30 JCR Presidents have signed a letter condemning Oxford University’s current mental health provisions. “What is needed is commitment from the central University to a comprehensive and universal approach to mental health provision across all colleges, ensuring that students who need help can get help, regardless of which college they happened to end up at.” “This leaves students as the main point of contact for those struggling with mental health problems: the SU found that 85% of JCR welfare reps are called out to crisis situations. This very [sic] troubling, and completely unsustainable.” Yet there is serious discrepancy between colleges. Only ten out of the 38 Oxford colleges and six PPHs offer an on-site counsellor. Colleges without an on-site counsellor rely on the University’s counselling service, which, according to their website, sees between 11% and 12% of the student population each academic year. “We must recognise that we are indebted to Student Welfare Services, including the Disability Advisory Service and the Counselling Service. We do not want their work to be eroded by overstretched budgets, and overdue by cases unsuited to their expertise.” The end of their letter expressed concern for the impact the inadequacies of the current mental health provisions were having on other areas of student support. In a collective statement given to Cherwell, the signatories said: “This letter expresses the frustration of the entire student body about the lack of central university leadership on the issue of mental health. All undergraduate colleges appoint Junior Deans, JCR Welfare Representatives, and trained Peer Supporters. In addition, all colleges have chaplains, who are often involved in pastoral care, especially as Welfare Co-ordinators. They went on to say: “The students we represent have seen no comparable public statements from key University figures, and no recognition of mental health as an institutional priority. Addressing their concern over the lack of student involvement in the development of any new mental health strategy, the Presidents called for: “extensive student consultation sessions regarding the implementation of the Mental Health and Wellbeing strategy” Shakil added: “The University is beginning to discuss the issue of wealth inequality on a meaningful level, but the impending mental health crisis will not wait for funds to gradually trickle into individual college welfare budgets. In the letter, the 30 JCR Presidents set out their demands, which included: “The senior leadership of the University, including the Vice Chancellor or Pro-Vice Chancellors, should declare their concern about student mental health. This should ensure that any efforts are transparent, so we can hold them accountable to these promises.” “Furthermore, the lack of student consultation in the creation of this strategy is highly irresponsible at best, and deeply negligent at worst. Common room welfare teams cannot be on the frontlines of the battle, yet remain as peripheries to this conversation.” The letter, seen exclusively by Cherwell, reads: “The collegiate system tends toward ad-hoc welfare structures. While at some colleges the welfare team can give much needed emotional support, or referrals to the counselling service or NHS, elsewhere, suitable procedures might be completely lacking. In their letter, the Presidents claimed: “There has been a severe lack of public leadership on this issue from the University governance, the sort of leadership that has been demonstrated elsewhere’, referencing the proactive role of Graham Virgo, Cambridge University’s Pro-Vice Chancellor for Education. Speaking to Cherwell, Mansfield’s JCR President Saba Shakil said: “The vast disparity in wealth between colleges means that whether or not students receive effective mental health support is a matter of pure chance.” Oxford University spends more on mental health services annually per student than any other university in the country, with £1,000,100 spent in 2016/17 according to statistics obtained by Cherwell last year. They also requested: “The Vice Chancellor should release a written statement responding directly to the requests made by this letter, which outlines the actions that the University leadership will be undertaking.” Signatories of the letter include the JCR Presidents from Merton, Jesus, LMH, Oriel, Magdalen, Balliol, and St John’s. The University is in the process of developing a ‘Mental Health and Wellbeing Strategy’ in order to address the problems surrounding the existing provisions, however there has been recent criticism over the way this has been managed. “We are committed to supporting the SU’s efforts to lobby the university to make mental health an institutional priority and have a constructive conversation with the Vice-Chancellor and Pro Vice-Chancellors. “The student voice is an essential part of the dialogue, and together with the SU’s open letter, we hope that the university understands the gravity of the issue.”
Crowds gather for the 15th Annual Chip Miller Surf Fest in 2018. By Tim KellyOn Friday, Ocean City will host the 15th Annual Chip Miller Surf Fest, to benefit research and raise awareness of a rare disease called Amyloidosis. An after-party is planned at the Ocean City Water Park, featuring food, music and surprises.The Surf Fest contest begins at 8:30 a.m., the after-party at 5 p.m.Amyloidosis is a condition which has no known cause and no known cure. It results in the buildup of amyloid proteins on the organs. Unless caught early, Amyloidosis almost always is fatal.Chip Miller, a longtime Ocean City resident and supporter of its surfing community, was stricken with the disease and passed away in 2004, just a few months after his diagnosis.The Surf Fest bearing Miller’s name will take place on Friday July 20 at 7th Street Beach in Ocean City. Sign-ins begin at 7:30 a.m. and the contest starts at 8:30. If there are no waves, the contest will take place on Saturday or Sunday July 21 or 22.To register for the event, visit the Chip Miller Amyloidosis Foundation website at www.chipmiller.org.“It’s hard to believe we are in the 15th year,” said Nick Bricker, one of the event organizers and a friend of Miller and his son Lance. “It has grown along the way. Amyloidosis is still largely unknown, but now at least more people have heard about it. If we can make someone aware and perhaps catch the disease its early stages and save a life, then we have accomplished our goal.”The Chip Miller Surf Fest will feature an appearance by local professional surfer Rob Kelly. Over the years some of the biggest names in the sport have taken part including Bethany Hamilton, Rob Machado, and “the Jersey Devil” Dean Randazzo, a Somers Point native.What began as a small event mostly for locals, has grown into one of the East Coast’s largest surf events.In addition to the contest, which will award prizes in all age groups, surf gear manufacturers will be on hand with products for sale and donations of a number of great surfing-related prizes.There are eight divisions in the contest and participants may compete in as many as four of them.“This is a chance for people to see some of the best surfers on the East Coast compete,” Bricker said, “but not everyone can be there on Friday during the day. That’s why we hope our after-party will appeal to anyone, whether they are (into surfing) or not.”The party, called the Slide for Amyloid, will take place at the Ocean City Water Park, near 9th Street and the Boardwalk, following the contest. Water Park doors will open at 5 p.m.Tickets are $30 for those aged 21 and over, $15 for those under 21. They include food, drinks and unlimited use of the Water Park facilities.“This is a rare opportunity to go to the Water Park and not have to stand in line,” Bricker said. “It’s going to be a big private party.”Lance Miller said “A taste of Ocean City” will also be a part of the festivities.“My wife Michele is handling the food part and is doing an incredible job,” Miller said. “We expect to have delicious food on hand from as many as eight different Ocean City and area restaurants.”Bricker said attendees can save money by registering for both the surf contest and the Slide.“We appreciate all of the community support, but we also appreciate people learning about Amyloidosis and spreading the word. That’s what is going to save lives. “Lance Miller said as tragic as his father’s passing was, a greater tragedy is that the disease is treatable if diagnosed in time, yet in most cases it has advanced past that point when recognized.“It’s very frustrating that some of the most advanced medical centers in the world are unable to treat this disease,” he said. But with education, awareness and early diagnosis, it doesn’t always have to be a sad outcome.“Additionally, with funds going toward research, we are hopeful,” he said.
