The Travelling Treadmill

Travelling anywhere by car is a nightmare. What’s new you may ask, but for me the impact of the daily commute is only just registering with me.

When I moved “over the Bridge” 5 years ago, the M4/5 junction was being improved with fancy new lane management and overhead display gantries. Ever the optimist, I told myself to just hang on, put up with the disruption and it would all work out in the end. This plainly hasn’t happened with no discernible improvement to traffic flow for the travellers who just want to drive right past the M32 exit and get on with their working day.

My journey varies between forty minutes and ninety minutes and that’s without any identifiable obstructions. Add an accident or incident to the mix and travel to work becomes a life-sapper.

I assumed that it was my misfortune to commute this particular route and I felt particularly hard-done-by, regularly ranting about my M4 journeys.

Considering driving to/from work consumes about 18 days of my life each year, my sympathy is with the morning travellers on the westbound M4, as I pass regular tailbacks of a mile or so. Multiply my 18 days by the rest of the drivers and it is a staggering waste of many hours of our lives.

I’ve now discovered I actually have it easy now, with a report in 2013 indicating that 1.8million people in the UK travel 3 hours or more to get to work (not necessarily every day, of course). It’s a hard way to start the day and I have first-hand experience, as my morning commute, daily when I worked in Manchester, was 2.5 hours. No wonder the time spent commuting is considered a health depressing factor, but then it can be made so much worse for your wellbeing depending on the transport mode you chose.

London commuters have the longest journeys in the UK averaging with travel times averaging 75 minutes a day. I used the Tube for a few years and at least you can read or catch up on emails.

CEDAR (Centre for Diet and Activity Research) have an on-going study into Commuting and Health in Cambridge, which considers the social and health benefits of modes of commuting. One finding, not surprisingly, is that people who walk to work tend to be more physically active and healthy than those who don’t.

So, not only does the amount of time travelling affect your health and wellbeing, but also the fact that you are driving rather than travelling actively. Add to this the potentially boring motorway route and that you can’t read or socialise easily when driving and the unhealthy combination is complete.

I’m surprised I’ve lasted this long…

Sauce for the Goose

VenusSuffragette, the movie, has highlighted what a long way we’ve come in terms of the equality of men and women to have and express their opinions. Gone too are the days when women were seen as somehow lesser than men in the workplace, constrained by society to specific job roles, although there are still some jobs where it is not straight forward for women to fill a role.

Campaigners have worked hard to get equal pay for women and men who do the same job role…and quite right too.

But when did the tables turn in the predatory leering stakes? When did it become OK for women to ogle men, but not OK for men to ogle women?

The male celebrities and/or dancers from Strictly Come Dancing take off their shirts and unleash a full-on female fancy-fest.

One person stated: “Christmas has come early tonight #Gleb #Strictly.” Others posted in agreement: “Can Gleb have his shirt undone every week please? #strictly #scd,” and: “Gleb Savchenko on Strictly wow.”

What is the difference between this behaviour (his and theirs), and the advertising poster featuring a scantily clad woman, enjoyed by passers-by?

For some reason, women saying they admire attractive men is now acceptable while men saying they admire attractive women isn’t.

Charlotte Proudman’s outrage at comments made about her LinkedIn photo being “the best LinkedIn picture I have ever seen” is an example of how women can claim to be offended by men commenting on their attractiveness.

We all appreciate beautiful things and personally, it doesn’t faze me either way around; it’s the dual standards that I can’t accept.

Is it OK to comment on attractiveness when the person, of either sex, is a “celebrity” who puts themselves in the public eye, but not when they are a private individual…?

Please hold, caller…

Communicating With Telephones Using Old Technology


NHS 111 is in the news again for all the wrong reasons.

Under-staffed, under-skilled, under-experienced, under-performing…all the old recognisable issues.

The report in the Daily Mail says that Ministers are demanding assurances there are enough staff for the service after reports that only one nurse was left to cover an area of 2.3 million people. The Royal College of Nursing warned that a “tragedy” could occur. According to the Sunday papers, tragedies are already occurring.

It is understandable that NHS managers want to protect the performance of the ambulance emergency services. We are all familiar with the business case for providing an alternative service for “urgent” cases, as opposed to the 999 service for “emergency” cases:

-reduce the emergency services time spent on non-emergency calls;

-reduce the response times for emergency calls; and

-make this critical emergency service more affordable.

But is it the concept of how the alternative is provided that is fundamentally flawed?

Would anyone chose a disembodied voice on the end of a telephone to advise at a critical moment in their existence, when at that moment the caller may well be stressed and fearful?

