24th December 2015

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Holly Impossible
News and Comment from Roy Lilley
Christmas isn't a season, it's a feeling.  What kind of a feeling it is, is personal. 
Feelings, maybe, of; regret, excitement, boredom, loneliness, exhaustion, generosity, family, optimism and of course joy.  Whatever you feel, one thing is for certain; there will be another one next year.
This year I'm totally confused.  No Duchess to tease, threatening to take her Xmas shopping in the petrol station and buy her a wok. And, in the garden; daffodils.  Yes daffodils! Upright, sentinel and on point.
My local school's nativity play wrote-in a part for an Interflora delivery man.  Beats the back end of an ass, any day!
To prove they are type-cast, flint-hearted and 'all they want for Christmas is a pair of grey socks' the Carbuncle has published Planning Guidance for 2016-17 to 20-2.   Groan?  No, in fairness, there is an intention to shift the NHS' tectonic plates and get people to working together.  Ignore the 'reforms' and get on with it.
Yes, I've read it and I'm not going to spoil your Christmas by quoting chunks of it but in a soporific moment after a turkey sandwich and a glass of Chateau Recougne (Go for the 2012 it's a bargain), sometime over the break, you'll have to flick through it.
On second thoughts; you might not have time for the sandwich.  Some of the requirements have to be assembled and submitted in 31 working days.  Looks like you could be working weekends.  Gosh!  Surely not!
There are two plans required; one for the local health economy (very sensible) and one for where you work.
If the guidance were a recipe it would be for Christmas pudding.  Open the store cupboard and chuck everything in!
Take a; Sustainable transformation plan and stir in return to aggregate balance, Lord Carter of Bog-Rolls tick box thing, reduce variation, local plans, Right Care programmes, up the quality of general practice, stop using agencies, find more nurses, achieve A&E and ambulance targets, sort out RTT target, and cancer targets.  Season with mental health targets, improve care for people with LDs and publish avoidable mortality rates.
In other words; do everything... better.
The HSJ has the best, easy read synopsis and if a subscription wasn't on your Xmas list, it's not too late.  We are all going to need the HSJ next year!
And then, of course, there is the money thing.  According to John Appleby, the King's Fund's reality checker on all things money... there isn't any.  How come?  Some legerdemain concerning pensions, a transfer of 1bn to LAs and a possible year end short fall of 3bn.  If Appleby says there ain't no money. Take it from me, there ain't no money.
It might be too late but if you were thinking of buying yourself a Christmas present, I'd recommend any book by Sir John Harvey-Jones; a sailor, a spy, chairman of ICI and inventor of the BBC Troubleshooter series on BBC.  He pioneered company doctoring on the telly; it ran to five series and won him a BAFTA.
He said organisations cannot concentrate on more than three things at a time.  I have no idea what Sir John would make of the labyrinth that is the planning thing for the NHS.  Sir John learned Russian in six months, maybe he'd have half a chance.
Let's take a pace back.  Be honest.  The NHS has been screwed up by a catastrophic political howler, the H&SCAct, plus the confluence of austerity.  We are going to have ten years of zero growth.  My blue-bit-of-death graph is still doing the rounds after six years.
Tarzan and King Herod have an unbelievable task ahead of them.  

The NHS is a bit like Christmas; it's a feeling.  Irritation, frustration, thanks, gratitude, stupidity, security and of course joy... and, it has to be around next year.
Next year is the first step in what I'm guessing will be a long and difficult journey.  The first responsibility for a leader is to define the reality, the last is to say thank you.  The bit in the middle is the tricky bit.
So, thank you for everything you've done this year, the hours you've put in, the problems you've sorted and the complications you've fixed.  Thank you for making one pound do the job of two.  Thank you for your skills, tireless effort, focus and dedication.
Next year let's start by doing what's necessary, then move on to the possible and before you know it... you'll be doing the impossible.
Merry Christmas. 
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