course, I have been very fortunate to be working with a great team of Executive and Non-Executive Directors and many of the folk I have met in both clinical and support services have been simply inspirational. Those ambitions, well now I have a fabulous team of people to work towards them with, and to do so with some brilliant partners. There are so many challenges to address, but in so doing, I have found it’s possible to create unlimited opportunities to make a difference every day.

So, 2021 might have been a difficult year for many of us, but there were glimmers, green shoots of hope for us to see. Last week I heard of one such ray of hope. It came from last week’s Wednesday’s BBC Woman’s Hour. I was on my way to deliver the last of our Christmas gifts to some of our family. It was a long journey, but made very bearable by listening to the absolutely delightful Susie Dent. If you need to get someone a birthday present this year, buy her book, Word Perfect; it is simply delightful. As well as being the TV show Countdown’s resident lexicographer, Susie is an accomplished etymologist and author, who knows the meaning of so many unusual words, which she shares with great humour. Right at the end, the Woman’s Hour presenter, Emma Barnett (an equally brilliant entertainer) asked Susie what word might describe how she herself was feeling that day. Susie’s word was ‘respair’. It is a 16th- century term meaning fresh hope, and a recovery from despair. She ‘discovered’ it in 2020, but in her words, ‘we need as much respair as we can get right now’.

Next week’s blog will be the first of 2022 – I want to say a final big THANK YOU to all those folk who week-on-week read my blog. Your kindness and support are much appreciated.  

Together, we can make the world a better place.

I wonder what you think about zoos? They are a little like Marmite, you either like them or not, or maybe they simply don’t feature in your life at all. Some folk absolutely can’t accept keeping wild animals in captivity, however realistic and spacious their enclosures and surroundings are. I have to say I like zoos and we are fortunate to live very near a good one. If the wind’s blowing in the right direction, we can even hear the lions roar in the evening. Both J and I are zoo members which means we can visit whenever we like. This can be a real bonus during school holidays so as to avoid the noise and bustle of families with little children.

My favourite animals to visit at the zoo are the giraffes. They are elegant, beautiful and they fill me with wonder. They are remarkable in many ways. They average only about two hours sleep each day, usually taking no longer than 10 minute naps at a time. They are vegetarians. They have big hearts, so as to be able to pump blood up their long necks to the brain. Those long necks have the same number of bones as human ones do. 

To my mind they are truly wonderful creatures. In their enclosure at the zoo, you can stand on a walkway that is level with their heads, which means you get a very unique view of each animal. You also realise that they are very powerful animals and can do a lot of damage to each other when fighting. Fortunately, this isn’t very often and giraffes like nothing more than to be surrounded by other giraffes. But this isn’t really a blog about giraffes, although in a way it is.

Last week I saw a picture that stunned, shocked and saddened me in equal measure. It was an aerial photo of six dead giraffes lying in a spiral shape. They had died of starvation and a lack of water. Giraffes drink remarkably little water, getting most of the fluid they need from the plants they eat. The picture was taken in the Saluli wildlife conservation park in North Eastern Kenya. The country, like many others in Africa, has been in the grip of one of the severest droughts in decades. It is estimated that 2.1 million Kenyans are facing starvation due to the severity of the drought. Last Tuesday, the United Nations said that nearly 3 million people were in urgent need of humanitarian assistance.

It makes our supply chain and food distribution worries here in the UK seem rather trivial. However, that said, whilst our food security issues are completely different to those in Kenya, we should also remember that over 2.5 million people in the UK are regular users of food banks. It’s a situation that is likely to only get worse. The Independent Food Aid Network (IFAN) recently reported that the Covid19 pandemic has forced tens of thousands of people to start using food banks for the first time. As we start the second Winter of the pandemic, with a new, even more infectious variant to boot, things are set to get much worse for more people. The loss of the £20 Universal Credit uplift, the ending of the furlough scheme and increases in fuel and food cost will just add many more folk to the numbers of people facing very difficult choices over what to spend their money on. IFAN coordinator, Sabine Goodwin, set out these stark choices in an article in the British Medical Journal last August – see here. It does not make for easy reading.

It’s clear that the pandemic has and continues to have an impact on all our lives. The UK population is 67 million people. Kenya has just under 57 million people. There have been 260,000 cases and 5,353 deaths from Covid in Kenya; here in the UK there have been 11 million cases and 147,000 deaths. The UK and Kenya are 4476.5 miles apart, but we share similar challenges albeit for different reasons. It is an example that reminds us that, whether it’s a threat brought about by natural causes or disease, no one country is likely to be able to deal with the consequences for their people alone. As a global community, we must find ways of using our creativity, inventiveness, money and other resources to make a better world for everyone.

I can’t leave this blog without sharing a story of some happy times I spent out in Kenya. I have been several times to work with Kenyan nurses wishing to increase their academic qualifications. It was part of a programme run by the University of Dundee. One trip coincided with my birthday. I decided I would buy the students a small gift, and I chose to give them bags of Uncle Joe’s mint balls. I can’t remember why, other than there was a story to tell about the sweets, and it was easy to pack dozens of packets in my suitcase. Unbeknown to me, one of the local students went home and baked a birthday cake, which at the end of the day they arranged for the local chief nurse to present to me. It was a moment I would never forget. Here was a community that had very little, but still found a way to give so much. It was a humbling but happiness filled occasion.

