Monday, 20 March 2017

Me, my identity and I

This blog comes from the reflections from a lecture I delivered earlier this week to medical students. I didn’t feel it went very well, and while reflecting on it on the train home, I wanted to blog to clarify my thoughts on it, and prove to myself (I hope) that I can be articulate and clear!

Wednesday, 8 March 2017

When medications are necessary but not sufficient…

I love the question “I’m really interested to hear what things you have been doing or have tried already to manage your [symptom]?”

I always share it with medical students when I am lecturing, and use it a lot in my role as a self-management coach, when supporting individuals. But recently, the answers I have received in conversations locally have made me question our approach and thinking as a system to managing pain. It was summed up for me in a conversation I had with someone who wanted to manage their pain better. I asked what they had done already to try and manage the pain and a list of medications followed. After asking them about what other ideas they might have about how to manage the pain, I asked if I could share some ideas that other people have found helpful. After they agreed, I mentioned things like breathing and relaxing techniques and pacing, as they hadn’t been brought up in conversation so far. With all the ideas summed up, I asked what the person’s thoughts were, and their answer left me shocked…

I don’t think the suggestions you made will work, because if they did work my doctor would have suggested them to me already!

Tuesday, 17 January 2017

Potential of GP Surgeries

This week it has been the turn of GPs to be at the receiving end of the government blame game... no doubt us patient leader types will be in line one day soon, so before my morale is flattened like May has flattened every other type of person within the NHS, allow me a few paragraphs of positivity and hope! 

I've been wondering for a while about the real potential within primary care for person-centred care and self-management support, and various conversations recently, not to mention tweets in response to May's comments, have finally made me finish off this blog and press publish...

One of the arguments I hear about federated GP surgeries is about the economies of scale. I get that in terms of procurements, and have heard many examples of the benefits of economies of scale meaning they can bring in specialists such as in house physio’s and diagnostic equipment etc. I also think economies of scale in primary care mean there are great opportunities for person-centred and community centred approaches in federated GP surgeries. Think what a large Trust can do - patient experience team, engagement teams, information teams, support workers.... If large secondary care services can do it, a la David Gilburt model of patient director in Sussex, so can primary care in the federated models. Let me share my optimistic vision for person-centred federated GP practices, facilitated by a specific job role... I know no-one in primary care has any time for this 'nice to have' stuff, but it is important, so lets gets someone to really focus on it. I'm not asking GPs to do this - god knows they have enough to do already. 

Thursday, 8 December 2016

The 48 hours when I didn't think self-management worked...

I had about 48 hours mid-2016 when I honestly thought self-management didn’t work. Everything that I had based the last 5 or so years of my life (personally and professionally) was a lie. Those 48 hours painfully passed, and left me with a reaffirmed understanding of self-management and belief in the process.

That invisible way stress accumulates, that way you start to be aware of it and think that you can cling on until X or Y and then you can rest and sort it all out… and then very suddenly, you can’t and it all crashes down around you. I had what I can only describe as a the worst panic attack, but it was nothing to do with panic and more a depression attack, but with all the standard panic attack symptoms. Typical for me, with my history of major medical events, this happened whilst I was out sailing. Whisked away by my (utterly brilliant and unconditionally supportive) parents to my grandmothers house, a real safe haven for me, I was in shock and quite numb. Everything had just got a bit too much, and I had burnt out. 

Saturday, 30 July 2016

Self-Management Support: Everyone's responsibility but no-one's job?

At an event recently of very senior Trust types, I started my talk by asking how many of those in audience had self-management support in their organisations - specifically a service, or someone with a role to facilitate it. In a room of about 70 or so, there were about 5-10 hands tentatively raised.

Are we in the era of self-management being 'everybodys responsibility but nobody's job'?

That’s Not My Job 

This is a story about four people named Everybody, Somebody, Anybody and Nobody.  There was an important job to be done and Everybody was sure that Somebody would do it.  Anybody could have done it, but Nobody did it.  Somebody got angry about that, because it was Everybody’s job. Everybody thought Anybody could do it, but Nobody realized that Everybody wouldn’t do it.  It ended up that Everybody blamed Somebody when Nobody did what Anybody could have.
I can't help feeling that the fifth figure of the right is how we feel as patients in this situation... and am reminded of the saying about elephants fighting and the grass getting trampled.

Wednesday, 13 July 2016

Red flags on a Monday morning…

Before 11am on a recent Monday morning, I felt in need of another weekend.

I was chairing a group of patients and carers, who meet to review transformation programmes locally.

In preparation for the meeting, I had spoken to the speaker to check timings and they were clear about what they wanted to discuss and how to do that. I was assured all was ok!

The meeting started well, and the first item on the agenda was introduced – prioritizing areas of a specific programme for in depth co-production engagement work. With 40 mins set for the item on the agenda, the first ten minutes quickly disappeared with an introduction on the process that got the programme to where it was that day, and the questions starting flying in… and my internal chimp mind (the italics below) went into overdrive and concepts of mindfulness went out the window.

Sunday, 19 June 2016

For everything else, there is MasterCard...

Yearly Pre-Paid Prescription Certificate: £104.00
Orthotics: £20
13 day inpatient stay, with MRI, CT and medications: ???
Neck brace and consultation with Orthotist: ???
Two days of tilt table diagnostic tests: ????

A supportive healthcare professional who understands: PRICELESS
Getting back sailing: PRICELESS

Tuesday, 31 May 2016

This Floats My Boat: Project Report

My two passions are sailing and self-management support, and last year I got the opportunity to run a project that combined the two! It took the most inordinate amount of work and really tested me. But I am really proud of the outcomes of the project and the steep learning curve that I've been on. 

The aim of the project was to extend the opportunity to sail through ‘peer to peer’ support for people with severe disabilities/long term health problems across Dorset, working with Chesil Sailability sailors, health and wellbeing groups and the ‘My Health My Way’ service, so supporting people to develop their confidence and therefore their ability to self-manage and take up and maintain healthy behaviours.

Tuesday, 5 April 2016

Whatever the question, I'm not sure leaflets are the answer...

I am a magpie for leaflets... anywhere I go, I try and pick some up. This is primarily because of my role as a self-management coach, having a 'resource table' of leaflets at courses I run and generally wanting to keep in the know about what is available in terms of information and support for the people that I work with.  I am not normal in my approach to leaflets.

Saturday, 13 February 2016

The novelty of a short term health condition - from the perspective of someone with long term health conditions

A few weeks ago I had an inner ear infection, labyrinthitis. The worse of the symptoms were only for four or five days, but it lasted about 3 weeks in total. It was a short-term health condition. This meant that many aspects of those few weeks were in stark contrast to my day in day out experiences of long-term health conditions.