Marathons and football - a sporting day!

The second day of the conference (Wednesday 13th June) was the big day for the participants - our presentations. According to the guidelines for the exchange programme during our 4 weeks we should have identified practical solutions on how to deal with a smaller and ageing workforce in hospitals dealing with the increasing needs of patients becoming older. The results of our findings will then be used in hospitals across Europe and contribute to the discussions on the further development of healthcare systems in general. We were given quite clear instructions on how to present and what this should include. I was awake from soon after 5am, refining and practising! I met Dian after breakfast - it was quite amusing looking around the hotel lobby at all the small groups having a last minute run-through. Lars joined us and we went to meet the sound technician to ensure that our presentation would run well. We were so fortunate having Lars as, being German, he was able to talk to them and get it sorted properly. It also helped that he is something of a technical genius! The rest of our team joined us and wished us luck. We were the first group to present. The others were concerned but I felt this was an advantage. There was not precedent, we would go in and set the bar.

Our team had decided to focus on both ageing workforce and ageing population as the two seemed to us intertwined. We took the theme of the Olympics as it is 2012 and specifically the marathon. If you would like to view our slides go to the following link -

http://www.hospage.eu/pdf/potcmulti/FI.pdf

The group had decided that Dian and I would present. The plan had been that after the 12th slide we would have an interlude showing people of all different ages with the "Chariots of fire" music being played by me on the piano. Unfortunately the piano was not to be so we had to make do with it electronically but it worked well.

Unfortunately this does not show me firing the starting gun!

In full flow!

The top slide shows the start of the marathon - our group are superimposed onto the start line. The banner had also been edited by Lars to read "HOPE marathon from Finland to Berlin". I invited the audience to take their places on the starting blocks and then took out the gun and "On your marks; Get set; GO!" At which point I fired the gun in the air and Lars popped the balloon. It certainly got people's attention! We gave some facts about Finland - it's total population is 5.4 million and due to the size of the country this gives an overall population density of 16 per square km. It has an infrastructure of 336 independent municipalities and 300,000 elk! We then discussed the first major challenge this presented - the population is dense in the southern part of the country but very sparse further north which impacts on the availability of services. The Finnish language means that they cannot recruit many people from other countries. We suggested that they made more use of electronic solutions such as telemedicine. The new structure for the principalities was shown and the hope that this would allow for greater co-operation and integration of health, welfare and education. 

The next slide showed the ageing population and the projected figures for 2040 and the impact that this would have on the workforce and the increasing numbers of those with chronic diseases was highlighted. The third challenge we presented was specifically around the impact this would have on the workforce. We proposed that the Finns developed their nurses and allowed them to extend their skills, that they started using untrained healthcare workers such as health care assistants, and that the voluntary sector could be a valuable resource in meeting this problem. We made passing reference to the fact the Finland closes for the summer and that maybe this needed looking at! I then made a comment that I was passing the baton (slightly mixing my metaphors!) on to Dian to continue this marathon journey and my part was done. 

Dian then spoke about the positive practices we had found, such as investing in good maternity and child health surveillance; supporting good parenting through initiatives such as "father's days" in kindergartens and cookery lessons; the emphasis on social skills through the summer camp programmes; the huge investment that they have made into health promotion with lifestyle checks throughout the life span and stressing that this should be continued not cut. We also highlighted that with the municipality system there was an integration between health, welfare and eduction and this needed to be continued and strengthened. We summarised that there was good co-operation between the generations through linking kindergartens and elderly people's centres but more needed to be done and particularly focusing on this problem of an ageing workforce. Thus Finland, like an athlete who has just run a marathon, needed to focus on the next challenge and maintain their strength and fitness. We then showed the "Finnish" line with our group standing there and moved to our reflection with the Chariots of Fire music. Our final slide took us back to the beginning with the Olympic slogan "inspiring a generation".

We felt it had gone really well and we got a lot of really positive feedback. I personally thought we had done our best. It was really good to her from the Finnish participants that we had represented them well. We then had another 19 presentations to sit through but could relax now. There were a few projects that were interesting - Switzerland have a system of case management for complex patients; the UK presentation focused on 3 individual projects - an acute response team in Carmarthenshire which is giving anti-biotics in the community, the butterfly scheme for dementia care which uses the symbol of a butterfly to alert that there are people who will support people with dementia, and a single point of access team. Generally this did not represent the healthcare in the UK and it made me realise that visiting a country for 4 weeks cannot do this. All you can do is see what happens in the area you are in and then try to compare this to what others have experienced. It was quite nice to see the Queen:

HRH - centre of screen!

