Danny Bowman
Danny Bowman
Conservatism Studies Conference 2023
University of Edinburgh
January 2023
I was delighted to present my most recent research on 'Conservatism and Mental Health Policy Across the UK' at Old College, University of Edinburgh. The core findings suggest that Conservative parties across the UK diverge in their approaches to mental health policy.
How to Maintain Good Mental Wellbeing During the Coronavirus
29th March 2020
The coronavirus continues to spread across the globe, causing a substantial number of individuals to become extremely anxious about the current situation we find ourselves in.
The constant barrage of information, some helpful, and some not so helpful continues to contribute to increasing mental strain on the population. It’s important to remember that within this crisis we must not only protect our physical health, but also our mental health. Below are five simple steps to maintain positive mental wellbeing for ourselves and for others during this crisis.
1) Speak to One Person Each Day
During the Coronavirus people are understandably reducing the number of individuals they see in a day. Keeping their distance from large gatherings and withdrawing from situations where the spread of the virus may be more likely.
Although, in our technologically advanced world we can connect with people over the phone, through Facetime, emails and even Facebook Messenger. At a time like this a simple message to a friend or a call or Facetime to a family member can make all the difference in the world. Its communication that is at the heart of who we are as human beings and communication can benefit not just our mental health, but others too.
2) Do Something Kind
A crisis like this demands kindness, it is one of the most important attributes that a population must hold if it endeavors to get through times of great struggle. Doing something kind doesn’t have to be some grand gesture, it can be simply smiling at someone as you walk in the street, helping out your neighbors with food supplies or even supporting a vulnerable person who may feel overwhelmed with anxiety during this difficult period.
3) Give Your Time - Volunteer
The coronavirus outbreak has left many vulnerable people across the United Kingdom without the resources they need to get by in their day to day lives.
You can change that and improve your mental wellbeing by volunteering to do it. There are many schemes out available now looking for volunteers to support the national effort of supporting our must vulnerable people in times like this.
An example of a scheme is run by the British Red Cross where you can become a Community Reserve Volunteer helping the most vulnerable in your community. The help may include going to get an elderly person’s shopping for them, picking up prescriptions, or simply just having a phone call with someone that may feel incredibly isolated during this time. By partaking in these tasks, you can improve your own mental wellbeing, but also that of others. This is the time for us all to come together to help each other in our communities and improve our mental wellbeing whilst at it.
4) Take a Balanced Approach to the News
At times like this it is so easy to continuously watch constant cycles of news, feeding us the same information repeatedly. I have been guilty of this over the last couple of days (as an OCD sufferer this was not helpful!) looking at the television or my laptop hopelessly unaware of the effect this was having on my anxiety levels.
Of course, it is important to remain informed, information is power, but overload of information in times like this can have the opposite effect, filling us with doubt and fear of what’s happening and what’s to come.
We must have a balanced approach to the amount of television (coronavirus related) we are watching. Choose specific things to watch for information. This could be the daily address by the Prime Minister and health experts for appropriate guidance, but don’t become fixated on unnecessary details that may be harmful to your wellbeing.
5) Maintain Hope, Optimism and Resolve
It’s very easy at times like this to become fixated on the situation in front of us, fearful of what it means and distant from any sense of hope, optimism and resolve, but if we are going to, and we will get through this, we need to cling on with all our might to these three things.
We can be hopeful about the steps that are being taken by people across the world to end this crisis in its tracks, we can be optimistic when we see the thousands of health and social care workers who continue to protect our most vulnerable, the supermarket workers who work tirelessly to keep our shelves stocked and the people in labs across the world innovating to find a cure for this virus. Finally, we can be filled with resolve in the knowledge that we will undoubtedly beat this virus, stop the spread and move forward together.
By allowing ourselves to feel these three important things, we are allowing ourselves the best chance of maintaining good mental wellbeing and enabling others to feel the same way too. I know this virus may seem scary, causing unimaginable anxiety in many of us, but we know that we will overcome it, and to do this we must maintain good physical and mental health.
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Turning Narratives into a Movement – The Leaders Movement
15 March 2020
I have experienced the best of educational establishments when it comes to dealing with student mental health and the worst. As a young person that has experienced poor mental health most of my teenage and adult-life, I know the barriers that can be faced when trying to succeed in the education system.
Even prior to attending university as a mature student, I had witnessed how educational establishments can let young people down. I felt let down when I couldn’t continue my schooling because of my poor mental health, dropping out at the age of 16 without any qualifications.
After a long period of getting back on my feet, I would attend university at the age of 23. I was much better at this point, but after working so hard to get my qualifications back and enter university the pressure was on. The pressures of a new environment, new people, new workload and being away from everything I knew played into my mental illness.
I remember having constant fears of failure, of falling behind and letting people down which continued throughout my first term. In a new environment it was hard to know where to turn on campus and who to speak to when experiencing these symptoms.
I didn’t want to seem weak, or like I wasn’t coping, so I continued throughout this period eventually making some good friends who supported me. I also fell back on some of the coping mechanisms I had learned in the past to deal with my symptoms.
Now in 3rd year and about to graduate, I still wish there had been something else back then, something that was concrete and would have saved me from so much suffering in silence.
That’s why the Leaders Movement is so important to me, it doesn’t just pay lip service to change, but rather delivers a powerful student-led initiative.
Why Student-Led Action is Important?
Too often, the decisions about student’s mental health and wellbeing have fallen into the hands of non-students, people who haven’t experienced what it is like on the ground. They make proposals and implement policies on student mental health without having the knowledge needed to make informed decisions on the matter.
A comprehensive set of narratives of students from across the country are better suited to deliver informed and sustainable change in student mental health. If we are to truly change the face of student mental health the solutions must come from these common narratives, not from distant university policy-wonks.
Why we Need to Lead the Change in Student Mental Health?
