Health-geekery October 2016

One of the challenges in my job is the sheer amount of information that crosses my desk; making sense of it, sifting out what is relevant, piggy-backing on the analysis of others while recognising that they too will have their own agenda.

A list of third-party links like the one below isn't the solution, but it is a way of ordering and keeping track of things. I'll try and mainly link to places that aren't hidden behind a paywall, but in the case of the Health Service Journal (HSJ) the issue is that the site itself is essential reading for anyone in the business.

And why put it on the blog? Hopefully it will be useful to others as well, but at least I'll know where to find it!

15 October - the Care Quality Commission launched its annual State Of Care Report

"More than 80 per cent of GP practices and six out of ten of adult social care services inspected by us so far have been rated as good or outstanding. Of the hospitals rated, 38 per cent were also found to be good or outstanding.

However, alongside these encouraging findings, there remains significant variation in quality and an unacceptable level of poor care. Up to 31 May 2015, 7 per cent of acute, primary medical and adult social care services had been rated as inadequate."

PS - the Walton Centre (specialist centre for brain and spinal conditions on Merseyside) got an outstanding rating from CQC.

And the somewhat less upbeat response from National Voices 

NV is the umbrella group for health and social care charities - the MND Association is unsurprisingly a member.

"The CQC’s State of Care report exposes the effects of chronic underfunding of social care services. Today we see people left to fund their own care, providers unable to deliver services, and a knock-on effect on overstretched NHS services as people repeatedly need help due to inadequate care arrangements."

National Voices' representation to the Treasury ahead of the Autumn Statement is also a very useful 'state of health and social care address' from the charity sector and well worth a look.

And while the NV love-in continues, here's their briefing on the current Health front-bench and their shadows.

Sustainability And Transformation Plans 

Birmingham first local area to publish its full STP submission (despite being told not to).

Birmingham City Council's Director for People has already expressed concern that there is too much focus on NHS finances in the STP proposal rather than a system-wide solution for health and social care (article here behind the HSJ paywall)

Behold the orientation briefing from Healthwatch Birmingham (plus the official NHS guidance on engaging communities in STP's)

Added 4 November - a round-up of further reporting online. Links do not imply endorsement, natch.

Birmingham Mail
Birmingham And Solihull Social Economy Consortium
Chamberlain Files (part the first)
Chamberlain Files (part the second)
Digital Health
Healthwatch Birmingham
Keep Our NHS Public Birmingham (pre-publication)
Local Medical Committee (pre-publication)
Local Medical Committee (post-publication)
Public Sector Executive
Solihull councillor Ken Hawkins

Further links collating known information on as many STP's as possible can be found on the Health Campaigns Together site.

King's Fund report on social care for older people

"The picture that emerges is of social care providers under pressure, struggling to retain staff, maintain quality and stay in business; local authorities making unenviable choices about where to make reductions; a complex set of causes of delays in discharging older people from hospital; and the voluntary sector keeping services going even when funding was curtailed."

25 October: Systems Not Structures Report on transformation of health and social care in Northern Ireland 

Written by committee chaired by international health expert Professor Rafael Bengoa, welcomed by NI Government. 

Full report, Executive summary, BBC article

At first glance, useful proposals and phrases from the executive summary:

• People in Northern Ireland are disproportionately high users of urgent care, perhaps due to the absence [...] of alternatives.
• 2 of the 3 ‘Triple Aims’ are improving patient experience of care and reducing the per capita cost of care, which are things we're talking about already (especially the former, pragmatically the latter).
• Recognition that some services are so specialist that they must be delivered at a Northern Ireland level.
• Support for exploring innovative primary care models (e.g. community nurse-led care models)

I'd like to add a transcript of Health Committee discussions from 27 October - the Minister for Health Michelle O'Neill + Professor Bengoa were briefing them on the report and how the Government sees it (broadly speaking, we know they like it). Unfortunately, I think it may have been in closed session.

Stark figures in Wales

Report from the Health Foundation analyses the demand and cost pressures facing the NHS in Wales up to 2019/20 and in the decade beyond.

At least £700m of efficiency savings needed, saieth the report.

And finally ... Uptown Trust Ranking

New oversight ratings for every NHS Trust (in England) from NHS Improvement - you'll need a Health Service Journal subscription to have a look at this.

Prime Ministers with pubs named after them

On the back of the John Wilkes post, and because it's been a while since we've done a list on the blog:

If I've missed anything out (entirely possible) add a comment and I'll update this post.

