30th July 2015

Live Health News  |  Weather  |  Archive
  For Local Authority, Council news and comment subscribe FREE for councilManagers.net HERE

Health Chat

Sir Robert Naylor

One of the longest serving leaders in the NHS, running one of the biggest Trusts.

What's life like at the top? Find out; in conversation with Roy Lilley; King's Fund 16th September 

This is close to a sell-out already.  Book now. 

Tickets here.

... aggregate that
News and Comment from Roy Lilley

First, the police motorcycles, then the promo-vans and advertising. Anticipation builds... a crescendo of buzzing, like angry insects. The crowd stretch to their tip-toes. A roar, a flash of neon colours... the peloton has arrived.


If you have never been close to a cycle-road-race... it's an 'experience'! The speed, the colour, the spectacle.


Cycling; the UK won 70% of the gold medals at the London Olympics. Wiggins went on to win the Tour. Chris Froome has done it twice.


The messiah of cycle training and management is Sir Dave Brailsford; famous for coining the phrase 'aggregation of minor gains'.


Now over used by the Plastic-PowerPoint-People with no ideas of their own, it's not magic; it's a management fad that simply repackages process control. Get the detailed processes right, stick to them, ruthlessly and good stuff happens.


Is there any application in the NHS?  Yes, I sense now, more than ever!


I think the NHS is turning purple, holding its collective breath; looking across the landscape of healthcare, waiting for the tanks to come... the next big idea.


The H&SCAct is a disaster. The NHS is waiting for the Act to be torn up. I can't see it happening. The trick is to work around it.


The future is in our hands, individually; the 'aggregation of minor gains'.  I think we will see that's what the Vanguards are all about. 


John Bytheway is an American author and Mormon speaker, credited with; 'Inch by inch, life's a synch. Yard by yard. it's hard'. Not sure if that attribution is correct but you can't argue the sentiment.


Tiny gains make a collective difference.


Example; goals, goal setting. The goal is only the outcome. Set it and forget it. How are you going to achieve it? Setting a schedule; inch by inch, that's how.


The schedule becomes more important than the goal. Aggregating the minor steps to achieve the goal. How to lose weight? The same way you gained it; ounce by ounce.


Want to run a better, fitter, leaner health service? Belief matters. Brailsford talks about belief; start by believing you are working in one of the best healthcare systems in the world (The Commonwealth Institute says it is) and you want to make it better. .


Behave the belief. Three things; person, performance, perception.


Person. Who are you? Three choices; I am too clever to be working in this mess. This place is a mess and so am I. I'm not messing around, this is a great health service and I am part of improving it.


Performance. Deliver on time; find small simple ways to make the money go further. Start with the patient and work backwards. Make your link in the chain the strongest it can be.


Perception. Be seen as a deliverer. Make a personal 'never miss twice' rule; never let the same thing go wrong twice. You are who you hang out with. Success breeds success.


In the meantime the NHS waits for a Tipping Point; another management fad. Its origins in the work of Prochaska and DiClementi; the 'transtheoretical model' of change that assesses an individual's readiness to act. It can be applied to organisations.


The NHS must go through eight tipping stages.

  1. Awareness that staying where we are is not viable;
  2. Realising the significance of change;
  3. Confidence we can make change for ourselves;
  4. Abandoning the fear of failure;
  5. Have a picture of what success looks like;
  6. Thought through ways of manipulating resources to make change sustainable;
  7. Gaining support by demonstrating things are getting better;
  8. Pioneering behaviour, duplicable and replicable... embedded as routine.

Are we ready for any of this?


Small gains and big changes? I was leafing through the Academy of Fabulous NHS Stuff 'shares' and came across a small idea that could mean big changes.


A community IV service in Swindon, developed by community nurses who understand the problems and can see the solution; convenient, cost effective and care closer to home.   They've done the 8 Stages.  Changed how they do things realised their idea is (Stage 8) replicable and shared it with us all.


An idea that works and as far as I can see could be duplicated across the NHS to bring big benefits to patients and make a big impact on the bottom line.


So far they have managed to save 2,000 bed-days a month!


... aggregate that!



Academy of Fabulous Stuff;

Have you looked at the fabulous stuff?

New 'shares' every day.

Make a note; be a sharer this week



  Contact Roy - please use this e-address


Know something I don't - email me in confidence.

Leaving the NHS, changing jobs - you don't have to say goodbye to us! You can update your Email Address from the link you'll find right at the bottom of the page, and we'll keep mailing.


MaM Logo  

Medicine for Managers
Dr Paul Lambden
What are yours like?

No need to think outside the box; we have great ideas gift wrapped
Team without walls; STRIDE; Monkey well-being, story books to support children going to hospital; 'To Know Me' dementia help.
Share your fabulous stuff.
Follow us on Twitter
Please share your good stuff!
News and Stuff
News boy
Search for good stuff
Sir Robert Naylor
One of the longest serving CEOs of one of the
 Biggest Trusts
At the heart of strategy and policy for over 25yrs.
What does the future hold for the Vanguards, strategy, regulation, funding.
Come and hear him in conversation with Roy Lilley 
King's Fund
16th September.
Book before you go on holiday, it will be a sell out.
Right Care
Interesting posts to help improve commissioning.
Tell us about your jobs or post them for free.
This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - major health union UNISON are calling on members to back Jeremy Corbyn in the leadership challenge.  Well, well!
>>  I'm hearing - more horror stories about the CQC's web-based recruitment portal. Just how bad is it?  Does the Board measure any of this stuff?  Aborted attempts might be a good place to start. 
Need inspiration, a good idea or solve a problem
Give Blood
Thank You Wall