Doesn’t get fixed

News and Comment from Roy Lilley.

I’m back… with a new pair of lairy socks and a bottle of Penderyn.  Christmas… what’s not to like?

Right, sleeves rolled up, ready?  My guess; it will be another year between a rock and no place.

We could make a resolution.  Bore everyone for a week, make excuses for seven days and by the end of the month the beers will be back in the fridge.

What about we pick a word for the year. 

There are 171,476 words in the English language… which one?  There’s one that is perfect.  Tailor made; an adjective, comparative adjective, superlative adjective and a verb.  The Swiss Army knife of words.

It’s polite, but used carefully… as sharp as a surgeon’s knife.  A steel word, in a velvet glove!

It started out as Latin, became French and found its way into English.  Seven letters…

The word is ‘curious’.  Let’s all be curious this year.  

For instance, I’m curious to know why, when we all see the NHS is drowning, the best the King’s Fund and the Nuff’s have got is to tell us how deep the water is.  Providers tell us how cold it is and the remains of the Confed tell us the water’s very wet…  

I’m curious to know why, given their collective brain power, they don’t have any new ideas?  There’s a vacancy for a think-tank. 

I was curious to read in the papers The Tinkerman’s been telling porkies that ‘the NHS was a Tory idea’.  Why would he?

Remember your history; 1942, the Beverage Report, called for a coordinated ‘free national health service’.  In 1944, the war-coalition government published a white paper, setting-out the need for a ‘free’ and ‘comprehensive’ health service, envisaging the existing infrastructure would remain independent.  

Unexpectedly, the 1945 election swept Labour into power.  Despite fierce opposition, including the Tories and the medical establishment, the upshot; Labour’s NHS Act, 1948, full-on nationalisation.  A state take-over.

I’m curious to know how long it will be before Uber Doc, Air-Care, Amazon Pharmacy, Gig-Contracts… become the every day.  Curious to know how long NHSE, NHSI and the DH can justify being separate organisations. 

I’m curious to know, why, given the par-less state of the NHS work force, HEE came up with a plan that is pretty much ‘more of the same’.

I’m curious to know why there’s no training revolution; the future redefined by new-style jobs, blending health and social care.  Multi-skilling, para-clinicians.  New ways into training.  Career breaks.  Realistic return-pathways for people to come back. 

I’m curious to know why we don’t look after our people?  Flexible rota, family-friendly.  Safe working.  Listening.

I’m curious to know why we don’t put more effort into learning from each other.  Sharing best practice with the people actually doing the job. Finding out what good looks like and doing it… better.

I’m curious to know why we kid ourselves that ‘putting patients at the centre of all we do’… is good enough?  So much of what we do has joins, interfaces, is difficult and clunky.

I’m curious to know why we don’t start with the patient and work backwards.  Start with the best we could hope for and work backwards, creating seamless services.  

I’m curious to know why, when we’re desperate to improve access to primary care, we struggle on, with a GP contract, predicated on buildings and bricks, stifling change.

I’m curious that Agenda for Change is still hanging on.  It has nothing like the flexibility needed to focus on hot-spots and flat-spots in recruitment. 

I’m curious and you should be too, why we don’t stop worrying about collecting data and start getting enthusiastic about using data.

I’m curious to know who is in charge of our digital future and what the plan is?

I’m curious to know why NHS Digital and PHE don’t make more use of the The Behavioural Insights Team

I’m curious to know why no one seems to understand The Data Protection Act exists to stop the misuse of data, not stop the use of data.  

Curious to know why the Caldicott malarkey hasn’t been dumped for something useable.

If you’re curious you don’t need talent, education or a lifetime of experience.  

The more curious you are the more you can see what doesn’t work and how curious it is, that it doesn’t get fixed.


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