Independent report - Ockenden review into maternity services at Nottingham University Hospitals NHS Trust

FINAL REPORT: 

'This independent review of maternity services at the Nottingham University Hospitals NHS Trust (NUH) considered the quality of care relating to newborn, infant and maternal harm at the trust.

This report covers the findings, conclusions and essential actions of this independent review of maternity services.

Based on a review of over 2,500 family cases that formed part of this investigation, the final report outlines:

• local actions for learning that staff at the trust must do
• system-wide learnings
• immediate and essential actions to improve maternity and neonatal care

The Independent Maternity Review (known as the Ockenden review) was led by Donna Ockenden and involved a multi-professional team of more than 160 reviewers. The review team held individual meetings with over 500 families, and more than 830 current and former staff at NUH engaged with the review.'

https://assets.publishing.service.gov.uk/media/6a3bb59c4c7605ab567238ec/ockenden-report-review-of-maternity-services-nottingham-university-hospitals-nhs-trust-e-lay.pdf

https://www.ockendenmaternityreview.org.uk/

individual

|
INTERPERSONAL : SCIENCES             

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

SOCIOLOGY : POLITICAL   

|

group

listening	Communication Processes  Health Systems
mothers families experience	LISTENING staffing funding

Previously: 'maternity' : 'risk' : 'safety' : 'compassion'

Auction: Twenty-two photographs of psychiatric patients at the Surrey County Lunatic Asylum [1850s]

DIAMOND, Dr Hugh Welch (1808–1886)

Twenty-two photographs of psychiatric patients at the Surrey County Lunatic Asylum [1850s]

Estimate - GBP 100,000 – GBP 200,000

Christie's London - December 10th 2025

https://www.christies.com/en/lot/lot-6564110?ldp_breadcrumb=back

Asylum patient by Hugh Welch Diamond, c1850-58
Hugh Welch Diamond (English, 1808-1886)
Public domain, via Wikimedia Commons

'The women Iook out at us across 170 years of history with a variety of expressions - bold and shy, serene and distressed. Yet all of them were regarded at the time as "lunatics". These faces were the  subjects of a pioneering project by the 19th-century psychiatrist Hugh Welch Diamond, superintendent of the female division of an asylum in London and the world's first photographer to take pictures of patients for the purpose of diagnosis and therapy.

Twenty-two of Diamond's asylum portraits - the largest surviving group - will be put up for auction on December 10 at Christie's in London, as part of a sale of books, manuscripts and photographs from the library of The Royal Society of Medicine. If they achieve their estimated prices, RSM, a membership charity, will raise more than £2mn to invest in physical and digital infrastructure.' ...

'Diamond was working at a time when society's views of people suffering from mental illness were changing. The earlier practice of shutting patients away in secure "madhouses" was giving way to more humane treatment. Diamond seems to have believed that photography would help doctors both to diagnose and to treat patients. His diagnoses were based partly on the idea, popular in Victorian medical circles, that an individual's physiognomy - their physical features, particularly the face - could reveal their mental state.

"He wanted to make people better and put them back into the world," says Sharrona Pearl, a medical historian at Texas Christian University who has studied Diamond's work. "He also enjoyed experimenting and liked the idea of bridging his expertise in medicine and photography.' p.32.

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group-population

Mental Illness PERSON - SUBJECT Patient's names not recorded Portrait - Consent?	Diagnosis and Treatment person - DATA - SUBJECT Photography as records Eagerness to classify - label
Social history Change in social attitudes Stigma and fear of mental illness Current relatives?	Confidentiality Institutional change Power imbalance Shift from 'custodial' to health care

My source:
Clive Cookson, Mind Hunter, FT Magazine, November 15, 2025, 1151, pp.30-34.

I have noticed Prof. Brendan Kelly is a regular FT respondent, as with this article:

'These photographs were likely to have been taken without meaningful consent and in the context of power imbalance. Yet publication can reclaim their individuality, address historical injustice and underscore our common humanity. Compassion, respect and humility should guide decisions. 

