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DR PHIL HAMMOND NEW TOUR DATES 2018

Happy Birthday NHS?

 

Celebrate 70 years of the NHS and rebuild it to your liking…. Choose Management Consultants or Common Sense, Hope or Fear, Cheap Prevention or Ridiculously Expensive Ineffective Treatment… A nutritious diet for all or gastric banding… Nye Bevan or Jeremy Hunt… Just £2,200 a head per year for absolutely everything or what they pay in Germany. It’s your NHS, apparently, so it’s time you sorted it out.

date Venue Box Office
14/09/18 Wiltshire Music Centre 01225 860100
15/09/18  The Curzon, Clevedon 01275 871000
19/09/18 Artrix, Bromsgrove 01527 577330
23/09/18 Newcastle Stand 0191 300 9700
24/09/18 Glasgow Stand 0141 212 3389
25/09/18 Edinburgh Stand 0131 558 7272
04/10/18 Norden Farm, Maidenhead 01628 788997
10/10/18 The MAC Belfast 028 9023 5053
17/10/18 Lincoln Drill Hall 01522 873894
25/10/18 Lyric Theatre, Carmarthaen 0845 2263510
26/10/18 Huntingdon Hall, Worcester 01905 611427
29/10/18 Lakeside Arts, Nottingham 0115 846 7777
30/10/18 Lakeside Arts, Nottingham 0115 846 7777
06/11/18 The Exchange, Twickenham 020 8240 2399
13/11/18 Theatre Royal, Bury St Edmunds 01284 769505
17/11/18 Borough Theatre, Abergaveny 01873 850805
18/11/18 Redgrave Theatre, Bristol 0117 3157800
21/11/18 Theatr Mwldan 01239 621200
22/11/18 Wyeside Arts Centre, Builth Wells  01982 552 555
07/12/18 Winchester Theatre Royal 01962 840440

“If Dr Phil were a medicine, you should swig him by the litre” The Times ****

“One of the most entertainingly subversive people on the planet.” The Guardian

“Hugely enjoyable, well crafted, poignant stand up” Broadway Baby 2016 ****

“Hammond is a passionate rabble rouser and impressively positive…. the perfect health secretary” Fest Magazine 2016 ****

“Very funny, honest, clever and moving. Passionate about the NHS” Dr Clive Peedell, founder National Health Action Party

Dr Phil Hammond Happy Birthday NHS Press Release

Here’s my previous show, ‘Life and Death…. but Mainly Death’

It’s my most personal show, with a few harsh truths, home truths and lies for laughs. But there are lots of positive health messages too. Feel free to share

For all other enquiries, please contact Shelley Devlin at the Richards Stone Partnership shelley@vivienneclore.com, 0207 497 0849

GET THE CLANGERS HABIT AND SAVE THE NHS

The daily habits of healthy, happy people are easy to say but harder to do. Try to do your daily CLANGERS, and help others to do theirs. Changes in lifestyle are far more powerful than any drug we have to offer.

My review in The Times of Dr Rachel Clarke’s riveting medico-political memoir ‘Your Life in My Hands’, which details the pressures felt by NHS junior doctors working in an unsafe system, and the desperation that lead them to strike.  Uncomfortable reading for Jeremy Hunt and the BMA

SUPPORTING JUNIOR DOCTORS

A SEVEN DAY NHS NEEDS MORE STAFF AND FUNDING TO BE SAFE AND HUMANE

Here’s my BBC NEWS interview about junior doctors. You can’t have a ‘truly 7 day NHS’ without truly 7 day funding and 7 day safe staffing levels. For junior doctors alone it would require another 4,000 to have the same high quality, safe care 7 days a week – you can’t just stretch 5 days’ staffing over 7. the same applies to all other groups of NHS staff. The 7 day NHS is an aspiration that will take time, training, inspiration and involvement to achieve.  It can’t be brutally imposed to a political deadline with no funding or staffing.

WHISTLEBLOWING IN THE NHS

Has anything really changed since 2011? Has any NHS whistle-blower been compensated or reinstated? Is it any safer to blow the whistle in the NHS?

‘Shoot the Messenger’ – a Private Eye special investigation by Phil Hammond and Andrew Bousfield into how NHS whistle-blowers are silenced and sacked was shortlisted for the Martha Gellhorn prize for journalism 2011. Available to download here

TO BOOK A SHOW FOR ANOTHER VENUE, AND FOR ALL OTHER INQUIRIES, PLEASE CONTACT SHELLEY DEVLIN OR VIVIENNE CLORE AT shelley@vivienneclore.com, vivienne@vivienneclore.com, 0207 497 0849

 

Phil bbc

Dr Phil Hammond

NEW BOOK

Staying Alive – How to get the best from the NHS – is full of inspirational stories from patients and carers and glued together with my own reflections of working in, thinking about and investigating the NHS over 30 years. You can read the reviews or add your own tips and tactics here

‘This is a fantastic book about how to live well. Phil Hammond’s goes beyond the usual tips about diet and exercise – we hear about the power of positive thinking, as well as how to get the best out of the health service. And this book is packed with real stories – from people who have become survival experts through their own experiences. Their stories are heartwarming, enlightening and useful.

Phil Hammond has a knack of being brutally honest and very funny at the same time. This is quite simply the most useful book about health and the health service that I’ve ever read.’

