5th December 2016

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Fab Change-Day Do-Athon
Come to a FREE workshop day with Helen Bevan, Roy Lilley and friends 
Help turn Change Day into a Year of Change.
Top speakers, great venue, join-in, help write some good practice guidelines and make a difference.  
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Humble Pie
News and Comment from Roy Lilley
Thanks to Wikipedia I am able to provide this gem:

"The expression derives from umble pie, which was a pie filled with the chopped or minced parts of a beast's 'pluck' - the heart, liver, lungs or 'lights' and kidneys, especially of deer but often other meats. Umble evolved from numble, (after the French nomble) meaning 'deer's innards'."

No one seems sure how we got to 'eating humble pie'.

I wonder if it is best eaten cold?  How much 'humble pie' has to be eaten to constitute a humbleness? 

I need to answer these questions... I'm about to eat some.  Here goes... gulp!

Some time ago the DH became infatuated with the Virginia Mason Hospital in the US.  The narrative goes; VM killed a patient in unforgivable circumstances.

Determined to ensure it couldn't happen again VM embarked upon a version of Toyota Lean to ensure their systems and lock-in safety; encouraging staff, at the high-risk, front-line of care to talk about their near misses and failures, turning them into a learning experience and be pivotal in service improvement.

The initiative was lead by their chief executive, a clinician.

It was an interesting experiment in organisational dynamics, process and methodology.  VM claimed success and the world became mesmerised by the thought of a safe, error free hospital.  The inquisitive and the curious beat a path to their door.

Many said it was just common sense and good management.  Including me.

VM branded their approach and sold it to hospitals around the world.

The reality is, it involves a forensic line by line examination of every part of a hospital's menu of work.  Everything in detail.  No segment left unexamined.  Processes under the microscope.

The real trick; the minute examination is undertaken by the staff themselves.  Some from the department concerned and some from elsewhere.  They are lead by VM trained people; as much councillors as they are work stream analysts.  They are empowered to make changes... there and then, reviewed at 30, 60, 90 days

In the sensitive time after Mid-Staffs, government here was anxious to look-busy on the issue of safe hospitals.  It didn't occur to them the problem was bullying, pressure to balance the books and not enough staff.  Corrosive management pressures that continue today.

The Tinkerman turned to VM and did an eye watering-costly deal to train five of our Trusts in the VM way.

At the time I said we'd be better off using the money to pay for a few more nurses.  I asked; do we really have to import US managers to teach us to run our NHS?  I said; we have some excellent examples of how to run a fabulous hospital, why don't we learn from them?

All that was true.  But I was wrong.  Everything I said was right, but I was wrong.

I have been to a 'Virginia Mason' Trust and I have seen the liberating impact it has.

I spent an all too short time with Surrey and Sussex Healthcare NHS FT Trust, one of the VM5, and have to say I was wrong.  

Like the VM, SaSH Trust is run by a chief executive, a clinician, Micheal Wilson.  He is urbane, skilled, networked and appears to know every member of staff by name.  He's been in post a long time.  Stability helps.

My guess is MW could run a hospital in Timbuktu and make it work; he's that kind of talent.

He has confidence in his leadership and consequently, in his people, to stand back and say; go and sort this place out.  Wilson has created a climate of empowerment.  

Using the  skills learned on the VM programme his staff are revolutionising their approach to every nook-and-cranny of care.

The key to the VM programme is that it provides the impetus, the fulcrum point and the levers for self managed improvement.  The people I met fizzed with enthusiasm and told genuine stories of how they are enabled and empowered to move forward.

No idea too small, no problem too big.  From the management of patients with diarrhoea, to the management of patient records. 

How many times have I written; want to fix something... ask the people doing it.

Go and see for yourself.  It's an eyeopening, jaw dropping, gobsmacking, superfizzin' Trust. 

I'd like to sing their praises more but I can't.  

I've got a mouthful of humble pie.
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Medicine for Managers

Dr Paul Lambden
'...moe common than you'd think....'
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All week we will be featuring the amazing NEW work of the Vanguards; you can see ideas in action here.
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STP Summit

The IHM have commissioned a report on their progress and prospects; taking to the people doing the job.
Published on 10th January; launched at the 
STP Summit 
RCN Conference Centre 
Cavendish Sq., London
Expect contributions from... 
  • Free copy of the report
  • Simon Tarzan Stevens, 
  • The Jim Reaper Mackey, 
  • Chair of NHSI, Ed Smith 
  • STP Leads, 
  • Local authority leaders
  • Workshops and an action plan report
 10th January 2pm-6pm 
followed by a drinks reception 
Come and find out what is the truth of STPs and their plans, what happens next.
Tickets limited, special IHM deal
Tickets are flying out!  Book now!
Peter Wyman
Chair of the CQC
24th January 2017
Yes, really, me and the CQC!
King's Fund
This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - major extension to HIV prevention programme will announced today.
>>  I'm hearing - there is a growing practice for Trusts to ring waiting list patients, at the last minute, knowing they couldn't make a short notice admission, enabling the Trusts to show the patient as a 'decline' and not a waiter.
>>  I'm hearing - Yeovil plan to take over 7 GP practices in a move towards vertical integration.
The Great Gooroo 
writes exclusively for us.
Should we just give up on waiting times?
This is a very good read!
Need inspiration, a good idea or solve a problem
New Health-Tec Award

'Nominate your technology that is making a difference to your patients 
for a Health Tech and You Award!'
We thought this was a really good idea so we are partnering the Professional Choice category
Nominate someone and make their day!