#NHSMillion: From one quadrant to another three

The image below is from twitter and the #NHSMillion campaign which I've RT a couple of times on @h2cm. The graphic is repurposed here representing the NHS as an organisation with its Socialist founding. On twitter the arrow would point to the twitter account holder's name. In Hodges' model we can readily travel from the individual to the million and more; from personalised healthcare to population health:

individual

|

INTERPERSONAL : SCIENCES

humanistic -------------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

|

group-population

Within Hodges' model the arrow points to the INDIVIDUAL axis. The stress is placed on a person* and their experience of the NHS whether for themselves or a family member. Care should always encompass physical and mental health care, with emergency care prioritised firstly of course.

As an NHS employee I have been cocooned from many of the financial vagaries of the world. This does not mean I work for nothing, don't pay tax, have holes in my pockets ... On the contrary I'm frustrated and increasingly annoyed about austerity and the pay situation over the past 5 years and more. Interest rates, Brexit, the Euro, the $ ... all count here too. Healthcare does need to be paid for - one way or another. The cocoon refers to the effect of the founding core principles of the NHS:

• that it meet the needs of everyone
• that it be free at the point of delivery
• that it be based on clinical need, not ability to pay

As well as the four domains Hodges' model carries within its structure a series of interdisciplinary bridges as previous posts reveal; psycho-social, psycho-somatic - you get the picture.

A further tweet from @NHSMillion brings home the SOCIO-ECONOMIC and SOCIO-POLITICAL dimension of health and social care. The cocoon is ruptured, the vulnerability of the NHS's core principles and values is laid bare:

individual

|

INTERPERSONAL : SCIENCES

humanistic -------------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

|

group-population

We need to assure and ensure that the many can continue to make a difference to the one. Even as that gratitude is increasingly reframed as people learning how to stay well for longer and better look after themselves.

*The arrow is also pointing to the center of the model. Truly person-centered care should be able to demonstrate that full round of the four domains have been factored into any assessment, plan, intervention and evaluation with the spiritual also duly considered.

HSJ Mental health: A sign of the time(s)?

I'm a subscriber to HSJ and greatly enjoy reading it, even if this includes catching up.

The January 13th issue was headlined "2016: THE YEAR OF OPPORTUNITY?"

The editorial/leader A year of opportunities with many unanswered questions (pp. 3-4) spanned more than the usual single page and commented upon:

• funding efficiency
• services transformation
• technology
• commissioning
• health and social care integration
• primary care
• hospitals
• mental health
• workforce
• regulation
• and leadership

Mental health has been much in the news of late with the promise of funding. HSJ noted:

"For mental health, the question is a simple one. Will the sector see the increased funding long promised?" p.4.

Leadership, regulation, workforce, health and social care integration, commissioning ... can all be related to mental health, but with February's news I wonder if mental health can be revisited as a piece of horizon scanning as per the sub-heading? Otherwise, before February is out - is this a case of "job done"?

There are roughly 60 sentences in the piece as a whole. Some of the sentences are quite long in contrast to the above.

Mental health 1 : 4 and yet here equivalent to 2 minutes - less in reality?
The mental health question may be simple, but the way it influences all the many unanswered questions including public - mental - health is obviously complex.
As a nurse manager I recall it being difficult to please everyone all of the time. Editors are similarly challenged, but mental health IS worthy of integration and journalistic recognition.


McLellan, A. (2016) A year of opportunities with many unanswered questions, Health Service Journal. 13 January 2016. 125: 6472, pp.3-4.

Clock image c/o http://www.oliverboorman.biz/projects/tools/clocks.php

Hodges' model: Watch, Listen and (really) Join the Edges

individual
|
INTERPERSONAL : SCIENCES
humanistic ---------------------------------------  mechanistic
SOCIOLOGY : POLITICAL
|
group

The EDGE NHS

Edge

Calling all healthcare radicals!