Professor Alice Roberts BSc MB BCh PhD Hon.FBAASc
Anatomist, author & broadcaster
Professor of Public Engagement in Science, University of Birmingham
www.alice-roberts.co.uk

NEW BOOK and EBOOK – WHAT DOCTORS REALLY THINK

AVAILABLE HERE

“This is a real find; funny, poignant, thoughtful, worrying, reassuring, and so good it should be on prescription.”
–Roy Lilley @RoyLilley

“Smart and funny, Phil Hammond is the perfect way to inoculate yourself against the nonsense which passes for most health commentary.”
–Alastair McLellan – Editor, Health Service Journal @HSJEditor

“A fascinating insider’s history of the past sixteen years of the NHS. This wise, witty and often moving diary reveals what really went on behind the political and managerial bluster. So well written it turned me into a compulsive page turner.”
–Dr Michael O’Donnell, author of The Barefaced Doctor, a Mischievous Medical Companion

With cartoons by Fran Orford

untitled23

PREVIOUS TOURS

‘GAMES TO PLAY WITH YOUR DOCTOR’  CLIP

 

Phil Hammond is an NHS doctor, campaigner, health writer, investigative journalist, broadcaster, speaker and comedian. He has done all these jobs imperfectly and part-time since 1987, and was also a lecturer in medical communication at the Universities of Birmingham and Bristol. As a doctor, Phil worked part time in general practice for over 20 years, and has also worked in sexual health. He currently works in a specialist NHS team for young people with chronic fatigue syndrome/ME.

Phil presented five series of Trust Me, I’m a Doctor on BBC2, and has been a presenter for BBC Radio Bristol since 2007. He is Private Eye’s medical correspondent, broke the story of the Bristol heart scandal in 1992 and gave evidence to the subsequent Public Inquiry. In 2012, he was shortlisted with Andrew Bousfield for the Martha Gellhorn Prize for Investigative Journalism for ‘Shoot the Messenger,’ a Private Eye investigation into the shocking treatment of NHS whistle-blowers. In 2014 and 2015, he was voted a Top 100 NHS Clinical Leader by the Health Service Journal. He has fiercely supported NHS junior doctors in their battle with the government against an imposed, untested and potentially unsafe new job contract.

As a comedian, Phil was half of the award winning double-act Struck Off and Die, with Tony Gardner. He has done three solo UK tours and is returning to the Edinburgh Fringe in 2016 with two shows – Life and Death (But Mainly Death) and Dr Phil’s NHS Revolution. Phil has appeared many times on Have I Got News for You and Countdown. His NHS comedy, Polyoaks, is written with David Spicer and has had three series on BBC Radio 4. He is a columnist for Telegraph Men and Reveal, and writes comment pieces for the Times. Phil is a Vice President of the Patients’ Association and a patron of Meningitis UK, the Doctors’ Support Network, the Herpes Viruses Association, Patients First, PoTS, the NET Patient Foundation and Kissing It Better. He is also a fundraiser and advisor for the Association of Young People with ME.

Phil has never belonged to any political party but was highly critical of the Health and Social Care Bill (now Act) in a BBC1 Question Time debate with then health secretary Andrew Lansley. He said the reforms were ‘wonk’, there was no convincing narrative explaining the reasons for the changes and that the focus on competition rather than the collaboration and co-operation needed for an integrated service.

question time

Phil has written  five books – Medicine Balls, Trust Me, I’m (Still) a Doctor and Sex, Sleep or Scrabble? ‘What do Doctors Really Think?’ and ‘Staying Alive – How to Get the Best from the NHS’.

Phil was revalidated by the GMC in September 2013. Below is the feedback from his colleagues and patients for my revalidation 360_feedback_Dr_Philip_Hammond[1]

Real time reviews of my consultations from patients and parents can be found here

My NHS work is as part of a specialist NHS team in Bath, treating young people with Chronic Fatigue Syndrome/ME, based at the Royal National Hospital for Rheumatic Diseases in Bath. Details of the service we offer are here Good advice on accessing specialist CFS/ME services and treatments available can be found via the AyME website (for people up the age of 25)  and the Action for ME website (for those over 25)

 I can’t give any personal medical advice via this site, and I don’t do any private practice.

 

Praise for Dr Phil’s comedy

                                  “One of the most entertainingly subversive people on the planet.” The Guardian

 “Tough on doctors, patients and politicians. And he’s funny.” The Telegraph

 

“Sceptical, irreverent, very funny and like a mighty gush of fresh air in a field that’s bedevilled with cover ups and cloaked in a vow of silence” Time Out

 

“Generates dozens of laughs and more ire than any amount of tentative taboo-breaching” The Financial Times

                                    ‘If Dr Phil were a medicine, you should swig him by the litre’ **** The Times

‘Consistently funny’ *****  The Sunday Telegraph

“You’ll never see a doctor in quite the same way again.” ***** The Scotsman

  Galaxy 749Born in the NHS

To read Phil’s Private Eye columns, written under the pseudonym MD, click on… er… Private Eye.

Dr Phil 2IMG

These action shots were taken in 1988, by photographer Homer Sykes, when glasses were riduclously big and babies were ridiculously slippery.

Dr Phil and Dr Tony, then and now

SOAD 8

 

Galaxy 375

Struck Off and Die’s first ever performance, Bristol, 1990

 

Dr Tony’s Braineater, Berkley Brasserie Bristol 1990

 

Dr Phil’s First Stand-Up, Berkley Brasserie, Bristol 1990



Healthy Living Advice for the Whole Family.

Our health is our freedom to live a life that we have reason to value, and our ability to bounce back when our circumstances change and life kicks us in the teeth. Both of these elements of health are more likely to happen if we try to adopt daily habits that are fun, good for us and rewarding. One way to remember them is the acronym CLANGERS, which depicts 8 daily vitamins (and joys) of health.

Try to do your CLANGERS every day, as part of a regular routine 

  • Connect
  • Learn
  • (be) Active
  • Notice
  • Give back
  • Eat well
  • Relax
  • Sleep

In 2008, research by the New Economics Foundation and funded by the government, came up with five evidence-based steps we can all take to improve our mental wellbeing. Connect, Learn, be Active, Notice and Give back (CLANG). I built on this to come up with a plan for ‘whole-body wellbeing’ by adding Eat well, Relax and Sleep. These are the fundamentals of feeling good and, if you can do them at regular times to fit in with your body’s natural 24 hour rhythm (particularly eating, exercising and sleeping), it should improve how you feel and your energy levels.

