Homework for 2012

As mentioned in my previous post, I am going to be gathering materials over the next few weeks to inform the design of two healthcare interventions: a self-care management document and 5 Key Messages, with dissemination programme. 


So here is the first post of one of the useful discoveries, a video from the California Healthcare Foundation about coaching patients for successful self-management.



If you have any additional suggestions for any written or broadcast material on self-care management or the use of 'key messages' with patients with chronic conditions, please leave a comment.

More on Design Thinking

My head is full of an exciting health project which kicks off the New Year and for which I will have responsibility. It will involve using design thinking to shape three interventions aimed at reducing the number of people with diabetes who lose their sight as a result of of an eye condition called diabetic retinopathy. We will be developing the interventions and testing them in my home town, which is an added bonus. 


With this in mind I have been glued to some of the latest videos posted on www.designthinkingnetwork.com. 


Two leapt out at me, one very short (2 minutes) that demonstrates why creativity needs time and one which outlines what design thinking is, and how it works (28 minutes). I am posting them both. Hope you enjoy.

Big Society- A story and a film

There were reports in the UK press yesterday of a Parliamentary Select Committee which came to the conclusion that the government's 'Big Society' policy was little understood and confusing to people. Commenting on this on Twitter, I referred followers to a blog that I had posted a few months ago about Big Society called 'Right Stick, Wrong End'. I believe that the politicians have grasped the right idea but by giving the impression that it is all about citizens running public services, they are limiting the possibilities and turning people off.  

The impact that Big Society could have is illustrated by this story and film from my past work in Bradford.

In 2004 more around a hundred people - all with a good idea to improve their neighbourhood by making it cleaner and greener - came together to agree which ideas should be awarded some funding. The money that was to be spent, £700,000+ , came from central government. Some were individuals with a passion for a particular action, others were from neighbourhood community groups, others were from schools or larger voluntary organisations. They shared the desire to take action to improve their neighbourhood environments. Many of them had never applied for funding before.


Local politicians and their partners from the public, voluntary and private sectors had been persuaded that involving local residents in making these funding decisions was worth trying.

It was one of the first examples in the UK of what has become known as 'participatory budgeting'. This short film of one of the two decision-making sessions shows the process that we developed.

At the start of the film, you hear the comments of Richard Wixey, then the Director of Environmental Services in Bradford. What Richard learnt from the process is what makes this such a good example of what 'Big Society' could mean.

As he listened to the tens of ideas that people were pitching, he began to understand something of the types of actions that local residents were prepared, and able to do. 

These included 'greening' areas that were being used for flytipping; running education programmes to prevent littering or to encourage recycling; developing allotments and pocket parks; organising neighbourhood clean ups and beautifying public spaces for people to enjoy. 

The process also clarified the sorts of things that local residents could not do. They could not enforce the law or run large scale rubbish collections and recycling.

It led him to reflect that in addition to concentrating on the core of what only his department could deliver, perhaps some of the budget should be used to support and encourage people to take the actions that they were prepared to take. This would both improve the quality of neighbourhood life for everyone and make his department's work more effective.

Within twelve months the funded projects had been delivered right across Bradford District enhancing the environments of eighty neighbourhoods. 

This then is the core for me about what Big Society could be about. Local residents, local government and partners deciding together what it is possible and proper for 'reasonably resourced' individuals, families and communities to do for themselves or in partnership with others; and then to agree what it is that we need government (local and national) to do.

To ensure that where people and communities are not reasonably resourced, or where improvements to community life would be enhanced for all, then a very modest amount of the public budget could be invested in individuals and groups to make their contribution.

It makes economic sense too in hard times for the public purse. Our Bradford experience of devolving funds to neighbourhood partnerships showed that for every £1 of public money invested, the partnerships brought in a further £10-20 to augment that original investment.

The Big Society policy needs to be clearly expressed in terms the nature of the partnership between government and citizens that is proposed. A proposal for a partnership that is good and right in and of itself, not a shirking of responsibility by central  government just because the public purse is strapped for cash.

