TRENDZ
Précis
ENVIRONMENTAL SCANNING
Effective environmental scanning is an ongoing process of tracking trends and systemic events within an organisation’s internal and external environments, occurrences that may have a direct or indirect impact on its success, currently and in the future. These results can be extremely useful, using the information to create scenarios and thereafter, to shape and inform an organisation's goals and strategies. Selecting a set of key environmental indicators, internal/external - qualitative/quantitative, believed to have the most important potential impact on organisation and its speciality, is imperative, examining these for both qualitative and quantitative changes.
Below you will find a selection of our latest Scans ...
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TRENDZ
Future NHS Failures - what's going on ?
The National Health Service (NHS) in the United Kingdom has long been the pride of the nation. However, the NHS continues to be hampered with significant challenges, leading to concerns about its usefulness and sustainability. There are questions around the driving forces contributing to the failures, the preventative measures that should have been implemented, and the current state of the medical profession.
With a shortage of doctors across the UK, one in nine graduate doctors have found themselves without work due to an over supply, whilst some GPs were made redundant due to an influx of 'cheaper' staff and a rise in virtual appointments. As the largest single employer in Europe, the NHS must continually raise nurses' and doctors' pay to stay competitive with other labour market wages due to the "cost disease" phenomenon, yet recruitment and retention of staff are hampered by inadequate remuneration and working conditions. This is leading to high levels of stress and burnout among healthcare professionals, contributing to high turnover rates and increasing numbers of GPs lost to suicide.
The general public complain of long waiting times for consultations, treatments, and dysfunctional Doctor's Surgeries, undermining patient trust and outcomes. Geographic disparities result in unequal access to healthcare services, with rural areas particularly affected. The bureaucratic red tape and system inefficiencies lead to ineffective management practices, hindering productive service delivery, and the lack of integration between different parts of the healthcare system, such as primary and secondary care, results in fragmented patient care and high staff disengagement.
In 2023 the Government committed to publishing an NHS comprehensive workforce plan to support strategies to address staff shortages and distribution. This would ripple through to working conditions; competitive salaries; professional development opportunities; and retaining staff loses, outdated equipment, and inadequate facilities. Yet so far this has failed. These key elements continue to exacerbate issues including chronic underfunding. For every pound the state spends on public services, 38p goes on the NHS, yet some practices receive only £107.57 pa per patient, regardless of health needs, and it is expected by 2050 the number of Britons 85yrs + is set to double. With resource allocation often failing to meet the demands of the increasing prevalence of chronic disease and an aging population, the future of the NHS remains concerning.
The failures of the NHS are multifaceted, involving wellbeing; financial; and operational challenges. Addressing these issues requires a holistic approach that includes adequate funding, strategic workforce planning, efficient management, and a focus on preventive care for both patients and staff. Ensuring healthcare professionals are well-supported and equipped to meet modern healthcare demands is crucial for restoring the efficacy and sustainability of the NHS. Implementing preventative measures, like the government’s Dental and Pharmacy initiative, allowing dental hygienists and pharmacy technicians to prescribe and administer specified medicines without a prescriber's approval, could prevent backlogs and assist in
creating resilient healthcare systems capable of delivering high-quality care to all patients, provided initiatives such as these are properly integrated.
Management reforms and investment in modern technology and infrastructure could streamline administrative processes and patient outcomes, reducing bureaucratic overheads, improve efficiency, and encourage innovation and best practices, to optimise resources and service delivery. Additionally, the current medical education system must adapt to prepare doctors for modern and future healthcare challenges, including digital health and interdisciplinary collaboration, with continuous professional development imperative to keep pace with advancements in medical science and technology.
Promoting public health initiatives and campaigns to address lifestyle-related diseases and encourage healthier behaviours can have a significant impact, along with interdisciplinary and multidisciplinary interventions, that can lead to patient-centred care models that coordinate services across the entire healthcare continuum. Implementing robust support systems to address mental health and wellbeing amongst patients and healthcare professionals is essential, promoting work-life balance, and providing resources for stress management and resilience building to alleviate burnout. Strengthening community participation and health services with a focus on accessible preventive care and early intervention could reduce hospital admissions and the burden on acute care services. Reassessing the future role of doctors, and improving the utilisation of other medical staff, to focus on patient-centred care, rather than administrative tasks, with a focus away from sickness societies, is necessary, with more encouragement towards health and relevant services. Well-being societies of the future must to be given priority.
