I’m as happy as a pig in poo!

James Cromwell is the actor, who played the farmer in the film Babe. It was a film that fundamentally changed his view of the world. During the preparation for the film and the actual filming itself, Cromwell had the opportunity to better understand and appreciate the intelligence and personalities of pigs. As a consequence, he decided to adopt a lifestyle free from animal cruelty. He became an activist for animal rights and a vegan.

He believed that pigs should live a life that allowed them to forage, have fun and decide how to spend their time as they wished – in a sense, all animals, should be as happy as pigs in poo (there are ways of repeating this idiomatic saying, but for the sake of younger readers, lets stick with the word poo).

Indeed, just the other week, I found that poo is the word being used by the NHS. It was used in a letter inviting me to have another poo test – the so called FIT (faecal immunochemical test). This is a bowel cancer screening test that replaced the original faecal occult blood test, way back in 2019. I have been doing both tests now for many a year. The current test is much easier to do than the previous ones for sure.

In the UK, bowel cancer screening is offered to all folk aged between 50 and 74. The test is offered every two years. This is because the risk of getting bowel cancer rises as people get older. Bowel cancer is one of the most common cancers in the UK. If cancer is detected early, and often before some of the symptoms appear, it can be easier to treat. This screening programme does just that.

However, whilst the screening programme has resulted in falling rates of deaths from bowel cancer in those over the age of 50, there has been a rise in bowel cancer in those under 50 years of age. Trying to understand why this might be is ongoing, but last week the results of a major, longitudinal research study into the relationship of diet to bowel cancer risk, was published.

It found that, surprisingly, meat free diets were seen to raise the risk of bowel cancer, and in particular, vegan diets. I say surprising as it’s been more than 10 years since that the World Health Organisation suggested that some processed meats, such as bacon and sausages were Group 1 carcinogens. This is the same group as cigarettes, alcohol and asbestos!

However, (he says with a ‘phew!’) vegetarians are much less likely to develop pancreatic, breast, prostate, blood (myeloma) and kidney cancers. Strangely, vegetarians were found to be almost twice as likely to be diagnosed with oesophageal cancer. I say strangely, (and possibly also surprisingly) as a diet that contains a majority of fruit, vegetables and fibre containing foods, and which avoids processed food has long been recommended as a way to reduce the risk of cancer.

The study suggested that the higher risk of bowel cancer seen with those folk adopting a vegan diet may be due to a lack of calcium in their diet. It’s a known risk factor. This is an area for future research. Vegan folk typically have a higher fibre diet and consume less alcohol than other groups. It’s clear that whilst vegetarians and vegans should take comfort from the research, it’s clear that both groups need to think about how they might replace any missing nutrients in their diet through taking supplements.

For example, as a long-time vegetarian, I know I cannot get enough vitamin B in my everyday diet. So, I take a vitamin B tablet every day. I have done so for over 50 years. However, I’m not worried about having a calcium deficiency, as cheese is one of my favourite foods, and something I eat every day. I’m a cheese addict, a turophile in fact (but that’s probably the subject of a different blog).

So being a vegetarian might bring many benefits, but I have to say, it’s not risk free. Nothing really ever is. That said, my poo test results came back on Friday. It appears I’m okay for another two years. So, this weekend we are celebrating in Italian style. Yesterday it was pizza, tonight meat-not meat balls and pasta, and tomorrow, minestrone and the best crusty bread I can find. There will also be some gorgeous Crumbly Lancashire and crackers. All of which have been and will be vegetarian. It’s a shame I can’t invite James Cromwell to join me.

Enjoying Snowdrops free from the fear of hippos and mosquitoes

Every year, for the past few years, we have gone to the magnificent Lytham Hall to look at the snowdrops. Every February, without fail, there is a wonderful display of snowdrops in the grounds of the hall and in the surrounding woods. Yesterday, as we walked around the grounds, it felt even more special. This time last year, it was the first trip Jane made after being discharged from hospital, following her brain bleed. I remember slowly walking around, enjoy the sunshine, quiet, and of course the snowdrops. They were magical moments of joy and happiness. This year was no different. In fact, there may have been even more flowers to be seen, and one year on, I think we both grateful to enjoy Mother Nature in all her glory.

