My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

Read my statement in full »

One person’s nonsense is the same person’s really good idea

Filed Under (Primary Care Trusts, Reform of the NHS) by Paul on 30-11-2009

Last week David Nicholson was quoted as describing as “nonsense” the idea that the provider arms of Primary Care Trusts should become Community Foundation Trusts. It would appear that the Chief Executive of the NHS is softening up the whole organisation for a complete U turn on how it is going to develop its community services.

This is the same Chief Executive who said something very different in his first operating framework for 2007/8. This was an important document for David because he had become Chief Executive in September 2006. This meant that the operating framework for 2007/8 was his first opportunity as the new boss to give the organisation its direction.
Read the rest of this entry »

How the coming financial pressure on the NHS compares with times past, and what are the levers that could be used to increase efficiency over the next few years?

Filed Under (Expenditure, Primary Care Trusts) by Paul on 23-11-2009

It is no secret to say that reforms within the NHS are incomplete. It is even less of a secret to say that much of the culture of the NHS (by which I mean the way in which we do things round here) still resonates with the song of the unreformed NHS.

Why does this matter?

It matters because over the next 4 years the NHS faces an enormous challenge -caused by the mismatch between the increased demand for NHS services that comes from an aging population and, at the very best, an increase in resources that keeps pace with inflation.
Read the rest of this entry »

I’m Spartacus! The new cry of NHS managers as Ministers seem determined to show how weak they are.

Filed Under (Health Policy, Primary Care Trusts, World Class Commissioning) by Paul on 17-11-2009

Something very strange is happening to current Ministers of Health in the run up to the election and at the end of this Parliament.

At periods of time such as these Ministers are usually trying to demonstrate both their surefootedness and their ability to make things happen in the NHS. They try to use Government to impress upon the electorate that they are powerful people who can make things happen. It’s not a bad tactic. 
Read the rest of this entry »

Department of Health struggling with Secretary of State’s Personal Preferences

Filed Under (Health Policy, Primary Care Trusts, World Class Commissioning, World Class Decommissioning) by Paul on 09-11-2009

In the last few weeks, following the Secretary of State’s speech in which he stated his preference for NHS commissioners to buy care from NHS providers, there has been an increasing interest amongst managers and policy wonks in how he is going to put this into operation.

Because let’s be clear, it is his personal preference, it is not the manifesto on which he was elected in 2005. Back in the days when Labour Governments went into elections with the expectation of winning large majorities, the 2005 manifesto pledged the government to increase the range of provision available to NHS patients but would do so from a range of different providers.
Read the rest of this entry »