Triumphs and Disappointments: I’ve had a few.

Last week was a real mixture of triumphs and disappointments, and at times, a mix of the two. I was well and truly fooled by a picture I saw on social media that appeared to show King Charles standing on the glass floor at the top of Blackpool Tower. I thought what a coup for our town! I felt disappointed when someone told me (J) that it was a waxwork figure borrowed from the nearby Madame Tussauds.

Blackpool was also in the news for other reasons last week. It appears all three of our piers are at risk of collapsing into the sea. The sand on the beach beneath them has been eroded over the years, by as much as 3 metres, leaving the iron legs and foundations dangerously exposed to erosion. Even more worrying is that it is the weight of the sand below that helped keep the piers stable. Sounded like a triumph for the sea and potentially a disappointment for us pier lovers if they get closed. I’m told the pier owners have bought a bulldozer. The aim is to move some of the sand back. I’m not sure it’s a struggle they will win.  

I heard about another struggle that feels like it might be difficult to win. It was a briefing led by Amanda Pritchard, NHS England Chief Executive, on preparing for this year’s Winter period. The briefing was in advance of the official guidance being released late last week. That in itself is a triumph for NHS leaders fed up with reading in the media news about changes to policy, new guidelines and so on before they have been told themselves. I was however, a little disappointed to find the briefing focused primarily on the positive elements - early preparation, joined up working with social care, increases in virtual wards and so on - and didn’t mention how performance over the forthcoming Winter, particularly around urgent and emergency care, would be linked to capital funding allocations in 2023/24. The targets are stretching and the threshold expectations high. I expect it will be a tough few months.

However, I did receive some excellent reassurance that my colleagues are up for the challenge last week. I was able to spend some time with a wonderful group of colleagues responsible for our Transfer of Care Hub. Now I like words and I was interested to find out if the change of name (from discharge to transfer) was something more than just words. It was. Discharging patients from hospital, even if they person is going to receive step down care, or supported care in the community or their own home can sound so final. For many families it can sound like we are abandoning the patient, their loved one.

Talking about a ‘transfer of care’ can lead to more positive and reassuring conversations with the patient and their families. Transfer of care is about continuity of care. It is about a ‘home first’ approach with levels of support and care being provided where this is not immediately possible because of an individual’s needs, and which can continue to be changed until such time as the person is able to return home safely. I was truly impressed with their absolutely effective teamworking approach; an approach that saw folk from different professions, organisations and sectors, all working at putting the patient at the centre of their endeavours. Truly a triumph for innovation, creativity, determination being translated into practice. Many thanks to my colleague Melissa Harrison and her team, for facilitating my visit and helping me better understand this important part of our Trust’s work.

I was also impressed last week when I attended the Stockport Council Fair and Inclusive Summit. On the morning of the summit, there were probably 200+ people gathered together in the magnificent Stockport Town Hall Ballroom. The summit was an opportunity to explore and hear about how the Council were working with partners, many from the voluntary sector, faith groups and social enterprises, to make Stockport a fair and more inclusive place to live, work and thrive. It was brilliant to feel the energy and passion in the room, to hear of the great work different groups, individuals and the Council were doing, often with limited resources. Thank you to Caroline Simpson, Chief Executive, and her team for organising such a great event, and thank you too for the invitation to be part of it.

It is the kind of partnership working that I witnessed at the Summit and in my visit to our Transfer of Care Hub that reassures me that working collectively and collaboratively, we stand a good chance of getting through the Winter and ensuring we are able to continue to provide safe and appropriate care to all who need it.

Finally, I also experienced a different kind of personal triumph and disappointment. I was shopping in Aldi (and why not?), minding my own business and thinking about that evening’s dinner, when I heard someone say, ‘Hello Councillor’.  For those that don’t know, I am a newly elected Blackpool Councillor. Now I was wearing my shorts and t-shirt, and having just completed a walk, my hair was completely windblown (a politer way of saying I looked as if I had been dragged through a hedge backwards). 

So I pretended I hadn’t heard. The voice persisted, ‘Professor, you are a professor’. I turned to find a man sitting on a mobility scooter smiling broadly. He had looked me up, and knew a great deal about my professional life, recognising me from my social media images, he decided to say hello. We had a great conversation, and I think (hope maybe) that neither of us were disappointed by our encounter. The triumph? Simply being an authentic me.   