I’m not a climate scientist, nor even a climate crisis campaigner, but days like yesterday make me reflect on the fragility of our world.  Nature is resilient, but you would have to be a hermit not to have noticed the changes around us. The dryer summers and wetter winters, melting ice caps, fierce storms and so on. What was once a fairly predictable, and reassuringly seasonally-ordered world has become very unpredictable and unsafe.

More of which in a moment – first let me take you to the other side of the world. A few years ago, I had the wonderful experience of travelling to Uganda with my university and colleagues from, what was then, Health Education England. It was a great opportunity to see how UK universities supported the training and education of doctors and midwives to work in their own countries. I was also able to visit some of our midwifery students on placement at a very rural clinic in Njara, many miles from any of the big cities.

I was impressed by the way they adapted to what were very unfamiliar surroundings, little equipment and often non-existent drugs. It was ‘back to basics’ for sure. Their knowledge, displayed through their practice, was a credit to my university colleagues. Over the 10 days of the visit, I witnessed much poverty, and saw the reality of how the extremes of nature could bring absolute devastation to communities. However, travelling around the countryside, there were two other things I worried about. One was the hippopotamuses that could be heard roaring at night and which, on land, could out run most people. I was warned more than once to not leave my accommodation at night, because of them.

The other thing I worried about were the mosquitoes. Tiny compared to a hippopotamus, but much more dangerous. Apart from nights spent in western-style hotels, every other night was spent under mosquito nets. I grew to hate the smell of the DEET mosquito repellent sprays I applied every day. I had to also take anti-malarial medication before, during and after returning to the UK. Thankfully, I didn’t suffer any ill effects either from the medication, nor the mosquitoes. And it was just for a short time. What about if we all had to live with this threat every day. Never going to happen in the UK? – think again.

Due to increasing global warming, the tiger mosquito, originally only found in Tanzania is spreading northwards towards Europe. These mosquitoes can cause serious health conditions such as chikungunya, dengue and zika. Such infections can be fatal in young people and frail older folk. Higher temperatures mean that these infections are now more likely for more than six months in places such as Spain, Greece and other Southern European countries, and for two months of the year, in the south-east of England. 

Treating some of these infections is expensive, and often unpleasant. Preventing the tiger mosquito from becoming established here in the UK is a much better option. That will only be possible, if we start to undo the damage we have done and continue to do to our planet. If we are successful, it will also mean there will be plenty of snowdrops to be enjoyed for many years to come. Jane and I want to be there to enjoy them too.

Seeing hope in a less restrictive future

Here is a word for you: ‘stobuften’ – it’s a German word and has characters and letters that being generally inept and not particularly computer literate, I can’t reproduce here. However, it is the word’s meaning that is important. It refers to the practice of ‘shock ventilation’ – opening a few windows wide for no more than a few minutes. It is something that happens in this household every single day. All the windows upstairs are opened, as wide as they will go, to ‘air the house’. It happens against the backdrop of creaking hot water pipes and radiators, as the central heating system tries (vainly) to compensate for the sudden loss of heat in the house. In Germany, this is a common practice. In this house, it is not me who opens the windows in this way…

Now don’t get me wrong. I’m all for fresh air, and love being outside, as much as I can. Whatever the weather, if I can be outside, I will. I love the sense of freedom I get from being outside walking, gardening and more recently, slowly passing through countryside on our narrowboat. Freedom, or rather the ability to make decisions about what we might do, was something we focused upon in our Board Development Day last week.

We were joined by colleagues from our Human Rights and HOPE(S) team. The HOPE(S) model* is a human rights approach, developed by our colleagues at the Mersey Care NHS FT. Its aim is to work at reducing the time service users spend in segregation. Being in seclusion for long periods of time is known to be counter-productive to good mental health and, wherever possible, should be avoided. The team shared a video of someone who, whilst receiving care for her mental illness, had spent a great deal of her time in seclusion. It was a very challenging video to watch. The negative impact on the patient’s mental health and wellbeing was clearly profound.

