06/02/2017 Inside Out South East


06/02/2017

An update on proceedings since Kent participated in the Telehealth experiment, which sought to monitor people's health at home. And things to look out for during winter walks.


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Transcript


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Whatever happened to high-tech health care in the home?

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It's a disaster for that family and the patient.

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Someone now needs to step up and take ownership of this and say,

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"I'm really sorry it has gone wrong, it was a trial, but

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The veteran airmen on a mission for the Guinea Pig Club.

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I hit the ground rather violently and this was an inferno.

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And how to navigate your way through the winter months.

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Winter is actually quite a fun time to do it.

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We've got fewer leaves on the trees so we can look at some things

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I'm Natalie Graham with untold stories closer to home,

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from all around the south-east, this is Inside Out.

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Hello and welcome to the programme, which this week comes

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to you from a rather wet New Haven in East Sussex.

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Now, no one likes staying in hospital if it can possibly be

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avoided and a few years ago, the government backed

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a new scheme called telehealth, designed to help people

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Kent was at the forefront of that experiment,

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Can you come and have a look a minute, please?

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He's a former Lord Mayor of Canterbury.

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When he was younger he ran marathons.

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He was also a rugby player and boxer.

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But these days he suffers multiple health problems.

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He's covered in cuts and bruises from regular blackouts and falls.

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He doesn't often move far from his armchair.

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I got kicked in the head playing rugby and had two blood clots

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on the brain and developed epilepsy from the heart.

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I then had a couple of heart attacks and that followed

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He fell unconscious while you are interviewing him and his wife.

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I asked Betty how often that happens.

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There are thousands of people like Pat in the south east -

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in and out of hospital - with long-term conditions that put

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But Kent was one of the first local authorities to

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experiment with a high-tech solution - telehealth.

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Telehealth is a system, first developed in America,

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where patients use high-tech equipment at home to take

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their own health readings, which can be monitored remotely.

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What it allowed us to do was monitor patients on a daily basis

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from our office or from where ever we were without having

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The government was so enthusiaistic about telehealth that it launched

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the Three Million Lives campaign, which aimed to get three

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million people signed up to telehealth within five years.

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And it apppinted Kent as a pathfinder authority,

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because Kent had been operating a telehealth system since 2005.

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So we are going to find out what happened to telehealth.

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There were certainly high hopes back on.

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We know that this saves money and improves lives.

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We know it has fantastic potential benefits, reducing the number

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of crisis admissions in hospital when everything goes

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wrong, which happens to often at the moment.

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But in the same year the NHS was reformed,

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devolving power from large primary care trusts to smaller clinical

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At the time, Roy Lilley, a former NHS trust chairman, sounded

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He said it would only work on a large sale.

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Because if you work as it is now, with a few local bits of kit that

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get plugged in in some way or other to the local GP's surgery,

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They were told to take Pat's vital readings every day,

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to include blood pressure, blood sugars and oxygen levels.

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These were relayed to a nursing team that monitored them remotely.

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The whole system gave him a lot of confidence that

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if he didn't feel well, put him on the machine

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and he would know roughly what was wrong with him,

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you know, whether it was the heart, the head or what.

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Rather than being in hospital maybe three times a month,

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it stretched it out to maybe once every three months and it made

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To start with, Pat and Betty were very happy

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It meant that despite Pat's severe health problems,

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they felt they had the security that someone was watching.

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But after a while, Pat and Betty noticed a change

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in the telehalth service - to them it seemed the

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If the readings that were going through to the listening station

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were above or below his parameters, then somebody would

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Or they'd ring me and say, 999, and then gradually this has gone

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The visits have come down to the fact that

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Betty became so concerned about the service that she started

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Every month I took, I started taking a picture.

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And were there are things that concerned you about his readings?

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That you felt you should have got a phone call?

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These are down in the threes, blood sugar.

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Was Betty right to be concerned that she didn't get phone calls

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from nurses when she thought perhaps she should have done?

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We are not experts so we don't know, so I have taken some of those

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readings and I am going to show them to somebody who might

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Dr Lawrence is a GP and a reader in medicine at Warwick University.

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He agreed to take a look at Betty's photographs.

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We can see certainly as far as the BP is concerned

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that there are times when it has been quite high and out

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of a certain range, or quite low and I would expect

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that there would be some kind of communication

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What I'll do is I will ring Betty now and see if she did

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I'm just looking at the BP readings from March of 2016.