CONNECT with the world around you. Human beings are social animals. We are leaves on a tree, needing to feel part of something bigger. Reach out to people, pets, plants, places and the planet.These connections are the cornerstones of our life. Take time and care to nurture them. Disconnection and loneliness may be as bad for us as smoking. And don’t forget to connect with yourself. Loving yourself may not always be easy, but are you happy in your skin? Do you enjoy your own company? Can you disappear inside your own head and not mind what you find there? People who like their own company like being on their own sometimes. You have space to think, reflect, explore and relax.

LEARN What do you want to do with your one wild and precious life? A purpose in life often stems from learning about what matters most to you, developing a passion for learning and keeping your curiosity alive. And there is good evidence that the more you learn, the better your health becomes. Try something new. Rediscover an old interest. Sign up for that course. Join a choir. Take on a different responsibility at work. Fix a bike. Learn to play an instrument or how to cook your favourite food. Develop new passions. Set a challenge you will enjoy achieving. Learning new things will make you more confident as well as being fun. And learning with others in your ‘circle’ often cements the skills and gives you confidence to use your new knowledge.

Be ACTIVE, in mind and body. Rediscover activities and passions you left behind, and have the courage to try new ones. Aim for five portions of fun a day, each different, at least one outdoors and one that involved getting pleasantly breathless. Being outdoors in the morning light wakes you up and helps you sleep well later. Gardening, dancing or singing in a choir are all excellent therapy. Physical activity is better for both mind and body than any drug, but keeps you awake if you do it too close to bed time. Choose activities that you enjoy, so you want to keep doing them. Park runs, dancing, singing, cycling and gardening are great examples. And let’s not forget the power of pets. They are usually happy to see you and . give you unconditional love when you are feeling at your lowest and least energized.

NOTICE, and be present in, the world around you. Try to be as still as you can be for fifteen minutes every day, preferably outside. Fill up your senses. Catch sight of the beautiful. Remark on the unusual. Enjoy the everyday. Savour the moment, and your place in it. Life is a balance and being and doing, and the older and wiser we get, we realise that most of the pleasure in life comes from just being. Notice how lovely your partner or children are without judging or diagnosing them. Simply slowing down and focusing on your breathing for ten minutes a day can pay huge dividends. Breathe in for 3, hold for 4 and out for 5. Feel those fabulous human air bags filling up to their fullest extent. Then slowly, slowly let it all out.

GIVE BACK. Helping and caring for friends, strangers and those less fortunate than ourselves is fundamental to good emotional health. It cements us as part of a community and develops more meaningful connections and insights. A friend of mine overheard a dad telling a waiter in the Glasgow hotel that is son was having chemotherapy in the nearby hospital, and that he was going to shave his head in solidarity so they would both be bald when they came down to breakfast in the morning. He wanted to warn the waiters so they didn’t feel uncomfortable. The head waiter said he would pass the message on. When the newly bald father walked into the restaurant with his son the following morning, they looked around and saw that every single waiter had shaved his head. The joy of being human is to be humane.

EAT WELL. Food is above all a pleasure. Learn what’s good and enjoyable to eat, and in what quantities. Learn how to grow it, where to buy it and how to prepare it. Set time aside to sit and eat with friends and family. Your gut is like a garden. It contains trillions of healthy bacteria that are as fundamental to your health as your DNA. Many people with chronic diseases have a fairly narrow range of bacteria in the gut. Healthier people seem to have a wider range of bacteria fed from a wide variety of different foods. Eat plenty of plants – vegetables and fruits of many different types and colours, nuts, seeds, whole grains and olive oil. Add in a little bit of what you fancy.  Sustainable fish, lean meat, dark chocolate and  the odd beer or glass of wine (note: alcohol can improve your chat but seriously disrupt your sleep). You can have the odd Pringle but you wouldn’t plant too many in your garden.  Cutting down on sugary snacks and drinks, processed food is a good starting point. Learn to love water as your ‘go to’ drink. And try to do all your eating in a 12 hour period (say 7am-7pm) to fit in with your body clock, give your gut a break and improve your sleep. It also keeps you at a healthy weight

RELAX. Take time to rest and reflect on the day you’ve had, reliving and re-savouring the happy memories and having gratitude for friends and family. Learn to meditate. Be kind to your mind and let it wind down and de-clutter. My Uncle Ron used to have a sitting room that was just for sitting. At the end of the day, he would really happy little things that have happened during the day, and be grateful for the love he had in his life. I used to think he was crazy, but I now know he was practising positive psychology. Our brains are neuro plastic, which means what we focus on is what grows. So if we learn to relive happy moments and have gratitude for the good things, it can actually make us happier. And this happy end of day wind down can really improve your sleep.

SLEEP Good sleep is one of life’s great joys. It’s also essential for mental and physical health, helping you prevent and recover from a whole range of illnesses and improving your energy levels, creativity and performance. The flip side is that sleep deprivation prevents you from recovering from many illnesses, and it’s the first and most important thing to concentrate on. Adults work best on a regular 8 hours sleep a night, adolescents need nine hours if possible and children need more. Half the population in the UK have poor quality sleep and feel more tired, more stressed, less energized and more anxious as a result. If you’d like to find out more about the importance of a normal sleep pattern,  I would recommend Why We Sleep by Matthew Walker or the The Four Pillar Plan by Dr Ranjan Chatterjee. Dr Chatterjee also hosts some excellent podcasts on health.