Twentieth century Prime Ministers with pubs (or other drinking establishments) named after them

Arthur Balfour (a Conservative Club in Bargoed, Caerphilly)
Winston Churchill (Bilbao, Montreal and less glamorously a Harvester in Rochdale; probably more besides)
Harold Wilson (the Lord Wilson in Huddersfield)
Margaret Thatcher (Maggie's Club in West London, natch)

Honourable mentions

David Lloyd George (a function room and former bar at the Liberal Club) 
Jim Callaghan (has a coffee shop named after him in the James Callaghan Building at Swansea University)

Surely a missed opportunity, left-wing types?

Clement Attlee 

Nineteenth century Prime Ministers without pubs named after them

The nineteenth century was very much the golden age of pub-naming if you were a politician (especially an aristocratic one)

Spencer Perceval (apparently being the only PM to have been assassinated doesn't warrant commemoration in this form)
Earl of Liverpool (no theories on this one)
Viscount Goderich (should have had a catchier title if he wanted a pub name, perhaps)

A business proposal

A small chain of pubs each named and themed after a different twentieth century Prime Minister. After all, there's clearly a gap in the market after 1900.

Wilkes and Lib-beer-ty

My inner history geek was pleased to find a pub in Leek named after eighteenth century radical, hellraiser and rabble-rouser (and particular thorn in the side of George III and his first Prime Minister the Earl of Bute) John Wilkes.

Wikipedia and Google tell me it's not the only pub so named - there's two more in Eastergate, West Sussex and Llandysul, Dyfed, and there used to be two more in St Ives, Cambridgeshire and Brentford, London.

This Wilkes Head claims to be one of the oldest pubs in Staffordshire, although I presume that's the site not the current premises! 

As far as I am aware, Wilkes also has no connection with Leek (which by comparison explains why Northampton has honoured local MP and early humanist Charles Bradlaugh with a pub named after him). So it's doubly fascinating to see how nearly 250 years later his infamy lives on in this and a few other scattered parts of the country.

'A ravioli set on toothpicks'

Whoever stashed this beermat sketch in the information rack at Tamworth station, hat off. Sadly your Facebook link does not appear to work.

A quick note on the Tamworth 10K

Last Sunday I ran the Tamworth 10K in 57 minutes, 40 seconds, my second 10K of the year. In fact, my second 10K ever.

This was nearly 4 minutes quicker than my performance in the Lichfield 10K last month. Despite having trained less, I ended up running less cautiously and it showed in the time I achieved. 

This shows that if I can combine a good fitness regime in the build up to a future race with maintaining a steady pace in the run itself I can hopefully shave a few more minutes off my time without too much difficulty.

Class struggle: Koushun Takami's Battle Royale

In Leviathan, Thomas Hobbes describes the condition of man before laws, before government, as a war of all against all. Life in this state of nature was 'nasty, brutish and short.'

This is also a pretty good summary of Koushun Takami's Battle Royale, except for the short part: the novel (in a new translation) is over 600 pages along.

Actually, the world of Battle Royale is a Leviathan simulating a state of nature, as the book sees an authoritarian Japan's ruling elite get its kicks by letting armed high school students loose on an island and ordering them to kill each other or be killed by explosive collars around their necks.

Whether this is also a safety valve for the regime or just an arbitrary exercise of power is never entirely resolved. Takami's characters try both ideas on for size, but what do they know - they're just kids, right? The contrast here with Suzanne Collins' Hunger Games trilogy is striking, where the role of the Games as a tool of social control is very apparent.

Battle Royale also lacks its literary descendent's concerns with performance, ethics and identity. Instead, it's sex and death nearly all the way (and mostly death at that). Altruism, friendship, trust and mercy are values that the class struggle to hold onto when life becomes survival of the fittest; pretty much the only motivation that survives alongside is love or adolescent lust.

How does it read? Like a bracing jolt of nihilism as we meet each student and hear their story, often shortly before the body count increases. And viewed in those terms it's an thrilling action-driven text that allows you to overlook the functional writing (at least in translation) and stereotypical characterisation.

But Battle Royale is not just pulp teensploitation. Its rather Freudian fixation on eros and thanatos, life, death and rebirth - has something of the ritual about it. As does its repetitive nature and obsession with counting - the number of classmates remaining, the numerical ID each one has, the division of the island into grid squares, even the time of day.

Something in the concept and the delivery then, somewhere at the heart of what Takami has done here, makes for a dark energy that transcends the material itself. You might not like it what it has to say, but it's powerful nonetheless.

Big thanks to book club friends, whose discussions informed this review.