Category Archives: Blue Sky & Left Field (Ideas & Pro Bono Activities)

why should Sudan’s health industry embrace Knowledge Management?

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A few month’s back during a Skype call with Dr Gada Kadoda a Professor at University of Khartoum she told me: ‘at last year’s KMCA Sudan many of the health industry delegates who attended expressed an interest in understanding what knowledge management might do for them. How might we do that?’.

Gada is one of those special people who when they pose a question you feel compelled to answer it. Which is why in a week’s time I am going to be back in Khartoum to participate in a two day Workshop on Knowledge Management for Health Care in Sudan.

Knowledge management in health is not new. The NHS Modernisation Agency was one of the early adopters and used a lot of Chris Collison’s thinking from Learning to Fly to build a pretty effective knowledge management operation with one of the first Chief Knowledge Officers in charge of it. Sudan’s health industry does not (yet) practice km in any formal manner so as part of the research for my presentation and the sessions I am facilitating I asked some of the actors in the NHS km story to reflect on more than a decade.  Here’s what they said (names omitted):

I have said on several occasions that when you multiply the number of employees by the years of professional learning,  the NHS is the world’s most knowledgeable organisation.  Or it should be.  With better networking, more curiosity, joined-up systems, a culture of improvement and leaders who value national above parochial, it would live up to its potential.

What I have seen is wonderful pockets of excellence – hospitals with a determination to improve, a passion for learning, and a curiosity which can even transfer lessons learned from Formula One pit teams to the operating theatres of children’s hospitals.  Pockets of excellence indeed, but in threadbare trousers.

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The idea of KM in that particular agency of the Department of Health was to ensure that the knowledge produced by one team (silo) would reach other teams (silos), that the whole organisation had a sense of who knew what, and that we could reuse knowledge across the Service.

We had a team of people and a CKO…a CoP with members from all different teams in the organisation; knowledge audit and SNA that involved quite a few people across the org and which changed the way they perceived the work of the KM team. Yet …our work became too focused on documents and content creation disguised as gathering of lessons learned.

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In my regular interactions with physicians in the NHS, a key frustration has always been the flow of information between doctors and commissioners. Differing agendas, treating patients vs cost-effectiveness, cause breakdown in communication. The problem usually arises from the discrepancies between the notion of an ideal patient and the realities of people walking into the clinic. Pharma is not particularly helpful in addressing this through the research conducted, however the shift in emphasis to real world data by health technology bodies such as NICE is creating a cultural shift in the sector.

A great story of information exchange relates to a melanoma patient who was being treated in London. The patient was a successful business man so he continued with his work. He was treated with a very new drug and experienced severe side effects while on a business trip in Switzerland ending up at a hospital there. Mismanagement of this drug’s side-effects can result in death. The Swiss physicians had never used the drug before, and most were not even aware of its existence as it is a specialist therapy. However, there was extensive global information exchange driven by the company, which meant that as soon as they saw the patient card which all patients on the drug were advised to keep on their person, the Swiss physicians were able to access a database of information and a 24 hour network of world experts in the condition. Luckily for the patient the KM network worked thereby saving his life.

The shift towards greater use of data and increased use of technology (from other industries) is where I hope much of the Khartoum health discussion goes. One of the leaders in Health Information Systems shared this quote:

‘In the next ten years, medicine will be more affected by data science than biology.’

Mobile & Internet penetration in Africa

Mobile & Internet penetration in Africa

Today’s Economist article on the use of mobile technology in Africa is a timely reminder of the strides being made on that continent and how widespread adoption will present huge opportunities as well as challenges for the health industry there.

I am also  going to share this clip from Grey’s Anatomy (US TV drama) about the use of Twitter in an operating theatre. Though fictitious it gives as good an illustration as any I’ve seen about the potential benefits of using mobile technology to share knowledge and mobilise a global community in the same was as the story of the melanoma patient above does.

As the F1 season is nearly upon us I was really struck by this clip from the BBC which shows how the Maclaren F1 Team’s driver and car monitoring system is being adapted/used in a children’s hospital in Birmingham.

And yet for the Sudan health system to adopt some of these technologies (against a backdrop of isolation) there has to be a huge mindshift. I recall with chilling clarity a phrase uttered by a health professional at KMCA Khartoum last year in response to a question I posed as to the barriers to the sharing of knowledge: ‘my information is my soul’.

In an environment where:

  • sharing of information (let alone knowledge) can have serious consequences
  • admitting a lack of current knowledge can cause a loss of face and prestige
  • continuing medical education is not a core requirement for the right to practice
  • the major drug companies have no presence and sell via distribution channels
  • the physician is beyond reproach

we have our work cut out if we are to get positive outcomes from the event.  Its an exciting prospect.