 Proceeds should support medical, educational, or justice-oriented programmes. Most importantly honouring forgotten patients of the past demands better care for people with mental illness today, who often languish, neglected, in homeless hostels or prisons. We can do better.'

Brendan Kelly Professor of Psychiatry, Trinity College, Dublin, Ireland.

Letters, FT Weekend. 22-23 November 2025, p.10.

See also: 'asylum' : 'photos'

NW England: NIHR Health & Care Professional (HCP) Internship Programme 2026

Dear CHAIN member,

We would like to draw your attention to the following opportunity. Please pass on as appropriate. Thank you.

NIHR Health & Care Professional (HCP) Internship Programme 2026

Are you a Nurse, Midwife, Allied Health Professional, Pharmacist, Healthcare Scientist or working in Social Care, Social Work, looking to embark on a practitioner research career and make a difference through undertaking high quality research?

Do you have the drive and ambition to be a future research leader?

NHS R&D North West is pleased to announce that alongside its regional partners from NHS Trusts, Professional Networks and HEIs it will be delivering the NIHR Health and Care Professional Internship Programme across the North West Region of England in 2026.

There are 23 places available on this highly prestigious 12-month programme providing predoctoral tailored and bespoke learning and development to the full range of health and care professions (not including doctors and dentists) across the full range of research related career aspirations i.e. from a desire to increase research awareness within clinical practice up to and including providing individuals with a strong foundation on which to build a research related career.

The internship provides a funded opportunity for early career health and care researchers with dedicated time away from their substantive role to engage in research-based activities.

Closing date for online applications, 5pm 19th December 2025.

For more details please see:
https://research.northwest.nhs.uk/our-work/nihr-health-care-professional-hcp-internship-programme/

Regards,

Irina Johnston

CHAIN Administrative Assistant

If you wish to publicise information on the CHAIN Network please email your request to: 

enquiries AT chain-network.org.uk

CHAIN - Contact, Help, Advice and Information Network – is an online international network for people working in health and social care. For more information on CHAIN and joining the network please visit website: www.chain-network.org.uk

Follow CHAIN on X: @CHAIN_Network ; Connect with CHAIN on LinkedIn

Report: Hospital at Home for frailty ...

 .... Current situation and future potential

Report: Hospital at Home for frailty

The BGS has produced report on Hospital at Home services for older people. This explains how they are currently provided and how they might develop in the future as a key part of community-based healthcare. The report is endorsed by the UK Hospital at Home Society.

Hospital at Home is a safe and effective alternative to acute hospital bedded care for people who are sick enough to be in hospital.

Hospital-level care provided at home means people living with frailty are not exposed to some of the risks arising from long stays in hospital, such as infections and deconditioning.

There is mounting evidence for the effectiveness of Hospital at Home services, which are greatly valued by those who use them. With 35,000 people a year benefiting from this alternative to hospital in England, further development of Hospital at Home should be encouraged as a key part of the Government’s ‘left shift’ from hospital to community.

continued ...

My source:
https://x.com/GeriSoc/status/1965676874111037547

Consultation: Community Mental Health Services [ UK Parliament ]

Source: Health and Social Care Committee, House of Commons, London, SW1A 0AA

'Community Mental Health Services

Inquiry

The Committee is undertaking an inquiry into community mental health services. The inquiry will examine what good looks like from the perspective of service users and their families/carers. The Committee would like the inquiry to shine a light on case studies of innovative practice and high-quality care across the country, and to undertake meaningful and impactful engagement with people accessing these services. 

The inquiry will consider how service users’ wider health and social needs can be addressed, including in employment and housing, and to understand what policy interventions are required to improve how these needs are met. As part of this inquiry, the Committee also wants to assess to what extent the Community Mental Health Framework is driving improvements in the delivery of more integrated, person-centred care. 

This inquiry is focussing on adults with severe mental health needs in particular, which includes but is not limited to people with bipolar disorder, schizophrenia and severe depression. The Committee recognises the scale of the challenge in children and young people’s mental health, and plans to do further work in this area in due course, building on its predecessor Committee’s 2021 inquiry. 

