7th August 2015

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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 

 Book now.  A few tickets left. 

Tickets here.

The taxpayers hard earned
News and Comment from Roy Lilley

There's not much surprises me but this takes the biscuit! The CQC, are advertising a 1.2m contract to start a Leadership Development Programme. 'Managing and Leading the CQC Way'.


Expect it to include modules on the CQC Way of making hotel and charabanc companies rich, planning and shipping armies of 'inspectors' around the NHS.


It seems the King's Fund Leadership Programme, the Leadership Academy, the NHS Leadership Framework, the NHS leadership self-assessment programme, the DH, the Nuffield Leaders' Panel, every business school in Britain and the new NHS Improvement are not good enough for the CQC Way.


Be an alumni of a CQC Leadership course and nod-nudge-wink; ensure a good inspection report every time! The CQC Way...


Awarding some bursaries I might go with but this has got to stop. Ignoring austerity and throwing money away, duplicating the work of a dozen organisations and every university in Britain. The CQC Way! The CQC is way out of control. Leadership and the Board; way past their sell-by date.


This time it's not just me getting on the CQC's case:


"Health and care regulation is incoherent and expensive and there is little evidence for its effectiveness; if it was going to improve care it would have done so by now. It's time to rethink regulation."


And this:


"...a regulator's role is to minimise harm and to seek to do so by changing individual or organisational behaviour. It is not at all clear whether system regulators have improved the quality of care in a significant, sustained way, or if the benefit of this approach outweighs the very considerable costs."




"The CQC's operational expenditure in 2014/2015 was 211 million...'




"This does not include the whole costs of compliance to the organisations they regulate... organisations complain they are inspected and reported on too many times, by too many bodies all... require data in slightly different formats."


Organisations end up working for the Regulator and forget they are supposed to be there for the patients.


The report I am quoting from says...


"... when a regulator stands between care and the people it is for we have surely lost the plot."


The Report? Just published; from The Professional Standards Authority. The regulator that regulates the regulators; they've woken up to the mayhem that is the NHS regulatory landscape.


They say:


"Health and care regulation is incoherent and expensive and there is little evidence for its effectiveness; if it was going to improve care it would have done so by now.."  Where have you heard that before!


At the end of July I wrote about the NMC, the GMC and eight other regulators all doing their own thing, duplicating... without a common purpose.


The PSA report says:


"A proliferation of regulatory organisations... impedes the pace of change and improvement... it also embeds operational inefficiency...There is no overarching design for these arrangements, nor any sense in which they have been fashioned to make them coherent or efficient."


Time to close them down; have a single web-based register for all NHS workers and their qualifications, run from a computer in a room above a chip shop in Warrington. Leave the rest to the employers. Re-invent HR departments.


The PSA report is well written, well referenced and points out;


"Denmark has recently announced it is abandoning hospital inspection as being counterproductive to quality..."


Should we abandon the goal of excellence? No, but there are better ways to achieve it. Let the data speak. Dr Foster, Health and Social Care Information Centre, NHS benchmarking networks, QualityWatch, the Health Foundation, the Nuffs, IWantGreatCare and HIMMS... if all else fails we could ask the patient.


We need to a consultancy model to help organisations meet their own standards. Preventing harm, not tripping over it, too late.


We have a confusing 'blame' no 'blame' approach, trusted by no one. Criminalising 'avoidable harm' has pushed the truth even further from our grasp, undermining trust and frustrating risky innovation. When you unwrap the woolly hyperbole of the CQC can anyone actually tell us what good looks like; benchmark it, measure it and reward it?


It is the role of a regulator to set standards and ensure they are met. The regulators' regulator sees what we all see; this is not happening, we need a change.


I'm guessing not many will have heard of the PSA.  Well they have now. Let's see what they can do to regulate the regulators, rein back their excesses.


Let's see if the PSA has any teeth, or they just another waste of the taxpayers' hard earned...


Have a good weekend.



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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.
Acute community nurse Essex; Operations manager Surrey
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 - the embryo Wirral Federation of GPs in running into all sorts of trouble over what constitutes consultation.  I'm wondering if they have to consult at all?
>>  I'm hearing - Manchester Trust has recruited nearly 300 nurses from India.
>>  I'm hearing - huge number of practices still experiencing payment delays from NHSE.
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