NHS Mediocrity


The NHS is mediocre, Jeremy Hunt will say today, and show that it costs lives.  But he's not the first person.

In 2003, Kate Silvester (Lean Thinking Hawk for the NHS) told us that "at any one time, 30% of waste and inefficiency can be taken out of the health service".  She was right, but it needs some context.

1) Dedication of Staff

A moral dimension to consulting

It's easy to assume that all of our decisions are purely rational, but they rarely if ever are rational.  And they always have consequences for others, usually consequences that we think we could not have predicted.

But consultants are not here to make decisions, only to provide information and advice.  Does this somehow absolve us from a moral responsibility?


Creating Organisational Capacity for Benefits Management

APM_SIG_Thought_2.JPGAPM (Association for Project Management) released its second Thought Leadership Guide on Benefits Management.
It's entitled Delivering benefits from investment in change - creating organisational capability, and it describes how to make the next step from Strategy into capability.

This guide is the second of a series of four, pitched at a strategic level, on how to make Benefits Management actually work.  And its authors embody many decades of experience between them.

Developing a CQUIN Commissioner-Provider Contract

North of Tyne PCTs (the management team for two PCTs in NHS North East) needed a contract for the Addictions service developed in line with the new model contract 2009, in place before end of March 2009 (ie before the start of the new financial year). Time was limited, so they engaged to provide extra resource.

Making time to make a change

"Edward Bear Coming Down StairsHere comes Edward Bear now, down the stairs behind Christopher Robin. Bump! Bump! Bump! on the back of his head. It is, as far as he knows, the only way of coming down stairs. He is sure that there must be a better way, if only he could stop bumping for a moment to think of it.“[1]

Treasury decides not to bail out charities who lost in Icelandic Banks

Would it be unfair to suggest a certain naivety? Since BCCI, and probably before then, the saying "if it looks too good to be true . . ." has marked a common-sense approach to money. Putting it simply, charities should steward the money in their trust, not try to profit from it. What has happened here could happen to anyone. Some charities (Cat Protection League and another 29) had gambled, looking for the most profitable place in which to deposit donors' money. The gamble didn't pay off.

More for Less - NHS Growth Money is coming to an end

"All bets are off" as David Nicholson tells NHS to prepare for cuts (HSJ 4June - updated Pulse 27Nov09). Massive investment over the last 8 years hasn't improved productivity (HSJ 28May). PCTs aren't making use of the wealth of experience and enthusiasm available through Practice Based Commissioning (PBC) (Primary Care Today May/June 09). The same old ideas are put forward as the solutions to all our problems - more care out of hospital, more innovation, more work led by nurses, more Health centres, more salaried GPs. Why haven't these 'obvious' solutions delivered?

Commissioning Innovation

I recently co-hosted a workshop bringing commissioners (mostly local authority and health) together with third sector (charity) providers to help each side understand how the other works.
The results were explosive!
The workshop demonstrated just how much . . . . .

Urgent Care Limited - Social Enterprise

Urgent Care Social enterpriseUrgent Care Ltd is a social enterprise to bring together the valuable skills of Emergency Care Practitioners and Nurse Practitioners for first contact, and Primary Care Trusts (PCTs) need to get responsive clinicians providing care at the point of need.

Innovation - Case for Investment in Social Care

Skills for Care (SfC) New Types of Worker programme wanted to help third sector organisations make the leap from using development grants to sustainable funding, in other words for commissioners to buy the services they provided at a price which enabled them to continue to provide the service.

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