I recently turned 60. As always when a significant number rolls around there has been some introspection, not least given how, apparently, turning 60 makes a new "me" appear.  The letterbox has brought some fascinating materials. I have also found my behaviour changing.  

"Me-directed" behaviours first.  I bought a senior rail card. So: if you want to meet me let's time it so I get on a train after 9:30 in the morning because then I save 30% -  but only if I hang around at your end so I can complete the return leg outside peak hours. I have started routinely to ask "are there concessionary prices please?" in all sorts of settings: museums, galleries, cathedrals, cinemas, my gym.  My sense of entitlement has rocketed, so for example I am outraged that I can't have a bus pass until I'm 66. Given I don't use buses I find that outrage mystifying, but never mind!

"Prompted by others" behaviours?  I do object that much of my mail seems to have turned its attention to whether organisations can sell me adaptations that it seems I will need to go on living.  Hearing aids, enhanced specs, late life insurance cover. Who, ME?  However, two things have given me pause for more thought.

First, within a week of my birthday the NHS sent me a kit to let me take part in the national screening programme to diagnose bowel cancer. You don't need the details on how to participate. Instead look at the reasons and results pathway. The problem they are trying to fix is that in over 60s this devastating, quickly-metastasising cancer is common.  Discovered pre-cancerous however, it can be treated. Potential savings are obvious: to the patient as family member, worker, taxpayer, and to the NHS from GPs to oncologists. The trick is breaking the cycle of under-or-late diagnosis, and breaking through the embarrassment people feel about addressing the condition.  The NHS is doing this work through education: with dietary advice, by asking us to talk about things we would rather not, and so on.  But this goes further. The kit comes to you, automatically, through the post.  In an ordinary envelope is a simple kit, with plain English instructions translated into around 20 other languages. All parts of the kit carry your NHS number but the testing organisation does not hold your medical history. A secure 1st class return envelope is included. As a woman, I am used to being called for screenings for breast and cervical cancer, so perhaps I automatically complied, but why would you not do so given this is so simple?  A week after I sent back my kit, the letter arrived declaring me clear and explaining what will happen every 2 years until I am 75.  All also translated into 20 other languages. I am reassured, and they have another patient recorded. The programme is in its relatively early days, so it's unlikely we have population level results or attached savings projections yet. But I am struck by the sheer simplicity of the experience. In the last couple of years, this no-nonsense diagnostic programme is calmly rolled out to those who qualify just by turning a particular age.  It's made clear why it matters. The language assumes you will be a grown up, get over yourself and take part. A classic piece of well judged behaviour change science at work.  Well done the NHS.

Second, I recently worked with the Essex Leadership Collaborative. This is the County Council and the two Unitary councils in Thurrock and Southend, the districts, health, police, fire and rescue, NGOs and citizens.  They have gathered round the challenges Greater Essex and it population faces, to work together to tackle them. Imagine the organisational and small-p political issues and ingrained habits they must set aside to start such shared problem solving. And here's a community leader who spoke about leading an international celebration.  She gave us two illustrations from a day when many communities used a shared space to learn from and about each other, to celebrate similarity and difference. Firstly there were 4 rice puddings: a British one; a Thai one; a Spanish one; an Indian one.  All sweet, all delicious, all rice, all different. Secondly the day ended with a Ceilidh - a Celtic barn dance and stomp, if that term is unfamiliar.  Nobody knows the dances but the caller, who leads you through them, then lets you loose to fantastic tunes and teaches you all again as you go stumbling through the hilarity and eventually get it right. The genius here? on that shared day the dances came from elsewhere than in the communities concerned.  For those of you who have never been to a ceilidh, the real trick is that many dances are "Progressive".  You change partners repeatedly as the dance goes round the room, until everybody has danced with everybody else.  

And with those two metaphors for the challenges we face and the problems we are all tackling, I sign off!