The sooner the better…

training primary care NHS the sooner the better...

We are obliged to wait. Not for a bus, or a new hip, although both are becoming increasingly scarce. I meant, a prime minister.

The nation’s business is on hold whilst one hundred and sixty thousand invisibles, with no mandate, chose a prime minister for our country.

Even a banana republic would be embarrassed… democracy? No, party before country.

All eyes are on the artful-shambles and Teresa-in-Trousers.

No18, our Digital-Dell-Boy is nowhere to be seen. In the meantime, in the NHS…

Five, perhaps more, patients in our hospitals are poisoned to death by sandwiches, which we gave them. No18 called for a root and branch examination… and then disappeared to get his ego repaired.

What would you have done?

I bet, you’d have said: I want a full report on my desk in 48 hrs; what happened; how did it happen; and what are we doing to make sure it can’t happen again. Call a press conference, reassure the public. Apologise and mean it. Speak, privately, to the families.

In other news… it’s taken since last July to sort out what it means, but the results of the inpatient survey for 2018 have been released. Most of the numbers are going south. The CQC is ‘disappointed’.

What would you do?

I’d say, a ‘disappointed’ CQC doesn’t do it for me. They’ve had years and millions of tax-payers hard-earned and quality is no better… what are they there for? Give me something that works.

I think we might both say, how does it take eleven months to analyse a survey. We’d want information and data, not a history lesson. Find me a way of answering the question; ‘what’s happening now’.

Perhaps No18 has caught sight of the 10 mental health trusts which are failing to reduce inappropriate ‘out-of-area-placements’.

This is horrible for the families as well as the unfortunate patients. Clare Murdoch is the head-honcho of mental health.

Several of you directed me to the HSJ and her antediluvian response; ‘there is insufficient grip’ on outliers, she demanded action.

I wonder if she thumped the table?

She threatened; future transformation funding will be ‘denied’ if there weren’t improvements. Plus, more reporting, targets. It’s obvious, she’s got the wind-up, the DH and ministers are on-her-back.

What would you do?

I think Ms Murdoch has been watching too many episodes of Chernobyl. That sort of threat and management style was the kind of bullying-thing we’re trying to scrape off our boots.

What would we do? I’ll bet we would get the struggling Trusts around a table, roll up our sleeves and go through their problems, line-by-line.

If it is impacting 10 places, it is a system problem. That means solid management, service design, capacity review, money, procurement, root-cause analysis, realism.

Threats and shouting don’t work unless you’re trying to train a mad-dog and even then, the dog will have its day.

I wonder if No18 has seen the upshot of the FoI into paperless-preparedness. Now, this is up his street… but it’s bad news.

Three-quarters of Trusts still use pen and paper to complete clinical documentation. Three out of four are nowhere near using speech recognition software.

It’s not a great read. No18 says he ‘knows about IT’. I doubt he knows anymore than you do.

He built an App. That does not make him part of the digerati. So did I, in an afternoon. It’s easy.

What would you do?

I’m guessing something sensible. Call time-out on the whole digital ‘thing’. Get some practical people from Trusts, primary care and community together and sort out the three things we really need and can realistically deliver and pay for by next Easter and go for it.

My guess, they will be underpinned by; interoperability, centralised procurement and performance standards.

So much of what needs to be done is uncomplicated, sensible, needs calm management, asking people and being able to prioritise what’s important.

Killing people with sandwiches, threatening managers, having no idea what ‘the customers’ really think and IT systems that are clogged up with stuff we don’t want, choking-off the basic things we do want… is a neglect of duty at best and at worse, paralysed incompetence.

Matt Hancocks’ time at health has been entirely forgettable. The sooner Jeremy Hunt appoints Rory Stewart, as No19, the better.

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