The Time for Further Health Improvements in our area is Coming

PLACE (Patient Led Assessment of the Care Environment) Is Back on in St Barts NHS Trust.

Royal London Hospital Main Entrance


One of the several bodies I am very proud to be a member of is the PLACE assessment scheme.

I have served on these teams for around 4 or 5 years now, and have seen with my own eyes how the recommendations made by a PLACE assessment one year is acted on when we return the following year.

Most of the thanks for this goes to the team co-ordinator. I would not like to have his workload, but somehow he keeps coming up trumps.

For those of you who are scratching your head, and are asking what the hell PLACE is, well here’s an abbreviated outline:

PLACE stands for  Patient Led Assessment of the Care Environment.

The aim of PLACE is to improve the patient’s experience in the hospital, and make life for patients more beareable.

Royal London Hospital 2

Just how does PLACE happen?


It starts with the NHS Co-ordinator liaising with the hospitals throughout the St. Bartholomew’s Trust to set dates for the assessments. From this time on, he is the only one who knows the full agenda. The hospitals concerned will usually arrange for senior management to be made available for the assessments.

Although the hospitals will know which days we will be on site, no-one except the co-ordinator will have any idea of which assessors will be on which teams, or which wards and/or clinics the assessors will visit.

On the day of the assessment, everyone will congregate in a previously arranged meeting room. It is only at this point when we will know which team we will be on, who else is in that team, and which outdoor areas, wards or clinics they have been allocated.

On a large site like the Royal London Hospital, it can take up to a dozen teams over two days work.

Normally an assessment team will comprise of 2 or 3 PLACE experienced patients, a couple of lesser experienced patients, a Senior Manager of the Hospital (who is there to clear the path for us), a couple of hospital staff, and we would often have observers from other trusts or hospitals.

At the start of the assessment, each team allocate a patient team leader and an administrator, usually one of the hospital staff attached.

Each team will usually be allocated at least two zones for assessment on each day.

What are the teams looking for?

We look at all areas and services that patients can access, from the state of hygiene of the area, cleanliness, compliance with health and safety regulations, to actually watching the process of meal serving on wards, and food sampling.

St Barts Food serving


On arriving at the area to assess, the team leader or accompanying manager will let the department be aware that we are about to carry out an assessment, inviting a senior member of the ward or clinic to accompany the team as a guide to advise on the service the ward/clinic provides, and ensuring the assessors avoid any contagious or dangerous patients or areas. This also helps in the event of the team identifying any major point which requires urgent attention, the ward are aware of the situation from the start.

Assessment teams will always allow areas to operate normally and will ensure that they use hand sterilizer on both entering any area and on leaving. Assessors will have shirts or jumpers rolled up so their arms are clear below the elbow.

As soon as the assessment of any area is completed, that team will use a small room or a quiet area to write up their findings. This is where each team administrator comes to the fore, and guides the team through the highly detailed and lengthy questionairre specially composed for that area. If there is an impasse on any decision on a matter, the patient team leader’s decision will override the impasse.

All teams usually return to our meeting room for lunch, provided by the hospitals catering provider, and then continue with the second session they have been allocated.

At the end of the day, all hospital and NHS employees will be asked to leave the meeting room, leaving the patient assessors free to discuss any pressures they may have had placed on them in making their decisions (if any).

One of the greatest compliments the PLACE teams can have is that they have now been asked to carry out PLACE assessments at hospitals outside of the St. Barts trust.

Over the next few months I will be blogging and photographing the PLACE assessments in action (not any confidention bits of course), so keep an eye on this site for updates.

For copies of PLACE documentation and details of previous PLACE assessments and results in the NHS, follow this link:—england

If you have any questions about PLACE, or you would like to join a PLACE assessment, please use the contact form below, and the appropriate person will call you back.


Vernon Coleman: Was Britain taken into the EU illegally?