collaboration: we work better when we work together speed: it doesn’t have to take weeks and months to change anything, no matter how small and innovation: that’s it’s not about coming up with the idea, it’s about having the backing and the permission to make the change And just like a war it’s forced us to improvise new ways of doing things, some which will become permanent because they are better ways of doing things.So for instance, before coronavirus, there were plenty of theories about how to transform health and social care.In fact, the last 30 years is littered with top-down reorganisations and big-bang structural reforms, quangos and quasi-markets, and theories and pilots and reports and boards and commissions.But something important has changed.In the post-coronavirus world we don’t have to rely on theory.Because we now have hard evidence how people choose to operate, under crisis conditions, when there is a novel and acute need to deliver.We must learn from how the NHS and social care worked during the peak.Both about what we must change. And critically, because so many things went right, we’ve got to bottle the best.And this is in a way how I see my job and role as Secretary of State for Health and Social Care: not to impose some preconceived utopia that might look good on a management consultant’s slide deck but bears no relation to reality on the ground.My job is to make the system work for those who work in the system, and work hard to make the system work: to free up, empower and harness the mission-driven capability of team healthcare.So what do I mean by this? For an illustration of what I mean, come with me to Helsinki.In Finland, town planners visit a park immediately after snowfall because the footprints reveal the paths that people naturally take.The next summer, they go out and pave those paths.They don’t sit in an office and decide where to put the path.They watch where people go naturally and then they pave the way.We too must pave the paths that people want to travel.Because our healthcare system isn’t just complicated, it’s complex. It’s best led not by diktat but by mission.And we are now at a critical moment in that mission.We are carefully restoring our healthcare system. And as we do so, we must not fall back into bad old habits.Instead, we need to take what we’ve learned, and build back better, capturing a culture that’s open to collaboration and change.And I just want to dwell on this collaboration point. We saw collaboration like we’ve never seen before: between different organisations, different professions and between teams in different organisations.And we saw things change. I mean really change. I’ve lost count of the times someone said to me since: “what would have taken months took minutes.”In the heat of the crisis we saw a shared understanding: Thank you very much.I want to start by taking you back to the tail-end of a long and very hot London summer many years ago.One night late at night, at a bakery in the City, a spark leapt out of an oven and ignited some nearby fuel.London’s largely timber-framed buildings were bone-dry at that time. Tightly packed together in the narrow, unplanned medieval streets.The year of course was 1666 and we all know what happened next.When a system is hit with a big external shock it can be utterly devastating.London lost a third of its buildings in the Great Fire, including its cathedral.100,000 people were made homeless.And the cost of rebuilding the city has been calculated in today’s money at 37 billion pounds.But that same devastating shock can force people to find new and better ways of doing things.The London Fire Brigade, the first insurance companies, building regulations that enforced access to running water, and of course Wren’s domed cathedral, the most ambitious public works project in the history of the city.All of these have their origins in the nation’s response to the Great Fire.And in that there is a lesson for us.Because once again we have been hit with a terrible shock. A small spark that quickly turned into a global crisis.Coronavirus has tested every single part of our infrastructure, giving us a new appreciation for what works and what doesn’t.And once again, brilliant ingenious people have risen to the occasion.Now it’s a long time since I’ve given this kind of speech.And a long time since I’ve been in front of an audience.And in these last few months, we’ve all been working every waking hour to lead the nation through the coronavirus crisis.I am fully aware of the pain and suffering that this virus has brought to so many people, and we pay tribute to everyone that we have sadly lost.Throughout this difficult time, we have protected the NHS, and in turn, helped protect us.And that was thanks to the heroic efforts of many, many people.This was a great achievement, in very difficult circumstances, but we know that we won’t have got everything right.And that there will be lessons that we need to learn from this pandemic.This includes what we’ve learnt both from our healthcare system and about it.And today I want to step back from the vital work in the management of the COVID-19 pandemic.That work continues every day, as we strive to keep this virus under control.We can see a second wave emerging in Europe and we will do everything in our power to stop it reaching our shores.However, today, I want to talk about what we’ve learnt about the health and social care system in this country.How it worked during the crisis, and how it should work best in the future.So first, what have we learnt?Coronavirus has been a moment of exposure, of stark clarity.Like sheet lightning on a dark night, it has suddenly and dramatically revealed our healthcare landscape in a way that we’ve never quite seen it before.We’ve discovered things about our system that we could not have learned in normal times: like building the Nightingale Hospitals in 9 days or doubling ICU capacity to treat the most sick or treating half of patients in outpatients and primary care online At the same time, our brilliant scientists drove forward the first robust clinical trial to find an effective treatment for coronavirus.And they are currently leading the world in the search for a vaccine.Coronavirus has catalysed deep structural shifts in healthcare that were already underway: how it performed under conditions of severe, sustained nationwide pressure the choices frontline professionals make if you give them greater freedom what rules and structures are essential to the effective delivery of health and social care and what are just a layer of bureaucratic barnacles that can be stripped away to streamline the vessel beneath set up registers for extra healthcare professionals and gave professionals the flexibility to postpone their revalidation allowed students to continue their studies while at the same time contributing to frontline care and most audaciously of all, gave clinicians from areas far removed from respiratory illness, for instance dermatology, gave them the confidence to work in unfamiliar COVID wards. telemedicine data-driven decision-making and working as a system not as atomised institutions that accepted truths or ways of doing things had to be challenged if they didn’t help that the needs of the patient mattered more than the silos between institutions and, crucially, that we value the contribution from everyone on the team I couldn’t agree more.So today I want to start a conversation about how we can put these values into action.How we can capture a culture that lets our carers care.And scythes away the red tape, attitudes and ways of working that stand in the way.And to do this, I’d like to draw on 7 major, cultural lessons that I think we’ve all learnt over the past few months.Lesson 1: value our peopleThe first is that we must value our people and trust them as professionals.Now, it’s easy to say we should value people. But there are some hard-edged changes needed to make it happen in reality in the NHS and social care.Too often before the crisis, people were treated as numbers on a spreadsheet, when they’re the most important asset that we’ve got.And when I say people, I mean all of our people: care workers, porters, cleaners, clinicians and leaders.Everyone, of every background, in every part of our health and care system, has a contribution to make, and everyone needs to be supported to do their best possible work.Now some of you may have heard, I love the story of JFK visiting the NASA space centre. He saw a janitor carrying a broom and asked him what he was doing.