14th October 2016

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Matthew Syed - author of 'Black Box Thinking'
Special half-price deal for IHM members 
This is going to be a sell-out
In conversation with Roy Lilley
25th October 2016 - King's Fund - tickets here. Hurry they are whizzing out of the door!
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Technical Note
Some of you lovely readers have reported missing text in the eLetter.
The problem seems to be confined to Firefox and some web-based email clients.  
The bobble hat department are on it and we will have it sorted by Monday or the beatings will begin.
In the meantime Outlook, IE and Chrome displays as it should.
Thank you for your forbearance and have a good weekend!
See you as normal on Monday.

Lock up the priest
News and Comment from Roy Lilley
Caroline edged the Clio into the traffic.  Chris Evans confirmed the time... ouch.  She was late. 
Mirror, signal, move out to the centre, wait for a gap in the oncoming traffic, check the mirror, turn right.  Caroline is a careful driver.  Her bus-driver dad taught her, all those years ago.  She passed first time.  It was difficult to know who was more pleased; Caroline or her dad.
She approached the traffic lights at Cherry Avenue, they flicked from green to amber.  Ahead of her the Honda and the Focus slipped over on amber. 
She was late for work and her first meeting with the new FD but she slowed, pulled on the hand-brake and groaned.
The lights turned to green; Caroline pulled away.  Out of nowhere, the blue Vauxhall came at her.
She jumped on the brake pedal with all her might; stamping it into the floor.  Her handbag, laptop, files and mobile phone flew off the passenger seat, crashing into the foot-well.  She closed her eyes.  Waited for the crash.  
The Vauxhall swerved and missed the Clio by no more than a whisker. Dad must have been watching over her...
She will never know how she wasn't killed.
A cyclist tapped on the car window.  "You OK, love?" 
Caroline mouthed a 'thank you' and drove off. 
She was still shaking when she arrived at the office and burst into tears of relief.  Amanda produced a cup of tea and agreed; "Stupid drivers.  Lunatic.  Should be locked up.  Must have been on drugs..."
The Vauxhall driver was Father Joseph from Our Lady Queen of Heaven church.  On his way to the hospice.  He told the matron he was lucky to be there.  He was very nearly killed by a woman driving a Clio.  "St Christopher was watching over you, Father."  They smiled at each other.
Later that morning contractors, ATS, responded to an emergency police request and arrived at Cherry Junction to reset the traffic lights.  Three hours ago the software had decided to show green all round.  The result was an accident and now, grid lock.
This story is an example of 'fundamental attribution error.'  
"... the tendency for people to place an undue emphasis on internal characteristics of the agent (character or intention), rather than external factors, in explaining another person's behaviour in a given situation. This contrasts with interpreting one's own behaviour, where situational factors are more easily recognised and can be taken into account..."
In English; if something happens, we jump to blame instead of asking why.
Yesterday the CQC did their annual state of the NHS report.  You can't polish a cow-pat... it's a bad.
One way or another we've been inspecting the NHS since 2003.  Here we are, 13 years later and the NHS still isn't delivering reliable, safe care.
The CQC's policy has been to blame boards, managers, nurses, doctors, special measures, closures, threats, bullying and Uncle Tom Cobley.  Fundamental attribution error.
However, yesterday the CQC said; 

 '... hospitals were coming under increasing pressure from the social care crisis...' 

... in terms, finally admitting, the pivotal role played by external factors, putting good care beyond the reach of inspection.
Corporate psychological projection... blame shifting.  'It's not inspection that doesn't work and we should stop doing it... it's social care.
The DH joined in and said; 'the NHS was performing well...'
Er... one care home a week is closing, 800,000 Britons are registered with family doctors in 'unsafe' practices and half of A&E's aren't 'safe'.
Let's take stock. 
The CQC have finally admitted external factors are more likely to be responsible for poor care than dozy management. 
Is it now time to ask why, (Fag Packet calculation), in 13 years, we've probably spent north of 1,950,000,000 on various regulatory regimes that are impotent to address the real issues undermining care.
If the CQC has a flaw in its corporate psychology, the DH are certainly suffering 'confirmation bias'; the tendency to stick to information that confirms a pre-existing view, right or wrong.
Two states of corporate mind-set; inviting errors in policy making.  Cultures; reacting to events when they should be reacting to their causes.

Reality smothered by the imperative to declare success when we all see failure beckons.    
Understanding how organisations think tells you why the CQC has failed as a regulator, why no one trusts the DH press office and Caroline wanted to lock up the priest.
Have a good weekend.
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Matthew Syed
Former Commonwealth Table Tennis Champion and author of Black Box Thinking

Half price tickets for IHM members
25th October
King's Fund
This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - the House of Lords are pressing on with their inquiry into the NHS and asking 'Is there a funding crisis'?  They must be the only people in England who don't know there is!
John Parry writes elusively 
for us 
'a necessary risk'
Need inspiration, a good idea or solve a problem
Dr Sir Sam Everington
Barrister, doctor, leader.
In conversation with 
Roy Lilley
He was even a 'rough-sleeper' and charged with making fraudulent job applications to highlight discrimination.  The first medic on the scene after the 7/7 bombings.
This will be a really interesting evening.  Medico-politics, the future of Primary Care.
Tickets for IHM members half price.