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Your husband's BP was around 105, 110 systolic.

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If it is quite low, then it can reduce the flow of blood

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to the brain and physiologically one will therefore feel dizzy

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I would expect that you may have received a call at this time.

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No, I haven't had any calls this year.

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Dr Lawrence, what do you think about the fact that they didn't

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So what has been happening with the Burke's telehealth service?

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In 2013, the NHS was totally reformed.

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Responsibility for telehealth switched from the Department

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Kent County Council is no longer involved.

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So with responsibility for telehealth now passed

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on to the NHS, we contacted the Clinical Commissioning Group

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We asked why Pat Burke didn't get calls from

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the service in March last year and if the service has deteriorated.

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The reply came from Kent community health NHS

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Foundation Trust who run the service for South Kent coast CCG.

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The Burkes told us that that's not the case and they hadn't

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agreed that Pat should come off telehealth.

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They also did not know about him being discharged. Betty said the

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reason a nurse came out to see him in March is because she called the

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service concerned about a bad cough he had at the time. We wanted to

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know what had happened to tele- health. All be Kent CCG 's gave us a

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joint statement. The Kent CCGs told us the telehealth

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system has gone. They sent out letters to telehealth users but the

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Burkes say they did not get the letter. Nothing has come to us. As

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we heard earlier, Roy Lilley was sceptical four years ago about the

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likely success of tele- health unless it's run on a big scale. He's

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critical of way the bags have been treated. It's a disaster for the

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reputation of tele- medicine and it's a disaster for the CCG and the

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practice because they have to take over looking after these patients in

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some other way. There is no failure regime when these things go wrong,

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it was put in under the terms of being a trial. The trial has failed

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now someone needs to step up and take ownership and say, I am sorry

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it has gone wrong, but we will sort it out. I asked if there was any

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prospect of the CCGs being able to prospect of the CCGs being able to

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organise a telehealth system that organise a telehealth system that

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works in the future. There are 212 telehealth CCGs in England. There

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are far too many and they are far too small and they are occupied with

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being avalanche with demand. Wherever tele- medicine was on the

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list to do, it's hip to the bottom. It makes a life that I had vanished.

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A way of life. It should not be taken away. It would be taken away.

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I think that is wrong. While we were filming with Pat, he had an

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epileptic fit which left him lying on the floor. In spite of his

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long-term health problems, the Burkes want to stay in their own

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home. They thought telehealth would be the answer, but at the moment, no

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telehealth scheme is in place in Kent. Coming up: We bring you tips

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on how to navigate your way through a winter wonderland. It's finding a

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way using nature, the sun, the moon, the stars, even buildings.

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Everything is a clue. He may be 95 years old but one that trend pilot

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is on a final mission, to build a memorial to the airmen who are

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seriously burned in the Second World War and to ensure we never forget

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the members of the Guinea Pig Club. The 22nd of September was a very

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important day of my life. By the end of the day, my life had changed. I

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hit the ground violently and this was an inferno. I undid the straps,

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the buckle, climbed over the starboard side of the aircraft and

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fell to the ground and then I was unconscious again, woke up in

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hospital. It was... Just a horrible feeling, like terror. You feel as if

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you are going to die now. Where are you? I am up there. You

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can tell from my hat. A trainee glider pilot

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on a navigation exercise in Warwickshire when the plane's

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engine stalled and it crashed. I was covered with aviation fuel and

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I was on fire. I got horrid burns of my entire legs and my hands and my

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face. He suffered 40% burns and in 1947,

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was sent to a pioneering plastic I was referred to Archibald McIndoe.

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He said I needed a further 14 operations, which gave me the face I

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have now. McIndoe had been appointed

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by the RAF to treat The Battle of Britain led to rising

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numbers of young pilots By the end of the war, the majority

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were from Bomber Command. McIndoe's patients became

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known as his Guinea pigs because of the experimental plastic

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surgery they had. He encouraged them to form

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the so-called Guinea Pig By the end of the war,

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it had 649 members. 75 years after the GPC was formed,

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Sandy feels it's time the severely burned airmen should be given

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a permanent tribute. With his wife Maggie,

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they've come to see it taking shape at Graeme Mitcheson's

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workshop in Leicestershire. You've got the drama. Yeah, quite

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sharp flames here, thinning out to smoke at the top. It's catching that

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drama of how the injuries were obtained. I commissioned this

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memorial because if I hadn't done so, nobody else would. At East

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Grinstead, Sir Archibald McIndoe needs 37 members of the day big

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clubs. His hands have given new hands and faces to burned their men.

