We Need to Be Ambidextrous in Solving our Health and Social Care Conundrum

UnknownAll this week on the BBC, there has been a focus on the NHS and the crisis we are in – don’t panic Mr Mainwaring…..There is a heady mix of opinions being thrown around – Question Time became quite a furore of ideas and thoughts last night – not enough beds, not enough staff, not enough money, too much money, too many patients, too many wasted appointments, too many malingerers, too many ill people, too many old people, too many managers, too many drugs, too many drunkards, disappointed clinicians, disappointed patients, disappointed MPs, a disappointed health secretary – what are we to think and what are we to do?

 

imgresWe love the NHS because it speaks something to us about our togetherness and our commitment to health justice for all. This circular argument about money is the wrong conversation and it is beginning to have a very nasty undertone about who we might be able to blame and scapegoat in order to solve the mess we are in. Let’s be very clear. The NHS is NOT in crisis because of refugees, asylum seekers, immigrants or health tourists. I’m going to stick my neck out here – it isn’t even the fault of the current and previous health secretaries, though it would be easy to play the blame game that way too. The NHS is in crisis, because the entire Western World is in crisis! Our economic systems are broken and our political systems are pretty defunct. We have built our nation state on the foundations of empire. We have built our economy on conquest and slavery and have used debt, violence and law to keep control….but everything is shaking.

 

There are some difficult truths for us to face up to. Are we brave enough to accept that things cannot remain as they are? Are we imagesLYB84K5V.jpgbrave enough to rewire our brains, realign our values and reimagine a different way of being together? If we accept that things simply cannot remain as they are, might we instead find one another in fresh ways and discover new ways of being in which we’re not always chasing the money, with all its strings attached, but choosing something altogether more life giving?

 

images3W7WQ07WI would suggest we need two things (an ambidextrous approach) – both of which are already happening, we just need to recognise them, fan the flames and watch the new emerge, whilst Rome burns around us.

 

The first thing emerging is a grass roots people movement around health, wellbeing and a kinder society. Think of this as the left hand. We must take a left handed approach to really listen to and engage with our communities. Many people are waking up to the fact that we are eating in ways that are unnatural and completely unhealthy for the human being. Global corporations like GSK have shoved Lucozade and Ribena down our throats and then very kindly provided the medication for the diabetes we have developed. Enough! Thankfully, peopleimagesOP6FM73O.jpg are beginning to think about how we are living and making a change. It’s a tough reality, but there is personal and corporate responsibility that we need to take. We cannot keep shoving poison into our bodies or treating them badly and expect that we will be well, or that we will be able to afford the drugs to fix us. Social movements are beginning to emerge and we need to be a part of them. Together, we can! Together we can cause corporations to change their behaviour and act in accordance with what is right, true, just, kind and loving. We can also choose to take responsibility for what we buy and how much exercise we do. Here in Morecambe Bay we are launching the Morecambe Bay Mile, encouraging everyone to move a mile a day without transport! We’re also working with our communities around diet. We’re also connecting with amazing people doing amazing things and seeing just how much kindness and goodness there is in the communities around us. Our happiness is directly linked to the quality and depth of our friendships. People being together and facing up to the issues together is absolutely key to our long term health.

 

imagesBCV6CE7Y.jpgSecondly, we must stop serving the system, re-humanise it, call it in line and cause it to serve the needs of the people and the planet (the right handed approach). Those in the health and social care system must refuse to be bullied by the powers into ways of behaving, stop thinking they have the answers and therefore coming up with another new scheme to do to people and be willing to listen to and work with the emerging social movements. This will allow us to see a society that is much more well and therefore in need of less care. But where care is needed, we have to accept that we have allowed ourselves to be competitive rather than collaborative, hierarchical instead of co-operative and our own attitudes and behaviours are stopping us from giving the compassionate care we long to deliver. We cannot make excuses. We must let go of self-protectionism. We must be willing to change the way we think and behave, breaking down walls, letting go of suspicion and cutting through red tape so that we provide the care which we can. This is happening, here in Morecambe Bay – but it’s not a quick thing. We are rediscovering the power of relationship and daring to make some bold steps into delivering care very differently – but for those of you outside the system, please understand, it takes time and feels pretty scary!

 

I believe it is possible for the NHS and Social Care System to be radically transformed at this time. It might enable us to model something for the rest of the world. That in our time of crisis, we did not sell out to the lie that the only way ahead was privatisation and insurance – (in our hearts, we know this isn’t fair and it doesn’t work for everyone). No – instead we chose to work with a grass roots people movement, calling for us all to beuntitled.png more healthy and well and we changed our ways of working to be more collaborative and kind. It is this ambidextrous approach to health and wellbeing, in which a heady mix of an invigorated people movement and a reorientated system working together for the good of everyone everywhere, might breathe hope into other parts of the world that out of the old can come something new. Maybe it is just possible that healthcare can be provided for everyone everywhere when people are brave enough to let go of old ways, embrace the brokenness of our reality and find a new way through together.

 

untitled.pngI’m telling you – it is nearly Spring time and the bulbs are beginning to break through. Can you smell the scent of something new emerging? Those rhizomal roots of the snowdrops – that interconnected underground network that shoots up its flowers, is telling us the winter of discontent is over. It’s time to turn off the radio, dial down the meta narrative of fear and instead, put on love, hope and faith, find each other, change our ways of working and step into the future we know our hearts yearn for.

