Hodges model: What is it? [3] The science of sailing...

Thanks Lorraine for your comment on Hodges' model: What is it? [1] - hope to hear more from you.

Like good weather and a pair of familiar lived-in walking boots Hodges' model should encourage exploration, but should it do more than that?

Definitely!

Policy, the health and social care literature and the media often refer to care pathways and the patient journey. A journey imposes cognitive and physical demands on the individuals concerned and involves the interplay of various forces and the expenditure of energy.

Care pathways require negotiation, especially if everyone is truly unique and services and care delivery are person-centred. The patient journey has a start and end point: whatever the outcome. For all travellers there is no such thing as a free-lunch in energy terms.

So far Hodges' model has been described as a house of ideas, a sailing vessel and an interface. What next? Well there's more to sailing than meets the I-skipper!

You see setting sail there are four forces at work...

The FIRST is the wind of time that blows fair and foul, from tranquil, stillness and peace to unpredictable, chaotic and turbulent. Foul winds exact pressure on the rigging, the sails, the whole boat suffers: noise. Relentless pounding. Physical forces act on our bodies and the sails. The winds attempt to heel the boat over. We use SCIENCE to understand this force.

The SECOND force is that of the keel, which seeks to counteract the wind of time. Pushing against the water the keel provides ballast. In health and social care there is a social and POLITICAL contract at work, health and social care services are provided to help those buffeted and battered by the wind. Break this contract and all-aboard are imperilled. Check the charts, take a regular bearing. Reflect. Beware the false lights of the wreckers.

THIRDLY, the wind creates pressure on the sails, high pressure to the windward and low pressure behind. This difference in pressure draws the boat forward. This equates to the combined effects of groups of individuals, carers and volunteers and the wider SOCIAL community whose energies help the patient (and their family) to muster their resources, strengths and progress whatever the context (heading).

The FOURTH force is the friction borne by the yacht's surfaces and the water. Those who sail do so largely because of the interplay of this and other natural forces. Water. Wind. Salt. Friction lets us know we are alive. Friction helps bring us into being, but this friction can hurt especially over time. See worthiness is tested, confidence wanes. Psychically isolation challenges us. The loneliness of the long distance runner. Sailing alone - true courage. We must go on drawing on INTERPERSONAL resources, with occasion to reach to others. To reach our destination.

WHO is at the helm? Well, I'll leave the 5th domain for you to decide as we all endeavour to travel in peace...