The language of friendship is not just words, it’s words and actions too

Last week, I opened our front door to find a large marrow and a rather grand cauliflower on the doorstep. They were a gift from one of our neighbours. It was a kind gesture, unnecessary but kind. Let me explain. It is the time of the year when our hens lay lots and lots of eggs. They do so for a number of reasons. They want to lay a clutch of eggs, go broody and, in the fullness of time, hatch out chicks. Last year we had 51 chicks hatched. That’s 51 extra mouths to feed, and we don’t need any more hens, 51 more hens to find home for!

Gregory Peck, our cockerel, is a handsome fella, and we wouldn’t get rid of him for anything. He clearly adores his hen harem. So, this year I’ve taken on the role of being the hens’ contraception. It’s easy. I simply remove the eggs as soon as they are laid. The chickens let the world know they have laid an egg by clucking loudly for a few minutes. Some of the chickens, the older, clever and more experienced hens, fight back. They find a dark corner, a hedge or some other out of the way spot, lay their clutch of eggs and then disappear for 20-21 days before returning with a bunch of chicks. This has happened twice this year. The first time we gave the chicks away; the second time Mother Hen is running around with her chicks. Thankfully she only hatched two, before abandoning her nest.

There is a problem with our approach, however. With only two of us living in the house, the hens are producing more eggs than we can consume. There are only so many boiled eggs one can eat*. So, for the past few months we have been given boxes of eggs to our neighbours. We were given a hundred plain egg boxes, and J got some personalised labels made up, and so now each gift of eggs comes in a custom egg box. The marrow and cauliflower were an act of reciprocity from one of our neighbours, unnecessary, but very kind, nevertheless.

We are blessed with a large group of friendly neighbours. We are a community that look out for each other, have fun together, and generally try and make our world a better place. I know and appreciate that we are fortunate to have such special people around us. Not everyone enjoys such neighbourly friendship. When we first moved here, we didn’t know anyone. That first Christmas, we sent Christmas cards to the folk living in the immediate vicinity of our house. For most of these folk we only knew them by nod as we met them walking dogs, taking out bins and so on. We didn’t even know most people’s names. In the card, we invited them to an open house Christmas party between Christmas and New Year. Much to our surprise and delight, eight couples came along and this first meet up has led to our friendly neighbourhood community.

Interestingly, some of our neighbours had lived beside each other for many years, but hadn’t previously really had any interaction with each other. This is an issue for many people and can be a situation that is difficult to improve. In our ever increasingly busy lives, building new relationships can be difficult, even with the people who live just next door, or in the same apartment block. I have been told I speak with anyone and J will too. I don’t need to know someone to start up a conversation with them. And I will do so wherever I might find myself. I have a sense that we might never know what the impact of sharing a few words with someone else might have for them.

We really don’t know what is going on in people’s lives. New ways of working, the rise of social media as a way of communicating, and the legacy of the pandemic restrictions have all contributed to many folk feeling isolated and alone. Loneliness is such a growing problem today. There are said to be nearly 26 million people in Britain who report that they feel lonely occasionally, sometimes, often, or always.

Most people are generally sociable, but at times, apart from going onto social media, it can be difficult to find others to be sociable with. Difficult, but not impossible. A few times a week, my 92 year old father will take himself off to Waitrose, not because he can’t get his shopping delivered, but because he likes the conversations with the folk working on the till. These are brief conversations, of course, but sufficient for him to feel a sense of companionship, particularly as they happen on a fairly regular basis. Indeed, in Holland, there is a supermarket company called Jumbo, yes that’s the name, which has recognised that many of their customers like to chatter with the till operators. They have created ‘chatter checkouts’ so that people can have a conversation and not annoy other shoppers standing in the queue behind. I have been in two social enterprise café’s recently where a couple of the tables have signs saying the same thing ‘conversation table’ – sit here and talk to others to other folk.

Making time to be with others, whether it’s in conversation over the garden fence, in the supermarket, church or bus might sound unimportant but these are golden moments of interaction. We don’t all have hens, or grow our own vegetables, and sometimes, a simple exchange of words can often help folk remain visible, valued and nurture both your and their sense of wellbeing. It’s these little things that can make the biggest difference to someone’s day. Pay it forward. You never know, one day it could be you who finds themself alone.

 

*According to a recent study from Waitrose, more than a quarter of UK adults have never boiled an egg, and they don’t know how to.     

Red, red wine, you keep me fine

Some 54 years ago, I fired 6 arrows at balloons attached to a straw bullseye target. The target was less than 50 metres away from me. The occasion was a celebration of the Boy Scouts Movement. The late Queen was there, and I felt so proud to be part of the event. However, my archery skills were pretty poor. Robin Hood I wasn’t; I missed every single one of the balloons. Now for 54 years I have blamed my abject failure on drinking a can of Coca-Cola* before going out there with my bow and arrows. I don’t think I ever had the drink before, and I have certainly never drunk it since. We have it in the house, J likes it. However, we only have diet Coke in our store cupboard – each can’s description says the drink has: a refreshing taste, no calories, and no sugar.

