Farai Pfende

She/Her Snr Lecturer @TrentUni #Dir @jocoinfo #RNLD #healthsocialcare #EDI #LD #Dementia #Publichealthresearch & being a #SENDmamabear Views here are my own

[Farai Pfende @FPfende]

Film: Unauthorised Absence out 10th Nov.
https://t.co/c5K6oniJNU
⚠️scenes of child & parental distress. #LearningdisabilitiesNurses shld be part of the conversation & solutions in school SEND support system. #SEND #RNLD #Neurodiversity #Inclusion #supportacrossthelifespan

[Farai Pfende @FPfende]

Love this!

[Open Future Learning @Open_Future]

An intellectual disability org asked AI to make support work sound exciting...

It turned driving the van into “travel opportunities,” bowling into an employee benefit, and mandatory training into an all-access VIP package.

P.S. drawing by @inkybrittany.com not ai

[NOBUNAGA🇯🇵🏯 @japan_nobunaga]

My neighbor Linda in Tennessee brought me a pound cake in a Pyrex dish back in March. That dish has not been empty since.

It was a very good pound cake. I want that on the record.

Where I'm from, you never send a container back empty. My grandmother was strict about it. You put something in, even if it's just a sheet of paper or a little box of matches. An empty dish going home basically says "we're done here."

So I washed it and filled it with onigiri. Rice balls. Twelve of them, in rows. Walked them across the yard.

Linda said, "Oh honey, you didn't have to do that."

Four days later the dish came back with banana pudding in it.

That's when I knew. She had the same grandmother.

I sent teriyaki chicken. She sent chicken and dumplings. I sent tamagoyaki, the rolled egg thing, and she sent a casserole with crushed Ritz crackers on top that I still think about at night.

By my count that dish has crossed the property line 23 times. I could be off by one.

Neither of us has ever said a word about it. You don't. You fill it and walk it over.

In August her husband Gary caught me in the driveway.

"You know there's a word for that? The little something you put in the dish? Down here it's a surcie. Her mama did it. Her mama's mama did it."

I told him we have a word too. O-utsuri.

He stood there a minute. "Huh. Y'all too."

Yesterday I flipped the dish over to wash the bottom. There's a strip of masking tape on it that says LINDA in Sharpie, so it finds its way home after church potlucks.

Under LINDA, same Sharpie, it now says NOBU.

It goes back tomorrow. Gyoza.

[Farai Pfende @FPfende]

Safeguarding after harm is not enough. Prevention please!
Learning Disability Nursing has fallen by a 1/3. RCN warns of “LD nurse deserts”. If @Alison_McGovern is serious about safer care for people with learning disabilities, protect pls rebuild #LearningDisabilityNursing

[Daniel Hewitt @DanielHewittITV]

Care minister: there are too many “rogue providers” in the care sector for people with learning disabilities, after our investigation into Blue Ribbon Healthcare

@Alison_McGovern said we need to change the kind of providers caring for the most vulnerable https://t.co/SGckntIzYB

[UCU @ucu]

“People who work in universities are feeling absolutely betrayed by being dragged into this conversation as if their contribution is not recognised.”

Migrant staff put down roots, build lives and make an enormous contribution to our universities and communities.

Their right to remain should not be treated as a political football.

[Farai Pfende @FPfende]

@PaulaMc007 @Alison_McGovern @YvetteCooperMP @ShaunLintern @Rebeccasmt @DanielHewittITV I’ve designed and delivered training for decades now & always welcome constructive feedback. This vitriol is not it & has no place in health and social care. I’m sad you have to see it. I’m sad for the patients and public we serve having to see it as well.

[Helen Bevan @HelenBevan]

How could we massively boost productivity in health & care? Part two.