Our HOPE(S) team is a result of an NHS-funded national roll out of the roles, training and approach that brings together healthcare professionals, service users and carers. It was good for the Board to see the enthusiasm and commitment the team had for training and supporting others to find compassionate ways to reduce the use of restrictive practices.

The Board development session reminded us that protecting peoples’ human rights is everyone’s business. Over a 90-minute period, and using an interesting and powerful approach, the facilitators took us through what protecting the human rights of the people we care for, looks and feels like. The first exercise involved us being given a piece of white paper, and a stubby crayon each. Some of the crayons were white. We were asked to list five things that were important to us in our lives. Next, we were asked to swap our papers with the person sitting beside us, and to then strike out three of the things on each of the lists.

It was a simple and effective way of demonstrating how easy it might be to take something that was precious away from us. The next exercise was even more vivid. We were joined by three members of our Prevention and Management of Violence and Aggression (PMVA) team. PMVA is a structured prevention-led approach used to reduce the risk of violence and manage aggressive behaviour, safely, lawfully and ethically.

The team asked for a volunteer, and our Chief Medical Officer (CMO) duly stepped up. He was successfully, and safely restrained. Although he wasn’t violent, the team showed how they could escalate their approach, whilst imagining that he was becoming increasingly more aggressive. Importantly, throughout the exercise, the team leader used calm reassurance, as she and her team restrained our CMO. Likewise, throughout the exercise, they ensured his dignity was protected. It was an impressive demonstration of what is possible to achieve in difficult situations, with the right training, teamwork and calm approach.

It was also a wonderful insight into how our Trust-wide ambition to reduce restrictive practices of all kinds could be achieved. There is a way to go, but goodness, we have a great team leading on delivering this ambition. The Board Development Day was just as it should be, stimulating and refreshing - rather like the impact of wide-open window on an arctic cold morning might have.

 

*Here is the Mersey Care FT description of the HOPE(S) model:

• It encourages teams to Harness the system through key attachments and partnerships
• Create Opportunities for positive behaviours, meaningful and physical activities;
• Identify Protective and preventative risk and clinical management strategies;
• Build interventions to Enhance the coping skills of both staff and people in services
• Whilst engaging in these tasks clinical teams and the System needs to be managed and developed to provide support throughout all stages of the approach.

Emergency Care: finding calm in a crisis

Last week, I shared an amazing experience with Jane. I accompanied her to an appointment with her neurology rehabilitation consultant. It was at the Lancashire Teaching Hospital near Preston. It has the worse visitor car-parking of any hospital in the North West. Like many visits I made last year, I eventually abandoned the search for a parking space, and we parked in the nearby local supermarket, and walked across.

The consultation was reassuring and helpful. What made it amazing was the consultant taking us through Jane’s various scans. I still find it fascinating that he was able to show us inside Jane’s head, where her VP shunt was located and where the aneurysm bleed had occurred. It was hard to grasp how the surgeons had both stopped the bleeding artery, and then subsequently fitted the shunt. What the consultant couldn’t show us was the original CT scan taken when we first attended the Emergency Department (ED) at Blackpool Victoria Hospital.

Apparently, the scans ‘belonged’ to Blackpool, and not Preston. One NHS? Shared patient records? Left shift, from analogue to digital? It was disappointing for sure. I was also reminded, in a PTSD type of way, of that dreadful experience, of sitting in a cold, noisy, uncomfortable and overcrowded ED waiting room for hours, waiting for someone to see Jane and tell us what was going on. That said, Blackpool ED is no different from many (most) accident and emergency departments in England.

Many EDs are not fit for contemporary emergency care. They are overcrowded, both because of the unremitting and increasing demand for help and care and because it can be so difficult to find a bed for those who need inpatient care. Increasingly, EDs are being negatively characterised by ‘corridor care’ as being the norm. These are not places you really want to be in, if you can help it. Despite this over 35% of those folk attending an ED for health care don’t actually need emergency care. Why do they go there?

