Sir Stephen Bubb

Sir Stephen Bubb

Thursday, 27 August 2015

Give more. Get healthy!

Had a great lunch yesterday with David Halpern, the CEO of the behavioural insight unit.  Better known as the nudge experts, they have been responsible for some fascinating  innovations in the way our public services work.  David is publishing a book on the theory of nudge next week.  Get it.  I shall. 

They have been responsible for some in depth work on how to nudge people to give.  And today they are publishing some new research on giving and health.  And it shows that spending money on other people is good for your heart!  

Giving generously lowers high blood pressure, an ailment that contributes to the deaths of an estimated 7.5 million people prematurely worldwide each year.


This remarkable effect that being unselfish with money has on health was discovered by a team of psychologists that ran two studies among older adults with high blood pressure.

The first involved 186 people living in the United States who were aged between 55 and 74 and suffered from high blood pressure.  The team analysed how much money they contributed to religious groups, political organisations and causes, friends and family and other organisations.

The researchers found the more money the participants spent on others, the lower their systolic and diastolic blood pressure was two years later.

The second study examined 73 participants with heart complaints aged over 65 from the Vancouver area of Canada.  They were randomly assigned to spend three lots of $40 dollars either on themselves or others for three consecutive weeks during a six-week study period.

When examined afterwards, participants who gave to others showed significant improvements in systolic and diastolic blood pressure compared to participants assigned to spend money on themselves. “Thus, prosocial spending was linked to lower blood pressure,” the team concluded in a paper about the trials.

The researchers believe these results represent the first-ever empirical evidence that engaging in “prosocial spending” can lead to lower blood pressure and healthier hearts.  They speculate that the improvement may take place in part because the generous act activates the release of the stress-reducing neurohomones.

This beneficial impact of generosity on well-being is good news because heart disease is the leading cause of death worldwide. High blood pressure, which puts people at a higher risk of a heart attack, currently affects 67 million people in the U.S. and, according to the World Health Organization, 1 billion people worldwide.

In their paper the team adds: “Together, these findings suggest that spending money on others shapes cardiovascular health, thereby providing one pathway by which prosocial behaviour improves physical health among older adults.” The team's paper goes on: “Across two studies, we provide the first empirical evidence that prosocial spending may lead to lower blood pressure among older adults.”


I wonder if this will be widely reported?  A good antidote to some of the hostile media publicity on fundraising.  It's great news for charities like the British Heart Foundation and their door to door fundraisers. So supporting them is not just good for the charity that is our leading heart research body but responding to their fundraising will help lower your blood pressure. What could be fairer than that! 

Thursday, 20 August 2015

We need charisma?

The debate around leadership at the Kids Company has revolved around charismatic leadership and whether this is enough.  As I said on the Today programme when the story broke charisma is good and indeed many of our great charity leader are both charismatic and  passionate, but when it is not coupled with sound administration and governance it can be disastrous.

Charisma is one of those things that we are supposed to fall for and admire.  God-given grace and charm is magical, not to be sniffed at.  Or is it?

I was fascinated to see that the dear old BBC Radio 4 is about to embark on a series about it in many walks of life, ranging from St Paul to Sarah Bernhardt and into the 21st century.  And I thought I'd reproduce the blurb from the BBC website to provoke thought on this. Franc one Stock writes,

 "Charisma is an external force of nature: confidence, charm, power, "quick-thinkingness", combined with physical impressiveness.
The more I thought about it, the more dangerous the whole concept became.  Beware of charisma, I say.  It will lead you into trouble.  I wracked my brains and in fact only a few business candidates come to mind.
For example, though they might like to think that they are - accountants are not charismatic, though they now often rise to the top of large organisations. Neither are bankers, though they may wield great power for a time.
Charisma is about more than power. It's about influence."