The Swedish presentation was very interesting. The participants described the community monitoring system in patients' homes. They also have a Senior Alert - a national quality register for over 65 year-olds. The Swedes have managed to have global electronic medical records across primary and secondary care. They have implemented "Marva" wards for the over 75's, frequent fliers and those with long term conditions having teams dedicated and skilled in their specific needs. Rehabilitation programmes start prior to surgery and overall they have a very proactive approach. I would really like to visit Sweden now and see all of this in action as this was the only model where I really felt we had something to learn. This is not said in an arrogant way - I really appreciate how forward thinking and advanced so much of our care and health systems are now. 

The day passed quite slowly. The Danish team presentation used a lego figure which was visually good and the Portuguese team used a football theme. The Maltese presentation was done by one of the UK participants and she was an excellent presenter. They had used prezi for their presentation which we were rather cross about as we had been told that we could only use a straightforward powerpoint format. 

The conference was brought to an end and there was a farewell to the Danish co-ordinator who was retiring on health grounds. We all sang a farewell to him to the Beatles tune "Let it be"! Then it was time for a quick change and off to the farewell reception. We shared a taxi and arrived at the Brandenburg gate. The setting and the environment was electric as we were right by the Brandenburg gate and it was the Euro 2012 match Germany versus the Netherlands. There were thousands of people. We went to go to the gate but there were police there searching everyone. It was at this point that I realised in my bag was the gun from our presentation! I had suggested that we buy Arto a present from us all but also give him the Chariots of Fire music sheets and the gun as a reminder of us. Now I was about to get searched by a German policeman. I called Lars back and explained to him and so we found another way round so that we did not have to go back through the Brandenburg gate but came alongside the British embassy. I kept telling the group that if I was arrested this was where they were to go to get me help! This was the area were some of the Jason Bourne film had been shot (mental note to self to re-watch when I got home!).

We arrived safely around the front of the gate without being stopped much to my relief!

The building next to the tall one with the green roof was our venue

literally right by the Brandenburg gate - the TV screen for the football in the centre of the gate on the other side

As you will see from the first photo our venue was quite impressive - we were at the top of it in the roof garden. We looked out over the end of the Unter den Linden and the gate:

There was an amazing atmosphere in Berlin and the noise of the crowds gathering on the other side of the gate to watch the match was electric. Our event started with a speech but as we were on an open roof area it was really difficult to hear. We realised they were announcing the results of the presentations. I had been really confident that we would be in the top 3 so was absolutely deflated when it was announced that Latvia had won, followed by Denmark and then Belgium. I have to confess I was a bit sulky and moody for a while. It was obvious that if Latvia had won then our presentation would not have been in the running. The Latvian presenter was a doctor from Moorfields and he had presented in the format of a keynote speech. It was very medically-focused and fitted with his background and perspective. I suppose I should have realised this even from my experiences in Finland. However, last year Finland had won and their presentation had been very much along the lines of ours. I suppose now I can see that we were in Germany and the general tenor was much more serious and formal and medical! I had actually challenged this after one of the presentations as I felt nurses really were being overlooked.

Lars was trying to get us all in the mood for the football so had his face paints and was drawing the German flag on everyone - much to Dian's disgust as she was from the Netherlands and was wearing her orange attire with pride!

Arto sporting the German flag on his head!

We sat around and talked for a while:

Steve - flag on cheek!

Cesar - flag on cheek, Lorraine - flag on arm!

Lars with beer in right hand and face paints in left 

The food arrived - it was currywurst and pizza. The queue was huge and eventually we got something to eat. Everyone was keen to go and watch the football. I think we all felt a bit let down with the presentation results and had been networking for the past 2 days. We decided to leave and go to a nearby bar and watch the football. We found out the event would be finishing by 11 but decided to go anyway. When we got in the lift we realised almost everyone else had come to the same conclusion!

Lars found a bar close by and we sat outside and watched the match.

Dian resplendent in her Dutch orange

Steve and Cesar enjoying the game

Lars face painting again - Berit facing, Lars' girlfriend who joined us

The match was very exciting. The drinks were very expensive - I bought 2 cokes, a white wine and 3 beers and it came to 25 euros - so I had spent my taxi money for the next day! The final result was 2-1 to Germany so Dian was very disappointed and Lars and the rest of Berlin were elated! Again, the atmosphere was amazing. Whilst we were waiting for our taxi I quickly took a photo of the gate lit up before I got run over byt the cars now approaching as the road had been opened!

Not the best photo!

We went back to the hotel and up to the Sky bar where most of the 121 participants and the co-ordinators also seemed to be. It was packed as it was probably designed for about 50 maximum! I was starting to feel really tired and when Cesar and Lorraine suggested leaving I went with them and went to bed. I knew that next day I had to sort my packing and travel home - by now I couldn't wait to get back and be with my family.