Tag: wellbeing

What Lies Beneath?

Do you sometimes wonder what is really going on? As the furore around the planned 5-day strikes by junior doctors unfolds, with all the clamour and the noise, the positioning, the power plays, the arguments and the counter-arguments, I wonder where is the truth amidst the madness? How have we reached a stage in which the government and an army of medics, surgeons and psychiatrists are at such loggerheads? What lies beneath all of this?

 

Theresa May, our Prime Minister tell us that “doctors have never had it so good” – I wonder when she last shadowed a Senior Registrar for Acute Medicine on a Friday night in an understaffed hospital? Jeremy Hunt tells us that he is a modern day Aneurin Bevan (I wonder what AB would think of that?!), whilst his shadow counter-part, Diane Abbott retorts that this is a ridiculous suggestion. The PM and the Secretary of State for Health both agree that the junior doctors are playing politics, something the other side refutes, but all agree that this is a disaster and patients lives may well be put at risk. The right wing press tell us it is all about pay and that the doctors are being greedy, whilst the left wing press tell us it is all about an underlying agenda to privatise the NHS. The Junior Doctors admit that some of this is about pay (who would want a significant pay cut for working long and unsociable hours?) but that it is more about resisting a policy to deliver a 24/7, 7/7 NHS, which they believe to be unaffordable and unstaffable due to shortages in funding and recruitment. Senior colleagues appear to be split down the middle in terms of support for the strikes, patient groups are understandably concerned and yet a solution does not appear to be forthcoming.

 

Shouting, anger, fighting, noise, name-calling, power-plays, hate and hollering. So, who will seek the welfare of the people and the nation? Who will make for peace? Both sides tell us this is what they are doing and this is why they stand their ground. The government apparently want to deliver the same standard of service throughout the 7 day week. The Junior Doctors say they are the ones really standing up for the people by resisting that which is unsafe and unfair.

 

So, let us learn from the peacemakers to find a way through. In apartheid South Africa, peace was not reached through hate and vitriol. It took deep courage from men and women to expose lies, to speak truth to power, but most importantly to tell their stories. It was not about the one man, Nelson Mandela, but the many together waking up to an alternative future that was fairer for everybody. In the battle for civil rights in the USA, a nation was awakened to the reality of injustice within its own borders. The story of one woman, Rosa Parks, who refused to be humiliated on a bus became a people movement as numerous as the stars, shining together for an altogether different day. In Rwanda, after the appalling genocide, those who lost everything, found a voice to communicate to their very oppressors, those who had raped and murdered their own families, not only their story, but forgiveness for the atrocities caused and found a way through to a new future. If we want peace and a better future for everybody, then we need to face up to our reality, be willing to really listen and then find that together we can embrace a new future.

 

We have an apartheid of globalisation and free market capitalism across the entire world. Every day, the gap between the rich and the poor is widened. Our entire economic system, founded on the oppression of Empire through expansion (via military violence), the creation of debt (through an errant banking system) and the rule of law (held in place by the state of the exception) is no longer fit for purpose. We see it in the plight of refugees stuck between war and barbed wire fences in a land they cannot call their own. We see it in the disproportionate imprisonment of Black American males in the USA. We see it in the vile island detention centres of Australia. We see it in the slums of New Delhi, the townships of sub-Saharan Africa and the Favelas of South America – in the eyes of children dying from such ridiculous things as diarrhoea and starvation. We encounter it in the streets of Athens and the public squares of Madrid. And yes, we find it in the midst of our NHS and social care system. Our world as we have known it is broken and no matter how much sticky tape or wrapping paper we apply, the centre simply cannot hold. The core is unstable. Everything is shaking. We must have the courage to let go of what we have known and embrace an altogether different future, a future that is fairer for everybody, where things don’t simply trickle down to the poorest, but in which the balances are re-set.

