Interesting Figures- not just numbers, but people too

Some weeks, if you are fortunate, you might get to meet or hear some really interesting folk. Last week was like that for me. The first person to mention is the fabulous Ruth May, Chief Nurse for NHS England. Last Tuesday, she spoke at the inaugural Pam Hibbs lecture at St Bartholomew’s Hospital, London. It was a great speech, and you can hear it here. She appears, wearing her nurses tartan face covering, at about 7 minutes into the video. Three things stood out for me in her speech. The first was the acknowledgment that to her mind removing the student nurse bursary in England was ‘fundamentally the wrong decision’. I couldn’t agree more. It was a short sighted economically driven decision that we are reaping the consequences of now.

However, the second thing that struck me was despite record numbers applying to study nursing in 2021 last August (possibly the Covid factor), the lowest numbers of new people entering onto the register for many years. Which links to my third reflection, Ruth’s declaration that the target of getting 50,000 new nurses by 2024 was simply not adequate. Again, I can do nothing but admire and agree with her in saying this. Without an appropriately educated and trained workforce, and nurses are by far the largest group in the health care workforce, it will take even longer to deal with both the enormous backlog of care and bring services back into something that resembles pre-pandemic levels*.

I once criticised Ruth in one of my blogs for wearing her nurses uniform on one of those interminable PM Covid TV updates. She sent me a wonderful message explaining the background to that incident and I was glad to eat humble pie in my apology to her. Ruth’s speech last week, was brilliantly timed, wonderfully executed and she said absolutely what needed to be said.

My second person of interest was Sir David Sloman, Chief Operating Officer NHS England. He and a raft of his team appeared to be touring NHS England Regional Office monthly meetings last week. The message he brought to the meeting I was in was one about protecting our ambulance services so they could provide an adequate response to those who most need it in an emergency. To my ears, there were perhaps too many ‘thank you’, to many appeals to use our ‘leadership’ to bring about change, and not enough said about what might be done to resolve the social and domiciliary care services. It felt like Sir David might have read my blog of last week, as what he was saying sounded very much like my thinking set out in that post. I can say it again, patient flow in and out of hospitals is the number one factor which has had the greatest impact on ambulance availability.

Wednesday’s interesting person was completely different.  It was a chap called Grant Harrison. Have you heard of him? I hadn’t, but he has made a huge impact to at least 5 million of us. In 1995, he was responsible for introducing and developing the Tesco Club card. His mission was to get more people to shop more often and spend more money. He achieved this by getting people to do more of what they were already doing. His secret was using data collected each time we shopped at Tesco as way of influencing our behaviour. His story was slightly worrying, but immensely interesting and had parallels for what we might want to be doing in tackling inequalities, improving health and to do that across populations.

Grant was evangelical about how mobile phones might be the key to improving population health. He even went as far to suggest that we might want to think about mobile phones as medical devices (again something I mentioned in a blog in 2021). The success of the Tesco Club Card resulted from giving people something they wanted. Apart from making individuals feel special, and noticed, there were money saving vouchers that reflected what customers had already purchased and other’s that they might want to consider buying. These messages were aimed at families rather than the individual. Just think what we might be able to do if we could use personal data to do something similar with tackling obesity. For example, the average child has no control over what they are given to eat each day. It's parents who have that decision making control. If we could harness social media messaging, in what Grant described as creating the ‘nudge impact’, which to me sounded like little and often, we could bring about change over time in peoples eating habits and desire to engage in physical activity. 

With 64% of the adult population, 14% of children aged 4-5 and 25% of children aged 11-12 being obese, current interventions and messaging are clearly not working. Borrowing from the Tesco Card experience may help us unlock new ways of using data to changing health behaviours. Clearly doing so is not without its problems. Tesco were able to do what they did because they were the sole recipient and holder of personal information gleaned from our shopping habits. We implicitly trusted Tesco’s to safeguard that information, possibly because we benefited. The same is not true in the NHS. However, that shouldn’t stop us from trying.

I have reached the end of my weekly blog word limit and still not mentioned a few other interesting folk I met or heard from last week – so apologies, but please Google them because, like me I think you will find what they have to say very interesting: Gill Galliano; Bevleigh Evans; and Andrew Snowden. And finally, its day 32 of the Russian war in Ukrainian. I continue to keep all those impacted by the war in my thoughts and prayers. On Mothering Sunday, this feels even more important as I think about all those families separated as a consequence of the conflict. Peace not War.

 

*Because it needs to be said, the Covid pandemic has not ended. Community infections continue to rise across all of the UK.  We are now seeing both the BA1 and BA2 Omicron variants at play. If you want to believe the unhelpful messaging about Omicron being a mild form of Covid, look towards Hong Kong, who are now reporting the highest mortality numbers in the whole of the world. Partly, this situation is a consequence of the decision not to vaccinate in age groups in the same way the UK did, and starting with the older and more vulnerable population groups.