Just realised you’re a carer? Three things it’s good to know now.

Lesson 1  – Don’t be passive in any situation, I don’t care how senior they are or what specialist knowledge they have.

Right off the bat I realised I needed to be the decision maker; I felt that there were some occasions when I thought someone else was the decision maker?  This was never the case, at the bedside in a hospital ward, during some social care meeting or just choosing a hairdresser to come to the house; I realised I had to make all of the decisions. That does not mean I did not include my Mother in these decisions, but it became pretty clear all decisions would have to be made by me.

This is particularly the case in healthcare situations. During my Mother’s last stay in Hospital, which should have been a short one, I quickly realised that the ward staff were unable to make any decisions about my Mother. She was not well enough to go home without a care package and no one could decide how big that would be or who should provide it.  So we kept going round and round in circles with me asking their advice.  I found I had to guard against being passive and learnt how to challenge decisions that were or were not being taken.

Lesson 2-  When someone tells you something check both you and they understand what they are saying.

People called me out to the blue and started chatting about my Mother and her needs. This initially seemed like good news.  On at least two occasions I realised that they were not talking about my Mother, some transposition of phone numbers on a list perhaps.  So when I  got one of these calls I did the following:

  • Asked them to identify themselves
  • Got their contact details –  I always did this first. Get their general contact details to and their specific job title.
  • I recorded all of these interactions into an Evernote Notebook; you can, of course, use a paper notebook
  • I confirmed who they thought they were talking about –  I did this through active questions like; “ You wish to discuss Mavis Coulthard with me who’s on Ward XX at the Royal Surrey Hospital?  Is that correct?
  • I would then confirm who they thought they are talking to.
  • Then and only then would I have the conversation
  • Finally, I would confirm the agreed actions back to the caller.

Lesson 3 – Write it all down and keep your eyes and ears open

Don’t rely on your memory, write everything down how ever trivial it might be.  A mobile phone camera is really good at capturing complex meds and forms.   I found that I was often the only person that had all of the information.  The last hospital discharge letter, a list of the latest meds, the name of the intravenous antibiotic Mum was on.  I found that no one seemed to have the right information at the right time.  More of this in another Post.

Once my Mother was discharged from the Royal Surrey Hospital without any medication.  At the time, she was on about 13 different pills.  Fortunately, I had a photo of her medications and the schedule associated with them.  I was able to send this to a local pharmacy and they were able to sort out the mess with some help from my Mother’s GP. Without that intervention, I guess Mum would have been back in Hospital that night.  The healthcare ombudsman has recently published a report into the discharge of older people from hospital.  It does not make good reading.

I found I needed to be aware of the conversations around me and my Mother, I read all of her medical notes, I asked open-ended questions and listened hard to the answers.  I found it easier and easier to challenge the jargon. The NHS loves jargon, three and four letter acronyms abound and I just asked what they meant.  Sometimes not even the user knew what they stood for.



Hello, we’ve had an idea that may change the way older people access local services. It stems from the challenges I faced caring for my Mother, but I guess you may have spotted that.   We  have been at it for eight weeks now and we have learnt a thing or two.

Lesson 1:   Read The Lean Startup and once you have done that, read it again.  It’s not about Startups it’s about constant innovation.  It will save you time and more importantly money.

Lesson 2: Work out, as concisely as possible, how to describe your idea.

We started with:

The leading marketplace to make the provision of personal, household and community services easier and more accessible, helping older people and their families live happier and more connected lives“.

We are now:

BriteLives.com is the place where you can find and review local and personal services for older people.

Cutting out those words was a great deal harder than writing them in the first place.

Pitch it to friends and to yourself.  Make sure you do it slowly, accent the name of the Business. Something like:

BriteLives.com  (pause) is the place where you can find  and review (pause) local and personal services (pause) for older people.

Lesson 3:  Join an innovation accelerator.  You may be sceptical about the value, don’t be. You can’t think of everything, so let someone else force you to think about the relevant things and set some deadlines for you. It will accelerate the development of the idea more than you could imagine.  We are part of BGV and wow what a difference they have made already.

Quick Test: Can you guess what BriteLives.com does?




What should our response be to trading Charities?

