Shirley Cramer, CBE

 

Roy and Shirley Cramer Jan 18

Yes, of course it’s water…Roy and Shirley settle in

I needed to look Shirley up after hearing her speak and before writing about her. Her NHS Health Chat at The Kings Fund in London, was so wide ranging that at the end I was confused about what she actually does…

 

Shirley Cramer, Public’s Health guru. Well, that’s how she came over! Luckily, her main job is Chief Exec of The Royal Society for Public Health, the oldest Public Health organisation in the world (161 years old).  And she gets involved in a lot of other things too – see later.
As ever, my views prevail here as the writer, but you can watch the podcasts (4 segments, easy to digest), to see if you agree with my take or not…click on the links below:

Section 1           Section 2           Section 3            Section 4

or the whole thing:  CLICK HERE

It is often the chatees (interviewee is the right word, but doesn’t fit Roy’s avuncular evisceration technique) – the chatees back story that informs why they have ended up in that chair right now. Shirley’s was more varied than normal.
17 year old girls from the unfashionable coast of West Cumbria don’t do their last year of school in Colombia in USA? Billeted with a family and schooled in a very different environment and style of schooling – she did a 7 page essay when everyone else did a paragraph or two, about a book – is a bit of a full on 24/7 learning experience. She just remembers it as a big adventure, but feeling homesick for first 3 months…

Went to uni after A levels. Applied Social Studies – 4 year course and come out as fully qualified Social Worker. 22 year old, in the Emergency team, even sectioning people in ambulances…

Married, husbands job goes to USA, so couldn’t work herself, as no permit. Masters in 13 months at private univ. Left in 86, and went voluntary, learnt about fund raising. East Side, NYC. Tough, I imagine…

Back in UK – involved in Muscular Dystrophy – already managing…

Back to New York City. (Tired yet?). Voluntary sector again. Learning Disability. Set up a Washington office. And was told to be bi-partisan, as she was issues based. Managed to befriend both sides, which stood them in good stead. Clinton 1 administration at the time. Worked. Televised Summit – “No child shall be left behind”.

A book fell out of this – still available – “Learning Disabilities – Lifelong Issues”. Click to see..

So why all this history? Everything that Roy Lilley and Shirley talked about afterwards was completely built on the foundations of that history. I’m not sure I have listened to anyone who has convinced me completely that they have learnt from every scrap of their experience. That’s what felt powerful tonight…

The Royal Society for Public Health is the oldest of its type in the world -as I said before. Abroad, it is talked of reverentially. Roy batted that back with the he rejoinder that Public Health had failed.

We did have a lot of talk about the reports they publish. Interesting, they are both fact based at the start, but also add in public opinion of those facts to find out if change is plausible and possible?

The discussion ranged wide – as wide as The Public’s Health remit is. Smoking? Tony Blair given plaudits for it. Sugar tax? £430 m – already taken, and has been allocated to schools specifically for fitness and outdoor kit. It’s probably only £20 000 per school, but it’s money they wouldn’t have and they can’t spend it on anything but sports stuff. Will it prevent childhood obesity? Maybe a step in the right direction?

There are pockets of excellence to copy. Portugal making possession of drugs for personal use legal. Crime and death rates have dropped. Scandinavia has the infrastructure (and smaller populations, I contend) to manage poverty well. There is also a positive attitude to ‘herd immunity’ everyone gets their kids immunised, to protect next door. We do it for our own.

There have been som excellent nudges in the right direction (report on high streets and poor areas having the worst range of shops).
I liked Shirley’s “evidence alone is never enough”. Her attitude also adds in public opinion. It gives the facts nudge worthiness…

I think though I tend to side with Roy.  Once we have the pointers from pressure groups such as RSPH, then Brits need legislation (Crash helmets; Smoking; Speed limits).  If you visit Scandinavia, you will note that (e.g.) the Danes don’t venture forth to cross a road until the little green man says so.  Brits ignore that, and get tutted at.  We are essentially a little bit rebellious, and don’t like to be told what to do.  But if it’s law, we do tend to do it right.  But we need to be pointed in the right direction first, and bodies like RSPH can do that very effectively.

