This is another 'you've not really thought this through, have you Lou?' post. Sorry about that - if you want more professional and cohesive writing go see here where Hewlett Packard are kindly hosting some of my scribblings.
Mobile libraries, I am willing to bet, are an endangered species right now. Rarer than the Thompsons Gazelle, harder to find than a public toilet. And in some areas, that makes sense, being as how there is probably a brick version of the same thing within easy walking or bus ride distance.
Unless, of course, you can't walk or their bus route got cut. But we shant dwell on such inconveniences.
No. Instead I'd like to think about why more services are not mobile. We have mobile breast screening trucks. We have mobile blood donation trucks. Both of these services must have been provided on some kind of research based decision which said people were more likely to do something a bit inconvenient and distasteful but ultimately absolutely necessary if the mountain moved and was more accessible to people.
I imagine both of these services are aware that overheads of running a fixed site compared to running a mobile truck are at the least comparable if not less - price of fuel and upkeep/depreciation of the vehicle compared to price of utilities, rent, business tax, repairs to the building for the fixed site. Staffing costs one imagines are the same as long as you can find someone who can multi-task and there doesn't to be a shortage of people with a not inconsiderable amount of nothing to do on their hands at the moment.
So what kind of services am I thinking about? Libraries are obvious especially in rural communities - taking into account driving between villages and stops, you can surely easily service 4-6 villages per day running on a weekly or fortnightly rotation. Turning existing central libraries into storage warehouses can't be entirely outside the realms of possibility. Mobile e-book rental points are probably also the way forward as well as sticking a mobile municipal wireless broadband broadcast inside the van with the wep key available as long as you come into the van and ask for it.
Then there's fostering and adoption and public health information distribution. Run walk in information surgeries but instead of paying to hire other peoples spaces, take your own. Have somewhere reliable and warm to book out and take on the road - there's bound to be more than those two service areas in need. Planning consultations? Take them out into the community if it's a major project. Consultations on road layouts? Off you go then, just make sure you give feedback on your experience of getting the truck out of the town centre and out into the suburbs and rural areas as part of the consultation.
If we are going to be looking to base future communication strategies on fishing where the fishes are, i.e. taking the information, discussion and engagement to the places where people have the time and are comfortable discussing and engaging, then why not the same for all Council Services it is suitable for. Place service delivery in front of peoples eye balls, insert yourself into their foot fall. Be where they go.
Or, failing the mobile approach, just set up a permanent stall in the local Mall and get people to donate blood, talk about their health problems, inform them of a coming heatwave and that there is a major consultation on road redesign there instead. Consumerism is taking over our country so we might as well acknowledge it and use it to our advantage.
Thursday, 29 September 2011
Tuesday, 27 September 2011
Tearing the heart out
I feel like I'm watching the biggest game of skittles.
My favourite guilty pleasure is a carrot cake cupcake from a place called Huntleys which is a local farm shop which also supplies us with potatoes familiar with soil and bread familiar with real hands. Not as rare up here as some people might like to think - you've simply got to be a bit persistent in hunting then down, but anyway, that's not the point.
What is the point, is that one summers day when we had a day off after a Bank Hol, we went during the day to Huntleys. Specifically around lunch time. And the queue at the handmade sandwich counter was epic. A rarity in London, here there are still a large number of businesses fuelled entirely by local hungry tummies.
What was different about this is that Huntleys is a little bit in the middle of nowhere. In fact, strictly speaking it should be dead, because while once upon a time it lay along the main road between Blackburn and Preston, it no longer does with the advent of the M65. It's reputation precedes it and it does a very very nice line in coffee shop fodder but why the long queue around lunch time?
BAE.
Which is potentially shedding up to a 1/4 of its staff in the near future (potentially including my cousin. Who is a single parent with a young lad to support - I thought it important to say). So what effect, exactly, do we think that's going to have on Huntleys? The retired set will keep on visiting but I give it not very long at all before the two ladies behind the sandwich counter are employed no more, certainly during the week. How many children do they have relying on the money they bring in?
Estimates are currently sitting around 4:1 for the ratio of jobs away from BAE affected by the loss of one job inside BAE's perimeter fence. The company itself is entrenched in the local area, when I first moved here, my boyfriend drove me around the edge of the site to see the planes by the front gates. Yeah he's a plane geek but he's also proud.
Pride is a funny word. These days we use it in limited ways, in terms of being proud of others, more than being proud of where we live, who we are, what we believe in and what we achieve. It's not terribly British to shout about anything, really, in fact it seems to be becoming quite British to instead focus on the negative. But that pride that my boyfriend feels when it comes to BAE is replicated quietly in thousands of peoples minds. And while it's fine for people living in Accrington or Blackburn or Burnley to moan about how crap their town is (at least of those officially being crap featuring as it did in the relevant book), try having a go if you don't live in the town. Short shrift and flea in ear. Same as anywhere really, except you'd need to visit to understand. You'd need to live here, to be here, to work here, to know the disparity between beautiful Victorian parks and run down terraces, between ancient woodland and by-ways and every window smashed closed pubs.