 

‘…if we want to give our customers choice we will produce surplus food.’

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Recent tabloid headlines about how much food is thrown away provided a timely backdrop to a meeting held last Wednesday at City Hall by Plan Zheroes. In attendance were charities, soup kitchen, faith groups, donors (including Paul UK, Pret a Manger, ‘Corporate Catering’) and logistics organisations (including FareShare and Best Before) all keen to make use of surplus food to ensure as much as possible goes to those who could use it and not to landfill or as a component in the production of energy.

We were there to discuss the technological requirements for a new application that will radically improve communications between surplus food donors and recipients which is in development by an expert team from Ricardo-AEA, supported by WRAP. I was there on behalf of those organisations who’ve committed to being part of the Plan Zheroes movement in Sussex.

It was such a cosmoplolitan gathering with significant Gallic representation I thought I’d share a factional story from South West France to illustrate how technology can enhance the logistics chain for even the smallest of donations.

un petite Restos du Cœur?

In a small rural community near Toulouse its nearly closing time at the local supermarche. Mme St Arroman gets the sms message she’s been waiting for from the manager: today’s surplus food is 7 pains, 3 poulet rotis, a selection of legumes, some packed boeuf and 5 jambon fromage pizzas.

Enough she thinks to meet the requirements of the local sanctuary for the homeless who have grown in number since the austerity measures have started to bite. At least they’ll get a good meal tonight!

She makes her by now regular call to Yvette one of the dozen or so volunteers who collect the food and deliver it to the sanctuary and the other self help groups and charities supplied by those local food stores and restaurants who’ve agreed to donate surplus food.

While Yvette is enroute Mme St Arroman has been receiving messages requesting deliveries. She never imagined when she and a group of local women started this initiative a few years back that it would have taken off in this way and now she has the difficult decision of apportioning the food that has been gifted.

Early on they signed up many charities and faith groups keen to have supplies to augment other food donations. It worked well to start and the charities collected the food directly; then as they failed to show up the surpermarche and the bistro cafe (who’d also been a supplier) had staff waiting after hours facing a disposal problem.  Mme St Arroman and her team solved this by engaging with the local community and finding a number of volunteers willing to do the transportation. The locale municipality did its bit too gifting storage equipment such as a refrigerated van so the food was not degraded in transit.

They learned a great deal about human nature: one of the core prinicples of the using surplus food programme; that all gifted food must not be used for profitable activities was being flouted on a regular basis.  The offenders were removed from the programme. Another principle, that wherever possible all donations would be applied to charities and groups that aspired to get people back on their feet and not become dependent is being carefully monitored and progress being made.

On a wider scale in France the national Restos du Cœur movement comprises more than 40,000 of all backgrounds with one point in common: generosity devoid of political or religious points of view. Their actions are based on the Volunteers’ Charter, whose 6 guiding points guarantee the good working order of the organisation.

The Restaurants du Cœur (literally Restaurants of the Heart but meaning Restaurants of Love), commonly and familiarly known as the Restos du Cœur, is a French charity, the main activity of which is to distribute food packages and hot meals to the needy. It was founded by the comedian Coluche in 1985.

‘fog in the Channel, Europe cut off’

Back in blighty with the chattering classes debating the sanity of Prime Minister Cameron’s EU referendum speech it became clear to the assembled gathering that the ability to provide real time alerts (similar to the French ‘story’) is a critical requirement for the new application. The core functionality included:

  • measurement of the social and environmental impact
  • a mechanism for rating
  • a way of active virtual engagement and
  • alerts

Back in the summer the then Environment Minister Caroline Spelman convened a summit in London of interested parties in the food retailing and distribution chains aimed at creating among other things a food-share database. The event was duly recorded in The Daily Mail with the charities are supporting the introduction of a so-called Good Samaritan law which exists in the US, to ensure firms that donate food in good faith are exempt from legal action arising from any adverse consequences.

I note it here since some of the comments on the article were very revealing and with due acknowledgment to the Daily Mail I’ll quote an extract from one written by an ex employee of four of the supermarkets:

Contrary to popular opinion, supermarkets do NOT throw away decent food unless they have a bad store manager- why would a business want to damage their profit margins?- it’s rotten food being left ON SALE that’s the biggest problem!!

plus ca change plus c’est la meme chose

While last July’s developments seemed promising at the time its difficult to discern real action and for some reason I cannot shake off an image of the ‘clunking fist’ that is governmental bureaucracy preventing action. Yet back across the channel I discover French Law actually prohibits the donation of food to its employees on taxable benefit grounds which you would have thought plays into the hands of surplus food donations to charity.

and finally

Wednesday’s meeting revealed a host of people passionate about making a difference: Church groups who need another tea urn but who have an ingenious and simple measurement device to see how many people they are serving (count the cups!); mobile soup kitchens whose volunteers don’t have cars and who would love to do more if only they knew where demand is not being met; and food donors who hate any waste and will provide food that meets dietary and religious sensitivities.