“Mr President”, the janitor said proudly, “I’m helping put a man on the moon”.This is what it means to be a mission-led organisation.And we know what support for staff looks like in practical terms.Because as well as that great outpouring of emotional support from the British public, the crisis brought real, practical help for the frontline.Good food. Decent rest facilities. Someone to talk to about the most difficult experiences that frontline colleagues faced.It shouldn’t take a pandemic.All of this needs to become the norm for the NHS and social care: that we listen to our people and we look after them. Not just an emergency response to a crisis but all the time.I am determined to make it happen.We also learned that people do their best work when they’re trusted to get on with the job.Don’t just take my word for it. Look at Admiral Nelson, one of the most inspirational leaders of all time.When the British navy was heavily outnumbered at the Battle of Trafalgar, it was Nelson’s approach to leadership – the Nelson Touch – that proved to be decisive.He worked hard to build an agreed strategy that everyone knew and understood – and then he expected everyone to use their own initiative to put it into place.So, amidst the fog of war, while his adversaries were hamstrung, waiting for instructions from their admirals, transmitted by cumbersome flag signals, Nelson’s fleet knew what they needed to do, and they were trusted to work out how to do it.Admiral Villeneuve, whose fleet was defeated by Nelson, said it best:“To any other nation, the loss of Nelson would have been irreparable, but in the British fleet, every Captain was a Nelson”.This is the mentality that we need. I want an NHS and care system that is full of leaders. Leaders at all levels. This is the principle embedded in the People’s Plan released today.Everyone, at all levels, thinking like a leader and being encouraged to use their initiative and take ownership of their decisions.And that means getting rid of what stands in their way.I think it is vital to understand what happened when we made emergency changes so staff could focus on the crisis.Take the GMC and NMC, who: Now, throughout I’ve been talking to the people responsible for making the system work: from regulators to frontline staff, to leaders of trusts to local directors of public health.And I ask what they think are the things we need to ‘bottle’.In organisations as diverse as NICE, the Royal Colleges, the BMA, people come up with the same list: If you think about it, in terms of mobilising the resources of the state, the pandemic has been as close as you can get to fighting a war without actually fighting a war.We achieved things that people never thought possible: Or look at the CQC’s Emergency Support Framework.The CQC adapted their traditional inspection-based model of regulation to the new reality, using data and feedback to identify problems in real time.And where there was a problem, working with them to have ‘honest conversations’ and provide ongoing advice and support.Now when we made those changes the sky didn’t fall in. On the contrary.The NHS was protected. Patient safety was protected. And crucially frontline staff felt empowered.But empowerment is not just about giving people the freedom to make decisions.It’s also about requiring them to make those decisions.If you give people responsibility, they will act responsibly.So we cannot, we will not, revert back to before. The GMC, the NMC, the Royal Colleges, the Academy of Medical Royal Colleges, the CQC, NHSE, we are all together on this mission.The regulators and our NHS and care colleagues excelled during the pandemic, showing their ingenuity, their resilience and their versatility when it mattered.And over the coming weeks they will be building on the action they’ve already taken to put this agenda into practice – for the long term.Today the NHS published the latest part of its People Plan.And aligned to this vision of an empowered culture where leadership at all levels supports every single NHS employee to reach their potential.This is all about building that culture of trusting people to use their professional judgement, to do the right thing, instead of seeming, appearing to assume someone will do the wrong thing unless they have layers of management peering over their shoulder.Together we’ll build a system of distributed authority, where decisions are made as close as possible to where the information is, with everyone working right at the top of their skill set and qualifications.Where people feel empowered and encouraged to crack on with improvements, instead of having good ideas blocked by bureaucratic inertia.And in a world where multi-morbidity is increasing, where we encourage and celebrate generalist skills, as well as supporting those who want to specialise.Frankly, we employ some of the most compassionate, brilliant, intelligent, mission-driven people in the world in our health and social care system.Why stop them from doing their best? This has to change.Lesson 2: bust bureaucracyThat brings me to the second lesson.Supporting a culture of collaboration and change by busting bureaucracy.Now, we shouldn’t beat ourselves up too much.The latest OECD data shows that we only spend 2p in the pound on administration in the NHS, compared to, for example, to 6p in France, and 8p in the USA.But the crisis proved that there’s more bureaucracy that our healthcare system can do better without.That barnacle-like encrustation of rules and regulations.And I can see people smiling and I know everybody is thinking about some particular, frustrating, illogical rule.It has been disempowering to many brilliant, highly motivated frontline staff who just want to get on with caring for patients.Now, first, a caveat. Healthcare is a risk-based business, and many of the rules exist for good reason.Of course they do. High-quality rules are the tramlines of high performance.We know that checklists save lives, we know that professional standards must be rigorous and exacting. Clear standards are necessary for a disparate system to function.In the crisis, we imposed some clear, high-level rules, around infection control, for example. And tech standards are vital for interoperability.Done best, high-level, mission-based standards support people to deliver within them.Done best, the centre sets clear tramlines, and holds the frontline transparently to account for delivery.Kennedy set NASA the goal of getting to the moon by the end of the sixties. He did not specify what alloys the rocket should be made out of.We need a framework that encourages local initiative in service of the overall goal.Again the pandemic forced us to decide which rules and processes were essential to the NHS mission and which were getting in the way of that mission.Sometimes it’s just an encrustation of decisions made over time, like the regulations which required thousands of pages of information from doctors who want to move here from Australia, which have been removed.Other times, it’s how the law is over interpreted with layers of gold-plating.Our information governance rules are a good example of the latter.Complex, confusing advice leads to over-cautious interpretation. For instance, without changing a jot of the law, early in the crisis NHSx issued radically simplified new guidance to support new ways of working.This guidance, information governance guidance, was on one page, and targeted at every single front line professional – not just at Information Governance experts.For example, we it made clear that it’s fine to use secure messaging services like WhatsApp to share information with colleagues or patients where the benefits