So. Looking back at what has happened in the last year, I wonder, how much more. I look at the proposed demonstrations and marches about public sector pensions and though I wont be walking (another story), I will be watching. I will be expecting. Because I believe there is only so much heart you can get away with tearing out of a proud county full of proud people with gritstone bound hearts of gold. I believe there is only so far you can push decent, down to earth, genuinely caring hard working people. I believe MP's expenses and bankers cock ups and the persistent problems with markets, oil prices and house prices are rolling us towards an edge we will not be able to retreat from.
So answer me this, What false assignation of motivations will we give when it is no longer only the teenagers who have had enough? Is anyone listening? Has anyone taken ownership of the stethoscope which if used could measure and interpret public feeling so very easily?
I'm alright. We're alright. We've lived off pennies from the penny jar anxiously poured into the machine at Asda before now and I am under no illusions that that may indeed happen again. But others do not have the luxury of such philosophy and have smaller mouths to feed. And I am worried. I am very worried.
My favourite guilty pleasure is a carrot cake cupcake from a place called Huntleys which is a local farm shop which also supplies us with potatoes familiar with soil and bread familiar with real hands. Not as rare up here as some people might like to think - you've simply got to be a bit persistent in hunting then down, but anyway, that's not the point.
What is the point, is that one summers day when we had a day off after a Bank Hol, we went during the day to Huntleys. Specifically around lunch time. And the queue at the handmade sandwich counter was epic. A rarity in London, here there are still a large number of businesses fuelled entirely by local hungry tummies.
What was different about this is that Huntleys is a little bit in the middle of nowhere. In fact, strictly speaking it should be dead, because while once upon a time it lay along the main road between Blackburn and Preston, it no longer does with the advent of the M65. It's reputation precedes it and it does a very very nice line in coffee shop fodder but why the long queue around lunch time?
BAE.
Which is potentially shedding up to a 1/4 of its staff in the near future (potentially including my cousin. Who is a single parent with a young lad to support - I thought it important to say). So what effect, exactly, do we think that's going to have on Huntleys? The retired set will keep on visiting but I give it not very long at all before the two ladies behind the sandwich counter are employed no more, certainly during the week. How many children do they have relying on the money they bring in?
Estimates are currently sitting around 4:1 for the ratio of jobs away from BAE affected by the loss of one job inside BAE's perimeter fence. The company itself is entrenched in the local area, when I first moved here, my boyfriend drove me around the edge of the site to see the planes by the front gates. Yeah he's a plane geek but he's also proud.
Pride is a funny word. These days we use it in limited ways, in terms of being proud of others, more than being proud of where we live, who we are, what we believe in and what we achieve. It's not terribly British to shout about anything, really, in fact it seems to be becoming quite British to instead focus on the negative. But that pride that my boyfriend feels when it comes to BAE is replicated quietly in thousands of peoples minds. And while it's fine for people living in Accrington or Blackburn or Burnley to moan about how crap their town is (at least of those officially being crap featuring as it did in the relevant book), try having a go if you don't live in the town. Short shrift and flea in ear. Same as anywhere really, except you'd need to visit to understand. You'd need to live here, to be here, to work here, to know the disparity between beautiful Victorian parks and run down terraces, between ancient woodland and by-ways and every window smashed closed pubs.
So. Looking back at what has happened in the last year, I wonder, how much more. I look at the proposed demonstrations and marches about public sector pensions and though I wont be walking (another story), I will be watching. I will be expecting. Because I believe there is only so much heart you can get away with tearing out of a proud county full of proud people with gritstone bound hearts of gold. I believe there is only so far you can push decent, down to earth, genuinely caring hard working people. I believe MP's expenses and bankers cock ups and the persistent problems with markets, oil prices and house prices are rolling us towards an edge we will not be able to retreat from.
So answer me this, What false assignation of motivations will we give when it is no longer only the teenagers who have had enough? Is anyone listening? Has anyone taken ownership of the stethoscope which if used could measure and interpret public feeling so very easily?
I'm alright. We're alright. We've lived off pennies from the penny jar anxiously poured into the machine at Asda before now and I am under no illusions that that may indeed happen again. But others do not have the luxury of such philosophy and have smaller mouths to feed. And I am worried. I am very worried.
Sunday, 25 September 2011
Self belief in the modern age
The problem with the internet (yes, I am capable of acknowledging there is one) is it creates insecurity.
Think about it. We've got a generation of young people growing up in this country who think failure is no Likes on their Facebook posting. No comments on their Flickr, no Likes on their Instagram. Nothing but silence as they tweet their latest blog post which they poured their heart and soul into.
The web brings people together. But it also separates them. It is easy to hit a Like button but it is easier to not bother at all. It is even easier to simply lose a voice in the sheer volume of noise, through nothing more than not noticing their voice is no longer there.