Finally, as much as I like going to our zoo and getting up close and personal with the animals, it is not as good as going out on a safari, in an open-sided Landrover, complete with a rifle toting guide and seeing the same animals in their natural habitat. Now that was a real privilege, added to by having the opportunity to do so with my nursing colleagues in Kenya, and yes, I did get to see giraffes there too.

Story telling at the proverbial cheese and wine party

Over the 12 years I have been writing my weekly blog, people have often asked me how, when and why do I write the blog? The why is easy. I write it primarily to keep my mind active and because I cherish the opportunity of having a voice. When do I write it? Usually, I write a rough draft on Saturday evening. I do it then, so that J can check for any unintended consequences of my dyslexia, as my thoughts get transposed into words. The final version is written at 4.30am each Sunday morning, and posted at 5am. How do I write it? Well during the week I collect and save words and phrases that I have heard or read, or even pictures which, in the moment, resonate. On the Saturday evening, I look at these and try and weave a story using some of them, and that story eventually becomes my blog. If I get stuck, I go for a walk and let my mind bring a story together. It usually works.

Last weeks list of words and phrases included: John Lennon, BoJoCop, Belarus, future generations, pandemic babies, wilful blindness, Christmas, Sophie Howe, booster jabs and Abigail’s Party. The 8th December was the 42nd anniversary of John Lennon’s death. Whilst I was always a Rolling Stones fan and didn’t particularly like the Beatles music, John Lennon was a hero of mine in my youth. I thought he gave so much more to us than simply a few good songs and tunes. In 1971 he wrote the beautiful and somewhat haunting song ‘Imagine’. Take a listen to it here.

It is a song about hope, freedom and peace in the world. It describes the possibility of seeing difference as something that might be celebrated and bring people together, rather than result in war or conflict. All these years later, his words seem so appropriate as many of us watch with trepidation what is going on in Belarus, the Ukraine, Russia, North Korea, China and Syria. There is the threat of, or actual conflict in many of these parts of the world. There is great suffering, fear and trauma too; most of which is the result of the inability of many to embrace difference (of all sorts) and to see diversity as a positive attribute.

Of course, for many of these people, their suffering, want, fear and trauma is overlaid by the continuing Covid pandemic. We don’t know enough about the new variant, Omicron, but we are witnessing an exponential rise in community infection rates. This should make us pause and take stock. Yesterday we were told that the Astra Zeneca vaccine might not be as helpful in protecting even double jabbed individuals, so wherever possible, and whenever possible, folk should get their booster jabs. We also saw the reintroduction of some Covid restrictions, including compulsory mask wearing in most public places and venues. 

It was good to see our somewhat hapless Prime Minister finally remembering to wear a mask, as he paraded around in his BoJoCop outfit. It was part of what should have been a week that focused on tackling drug misuse and the crime that is often associated with it. Sadly, this important and long overdue initiative and funding was largely overshadowed by the outrage following the disclosure that last year, during a period of lockdown, members of his team, ministers and so on were having a Christmas party, which appeared to include games and cheese and wine. While thousands of millions of us obeyed the rules, even where this might have meant we couldn’t be with loved one as they were dying, it seems our politicians and their teams were flaunting the rules. Trust in the government has been damaged, and probably even more so than that Dominic Cummings road trip to get his eyes tested did. We are already seeing reports that suggest high numbers of the general public are unlikely to comply with the new restrictions – a situation that will not only lead to avoidable conflict, but a real risk that our NHS will be in greater difficulty than that faced before the first lockdown.

I guess the one moment of happiness Mr Johnson would have experienced last week was the birth of his new daughter. I am certain that would have brought great joy to him and his family. Last week I also came across the term ‘pandemic babies’. It came up in a webinar conversation with the totally inspirational Sophie Howe. The term refers to the growing evidence that many of the children born during the last two years are showing signs of poorer development of their social skills.  A possible consequence of limited social interaction children might have experienced during the pandemic.

The conversation with Sophie Howe was an exploration of her work as the world’s first, and only, Future Generations Commissioner. I don’t have room in this blog to describe the conversation in detail, but I urge you to take a look at the Commission’s work here. What has been achieved is simply fantastic. Specifically, her work in health has been limited due to the pandemic but even so, she has achieved a great deal in addressing the social determinants of health and wellbeing. We could learn a great deal from this experience as the English health and social care system begins to develop placed-based services. A sense of community makes a 19% difference to our life expectancy. The difference health services make is just 10%. In England, Lord Bird (of Big Issue fame) is currently taking a Private Members’ Bill, the Wellbeing of Future Generations, through the House of Lords. I hope he succeeds.