We know that student mental health is on the brink, the figures, media coverage and personal narratives of students all show that something needs to be done to improve the current situation. When we are seeing students suffering in silence, dropping out of university and some sadly loosing their lives, we know something desperately needs to be done.
When discussing the crisis in student mental health with others they always agree that things need to improve, but question their role in it and why it should matter to them?
The reality is that student mental health matters to us all, both on campus and off campus. If university staff want an engaged and hardworking student population, then student mental health must be a priority and at the centre of all university’s decision making. If employers want a well-equipped, healthy and driven workforce, then student mental health needs to improve on-campus to prepare students for life off-campus. If society wants a resilient generation coming through, guess what? Improving student mental health must be at the centre of achieving this. It matters to all of us!!
Turning Narratives into a Grassroots Movement for Better Student Mental Health!
There is a comprehensive array of narratives out there of students who have faced a range of different mental health problems. These narratives are filled with knowledge and experiences that connect students from across the country.
The Leaders Movement is bringing these narratives together enabling grassroots change that is informed by and delivered by students, for the better mental health of all students.
This innovative and powerful movement aims to change the face of student mental health forever by brainstorming, campaigning, organising, and fundraising in our local areas. By bringing students together, we will deliver the changes that are needed to make sure that the good mental health of all students is secured.
The message is clear, we are the Leaders Movement, and together as one movement we are going to change the face of student mental health forever.
Find out more about the Leaders Movement and donate to power student led change today!
Social Media Companies – Take Responsibility and Take Negative Imagery Down #instaNTLY
7th June 2019
In the last couple of months, we have heard about horrifying stories relating to the relationship between negative imagery shown on social media and young people’s mental health. The vast wilderness of social media has made it an easy place for negative imagery, videos and other content to exist, the negative impact on some of the most vulnerable users duly noted. What is worse, the social media platforms seem to be making so little or no attempt to take them down.
In January we heard about the heart wrenching story of Molly Russell, a 14 year old girl who took her own life partly because of the effects of social media imagery according to her father. The glorification of self-harm, suicide and negative body image on social media is arguably acting as a catalyst to vulnerable users with a disposition to these issues taking turns for the worse.
The Health Secretary, Matt Hancock at the time warned social media companies to protect children online, but unfortunately social media companies don’t seem to be listening.
Today, Sky News released an article demonstrating that social media companies are still not doing enough to remove negative content on their platforms. The Sky News investigation found it extremely easy to locate a number of videos depicting suicide and self-harm without any warning or barriers to viewing. They simply set up an account and were able to view what they describe as ‘disturbing’ images on Instagram.
It was only a couple of months ago when Instagram apologised by saying they were ‘deeply sorry’ for the case of Molly Russell but denied allowing negative imagery of this kind on their platforms. The simple lack of responsibility and careless nature of Instagram in addressing this issue is flabbergasting.
All of this comes as the all-party parliamentary group on social media and young people’s mental health and wellbeing and the Royal Society for Public Health (RSPH) released a report acknowledging the growing relationship between social media content and young people’s mental health. A number of acknowledgments were made including the effect of social media on vulnerable people, the lack of action of negative imagery and the tactics that are enforced by social media companies to entice individuals back on their platform.
A spokesperson for the RSPH said that there is a need for social media companies to have in place a duty of care to protect young people and, vulnerable people who fall foul to the negative content on social media. In addition, that to stop social media platforms from becoming a ‘lawless digital playground’ further regulation of the platforms would need to come into place.
The reality is that social media companies need to find their moral backbone and remove negative content including self-harm, suicide and body shaming imagery from their websites. They have a fundamental obligation to protect their most vulnerable users and enable a safer, more secure online experience for all. The message is simple for social media companies – Take responsibility and take it down.
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What is Critical for Theresa May’s Ten Year Plan on the NHS?
January 2019
On Sunday our Prime Minister Theresa May and Health Secretary Matt Hancock will take to the television studios to announce what some are calling a substantial plan to support under-18s who suffer from mental health problems. The burning injustice that Theresa May echoed across downing street in 2016 will now reach substance, but it’s important to stress that the government must provide long-term progress and not sticky plasters on an increasingly worsening mental health crisis among young people.
The social and economic hardships faced by mental illness is vast and many individuals and families across the country will be hoping tomorrow signals a 10-year approach that will see an end to the injustices they face.
The problem of staffing
There are a range of issues that are preventing young people with mental health problems from accessing good quality care, but none more than the inadequate staffing shortages in mental health services across the United Kingdom.
The last health secretary Jeremy Hunt MP outlined a plan to expand staffing in mental health services, recruiting 21,000 more staff by 2020 to fill the shortages. Although, in recent months figures have shown that the number of extra staff has only risen by 1,524 as of August 2017 (the latest figures available). This means that by 2020 the target will have been missed by a staggering 14,904.
The abolition of the nursing bursary
This doesn’t consider the other issues around training the correct number of people to the appropriate levels to work in mental health care. Since the abolition of the bursaries for university students training to be mental health nurses we have seen a dramatic slump in people applying. The number of mental health nursing students has dropped by 13% among applicants aged 21 to 25 years of age and by 6% in those over 26 since the nursing bursary was removed.
Nursing the effects of leaving the EU
The effects of leaving the European union on staffing levels in mental health and nursing in general must be considered. The Nursing and Midwifery Council have confirmed that 3,962 EU nurses and midwifes have left the register. In addition, the number of EU nurses and midwives joining the register has dropped by 87 per cent.
It may not be specifically mental health care that is facing the backlash of the EU vote, but it will have some effect on the number of trained mental health personnel working on the frontline of the NHS and without bringing in new staff through our universities it seems the promise of better support for under-18s experiencing mental health problems may simply be that.
Training Minds to Save Minds
Last year Parliament Street released a policy report outlining a structured to plan to help produce more university trained mental health professionals to fill in the gaping holes in the mental health system and young people’s services.
