May is the month of expectation, the month of wishes, the month of hope*

And so May 2026 ends. For me, it’s been a month of change, memories, challenge, opportunity and celebration. Jane and I have enjoyed celebrating five different birthdays across the whole of the month. It was also the first anniversary of my mother’s death last year. My mum was 91 when she died. The folk who cared for her in those last few months made sure she had a good death.  Her passing made me realise how fast time flies and how important it is to make every day count. We have but one life, it’s important to live it.

However, sometimes the plans we have don’t always come to fruition. I have long wanted to climb Mount Everest. My heart still has this as an ambition, but my head tells me I’m now probably too old to try. It’s an itch that won’t go away. We travelled to Nepal in 2023, an extension of our Golden Triangle tour of India. Knowing we were so close to Mount Everest, we took an airplane flight up to, and around, Everest. It was a fantastic trip and I’m glad I got to see it up close.

It may not just be my age that makes me feel it’s unlikely I will get to climb Everest. This May saw the largest number of folk climbing up the mountain ever. A couple of weeks ago now there was one day where 274 people were recorded climbing Everest at the same time. There was literally a queue to get to the top. I think at £12,000 a go I would be really cheesed off to stand there in such a queue!

These days my ambitions are a little more modest. I write this blog from our wonderful narrowboat Bluebell. We are currently cruising the Lancaster canal, traveling from one end to the other and back again. At one time due to the fact that there are no locks to worry about, the journey from Preston to Kendal could take as little as 10 hours. In its heyday, the canal was used to transport coal from Lancashire, and limestone from Cumbria earning itself the nickname of the ‘black and white’ canal.

We have planned to take up to 10 days to do the same journey. This is day five, and so far, so good. The weather has been kind and Bluebell has behaved herself, and there has been no problems. Indeed, my recent episode of sciatica appears to have resolved itself, and I’m now largely pain free. And finally, the rather large and very colourful haematoma on my left arm is beginning to fade.

The latter was a result of my latest blood donation. For some reason, the folk at the blood donor centres seem unable to find a vein in my right arm, so the left arm gets used every time. The problem is that whilst they can find a vein to use, it apparently ‘jiggles’ making it more difficult to get the needle in. When this happens, as it did last week, I get a rather spectacular bruise. 

It is no fault of the donor carer folk. They are highly skilled practitioners, in whom I have every confidence. The NHS Blood and Transplant (NHSBT) service collects over 1.6 million donations of blood and blood products in centres across England every year. No, we have collectively come to the conclusion it’s my ageing body that is the problem. However, that said, in my local area, the oldest donor is now 81 years old, so there is hope for me yet!

Giving blood has always been a great experience for me. The folk that care for me all through the donation process are absolutely person-centred people. Unlike our canal journey which is slowness personified, I sense that they are up against the clock to get donors seen, blood collected and stored. However, you wouldn’t know it. The NHSBT folk always make me feel as if I’m the sole focus of their attention. Always calm, and always professional. Every one of them has, of course, received formal training and are appropriately supervised, but it’s their passion for people that you really notice. As in many areas of health and social care being able to be there and with people is what really makes the difference.

 

*Thank you Emily Bronte 

Once a nurse, always a nurse

This time last year, the UK government announced that it intended to make the title ‘Nurse’ a legally protected title. At present, only ‘Registered Nurse’ and ‘Advanced Nurse Practitioner’ titles are legally protected. Without such legal protection, it’s possible for anyone to call themselves a nurse and practise as a nurse; this is a situation that does not protect the public. There have been many cases, where a registered nurse, having been struck off the Nurse Midwifery Council (NMC)’s register, continues to present as a nurse. This is something that is not only potentially harmful to individual patients, but also risks undermining the hard-won reputation of the nurse profession.

The Early Day Motion calling for the title ‘Nurse’ to be legally protected was long overdue and most welcome. The former Secretary of State for Health and Social Care, Wes Streeting, fully supported the motion and a potential three-month consultation across all four nations of the UK was proposed. As far as I’m aware, and please dear reader if you know something different, we are still waiting for the consultation to start and conclude.

New legislation can take a long time to reach fruition. Of course, Wes has been busy over the last 12-months trying to manage the self-inflicted chaos of the reforms (not reforms), aimed at bringing together NHS England and the Department of Health and Social Care. And now he’s gone, hoping to become the UK’s next Prime Minister. We now have a brand-spanking new Secretary of State, James Murray. He has assured us that there will be no changes to the pace and purpose of the reforms (not reforms). So, watch this space folks, but please don’t hold your breath for too long.