If these difficulties are true for those presenting with some physical problem, it’s arguably more so for those experiencing a mental health crisis. Although people with mental health problems account for about 2% of all those who attend an ED*, one in four people presenting with a mental health problem will wait longer than 12 hours there. This compares to one in 10 of all other patients. Waiting in an overcrowded, noisy, busy and often chaotic environment is unlikely to be conducive to reducing distress or agitation.

The NHS 10 Year Health Plan recognised the problems experienced by healthcare professionals in responding appropriately, and in a timely way, to the needs of those attending ED in a mental health crisis. The plan sets out a transformational investment of £120 million over the next decade to develop a range of specialist mental health crisis assessment centres. These are to be located in, or co-located with existing EDs.

There are currently 10 pilot sites across the NHS. One of which is at the Blackpool Victoria Hospital ED. It is co-located next to the main ED. Anyone who is triaged as needing a mental health assessment, can get this by literally stepping across the road.

Whilst some have described this policy approach as being almost Cartesian in approach (splitting the mind from the body), services such as the Blackpool one can provide access to both mental and physical health care expertise. The Centre for Mental Health note that some 42% of people presenting at their ED with a mental health problem will also be flagged with a non-mental health diagnosis. Whilst liaison psychiatry services can help here, often these folk are few and far between in EDs.

I welcome these developments in mental health crisis care, well at least the Blackpool type model. But I also know that such services won’t, in themselves, deal with the problem of finding a bed where inpatient care is the appropriate way forward. Likewise, I also know that some 70% of people who chose suicide as a way of resolving their mental health problems, haven’t been anywhere near an ED. There really is no health without mental health, and finding ways of recognising this in practical ways has always been a challenge. However, improving ED mental health crisis services does feel like a positive step in transforming how good mental health care might be provided.

 

* Despite recent announcements to invest in mental health care, mental illness represents 20% of the UK’s disease burden but receives only 10% of health funding.

Read, it might change your life

I’ve found out I’m apparently what’s called a ‘mega reader’. That is someone who reads at least 50 books in a year. During the month of January, I have read 7 books. They were all novels, and as such, relatively easy to read. That said, they were highly enjoyable, with great plots and characters. It beats scrolling through TV channels trying to find something interesting to watch. The simple fact is, I love reading. Always have. These days much of my reading is done on my iPad, and although my virtual library is pretty large, it's not quite as satisfying as one I once had made up of real books.

I don’t just read novels. Last week, for example, I discovered that 2026 is the UK National Year of Reading. It is the third time there has been such a reading campaign – and this year the focus is on all forms of reading options. Strangely, this year, it also includes listening to audiobooks. Whilst Jane does this while working out at her gym, it’s not something that appeals to me.

The campaign is aimed at all ages. Interestingly, older folk (over 65) are more likely to be readers then others. The number of books adults might read in a year varies greatly. Around 25% of all adults reported they just read or listened to between one and five books a year. A much smaller number (10%) of people said they would typically read between 11 and 20 books in a year. Twice as many women as men are likely to be regular readers. Sadly, 40% of the UK population reported that they hadn’t read or listened to an audiobook at all in the past year.

I say sadly for a reason. This year there is a particular emphasis on getting more children interested in reading. The latest report from the National Literacy Trust (published in June last year) showed that only one in three children aged 8- 18 enjoys reading. Research suggest that low levels of reading for pleasure in childhood have been linked to poor academic achievements and can have a negative impact on an individual’s life chances.

Encouraging children to read is one of the greatest gifts a parent can give their child. However, if parents are not reading books themselves, it’s unlikely they will be reading to their children. Reading to young children, even before they are able to talk, can help prepare the neurological pathways for effective language use and literacy in later life. Research from the Ohio State University showed that children who are read just one book a day with their parents will hear about 290,000 more words by the age of 5 than children who don’t regularly read books with a parent or some other caregiver.