Abagail’s Party? Well, you have to be of a certain age to remember this TV film. It came out in 1977, and was a play about a drinks party, the original cheese and wine party, which takes the viewer through the sometimes excruciating suburban approach to ‘good manners’. Covid restrictions permitting, J and I will be hosting our own ‘cheese and wine (and gin and beer) party’ next week. And so, this week’s story ends. Until next time, stay safe.

Eyes Wide Open - wearing a mask will enhance your life chances

I wonder what in your life you might be passionate about dear reader. I know some of my readers are passionate about their running, others about their garden, and one who is passionate about knitting and helping seafarers in trouble. I know of one reader who is passionate about her cat, another about ensuring no harm comes to patients in the future. I have another reader who is passionate about musical instruments and has a house full of extraordinary instruments of all sorts. 

Regular readers of this blog will know that among other things, I am passionate about chickens and have been for many years. My (now ‘our’) chicken collection runs into thousands of pieces and of course we also have 21 real chickens free ranging outside in our back garden.

Some passions come and go. At one time I was passionate about travelling the world, and have been fortunate to have been able to do so for many years. Now I have no interest at all in travelling, much to J’s disappointment. I was once passionate about doing research, and whilst I still have an avid interest in the outcomes of research, and the evidence base this creates, I am no longer passionate about the ‘doing’ of research myself. However, last week I met some researchers who were absolutely passionate about what they were doing with a number of clinical research programmes. The person leading the research team was Wiesia Woodyatt who has been working on a number of Covid-related clinical trials, and this work had made a significant contribution to the development of new Covid vaccines. This is important work; it is collaborative working too. It is work that recognises the effectiveness the Stockport NHS FT research team has in consistently recruiting participants to clinical trials, thereby ensuring great validity is achieved across the research programmes.

Such research is necessary. Across the world, the Covid virus is still infecting 50 million people every 90 days due to the high transmission rates of the Delta variant. Now we have a new variant, Omicron. We don’t yet know what impact that will have on our lives, but it is important that we continue to take care and perhaps get back to thinking as we did in the early days of the pandemic. Whilst vaccinations are the most effective action to take in keeping each other safe, wearing a mask is the single most effective other health measure we can take. Don’t just take my word for it. A systematic review, published in late October this year found that mask-wearing was the single measure linked to effectively reducing the incidence of community infection rates.

So, like me, I guess you may have been dismayed at a couple of the stories in the media that seemed to go against this advice. Our PM still wanders around crowded places (including hospitals) without wearing a mask. Indeed, the House of Commons have stated that MPs don’t need to wear a mask when they are in the chamber, something we can witness through the live TV coverage of each parliamentary sitting. It’s easy fodder for Covid conspiracy theorists. At least our Secretary of State for Health and Social Care upholds the guidance to wear a mask in places where you might be in close contact with others.

The other story to catch my attention was that of pupils at Abbey School (Kent) who had been asked to leave the classroom, because they wanted to wear a face mask while in class. These are 12 – 15 year olds who have an acute sense of the need not only to protect themselves, but also to protect those around them. I know the other week when I met a similar group of young people receiving their first Covid jab, they could clearly articulate the need to get the vaccination and maintain the other health promotion advice around space, hand washing, mask wearing and ventilation. They were passionate in articulating the need for everyone, young and old to keep taking these precautions.

I found it strange that a school that advocates a culture of ‘politeness, courtesy and respect’ should be so inflexible in its approach. I liked how they wanted to pupils to demonstrate these values, including the children and young people sitting up straight, listening, remembering basic manners, talking in full sentences (what a great idea) and greeting each other and asking if folk were having a good day. The given reason that they were sent to detention for wearing masks in the classroom was that masks are a ‘barrier to learning’. Now, I’m passionate about lifelong learning. I’m aged 66, 6 months and 24 days (yes, every new day is a blessing) and I learn something new each and every day. As a NHS Trust we have been running a Board Development programme since May 2021, with each session being face to face, socially-distanced and where mask-wearing has been the norm. I have learnt a great deal at each session, as I believe my fellow Board colleagues have too.

Likewise, I have successfully supervised many PhD students who have come to sessions wearing a niqab, and the University School at which I was Dean, recognised many years ago that face coverings were neither a barrier to learning nor successful therapeutic relationships. I might be accused of being too passionate about the wearing of masks in public and crowded environments, but I don’t apologise for being so. Last week I talked to a doctor colleague who had spent much of the day with her team in theatre, wearing masks and performing life changing and life saving surgery. If she could do that for others day after day, the least we can do when out and about, shopping, travelling on a bus or whatever, is to put a mask on. Let’s all become passionate about this folks. I ask this not in the Stanley Kubrick sense of ‘Eyes Wide Shut’ mask wearing, but I do ask it in with same amount of passion shown in the film. If we don’t, we might not enjoy the Christmas we hoped for.

Here is a big THANK YOU for all those folk, day after day, who wearing their masks, deliver services that keep us safe, well, fed, and warm, slowly returning us to a new normal where we are able to once again indulge in each of our individual passions unhindered by pandemic restrictions.