All of which might be true. I have never drunk it so cannot comment on what it tastes like. It certainly doesn’t have sugar; instead it is sweetened by Aspartame, an artificial sweetener. Now if you have been watching the news last week, you cannot have failed to have seen the story from the World Health Organisation (WHO) who described aspartame as being carcinogenic. It was an announcement akin to saying that a glass of red wine a day protects you from a heart attack or a stroke. More of which later.

For a moment, let’s go back to aspartame. It was first developed in the 1960’s and is said to be 200 time sweeter than sugar. It started to be used in the 1980’s amid a growing awareness and increased legislation over the use of sugar in food and drinks. Now the WHO have stated that a safe daily limit of consumption of this sweetener is 40mg per kg of body weight per day. To put that into perspective, it would mean that the average person (which is probably worth a blog on its own) would need to visit our store cupboard 14 times a day, take a can of diet Coke and drink it every time.

What concerned me about last week's WHO story was both yet another ridiculous and sensationalising public communication over aspartame and the fact that this additive is to be found in so many other everyday products that I didn’t know about. Here is a simple example. Last Wednesday I took a walk from Lytham to Preston. It’s about 21 km long and the route is largely along a coastal path. I always walk light, and prefer to buy a bite to eat and drink along the route. It was a very hot day, I was thirsty, and was seduced into purchasing a can of no sugar 7Up. I thought it was a healthy choice. However, like many soft drinks, the sugar is replaced by aspartame. The WHO recommendation is just to drink water as sweeteners in drinks such as  diet Coke, and sugar free 7Up is not the answer to helping us keep healthy.

Even if we do, as the O recommends, WHO recommends, replace our fizzy dinks with water, aspartame is still in many other products. Toothpastes, mouthwash, sugar free sweets, our yogurts, no sugar Ribenia, and even in health products like Lemsip and chewable Vitamin C tablets. But actually, just how much of a risk are we from consuming aspartame in all these possible ways. The 14 cans of diet Coke test would seem to suggest the risk to our physical and mental health is low. Unless you are Donald Trump, that is.

The WHO announcement was based on work undertaken by the International Agency for Research on Cancer (IARC). Despite the IARC researchers admitting there was limited but not convincing evidence, they still published the warning that aspartame could cause some types of liver cancer. The real risk appears to be for those people living with phenylketonuria (PKU), a rare inherited condition. These folk lack an enzyme which means they are unable to break down the amino acid, phenylalanine. Phenylalanine is the major building block for aspartame. Those living with PKU have to abide by a very strict low protein diet, and avoid foods where naturally occurring phenylalanine is found. This can be particularly difficult for families bringing up a child with PKU – take a look at Hannah’s story here. There are around 2300 people living with PKU in the UK.

So perhaps because of this clearly defined and well known risk to a small number of the population, rightly, there was a storm of criticism on social media. Some of which came from eminent scientists in the field of nutrition, statistics and dietetics. The general thrust of the criticism was over trying to use what was described as scaremongering tactics based on limited data, to try and persuade people to change their diet and behaviour.

This is not only not ethical, but also confusing and somewhat disingenuous. It runs the risk of more soundly researched-based public health messaging being ignored in the future. We saw what that could lead to during the Covid-19 pandemic as people were told government decisions were following the science. And when it became apparent that those who were taking the decisions were not abiding by them, many people chose to ignore them as well. Once people’s trust in the power of science is lost, it can be very difficult to regain.

And the red wine thread? Well Betty Regnard, who is a resident at the Westhaven Care home, has her 105th birthday coming up shortly. When asked what did she feel was responsible for her long and healthy life, she unequivocally responded by saying a glass of red wine every day. That said, back in 2018, Theresa Rowley, from Michigan in the US, celebrated her 104th birthday, and credited diet Coke for her long and healthy life. Now, I’m not a scientist, but if it came down to a choice between a glass of diet Coke or a glass of red wine, I know which one I will be drinking.

*Released in 1880, the first publicly sold bottle of Coca-Cola contained around 3.5 grams of cocaine.