‘This policy aims to train 15,000 more NHS mental health nurses over a 9-year period by subsidising the university fees of 5000 individuals each year. Furthermore, those in receipt of this subsidy will have to work in the NHS for a minimum of five years. The salaries of individuals who take up this subsidy will be capped at £30,000 a year for five years which is high enough to entice individuals, but low enough to create savings. Newly qualified nurses start at a Band 5, but the proposed amount that the salary would be capped at does not prevent them gaining promotion to a high Band 6 or a low Band 7.
This policy will allow more trained staff to help individuals who suffer from mental health disorders. The policy aims to reduce the overwhelming cost of poor mental health on society which currently stands at £105.2 billion (Centre for Mental Health, 2010). Furthermore, alongside reducing costs, this policy will aim to help more individuals get the support and help they need due to more qualified staff being provided, helping the individuals accessing services to live healthier lives.
This short-term investment could lead, not only to substantial savings in public expenditure, but produce good quality, timely treatment for our citizens who suffer from mental health problems. It will create more opportunities for individuals to get a subsidised university education and a career in the NHS’
We believe without a structured approach to training the next generation of mental health professionals we cannot achieve the changes we want in mental health.
See full report here: http://parliamentstreet.org/research/2018/training-minds-save-minds/
Conclusion
There are numerous issues stopping young people with mental health problems from accessing the care they need to go onto live happy and rewarding lives. It must be acknowledged that staffing levels play a major role in improving the situation for so many young mental health sufferers across the UK. Without a well-trained and appropriately staffed workforce in mental health all the promises made will simply just be warm words lacking action.
We face a multitude of difficulties when it comes to staffing including missed growth targets, falling numbers of young people training to be mental health professionals and the concerning implications on staffing post leaving the EU. All these concerns are legitimate, and it seems almost obvious to myself and many mental health campaigners and professionals that without the reinstatement of something resembling the nursing bursary mental health care for young people could suffer.
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How Employers Can
Play a Role in
Healthcare?
August 2018
August 2018
This is the third of six blog posts looking at innovative ways in which we can reform and improve healthcare in the United Kingdom.
When we think of healthcare in the United Kingdom, it would be a surprise if every citizen didn’t immediately think of the three words that have defined our approach to health for 70 years; National Health Service.
The NHS has unquestionably been the best solution when it comes to managing our citizens health from ‘cradle to grave’, but we must not become dogmatic on healthcare.
Whilst acknowledging the importance of such a service, we need to look at new innovative solutions to the constant stress around healthcare.
The relationship between private business and health has been a complex one, but involvement can be a positive. Only today have we seen a new initiative by the Duke of Cambridge launching a workplace wellbeing website according to Sky News.
The constant disdain towards anyone who suggests that some level of private sector influence in health could be useful is not going to go away.
In times where the health system is struggling to cope however, how can we remove ourselves from our dogmatic state towards a more pragmatic understanding of where private companies may be of use for employees’ health and in tow, reduce the pressure on the NHS.
The role of private companies shouldn’t be to place themselves at the epicentre of health in the UK and take over previously NHS-run contracts, but the role of private companies should be to offer unquestionably good occupational health to all their employees – allowing workers to be healthy and more productive in their business allowing economies to be made.
We should not however settle for making sure occupational health is merely up to scratch – we need a change of culture and attitude towards health in private companies. They need to carefully measure the impact of their business environment and attitudes towards work in relation to employee’s health.
Do you allow flexi-working hours?
Do you take kindly to sick days?
Do you have anyone in your business for employees to talk to about their health?
Well, although many employers would say yes to the statements it seems that current approaches aren’t working with recent research by Aviva suggesting that 70% of employees go to work when they are ill and that some employees believe their employer always puts the business before their health.
If our private businesses are going to be world leaders in their trade, they need to be health and wellbeing leaders too.
So, what’s the solution?
The Business Health and Wellbeing Agreement
We need to develop a system that allows accountability, better information partnerships between the local NHS trust and local private companies and pursues an agenda of richer health and wellbeing support in business.
The Business Health and Wellbeing Agreement would be a localised system of businesses who would work closely with their local NHS Trusts to improve health and wellbeing in their offices and inevitably aim to reduce the strain on their local NHS Trust through improving the health of their workers.
This would aim to achieve the following:
Accountability and Transparency: All local businesses who sign up to the agreement would survey their staff covering their lifestyle, behavioural and other areas of health over the last year. This system would look to replicate parts of the Britain’s Healthiest Workplace VitalityHealth scheme but on a more localised scale.
At the end of the year, this information would be made public ensuring the highest level of transparency and putting a level of accountability on businesses to succeed in achieving a healthier working environment.
Regaining the partnership between private and public: This scheme would look to improve the partnerships between the public and private sector. Through changing governance arrangements and approval from staff, certain levels of health information could be shared between the correct channels stopping both sectors working in silo. It would aim to allow localised partnerships between the NHS and businesses allowing sharing of information on maintaining good health, health education sessions and closer collaboration on the health issues most visible in local businesses.
Reducing the strain on local NHS trusts: By improving the health of local employees and gaining healthier working environments we can reduce the strain that negative health has on local NHS Trusts. Through better health awareness and healthier working environments, pressure could be reduced.
Better health means better business: Mental ill health, which equated to 15.8 million days lost (11.5%) in the latest research from 2016 by the Office of National Statistics. Healthy employees boost productivity, and therefore the bottom line.
A change of attitude: Businesses need a change of attitude when it comes to health in the workplace. As business evolves further into the globalised world of the 21st century, the key to success must lay in maintaining a healthy, driven and productive workforce. This will involve focusing in on certain issues that may be of concern.
The health issue of focus would depend on the area and the most pressing health concerns for local businesses. Businesses can innovate with the help of the NHS in health and through a change of attitude can make the necessary changes to improve the health of the workforce.
