YouTube Part 2

There are some more channels on YouTube:

What to watch on Youtube now v1.0

I’m a fan of YouTube.  Here are some of the shows I like:

  • Nerdwriter1 – The Nerdwriter is a weekly video essay series that puts ideas to work.
  • Vox – Vox helps you cut through the noise and understand what’s driving events in the headlines and in our lives, on everything from Taxes to Terrorism to Taylor Swift.
  • Max Joseph –  sometime filmmaker and part of Catfish .. just not the one you are thinking of.

More next week.

When work tells you, “we’re family here”.

Decoding the world of work is becoming more tricky by the day. Our colleagues at work get mixed up with our Facebook friends and become frolleagues. Our employer tells us that “we are like family here”. Perhaps in the back of your mind, there is a worrying thought that this is all about trying to make sure work is the most important thing that we do in our lives.

I like the way Reed Hastings of Netflix puts it.

Netflix

Have this slide in the back of your mind when you hear the paternalistic siren call to family values. It isn’t at all what it seems or what it should be.

 

 

 

 

Are single-handed GP practices safe?

You may have felt a tremble in the force over earlier this month.   NHS England got its revenge or  perhaps better described as a “premptive cringe”, in early ahead of a BMA strike on the Director of Primary Care at NHS England Dr Arvind Madan.   I am no expert but the BMA (the Doctors Trade Union) is not keen on the closure of small GP practices,  I am sure they will comment below if they’re concerned about my lack of understanding here.

But here is some evidence, there’s not much of it, but it’s pretty clear; if you’re a patient stay away from small GP practices. 

Elaine Kelly and George Stoye published Does GP Practice Size Matter?
GP Practice Size and the Quality of Primary Care in Nov 2014. You can read it for yourself.

Here are a few bullets from the executive summary:

  • Single-handed practices have the lowest average (mean) QOF scores
  • For ACS admissions, there is some evidence that smaller practices perform
    worse, on average, than larger practices and are more likely to be among the worst performing.
  • Practices with three or fewer FTE GPs are less likely to refer their patients for secondary care than larger practices. Single-handed practices are also less likely than larger practices to refer patients for treatment by independent sector providers (ISPs)

So what should you do as a patient, well you can make your own mind up?  I look for the largest practice with the lots of doctors and nurses.

It’s a shame that NHS England felt it could not stand up for patients and those GPs that provide better care.  I’m sure their action is counter to the NHS Constitution Principles 3 and 6, but we don’t hear much of that these days.

 

What’s the point of Health and Wellbeing Boards?

You may have been following the changes to the NHS over the last few years. Or perhaps you are just a user of services, going to your General Practitioner and then to a local hospital. Either way, you should know that your local Council has been given some wide-ranging powers to provide local health and social care services. Who cares? It’s a reasonable response to all of the changes. But there are some things should concern you.

Look at these three data points about health services in England.

  • One in two hundred babies are stillborn in England
  • Young people can wait months to receive mental health services
  • In the UK young men die younger than in just about any other European Country.

in the light of these issues I want to look at what Local Health and Wellbeing Boards are discussing in their meetings.

Using a search engine of your choice, you will quickly find the papers of you local HWB on the internet. And that’s where it pretty much turns to rat shit. The jargon and impenetrable language are there in the first paragraph. Here is the explanation of what the HWB does in Brighton.

The purpose of the Board is to provide system leadership to the health and local authority functions relating to health & wellbeing in Brighton & Hove. It promotes the health and wellbeing of the people in its area through the development of improved and integrated health and social care services.

The HWB is responsible for the co-ordinated delivery of services across adult social care, public health, and health and wellbeing of children and young peoples’ services. This includes decision making in relation to those services within Adult Services, Children’s Services, Public Health and decisions relating to the joint commissioning of children’s and adult social care and health services (s75 agreements).

Are you any the wiser? Perhaps the focus on young people caught your eye. Although you may now be worrying about the three data points I highlighted.

Reading the Agenda and the Minutes of the meetings won’t help you. They’re even more Delphic.

The most concerning element for any Public body are the meetings they held in camera. They regularly exclude the public from their discussions.

Members are often keen to show they have no conflict of interests, and it’s usually the first agenda item. But no one seems concerned that as mainly elected officials they are in conflict with their electorate for excluding them. You might also reasonably ask why there are so many doctors and so few nurses as members of your HWB. Perhaps too much interest all round.

So, if you have the time to attend an HWB meeting, go and listen to their arcane discussions, see if you understand what they are doing in your name.

The next meeting here in Brighton is in September. I will be there.

Who pays for local journalism – we do?

You may have felt a little schadenfreude when you read the $Billion reduction in the value of Facebook. Not unlike the 2008 crash, this money has gone to money heaven, and will probably never reappear.

However, something else is also dying as the Facebook and Google scorched earth policy rips the heart out of the paid-for newspaper advertising revenue. It’s journalism, as the business model of newspapers comes under threat, the newsroom can no longer afford a full roster of journalists.

The effect is both National and Local, but the local impact is much more significant as there is no one else to scrutinise local political and public services.

In New Jersey, the state’s lawmakers will begin to  fund community journalism, and this will include for-profit as well as non-profit groups.

I sadly can’t see this coming to our communities anytime soon; who would be prepared to pay for such a subsidy? It’s a real dilemma, failure to scrutinise local political decision making will lead to poorer decisions. In turn, this will lead to a more significant waste of public money. Undoubtedly more than the cost of the subsidy in the first place.

I think there may be three practical steps we can all take:

  • Find our local news site; it may be a newspaper or a community group, sign up and join the discussion.
  • Attend local Council and Public service meetings and remember to ask a question, how they handle the response may tell you a great about how they feel about scrutiny.
  • Support national and regional newspapers through their subscription services, pay a little to benefit a great deal.