Perceived wisdom may say there is no truth in it, but there is a body of work* that indicates that any communication is made up of:
Body language 55%
Voice 38%
Words 7%

Based on this premise, the NHS 111 service can only ever communicate 45% of the whole, to callers whose anxiety levels are likely to affect their ability to make well-thought out decisions.

Add to this the “remoteness” of the operator (who are they?), which may well contribute to trust issues (are they unaccountable?) and the delays experienced (do they really care?) and you have a complete turmoil of emotions that is not helped by the telephone as a communications medium.

I don’t have any bright ideas for how else the service could be provided, but I’d be pleased to hear any suggestion you might have…

*Mehrabian, Albert, and Ferris, Susan R. “Inference of Attitudes from
 Nonverbal Communication in Two Channels,” Journal of Consulting Psychology,
 Vol. 31, No. 3, June 1967, pp. 248-258
 Mehrabian, A. (1971). Silent messages, Wadsworth, California: Belmont
 Mehrabian, A. (1972). Nonverbal communication. Aldine-Atherton, Illinois: Chicago

Excuses, excuses…

© Lori Martin | Dreamstime Stock Photos
© Lori Martin | Dreamstime Stock Photos

I’ve been having a “bit of a moment” over the last few months where the superficiality of leadership in business in general and government specifically has caused me lots of tutting and fuffing.

It’s finally dawned on me what’s bothering me and wondered if my conclusions made sense to anyone else?

I realised a while ago that one business driver in the health sector was the sheer complexity of information around the provision of health care now. The volume of data available to inform decisions is so vast and disparate that we cannot expect an individual to consider it all when reaching decisions about care journeys and pathways. When things go wrong it is always easy for others to point to yet another set of data which “should” have been considered.

Hence the growing traction of “expert systems”, that are attempting to assist front line staff in their decision making, and “management systems”, that are attempting to assist front line staff in…well, just keeping track.

But what sort of systems are available to our business and government leaders to help them to consider all that is under their jurisdiction and to keep track of it? Nothing…they are reliant on their staff to provide them with an objective view of what’s happening and they need to be asking the right people, the right questions…even down to what they are actually spending.

Now, in my experience neither of these things happen with any rigour, if they can be avoided, as it’s all takes too much commitment to basic information gathering and analysis, when there are fun things like self-promotion to be done.

The result of this failure to gather information is that whole businesses and departments can be so badly off track before those who are leading them have any idea that things might not be as they seem.

The reaction of the leadership and their staff is to spin the real reasons that the situation is so far out of control…shock, horror…thereby maintaining the status quo and protecting both set of jobs.

We’ve seen it in government departments and the private sector…in banking it seems to be part of a standardised cycle with fines every year. It is a useful technique to master if you are a business leader who wants to avoid being saddled with responsibility…

…the alternative, which seems to have fallen out of fashion is “the buck stops here”.

Pharming the Health Sector

I’m always wary when I see the words “NHS” “drug companies” and “partnership” in the same sentence. Call me an old cynic, but conflict of interest springs to mind. We are purposeful beings and there is a purpose to everything we do no matter how remote or obscure it might seem to others. Just as there are always two sides to every argument, one man’s meat is another man’s poison, etc.…there are always two sides to the coin:

Safety education for medical staff v converting more sales;
Promoting correct drug usage v converting more sales;
Encouraging economic medicine management v converting more sales.

© Alexey Lisovoy | Dreamstime Stock Photos

© Alexey Lisovoy | Dreamstime Stock Photos

The recent article by Margaret McCartney in the BMJ makes reference to medicine management programmes paid for by the drug industry, and of course such a well-researched piece caught my imagination.

Apparently, a 1995 parliamentary enquiry called for “greater restraint in medicines promotion, particularly soon after launch.”…which I must admit I read as “soon after lunch”…but then as I said I’m just cynical.

So, how have we arrived at the current position? I think it has to be because NHS staff value the services they are receiving from Pharma and Pharma are prepared to provide the services for the return on investment they are making. The basic business of supply and demand, then.

And what are the services that NHS staff value? It seems to me that medical staff are being provided with information based on data, often gathered from their own patient cohorts, which happens to indicate the need for increased/changed drug usage. The key here is that the data evidences the need and it is difficult to disconnect the statistics from the clinical decision-making process which is more subjective based as it is on skill and experience. It is hard for anyone to ignore information about a possible risk without worrying that that risk might occur and they would be “to blame”.

NHS Informatics groups already know what is prescribed, why, when, how long for and to whom. What is missing is the bit before and the bit after…the inputs and the outcomes, such as what did the patient present as their symptoms and when the course of treatment was over did they recover or is it on-going? There is much talk of the “Patient Journey” but in terms of information in the NHS we are a long way off joining the dots.