However, it’s not just about words – reading can help the child gain a sense of perspective, and begin to understand different contexts such as physical settings, a zoo, farm, park, school, hospital and so on. It can also help a child make sense of what they are feeling and learn what their emotional response options might be. Of course, the simple act of being together is obviously also a chance for parent/child bonding to occur.  

Now it might seem to some of today’s readers of the blog that I’m judging those parents who, for whatever reason, don’t read with their children. I’m not. However, I did pause to reflect on the support we provide to families to navigate an ever increasingly difficult world. Last Monday, the UK Health and Social Care Committee published their latest report on the First 1000 days of Life (that is, from conception to age two). You can read their report here. It’s a challenging report. It makes some great recommendations. Equally, there are some fairly unfavourable comparisons to the previous ‘Sure Start’ programme, which was very successful, albeit it was a costly initiative.

There’s the rub. ‘Sure Start’ was one of the most successful health promoting programmes ever. But during a period of economic downturn, the annual costs became more important than any long-term gain, and its momentum stalled, and then stopped. Hopefully, the renewed recognition of investing in our children today, set out in the First 1000 days report, will help improve the future of our children’s and their families. Likewise, let's hope the campaign to get children interested in reading once more helps each child have a better future too.   

Brave New World - working towards values-based realism

Last Monday, I was a non-participant observer at our Integrated Performance Group meeting at our Trust, Greater Manchester Mental Health (GMMH). This is a new element of our re-engineered governance processes. It’s an approach that aims to make sure decision-making takes place at the most appropriate level of the organisation; in this case, the Care Group leaders. They form an important group of our senior leadership colleagues. Each Care Group presented on their progress to date, issues to be escalated and achievements to be celebrated. I was impressed with their depth of knowledge, their willingness to appropriately challenge each other, and their determination to make a difference.

To draw on the words of the Canadian Prime Minster, Mark Carney, it was a sign that the old order was disappearing. What I was witnessing was something new, fresh, and hopeful. Mark Carney also quoted Alexander Stubb, the Finnish President, and his approach to the current global uncertainty. The term he used in capturing this approach was ‘values-based realism’. The notion of being both principled and pragmatic. It is an approach that feels equally applicable to the increasing challenges we face in the NHS.

The past year has seen much turbulence, change and yes, uncertainty across all levels of the NHS. It has not been NHS England’s finest hour. Over the past 12 months, this turbulence has formed the backcloth to our recovery work as an organisation. One thing that has become clear over this time, is the need for all NHS Foundation Trust Boards to take ownership of the issues they face, find the solutions and be accountable for all their actions. To quote from Mark Carney’s speech once again*, we have become ‘middle powers’. As an NHS Foundation Trust, we sit between the Regional Offices of NHS England and the Integrated Care Boards of our integrated care system.

It feels like a good place to be. This was something I was able to explore twice last week. The first was at a small dinner party hosted by the wonderful folk at the Good Governance Institute (GGi). Andrew Corbett-Nolan, GGi’s Chief Executive was there in person. He is one of the good guys for sure. We were in Liverpool, at a restaurant on the Albert Docks. It was a great evening of good food and equally good discussion and conversation.

Although Jane wasn’t at the dinner, she travelled to Liverpool with me and watched the football. We stayed over, and spent a wonderful time the following day exploring Liverpool city centre. One of the things Jane wanted to do was visit the Walker Art Gallery, which had a special exhibition of Turner’s paintings. We weren’t disappointed. Next stop was to visit both the city’s cathedrals. Whilst they were both magnificent in their own right, we did prefer the majestic Anglican cathedral. Then it was back home and a late afternoon meeting with my Non-Executive Director (NED) colleagues.

The next day I was once more in the company of Andrew, albeit we were in a Zoom meeting. It was the first NHS Chairs and NED webinar of 2026. I was there to present a little of my experience of being a Chair at GMMH during our recovery journey. It was an opportunity to reflect on where we had come from as an organisation – not a place I ever want to return to – and where we are today. At one time, we were top of NHS England’s worry list. Thankfully we no longer occupy that position. The telling of my story revolved around a shared approach that both our Chief Executive, Karen Howell OBE and I had relentlessly pursued over the nearly two years that we have worked together. Our approach was and is centred around consistently promoting trust, authenticity, and transparency.

