A lot to prove…

Training Primary Care NHS GPs A lot to prove...

From the Guardian;

‘… I have never seen such an empty vessel as a cabinet minister. This is one NHS chief executive’s verdict on Matt Hancock’s stint as health and social care secretary…

… it reflects a widespread view among NHS bosses that if Boris Johnson’s imminent formation of his first government leads to Hancock leaving for another job, few will miss him…’

Well, we’re stuck with him. At least for the foreseeable. We’re baby-sitting.

The Guardian is right, No18 is neither liked nor respected by the NHS. We know; ‘it’s all about him’. A headline chaser.

Nevertheless, his skilful tergiversating has got him back around the Cabinet table.

A year ago, he identified three priorities; staffing, prevention and adopting technology.

Since then, because he couldn’t secure Treasury buy-in, he delayed the publication of the Interim People Plan. We still have no way out of the workforce crisis. Tried to fiddle the publication date of the Prevention of Ill-health green paper, for political advantage and we’re still no nearer keeping people fitter for longer.

And, technology…

He is an evangelist. So am I. He is an enthusiast, aren’t we all? Are we zealots? No. I’m not going to start a bonfire of the faxes, because I understand why they are still used.

‘There’s an App-4-That…’ is no answer. Most IT strategies have been botched, eclipsed or starved to death.

If No18 is to do anything in the time he has left, he must better understand, the problems the NHS faces around implementing digital solutions.

  • The NHS is populated with competent, open-minded leadership, all of whom understand benefits from technologies.
  • The government understands the significance of what technologies could deliver.
  • The sector is brimming with ideas, manufacturers and big-brains with solutions.

At the intersection of that Venn should lay a zone-of-peak performance.

Instead, it is a desert of indecision, strewn with the bleached carcasses of initiatives, ideas, policies, departments, companies and leaders, who’ve failed. Why?

The fault is not in what we do, we do too much.

Like the moth that flies at dusk, through the fluttering candle flame, the NHS is attracted to the latest bright-shiny-thing and watches its money burn in the aftermath.

The fault is in what we don’t do.

What we’ve never done is decide what we want technology to do for us. We have to stop thinking about the ‘tools’ and figure out what the job is.

A JCB is fun to play with but if we want to plant a rose bush… a spade is good enough.

We look at problems but we don’t really see them. All we see is what we have solutions for. We don’t ask; ‘Bright-shiny-thing, are you what we need‘.

We need patients to be in-charge of their own records. Do that and pretty-well all-else falls into place. Australia have it, achieved, done.

Then you can ask patients to ‘crowd-source’ their data for research and population planning. We are years from that.

We need interoperability. Simple, if everyone has the same kit. Learn from the front-line, procure from the centre.

But, we have no powers to make 150 independent Trusts and 8k GP surgeries buy stuff that talks to each other.

The NHS is not system-engineered, it’s a Heath Robinson bodge. An Emett concoction.

How do we embed ‘mission critical’ into political thinking. How do we move-on from departments that only think in terms of rules and guidance, to systems-thinking and problem-solving.

Most of all, we need a simple narrative. Describe to me what a digital NHS looks like and most important, why. Base it on the facts, on data and the best examples we can find.

Give the narrative to an authority charged to deliver it. Mark their homework.

I’m concerned No18’s personal fiefdom, NHSX, will bring us no closer to a solution… geek-elites, cut-off from understanding the basis of what’s important.

I fear, they will only invent solutions to the problems they can see. They risk being caught up in DH politics and become as bureaucratic and dysfunctional as the rest.

I don’t want No18 to be the worst there’s been. I want the NHS to be the best it can be.

He has a lot to prove.

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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.