outweigh the risks.And we made it easier to link the primary care records of millions to the latest data on coronavirus.Helping us to do the world’s largest analysis of coronavirus risk factors.This work normally would have taken years, but thanks to our new framework for processing data, it went from proposal to execution in just 42 daysI can’t tell you how many people at all levels have begged me never to go back.And it worked because the emphasis was on enabling, on how people can safely share information rather than an emphasis on restricting.And now we’ll work to simplify that guidance yet further, to make it yet more empowering.Rest assured, this bureaucracy will not be coming back.In fact in the future, I want us to go even further.Lesson 3: better tech means better healthcareThat means lesson 3, better tech means better healthcare. We want to double down on the huge advances we’ve made in technology within NHS and social care.Because it’s not really about technology, it’s about people.It’s the child with cystic fibrosis who can have his lung capacity measured at home with a spirometer and an app instead of having to go to hospital, with all the risks that entails.It’s the elderly care home resident, socially shielding for months, able to meet her new grandchild on an iPad.It’s the local GP, already time poor, not having to spend time donning and doffing PPE because she can do her care home check-in online.I know I’ve taken a bit of stick for making technology one of the central issues for the NHS.Before coronavirus, there was a view advanced by some people, would you believe it, which held that anyone over the age of 25 simply could not cope with anything other than a face-to-face to appointment.That video consultations, a technology by the way that’s been around for decades, was too modern and new-fangled for the NHS. Remember that?That apps had about as much relevance to present-day healthcare as nanobot surgery and missions to Mars.When it came to social care this attitude was even worse.Take away their fax machines, people told me, and care homes would collapse.Well all I can say is thank God we didn’t listen to the naysayers and that NHS Digital, NHSx and NHS teams right across the country, worked so hard on digital transformation.Imagine if we hadn’t put the investment into broadband infrastructure so 99% of surgeries could offer remote consultations, virtually overnight.Imagine if we hadn’t digitised prescriptions so people could get repeat prescriptions online.Or imagine the massive pressure on NHS 111 at the peak of the pandemic if we hadn’t developed it also as an online service.At a time when over 750,000 online assessments were carried out in just one day in mid-March.Now, of course sometimes developing new technology is hard, and you have to have an attitude of iteration and of flexibility. But none of that makes it any less valuable.So to promote collaboration and change, we need more transparency, better use of data, more interoperability, and the enthusiastic adoption of technological innovation that can improve care.This crisis has shown that patients and clinicians alike, not just the young, want to use technology.Just look at how many families, all different generations, kept their precious encounters going through parties on Skype and quizzes on Zoom.And when it comes to their healthcare, whether they’re digital natives or digital converts, they don’t want to have to sit around in a waiting room if that service can come to them at home.In the 4 weeks leading up to 12 of April this year, 71% of routine GP consultations were delivered remotely, with about 26% face to face.In the same period a year ago, this was reversed: 71% face to face and 25% remotely.Now of course there always has to be a system for people who can’t log on.But we shouldn’t patronise older people by saying they don’t do tech.The feedback from this transformation has been hugely positive.And especially valued by doctors in rural areas, who say how it could save long travel times for doctors and patients.So from now on, all consultations should be teleconsultations unless there’s a compelling clinical reason not to.Of course, if there’s an emergency, the NHS will be ready and waiting to see you in person – just as it always has been.But if they are able to, patients should get in contact first – via the web or by calling in advance.That way, care is easier to manage and the NHS can deliver a much better service.Not only will it make life quicker and easier for patients.But free up clinicians to concentrate on what really matters.The fourth lesson is about open bordersThis crisis showed that we were at our best when we were looking outwards, drawing on ideas and expertise wherever they may be found – and that means the private sector too.And that takes me onto the fourth lesson: the NHS needs open borders.Better joint working between local authorities and the NHS locally to embrace the solutions that work.They say there are no atheists in a lifeboat. Well, there are no ideologues in a pandemic.Take testing for example.If you’d have asked most people who’d taken a swab test whether they were part of pillar 1 or pillar 2 you’d have seen some fairly blank looks.People don’t care who has provided the test.They just want a test that’s easily accessible, that works and that they can have confidence in.And I want to thank the teams – public and private – who put themselves on the front line every day to swab people at risk.Restrict yourself to the false divide of public or private and you are only fishing for solutions in half of the pond.As part of our response to coronavirus, we were able to call up the logistical knowhow of Amazon, the production lines of Burberry, the car parks of IKEA, and literal boots on the ground from the British Army.The independent hospitals stepped forward and provided services to protect the NHS.And the NHS worked side-by-side with them all as part of this incredible national effort.One diverse, talented team, working towards a common goal.And we were all better off as a result.In the face of unprecedented challenges, our sense of enterprise and pragmatism is mission-critical to the success of our health and care system.It’s part of the spirit of collaboration and change that we must bottle for the future.Now we have made this huge step forward, we should never walk back.Lesson 5: no trust is an islandLesson 5 is that the system works best when it works as a system: collegiate, co-operative, collaborative.As opposed to a series of atomised, fortress-like, rather lonely institutions.The future of health and social care will be built by those striving to keep the population healthy, not just to fix the ones who are ill – just as is spelled out in our NHS Long Term Plan, and in our social care reforms.This can only be done by the delivery of healthcare based on the needs of the population, not the design of the institution.To deliver this type of care, systems will become the foundation stone of the future of the NHS and social care.We have already seen local areas in England embracing system-wide working.With more streamlined planning, bringing together clinical commissioning groups, providers and local authorities to plan services across an area.These plans will of course help reduce admin costs, but that’s only half of it.System working means better, less fragmented decision-making.This is how people work when they really need results.So we must work to break down the silos that exist between providers and trusts of all kinds.Primary care, community care, pharmacy, mental health and acute trusts, the barriers between these services are decades old.But they don’t work now.Not in a crisis. And not in an age where ever more patients have the kind of long-term, complex conditions which mean they can’t just be bandaged up and set on their way.The strict barrier between primary and secondary care goes right back to Lloyd George’s National Insurance Act of 1911.Now I’m a great admirer of David Lloyd George but what was right for 1911 is not right for the 2020s and beyond.The past few months have