A call to action: Helen Bevan’s blog (BMJ)

Rocking the boat and staying in it: how to succeed as a radical in healthcare

 

 

Corporate Rebels United is a global movement of “corporate rebels” across multiple industries and sectors. Many healthcare rebels/radicals are part of this. This is the manifesto of Corporate Rebels United which perfectly captures the mission of organisational radicals in healthcare to deliver the new truth of healthcare transformation.

Through Hodges' model I am an advocate for 'radical history', nursing care lessons from the past can (must!) inform future health and social care.
 

Health 2.0 Europe 2013: Nurses, registration and £££

This year I've really enjoyed the Health 2.0 Manchester chapter meetings and there's some great evening sessions to follow this northern autumn. In June as I posted on W2tQ I also spent a weekend at the NW Health Hack in Knutsford. 

For several months European Health 2.0 conference has been publicized at the Manchester meetings. I was keen to attend until I saw the registration fee even with a 15% reduction. The fee increased yesterday too as I was reminded by Pascal Lardier on twitter.

I retweeted and replied to Pascal and Health2eu, with the thought that few nurses would be able to afford the registration fee.

NW Health Hack was a success for me (in addition to our group coming 3rd) because it was free, apart that is from driving there over the weekend on my days off (thanks again to all the sponsors). As the NHS is trying to save money I've also taken some unpaid leave this year.

NHS nurses, like many public sector groups have effectively had a pay cut these past few years. There are other general challenges:

• Are those nurses who might attend already 'onboard'?
• Does nursing engagement itself need a health check (what is 'clinical engagement' now)?
• Much was made of achieving clinical engagement in previous NHS IT projects. How can clinical engagement that reaches nurses be assured now?
• If (technical) innovation is to be a constant stream, please don't leave the nurses on an island: they can set sail too.
• Are nurses, like the one writing this, tainted, having been sat on the fence (health care || ICT) for too long?
• Once projects are established how can nurses, patients and carers stay the course and keep in touch and engaged?
• As 'NHS clinicians' can nurses participate in initiatives such as the forthcoming Code4Health, or will operational constraints limit their involvement?
• How are the socio-technical aspects and outcomes measured (hospital vs. home personal use vs. self-care...) ?
• Is there a golden ratio for the mix of delegates?
• If there's a strategic partner involved where's the strategy?

Pascal sliced through my query and many of the points above:

Pascal Lardier ‏@pascal_lardier 19 Sep
- then they should reach out to me!

So if the World Wide Health 2.0 conferences are of interest to you, do as Pascal suggests. New communities can provide new opportunities. Don't just help make your day, help make tomorrow too.

In 2012 the NHS employed 146,075 doctors, 369,868 qualified nursing staff, and 37,314 managers. 
http://www.nhsconfed.org/priorities/political-engagement/Pages/NHS-statistics.aspx#staff

Additional notes 29 Sept:

Health 2.0 MCR ‏@H20MCR
@h2cm patients are also asking how can @Health2eu Health 2.0 Europe conference be made more accessible for them @pascal_lardier?

Pascal Lardier ‏@pascal_lardier
@H20MCR @h2cm @Health2eu @pascal_lardier they should email me pascal AT health2con.com there is a FREE reg code for them.

Piloting (online) health literacy - 'easy as she goes?'

On Thursday afternoon I introduced Hodges' model to six student nurses. In wrapping up the session I suggested the students look up 'health literacy' indicating how Hodges' model can incorporate reflections on the many literacies essential for life (and death) in the 21st century. For one student this small kernel of news was unfortunately too late, a piece of work having just been handed in.

Great to see the following item in this week's HSJ - Health literacy training on offer for 100,000:

The NHS Commissioning Board will work with a charity to offer 100,000 people access to training in online health literacy over the next year, it has announced.

The board’s national director for patients and information Tim Kelsey said on Thursday it had made the agreement with UK Online Centres, an organisation which specialises in tackling digital exclusion.
The work comes in the run up to the board’s deadline of 2015 for patients to have access to their GP health records. ...

Health literacy training on offer for 100,000, Health Service Journal. 14 March 2013, p.10.