So, if the NHS was able to provide end-to-end informatics on drug usage e-prescribing solution could be developed and medics wouldn’t need to accept the drugs companies conclusions. Bearing in mind the complexity of all the factors that need to be considered these days when prescribing, it’s only a matter of time before this type of system becomes essential to protect the prescribers.

Perhaps Big Pharma could make an altruistic move and use the existing funding that they have already set aside for the creation of an independent NHS “drug squad” to review prescribing and ultimately to implement an e-prescribing system that works. could have been the NHS’s ultimate repository of patient data, making a useful contribution to the institution that provides care free at the point of use. Could we re-task them?

Rest In Peace

© Lisa F. Young | Dreamstime Stock Photos

© Lisa F. Young | Dreamstime Stock Photos

When I heard that the NHS was planning to add a “Death Plan” to patients’ records, I was pleasantly surprised that the management of End of Life Care and someone’s death wishes would be taken into consideration. We often hear that the NHS has no time, or that it’s soulless, leaving vulnerable people to die on trolleys but this is clearly not what the NHS wants nor anybody else for that matter.

I’ve had a Living Will for years now, which specifies everything down to the music to be played at my funeral and family reactions are varied. “Oh, listen…they’re playing your tune” has taken on a whole new meaning.

There is so much news today about dying with dignity and people fighting for their right to do so, that it seemed to me that the whole thing is down to the individual and what they want. It’s a fine line between choice and protection.

The Daily Mail says that patients will need to “sign here if you’re ready for death”. It makes a great scare story.

There are medical professionals who say it is ‘blatantly wrong’ and that it will frighten the elderly into thinking they are being “written off”. One expert said that the guidance was “the thin end of the wedge of assisted suicide”. But if you want to die at home, what can you do other than set down your wishes and sign them?

Some GP surgeries have been cold-calling their patient list to check what they want and have been condemned for doing so. This might not have happened when patients’ had a personal relationship with their GP; when they had more time, GP’s could find out what their patients wanted without appearing blunt. But let’s get over it…those days are gone.

As usual the real problem is caused by peoples’ approach…everything can be interpreted to suit the point of view of the interpreter.

Whilst I don’t want to give anybody the right to legally end my life, I would definitely chose peace and respect over brain damage and broken ribs.

Death Plan…good idea, better way to go about it…?

Skills for the Job?

© Lisa Turay | Dreamstime Stock Photos

© Lisa Turay | Dreamstime Stock Photos


On the drive to work my traffic stream was halted by a huge truck reversing round a corner into the tiny domestic driveway. I gazed at the scene without registering it…thinking about my day and what was waiting for me at the office.

Suddenly the scene snapped into focus and realised how amazing the skill of the truck driver was, reversing while turning 90 degrees, with inches to spare on each side, at some speed so as not to disrupt the rest of us for any longer than necessary.

I realised that the thought of making the same manoeuvre would have brought me out in a cold sweat, especially as it would have had to be performed in front of a host of impatient drivers cursing me for holding up their day.

Now, let’s be clear. I’m not a bad driver. I can pretty much get into any vehicle and drive it. I can park parallel or otherwise, although my concentration slips sometimes and I have done that thing where you set off on a familiar journey and on arrival at your destination, don’t remember how you got there.

The driver of the truck was a man (I’ve never seen a woman truck driver in the flesh, although I’m sure there are many, so please don’t get on your high horse) and that fact took me back to my early staff management training when my lecturer told me that men are better at some tasks and women better at others.

His reasoning was that the male/hunter brain was able to focus on a single task without being distracted by anything else, whereas a female/social brain was programmed to cope with many inputs at any one time. He was telling me this to justify his opinion that women are better at repetitive production line tasks and should be restricted to this type of work, but hey,…it was the 80s.

So, the truck driver can reverse with total focus, while I am programmed to be distracted?

Is this true? Surprisingly, according to the BBC research finds it may be so.

Whilst I believe that there is probably a continuum for brain performance traits with “male” and “female” at either end, I don’t think that all male traits are a male preserve and similarly for females.

Have women and men evolved to perform some specific task better than others? In a business environment which tasks would they be, then?

Lifeguards for the Tech Pool

The Tech Partnership? Never heard of them? If you have any staff who you class as tech-enabled then have I got news for you…

Tech Partnership Logo

The Tech Partnership is a growing network of employers, collaborating to accelerate the growth of the digital economy, and Quicksilva is a member along with the “great and the good” of the technical sector. Quicksilva is an SME, but we identify with the agenda of the Tech Partnership, just as the giants of our industry do…and you probably will do too.