shown that there is another way.During coronavirus, when many secondary care appointments were cancelled for those with chronic complex conditions.Primary care clinicians were able to support them, using digital technology to take advice from consultants where needed.So the best possible care could still be delivered in the community.Pharmacies provided open-access support and care that is deeply embedded in the communities they serve.Pharmacies showed just how much more they can do.And this is the spirit that I want us to channel as we move out of this pandemic.Collaboration doesn’t just mean inside the NHS either.The NHS must be connected to the places they serve, coterminous with local authorities where the crisis has shown that councils and the NHS can work wonders when they work together.Look at what was achieved with rough sleepers by working across the system, from housing to the NHS to public health, to protect the most vulnerable.And then look at the acute response team. Take Thanet, a dedicated team of GPs, nurses, paramedics, AHPs and geriatricians that provide Thanet’s 61 care homes with assessments and advice on all aspects of old-age care.Now during the pandemic, that model came into its own, with 7-day support so care homes and district nurses always had someone they could call if they couldn’t get through to the local GP.Integration is not a silver bullet for all problems in healthcare, not by any means.But what is clear is that once you think about the delivery of health and care as a system in a place it changes the conversation.So money spent on a care package rather than in a hospital looks less like a loss to the hospital for example, and more like a better outcome for all.There’s a stronger imperative to treat people in the right settings.And data flows more easily.So together we will build our future health and care with the system by default.And this will include a financial and inspection approach that encourages and rewards collaboration.And as we do this, we need to look beyond healthcare, at everything that makes us healthier and happier.Recognising that access to a gym or a park can have just as great an impact on our wellbeing as a GP surgery or hospital.We must move away from thinking about spending as an NHS pound or a Council pound.But a Darlington pound or a Dudley pound.We need local authorities and the NHS to plan and budget together, to work together, and to be accountable together to local people.Lesson 6: accountability mattersWe also need this collaboration at a national level too.All of our national organisations have done exceptional life-saving work during this crisis.The NHS has withstood the worst global pandemic in a generation…PHE rolled out a diagnostic test faster than ever before in recent history.And we saw the strength of the Union coming to the fore, with a UK-wide approach helping us to expand testing capacity.Procure PPE for every corner of the UK.And of course search for a vaccine that can help us return to normal life.Just as we need a more joined-up, collegiate working on the ground, so to we need the same at the centre.We’re making progress already, with NHS England and NHS Improvement now operating as a single organisation.But our national healthcare institutions are too siloed, in many cases by law under the 2012 Act.Huge amounts of energy are wasted managing the legally imposed silos.That’s why the NHS itself has proposed adjustments to join up services both nationally and locally.Fortunately, there are many practical steps that we can now take.Take just one example: we have many bodies: DHSC, NHSD, NHSE&I, PHE and the CQC all making separate information requests from providers, often for the same information.It’s a huge burden, and Instead we should ask for information once, and use that across the system.This spirit of collaboration is so important, and nowhere is it more important than the relationship between health and social care.We’ve heard about GPs going the extra mile for care homes and telemedicine enabling care in the peak of the pandemic.The NHS has also given every care home a dedicated clinical lead and hospital trusts have provided thousands of infection control training sessions.One of the silver linings of this incredibly dark period has been the widespread appreciation for the care sector, and the brilliant work that our carers do.Now it’s time to set clear ambitions about the future of social care in this country and fix an issue that has been ducked for far too long.We should aspire for everyone to get the care they need at whatever stage of life they need it.Given in the place that best meets people’s needs, by carers who are properly recognised and rewarded.We already know that we need a fairer system for paying for care, that protects people from the exorbitant costs that require them to sell their home.And that we need to get more money overall into social care and fix the funding shortfall.Achieving this will involve bold reforms, not just about funding, but also effective structures for oversight and accountability.We will be saying more about this over the coming months but this is a top priority for me.So we can create an enduring model of care, focused on early intervention, prevention and technology.And keep people living independently for as long as is possible, supported by care that you or I would be happy about for our own daughter, father, or grandparent.Lesson 7: the nation’s health is bigger than just the NHSAnd now, my seventh and final lesson for today.Our NHS is a place where miracles are an everyday occurrence.But they cannot, must not, shoulder the whole burden of keeping the nation well.The nation’s health is so much bigger than just the NHS.The best evidence suggests that only about a quarter of what leads to a longer, healthier life is the result of what happens ina healthcare system.Prevention matters, as the pandemic has vividly shown.That sheet lightning revealed that your chances of dying with coronavirus are tragically markedly higher in a more deprived area, much higher for the obese, and much higher for people from an ethnic minority background.This should be a wake up call for us all.As a nation, we went into this crisis in worse health than some of our peers.Japan and South Korea for instance, have the lowest rates of obesity in the OECD.And this left us more vulnerable to the disease.This is not the only factor that explains our relatively high mortality rates during the pandemic. Far from it.But nor is it a factor that any responsible government could just ignore.The lightning strike of the pandemic exposed stark inequalities in the health of our nation.Between ethnic groups, between city and country, between occupations.The disproportionate impact of the virus upon black and minority ethnic people – including in the NHS and care workforce – has been particularly troubling.People are understandably angry about these disparities, and I feel a deep responsibility to get this right.Because the quest for equality isn’t just about jobs and housing.The Prime Minister’s mission is to level up. And there is no more important levelling up than levelling up your health.In this country there is a complex interaction between ethnicity, economic opportunity and healthy life expectancy that we need to urgently understand and unravel.That means asking difficult questions about the way in which our society is configured.About who gets to work from home and who does not.About how much easier it is to have a healthy life if you don’t have to worry about next month’s rent or next week’s food shop.There is a famous passage in ‘The Road to Wigan Pier’ where Orwell is talking about the diets of unemployed mineworkers, which in 1937 consisted of white bread, corned beef and sugary tea.