NHS

Tesco helping people with autism cope

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See earlier post on this topic here.

Mike the Psych's Blog

Well done Tesco Burnley. Now how about a slow lane for older customers?

For more information on autism spectrum disorder (ASD) check out NHS info page

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Sickness absence rates don’t tell the whole story

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The number of sick days taken per person has fallen to its lowest levels ever recorded, according to the Office of National Statistics (ONS).

Last year 137 million days were lost which works out at 4.3 days per person – down from 7.2 days in 1993 when the government started keeping records.

That means a sickness absence rate of 1.9% compared to the 3.1% in 1993.

Public sector sickness absence rates were 2.9%, down from 4.3%, contrasting with the private sector rate of 1.7%.

Public sector rates have always been higher than private sector which has been attributed to its generous sick pay schemes.  The private sector rate is more like the rate in the US where until recently few workers got sickness benefits.

Within the public sector the NHS had the highest rate of sickness absence at 3.5%.

When I was a director of a large NHS Trust in the 1990s I was tasked with helping management reduce sickness absence (I had to convince the chairman that it was a line management responsibility which HR could support in different ways).

Carrying out quarterly surveys and publishing league tables I found that levels varied by occupation. Nurses had the highest rates of sickness absence, above 6%, whilst senior managers had the lowest at just over 1%. Admin staff were around the mean of 3.0%.

Taking that data alongside well-being surveys we carried out showed that nurses were the ones who smoked the most (and took off more single days) but managers drank more.

We introduced  “first day reporting of sickness absence, in person to the line manager” where possible, “return to work interviews” when the person came back to work. Monthly reporting of sickness for everybody so we could calculate days lost, number of spells (occasions) and see suspicious patterns around weekends and bank holidays.

We also introduced No Smoking policies, Healthy Eating options, Stress Management programmes, a staff counselling service, provided a gym, a physiotherapist and yoga classes. We also had an occupational health service and offered air miles as a reward to people who didn’t take time off work through sickness.

Despite this mixture of approaches it wasn’t easy reducing the levels. The latest downturn has been particularly dramatic since the economic crash of 2007 and the ONS suggests that job insecurity is a significant factor. Zero hours contracts, currently at a their highest level, can’t be helping and there are more people working as self-employed. Who measures their sickness absence?

Other factors include the opportunity for some people to work from home when they are unwell rather than actually take a day off sick. In fact the TUC believes that far too many people go to work when they are ill and shouldn’t. And that argument has been strongly made for health care staff in contact with patients and you can see the point. Would you want someone sneezing all over you as you lay in your hospital bed?

The TUC say that over the Winter half a million people went into work despite feeling ill because they didn’t want to let down their clients, colleagues, or employer.

Twenty years ago, when I was involved in helping to manage the sickness absence problem, national data, produced at that time by professional bodies, showed that older workers took longer spells of absence whereas younger workers took off more short spells. The new ONS data shows that that is no longer true.

Older workers (over-65s) now take the most time off sick whereas workers aged 25-34 take off the fewest days with a 1.5% rate. The fact that people are still working after what used to be the normal retirement age also says something about the impact of the 2007 slump and people’s needs to top up poor pensions and keep themselves active.

Older workers are more likely to suffer from chronic illnesses but not enough is done to adapt the work for them and lower productivity can be attributed to a lack of investment in training older employees.. BMW in Germany are a good example of what can be done to accommodate older workers and keep them productive,

As I said at the top of the post – there’s more to sickness absence than just the numbers.

HR practices in NHS are embarrassing

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As a former NHS Trust HR Director I cringe with embarrassment every time I read about yet another recruitment cock-up in the NHS.

At the end of 2016 we had the case of Katrina Percy, CEO of Southern Health Trust,  who, after coming under severe criticism following the death by drowning of a vulnerable teenager, was seconded into a made-up job, for which there were no other candidates, on her existing salary. Public pressure eventually forced her to resign.

And her chairman Mike Potter resigned just before the publication of a damming report by the Care Quality Commission.

