7th April 2016

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Think the same
News and Comment from Roy Lilley
Picasso's Guernica is a big picture.  So is Velázquez' las Meninas.  The big picture is always worth a closer look.  What are they really about?
Some people can't see the big picture.  As Rommel found out when he got tangled up with Monty.
Leadership is about seeing 'the big picture'. 
Lurking in the commodious shadows of the public sector you will find Health Education England.  This is a link to their web-ste (note the lack of diversity).  

HEE is run by Professor Ian Cummins.  I have never met him and I am sure he is a nice man.  If you lived next door to him he would lend you his lawn mower.  However, don't ask him anything about running a hospital in today's turbulent climate.
He wrote to Trust CEOs recently, he thinks it 'essential to safeguard the (his) organisation'.  I don't think he can see the big picture.
He is concerned that the proposed contract for junior doctors is so contested and difficult that Trusts might be tempted to attenuate the conditions and offer local terms.
He says; 

'We are (he is) not prepared to see a system where a competition based on local employer's ability to offer different terms is part of the recruitment process'.
King Canute aka Cummins, will single handedly hold back the tide of competition and choice.  Oh, really!
There is more.  A sort of a threat; 

'... implementation of the national contract will be a key criterion for HEE in making its decisions on our investment in training posts'.
Is this threatening, bullying or just plain ridiculous?  He says a single method of delivery is essential to safeguard medical training.  Perhaps what he really means is a single system of delivery is convenient and makes his job easier.
If Trusts do their own thing he will have to be very nice to them to place the doctors he has trained.  Indeed, an over-supply may be no bad thing.  An undersupply is crippling us.
NHS workforce planning is in almighty mess.  Cummins may wish to blame his predecessors and his inheritance.  He seems to have forgotten nurse bursaries are on the way out, Trusts are training their own nurses, as are the pioneers, training their own doctors.
Back in the mid-90's, at a Trust I had the honour to chair, we had talented managers, a committed staff, innovative trades unions and a desire to do what was best for the people, relatives, carers and friends we looked after.  We evolved local pay and conditions and the only no-strike deal in the NHS.
It was tough going but the prize worth the struggle.  By working together, we did it.
All Trusts, not just FTs have the legal right to do the same thing.  There is nothing that Ian Cummins can do about it.  Nor for that matter the Tinkerman, who, if he does not unravel the mess he is in, could well face the same problem. 
Trust bosses are sick to the back teeth with bearing the brunt of a row that is not theirs.  Break-away terms are a likely up-shot.
It seems to me King Cummins is concerned with holding back the tide to make his organisation's life-easy.
Could he say; 'I know what a difficult time this is for the NHS, boards and CEOs?  No.
Could he say; 'If there is anything we can do to help, please contact me direct...'   No.
Could he say; 'If there is some local flexibility you want to introduce, please let me know, how we can help.'  No.
Could he say; 'If you have any innovative ideas that might help, let me know.'   No.
What he did say was he was fed-up with 'reports on social media... extending... into the realm of abuse'.  Ah...
Right now, above all, the NHS needs innovators, thinkers-outside-the-boxers, idea mongers, thought-scavengers and system workers.
We do not need turf-protectors, back-watchers and box-tickers.

King Cummins; can you feel the water lapping around your ankles?  
If I ran a Trust I would want to make it the go-to place to train, the epicentre of best practice and learning, family friendly and fun.  

I suspect there will be a fair few running trusts, right now, who think the same.
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This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - There are a number of Trusts thinking about introducing local pay and conditions.
>>  I'm hearing - all the DH ministerial team have gone missing for the duration of the strike and won't do media interviews.
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