Which is worse? Unintentionally losing someone's voice from a conversation and never noticing, or intentionally being removed from a conversation and be left wondering why you were not good enough, what you didn't contribute, what wasn't good enough.
The language used here is telling. It is easy to think you are not good enough because people have stopped commenting. It is easy to think your words are nothing but failure because no one is reading them any more. It is easy to think no one cares in the silence. And for a lot of people the silence reciprocates and there are no more tweets and no more blog posts and no more sharing.
If we raise a generation to think that if someone else is too busy to read or comment that somehow they are a failure then we have a problem. Because we are all time strapped. We are all trying to juggle balls, even if we don't have children (and the assumption I somehow have more time to choose to do what I want with as I have no children frustrates me immensely - when I have time empty, I fill it, with fun things I like to do, just like you chose to fill yours with a child's laughter) and some of us sometimes have time to comment and discuss and feedback but it's not guaranteed. Not always guaranteed.
Self belief is the same as it always was and it hasn't changed for the digital generation. Self belief cannot rely on anyone else, it must come from inside. And increasingly I am realising that self belief is not to be found in a computer screen at all. It is to be found on a bicycle. It is to be found in a team discussion, contributing passionately and voraciously and standing ground and learning to be right instead of always assuming being wrong. It is in getting feedback from someone face to face and understanding time is precious and is still being given. It is in choosing to deal with a situation in a way which is risky but necessary and acknowledging that life does not always come in pre-packaged shrink wrapped boxes with clear instructions attached.
Growing up is hard. It always was hard. I think that right now, the hardest thing for the under 25's around us is learning what the web is good for and what the web is not good for. The web is good for creating content. But feedback on that content is still more valuable offline.
Think about it. We've got a generation of young people growing up in this country who think failure is no Likes on their Facebook posting. No comments on their Flickr, no Likes on their Instagram. Nothing but silence as they tweet their latest blog post which they poured their heart and soul into.
The web brings people together. But it also separates them. It is easy to hit a Like button but it is easier to not bother at all. It is even easier to simply lose a voice in the sheer volume of noise, through nothing more than not noticing their voice is no longer there.
Which is worse? Unintentionally losing someone's voice from a conversation and never noticing, or intentionally being removed from a conversation and be left wondering why you were not good enough, what you didn't contribute, what wasn't good enough.
The language used here is telling. It is easy to think you are not good enough because people have stopped commenting. It is easy to think your words are nothing but failure because no one is reading them any more. It is easy to think no one cares in the silence. And for a lot of people the silence reciprocates and there are no more tweets and no more blog posts and no more sharing.
If we raise a generation to think that if someone else is too busy to read or comment that somehow they are a failure then we have a problem. Because we are all time strapped. We are all trying to juggle balls, even if we don't have children (and the assumption I somehow have more time to choose to do what I want with as I have no children frustrates me immensely - when I have time empty, I fill it, with fun things I like to do, just like you chose to fill yours with a child's laughter) and some of us sometimes have time to comment and discuss and feedback but it's not guaranteed. Not always guaranteed.
Self belief is the same as it always was and it hasn't changed for the digital generation. Self belief cannot rely on anyone else, it must come from inside. And increasingly I am realising that self belief is not to be found in a computer screen at all. It is to be found on a bicycle. It is to be found in a team discussion, contributing passionately and voraciously and standing ground and learning to be right instead of always assuming being wrong. It is in getting feedback from someone face to face and understanding time is precious and is still being given. It is in choosing to deal with a situation in a way which is risky but necessary and acknowledging that life does not always come in pre-packaged shrink wrapped boxes with clear instructions attached.
Growing up is hard. It always was hard. I think that right now, the hardest thing for the under 25's around us is learning what the web is good for and what the web is not good for. The web is good for creating content. But feedback on that content is still more valuable offline.
Monday, 19 September 2011
Back office blues
Picture this:
Girl sits at a desk. It's an okay desk, as it happens it's not the smallest desk she ever had. Actually, she used to have her own office - in a portakabin admittedly - but it was her own space in one of those weird local government twists of fate. Anyway, she's got a set of drawers with the obligatory missing key and a set of shelves a short walk away but there's barely anything on them because she doesn't work in the world of books any more, to be honest. She doesn't need a filing cabinet either. She doesn't need much except her desktop PC, obligingly old, obligingly capable of doing what she needs it to do. She misses her old 20 inch screen but understands she couldn't make a business case if she tried. Multiple data streams does not a business case make. She has a phone but it rarely rings, a stapler which is used more often by others. Her mechanical pencils litter the desktop as she prefers to write in pencil - less resistance and a long story. Full notebooks, half full notebooks, waiting to be full notebooks litter the desk and strew through the drawers in an unpredictable mess of some faintly remembered filing system which said this notebook for notes and that one for minutes. She sits, and she types, sometimes frantically and sometimes mechanically, but always faithfully and most of the time she feels that typing furiously has some value, has some weight, has some impact as she desperately tries to convey all she knows before the invisible timer which silently ticks down the hours, seconds and minutes reaches the inevitable climax and her time at this desk will end.
