12th August 2015

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Health Chat

Sir Robert Naylor

In conversation with Roy Lilley, Kings Fund 16th September


Returns maybe here.

Work to be done 
News and Comment from Roy Lilley
As the bougainvillea petals drift across the azure water of the pool I expect you are lying in the shade, with thoughts of a light lunch on your mind.
Lobster, Les Monts Damnés Sancerre, expresso and a brandy? Just the job. You deserve it!
Is there a little bit of you thinking about your inbox? We know you are too important to take a holiday. The place will collapse and you will come back to a compost of emails.
There's a lot of advice on how to unwind on holiday; mostly rubbish. Stop thinking about work? You might as well try and stop a runaway train. It takes days to unwind.
Switch off your mobile. Yer 'aving a larf; you'll be hanging out of the window trying to get a decent signal!
You'll not switch off but holidays can provide a pause and a back drop to that most important of management facets; uninterrupted thinking. Clear your mind; think about stuff. Proper thinking.
We have plenty to think about. Money, Vanguards, regulation, staffing, patients, people, I could go on but it's getting close to lunch...
Who knows what's next? The party conferences, the autumn statement, the press and events set to buffet the NHS in every direction. And, it will be the season of the big set piece conferences.
The Confed, NICE and just about everyone else, NAPC, the Alliance, the Kings Fund and Uncle Tom Cobley will be flogging their tickets. So much tax payer's money spent (yes it is, in the end, by and large, taxpayer's money), spent on an agenda you could have written yourself, three years ago. Showcasing ministers with Tippex on their speech notes, recycled from last year.
"Pleased to be here [insert]... recognising vital contribution of [insert], tough times... ring-fenced £... want more effort... small announcement [insert]... thank you..."
Question; do the organisations that claim to represent us really reflect the 'now' landscape.
It is not about 'just hospitals' anymore; so what is the point of the Confed or the FT Network. It is not about 'just primary' care; the NAPC and Alliance are stranded in the Thatcher years. NICE, a sclerotic behemoth; what can they say to a nimble, innovative health system that's moved on. Monitor is irrelevant to a collegiate, collaborative, integrated healthscape.
Think-tanks seldom think; they make infographics of  guidance, publish surveys, tell us what we already know; look for ways to get the DH to fund their latest wheeze.
Aren't most of them stuck in a time-warp?
What is the point of an organisation that represents hospitals in an NHS that is trying to shift care out of hospital? What is the point of an organisation that represents primary care when we all know they are just a link in the chain between secondary care, community care and social care?
As healthcare is being redesigned by the ineluctable forces of demand and resource, the hinterland, representing health care, is like a gramophone in an iPlayer world.
We know the NMC, the GMC and the nine regulators are born of a gas lamp generation, struggling to cling to the remnants of a commodious past; paid for by their members.
In the digital world their costs could be quartered, their headcount reduced to a handful. Ask yourself; if they didn't exist, would you reinvent them the way they are?
Isn't the same true of most of the societies, clubs and groups that take our money and claim to speak for us? What do they speak for? Who do they speak to? What difference do they make? What have they actually changed?
If they argue, cause a row, say what needs to be said, they will lose their place 'in the tent'. Right now we need trouble makers more than any time I can remember.
Who makes trouble over staffing ratios? Who makes trouble over futile regulation?   Who speaks to power with the words we share every day and the thoughts you will be having, right now... as you edge the Lucia, Plantation Teak lounger out of the mid-day sun.
Who is planning a virtual, people light, on-line, social media based organisation; crowd resourced, impossible to ignore, block-chain transparency, immediate and responsive... spanning care pathways and organisational boundaries?  And speaks with a united voice and a common purpose.
Hurry back, there's work to be done!
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