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

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.

The Big Bang for Girls

It has always been a male thing…adolescent boys hunkered down in their dim, fetid bedroom fantasising about computer generated heroes…no interpersonal skills and no hope of a girlfriend. Why is it always boys? When does it start? Why do they always seem to “get” IT?



At the risk of upsetting our female readers, I suppose most men like gadgets and geeks just take this to the extreme becoming the early adopters in society. To turn this around then, they are smart, aware and engaged with technology.  This is a stereotype that girls just don’t seem to enjoy, either as potential IT users themselves or by having geeks as friends.

In the mid-2000s, Geek Chic became fashionable and there was a slight surge in girls wanting to look nerdy.  TV programmes like “The Big Bang Theory” though, have done nothing to encourage girls into technology as they portray girls in the industry as plain, desperate and un-dateable.

But girls are missing a trick here, as research by eSkillsUK, the sector skills council, shows that 1 in 20 of the total UK workforce is employed in IT…jobs in the sector are growing nearly 5 times faster than the UK average…over half a million new entrants are needed to fill the jobs over the next 5 years.

Over a number of years eSkillsUK have made inroads into understanding the psyche of young girls, finding that 11-14 years old is where their interest in IT gets closed down.  Whether this is down to the school syllabus, the subject matter or purely down to the scarcity of other girls in IT to relate to, is up for debate, but eSkillsUK have tackled the problem on all fronts.

The first indications that female students are beginning to show an interest in Information Technology were probably missed by most of us, but figures released this week by the Joint Council for Qualifications show that more girls in total took the ICT GCSE qualification this year: 38,608 in 2013, compared to 32,994 in 2012.

Girls have also excelled from an achievement perspective: 30.9% of female candidates achieved an A* or A grade, compared with 23% of males. But less of the male ego bashing, the ICT entrants as a  whole did well, since only 21.3% of all GCSEs receive an A* or A.

ICT GCSE entries have risen by 25% in 2013, with 87,788 candidates sitting the exam this year, compared with 70,420 in 2012. This is the first time since 2005 that the number of candidates has increased.

While there is a long way to go, if you believe as I do that the IT talent in UK plc is worth developing because its output is likely to drag us out of recession, give a girl geek a pat on the back.

The Glorious 12th – the new NHS Killing Season?

Apparently, grouse in the UK aren’t yet healthy enough to shoot this year as the bizarre weather has stunted their development…in other news though; the month of August has triggered the annual influx of newly qualified doctors into hospitals across the UK, signalling the start of the annual open season on patients.

© Tolchik | Dreamstime Stock Photos

© Tolchik | Dreamstime Stock Photos

The ’Killing Season, so called because research shows that the 6,000 new doctors that are already in place at our hospitals are putting patients at risk, prompting a six per cent rise in unnecessary deaths. We know this as a matter of record, and the Government finally responded to the issue last year.

There is now a mentoring scheme to ensure that graduates have access to support from more senior medical staff as they learn the ropes. The Independent reported that the mentoring scheme requires junior doctors to shadow their predecessors for a minimum of four days before they start their jobs on 1st August. It must be nerve-wracking for them suddenly to be faced with real live patients…and four days sounds like being thrown in at the deep end to me.

But then…it’s worked well in University Hospitals Bristol, figures showing that there were 52% fewer errors made by the junior doctors on the scheme in the first four months. This is great news for all those patients who might not want to replace the grouse as “fair game” this August.

So, problem solved then? Well, this certainly goes some way towards it, but we can’t congratulate ourselves just yet as the EU’s Directive around working hours has been thwarting those same junior doctors since 2009. Senior medical professionals have argued that the EU’s strict rules on working hours have been frustrating the development of graduates who need to experience the fullest range of conditions and treatments they can in their first few weeks…or first 4 days if they’re really lucky.

But, by limiting the hours junior doctors can work and train, the EU’s rules are putting them under a strain to perform well while learning an enormous amount of information in a stop/start manner. In October 2012, Professor Norman Williams, President of the Royal College of Surgeons, argued that shorter working hours meant that junior doctors are failing to meet a full range of challenges and applauded the Government’s effort to instigate a change to the directive. He wrote that a “48-hour straitjacket has led to too many unnecessary handovers and has resulted in a fragmentation of patient care.”

In February this year, the GMA highlighted the results of the restrictions imposed by the EU working hour’s directive, also. They cited some issues around providing out-of-ours care for patients and being given less opportunity for valuable training causing even more pressure. When so many health authorities agree on a topic, it’s worth noting as it is a rare event…

Working in the medical profession is not like any other, it is literally life or death, and not just statistics. The NHS is at least trying to support new doctors, but with their hands tied by the Directive, how are we to maintain the take up by graduate doctors and save patients’ lives?

I’m with you on this one, Professor Williams….Pull!



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.




Darwin Strikes Again…

© Dana Rothstein | Dreamstime Stock Photos

I’m sorry to bring this up again after all the uproar has died down…but there are lessons for all of us from the Paris Brown affair.  I think Police Commissioners everywhere will be feeling the strain of this one for a while yet…but for the rest of us the worst may be yet to come…

As managers, we must be left with the unease that a member of our staff might cause our company name to be linked with the disreputable, damaging reputations and ultimately costing jobs.  Of course, this is covered off in company policy…but can we ever be sure that “one of ours” isn’t going to have their moment?  Is it our head on the block, too?