The private sector should not be completely excluded from a 21st century healthcare approach. It can forge a more economically healthy future by improving the health of their own employees in their own local areas.
Through partnership and guidance with the NHS, businesses can play a role in paving the way to a healthier, more productive and thriving workforce in their local area and in turn, reduce the strain on local NHS trusts.
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Change Begins on the Front Line in Healthcare
July 2018
This is the second of six blog posts looking at innovative ways in which we can reform and improve healthcare in the United Kingdom.
When we think of healthcare in the United Kingdom, it would be a surprise if every citizen didn’t immediately think of the three words that have defined our approach to health for 70 years; the National Health Service.
The NHS has unquestionably been the best solution when it comes to managing our citizens health from ‘cradle to grave’, but we must not become dogmatic on healthcare.
Whilst acknowledging the importance of such a service, we need to look at new innovative solutions to the constant stress around healthcare.
When it comes to the frontline of healthcare we have all seen from the figures released yearly, the constant reduction in staffing levels:
There are shortfalls in every area of the NHS when it comes to staffing with almost 50,000 vacancies across clinical staff as of 2014 according to the National Audit Office.
The hardest hit areas are nursing and midwifery with shortages equalling 27,980 and in addition, there is a shortfall when it comes to junior doctors of 2,550 as of 2016.
To address this issue, we need to look at a multitude of different areas including working hours, investment in training within key areas and in the reduction of pay for those at the top and making sure change starts from the bottom.
Flexi-Working Hours
It is hard if you are not a health worker to know how stressful life on the frontline can be – constantly rushing from patient to patient or house to house. This is the reality for many health workers in the NHS right now and it’s causing negative adverse effects on individuals within the workforce.
Research by the mental health charity Mind – they found that 40% of GP’s suffered from a mental health problem. In certain cases the heavy workload and intense levels of responsibility are the reason for bad mental health. In addition, we have heard horrific stories of doctors experiencing suicidal thinking due to “Long hours, work-related anxiety, and despair” as parents who lost their daughter who was a junior doctor wrote.
For best-practice in a globalised society, we need to change the working arrangements of doctors and other health professionals in the NHS.
By implementing flexible-working hours for doctors and health professionals in certain areas we can revitalise the health workforce and deliver better and more efficient care to those who use the NHS.
By implementing flexi-hours to health professionals, we will no longer see a tired workforce, allowing healthcare workers to do what they love in an environment in which they feel supported and not over stretched.
Although there is already ‘flexible working’ within the NHS – I believe we need to go further and acknowledge that every healthcare professional can sometimes need time off who may not fall into the current criteria for flexi-working. That’s why we need to make sure that flexi-working is ingrained in the apparatus of the NHS.
Investment in Training
As discussed above, the change comes from the front-line, but unfortunately due to staff shortages and the lack of trained individuals coming out of our universities going into the healthcare professions such change is not possible – we need to make sure we invest not only in training, but subsidise training in certain areas of most need including:
Nursing (in general).
Mental Healthcare
Healthcare scientists
These areas are just some of many that needs investment for training to renew and revitalize our workforce allowing younger voices to come through.
It is my belief that we should firstly start with nursing – in nursing there is a high shortage of staff and to enable us to train the next generation we need to invest in subsidizing a certain amount of degrees every year, but we should expect more from those we train.
An example of this sort of approach comes in mental healthcare, where I authored a policy paper on behalf of Parliament Street to train 15,000 more mental health professionals:
15,000 more NHS mental health nurses – over a nine-year period by subsidising the university fees of 5000 individuals each year. Furthermore, those in receipt of this subsidy will have to work in the NHS for a minimum of five years. The salaries of individuals who take up this subsidy will be capped at £30,000 a year for five years which is high enough to entice individuals, but low enough to create savings.
Newly qualified nurses start at a Band 5, but the proposed amount that the salary would be capped at does not prevent them gaining promotion to a high Band 6 or a low Band 7.
The overall cost of such a policy would be £2.6 billion. With just a 3% saving in the cost of bad mental health, the policy would have already created economies.
This sort of approach could be implemented in other areas of healthcare where by investing in training more people, could save money in the long term. I believe that such an approach in nursing would invigorate people into studying it at university and with only 5000 subsidised degrees a year – competition would be stiff meaning we get the brightest and the best into the nursing profession.
A Meritocratic Pay Scheme and Cutting Down on Abuses at the Top
It has been acknowledged that the rise of chief executives and managers in the NHS has soared whilst we still experience shortfalls in the number of nurses, doctors and other healthcare workers.
It has been found that the number of managers within the NHS has risen by 11 per cent between October 2014 and 2017.
In addition, there have been jobs created in the NHS, but the type of jobs are communication executives and management teams according to a report by the Health Foundation with combined annual salaries equating to £8.5m.
To add, it was found in 2017 by data obtained by the Telegraph that 600 health quango chief- executives were earning six-figure salaries and 93 of them getting more then the prime-minister.
Managers and executives are important, but it should be acknowledged that over investment in these areas of the health service is not only causing an over bureaucratic system but is costing the NHS an unnecessary amount of money.
In a modern healthcare system, we need to incentivise the nurses, doctors and other healthcare workers to work in the NHS and feel like they are rewarded for their hard work.
We need to make sure that a modern NHS believes in meritocracy, where regardless of status within the organisation, you can be rewarded with a bonus for exceptional work.
For too long we have seen some at the top being rewarded with pay-rises for failure. I believe we need to only reward exceptional success across the board. This is an approach that should be implemented across the board.
I would have no problem with a chief-executive being awarded a bonus for exceptional success over years and neither would I have a problem with a nurse who has shown exceptionally high standards being given a bonus – what we need to avoid is bonuses for failure.
In addition, we need to cut down on the number of abuses by those at the top for example a redundancy pay-off of almost £1 million for a married couple of health chief executives who within months were in high paying jobs in another NHS trust. This is unacceptable.