Just as an aside, the UK has had 11 health Secretaries of State since 2015. Only two have been in the role for more than three years. The average time in office is just 487 days. Wes lasted for 677 days. Probably the most inappropriate health minster was the cigar-smoking, wine-drinking Therese Coffey who, thankfully, lasted just 49 days in the role.  

Hmm, well that has been a very long introduction to what I wanted to write about this week. We held our first Nursing Awards Day at Greater Manchester Mental Health Trust last week. I was fortunate and privileged to attend and take part, as was our Chief Nurse, Chief Operating Officer, and our Chief Executive Officer. All four of us were, or still are, practising nurses. For a large mental health organisation such as ours, this fact alone made me feel very proud.  

As well as announcing some of the winners, I had also been asked to introduce the afternoon and say a few words. My starting point was to share that I was a nurse. When I retired, I also took myself off the NMC register. As such I cannot practise as a nurse (see above), but my belief is, ‘once a nurse, always a nurse’. In my introduction, I told of the work of both Virginia Henderson and Carl Rogers. I think the hundred or so nurses in the audience were more familiar with the work of Carl Rogers and in particular, his concept of unconditional positive regard, when we work with our patients (and colleagues too, I suggest).

On a former part of my life journey, I was the Dean of one of the largest nursing schools in England. Twice a year, I would welcome eager new student nurses, and like last week, share the works of Henderson and Rogers. I would also talk of how it was the work of Michel Foucault and his notion of the importance of revealing ‘the language of the silenced voice’: that is listening, with attention to what is not being said, that helped shape my own practice.

Whilst last week’s Nursing Awards were a triumph, it was sad to read a survey published by the Royal College of Nursing last Monday. This reported that 64% of nurses taking part in the survey believed there are too few of them to keep patients safe and provide good quality care. I think there is a great deal of work going on nationally, on what safe staffing might mean in practice. We are doing similar work in our Trust, but I don’t think that safe staffing levels can purely be about numbers.

However, I don’t want to end this blog on such a downbeat note, especially as our Nursing Awards event was such a celebration of both individual and team achievements, of pride in the contributions being made across our improvement journey. It was an absolute testament to the powerful contribution nurses continue to make to improving the health of our nation and the varied ways they continue to make a difference to the lives of others. I was left with a warm feeling that the profession was in good hands.

Lemur-inspired steps to improve my mental health and wellbeing

One of the great things about having a dog is that, at least twice a day, they need to be taken outside for a walk. It doesn’t matter what the weather is doing, rain or dry, hot or cold, out for a walk Dylan and I will go. Sometimes, usually early morning, he can be reluctant to leave the house and will try and hide somewhere. He always gives himself away, as I call his name and he starts thumping his tail! I tell him that exercise is one of the five steps we can take to improve our mental health and wellbeing.

One of the other reasons I like walking with Dylan, is that we invariably meet other folk. Even on our first morning walk at 5am, there are other people out and about. Most of these people I know only by sight, but it’s always good to exchange a greeting, a smile and maybe a word or two. Although we have various routes we tend to take, we always walk through streets and across fields. It never ceases to amaze me how much wildlife there is to be seen, so close to the houses. I often see foxes, and this Spring we have enjoyed watching and listening to a little woodpecker.

On Friday, I had a rather different animal experience, however. I got to hand feed a troop of ring-tailed lemurs at our local zoo. It was a birthday present from Jane and it was a wonderful experience. I had a bucket full of kebab sticks threaded through with fruit, raw vegetables and boiled potatoes. Crouching down, these lovely little creatures came and held onto the sticks I was holding, while eating the fruit and veg off them. Boiled potatoes and grapes were the favourite choices. These were wild animals and they were both bold and also suspicious. Knowing how to ‘be’ with them was a new one for me. Although perhaps not in the same league as the David Attenborough mountain gorilla moment, I can now add ‘ability to commune with lemurs’ to my CV.

When we got to their enclosure, a huge space which allows them to run free, climb trees and so on, they were collectively all sunbathing. It was a most amusing sight, they sat upright facing the early morning sunshine, looking like a Bank Holiday crowd on a sunny Blackpool beach. Visitors can walk through their enclosure and get up close to the lemurs. I was very fortunate to meet Shelley, a 30 year old, red-ruffed lemur, seldom seen by the public. She just appeared from the undergrowth, and I was able to stroke her as she took food from my hand.  