Building great leadership teams that bought into our three organisational priorities (recovery, reengineering of governance process and strategic aspirations) was where we were able to start to build trust. Nurturing neglected relationships, within the Trust and with partners, through consistently presenting one version of the truth helped promote authenticity. And finally, improving the quality and safety of our services, alongside financial sustainability, and good governance, ensured we remained transparent in all we did. At the meeting last Monday, I think I caught more than a glimpse of the difference such an approach can make, and I say a big THANK YOU to all my colleagues who have helped us get this point – the next phase of our improvement journey is about to begin.     

 

*I found Mark Carney’s speech at Davros inspirational, and I would encourage folk to try and read it in its entirety.

Stories to be told, and stories that require us to be bold

Last week, I was full of a head cold. Nothing too bad, but it meant I had a more slowed down week than normal. It also meant I had more time to catch up on my reading. I was so pleased to read of the Darlington nurses and their success at an employment tribunal last week. Common sense prevailed, and we should all be truly grateful the eight nurses had the courage to put truth to power. It was a great story, with a brilliant outcome.

That said, there were some really dismal stories around in the media last week. I find it difficult to believe that so many people are really interested in the Ramsey/Peaty feud or even the Beckham family feud, and don’t get me started on the banal Molly-Mae or Eamonn Holmes sagas. Tedious is the word that comes to mind.

Equally tedious, was the painful video of the dancing Meghan and Harry – I think I must have missed something along the way as this was a post, similar to several of the social media posts I saw last week, that used the caption ‘when 2026 feels just like 2016… …you had to be there’. In 2016, I was Dean of a large School of Nursing. During that year I presented research papers in Australia, Germany, Czech Republic and Hungary. I was there then, and I’m here now. So, what am I missing?

I haven’t, however, been to Venezuela. What a pathetic and wretched story we witnessed involving Venezuela and the US President last week. The Venezuelan opposition politician, Maria Corina Machado gifted her 2025 Nobel Peace Prize medal to Donald Trump. The fact that he gleefully accepted it made me think just what a sad man he is.    

On a happier note, was an old story from Japan that had a reprise last week. This was about the introduction of blue LED lights at many of Tokyo’s railways stations. Apparently, the blue lights are said to create a ‘calming pause’, which results in subtly influencing mood during moments of distress. Since they were introduced over 10 years ago, there has been a dramatic (84%) reduction in suicide incidents at these stations. Literally lifesaving.

Not lifesaving, but there was a ‘life changing’ story that caught my eye last week. It came from a Dr Alex George. Apparently, he is a famous ‘Love Island’ star and a former A&E doctor who has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), aged 30. Now I don’t know what a ‘Love Island’ star might be, but of course I know what an A&E doctor is; however, it was the notion that getting an ADHD diagnosis had changed his life that intrigued me.

Now, like me, you can’t have missed the number of ADHD related stories in the news over the last few weeks. There is clearly a challenging issue facing both the NHS and individuals like Dr George. Last December, our somewhat politically ambitious Secretary of State for Health and Social Care, Wes Streeting, launched an independent review into what seems to be an ever-increasing demand for assessments and treatment. Many adults and children can wait an average of eight years to be assessed and even longer for treatment. The government’s ADHD taskforce warned late last year that the people with ADHD, who have not been assessed, often struggle with education, work and social relationships. They put the hidden costs of such delays at around £179bn a year as a consequence of crime, educational underachievement, drug and alcohol misuse and mental illness.

The Guardian newspaper last week reported that NHS spending on ADHD services will be over budget by some £164m by April this year. It is perhaps no wonder then that Wes Streeting’s independent review has also been charged with considering whether there is any evidence that there might be over-diagnosis of this condition, and by implication, other mental health problems. For me, this is a story that has been nagging away in my mind for a while now.