Tallbloke's Talkshop

This is a followup to a post about the issue of sovereignty and Britain’s membership of the EU I put up a while back. These are weighty issues the public needs to consider. Needless to say, the BBC won’t be promoting in depth debate about the matter, so it’s up to bloggers and journalists to do the job. Actually, not many journo’s seem to want to raise their heads above the parapet either. I know it’s dull stuff, but please read and think about this. It’s up to us to let the political class know we don’t take kindly to having our liberties, fought for since Magna Carta, signed away to an unelected foreign commissariat which subjects us to summary extradition through European arrest warrants, dictates how we (dis)organise flood defences, and forces us to put the ‘human rights’ of criminals before those of their victims.

edward-heath-treason Was Ted Heath committing treason when…

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Brexit 1

A lot of the general public seem to think that Boris Johnson is in for a tough ride in his aim to get Brexit signed and sealed by 31st October. Maybe the truth is that not only is this going to be difficult, it’s almost impossible.

Let’s look back at the true cause of the current situation. Before the referendum, there was a massive majority in support of remaining in the E.U. through-out the House Of Commons and the House of Lords , so that when Ministers thought that a full referendum on Brexit would have resulted in a definite no vote, all of the House of Commons loudly declared that no  matter what the result of the referendum, they would support and act on it


Nigel Farage portrait 1

Nigel Farage – Chief campaigner for Brexit

The problem here was that the general public had a different viewpoint. They were fed up to the teeth with the  EU court over-riding Parliament and the British Judicial system, with immigration at the existing phenomonal pace, with the loss of control over our own fishing waters, and the impending passing of control of our own military into a new conbined EU military force, even though there is an existing NATO and UN fighting force.

Brexit - Winston Churchill quote 1As a result of these actions by the EU, politicians must have had a fit when the Referendum results finally came in, with a majority of the public voting to leave the EU.

Now as their own words had assured compliance with the result being followed through, they were left in a dilema, how do they stop Great Britain from leaving the EU?

Firstly they ensured that they have Remain supporters in position to play for time, for example Mrs Theresa May as Prime Minister, and other Remainers in key positions in the Cabinet.

Theresa May Brexit 1

When they discovered the public would revolt if Brexit weren’t followed through, they tried another angle, by telling everyone that those who voted for Brexit did not have an understanding of what their vote meant. This caused a further uproar as it appeared that they were calling those who voted for Brexit stupid.

Parliament now had a desperate situation where there was a major gulf between themselves and the voting public. Measurements had to be taken to show the voting public that they were being listened to.


Firstly they ensure that there was an almost impossible time gap to reach a good deal.

They then made sure that a ‘No Deal’ hard Brexit was seen as an inappropriate option, and any other agreements were seen as impossible to achieve.

Once this was achieved, there was a dramatic vote of no confidence in the Prime Minister, resulting in a completely different attitude, where we now have a Pro Brexit Prime Minister, Boris Johnson. The rest of the Cabinet resigned in ‘indignation’ with the clearly up and coming changes at the top, using their resignations to bolster the Remain arguement. These resignations really came before they were fired and replaced by pro Brexit Cabinet members.

Boris's initiative achieved these trade opportunities, with Farage, Leadsom and Stuart

Prime Minister Boris Johnson

The situation now is that we now have a pro Brexit Prime Minister and Cabinet (which only proves that this could have been done in the first place – not as a last resort), with an Anti-Brexit Parliament which will still vote against any new deal brokered by the new PM and Cabinet.

The question we have to ask is: Will the House of Commons (and the House of Lords – also Anti-Brexit) ever approve any agreement now raised. The real problem may be that too many politicians have had their snouts (and all four trotters) in the E.U. trough. Those who haven’t will hope to sometime in the future, hence the very high number of Remainers in the Palace of Westminster.

The Remainers are now trying any and every reason to stop or further hinder Brexit.

The next steps of the Remainers will be to push for a Second Referendum, before the result of the first is followed through, force a general election, or force a No-Deal Brexit and blame the new Cabinet.

Brexit 4When will Ministers realise that if they continue to ignore the voters, who put them into office, they will soon be out of office.

Can Brexit be achieved as long as the House Of Parliament are so Pro Remain?