In line with the general practice of select committees, the Health and Social Care Committee is not able to take up individual cases or complaints. If you would like political support or advice you may wish to contact your local Member of Parliament.

This inquiry is currently accepting evidence

The committee wants to hear your views. We welcome submissions from anyone with answers to the questions in the call for evidence. You can submit evidence until Tuesday 4 February 2025.' 

Read the call for evidence before submitting:

https://committees.parliament.uk/work/8755/community-mental-health-services/

Consultation: CHANGE NHS

 
Our NHS is broken, but not beaten. Together we can fix it.    [ c/o https://change.nhs.uk/en-GB/ ]

The NHS has been there for us for over 76 years. But to make sure the NHS is here for the next 76 years, doing all it can to support the health of everyone, we need your help.

We want to have the biggest ever conversation about the future of the NHS.

It doesn’t matter whether you have a lot or a little to say. Your views, experiences and ideas will shape a new 10 Year Health Plan for England. 

This is open to everyone. If you are a member of the public or someone who works in health and care in England, 'Start Here', to tell us how the NHS needs to change.

If you are contributing as a representative of an organisation, complete the organisation questionnaire. This is an early opportunity to share your insights as we begin an extensive programme of engagement to develop the 10 Year Health Plan. 

If you register your email address, we will stay in touch to seek your views as the 10 Year Health Plan develops.

[video no longer available]

'change' in Hodges' model

The NHS and people's health is more than 

a machine, more than a mechanistic thing 

that if broken can be fixed.

By definition you cannot be 'inclusive'
if you do not achieve balance
with the humanistic; and the
values of humanity and
 the spiritual as per context.

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

purposes person-centredness personalised care experiences continuity mental state; mental health attitudes - mindset expectations (public education) my health literacy (all of them: education)	processes (care inc. 'writing' records, 'gates' access) demographically-driven care  define 'success' - metrics - data utilise evidence peak CO2 peak obesity physical health: chronological age - pathological age encourage self-care to support sustainability
social care social attitudes child support - support for families proven practices that delivers community as resource community: homes for living in - not profiting from Public involvement:  #NHSCHANGE #CHANGENHS Protect / Create green spaces for outdoor play	funding, finance, budgets, economics POLICY: FROM: National ill-Health Service TO: National Health Service  long-termism E3^ for all the literacies address: food quality,  air, water, noise, litter SOCIO-tech approach to applied technology Teach Hodges' model to teens, and prisoners as part of PSHE and rehab programmes

E3^ education, education, education - by literacies we include: information, emotional, media, finance, spiritual, cultural, scientific, religious, climate...

'delivers' includes: improved care experiences, integrated care (related to all the domains), patient, carer, public safety, cost effectiveness, research questions, accurate - valid reporting.

All health disciplines / professionals, social care, and APPGs ... share a common model - a conceptual framework for critical thinking and reflective practice.

A Workforce Strategy for Adult Social Care in England

"For the first time ever, the adult social care sector has come together, led by Skills for Care, to develop the Workforce Strategy it needs. Adult social care needs a workforce strategy to ensure we have enough of the right people with the right skills to provide the best possible care and support for the people who draw on it. 

Development of this vital Strategy has been truly collaborative and it could not have been developed without the expertise, time and commitment of many stakeholders."

Estimated number of adult social care filled posts by individual job roles

Individual

|

      INTERPERSONAL    :     SCIENCES                   

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

Job satisfaction Personalisation - Belongings Motivation Attitudes, Opportunities, Incentives Access to Training	Activities, Reablement Arts, Dance, Music Dental and other services Systems view - Demographics Collaboration / Liaison
Social Care: At home & residential care Job status Local community, schools Funding of Social Care Integrated & Person-centred Care	Workforce strategy Pay - terms and conditions Government policy Workforce recruitment & retention: National - International

Source: Email - Skills for Care and BBC Radio 4 Today.

Paper: Florence Nightingale and J.S. Mill Debate Women's Rights

EVELYN L. PUGH

"In Florence Nightingale's correspondence a series of letters to and from
J.S. Mill treat a different subject than her usual correspondence with
government officials, health and sanitation reformers, and hospital
administrators in many parts of the world. Although it was never her
intention when she initiated the exchange of letters, she and Mill quickly
became involved in a controversy concerning the role of women.

