Oh!?! What’s been occurring?

 A colleague asked me the other day what did I think was different about Greater Manchester Mental Health (GMMH) now that a year had passed since I had been appointed Chair. It was a great question and I will touch upon my response in a moment and more fully in next Sunday’s blog. But first…

It finally happened. The right outcome was achieved. Ok we feel a tad sorry for Sonia. But many folk I guess, after turning on their TV at 9pm last Wednesday night, would have thought Sonia had ruined yet another Christmas. Sonia is Laura Aikman, a superb actor who convinced us all she was the villain in the long-running fabulous Gavin and Stacey series.

She was last seen on our screens in the 2019 Christmas special, and goodness did we all shout at the TV set on that occasion. It was a cliff-hanging episode that ended with Nessa (Ruth Jones) proposing to Smithy (James Corden) and for the last five years nobody knew what Smithy’s answer was. It made for brilliant television.

Now, if you have never watched Gavin and Stacey, and truth be told, J had never watched any of it before we got together, all of the above will just be gibberish. Sorry. However, if say that 12.3 million tuned in to watch the Christmas Day episode, (that is nearly 19% of the entire UK population) it is clear that the series is very popular, and we were all wanting to know the answer to that 2019 question. And we found out.

Way back then, what did Smithy say to Nessa? Well, as the storyline goes, he didn’t say anything at all. Now there may be some of my regular blog readers who have been working non-stop over the Christmas period and perhaps haven’t yet caught up with their viewing on catch up TV. So, first of all, a big THANK YOU for being there for others over Christmas. But no further spoilers here. Just to say if you haven’t yet watched the Finale, you might need to grab yourself a box of tissues before watching it.

The fact that the Gavin and Stacey Finale attracted the biggest TV audience in a decade, and even (sigh) beat the new Wallace and Gromit film, is testament to the wonderful creative writing relationship that exists between Ruth Jones and James Corden. Theirs is a very special relationship. I hope that, now that Gavin and Stacey is finished, and it has, they look for a new world to create for our delight.

It's relationships that connect me back to the ‘what is different about GMMH 12 months into my taking up the Chair’s role’ question. There is much that is different and I intend to share more about what’s different in my first blog of 2025. Writing that blog will give me the opportunity to not only look back over the last 12 months, but, and perhaps more importantly, look forward to what I expect will be a very challenging year.

For now, it is primarily the last six months upon which I want to reflect. Six months ago, our new Chief Executive, Karen Howell, joined us. Karen landed, hitting the ground running. Although it has only been six months, I believe we have put in the foundations for what will become a positive and effective working relationship. The signs are all there. Whilst there is much to do, and we are still not getting everything right, we are making progress. We are moving forward. Karen and I are now very much supported by a brilliant group of Executive and Non-Executive Directors. Each one is a first class and experienced individual in their own professional field of practice. They have all chosen to join us, and all are committed to making a difference. We are making a difference, and we will continue to do so.

Suffice to say, it has been a challenging year for several of my colleagues. Next year looks to be no different. There will be some tough decisions to be taken along the way, that is for sure. However, working together we can address each and every one of the challenges that come our way. In doing so, we will take those tough decisions by continuing to nurture our close partnership and collaborative ways of working.

As 2024 comes to a close, I hope there will have been many moments for each of you to cherish. There has for me, and for that I’m grateful. I wish everyone the very best for the new year ahead of us; lets get out there and continue to make a difference. See you all in 2025!

Happiness - share it, embrace it and promote it

It will all be over in three days time. Christmas Day that is. J and I will be spending our Christmas Day on our own. It is a very deliberate choice. We both like the freedom a day on our own brings. What it means is that before and after the 25th we find time to spend with family members, usually to have a Christmas meal and exchange gifts. Last Sunday one of our daughters gave us a bag full of presents and then announced that she wasn’t buying me any alcohol this year. She has for many, many years always given me a bottle of Harvey’s Bristol Cream sherry for Christmas. There are of course, alternatives to this blue bottled sherry.

Gifts are always a personal choice, but when I showed my surprise, she told me that I drank too much alcohol and she wanted me to cut back, so I might still be alive when her youngest graduates from university. Given his age, that will be at least another 10 years’ time. I do like a glass or two of red wine, that is for sure. We had a laugh about it at the time, but I wondered why she had become worried about my health now.

I’m well and truly in that later life space. I’m not alone. Baby Boomers like me on average are living longer, certainly longer than folk in 1900. On average, 75% of the population are reaching their 65th birthday and many far beyond this. The average life expectancy after men retire at 66 years, is another 22 years (I can’t find the data for women). That is a long time. Contemporary medicine has made it possible for many of us to live much longer lives. However, a longer life doesn’t always mean a healthy life. As we get older, individual health and wellbeing can rapidly deteriorate. It is also a time that can give rise to questions of one’s purpose and even identity.