Despite being in the widest job brief I can imagine, she also gets involved in other charities and groups. It seems she may not know the detail or the specifics, but that doesn’t matter – she has great people around her. And she is very good at leading and motivating a team. A vision person, I think.

Her one wish? Politicians to become more engaged and brave.

If that happens, maybe we could slowly move from a sickness based service to a Public’s Health service, with the NHS there for the fewer sick?

It’s a thought…

Alwen Williams Chief Exec Barts NHS Trust

Alwen Williams

Alwen Williams, CEO, Barts Trust.

The last NHS chat with young Roy Lilley of 2017. And what a fine send off the year had.

Alwen is patently well suited to her role, and has most definitely inspired me. She was calmness personified under the usual Lilley onslaught of contentious questioning. I especially enjoyed her almost complete blanking of “so what does a Chief executive actually do?”. Ignore impertinent questions! Not a bad start…

37 years in NHS. Barts trust will be her last job, she said. Lived in East London all her life; honoured to be involved in making the most important local employer better.  Been through all the “reforms” from Griffiths, to Lansley, to Austerity. After languages at uni, decided it wasn’t for her.  Looked for management training scheme, and found the NHS one suited. Been in operational management for a lot of her time in the NHS.  Her first contentious statement. Which I totally agreed with, (as did Roy…Christmas love-in?), was when she said most of the reforms only created change at the margin.  So all that messing about, like getting rid of RHAs, competitive tendering, FPC becoming FHSAs morphing into PCTs then CCGs , with a soupçon of fund holding…only had effects at the margins.  And I bet 5% of the budget went on management consultants fees to try to explain to everyone what was going on! It doesn’t really work…

In NE London and The City, she was there when 7 PCTs were amalgamated, and she was the overarching boss. Sorry, accountable officer. It was a bit easier to be strategic, when at least the NHS boundaries were co-terminus with the local authorities…

“Having an Internal Market is not the panacea for service improvement”. Alwen quietly kept hitting us between the eyes like that. I guess her teams know this already.  Not a quiet assassin. Just a highly committed people person.

Roy asked her more about what she did and how she did it.  Deep seated core values just flooded out. Here’s a flavour:

  • They have 200 leaders in their trust. These can be Chief Execs or Porters. All equally important.
  • The leaders need to define the needs of the organisation, then make that happen.
  • There has to be continuity of purpose, and everyone needs to know it, live it and share it
  • “I make sure I have great people around me” It is simple isn’t it?  Simple to say, but hard to keep doing…
  • You need to pay attention to what staff are saying, and act on it
  • If you espouse Safe and Compassionate as your core reason for being, you have to recognise it, do it, support it, laud it, praise it and kick out those who can’t or won’t do it! (I added the past bit. always is too polite to say that!)
  • You have to nurture and develop people. Not command and control. No Ivory Tower.
  • Everyone is respected. There is no hierarchy espoused. Everyone is as important as each other.
  • Leaders set the direction

In the end, it was all about engaging the staff.  Operational imperatives emphasised this, for me. Like the following:

  • Make joint appointments so that the prestige St Barts post also had sessions in difficult to recruit parts in their area.
  • Whistle blowing – encouraged and protected ( and I assume vindictive claims equally stamped on?)
  • Have a great Occupational Development team, to make sure the big conversations happen.
  • Move away from Agency cover to home grown Bank cover. (Please, steal this idea, everyone…)
  • Huddles – for specific communication purposes. Like, Safety: or Cyber Attack coordination (which she says she never wants to live through again…which is very understandable.)
  • Take your services to the people…don’t make them travel miles to you if they are ill, infirm or very worried.

16000 staff and  2.2 million people covered in the area. It feels big.  It feels very accountable.

It feels in good hands. Calm and effective.

Gives you a bit of confidence, and a lot of pride, yet again, in the standard of leadership we witness within the NHS. I’m smiling whilst writing.  There’s no need to grieve for our NHS yet.

If you missed the chat, you can view it by clicking here

Ed Smith, NHSI

Just stepped down as Chair of NHSI – after a positive marriage guidance role betwixt Monitor and NHS Trust Development Authority.  And ex captain of the Titanic (no relation – but hey, we always get someone who asks about re-arranging deck chairs when Ed is on stage…he has the decency to smile still…).

