Atul Gawande, dreams and action

One of my favourite gifts is a book. Last year Nic told me about a powerful book that she was reading, and generously sent me a copy. I know to say that ‘the book changed by life’ is a tired cliché, but it had the impact of focusing my work in a way no other book has.

The book was Atul Gawande’s ‘Being Mortal’. By the end of the year I had bought and given away a further seven copies.

One of these copies was for Gill Bailey.

In November we were driving together to Telford, where we were both speaking at Dementia Congress. We talked about ‘Being Mortal’ and our dream of having our own care home to demonstrate what could be possible. As we could never really afford our own care home I wondered who could help. In the car, I emailed Neil Matthewman, Chief Executive at Community Integrated Care. I had met him once, and Community Integrated Care are one of our customers.

Here is the email.

Dear Neil,

I know it is bold to write directly to you, but I am working on being brave, and asking and seeing what is possible.

Please can I share a dream that I have?

Gill Bailey (our lead for dementia) and I have a dream for demonstrating what the innovative greenhouse model (developed by Dr Bill Thomas) could look like and take it further by fully embedding person-centred practices and community involvement. Our dream is to have one place (one home) to fully demonstrate what is possible – best international practice, that could establish the model of the future of care homes. We are looking for a partner to do this with.

Have you read Atul Gwande’s book ‘Being Mortal’? That is our inspiration – to show how this can be delivered in practice in the North West. Please could I send you a copy of the book if you have not read it?

If any of this is at all interesting, please let me know.

Best wishes


His reply was positive. At Christmas, I sent him, and four of his leadership team, copies of the book with a bookmark at Chapter 5 that talks a different way of thinking about care homes. Juggling diaries was tricky and we met on the first day back at work in January. I had prepared a poster about what older people want (taken from the Demos report) and what we had tried and learned already to move towards this, from our work at Bruce Lodge and Flintshire.FullSizeRender[5]

There was a remarkable synchronicity, with where Community Integrated Care were too. They had been working at extending their award-winning Each Step approach to Blackburn, and the building was well underway, and due to open in May. We explored how we could build on Each Step to fully embed not only person-centred practices with people who live there, but include person-centred teamwork. How we could build on the community connections they had already invested in, to bring this to an individual level with Community Circles. How we could go beyond excellent care to also focus on choice and control through using the principles of Individual Service Funds.

We are making a joint investment in this. We are sharing the costs of Gill Bailey working two days a week to support the manager and coach staff, and we are paying for one of the two year investment of a Community Circles Connector. It is part of our dream, part of seeing how close we can get to deliver the change manifesto of ‘Being Mortal’. Like all ambitious plans we will try, and fail and learn, and try again, and keep getting better. I will share what we are trying and learning here.

So I want to start by sharing what we are aiming at – here is a quick summary of what we plan.

I am also working on a version of Progress for Providers for Each Step, so that you can see what we are aspiring too in more detail.

The Community Circles Connector starts at the beginning of April, and will be finding and training facilitators, to get ready to match people as they join Each Step. Cath tweeted last week that she already has the first Community Circles facilitator. It is starting, I will keep you (and Atul Gawande) updated here.

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