Dear Editorial Office,

Dear Dr. Jones,

My name is Editorial Office, and I am writing on behalf of the selected journal. I came across your article, "A Conceptual Mapping Exercise of Deprivation of Liberty Safeguards in Residential & Community Care Using Hodges' Model and Threshold Concepts". Its focus on deprivation of liberty safeguards, Hodges' model, older adults caught our attention. I would like to invite you to consider a new and unpublished contribution to the selected journal.

For this invited contribution, we are pleased to offer a Full APC Waiver. Invited manuscripts receive priority editorial handling, and we aim to provide an initial editorial decision within one week. This invitation does not imply acceptance, and editorial standards remain unchanged.

If you are interested, a working title or short abstract is enough for an initial discussion. If your current work is not closely aligned with this journal, you are also welcome to share your present research topic and we can check whether another journal in our portfolio may be more suitable.

I would be glad to answer any questions and look forward to hearing from you.

Best regards,
Editorial Office
the selected journal

Dear Editorial Office,

Re. 'the selected journal: Invited Contribution – Full APC Waiver'

Thank you for your communication and recognition of my recent paper.

Unfortunately you have not specified the 'selected journal'. Without this detail it is difficult to proceed at all, or ascertain what benefit is provided by the 'full APC waiver'. 

I am more troubled, however by your name. Is it really 'Editorial Office'?

Again the specific journal matters here. If it is materials science, chemistry, or quantum physics or related this is (slightly?) less of a problem. Otherwise, I do worry that with Hodges' model being person-centred your being de-personalised does not sit very well with the purposes and values of Hodges' model.

It is however reassuring to learn that I should not take your invitation to suggest acceptance, and that accordingly your editorial standards remain intact - especially in these times.

Again, even if I were interested, I am at a loss to provide either a working title, or abstract.

I do hope you understand my difficulty? 

Although perhaps I ask too much.

Can it be - this IS in fact the journal?

'The Selected Journal'?

Yours Faithfully,

Mr^ P Jones

^'Conceptual Surgeon' 4th class

(and not sent.) 

iii 'Our Housing Disaster'

'Our Housing Disaster'
Image: Goodreads

Here on W2tQ many posts have referred to 'common sense' over the years. Apparently, there is no such thing - which may be another blog post).

https://www.psychologytoday.com/gb/blog/too-many-goals/202005/theres-no-such-thing-common-sense

In 'Our Housing Disaster' Julian Richer is simultaneously analytic in identifying problems and potential solutions, logical and to me commonsensical. There is a need for debate and decisions at a political level. Residents, must also be involved, have a say. Chapter 10 lists shorter-term actions and longer-term. 

The history of this disaster is tackled in chapter 3. Chapter 4 links very well explaining the rise of renting. If there was ever to be another edition - which the book and issue well-deserve; it would be good to a nod to evidence-based housing policy? This is suggested, as is integrating the many threads of housing; work, transport, infrastructure, shops, water and services. I've posted here about the number of All-Party Parliamentary Groups and talk of joined-up government. Housing is anything but joined-up. You could argue all MPs and Lords should read this book. 

Overall, the book is well produced, the text very readable, large size and well laid out. The 'references' for each chapter are in the form of links. Needless to say, I have only tried a few. The book seems smaller - narrower than a standard paperback, so may have fewer words / line. For posts i & ii, I extracted text from photos, which is a challenge without stressing the book's spine (as I've written before no doubt, I'm squeamish when it comes to books).

In the UK, the Right to Buy and Help to Buy, have long been a feature of housing policy. Of Help To Buy, it has 'cost taxpayers £29 billion in cash terms by 2023' (p.45) and has additional consequences. Milton Keynes is the 'right-to-buy-to-let' capital of England (2017, p.48). Surely, it is time to move on -  and quickly. The history of how we got here is fascinating, like a slow car-crash with critical events that accelerated the inevitable. Taxpayers and citizens all: we have missed out. There is mention of preventing corruption (but yes, more effort on money-laundering and tax evasion please!). The need for buildings inspection, standards of construction and materials and responding to the climate crisis and high energy costs are also stressed.

