Not in his day… News and Comment from Roy Lilley

'The woman has only had the job for five minutes and already she's causing trouble...'

That was the answer I got when I rang a surgeon friend and asked her about the NHSI report telling us; operating theatres were turning into museums and missing the chance to do 280,000 more operations a year.

She was referring to Dido, the new chair of NHSI.

The report was given to Hugh Pym at the BBC, in advance of its publication, scheduled for today (Wednesday).  Of course, he made a meal of it.  Accusing the NHS of wasting time and what not.

The report was passed to Pym via the NHSI press office.  Deliberately.  How do I know... the boss there is Kirk Mills-Ward, who had the 'breaking' BBC story pinned to his Twitter feed.  He knew what he was doing.

It was given to Pym in advance of everyone else.  Why?

Is the purpose of NHSI to help Trusts improve their performance in the quite knowledge they can share their failures, their best practice and get on and do things better.  

Or, is the purpose of NHSI to make life difficult for the Trusts.  Mister Mills-Ward clearly thinks it his job to stir-up controversy, argument and be a bloody nuisance.

The report?  I have no idea.  As I write this, all I have got to go on is Pym's interpretation.  By the time the report is published it will be yesterday's news.  By then the public firmly of the impression the NHS is loafing about.

Reading between-the-lines and from what insiders tell me; the report is based on year-old data from around 100 Trusts and the final conclusions based on extrapolations.  It's the kind of thing the car industry used to do; the time-and-motion studies of the 1970's.  And, extrapolations are what opinion pollsters do, when they get their elections forecasts wrong.

Does time get lost on operating lists.  Of course.

As my contact says; 

'You come in, in the morning, expecting to do a full list only to find overnight surgical beds have been taken by emergency medical admissions... it can take 'til lunchtime to find out if you'll have a bed to put post-op-people in.'

'Open someone up and find the procedure is going to be more complex that you thought... it all takes time.'

'At the high-end you might need an ITU bed and if someone is too sick to move out of a bed, you might be unable to start your planned procedure.'

'We need more capacity'.

Hugh Pym claims that two hours a day is being 'wasted' in operating theatres.  On a full day, in one theatre, with, say, ten procedures, that's about twelve minutes a procedure.  We don't need reminding; surgery is surgery, not a pit-stop.

The claim is, sort out the 'waste' and 280,000 more procedures could be carried out in a year.  On an average tariff price of, say, £2000, I make that £560,000,000 commissioners will have to stump up, to pay for them.  Plus, whatever social-care might be needed, primary care, domiciliary care, community physio, pharmacy and the whole shebang.

Where will the money come from?  Has anyone asked?

What is the point of forcing the publication of the report in advance of circulation?  Will the public read the report.  No.  Will they read the headlines and conclude the NHS is run by numpties, sitting around drinking tea.  Yes.

Is the NHSI press office so naive as to expect anything else?  On top of all the flack the NHS has to put up with, do we really need idiots in a press office making it worse?

Is there room for greater hospital efficiency.  Yes, of course.  Does this report have value for planners, flow-designers, technical experts, list compilers and management.  Yes, of course.  

Is there room for sensationalist reporting of careful studies, headline-grabbing, grand-standing and cack-handed press management. No.

Is there room for placing leaks of technical documents that are bound to be the subject of misinterpretation and sensationalist reporting.  No.

I'm told a Trust in Croydon has done some good stuff around theatre usage.  Now, they'll never get the kudos they deserve, not after the NHSI press office car-crash handling of the media... ending in criticism and disappointment.

Whoever you are; post it on the Academy of Fabulous Stuff for free and show us all what good looks like.  Stay away from NHSI.

Was this kamikaze press strategy authorised by the Board?  It must have been.  If it is an indicator of things to come... they have the wrong chair.

If it wasn't approved... they have the wrong press officer.

Bring back Ed Smith... it would never have happened in his day...

I'll be interviewing Ed Smith at the King's Fund on 8th 

November.  Come and ask him how he would have handled it.

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