Interwoven with some religious and philosophical matters, the
Nightingale-Mill correspondence which falls into two periods, 1860 and
1867, is essentially a debate on women's rights. One debate concerns
terminology and hinges on the entire validity of the question of publicity
for the women's movement, then in its infancy, as well as the opening of
the medical profession to women. The other focuses on differing percep-
tions of the role of women in political action. The exchange never became
public during the lifetime of the participants, emerging with little notice
only in the twentieth century with the complete publication of their
correspondence in the journal Hospitals in 1936.¹"

  Self - INDIVIDUAL - Person

|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC -----------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

Community - Group - Population

thought belief logic, philosophy, ethics 'duty' dichotomy of thought	action active-passive medicine scientific progress 'professions' theory of feminism
social and economic history social progress role expectations publicity public awareness	politics nascent political movement women's rights law 'duty'

 

¹"Florence Nightingale as a Leader in the Religious and Civic thought of her Times,"
Hospitals, X (July, 1936), 78-84. There are a total often letters, five from each, in the correspon-
dence. Three of Mill's letters to Nightingale, with some omissions and two of them identified
only as "To a Correspondent," were published in Hugh S. R. Elliot, Letters of John Stuart Mill,
(London, 1910). Some of her letters to him with portions of his replies were published in Sir
Edward Cook's official biography, Life of Florence Nightingale, (London, 1913). (The edition of
Cook used in this essay is the 1914 printing).

Pugh, E. L. (1982). Florence Nightingale and J.S. Mill Debate Women’s Rights. Journal of British Studies, 21(2), 118–138. http://www.jstor.org/stable/175536

 

A window on social history ...

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

Ask a child to draw a house ..?	Light Air*
A row of coal miners' houses with no windows to the street, Halifax, 1937 by Bill Brandt	HUMAN RIGHTS

 

Source:

A row of coal miners' houses with no windows to the street, Halifax, 1937 by Bill Brandt. Nostalgia is a seductive liar. pic.twitter.com/zrpzQySRjt

— Davenant 📸 (@MarcDavenant) March 29, 2021

 

https://www.billbrandt.com/bill-brandt-archive-print-shop/sp03-coal-miners-houses-with-no-windows-to-the-street-c1937

*and its quality

Fortress of the Mind :: Fortress of Slavery

From 16 May – 5 July 2020
 Gallery 1957 
Accra, Ghana 
will present

“The Past is Never Dead”

 a solo exhibition by Langlands & Bell that explore 
the architecture of the ‘Slave Forts’ built on the coast 
of Ghana by European slave traders following the construction
of Elmina Castle by the Portuguese in 1482.
Langlands are working with local artisans to produce
 many of the art works for the exhibition.


INDIVIDUAL

|

INTER-PERSONAL : SCIENCES

HUMANISTIC -------------------------------------------------- MECHANISTIC

SOCIOLOGY : POLITICAL

|

GROUP

individual resilience FORTRESS of the MIND ?
	English Fort Komenda, 1695 (2019), Langlands & Bell.   Courtesy the artists and Gallery 1957

My source:
Christopher Turner (in Accra), 'The dungeons are decorated with wreaths left by slaves' descendants', Letters. Apollo, November 2019. Vol CXC No. 680. pp.33-34.

"Bleak House" - not just a book: Family Homelessness

individual - home?

|

INTERPERSONAL : SCIENCES

humanistic - HOME? ----------------------------------------------- mechanistic - HOME?

SOCIOLOGY : POLITICAL

|

home? - population

"Bleak House" - a work of fiction ... Charles Dickens - Bleak House	"Bleak Houses" - a work of Government ... Bleak Houses - Report

See also:
The Stranger in the Mirror in Bleak House

Book cover - Waterstones

My source
Radio 4 and BBC 2 - Newsnight

"Bank of England shows green light for mental health drive" c/o The Times

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

Mental Health Awareness Week
	Mental Health Funding Mental Health Green Paper Mental Health White Paper Recovery Space

See also:
Money and Mental Health

My source: Green light for mental health drive, The Times. 14 May 2018, p.36.