And then we had Mike Scott CEO of St George’s University NHS Trust which was put into special measures under his watch. Did he lose his job? No, he was seconded on his salary to the NHS Improvement team helping other Trusts (not to go into special measures presumably).

And his successor, Paula Vasco-Knight, had been the COO under him and you would think would bear some responsibility for the Trust’s deteriorating position. She only actually lasted two weeks in the CEO role before she was suspended after allegations of fraud by her previous employer Devon NHS Trust.

She’d already been severely criticised at an employment tribunal after the way she treated whistle-blowers who accused her of nepotism. She’d tried to play the race card at the tribunal but to no avail.

Interestingly at one time Mrs Vasco-Knight was NHS England’s national lead on equality and diversity matters, was the first female BME Chief Executive in the NHS, received an honorary doctorate in Law from Exeter University and a CBE in 2014 for her work on equality and diversity. So obviously ticking a lot of the right boxes.

And is that why people turned a blind eye and didn’t carry out proper checks before appointing herald then ignored her bullying behaviour?

I ask because this week it’s been revealed that a senior NHS boss built £1 million, 10-year career on a fake CV.

Jon Andrewes (photo on right from ITV) called himself a doctor and claimed to have two PhDs. One in ethics management from Plymouth University, and one in business administration from Heriot-Watt in Edinburgh.

He also  claimed a master’s degree from Edinburgh and a degree from Bristol University, plus a diploma from CIMA.

He actually had a diploma in social work and had worked as a builder and probation officer and not, as he claimed, for the Home Office.

He got a job as CEO at St Margaret’s Hospice in Somerset in 2004 and was later appointed to the job of Chairman of the NHS Torbay Care Trust in 2007. In 2015 he beat 117 others to become Chairman of the Royal Cornwall NHS Trust.

Andrewes, aged 63, admitted obtaining a pecuniary advantage by deception (when applying for the Torbay and Cornwall jobs) and two counts of fraud (at St Margaret’s hospice). He was jailed for two years and an application has been made to seize his assets.

The Department of Health says it is examining how he came to be appointed to posts such as chairman of the Royal Cornwall Hospital Trust.

After he was convicted, NHS Improvement admitted that it had not checked his qualifications when it appointed Andrewes under its previous guide of the NHS Trust Development Authority. I wonder if anybody in HR is being disciplined for that oversight?

The Department of Health said:

Mr Andrewes held a significant position of responsibility and trust, and this sentence sends a clear message that fraud of any kind will not be tolerated in the NHS.

What about tolerating serial incompetence?

Some of the people I’ve referred to have probably done more damage to the NHS than Andrewes did but they were rewarded for their failures. It’s a pity we can’t send people to prison for incompetence.

As I said at the top of this post; I despair at the state of HR practices in the NHS. It seems not even the most rudimentary checks are being made. It seems senior people were blinded by his “qualifications”  – as, I suspect, with some of the others when it came to overlooking poor performance.

I’ve said it before, the NHS can’t afford to go on rewarding failure like this

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Following the shambles surrounding the disgraced CEO Katrina Percy – who eventually resigned from her overpaid, invented position along with her previous chairman, we now have yet another example.

Again a failing Trust, and again the NHS don’t seem to have the determination to deal with a highly paid CEO  who is not delivering.

03cdc52Miles Scott, the former CEO of St George’s University Hospital Trust which has been put into special measures, has walked into a new job on a fixed term secondment to health regulator NHS Improvement on a £220k salary.

He’d been at St George’s for five years (and CEO at Bradford prior to that) so plenty of experience at board level. But he failed to stop the trust being put into special measures by the Quality Care Commission this week.

Sir Mike Richards the chief inspector of hospitals said “I am disappointed that we have found a marked deterioration in the safety and quality of some of the trust’s services since we inspected two years ago, as well as in its overall governance and leadership.”

Worryingly we found that areas in which children and young people with mental health conditions were cared for had not been checked for ligature points and that half the medical staff working with children and young people had not completed level three safeguarding training”

Scott is reported to be “undertaking specific change management projects and providing additional support to the executive team” On £220k a year! Rather overpaid for that remit I think.

