To mark the National Walking Month of May, Dr Rineke Schram, Lead Assessment and Remediation Adviser at NHS Resolution, describes her recent commitment to walking and the benefits this has brought her.
The pandemic intensified a recent focus in the West on both our physical and mental health and wellbeing. Obesity has long been flagged as underlying many of the health hazards of our current age and it has been on the increase for nigh on half a century; since 1980, the prevalence of obesity has doubled in more than 70 countries. It has also been found to increase the risk of Covid. Mental health has more recently come to the fore in public discourse and it is now recognised that it plays an important role in our physical health and wellbeing. Since the pandemic and its requirement that people isolate and endure long lockdowns, reports of mental ill health have rocketed. Walking is an activity that is widely available and requires little or no financial outlay, and which has been found to be a useful means of tackling both increasing weight and mental ill health. Long-standing research shows that walking increases both physical and mental wellbeing.
To mark the National Walking Month of May, we spoke to Dr Rineke Schram, Lead Assessment and Remediation Adviser at NHS Resolution, about her passion for walking and the many benefits, both physical and mental, walking has brought her.
Rineke, please tell us about yourself
I’m a Lead Assessment and Remediation Adviser at NHS Resolution and I also work for the Lancashire and South Cumbria Local Maternity Service as their Lead Obstetrician. I went to medical school in the Netherlands and came to the UK to do my postgraduate training. My initial intention was to undertake postgraduate medical training in general practice, but this training was not immediately available to me, so I made the decision to undertake training in O&G instead, which I did up in Hull. I’m really pleased I did so, as O&G is a very interesting medical specialty that requires a varied skill set. It includes surgery, but also preventative medicine and elements of public health as part of antenatal work. Over the last 36 years, I’ve worked for 25 years as an O&G consultant in an acute trust in the North West. I’ve also spent more than 20 years as a medical manager, including as Medical Director.
Please tell us about your role at NHS Resolution
Well, I’m currently a Lead Assessment and Remediation Adviser in the Practitioner Performance Advice (Advice) service within NHS Resolution, working three days flexibly a week. I took up this role in September 2020. I had previously been a Lead Clinical Assessor for the Advice service, for several clinical performance assessments. Then, as now, I combined my role with other work within the NHS, as outlined earlier. This work outside of NHS Resolution complements and provides useful insights to my work at NHS Resolution.
In my current role, I lead the Assessment and Remediation team within the Advice service, which includes the Assessment and Remediation Adviser, Team leader and (Senior) Assessment and Remediation managers. Our work is focused around providing clinical performance assessments and behavioural assessments to help clarify and understand the performance of individual practitioners (doctors, dentists and pharmacists). We also provide return to work action plans, for individual practitioners who’ve been identified by their healthcare organisation as needing support to deliver sustained, safe and effective practice.
More broadly, the Advice service provides expertise to the NHS on resolving concerns fairly and sharing learning for improvement. As part of this broader work, the service has recently published a suite of resources on practitioner exclusion. These resources aim to help healthcare leaders make the right decisions on exclusions, to ensure patients and staff are protected from harm whilst the practitioner concerned is treated fairly and compassionately, in line with a just and learning culture.
Please tell us about your interest in walking
For me, my recent interest in walking dates to March 2020. Having started a weight loss journey several months earlier, I was at this time still quite overweight and was beginning to have trouble with my knees. In fact I was having to use crutches at times and I did not want this to become permanent. I also wished to avoid the need for surgery on my knees, as this can often bring complications and/or weaken the knees permanently. Around the same time that the first lockdown was announced, I saw Cancer Research UK’s Walking Challenge. This involved walking 10,000 steps per day to raise money for the charity. I saw this challenge as an opportunity to raise money for a worthwhile cause, while also using the walking as a means of exercising to lose weight. This would take some pressure off my knees and would also aid in building muscle and flexibility. As I live in the Rossendale Valley, I had a lovely setting to walk in to reach my daily 10,000 steps. While difficult at first, walking 10,000 steps a day soon became a habit. After the challenge was completed and I had raised nearly £500 for the charity, I continued to walk, increasing my walking distance as my fitness improved. And in fact I walked 2,000 kilometres in 2020. I then walked 3,000 kilometres in 2021 and am aiming to walk 4,000 kilometres this year. I’m no longer overweight and my knees are much better than they were. I now regularly undertake a five kilometre walk during my lunchtime, take long walks at weekends and go on walking holidays with family members.
What is it about walking that you especially like?
I love that it is easily available and that you never ever regret going for a walk. You always feel better afterwards. It improves your physical health and also your mental wellbeing. And as the saying goes, there is no bad walking weather, only bad walking clothes! So long as you dress appropriately, walking can be done in any weather, and in any location. I’ve walked in Scotland, Cornwall, Brittany and Oman. My current dream holiday is walking in Iceland. You can organise your walking holiday yourself, or you can go on organised walking holidays where your luggage is transported by car to your overnight location. My sister and I went on a walking tour in Brittany last October, where for four days we walked 25 kilometres a day, with the luggage being delivered to us each night.
What is your advice for people who’re thinking about taking up walking?
To dress appropriately. Lightweight, waterproof clothes are ideal. It’s important to have good walking shoes – ideally walkers should have two pairs for very long walks; I like to start off with a pair of walking boots and then for the later part of the walk I change into a lighter pair of walking shoes. It’s possible to have walking boots and shoes personally fitted, although there are not many places that do this. It’s possible to research this. Good walking socks are also invaluable. I use Nordic walking sticks as a means of building muscle in my arms and also for balance and reducing impact on joints. This is worth considering. I also like to have a backpack with water, protein bar and any other necessities, an emergency first aid kit. For longer walks I take a compass.
Where do you think working for NHS Resolution brings the most value for you?
It’s a very different environment from working for an NHS provider and I was drawn to my current role for the opportunity to put my experience gained within the NHS to good use in a slightly different area of the service. It also represented a new challenge for me. I also really like the organisational culture at NHS Resolution. Morale tends to be high and I feel the organisation has a very open, collaborative culture. Additionally, I’m able to work from home and this allows me to go for my lunchtime walks in the Rossendale Valley.
