Thursday, 29 August 2013

National Leading Health and Wellbeing Programme 2013/14: From Transition to Transformation

Dear Colleague

Call for applications to join the national programme on 'Leading Health and Wellbeing from Transition to Transformation' (2013/14) starting November 2013

I write to invite you to nominate key senior staff in your organisation, partnerships or networks to join the National ‘Leading Health and Wellbeing Programme for 2013/14 - from Transition to Transformation’. 

Durham University, working Public Health England and a range of key partners, has designed this programme as one of a portfolio of Health and Wellbeing leadership programmes. Speakers on the one year programme will include a wide range of national experts in the fields of health and wellbeing improvement, leadership and system improvement methodologies, backed up with personal development tools, coaching and action learning support.

Attached to this email are further details of the programme which commences in November 2013.  Those taking part in it will be able to better understand the new public health system in England and hear about developments elsewhere in the UK.  They will also be able to  share progress, issues and aspirations around the shift of public health functions and services to local government, the implementation of Health and Wellbeing Boards, Clinical Commissioning Groups, Public Health England and Health Education England, as well as all other aspects of improving health and reducing health inequalities  at national and local levels.

Individual applications are very welcome, but for maximum benefit it is recommended that multiagency teams of 3-4 people working on a shared agenda from across local partnerships, in particular Health and Wellbeing Boards, apply to join the programme. A substantial discount applies to applications from teams of four or more.

This one year evidence-based leadership programme has now been well tested and externally evaluated, and has been run at both national and regional levels in association with the LGA.  It has been run across Yorkshire and Humberside, the North East, South Central, and has been run in Scotland with the support of NHS Scotland.  We are well aware of, and fully appreciate, the immense pressures and challenges arising from the present economic situation and from the major changes underway but, as I’m sure you’ll agree, we believe these developments make the need for such systems leadership programmes all the more timely and necessary. Leading in new ways beyond boundaries across places and systems is essential if limited resources are to have maximum impact in meeting the complex challenges facing those engaged in health improvement and wellbeing. 

The advisory board for the programme comprises a range of national organisations, with the programme serving as a platform for delivering key policy messages and developing leadership and improvement skills across the health and wellbeing community.  We have an extensive network of well over 600 senior individuals who have been through this one-year programme and who continue to be part of a national network of improvement leaders. 

Please do help spread the word about this programme by cascading the information through your local public health and partnership networks. The closing date for applications is 5pm Monday 30th September 2013.

Finally, do not hesitate to contact me directly (d.j.hunter at or the Programme Director, Dr Catherine Hannaway (c.j.hannaway at, for further information or to answer any queries you may have. All details, including module dates, cost, eligibility criteria and an on-line application form can be found at: << Click Here >>

With kind regards, David 

David J Hunter
Professor of Health Policy and Management
School of Medicine, Pharmacy and Health
Durham University
Michelle Cook
Programme Co-ordinator

Centre for Public Policy and Health
School of Medicine Pharmacy and Health
Durham University
Queen's Campus
TS17 6BH
*: michelle.cook at

Monday, 26 August 2013

An International Bill of the Rights of Man (reissued)


How do we address the mental
health status of our leaders?
How can science and technology work positively to assure the Rights of All, to secure evidence of war crimes?
Where does the biosphere stand
(side-by-side : hand-in-hand)?
Should war crimes once perpetrated be relegated to cultural memory:
baggage carried forward for generations anew to avenge? How must they do this other than learning (remembering) how to hate?
What are the important lessons; of what must be remembered and what we should forget? 
An International Bill of the Rights of Man
group - population

Saturday, 24 August 2013

50 years "I have a dream..."


"I have a dream!"Do things and science and technology have to dictate humanity's dreams?
We have a dream...A man had a dream...
group - population

Friday, 23 August 2013

HIFA publishes paper in The Lancet Global Health: Governments are legally obliged to ensure adequate access to health information

The Lancet Global Health published a paper on 2nd August 2013 that we can all use in our advocacy to increase the availability and use of healthcare information in low- and middle-income countries. The paper was written by three HIFA Country Representatives for India – Soumyadeep Bhaumik, Tamoghna Biswas, Pranab Chetterjee – together with the HIFA Coordinator, Neil Pakenham-Walsh. The full text is freely available, open-access, here.

Here is a brief extract: ‘Should governments be held responsible for ensuring that every citizen and every health professional has access to the information they need to protect their own health and the health of those they care for? Should governments be held to account for, and to stop, any action that denies the availability of health information, or that misinforms the public or health professionals contrary to scientific evidence? The answers to these questions are yes and yes, as clearly stated in international human rights law.’
My source - above text: HIFA2015

Monday, 19 August 2013

The Case for Information: Investment in patient information improves outcomes and reduces costs

A new Patient Information Forum (PiF) research report highlights how providing information to patients and their carers improves outcomes, reduces costs and gives people a better experience of care.