“When you are unemployed,” Orwell said, and I quote:“which is to say when you are underfed, harassed, bored, and miserable, you don’t want to eat dull wholesome food. You want something a little bit ‘tasty’. There is always something cheaply pleasant to tempt you.’’And the structure of our economy and the make-up of our society have both changed hugely since the 1930s.But that insight of Orwell’s is borne out by modern epidemiology.It harder to stay healthy if you are poor.So, as much as levelling up on economic opportunity, we need to level up the nation’s health and care provision too.And this isn’t simply an aspiration. It is a moral imperative if we are to uphold the values of equality and fairness upon which the NHS was founded.But there’s no easy answers to any of this. The causes of ill health are complex and multifaceted. And our response must be too.We must understand who is most at risk of COVID and why, and I am working with Kemi Badenoch on urgent cross-government work on this.Longer term, we must be more proactive on public health.Earlier this week, we launched our new obesity strategy, which is full of measures to help people make healthier choices.Like mandating clearer calorie information in restaurants and takeaways, and banning the advertising of high-fat, sugar and salt products before 9pm on TV and online.But this is the beginning and not the end of our work.One of my main priorities is making sure more people stay out of hospital, as well as providing the best possible care when they come in. And the NHS has a vital part to play in that.Supporting people to make healthy choices. Using those teachable moments to help people to make the change. With employers, town hall planners and the food and drink industry all playing their full part too.And we must keep striving to add life to years as well as years to life. Not giving in to the defeatism that says you can’t have a healthy old age.So what do we need do?These for me, are the 7 big lessons of the crisis.But this is only the start of the conversation, and I want to hear what you think too.From frontline staff to regulators, from chief execs to caterers across health and social care.I want to discuss what works and what matters to you, as we implement our NHS Long Term Plan.And what we need to change to get there.We have already mapped out over 50 different reforms that we introduced due to coronavirus that we want to keep and drive forward.Where the question is not what to roll back but how to go forward. How we can build back better.And there are a few themes that I think are especially important.First, we need to push power out of the centre to closer to where care is delivered.Second, we need to tackle unnecessary bureaucracy.So I will be setting our health and care system a Bureaucracy Challenge.Challenging every new proposed regulation or process and asking if it makes sense given the realities of modern, integrated healthcare.This means inviting everyone who has to work under this bureaucracy, from the most eminent Royal College president to the most junior healthcare assistant, to tell us what they think should be scrapped or improved.Today we have launched an open call for evidence on this to invite views from health and social care colleagues on how we can bust bureaucracy.This is unapologetically based on the Red Tape Challenge that we issued to business after the global financial crisis and which helped spur a British jobs miracle.We don’t need a pilot to know how necessary this is in healthcare. We’ve just seen how empowering it can be and we must go further.Third, we need to drive forward the integration of health and social care.By pooling budgets and giving the NHS responsibility to support people out of hospital, we radically reduced the number of people getting care in hospital when they should have been at home.But there is so much more to do.All parts of the system need to pick up this agenda and drive it forward, with what Martin Luther King called the “fierce urgency of now”.And there’s one very urgent reason why we can’t go back: which is winter.Though I deliver this on a hot summers’ day, we know for sure that winter is coming.Unusually cold weather or a more virulent strain of flu would put real stress on the system.There is still a lot we don’t know about COVID-19, from the long-term health impacts on those who’ve recovered to how it interacts with the cold.And although we work in hope that a vaccine will appear, we may have to live with COVID for some to come.A health service that’s collaborative and open to change will be much better placed to withstand whatever headwinds will come.ConclusionSo I hope that you will join me in this mission.At a time when the world around us is changing faster than ever before in human history.We mustn’t simply keep pace with the change, but once more show the world what can be done.We need a healthcare service that’s built on collaboration not competition, on trust in professionals and not box-ticking bureaucracy, and protects the most vulnerable and helps people live longer, healthier lives.And just as modern London rose from the ashes of the great fire, we protected the NHS in the peak of this epidemic.And out of its ravages, let us build a health and social care system of the future.Thank you very much indeed.
Athletics for the 21st century Related Massachusetts native brings Ivy principles to lead program into future A first-ever study of Harvard Athletics found that the majority of student-athletes consider their experience on teams to be formative, rewarding, and demanding, and they feel supported by coaches, teammates, and the athletics staff. It also revealed that many find it difficult to balance academics, athletics, and social lives.The study, released last Friday, was commissioned by the Faculty of Arts and Sciences to inform strategic planning for the department, as it approaches its centennial anniversary in 2026. A team of researchers from the organizational consulting firm Mercer studied the culture of athletics at Harvard and documented the experience of student-athletes and members of the department. Using various data-collection techniques, including interviews, surveys, and on-campus observations, researchers gathered feedback from students, coaches, staff, faculty, administrators, alumni, and fans from September 2019 through May 2020.“When reviewing the results emerging from the Mercer study, I was particularly struck by the voices of our student-athletes, who spoke so honestly and openly about their experiences,” wrote Claudine Gay, Edgerley Family Dean of the Faculty of Arts and Sciences, in her letter to the Harvard Athletics community. “In that candor, I see both opportunity and motivation for our work together to support them and enable their success, on and off the field.”A survey of student-athletes, conducted as part of the study, found that the vast majority of the 827 respondents feel they are learning important life lessons at Harvard (93 percent) and feel happy about their decision to attend (91 percent). Of the student-athletes who completed the survey, 65 percent said that they valued the sense of community, camaraderie, and friendship that their team provides.Survey results also indicated student-athletes face some challenges. The majority (524 out of 827) of respondents reported difficulties balancing their academic, athletic, and social lives. They also reported struggling to find free time to relax, unwind, and take advantage of community experiences, with 45 percent of respondents reporting that they felt as if they were active members of their residential communities. Student-athletes also reported higher levels of emotional health compared to physical health. While 83 percent reported feeling generally happy with their lives at the moment and 78 percent felt they had enough tools to manage stress, 53 percent indicated they were getting enough sleep to feel healthy, and 59 percent were able to maintain a healthy diet.The study also looked at the staff experience. Survey results showed that coaches and staff are highly engaged and deeply committed to the mission of Harvard Athletics and Harvard College. Ninety-four percent reported that their jobs gave them a sense of meaning and purpose. The same percentage reported that they were motivated to go “beyond what is normally expected to help Harvard be successful.” However, coaches and staff felt less satisfied with