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19th February 2016
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HealthChat 
Prof Sir Mike (Deep-Diver) Richards - CQC
In conversation with Roy Lilley - King's Fund March 1st, 5.30pm
I don't think there are any tickets left, maybe some returns  HERE

A poor service for poor people
News and Comment from Roy Lilley
"I'd rather stick needles in my eyes..."
 
Jack Nicholson, Terms of Endearment.  Great movie, great quote!
 
Sadly, there are some people who do have needles stuck in their eyes; part of their treatment.  There is a little plastic gizmo that is like the eye-baths of the old Optrex era; a tiny funnel bit added on, so the eyelids can be wedged open and a needle slipped down the funnel and the eye injected.
 
The plastic bit is about the size of an eggcup and takes about tuppence worth of plastic.  By the time the NHS gets to use them they cost ten quid.  I have no idea why.  In one hospital, alone, they spend 4.4m a year buying them; apparently, 1% of their turnover.  The gizmos are not reusable.
 
I know this because they were paraded at the Future Focused Finance hoedown last Friday, at the King's Fund; home of the world's best chocolate muffins.  The FFFs were having another bash at persuading us; finance is everyone's business.
 
They have a tool-kit thingamabob.  Various people gave examples of how they had socialized the finance tribe, dragged them out of their offices to talk to front-line staff about balance, budgets and the fact, actually... there is no money.
 
It works; show people what good looks like and they'll do it... better.
 
This might be unremarkable in any other business but the NHS has built careers on turning little more than adding-up and a lot of dividing, into a dark art.
 
It was by remarkable happenstance that the launch of the love-your-finance-folk initiative came on the very day that the deficit for the year end was published.  PaddyPower would probably have given 6/4-on it would be over 2bn.  The real bet; how much over two billion?
 
We now know; the NHS provider sector recorded a deficit of 2.26 billion which is 622 million worse than planned.  Ouch.
 
The Gov.uk web-site has a dissembling, shuffling half-hearted explanation telling us the shortfall is because we are busy.  We know...  The real reason for the shortfall; the NHS is doing more work than it is funded to do.  
 
One day the powers-that-be will arrive at the simple truth; they either give the NHS enough money to do the job, up front at the beginning of the year and let them get on with it, or keep them short of money and bail them out at the end of the year. 
 
The bit in the middle is a tedious series of arguments, austerity, muddling through, recriminations and spending a shed load of money, thinking up new ideas about how to not to spend the shed-load of money we don't have.  Insane!
 
I'm a fan of Ed and Jim at the new, Not-Monitor and have been cheer leader for Tarzan since he started.  All three, are clever, bright, experienced, persuasive and resort to a comical hint of menace about not spending any money.  Let's face it, however hard they try, they are not magicians, Houdini, Mystic Meg, Mary Poppins, Mrs Doubtfire, Stalin or Kim Jong-un.
 
They know, you know, we all know; NHS underfunding has produced a set of circumstances that is pushing recovery beyond our reach.  If the NHS was a business, it would be broke.
 
The finance luvvies are right; finance is all our business.  Finance can't be a department, money is the stripe in the toothpaste; a theme running through the whole NHS.
 
It is no longer acceptable for people to say they don't understand the numbers.  Money is all our business; who spends it, on what and who with.  

Let's close finance departments and have money experts embedded in every team and department.
 
Professional competencies, clinical skills, management qualifications are no longer enough on their own.  We must bring our whole selves to work; our curiosity, our common-sense and a big box of questions marked 'Why?'
 
'Why', we all have to ask, does an egg-cup cost ten quid?  Why don't we buy them in China; bring them in by the container load? It's all our business.  An iron grip on NHS finance will only come when we all hold the levers.
 
The 'money thing' is now beyond serious; pretty soon, if we don't all get involved, we'll be using the quote from the other Nicholson; David (former boss of the NHS)...

He said; 'we're heading towards becoming a poor service for poor people'.
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New
HealthChat
Jim Mackey
Chief Executive
NHS Improvement
Financial discipline, quality and knitting fog.  Can he do it?
Come and find out
In conversatin with Roy Lilley
King's Fund 
14th April
5.30pm
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Coming soon
HealthChat
Boss of the GMC
Niall Dickson
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Gooroo
The Gooroo
writes exclusively for us.
Managers managing; adaptable and granular
Don't miss it!
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The Facey Romford Papers

The hysterically funny series we ran last year has been turned into a must read book.
The 50 original episodes + 20 bonus pieces previously unpublished.
Special Discount Price 
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Health Chat
Prof Sir Mike Richards
Chief Inspector of Hospitals 
1st March 2016
King's Fund 5.30pm
A few tickets left
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Gossip
shh
This is what I'm hearing;
if you know different,
tell me here
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>>  I'm hearing - following the appointment of a part-time boss, arrangements for the new board to run the National Guardian 'thing' are under-way.  Guess what; the preliminary board will be drawn from 'arms-length bodies' nominees.  No public appointments process.  Nothing like starting as you mean to go on.  This is infuriating the patients' pressure groups and rightly so.  This organisation is doomed from the off.
>>  I'm hearing - the Carbuncle is planning more help for 'atypical' practices serving difficult populations.
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Need inspiration, a good idea or solve a problem
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Dr Rodney 
Jones
The biggest single year rise in deaths for almost 50 years.
Did you know that?
This is very significant, methinks...
Can you believe it?
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