A summary of comments on my last post about "Productivity starts with people", co-authored for @BMJLeader. These come from across multiple social platforms. Five themes stood out:

1. Who creates productivity? Richard Wylde argued productivity cannot be done to people. Those closest to the work see the opportunities and barriers most clearly, given trust, support and space. Ian Carruthers said the NHS needs to give people permission and authority to fix obvious problems. Marion Dixon asserted that good leadership which supports staff to “change their world” really matters. Dr Sadia Khan contrasted “control” that yields compliance, and “psychological safety and agency” that yield innovation. Laura Yearsley described people choosing the improvement areas themselves, with learning as the strategy in place of a detailed plan, with people from surgeons to nursing assistants choosing to make time for the work within demanding jobs.

2. Permission, time and support: David Groom noted change cannot sit on top of the day job. People want to be productive and need permission, structure, time and senior support. Jonathan Sunkersing observed progress comes from modest improvements done consistently, which makes it accessible to everyone. As a leader, Lesley Parkinson would agree the improvement gap with the team and hold those conversations weekly. Anthony Lawton recalled a manager complaining he produced ten ideas a week, and a finance director who asked how many were good.

3. The conditions for professional judgement: @farhadali said that protocols and prescribed ways of working protect safety; leaving no room for judgement kills the capability productivity depends on. Sarah Jenkins reported the instinct was to hand “productivity” work to finance colleagues, when culture and psychological safety affect us all. Vijaykumar V said without trust and relationship we can do nothing. Jennifer Carroll described creating the conditions for people to do their best work and connect authentically.

4. Shift from managing queues and capacity crises to designing for timely movement of patients, information and decisions: Chris Cooper argued for adopting economies of flow and features of the on-demand economy. Mike Chitty wants managerialism and care to become more comfortable partners. Richard Ogden would concentrate on the bottleneck. Martin Silcock asked who looks strategically at pathways. John Mortimer found the professional taking the call and visiting the person used 14% fewer resources with better outcomes.

5. Who and what we count: Sharon Anderson pointed to family caregivers as a second workforce, invisible in planning and productivity measures, creating hidden work on both sides. Tina Patel Gunaldo wants the same emphasis on what is going well as on what needs improving. Sonya Cullington said sustained AI use can erode the cognitive conditions improvement needs. Farai Pfende cautioned that extra effort and workarounds can make a struggling system look productive.

Thanks to all who commented.

[Farai Pfende @FPfende]

@JamesBlunt 😂 genius

[Farai Pfende @FPfende]

@HelenBevan @LauraJYearsley Love this! Productivity without efficiency & good governance can mask dysfunction. We can appear productive coz of staff extra effort & workarounds to compensate for inefficient systems. Being “unstoppable” should drive improvement & innovation, not simply keep services running.

[Farai Pfende @FPfende]

This resonated with my beliefs about organisational transformation. Leaders are often under pressure to achieve ambitious goals, but can lose sight of how change is experienced by the people delivering it. Making space to understand those perspectives matters. #HopeandRealism

[Helen Bevan @HelenBevan]

“Hope” is something we should think about every time we embark on change in organisations and systems.

A new @HarvardBiz article by Alyson Meister, Nele Dael and David Bach (“For Hope to Inspire, It Has to Be Grounded in Organizational Reality”) provides insight for everyone leading change, especially in health and care.

Our sector is saturated with aspiration-heavy narratives: “transformation,” “integration,” “prevention,” “AI-enabled futures” etc, etc. But the lived experience for many colleagues is different: constraint-heavy, change overload, fatigue, rising demand.

Having a sense of hope drives change, but the authors say we need to think about two factors. Both of them contribute to hope but can lead to very different outcomes:
- Aspiration (the future people are invited to work toward)
- Credibility (how far that future aligns with the reality people feel).
They set out four forms of hope based on these factors (see the graphic).

Often we see “Inflated hope” (high aspiration, low credibility). Leaders promise transformation without the clarity or resources to deliver it and change (and trust) fizzles out.

The two kinds of hope we should make the most of are:
-“Stabilising hope” (low aspiration, high credibility), particularly in times of high disruption and uncertainty, where we focus on morale, psychological safety and what we can achieve this week.
- “Mobilising hope” (high aspiration, high credibility). Needed greatly in our systems now: a compelling vision matched by robust diagnosis, clear pathways towards the future and visible follow‑through. It means people can see how their actions today build tomorrow’s better health and care system.

