It had been another turbulent week at NHS Blithering. Former accountable officer Liz Wanhope had stepped down suddenly. A brief press statement hinted at mild impropriety but the real reason for Wanhope’s departure was that she was a cipher who made very little impression on anyone.
It had become a standing joke that Sir Trevor Longstay referred to Wanhope as “the new woman”. They had worked together for five years.
Martin Plackard, newly promoted to STP-wide head of integrated place-based communications, had battled in vain to save Wanhope’s reputation by linking her departure to unexplained holes in the accounts, but as there were always unexplained holes in the Blithering accounts this had cut no ice with the media who declared it a non-story. The almost total lack of scandal on Wanhope’s CV meant that even a back-office job at NHS Improvement was unlikely.
As chief clinical officer Dr David Rummage put it: “Whoever said there was no smoke without fire hadn’t met Liz.”
Longstay takes charge
Sir Trevor Longstay was absent from the Monday strategy meeting. He was taking a close interest in Blithering’s planning for Brexit. Nobody could argue that anyone was better qualified for a disorderly exit than Sir Trevor.
The Blithering Brexit Preparedness Strategy had been launched a year ago, when Plackard had issued a press release boasting of detailed plans at an advanced stage of preparation. Now, with Brexit just two months away, it was time to start making them.
Sir Trevor rarely missed the Monday meeting, so his absence showed the gravity of the situation. He would spend the day “exerting my influence on key international suppliers to ensure the continuity of vital provisions in the event of a worst case scenario”, he had announced gravely.
Gail blows in
Sir Trevor’s chair was occupied by Gail Hardcastle, chief officer of neighbouring South Dedley CCG and self-appointed leader of the local “CCG Alliance”, an organisation formed officially as a “locus for collaboration and system thinking” and unofficially as somewhere for people who loathed each other to fight to the death for a dwindling number of top jobs in commissioning.
Sir Trevor admired Hardcastle and could even remember her name, which Plackard saw as firm evidence that she would be Wanhope’s permanent replacement. It explained the impressive levels of obsequiousness in his introduction.
“Thank you, Martin,” Hardcastle said, before making a short and well-rehearsed speech of her own about her inclusive, people focused management style. “I want you to call me Gail,” she concluded, eyeing everyone around the table in turn as if daring them to actually do it.
Hardcastle proved to be a skilful chair, thanking people warmly for their contributions when they agreed with her and “parking” any thorny issues of disagreement for discussion at an unspecified later date.
The smoking service
The natural rhythms of consensus were second nature to Plackard, but others were clearly struggling.
Alan Spume, leader of Blithering Council, grew red-faced as he railed against public health cuts, which meant he could no longer mend the district’s roads or maintain its street lighting. Challenged about his definition of public health, Spume fought back gamely providing evidence of increased injury to cyclists and mounting pressure from dog owners, skateboarders and other “pavement and precinct stakeholders”.
Questioned about the council’s decision to axe the smoking cessation service, Spume said that a consultation had clearly show that damage to wheels and shock absorbers was a matter of greater public concern than the state of people’s lungs.
Hardcastle thanked Councillor Spume for his contribution and agreed that respecting the will of the people was more important than doing the right thing.
Calm returned to the meeting during a brief debate over whether Blithering was a “place” or a “sub-region” in integrated care terms. The chair congratulated Plackard for his suggestion that it could be both, depending on the strategic context.
Rummage drops a bombshell
“Is there any other business?” Hardcastle asked, as the meeting neared its end in a record-breakingly brief three hours.
Plackard piped up again. “I think we should congratulate David for his piece in the national press highlighting innovative GP apps,” he said, passing copies of an article from The Times around the table. The piece showed a grinning Blithering chief digital officer Rummage shaking hands with the boss of a Finnish technology firm whose QuikDok app promised to “revolutionalise patient convenience and shareholder outcomes”.
Rummage looked uncomfortable. “Ah, about that,” he said. “Timing might be a bit unfortunate. When I did the interview it had slipped my mind that I’d accepted a job with them. I start tomorrow.”
Averting a no-deal bresaola
“Yes, sorry Plackard,” said an airport-bound Rummage later, when the distressed comms man called him on his mobile. “Should have mentioned the job when you got me the interview. How could I refuse? Chance to make a real difference to the lives of patients, fantastic company car, private health insurance in case the NHS goes tits-up and no more pretending to be interested in Spume’s problems with potholes or Sir Trevor’s endless anecdotes about the clinical waste industry.”
“Talking of his lordship, I’ve just seen the old fraud deep in Brexit emergency negotiations. If you nip down to Waitrose you’ll catch him loading cases of wine, French cheese, cold meats and other vital supplies into the boot of his Merc.”
Plackard shook his head sadly. Even so, he made a mental note to do a big shop in the morning. The middle classes could turn ugly when supplies of bresaola and Malbec were under threat and he didn’t want to get caught up in civil disorder.
Current affairs editor: Julian Patterson
Reproduced at TrainingPrimaryCare.com by kind permission of Julian Patterson.