I believe for a modern NHS to thrive in the 21st century it needs to become a rounded organisation which incentivises and rewards those at the bottom as much as it does those at the top.
These changes will enable the NHS to become an organisation moving with the times, enabling innovation and change coming from the frontline. In addition, the NHS must become meritocratic for those at the top, as well as those at the bottom.
We need to recognise that training the next generation of nurses, doctors and other healthcare professionals is vital as part of an invest to save scheme. If by increasing the number of trained professionals in an area of the NHS will save money by training more staff – we must invest to achieve that.
Finally, we need to acknowledge that as the population grows, more pressure will be put on the NHS and to sustain the high standards expected by the public, we need to look at expanding flexi-working hours to all.
This will not only allow for a refreshed workforce, stopping staff sickness, but will incentivise those that may have been discouraged from doing a healthcare profession to believe in it again.
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A MODERNISED AND REVITALISED MENTAL HEALTH CARE SYSTEM
June 2018
Mental health care has become front and centre in the minds of society. The countless repetition of a broken system – a system with long waiting times and long waiting lists.
It has been noted the catastrophic effect that such a broken system is having on our society with growing economic and social consequences.
To solve this growing issue, a new outlook is required; an outlook that doesn’t just rely on the NHS to solve the growing mental health crisis, but considers how areas such as within the education system, policing and in the collection of data can make a difference
It demands innovative solutions to complex problems.
By modernising our approach to mental health in all areas, we can have better economic and social outcomes.
An education on mental health
The negative effects of mental illness have been shown to reduce life chances for young people in the UK’s education system. There are a range of factors causing this:
Lack of recognition of mental illness.
Minimal mental health training for educational staff.
Increased exam pressures on young people.
And young people lacking awareness of maintaining good mental health.
An example of the loss of life chances is:
Exclusion from school – recent research by the IPPR showed that half of excluded pupils suffer from a mental health problem.
To solve such inequalities, we need to create partnerships between a range of organisations to support pupil’s mental health and work in the prevention of mental ill health in education.
Mental Health Partnerships: mental health partnerships would bring together teachers, local NHS trusts, local charities and local social enterprises to create a localised plan of action to support local pupils. For too long these different agencies have worked in silos and bringing them together to train, innovate and inspire better mental health support in schools is a start.
This approach could make an enormous difference to secondary schools around the country, supporting those at the age range most at risk of developing mental health disorders.
A health service that leads on mental health
Our national health services has always been the first line of call for people with mental health problems. Although, there are large issues currently with:
Long waiting times
Long waiting lists
Reduction in trained staff- the number of mental health nurses has dropped by 15% since 2010 – lack of trained staff means longer waits.
To reduce waiting times, we need to start increase the number of qualified staff in the profession:
15,000 more NHS mental health nurses - over a nine-year period by subsidising the university fees of 5000 individuals each year. Furthermore, those in receipt of this subsidy will have to work in the NHS for a minimum of five years. The salaries of individuals who take up this subsidy will be capped at £30,000 a year for five years which is high enough to entice individuals, but low enough to create savings.
Newly qualified nurses start at a Band 5, but the proposed amount that the salary would be capped at does not prevent them gaining promotion to a high Band 6 or a low Band 7.
We need to of course support the next generation of mental health nurses, but we should also expect more from students who take up the scheme including supporting fellow students at universities and working in our NHS.
The overall cost of such a policy would be £2.6 billion. With just a 3% saving in the cost of bad mental health, the policy would have already created economies.
Policing a modernised mental health approach
The research I have undertaken on behalf of Parliament Street think tank has unveiled what I like to call the ‘side effects’ of poormental health on society.
We found that there were just over 295,000 police incidents where mental health was recorded as a factor.
There is some fantastic work going on in Kent, with police and crime commissioner Matthew Scott coming up with some key ideas which I endorse:
Linking with charities- Kent Police now have counsellors from the Mind charity supporting staff in the control room – supporting vulnerable callers and freeing up more time for police to fight crime.
Local police funding to tackle mental health- Mr Scott has also put £250,000 of protected funding into local projects that reduce the amount of police time spent on mental health.
Crisis Café’s- There is the example of Crisis Café’s which creates a safe space within a café environment to discuss mental health issues.
All these responses allow a localised, non-exclusion and refreshed approach to mental health support by the police.
Data collection and governance arrangements fit for progress
Data collection
To truly track the difference policy ideas have on mental health care, we need better data collection by organisations.
This means data being recorded needs to be in a reportable format. The amount of times I have done research and a response has been received declaring ‘not in presentable format’.
It requires more in depth recording of information and the availability of such information being more readily available to the public.
In addition, it demands all services by law to record and hold such information which too often is not available when called upon.
Governance arrangements
The governance arrangements currently in place in organisations such as the NHS protect data well, but we need to make it easier for information about young people’s and adults mental health to be shared responsibly with the appropriate parties through renewed governance arrangements.
In a young person’s case, it could be very useful for information to be shared between schools and NHS trusts allowing better understanding of the pupil’s situation and stopping expertise working in silos.
Renewed governance arrangements for mental health.
Sharing key information through appropriate channels.
Stopping services from working in silos.
To conclude, we need a revitalised and modernised mental health care system. Mental health is one of the biggest issues of this generation and mental illness can lead to some of the biggest inequalities of this time – we must revitalise and modernise the system to meet the challenges posed in this sector in the 21st century.
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Nursing the Unhealthy Side-Effects of Brexit - November 2018
November 2018
This is the final of six blog posts looking at innovative ways in which we can reform and improve healthcare in the United Kingdom.
When we think of healthcare in the United Kingdom, it would be a surprise if every citizen didn’t immediately think of the three words that have defined our approach to health for 70 years; National Health Service.
The NHS has unquestionably been the best solution when it comes to managing our citizens health from ‘cradle to grave’, but we must not become dogmatic on healthcare.