In terms of health literacy as a whole this is one aspect, but as the previous post point out we need to consider human factors. Innovation  also involves physical and cognitive access, relationships, referral, the interplay and dependencies between existing literacies (poor functional literacy and yet high health literacy?), differentiating between literacies, motivations and to what extent can participants themselves be mobilised as a force for change beyond 100,000 ...?

The Telehealth supplement in the same issue of HSJ notes that small companies struggle when they are offered yet more pilot projects with 30 patients.

100,000 - well that should be a good shot in the arm.

Trueland, J. (2013) The six billion dollar question, Telehealth supplement. HSJ, 14 March, 8-9.

New: NHS Change Model (and a question from the future 20:20 vision?)

The NHS has a new model to help deliver change, a critical objective over the months and years as new commissioning arrangements are also implemented. The introduction below is from the website, from where the components of the model are also explained following registration and this is a chat forum:

Welcome to the NHS Change Model

The model has been created to support the NHS to adopt a shared approach to leading change and transformation.  We hope to build this website further and add practical information, tools and support over the coming months.  Please tell us what you think to help us shape this model and the ongoing future work using the chat room facility.

Why do we need a change model?
Building on what we collectively know about successful change the ‘NHS Change Model’ has been developed with hundreds of our senior leaders, clinicians, commissioners, providers and improvement activists who want to get involved in building the energy for change across the NHS by adopting a systematic and sustainable approach to improving quality of care.  

What does the model do?

The model brings together collective improvement knowledge and experience from across the NHS into eight key components. Through applying all eight components change can happen. This means no matter whom or wherever you are in the NHS you can use the approach to fit your own context as a way of making sense at every level of the ‘how and why’ for delivering improvement, to consistently make a bigger difference.

NHS Change Model [link no longer available]

Q. Does the NHS and Social Care still need a change model?

Musings on a mixed and busy fortnight: Oxford Drupal Education Camp

There is a busy fortnight coming up here. If all goes according to plan it runs like this: Drupal, Visual Methodologies and Ruby.

On Thursday evening I will travel down to Oxford for Drupal Education Camp. My first Drupal effort is taking shape. There are five photos in a jCarousel. I think I'm almost there but after the five scroll through there are five empty placeholders or blanks. It's probably just a tweak to the settings. The enquiry form is completed. I'm not happy about the formatting which seems to characterise many Drupal pages: that of the long series of fields. Listening to discussion at Drupal NW this month also reminded me of the need for spam capture.

I'm hoping one or two Drupal mental health contacts from Cambridge in January may also attend. The accepted sessions for Oxford present a very useful mix (timing permitting), especially:

Drupal 7 Semantizer

How we built a virtual learning environment

There was a debate on the longevity of VLEs in Wolverhampton in 2008-09. As I tried to look up that event I noticed that variations on the theme of "The VLE is dead, long live the VLE" are still doing the rounds. Clearly a case of the undead.

So, three - four years on this should insightful: What is a VLE? Is there a hybrid form? How far can Drupal be pushed? Why do students use FB and by-pass the institutional 'tools'? Perhaps it's because the institutions are busy deliberating the existence of this TLA versus that?

Migrating data into Drupal using the migrate module

NeuroHub: The information environment for Neuroscientists

The content of a new h2cm website will (yes, I know....) combine archive material - Brian Hodges' notes - with new work. For student users a means to assess and measure understanding of the content makes sense. I implemented a crude multiple choice test. The questions were probably not too bad, but there was no log-in, administration. If assessment can be done in a standardised way then that would be a huge bonus. What a new site should be about though is facilitating students in developing their knowledge and application of Hodges' model. The context of that knowledge and application need not be wholly limited to nursing.

After Oxford, on Monday 25th and after work I'm heading east to Newcastle for two days. I'll reflect on that soon. The trick is going to be threading all these together.