Health Chat 51 (I only know it’s the 51st because the last one was the 50th.)

Did we get anywhere near finding the answers to Health Care in the UK? Well maybe not? We expected more from this health chat more than others? Just because he has left his role? Well, a lot of people had arrived in the hope…I think

I just loved some of the themes. I do find it difficult to keep up with Ed’s train of consciousness. So maybe I haven’t noted everything!  But I hope you get the overview. Biased by Phil, of course. If you want to see the whole, to make your own view, see here.

The great thing about all the people Ed encountered in his time was simply summarised. “Desperately committed”. And they were exhausted, in the main. And had never been thanked. Just so many great people. Daft. It didn’t help that we have had to endure the Lansley legacy. Reforms that were specifically not only left out of the 2010 Tory manifesto, but we were told there would be no change whatsoever in the NHS, as too much re-organisation had been frosted on it already.  You can always tell when a politician is lying, because you can see their lips move…

How would Ed fix the NHS?  Three phases, he started with. He and Roy Lilley kept going off at tangents (Roy said and interrupted more than Humphrys, so I got a bit lost. I think, like all of us, he got a little excited…and his respect shone through).

Immediate need? Emergency level of funding. If there is a Flu epidemic (it’s overdue, and is already happening in Australia) we are up that creek without a paddle. And the biggest problem? If 10 % of staff are laid low, when we have unfilled vacancies everywhere (which is why everyone is knackered and deserve even more thanks. Just remember, these are the guys who run towards the shit hitting the fan.). So the emergency money has to fund temps. Tough. But please, get someone to negotiate this well? And if someone takes the rise, stop them being used anywhere in the NHS. Or let’s simplify stuff? If most agency nurses (for example) are NHS staff, pay them sensible overtime. It’s a lot cheaper and safer from a continuity point of view…

Second? We do need to invest money, Keynsian style, to bring down waiting lists.  OK, you do need fiscal responsibility. I do think a lot of the Brown Blair money was wasted. Setting the target as spending up to the GDP average of the EC doesn’t mean you get value for money.  We need to get back to basics, I think. Ward level budgets, real time spend on dashboards on every ward (like they do in every manufacturing company I work with, who are successful). And a sister in charge of that budget,moraines and incentivised. (Sorry. Last 5 lines were my views…back to Ed and Roy…)

There’s a maintenance backlog as well as a workforce challenge.  The estate will not be fit for purpose if we don’t fix stuff and just let it decay.

Thirdly? A need for investment in transformation. Luckily, although ere is legislation to back the Lansley reforms, the people on the ground ignore it, and just get on with doing things properly. This will need 3 to 4 billion per year over 3 to 4 years.

There is no one magic bullet…no one size fits all. There are different needs in different communities.  There are different patients with different levels of confidence in their own input into their healthcare in all parts of the kingdom.  We really need to change the mentality.

How? Ask the citizens? That’s Ed’s view (- although there was some concern that Brexit result shows what happens if you ask…). But if we start with free to use at the point of care? My view is there will still need to be rationing, and we still have to think health improvement as well as sickness fixing.  We still have to make digital work for us, and keep it simple. Maybe we all have to hold our digital record, if we want to, on a phone or a memory stick or on a personal cloud?

Primary Care is just another provider, Ed said.  But we maybe need to change the way we think about how we fund the patient interaction across the whole of health and social care? Pay for inputs by the General Practice, not an annual fee per patient. (Sorry guys – I think we either have GPs as fully small business or we have all of them salaried. This in-between level just confuses funding.)

What is the plan? He talked about when he started at NHSI, that their main aim was jet to keep the lights on.  Have we moved on? It doesn’t feel like.  Workforce planning would be OK for unskilled jobs? But most of our NHS and Social Care gaps have a 5 year lead time to fill them.  That was one of Ed’s regrets, not adds sing that earlier.  Along with not convincing politicians of the need for collaboration. On the plus side? Very proud of working with the Grim Reaper (Jim Mackey).  And to be trusted by the people he worked with.