The most important idea I take from this article is not to “be hopeful,” but that hope is constructed through experience, not declared through rhetoric. Credibility is the currency of change. People are constantly assessing: “Does this make sense given what I know to be true?” In complex systems like health and care, our colleagues are highly attuned to misalignment. We can’t “message” our way to hope, we have to demonstrate it.

Three things this means in practice:

1) Ground the present: Our colleagues don’t need protecting from reality. They need help making sense of it. Naming constraints (“we don’t yet have the workforce”) actually increases trust.

2) Calibrate aspiration: Big visions matter, but timing matters more. Often the work is: stabilise today, improve tomorrow, transform over time.

3) Make pathways towards the future visible: If people can’t see what they can do differently on Monday morning, how that links to outcomes and how leaders will respond when things don’t go to plan, then hope never converts into action.

For change leaders, this is much more than a communication skill: it’s a relational and behavioural practice. It’s built through consistency, integrity and visible follow-through. People don’t need leaders who promise a better future; they need leaders who help them see how they can build it from where they are.

The article: https://t.co/Z43IaM25xl.

[Farai Pfende @FPfende]

@PaulaMc007 This is good news! I hope it makes them realise how much more they need to learn & understand. The #DWP #Accesstowork experience for people with LD leaves a lot to be desired 😭

[AlzChat @AlzChat]

#AlzChat 3pmEST/8pmUK Topic today: Art and creativity in dementia care @TommyTommytee18 @bikerwise @AmyGoyer @BrainToday @FPfende @OrangeChuck @Dementiawho @ministry_hands @AdrianzWall @Jennifer_Fink

[Farai Pfende @FPfende]

@itsme_urstruly Genius 😆

[Kentah Gwanjez @GWANJEZ]

"You got this."

[Farai Pfende @FPfende]

Ideas worth sharing with any #healthcareleader #healthcareeducator passionate about #transformation & #change @HelenBevan @HorizonsNHS
What if we've been getting resilience wrong?… TY
@GemmaStacey10
https://t.co/LQdlCPOafX

[Farai Pfende @FPfende]

Is it just me, or is “practice learning in a community setting across health and social care” too vague? Community healthcare, community social care & residential social care are very different. And residential social care nursing still isn’t given parity of esteem???

[Nursing Standard @NurseStandard]

Nursing students could see their practice learning cut by 500 hours, as the NMC seeks to launch a consultation on education standards.

The plans include mandatory community placements and limits on simulated hours.

https://t.co/dZmJdiD1Tc

[Farai Pfende @FPfende]

@currys Nativity!!!!

[Farai Pfende @FPfende]

Honestly, I’m troubled by the “shock” the public feel. It means we’re still in the low awareness & denial phase of these wicked problems. TY for raising societal awareness hopefully folk challenge these issues with their local Cllrs, MPs and others in power.

[Daniel Hewitt @DanielHewittITV]

For the past year we’ve investigated how the care system, NHS and courts are failing and neglecting learning disabled people, with fatal consequences.

They consistently tell us: we don’t have a voice.

We decided to listen. Their words should shame us all https://t.co/BjxbKMY7si

[Farai Pfende @FPfende]

@DanielHewittITV Honestly, I’m troubled by the “shock” the public feel. It means we’re still in the low awareness & denial phase of these wicked problems. TY for raising societal awareness hopefully folk challenge these issues with their local Cllrs, MPs and others in power.

[Farai Pfende @FPfende]

*Dr* Claire Chick #nurselecturer such a sad loss, rest in perfect peace. What a loving legacy for nursing students 💕

[Nursing Standard @NurseStandard]

A fund has been set up in the memory of a much-loved nurse lecturer who was murdered by her estranged husband in January.

The Claire Chick Nursing Fund aims to support nursing students in memory of Ms Chick, who has also been awarded a posthumous PhD.

https://t.co/gWfWU6JnLQ