Somehow, here in the UK and especially over the past 12 months, we seem to have conflated mental illness, autism, learning disability, and all kinds of neurodiversity into a single undifferentiated set of problems. Clearly this is not right, and such reductionist conceptualisations don't serve people living with any of these problems well. Like the Darlington nurses, I have now started to articulate my concerns at a local, regional and national level. I’m pleased to report I’m getting some very positive responses – hopefully, we will, collectively, make a difference. Everyone, whatever the diagnosis or societal label they are given, deserves to have their individual needs recognised and met.  

Improving neighbourhood resilience for better health and wellbeing one step at a time

I love to walk, and  I walk everyday One of my favourite walks is from Fleetwood to Lytham. We live halfway between the two towns. The walk is just over 12 miles long. You can walk along the promenade or on the beach for most of the way. If the wind is with me, I can walk it in three hours, but usually it takes just under four hours. I sometimes vary the walk, by taking a bus to Lytham and walking back to Fleetwood. It’s easy to do this as there are many great pubs selling food and drink in both places. If you are visiting Lytham, I can recommend the Queens Hotel on the front. At the other end, there is the fabulous and famous North Euston Hotel.

The North Euston Hotel is still a rather grand building. It was designed by Decimus Burton. It is a semicircular building, built in 1841. I have never stayed there but I think every bedroom will enjoy super panoramic views over the Wyre estuary, Morecambe Bay and the Lake District. The hotel got its name from being at the end of the railway line that started at Euston Station in London. It was a gentler version of the now defunct HS2.

The hotel was, at one time, said to be the jewel in Fleetwood’s crown. Sadly, these days much of Fleetwood is showing many of the physical signs of a deprived northern town. Much of the once thriving deep sea fishing industry has disappeared, and one of the other big employers, ICI, closed its doors in 1992. The main employer now is Lofthouse’s of Fleetwood Ltd. They make the menthol lozenge Fisherman’s Friend, which although very popular worldwide, seems to have a special place in the hearts of folk from Japan.

The steady decline in industry and the increasing unemployment of the town’s population has adversely impacted on the health and life expectancy in the town. Back in 2016, a local GP, Mark Spencer, and NHS Practice Manager, Karen Boylan called a public meeting (held at the North Euston Hotel) to see what could be done to improve the health and wellbeing of the town. Healthier Fleetwood, a not-for-profit organisation, was formed. This aimed to support and improve the physical and mental health of Fleetwood folk by connecting them to each other, and to services and voluntary groups across the Fleetwood community.  

To me this initiative is very much an early example of what can be done through place-based, and neighbourhood approaches to promoting good health and wellbeing. It works through addressing more positively some of the underlying social determinants of poor health. There is lots of evidence that tells us people who are supported to take greater control of their own wellbeing and take an active role in the decisions that might affect them, have better health outcomes. Indeed, the number of people with Fleetwood postcodes seeking appointments at their GP practice and/or attending Blackpool A&E department has consistently reduced year on year since 2019.

So, I was delighted to read last week, that Dr Mark Spencer has been appointed to Chair the Pride in Fleetwood funding Panel. The town is set to receive £2 million each year for the next 10 years, funded by central Government. How the money is spent in revitalising Fleetwood’s public spaces, high street and other community assets will be determined by local residents. I love the idea of trusting the residents of Fleetwood’s communities to use this money to build upon the great work of Healthier Fleetwood. Mark Spencer will bring a wealth of experience, knowledge and energy to the role. I’m sure with his leadership, the funding will be transformative. Whilst similar funding approaches won’t always be possible in other areas, the model of local people determining what best improves their health and wellbeing is surely replicable and desirable.

There is no doubt that we need to see a shift away from individuals and communities always being reliant on others for help and support. There is a place for that of course, but it shouldn’t be the first response to life’s challenges and problems. Individuals and communities need to learn how to better support themselves and others around them, and to be much less dependent on the State to provide solutions and services.