... back to Drupal! ;-)

The Socio-Politics of Migration...?

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

Julian Simpson (2018) Migrant architects of the NHS - South Asian doctors and the reinvention of British general practice (1940s-1980s). University of Manchester Press.

Alex Matthews-King. The Independent, Jeremy Hunt backs special visa for foreign people coming to work for NHS. 9 May, 2018.

My source (book): Noted in Blackwells, Manchester, £25 from £75.

Person-centred care [PCC]: is it really happening? c/o National Voices

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

PCC = what’s important to the individual, is co-ordinated around their needs and involves them in decisions. "To be person-centred, that care needs to work together to wrap around all the needs of the individual in a holistic way. Sadly, our report found that neither the NHS nor adult social care can demonstrate co-ordination of care, despite ‘integrated care’ being a key goal of all national and local leaders over the past five to 10 years. The way health and care services work must change to reflect the needs of the population. It would be a start to recognise that co-ordination of care is an important factor, and that we need to be measuring whether it is happening."	(many) Definitions = 5 key indicators of pcc:  good information, good communication, involvement in decisions,  care co-ordination  and care planning. Service user reported data from 19 nat. surveys NHS:  in primary care, only 39% of patients said their GP was ‘very good’ at involving them in decisions. What’s more, personalised care planning doesn’t really happen. Only 3% of GP patients with one or more long-term conditions reported having a written care plan, suggesting that opportunities to deliver personalised care in the NHS are being missed.
"Personalisation of care is more advanced in adult social care than in the NHS, with 89% of adult social care users reporting that the care and support they received helped them to have control over their daily life. Similarly, 63% of people using a social care personal budget said that this had improved their ability to make everyday decisions. Participation and control of decisions is well-established in adult social care, with just over 90% of those using community adult social care saying they were involved in decisions about their care and support needs." (See original post - report for important additions)	20+ years policy  England Care Act 2014 National Voices coalition of health and care charities  report ‘Person-centred care in 2017' No National data on this... "It is clear from our report that a strategic overhaul of how care is measured is needed. Rather than single-service, single-setting, activity measures, more credence needs to be given to the experiences of the people who rely on services. Only then can we help local systems succeed in offering personalised, integrated and holistic care. Whilst there have been some advances in the delivery of person-centred care, there is still a long way to go before the policy rhetoric matches the reality experienced by people."

Quadratic Social Erosion..?

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

(a) lived experience	mobility
SOCIAL MOBILITY	SOCIAL MOBILITY COMMISSION

Please see (for context):

BBC News

Social mobility board quits over lack of progress

"Mr Milburn, a former health secretary, took up his role at the commission in July 2012, under the coalition government led by David Cameron and Nick Clegg.Speaking on the BBC's Andrew Marr Show, he said divisions in Britain were becoming wider - pointing to the ongoing squeeze on wages.
The government lacked the "bandwidth" to tackle social division while also dealing with Brexit, he said, describing his task as being like "pushing water uphill". [My emphasis]

As can be seen, in broad terms, above, Hodges' model can help to promote awareness of holistic bandwidth, facilitating reflective practice, critical and transdisciplinary thinking and person-centeredness. Social mobility is clearly sociopolitical.

Stamping about the world and Hodges' model

I don't know if they say things about stamp collectors but there's one over here. In mitigation I'm of the dormant type, it's more about buying gifts for junior family members. Things to keep if the recipients are minded to. Over the years stamps have taught me a great deal: the rise plateau and fall of an empire; the changing face of Africa and the 'Rest of the World', the politics of the world and the truth and lies behind geographic projections. Like painting, drawing and other possibilities the stamps are there, imprinted on my brain as a possible thing to do.

As a mental health nurse I've come across many people (demographically predictably usually males) who have planned for retirement for quite a while and then when it happens the impact is a psychological sledgehammer. While it's also surprising to learn of the people who do not have any interests, you can also see how trite, inappropriate, insensitive ... the question of "Do you have any hobbies?" can seem.