Richer's stance is tempered, and sets an effective tone. He is not preaching, even as he points to land owned by the Church of England. I remember the NHS selling estate, and yet there is more. While the book is not long, an index would help. I like the final summarising and concluding sentences for each chapter. Physically, they are bound to be there obviously, but there's a welcome sensible thread to these imho. With an index, perhaps I could check back to look up 'productivity, reduced', a problem that has plagued the UK economy. To what extent does housing contribute to this now; since the 1960s? The King's Fund and many other organisations and commentators advocate daily for social care. While it is acknowledged, social care is not one of the government's 5 key 'missions', and now (5th Dec.) there are milestones. Richer refers to the problem of bed-blocking in the NHS, and the need for suitable future housing so older adults can continue to 'live' in their homes.

So often in health we are taught, and learn to assess, plan, intervene, and evaluate a person-centred set of needs, a patient's needs, and a carer's needs. It is welcome to see a collective - population-based focus on needs. The book delivers on the title. So there are no details of nations (or cities) that have a  much better housing system and controls. Over the years it's been interesting and encouraging to read about Vienna in the FT. Below I have mapped/associated selected concepts to the care / knowledge domains of Hodges' model:

INDIVIDUAL

|

INTERPERSONAL : SCIENCES              

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

SOCIOLOGY : POLITICAL   

|

GROUP

psychological security mental health 'my' home, my space identity peace of mind when costs met facilitate well-being memories LAND - the 'hope' value sense of continuity / permanence children being safe making friends access to 'GREEN' spaces my life course - personal history Cognitive assurance: my area - family & friends / pets /school / work - attachment	LAND - UK geography physical shelter physical health (NO damp, mould, noise...) House building targets/programmes my space/room having an address - identity displacement public/environment health eviction house building - infrastructure land - costs transport links bed-blocking in hospitals Climate Change
place to make a home raise a family belonging sense of community friends & neighbours  anti-social behaviour by tenants social care - older adults social care disabled access to work, schools resources to service a community lack of spare capacity to support people & families in need/crisis	the economy: interest/mortgage rates indebtedness - poverty housing POLICY :: COSTS national housing & land assets inspection and building standards forms of tenure: private, rented, housing assoc. LAW - housing & land legislation housing rights migration, refugees independent advocacy / NGOs compulsory purchase

Thank you Mr Richer for an excellent read and synopsis. I do hope the government listens! My daughter's partner works in estate agency, so I know where my copy is heading: a new home!

OHD i

OHD ii

'Our Housing Disaster' ii

'Our Housing Disaster'
Image: Goodreads

Late to reading about economics, apart from the 'quality press' and an 'O' level in social history (which has actually been really useful in my nursing career), this book can ground and crystallize 'housing' as heard and viewed in the news.

I've a love for hi-fi that I share with Julian Richer, but my wealth lies elsewhere and is decidedly non-monetary. Reading his column in The Sunday Times, I'm impressed with Mr Richer's insight and the extent of his philanthropy. The book notes several initiatives and collaborations, e.g. TaxWatch -https://www.taxwatchuk.org/

On the news you hear of 'intervention' in the market - usually equity or bonds. You - the government - can intervene, or let the market, a market by implication, look after itself. Markets find their own equilibrium, shift to stability ultimately; and this despite economic crises, billion-busting scandals and political parties totally screwing-up.

So, it appears governments have allowed the housing market, to make its own moves.

It's back to the future, the 18th century of laissez-faire: the market has spoken, and its a utter mess.

The book's contents are well structured and delivered in full.

