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From Harriet Ruysen - Harriet.Ruysen AT lshtm.ac.uk

The Times: Education Commission

"An education commission is being set up by The Times that could lead to radical change across schools and universities.

It brings together experts including senior MPs, head teachers, academics, vice-chancellors and a children’s author who will work on the year-long project that is expected to inform government policy. They say school closures during the pandemic and the resulting surge in online learning have provided the perfect opportunity for an overhaul of the system to be considered."

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

Lifelong Learning (Attitude (cognitive access)) Knowledge & Skills (Purpose of education) Critical thinking, Problem Solving, Reflection	Curriculum New Technology (Anticipating AI & Robotic Process Automation) Lifelong Learning (Physical access, Technology Enhanced Learning)
Lifelong Learning Social mobility (Social access) Exclusions Social skills How many forms of 'literacy'? Team work / Collaboration Challenge social gender stereotypes	Lifelong Learning (Policy, Economic access) Government policy - Work creation University entrants - nos. Exams? Curriculum 21st Century Qualifications Still the 'Two Cultures'?

My source:

Woolcock, N. (2021) Push to give children a better start, The Times, March 24, p.4; The pandemic has exposed weaknesses in education, leading article, p. 27.

https://www.thetimes.co.uk/article/the-times-education-commission-children-better-start-lockdown-5bvf2bhwm

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.

The Willis Report on Nursing Education [ III ]

See also:
The Willis Commission on Nursing Education [i]
The Willis Commission on Nursing Education [ii]

Having related (in part ii) some of the skill sets within the technical papers to Hodges' model what next? Well, instead of the 2x2 table, below I've included a screen capture of the quads page [no longer available]. This indicates the potential conceptual scope of the four care domains of Hodges' model. If the skill set listing by Watts and Gordon (2012) is succinct, the quads page is anything but. It might however drive home, the need for the Willis report and the educational challenges for nursing and other healthcare disciplines. Another common element here with Willis' findings are some of the original purposes that Hodges' model can address:

• the theory - practice gap (Watts and Gordon, 2012, p.7)
• curriculum development 

Just for the moment imagine picking up the curriculum? Yes, picking it up; all of it.
Can you feel it? Can you? OK well, try this (odd - Find Wally-like?) exercise:

1. Visit the quads page.
2. Print the page (in black and white).
3. Make a cup of your preferred beverage.
4. Cross out what in your opinion is NOT part of the nurse curriculum.
• Most of these items are learned through our being socialised and during formative education (when available)?
5. Outcomes are certainly in vogue, so what are yours in completing steps 1-4? Any surprises, frustrations; did you find the plumbing - kitchen sink and all...?
6. If you feel there is something - important - missing please let me know.

individual

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

group

Former web page - Indicative content of Hodges' model

You have to hand it to educationalists and policy makers who wrestle with curricula. The very word could almost be some disorder of the posture, such are the contortions the curriculum demands. What to include, what as a consequence to remove. One thing not included in quads.htm is the hidden curriculum. Additional complications are no doubt many; I'll add just one. Such are the recruitment challenges that a Trust setting out to train their own student nurses, that is through non-Health Education England places (Hazell, 2015).

The word 'innovation' is all over the media, the HSJ, and this blog. As I read the recommendations of Willis (see emphasis in first post), the technical papers and Hodges' model I can't help but wonder about history and the potential here - and now. Especially in terms of supporting learners in their acquisition, practice and delivery of compassionate care or caring behaviour.

View the full report here (1,105kb)


Hazell, W. (2015) Lancashire trust to train its own nurses, Health Service Journal, 16 January. 125:6430, p.15.

Hazell, W. (2015) First self-funded nursing course launched to tackle shortage in NW, Nursing Times, 7 January.

The Willis Report on Nursing Education [ ii ]

The Willis Report -

https://www.macmillan.org.uk/documents/newsletter/willis-commission-report-macmail-dec2012.pdf

includes a series of technical papers one of which Pre-registration nurse education: Overview of themes from literature 2010-2012 outlines Skill Sets. I could relate Hodges' model to the identified skill sets in this paper using the 2x2 HTML table, but perhaps there's another way by considering the skills sets:

• ICT skills/health informatics 
• Literacy and numeracy skills
• Life support and airway management 
• Infection prevention 
• Genomics
• Bioscience 
• and Learning disabilities

Using these I can also explain how they both help and hinder the case for Hodges' model and illustrate the complexities of nurse education.

The subjects of genomics and bioscience can be placed quite reliably in the sciences domain. Life support and airway management are pretty explicit in their physicality. In an emergency you need to act. The individual's physiological (mechanics) functioning is compromised. This must be assessed urgently and compensated for. The model was also created with people living with learning disability very much in mind; consider the reference to the individual, the family, the increasing relevance of the POLITICAL domain to this client group and their families? ICT skills are primarily directed at intrapersonal knowledge and skills, physical and virtual spaces, drawing on the sciences. These domains are the preserve of the individual, in terms of learning, experience and sense making.

The biggest challenge for Hodges' model is context. Context is rarely rectilinear, try as we might it springs out of the intended boxes and categories we try to stuff it into. We very quickly have to acknowledge the social and political dimensions of ICT skills and health informatics. For example, the importance of information governance, confidentiality, legislation, policy and training provision. Returning to the learning disabled individual, they must contend (often as a community) with ongoing social stigma and the socio-political matter of having access and opportunity to education, buildings, facilities and technologies. Access then is not just a matter of cognition and physical mobility, movement and proximity.

If Hodges' model encourages us to place concepts in boxes

(the care domains)

 it also forces the realisation of the need 

to think outside the box. 

To relate, to associate with the domains adjacent - 'next door'. Ultimately can we integrate the care concepts providing a conceptual scaffold for person-centred, holistic care? There is in effect a cognitive rule, a heuristic - that is not necessarily very expensive cognitively or temporally, but can (I believe) pay huge dividends in assuring the quality of care. It runs as follows:

For any given care concept in learning

 consider how it applies and relates 

to each of the care domains.

See also:

The Willis Commission on Nursing Education [i]
The Willis Commission on Nursing Education [iii]

The Willis Commission on Nursing Education [ i ]

from the commission website:

The Willis Commission has now published its full report into the future of nursing education.

See the key findings from the report below (with my emphasis)

• Patient centred care should be at the heart of all pre-registration nursing education and continuing professional development.
• There were no shortcomings found in nursing education that could be directly responsible for poor standards of care or a decline in care standards.
• Nurses and their organisations must stand up to be counted on the challenge of poor care and loss of public confidence in order to restore professional pride.
• Nursing education needs to imbed patient safety and dignity as a top priority.
• Better evaluation of and research into nursing education programmes is necessary to ensure a programme that is fit for purpose.
• The future nursing workforce requires nurses to work in a variety of settings.
• Recruitment campaigns need to widen their diversity in order to encourage the widest, best possible range of applicants.
• Health care service providers must fully support nursing education.
• Universities need to recognise nursing as a practice and research discipline.
• Attention needs to be paid to developing a strategic understanding of the nursing workforce as a whole and as a UK-wide resource.

View the full report here (1,105kb)


Previous posts:
The Willis Commission on Nursing Education [ii]
The Willis Commission on Nursing Education [iii]

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.