Whilst acknowledging the importance of such a service, we need to look at new innovative solutions to the constant stress around healthcare. Although, in the final blog I examine the side-effects of Brexit on that reformation.
The issue which seems to have confused the health agenda and the direction of our healthcare system is Brexit. The complexity of trying to guess the overall outcome of the Brexit negotiations has made it hard to decipher the future of the healthcare system outside of the EU but serious questions remain.
I am not going to focus on a referendum that happened two and a bit years ago but look at one of the key anxieties after Brexit – staffing and recruitment of health workers.
A record number of nurses and midwives from the European Economic Area (EEA) have left the Nursing and Midwifery Council register between 2017-2018. It has been said that around 4000 nurses and midwives have forfeited their place on the register with only 800 coming in, resulting in a net loss of 3,157.
In addition, the Royal College of Nursing has said the number of registrants for the NMC from the European Union has fallen by 77% between 2017-2018.
This begs the question- how are we going to maintain sensible staffing numbers in the NHS if we are losing 3,157 in one year alone?
The Pro- Brexit side would argue that we can train our own nurses and midwives here in the UK, but this suggestion doesn’t stand to reason.
Since the removal of the nursing bursary, the number of citizens applying for a place at university to study nursing has fallen by a third since 2016 – there was a 23% reduction in 2017 and in 2018 there was a further reduction of 13%.
To add to all of that, In 2017 there were 133,660 nursing and midwifery vacancies in the NHS. This has been reported to cost the NHS £2.4 billion from bringing in agency workers.
The concerning findings show that firstly, we are seeing a number of nurses and midwifes from the EEA leaving the profession.
Whichever way we dress it up, we simply don’t currently have the number of UK citizens coming through the system to fill in the gaps in nursing and midwifery.
On the face of it, you could assume that the divisive nature of the last two years along with the uncertainty for EU citizens working here has led to the reduction in EU NMC registries. We don’t exactly encourage British people to go into nursing or midwifery either.
We need to take two steps to some way rectify the situation facing us – we must stop ostracising EU health workers and flippantly ignoring the contribution they have and continue to make to our health service. That is not the British way of inclusivity and respect.
Secondly, if we truly want to continue the high standards of the NHS after Brexit we need to acknowledge the need to return the nursing bursary and start a significant recruitment drive through a multitude of channels.
This could be done by creating fast streams into areas of healthcare where we have a shortfall in recruitment. We can work with the education system to enable this and in addition work with welfare agencies to enable unemployed citizens to gain the skills necessary to work in the NHS.
In the constant noise of Brexit negotiations, we must not let the vital domestic services which we rely on fall by the wayside because of blinded ideology
When whatever future government finally completes the Brexit process and returns to governing domestic issues, let us hope there is still a healthcare system left to be improved
How to Depoliticise Health- October 2018
October 2018
This is the fifth of six blog posts looking at innovative ways in which we can reform and improve healthcare in the United Kingdom.
When we think of healthcare in the United Kingdom, it would be a surprise if every citizen didn’t immediately think of the three words that have defined our approach to health for 70 years; National Health Service.
The NHS has unquestionably been the best solution when it comes to managing our citizens health from ‘cradle to grave’, but we must not become dogmatic on healthcare.
Whilst acknowledging the importance of such a service, we need to look at new innovative solutions to the constant stress around healthcare.
In UK politics, healthcare has always been an important political football that is used by each party to attempt to win elections.
It seems every five years we hear the devoted rhetoric around the NHS from each political party as they compete to win the hearts and minds of the British people. Political parties promise lower waiting times, improved care and a better functioning health service – but, it seems to many, that giving politics such a big say in healthcare may not be working.
When a new government comes to power they outline their agenda for the NHS – mostly by undermining the work of the past government and attempting to change everything possible to turn the NHS into a more reflective organisation of the approach of their party.
It has become evident, that such picking and choosing, overhauling and undermining in such a short period of time is not just leaving staff in a constant bubble of confusion, but is arguably eroding the very foundations of the NHS. The very foundation of the NHS is good care, but with constant politicking, good care is being jeopardised through constant unnecessary changes.
Our system is far removed from the consensus politics of the Scandinavian countries which welcomes a wide range of views on an issue.
This is no more evident in Britain then in the politics of healthcare, where governments can take hold of the healthcare agenda over smaller parties.
The issue seems to be that the politicising of an issue like healthcare is unhelpful and creates confusion, bad-practice and even worse legislation. We have seen too many times MPs disagreeing on potentially positive health policy for the sake of political gain and in some cases, simply for the sake of disagreeing. This needs to change.
There have been many accusations of this including a tory minister being accused of filibustering to stop a new law to provide cheap and effective drugs on the NHS in 2015, arguably because his government didn’t support it, but all parties are guilty of this.
The only way it seems to enable the needed reforms in the NHS to see the light of day is by taking the control of healthcare funding and reform off politicians.
The depoliticisation of healthcare was attempted as part of the Health and Social Care Act 2012. The centre piece of the legislation was the creation of clinical commissioning groups (CCG’s). But the legislation was flawed. Even though clinical commissioning groups could allocate the funding, the amount of funding CCG’s received was still decided by central government and central government still steered the NHS reform agenda.
I believe that the only way to decrease the partisan, pick up and rip up approach to healthcare policy is by creating a Royal Commission on Healthcare. The decision makers on healthcare policy would be appointed by the crown on the recommendation of the government.
This would mean that those making policy decisions about the NHS would not be politicians, but experts in the health arena.
This would enable cross party consensus, better health policy recommendations and legislation implementations. Most importantly, it would enable the needed, informed healthcare reforms to be passed to allow the sustainability of the NHS.
This would rely on a cross-party agreement on a Royal Commission, so it can’t be removed as happened in 1979 when a new government came to power.
For too long healthcare has been the political football, with policy being changed every time a new government comes to power causing confusion and endless amounts of frustration.
