News and Comment from Roy Lilley
He’s a big fellah. Fills the stage. Past his athletic best but still sends out an aura of not really knowing what to do with prisoners, even if he was minded to take any.
Persuasion is probably not his best suit. He has a delivery reminiscent of Tommy Cooper, with menace.
‘If the whole of the NHS did it, just like that, we’d save millions and I’m gonna make ’em do it.’
Sit up straight and listen to this man, he has the most important message in the NHS and the worst set of slides with which to deliver it.
This is Tim Briggs head of the Getting It Right First Time programme. GIRFT
(AKA); Grip, Impavid and Really Flippin’ Tough.
If you ever get a chance to watch him, do but sit at the front. Anything three rows back and the graphs and numbers are beyond even SpecSavers.
You have to take his word for it… but you wouldn’t argue; his graphs and numbers represent millions in savings and an unquantifiable reduction in human misery.
What he does is simple. He gets the data for outcomes for particular procedure, compares hosptials and doctors, one with another and asks why some places are better, faster, safer than others.
It’s been done before. The professions can be remarkably resistant to acting in a professional way and doing stuff, not just right-first-time but better-all-the-time.
Briggs data is black and white. Unmissable. I suspect Briggs will have his own, powerful way, of persuading Mr Black to pull his finger out and get as good at fixing us up as Mrs White.
He is tough and he will have to be. There is no way of obliging surgeons and their employers to do it his way. The NHS doesn’t do JGDI.
We have an irritating line in consultation and pussy-footing around when we should be putting the boot in.
The CCGs blithely carry on buying dangerous, costly stuff, oblivious of their stupidity.
I think, being operated on by a surgeon with demonstrable dodgy results is an assault and the employer and commissioner, criminally complicit.
Variation points to a catastrophic failure of medical directors. What are they there for, if not to keep us safe?
Briggs’ work is made immeasurably more difficult than it should be by obliging him to trail around the country, to hospitals and conference platforms explaining the bloomin’ obvious.
He should be able to pick up the phone and make things happen. Instead he has millions of pounds, work streams and acolytes of talent discipling for him.
Someone who shares his frustration is No18 who has made no secret of his exasperation with NHSDigital and is now proposing to set up NHSX as a subsidiary of DH+. DHX, perhaps?
He is right. The digital muddle created by NHSD, I and E has spelled out the health-knell of NHS progress with its agenda to manage patients, their administration, information and speedy, safe treatment, by the use of technology.
No18 is reported rolling up his selves and taking the lead, intent on showing us how to make it happen.
He needs to be able to answer three questions (as does anyone intent on making stuff happen):
• What problem are we trying to solve?
• If there is more than one problem, which is most important?
• How does solving this problem impact on wider organisational goals?
• What is the simplest fix we can go for
For Briggs the answers are;
• Variation, which is the enemy of safety, outcome and cost
• The problem is endemic; go for the quick, high-profile, wins, use them as exemplars and enthusars.
• Efficiency, safety, law suits and cost
• Ring people up, make ’em do it.
• The NHS is stuck in the 1980’s
• Target a couple of things and do them well. Probably outpatients and GP access. Exemplars and enthusars.
• Driving a determined Digital-First strategy releases capacity for face-to-face care.
• Procure centrally, for interoperability, ring people up, make ’em do it.
It’s time for some management-by-not-messing-around. Everyone likes it when the boss says yes, but they pay attention when the boss says no.
I predict, patients will breath a sigh of relief and most, right-minded people working across the NHS will whisper a silent, yesss!
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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.