10th November 2015

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Health Chat

1st December King's Fund 5.30pm

Janet Davis - New CEO and Gen Sec of the RCN

What is the future for nursing?

Tickets here.

RCN concession.

News and Comment from Roy Lilley
A couple of articles in the Guardian got the Twitterati going yesterday.
The first; from the chairman of a London hospital, telling us the NHS is going to run out of money. Nothing new in that, other than it's the chairman of a Trust saying it. To write the article he has dipped his pen in the green ink of frustration. Excommunication probably awaits him.
The second, written by the Fragrant Jennifer, boss of the Health Foundation. Normally, apparently enthral to the Tinkerman and a coasting NED at the CQC, quite who has awakened Cinderella from her slumbers I have no notion. The article is full of spikey, awkward facts and a must look. Alas, Dixon provides no solutions other than;
"...trust and support the staff and commit to mass engagement, rather than hope for a quick fix."
Yeh, yeah...
The brave chairman is bolder. He says;
"... Those drawing up the autumn statement need to be aware of [the] realities. Even if the Treasury does provide more money, but substantially less than the annual 4bn needed to restore hospital finances and protect standards, there will still be a car crash, just one in slower motion."
Thank you Mr Chairman.
It is impossible to pick up a health trades journal and not find people predicting the death and destruction of the NHS or a newspaper that isn't writing leaders and articles about the dire state of NHS finances.
If you don't know about the par-less state of health and social care you must have been living down a hole in the ground. You know, I know and guess what; the Department of Health knows, NHS England know, the Treasury know, Downing St., know and the bloke in the chip-shop knows.
We also know the government has no desire to do anything other than deliver a low tax economy and sort out the deficit. It is highly unlikely that the Chancellor is going to anything magic when he announces his spending review on the 25th November.
He will want to surprise backbenchers and the Daily Mail so we can expect a few quid, some element of front loading, probably. Then comes the row; is it enough? I can tell you, it will be enough to set a trajectory to make sure the NHS is not a problem at the next election, when Osborne will be hoping to be PM. 
Remember; between 2010 and 2015 the NHS was running on flat line funding against 4% growth. Do you remember the Tetrahedron of Doom?
That period of austerity hobbled the NHS. A further period of austerity, 2015-20, will cripple the NHS. Cripple the NHS even if the Chancellor announces all 8bn next week. The damage has been done. The NHS will never be the same.
We are pushing a 2bn bow-wave of debt from the last spending cycle. There will be a 30bn (at least) gap in NHS funding in this spending cycle and social services, upon whom we rely more than any other partner, are reduced to a warm drink and a biscuit.
We are almost a year into the 5YFV, nothing much has happened, leaving us looking for, probably, 3% pa efficiency gains. Historically we do 1%, more recently Trusts managed 0.4%. We are looking down both barrels of a strike, 13% of Trusts inadequately staffed and a pay restraint row, pegged at 1%.
Any spending review money is not largesse, it will just about keep the lights on and might kick-start reforms that could turn up trumps from 2018, onwards but it's a gamble.
The issue, now, is 'efficiency'. How fast can we do it? Innovation, how quick? Doing stuff differently, how different? Eliminate variation, how swiftly? Procure smarter, how much smarter? Consolidate the estate, how rapid?
We are in a period where we need velocity and turbo-charged, breakneck, scorching, meteoric change and I don't see anyone with a pair of jump leads.
We need ambidextrous managers who can hold on to the best we have and let go the rest... setting free the nimble, fleet-foot, nippy, smart, imaginers, the believers, the envisagers and the supposers.
It's too late for the money to make the difference. The NHS is broke. To fix it we need the exploiters, adventurers and achievers. People who create their own weather, their own eco structure and their own climate.
Focussing on the money traps us in the past.  Makes us think about more of the same.  The money will be whatever the money is. 
We must turn our attention to something more valuable than money... talent.

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1st December
King's Fund 5.30pm 
Janet Davies
New boss at the RCN
King's Fund 1st December 5.30 pm.
19th November
King's Fund 5.30pm
Lord Hunt
Labour's Health Leader in the Lords.
A remarkable career; from leader of NAHAT (a forerunner of the Confed) and Trust Chair to the front-line of politics.
This will be an absorbing evening of politics, policy and no few insider secrets (we hope).  In conversation with Roy Lilley; come and hear from the heart of Westminster.
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>>  I'm hearing - a number of private equity firms have been looking at investing in the care sector but are parking a decision because of the par-less state of social care funding.
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