Strangely, just being with Shelley made me feel somehow humble. In lemur terms, she was an old lady. They don’t usually live past 20 years. Her calmness and simple presence elicited a wonderful mindfulness moment in me. It was a moment to add to my resilience store. Last week, also gave me another moment to reflect upon. I was out with Dylan, and it was a mid-morning walk. The sun was shining, the birds were singing and I felt at peace with the world.

As we were walking across the fields, a man came into view, also walking with his dog. As we passed, I said, ‘it’s a gorgeous summer’s day’, he responded with ‘I think you think every day is a summer’s day. Now I don’t know him, although we often see each other, as we walk our dogs. I think his observation was a reference to the fact that I habitually wear shorts, whatever the weather. However, it made me think just how different we might feel, if we treated every day, as if it was a gorgeous summer’s day. Of course, it’s not always possible to feel like that all of the time. I know there have been times in my life where whatever was going on has felt overwhelming and even depressing. In such times, it is being connected to others, however tenuous that relationship might be, which can provide help and support.  

I write this blog on the last day of this year’s Mental Health Awareness Week. The theme this year has been on action – awareness of mental health is one thing, but taking action ourselves, and for, and with others, is where positive change can occur. Have a look at this fabulous Mental Health Foundation website to see what you might be able to do, to improve your own mental health and wellbeing too.  

A pocket full of wisdom, and taking snooker as my cue

Like many folk I guess, I watched this year’s Snooker World Championship games with huge enjoyment. My favourite snooker player of all time, Ronnie O’Sullivan went out fairly early on in that competition, but I enjoyed watching him play while he did. He is a real crowd pleaser, always drawing packed audiences wherever and whenever he plays. No sooner was the World Championship over than Ronnie was back on our screens, playing once more at the famous Crucible venue.

Aged 50, this is the first time he is taking part in the World’s Seniors Championship tournament, which has been running all last week. As I write this Ronnie is struggling, and appears to have lost his mojo a little. That said, he is in the final later today! Whilst many of snooker’s greats are taking part, actually any professional player aged 40 or over can participate. There was a slight divergence of opinion in our house on discovering the competition was on TV. Whilst Jane observed that ‘Seniors’ implied it was an old man’s competition, I thought of it being a competition of skilled players, as in the dictionary definition of someone who has the training and experience to do something well, usually better than others – think consultant doctors versus resident doctors for example.

Consultants are regarded as senior doctors, whereas resident doctors, until recently were referred to as junior doctors. Arguably, both possess knowledge, have or are acquiring skills and experience. It is the specialist knowledge and how to use this, that sets both groups apart. What I would call wisdom. The recent bouts of industrial action on the part of resident doctors provided a good example of this. Many services managed well, and in some areas, better than normal.

It is thought this might be because consultants (who stepped into the space left by absent resident doctors) are much less risk adverse, do fewer tests and investigations and can see and treat people faster, more safely, and with greater confidence. In the words of Martin Luther King Jr. ‘knowledge is a process of piling up facts, wisdom lies in their simplification’. These days, most doctors who become consultants do so in their mid-thirties and 40 is the average age overall for doctors to become consultants. However, only 25% of all doctors in training become a consultant.

When a doctor becomes a consultant, is of course, dependent upon many factors, such as their chosen speciality, employment opportunities, work/life choices and so on. But clearly, age isn’t necessarily one of these factors. However, age can be for other changes to our lives. As I have grown older, my hair line has receded and what remains has turned almost grey (I think white), I have wrinkles where there were none before, and I can go upstairs for something and then not remember what I came up for. I’m nowhere near as strong as I once was, both physically, and in some situations, confidence wise too.  

For example, I once worked with a senior clinical psychologist called Clive. He taught me how to climb, and he helped me nurture my love of rock climbing. At my peak (sorry), I was taking on extreme routes and even free climbing (no ropes). I practised on indoor climbing walls three or four times a week and went out with Clive, whenever he was free. I learnt a lot from him and in so doing, learnt a lot about myself. Over the years, age began to catch up with me. Creeping arthritis in my hands began to make me doubt my ability to rely upon them. Although good climbing is more about legs, feet and balance than just holding on with your hands, feeling confident about using every part of your body is important. I guess that is where wisdom kicks in.