Corporate charisma:

For example, Henry Ford is probably the most striking example of what must be corporate charisma.  Farm boy, suspicious of banks all his life, opportunist who created the production line (out of existing manufacturing techniques) because there were no skilled engineers to be hired in Detroit (they were all making railway wagons).
Because he had to take unskilled immigrants with little English he broke work down into small repeatable tasks on a moving line.  He reduced work to monotonous repetition, but he paid well for it.
Fordist mass-production and the production line became so influential that they rapidly became the way of doing things in manufacturing, not just of cars but of almost everything else. 
Big and hugely influential maybe, but was this charismatic? I think it was.  Henry Ford used to go "camping" with his friends Edison and Firestone in a convoy of tent trucks.  The press would follow and record their fireside chats.  Edison had an ear trumpet.  Trumped up charisma, but a pretty big impact on the way many of us still work. 
Business charisma often coincides with a wave of technology change, which the charismatic leader rides like a surfer.  Ford was a part of the great automotive disruption of the early 20th Century.
Charisma has a lot to do with how the American media portray their business leaders.  Getting rich quick is only half the story.  Business leaders need to be "awesome" as well, and probably short-tempered.

Jack Welch was charismatic during his long reign as a chairman championing shareholder value at General Electric.  But his reputation shrank almost as soon as he was out of office.
Like politicians (as Enoch Powell nearly said) the careers of most of those admired as "charismatics" end in failure.

Larger than life:

One charismatic business person of whom that was not true was the late Steve Jobs of Apple.  He was, I'll admit from my only encounter with him, utterly charismatic in how he behaved and what he achieved.

Jobs upended personal computing, the music industry, animated cartoons, and retailing.  But he was impatient and irritable, not nice.  Maybe that goes with the aura.

Francine Stock has zeroed in on one of the cornflake kings, W K Kellogg, who made a fortune out of his brother's cereal invention, which was launched out of his clinic in Battle Creek, Wyoming.

But where are the British charismatics? Fry, Rowntree, Cadbury - were those self-effacing Quakers charismatic? The question is naturally self-contradictory.

One genuine candidate is John Spedan Lewis who gave the John Lewis company away to the workforce and then sat at home writing awkward had-to-be-answered letters to the partnership's weekly newspaper, the Gazette, for the rest of his life.  A forceful man, a forceful idea.  No-one else I can think of in Britain gets near.

And apart from Steve Jobs, the only other candidates I have met were Richard Burton and Elizabeth Taylor, superbly charismatic together as only movie stars can be.  They bent the air when you looked at them, especially her.

But do we need charismatic leadership? The media do: charisma makes good stories, larger-than-life people behaving quite unlike the rest of us.

The force-field of charisma and its impact on others is usually accompanied by huge self belief. Several of the American billionaires are convinced they will find a way of living forever, for example.
Falls from grace.

Charisma breeds a dangerous deference in underlings. It leads to diaries so packed there is no time for reflection, and no need for it either.  Self-confidence is fine for movie stars, but in the business world it stops bosses from being challenged, and from realising that their big ideas are mostly fleeting, insubstantial and troublesome.

A bad plan produced by someone temporarily regarded as charismatic looks good at the time, but when the wind changes (or the economy stumbles) it often turns to ashes.  And British business is scarred with repeated stories of seemingly just-for-a-moment charismatic leaders who rapidly fell from grace, and took their companies with them.

One is tempted to say: "happy the land that has no heroes." 

I'm not sure I buy all this but I shall be listening out!

Charisma: Pinning Down the Butterfly is a two-week series presented by Francine Stock starting on BBC Radio 4 on Monday, 24 August at 13.45. 


Monday, 10 August 2015

Kids Company – a watershed moment?

It’s not David Cameron or indeed Gordon Brown’s fault that Kids Company has gone under. Indeed I applaud them for their instincts in wanting to support a charity they knew was working at the front line with vulnerable kids not reached or known by local authorities. But politicians, the charity sector and the public must learn the lessons from what has happened – and support charities that provide crucial services properly.

Kids Company is an important case in point. Their founder, Camilla Batmangeilidh was a wonderful character but she was also clear on one thing: the frontline was where the money had to go. She was very opposed to spending on overheads as she thought all the money must go out to her kids. This is a noble idea but if you take the time to view their publically available accounts their overhead costs are alarmingly low – way below what any sustainable organisation should expect. When you couple that with rapid, government-funded growth, which emerged in the wake of significant cuts to government provided services, problems are inevitable.