Introduction
1 Disaster? What Housing Disaster?
2 A Housing Crisis That Harms
3 Where Did Housing Go Wrong?
4 The Rise of Renting
5 The Shrinking of Social Housing
6 Underregulated and Oversubscribed
7 Land and Planning: The Price of Permission
8 Making Better Use of Buildings and Land
9 Building a Solution
10 Time for Action - My Housing Manifesto
Conclusion

OHD covers the population as a whole, but 'health' is very well represented in terms of personnel and the impacts of lack of housing and poor quality, unregulated housing: 

'Inability to afford housing is one of the grievances feeding into strikes by public sector workers - even better-paid ones. A survey by the British Medical Association (BMA) in December 2022 found that nearly half (45.3%) of junior doctors had struggled to afford their rent or mortgage in the past year. To earn more, some were taking on extra shifts and the BMA said this added to its concerns around junior doctor exhaustion and burnout. 

The consequences reach out to the public at large, as housing problems hit staff recruitment in health services, education and so on. The NHS visibly cant cope: basic structures are crumbling.' p.25.

We can imagine the anxiety and depression this might provoke. Even for people you might think (assume) would be ordinarily resilient. These are clearly extraordinary times. An email - RCN Magazine - today supports the same conclusion:

The relationship between health and housing is not limited to chapter 2. In chapter 2 though damp and mould (yes a specific case), unsanitary conditions the loss of environment health officers and skilled personnel, reminded me of decades ago an article in HSJ, or in that 'quality press' about the community health councils - CHCs having their teeth extracted. Public (MENTAL) health has taken a stunning fall and desperately needs to be put back together.

More to follow...

'Our Housing Disaster'

Our Housing Disaster

I must finish the spring and summer's reading as pictured, with another two books in the wings. While the smallest text Our Housing Disaster is cheap to buy, an important read and insightful.

Politically, in the UK and many other nations, housing and its opposite -  homelessness, and the supply and cost of housing are ongoing issues.

Julian Richer's book is low cost £4.99 post free with a promo-code; even as I obtained a free copy, learning of the book in Business section of The Sunday Times. 

Our Housing Disaster gets off to a flying start:

'Falling or stagnant house prices are seen as national 'ill' that we must recover from but, in fact, fast-rising house prices and interest rates have proved to be the real ill, destroying the dream of a property-owning democracy that was supposed to benefit all.

Britain's housing policy, such as it is, has failed on its own terms.' p.9.

I remember when Grand Designs appeared on our TVs. Especially the episode with the wood-frame eco-house by Ben Law. This seemed sustainable and time-limited too. Julian Richer really nails the housing problem without delay. Unfortunately, the audience appeal of TV programmes like Grand Designs, Location, ... seem to me symptomatic of the issue Richer raises above. I used to think that the 'middle class' were shooting themselves in the foot; as house prices rose and rose. There was a collapse at one point with the trap of negative equity that my family almost got caught in (had we bought a new home). Richer corrects this view, with a national perspective across ten chapters and 180 pages.

 If the link between health and housing needs to amplified Richer ably achieves this, and quickly:

'Poor housing is harming the nation's health. The housing ombudsman, Richard Blakeway, whose office deals with complaints from social housing tenants about disrepair and mould and damp in their homes, problems recognised now to be a threat to health, has found the situation to be so bad that he has called for a Royal Commission to look at the links between housing, health, and welfare. Too often, the various agencies in housing, health and social care tend not to link up, or even know what the others are doing. which can end up making people's housing situation worse. Someone who has been homeless or who has mental health needs, for example, can require a lot of support once they are housed so that they can pay the rent and maintain the tenancy. If they just get housed and then left to cope on their own, they can struggle, lose the tenancy, become homeless and whole cycle starts again, with all that waste of money and damage to lives.' p.16.

'In addition to the 8m, there must be millions more who are not in crisis, but who have a blight on their future: typically, young, working people, perhaps with children, who are living in private rented accommodation, with a roof over their heads but always worrying they might be evicted. The insecurity and uncertainty that they experience is not good for them or their children. Just as job insecurity makes it hard for people to build a career, housing insecurity makes it hard for people to establish a life.' p.19.