PiF commissioned research to identify the benefits of investing in health information. The project, which looked at over 300 studies, found that there are good business reasons to justify the investment of more time, money and training in health information provision and support. These include positive impacts on service use and costs, substantial capacity savings, and significant returns on investment by increasing shared decision-making, self-care and the self-management of long-term conditions.

To access the report please see:

My source: Irina Johnston, CHAIN Administrative Assistant

Sunday, 18 August 2013

International Health Terminology Standards Development Organisation: 2012 Report

IHTSDO CoP: 2012 Annual Activity Report Now Available

Our annual activity report for 2012 is now available in two formats:

Online magazine:


We hope you enjoy it! Any comments or questions can be sent to info AT

Source and many thanks to Juliet Krarup (ihtsdo staff)

Saturday, 17 August 2013

High quality nursing care: Staff numbers + Management + Complexity = Goat (Rabbit or Duck)?

When did someone last get your goat?
For me I owe a vote of thanks to Mr Harry Cayton in the (print) Health Service Journal, 2012
 The wrong answer to the wrong question. 

I know it's hard to believe, but I've been simmering for a year and a half; especially watching, listening and reading about the NHS and the state of nursing in the media.

The subtitle of this short opinion piece (p. 16-17) reads:  

"There is no direct link between staff numbers and care quality, 
so a minimum staff ratio is a fig leaf performance measure." 

Online it is: 15 March 2012 'Mandating staffing levels is not the answer to reducing poor care'
 - so you get the gist...?

As a nurse, the subtitle did its trick, it rubbed against the whole tree of experience, not just a branch or two.

It is a long time since I was a deputy charge nurse on what was then 'psychogeriatrics'. Relatives would arrive on the ward for the first time and start to weep. We had to reassure and demonstrate that we cared not just in words, but actions: nursing care. We got things wrong: teeth, clothing. ... A variety of 'lists' and books signified institutional care. That Victorian institution is no more, this is progress. The change has been amazing. It is also a long time since I was a charge nurse on acute female admission. The thing is numbers always counted. How many times did we, the team, wonder what we could have done with another two, or four hands? Within mental health care risk is a positive and negative companion to all our patient contacts. There may be confusion in numbers, but there is safety too.

You know that numbers do count.

As Mr Cayton points out - poor management is a primary factor in poor care. He quite rightly refers to the complexity that arises. As I have posted here several times, staff attitudes and skills are central to the quality of care that follows. Mr Cayton highlights the same.

If evidence based health care is so powerful why are we still deliberating upon this?

This isn't just complex, it's complex as in complexity science. In the late 70s - 80s and even today there is discussion of dependency and workload measures. There is a real illusion at work.

As a nurse in this context you recognised the limitations of know thyself. You have to know yourself, especially: can I delegate effectively? Am I a manager's manager? How can I balance the office and the ward?

The limitation is: do I know my team? Since the 1980s I wonder how well ward managers know their team. What is the impact of agency workers - nursing and medical? How has this workforce development influenced the work and performance of the FY1s (foundation - first year doctors)?

We ensured we had covered the 'basics' as comprehensively as we could. Everyone was safe, warm, clean, skin clean and intact, dressings completed, fed, watered, given a smile, (if possible) gave a smile and as much reassurance as could be provided. Any care outstanding was reported to the next shift to ensure it was completed as a priority.

Returning to the question of evidence and the illusory, chimeric character of this debate. There is a great post-grad student essay on the relative and normative dimensions of nursing staffing to be written. Health services must wrestle with standards, local responsiveness, person-centredness, outcomes and umpteen other requirements in care delivery. If funding (staffing!) results in nurses having an arm tied behind their back, perhaps mandated staffing levels does the same for managers?

There is undoubtedly much to consider in relation to the equations that abound in staffing numbers and quality of care. As we think of trees of knowledge,  experience and branches, let's remember the leaves; everyone unique.

Update: 24 Aug 2013
News, Health Service Journal, 23 August 2013, Minimum safe staffing work yet to begin, 123, 6364, p.7. 123
"We need tools that are relevant to the care environment; we need leadership locally that has the resources and responsibility to meet the levels the tools are demanding and we need some degree of professional responsibility and decision making at ward level."
(Prof. Jim Buchan)
Additional links:

Policy Unit. Royal College of Nursing (2010) Guidance on safe nurse staffing levels in the UK

Safe Staffing Alliance

Kay, J. (2013). Making the case for more nurses, Health Service Journal, 123, 6355, 30-31.

NHS pays £1,600 a day for nurses as agency use soars, The Telegraph, 14 Jul 2012.