Author’s note: when one looks back to understand how we got to now, the intention to provide fully-funded health care was ingenious. Yet without a systems thinking approach, this was bound for failure. Without every day adaptive focus on agile practices that readjust as complex adaptive systems evolve, for instance to accommodate population growth; ageing populations; a rise in Non Communicable Diseases (NCDs); and Communicable Disease (CDs); as well as black swan events like Covid 19, and the resulting mental health epidemic that arose as a consequence, the nation will continue to be set for failure.
The future will be in governments employing Foresight Practitioners to bring their expertise, to bolster what is blatantly missing within many strategic planning sessions. Foresight Practitioners are future-focused, big picture thinkers & expert problem solvers, visionary disrupters and change-makers, able to effectively scan and research environments, whilst spotting relevant patterns in complexity, to understand how these signals may play out in the future. Futurists effectively apply their talents across varied roles and fields including Social, Technological, Environmental, Educational, Political (STEEP) landscapes. Remember, if it looks the same as today, it’s not the future.
If you’re an organisation who needs to “put the vision back into your strategy”, don’t get left behind. Let's schedule some time together.
References:
BBC News. (2024). Behind-scenes NHS problems leave new doctors without jobs https://www.bbc.co.uk/news/health-68849847
The King's Fund. (2023). The NHS Budget And How It Has Changed. https://www.kingsfund.org.uk/
House of Commons Library. (2023). General Debate on the future of the NHS, its funding and staffing. House of Commons Library
Gov UK. (2024). New powers for dental and pharmacy staff to free up appointments https://www.gov.uk/government/news/new-powers-for-dental-and-pharmacy-staff-to-free-up-appointments
Institute for Fiscal Studies. (2023). NHS funding, resources and treatment volumes. Institute for Fiscal Studies
Practice Business. (2024) GPs warn of funding crisis practicebusiness.co.uk/news-gps-warn-of-funding-crisis
GP Online. (2024) NHS England must respond to GP unemployment crisis, senior official says https://www.gponline.com/nhs-england-respond-gp-unemployment-crisis-senior-official-says/article/1876880
Telegraph. (2024) I had a happy family and a good job as a GP – but I decided to kill myself www.telegraph.co.uk/health-fitness/wellbeing/mental-health/gp-suicides-crisis-ellen-welch-book/
The Economist. (2023) How to fix the NHS www.economist.com/leaders/2023/05/25/how-to-fix-the-nhs
Daily Mail. (2024) GPs are being made redundant amid rise of virtual appointments and influx of 'cheaper' practice staff https://www.dailymail.co.uk/health/article-12946053/GPs-redundant-amid-rise-virtual-appointments-influx-cheaper-practice-staff
Sam McDonald, (Mphil Futures, Cum Laude), WITH-HUMANITY, 20 June 2024
TRENDZ
Précis
With Continued Strikes and inequality of Workers, are Labour Unions still relevant in the future?
Trade Union membership has been in decline in the UK since the 1980 Conservative Government reforms, The biggest decline in Europe is in the UK, from figures of 49.9% in 1981 to the low 20’s currently, the lowest ever recorded since 1995. Female membership increased numbers to 27% between 2017-2020, tapering off in 2021. Many systemic factors impact unions today, including the move to a knowledge-based economy in a world impacted by globalisation, and environment and technology changes.
The ongoing NHS strike in the UK, which began in October 2022, has workers looking towards trade unions to play a leading role in creative solutions, bringing a spirit of co-operation between themselves and all social movements and unions. The need to build union branches with trained representation in all workplaces has been a recognised factor, moving away from the traditional model of having one overworked rep, and with it a collaborative approach of active membership and Trade Union activists. This may be the final hope in sparking campaigns to achieve goals for workers both local and nationally, having a long-hoped-for knock on effect for patients and medical staff alike.
