Healthy Schools

Last week, I had the privilege of being at Morecambe Bay Community Primary School. The school is a beacon of hope in this area. I found it extremely moving to walk round, with Siobhan Collingwood, the visionary and big-hearted headteacher and see the incredible love displayed by all staff towards the amazing children there. It made me realise again how centrally driven targets often make no sense for so many of our children and communities, especially when the base from which they start is so very different. Siobhan and her team are doing the most incredible job at caring holistically for the children here, dealing with complex behavioural issues with such kindness and brilliance that it brings tears to my eyes, even writing about it. Not only so, but the standard of teaching to then try and help these kids come up to the ‘required standards’, being creative with the resources available, is nothing short of miraculous. I would defy any school inspector to rate this school as anything else than ‘outstanding’.

 
Siobhan and I had a great discussion about the need for health, social care, the voluntary and faith sector, the police and education to work more closely together for the wellbeing of children and young people in our communities. This is already happening in part, through our health and wellbeing partnership and ‘better care together’, but there is far more we can do. We thought about what it might be like if we parachuted fresh into the community now and had to start from scratch, what we might do together…….

 

We would start with stories – we already have many, from the conversations we’ve had in the community, but we want to really listen and be changed by the responses that we hear. We’re so grateful for the work of the ‘poverty truth commission’, helping us to do just that. We would also definitely pool our resources and prioritise key services that would not be taken away once the community begins to thrive, such as parenting classes, cooking lessons, early support services, a radically caring housing sector, preventative policing strategies (now emerging powerfully in partnership with our town and city councils), social care, mental health champions (something Siobhan has already been part of recruiting 150 locally!), children’s centres and adult education centres as a starter for 10. We would overlay this with the things that are working now – there is so much goodness happening and we don’t negate this. We want to ensure that we could see the health inequality gaps close.

 

In order to build on this idea of ‘healthy schools’, we would see kids being active every day – despite, limited grounds space, this school, like many others locally are running a mile a day. There is a great scheme here in which all the kids are learning to cook healthy, nutritious food, building vital life skills needed now and in the future. The breakfast and after school clubs are providing many healthy meals each day for the kids and throughout the summer holidays the schools cook – another woman with an incredibly big heart, opens the hall to feed families, who cannot afford to eat during the long breaks. A huge amount of work is being done around gender equality (have you seen the amazing documentary series “No more boys and girls: can our kids go gender free?” On BBCiplayer?). Kids are also given a huge dose of self esteem and know that they are loved and belong. If only the same level of caring support could be afforded through the transition to high school…..

 

Over the coming months, we hope to co-host some conversations with the community, not on our terms but shaped together with them. Siobhan spent years trying to think of great ideas to get the parents to come into school and interact with her. It wasn’t until the parents set up their own coffee morning in the old garage of the school playground, that she went to meet with them on their terms and started to build some staggeringly life-changing relationships. We know we are changed every time these kind of conversations happen and it blows our world view up so that we can collaborate effectively and co-design services with them. We want to share data with them about health and educational outcomes in order to create a passion for change and do some appreciative enquiry about all the great stuff already embedded in the community. Through these conversations, we want to connect people together and see a social movement for positive change.

The future of Morecambe is bright and full of hope. The communities are strong, the place is beautiful and the people are amazing. Siobhan is just one of many incredible headteachers in this area, committed to one another and this geography through bonds of friendship. If a genuine partnership between health and education can develop here (and it’s part of my vision and ambition to see this done) then who knows what might be possible over the coming months and years?

 

It is time for Morecambe to find its joy again. It has been the joke for too long, but soon it will become the place where the joke is found and everyone will want to know what we’re laughing about.

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Learning from The Well

The Well is an extraordinary community of people. I respect them deeply and learn so much from every time I have the privilege of being with them, listening to their stories. They are all people on the journey of recovery from drug and/or alcohol addiction. They are welcoming, non-judgmental, caring, embracing and kind. Most importantly of all, they offer hope that no matter how far into hell you have been, there is a way out and no matter how badly you have messed up, you are lovable and worthy of a new chance. There are countless stories of those who have gone before, through the “12 steps”, and found transformational grace and and the chance of a new life. The support they give to each other, especially at times of trouble is based on openness, honesty, trust and a genuine love for each other that holds through difficult battles for a better future.  Every story I have heard has humbled me, and each time I am with them, I go away changed and filled with fresh hope. I am so grateful that I can now count several members of the community as my friends. I feel we, as the medical community have much to learn from them.

 

 

After my last meeting with The Well community, which was in Barrow In Furness, I then spent some time with an excellent Diabetologist, Cathy hay, who is employed by Cumbria Partnership Foundation Trust, but works at Furness General Hospital (another example of how we are breaking down boundaries and working more effectively as part of Better Care Together). I was learning from Cathy about how she and her amazing team are transforming how they care for and work with people who have diabetes. Like me, she believes that hierarchical behaviour gets in the way of building good relationships across teams, playing to each other’s strengths and working effectively with patients. She has worked hard to break down the ‘need’ for consultant follow-up clinics, putting the power back into patients hands. They have had a much more proactive approach at working with patients to really educate them and empower them about their own conditions through the fabulous work of the Diabetes specialist Nurses and Dietitians and a team of Psychologists, lead by Elspeth Desert, who help patients learn how to face up to and cope with physical health issues.

 

Group programmes (such as DESMOND, DAFNE or the X-PERT courses) enable patients to build supportive relationships with one another and networks form in which patients are rightly able to become the experts in their own conditions, supported by a team of people who they can draw on, as and when needed – determined by the person with the condition. This cuts the need for outpatient appointments drastically and releases the team to work far more effectively. The ‘Walk Away from Diabetes’ programme encourages those with the earliest warning signs to try and avoid lifelong medication altogether through exercise, dietary changes and accountability with one another.

 

In some ways, the approach is similar to what I have experienced of The Well and it got me thinking about just how transferable this approach could be across health services, in an extremely timely and cost effective way…..(which although sounds potentially a little mercenary is actually really important – we do actually have a responsibility to use the resources we have as well as we can, and our previous models are no longer deliverable, given our financial and staffing pressures, let alone the increased numbers of people accessing services). What if, once people are diagnosed with a long-term condition, we give them the option of a self-directed, learning approach to their condition, in the context of community with others and a supportive network around them? We could save an inordinate number of unnecessary outpatient appointments. It puts people back in charge of their own bodies and conditions, far more empowered to make informed choices and enables care to be available in a more efficient, cost effective and timely manner. Communities of people, facing up to their conditions together, learning together, helping each other, supporting and resourcing each other and finding improved health and wellbeing at every level as a result.

 

Many people across the UK have at least one long term condition. Many of these people also struggle with a mental health problem at the same time, often linked to the condition they live with. A more cooperative approach can break down some of the barriers and enable people to connect, which will improve both their physical and mental health at the same time.

 

We are beginning to see an exciting redesign of our respiratory services along these lines, lead by Pat Haslam, Farhan Amin, Tim Gatherall, Shahedal Bari and the team……I wonder how brave we can be across the board and how much better our care might be together if we did?

 

 

 

 

 

 

 

 

 

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