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7th November 2016

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HealthChat - Xmas Special

Simon Stevens

In conversation with Roy Lilley

6th December - King's Fund - Details here.

Ask Teresa May

News and Comment from Roy Lilley

Ever moved house?

... ages to find a new place, get the money, the lawyers tee'd-up... surveys, removal company, chains, palaver and come the day...

... last minute panic over some legal nicety and the boundary fence... eventually, sitting, dazed, amongst a pile of boxes... eleven o'clock at night, wondering what happened.

... saved by the finest invention of the twentieth century. An innovation that makes removals and most days bearable; the screw-top bottle of wine. No hunting for the corkscrew!

Now the fun begins. Tell everyone, redirect the post, remember a new phone number. New neighbours to wine and dine...

Got kids? That means half the family wont want to move! New schools and all the harrumph that comes with broken friendship circles... finding ways to create new ones.

Yer mum thinks a 10 mile move will put you on the outskirts of Kazabeutystan.

Utility suppliers, new tariffs, new meter readings. Find a decorator, find a GP, find a new kitchen... find a landscape gardener.

I read somewhere, moving house is among the top three most stressful events in our lives. Divorce and a new job the other two.

Brexit... like moving house... but more complicated. This is not going to be easy. By comparison Brexit will feel like an eviction.

For over 40 years the UK has become entwined with Europe. Every part of our daily lives, in some way, influenced, made safer, made more frustrating by the benevolent, or malevolent (your call) influence of the European Union.

Half the family don't want to move, new neighbours to wine and dine, new tariffs, new everything and to make matters worse, the High Court have induced panic in the ranks with a legal nicety.

Take time to read the judgement; they are at pains to decouple the political decision to leave, from their opinion of constitutional law.

Any schoolboy student of British Constitution will tell you; Parliamentary Sovereignty is supreme. If the Brexiteers are so sure of their case and the Remainers respect the will of the people... what could possibly go wrong!

The answer; everything. The list of known unknowns is very long and the list of unknown unknowns, longer!

In the name of democracy the processes could stall the process... expect an election.

All this malarkey has a resonance for the STPs; the new landscape gardeners, trying to reshape a tapped-out NHS. Change everything.

They're not messing about. Crashing services together, circling the wagons, closing this, moving that. Amalgamating, merging, mixing things up. Getting on with the job.

There are only, about, 160 weeks of the Five Year Forward View left.

No matter how collaborative they try and be, (remember Brexit had a referendum) there will still be people who just don't want to change anything. No matter how inclusive; the awkward-squad could use the processes to scupper the process.

The trick is to consult like crazy. Here are my top nine tips for consultation:

have a clear transparent public schedule;
clarify the message, why no change is not an option and is going to happen, be honest. If it is the money, say so;
be inclusive, not the usual suspects, go through schools, clubs, workplaces and social media;
don't front load with solutions, lay out the problems;
don't say services will be better, say they will be different because they can be (safely) and have to be (financially);
remember the ambulance service is your best ally when deciding safe relocations;
decide what you want, endorsement or acceptance, they are different;
question yourself, is this the way you'd want your family asked for their views;
above all, be honest...

... financial and demand pressures are obliging us to reshape parts of the NHS. We will have to provide some services differently and some in unfamiliar places. We will use technology and thorough planning to develop safe solutions to our huge problems as best we are able. We don't like this anymore than you do.

Do all this and still, local councillors and MPs, worried more about reelection than relocation of services, will try to derail you.

GPs will panic at the potential loss of income, Trusts Boards rage at being downsized and reputations undermined.

STPs are a neat invention. With no laws nor budget, they offer a strategic over-view and done right, should be inclusive, consensual and have traction through buy-in.

But... the bigger the changes, the trickier it becomes.

Ask Teresa May.

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Contact Roy - plse use this e-address

roy.lilley@nhsmanagers.net

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

Leaving the NHS, changing jobs - you don't have to say goodbye to us! You can update your Email Address from the link you'll find right at the bottom of the page, and we'll keep mailing.

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Disclaimer

Medicine for Managers

Dr Paul Lambden

The Rise and Fall of the GP

'...in a departure from his normal topics Dr Paul takes us on a journey though the history of GPs and primary care. This is a tour-de-force and an absolute must read....'

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Come and Join us

FREE

at this Year's Academy of Fabulous Stuff Awards

24th November

The Indigo - O2

12.30 - 4pm

Free tickets

First come first served

Apply here.

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Join the IHM

Find your voice.

Exciting announcements coming up

JOIN HERE

Have a voice

23 people joined last week.

Will you join this week?

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See all the

Change Day videos, photos and visits

here

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Writes Exclusively for us.

The power of visualisation.

It's about more than the numbers

Read it

here for Free!

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Academy of Fabulous Stuff Awards

Vote for the overall winners of the year.

All the winners are chosen by you.

Please do it

Here

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A golden harvest of good stuff is

HERE

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Doin' some good stuff?

Share here.

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News and Stuff

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>> Infection control - The Tinker man is having a Tinker. E-coli rates are up 20% in 5 years. So is hospital through-put. I wonder what the real story is? I have no doubt a Prof somewhere will tell us!

>> Do the public trust the Judges - neat infographic.

>> STPs mapped - HSJ.

>> GP survey on willingness to withdraw services - more dancing around handbags.

>> HEE - apparently it is not their job to fill rota gaps. Really? Just what are they for, other than for duck-shoving?

>> Nicola Gorb, the speech therapist from GOSH - made some ill judged statements on BBC Question Time, getting hounded in the press. Sure, what she said came out all wrong, but she doesn't deserve this. Whyat I think she way trying to say was the NHS depends on the EU for research and collaborative working. Don't complain if it comes to an end because of Brexit and us and our kids miss out leading edge stuff. she might well be right?

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Dr Rodney Jones

The latest from our favourite analyst and data cruncher.

Using Social Groups to Locate Areas with High Emergency Department Attendance, Subsequent Inpatient Admission and Need for Critical Care

Read it here Free

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HealthChat

Simon Stevens

6th December

This will be a sell-out. Get your tickets organised today!

King's Fund

Tickets and special deal here

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Gossip

This is what I'm hearing;

if you know different,

tell me here

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>> I'm hearing - St George's operating theatres have been causing problems for ages. Temperature control being the favourite problem. Some of the ventilation parts date back to the 80's and engineers have been searching for spares on E-Bay. St George's apparently spent �3m with KPMG to help sort out their financial problems. The financial problems stem from flowing unprofitable patients. The CQC are suggesting a larger department - to flow more unprofitable patients. The former incumbents in the top jobs at the Trust; Miles Scott (CEO), Steve Bolam (CFO) and Jennie Hall (Chief Nurse) now work for NHS Improvement. You couldn't make it up!

>> I'm hearing - 14 practices in Suffolk are set to merge. I think that makes them the largest in England?

>> I'm hearing - a Canterbury, single handed, GP practice was inspected and the report took five months to appear and the practice given 5 days to reply. And they wonder why everyone hates the CQC!

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