Of course, questions about one’s purpose and identity can happen at any time in someone’s life. For example, I know of several mums who, having looked after their children from birth, suddenly become bereft as those same children leave home for university, travel or marriage. It is also quite common when people first retire. Whilst I retired from full time employment many years ago, I have continued to do things for both my university and the NHS, that other folk might consider work. I don’t see it that way in the strict sense of being employed. I do the things I do, because I enjoy doing them and feel I still have something to offer – and there you go – something about having a purpose in life.

Now J does work full-time still and is a little way off retiring just yet. Consequently, I have happily become a stay-at-home man. I take great joy in doing the blindingly obvious tasks, shopping, gardening, occasional washing and so on, but also in also those often-hidden tasks that help keep our lives running smoothly. It is my own version of the Adam Smith metaphor of the ‘invisible hand’, something he used in describing free market economics.

From an economic perspective, the invisible hand describes how free markets can motivate individuals who, in acting in the own self-interest, produce what is societally necessary. The outcome is a system of mutual interdependence. It was a concept I explored in my PhD, through the lens of General Practitioners’ decision making in the NHS internal market at the time. At home, the concept is much simpler.

I’m very happy to get on with whatever it takes to ensure that J has the time, space, and energy to get on and do what she does best – and she is good at what she does in her work. However, sometimes my approach annoys J and she will tell me to simply sit down and stop. Hard to do. I work off a mental Gantt chart that allows me to constantly tick things off in a sequence that works for me, even if it is not obvious to others. I like doing things and can’t rest (easily) until I feel everything is done. It would be wrong however, to think that I do everything while J does nothing at all. She is a ruthless tidier for a start and she contributes to the smooth running of our lives in ways that are often just as invisible and difficult to articulate as some of my efforts. And for that, I’m more than grateful.

As we all move through life, it is important to think about what we can do, and perhaps not what we can no longer do. I know that as I have slowed down, I’ve become more aware of the important things that contribute to our happiness. There is no place for an approach that draws upon a strict division of labour. It is a much more transcendental approach that will ensure a shared happiness every time.

Finally, whatever you might be doing, and whoever you might be sharing your Christmas with, I hope you all have a very happy Christmas.

 

 

Enjoying a Jacob’s Join: tales from the dinning table

One of my life’s ambitions was to build my own library. I started collecting books in my early 20s. Living in rural Wales at the time, and not owning a television, I read voraciously. By the time I moved to Manchester, I had a couple of thousand books. However, for all kinds of reasons, I eventually gave up on the idea of creating a library and have over the years steadily downsized my book collection. Just recently, I went through my remaining bookshelves and donated a load of books used during my doctoral studies to our local charity shop.

One of things I most enjoyed about doing my PhD was visiting the university library and developing an idea by looking up information to be found in peer reviewed papers and book chapters. Fortunately, I had a brilliant PhD supervisor who opened my mind to so many different ways of viewing and making sense of the world. During my doctoral journey, there was nothing I liked better than sitting in the library reading.

Sadly, in my view, much of the information students and academics need for their studies today can be found online. Indeed, much of my reading these days is done on my iPad. J on the other hand loves nothing more than turning the pages of a real book. One of the things I find almost magical and certainly challenging (in an interesting and good way) when writing my blog is to make connections from things that I have read during the previous week, sometimes supplemented by something I might have read many years ago. The blog may only be 700-800 words, but I really enjoy pulling them together into a narrative each week.

This past week I have been drawn towards food stories; sparked I think, by reading about the great ‘Sandwich versus Steak’ debate between the Prime Minister and the Leader of the Opposition. Given all the catastrophic, challenging and horrific things going on in the UK and around the world, why on earth was there so much attention paid to what their lunchtime preferences might be? This was a lunch meal conversation, and the Leader of the Opposition, Kemi Badenoch, declared that ‘lunch was for wimps’, continuing to say that ‘sandwiches aren’t real food, they’re something you have for breakfast’.

I love sandwiches, peanut butter (with either tomato ketchup; marmite and cucumber; or banana) are my favourite. But I rarely have breakfast. Most days I’m awake before 4.30am and food is the last thing on my mind. Often, I don’t eat until the evening, although I do very occasionally have a sandwich at lunchtime.

According to a Spanish study published last week, missing breakfast may shorten my life or, at the very least, cause me to gain weight.  If I do eat breakfast, it tends to be when I’m staying in a hotel and then it is usually a Full English Breakfast, which apparently is worse for my health than not eating breakfast at all.