 

‘CLANGERS’ WHEN YOU’RE KNACKERED 

 The CLANGERS you can do when you’re ill will be very different from the CLANGERS you do when you’re well, but they are equally important

Severe fatigue often happens to previously very active people. As one of my patients put it; ‘It’s like I used to have Duracell batteries but now I have Poundland batteries.’ If you overdo your activity, you can boom, bust, crash and take days to recover, which is why you have to use your energy wisely, and switch to rewarding activities that are less exhausting.

One young man played football for Bristol City but got severe fatigue after glandular fever and had to stop, which was a crushing disappointment. His Dad encouraged him to take up the guitar – a much less energy-draining hobby – and he gradually taught himself to play, finding the strumming very therapeutic. He has now fully recovered, formed a band, played a gig at the Fleece and Firkin in Bristol and made an EP. He sent me a lovely letter saying how much he loved his music and if he’d never have had severe fatigue, he’d never have picked up the guitar in the first place. Sometimes doors close in life, but another door opens.

Severe fatigue can be caused by many things, such as sleep deprivation, stress, anxiety, low mood or just about any illness, including Chronic Fatigue Syndrome/ME, which is a physical illness that may be triggered by an infection, or repeated infections, or other stressful events. Sometimes there is no apparent trigger, and there may just be a strong genetic predisposition to fatigue. A nutritious diet is essential for all of us but with severe fatigue you may find little and often is easier than eating big meals. Try to do your eating in a 12 hour window, and not late at night. It’s also important to try to optimise your sleep. As a teenager, this means trying to get 8-9 hours good quality sleep at the same time every night, including weekends, and trying to avoid oversleeping (you get no extra benefit unless you are sleep deprived) and afternoon catnaps (which, beyond half an hour, can interfere with the quality of your later sleep). Adults  of all ages function best after 8 hours sleep

Teenagers have it tough because their body clock shifts to make their natural going to be time later (11 PM onwards) but school demands that they get up early (often 6.30 am or before). So many are sleep deprived and stressed-out for no fault of their own. Severe fatigue on top of early school wakening is a double whammy.  It is far more important for your health and recovery to fiercely protect the 8-9 hours sleep and aim to get to school at morning break at the earliest, until you have fully recovered

A high quality sleep routine that fits in with your natural body clock is absolutely vital to recovery. Below are 25 tips for better sleep, not all of which may work for you, but they may start your journey to recovery. A normal sleep pattern can improve memory, energy, pain and many other unpleasant symptoms.

 

25 TIPS TO TRY TO IMPROVE YOUR SLEEP

  1. Try to go to bed at the same time and – most importantly – wake up at the same time each day, including weekends, even if you have had a bad night. This may not always be possible. Aim for 9 hours sleep every night. This isn’t easy, so decide which timing works best for you and your daily functioning. You will probably need to ensure 9.5 hours in bed to give you adequate nodding off time. Keep a sleep diary if this helps.
  2. If this routine goes wrong, don’t beat yourself up. If you don’t get good, refreshing sleep you will build up a sleep debt that has to be paid off on days off. And if your red (high) energy allowance is set too high, you will sleep longer or more deeply to try to recover
  3. If you are asleep all day and awake at night, treat this like jetlag and cut back your going to bed time and your waking up time by 1 hour each day. Day One: 6 am sleep 3 pm wake Day Two: 5 am sleep, 2 pm wake Day Three:4am sleep – 1 pm wake etc until you wake at the desired time.
  4. Have the right sunlight exposure. Daylight is key to regulating daily sleep patterns. Try to get outside in natural sunlight for at least thirty minutes each day. If you aren’t sensitive to light wake up with the sun or use bright lights in the morning. If you have problems falling asleep, you should get an hour of exposure to morning sunlight and turn down the lights before bedtime.
  5. Enforce a strict ‘no caffeine after noon’ rule. Coffee, colas, certain teas, and chocolate contain the stimulant caffeine, and its effects can take as long as twelve hours to wear off fully. Nicotine in cigarettes and e-cigarettes, and alcohol also severely disrupts your sleep, as can some medications. Check with your pharmacist.
  6. Come off close-up screens and games 60-90 minutes before bed. The blue light and excitement they give off boosts cortisol and blocks melatonin release.
  7. Set an alarm to tell you when it’s time for bed, and stick to it. Alarm clocks in the morning freak out your heart and are best avoided if possible.
  8. Fit blackout blinds in your bedroom. The darker your room for sleep, the better. A black-out mask is a cheaper option
  9. Remove ALL screens from your bedroom, so temptation is avoided.
  10. Consider opening the bedroom window. The perfect temperature for sleeping is around 17ºC/ 65ºF. A cooler room is much better for sleeping than a hot one
  11. Eat earlier in the day, before 7 pm if possible. Don’t snack at night.
  12. Exercise earlier in the day, and outdoors when you can. Exercising 2 hours before sleep time raises your metabolic rate and temperature, and makes it hard to sleep
  13. Socializing is important but don’t do it late at night except on special occasions.
  14. Consider red lights for night-time illumination
  15. Consider amber glasses to filter blue light from screens
  16. Don’t use your phone as an alarm clock
  17. Install f:lux on your e-devices, or switch on ‘night-time mode’ from 6pm
  18. Don’t take catnaps after 3 pm and keep them short, ideally less than 30 minutes. And keep the curtains open. You are not trying to fall into deep sleep as this disrupts the next night’s sleep, but trying to have a quick refresh.
  19. Relax before bed. Don’t overschedule your evening so that no time is left for unwinding. A relaxing activity, such as reading, listening to music, chatting through the day with friends or family or stroking a pet should be part of your bedtime ritual.
  20. Take a hot bath before bed. The drop in body temperature after getting out of the bath may help you feel sleepy, and the bath can help you relax and slow down so you’re more ready to sleep.
  21. If you can’t sleep, counting sheep isn’t as effective as repeating the same word over and over (the, the, the, the…) or filling your mind with peaceful music
  22. Don’t lie in bed awake. If you find yourself still awake after staying in bed for more than twenty minutes or if you are starting to feel anxious or worried, get up and do some relaxing activity until you feel sleepy. The anxiety of not being able to sleep can make it harder to fall asleep.
  23. Keep trying to improve your sleep, little by little. It’s about quality as much as quantity
  24. We all have bad runs of sleep, particularly in stressful times, but if we allow ourselves to get back in synch with our body clock, we may rediscover the joy of a good night’s sleep
  25. Some drugs may appear to help you sleep but your sleep quality will be better if you can manage without them, so try these tips first, keep a sleep diary and ask your doctor or nurse to review your progress.