It appears that this was made worse by what is often called "founder syndrome." Any chief executive must surround themselves with a top quality team to deliver essential administrative functions. Batmangelidh’s approach appears to have relied heavily on her indomitable spirit, force of character and charisma. Without the sufficient collateral support of good governance and sound administration, these things, are, simply, not enough.

As council social care is cut to the bone, Kids Company was a major player in town. The social consequences of their demise are catastrophic for the individuals concerned and costly to the exchequer. Yet it would compound the catastrophe if criticism of the decisions by government on the funding of Kids Company caused government ministers to micromanage charities with which they work, or out of fear, overlook them altogether.

In order to square this circle, we need a more adult discourse on what it means to run a successful charity in the twenty first century. There is a broad lesson for the media, which must be less hypocritical about what it wants from charities. Take the recent furore on charity fundraising, which arose as a result of charities outsourcing this part of their activity to keep overheads down and funnel more money to the front line.  The negative stories were understandable but must be coupled with the understanding that to bring these functions in-house costs money – and that money will not go to the front line. And yet you can then be sure that the next slew of negative stories about charity overheads are on the horizon.

We must not return to a Victorian-style philanthropy where we rely on the occasional good will of some philanthropists but do not have the temerity to complain about the causes of poverty, to create sustainable organisations that make a difference for the long term and to fund and lead them effectively. The right lesson would be to acknowledge that running an organisation that helps people in the twenty first century requires good governance as well as good intentions – and the Government must support good governance and high quality leadership in the charity sector if it is to prevent future catastrophes.

Monday, 20 July 2015

Using communities to tackle extremism

David Cameron's five year plan to tackle extremism must focus on curtailing demonisation and promoting engagement with communities.

In a recent letter to Home Secretary Theresa May, I warned that the group and individual banning orders to be introduced in forthcoming legislation could be counter-productive and hinder rather than help the fight against extremism. I argued that the key weapon in the fight against radicalisation will be to harness the often unsung civic spirit represented by the work of the 1,200 plus Islamic charities in the country.

The Prime Minister has hit the nail on the head today in identifying “the overshadowing of moderate Muslim voices" and “failures of integration” as central elements of the radicalisation that has so far taken place.

Speaking on the Today programme this morning former MI5 chief Eliza Manningham-Buller said that talk of one central Muslim identity and community is misguided, rather that there are hundreds and thousands of separate communities all of which must be reached. This is why it is so important that the Government, indeed all of us, embrace and celebrate the work done by Islamic charities across the country. This would go a long way to bringing the moderate Muslim voices out of the shadows.

I met only recently with Home Office Minister Lord Ahmed to develop these dialogues and agreed to draft some proposals for adoption by the Government.

Friday, 17 July 2015

Gove is right. Let's back him...

Michael Gove has wasted no time at all in pushing ahead with reforms since taking over at the Ministry of Justice.  So far, he has lifted the petty and silly prison book restrictions.  Well done on that.
In a speech today, Gove will focus on the role of education in rehabilitating prisoner s<http://politicshomecom.cmail20.com/t/t-l-irhhjjy-irdhuysk-c/>. 

“No government serious about building one nation, no minister concerned with greater social justice, can be anything other than horrified by our persistent failure to reduce re-offending.  In prisons there is a - literally - captive population whose inability to read properly or master basic mathematics makes them prime candidates for re-offending...
The failure to teach our prisoners a proper lesson is indefensible.  I fear the reason for that is, as things stand, we do not have the right incentives for prisoners to learn or for prison staff to prioritise education.  And that's got to change."
How right this is.  And it's a change that many ACEVO members will warmly welcome. He’s considering what would be a very radical overhaul of the prisons system: introducing an “earned release" system to encourage prisoners to improve their education while in jail.  I'm also writing to hi.  To encourage him to look at the rehabilitation revolution programme. It's been a huge disappointment for our third sector. We wanted to see programmes that galvanised the power of charities to prevent  re-offending and to tackle the revolving doors in prisons where half of all prisoners released return to prison in a year. 