Cereal (such as muesli or bran flakes), wholemeal toast and fresh fruit, (but not more than 300 – 400 calories) are the best items for a health-promoting breakfast. Interestingly, a separate American study published a couple of years ago showed that if you can eat your breakfast between 6 and 7 am, you would reduce your risk of a premature death from heart disease or cancer by up to 12% compared to those who eat their breakfast later. Importantly, your breakfast drink should avoid tea or coffee. And I cannot believe that the most popular coffee drink in 2024 is an onion latte. Apparently, this drink, both drunk cold and hot, has racked up over 20 million views this year on TikTok. I don’t do breakfast and thankfully, I don’t do coffee. I like my onions in stews, and spring onions in salads.

Last Thursday, I enjoyed salads aplenty. The occasion was a Board meeting and Board development day. We all wore our Christmas jumpers, and our lunch was a ‘Jacob’s Join’. If you have never lived in Lancashire, you may not recognise the term – but think ‘potluck dinner’, ‘bring and share’, ‘bring a plate’, or if you’re Finnish, a ‘bundle feast’. It simply means that you invite folk to bring some food to a meal that they then share with others. One of our Non-Executive Directors was once a chef. Her salads were simply amazing. We enjoyed sandwiches, dips, meats, cheese, and scrumptious cakes. There were plates of traditional food from all over the world. 

However, whilst the food was a wonderful, it was also wonderful to take the opportunity to spend time with each other, and time that wasn’t focused on work. It is something we maybe should do more of during 2025.

Vaccinations and the Kiss of Life

There were a number of really good things that happened for me last week. One was a piece of positive news that I had been waiting on since May of this year. Sadly, I can’t share what that news was here as it’s embargoed until next Tuesday. But it is a decision that will make a difference to so many people. Watch this space folks!

The second good thing to happen last week was being invited to lead the discussion at the last Good Governance Improvement (GGI) peer-to peer seminar of 2024. GGI is a brilliant organisation committed to improving governance across the NHS. I have worked with them at Blackpool NHS FT and at Stockport NHS FT. A part of what they do, in promoting and enabling good governance, is to run a monthly virtual meeting for NHS Non Executive Directors (NEDs). The meetings are bound by Chatham House rules. Each meeting provides NEDs from across England with an opportunity to share ideas, challenges, and their concerns. I try and attend as often as I can.

Last week’s meeting looked at a range of issues: the impact and consequences, intended and unintended of the recent Budget; the potential impact of the proposed regulation of NHS managers and leaders; and how NEDS might address these issues within their Board meetings. I really enjoyed the opportunity, and the discussion was informative and lively. The hour flew past.

I chose to attend from the comfort of my lounge-cum-office, so there was no commute, plenty of tea on hand and the central heating was on. Billy, my parrot, likes to listen in to all my meeting conversations, although as far as I’m aware, he has never broken the Chatham House rules. I also had a table next to me that had two glasses of water, a bottle of chesty cough medicine, a box of tissues and an assortment of cough sweets.

Yes, my cough and cold lingers on and just occasionally, I get a tickle in my throat that breaks out into a hacking cough and leaves me unable to speak. So, I was prepared. However, it is getting better, albeit slowly. It wasn’t Covid nor was it influenza. I have tested for the former (negative) and had my flu vaccination at the beginning of October. Sadly, I passed my cold and cough on to J who has, this past week, been very much under the weather. It may well have been our own fault.

J had read an online article that posited the idea that couples who kiss for six seconds or more, each time they kissed, had healthier lives and lived longer. I’m not sure of the science (and you can judge for yourselves here) but I’m never going to pass up an opportunity to kiss my lovely wife. Unfortunately, in so doing I may well have given her my cold.

However, we take consolation in that we are enduring the pain and misery now and not over the Christmas holiday period. I’m also extremely glad it’s neither Covid nor flu. We should not forget that both these diseases are potential killers. They are also highly infectious, and more prevalent during the winter months.

All of which makes it difficult to understand why the number of people being vaccinated is falling. At the end of September this year, the UK Health Security Agency published the latest data on the number of flu-related deaths over the past two winters. Between Oct 2022 – May 2023 and Oct 2023 – May 2024, at least 18,000 people died of flu-related illnesses. During the same time periods, 19,500 people died of Covid. Last winter was a relatively mild flu season. Last week, 406 people died of flu or pneumonia and 100 people died from Covid in England.

