17th 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!
Vocation, innovation and perspiration.
News and Comment from Roy Lilley
I guess we are as ready as we will ever be.
Emails, Tweets, WhatsApp, texts.  Telecons, training weekends, meetings, liaison and phone calls.
Scheduling, air traffic and safety clearances for the IMS helicopter.  Press releases and media briefings.  Visit timing, local press.  Camp beds in the control room and vittles.
I think we are ready.  Fingers crossed, touch the lucky rabbit's foot; we are at the starting gate.
We are ready for 24 hours of FabChange Day 2016 and our Marathon Challenge to visit 12 health and care locations, coast to coast, in 24hrs. Around the clock.  You can follow us here.
Change Day has come a long way.  Since a handful of enthusiasts, mainly alumni from the Leadership Academy came up with the idea and the fabulous Helen Bevan fanned the embers of innovation into life; Change Day is a social movement, owned by the people who make it happen and replicated around the world.
This year there is a difference.  The boffins at KPMG have lent us a version of the Change Day App their company uses, one day a year, to communicate with their thousands of staff around the world.  They do Change Day, too!
You can access it here, for free.  Make your pledge and post, Tweet or download a neat little poster (with one of my graphics), and share it.
We don't want to change Change Day; its spontaneity, its sense of revolution, innovation and join-de-vivre but we do want a platform for pledges to be shared, ideas syndicated and success recognised.  No idea too small, no proposal too big.
In the history of Change Day, this year is probably the most important.   Evidence is clear, top down innovation and change seldom delivers.  It is generally disruptive; rarely evidence based and takes every one's eye off the ball.
Trying to mandate corporate-renewal, which is essentially what Tarzan and the Jim Reaper are about, has limited impact where the essential work is actually done.  Bungs or beatings, incentives or targets.  Treats or threats.
However, grass roots change presents management with equal and opposite problems.  How do they direct, undirected-change?
He trick is a balance.  Senior management sets the direction without insisting on specific solutions. It takes courage! And, may produce a variety of solutions in an environment where variation is seen as the enemy of corporate quality.
Organisational change with planning, process and systems takes management and administration.  Developing change through ambassadors, innovators and local initiatives takes leadership.
Finding a framework to share spontaneous ideas presents another challenge.
Unwittingly, managers will signal their attitude to change.  Directive or careful shepherding.  Holding on or letting go?
Thinking corporately, acting locally.  The improvement paradox.
I believe FabChange Day goes a long way to providing the answer.
Clearly it has support at the highest levels in the NHS and enthusiasm at the front line of care.  The new App resolves the difficulty of giving wider access to the pockets of innovation and ideas that can so easily be an unintentional well-kept secret!
There is another reason why this year's FabChange Day is so important.  The NHS has been plunged into a finance mess, not of its own making. 
Put simply, it is providing more care than it is paid to do.  The required level of commissioner efficiencies is forecast, by the HFMA, to be in the region of 50%.  Year to date 77 CCGs are overspent and 68 in some sort of financial jam.  Three quarters of Trusts, skint.
Change Day won't fix that.  Change Day, enjoyed for its liberating spirit but taken deadly seriously, could make a difference to health service efficiencies.
If I hear the 'aggregation of marginal gains' story and slippy Lycra again... I'll put my bike on E-bay.  But, you know what, it's right.  Little things do add up.  Many a Mickle makes a Muckle. From acorns, big oaks do grow.
If you have an idea, if you have a new way, a better way, a promise to improve something you do, please, use the FabChange Day app.  Post it, share it and let the rest of us look at it, admire it and copy it.  If you want; we may be able to help you 'make it happen'.
For one day of the year let's have an amnesty; no politics, no naysayers, no no-it-can't-be-done. No, what's the point, no I'm-too-busy.  Non managers blocking or stopping ideas.
Let's see what the NHS is made of.  My guess is; vocation, perspiration and innovation.
Thank you!

A special thank you for A Year of Change, Powered by IMS Maxims, 'pledge, save and share' by KPMG's App and Coloplast for their secondment of a senior manager, administration know how and education support.  
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Medicine for Managers

Dr Paul Lambden
'...try and stay awake long enough to read this....'

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News boy
Dr Rodney Jones
Hospital mortality rates and changes in activity.  
Wow!  This is a good one!
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 - several hospitals are about to acquire their own step-down care home facilities, to ease discharge problems.
>>  I'm hearing - NHSE is about to launch a @NHS Twitter account with a very interesting twist!
Need inspiration, a good idea or solve a problem
Dr Sir Sam Everington
Barrister, doctor, leader.
In conversation with 
Roy Lilley
He's been 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.