By creating a Royal Commission for healthcare in the UK, I believe we could pass the needed, informed reforms to allow the sustainability of the NHS.
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How can we make the digitisation of the NHS
hAPPen?
September 2018
September 2018
This is the fourth of six blog posts looking at innovative ways in which we can reform and improve healthcare in the United Kingdom.
When we think of healthcare in the United Kingdom, it would be a surprise if every citizen didn’t immediately think of the three words that have defined our approach to health for 70 years; National Health Service.
The NHS has unquestionably been the best solution when it comes to managing our citizens health from ‘cradle to grave’, but we must not become dogmatic on healthcare.
Whilst acknowledging the importance of such a service, we need to look at new innovative solutions to the constant stress around healthcare.
The NHS was founded in 1948, at that time there was limited sight of the technological age that we are living in now. It was a service that was for people and by people.
It relied heavily on the expertise of the individuals (humans) to keep the nation healthy, but in today’s globalised, technology driven society, it may be time for the power of technology to hold some of the burden of responsibility in the provision of support.
The technological boom that has occurred over the last decade or so has seen the rise of social media, mobile apps and even virtual reality. In our 21st century national health service we have yet to fully understand how technology could be useful to transform not only the health service, but people’s lives.
The health service is planning to release its first app in December 2018 which is a world-first and was unveiled under Jeremy Hunt, the former health and social care secretary. I commend this move which will allow the ability to make GP appointments, order repeat prescriptions, manage long-term conditions and access 111 online for urgent medical queries.
It will allow people to state their preferences regarding organ donation, data sharing and end-of-life care.
Although these early drives towards the digitisation of the NHS are commendable, if we truly desire a 21st century health service we need to go further by creating a world-first digitised approach to healthcare.
The National Health Digital Innovation, Apps and Social Media Service
This approach would look to achieve the following:
Standards and regulation of health apps to meet and be prescribed on the NHS.
The NHS has already started a new drive with their app library online putting forward health apps which are useful in maintaining positive health and wellbeing. I believe we can go further and create an app directory for GPs which they could prescribe on the NHS. This idea would focus not only on prevention, but as part of a support package for people with early symptoms of illness.
The idea of digitising provision could reduce the numbers of people trying to access in house treatments. The apps would need to face a quicker and more efficient form of scrutiny as technology moves on so fast, but it would make it easier, more accessible and relatable to younger generations.
The creation of ‘NHS Social Media’ which would work with leading social media platforms in innovation, signposting and prevention online.
Social media has been the best outlet to get your message out there and that’s exactly why the NHS needs its own social media sphere.
Social media has its issues, with high numbers of young people experiencing heightened anxiety and depression, but how can we turn social media into something positive?
By creating a new team as part of this brand-new division within the NHS, we can work alongside social media companies in sending out positive messaging about health and wellbeing.
In addition, we can work with social media for signposting, if an individual themselves is worried about their health or individuals are worried about someone else’s health there would be an NHS button on all UK registered social media sites.
By pressing the link, it would lead to a pre-prepared email box in which you would send your digital health concerns directly to someone in the social media team. The social media team would then take the appropriate action which could include messaging the individual directly on social media (in serious situations), targeting the individual through support ads, or in other cases working alongside social media platforms to take down certain images or text.
In conclusion, digitalisation does not have to be a bad thing and can be used in a positive way to improve the health of our nation. By creating a new department within the sphere of the NHS we can modernise our health service and enable an advanced level of innovation, partnership and measurable success in the prevention of bad health.
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Why Schools Can Play
an Important Role in
Young People’s Health
May 2018
May 2018
This is the first of six blog posts looking at innovative ways in which we can reform and improve healthcare in the United Kingdom.
When we think of healthcare in the United Kingdom, it would be a surprise if every citizen didn’t immediately think of the three words that have defined our approach to health for 70 years; the National Health Service.
The NHS has unquestionably been the best solution when it comes to managing our citizens health from ‘cradle to grave’, but we must not become dogmatic on healthcare.
Whilst acknowledging the importance of such a service, we need to look at new innovative solutions to the constant stress around healthcare.
One of the key areas of health that has caused constant worry for contemporary society is children and young people’s health. From increased levels of anxiety and depression to the challenge of obesity, children and young people’s health continues to be a concern in contemporary Britain.
I believe in the worth of schools when it comes to maintaining the positive health of our younger generation. We sometimes forget that most children and young people spend a minimum of six hours at school from Monday to Friday’s.
Schools also bring together different areas of society enabling a better outlook of the growing health problems facing our young people.
This makes schools a perfect place to peruse the positive health agenda working towards the prevention of illness.
The issue with health and education decision making is that too often choices are made that don’t reflect the diversity and make-up of schools and health concerns in different areas of the country.
For example, the health concerns of someone living in a city environment would differ from someone growing up in a rural area and may also require different approaches to solve.
I believe that for successful, workable solutions to health issues effecting school-aged children we not only need to focus in on schools but localize our approach to enable the right, reflective solutions to be found depending on the school and area.
School Health Boards and Physical and Mental Health Partnerships
I believe we can create self-sufficient localised approaches to health through an apparatus like the health and wellbeing boards (HWBs) established under the Health and Social Care Act 2012. The Health and Wellbeing Boards (HWBs) conceived in 2012 looked to bring together leading figures in local health and care to improve local standards.
This approach is similar in the sense of integration, allowing a range of different people and organisations to work as part of the Health School Boards or the Physical and Mental Health partnerships to improve levels of good health among school aged children and young people.
Although the approach I’m outlining below is like HWBs, it differs in a couple of areas:
It puts schools at the forefront of children and young people’s health
It gives more powers to pupils, teachers and parents who know the health issues effecting their school best, to make the decisions around health education and support.
It allows Health School Boards (HSBs) to be a micro executive decision-making body when it comes to health education and support within their school.