I'm offering Michael Gove the hand of friendship in tackling his reform agenda.  He has shown exactly the reform zeal we need! 




Thursday, 16 July 2015

Fundraising

I wonder how many papers will carry the report of the inquest into the tragic death of Olive Cook.  Will the Daily Mail splash this on its front pages?

This is what was said re charity fundraising,

"But her family insisted that - while the letters and phone calls were intrusive - the charities were not to blame for Mrs Cooke's death".

How does this square with media coverage and some politicians comments?  Of course it is right to review how we fund-raise. And it is right to look particularly at how outsourcing calls work as this is not always done to the highest ethical standards.  Bad fundraising practice harms all charities.  ACEVO has asked its CEO members in the fundraising charities to review what they are doing.  That is a right thing to do and it's the right time to do it.  But some of the more OTT comments about a "crisis" are wide of the mark.  And it is perhaps questionable why this issue is being pursued so vehemently in some papers.  Surely it couldn't be anything to do with duffing us up so we feel less able to be robust in our campaigning?  For us our guiding star must be our beneficiaries and not the tabloid  press.


So yes, a good time to review and strengthen good practice and root out bad.  But let's also remember at this time less asking means less giving and that harms our beneficiaries.  Together with the IoF we will be convening a meeting of leading fundraising charity CEOs and Fundraising Directors to discuss all this and look at what we need to do that secures the balance between effective fundraising and meeting public concern over bad practise. 

Tuesday, 14 July 2015

Winterbourne View - Time is running out

7 months ago I produced my independent review on the failure of Government and the NHS to implement their promise to close all Winterbourne style institutions.  I made a number of recommendations.  I was also asked by NHS England to review progress after 6 months and then after a year.  I have just concluded my 6 month review and its published today.

I think the main messages are in my foreword so let me report that here:


Winterbourne View - Time is Running Out: Foreword
When Winterbourne View – Time for Change was published in November 2014, still more people with learning disabilities and/or autism were being admitted to inpatient facilities than being discharged. This is despite a promise from Government to close institutions such as Winterbourne View. Time for Change has been widely supported but I understood the deep scepticism of people with learning disabilities and/or autism and their families that anything would actually change. I am acutely aware that we do not just want more reports.

I believe that things have changed, and that we will see the closure of inappropriate institutions and the scaling up of community provision that has been needed for so long. The leadership being displayed by NHS England’s CEO, Simon Stevens, does give me that optimism. The Government endorsed my report and moved forward with a consultation on its recommendations, including the ‘right to challenge’ for people with learning disabilities and/or autism and their families. That is a step change.

The report laid out a clear roadmap of action – a new national framework in which commissioners choose community-based provision over hospitals. The programme would deliver closures and enable providers to work in partnership to offer new facilities, to ensure community support and independence for people with learning disabilities and/or autism. In particular I argued that people with learning disabilities and/or autism must have a central role in designing the care that will best meet their needs. And they should be able to challenge decisions when it does not.

There has been progress since the publication of my report. We have seen a definite shift in the direction and commitment to change which was not apparent when I started the review. At last we have an acceptance that institutions must close and I congratulate Simon Stevens on making his promise to the Public Accounts Committee that NHS England will produce a closure timetable. We expect this to be published in October.

The last Government were swift to move on the recommendations to strengthen the rights of people with learning disabilities and/or autism and their families. A consultation has been made through the Green Paper No Voice Unheard, No Right Ignored, which has seen over 400 responses. I look to the new Care Minister, Alistair Burt, to move on introducing legislation that will enshrine peoples’ ‘right to challenge’ in law.

The number of people being discharged from institutions is now greater than those being admitted. At the end of May 2015, over 1,700 Care and Treatment Reviews had been conducted. However it remains abundantly clear that a ‘revolving door’ of discharges and admissions will continue unless a closure and transition programme is acted on.