 

We have become slaves of the ‘free market’, fodder of the beast that requires ever more of us. What lies underneath the row over Junior Doctor pay and the forthcoming strikes is a great gaping hole that scares the hell out of many of us. Oh, we can sling mud until the cows come home, but it’s not going to get us anywhere. Top down, pyramidal, heroic leadership that stays its course and demands it’s own way is simply not going to cut the mustard. We must have some brave and difficult conversations about the detrimental effects of making policy from the safety of ivory towers, and learn to really listen to the stories of those affected. We have so much to learn from the Leeds Poverty Truth Challenge, the Homeless Charter in Manchester, the Community Conversations in Morecambe Bay, the Cities of Refuge initiative, the Civil Rights movements, the Mediation work done in Rwanda…..we don’t have the answers right now. The problems facing the NHS are fare more complex than trying to ensure an undeliverable manifesto promise is outworked. We need humility on all sides, collaboration and partnership.

 

It goes deeper than people right across the UK needing to manage their own health and wellbeing more effectively. It is more complex than needing to recognise where there is waste and dealing with it. It isn’t just as straight forward as needing to talk about chronic under-funding and under-recruitment. We face an existential crisis, an ontological question about the future of humanity together. Resting back onto familiar ways of operating or antiquated leadership styles will simply not work for us any more. The black hole we face is either a death or the opportunity for re-birth. A squeeze that will force us into something new. We can’t keep dancing around it forever. We must take the plunge, accept that there is no going back and see what new creation we might just co-create with Love on the other side. Don’t be afraid…….there is light at the other end of the tunnel.

 

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5) GIVE (5 Ways to Wellbeing)

Here is my latest vlog on using the 5 ways to wellbeing to help change the culture of the NHS.

 

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4) KEEP LEARNING (5 Ways to Wellbeing)

Here is the 4th vlog in a mini-series, exploring the 5 ways to well-being from the New Economics Foundation to help transform the culture of the NHS.

 

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Healthy Conversations

We live in a political climate in which it appears that those in power do not listen to the voices of the ‘multitude’ (e.g. with the current protests around the NHS and education), but press ahead with their own agendas regardless. This is not only true of the current government, but a symptom of the way in which our entire political systems are set up. Here in Morecambe Bay, we need to recover the power of people movements and decide together what kind of future we want. Here is an invitation to come and be part of the emerging conversations about health, well-being and the health system around the Bay.

 

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Changing Health and Wellbeing Through ‘Self-Care’

imgresBetter Care Together is the way in which health services are now being redesigned and reorganised around Morecambe Bay, so that we can provide the best care we can for the people who live here in a way that is safe, sustainable and accessible. It is an on-going process and involves the breaking down of barriers between General Practices, the Hospital Trust (UHMBT), Community Nursing and Therapies, Mental Health Services, Social Care, Allied Services – like the Police and Fire Service – and the Voluntary Sector.

Here in Carnforth, we are piloting some work around ‘self-care’ and exploring what it means to be a healthy town. This is now beginning to spread like wild fire around this area, which is exciting to watch! Part of this work is rooted in the fact that currently 1 in every 5 pounds spent in the NHS is due to our lifestyle choices. If we’re going to have a NHS in the future, then we need to try and choose to live more healthily together. We must also recognise that being healthy and well is far more than just physical health. It includes mental health, social heath and systemic (or environmental) health. A few months ago we hosted a number of conversations in Carnforth about what it might be like if Carnforth was the healthiest town in Lancashire. Some really interesting ideas emerged from the community about singing together more regularly, having less dog poo on the streets, creating safe places for the children to play, getting more exercise into our schools, encouraging healthy eating, a mental health café, help for carers and many other brilliant suggestions.

From these conversations, a ‘Self Care Tree’ has grown with four roots and three clear branches that we believe will help us grow together into a healthy and well town. The roots are straight forward –tn_TreeRoots_resized_b-300x300[1] 1) Really learning to engage with our local community instead of assuming that we know what they need and learning to do things with them instead of to them, 2) being part of an Integrated Care Community – see below, 3) Being part of Better Care Together, 4) Understanding Wellbeing – shifting our mindsets from an ‘illness model’ of health to a ‘wellness model’.