Despite my skill, knowledge and years of experience of rock climbing, the gradual erosion of my confidence and my physical prowess, the wise thing to do was to stop climbing. So eventually, I did. These days I walk, although I have dusted off my snooker cue and have enjoyed a few friendly games. Truth is, like Ronnie, I’m struggling, but at least I’m safe. However, the month of May is a great month in our family. Jane celebrates her birthday as does one of my children, and a young grandson celebrates his birthday too.

May is also my birthday, so even if I can’t climb Malham Cove any more, or score a maximum 147 when I play snooker, I have to say right now, life is good, and bring on whatever the next adventures might be.

Population health and condom sense

The Dutch philosopher, Desiderius Erasmus, in the 16th century, popularised the phrase ‘prevention is better than cure’. Today, it has become the adage for so many things in life, but particularly when it comes to public health and health prevention. It is a concept that underpins one of the three ‘left shifts’ set out in the NHS 10 Year Health Plan (from hospital to community; from analogue to digital; from sickness to prevention).

This is not a new idea. For example, the Sure Start scheme was very effective. The use of early intervention, providing help and support to new parents, made such a difference to the wellbeing of families and enabled many children to thrive and enjoy better life chances. Sadly, the scheme was abandoned almost in its entirety after 2010.

Norman Lamb, the former MP and Minister of State for Care and Support has been a long-time advocate of joined-up health care. He championed a greater focus on preventing ill health. He has long campaigned for mental health to be given the same priority, as physical health. Last week, he published an article in the Health Service Journal on what the 10 Year Health Plan might mean for mental health care and services in England.   

His article focuses on many areas of mental health that he feels need reforming. Rightly, he notes that demand for mental health care is growing exponentially, and in particular with young people. Currently services cannot, or do not, meet this growing need. Norman shares his concern, a concern shared by many others, that too many young people are turning to chat-bots and other AI sources for help and advice. The evidence is mounting that many of these online services are potentially harmful. I absolutely agree. As the NHS moves from analogue to more digitally-resourced service provision, we need to find ways of distinguishing what might be truly therapeutic and what isn’t.  

In so doing, not only will it require governmental direction and support, but also greater clinical leadership.  Such leadership must combine the best that primary care can offer, with greater accessibility to specialist consultant-based care. There are early signs that this is happening, but I would argue, it is probably not happening fast enough. However, speed is not always the answer.

Last week, saw the passing of the Tobacco and Vapes Bill. It’s a very clever piece of public health legislation. Essentially, anyone born on or after 1st January 2009 will now never be legally able to buy tobacco products. From 2027, the legal age for the sale of tobacco will rise by one year. Currently the legal is age is 18. Generally, if someone hasn’t started smoking by the age or 20, they are unlikely to ever start. Over time, the number of people who will be able to legally smoke will become smaller and smaller. A good thing!

The law relates to those who sell tobacco products, not to those who choose to consume them. It’s an important distinction, but I do wonder how it might be policed. That said, I foresee similar approaches perhaps being considered over the sale of alcohol and ultra-processed foods, both of which cost the NHS millions of pounds in treatment costs for the conditions both can cause. What I didn’t foresee, however, was the condom crisis.

Apparently, the conflict in the middle east and the shutting of the Strait of Hormuz is pushing the cost of the raw materials used in manufacturing condoms to unacceptable levels. The result is a steep rise in the cost of condoms. The fear is that such a price rise will stop people using them. Now for some, the condom is the ultimate symbol of prevention (think HIV, sexually transmitted diseases and unplanned pregnancies). Indeed, when I read the story, I was reminded of a conference I attended with a couple of colleagues in Evora, Portugal. We sat in the audience listening to a speaker from a university in Liverpool, talking about research she had undertaken into the sexual health of sailors in the Port of Liverpool.  

I’m ashamed to say that my colleagues and I started giggling like school children, as she referred to her participants as seamen and not sailors. In my defence I would point out it was 24 years ago, and I have hopefully somewhat matured since then. Interestingly, I looked up when it was, we presented the paper at that conference. I was intrigued to see that the paper’s title seemed very apposite: The NHS Plan: A health rhetoric and an unhealthy reality? I hope today’s NHS 10 Year Health Plan proves to be neither.