Game of Thrones…

Primary Care Training - NHS - Game of Thrones-01

There’s another kid on the block. Strictly speaking they are a new kid. New name, new bosses and all the usual. In realty they are just another.

Another organisation promising us a bright techno-future of clicks not bricks. A byte-size future. Plug-in once… see the whole landscape of healthcare unfold before us.

NHSX has arrived amid a swirl of visions, values, half promises and blah-blah.

No18’s mate, Matthew Gould is the boss, Simon Eccles has been recycled from NHSD or DH or somewhere and is doing something and No18’s other mate, Hadley Beeman is chief-something-or-other. In the world of IT, everyone is a chief.

Beeman is going to give us;

‘… a federated data ecosystem’

… and on the way, let’s hope he learns to speak English.

Gould, told Digital Health he has five “missions” . Including, freeing up more time for staff to spend with patients, giving patients better access to digital healthcare tools and improving the use of technology within the NHS.

Have I heard that before? Can he bridge the gap of 40,000 vacancies, has he seen the number of health Apps and tinsel out there and does he realise, if its as easy as Amazon, people will use it.


Gould is placing emphasis on the ‘weight’ No18 brings to his party. Beware, Hancock is desperately massaging Johnson for a new job. NHSX could become NHS-ex.

It’s no lack of technical skills that finds the NHS in its par-less IT predicament. It’s the lack of the skills to get things done.

It is no lack of vision that is holding the NHS back, it is the backbone to turn it into a reality.

It is no lack of knowing what is needed. It is the impossibility of doing it.

Gould and his band of vapour-ware salesmen have to understand the enabling legislation for Trusts and Foundation Trusts means he is dealing with 150-old independent organisations over which he has no power to command and eight thousand independent contractors, called GPs.

These are not branches of the NHS that will buy the same kit on Monday, plug it in on Tuesday and have it working by Thursday.

They are 150 semi-detached branches of the NHS franchise, with separate balance sheets, a shedload of legacy systems, differing levels of digital-maturity and frankly a pile of other stuff they have to do before they get to IT.

Capital budgets have flat-lined for ten years and now there is a whiff of more cash in the system, Simon Stevens is already asking for capital budgets to be cut by one fifth.

Gould needs revenue solutions that are ace-tastin-super-fizzin, that plug-n-play, easy-peazy, right-first-time, talk-to-everyone…. and work.

Good luck with that.

In the real world and dare I say, in other parts of Whitehall, there are profound changes emerging as technologies arrive and we are better able to interrogate data.

The NHS needs a new philosophy. Intellectual skills. Transformation. Move the fulcrum point.

The NHS survives by being able to deliver a budget. Spends money. That’s how it’s regulated and measured. We are now at the point where it should be judged on how it invests its money.

The NHS survives by exploiting its reputation for care and vocation and entices staff into an unforgivably bad working environment and wonders why people leave.

In a world where there is a global shortage of care-people. We are now at the point where it needs to figure out what it can rely upon machines to do. There’ll never be enough people.

Gould’s world needs to deliver us an administrative capability that is intelligent enough to work itself. A unified structure that talks to itself and outside and is as easy to use as FaceBook.

Gould must be an imitator not an innovator. The answers are in every nook and cranny of our daily lives.

Gould is giving us soft answers to the hard question; ‘how’. How do we mobilise the entire NHS resource around an urgent response to a critical problem?

Gould must realise, we don’t need Love Island. We need Game of Thrones.

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Reproduced at by kind permission of Roy Lilley.