28th April 2016

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Niall Dickson Boss of the General Medical Council in conversation with Roy Lilley
'We feel generous deal'
Buy a ticket for the Lord Carter interview and Niall Dickson and get a special price 
News and Comment from Roy Lilley
Let's park the 7-day strike 'thing'.  Heroic planning managers have made the last 48hrs safe and drama-free.  Well done and thank you! 
One way or another, in some shape or form, 7-days will happen.  As predicted... it'll be resolved locally.
Frankly, it's behind the curve.  Why an organisation, the size of the NHS, with the investment in kit and caboodle the tax payer has made, shouldn't sweat the capital assets is beyond the understanding of anyone who has run a whelk stall.
How it can fall out with the backbone of its workforce is beyond anyone who has run a Scout Troop.
Forget all that.
The future is about transformation.  Not-Monitor, now called something else, has a 'mission to transform'.  Great idea... except no one is really sure what it means.
The common misconception is that it means doing stuff slicker and quicker, faster and cheaper. 
NHS IT strategy, son of 'Connecting for Health', now called something else, will try and persuade us that doing the stuff we did on paper, on a computer, is transformation.  Or, stuff we did on a computer, on a tablet... is transformation.  

It is not transformational.  If we are still doing what we used to do but using a keyboard, that's not transformation.  It's called catching up.
This week, the  destruction of two of the best know names in the high street, Austin Reed and BHS tells the tale of on-line shopping and analysing customer preferences.  People are still buying suits, ties, cardigans and light fittings.  They are just buying them from the sofa, not from the high street.
Think BlockBuster, the high street, video rental company.  Great timely, business model copied by Netflix who dumped the costly shops and did the whole thing by mail order.  Then, as the technologies allowed, they switched to downloading and streaming.  That is not transformation; it's just keeping up.
Not content with that; they studied their data, figured out what people really wanted to watch and started making their own movies.  

Not content with that; to keep their customers loyal they now make series and episodes.
That is how to transform a business and keep ahead of the curve.
So what is 'transformation'?  Google.  They are 'transforming' by going from search engines to real engines.  They are making cars; challenging Ford and Fiat?  Not really.  Google mapping technology makes driver-less cars a reality.  General Motors and BMW will never catch up.
Apple are doing what Swatch can't do and playing with TV like Samsung never thought about.
What does transformation mean for the NHS? It does not mean electronic patient records, websites, piddling Apps and palaver.
Real, proper transformation means turning the NHS into a wellness organisation.  Studying the data on prescribing and GP consultations, finding out what is making us sick and stop it happening.
Redesigning the contribution of 'public health' to public wellbeing and personal welfare.  Health planners who know at least as much about us as supermarkets.  
Suddenly, the most important people in the NHS are not the doctors.  They are relegated to the 'fixer-you-uppers'.  The most important people become the data analysts.  The Talk-2-a-Doc-on-Yer-phone', App developers.  Algorithm gurus. 
The life-style advisers, the health brokers and the wellness coaches.  The ologists of life, lifestyles and what makes us happy.  Sickness is a failure and 'easy' but costly to deal with.  Keeping us fitter for longer, that is transformational.
Change the default access to primary care to phone triage run by clinically led call centres.  Change the base-line model of care for long-term conditions to supported-self-care, remote care, monitoring and call-backs when algorithms show up a red flag.
Not all patients could cope?  No, but the ones who can create the headroom to look after the ones that can't.
Integrate primary and secondary care, have specialist A&Es for eldercare, just like we do for paediatrics........
Doing what we did yesterday, better today, at best makes what we are doing now, the best it was in the past.
Real transformation means reinventing the core business model.
Transforming the NHS... really? 
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>>  I'm hearing - St George's Trust boss, Miles Scott, is leaving.
>>  I'm hearing - in most Trusts work is well under way to recruit safe-working guardians.
>>  I'm hearing - Will Cavendish has popped up, working in the Cabinet Office.
>>  I'm hearing - tales of cuts to Better Care Fund budgets.
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