        

75 reasons for doing the NHS 1000 miles challenge

It is funny how you become attached to things. I still have the second guitar I ever owned. It is now 52 years old and still plays beautifully. My first guitar got smashed at my local church youth club, and I can remember vividly how distraught I was at the time. Last week I had a similar experience. My university laptop died. No other word for it. It wouldn’t charge, and just sat there silently, a useless grey plastic box. Over the week I went through all the classic Kubler-Ross’ stages of grief*. Now you might say, what is your problem, it’s not a child, sibling, parent or friend you have lost. It is a laptop.

That was the strange thing. My logical self clearly recognised this. Most of the important information on the computer was backed up on a separate hard drive. I could retrieve it all if I wanted to. Although the laptop wasn’t as old as my second guitar, (perhaps at most 7 years old) and was dented, dirty, and had a keyboard where the letters N and E often didn’t work, I was very attached to it. It is the laptop I use to write my blogs on, to send Twitter messages, to do Google searches and do online shopping with. And yes, I could do all of these thing on any machine. Indeed, I have an NHS laptop, a Blackpool Council laptop as well as my own personal iPads.

On Friday, I took the laptop to our local PC doctor. He was non judgemental when he looked at the state of the machine, just smiled and said, ‘let’s just take a look at it’. With that he whipped off the back of the laptop revealing its never before seen innards. ‘Hmm’ was all he said before poking at different parts, testing to see if there was any electric current to be found. ‘Hmm, I don’t know’ was his next comment. He disconnected the lead to the battery, counted to 10 before reconnecting it. 

Would you believe it the screen started to glow and within seconds the login page was showing. I simply didn’t believe it. The PC doctor wouldn’t take any money, as he felt he hadn’t actually done anything. I gave him some anyway, told him to have a drink on me that evening. I was beside myself with joy as I walked home.

And last Thursday, I came across someone else who was beside themselves with joy. I was visiting our finance department at the hospital. One of the colleagues I met was Lisa, an Associate Director of Finance. I had met her before at different meetings and on numerous occasions, but this was the first time on her turf; she was in her office. Lisa was very excited about being one of the people chosen to attend the NHS 75 years’ celebrations in Westminster Abbey last Wednesday. She had joined the great and the good (Rishi, Keir and Steve were also there) in celebrating the NHS. I liked what Amanda Pritchard, Chief Executive of NHS England, had to say about the NHS at the event: ‘We come together today, not to celebrate an idea, but to celebrate all those who have breathed life into it, who have made it mean something real to millions of people over three quarters of century, and who continue to give us hope for the future’.

I would have liked to have been there, but was content to see the service online. At the start of the service, the George Cross, awarded to the NHS in 2022, was processed to the High Altar by May Parson, the nurse who administered the first Covid-19 vaccine. She was accompanied by Kyle Dean-Curtis, St John’s Ambulance cadet of the year and Enid Richmond, who worked for the NHS when it was founded in 1948.  J and me chose to celebrate in a different way. We went for a seven-mile walk in a lovely part of Lancashire. We have been supporters of the #NHS1000miles initiative, since it was conceived back in 2017 and brought to life in 2018, the year the NHS was 70!

Antony Tiernan led on organising those 70th celebrations. This year he was seconded to NHS England from his day job with London Ambulance to help organise the NHS 75 celebrations. I think he did a great job! It was while he was organising the 70^th celebrations, and asking folk to come up with creative ways to celebrate, that #NHS1000miles was created by a small group of NHS folk who thought a great gift to give the NHS was for all of us to support each other in becoming more active. There is much evidence that keeping active is a brilliant idea for protecting people’s health and wellbeing. So in 2018, the #NHS1000miles community went live. It is such a simple, but clever idea. From January 1st, people pledge to either run, swim, cycle, walk, even spin (or a mixture of all these), and record their mileage each week. On Sunday evenings around 19.30, folk post what they have achieved during the week, with pictures usually of where they may have been or what they did. Each week’s mileage is added to the previous week’s, with the aim of trying to reach a thousand miles by the end of the year. One of the reasons I grieved for my laptop was that all those mileage recordings and pictures were sitting on its hard drive – which I have now moved to the ‘Cloud’!

And those NHS 75th celebrations? They happened against a backdrop of the Covid-19 legacy of large waiting lists; 8 months of industrial action; a shrinking number of people working in the NHS, and the perpetual problem of not enough funding. That said, it was wonderful to remind ourselves of where the NHS came from, what, collectively, it has achieved over the past 75 years and what, in the future, our NHS might look like. Like my guitar, and laptop, people are greatly attached to the NHS. More than ever, we need to find ways to protect it. If we don’t, it’s unlikely the NHS will still be here in another 75 years.