their work-life balance, with 55 percent reporting that they had a reasonable balance, and 25 percent reporting that they did not.Many expressed their desire to see more collaboration between Athletics and the FAS, including Harvard College. Just under 50 percent believed athletics is viewed as an important part of the Harvard experience, and about the same number of respondents did not see a high level of collaboration between the College and the department. That sentiment appeared to be shared by faculty and administrators interviewed for the study, who also saw opportunity in maintaining and growing partnerships between Athletics, Harvard College, and the FAS. Administrators, faculty, coaches, and Athletics staff were largely united in their interest and enthusiasm for helping student-athletes better integrate their dual roles on campus.Recommendations from the study included renewing Harvard Athletics’ vision and commitment to Ivy League principles for a new generation of students through community engagement and discussion as the department transitions to new leadership. The survey also suggested increasing efforts to support and strengthen integration between athletics and academics for student-athletes and conducting further research into specific issues, such as mental, physical, and social health and wellness, and those that Athletics staff deal with, such as work-life balance.“As the recommendations make clear, we need more opportunities for faculty, staff, coaches, and students to talk to each other about our priorities, our aspirations, and the barriers we confront in supporting our student-athletes,” said Gay. “This process is a first step to building stronger relationships among all those who are committed to the success of our students.”Looking ahead to next year, incoming John D. Nichols ’53 Family Director of Athletics Erin McDermott said she looks forward to continuing to build on the legacy of Harvard Athletics and its educational and mentorship mission.“I look forward to the work we have ahead internally, with FAS and campus partners, and with our extensive Harvard community in developing the future vision for Athletics, integrating athletics and academics in mutually beneficial and substantial ways, and fostering a culture of wellness and well-being within Athletics and across campus,” said McDermott. “The Mercer study has provided us with an aspirational and forward-thinking path while affirming the excellent and strong foundation already established from which to build.” Erin McDermott named athletic director New study to look at organization, programs, and student experience to lay groundwork for strategic planning Blocking fear When neuroscience major Sope Adeleye suffered a severe concussion, she knew better than most the risks she was facing
On October 1, 3,000 Brazilian Army and Navy personnel reinforced security in the favelas (slums) and other areas in Rio de Janeiro, ahead of local elections to be held on October 7, according to the Regional Electoral Court. About 140 million Brazilian nationals must vote in the first round of local elections on October 7, where over 5,000 mayors, deputy mayors and city councillors will be elected for the thousands of municipalities of the country. By Dialogo October 02, 2012 Since 2008, Rio de Janeiro’s authorities have been implementing a strategy to retake control of dozens of favelas that remain in the hands of drug traffickers or militias, ahead of the 2014 World Cup and 2016 Olympics games to be held specifically in Rio. “State forces are offering this support, so that we can reassure the population, and we intend for October 7 to be a great celebration of Brazilian democracy,” said Luiz Zveiter, head of the court, to Brazilian news agency Brasil.
Mark D. Killian Managing Editor Bar leaders and educators from across the state will gather at St. Thomas University this month to discuss diversity and develop plans to increase the numbers of minorities in the profession, education, and on the bench.“It is my desire not only to discuss the issues, but to reach some concrete conclusions as to how diversity in our profession can be achieved,” said Bar President Miles McGrane. “I believe it should be our goal that Florida law school enrollment, the Bar, and judiciary truly reflect the diversity of our society within the next 10 years.”The Florida Bar’s Symposium on Diversity in the Legal Profession will be held April 16-17 at the St. Thomas School of Law in Miami Gardens.Miami attorney Maryanne Lukacs, who is chairing the event, said the symposium attendees will discuss the historical foundations and definitions of “minority,” including race, ethnicity, gender, disabilities, and sexual orientation and how to achieve greater diversity in legal education, as well as how to strengthen minority participation in undergraduate programs that lead to law school applications.Lukacs said the participants will address such topics as minority lawyer employment issues, judicial clerkships, mentoring programs, and minority participation in Bar sections, committees, and staff. They also will talk about minority participation on judicial nominating commissions.“The whole purpose is to make sure the makeup of our judiciary and profession matches the makeup of society,” Lukacs said, adding that the key is getting more minorities into law school. “It all stems from education.. . it is not to lower the standards; it is just to increase the numbers.”Henry Latimer, a Board of Governors member who is on the symposium planning committee, said the profession, traditionally, does not have a track record where diversity has been a focal point of concern.“However, in recent years, society and our profession have become more sensitized to diversity issues because both have become more diverse and projections indicate that the trend will continue,” Latimer said. “Against this background, it is absolutely essential that the Bar takes the lead in exploring all aspects of diversity within our profession to gain credibility with all Floridians in believing in one of the Bar’s missions.”That is, Latimer said, to increase and maintain citizens’ confidence in the fairness of the justice system “irrespective of their race, gender, national origin, religion, ethnicity, or sexual preference.”“It is about promoting inclusion and not exclusion, which has been the widely held perception by many of our nonmajority citizens over the years,” Latimer said. “Exclusion has to be buried. The symposium is the beginning of an overdue journey which will definitely lead to immeasurable positive results.”While the most recent federal census finds 65.4 percent of the state’s population is Caucasian that is not of Hispanic or Latino origin, and 16.8 percent are Hispanic or Latino, and 14.6 percent are African American, Bar surveys show that 89 percent of the Bar is now Caucasian, 8 percent is Hispanic, and 2 percent are African American. Overall, 51.2 percent of the state population is made up of women.Yet, McGrane noted, of the state’s 872 judges, 86.5 percent are white; 6.5 percent are black; 6.1 percent are Hispanic; and women make up 24.4 percent of the judges.“Unless we have diversity at the Bar, we will never have diversity on the bench,” McGrane said. “Furthermore, if we do not have diversity among those passing the bar exam, we will not have diversity in the Bar, and we will not have diversity among those passing the bar until will have diversity in the law schools.”Lukacs said she is hoping to receive a lot of participation from the community, lawyers, judges, law students, and some of the undergraduate colleges — be it students or administrators— “so that they can be part of the conversation and offer some assistance to the panel members on what they have found and how we can all work together to come up with greater diversity.”Those scheduled to speak include McGrane, St. Thomas Law Dean Bob Butterworth, Dean Leonard Strickman of the Florida International University School of Law, Dean Percy Luney, Jr., of Florida A&M College of Law; Lee Milford, Katherine Silverglate, Judge Fred Seraphin, Judge Belvin Perry, Jr., Ramon Abadin, and Equal Opportunities Law Section Chair Tammy Fields. For more information contact Yvonne Sherron at [email protected] or (850) 561-5620. Bar’s diversity set for St. Thomas in April April 1, 2004 Managing Editor Regular News Bar’s diversity symposium set for St. Thomas in April