The three main branches we have developed in Carnforth are as follows: The first is that we have some ‘culture change’ to undergo, both in our medical and nursing teams and also as a wider community. Over the coming months we will see the emergence of what we are calling an Integrated Care Community – first modelled for this area in Garstang. As part of Better Care Together, we have appointed a fantastic new Care Co-ordinator, Sarah Baines, who was part of our District Nursing team. Sarah will work alongside Dr David Wrigley at Ash Trees Surgery to help co-ordinate care more effectively in the community for people with more complex health problems and provide more stream-lined care, preventing unnecessary hospital admissions and enabling faster and smoother discharges back home from hospital. Secondly, we are learning to take more of a ‘coaching’ approach to how we consult with patients, to encourage more partnership working with people, rather than telling people what to do (which isn’t actually very effective). Staff are training in ‘coaching practice’, ‘motivational interviewing’ and ‘shared decision making’. We are trying to be more proactive with information. If you look on our practice website, www.ashtrees.co.uk, you will find a tab entitled ‘self-care’. Here you will find videos (many more to come and some of which we are re-doing!) that talk about various common conditions you can treat yourself without having to go through the often difficult task of finding an appointment with one of our team. Our local pharmacists are a hugely valuable resource, who can offer excellent health advice and treatments over the counter, saving local people time and inconvenience.  Also, not too far away, we hope to have a brilliant new facility called ‘e-consult’, which will allow our patients to manage their own care more efficiently ‘on-line’.

Stack-of-British-one-pound-coins-1516897[1]The pressure on General Practice is huge. The government only allocates £136 per person per year to General Practice. this money accounts for all GP consultations, appointments with nurses, blood tests, investigations and referrals and indeed the payment of staff. If you want to know what this compares to, then for £136, you can buy 11 months worth of pet insurance for a rabbit or 3 months worth of coffee every day on your way to work!! No wonder the system is under strain! If we want to have a NHS that is free for everybody and still standing in the years ahead for future generations, then we do need to be careful that we don’t abuse the system and take care of ourselves better and think about whether we really need an appointment before booking one!

 

The second branch we have seen is the emergence of ‘community leaders’, who have seen a community need and have stood up to do something about it. We know there are already loads of il_340x270.575369125_lhd6[1]community leaders out there doing great stuff, like sports clubs as just one example. So, we have seen the start of a mental health café, called “Serenity” every Wednesday afternoon at Hunter Street in Carnforth, 2-4pm. A carer’s café has started on the 3rd Saturday of every month 2-4pm, again at Hunter Street. Carnforth Community Choir meets at 7pm every Friday evening at the Civic Hall – singing is well known to improve our health and wellbeing! We have volunteer dog poo wardens, trying to help our streets be cleaner (it’s amazing what dog poo says about a town), and people cleaning up our parks to give the children in our community safe places to play outdoors. We have trained 22 “health champions” who will be starting with various initiatives soon, and many others have volunteered to help in lots of exciting new ways. All of this serves to break down social isolation and encourage us to take care of ourselves and one another.

 

The third branch is ‘clinical leadership’. Right now, Morecambe Bay has some of the worst health outcomes in the country. We have terrible heart disease rates and people die here far too youngimage[1] of preventable illnesses.  It would be wrong of us, as clinical leaders in the community, to stand by and let these statistics continue as they are. Morecambe Bay deserves better. So, we are working with schools to encourage more exercise in the children and young people in our community. Two local schools (‘Our Lady of Lourdes, Carnforth’ and ‘Arch Bishop Hutton, Warton’, with ‘St John’s C of E, Silverdale’ soon to follow)  have started running a mile a day – all children and staff! This is an amazing achievement and there are some wonderful stories emerging already of the great impact this is having on pupils and staff alike. We’re seeing huge improvements in sleep cycles, behaviour, concentration and general health. Under the banner of ‘Let’s Get Moving’ we hope that all the primary schools in the district will soon be participating in other similar initiatives. We have also started a couple of programmes of work with Carnforth High School, in line with needs they have highlighted to us. We are also going to trial a new NHS shopping list and menu to try and encourage us as a community to eat more healthily and avoid some of the unhealthy ‘bargains’ that the advertising giants try and tempt us with, cutting down on meat, alcohol, sugar and too much fat. If we don’t learn to manage our appetites and our spending habits better, we will never overcome the alarming rise in diabetes rates and heart disease. We are responsible together and really can make a change! So, not long from now, people in this area won’t even need to stress about what to cook for the week ahead, because they will be able to turn up to their local supermarket and get some really healthy and tasty ideas, all costed out and easily affordable (with huge thanks to our amazing chefs, Andy Bickle and Lee Till, from our hospital trust, working with us)! By eating more healthily and taking more exercise, we can genuinely change the health and wellbeing in this area for the next 50 years! On a different tack, our district nursing team is also beginning a leg-ulcer café for those who have been housebound. Such cafés have been proven elsewhere to break social isolation and improve healing rates for patients. All of this work is being undergirded by amazing research projects with the University of Lancaster.

