21st November 2016

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HealthChat - Xmas Special
Simon Stevens
In conversation with Roy Lilley 
If you plan on joining us, do it now, on Friday there were 15 tickets left
6th December - King's Fund - Details here.
Hearts and minds
News and Comment from Roy Lilley
If you haven't got yer head around STPs and the urgent need for them to lead some strategic thinking, then you must be away with the fairies.
The press are catching up.

'Thousands of hospital beds are set to disappear, pregnant women will face long trips to give birth and a string of A&E units will be downgraded or even closed altogether as part of controversial NHS plans to reorganise healthcare in England.'

The Guardian had looked at half of, what it called, 'regional plans' and deduced;

'... health service chiefs plan to push through an unprecedented centralisation of key hospital services across England'.

Uncle Bruce said;

"... centralising some types of medical care benefits patients... improves their chances of a good outcome because doctors deal with more cases of certain ailments."

Of course, he is right.  Put yer best stuff in one place and it will become excellent.  A regional redesign of services reflecting modern capability is long over due.

By and large, the public disagree;

'Campaigners in Cumbria... are warning... patients will die, including mothers and babies, if they have to travel 40 miles from Whitehaven to Carlisle... a journey that can take up to two hours depending on the time of day, weather and traffic...'

The Guardian goes on;

'...several thousand beds in acute district general hospitals are likely to be cut... including... 535 in Derbyshire... 400 each in Devon and West Yorkshire and 30% of all [hospital] beds in Bristol, North Somerset and South Gloucestershire.  ...'


Closing beds at a time when the newspapers are full of stories about hospitals choc-a-bloc and ambulances queuing up, into the street, make no sense.

Closing beds makes perfect sense if you factor in improvements in length of stay, occasioned by better care, improvements in techniques and Pharma.

Closing beds makes no sense if you can't send well patients home because social services are running on empty.

Closing a maternity unit makes perfect sense if you cannot hire enough midwives to run a safe unit.

Closing an A&E makes perfect sense if you understand what a Tier 1 A&E is and how much better off you would be if your life was in the balance.

Closing an A&E might make perfect sense if you understand the formidable advances in Paramedic skills and how they have to be more like Connie Beuchamp than Lewis Hamilton. 

There are some good things that can come out of our current predicament.  Austerity will stimulate innovation but it will be stifled if MPs, who are the root-cause of our predicament, jump on the passing bandwagons.

Some STP plans might give us a once in a career opportunity to clear out the undergrowth, re-oxygenate the system and move to a new level of effectiveness.

The key will be how plans are communicated.  Left to the national press even the likes of the usually supportive Guardian will reach for the lexicon of closure, cuts and risk.

Stumbling over documents straying into the public domaine, meddlesome leaks and seat-scared MPs will generate a communications storm.

It is communications, as much as planning, that will see the NHS through this difficult time.  Well thought through communications strategies.  Professionals with half-decent budgets who can tell the story as it is, not as it is made out to be.

STP leads have to become communications champions; no meeting too small to attend and tell their story.  No council left un-briefed.  No councillor left undecided.    Golf-clubs, the Legion, Silver Circles, Mum's groups, schools, day centres, theatre groups.  Any one who will listen and of course... Facebook and Twitter.

Where there are three people talking the STP lead should be the forth.

A blitz of explanations, reason, facts and figures in infographics that a Martian could understand.

So far STP communications have been like the vicar preaching to the choir.  Now they need to turn their attention to the congregation.  They must be evangelists.

"Consultation' is not enough.  It is time for dialogue and discussion.  Evolving, listening, pow-wow, group think and citizens' juries. 

Is it too late?  Have STPs been caught flat-foot?  They have a huge battle ahead; for the hearts and minds of the public.

  Contact Roy - plse use this e-address
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Dr Paul Lambden
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Come and Join us
 at this Year's Academy of Fabulous Stuff Awards

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Voted on by you.  Not mystery men in shaded rooms!
24th November
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12.30 - 4pm
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For a full listing and tickets
This is a must-go-see!  I'll be at one of the shows; buy me a sherbet?

Simon Stevens
6th December
This is likely to be sold out today
King's Fund
Guest editorial
Dr Malcolm Oswald
Writes exclusively for us about
Citizens' Juries.
Are they the answer to the 'consultation problem'?
Dr Rodney Jones
This week's great analysis
Using social groups to identify high areas of utilisation.
You will struggle to read anything more interesting
Must read
This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - doubts over some Trust ability to achieve their monthly 'run-rates'.
>>  I'm hearing - Leicester called a major incident last week as they became choc-a-block and ground to a halt.
>>  I'm hearing - Brexit-drain is starting to impact on some Trusts as EU staff head for home and recruitment is down.
>>  I'm hearing - antibiotic recruiting is down!
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