Here’s my favourite and most personal show, recorded at the Komedia in Bath in 2017. It was first performed as ‘Life and Death… but Mainly Death’ at the Edinburgh Fringe in 2016. There are some home truths, some half truths and some lies for laughs – but I’m most proud of the positive health messages. Think of it as a Fit and Proper Person Test…



‘Why treat people and send them back to the conditions that make them sick?’
Michael Marmot

Universal healthcare in a society that is poor at prevention and in denial about death is like attempting to rescue a never ending stream of people from a river of illness. As science advances, we dive deeper and deeper into the river to pull out people who are sicker and sicker. The right to healthcare for all means that all too often, we treat the untreatable. Just because we can do something doesn’t mean it’s kind or wise to do so. A high-tech death can be very unkind. We spend so much time, effort and money pulling bodies to the riverbank, that we have no energy left to wander upstream and stop them falling in.

We live in a very unequal society, with huge disparities in both life expectancy and years lived in good health. Unless we can improve living and working conditions as well as lifestyle, with a strong emphasis on helping people to build resilience and stay mentally healthy, then no system of universal healthcare can cope, no matter how it is designed or funded. Those of us who are lucky enough to be healthy at present have a responsibility to try to remain so for as long as we can. The best hope for the NHS lies outside its structures. We must reduce poverty, promote healthy minds as well as bodies, lessen the burden of avoidable illness and permit choice in dying. There’s more than enough unavoidable illness to keep the NHS in business.

This burden of avoidable illness could be further reduced by being honest about medical harm and the limits of medicine, and restricting over-medicalisation. Too many serious errors have been covered up and repeated in healthcare systems primed to protect professional, institutional, corporate and political reputations. Too many tests and treatments of marginal benefit turn healthy people into anxious patients. Enough people fall into the river of illness without being sucked in by the health industry.

There simply isn’t a sound evidence base for the mass medication of the elderly, many of whom are either unable or unwilling to take so many drugs as prescribed. Waste due to ineffective treatments, non- attendance and non-adherence is significant. When patients are given the time and opportunity to fully understand and participate in decisions about their care, taking in the likely long-term risks and benefits in absolute as well as relative terms, they often choose less medicine, not more. Universal healthcare must also be prudent healthcare, using the minimal effective intervention wherever possible. Sound evidence based on real life data, as well as compassion, must inform health policy and provision.

Above all we must see healthcare in the context of all care. The boundaries between self, health and social care are entirely superficial, and we must extend our circles of collaboration and compassion as widely as possible and consider the environmental impact of what we do. Indigenous populations have a better understanding of how to live on this planet without taking so much as to threaten the health of future generations, and how to die. We only die once, and a gentle death for as many people as possible is the kindest service society can offer. As the Australian Aboriginal elder Dr Noel Nannup explains: ‘Human beings are the carers of everything.’ But to care for everything, we must first care for ourselves and build our own resilience. The NHS has had enough top down ‘re-disorganisations’. It’s time for a bidet revolution. From the bottom up.

Healthcare begins with self-care

‘Tell me, what is it you plan to do with your one wild and precious life?’
Mary Oliver

Self-care requires time to reflect and to do some ‘self- work’. What are our goals, values, passions and purpose? Can we get near them without burning out? How can we be kind to our minds? How will we cope with pressure, failure, and adversity? Is our current lifestyle making avoidable disease more likely or even inevitable? Physical health stems from mental health, and learning how to be happy, how to self-care and how to cope under pressure should be taught and revisited at every stage of our lives. And we need to build happy and resilient cities, communities and organizations that promote mental health and allow individuals to flourish.

And yet as a society, we aren’t great at talking about what matters most (mental health, sexual health, how we want to die). Self-care needs the self-knowledge that comes from these difficult conversations, and also self- love. Can you disappear inside your mind and like what you find there? Enjoying our own company is key to happiness and resilience. Accepting responsibility for self-care is also fundamental to the sustainability of universal healthcare. Every day we don’t need to use the NHS, someone who does benefits.

The CLANGERS self-care model

Universal healthcare must embrace the continuum of self-care to intensive care, and I would restructure it around the CLANGERS model. The Clangers of the children’s television series were, and probably still are, a community of mauve mice who spoke in whistles and ate sensible portions of soup, made by a dragon, and blue-string pudding, none of which was processed. They lived a simple yet serene life built around friendship, collaboration and enjoying the little things. Very seldom, if ever, did they need to go to hospital or indeed die, because they were so good at self-care and pleasuring themselves in a safe and sustainable way.

The Clangers’ habit for a satisfying and meaningful life can be learned by anyone, at any age:

Connect with the world around you. Reach out to people, pets, plants and places. We like to feel as if we belong, as part of something bigger. These connections are the cornerstones of your life. Take time and care to nurture them. And don’t forget to connect with yourself.

Learn. A purpose in life often stems from learning what matters most to you, developing a passion for learning and keeping your curiosity alive. Why do you get out of bed in the morning?