New [Lancet] study shows degree level nursing education cuts unnecessary hospital deaths

Monday, 12 August 2013

'Monitor Me' BBC 2 Horizon

This is an excellent TV program:
Dr Kevin Fong explores a medical revolution that promises to help us live longer, healthier lives. Inspired by the boom in health-related apps and gadgets, it's all about novel ways we can monitor ourselves around the clock. How we exercise, how we sleep, even how we sit.
Some doctors are now prescribing apps the way they once prescribed pills. Kevin meets the pioneers of this revolution. From the England Rugby 7s team, whose coach knows more about his players' health than a doctor would, to the most monitored man in the world who diagnosed a life threatening disease from his own data, without going to the doctor. (BBC 2 website)

Sunday, 11 August 2013

Drupalcon Portland session: Collaborative Learning Systems in Drupal & tpm

I'm still following Drupal here in NW England and around Europe since version 4.7. The next Drupalcon is in Prague next month and I'm all set. As what seems a lifelong learner of Drupal there are usually many sessions of relevance to me. There's repetition creeping in too (at Munich last year), which is a good sign for me. Perhaps it's a sign of Drupal's maturing but there are sessions of specific interest in health and education. This week the program for Drupalcon Prague starts to really emerge.

Until the 13th when the program appears, there was an educational-learning example from Portland in May 2013 embedded below, by Avram Sand and Fabian Franz. The introduction for which begins...
How can you use Drupal to add value to a Learning Management System? In this case study we will show how Trellon helped Population Services International (PSI), a leading global health organization, build a collaborative learning environment using common Drupal modules.

There are some great pointers in this session, modules to consider and insights into functionality.  Whatever TLA is employed - LMS (learning management system), VLE (virtual learning environment), TEL (technology enhanced learning) ... the lessons are transferable.

In the latest edition of the philosopher's magazine tpm 3rd Quarter there's a paper on TEL by David Mossley and Clare Saunders: A revolution in philosophy teaching? (pp. 40-45). Mossley and Saunders argue the case for tempering our expectations of TEL, framing their article around constructivism:
... TEL, presents entirely new and exciting learning environments which students can engage with in more ways, with greater self-motivation, and with more creative possibilities than ever before. If constructivist pedagogy is right, thr more "engagement" with a perfectly modelled environment of ideas in a virtual space a student can enjoy, the higher the quality of their learning experience will be; for they will be presented with just the "optimal" set of experiences needed to create their won meanings appropriately. However, once we start to analyse what the word "appropriately" might mean in this context, we suggest this starts to point us toward a different way of thinking about epistemology and pedagogy. p.42
More positively, they conclude that - technology enhanced learning:
... can and does furnish new spaces and opportunities for social learning - it opens up new avenues for us both to practise and enhance further our philosophical knowledge and capabilities and (thereby) to co-create the future of philosophy and of knowledge more broadly. p.45.
Mossley and Saunders also refer to Hegel's idea of Bildung:
describing education as the bringing into harmony of all one's thoughts, experiences, activities and practices in existing contexts; that is, education as shared approaches to ways of making meanings, of gaining competence, based on the meanings explored by others before us. p.43.
Here is another avenue to support the role of Hodges' model in education and practice.

Friday, 9 August 2013

Papers in progress, book reviews and volcanoes

There are three papers currently in process. There is some good and bad news; plus some similarity with volcanoes. This is in the sense of active, dormant and extinct.

The papers are - with no prizes for guessing the common feature:
  1. The Scope of Nursing and Hodges' model
  2. Case Formulation (Conceptualization), Diagrams and Hodges' model
  3. Recovery and Hodges' model
Two papers are active, that's Case Formulation and Recovery. On the stove is Recovery and it's cookin. I've two co-authors providing invaluable input.

I've just read Terry Marks-Tarlow's Clinical Intuition in Psychotherapy The Neurobiology of Embodied Response and a review will follow my recommending this book right now.

There's a review copy of another book in the post that I believe can inform the recovery paper:

Values-Based Commissioning of Health and Social Care (thanks CUP)

I'm sure the concept of values-based commissioning is a gift to Hodges' model and the recovery paper. A theme to return to on W2tQ. The paper includes the Recovery STAR and relates this to Hodges' model.

The case formulation effort is with my co-author, and after a meeting in Manchester one early evening may incorporate risk formulation too.

The good news is none of these projects are extinct. The first nursing scope paper was rejected. The nursing scope paper is dormant, but is stirring following the symposium on person centredness in nursing early in May 2013.

There are two other books to get to grips with and a project that is in danger of extinction. The sight of Vesuvius next month may help: shift matters.