What struck me is the level of commitment and ingenuity. The Plan Zheroes and Ricardo-AEA team who are going to be creating the application have a tough challenge ahead to match the aspirations of those who assembled at City Hall.

And in case you are wondering ‘…if we want to give our customers choice we will produce surplus food’ is a direct but unattributable quote from one of the delegates in response to a question as to why surplus food production occurs in the first place. The ‘fog in the Channel: Europe cut off’, is a play on the headline ‘fog in the Channel: continent cut off’ that appeared in the Dally Mirror in 1930.

Scoping recipient requirements

Scoping recipient requirements

eat or heat: making the most of surplus food in 2013

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A perfect food storm in 2013?

The rising cost of energy, food and transport combined with an effective reduction in disposable incomes meant many people went without this Christmas. Add in the Government’s drive for savings in the benefits budget, the cap on housing benefit and insufficient social housing and there are all the ingredients for the perfect food storm in 2013.  For the first time food is being delivered to centres in Lewes and there is talk of a Food Bank being set up mirroring initiatives in Uckfield, Heathfield, Hailsham and across the South. Many are now making eat or heat decisions and the growth in the incidence of food shoplifting bears witness to an increasing sense of desperation.

FareShare, Foodbanks and Plan Zheroes

Schemes such as FareShare (surplus food logistics) and Tressell Trust (Food Banks) tackle this need by redistributing surplus packaged food and tinned goods donated by supermarkets, food outlets and faith centres that would otherwise have gone straight to landfill.  Despite this the UK Food industry still sends millions of tonnes of prepared and cooked food to waste each year.  A group of London citizens believed it didn’t have to be this way and set up Plan Zheroes a charitable organisation that helps redistribute surplus food from restaurants,  food retailers, cafes and supermarkets to charities who then use it to feed those who are struggling to feed themselves.

Its so simple: the donor registers as a regular or occasional donor and indicates what surplus they are likely to have and when; the recipient registers to receive food specifying the type and quantity they are likely to require and how they’d like to pick it up or receive it.

Plan Zheroes in Sussex

Now this scheme is operating in Sussex and this Monday the V-Project set up in Lewes by a group of youngsters keen to provide a space for peer mentoring became the first recipient charity to sign up to take surplus food from Lewes based donors, East Sussex County Council, The Pelham Arms and Le Magasin.

In partnership with FareShare, Brighton, PlanZheroes is working on setting up new supply chains in Newhaven with NCDA and The Foyer (Salvation Army Housing Association residence for young people) and Uckfield.  More charity recipients and food donors are needed in Brighton, Lewes, Newhaven and Uckfield; all it takes is a couple of minutes to register on the PlanZheroes food map which you can find via their website.

One of our strongest supporters has been Councillor Ruth O’Keeffe who apart from promoting the Plan Zheroes initiative via her Radio Lewes programme has set up a meeting early in 2013 to try and consolidate all the various actitivities around making use of surplus food: Ruth helped launch the FareShare deliveries to Lewes and works tirelessly to ensure the less fortunate members of her consituencies have food on their tables.

And finally during a visit to Waitrose Lewes on Sunday afternoon I came across dozens of ‘unwanted’ red cabbages that were marked down in price.  Thanks to one of the partners Nikki we are now in dialogue with their local management about enrolling them as an occasional donor working alongside their other surplus food distribution channels.

an Austrian war hero, surplus food and corporate social responsibility

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Lotti Henley is remarkable. She was described earlier this year by the London Sustainable Development Commission as:

‘…an 86 year old war hero; an Austrian aristocrat who was forced to eat scraps of food from bins to survive during the Second World War...She says her lasting memory of hunger is the motivation behind her new campaign, Plan Zheroes, which aims to link up hundreds of shops, supermarkets and other food outlets across the capital with local charities in need of free food.’

I met Lotti on Thursday when she hosted the Plan Zheroes weekly team meeting. Articulate, witty and sharp she is an inspiration exuding the passion common in the volunteers who make up the PZ network.  And she makes a great soup!

Other than describing to the group the process by which I set up and run the Lewes Knowledge Cafe (encouragingly they’ve turned it into a blueprint for future sessions) I was there to hear about PZ’s continued progress in the area of Corporate Social Responsibility.  And its impressive.

