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Stories from the frontline of the NHS

Healthcare aims to be patient-centred but a large gap remains between the fine words and the reality. Care often feels designed for the convenience of the organisations that deliver it, and not enough around patients and their families, or even around the frontline staff who provide it. Why does this happen? What does it feel like? What can be done about it? This book stimulates reflection on these questions by listening closely to those at the frontline. It provides accounts from patients, carers and healthcare professionals who are patients about what it’s like when services get it right, and wrong, from birth up to the end of life. Quite simply, we want to draw upon the power of storytelling – which is increasingly valued as a tool for learning – to help policymakers and practitioners to understand how to deliver better care. We also hope to enlighten the general reader about how they might go about navigating “the system” while it remains imperfect. There is a growing literature of first-person accounts from patients and from healthcare professionals. This book differs by providing a collection of narratives of experiences of the NHS in England to paint a rich and varied picture. Alongside these narratives we provide some international context, and an overview of the history of moves towards a more patient-centred approach to care. We present the theory and practice of storytelling in the context of healthcare. We also seek to help the reader to draw out the practical learning from the individual accounts.

Anne Kerr
Choon Key Chekar
Emily Ross
Julia Swallow
, and
Sarah Cunningham-Burley

Chapter 7 considers non-participation and exclusions as well as reservation, consternation and rejections around genomic medicine in our research and in the public sphere more generally. We investigate the particular social and cultural contexts in which disengagement and resistance are generated. Exploring negative views and experiences or simply a lack of response to genomic medicine, we consider when these kinds of personalised medicine are ‘not relevant to us’ and why some people just do not have the capacity or resource to engage with them. Rejecting or refusing opportunities to engage with genomic medicine also results from the awareness of competing priorities such as health equality or preventive healthcare as well as a commitment to other forms of care. Not every patient can or wants to craft their own treatment pathways, or looks to the future with a sense of agency and control, and we reflect on what it means to opt out, be excluded or feel left behind by these kinds of research and care. We also discuss the ways in which different agencies and actors strive to tackle disengagement by reaching out to different communities to appeal to their sense of responsibility towards contributing to the prospects of better care for individuals and community now and in the future. We argue that these practices present an important counterpoint to the dominant, inclusive vision of P4 medicine, particularly with regard to personalisation and participation.

in Personalised cancer medicine
Carol Helmstadter

This chapter discusses nursing in the naval hospital in the context of the new medicine’s need for expanded and much more expensive resources and the social determinants of health. The navy took much better care of its men, resulting in their being able to recover faster and better than the soldiers whose officers gave them little support. The Naval Brigade which fought on land with the Royal Artillery was a crack unit which distinguished itself both for bravery and for the accuracy of its guns. Dr. John Dawson directed the nursing service, which was run by secular lady nurses with the help of a number of working-class hospital nurses. The able Lady Superintendent Eliza Mackenzie was fortunate in her three lady nurses, two of whom were experienced clinical nurses. Motherly nursing care, which the Victorians believed to be the best possible nursing care, is explored in the example of a mother who came to Scutari to personally nurse her wounded son, Midshipman Evelyn Wood. The chapter also analyzes the work of Nurse Ruth Dawson, and why Nightingale thought her one of her best nurses.

in Beyond Nightingale

Anglophobia in Fascist Italy traces the roots of Fascist Anglophobia from the Great War and through the subsequent peace treaties and its development during the twenty years of Mussolini’s regime. Initially, Britain was seen by many Italians as a ‘false friend’ who was also the main obstacle to Italy’s foreign policy aspirations, a view embraced by Mussolini and his movement. While at times dormant, this Anglophobic sentiment did not disappear in the years that followed, and was later rekindled during the Ethiopian War. The peculiarly Fascist contribution to the assessment of Britain was ideological. From the mid-1920s, the regime’s intellectuals saw Fascism as the answer to a crisis in the Western world and as irredeemably opposed to Western civilisation of the sort exemplified by Britain. Britain was described as having failed the ‘problem of labour’, and Fascism framed as a salvation ideology, which nations would either embrace or face decay. The perception of Britain as a decaying and feeble nation increased after the Great Depression. The consequence of this was a consistent underrating of British power and resolve to resist Italian ambitions. An analysis of popular reception of the Fascist discourse shows that the tendency to underrate Britain had permeated large sectors of the Italian people, and that public opinion was more hostile to Britain than previously thought. Indeed, in some quarters hatred towards the British lasted until the end of the Second World War, in both occupied and liberated Italy.

Challenges and opportunities

This book explores the evolving African security paradigm in light of the multitude of diverse threats facing the continent and the international community today and in the decades ahead. It challenges current thinking and traditional security constructs as woefully inadequate to meet the real security concerns and needs of African governments in a globalized world. The continent has becoming increasingly integrated into an international security architecture, whereby Africans are just as vulnerable to threats emanating from outside the continent as they are from home-grown ones. Thus, Africa and what happens there, matters more than ever. Through an in-depth examination and analysis of the continent’s most pressing traditional and non-traditional security challenges—from failing states and identity and resource conflict to terrorism, health, and the environment—it provides a solid intellectual foundation, as well as practical examples of the complexities of the modern African security environment. Not only does it assess current progress at the local, regional, and international level in meeting these challenges, it also explores new strategies and tools for more effectively engaging Africans and the global community through the human security approach.

Open Access (free)
Naomi Chambers
Jeremy Taylor

the end of life. Quite simply, we want to draw on the power of storytelling – increasingly valued as a tool for learning – to help practitioners understand how to deliver better care. There is a growing literature of first-person accounts both from patients and from healthcare professionals. This book differs by providing a collection of narratives, from a variety of viewpoints and stages in life, to paint a rich and varied picture. Alongside these narratives we provide some context: an overview of the history, theory and evidential underpinnings

in Organising care around patients
The influence of Florence Nightingale on Southern nurses during the American Civil War
Barbara Maling

Commission was modelled after the Royal or British Sanitary Commission. Influenced by Nightingale, the British Sanitary Commission’s goal was to see that better care was provided for soldiers and to press the English government to live up to its responsibilities for wounded British soldiers. These goals were shared by the US Sanitary Commission, which was an official agency of the United States government (created by legislation and signed by President of the United States, Abraham Lincoln), on 18 June 1861. It coordinated the volunteer efforts of women who wanted to

in One hundred years of wartime nursing practices, 1854–1953
Open Access (free)
Religion and spirituality in environmental direct action
Bronislaw Szerszynski
Emma Tomalin

movement and felt that it was an area needing attention. One of her primary interests was making people more aware of camp illnesses, including visitors to protest sites, and in encouraging people to take better care of themselves. She also drew attention to the stresses of a life of protest and the fact that people often drink too much in order to block out the pain of evictions. She was training in reiki, learning about different herbal remedies (‘as most people are shy of Babylon drugs’) and attempting to introduce health as a serious issue into the camps where she

in Changing anarchism
The impact of the First World War on attitudes to maternal and infant health
Fionnuala Walsh

better care of their children rather than improving the adverse conditions in which many working-class people lived. Influential contemporary commentators dismissed the impact of poverty and the poor housing and sanitation conditions in overcrowded urban areas as of little relevance to infant mortality rates. Arthur Newsholme, chief medical officer of the Local Government Board

in Medicine, health and Irish experiences of conflict 1914–45
J. Peter Burgess

with its societal ways and means. Should ‘society’ have taken better care of the youths on Utøya? Does this mean that society should have taken better care of Anders Behring Breivik in his growing up and moral education? In other words, from the very outset, ‘society’ is considered responsible for preventing or protecting from terrorist attacks in general, and the

in Security after the unthinkable