Rare Disease Day 2012 - reflections using h2cm

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

Is it ironic that ‘I’, this ‘self’ becomes an expert of my condition by virtue of it being rare? Is it also rare because so few must live with the emotional consequences? Yes, personalised medicine holds great promise, but please don't forget - me: this person : I don't want to be left here.	Being that expert I may even know the ICD-10 … codes for my condition. I know the symptoms very well. I know the 'current' evidence and may also be able to tell you about the gaps in the knowledge base.  My family physician learns with me. Supported by policy and united as a group what might citizen science deliver?
Your carer may be the expert because for you this rare disease means you cannot readily self-advocate. We all need to know we are not alone. If there is a role for social media here it is: "Rare but Strong Together"	For those people with rare diseases we have to help them unify in order to shout, wave and raise awareness. After all: WE seek global health don't we? Being rare is there investment in funding for research? Must there be a market first to bring forth drugs / treatments? We know about individual motivation, whither the corporate drive - social responsibility.

My prompt and thanks!: Stu Young, Royal College of Nursing Students

Follow-up: Drupal ScienceCamp Cambridge 20-21st Jan 2012

Stefan van Hooft @_iCompute kindly took these notes for the Mental Health session, 10.45am 22 January 2012 (mentioned previously on W2tQ). Stefan captured the topics that were quickly and briefly raised among the seven attendees (contact details provided but withheld here). I have added some [additional comments] and my response follows:

--- Twitter hash tags ---
Mental Health #mhuk #ukmh [global mental health hash?]

RDF
Solr
Sparkle [SparQL]

• accessibility within website
• openair Open source mental health [OpenEHR]
• mental health record
• care plans
Who has access to information?

•  Set up a system, you can give and revoke others access to your data
• "Flourishing" or "In treatment"

Use Drupal:
     - distribution
     - accessibility
     -
Is there a Group on drupal.org about mental health?

Security is crucial!
Pubsubhubbup [ http://code.google.com/p/pubsubhubbub/ ]
Spartacus report
Burn out
#Nhssm, NHS social media

<->

Dear Stefan and All,

STEFAN'S SELF-ASSESSMENT TOOL

I am interested in the application you showed, it reminds me of the STAR - SPIDER format and approach. I think there's a tool like this in forensic mental health - and no doubt other areas?

http://hodges-model.blogspot.com/2010/06/carers-support-evidence-measures-and.html

At some point Stefan it would be good to feature your image based tool when suitably complete on my blog; do you have a video at all?

HODGES MODEL

If anyone is interested in receiving more details on Hodges model please let me know. This model looks simple but it is really powerful in terms of scope and application.

...

FUTURE MEETING

Matthew mentioned the possibility of a small gathering combining mental health and Drupal. I'd be pleased to help with publicity - twitter, FB, Linkedin and the blog and have links with many other groups.

DRUPAL HEALTH GROUP

Here is the link to the health care Drupal group:

http://groups.drupal.org/healthcare

- note at the top the link to Drupal health care sites.

openEHR

Here is openEHR which I mentioned:

http://www.openehr.org

RDF and related

http://drupal.org/project/neologism

Lovely to meet everyone and really pleased to have the chance to share an hour (after the meeting) with Beatrice and Matthew. It is very good that mental health and disability came up at a Drupal meet. I hope to attend Drupalcon Munich so maybe there is scope for a BoF meeting in the summer?

<->

Shortly I'll post some additional observations by Matthew Taylor another participant. There I'll expand on my requirements and expectations of Drupal.

Drupal ScienceCamp Cambridge 20-21st Jan 2012

Two weeks ago Drupal ScienceCamp was a great success thanks to the organisers and sponsors. There were about 60 attendees with a European flavour too. Being a Science Park we had to circumvent the fence, the alternate access gates closed over the weekend. The three of us who left the hotel soon became six ... as we walked around to the very smart venue - Napp Pharmaceuticals Limited.

On the Saturday I attended sessions on responsive design, Drupal modules, Less CSS (at this point I wish I could have split in two Drupal search and Solr Wizardry had very positive comments), From flipcharts to Drupal Features, and Migration, upgrading and moving house. All very helpful.

Sunday was spontaneously self-organising. People offered to deliver sessions and meetings in a BoF - birds of a feather format, others requested the things they were seeking. Whether a sign of my time in Drupal [v. 4.7], or possibly Drupal's ever increasing diffusion or both; seven of us gathered around mental health and disability.
More on this to follow.  ...