Plan Zheroes have developed and run programmes for organisations who invest in corporate social responsibility. In short, organisations who care: about the environment in which they work; their staff; and their impact on the local community. And the programmes tick many of the boxes CSR/HR/Marketing professionals look for in running an event:

The formats are brilliantly simple:

  • One off team building events for 150 or so wherein teams compete to see who can sign up the most food outlets and charities to the Plan Zheroes map.
  • Incremental competitive volunteering wherein staff use ‘CSR’ time to sign up outlets over an extended period with progress measured on the PZ food map.

A recent event conducted for 130 graduate trainees of a construction group generated:

  • Visits to 20 charities, all of who are now registered as recipients of food.
  • Contact with over 150 food outlets, of which 80 have now signed up to the map and are committed to giving surplus food on a regular basis.

It’s a great way for organisations to make a tangible difference and bring a CSR initiative to life and one of PZ’s biggest supporters Paul UK has just won the 2012 Springboard Award for Excellence for Corporate Social Responsibility.

Back in Sussex, I am about to meet a local volunteer organisation who are keen to be the first to sign up to the PZ map and donate surplus food. Expect an announcement shortly. I’m told it takes time to get early adopters willing to donate surplus food, charities willing to accept the food and intermediaries willing to bridge the logistics gap.

Food Banks: from Chicago to Coventry

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On Tuesday night the BBC ran a programme about a food bank in Coventry. Last night I attended a thought provoking lecture at Chatham House on the future prospects for the US economy. I intend to show you why I think the two are connected.

Dr DeAnne Julius the speaker at Chatham House is an influential economist on both sides of ‘The Pond’ and was a founding member of the UK’s Monetary Policy Committee.  Her assessment of what the incoming President will face over the next four years is chilling:

  • Continued low growth of 2% p.a. and high unemployment of above 8%;
  • Increased inequality between haves and have nots resulting in children being tied to the social class of their parents, signalling in effect the death of the American dream – no longer will the next generation be better off than the last;
  • Deadlocked legislature placing a constraint on the President resulting in increased State level involvement who will implement experimental local policies and taxes; and
  • Continued growth of voluntary sector (church groups and baby boomers with time on their hands) as middle and low income jobs are replaced by technology and, with increased globalisation, outsourced to lower cost markets.

The demographic similarities with the UK are striking: fewer young people going to University; a growth in the number of single parent families; a rise in short term and part time contracts; graduates doing unpaid internships (where they can get them) as a precursor to employment; and a declining population supporting an aging population with unsustainable pensions and benefits.  One in six Americans are on food stamps and US debt is at historically high levels being 7% of GDP (remember those aspirational times in Europe when country debt was not supposed to exceed 3% of GDP).

You get the picture: the recovery in the US will be long and painful for an increasing number; more and more people will end up relying on food handouts and support; and it is less likely that any recovery in the UK will be fuelled by one from the US.

Britain’s Hidden Hungry broadcast on Tuesday night investigated the growing importance of charity foodbanks to thousands of hungry people across the UK by following the stories of three users of a foodbank in Coventry. Here’s a taster:

Care-leaver Charlotte eats just one meal a day. It’s all she can afford, so she starves herself till evening. Sandra, middle class mother of five, is embarrassed that all she can give her son for his school packed lunch is bread and butter. Middle manager Kelly, mother of two, hasn’t eaten for two days. Meet Britain’s hidden hungry – and they’re not what you’d expect.

As of 2012, more than 170,000 people are believed to be dependent on a chain of 300 foodbanks run by a Christian charity, the Trussell Trust.

 

Coventry food bank volunteeers (courtesy of BBC)

 

 

A month ago I ran a Knowledge Cafe in Lewes that looked at the potential to make better use of surplus food using a model developed by Plan Zheroes in London. Among those attending were volunteers from church groups, councils and local interest groups. There was broad agreement that with next April’s changes to housing and benefit entitlement there would be an increase in the number of people torn between food and heating or children’s clothing. As the write up said quoting local councillor Ruth O’Keeffe, ‘this is a theme which has reached its moment… there is definitely a need for this’. 

Just down the road Newhaven shoppers have been doing their bit to help (mirroring one approach shown on the BBC programme). ‘Generous shoppers in Newhaven help to donate 6,000 meals to needy’ was the headline in the local Sussex Express applauding the joint efforts of Sainsbury’s and FareShare in giving food for onward distribution to those who need it.

Next week I will be attending my first PlanZheroes meeting in London.  My aim is to see how (having established there is an issue to be addressed in Sussex and beyond) the PZ Map can augment the excellent efforts already in place and mobilise additional surplus food.  Watch this space and please if you are interested in helping get in touch.