As employers, the recruitment scene subtley changed when social media became a source of addtional information about prospective candidates. Thanks Yahoo, you may have spoilt it for us by explaining to people that vitriolic tweets can catch up with them… and yet there are still people out there who appear not to care what impression they give and employers can manage to avoid them.

As parents, what if our precious offspring follow Ms Brown’s lead and broadcast their immaturity to the world…the world that you and they hope will one day offer them a living. How do you get over something like this?

At Quicksilva I usually say “Recruit for behaviours as you can always teach skills” and this is becoming accepted by more and more businesses as the competition for jobs increases.  It is sad to see so many young people who do not have all the skills needed to communicate in the workplace as reported in The Guardian.

So, once they have these skills, how do we teach them about the consequences of using them?




Legs 11 (1)…thoughts on the NHS lottery

It's a lottery out there...Don’t you just despair over the constant stream of NHS bad news? It’s like a lottery out there if you’re sick…
The main cause of recent Press hysteria is the NHS 111 Service…and yet reading the various articles there is no consensus amongst journalists about what really is the problem. Of course, there is “The Computer System”, that baddie from the sci-fi genre of the 50s and 60s. If you are my age you will recall that computers are violent towards humans and are looking to take over the world.
There is no grasp that today’s services are brought to us through many systems working together (or not) and in the case of the NHS 111 Service I imagine there to be Call Centre Systems, Triage Systems, Patient Record Systems…which has failed us? Or are we blaming them all?
The BBC talks about high call volumes. Is that the Call Centre system causing the long wait? Or is it the staffing levels?
While the Daily Mail sees the Triage System as possibly the main problem…or could it be that staff with only 10 days training, who are so desperate they admit “I don’t know what to do”?
Reports of IT crashes are common in all reports and maybe that was a reference to the Patient record System…or maybe not. Or could it be that as usual a Government project of this size is suffering from flawed planning, know-nothing procurement, poor project management and inadequate testing?
All of the above I suspect, the bigger-is-best policy wreaks havoc again, it never changes and it never will until leaner, meaner, providers are given the chance to prove themselves on Government projects.
I feel a twinge of sympathy for the solution designers as, having worked for years within Government, call volumes have probably been vastly underestimated. The NHS 111 Service is designed for “urgent” calls; the NHS 999 Service for “emergency” calls. However, if you give the public an easy option, they will take it…and hey, who wants to wait two weeks to see a GP?

Don’t get sick…just yet

Last week, alarmist headlines warned readers of an NHS ‘killing season’…a period when the average mortality rate increases in UK hospitals due to the intake of newly qualified medical graduates. To counteract this dip in the quality of patient care, the Department of Health has published details of a plan to better provide trainees with the skills they need to hit the ground running. But is it enough…after all it seems the Department of Health are happy to inflict on us medical staff who can’t speak English, so are we any worse off under inexperienced doctors?

We need more than a quick-fix solution…we need to be pre-empting both problems earlier on and providing sustained support to junior staff in the UK by better nurturing their skills and attracting, retaining and developing the very best home-grown talent from the start.

At present, it is reported that patients admitted to British hospitals in an emergency on the first Wednesday in August have, on average, a 6% higher mortality rate than those admitted on Wednesday the previous week. The Department of Health’s measures to eliminate this ”blip” look to smooth out the change-over period in August by introducing strategic, targeted training which aims to better prepare trainees for the reality of life on the wards.

The Department of Health has stressed the importance of a better transition period: “Our aim is to ensure that all junior doctors spend a minimum of four working days shadowing the job that they will be taking up and completing a Trust-based induction.” It’s this kind of exercise that will lessen the shock-to-the-system reaction which seems to be fairly common when juniors first have to face the literally life and death situations that they come up against on duty…another shock to them must be the hours they are suddenly expected to work and the exhaustion that results. Most of the working world has already worked out that by helping new starters to become more familiar with their new working environment, combined with a thorough handover of their responsibilities, they will be better prepared for flying solo.

Indeed, it’s encouraging to see that trials in Bristol of week-long shadowing and additional teaching have reduced mistakes made by new doctors by 50%. If this is truly representative of the benefits, I’d say that we’d be short-sighted to set this kind of skills development at just four days. The plans put in place so far are a great start, but more can be done both in advance and in the longer term to not only bring these statistics down, but to ensure that the very best doctors are providing the very best care in our hospitals.

To attract home-grown talent we need to be encouraging Britain’s young people into medical training, from an early stage. Over the past eight years, nearly 200 UK nationals have headed abroad to train as doctors and dentists at medical schools in the Caribbean alone. We need a system in place that can attract and retain the skills we have in the UK in a world that has become globally competitive for such talented individuals.

It’s important that we’re looking at the longer term effects of the culture too when shaping the way we go about training juniors. A recent report highlighted that during their training junior doctors do not feel valued by their superiors or the organisation as a whole: managers (83.3%), the chief executive (77.7%), the organisation (77.3%), the NHS (79.3%). These figures are not a surprise when you poll at the bottom of the heap…same in most professional sectors I would say.

So what’s in store for all of us who might fall sick next month? It’s thought that 7,000 junior doctors will voluntarily begin the new induction scheme later this month, before they start their posts in August. Compulsory from next year onwards, this personalisation of skills development is a big step towards improving patient care at this crucial time. Whilst more can be done to improve training, it is certainly a good sign that at least things are moving to bridge the massive gap between being a student and becoming a medical professional…safer too!