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the Queen Victoria Hospital in East Grinstead.

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It's still a leading centre for the treatment of burns injuries.

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Welcome, gentlemen. Like Sandy, Roger Chaplin has also been treated

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at East Grinstead. After crashing his private plane, he has had 70

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operation so far. The guinea pig story gives him hope. It is quite an

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inspiration. When you have a serious burn, you deal with the aftermath.

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It is easy to get into a very low situation psychologically. To see

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that they can come through that particular low and come out on the

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other side and go out to have a decent and fulfilling life, it is

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very uplifting. Sandy's mission to have a memorial is nearing

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completion. He has managed to raise ?20,000 to pay for it. The edge

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traces the profile of Archibald McIndoe's face. He is his face. His

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hands touched me and now I am touching him. It doesn't half bring

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back memories. The day of the back memories. The day of the

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unveiling at the National Memorial Arboretum in Staffordshire. The Duke

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of Edinburgh became president of the Guinea Pig Club after McIndoe's

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death. He is here to pay his respects alongside some of the loss

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of bribing members of the club. It's very appropriate, I think. The

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bottom bit and aircraft going down in flames. I am only a lightly

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toasted one. It's overwhelming. Absolutely overwhelming. I think

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he'd be slightly up at the extent to which 75 years after it was founded

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and 56 years after his death that something of this nature can attract

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such interest from around the world and nationally for something that

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started in a little cottage hospital in Sussex all those years ago. I'm

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very grateful to be able to live to see it on failed. I am glad I took

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the initiative. Archibald McIndoe inspired Sandy to train as a doctor

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after the war. He practised as a GP for 40 years. Now in his 90s, Sandy

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has terminal cancer, but he has one more chance to fly in a Tiger Moth.

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It just brings it all back. Yes. I wish I were young again.

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Sandy has tracked the Himalayas, sailed the Atlantic and skied until

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he was 82. He has led the full and active life that Archibald McIndoe

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wanted his guinea pigs to lead. Now his final mission is complete. There

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is a place where the injured their men will always be remembered.

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It can't have escaped your notice that we are in the depths of winter,

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but it's a good time to enjoy the great outdoors. As long as you know

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how to find your way about. From its headlands to its beaches

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and waterways, the South East of England is surely one of most

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beautiful corners of the country. Perfect for a walk in

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the crisp fresh air. But this is the time of year

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where you probably want nothing more than to snuggle up indoors and see

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out the cold weather and the long dark nights with a warm

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drink and a good boxset. After all, in the dead of winter

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you might think, quite reasonably, that there's nothing

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of interest to see. The Natural Navigator,

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AKA Tristan Gooley, is going to show me -

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and my dog Boris - how to find our way around

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the South East at this time of year, and why it's not so much bleak

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mid-winter, it's more You are the natural navigator. Tell

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me what that means. It's finding a week using nature. Using the sun,

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moon, stars. We are going to go on a small adventure but first we need to

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check the weather and see if there are clues to tell us what the

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weather is going to be like today. Tristan has got me gazing up

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to the skies to try to forecast the weather

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by just using the clouds. It's a day of blue skies but not

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perfect blue skies. Can you see these wispy, very high clouds? There

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is a vertical ones, striped? Yes, they are tailing away and that can

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be a sign that the weather is going to change. It is not a caste guy

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cast-iron guarantee. -- cast-iron guarantee. It's a sign that says

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don't assume is good weather will last forever. Let's make the most of

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it. The one thing I lead in the guide is if you are lost in the

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woods, look for the moss growing on the side of the tree and that will

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take you which way is North. That is what everybody thinks, but Moss is

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one of the most unreliable indicators. All it tells us is that

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there is moisture. There is something here which makes a

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fantastic compass. This gold colour here. It's a beautiful light can,

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one of my favourites and it loves light. When it gets lots of

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sunlight, it turns gold and we get most of our light from the South so

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the more cold it gets, that tells us which way self is. -- old. One of

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these birches, it's a good sign if you think you are lost because they

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tend to grow at the outer edges of a woodland. It did not take me long to

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notice some of the other clues for myself. Look, that is a colour

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compass. Yes! Can you see just here we have got what looks like hair

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lichen again and it loves fresh air lichen again and it loves fresh air

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so it is telling us we are in our own little patch of wilderness.

