6th June 2016

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What is the future for Public Health and the Public's health?
From pork sausages to Porton Down.
Come and join me in conversation with PHE boss Duncan Sell-by (ho-ho)
King's Fund - June 21st, 5.30pm - Drinks, some larfs, some policy, a conversation and networking 
In this mess
News and Comment from Roy Lilley
Recent events have called to mind a book buried on the shelves in my study.  It's by Eileen Shapiro.  'Fad Surfing in the Boardroom'.  In it she says:
Fad Surfing: "The practice of riding the crest of the latest management panacea and then paddling out again just in time to ride the next one; always absorbing for managers and lucrative for consultants; frequently disastrous for organisations"
Fad management in the NHS?  Surely not!
Light touch, grip, organisations with a memory, quality circles, inspection, regulation, earned autonomy, safe staffing, every contact counts, right-treatment right-place, no decision about me without me, drop-in, walk-in, crawl-in... blah, blah. 
I could fill the page with management fads the NHS has employed to disguise the fact that the service is not adequately staffed by happy, motivated people, secure in the knowledge that they work in a stable environment, with a clear focus on what they are supposed to be doing.
Management crazes, deployed to camouflage the fact the NHS is obliged to deliver more care than it is funded for.  The latest infatuation is intended to disguise the fact that there are not enough talented people, willing to take on the Sisyphusian task of running a hospital.
The average tenure of a Trust boss is just over 20 months.  Does the NHS have a special aptitude to find the klutz of this world and give them a job?  I don't think so. 
I think the NHS has a special talent to regulate, govern and oppress managers to the point where they hit the targets and miss the point or miss the targets and get hit on the head with a pointy-thing.  
Most Trusts are unable to balance their books and two thirds of them can't reach the CQC's Mickey Mouse, arbitrary, quality requirements.  Does this mean two thirds of Trust bosses are fit only to run a whelk-stall?  No?  
Does this mean the task of running a Trust, whilst complying with the plethora of made-up standards, goals, guidance and political vanity projects, is no longer possible?  Probably...
It is true that some Trust Chief Executives, mainly a handful who have been in post for many years and sit on a cushion of stability and reserves, are likely to be able to ride out a storm but in time even their buttresses will give way.
And, therein the seeds of the next NHS fad.
The cockamamie idea that because a Trust boss can run one hospital, they can run two, or three, or more.  They can't.  Only hubris would whisper to them that they can.  Flattery persuades them.  Force-majeure obliges them.
The grand deception that the shortage of stable, senior management talent can, somehow, be overcome by getting people, good at doing one job, to do two.
Running a Trust is like running a village... a community.  A family of people.  People driven by a common purpose. Shared objectives.  Good Trust CEOs create a presence, an aura and they do that by being ubiquitous and omni-present.  

They are open about their problems and turn staff into fellow travellers, to
help them with the journey.
The idea that a successful trust boss can run more than one trust brings us to the inevitable question; could they run three, or four, or more?  

That drives us to the conclusion that a super-talented-boss could run all the Trusts from a desk in Whitehall... that is the worst kind of stinking thinking.
There is only one way a canny and successful trust boss might expect to run an extra hospital.  
I'll tell you how...  

They would scour the management ranks for a talented, trusted lieutenant; develop them, create a rapport of confidence and an environment of certainty.  Install them, back them, celebrate and fête them.  Protect them; stand-point, watch their back... and give them the freedom to express their skills and gather experience.
They would step forward and help them in the bad times; step back and let them take the credit in the good times.
And if you think about it; if we'd have done that in the first place we wouldn't be in this mess now.
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Health Chat
Duncan Selbie
Chief Executive Public Health England
In conversation with Roy Lilley
21st June - King's Fund 5.30pm
New HealthChat
Sir Andrew Dillon
18th July - King;s Fund - 5.30pm
King's Fund
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This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing -  Junior Doc's BMA committee are abdicating any leadership role and letting members argue the new contract for themselves. More here 
>>  I'm hearing - there is row amongst the Junior Doc's committee about publish the names of the people on their committee.  I don't see why?  It's easy enough to find - it's here.
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