ShareShareSharePrintMailGooglePinterestDiggRedditStumbleuponDeliciousBufferTumblr The number of Louisiana credit union employees affected by statewide flooding has reached roughly 300, and the generosity of the credit union movement is matching the pace of the need.Now being called the worst natural disaster since Hurricane Sandy four years ago, eight days of storms inundated Louisiana with 7 trillion gallons of water.The National Credit Union Foundation reported that donations to CUAid.coop nearly doubled–to more than $106,000–over the course of last week.“It’s remarkable that the credit union community heard the renewed call for help, and we’ve now doubled the amount of funds to support those credit union people in need,” said Christopher Morris, Foundation communications director.Among the donations to CUAid was $10,000 from Credit Unions Care Foundation of Virginia, and $10,000 from Los Angeles FCU.Other credit unions stepped up to take part in “Louisiana CU Strong Challenge” from the Louisiana Credit Union League. In addition to encouraging donations, the campaign challenged participants to do 20 pushups or jumping jacks representing the number of affected branches. continue reading »
Daily Mail (UK) 28 Nov 2011Violent video games can alter the brain in just one week and make players more aggressive, according to researchers. A study has found that key areas in the brain suffer reduced activity, and leave it physically altered. The findings will fuel the debate over the impact that violent games have on regular players and links to anti-social behaviour. Scientists at the Indiana University School of Medicine in Indianapolis took a group of 22 men aged 18-29 and performed MRI scans on them. They then divided the group in half, and while one group was asked to play violent video games for at least 10 hours a week while the second group played none.According to the Sunday Times, the researchers found that the effects on the brain were discovered in the left inferior frontal lobe and the anterior cingulate cortex. An abstract of the report which will be published at the annual meeting of the Radiological Society of North America later this week said subjects experienced alterations to their brain.http://www.dailymail.co.uk/sciencetech/article-2066803/Violent-video-games-DO-make-people-aggressive.html#ixzz1f7Oy7V99
New York Post 17 February 2019Family First Comment: So true…“‘Harm reduction’ in a contemporary context, also means ‘a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.’”Think Drug Foundation, Green Party….Drugs are destroying San Francisco’s most densely populated and desirable neighborhoods, as more and more addicts, many of them homeless, fill the streets. Politicians and activists are pushing “harm reduction,” which, in a clinical sense, means a “set of practical strategies and ideas aimed at reducing negative consequences associated with drug use,” such as overdose or the transmission of disease. But in a contemporary context, it also means “a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.”Harm reduction, originally a controversial public-health measure, has become a religion among advocates, even as fears that the practice would normalize drug use have been borne out. Organizations like the San Francisco Drug Users Union demand “a safe environment where people can use & enjoy drugs” and a “positive image of drug users to engender respect within our community and from outside our community.” True believers dominate City Hall as well as a network of affiliated, politicized nonprofits that operate in the city with little oversight or accountability. In this environment, questioning harm reduction or its effects borders on heresy. But are the programs actually helping impoverished addicts? And what is the impact on the community?The Department of Public Health distributes 4.45 million needles each year to the city’s 22,000 intravenous drug users. Heroin and prescription opioids are the most injected substances, though use of methamphetamines and Fentanyl is on the rise. It’s true that sterile needles reduce the transmission of blood-borne infections, and injecting narcotics under supervision can lower the risk of overdose and death. But harm reduction goes far beyond promoting these kinds of needle-safety measures. For example, At the Crossroads, a nonprofit, assembled “safe snorting kits” for at-risk and homeless youth. Baggies were filled with straws, chopping mats, plastic razor blades, and instruction sheets. Other groups offer crack-cocaine “safe-smoking” kits. A proposal to open “safe injection” sites, opposed by Jerry Brown, is favored by Governor Gavin Newsom, and is likely to succeed.Harm-reduction efforts are sometimes sold as ways to connect with addicts, offer them other services, and help them get off drugs. But those laudable goals are not really what motivate advocates, who want mostly to remove the stigma surrounding drug use. Addicts may eventually pursue treatment or stop using on their own, but a central principle of harm-reduction theory is accepting and respecting drug use. As a result, an astonishing number of addicts on San Francisco streets hover on the edge of death, despite a continuous supply of clean needles.Erica Sandberg is a widely published consumer-finance reporter based in San Francisco. This essay was adapted from City Journal.READ MORE: https://nypost.com/2019/02/17/harm-reduction-drug-policies-are-destroying-san-francisco/Keep up with family issues in NZ. Receive our weekly emails direct to your Inbox.
“Even health experts I have spoken with agree that the ECQ should be extended to sustain the gains it has brought in the government’s drive against the pandemic,” Galvez said. As of Monday afternoon, the Department of Health has reported 168 new cases of Covid-19 infection, bringing the country’s total to 3,414 and eight new deaths bringing the total to 152./PN “He is evaluating the best option to take that will effectively ensure the success of our war against this wily and faceless global enemy. He will make his decision in due time,” he added. Panelo’s statement came after Peace Adviser and National Task Force (NTF) Covid-19 chief implementer Secretary Carlito Galvez Jr. said the government is currently studying whether to extend the quarantine for another 15 to 20 days. “Ang nakikita ko magdedecide ang Presidente between April 12 and April 14. Ihahanda pa rin natin ang mga pangangailangan ng ating mga mamamayan,” Galvez said in an interview with DZMM on Monday. “Lifting the quarantine as scheduled on April 12 might wipe out the gains we have so far achieved in containing the virus,” Panelo said. “The President is all ears and eyes on this unfolding reality and expert opinions.” Galvez, also the Presidential Adviser on the Peace Process, said he supports the extension of the ECQ since the curve on cases of the coronavirus disease has not been flattened yet. He noted that deaths continue to increase while the number of recoveries is still low. “In the meantime, we call on our countrymen to be steadfast in our commitment to take care of each other in this imminent threat to our nation’s survival,” the Palace spokesperson said. Panelo has also urged the Filipinos to do their part in helping reduce the transmission of the highly-infectious disease. MANILA – President Rodrigo Duterte will decide on whether to extend or lift the the enhanced community quarantine in Luzon “in due time” with the current situation still far from normal. Presidential spokesperson Salvador Panelo said the “emerging consensus” from medical experts, businessmen, government officials, and others is that it is still premature to lift the declaration. President Rodrigo Duterte addressed the nation about the COVID-19 crisis in the country on Monday night. PCOO