Some of the time she feels invisible. Splashed with the can of paint thrown regularly and wildly at back office functions, red clashing with the white calm she tries to hold on to. Some of the time she feels all too visible, responsible for the future encapsulated in the acknowledgement that the future comes but it comes at different paces in different parts of the country and that she might be of the right time but in the wrong place or perhaps the wrong time in the right place, who knows? She goes home and types furiously. She goes to work and types furiously and where do all those words go? Does anyone read them? Does anyone really care? What difference is she actually making? What happened to the fire and the belief and the conviction?
I should go quietly. Really I should. But it's not in my nature, you see. Nothing to lose, something to gain and does it matter if the gain is not personal but simply a small tiny little piece of sand in a wall so big she cannot possibly conceive of it. Does it matter she cannot conceive of it? Does it matter she cannot change the size or colour of the wall? Does it matter that she no longer believes she could bring the wall down entirely and assist in rebuilding it and sometimes wonders at the audacity that ever led her to believe she could?
Flicker, flicker, flicker. The candle gutters.
Girl sits at a desk. It's an okay desk, as it happens it's not the smallest desk she ever had. Actually, she used to have her own office - in a portakabin admittedly - but it was her own space in one of those weird local government twists of fate. Anyway, she's got a set of drawers with the obligatory missing key and a set of shelves a short walk away but there's barely anything on them because she doesn't work in the world of books any more, to be honest. She doesn't need a filing cabinet either. She doesn't need much except her desktop PC, obligingly old, obligingly capable of doing what she needs it to do. She misses her old 20 inch screen but understands she couldn't make a business case if she tried. Multiple data streams does not a business case make. She has a phone but it rarely rings, a stapler which is used more often by others. Her mechanical pencils litter the desktop as she prefers to write in pencil - less resistance and a long story. Full notebooks, half full notebooks, waiting to be full notebooks litter the desk and strew through the drawers in an unpredictable mess of some faintly remembered filing system which said this notebook for notes and that one for minutes. She sits, and she types, sometimes frantically and sometimes mechanically, but always faithfully and most of the time she feels that typing furiously has some value, has some weight, has some impact as she desperately tries to convey all she knows before the invisible timer which silently ticks down the hours, seconds and minutes reaches the inevitable climax and her time at this desk will end.
Some of the time she feels invisible. Splashed with the can of paint thrown regularly and wildly at back office functions, red clashing with the white calm she tries to hold on to. Some of the time she feels all too visible, responsible for the future encapsulated in the acknowledgement that the future comes but it comes at different paces in different parts of the country and that she might be of the right time but in the wrong place or perhaps the wrong time in the right place, who knows? She goes home and types furiously. She goes to work and types furiously and where do all those words go? Does anyone read them? Does anyone really care? What difference is she actually making? What happened to the fire and the belief and the conviction?
I should go quietly. Really I should. But it's not in my nature, you see. Nothing to lose, something to gain and does it matter if the gain is not personal but simply a small tiny little piece of sand in a wall so big she cannot possibly conceive of it. Does it matter she cannot conceive of it? Does it matter she cannot change the size or colour of the wall? Does it matter that she no longer believes she could bring the wall down entirely and assist in rebuilding it and sometimes wonders at the audacity that ever led her to believe she could?
Flicker, flicker, flicker. The candle gutters.
Saturday, 10 September 2011
Risk aversion is killing local government innovation
Usual disclaimers here. One persons view etc.
Innovation, to me, is experimenting. It's playing with things and seeing different outcomes depending on different inputs but most of all, it's about never before tested inputs. If you just re-invent the wheel, you'll just get the same outcomes. Always get, always got yada yada etc etc.
Instead, different inputs mean thinking differently. It means approaching systems and processes like a chemist - you've got 15 different chemicals which could equate to 15 different people, Departments, sets of data or system configurations - and you sit in your lab and systematically and with testing, lots of testing, and recording of outcomes, you work out what is possible and what is not with those 15 different outputs.
It's not an instant process. It's not predictable. If it's actually innovative, I don't believe there will be prior case studies to reassure, nor predictability even in outcomes to inputs. In the same way that two people can come from exactly the same backgrounds and turn out differently, an app, for example, launched in one area may absolutely bomb in another and we are not yet far enough advanced and with enough data at our fingertips to predict that.
Now an app is an expensive experiment. But there are other experiments which are not expensive, or rather may seem expensive on the surface but where the cost can be minimised with a little attention to detail. This reduction in cost leaves you to focus on the true desired outcome with is 'will this work here?' Is this of value, who to if so, what's the investment, what's the persistence of outcome?
Innovation isn't tidy. It cannot be neatly explained in zeroes and ones. I believe it should be chaotic, disordered and yes, involve a little bit of risk.