As the Get Winter Stronger campaign, which ended this week, reminded us, it is not just about folk dying. People can experience severe health problems from flu, Covid and respiratory syncytial virus (RSV), severe enough to need hospital treatment and care. Professor Sir Stephen Powis, the National Medical Director for NHS England, and Professor Sir Chris Whitty, England’s Chief Medical Officer were both in the news last week talking about the exponential rise in hospital admissions for flu, Covid and RSV. If beds are increasingly being used to treat people with these conditions, then it will add to the difficulty of reducing the waiting lists for other health problems.

Nobody has actually asked me what I want for Christmas but, if they did, I think I would like the gift of people of all ages getting vaccinated against flu and Covid. That really would make a difference for the NHS to be better able to provide care for everyone.

 

The journey of 1000 km still starts with the first step

I’m immensely proud of J’s determination and application to keeping up her regular running routine. I don’t run, I walk, so J always runs on her own. While this is usually not a problem in the spring and summer months, at this time of the year it can be more difficult. One night last week, she changed her regular route and was out running slightly longer than usual. I was worried. Although we have phone trackers, dependent on the strength of signal, these are not always fully functional or accurate. Consequently, knowing where one of us happens to be at any particular time can sometimes be difficult, and also frustrating.

Like most towns, our local pavements are poorly maintained and it’s easy to trip up even in the daylight. In the dark it can become even more hazardous. Way back in 2018, the AA using Freedom of Information requests, found that uneven pavements were more prevalent in the North West of England (77%). This is where we live. Some 64% of respondents reported pavements being encroached by overgrown trees and hedges.  Uneven pavements and pavement hazards all contribute to the risk of a fall. Whilst falls can happen to anyone, older folk are more likely to fall, as are those with a physical impairment. Runners also fall (sorry) into this category, as they tend to be moving at speed. 

I worry, not just about J having an accident, but about her running alone at night or in the early morning. The recent report published by This Girl Can noted that 72% of women change their outdoor activity during the dark winter months. They do this because of the threat of abuse, intimidation and assault. The University of Manchester published a study earlier in the year that found 68% of women had experienced abuse while running. Sadly, very few of such incidents get reported to the Police.

Running in groups can help of course. However, J likes to run on her own, to enjoy her music, clear her mind and of course to reap the rewards of regular exercise. Following last week’s fright and in reducing the risk and staying safe, J has changed her route. It is now a well-lit and public route. She shouldn’t have to do this. For my part, given that I’m not going to start running with her, (she will always be faster than me) we have agreed that I should be more aware of timings and routes. To this end, we touch base before she goes out and J tells me her route and her expected time back. Again, this doesn’t feel like it’s something we should have to do either.

It is sad that there are so many people out there who feel it is okay to intimidate folk in this way. Ironic too. The last government’s ‘Gear Change’ strategy, published as we were coming out of the Covid pandemic, had a bold ambition to ensure that by 2030, half of all journeys in UK towns and cities would be undertaken by walking or cycling*. Both activities, done regularly, can help reduce the risk of more than 20 chronic health conditions being experienced. Inactivity is said to be responsible for one in six deaths (equal to smoking) each year in the UK. According to the World Health Organisation, 1.4 billion people globally don’t do enough physical activity.

Where we live, just outside Blackpool, the Active Lives Adults Survey carried out in 2023 showed that only 59% of adults in Blackpool regularly achieve the recommended amount of physical activity per week (150 minutes of moderate exercise). The national figure is 67%. At any time of the year, keeping active is a good thing. It is more important during the winter, when short days and often inclement weather can mean we spend more days indoors and therefore less active. Like many others, I love being outdoors, and we are fortunate to live by the sea. We have just a 10 minute walk to the beach. I walk every day – and this can mount up, usually around 40 – 50 miles a week. So far this year I have walked 2,107 miles.

Of course, you don’t have to walk that many miles a week to feel the benefit. There are many other ways of keeping physically active and improving your mental health and wellbeing in so doing. One of the places I like to walk to is the coastal town of Cleveleys, some 5km away. It makes for a lovely circular walk and has the bonus of a superb microbrewery on its main street. Cleveleys sits in Wyre Borough and they have a brilliant evidence-based ‘Wyre Moving More’ strategy which successfully makes the connections between physical activity, sport, active leisure and health and wellbeing. Importantly, it does so across all points of the life span. To deliver some the strategy’s ambitions will need additional funding. But more will be achieved through motivating folk to find the physical activity that best suits them. I can’t run, but I can walk. I intend to keep doing so until I can’t. When I can’t, I will take up chair yoga. 

 

 

 

* I work in Greater Manchester, and our Mayor, Andy Burnham, has long been a fantastic supporter of Greater Manchester Moving. I remember one meeting where Andy ‘gave permission’ for all his colleagues to wear trainers to work on the basis that folk actually used them for walking and keeping active.