He talked with passion about about being involved in a good, positive regulator. And of a blended ‘bricks and clicks’ style of healthcare provision, tailored to each citizens need – which will vary by citizen of course, depending on each situation they are in.  He often described what he was saying as ” romanticised “. It maybe was.  I call it passion.

He did show that passion at the end, expressing his view that Roy should Keep Going. He loved him, for representing the citizen in those e letters we all read.  And I agree.

We may have lost him from the NHS at the moment.  Ed Smiths legacy though is that he hasn’t really left. His ripples keep expanding.

 

 

Health Chat 50

“So, what is a Health Economist doing in a place like is?”.  Being chatted to by Roy Lilley of course, at The Kings Fund in London, at one of the NHS managers.net. This was a landmark occasion – the 50th Health Chat. I was there for the first, and the majority in-between. And always, always have been uplifted and learnt something.

Roy & Anita Charlesowrth

Anita Charlesworth with Roy Lilley

The willing interviewee was Anita Charlesworth, Director of Research and Economics at the Health Foundation.  She is also Honorary Professor in the College of Social Sciences at the Health Service Management Centre at The University of Birmingham

Interesting Roy alluded to the first ever interviewee, Dame Ruth Carnall. He linked the fact that the 50th interviewee was another woman in a senior NHS role.  As Anita pointed out, the fact remains we are still less at than 3% of senior positions held by females.

She did hanker after going back to berate her Careers Advice teacher.  There are more possibilities  than becoming a nurse or a teacher (with nothing against those prospects, but she is right, there is more that is possible).  It just that no one told you that back then…

Gosh, it was a free ranging discussion.  We started with how and why Health Economics was her calling.  As ever, serendipity and an influential inspirational boss were the enzymes. It was the Masters in Health Economics at York that got her started.) (all the degrees, even chemistry and physics, used to be BAs at York.  I play am still rather upset that all economics degrees are BAs and MAs.  Why can’t it be a science?)

But what do Health Economists do?  Anita’s Masters dissertation gives you some idea of the questions they try to answer.  “Should every woman be screened for Breast Cancer?”  The attempt is to have science and numbers answer those sorts of question, not passion or opinion.  I suppose that sums up the raison d’etre, really?

Let’s get some of the quotes:

“We often focus on what you can measure”  (Sadly, what gets measured gets done – even if it is only measured because it is easy to do so…)

“Show me the evidence”

“If you were good, anywhere in the senior civil service, Treasury stole you”

I got the feeling that no one is leading the NHS.  No one is looking at the whole piece – old style DHSS.  Health and Social Care together.  Surely my cynical alarm can’t think the government might have sectioned off social care and community services to save money and screw up local authority budgets (so they get blamed rather than the government)? And maybe, hyper-cynically, to make the NHS wither on the vine?

I did want answers from Anita.  I wanted my cynicism to be assuaged.  I got a list of priorities, that were evidence based.

What were her priority concerns? (I liked them).

  1. New government 2015 decisions were worse than 2010 coalition.
  2. Austerity is proven not to be a good way to fix funding shortfalls
  3. We might need Keynes mentality, not Cameron / Osborne austerity continuation
  4. Investing in people’s health is worthwhile – Public Health, not Sickness is cheaper, but needs investment
  5. Tax funded health service, free at the point of use, is sustainable
  6. The model is fundamentally right
  7. Anita worried about the next few years – especially the potential for staff leaving who just throw in the towel, because they are undervalued and not engaged
  8. We might need to invest first before we gain….sorry, we need to do this, not might.
  9. It’s not worth doing investment in one specific area which might give a positive sound-bite…like more consultants…if they have no nurses to support their work. No one thinks of the whole piece

There are amazing and effective new models of care out there, and need to be out there:

  1. Sam Everington from Tower Hamlets (a previous interviewee, and very enlightening), where 93% of first contacts in NHS happen in GP land, for only 11% of the budget. It is a bargain.  And works. (Click here for more)
  2. Primary Care Home works well in areas it is being trialed (see NHS England summary here)
  3. Buurtzorg could easily be adapted to our UK funding model, and nurses would love it, and so would patients and their families. Let’s not forget that.  And suddenly, we don’t have as much delay in transfer of care.    And powerfully. (See founder Jos de Blok presentation to Kings Fund

OK everyone – you may have noticed at health chat 50 I have been more self-opinionated than normal.  But the whole NHS and Social Care arena feels like it is under attack, and that attack is not going away.  And that is not for the want of all the totally committed people who keep it rocking and rolling.  The staff.  The poor overworked and under resourced stalwarts, who get abused from all sides, and hopefully never read The Daily Mail.  Let the good people and their managers and leaders get on with it – they can keep it going.  Let’s just get the politicians out of the way. Except to sign the cheques.  And maybe agree and set some boundaries.