We believe that for the UK economy to grow, the digital economy has to grow to drive it along…and we can all support this aim by:

  • Inspiring young people to embark on technology careers;
  • Improving opportunities for apprentices and graduates;
  • Developing strategically important digital skills; and
  • Raising quality and standards in education and training.

So, it’s about investing in the future? Well yes, that’s a huge part of it, but there are benefits being delivered to the Tech Talent Pool from day one…and everyone in our industry needs to be a lifeguard, safeguarding the life of that valuable Pool.

The Tech Partnership is the place to go for tech training and development support for your company. Match funding for courses is available now and it is there for you to help make a difference to your team.

I will be making use of this fund myself and I wanted all our contacts both private and public sector be aware of what they are missing out on. Ask me about it next time we are in contact, or…

You could just Join us

Cradle to Grave – the New Battleground?

© Robert Bayer |

© Robert Bayer |

It all started when I was on the Tube last week and a woman in her 30s gave up her seat to an elderly man on walking sticks, he thanked her and took the proffered seat…next to the child, whose mother didn’t think it necessary to get her little girl to stand for the man.

I suppose when you think about it, the question is “Does this show a lack of respect?”

From the mother, from the child? To me it seems to be the norm these days, in a Britain that is too cool to stand up (no pun intended) for what are now see as old-fashioned values.

In Britain in the 1900s, respect was demanded by those who held the power, money and status, but it was likely to be a sham respect, not earned by the actions or manners of the one demanding it. In the 1940s it was all about “being a lady” or a “real man”, and good manners earned you respect and “genteel” was something people aspired to. Following the levelling of society’s powerful and the upper classes in the World Wars, being polite and respectful developed a bad rap to be rebelled against and was becoming viewed more as “putting on airs and graces”.

Is it any different abroad?…probably not. There seem to be many people like me, stuck in the past, who don’t get the modern vibe around the culture of self, self and more self.

Showing respect for others these days seems to be a sign of weakness, almost as if giving respect selflessly, detracts from the giver in some way, maybe even making them look naïve or a bit dim.

Once respecting others becomes an act that attracts a personal cost, where do we go from here?

How about the case this week of the 6 care workers sentenced for ill-treating residents. The son of the abused resident said of the convicted “there was no respect”. The strong generations now having their day, seem to have little if any respect for older people, who might be viewed as just living longer and longer and using up resources that could be conserved.

What about those at the end of their life…often treated with indifference in the health sector as seen in its discredited use of the Liverpool Care Pathway and more recently in a new report claiming that hospitals continue to fail patients at end of life.

To take this to its inevitable conclusion…with the assisted dying legislation paving the way for an “acceptable” solution, and with respect for others on the slide, will we slip into a future we weren’t expecting?

The future “cultural war” to be waged is likely to be young v old, as the scary prospect of a world populated by millions of old people, who need care, but aren’t valued, overwhelms a generation who were never taught to respect older people anyway.

Sixties sci-fi at its most horrific.

Bullseye…or a shot in the foot?

© Andres Rodriguez | Dreamstime Stock Photos

The recent reports of A&E waiting times are an about face worthy of Alice Through The Lookinglass…”Shock 250% rise in patients waiting more than 4 hours in A&E: Six-month total soars by 146,000 – as Labour says crisis is worst in 20 years” from the Daily Mail.

Apparently, since the Government took over the “4 hour wait target” for A&E patients introduced by Labour in 2002, waiting times are supposed to have rocketted.

Not long ago, in the days of Labour, the Press were tutting over the fact that the 4 hour wait target was causing patients to be left in ambulances rather than being brought into A&E departments for the clock to start ticking…now it’s missing the target that is the issue.

The Guardian further explains that “NHS failed to meet four-hour A&E targets for past two months” and that 93.3% of patients have been dealt with under the 4 hours instead of the required 95%…and this is with 1 million patients more being dealt with than in a similar period last year.  Ahhh…that explains it then…there are just too many people presented at A&E…

The Scotsman seems to have it right with their stirring story “A&E patients told: If it’s not an emergency, visit GP” and quite right too. Its the worried well that cause prolems not only in emergency situations at A&E but also with England’s new 111 Service where the volume of call to this urgent number have brought down the systems.

If I was in A&E with a life threatening problem and the guy next to me was being treated for a cut finger as he was nearing the 4 hour wait target I’d be pretty vocal. Surely it’s the triage professionals that should be making the decisions about who is seen first? About who is emergency and who is urgent?

They could always install direct lines to the 111 Service in the A&Es for those who are fed up of waiting.