NHS England has made it a top strategic objective to improve the health outcomes for people with learning disabilities, by implementing new service models that provide care for people in their communities rather than in hospital. The Care Act is a landmark piece of legislation, and the Green Paper is progress that should not be underestimated. 

But the pace of change remains slow, and this is unacceptable. While a priority for NHS England, the Transforming Care programme has not yet delivered anything tangible in terms of new community facilities or closures.  This is worrying; robust community provision does not appear overnight. And yet the closure of institutions can only happen when there are sustainable alternatives built up by commissioners and providers.  
In responding to Time for Change, the Transforming Care partners committed to a series of actions. I accepted Simon Stevens’ proposal that my steering group be reconvened in 6 months to review progress and that a formal stock take of actions be taken in 12 months. So this report is a warning call – my steering group was clear on the changes that need to take place. Where positive step changes have been made, I have recognised the success. Where delivery has been lacking, my appraisal will be severe. 

I will be reviewing the adequacy of closure plans when published. The Transforming Care programme recently announced five ‘fast-track’ sites where services will be shifted away from hospitals. These sites will help shape the service model that is being developed to re-design care across England. A programme of action is clearly starting to take shape, but we must expect a closure programme to cover the whole country and not just five areas. We know that people with learning disabilities and/or autism are often in hospitals very far from their families – a nation-wide programme is therefore essential.

The scaling up of community provision is a fundamental part of this programme. Yet there has been little to no discussion with providers and stakeholders outside of the Transforming Care partners. Lack of communication from the centre prevents local commissioners and providers from readying themselves for change, or even being aware that they will be expected to respond to a new service model. 

That is why I have set up a Provider Delivery Taskforce, alongside the Voluntary Organisations Disability Group and Housing and Support Alliance. This will work with excellent providers of community-based care (using NHS England and LGA’s own ‘Ensuring Quality Services’ guidelines) to make sure they can be responsive and proactive in transitioning people out of institutions. But that is not enough. 

Time for Change was clear that building this capacity in the community is an absolute priority. But the two recommendations made to this effect – workforce development, and investment in community-based services –have seen little progress. This is unacceptable and risks undermining the work being done elsewhere to create a new framework of care for people with learning disabilities and/or autism. 

So I am now calling on NHS England to establish a Transition Taskforce which will be mandated to work with providers, commissioners, people with learning disabilities and/or autism and families to set out the national framework for scaling up community provision. It will plan for ‘shovel ready’ schemes that can be sustainably established to allow for the closure of institutions and the appropriate transition of individuals into the community. The Taskforce will examine the financial models that are needed, as well as how to secure a skilled workforce.

This will build on the excellent services that are already provided by charities and social enterprises, many of which pioneer innovative ways to support the wellbeing and independence of people with learning disabilities and/or autism outside of hospital settings. For example, there is wide-ranging good practice for staff training and Positive Behaviour Support. I am clear that restrictive practices, such as the use of mechanical restraint or seclusion have no place in the 21st century of care for people with learning disabilities and/or autism, and this report gives recommendations to that effect. Given that it will take time to effectively transition care from institutions into the community, there must be steps taken now to ensure people are receiving the best support.

Since November, I have visited and spoken to a number of providers, as well as institutions about Time for Change. Any closure programme will lead to concern within this sector, especially the workforce, around whether such a shift can and will be managed effectively. Individuals with learning disabilities and/or autism, their families and carers cannot be isolated from the Transforming Care programme; they must be at its core.

I want to thank all of my colleagues on the steering group, and all those I have met or spoken to. In November, I cautioned NHS England and its partners to be realistic about the timeline for success – to not promise another ‘false dawn.’ However the call for urgent action remains and I will be holding Transforming Care to account on its commitment to deliver lasting change. 


I will review further progress at the year anniversary of the publication of Time for Change – the steering group will be reconvened on 7th December 2015. I expect to see change being delivered on the ground. This is the opportunity for us, as a nation, to provide the care that people with learning disabilities and/or autism deserve and have been denied for so long.