Can no-one see the irony of someone who led a deteriorating (in terms of safety standards, governance and leadership) NHS Hospital Trust for two years advising other trusts on how to raise standards? The same with Katrina Percy. What are they thinking of when they make these appointments? Do they think people will really take advice from them in the circumstances?

4982778To make matters worse at St George’s, according to a report in the Times ,his successor, Paula Vasco-Knight, who was the Chief Operating Officer at St George’s before Scott left last month, was suspended after less than two weeks in the job.

This followed serious financial allegations by her previous employer, Devon NHS Trust, that she defrauded them by abusing her position to bypass normal procurement arrangements and essentially siphoned off money to her husband’s company – which she has denied in court.

A statement by St George’s said: “As a result of serious allegations being made against her, Dr Paula Vasco-Knight has been suspended from her role as acting chief executive at St George’s University Hospitals NHS Foundation Trust. The allegations are financial in nature and relate to her work at a previous employer.

At one time Mrs Vasco-Knight was NHS England’s national lead on equality and diversity matters, was the first female BME Chief Executive in the NHS, received an honorary doctorate in Law from Exeter University and a  CBE in 2014 for her work on equality and diversity. So obviously ticking a lot of the right boxes.

However that passion for equality obviously didn’t extend to recruitment as she was accused of nepotism by two whistleblowers for giving her daughter’s boyfriend a job at Torbay Hospital for which she was criticised by an employment tribunal.

She tried to play the race card at the tribunal saying “On a personal level I found the allegations as nothing less than personal slander and I wonder if a white middle class male chief executive officer would have been treated with such disrespect.”

However that didn’t wash with the tribunal judge Nick Roper who ruled:”We find that there was a concerted effort by the South Devon Healthcare Trust to manipulate the investigation, accuse the claimants of malice, suppress the report and to mislead the other parties as to its contents, with the apparent aim of protecting Dr Vasco-Knight and Mrs Murphy against the force of the claimant’s allegations.

Mrs Murphy was a senior colleague in whom the whistle blowers confided who told them they would lose their jobs ‘through dirty means’ which left them feeling ‘bullied, threatened and intimidated’.

“This was completely contrary to the protection which they should have been offered under the Whistle Blowing guidelines.” said the judge. One of the whistleblowers returned to work, the other received £230,000 in compensation.

You don’t get the impression of a healthy culture under her leadership do you?

That event led to her suspension from the Trust and her eventual resignation. The official line was that she moved North for family reasons and for a time worked for East Lancashire NHS Trust as a management consultant, reportedly on £1,000 a day.

Her LinkedIn page, currently closed down, reportedly gave her roles as a “turnaround director/director of transformation” for Solitaire healthcare, where she says she had been since July 2014, and interim chief operating officer, a role she has held at St George’s since September 2015 where she worked under Miles Scott. So wasn’t she as culpable as him for the failures there? Why then appoint her?

Yet again we have a number of embarrassing failures of leadership or worse and the NHS seem incapable of dealing with them. No wonder the Taxpayers Alliance is up in arms. John O’Connell, the CEO, said “there is a worrying trend of impunity in the public sector where fat cat salaries don’t seem to reflect performance and nobody is held accountable for the failure to provide taxpayers with the services they pay for and expect.

“How can a Trust put in special measures possibly justify such a ludicrously large salary for its former chief executive and – bizarrely  – continue to pay him even after he’s taken on a new role elsewhere?

My point exactly. Why wasn’t he just sacked for poor performance? Why do we have this continuous revolving door of failed executives? Why are we still rewarding failure?

NHS can’t afford to reward failure like this

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hEFGqWFbq4rM2_uOeHbVLAwqtt1UqJeYUGU5cjJmrhSXx7TLIftY0Sy8Z6V9GiDxQzIaEJA=s151Katrina Percy, the former Chief Executive of Southern Health Trust, has been under pressure to stand down for months after the mental health trust she led failed to investigate the deaths of more than 1,000 people with mental health and learning disabilities between 2011 and 2015.