As part of our on-going conversation with this community, we are hosting a further 781-T[2]evening, alongside our Mayor, Malcolm Watkins. It will be on Wednesday 6th April, 7pm at Carnforth Civic Hall. There will be other conversations in the next couple of months in Warton (for those living in Warton and Silverdale) and in Bolton-Le-Sands, for those in BLS, Halton and the Kellets. On Saturday 25th June 2016, we will also co-host a huge Health Mela at Carnforth High School. If you live in the area, please do come along to either of these events and talk with us about what is already going on and how we can all work together to make this town and district a truly healthy place.

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5 Ways to Wellbeing 2) BE ACTIVE (Changing the culture of the NHS)

In my last vlog, I started looking at how we might use the 5 Ways to Well-being  to help build resilience and promote health, particularly for those who work within the NHS (though it can apply to anyone). This second vlog takes a look at the being active and how it can improve health and well-being.

 

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Time to Face the Music

UnknownWe have yet to really face up to the crisis we are in. We keep on pretending that by making a few alterations here and some adjustments there to how we deliver health and social care, we might be able to save the NHS. But this simply isn’t true. Last weekend saw a crisis conference for GPs nationally as 38% think they will be forced to leave the profession in the next 5 years due to severe under-resourcing and increased stress (that would be a loss of 10000 GPs throughout England, with government plans to recruit only 5000 by 2020). Yet again our Emergency Departments are at breaking point, Junior Doctors are staging further strikes, Public Health Services have been decimated and although new partnerships are being forged with social services and (to some extent) the education system, deep cuts in both those areas mean there is little time or energy left to find new ways of working for the future health of our population. Throw into the mix a need to save £22 billion through “efficiencies” and couple that with the crippling debt caused through programs like PFIs in our acute hospital trusts and we really do have a problem.

 

Complicating this picture is the stark reality that 1 in every 5 pounds spent in the NHS is as a direct result of our current lifestyle choices and we have images-2believed a lie that the NHS is “free” and therefore we can treat it however we like and live however we want and it will somehow magically sort us out. On top of this we have an ageing population with increasingly complex health needs and an ongoing under funding of the entire system (only 8.9% of GDP).

 

And we cannot we forget the financial crash of a few years ago which was a major warning sign to us that we are living in a broken system and the god that is
imagesthe Nation State is beginning to crumble all around us. Let me just repeat that difficult statement in another way. The grandfather that is the Nation State is now utterly riddled with a cancer and it is dying. The cancer, like all cancers needs ever increasing growth in order to sustain it’s life and our economy is set up to feed it, but even built on the pyramid of power, control and debt, it can no longer survive. Like any dying man, it is holding on for dear life and as it does so, it puts the squeeze ever tighter on to health, education and other public services, pretending it is still powerful, controlling public services through the slashing of budgets and ever tighter and undeliverable targets whilst not actually dealing with it’s debt issue at all, but telling us all a story that it is. And the mouth of Unknownthis dying beast, the media that has become utterly complicit with it all, spouts out tale upon tale of how mighty the State remains, “punching above it’s weight” on an International scale (using violence and threat where necessary to do so), but tightening it’s belt to ensure economic sustainability. Am I being dramatic? Listen, when 85 people now have more accumulative wealth than half the world and when the 50 richest global corporations are richer than the 50 richest Nation States (and are therefore powerful enough to tell them what to do), the facades must come down. The Emperor has no clothes on.

