Exciting

Mike Duggan.  I'm guessing there won't be many of who will know who he is. (Here)

He's taken on one of the toughest jobs you can imagine.  He is the first white mayor of Detroit in 40 years.  A basket case of a place.  An urban disaster story.

Dugan is reversing the slide.  In a fascinating interview in the FT (£-walled so I can't link to it), he talks about his approach.  His trick, he says, is 'boring'... and it's fascinating.

He says; 

'...if each individual person says, ok it's my job to cut the grass in the parks; therefore it is my job to get the mowers repaired faster, to get the grass cut in the parks...'

Performance improves, the parks look great and the people enjoy them.  It's not rocket science.  It's obvious.  It's boring.

Every week, Duggan sits down with 15 or 20 residents, in a city living room and asks them what he can fix.  He says he will change the fortunes of Detroit, one boring step at a time.  

The signs are he will.

I like this man.  I've never met him but I like this unremarkable looking man.  The sort of man who you would sit next to on the subway and never know it.  An extraordinary man, intent on bringing idealism back to the city.

As the NHS struggles to find its footing amid the chaos of a merciless flu out break, sweeping from China to France we are left thinking; what's next.

How ever long this lasts (probably another sixty days) we will come out the other end.  Scarred, battered and wiser... maybe.  The excitement over, back to the grind.  Boring.  What's next.

You can make a guess.  Yesterday, The Tinkerman was in Number 10 for an hour.  An hour...

Long enough to get the sack, long enough to argue a case, plead for a job?  I don't think any of that.  I think it was an in depth conversation about a major policy decision; how to merge health and social care with the minimum of Parliamentary time available for new legislation.  What's next is the Department of Health and Social Care.

Boring... From the National Archives;

"...throughout its history, the Department has evolved... the first major organisation took place in 1968 when the Ministry of Health merged with the Ministry of Social Security to form the Department of Health and Social Security. 

The Department underwent further restructuring in 1974, following the National Health Service's own reorganisation.

The Department split again in 1988 to form the Department of Health and the Department of Social Security...

... the 1990 Community Care Act, which declared... local authorities should be the brokers and care managers of social care..."

Boring...

It's boring, the way we go around in circles.  It's boring to stand on the side lines to see the obvious, done, not done, undone and done again.

If people need help to stay out of hospital and once in, need help to get home safely, organise it, like maintaining the mowers in the Detroit Parks.  Systems are continuums.  Boring, because it's so obvious.  

This is nothing exciting, not innovative, just the management cycle taking another turn.  Boring.

Be like Duggan; talk to people who use the services, run the services, watch the services, it's obvious.  Its a management puzzle and a labyrinth for people using it.  Crunch health and social care together... just do it.  Boring.

If only...

Health is free and social care means tested.  Social care is run by councillors in local authorities, the NHS has next to no accountability to the electorate.

NHSI and NHSE are not equipped to play in this park.  The CQC have no idea, they are in Jurassic Park.

HEE focusses on training a silo'd workforce.  They'll need to rethink or get parked.

For everyone, this is a new ball park.  It's complicated but boring.  This is not rocket science.  It's what everyone has been talking about, nudging towards.

This is no big deal.  It's technical... that's boring.  It's detailed... that's boring.  Like Detroit, we have to reverse the slide. 

Kicking over the boundaries, working together, seamless services, one budget, one plan, one vision.  One boring step at a time.  Exciting.

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roy.lilley@nhsmanagers.net 

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