Lord Bog-Roll has spoken. The Carter Report into unwarranted variations in operation productivity in Trusts is published.
If you want something done, ask a busy man because he can organise his time to get things done.
Patrick Carter is a busy man, he: reviewed the procurement of legal aid; reported on pathology; chaired Sport England; made a life peer; played a lead role in resolving the finance row surrounding the hosting of the Manchester 2002 Commonwealth Games; lead facilitator in the resolution of the dispute between Multiplex Construction UK Ltd and Wembley National Stadium Ltd and a shed load more stuff I don't have room for.
He is a business man, a socialist, understands the public sector and from all reports I have had from the Trusts that have met him (around 40) he is thoroughly liked by the folks on the ground.
I agree. But, he is more than that; laughs when I call him Lord Bog-Roll, is inquisitive, knowledgeable, rounded, experienced and lives in pursuit of excellence to chase down his target of �5bn efficiency gains. It is excellence that is the unwriteen theme of his report.
The report is a determined but rewarding read. Full of facts, figures, comparisons and benchmarks. A PowerPoint user's cornucopia!
Carter makes five key points: the need for better resource management and 'grip'; a 'single version of the truth' reporting framework, used locally and nationally; the curse of delayed transfers of care; the need for national coordination of collaboration to do good stuff (Err... that's what The Academy of Fabulous Stuff does); and the need to get a move on... 2020 is just around the corner.
Let's start with the bad news. The 5 Year Forward View isn't five years any more it's the 221 weeks forward view and saving �5bn in that time scale means, today, you'll have to find �3,232,062.50p.
Trusts claim they already have �3bn earmarked. Mmmm... Will we hear �5bn rattling in the tin. I don't care. NHS funding short-falls are political choices. The Chancellor decides on 'austerity'. When the NHS falls apart we have to make sure the finger is pointed at Downing Street... they either come up with more money or they call for the removal van.
What we must be sure of is the finger cannot be pointed at us. We have to do our bit. That is what Carter is all about and why this is such a humdinger of a report. The recommendations summary is around page 9. He shows us what 'doing our bit' means.
No nook-nor-cranny of the NHS is left unexamined. Electronic staff record, e-Rostering, AHPs, medical staff, pharmacy, diagnostics, back office, procurement, estates and patient pathways.
Some of the ideas; care hours per patient per day and estates capacity analysis are controversial and probably not doable. But, the important thing is... we have permission to think about them and get on and come up with something better.
I like this report. I could have written this:
"Our staff are by far our biggest asset and at �45.3bn this represents a huge investment; however workforce is often regarded as a cost to be controlled rather than a creative and productive asset to be harnessed. The term workforce only serves to reinforce this. We have arguably the greatest concentration of intellect and talent of any UK business, but there is little evidence it has been fully engaged to solve the efficiency and productivity issues Trusts are facing."
Essentially Carter has made a mirror and a matrix for us to see and compare ourselves with others, like us, in the system. Find out what good looks like and do it, benchmark and find out where we are.
He helps us to ask the question. How are we doing; why are they better than us?
If I wanted to be critical of this report (and I don't) I would say it is too wide, too all-embracing and could be summed up as 'do everything better' and we don't have time. A huge national imperative and coordinated push is required. I fear it will become a bully's charter, more targets and another stick to beat people with.
That is not Carter's intention; he is collegiate and sensitive to organisational culture.
That said, no non-executive can be worthy of the job without having read this report. And, there is no manager in the NHS who cannot draw something from this report for their department and their bit of the NHS and get on and do.
This
report is Board's crib-sheet, bible, compass, signpost, inspiration and road map for the next 200 weeks and I suspect, the next 200!
Please make time to read it and have a good weekend.