 

images-1And so it is time to face the music. Once we realize that the centre cannot hold, we can permission ourselves to find new ways of being. There really are alternatives to what we have now. there are other ways of being. Life will go on. We can learn to dance to a different tune, we can sing a new song and begin to reimagine a different kind of future. We can learn to live differently. There are some tough conversations to be had. But, as the old systems begin to pass away, what might emerge instead? What brave or holy experiments might we try without letting go of the wisdom we have learned? What might it be like if politics and economics were just part of a collaborative and cooperative world rather than assuming the role of dominant sovereignty over every other sphere of society? What if we can’t have everything we want right now, learning some new and more effective boundaries around the ways we live? What might we prioritise? How might we move towards a more peaceful world? How are we going to live in a way that is sustainable and leaves the environment as a gift rather than a burden for the generations to come? How might we develop an economics of equilibrium (the state of a healthy body) rather than one of continual growth which requires us to feed its ever hungry belly with our own lives? What might we recover in education? How could we shape regional wellness services? How might cities and regions gift their expertise to one another? How might we choose to protect the most vulnerable in society and provide for the most deprived, keeping love at our core over self-preservation, greed, fear or hate?

 

Unknown-1Truthfully, we can no longer afford to avoid these conversations or hide away in our business. If we want things to remain exactly as they are, then so be it, but what will we leave for our children’s children? In the NHS we spend our lives trying to preserve and prolong life at all costs. But we must learn to face death, because there is life the other side of it. There is life the other side of the Nation State as we have known it. There is still ethical, free, safe, sustainable and accessible healthcare for all the other side of the NHS in its current form. It might become a National Wellbeing Service. Or it might be more regional and cooperative. It will mean some different lifestyle choices and some more effective partnerships. It will mean changing our attitude towards how and where care is provided. But I’m sorry to say that unless we make some radical choices to either pay a lot more tax or not renew trident and spend all of that money on healthcare, there are some deep cuts to be made in the mean time. It is going to be a very painful few years ahead. We must not imbibe ideologies that protect the rich and punish the poor. But we have to be brave enough to let go of the good we have known in order to embrace a future that is better for everybody together.

 

Unknown-2And that calls for a different kind of kenarchic leadership. We need leaders who will serve and collaborate with communities in open and honest conversations, so that cuts do not happen in an isolated boardroom, but witUnknown-3h and among the communities most affected. Leaders must learn to ‘hold the space open’ for the new to emerge. It will mean understanding that we must make choices about which targets we do and don’t decide to meet, prioritising some services over others and taking better care of ourselves individually and in community. But it is not a time to lose hope! There is much goodness to come, much rediscovering to take place. Much creative reimagining to enjoy. Many songs to be sung. So, let’s face the music and dance.

 

 

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1) CONNECT (5 Ways to Wellbeing) – Changing the Culture of the NHS

Here is the first of a series of little video blogs about how we can change the culture of the NHS. The first cohort look at using the “5 Ways to Wellbeing” from the New Economics Forum to help us on our way. This vlog also gives a bit of an intro into the series, so is a little bit longer than the others which will follow.

 

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How Well Are You?

I have the joy of leading some health and well-being retreats with a good friend of mine, who is a life coach. The retreats look at the idea of alignment. Human beings are unique and beautiful, incredibly intricate and are made up of layers, like an onion. Some of those layers are individual and some are corporate, because no person is an island. At the core of who you are is your spirit, your unique self. Then there is your soul – that sweet mixture of emotions, thoughts, ideas, hopes, longings, memories, hurts, resentments, desires, etc. All of that is encased in a physical body, with all the complexities that the intertwining systems entail. And these 3 parts of you are constantly interacting and affecting one anoiuther. For example, physical pain caused to you by another person, may cause you to feel emotionally hurt also (soul pain) and crush your spirit. Or indeed, as I see many times in my work, emotional pain leads to a resentment, which causes a bitterness which manifests itself in a physical pain and so too your spirit is negatively affected.