• be Active, in mind and body. Rediscover activities and passions you left behind, and have the courage to try new ones. Aim for five portions of fun a day, each different, at least one outdoors and one that involves getting pleasantly breathless.

Notice, and be present in, the world around you. Fill up your senses. Catch sight of the beautiful. Remark on the unusual. Enjoy the everyday. Savour the moment, and your place in it.

Give back. Helping and caring for friends, strangers and those less fortunate than ourselves is fundamental to good emotional health. It cements us as part of a community and develops more meaningful connections and insights. The joy of being human is to be humane.

Eat well. Learn what’s good and enjoyable to eat, and in what quantities. Learn how to grow it, where to buy it and how to prepare it. Set time aside to sit and eat with friends and family. Eating well on a budget isn’t easy. For excellent help try Cooking on a Bootstrap by Jack Munroe

Relax. Take time to rest and reflect on the day you’ve had, reliving and re-savouring the happy memories and having gratitude for friends and family. Learn to meditate. Be kind to your mind and let it wind down and de-clutter.

Sleep. Don’t cheat on your sleep. It’s vital recovery time for mind and body, and boosts your energy, creativity and productivity. You eat better and exercise more when you’re well rested. Relaxing and winding down beforehand is key. Learning to housekeep your mind and deal with stress is vital. If you doubt the power of sleep, read Why We Sleep by Mathew Walker

Some lucky people will do all eight steps intuitively, partly out of habit. Others will struggle through sickness and circumstance but with support and time, can continuously improve and slowly raise their own bar – hopefully without the stress of comparing themselves to others. If you need more detailed help with your CLANGERS, I recommend the book The 4 Pillar Plan – Eat, Sleep, Relax, Move – by Dr Rangan Chatterjee. He is one of the few lifestyle medicine gurus who isn’t trying to sell you a fad diet or his own brand of nutritional supplements, and his enthusiasm is infectious. You can also check out his podcasts here.

Your Clangers may be very different to my Clangers, the only rule is that we should try not to harm ourselves or others. The ‘clang’ in CLANGERS comes from the government-funded Foresight report, ‘Mental capital and wellbeing: making the most of ourselves in the 21st century’. It gathered the evidence on simple ways to a fulfilling life that just about anyone can do, irrespective of wealth or health. I added the ‘ers’ because they’re also fundamental to living well and slowing down the rust.

CLANGERS works not just as a model for living well, but also as a way of coping in adversity. When I interviewed patients and carers for a book about how to get the best from the NHS, it was striking how it fitted in with a successful model of patient engagement.

• Connect with the team treating you, and get to know them if you can. Know their names and something about them. It’s easier to ask questions when you know someone.

• Learn as much as you can about your illness, the treatment options, what you are entitled to, the standards of care you should be getting, what you can do to improve your odds and who to speak to if you have concerns.

• Be Active, both in the management of your illness and preventing further illness, be your own advocate when you can, have others to act for you when you can’t. The five portions of fun a day may be different to the ones you might enjoy when you’re well, but still try to have the energy for joy, warmth and purpose each day.

• Notice the good and bad in your care, and speak up if you have any questions or concerns. Notice the little acts of kindness that make illness bearable, and be thankful for them.

• Give back to the NHS and your carers by providing thanks and constructive feedback. Share vital information with other patients and carers. Get involved in research, service improvement and design and volunteering for your local NHS and charities.

• Eat well, Relax, Sleep – even more important when you’re ill.

The CLANGERS model equally applies to staff engagement and wellbeing. Health systems will always be high pressure places to work and so need to comprise of resilient organisations that support the mental health of the staff, encourage learning, are free from fear, bullying and blame and encourage everyone – patients, carers and staff alike – to speak up, feedback and continuously improve.

Ultimately, patients and carers must be handed as much control and responsibility as they want, and supported to live lives governed by their own goals and values, not the mass-produced end points of clinical trials. The best population evidence has to be combined with empathy for the individual. There is no single structure for healthcare provision that works in any context, and to continually seek the perfect structure in the NHS has proven to be hugely disruptive and disastrous for morale. Different models and structures will work in different parts of the country, but they must be built around common values and understanding of the needs of the individual. If each person can go about their daily CLANGERS, united by compassion, candour, competence and collaboration, then we can rediscover a values based service that is also effective and affordable.

Conclusion: competent, compassionate, cost-effective collaboration

In the 34 years since I first set foot on an NHS ward, I’ve lived through a dozen major structural reforms, more ideological than evidence-based, seldom embedded long enough to prove their worth before being uprooted by the next political vanity project. So I’m loathe to suggest any structural miracle pill for universal healthcare. Continuous evidence-based improvement is far more likely to work, raising the quality bar a little at a time, as resources allow. Consultations – or rather meetings between experts – must be long enough to be safe, effective, enjoyable and meaningful. Transparency and accountability must embrace innovation and learning from failure. The spirit of competent and compassionate collaboration must triumph over competition.

Patients and carers must have as much choice and control over their illnesses as they – and a fair system – can manage. Anyone must feel free to speak up and challenge, knowing their concerns will be acted on. Pure knowledge, like pure water, must be available to all who need it. Communities must promote health and meaningful work for all, and we should all be taught the skills of resilience from a young age. The healthy must accept responsibility for trying to remain so, and society must support them. Artificial divisions must melt away (self-care, healthcare and social care are all care). And all of this care must be prudent, and mindful of the cost for the planet and the payer. The minimum necessary intervention is usually the kindest and the least obstructive. We have but one wild and precious life, and we want healthcare to improve us, not imprison us. Release the joy of your inner CLANGERS.