Though Wales has many economic issues, compared with the rest of the UK, the political landscape is optimistic as unions remain active, with membership in excess of 35%. Their recent request to the Welsh government to fund a Union Renewal Fund, is an initiative to reach those not joining unions, including people in the gig economy, young workers, and private sector workers. Influence has also come from the Well-being of Future Generations Act which takes a forward thinking approach to encourage improvements in economic, environmental, cultural and social, well-being within the coming decades, an inclusive and systemic approach that has been gravely missing in many institutions.
Wales has been looking to the example of union membership in Nordic countries such as Sweden (over 65%), Iceland (over 90%), and Denmark (67%) which work towards meaningful improvements such as economic equality, productivity, and living standards, for low- to middle-income workers. They see social partnerships, devolution of powers, and collective bargaining as the future, underpinned by strong trade unions.
In Ireland, after a campaign for the passing of a work-life balance bill by the Irish Congress of Trade Unions and affiliated unions, a bill was recently passed, with Ireland now leading the way as one of the first countries to introduce rights for flexible working arrangements and remote work, as well as statutory time off for domestic violence, acknowledging leave required to support victims of domestic violence who want to leave abusive relationships, sending a strong message of change.
In developing countries, co-sponsored by the International Trade Union Confederation (ITUC), female app-based drivers who are among 2 billion informal sector workers with few legal safeguards, are calling on platform workers to form unions and stand up for their rights. Multimillion dollar companies who own platform businesses, provide no workplace benefits, leaving employees without protection or recourse when facing risks of injuries from traffic accidents, as well as adverse incidents of gender-based violence. As part of a wider campaign to achieve workplace dignity and respect, platform workers, some of whom have brought legal action against platform companies, are working alongside the ITUC as they want the international labour laws to bring guarantees for salaries, along with rights and protections and for all workers.
According to the General Secretary of UNI Global Union, post Covid, collective action and labour unions is gaining traction. Trade unions are calling on governments to allow for collective bargaining and greater worker representation after years of policies built to undermine labour market institutions. Strong trade unions play a crucial role in bringing powerful social dialogue, mediating concerns between governments, employers and workers, which build economies better geared to resist shocks. According to US data higher middle-class income is connected to increased union membership.
With an on-going global recession labour unions are playing an active role in securing rights for workers, engaging with policymakers to protect wages against high inflation rates, driven in large by the Russian war against Ukraine. Unions played a similar role during the covid pandemic negotiating agreements to ensure workers had access to social benefits, reduced job losses, and secure working conditions. Workers themselves re-evaluated their worth and expectations, resulting in a refuelled desire for economic justice and dignity.
In the ITF Global Poll 2022, 85% of people expressed a desire for governments to bring policies for proper minimum wage for transport workers, and 81% of people said governments should invest in job creation for transport workers. Governments and businesses need to invest in the very people who keep the public services running, which itself can play an active role in preventing disruptions and recessions. If not, unions will continue to fight to strengthen collective bargaining, forming more competitive trade union movements, which in turn may result in more strikes and other disruptive actions against increasing inequality in our workforces.
Unions are being viewed as militant In the midst of a 96-hour stoppage by Junior doctors in the UK this week, demanding a 35 per cent increase, this after a 14-year pay squeeze. The systemic implications could include record waiting lists that lasts for years, yet unions are showing no signs of compromise. The National Education Union (NEU) has also called a strike for Teachers in England for two days, to coincide with the exam season, after a 4.3 per cent pay rise for most staff, and a starting salary of £30,000 pa, together with a £1,000 one-off payment was dismissed as "insulting” by staff. In real-terms, wages have dropped over the past 10 years. Many are looking towards Ministers to intervene, yet The British Medical Association (BMA) and the NEU say the strikes are for the good of the NHS and schools. Unions play a pivotal role in bridging the gap between staff, employers, and governments, one that should they not have such a presence, much of what needs to change in the future would remain stagnant.