That's because when you listen and hear:

the harried, hesitant, hopeless bound accounts of not knowing who is looking back in the mirror in a morning. Why am I standing there at all? Walking the dog, whatever the month, you see the crucial umbilicus is failing. The one that connects me simultaneously to myself, others, the world at large and joie de vivre:

then you know.

Then you listen and watch for the positive change working with colleagues. You look for the chinks of light that might show the darkness is perforating and the light shows through. Maybe then there is promise in hobbies and interests of all kinds. Keeping mind, spirit and body active, alive. 

Maybe though - it is just being able to be once again.

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL
|

group

Dr. Arieti, Italy, pinterest.ca	Einstein, stamp, ebay.com
Australia, Community, Stampgallery	UN Stamp: End Violence Against Children unstamps.org

Self-determination: individual - group (high-low) resolution

individual
INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

group

	Border Binary Decision
magnanimity

Image sources:
"Flag of Scotland (Union Jack colours and proportion)" via Wikimedia Commons.
https://commons.wikimedia.org/wiki/File:Flag_of_the_United_Kingdom.svg

Launch of the National Care Service in England

Source: Department of Health, 30/03/2010

In the biggest change to the welfare state since the creation of the NHS, everyone who needs care when they are old or disabled will get it for free, Health Secretary Andy Burnham announced today as he launched the National Care Service in England.

The National Care Service will be based on a principle of shared social insurance and will be funded by contributions from everyone in a fair way. The National Care Service will ensure people get high quality care when they need it and it will give peace of mind that savings and homes will be protected from the expensive care costs that arise from serious long term conditions, such as Alzheimer’s or recovering from a stroke.

Andy Burnham said:

“Today we are launching a National Care Service that is fair for all, ending the cruel care lottery we have today. Like the NHS, everyone will contribute and everyone will get their care for free when they need it. This is the biggest change to the welfare state since 1948 and, like the NHS, it’s going to take time to build.

“The National Care Service will mean that people will be treated with dignity and respect, people will have control and choice over their care and they will be helped to stay in their homes for as long as possible. People who have to live in residential care will, from 2014, get their care for free after two years and there will be more help to pay the residential costs.

“We’re not replacing the millions of carers or families who look after each other. They are the underlying principle of the National Care Service and we will better support them.

“We’ve already laid strong foundations through reforms over the past few years. But, with an ever growing older population – there will be 1.7 million more people needing care in the next 20 years – we must radically overhaul the way care is paid for and provided.

“I feel very strongly that this is a responsibility we must all help to shoulder. And it’s clear from what we have heard from the thousands of people who have given us their opinions on this over the past twelve months, that people agree. That’s why we know that the fairest way to help everyone who is affected by a serious disease, illness or disability is for us all to pay into a system so we get free care when we need it.”

The cost of care is currently a cruel lottery. No one has any way of knowing how much care and support they may need in the future. A 65-year-old can expect to need care costing on average £30,000 during retirement. However, some people, for example people with severe dementia, could end up needing care costing as much as £200,000.

The National Care Service will put an end to this unfair system. It will be built on strong foundations of recent reforms and will overhaul the way care and support is paid for and provided. It cannot be built overnight and will be phased in three stages:

Stage One
• Build on the best of the current system through reforms that are already underway and deliver the Personal Care at Home Bill.

Stage Two
• From 2014 extend the coverage of free care so that people will receive free care if they need to stay in residential care for more than two years.
• Set up a commission to support consensus and advise the Government on the fairest and most sustainable way that people can make their contribution to a care system which is free when they need it.
• Set up a National Care Service Leadership Group of expert stakeholders who will advise Government on the implementation of the National Care Service, focussing on the systems and business processes that need to be put in place to make the National Care Service a reality.
• Introduce a National Care Service Bill to set the legal foundations of the National Care Service.
• Enshrine in law for the first time nationally consistent eligibility criteria for social care helping to remove the postcode lottery of care that exists now
• Push forward with the prevention agenda and continue the drive towards personal budgets so that by 2012 everyone who would benefit from a personal budget will have one.
• Ensure accurate, relevant and accessible information about what people are entitled to, how the assessment process works and how to access care services is provided to everyone.
• We want to improve the gateway for accessing social care and disability benefits to make simpler and easier for people.
• Introduce a quality framework including a body to drive up quality in social care.