(Thanks to Roy Lilley – and here’s to number 100!)

(If you want to see the whole interview – it is available here )

Do Life Sciences & Pharma have a future in the UK?

A debate at Quintiles IMS,London, chaired by Roy Lilley.

And just look at the panel…

Roy Lilley (NHS Writer, broadcaster, commentator and conference speaker), chaired and cajoled

Meindert Boyson represented NICE

Chris Carrigan, patient involvement via My Data

Ben Howlett – Director of Public Policy Projects, and ex MP

Prof Keith McNeill, NHS Chief Information Officer, Ops and Info at NHS England

Mike Thompson, Chief Exec ABPI (Pharma Industry Group)

Tim Sheppard, General Manager QuintilesIMS – our hosts for the evening – thank you!

And the audience was a good cross section of patient group advocates, senior NHS folk, and high level representatives of global Pharma.

Pharmaceuticals is a big business – and personally, I do hope it continues to be successful, as I have pension interests tied up in that! £60bn turnover. £30bn exported (probably only defence is larger?). Anyway, pretty darn big.  We did really only have space for the question in the title, but with nuances around Brexit, John Bells report and a few asides to show Roy hasn’t lost his shin kicking skills. As Tim from Quintiles IMS said in his closing remarks, the shin kicking at least had been distributed equally…)

There was a lot of positivity from the panel – with Mr. Lilley providing the negative balance!

What do we think about the NHS? Here’s a feel for the opinions:

Patients love it, but good news doesn’t sell well, so we hear mainly bad.  Our Aussie prof (Keith) suggested we are excellent at beating ourselves up, and we should be proud of the level of care provided, and celebrate rather than denigrate. Tim, from the sponsors, felt it is creaking, and change, rather than evolution, might be necessary. Our ex MP reminded us that two million people more are seen in 2016 than in 2010.

What about Brexit – is it really the road to hell in a handcart? This question took us into John Bells report on the future of life science in the UK, and into Pharmaceutical Research and more. Roy was concerned this 75 page report specifically excluded pricing.  He did have more concerns – and I did too – read Roy’s critique on his e newsletter here, and look at the full John Bell report here.  It was this second question which took us all the way to wine and canapés ! OK there were many supplemental tangents and some inputs from the audience, but it does show how much people have invested in thinking about the effects it will have.  It was fascinating.  Let’s have a game of positive and negative tennis, shall we?

  1. The NHS helps to make the staying in UK decision easier. 60 million captive cohort to work with.
  2. The negative is our difficulty in sharing the data. We had one story of 30 contracts having to be drawn up to allow this to happen in one small research project.
  3. On the other hand, one of the audience talked of their local project needing only one sheet signed contract to gain consent
  4. NICE sounds like it has become very positive and cuddly, despite the chairmanship acerbic comments. 80% positive outcomes the institute that likes to say yes! They could also be recommending spending more on treatments that are more effective.  It isn’t just about saving money
  5. Not ugh MPs or people on the Clapham Omnibus really know what Life Sciences is all about, which doesn’t help the public debate
  6. Patients want to share their data, in Chris’s experience. Yes, many want safeguards, but data boundary issues are all solvable
  7. We are bad at spreading good practice.
  8. High skilled workers will continue to be allowed to immigrate
  9. But we need the lesser skilled too.

It does sound like a lot of positive things may be happening.  I was particularly heartened by the local initiatives stories. As an example, the Pharma Challenge from Christies in Manchester.  This grew out of a Vanguard group, doing what was said on the tin, and this forum manage to make things happen, and saved a lot of money. Everyone was involved motivated and they made it happen.