Local government as a national entity is mostly risk averse. So while I do not believe it is impossible to innovate within local government, I do believe there needs to be a culture change and a fundamental acceptance that innovation is difficult. For some it is painful, frustrating, annoying, irritating, stressful and a constant source of sleepless nights.
Being first means taking risk. It can be minimised but it can never be eliminated.
Innovation, to me, is experimenting. It's playing with things and seeing different outcomes depending on different inputs but most of all, it's about never before tested inputs. If you just re-invent the wheel, you'll just get the same outcomes. Always get, always got yada yada etc etc.
Instead, different inputs mean thinking differently. It means approaching systems and processes like a chemist - you've got 15 different chemicals which could equate to 15 different people, Departments, sets of data or system configurations - and you sit in your lab and systematically and with testing, lots of testing, and recording of outcomes, you work out what is possible and what is not with those 15 different outputs.
It's not an instant process. It's not predictable. If it's actually innovative, I don't believe there will be prior case studies to reassure, nor predictability even in outcomes to inputs. In the same way that two people can come from exactly the same backgrounds and turn out differently, an app, for example, launched in one area may absolutely bomb in another and we are not yet far enough advanced and with enough data at our fingertips to predict that.
Now an app is an expensive experiment. But there are other experiments which are not expensive, or rather may seem expensive on the surface but where the cost can be minimised with a little attention to detail. This reduction in cost leaves you to focus on the true desired outcome with is 'will this work here?' Is this of value, who to if so, what's the investment, what's the persistence of outcome?
Innovation isn't tidy. It cannot be neatly explained in zeroes and ones. I believe it should be chaotic, disordered and yes, involve a little bit of risk.
Local government as a national entity is mostly risk averse. So while I do not believe it is impossible to innovate within local government, I do believe there needs to be a culture change and a fundamental acceptance that innovation is difficult. For some it is painful, frustrating, annoying, irritating, stressful and a constant source of sleepless nights.
Being first means taking risk. It can be minimised but it can never be eliminated.
Wednesday, 7 September 2011
The Titanic is for Turning
So. If you know me, you may have noticed some tweets lately about the appalling nature of the NHS. There have been two contributing factors to this, I must confess, the first which resulted in some scan results not being available from a sub-contractor the NHS were paying because the one person who had access to the results was on leave. This was, I am sad to say, only the final straw in what had become a farcical tale no one should have to endure.
The second experience was rather more pertinent to the point of this blog. The father of someone close to me used to be a very well man.
I'm sorry, this is going to be hard reading, I'll warn you now, if you don't want to, drop to the bottom, I'll put an obvious break in and you can read about my suggested solution to stop this happening again. But some people need to read this, hear about this, know about this because it's appalling. It really is.
So, a dear friends father used to be a 100% Egghead question answerer. Could, and regularly did recite the plotlines of Ian Rankin and John Connolly books. I used to enjoy those chats, it's rare up here to find fellow crime trash addicts. He was a nice chap, to be honest, reasonably easy to talk to, bright as a button. And I do mean, bright as a button. 70 something, used to be a postie, smoked since god knows when but never suffered from an ailment which needed a doctor for a day of his life.
Until Easter. When, if you remember, there was the small matter of some unfortunately placed Bank Holidays. Sadly for my friends father, this coincided with what had begun as an irritating toe infection becoming so swollen shoes wouldn't go on and sleep couldn't be had.
So off to the doctor they went. Who sent them straight to A & E. Where a consultant took a look, ordered an angiogram, prescribed 2 weeks worth of antibiotics and said it was urgent.
3 weeks later......
Yes. Nothing. The mans wife by this point was mad with worry. Her husbands toe was black and shrivelled. She phoned the angiogram department every single day, she phoned the doctor every single day, she phoned the pharmacy every single day to try and find out how she got more antibiotics, how she got the angiogram to happen, how she got help. She got batted from pillar to post and no one took ownership of the problem.
As a result, an ambulance was called, 4 weeks after Easter, ironically 3 days before the long awaited for angiogram appointment finally turned up on the doormat. You see, the man was doolally, shouting in his sleep and punching thin air - or his 60 something double kidney failure recovering from a stroke wife. Unacceptable. Off to A & E he went again.
He didn't come out of hospital until last week. In that time the following happened:
A toe amputation
3 day old sheets left for him to lie in covered in blood (there are pictures)
Nurses throwing hissy fits when called on the above
Periods of lucidity gradually diminishing to permanent dementia
Left on his own in a room with the door closed with an en suite toilet into which he regularly dumped the contents of the bin next to it containing medical waste
Fell out of his bed because the guards were not up (I assume) and broke his hip
Prior to this on a different occasion, fell out of bed flat onto his nose and gave himself a black eye
Lost 4 stone due to lack of food (fussy eater/dementia but no effort to investigate)
Incontinent
Stents in both femoral arteries
He was moved to a home last week after a meeting 2 werks prior to that, finally with social workers, nurses and other medical professionals. Apparently, there was a lot of scribbling. The wife was told at this point the results of an MRI carried out some 6 weeks prior which showed destruction to the frontal lobe which is permanent and irreversible. Vascular dementia. She still has not been told what kicked all of this off in the first place. She was told that if the stents didn't work he would need a double leg amputation.