The statistics flow thick and fast but as readable as they are focussed they weave an effective narrative referring to the history of just how we got to this point. The text make stark the dire crisis and need for action and an urgent government response. 

More to follow.

Eroom's Law

Stephanie F. Scholtz

 

individual
|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

digital literacy health literacy ...	Moore's Law*
social justice 'laws' translated social capital	Eroom's Law

 

*This is not to underestimate the economic impacts of Moore's law, or in both instances the question of access to digital technology and health care.

Kill or Cure? Technology Quarterly - Personalised Medicine, The Economist, 434: 9185; 14-20 March 2020. pp.9-11.

https://www.stephanie-f-scholz.com/

The Healthy Brains Global Initiative: Mental Health Care NOT only by the Quarter II

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

The Healthy Brains  Global Initiative	Tuberculosis, Malaria, HIV Aids Cancer, Infectious disease, Heart disease
The impacts of mental illness in societies	"25 per cent of people worldwide experience mental illnness" HBGI funding of $10 Billion direct & indirect costs of mental illness = $3 trillion a year $6 trillion by 2030 GeoPsychiatry, PsychoPolitics, SocioPolitical

 

Clive Cookson, Global drive aims to fight mental illness, FTWeekend, 10-11 October 2020, p.4.

 

Plus c/o HIFA: 

Today 10 October is World Mental Health Day.

The current issue of The Lancet carries a lead editorial on this subject: 

 CITATION: Mental health: time to invest in quality Editorial| volume 396, issue 10257, p1045, october 10, 2020 The Lancet Published: October 10, 2020 DOI: https://doi.org/10.1016/S0140-6736(20)32110-3 

EXTRACTS The theme of this year's World Mental Health Day, on Oct 10, is increased investment in mental health. Why invest, and why now? The answer is simple. At the best of times, good mental health is needed for a society to thrive. During a pandemic, good mental health is more important than ever. Without a focus on mental health, any response to COVID-19 will be deficient, reducing individual and societal resilience, and impeding social, economic, and cultural recovery... Investment must be about more than just money if mental health services are to be made fit to address the challenges of the COVID-19 and post-COVID-19 era and to become resilient against future public health crises. There must be an investment of thought, time, and a commitment to change.

COMMENT (NPW): I would like to invite HIFA members to share their experience on mental health services in your country. What changes have you seen during the pandemic in terms of demand and provision? What approaches have worked well, or not so well, in dealing with these challenges? 

Best wishes, Neil

 Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org

Social Care: in the round and square c/o King's Fund

Simon Bottery's Long Read -

What’s your problem, social care? The eight key areas for reform

- and listed below, have been mapped to Hodges' model. The full article and comments are well worth reading and may help readers discern the relationships between the key areas identified.

1. Means testing: it’s not like the NHS 
2. Catastrophic costs: selling homes to pay for care 
3. Unmet need: people going without the care and support they need 
4. Quality of care: 15-minute care visits and neglect 
5. Workforce pay and conditions: underpaid, overworked staff 
6. Market fragility: care home companies going out of business 
7. Disjointed care: delayed transfers of care and lack of integration with health 
8. The postcode lottery: unwarranted variation in access and performance

I have associated each with the respective knowledge (care) domain in which they are placed:

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

1. Parity of Esteem in Means Testing 2. (Catastrophic) Cost to me, anxiety, depression, stress 3. Unmet need (mental health, counselling ...) 4. Quality of Care (Mental Health, Well-Being..) 5. Workforce (values, person-centred, self-esteem, job-well-done, BE the Difference?) 6. Market fragility (attractiveness as career pathway, having a leader) 7. Disjointed care (number of carers, lived experience...) 8. Postcode (I thought this had been addressed?) (postcode? - a remote 'thing' outside through the window and (summer) garden]

1. Parity of Esteem in Means Testing 2. (Catastrophic) Cost to NHS - innovation, change, prevention, transformation 3. Unmet need (physical, access ...) 4. Quality of Care (Time, Logistics) 5. Workforce (tasks, scheduling, physically reasonable?) 6. Market fragility (scale, bed occupancy, local demographics...) 7. Disjointed care (geography, transfers, A&E admissions...) 8. Postcode ('literally') North, West, East, South, Regions, London, Urban, Rural ...