But you do not just float around in a bubble. You exist in a corporate body, in a family, group of friends and community. You live in an environment of some sort, and your surroundings have an incredible amount of ability to affect your health and well-being. This is evidenced in the effect of air pollution on respiratory disease or the effect of isolation or indeed bullying on mental health. We are all aware of the sights, sounds, smells and stressors in our physical geographies. Added to this corporate body is our corporate soul. And in the corporate soul we find corporate memories, ideas and beliefs, fears and dreams, things we have been taught, world views that shape us and all of this feeds into our meta-narratives, the stories with which we align our lives, that give us some sort of meaning. Surrounding all of this? The corporate spirit. Love. God is Love, not fear, or hatred or violence or bigotry or judgment, but Love. We find time and again in our own lives and in the lives of those who come on retreat the misalignment/disalignment/nonalignment that happens so easily, not necessarily through anyone’s fault, but because life is so complex.

 

It’s not as simple as tweaking one thing and then everything falls into place. Many of us still have to live with chronic and enduring illness of various sorts, be that mental or physical and achieving images“perfect health” may not be possible. But alignment is possible and it is this that gives us a sense of well-being. So, how well are you? Do you know how much you are influenced by the corporate body and soul? What are your meta-narratives? How aligned are you? There are things we cannot change, but we can chose how we respond to them and the choices we make within them. I want to unpack this a bit more in subsequent posts, but this might just kick off some musings.

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Healing our Corporate Soul

In my video blog about ‘Reimagining Health’, I talked about the fact that our well being is not and cannot be an isolated, individualistic experience. The truth is that we are part of a Corporate Body (that is a community of people with a physical environment in which we live) with a Corporate Soul (a set of beliefs/mindsets/worldview) and a connection to the Corporate Spirit (which in my view is either the spirit of love aka God or the spirit of fear). These corporate experiences have a massive impact on our individual sense of health and wellbeing, and actually, as we are part of the corporate, our individual wellbeing has an impact on others around us also.

Our Corporate Soul is the issue I want to concentrate on in this post. It is complex and something to which I believe we pay little attention. However, it’s effect on our individual and corporate wellbeing is vast. Take a moment to think about the subliminal messages that come through our various forms of news and multimedia everyday.

“Your life isn’t as good as your ‘friends’ on Facebook”

“You need to be on Facebook or you are missing out on so much”

“Unemployment is being caused by Immigrants – be wary of them”

“Be afraid – people hate our country and are trying to kill us for the ‘values’ we uphold”

“The way our country does things is right and just and those who die for ‘our country’ are never to be forgotten”

“Pollution is rising – we are heading for natural disasters”

“Buy the new car – you need it, don’t worry about the pollution – live for the now”

“The chocolate industry is built on the slave trade”

“You can’t change anything, so keep on eating all the chocolate you want”

“Banks are to blame for the financial crisis”

“We have bailed out the banks with taxpayers’ money, because we need them so much.”

“Really the reason for our national debt is the poor, who claim too many benefits – we should blame them because they are lazy – we won’t bail them out”

“We all need to live longer”

“We can live however we want – our healthcare is free”

“Our children aren’t doing as well as some other children around the world when we measure them against a set of very narrow targets – therefore we need more targets and more testing”

“The only way to keep our nation really safe is to keep the nuclear deterrent – in the end, this is what makes us safe”

“Our armed forces protect us by using violent force to topple regimes which do not suit our national interest. Power vacuums are now left in those nations with untold turmoil and the rise of significant extremism of which we should be even more afraid and need to silence. We will do this with more force. The use of violence make us feel safe”

 

No wonder we are so messed up. We have some very damaging and also conflicting messages coming at us, especially through the (social) media 24/7. When do we stop to ask ourselves how healthy our worldview/beliefs/mindsets are? How much of our life is driven by fear? A fear of want? A fear of lack? A fear of the ‘other’? A fear of loss? A fear of debt? A fear of attack? And how much of this feeds our individual(istic) souls of self-protectionism?

How badly we need some conversations together that enable us to challenge some of our current core beliefs. We will not find a place of health and well-being, happiness or wholeness until we do. We have aligned our lives with the Spirit of Fear and our Corporate Soul is entirely broken as a result. We must realign ourselves with the story of Love. There is so much goodness out there. Can you see it? Only love can drive out fear. Only love can heal and awaken our souls to another holistic way of being.

 

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