29th February 2016

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Prof Sir Mike (Deep-Diver) Richards - CQC
Sold Out 
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Nothing on the telly
News and Comment from Roy Lilley
By the time you read this the airwaves will be thick with stories about the shortage of doctors and nurses in the NHS.
The BBC has spent the last couple of months FOI-ing Trusts and others, to find out precisely what anyone working in the NHS could have told them at the factory gates; there is indeed a shortage of doctors and nurses in the NHS.
Whilst I don't expect the BBC to read anything I have written; if they did, they might have discovered what we have discovered; there is a shortage of doctors and nurses working in the NHS.
Should the BBC have turned to the wise words of the HSJ or the Nursing journals or Pulse, or GP or any other of the authoritative trade journals; they would have discovered there is a shortage of doctors and nurses in the NHS.
I have known this day of 'the NHS doesn't have enough doctors and nurses' programming from the BBC was coming as many of you, working in the engine rooms of the NHS, have had to put together the numbers to feed the insatiable appetite of the BBC.
In general I think I would up-sum your views as 'these things are a *&##%$ nuisance'.  In 2012 an estimate put the cost of answering FOI enquiries in the NHS at 30m.
The Prime Minister once said FOI was furring up the arteries of government.  Of course we should be free to access information but it comes with a price.  If the BBC is using FIO to make programmes perhaps the costs of us, writing their scripts, should be on their programme budget, not our administration budget.
Democracy must be built on openness and transparency; being prepared to share information.  Perhaps the answer is to put every scrap of information we have on a web-site and let the BBC do their own research? 
Shortage of nurses?  Yes.  Why?
When the pressure was on, to force Trusts to become Foundation Trusts, however unprepared they were, they had to present Monitor with a set of books that balanced. 
The easiest way to balance an overheating set of books was to understate the number of nurses that Trusts would employ.  Nurses being 70% of the cost base.  That under-stating fed through into forecasts for nurse training places.  The numbers were wrong from the off!  The situation later compounded by austerity cuts in funding for Health Education England.
Since then we have had the Francis report wanting more nurses.  Later there has been much confusion; Francis appears to have rowed back from his safe staffing recommendations.  He became a NED at the CQC and they signed up with NICE, Monitor, NHSE and Uncle Tom Cobley, to demur from safe staffing calculations and he has since gone silent following his appointment as the Patient's Association's President.
I have no idea what the latest is on safe staffing and I don't think anyone else has?  So how many nurses we need is anyone's guess.

A ban, or not on overseas nurses (the decision still hangs in the balance), withdrawal of bursaries for nurse training places (the impact of which does not seem to have been risk forecast) and house prices putting accommodation out of the reach of the under 30's delivers a toxic cocktail.
Doctors?  Applications for training places have, for the first time in living memory, dropped.  Negative publicity from the profession itself, doctors slagging off the NHS, pressure on GPs,  OOH palaver, A&E stresses and the running sore of the junior doctors strike are putting the brightest and the best, off.
For doctors and nurses the lure of a sunshine life style means easy pickings for advertisers like this.
So, what have we learned?  

Yes, there is a shortage of doctors and nurses.  Yes, it makes Trusts impossible to run.  

Yes, it gives the bone-heads at the CQC an easy target.

 "...this hospitals doesn't have enough nurses = this hospital is badly run = this hospital is badly led = the Chief executive gets the bullet and the Chair resigns = an interim is put in = the Trust gets a bung = cost go up = the Trust runs into troubles = Monitor turn up = the interim gets changed = ..... blah, blah. "  Groan...  
So, now you know what you knew already and we've also learned there's not much on the telly.
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