Being Mortal 

by Atul Gawande

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For years when looking for a book to read (or now to listen to) it has always been the epic fantasy and sci-fi novels that I have reached for.  This book had been recommended to me so many times however, including by leaders and colleagues in our Next Gen GP programme, that I thought I would give it a try.

​In this book Atul Gawande, a world-renowned American author and surgeon, explores what it means to be mortal in the 21st century.  We are taken on his journey of facing our mortality, from the difficulties of aging to what it means to care, and finally to facing our ends. Challenging the beliefs we have as professionals and patients about the aims of healthcare.

This book is a sensitive and enlightening exploration of the trials that we face in healthcare in looking after an aging population, challenging many of the thoughts and practices that are commonplace.  The reminder that in our attempt to do good and extend life, we can in fact cause harm and distress is a humbling one. Even when we feel that we are aware of these difficulties it is still a fascinatingly complex situation to navigate.  Atul Gawande’s touching stories of his own experiences with his father’s illness and end of life expose and explore many of the anxieties and struggles that clinicians go through.  The theme of personal experience and narrative runs through every part of this book. There is humour and inspiration from his encounters with the pioneers of elderly community care, and their paradigm breaking approaches to what people want vs what we think that they need – including the surprising success of filling a care home with hundreds of live animals! This humour is contrasted with the sensitive and heartfelt exploration of what the true consequences are of when we get it wrong, and the peace and life (and for that matter death) changing impact that can be had when we get it right.

Reading this book has already changed my practice, encouraging me to have the difficult conversations with families and relatives earlier, so that in their life they can be brought into the discussion of their wishes and their mortality. Moreover, it has changed the way that I have these conversations, considering what really is important to people is a very personal thing. As Gawande puts it “Our ultimate goal, after all, is not a good death but a good life to the very end.”

Finally, it has also changed my outlook on relationships with my family and loved ones. It has helped me realise that whilst care for others is at the heart of what we do we need to attend to ourselves and families as well, as – at some point – we all have to confront what it means to be mortal.

James Waldron, GP and Nottingham Next Gen GP Leader


by Jake Knapp

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 A friend and colleague recently asked a group for ideas and advice on how she could support her practice in their ambitions to improve patient access as they were planning to hire in an external organisation to help. Lots of ideas were suggested and, in the middle of the discussion, this book popped back into my mind. Written by 3 designers from Google Ventures, the venture capital branch of the company, it documents an intensive 5 day ‘sprint’ process to develop and test new ideas in an organisation.

Now, I know most general practices and healthcare organisations don’t have that a whole week to spend on developing and testing ideas for improvement… but what stuck with me was the realisation that – unlike most of my prior experiences trying to change things in my workplace –  quality improvement doesn’t have to take a long time. Although the time frames suggested in this book are a thing of fantasy for most teams there are still loads of ideas that can be taken and used individually as part of a (slower) QI process. Suggestions for rapidly understanding processes and problems, for developing creative ideas and consensus in decision making, and for quickly prototyping changes to get rapid evidence of impact (or lack thereof). This book won’t be for everyone, but for those interested in refining Quality Improvement processes it might be worth a look.

Will Owen, Next Gen GP

The Power of Habit 

by By Charles Duhigg

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I’ve read this book twice in recent years, and both times have found ways to break some bad habits and start some good ones! Duhigg is responsible for me being able to drag myself out of bed at 5am in winter for a run- something I spent years trying to get into the habit of doing!

He presents the science behind habit formation in an easy-to-read way, and is optimistic about our ability to break them: “Once you understand that habits can change,” he concludes, “you have the freedom — and the responsibility — to remake them.” 

He makes his case by presenting fascinating stories and case histories. You’ll learn how and why Target can tell which of its female customers are pregnant before they tell anyone; how Rick Warren went from a depressed minister of a small congregation to the leader of one of the biggest megachurches in the world; and why Rosa Parks’s refusal to give up her seat started a movement when similar refusals by others had not.

I won’t spoil it for you….needless to say the “Power of Habit” is a fascinating read, and a permanent fixture on my bookshelf  to return to when I find those bad habits creeping back in. 

Nish Manek, Next Gen GP

Radical Help 

by Hilary Cottam

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This inspiring book is based on a social activist’s series of experiments giving people the control to improve their own lives. At the heart of this way of working is human connection. Upending the current crisis of managing scarcity, we see instead that our capacity for building relationships to make sustainable, holistic change are abundant. Her research is painstaking and her practical examples are inspiring, casting a compelling vision for doing things differently. Definitely worth a read!​

Nish Manek, Next Gen GP