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Doing the Impossible – Turning the Tide!

It’s time to do the impossible. It’s time to turn the tide.

imgres.jpgIn my last blog, I talked about the exponential potential of what could be possible if clinicians worked together in a more collaborative way. However, far more can be achieved if we work together in and with our communities to create a social movement together around being more healthy and well. I’ve talked previously about the “battle royale” that occurred between Béchamp and Pasteur over whether we should promote health or fight disease. The answer is, of course, that we need to do both, but the clinical community is not equipped with the resource or power to do it alone.

What we cannot accept, though, is our current apathy or malaise that some of the health imgres.jpgcrises we now face are too much for us to do anything about. We are in the midst of a battle, which we are currently losing and it is time to gird our loins for a turning of the tide. Here in Morecambe Bay, we have started a conversation, not just among the Clinical Community but with the wider population about how we might become the healthiest place in the UK. Yes, we mean this in a very holistic way, but there are also some specific foci we have so we can together reverse some of the appalling health statistics we are facing.

For too long, we have simply laid down and allowed exercise to be taken out of schools, whilst our kids consume a bath full of sugar every year. All the time our own work and eating habits have become significantly unhealthy. We have relied on expensive drugs to fix our problems, rather than tackling the root causes of our excesses. It has lead to 1 in every 5 pounds in the NHS being spent as a direct result of our lifestyles and 1 in 11 pounds being spent on diabetes. We say we value the NHS above anything else as a nation (maybe an issue in it’s own right…..) but we do not behave in ways that show this value to be true. We have not been brave enough to challenge the status quo and together make a wholesale change both about how we promote health and look to aggressively reverse it when things begin to go wrong.

images.jpgI suggest that within a generation, if we wanted to, we could render Type 2 Diabetes a rare diagnosis. We can do this through encouraging far more healthy lifestyles in our children and young people now, like running a mile a day and learning to eat food that doesn’t actually harm them! I believe we could significantly reduce the need for so many people to be taking medication for hypertension and diabetes now, prevent many strokes and heart attacks, by being violent towards these conditions with major changes in lifestyle, though diet and exercise, rather than the prescription of drugs, using coaching, peer support and local champions to give psychological motivation and encouragement. We are beginning to have some excellent discussions and develop some exciting plans around this.

Our NHS health checks should serve as a major motivational opportunity for someone toimgres.jpg pull themselves back from the brink of a lifetime of medication and we should use all medication reviews as a chance to help people adopt lifestyles that might reverse the need for such drugs. In the process, we would also significantly reverse our number of cancer diagnoses – many of which are linked to our lifestyle choices. We simply can’t afford for our current and failing approach to continue. We need to be braver together! And this means the NHS must be willing to partner in new ways, not only with local people, but also with businesses like the major supermarkets to help reverse our current direction towards the abyss, in which there is no longer a healthcare system that serves the needs of everyone, no matter where they come from or how much they do or don’t earn.

Don’t get me wrong! We should absolutely use medication to its fullest use for those who are at risk and have not responded to major lifestyle changes. For example, we can wage war on Atrial Fibrillation, ensuring far more appropriate use of anticoagulation, in the most cost effective and safest way, therefore preventing many life-changing strokes in the mean time. And for those who, despite lifestyle measures, still have a high blood pressure or continue with diabetes, we should not withhold medication that would prevent major issues later on. It’s just at the moment, we’re reaching for the prescription pad too readily and not looking to reverse conditions completely before they set in. We need more education out there around the early signs of cancer, so we can hit it early and reverse it’s effects when we have a better chance. Respiratory disease is another area where we could seriously make a change. We need to think of ourselves as one big respiratory team, tackling smoking, housing damp and carpeting, whilst ensuring every person has an understanding of their condition, how to use their medication effectively and what to do when things flare up. A cohesive clinical community really could deliver something special in each of these disease areas.

We could also be a great deal more effective in how we care for the frail elderly. We don’t need anywhere near as many hospital beds. We can provide care in residential and nursing homes, avoiding double payment for beds, by shifting resource out of our acute hospitals and into the community. We need to have a far more grown up conversation about why we admit people to hospital when there is very little proven benefit of doing so.

Taking a strategic shift towards a social movement for health, significant lifestyle changes and treatment only after these things have been given serious attention, but unapologetically so once they have, we can turn back this battle at the gates and change the health of this nation for generations to come. We can undo the unaffordable situation we find ourselves in and discover together a much more healthy future.

images.pngWe can absolutely do this!! It’s going to take some serious resolve and we’re going to have to withstand the fear and pressure of some pretty powerful lobbies, like the sugar, alcohol, tobacco and pharmaceutical giants, and perhaps even the government itself, but it is time for us to do the impossible. With love, hope and faith, we can do this! Yes we need to focus on schools and work places. Yes, we need to partner with organisations we’ve never worked with before. Yes, we need a far more effective media strategy and yes, we need to allow clinicians to work very differently. But we cannot do nothing. So let’s try something a whole lot more radical. That’s what we’re going for in Morecambe Bay – not just better care together, but better health together – you can watch and wait, and see if we sink or swim, or you can join us!

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