Trade unions in transition: What will be their role in the future of work?, International Labour Organisation, July 2021
https://www.ilo.org/infostories/en-GB/Stories/Labour-Relations/trade-unions#introduction
Employee Engagement - A Union Perspective, John Hannett is General Secretary Usdaw,
https://www.ipa-involve.com/news/employee-engagement-a-perspective
From trade unions to future wellbeing, Wales is quietly pioneering a different way of doing politics in the UK, Auriol Miller, The Guardian, 31 Mar 2023
Unions welcome passing of work-life balance bill, Ronan Smyth, Irish Examiner, 30 March, 2023
https://www.irishexaminer.com/business/economy/arid-41105539.html
With Unions, Women App-Based Drivers Steer Toward a Fair Future, Tula Connell, Solidarity Center, Mar 8, 2023
https://www.solidaritycenter.org/with-unions-women-app-based-drivers-steer-toward-a-fair-future/
Unions Must Organise to Save the NHS, Helen O’Connor, Morning Star, February 10 2023
https://morningstaronline.co.uk/article/f/unions-must-organise-to-save-the-nhs
Recession in 2023? Here's how trade unions are gearing up, Veronica Nilsson, World Economic Forum, Jan 16, 2023
https://www.weforum.org/agenda/2023/01/trade-unions-recession-davos2023/
The Government must plan to better combat strikes led by militant unions, Telegraph, 11 April 2023
Sam McDonald, (Mphil Futures, Cum Laude), WITH-HUMANITY, 15 April 2023
TRENDZ
Précis
What if the future of brain ailments is Organic?
How will we discern the future of what constitutes brain ailments when one considers the increase in the multitude of neuropsychiatric and neurodegenerative diseases in the world?
The biases around how individuals with mental illness (MI) and health are perceived, relative to individuals with neurodegenerative diseases such as Parkinson’s disease (PD), Alzheimer’s disease (AD), and multiple sclerosis (MS) are different, where the former is feared and stigmatised. Yet research is unveiling there may be viruses at play in both MI and other neuro/degenerative diseases, which begs the question as to what underlies these similarities? Emerging evidence is suggesting links between these and infectious agents.
A study conducted by UK Biobank, found people who had experienced viral encephalitis were 22 times more likely to develop AD than those without a history of encephalitis. Additionally, data from the FinnGen study found that individuals who had viral encephalitis were 30 times more likely to be diagnosed with AD compared to those without encephalitis. These studies show an association between viral encephalitis and Alzheimer's disease, even though they do not necessarily prove causation.
As with MI and neurodegenerative diseases, which have risk factors including age, genetics, and lifestyle, such as smoking and poor diet, these, together with long Covid are being recognised as a growing public health threat. When individuals began to experience psychosis from Long Covid, sometimes termed post-viral syndromes, a well-known term in the medical field, some scientists began to question whether this was indeed psychological and began questioning the medical bias towards psychosomatic symptoms, beginning research into organic causes instead. Their point being that surely not everyone can possibly have the same psychosomatic reaction to Long Covid. In some instances, antiviral medications have been known to eliminate symptoms in Long Covid. This also begs the question as to whether antiviral medications may work for neurodegenerative diseases and MI, and also whether there are similarities and connections that science is perhaps missing.
A recent article on childhood infections stated being hospitalised for an infection during childhood, increases the chances of being hospitalised for a mental health issue such as Obsessive-compulsive disorder (OCD), Schizophrenia, Autism, Depression, and Attention-deficit/hyperactivity disorder (ADHD) by 84%, and the likelihood of taking medication for a mental health concern by 42%. With less severe infections from childhood, this increased hospitalisation for a mental health issues by 40% and taking medications by 22%. However, the article points to a question around whether this is the infection itself, or the actual treatment of the infection that increased the risk.