*Elisabeth Kübler-Ross, an American-Swiss psychiatrist, first highlighted 5 stages of grief in the 1960s. Since then, her approach has been adapted and extended to 7 stages. As of April 2022, prolonged grief, also known as complicated grief, is officially recognised as a mental health condition, and appears in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) — the guidebook used by healthcare professionals around the world.

Tipping the scales in favour of honesty, happiness and good health

Do you know how many bathroom scales there are in the UK? Or even how many are sold each year? I don’t. It is almost impossible to find out unless you are prepared to access pay-walled market research. Which I’m not! I can tell you that the UK has the largest market share of bathroom scales sales, but I can’t tell you what that is. I do know that global sales are estimated to grow to £2.2 billion by the year 2030. I don’t like not knowing, or not being able to find out, but let’s leave bathroom scales for a moment and consider the integrated concepts of honesty, happiness and health.

The worst thing an academic can do is to have a sexual relationship with one of their students. The second worst thing an academic can do is to falsify the data they use when publishing a research paper. Proving that someone has falsified their data can be tricky. It depends on what the data consists of. I have supervised a few PhD students who have ‘cleaned up’ the narrative data they have collected. In the main this will have been done in complete ignorance and can soon be sorted. However, well-established academics should know better.

So, I was surprised and perhaps a little dismayed to read of the allegations levelled at a Harvard Business School professor called Francesco Gino. She has been accused of falsifying results in several behavioural studies she has used when publishing the outcome of the studies. No case of deliberately trying to manipulate the outcomes to suit a particular espoused view has yet been proven. However, in a somewhat ironic twist, Gino is a professor who studies honesty.  What I do know is she is not a happy bunny.

And increasingly, happiness has grown in importance when it  comes to  living a well-balanced life, free from mental health issues, and improving one’s sense of wellbeing. This year’s World Happiness Report has been published listing Finland as the happiest nation and indeed, for the sixth year running! For the fourth consecutive year, the UK has slipped down the happiness rankings and we are now ranked 19th in the world. But we are in front of Afghanistan and Lebanon, two of the most unhappy countries in the world. The report uses an evaluation tool called the Cantril Scale. This is not a bathroom scale, although I will return to them shortly. The Cantril Scale looks at a number of factors that might influence the degree of happiness people feel, including generosity, freedom and trust. Finland scores well on many of these factors, including equality, healthy life expectancy, a lack of corruption and a great GDP.

As a nation, they face the same global challenges as the UK. The Finnish response to these challenges is somewhat different to ours in the UK. It is underpinned by a national commitment to equality, education and transparency. Three things that have been in short supply recently in the last few years in the UK! When I first started going to Finland, I thought their general acceptance of what life gave them was rather strange. However, over the years I visited, I came to realise that what it actually demonstrated was a sense of contentment, again, something not seen everywhere in the UK. So many people continuously look for something that they think might bring them happiness. The older I get, the more I realise I have much to be grateful for and that gives me a sense of contentment too.  

One of the things I remain grateful for is my reasonable health. Yes, I do get a little help in the shape of a daily dose of statins, and regular cholesterol and blood pressure tests. And now it seems, such ‘simple to do’ health checks are to be made available to many more folk. The new NHS initiative, to be launched next Spring, will be in the form of digital health checks accessed by one’s phone, tablet or computer. Leaving aside for a moment the many people who won’t be digitally literate or won’t own a smart phone, this initiative sounds like a great way forward.

The digital health check is expected to ‘identify tens of thousands of cases of hypertension, and see hundreds of stroke and heart attacks prevented’. Apart from having your blood pressure taken at a pharmacy, people will be able to record the result of a self-administered cholesterol test and chart their height and weight. Reading the story, it was at this point I started to wonder about bathroom scales.

I wondered if everyone owned bathroom scales. We do. It is one of the simple electric digital types, although I find it difficult to turn on. And I think it also lies about my weight. Whilst they might be marginally better than the older mechanical scales that have a pointer that moves around to tell your weight, both can be wildly inaccurate. Indeed, since 2003, it has been illegal for hospitals or GP practices to use domestic bathroom scales in medical situations because they can be so inaccurate.  

It's not just the scales that can tell lies about how much someone weighs. We might do that too, particularly when you think you have lost some weight and yet the scales tell you something different. It must have been that extra glass of wine or second helping at dinner last night, so this weight gain is not real, a temporary blip. And we all know that’s not true! So, I hope reading this little blog has resulted in the ‘scales falling from your eyes’ and you can see more clearly, a relationship between honesty, happiness and good health.