In addition, HSBs would be supported by area physical and mental health partnerships which would act as the organisation allocating the resources to individual schools. The Partnerships will oversee the arranging of events and campaigns for the local area.
Health School Boards- The Health School Boards would be run by pupils, teachers and parents who volunteer within a school. Every school would have their own Health School Board, meeting once a month to share ideas about how to improve health in that school, they would then be given certain powers to implement small changes in their school to improve health.
This would allow changes to be made at a micro level. This could be through education on certain issues that may be needed in one school, but not another. This could help in the prevention of:
Negative behaviours which lead to negative health such as smoking, illegal drugs and alcohol.
Challenging obesity in young people through adapted school meals to fit the situation in a school environment. As well as recognising the dangers of under eating by implementing balanced diets in school.
Sexual education- allowing young people to be properly educated on sexual health at the appropriate age.
The next step in the apparatus would be area run through local councils, schools, local NHS trusts, local charities and local social enterprises through the creation of:
Physical Health and Mental Health Education Partnerships– The Physical and Mental Health Partnerships would be run area wide (e.g.) Northumberland.
The different organisations from the public, private, not-for-profit and charitable sector would work together to provide education on positive physical and mental health. They would work closely with local School Health Boards in understanding the key issues and the resources needed to improve the health and wellbeing of young people in their area.
They would oversee, providing innovative solutions in the prevention of negative physical and mental health.
The partnerships and those involved in running the partnerships would be given new powers to implement a range of different schemes involving all sectors to reduce the strain of negative health.
They would be provided with stronger governance arrangements to allow better sharing of information between the different sectors.
This would not only allow certain levels of targeting for pupils most vulnerable to being in bad health but allow sharing of expertise between the different groups which could lead to more innovative and successful solutions.
These two approaches would be overseen by the Department of Education and the Department of Health and Social Care.
School Health Boards – Physical and Mental Health Partnerships – Joint responsibility between Department of Education/ Department of Health and Social Care.
Conclusion
When it comes to children and young people’s health there are some major issues facing us including physical health and mental health difficulties.
The school environment in my opinion is the best route for the prevention of negative health.
Through this approach it offers a micro approach in the form of School Health Boards to address issues that may be facing individual schools through to a more comprehensive address of healthcare concerns at an area level and eventually at a national level.
By localizing our approach to young people’s health, we can make sure that we are addressing all young people’s health needs and not just providing a one size fits all approach. Every community’s health needs are different, and every school faces a range of health issues as well as the young people themselves
By creating and providing new powers to these boards and partnerships in the education of health and in the implementation of healthcare approaches at a more localized level, I believe we can meet the growing youth healthcare challenges of the 21st century.
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IF FACEBOOK WANTS TO CALL THEMSELVES A COMMUNITY, THEY SHOULD ACT LIKE ONE
April 2018
Social media has become an integral part of our make-up as a society whether you like it or not, so we should treat it like we would any traditional community or society. It was reported by Facebook that 1.45 billion people were using their platform daily and 2.20 billion monthly users as of March 2018.
Social media has guided us all firmly to a more connected world of ideas, culture, and lifestyles. Unfortunately, it has correspondingly created a safe space for crime, bullying, and body shaming as well.
The bubble of social media in 21st-century life has divided opinion. Some argue it has provided a strengthening bond between citizens of the world. Others, including myself, have faced the undesirable side-effects of social media: side effects filled with heightened anxiety, body image pressures, and bullying.
How can we bring forward a safer society online?
It’s time for users to have a say on the guidelines of social media, not just by writing a letter or reporting a post, but through democratising social media.
Social media is a community; whilst cruising over Facebook’s guidelines, for example, you will see they mention the word ‘community’ a lot. In any community it is important that people feel they have a voice that will be listened to. It is important that in the event of a concern being expressed, people feel that the leaders of the social media community will, at the very least, take some action to reassure them that steps are being taken. In the labyrinth of social media some believe such responses of reassurance and the promise of action are more of a phenomenon then a frequent happening.
With that said, how could we democratise Facebook?
Step 1: Every year, social media companies ask their users to rank their top three concerns of the platform. These responses will be formulated, narrowing it down to five key concerns.
Step 2: The five key concerns will then be investigated by the social media platforms leaders. The leaders of the social media platforms will formerly produce two steps of action for each concern.
Step 3: The formal steps will then be provided to the community of social media, who will then be given the opportunity to vote on which suggestion they believe would be most useful in counteracting the issue. After the results are counted, social media companies will then have a responsibility to pursue the selected promises of action.
The side effects alluded to above could be reduced by starting a conversation allowing users a level of citizenship within the community of social media. This would-be part of a greater development of civic responsibility for the citizen online, as well as those in charge of the social media platforms.
This idea could create better governance, policies more reflective of the community, and better accountability on the leaders of social media and their decisions regarding the community. Allowing decisions to be made in the light, instead of the dark.
This approach could offer both members of the social media community and those in charge of social media platforms an opportunity to provide their thoughts. Members (users) of the social media community would have the ability to provide their thoughts on the guidelines of the platform, providing users with a much-needed voice and putting a level of accountability onto social media companies to deliver on their promises.
This would not disallow the social media communities’ leaders from having a say, rather the contrary. Social media companies would be able to provide two solutions on the top five anxieties of the community members to be voted on. The leaders of social media platforms would be able to write the policies, but by adhering and being led by the concerns of the communities’ members through a democratic process.
This idea removes the large divide between the users of and leaders of social media. Instead of the social media community working in silos, this idea champions a closer partnership between community members and leaders.
In conclusion
It must be noted that this idea is exactly that – an idea. Although, by increasing accountability, growing the level of transparency in the policy and guidelines process, and providing members of the social media community with a greater platform and a louder say in the direction of policy, social media would arguably become a better community to be part of. Only then can social media platforms begin to honestly call themselves a community.