Unlocking the vast data store we have does not seem beyond the wit of man.  It needs to be shared and used well to inform patient outcome improvements. It has been done. It can be done more.  Care.Data 2 or the MY data patient led project need to happen quickly.  It feels like we need also to improve the speed at which Pharma research can start. It only takes 90 days in USA, and up to a year in UK. That could drive people away?

It does feel like a lot of things will focus minds with Brexit actively driving innovation through fear of the negative consequences?

Professor John Bells summary of the future of life sciences in the UK concluded, “This strategy provides a unique opportunity for the country and I hope it can be delivered effectively in the coming years”.

I think there are reasons for remaining optimistic.  The panel talked a good game.  The many local golden nuggets of good practice, already happening, gave me the most positive feeling.  We just need to keep innovating, which is what Britain and the whole Life Sciences sector has historically been good at.

Especially when under the cosh.

 

Winchcombe Fire and Rescue Service

Photo of Winchcombe Fire Station

Iain Robertson, Manager and Station Watch Commander, Winchcombe Fire and Rescue, managed to fit in a chat to our new Winchcombe U3A monthly meeting in August – in his very busy schedule!

So, I thought, this is one of the people who look after us.  The people who run towards when most of us will aim to run away from some of the terrible things we see in the news.

The Winchcombe Area U3A members were ready to learn more from Iain , Incident Commander in Winchcombe.

(As ever, there were loads of particular sayings and acronyms that all professions have. If you attended, you may notice that I have mis-noted some.  Iain, if so, I apologise…)

“We risk our lives to save save-able lives and save-able property”.

OK – our attention was most certainly grabbed.  We wanted to know more.  Why add “rescue” to the title? Part time firefighters? So, just volunteers, and amateur?  I wasn’t brave enough to ask these as questions, you understand, but I think similar thoughts might have passed through the minds of other audience members.

It used to be The Fire Brigade.  Remit is now much wider. Fire calls have dropped 63% in 5 years.  Road traffic accidents continue to increase.  Flooding rescues and fixing still continue to escalate.

Nowadays, the Retained Duty system Firefighters tend to be more rounded in their skill sets.  They have to do the firefighting, of course, but there are presentation skill needs, social work style inputs at safe and well visits to the vulnerable and socially isolated, defibrillator use, and more.  There seems to be much more emphasis on prevention and protection as in fixing an incident.

The trainees have exactly the same training as full time fire fighters.  3 to 4 years. Then exams.  Practical stuff after that, like use of breathing equipment, how fires develop, and a full day long assessment.  And they have a day job too.

I was most taken by Iain also talking about the effects on family life.  They have to be 5 minutes from the station, sober, and ready to leave whatever they are doing as soon as their bleep goes off.  It’s the effect on family life that seems too intense for many, I would think.  120 hours a week on call?  Wow.  Just so surprising.

Other facts that fascinated:

  1. 1800 litres of water are weighing down that truck. It will be used in 2 minutes. 2 MINUTES! Other sources from geysers to known rivers and ponds are built into local contingency planning.
  2. The firefighters have to have periodic fitness tests and pass a minimum level of strength test.
  3. The most common cause of damage and death in a fire are fire gasses, not burns
  4. The truck is ready to roll in 3 minutes from a call out
  5. It needs a minimum of 4 crew, and one has to be qualified (so Iain can be last all the time!)

Advice to us all?  It is no trouble to be called out.  “The second you think you needs us….call”.  And as a family, have a fire plan.  And it’s better if you can, to just get out.

The safe and well visits, plans for the vulnerable, prevention and protection all seem to be bearing fruit.  I suspect it is just far more logical, but with much less adrenalin! They have partnerships with GP surgery, day care centres and food banks.  There is a sensitive amount of social awareness here, and it feels like it is working well.

I’m glad they do the running towards, on our behalf.  And although currently all 11 are male, 3 of recent applicants were female.  Winchcombe Welcomes walkers, and fire women!

(Iain had to rush off after questions to do a safe and well visit. After much applause).

 

Claire Murdoch, with Roy Lilley

I have mentioned before what I feel links all the speakers I have ever seen at Roy Lilley’s Health Chats: it is the passion the interviewees have.  It is more than vocation, which must be where it begins, I assume. Most of those I have heard interviewed have been in and around the NHS most of their working lives. The passion is not just part of their make up, or a line on a CV.  It is the umbrella over their whole, the glue, the oil, the Raison d’etre.