This catalogue of disasters in a Trust that states its aim is: “to provide high quality, safe services which improve the health, wellbeing and independence of the people we serve”.

Her LinkedIn profile describes her as: Passionate about leading organisations through transformational change of their clinical service; placing a very strong emphasis on the leadership and team development throughout the organisation to enable this.

That’s her opinion. An independent review found that “a failure of leadership” had led to these deaths going unanswered but she resisted efforts to resign until this week.

3016053_Katrina_Percy_14th_MayAnnouncing her resignation she said “I have reflected on the effect of the ongoing personal media attention has had on staff and patients and have come to the conclusion that this has made my role untenable.

I have, therefore, come to the difficult decision to step down from my role as chief executive after nine years.

“I am delighted to be taking on an alternative role, providing strategic advice to local GP leaders as they work with others to transform the way in which health services are delivered across Hampshire, and I feel that now is the right time to take on that new challenge.

I know and understand that many will say I should have stepped down sooner given the very public concerns which have been raised in the past months. I stayed on as I firmly believed that it was my responsibility to oversee the necessary improvements and to continue the groundbreaking work we have begun with GPs to transform care for our patients“.

Not one word of apology or any sign of contrition. This “I’m the only person who can fix it” attitude, despite getting the Trust in a mess in the first place (she was CEO for 9 years), is not uncommon. It’s also been used by Police Chiefs and other public sector chiefs.

And of course she’s delighted with her new role – she’s still being paid very generously – on the same £180,000 + benefits – in a consulting role. But why would GPs take advice from someone who has been criticised for leadership failures?

It now turns out that the post was created especially for her, there were no other candidates and no interviews. This is not the way to recruit top executives in any organisation.

And what were the chair and board members doing about the independent report? Well the Trust’s Chairman Mike Petter resigned days before the publication of the Care Quality Commission report which said that the Trust was still failing to protect people.

The interim chairman, Tim Smart, says “Katrina has ensured that Southern Health is now working more closely with other health and care organisations in the region to provide more joined-up care, so more people receive support at the right time and place

But Andrew Smith, the MP for Oxford East, said that her continued employment was evidence that the Trust was “not fit for purpose“. He also said “it’s disturbing too that her comments and those of the Trust blame her resignation on media attention rather than acceptance of her ultimate responsibility for the abject and fatal failings of Southern Health

The mother of a vulnerable teenager who drowned in a bath after having an epileptic fit , an incident a jury inquest ruled as caused by neglect, also criticised the Trust. “It’s good that she’s no longer CEO and hopefully there will be more movement at board level. To reward her with a made-up post at the same salary is simply scandalous”.

I think most people would agree with that sentiment.

What Type is your compassion?

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When junior doctors are threatening strike action you have to wonder what has gone wrong with a profession which you expect to set the highest standards among the caring professions.

CareAndCompassion_TypeTable_Oct2015_594x690mmAnyway here’s a MBTI type table (courtesy of OPP) which illustrates how different types demonstrate their compassion.

 

Empathetic Introverts make the best Carers

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female_nurse_1600_wht_9033According to the MacIntyre charity, cited by Camilla Cavendish, the Times journalist who has just published a review of healthcare support workers.

The charity, which provides services for 1,000 adults and children, has created detailed psychological profiles of care workers.

The best ones, the “naturals”, are:

  • empathetic introverts,
  • good listeners,
  • reflective, and
  • wanting to work within clear rules
  • in structured environments.

Click here for more information and a quiz for you to check out if that kind of work is right for you.

Recruiting people with emotional intelligence and the right values would be a good start. Companies like Nokia have been recruiting for values and attitudes for decades taking the view that they can train people in the technical stuff quite easily.

6c-logoThe Chief Nursing Officer’s vision Compassion in Practice (the 6 Cs) highlights the importance of care and compassion.