Above all, we need Collaboration to solve the complex problems facing us. It was defined brilliantly by Margaret Heffernan in her book ‘A Bigger Prize

‘Innovative organizations thrive not because they breed superstars but because they cherish, nurture and support the vast range of talents, personalities and skills that true creativity requires. Collaboration is a habit of mind, solidified by routine and prepared on openness, generosity, rigour and patience. It requires precise and fearless communication, without status, awe or intimidation. Everyone must bring their best. And failure is part of the deal, an inevitable part of the process to be greeted with support, encouragement and faith. The safest hospitals are those where it’s easiest to acknowledge an error. The biggest prizes grow as they are shared.’

I believe politics would lead to much more progress if we adopted this constructive, collaborative scientific approach to all the great challenges of our time – Brexit, improving public health, reducing poverty, funding public services and pensions, caring for an older population, Global warming etc. I also believe we need experts rather than politicians overseeing their fields of expertise (education, pensions, health etc). The issues facing us are far too complex for politicians with little or no experience and damaging tribal loyalties to flit in and out of every few months. Time to put some grown-ups in charge.



Staying Alive: How to survive the NHS - Advice From a Doctor Book Cover

In this committed and compassionate book, Phil Hammond – a doctor, journalist, campaigner and patient – argues for a bidet revolution in the NHS – from the bottom up, with patients leading the charge. What we can do for ourselves to live well often far outweighs what modern medicine and the NHS can do for us. And when we do need to use the NHS, getting involved, speaking up and sharing our expertise can improve not just our care, but the care of others. We won’t always succeed, but we can learn from failure as we try to get the best care possible in our precious and precarious health service.


Dr Phil shares his own experiences of working in and investigating the NHS for 30 years, and combines it with the experiences and tactics of inspirational patients and carers, some of who have survived and thrived in the NHS, some who are planning a gentle death at home and some who have suffered greatly but are determined to improve the NHS so others don’t have to suffer.

  • The NHS is facing a crisis in care and a £30 billion black hole in its finances over 5 years. Politicians can’t fix it, but patients can.
  • Of the things that can be changed to improve our health, 70% depend on the way we live, 30% depend on the right healthcare. Most lives need living, not medicalising.
  • Getting the right care, right first time, improves both your life and the NHS for others – and patients can help to get it.
  • An invaluable book for people who use and work in the NHS, and those who want to get by without it.

 

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Reviews

Publicity and reviews from:
The New Statesman
The Daily Mail
The Sunday Times

“This is a fantastic book about how to live well. Phil Hammond’s goes beyond the usual tips about diet and exercise – we hear about the power of positive thinking, as well as how to get the best out of the health service. And this book is packed with real stories – from people who have become survival experts through their own experiences. Their stories are heartwarming, enlightening and useful.
Phil Hammond has a knack of being brutally honest and very funny at the same time. This is quite simply the most useful book about health and the health service that I’ve ever read.”

Professor Alice Roberts – Anatomist, author & broadcaster, Professor of Public Engagement in Science, University of Birmingham

“Phil’s words are informative, always honest and insightful. He gives us salutary lessons in what to look for, what levels of care we should expect, and are entitled to, how the NHS should work, and what to do if it’s not working for you. But perhaps the real strength in this book is the way he lets other people tell their stories. Whenever a patient’s experience can illustrate his point, there is one. Often there are a few. Towards the end of the book there are several that will uplift you, empower you, and one in particular that will break your heart. Phil is not one to shy away from NHS failure; he wants us to know what to look out for, what to be wary of, as well as when to know that we are being cared for safely and well. He knows that only by being informed about what to watch out for can we, together with the people who work within the organization, make the NHS the brilliant thing it can and should be. The brilliant thing it mostly is. Every home should have a copy of Staying Alive. I wish he’d written it before I started my patient journey. I’m glad you have it before you start yours.”

Wendy Lee – writer and patient leader

“Phil has become trip-advisor, tour-guide, navigator and the writer of a new bible on good-care, bad-care and a general what’s-what in the NHS. We expect Phil to be light hearted and in this book, he is. We expect him to be razor sharp and he is. We expect him to know a thing or two about being a doctor and he does. Everything we expect is in this book and more. From your legal rights to the right way to approach a doctor (shake his hand), this book has it all. Life style advice, healthy living and what to do when it all goes wrong. From common-sense to cervical-screening. Chronic diseases and the time when pull yourself together might not be a bad idea.
Do we ever really know what care we should be getting? Few do. This book will make sure there are a good few more! There are real life tragedies in this book, patient experiences alongside good news of the success the NHS delivers on a daily basis. This book should be on prescription, required reading for every family in the land and be on the top shelf of the medicine cabinet. This book has it all. It is the Swiss Army Knife book of the NHS. Prepared for everything.”

Roy Lilley – health writer, commentator and carer

“I read it cover to cover in three days; it’s a brilliant book which all of us should read – patients and professionals.”

Dr Alf Collins – specialist in chronic pain and person-centred care

“Enjoyable and very accessible, Hammond makes the argument for a new relationship between the patient/public and the NHS very powerfully. This argument is in my view vital for the future sustainability of the NHS and good health. CLANGERS is an approach to managing our own health and healthcare that could help the NHS and the people it serves”

Sir David Nicholson – former chief executive of NHS England and patient

“A storming book. Everyone serious about keeping healthy or overcoming serious ill health should read this book. The call to patients to look after themselves and sort themselves out without NHS intervention is a powerful one.”

David Grant – cancer survivor and patient leader

“This is an honest and simply wonderful book. Buy it, read it, read it again, and give it to others. It not only helps you to ‘stay alive’ – it helps you lead a much better and healthier life. From cradle to grave, this book shows you how you can ‘team up’ with our wonderful NHS – from supported self-care to making decisions about treatment and operations, and so much more. Dr Phil Hammond has ‘nailed it’ again and beautifully makes the case for his overarching message: that ‘great healthcare is all about kind, honest and trusting relationships.’