The view from the  Maritime Museum showing Greenwich Park and the Royal Observatory

Three members of Tower Hamlets’ Local Voices held an introductory meeting with Helen Wallace of Greenwich Park looking to see how the park and it’s historical surrounding buildings could become more disability friendly.

IMG_0768 (2)

Rob, Marc and Helen

To start off, we carried out tests on the proposed new tranfer buggy that the park will be using to enable the disabled to climb the steep hill to the Observatory, allowing them to visit buildings like The Royal Observatory, The Planetarium, and the many other sights on top the high ground of the park.

It was discovered that although the buggy was too narrow to take the largest mobility scooters currently on the market, but will comfortably cater for the standard wheelchair (including powered ones) and smaller mobility scooters.

The ramp to board the buggy although frail to look at comfortably handled the 250kg load we put on it.

After these tests we made our way up the hill, ( Rob and Marc on the Transfer Buggy whilst I rode up taking a wider angle on my scooter) and discussed further measures over soft drinks and tea at the Pavilion Cafe.


Rob and yours truly with Helen Wallace in discussion (photo by the other Marc)

Afterwards I carried out my own tests on some of the buildings which form part of the attraction. One of the biggest limitations placed on these buildings are their age and that most of them are historically Graded buildings. I was pleased to find that most areas in the majority buildings are accessable to wheelchairs and most mobility scooters.

Sadly one of the key lifts was out of order on my visit.

I would have had access to most areas during this visit, if it hadn’t been for the high number of visitors  moving around limiting my access. Clearly on almost any other day this problem would not occur, but with schools on end of year trips along with the blazing sunshine making the park a major attraction meant that there were an abnormally high number of visitors.

I was able to access and make purchases from the multitude of souvenier shops around the area.

Surprisingly the biggest problem I had was in accessing the lift in the Maritime Museum, where little thought had been given in it’s siting with regards to the limitations of turning circles combined with heavy manual doors which made access to wheelchairs and mobility scooters extremely difficult.

Arrangements were agreed to carry out further tests making use of some other members of Local Voices.

I really do look forward to the completion of this project, and I plan future visits soon.





I bet you think you make the decisions over what you and your family eat and drink. I hope this article will make you think twice.

Supermarket logos 1

My first question is – where do you do your main shopping? The answer is usually the same. It’s one or other of the main supermarkets, whether it’s on-line or in their stores.

So if you think about it, you could only purchase items they have on their shelves (or website). This is the first limit placed on you from the start. Each supermarket carries out stock rotation. I’m not just talking about putting out fresh stock of the same line, but rotate the varieties they have for sale in their stores. For example, one store will carry out a specific item for a while, sometimes on a special offer, whilst other stores do not stock it. After a couple of weeks or so, that item is removed from the shelves, and as if by miracle, that exact same item will now appear as if by magic in a totally different supermarket.

This exchange of items means that one item will be in only one store at a time, and this seems to be happening with a lot of items.

You should always keep one thought in mind when you shop in these stores – Which items are not on the shelf?

Supermarkets are now in a position to control exactly what is or isn’t on their shelves, and as a result, what was previously the RRP (Retailers/Recommended Retail Price) and the MRP (Manufacturers Recommended Price) are no longer applicable. These have now been replaced by the HMCWG, or How Much Can We Get. Prices are now controlled entirely by the supermarkets. As a result only high profit items reach their shelves, although they will include major popular brands which they know their customers will expect to see. or they will go elsewhere, but they then counter this by producing their own brands of the same products, hence increasing their sales and profit margins, whilst reducing the sale of the original item. A clear example of this can clearly be seen with something as simple as Heinz Baked Beans. This item is always available, but right next to them are the store’s own brand of baked beans, cheaper than the original.

Baked Beans Heinz 1

The price of Beans?

The supermarkets have now turned the increasing of prices into a fine art. How many times have you been looking for an item you have bought regularly, and all of a sudden the item has been removed from the shelf only to be replaced by a multi-pack which is dearer than buying the same number of your original product?

How often have you seen a ‘Special Price’ which was higher than the price previously charged?