One of the 6 Cs is courage and it’s interesting that McIntyre found that the best carers, being introverts, were not very gregarious but would stand up for the people they cared for.

There is also some good research which shows that people with introvert preferences can be more effective leaders than extraverted types.

And you may have heard of Susan Cain, best-selling author of “Quiet: the power of introverts in a world that can’t stop talking” (2012).

books

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Keeping up with speed 

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Keeping up with speedThe report that 10% of Cambridge University students are taking cognitive enhancing drugs is hardly groundbreaking news.

This has been known about and reported on for several years.

For example back in 2010 The Times  reported (6 July) that UK undergraduates were resorting more and more to “smart drugs” to boost exam performance and to enable them to cram better. Prescription drugs such as modafinil and Ritalin were being used by about 10% of students, mostly obtained via the internet with the risks that students were buying counterfeit drugs.

Modafinil is used in Britain to treat serious sleep disorders and in the USA for shift workers with attention deficit hyperactivity disorder (ADHD). It’s also used by the military to enhance alertness. (There were suggestions during the first gulf war that American pilots involved in friendly fire incidents might have been using amphetamine-related drugs at the time to prolong time in combat).

And 1 in 5 academics surveyed internationally by the journal Nature admitted taking cognitive enhancing drugs, some to combat jet lag. Nice to see the professors setting a good example!

A year after that news report the release of the film “Limitless” – “One pill. Anything is possible”,  re-opened a discussion about the use of smart drugs.

Modafinil and Ritalin are particularly mentioned as cognitive enhancers favoured by students, lecturers, combat troops and shift-workers. Pretty much a rehash of last July’s Times story on the BBC News web-site.

The late Richard Carlson, author of the best-selling “Don’t sweat the small stuff“, also wrote Slowing down to the speed of life”with Joseph Bailey in 1997.

Carlson was a Californian psychotherapist who specialised in stress and what would now be called positive psychology – learning to be happy and not worrying about the small stuff – “because it’s all small stuff“.

Even then he was encouraging us to slow down and live more in the moment. In the introduction to “Slowing down ….” Carlson talks about the use of computers as time savers (in the days of fax and before Facebook and Google) and multi-tasking, but argued that we don’t then enjoy the time we have saved but fill it with even more tasks in an effort to be more productive and squeeze even more into our lives.

Now only 15 years on, some Attention Deficit Disorder (ADD) experts believe that constantly changing attention and distractions caused by modern technology in all its forms can lead to mild forms of ADD: impulsivity, irritability, ineffectiveness, being disorganised –  at the expense of creativity and productivity. All in an attempt to keep up with the flood of information, some of which is self-generated.

It’s no surprise then to read that sales of a drug used to treat ADD are soaring as increasing numbers of American adults report the condition. In 2011 Shire Pharmaceuticals reported Q1 sales up a third with the market expanding at 10% a year mainly because of an 18% annual increase in adults being diagnosed for what many thought to be a childhood condition (10 million adults and 4.5 million children have been diagnosed with this condition in the USA). The latest research shows that children treated for ADHD are three times more likely to misuse drugs as teenagers. No surprise really if they’ve been brought up on medication and believe that’s the answer to everything

And what happens in America …  Britain got its first support group for adults with the condition in 2010.

A full-page story in the business section of the Sunday Times (30/5/10) elaborates on the success of Shire pharma currently outselling Ritalin with their medications for ADHD and. who made news paying their US Chairman $10 million in salary and shares.

The CEO expects ADHD to be increasingly acknowledged as a source of adult problems here as in America including in the prison population. He says that in Europe if your child has ADHD it is considered a failure of parenting; in America; “they just want the best for their kids” so have doctors and psychiatrists prescribe them amphetamines.

I met Richard Carlson and his wife when they did a book tour of the UK in 1998. He looked the epitome of a laid back Californian. He signed my book with; “Keep a sane pace”. Sadly he died in 2006 of cardiac arrest on a plane in the middle of a tour to promote his latest book. It seems not even the experts are immune from the pace of modern life.

 

Original post 3 June 2010 with updates