Claire Murdoch

Claire Murdoch exuded it in everything she said and had done and is doing.  Even to the point of giving the Lilley a good going over! (He is only as interrupting as John Humphrys like as he is, if he likes and respects the interviewee. I think I would worry if he suddenly became nice…)

Roy, Claire and sponser Michael

Roy Claire and Sponsor Michael (Fab socks!)

I think though, I missed out on one bit. Are we over medicalising mental health? Is the model of care clinical or what? I think it dripped out later but not as a straight answer? Check out the NHS Health Chat You Tube recording here to see if you agree, and also if you agree with my opinions here.

Mental Health certainly has changed from the Asylum days (although asylum is quite a positive, cosy and protective word, just lost in negative connotations.). And in 30 years time we know that people will look at what we do now, and think ‘they did WHAT?”, like we do to our predecessors.

I got some new stock phrases that I may have to steal. “Rich and textured view”. “Peer support workers”. “Lived experience”. Like those? There were more…(I knew peer support workers, honestly.  The others felt new to me, and felt apposite.)

First question was about the impossibility of recruiting 10 000 staff by the end of the 5 year forward view. (5YFV).  Spread over 44 STPs that is only 300 each…which does sound more possible? And retaining just 1% more than today gives 6000 extra workforce anyway…

And one way to achieve that? Claire hit back at Roy’s assertion that Mental Health is hard.  “We have got to get away from that thinking – always describing the arena as awful and tough. That’s not my experience. And not the experience of the people I work with.” Talk up the job, and ignore The Daily Mail? Maybe easier to say than do?

Next excellent forehand return was to the rejoinder “so what stopped you being patient facing and going into management?” The reply – “I am still,patient facing, and always will be”.  Lilley trailing 30 love already…

It felt like her rise through to the top had been serendipitous rather than driven.  I loved the reason she applied for the Chief Exec role at her Trust. “I didn’t want anyone else to do it”. Fab!  Ruth Carnell was on the panel, and said to her that there would be a time in her first twelve months when she would hit a wall and wouldn’t know what to do.  Claire was congratulating herself on getting past her 12 month point.  But it did happen, after 14 months.  She phoned Ruth, 9 pm on a Friday (as she had offered), and it worked for her.  A peer support worker is needed by us all! (Why do crises always happen at 9 pm on a Friday, with the phone boring with vitriolic reporters? The only solution is to go home at 8!)

Listening to Claire you do get the feeling that this is the time for Mental Health to make the most of its positive standing in the 5YFV. And the extra funding  (which has happened, and continues to happen, and is actually a positive return on investment. There has been an explosion in demand, but the reason for that is simple.  We are talking more, being more open to discuss and so intervene…

There were a lot of initiatives, copiable and shared.

  • Navigo at Hull. Bought a Garden Centre.  So people being treated could have a job as part of that treatment.  This goes alongside having a good place to live, and someone to love….
  • Lincoln Young Mums club – Peer support Network par excellence.
  • Talking therapies for the elderly – one of the most effective talking therapy results.  You forget that loneliness kills…
  • Early intervention – prevention are at least preventing escalation, is becoming the norm.

There is currently a greater appetite for Mental Health than there has ever been.  There is a very talented workforce. And a great team at NHS England.  There is less stigma.  More organisations are putting it positively and centrally in their training and support services…even the NHS it would seem!

The twitterarti fed back how much they enjoyed Claire’s masterclass in handling the Lilley. One assertion she didn’t like was met with a 15 second silence – just excellent, I thought!

She thanked her parents for making sure she was a glass half full person. And this meant she wanted to celebrate the fact that our MH provision is world class. If the people you work with are courageous, sympathetic and amazing, as Claire suggested, then it is hardly surprising that this is so.

Yes, pathways of care will have to continue to be worked on to remain properly inter grated across all parts of the service.  And people with dementia will number 1 million in 2025, and how will we manage that?

If MH has come of age, then I have to feel we will cope well.  And it does feel in very good hands.