1. What is your Parity across 2. (Catastrophic) Cost to my family. 3. Unmet need (socialising, access, carer ..) 4. Quality of Care (Relationships, Belonging, Communication, Family Groups..) 5. Workforce (job satisfaction, status, social worth ..) 6. Market fragility (Public perception, marketing, negativity bias - local news, time for outreach, intergenerational engagement...) 7. Disjointed care (input of family, local provisions, self-funding - budgets...) 8. Postcode (pre-social care, pre-lottery?)

Means (let's Test that.) here too?  2. (Catastrophic) Cost to the State? 3. Unmet need (my choices, informal carer ...)  4. Quality of Care (Value for £, Measures, Inspection, safety..) 5. Workforce (pay and conditions, minimum wage?, Unions, contracts, training, BREXIT ..) 6. Market fragility (FUNDING settlements, estate, investment, staff turnover, Qualified staff, commercial history, profit, governance..) 7. Disjointed care (commissioning, ...) 8. Postcode (local policy, funding, protocols ..)

Top 5 worst EMR myths: c/o Healthcare IT News

I came across this post by Molly Merrill, Associate Editor and thought I could add some comments.

I'm usually wary of posts of the list of ... and top 5, top 10 variety. You see much of social media is cordial - not the concentrate form - but the dilute as observed in many of the comments. Anyway ....

You can read the original full text for each of the five on Healthcare IT News, here are some additional thoughts:

1. EMRs are bad for “bedside manner".

They can be BAD it all depends on usability, engagement, attitude, requirement, the overall environment and the extent to which the EMR is considered in all its socio-technical glory. Whatever the research does show item #2 admits the qualitative differences that exist in the marketplace - some EMRs are easier-to-use. If we expand the engagement beyond the professionals then the bedside equation demands the patient is factored in.

With the right care philosophy and conceptual framework (#h2cm?) e-health records of all varieties (EHR, PHR, EMR, Summary ....) can also support a positive, person centered bedside manner - transforming it to one that chomps at the bit ;-) to become a community based manner.

2. You can't teach old doctors new tricks.

Continuing professional development (or its equivalent) dictates that older doctors and other senior members of the multidisciplinary health and social care team can (should and must!) learn new tricks right up to retirement. Lifelong learning applies to all.

3. Only hospitals use EMRs.

I've little experience here working in the community (and in mental health), but judging from the applications and the infrastructure that an older EMR may demand, I suspect that they are indeed hospital (organisational) centered. That clearly is changing as mobile, mhealth applications mature to meet the rigorous demands of this market.

4. Having my data stored in an EMR is a security risk.

The security of electronic records cannot be assured. Data on devices that is not encrypted - is an open door, especially when those devices are portable. (If the use of encryption leads to complacency then I am uneasy.) Disciplinary measures may follow, but they are not a remedy. The human link in the chain aside - electronic records can be security assured to international standards. Far better than paper records and the photographs (anybody?) of paper hospital files sitting at the side of a corridor and other horror stories.


(Former link: The New York Times, 21 August 2011, New Data Spill Shows Risk of Online Health Records)


5. EMRs are expensive.

There are beholders, stakeholders, budget holders and tax payers. Despite the need for research findings I like the reflection of reality in item 5 that presages new players using new architectures and approaches. I've always felt that standards are essential and yet how do they relate to the scope for innovations? What is the relationship and how does that impact the market and in turn costs?

I've come across an item in .Net magazine that relates to EMRs - indeed all health informatics - I'll post on this while in London and attending Drupalcon.