Such a change in approach to how we live our lives, will help bring to life the ambitions in the NHS 10 Year Plan, particularly preventing poor health earlier than we do now; and where care is required, moving services away from  hospitals and closer to people’s homes; and harnessing the opportunities provided by new digital technologies to transform how and where people access their health care and social care support. We can all do something to help improve our health wellbeing. I walk, but there are many others ways to improve your health and wellbeing that are both simple, cost nothing, and are easy to do. Why not find out what works for you and take that first step on your improvement journey of a 1000 miles.

Believe in being courageous, compassionate, caring and pickle juice

It’s almost hard to believe that a year has passed, since I sat down to write my first blog of 2024. This is blog No. 856. Although I don’t really make New Year resolutions, I am resolved to try and carry on writing and posting my weekly blogs, every Sunday, for the next 12 months. So, thank you to all of you, who have supported and read my blogs, and I hope you will continue to do so. Amongst all the celebrations, carol singing, eating and drinking and family and friends catch ups, there has certainly been much to read and think about over the Christmas period.

One of the stories I read came from a long-standing NHS colleague, and pioneer of the #earlyrisersclub, Kenny. He told the story of him and his late husband Phil, in particular their last five years. Back in 2020, Phil was diagnosed with T6 spinal cancer, and early treatment had left him with permanent paraplegia. Together, they developed #TeamBelieve as a way of telling the story of their journey. Phil died in September last year, but it was only as 2025 was ending, that Kenny felt it was the right time to share one last post of the #TeamBelieve story. Apologies for the alliteration, but theirs is a story of courage, compassion and care.

Kenny and Phil had been together for 34 years. Like everyone who experienced the loss of a loved one last year, Kenny is now facing a future that will be very different from his past life. My mother died last year. My parents had been married for nearly 69 years. Although my father has done remarkedly well since her death, the change in his life has been profound.  

Kenny had no choice about where he found himself at the start of 2026, but January is traditionally a time of the year where people do make choices, sometimes referred to as resolutions, about how to live their life. Now we enjoy the presence in our lives of not one, but two, Gen Z young ladies. They do make resolutions, and goodness they are organised in how they frame these. One has created an eight-themed set of resolution categories. It was the stories of how many Gen Z folk are looking to improve their lives in 2026 that provided me with much amusement over the Christmas break.

You will, I’m sure have seen of the stories as well. I particularly liked the notion of gargling with the pickle juice from a jar of pickles. Apparently, it’s a great source of electrolytes. I just want to know what they do with the pickles. It also appears that beetroot juice is making a bit of a comeback too (it is meant to reduce high blood pressure).

Of course, we can’t neglect the Nootropics (yes I had never heard of the these before). These are supplements, which allegedly improve your cognition, concentration and reduce stress. They come with some great names too. However, I don’t think your local Tesco will be stocking ‘Lion’s Mane’ or ‘Ashwagandha’ any time soon. Call me cynical (or just an old grump), but I’m not sure a daily dash of ‘Lion’s Mane’ is actually going to help someone understand, and deal with, whatever is causing them stress in the first place.

However, I may be a little frivolous in my observation there, as there is lot we can all learn from the Gen Z folk. They are, after all, a generation whose mental health and wellbeing has been adversely impacted by the consequences of global turbulence, wars, a very sustained cost of living crisis and of course, a disruption to their education resulting from the Covid-19 pandemic. Against this often-challenging backdrop to their lives, Gen Z folk have clearly recognised the critical importance of building and sustaining healthy relationships with others, as a way of protecting and maintaining their mental health and wellbeing.

They actively work at nurturing such relationships. Emotional intimacy is as important as physical intimacy. Easy words to write, but I think more difficult to translate into practice. It is also easy to see why. Gen Z are ‘digital natives’. They are the Instagram, Tik Tok generation. Navigating an online persona and online interactions with real world ones, can be challenging. However, they are showing us it’s possible to do so. And it’s not just about beetroot juice or Lions Mane supplements. It’s about holding on to, and living lives that promote those values and behaviours that were so evident in Kenny and Phil’s story: being courageous, compassionate and caring within all our relationships, and of course, being kind. Kindness matters, always. Wishing everyone a wonderful start to the New Year.