The final hilarity? A GP called at his house this morning. His old house where his wife still lives. Apparently the care home are concerned about his foot which is swelling again and had asked for a call out visit. They nor the hospital appear to have updated the GP practice on his change of address, but hell, at least the wife was kept in the loop, at least if only accidentally.
If you detect certain emotions in this account, well done. Biting sarcasm, bitterness, resentment, laughter, derision, shock....all these things my dear dear friend has felt and by extension so have I. I care for him and therefore to see him watching his father and by extension his mother going through this has been upsetting, traumatic, painful.
So why am I telling you all this finally? This reason for my disenchantment?
________________________________________________________________
I tweeted this evening a pipedream, one this whole experience has screamed to me the need for - some kind of tablet or device which follows each individual patient around, which we all hold in our pockets or purses or handbags which can only be accessed by us and our next of kin. Which holds everything about us. Which can be overridden by designated health professionals on calling in to our designated GP who also will hold the code. Which would mean that every ambulance crew would know our history instantly. Which would mean that those of sound mind could add to documents bespoke to our conditions which would allow us to record the trials and successes of managing our conditions. Which could be removed from our care when we entered a hospital environment and which would be tagged to the wall behind the A & E doctor station and be constantly updated through a quick and easy set of medical/biograde screen protectored touch screens. This would then follow the patient either back to the GP or to the ward. On the ward it would go behind the nurses station. It would beep when drugs were due. It would beep when sheets needed to be changed. It would be used to order food choices from the kitchen, to order drugs from the pharmacy.
It would be the centre. But it would be backed up in case of loss. It would be bestowed on Next of Kin if the patient were not of sound mind, or perhaps a Personal Assistant or other designated carer such as a care home point of contact.
It would use token technology for security. It would send reminders of folllow ups until follow up appointments would made, it would deliver results (but with caveats possible if they needed a GP chat to be delivered).
In 140 characters I shared my pipedream and 4 different people told me it was possible, it was being looked at and it was not such a pipedream after all.
And I can close the book now. Put the experience in the box it belongs it in and stop it tainting my view of everyone who works under those three letters. You see, it's easy to tar everyone in a massive Titanic organisation with the same brush. It's not so easy to understand that the lifeboats are going out and they're coming to save us.
The second experience was rather more pertinent to the point of this blog. The father of someone close to me used to be a very well man.
I'm sorry, this is going to be hard reading, I'll warn you now, if you don't want to, drop to the bottom, I'll put an obvious break in and you can read about my suggested solution to stop this happening again. But some people need to read this, hear about this, know about this because it's appalling. It really is.
So, a dear friends father used to be a 100% Egghead question answerer. Could, and regularly did recite the plotlines of Ian Rankin and John Connolly books. I used to enjoy those chats, it's rare up here to find fellow crime trash addicts. He was a nice chap, to be honest, reasonably easy to talk to, bright as a button. And I do mean, bright as a button. 70 something, used to be a postie, smoked since god knows when but never suffered from an ailment which needed a doctor for a day of his life.
Until Easter. When, if you remember, there was the small matter of some unfortunately placed Bank Holidays. Sadly for my friends father, this coincided with what had begun as an irritating toe infection becoming so swollen shoes wouldn't go on and sleep couldn't be had.
So off to the doctor they went. Who sent them straight to A & E. Where a consultant took a look, ordered an angiogram, prescribed 2 weeks worth of antibiotics and said it was urgent.
3 weeks later......
Yes. Nothing. The mans wife by this point was mad with worry. Her husbands toe was black and shrivelled. She phoned the angiogram department every single day, she phoned the doctor every single day, she phoned the pharmacy every single day to try and find out how she got more antibiotics, how she got the angiogram to happen, how she got help. She got batted from pillar to post and no one took ownership of the problem.
As a result, an ambulance was called, 4 weeks after Easter, ironically 3 days before the long awaited for angiogram appointment finally turned up on the doormat. You see, the man was doolally, shouting in his sleep and punching thin air - or his 60 something double kidney failure recovering from a stroke wife. Unacceptable. Off to A & E he went again.