Image source:
http://www.computerweekly.com/blogs/cwdn/2010/08/carry-on-doctor-your-electronic-patient-records-are-secure.html

Frontline First campaign: cost-saving innovations whilst improving patient care

Dear Peter,

Innovations are the key to saving the NHS money. Every day, nursing staff on the frontline are finding new and better ways to deliver patient care.

As one nurse recently wrote to us:

"Without a working knowledge of clinical care provision how can ideas be practical and ensure quality of care is maintained? Nurses are in a prime position to look at care provision to identify better ways of working and therefore identify cost savings without sacrificing patient care and experience."

As part of our Frontline First campaign, the RCN is collecting examples of cost-saving innovations at NHS services across the UK. What nursing solutions have you seen in your workplace that could achieve savings without sacrificing patient care?

http://generalelection.rcn.org.uk/innovation

There are two ways the NHS can find billions of pounds in efficiencies:

discover innovative ways to save money
or
make cuts to staff and services

Every day, UK nurses are helping to devise and implement cost-effective solutions saving their employers money and helping to protect jobs. We've already heard from dozens of nursing staff who told us about innovations in their workplace, from changes to day-to-day practices to
whole new ways of working.

Please take a moment to report any cost-saving innovations you've seen at the workplace:

http://generalelection.rcn.org.uk/innovation

Thanks for speaking up and helping to protect patient care.

Yours sincerely,

Janet Davies
Director of Nursing and Service Delivery

My source:
Subject: Improving patient care
From: "Janet Davies, Royal College of Nursing"
Date: 04 August 2010 16:53:30

The cost of anholistic care

Being 'holistic' in care delivery can seem anachronistic, paying homage to new age thinking and practices. Paradoxically, being holistic in nursing can also mimic an admin exercise that amounts to ticking the boxes. So for Hodges' model - have you visited all the care domains?

• INTERPERSONAL care ✓
• POLITICAL care ✓
• PHYSICAL care ✓
• SOCIAL care ✓

Advanced discharge planning is many things:

• idealised care;
• standardised care;
• evidence of policy, targets;
• sign posting for the care pathway;
• an essential care aspiration that emphasizes the individual's strengths and resources.

As Wimbledon once again reaches its climax we observe that a fast serve needs to be prepared for a fast return of serve.

Last month 23 June, 2010 The Guardian, Society Guardian featured The high cost of return:

Hospitals could lose up to £1.5bn of NHS funding a year because of the government's decision to penalise those where patients return within 30 days of being treated. That is the conclusion of research conducted by health analysts Dr Foster into the potential impact of the tough new policy. It warns that NHS trusts face large potential losses, the biggest could reach £28.7m, as a result of the new approach. In all, 146 acute, specialist and mental health trusts could lose out. Denis Campbell, p.3.

Apparently -

Andrew Lansley wants to force the NHS to provide better care in hospitals and mental health establishments, to keep treating patients there until they are fit to leave and to work more closely with community-based healthcare professionals, such as GPs and district nurses, to ensure sick people receive more help with their convalescence after discharge and so are less likely to return to hospital. "Making hospitals responsible for a patient's ongoing care after discharge will create more joined-up working between hospitals and community services and may be supported by the developments in re-ablement and post-discharge support," he says.

I hope in reading the above you have a sense of my frustration in that the health career model can encourage and support timely reflection that can help achieve holistic, integrated - coherent care.

If the model was shared
- a common resource -
across disciplines and available to patients and carers
then the potential benefits (and savings?) are even greater.

Professor Enid Mumford

I am very saddened to hear of the death of Enid Mumford.

In February 2004 Prof. Mumford responded to my email about her website and sociotechnical design explaining her work and offering help if needed.

This was then and remains a great encouragement to me.

Now I wholly appreciate her situation, response and kindness as she stated - having joined the health care community for older people herself.

Bless you Enid and your family...

https://www.theguardian.com/news/2006/may/03/guardianobituaries.obituaries