A commonality in diseases of the brain include inflammation and immune dysfunctions and MI is known for having autoimmune as a comorbidity. However, it has recently been hypothesised that autism spectrum disorder (ASD) may also result from immunological defects. Several studies have pointed to antibodies affecting parts of the brain in children with autism. Conversely, there are other studies that have failed to find an association between autoantibodies and autism, which potentially points to a connection, but not necessarily causation. What it does point to is that everyone responds uniquely to infections and that a multidisciplinary approach is necessary
There are a number of autoimmune dysfunctions that affect the central nervous system that have been linked to causes of mental disorders. An illness called Paediatric Autoimmune Neuropsychiatric Disorders (PANDAS) specifically associated with children, is a diagnosis associated with Streptococcal infections. The neuroinfectious disease crosses the blood/brain barrier and begins to impact regions of the brain in such a way that the behaviours that manifest have been mistaken for MI. Questions to ask is how many people have been incorrectly diagnosed and/or incarcerated, as well as whether adults experience the same mental disorders from Streptococcal and other infections, and to understand why or why not, as conditions similar to this have been associated with autism in children.
Additionally, higher mortality rates are experienced due to infections by people diagnosed with severe mental illness (SMI), such as major depressive disorder, bipolar disorder, and schizophrenia, relative to those without SMI. However, among those infected, more research is still required to ascertain whether SMI is linked to increased or decreased case fatality rates.
A systemic look at the change in our diets to much higher sugar content over the last century and the link to neurodegenerative and/or brain diseases has to take into consideration what we eat. These changes to our dietary intake has been linked to an increased risk for developing AD and worsening brain health. Science is also beginning to uncover this and the link to our microbiome.
A recent trend after probiotics, is Psychobiotics which are said to positively increase our mental wellbeing. Psychobiotics are said to include chemicals produced by bacteria from probiotics which contain specific species of bacteria called Postbiotics, and prebiotic supplements that support good bacteria in the gut. A group of medical professionals in psychiatry at Cork have been investigating the negative impact diets may have on our brain functioning, and as such, have been looking at Psychobiotics as an intervention that may have positive implications on mental health by targeting the microbiome, recognising the gut/brain connection. Through the elimination of the intake of processed foods and increasing the intake of fibre and fermented foods necessary for a Psychobiotic diet, they believe this will assist in help deal with stress.
This leads to the idea that in the future a systemic and multidisciplinary approach is essential and what will be required to understand any diseases of the brain and their manifestation on our behaviours, whether these be neurodegenerative diseases, MI, Autism, etc more especially when one considers the multitude neuropsychiatric and brain diseases that appear to have so much in common.
Links found between viruses and neurodegenerative diseases, Levine KS, et al, National Institute on Ageing, February 28, 2023
https://www.nia.nih.gov/news/links-found-between-viruses-and-neurodegenerative-diseases
The knowns — and known unknowns — of long Covid, explained, Dylan Scott, Vox, Mar 13, 2023
https://www.vox.com/coronavirus-covid19/2023/3/13/23627229/long-covid-science-symptoms-treatments
Do Childhood Infections Cause Mental Health Disorders?, Jayna Nickert, HealthNews, March 14, 2023
Abnormally low autoantibody activity significantly associated with autism severity, Dr. Priyom Bose, Ph.D., News Medical Life Sciences,Mar 13 2023
Association of severe mental illness and septic shock, Ines Lakbar et al, Plos Medicine, March 13, 2023
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004202
How Sugar and Sweeteners May Affect Your Brain, Austin Perlmutter M.D., Psychology Today, March 6, 2023
Sam McDonald, WITH-HUMANITY, 15 March 2023
TRENDZ
What are the future demands of our workforce?
Born between 1997–2012, Generation Z (Gen Z), are the most current generation to enter the labour market, and have come of age in a rapidly changing world. As a result, they differ from those of previous generations, and access to a wide range of information across vast geographical locations is impacting how they think, creating expectations for work that reflects a broader shift in the workforce.
According to a recent British Council report, Gen Z Indonesia want work they love that has a sense of purpose. Gen Z are more confident and want greater relationships at work, citing in person contact as a top priority. Many expect greater opportunities and are ready to leave their current positions, stating better pay as a key factor. A report from LinkedIn indicated 80% of those aged 18-24 are considering changing jobs.