He didn't come out of hospital until last week. In that time the following happened:
A toe amputation
3 day old sheets left for him to lie in covered in blood (there are pictures)
Nurses throwing hissy fits when called on the above
Periods of lucidity gradually diminishing to permanent dementia
Left on his own in a room with the door closed with an en suite toilet into which he regularly dumped the contents of the bin next to it containing medical waste
Fell out of his bed because the guards were not up (I assume) and broke his hip
Prior to this on a different occasion, fell out of bed flat onto his nose and gave himself a black eye
Lost 4 stone due to lack of food (fussy eater/dementia but no effort to investigate)
Incontinent
Stents in both femoral arteries
He was moved to a home last week after a meeting 2 werks prior to that, finally with social workers, nurses and other medical professionals. Apparently, there was a lot of scribbling. The wife was told at this point the results of an MRI carried out some 6 weeks prior which showed destruction to the frontal lobe which is permanent and irreversible. Vascular dementia. She still has not been told what kicked all of this off in the first place. She was told that if the stents didn't work he would need a double leg amputation.
The final hilarity? A GP called at his house this morning. His old house where his wife still lives. Apparently the care home are concerned about his foot which is swelling again and had asked for a call out visit. They nor the hospital appear to have updated the GP practice on his change of address, but hell, at least the wife was kept in the loop, at least if only accidentally.
If you detect certain emotions in this account, well done. Biting sarcasm, bitterness, resentment, laughter, derision, shock....all these things my dear dear friend has felt and by extension so have I. I care for him and therefore to see him watching his father and by extension his mother going through this has been upsetting, traumatic, painful.
So why am I telling you all this finally? This reason for my disenchantment?
________________________________________________________________
I tweeted this evening a pipedream, one this whole experience has screamed to me the need for - some kind of tablet or device which follows each individual patient around, which we all hold in our pockets or purses or handbags which can only be accessed by us and our next of kin. Which holds everything about us. Which can be overridden by designated health professionals on calling in to our designated GP who also will hold the code. Which would mean that every ambulance crew would know our history instantly. Which would mean that those of sound mind could add to documents bespoke to our conditions which would allow us to record the trials and successes of managing our conditions. Which could be removed from our care when we entered a hospital environment and which would be tagged to the wall behind the A & E doctor station and be constantly updated through a quick and easy set of medical/biograde screen protectored touch screens. This would then follow the patient either back to the GP or to the ward. On the ward it would go behind the nurses station. It would beep when drugs were due. It would beep when sheets needed to be changed. It would be used to order food choices from the kitchen, to order drugs from the pharmacy.
It would be the centre. But it would be backed up in case of loss. It would be bestowed on Next of Kin if the patient were not of sound mind, or perhaps a Personal Assistant or other designated carer such as a care home point of contact.
It would use token technology for security. It would send reminders of folllow ups until follow up appointments would made, it would deliver results (but with caveats possible if they needed a GP chat to be delivered).
In 140 characters I shared my pipedream and 4 different people told me it was possible, it was being looked at and it was not such a pipedream after all.
And I can close the book now. Put the experience in the box it belongs it in and stop it tainting my view of everyone who works under those three letters. You see, it's easy to tar everyone in a massive Titanic organisation with the same brush. It's not so easy to understand that the lifeboats are going out and they're coming to save us.
Tuesday, 6 September 2011
10 questions I'd ask our residents about digital
As far as I can work out (I am struggling to find clear guidance on this) us local government types still have a duty to consult. So here are 10 questions I'd ask our residents if money were no object.
Is that a smartphone in your pocket or are you just pleased to see me?
Everybody wants an app. Apps are cool. Apps will save the world! Hmmm. Unlikely if no one has a smartphone within a 5 mile radius.
How have you spoken to Council shaped people in the last 12 months?
And, was it an awesome experience? Or did it suck? And whichever, why?#
How would you have chosen to speak to Council shaped people in the last 12 months if you could have really chosen in the truest sense of the word?
It's no use knowing how people have interacted. We need to know how they want to interact. What do they expect of us, and are we delivering it?
How many times did you play telephone/email tennis with us in the last 12 months?
If you think this doesn't happen in your Department - it doesn't while you're around to hear. I can guarantee you that the second you walk out of the door, the cul-de-sac calls start. The ones where someone asks 'is this the Housing Department?' and the Council employee on the other end says 'no'. And nothing else.
Do you feel that the web is swallowing your children alive?
If the answer is yes, we need to do more educating. Way more educating. And I'm scared 90% of the UK parenting population would say yes. I don't think they would, I like to believe our E-Safety Unit kicks butt but you know....
Would you buy more local if local actually had a web presence?
I'd give all my money to local businesses if they had a web presence which didn't make my eyes bleed. No name/shame but I do have a specific business in mind. Does it only matter to me or are we doing our local economies a disservice by not empowering/educating/enabling?
Did you know you can do shopping online when the pavements are too treacherous to walk on?
Cos I don't think a lot of people do. And whilst we can't grit every pavement (nor every road, actually), what we can do, I believe, is teach you to make sure you don't go hungry or without medicine ever again. If you want us to.
Do you care digital saves us money?
Is banging on about money savings turning the public on to digital media or off it is a fundamental question to me. I don't know how all the Joe Bloggs feel. I need to know before I put barriers in peoples minds that just don't need to be there.