But don’t just take his word for it; the book is full of insightful and moving stories from patients, carers and others that Phil does what “the NHS needs to do: listen to patients”! Despite having worked in the NHS for over 20 years, I’ve learnt something new on almost every page.”

Dr Knut Schroeder GP and founder, expertselfcare.com

“Dr Phil Hammond has the prescription for a healthier life for you and has some pretty good ideas on how the NHS could be improved for all of us. Recommended.”

Marian Nicholson – Director, Herpes Viruses Association.

“Want to get the best from the NHS? How many strong, independent adults turn to shy, tongue-tied patients, and don’t ask questions for fear of seeming presumptuous. I did when my kids were ill – and I’m a doctor! Now Dr Phil Hammond has written a fabulous practical guide in his book Staying Alive – how to get the best from the NHS. Like me, he loves the NHS – but he knows we all need some help to navigate our way through it.

Dr Sarah Jarvis – GP, writer and doctor for The One Show and patient.co.uk

“If you use the NHS (i.e. all of use), you MUST read this book. If you’re a doctor you NEED to read this book. If you’re an NHS manager this book is VITAL”.

Dr Chris Steele – GP and doctor for ITV’s This Morning

“To describe “Staying Alive” as a bidet revolution does not do it justice. It is more colonic irrigation than bidet. Dr Phil wants to turn the NHS upside down and wash out the bureaucratic complexity that both infuriates and disempowers. He wants patients to be informed and powerful not ignorant and grateful. Ironically, he believes that it will be patients that save the NHS. Amen to that! “

David Prior – Chair, Care Quality Commission

“Ever kicked yourself for not being clued up before going through something risky and serious? For missing opportunities to prevent something bad from happening? Phil Hammond’s here to run with you on a journey of powerful stories, stats and wisdom. The destination? An activated and informed patient that can see the big picture, ready to support those around them, and ready for the NHS.”

“This gives you a good understanding of what it’s like to be a patient, what you need and can do to get it right, and what doctors are afraid to tell you but wish you knew. Hammond says that falling into illness is like falling in a river, which ‘can lead to numbness, anger, denial and confusion. But when you’re ready, you need to stop treading water and learn how to swim.’ This is just how to do that, stop yourself from getting in the river in the first place, and best ask the NHS boat to pull you aboard.”

“Want to get an insight into what it’s like to be a patient? Want to be a better patient? Want to support patients better? Read this book. It also tells you how to stay alive and well. And that care workers and carers should not be meek and mild. We are advocates. This sums up the book – a manual on how to advocate for yourself and those you love.”

Tom Stocker – patient and activist

 

Opinion Piece in the Nursing Times:

‘Patient experience is the secret to staying alive in the NHS’

14 May, 2015

So who did you vote for? As the NHS promise auction unfolded, I smiled as each fantasy unravelled.

Politicians know they don’t have a hope in hell of providing a seven-day NHS (Tory), a sameday GP appointment for anyone over 75 (Tory), or a midwife by your side every minute of labour (Labour). Even if the money were available, how would we suddenly grow 8,000 more GPs, 20,000 more nurses and 3,000 more midwives (Labour and UKIP)? And is being able to see a GP on a Sunday afternoon really the best use of the NHS’s precious resources (Tory)?

My guess is that I did more for my own health – and that of the NHS – by walking to and from the polling station than by placing my cross. But then I also believe that for 90% of symptoms, you’d be better off with a dog than a doctor.

What we can do for ourselves to stay well often far exceeds what the NHS can do for us – we just need to give people the confidence, courage, hope and support to realise it. Whoever’s in charge of the NHS, it can’t survive without a massive shift to self-care and a bidet revolution in healthcare: from the bottom up.

I’ve written a book, Staying Alive – How to Get the Best from the NHS, about how patients can get the right self-care and NHS care. Well, actually patients and carers wrote half of it. I know a bit about mental health and resilience (my Dad suffered from depression and took his life when I was seven) but I’ve never been poor or seriously ill, and I’m in no position to tell people how to live their lives and how to behave when they become patients.

So I spent a lot of time listening to people who have survived and even thrived as patients, in and out of the NHS, and combined their tips and tactics with my insider knowledge. And I also listened to those whose NHS care had gone terribly wrong, and their advice on how to stop it happening to others.

Those with the most difficult, stressful lives are used to taking tough decisions every day. With the right information and support, they can use these skills to make the right choices when they use the NHS. Nearly all the patients and carers I spoke to wanted to improve the NHS, not just for themselves and their family, but for other patients. Most have had a satisfactory to excellent experience of the NHS and wanted to share their thoughts and ideas with others. And those who had poor or disastrous “care” were very driven by the needs to stop it happening to other people.

In 30 years in the NHS I’ve lived through 15 top-down structural reforms driven by ideology rather than evidence. My book isn’t party political because I strongly believe politicians of all sides should grow up and collaborate around evidence, compassion and patient experience.

If all we ever did in health and social care was listen to the suggestions and concerns of frontline staff, patients and carers, and act on this to continuously improve the service, the NHS would be the best in the world. We still need to put more money into it, but we need to be certain that money benefits patients.

And to deliver patient-centred care, patients need to reveal themselves as people – what matters most, their hopes and fears – and we have to listen.

As poet Mary Oliver put it: “Tell me, what is it you plan to do with your one wild and precious life?” No one said on his or her deathbed: “I wish I’d spent more time hanging around the NHS.” Most lives need living and loving, not medicalising.

• Nursing Times readers can order a copy of Staying Alive – How to Get the Best From the NHS for £10 (instead of £14.99) at Bit.ly/1zBbdvJ, using the code: STAY.