Another more recent trick is to hide their own brands giving the false impression that they have been produced in a farm, or under healthier and/or greener conditions, which are often totally misleading.

Only recently the price of milk was in the news headlines. Small dairy farmers were simply going out of business because it was costing more to produce milk than the farmers were receiving from the supermarkets for the milk they provide.

Dutch milk

One thing I would love to know is how many items have been turned down by supermarkets which we could have enjoyed if it were truly a fair marketplace.

Even if we come off of the food shelves and go on to other items they sell. Lets look at Books, CD’s and DVD’s. The majority of these stocked are those in the stores’ own generated Top 20 or Top 50 list. Where are all of the other items which deserve as much marketing?

What about clothes? How come the vast majority of clothes sold by the supermarkets now seem to be their own brand? Are so many manufacturers out of business, or are the stores being clever and only stocking those which ‘compliment’ their own lines?

The supermarkets are now also selling crockery, household items, Banking services, mobile phones,pharmacy, in-store cafes, televisions, insurance services, and the extras which go with them, and the list goes on.

The supermarkets will argue that they are encouraging fair trading, making services easier to obtain.

I ask, are they really just lining the pockets of shareholders and their board of governors?

The real problem is that the general public have allowed this to happen over the last few years. People like to have everything in one place. In other words  they have become too lazy to shop in a High Street where you would have had a wider range of items on offer, and the personal service that comes with them.

Closing Down sale 1

Now we have shops closing in high streets all around the country, when they can’t possibly match the services you can receive in the local supermarket. Why is that? I believe one of the biggest contributions is the opening of smaller ‘local’ branches of the supermarkets. Local shops could have survived when supermarkets were located outside of  town centres, but once they started moving mini-supermarkets into the high streets, local shops are sadly doomed, tightening the grip the supermarkets have on the public purse.

Unless the general public wake up to what’s happening, there will no longer be a High Street.

Only the shopper has the power to stop this process, and the way to stop it is to shop in your local high street more, but not at the supermarket, or local mini-supermarket. But will you do it? I doubt it.

Closing Down 2

(Photo: BBC)






I today attended the Travel Focus Group for Tower Hamlets held at the Idea Store at Whitechapel, only to realise that these group meetings are only being held as a tick box event, to show that meetings with the public had been carried out.

The first milestone was the fact that as the venue’s lifts were too small to take my mobility scooter, so it had to be left in the enrtance to the venue, forcing me to walk and use the lift up to the 3rd floor!

Then the refreshments arrived, only after we had already started the meeting!

The meeting was constantly interupted by late arrivals.

As well as attendees being asked what problems they had in getting to this very central venue, the meeting really focused on only three main subjects, Cycling, Walking and Driving.

If I hadn’t brought up some of the problems I have getting around the Borough and on public transport using my mobility scooter, facilities for the disabled would have been totally ignored.

Other than my comments, there were no other wheelchair dependant or mobility scooter dependants at the meeting, and no others with clear disabilities, so although I tried to expand the questions, before we knew it, the one hour allocated was up, and the organisers ensured the meeting finished on schedule, with all of my remaining questions unasked, even though I clearly stated that I had a lot more questions to ask, as the filming of the event will show.

Although there were 3 of these ‘Focus Groups’ being held over 2 days, it is clear to me that this was no more than a paper exercise to please the record books.

The problems being experienced by the disabled in the borough was being brushed under the carpet. Again.



London's East End Guard Dog


Bus Stop Closed 1

Recently in my area there has been a TfL bus stop closed (Barnet Grove West Bound) for weeks now.

There is a small building site next to the stop, but there has been very little activity on the site to quantify total closure of this stop.

The biggest problems closure of this particular type of stop is to the elderly, pregnant ladies, and the disabled, many of whom use this stop, as the distance to the next one is quite a distance away.

I have noticed in the past that there are frequent bus stop closures in London for no apparent reason.


Do you have the same problem?

If you do suffer from unnecessarily closed bus stops, specially in London, please let me know using the  contact form below.

Any personal information will not be passed on…

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