The Jim Reaper sends a chill down my spine. When I type his name I sit up straight...
The thing is; he is a thoroughly nice chap, ran a superb
Trust, staff love him and the relationships he forged with primary care... exemplary.
Who else do you know who would be able to persuade his local authority to buy-out his PFI deal. He made not-knowing-the-answer an art form. A demonstration of the blinding obvious... 'of course I can't answer that, it is a stupid question'. (Sub-Text)
I claim no credit for this but it would seem his present thinking aligns with my postbag and in consequence, what I have recently written about.
The number of CCGs is little short of an outrage. The legacy of Andrew Lansley's disaggregated mess. Over two hundred organisations doing, pretty much, identical things and no resource to create differentials... even if they could think of one.
Two hundred chairs, two hundred boards, two hundred overheads, two hundred lecky-bills. Two hundred meetings about two hundred more meetings, thousands of sub-groups, huddles and get togethers.
Thousands of people doing identical things, never in step and can't even hear the same tune.
Costs? If their admin costs come to �300k a year each, you can wave goodbye to �60m. Add to that costs-in-flow around contracting, commissions and the rest. Plus, the cost of Trusts and others, engaging with them and we must be looking at well over �1bn.
A billion for what? There is no evidence a market in healthcare improves anything and anyway, everyone is running on empty.
I'm sure the good people working in the CCGs do their best but I have to reveal, my inbox is something of a confessional; people working in them write about the ludicrous waste CCGs have evolved into.
"(STPs) could lead to a major rationalisation of back office costs... we'll be working through... what extent can we devolve the arm's length body resource to you, the ability to harness all the back office costs in that area, CCG, CSU costs and corporate back office costs in providers... which you all know, in each community, is absolutely huge.
If we can get to a point where ... you want to rationalise... turn it into money to invest in patient care, fantastic.
We haven't worked out how to do it yet, there will still have to be some accountability, but let's slim it down."
I'll go for that...
But, dare I mention it? There is something being overlooked...
There are three other organisations that could do with bashing together.
In my view, it serves no purpose to have the huge overhead costs of the Department of Health, waz-Monitor and NHSEngland.
In the quest for finding the last shilling down the back of the NHS sofa, how does anyone justify the enormous costs of three chairs, three boards, three bosses, triplicated staff, overheads and coffee cups.
To repeat the Reaper; "We (I) haven't worked out how to do it yet, there will still have to be some accountability, but let's slim it down."
It is possible to fiddle our way around the legislative requirements by setting up another organisation with a vowel. We have NHSYou, NHSE and NHSI... let's crunch them into NHSO... operations.
A joint group, chaired by a local authority boss; sending the message of joint working; amalgamated back office costs, whistling one tune that everyone can march to.
Crazy? Maybe, but STPs do create a real opportunity to shake things up.
The Jim Reaper is talking of 'rebooting' STPs, shifting emphasis to communications and buy-in. STPs are too important to ignore, too easy to trash but too new to dismiss.
That's why we are arranging the STP summit on the 10th January at the RCN Conference Centre. STPs are part of our future and we should be part of their plans. STPs are on top of the day job but they are likely to become our regular work.
Come and drill down into the opportunities STPs create, dig into what they are up to and decide for yourself... I look forward to seeing you on the 10th... I'll leave it to you to have a word about head-office overheads with the Jim Reaper!
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