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 »

Doctors to take industrial action to secure better pensions than most of their patients.

Filed Under (BMA, Uncategorized) by Paul on 31-05-2012

Blog readers will remember the fury of the BMA when the Government continued with their Health and Social Care Act . Month after month – from the autumn of 2010 to the passage of the Bill in March 2012 – the BMA warned that the Bill would endanger the NHS.  Read the rest of this entry »

Real integration needs tough, powerful integrators

Filed Under (Contracts, GP Commissioning, Integration) by Paul on 30-05-2012

Over the last few weeks I have been outlining the different mechanics of new elements of reform that will be necessary if commissioners are going to be able to transform health care for NHS patients. A few weeks ago I mentioned the importance of them buying effective packages of self care. Last week I outlined two different approaches to the way in which commissioners contract health care and today I want to outline some of the radical thinking that is taking place about how the provision of integrated care can be developed. Read the rest of this entry »

Developing prices for a ‘year of care’

Filed Under (Health Improvement, Health Policy, Patient Choice, Self Management) by Paul on 29-05-2012

Over the last few weeks I have been outlining the nature of the reforms that NHS commissioners will need to implement if they are to transform NHS health care. Last week I explored two different forms of contractual relationships that are being created and will be necessary if there are to be different relationships with providers. Read the rest of this entry »

What are the necessary components for transformational commissioning of NHS patient services?

Filed Under (Contracts, GP Commissioning, Health Policy) by Paul on 27-05-2012

Over the years people have often asked me how all this reform fits together. I am afraid that the answer is that as I look at each individual aspect the conclusion I come to is that if you want transformational change in the NHS you have to do a number of new things at once.

Over the last few weeks I have been writing a series of blogs to try to outline the different mechanics that need to be at hand for NHS Commissioners to transform the health and health care that they commission. Read the rest of this entry »

Competitive dialogue – a better way of commissioning NHS services?

Filed Under (Competition, GP Commissioning) by Paul on 24-05-2012

Over my decades of working in the public sector, nearly all of my experiences of public sector service tendering have been a variation on some truly awful and nervous experiences. This was as true of my time as a public sector manager tendering for services as it is now – as a private sector person bidding to supply them. Nearly every part of every experience has been hedged around by the fear and anxiety of putting a foot wrong or saying a word out of place.  Read the rest of this entry »

On television Lansley demonstrates that the Secretary of State is in charge – whilst continuing the pretence that he isn’t.

Filed Under (Health Policy, Reform of the NHS, Secretary of State) by Paul on 23-05-2012

Harold Wilson once famously said that a week is a long time in politics.

Apparently the current Secretary of State for Health is quite chipper as he goes about his work at the moment. Looking forward to implementing his Act and paying no attention at all to the very deep mess into which he plunged the Government and the NHS only 10 weeks ago. For him these have been 10 weeks during which apparently everyone has forgotten that he was about to finish off the NHS. Read the rest of this entry »

COBICs – another form of outcome based contract being developed by GP commissioners

Filed Under (Contracts, GP Commissioning) by Paul on 22-05-2012

10 days ago I attended an interesting discussion about new forms of contract between GP commissioners and providers.

Yesterday I mentioned the alliance contract and today I want to talk about the main theme of another new form – the Capitated Outcome Based Incentivised Contracts (COBICs). I have been involved with GPs and others in developing these contracts so I was particularly interested in how the very different people in the room would take to the idea. Read the rest of this entry »

Alliance contracts and their relevance to commissioning healthcare.

Filed Under (GP Commissioning) by Paul on 21-05-2012

Over the last few weeks I have been hearing more and more about attempts by new clinical led commissioning groups to develop new forms of contracts between themselves as commissioners and health care providers.

Read the rest of this entry »

Cuts in the social care budget are having an impact on NHS work – and there will be many more to come.

Filed Under (Public Health, Social Care) by Paul on 17-05-2012

Looking back over the posts on my blog the only time that I have really talked about cuts in local government services has been in the context of how lucky the NHS is to have overall funding that has not been cut. Read the rest of this entry »

“We will scrap politically motivated targets…”

Filed Under (Coalition Government, Conservative party, Health Policy, Manifestos, Targets) by Paul on 16-05-2012

(Conservative Manifesto 2010)

It was always going to be interesting to see how the Coalition government would live with this pledge.

Over the last weekend, just prior to its conference, the Royal College of Nurses published a survey of its members reflecting their experience of patient waits in A and E. Their President was on the airwaves saying that the progress that had been made on speedier and better working with A and E patients was being lost as more were being treated on trolleys. Read the rest of this entry »