Stage Three
• The introduction of a comprehensive National Care Service that is free when they need it for all adults with an eligible care need, funded by contributions.
Following the biggest ever consultation on care and support that saw over 68,000 members of the public, carers and representative organisations have their say, it is clear that people believe it is right that everyone should contribute to a care system that is free when people need it– similar to the NHS. However, the necessary consensus on how people should pay into such a system has not yet been reached. A National Care Service Commission, will therefore be established to advise Ministers on the fairest and most sustainable way for people to do so.

Care Services Minister Phil Hope said:

“We must find a fair way of funding the National Care Service. The stakes are very high. That’s why we must have a clear consensus. We are setting up a commission to tell us what would be a fair way for everyone to pay into this new system.

“Everyone will pay into it in a fair way and in return everyone will then have peace of mind that their savings and homes will be protected from high care costs. The whole of society will benefit and the National Care Service will support individuals and families for generations to come.”

The National Care Service will have six founding principles. It will:

1. Be universal – supporting all adults with care and support needs within a framework of national entitlements.
2. Be free at the point of use – based on need, rather than the ability to pay.
3. Work in partnership – with all the different organisations and people who support individuals with care and support needs day-to-day.
4. Ensure choice and control – treating everyone with respect and dignity, ,putting people in charge of their lives.
5. Support family, carers and community life – recognising the vital contribution families, carers and communities play in enabling people to realise their potential.
6. Be accessible – easy to understand, helping people make the right choices.

Contacts: Department for Health Email: NDS.DH at coi.gsi.gov.uk

Additional links:

DoH: 30 March 2010, The White Paper, Building a National Care Service

The Big Care Debate

Prime Minister’s Commission on the Future of Nursing and Midwifery in England – 2010

Earlier in March The Prime Minister’s Commission on the Future of Nursing and Midwifery in England published its final report.

You can download the report in full.

Box 3.1.2 (on page 43) features key statistics on nursing and midwifery:

• In 2009 there were nearly 595,000 RNs on the register residing in England, 77% of them registered in the adult nursing branch.
• In 2009 there were over 31,000 RMs on the register residing in England.
• Nine out of 10 of RNs in England are female.
• There are disproportionate numbers of men in more senior nursing positions and certain specialties: a third of mental health nurses, for example, are male.
• Nearly all RMs in England are female. There are 131 male midwives.
• Well over half the RNs and RMs working in the NHS in England (57%) are aged between 35 and 54, with less than 3% under 25. Almost 70% of RNs and RMs on the NMC register in England are aged 40 and over.

Reporting on the Commission's report the RCN Bulletin (10 March) notes the need to encourage more men into the profession and people from black and ethnic minority groups. As the list above highlights, however - There are disproportionate numbers of men in more senior nursing positions and certain specialties: a third of mental health nurses, for example, are male.

From my early nurse education days (especially from mental health to general nursing) you had no choice, but be aware of gender and just w(h)ere you had landed. Upon my first encounter with Hodges' model, the model stood out in the list of theories and models of nursing.

It was not listed on the original nursing theory website.
(Hence, the initial website project)
The majority of models and theories were created by women and outside England.#

The future of nursing depends on successfully addressing* the numbers: totals, proportions, recruits, retirees*. ... We can use the numbers, quality, safety and I have to say - Hodges' model to help craft the creative and innovative messages needed. We really are in for a fascinating and exciting 20-30 years in nursing; here in the UK, EU and Internationally.

* Note the use of 'addressing' not balancing - that's why this is also challenging.
# This is not a complaint, just an observation.

Long Man of Wilmington

Although Brian Hodges created the model in the 1980s the key elements have been around a long time!


Thanks to the Culture Show BBC2 27 Oct 2007