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 »

Architectural problems with the new NHS reforms (number 64).

Filed Under (Clinical Commissioning Groups, National Commissioning Board, Reform of the NHS) by Paul on 06-03-2013

The new NHS reform architecture contains within it a number of problems that have always been predictable. As I have suggested on many occasions previously this is in part a consequence of the very many different and opposing minds that have been shaping the reforms as they have been developed. The famous pause in April 2011 led to a considerable strengthening of the centre at the expense of CCGs in the localities. Since then the reforms have always been a combination of greater decentralisation, combined with greater centralisation.  Once that process began relationships between the NCB and the CCGs were always going to be difficult. Read the rest of this entry »

A manifesto ‘to’ primary care or a manifesto ‘for’ primary care. Small change but a whole world of difference..

Filed Under (Healthcare delivery, Patient involvement, Reform of the NHS) by Paul on 10-01-2013

Today I am taking part in an interesting conference organised by the NHS Alliance about the future of primary care. They have asked me to develop challenges to an important set of chapters that clinicians and others are writing about the future of primary care.

Let me share some of the challenges that I will be making. Read the rest of this entry »

The Nicholson challenge is now for 10 or 15 years. Will the NHS meet it?

Filed Under (Economics, Nicholson Challenge, Reform of the NHS) by Paul on 24-12-2012

For my last post of the year I want to return to one of the main themes of the year – the short, medium and long term relationship between the state of the British economy and the consequent necessary changes to the way in which the NHS will operate given the reduced level of resources that it has to spend. Read the rest of this entry »

Exactly how does the new Secretary of State think he is going to influence the NHS to do his bidding?

Filed Under (Reform of the NHS, Secretary of State) by Paul on 05-12-2012

On further reflection I think there is an even more important issue about the speech that Jeremy Hunt gave at the King’s Fund last week than the one that I discussed on Monday. Read the rest of this entry »

How commissioners can develop new value with the NHS

Filed Under (GP Commissioning, Patient involvement, Reform of the NHS, Self Management) by Paul on 30-10-2012

This morning I will be on the platform at the beginning of the National Association of Primary Care’s (NAPC) conference talking to one of the two GP organisations that have helped develop GP led commissioning. I am one of four speakers speaking on the theme of “Transforming the NHS”. Unfortunately for the NHS, transformation is a topic that has been much discussed but rarely put into practice. Read the rest of this entry »

What might the Conservatives say about NHS policy at their Conference?

Filed Under (Conservative party, Health Policy, Reform of the NHS) by Paul on 08-10-2012

In two years time the Conservative Party conference of 2014 will take place just a few months from the General Election. The Conservatives will not want to go into that Conference with their opinion poll placing on the NHS as far behind the Labour Party as it is now. Read the rest of this entry »

When is an NHS reorganisation not an NHS reorganisation?

Filed Under (Health and Social Care Act, Health Policy, Labour Party, Local Government, Localities, Reform of the NHS) by Paul on 05-10-2012

Andy Burnham made an important speech to Conference about the Labour Party’s policy on health services. In doing so demonstrated why it’s important for opposition parties not to announce policy specifics 30 months before the election. What he has discovered is that when you announce one big thing it leads to a whole host of questions about everything else. .

He announced a number of things that will now be probed in great detail. Read the rest of this entry »

Takeover: Tackling failing NHS hospitals

Filed Under (Health Policy, Hospitals, Reform of the NHS) by Paul on 01-10-2012

Last Friday a pamphlet with the above title to which I contributed was published by Reform which received some publicity in the papers and on the Today programme.

The rationale for this pamphlet will not surprise blog readers. Over the past couple of weeks I have posted on several occasions with examples of the growing clinical concerns about safety and the current configuration of hospitals. The evidence is there that the variations of outcomes that exist between hospitals are in part caused by this configuration. It will not be long before clinicians refuse to work in unsafe hospital environments. Read the rest of this entry »

More thoughts about the possible development of different party political narratives about NHS reform

Filed Under (Narrative of reform, Reform of the NHS, Secretary of State) by Paul on 17-09-2012

Last week I posted about the different way in which party political narratives about NHS reforms may develop. I expect a very different kind of debate now that the Government may have the ability to communicate some form of message about what it is trying to achieve. Read the rest of this entry »

The politics of Nationalisation, the NHS and the General Election of 2015

Filed Under (Narrative of reform, Reform of the NHS, Secretary of State) by Paul on 12-09-2012

Since Monday’s post appeared a number of people have asked me to clarify what I meant by the Government failing to make critics pay for constructing even the oddest arguments against their reforms.  What am I suggesting? What should Governments, or any other major institution  do when they are involved in an argument with opponents? Read the rest of this entry »