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Telling us the countryside is clean. It's fascinating getting to decipher

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some of the secrets the natural world has to offer. Can you see the

:24:42.:24:46.

lines in the sky there. Are they from planes? Yes, we didn't see any

:24:47.:24:53.

of that earlier and suddenly we are seeing these lines spreading out and

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staying out in the sky. It's not a good sign. It means the air is

:24:59.:25:03.

getting moister which means they weather is probably turning. It's

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the end of day one of our mini adventure and Boris and I have

:25:09.:25:13.

enjoyed a woodland walk. Let's hope the weather holds for the next leg.

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The following day the winter sun had been replaced by wind and rain.

:25:19.:25:23.

Boris decided to take a rain check and stay in his basket by the fire

:25:24.:25:28.

at home while Tristan and I hit Camber Sands. It's pretty cold and

:25:29.:25:31.

windy today. At least we have the windy today. At least we have the

:25:32.:25:35.

beach to ourselves. Yes, in amongst these doings, can you see how they

:25:36.:25:44.

have been swept over by the wind and our prevailing wind comes from the

:25:45.:25:46.

south-west so the south-west must be south-west so the south-west must be

:25:47.:25:50.

out there somewhere. Let's see what the water is like. We have some

:25:51.:25:56.

ripples here but they have flat tops and that's a sign the water has

:25:57.:26:00.

flowed quickly one way and then quickly back the other way. But

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actually the wonderful thing is this is a work of art and nobody will

:26:06.:26:09.

ever see anything exactly the same as this ever again. It is lovely.

:26:10.:26:16.

Shall we get an ice cream? We left the seaside and travelled to ride

:26:17.:26:22.

but can you try your hand at natural navigation in a town? And if you

:26:23.:26:27.

thought Tristan's use of lichen is a makeshift compass was inventive, you

:26:28.:26:33.

nice compass up here I would like to nice compass up here I would like to

:26:34.:26:39.

show you. This is it, your giant compass. Churches can be brilliant

:26:40.:26:48.

compasses. The alignment, churches are online from west to east with

:26:49.:26:53.

the altar at the eastern end. The auto traditionally would be in the

:26:54.:26:58.

direction of the holy land. Tradition means the church would be

:26:59.:27:02.

a line towards sunrise on the feast Day of the Saint that the churches

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Church and I believe the day in Church and I believe the day in

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question is August 15 and the sun rises north of East in August, so we

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north of East. The graves face a north of East. The graves face a

:27:19.:27:23.

certain direction because of the beliefs of those who are buried in

:27:24.:27:28.

them. Gravestones will be at the Western end and the feet of the

:27:29.:27:32.

person buried will be at the eastern end. On the day of judgment when the

:27:33.:27:38.

dead shall rise, they should be facing the holy land. If you are

:27:39.:27:42.

ever struggling to find your way in the centre of a town, find a church.

:27:43.:27:48.

They will give you a good sense of direction. If you can pull yourself

:27:49.:27:58.

away from your scented candles and socks, there is much to see at this

:27:59.:28:02.

time of year. Let's not forget about using the church as a giant compass.

:28:03.:28:04.

Surely this proves that we really do live in a winter wonderland.

:28:05.:28:17.

For more information about the programme, you can go to our pages

:28:18.:28:25.

on the BBC News website. You can watch the programme again on BBC

:28:26.:28:31.

iPlayer. Next week: The fisher men who are abusing drugs in the English

:28:32.:28:36.

Channel. That's what we have to live with, you have gone from being a

:28:37.:28:42.

good fisherman, strong, great man to a druggie. An organ donors who have

:28:43.:28:47.

their final wishes overruled. If someone has taken the time and

:28:48.:28:51.

effort to express their wishes by carrying a donor card, no one should

:28:52.:28:55.

have the right to overwrite that wish. That's all from us tonight.

:28:56.:29:02.

Hello, I'm Riz Lateef with your 90-second update.

:29:03.:29:05.

Overcrowded - the number of patients on wards in England have been

:29:06.:29:08.

at unsafe levels in nine out of ten hospitals this winter.

:29:09.:29:12.

A few years ago Kent was at the forefront of a Telehealth experiment to monitor people's health at home - so what's happened since? Has it kept people out of hospital? And the surprising things to look out for during winter walks in the south east countryside.