Tuesday, 6 August 2013

A New Dynamic of Ageing: The NDA Programme & Age UK research showcase of the decade

London, The Business Design Centre, 52 Upper Street, Greater London N1 0QH

You’ll know that the UK population is ageing. You’ll know that there is significant work to be done to be better prepared for ageing in our society. So it’s crucial that all of us who work in and for later life use latest evidence on ageing to support those preparations. The New Dynamics of Ageing (NDA) Programme and Age UK are proud to provide a unique opportunity to present that evidence at our joint event, held on Monday 21 October, at the stylish Business Design Centre, Islington, London.

This is the ageing research showcase of the decade, presenting the most comprehensive selection of state-of-the-art ageing research ever seen in the UK. This includes active ageing, quality of life, independence, dignity, money, work, environments, participation and connectivity to name a few. Throughout the day, you can hear from high profile speakers, pick up latest knowledge through our themed sessions, interact with exhibits in our innovative marketplace and meet the researchers. It will also be your chance to network with a wide range of colleagues from the public, private and charity sectors.

Hope to see you there! PJ

Monday, 5 August 2013

5th UK Swallowing Research Group Conference 2014

Swallowing tends to be something we take for granted, working in mental health it is a long time since I had to deal with nasogastric (Ryles) tubes. Choking is a very unpleasant experience to say the least. Should we witness someone choking we recognise the need to assess the situation quickly and assist. The alarm felt by onlookers is palpable.

Swallowing, is an element in our assessments of people and their carers who are living with dementia and possibly the effects of a stroke. Is the person experiencing dysphagia, or at risk? This is also part of the NHS continuing healthcare and NHS funded nursing care assessments. I learned about the UKSRG this weekend and was informed about their conference:
The UK Swallowing Research Group [UKSRG] comprises clinicians and researchers from a wide range of professional disciplines including biomedical engineering, speech and language therapy, radiography, radiology, ENT, gastroenterology, stroke medicine, dietetics, oral health, general medicine and neurology.

The group recognizes the multidisciplinarity of the clinical specialties and basic science that supports developments in the field and runs a biannual conference:
UKSRG will be hosting the fifth UKSRG Conference on 6th and 7th February 2014 at Institute of Child Health in London.
Thanks to: David Smithard, Visiting Reader at University of Kent

Friday, 2 August 2013

5th Qualitative Research on Mental Health Conference 2014

Practicing mental health: Qualitative approaches to investigating services and interventions

Crete, Greece, 2-4 September 2014

The Qualitative Research on Mental Health conference has been established as an international transdisciplinary forum for dedicated qualitative research on a range of topics in the field of mental health, using a variety of methodologies and approaches.

The 1st and 2nd Qualitative Research on Mental Health Conferences were held in Tampere, Finland, in 2006 and 2008, and the 3rd and 4th in Nottingham, U.K., in 2010 and 2012. Previous conferences attracted strong international interest with about 150 participants from a diversity of backgrounds, including service users, health and social care professionals, social scientists and health policy makers, and created a space for lively and enriching discussions. The 5th Qualitative Research on Mental Health Conference is due to take place from the 2nd to the 4th of September near the beautiful city of Chania, in Crete, Greece.

In several qualitative research trends, mental health is approached as a set of practices; these include the professional practices implicated in defining and treating mental distress, the practices through which individuals in distress live with, make sense of and manage their experiences, as well as the wider socio-cultural and institutional practices of understanding and dealing with human suffering. This conference invites qualitative studies, from a variety of disciplines, which describe these practices, their functions and their effects, examine the discourses associated with them, and explore how these practices are viewed and experienced by the parties involved. The conference aims to promote critical engagement with mental health practices through highlighting the personal and socio-cultural processes that underpin them, as well as their intersections with gender, culture and social position.

Submissions for symposia, individual presentations and posters are welcome.

Deadline for submissions 24th January 2014
For further information, please consult the conference website:

I will try to submit and attend (being sure to also take snorkel and flippers).

My source and with thanks:

Thursday, 1 August 2013

The Hundred-Year-Old Man Who Climbed Out the Window and Disappeared

 It all starts on the one-hundredth birthday of Allan Karlsson. Sitting quietly in his room in an old people's home, he is waiting for the party he-never-wanted-anyway to begin. The mayor is going to be there. The press is going to be there. But, as it turns out, Allan is not...Slowly but surely Allan climbs out of his bedroom window, into the flowerbed (in his slippers) and makes his getaway. And so begins his picaresque and unlikely journey involving criminals, several murders, a suitcase full of cash, and incompetent police.

As his escapades unfold, we learn something of Allan's earlier life in which - remarkably - he helped to make the atom bomb, became friends with American presidents, Russian tyrants, and Chinese leaders, and was a participant behind the scenes in many key events of the twentieth century. Already a huge bestseller across Europe, The Hundred-Year-Old Man Who Climbed Out of the Window and Disappeared is a fun, feel-good book for all ages.

Image: Sincerely, Anna
Text: Waterstones