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 »

Is the ‘family and friends’ question really too hard for patients?

Filed Under (Health Policy, Public Health) by Paul on 09-01-2013

Reading some of the press reports on Monday, following the Prime Minister’s announcement of the extension of the ‘families and friends’ question to more organisations serving NHS patients, felt like an old and welcome friend from some years ago had returned. It made me wonder whether, after more than two and a half years of complete mayhem, the Government may be starting to find its touch with the politics of NHS reform. Read the rest of this entry »

Reform and Healthcare in Canada

Filed Under (Canada, Healthcare delivery, Public Health, Public service reform) by Paul on 12-11-2012

I spent last week in Canada talking to people engaged in health care reform in the provinces of Ontario and Quebec. Canada has a socialised medicine system with a lot of similarities to the UK system. The very existence of a socialised medicine system is very important to most Canadians.  Many would say that it is their socialised medicine system that differentiates them from the USA. 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 »

More thoughts on new models for creating more value from patients.

Filed Under (Health Improvement, Patient involvement, Public Health, Self Management) by Paul on 14-05-2012

I received some interesting comments on last week’s posts about the necessity for investment in improving self-care to improve value for the NHS. Most of my posts concerned the implications of some recent work on diabetes and also articles in the Lancet from last Friday on co-morbidities in Scotland. Read the rest of this entry »

To realise patient based value will require some investment – So where, in times of austerity, does that come from?

Filed Under (Creating public value, Health Improvement, Patient involvement, Public Health) by Paul on 11-05-2012

Having set out the general case for moving away from the old fashioned idea that value in health care can only be found by buying more medical staff, kit or drugs, I have suggested that investment in patient health literacy would increase the value they contribute to their own care. This would, as a consequence,  add value to the NHS as a whole and help change its resource base at this time of austerity. Read the rest of this entry »

Building progressive NHS practice from the rubble of the Government reform programme,

Filed Under (Clinical Commissioning Groups, Health Improvement, Public Health, Targets) by Paul on 02-05-2012

No 1 Working towards improving health care outcomes

We are now a few weeks on from the passage of the Act. The glimpses of the direction of its implementation that we have had since then are as contradictory as the Bill itself. The Secretary of State writes to the NCB saying that they must ensure that there is autonomy for CCGs and the Chair of the NCB responds by saying that it will be some time before the NHS will be liberated from its centre. Read the rest of this entry »

The core business in which we are involved..

Filed Under (Health Improvement, Public Health) by Paul on 30-01-2012

It’s very easy to forget what our core business is. It’s not the governance arrangements of CCGs nor is it even my quest for anyone to tell me what ‘clinical senates’ might be when they are at home. Read the rest of this entry »

The progressive argument in favour of lifting the private patient income cap for Foundation Trusts.

Filed Under (Foundation Trusts, Health Policy, Private Sector, Public Health, Reform of the NHS) by Paul on 10-01-2012

As I commented last week, I have given up waiting for the Government to make a coherent case for its reforms. So when, in late December, the Times published the story that a new amendment had been laid in the Bill to increase the level of the private patient income cap for Foundation Trusts, I did not expect too much from the Government by way of an explanation about why this was an important and necessary aspect of the whole NHS reform programme.

I was not disappointed. Read the rest of this entry »

Events, dear boy, events

Filed Under (Health Policy, Narrative of reform, Public Health) by Paul on 09-01-2012

I don’t really want to turn this blog into a set of explanations of the way in which those steeped in politics understand the world, but following some of last week’s feedback on my post about Nixon’s recognition of China, I think some people might find it useful for me to explain something of the ways of NHS politics.

Over the last week there has, quite rightly, been a great deal of publicity about the silicone implant problems being experienced by a significant number of women. Watching the DH and the Secretary of State wrestle with this difficult problem and developing their argument has been a bit painful at times and people have asked me how issues like this might be dealt with in a better way. Read the rest of this entry »

Developing the NHS in a long age of austerity

Filed Under (Public Health, Reform of the NHS, Resources) by Paul on 06-12-2011

Last week’s autumn statement underlined all the other economic news and left the nation with the recognition that hard economic times are here to stay for a lot longer than we might have hoped.

Some of the economic statistics about the difference in our living standards in this decade compared with others are really shocking but are worthwhile rehearsing.

Since World War Two the previous decade when living standards took a bit of a knock as compared to others was the 10 years between 1973 and 1983.There were ups and downs during that decade, but taken overall average living standards only increased by 14% over the decade. I say ‘only’ 14% because this was, when compared to every other 10 year period, the most difficult. In every other decade improvement in living standards were higher. Read the rest of this entry »