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4th November 2016

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Dr Sir Sam Everington

GP extraordinaire! In conversation with Roy Lilley

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Not fit for purpose

News and Comment from Roy Lilley

What do you make of the phrase; 'not fit for purpose?'

Would you want to fly in an airplane 'not fit for purpose'? How about drive in a car or put your laundry in a washing machine; 'not fit for purpose'...

Would you eat your dinner from a kitchen 'not fit for purpose'? Walk a tightrope, use a parachute? I don't think so!

How about getting yer kit off, being zonked-out and having yer wobbly bits under the knife in an operating theatre officially described as 'not fit for purpose'?

I think you'd run a mile. You'd expect who ever it is flying the plane, manufacturing the car, making the washing machine, cooking yer dinner, stretching the tightrope, packing the parachute to stop. Close down, desist, end activities.

For fear of accident, disaster and the roof coming-in under the weight of lawyers; the car company, the washing machine manufacturer, the restaurant, the rope maker, the sky-fall company would shut-up shop. Get more investment, get sorted and try again.

The one thing they would not do is keep going.

Now, here's a thing; months ago the CQC pitched up in their charabanc and crawled over St George's FT in south London.

The Trust is in the front-line of healthcare. One of the trickiest places in England; demand, diversity, staff and accommodation shortages, cost of living, capital starved estate... you name it. They've got everything they don't want in spades and nothing of what they do want, even in a spoonful.

The CQC say the operating theatres at St George's are 'not fit for purpose'.

There's no money to refurbish them. Do they close them or try and keep them going? Morale is low. It is a daily battle to struggle on. The NHS at its most gritty.

If you are due an operation there, you'll be zonked-out in one of the 'not fit for purpose' operating theatres.

When you recover, have your nearest and dearest bring grapes and yer lawyer. Be sure to sue them. It doesn't matter if you can't find anything actually wrong; sue for mental stress and anxiety; occasioned by the fact you have been operated on in a place 'not fit for the purpose' of operating on you.

You might as well have been in a bike shed, or a chip shop.

If something, anything, is not fit for purpose, then common-sense tells you; do not use it for that purpose.

If there were reasons not to use inspection as a method to enhance quality, surely, this is the copper bottom reason. A gold plated regulator telling a tin plated service, it is 'not fit for purpose'. Surely, it is the other way around?

Shut the operating theatres. St George's; too big to close. The CQC; impotent.

Give them a bung to sort them out... the only answer.

The CQC have 17 trusts in some sort of special measures. Waz-Monitor have about 7 Trusts in financial meltdown, probably broke but still trading.

Wouldn't you say we have a system failure? Wouldn't you say something quite important is happening when 24 Trusts out of about 150, have the wheels coming off?

Wouldn't you say it can't all be down to daft people doing stupid things? Wouldn't you say it is heroic they can still find people with the courage and commitment to turn-up for work.

The Health Select Committee seem to think so.

Add to that, there's no capital for renovations and repairs and the ludicrous stumbling block; the DH's approach to simple mathematics;

�10bn-�2bn-�3bn = �10bn

... you can see the mess we are in and the irrelevance and utter pointlessness of the CQC.

What's the lesson here? Stop inspecting and start investing? That seems to make more sense.

You no longer have to be an insider to know the Treasury, not the Tinkerman, is running the NHS. Insisting the books balance.

What to do?

It's time Trust Chairs had a quiet word with the Secretary of State for Health and remind him who votes for who.

Who works for us. What's he going to do? He knows what we know... what we've got isn't 'fit for purpose'.

Have a good weekend.

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Contact Roy - plse use this e-address

roy.lilley@nhsmanagers.net

Know something I don't - email me in confidence.

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Disclaimer

Medicine for Managers

Dr Paul Lambden

Meziere's Disease

'...don't be caught off balance....'

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News and Stuff

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>> Breast Cancer - NICE guidance.

>> PWC report - staff want 'more reforms' Really a vehicle for Alan Milburn to postulate local taxation to supplement health funding. Generally a daft Lib-Dem idea that will make rich areas richer and have better healthcare.

>> Southern Health - new review. Really bad idea; this Trust needs a period of stability and to get its confidence back.

>> Capital (them again) - now the MPs are wanting to have a look at what's gone wrong in Primary Care. I warned months ago this would get worse. I can't believe such a bigg and experience company as Capital could end up like this. I can't see them getting a sniff of anymore NHS contracts...

>> Australia - to stop importing GPs.

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Dr Rodney Jones

Another storming paper

Role of a day-of-week cycle in blood biochemistry in the weekend mortality effect.

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HealthChat

Simon Stevens

6th December

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Gossip

This is what I'm hearing;

if you know different,

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>> I'm hearing - The Treasury are getting increasingly fed-up with the NHS finances and are pushing for some sort of co-payment model.

>> I'm hearing - real concerns about the recent cyber attacks on hospital systems. They are not robust enough to withstand a concerted effort.

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NEW HEALTHCHAT

Dr Sir Sam Everington

Barrister, doctor, leader.

In conversation with

Roy Lilley

King's Fund

9th November

Tickets for IHM members half price.

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New Award

'Are you using health technology that is making a significant difference to your patients?

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>> Staff voices - if you only look at one thing today - make it this.

>> Patient deaths - communications issues.

>> Unsupervised HCA - gave drugs.

>> Using data to identify good quality care for older people - this is the latest from the Nuff's; looks like lot of twaddle to me... see what you think.

>> HEE - set to recruit GP 'failures'.

>> Merger - off; I suspect the PFI has something to do with it.

>> Brum Womens' FT - fall foul of the CQC; who cares? Some palaver about governance. There are in the middle of a take over so I guess there will bound to be some admin issues.

>> DH newsletter thing - out of date but an interesting round-up of what they think is important.

>> Shelford Group - flexing their procurement muscle.

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Fabulous Stuff

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