Do you want us to talk to you like a Council or like a person?
You see, I want to be spoken to as a person. But I know the Council contains humans. Are there people out there for whom humanity destroys the illusion of competency? Are there people out there who need formality from public bodies in order to trust them?
If we said you can talk to people if you want to and you make the call on whether you need to but we tell you how much it's going to cost to do so, is that cool?
I don't think people know. I think if people knew, they might choose to go do some legwork themselves, just like us Trip Advisor, hotels.com, kayak.com bods do when booking hols.
Saturday, 3 September 2011
A sinking feeling
I'm watching the wikileaks Twitter account with great interest right now. As I type this, there is a steady stream of accusations aimed at the Guardian newspaper streaming up my screen.
One of the things which has been linked to is this. It is Arus Rusbridger confirming the terms of receipt of 'package 3', agreeing to 3 requirements Julian Assange placed on them in return for the Guardian being able to review the documents.
It is being used to demonstrate that the Guardian have broken embargoes and agreements. But it doesn't say what the @wikileaks account seems to think it says.
It doesn't, for example, specifically prohibit publication of a password which was given to the Guardian in order for them to access the data. It doesn't, for example, explain that after a certain period of time, the password will no longer work, because it will have been changed. It doesn't for example, specifically state that passwords should never ever be published in written documents as even if the password has been changed, revealing someone's very personal MO for choosing passwords can be fatal, especially when messing with foreign intelligence documents. And for those of you who don't use the same schema to pick your passwords - either you only need one password for your work and home machine or neither of those places enforce secure passwords using a combination of letters and numbers blah blah blah.
What I'm trying to say here, I think, is that David Leigh was an idiot to publish a password. He was. Sorry. You just don't do that. When people say don't write passwords down, they're not messing about. You can read more about what the consequences of that decision by Leigh was here. But the fundamental crux of this matter, to me, is that Wikileaks and Julian Assange screwed up and they screwed up because they made a fundamental mistake - they assumed everyone at the Guardian who came into contact with this story understood technology well enough, understood implications well enough, understood the intricacies of computer security well enough to not accidentally completely screw up. And because they didn't spell it out in black and white, I am afraid I don't believe the Guardian can be blamed for doing what they've allegedly done. I don't believe Wikileaks should be playing in computer security related playgrounds if they don't understand that not everyone is comfortable in the same playground, and indeed that each different playground has a different rule set posted on the entrance gate.
The simple fact is, Wikileaks made an assumption. It was the wrong assumption. And the sad and sorry thing is, it wont be anyone at the Guardian or Wikileaks who pays the price of that. And none of us civilians may ever know what the price was that was paid.
I believe in government transparency. I do not, any more, believe in blanket transparency. There's too much at stake and we do not yet live in a world where media, or indeed any other sector apart from the computer tech sector, understand security.
One of the things which has been linked to is this. It is Arus Rusbridger confirming the terms of receipt of 'package 3', agreeing to 3 requirements Julian Assange placed on them in return for the Guardian being able to review the documents.
It is being used to demonstrate that the Guardian have broken embargoes and agreements. But it doesn't say what the @wikileaks account seems to think it says.
It doesn't, for example, specifically prohibit publication of a password which was given to the Guardian in order for them to access the data. It doesn't, for example, explain that after a certain period of time, the password will no longer work, because it will have been changed. It doesn't for example, specifically state that passwords should never ever be published in written documents as even if the password has been changed, revealing someone's very personal MO for choosing passwords can be fatal, especially when messing with foreign intelligence documents. And for those of you who don't use the same schema to pick your passwords - either you only need one password for your work and home machine or neither of those places enforce secure passwords using a combination of letters and numbers blah blah blah.
What I'm trying to say here, I think, is that David Leigh was an idiot to publish a password. He was. Sorry. You just don't do that. When people say don't write passwords down, they're not messing about. You can read more about what the consequences of that decision by Leigh was here. But the fundamental crux of this matter, to me, is that Wikileaks and Julian Assange screwed up and they screwed up because they made a fundamental mistake - they assumed everyone at the Guardian who came into contact with this story understood technology well enough, understood implications well enough, understood the intricacies of computer security well enough to not accidentally completely screw up. And because they didn't spell it out in black and white, I am afraid I don't believe the Guardian can be blamed for doing what they've allegedly done. I don't believe Wikileaks should be playing in computer security related playgrounds if they don't understand that not everyone is comfortable in the same playground, and indeed that each different playground has a different rule set posted on the entrance gate.
The simple fact is, Wikileaks made an assumption. It was the wrong assumption. And the sad and sorry thing is, it wont be anyone at the Guardian or Wikileaks who pays the price of that. And none of us civilians may ever know what the price was that was paid.
I believe in government transparency. I do not, any more, believe in blanket transparency. There's too much at stake and we do not yet live in a world where media, or indeed any other sector apart from the computer tech sector, understand security.
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