Yad Vashem, Israel

 "And to them will I give in my house and within my walls a memorial and a name (a "yad vashem")... that shall not be cut off." (Isaiah, chapter 56, verse 5)

The threatening clouds in the sky on Friday matched the feelings engendered by this visit to Yad Vashem, Israel's national Holocaust memorial. Having been to Auschwitz, I was prepared for the likely impact.

The terrible story is carefully laid out along a timeline, starting with a historical summary of Jewish persecution.

On my visit to Auschwitz in 1994, I was undone by how powerfully the place spoke not just to the past, but to the present. It was the time of Rwanda genocide. However the holocaust memorials speak not just to atrocities but to the everyday slights and discourtesies that breed permission for atrocity.

I heard that discourtesy on the flight over to Israel, in conversation with someone from the Jewish community. The person spoke contemptuously about the Palestinian people, blaming them for the lack of peace. It was doubly hard to hear in the face of Jewish history and experience. Time to check out my own behaviour and attitudes.

The three photos are of Jaume Plensa's work referred to in the previous blog.

In See No Evil, Hear No Evil, Speak No Evil, three internally lit fibreglass figures have the terms panic, stress, anxiety, insomnia, hysteria and amnesia inscribed on their faces. The Exhibition Guide says:

'The physicality of these words branded on the skin openly reveals conditions of the mind that are usually internal and hidden. Their posture reflects a natural method of defence, to make the body small, curling it in on itself for safety, echoing the protected position of a baby in its mother’s womb.'

The wonderful humanity of artist Jaume Plensa

Photos taken on 1st November 2011 at Yorkshire Sculpture Park @YSPsculpture

Urged on by my friend Jane, I visited the Yorkshire Sculpture Park to see this extraordinary exhibition. Jaume Plensa's work is normally displayed in urban settings, indeed I discovered I had seen some of his work in the centre of Nice.


In the glorious Yorkshire landscape it was breathtaking and deeply moving. Here is a taste of Jaume Plensa in his words and sculptures.

Living democracy

I wonder how many of us really think much about the quality of the democracy we live in? 


When compared with what we have witnessed across the Middle East, our political arrangements look incredibly benign. Complacency or frank disinterest would be the response of many in this country to debates about the quality of our democracy.


For instance, how many of us have rushed out to read and respond to the Boundary Commission review of constituency boundaries? What are the implications of having fewer MPs representing more of us? 


Are these proposals a good move to strengthen democracy or about saving money by having fewer MPs, or a conspiracy to skew the constituencies in order to increase the chance that a particular party remains in power. 


To my shame, I cannot give an informed response to this issue - and I would say that I am interested and informed about UK politics and democracy! 


On the other hand, the recession is prompting debates about how we organise local and global finances (the Occupy movement); the Health Bill's seeming threat to the NHS has galvanised tens of thousands to debate, march and sign petitions; public service cutbacks are forcing us as a country to weigh up whether public services are the villains some politicians would have us believe. 


All these jumbling thoughts were prompted by an email from a friend at the week-end confirming that he had handed in his resignation from a job that he loves.



He is a senior public servant of long years standing and lives in a country that is openly proud of its democratic credentials and history.


Over the last couple of years, he has become deeply concerned about the 'systematic and methodical' action being taken by corporations and political extremists that have started to do real damage in communities and wider society. From his particular position in the public sector, he has had to deal with the fallout. He has become so alarmed that he feels he can no longer remain in a public position where he is unable effectively to challenge and resist - hence his resignation


Even in an allegedly mature democracy, standing up to challenge powerful interests is still not for the faint-hearted. My friend has not been put off by the thought that he is one man. His soundings and early actions have uncovered others who share the concerns. With his deep understanding of communities and a track record of building citizen participation, he will certainly create a force to be reckoned with.


I am reminded of Margaret Mead's now famous words:


“Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.” 

Play, Creativity and Impact

Are you and your colleagues or employees fully engaged at work? Are you continually in a position where you have the right challenges that employ your skills, stretch them and cause you to want to develop further? Are there creative opportunities for you to contribute and develop ideas or innovations? If the answer is no, you might find this illuminating.


If you are an employer and are not sure how to maximise the potential of your employees then here is a video that might give some food for thought.
With thanks to 99% - Behance.