Conversely, as the rising costs of living impacts salaries, white-collar workers are finding ways to earn double salaries. An article from Forbes refers to the over-employed - individuals who are taking on more than one full time position, often secretly, either wanting to make the most of their time due to underutilisation, or as a way to supplement income. 6% report working less than five hours a week, and 35% fewer than 30 hours per week, in their primary role. Of the 57% working only one job, these said they would consider adding another position, some as a way to learn new skills.
In order to meet expectations of a rapidly changing world, companies need to be recognizing the varied needs of a modern and diverse workforce. According to a report from Gallup, organizations know how to measure just about everything except the contentment of their workforce and over the past 10 years unhappiness has been steadily rising. A Fortune article states a third of current workers say unemployment is a better choice than being unhappy at work, even with the risk of a global recession.
This points to employees who are much choosier about how and for whom they work. A Randstad report cited the importance some global workers place on hybrid working as a primary choice, even after the Covid Pandemic. Other studies have shown caregivers and ethnically/racially diverse individuals prefer hybrid work arrangements.
Further, an article by UK Recruiter states that although Gen Z have experienced online and social media as a constant in their lives, these individuals want to be in the office and want to build connections with colleagues. They are demanding better work/life balance, citing a request for a 4-day work week and flexible working conditions. They expect employers to invest in their development and mental health and well-being and do not tolerate exclusion, and as such will consider leaving their employer if they sense diversity and inclusion issues.
The death of George Floyd in 2020 gave rise to greater focus on diversity, equity, and inclusion (DEI) leading to an opportunity to reimagine the world of work and bring greater representation. This has brought with it multifaceted ways in which employees want to express their identities, in turn assisting with building trust, belonging, and creating inclusive cultures.
In keeping with DEI an ‘age inclusive workforce’ is coming to the fore as many older individuals, who were often the first to leave the workforce during the Covid pandemic, have faced barriers to re-entry. A recent event in Wales, UK, highlighted the value organisations can gain from a mixed-aged workforce. Older employees are often better positioned to develop more financially secure futures and navigate cost-of-living crisis’ than their Gen Z counterparts.
To attract and retain talent and maintain a happier workforce in the future, a move away from linear, one-size-fits-all policies is necessary. Engaging workforces, embracing DEI, and demands for
more individualised, flexible ways of working, and spaces that foster a sense of purpose and fulfilment has become a societal imperative.
Next Generation Indonesia. Guy Allison. British Council. Oct 2022
https://www.britishcouncil.org/sites/default/files/t0073_next_generation_report_a4_web_aw.pdf
Four in Five Gen Z Workers Want to Move Jobs This Year. Irina Anghel. Bloomberg. 08 Feb 2023
The Global Rise of Unhappiness. Jon Clifton. Gallup. September 15 2022
https://news.gallup.com/opinion/gallup/401216/global-rise-unhappiness.aspx
Would you rather be unemployed than unhappy at work? 1 in 3 workers say they would, major study finds. Chloe Taylor. Fortune. January 18 2023
What Gen Z Value Most at Work. Louise Triance. UK Recruiter. 12.Jan.2023
https://ukrecruiter.co.uk/2023/01/12/what-gen-z-value-most-at-work/
Overemployment is here: Nearly half of workers have more than one full-time job. Jane Their. Fortune. February 13, 2023
https://fortune.com/2023/02/13/overemployed-workers-juggling-full-time-jobs/
How CEOs are embracing the future of work to help advance DEI in 2023. Michael Fenlon and Sarah Cambrelen. Fortune. 27 January 2023
https://fortune.com/2023/01/27/ceo-initiative-pwc-future-of-work/
Event spotlighting the benefits of an age-inclusive workplace. Cerys Lafferty. Herald, Wales. Jan.2023
Building an Inclusive Workplace? Prepare to Shield It from Economic Fears. Hise O. Gibson and Nicole Gilmore. Harvard Business School. 08 Feb 2023
https://hbswk.hbs.edu/item/building-an-inclusive-workplace-prepare-to-shield-it-from-economic-fears
Sam McDonald, WITH-HUMANITY, 16 Feb 2023