Was I the last to know that most of the big charities make more money by “trading” than they do from donations.   So if I look at a few :

  • Leonard Cheshire – 92% of income from Charitable Activities 7.5% from donations
  • Action for Children  – 90.8%  of income from Charitable Activities  7.7% from donations
  • BARNARDO’S  -64 % of income from Charitable Activities 17.8% from donations

Many do rely on donations:

  • Help for Heroes  – 14% from Charitable Activities and 79.7% from donations
  • NSPCC – 15% of income from Charitable Activities 76% from donations
  • ALZHEIMER’S SOCIETY – 34.9% of income from Charitable Activities 54.2% from donations

You can find all of this information from the Charity Commission web site.

Should the corporate response be the same for those both groups?  Perhaps businesses should provide more support to those that rely on donations.

Ten things I learnt at the Supply to Government Conference 21 Nov 2011

When I listened beyond the rhetoric and read between the lines (thanks to the King’s Fund for teaching me how to do it)  I discovered:

1. Frances Maude blames the Civil Service for all the poor procurement, delivery and funding issues in Government today.

2. The Civil Service blames the suppliers for all the poor procurement, delivery and funding issues in Government today.

3. Civil Servants working in Government ICT blame Microsoft, Oracle, SAP, IBM, HP, BT, the “big 4”, and anyone in IT for all the poor procurement, delivery and funding issues in Government today.

4. Anyone working in Government would prefer to mention a US digital company… like Twitter or Facebook long before they mention a British firm like ARM or Huddle.

5. Left on their own Civil Servants will look after themselves first, look no further than MyCSP (My Civil Service Pension), the first Social Enterprise to come out of the Cabinet Office.

6. No one in the Civil Service seems to know what a Social Enterprise is… one senior leader in Civil Service said … “oh yes all the Twitter and Facebook stuff… oh very good”… words fail me!

7. In talking about New Business Models for delivery of public services Civil Servants  can only talk in terms of the old ways.

8. When discussing the leadership of change they refer to civil servants changing their jobs; never losing their jobs… there is a difference.

9. Most Civil Service leaders I met at the conference gave the impression that it is impossible the think about or visualise the future, and they seem to have no knowledge of the Popcorn Institute , IDEO, Imperial College or UCL or anyone that has a track record of doing just that.

10. And finally I learnt never to go to one of these things again.

public services…not in my name

Recently I have attended a number of meetings to  discuss public service reform, it has been a theme that has come up over coffee, Sunday lunch and at the pub as well as these more formal gatherings.

In most of these discussion we seemed to reiterate all the old themes.. with the odd politicians stoutly defending the status quo while seeming to talk a new reality.  And when the old guard were present they saluted the unfathomable issues and nod to the half-truths used to explain the impossibility of thinking anything different.   While I agree with Hume that truth only exists in a discussion between friends I doubt that  much truth was agreed in any of our discussions. 

The quick polarisation to Ryan Air and “I don’t like the Easy Jet web site” show that no one wants to know that if Central Government took Easy Jet’s approach to ICT then Central Government would save £15Bn a year in ICT costs…. Yes that is £15Bn,  no really £15Bn a year .. yeah I know….

There has been no chance of thinking that the 3rd sector might play a role or god forbid that the private sector might be better at anything… whenever the subject of  private education raised it is quickly  is glossed over as being unimportant or irrelevant by the  civil servants present.    Maybe I am meeting the wrong Civil Servants…. I am sue I am asking the wrong questions.

To my mind there was an elephant standing close to these conversations, the silent civil servant majority, the saboteurs, as someone said during one of these round trips to the eventual Blinding Glimpse of the Obvious.   People, that for the last few years have been the butt of all that is “wrong” with the Public Sector.   Expect that  they are the building blocks of the huge state bureaucracies that support the careers of the senior civil servants.  The issue is Leadership not the workers… shocking that anyone would think otherwise.  Honestly, why does the each Government Department need a CTO for goodness sake.  .

My real concern is that if we are to reform  public services then inviting the Public Sector to discuss it is worthwhile but it not THE answer, you need to get; Peter Holbrook,  Patrick Lewis, Julia Grant, Nick Bosanquet, Charles Midenahall and Ceri Jones in a room… listen to them you will hear the new reality,yet again  the future is here it is still poorly distributed.