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 »

Does the reform programme act as a diversion from the necessity to improve value in the NHS? Let’s look at commissioning…

Filed Under (Clinical Commissioning Groups, GP Commissioning, Health and Social Care Bill, Primary Care Trusts, World Class Commissioning) by Paul on 25-01-2012

Yesterday’s Health Select Committee report makes an important case against the Government’s NHS reforms. It argued that the reform programme has and will act as a diversion from the main task of improving value for money for the health service. Read the rest of this entry »

This really is Extraordinary! – Secretary of State halts all health service improvement in the East of England in order to save face.

Filed Under (Primary Care Trusts, Secretary of State, World Class Commissioning) by Paul on 05-03-2010

The story so far…

Last September the Secretary of State for Health made a speech where he declared that his personal preference was for NHS providers to provide care for NHS patients. Since then he has been trying to impose this preference on all NHS Commissioners.

The problems of the last few days stem from the fact that he has been successful in bending some PCTs to his will. A letter from David Nicholson drawing their attention to his policy, resulted in some PCTs limiting their approach to tendering to those service providers that the Secretary of State prefers.
Read the rest of this entry »

What the NHS needs now are commissioners that are good economists, not just accountants.

Filed Under (Expenditure, Primary Care Trusts, World Class Commissioning) by Paul on 29-01-2010

Last Monday January 25th every PCT in the country finished its Commissioning Strategy Plan (CSP) for the next three to five years. Over the next month these will be published and somebody should be making sense of this “bottom up” approach to planning the future of the NHS. In a way, since this is the commissioning intent over five years for about £500 BILLION, it is more important than any DH operating plan or white paper. The collective wisdom of these documents should be describing the future of the NHS.

Even more significant is the problem that if the PCTs do not have the capability to bring these plans into reality the NHS will probably have no future.
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 »

NHS Competition Policy – the debate continues.

Filed Under (Health Improvement, Primary Care Trusts, Public Health, Public service reform, Reform of the NHS, Uncategorized, World Class Commissioning, World Class Decommissioning) by Paul on 29-10-2009

On September 17th the Secretary of State said that he had a preference for NHS providers over others. This change in policy has caused some concern but that debate has not been held in public. In this weeks HSJ it now surfaces in a public debate about the future of commissioning. I have written an article (1,2) and so has the Secretary of State (1,2). The editor has a leader on the topic.

I am sure this debate will contnue in public for some time now before it reaches a settled position. The Financial Times commented in an article published on 29th October 2009

World Class Decommissioning

Filed Under (Health Improvement, Primary Care Trusts, Public service reform, World Class Commissioning, World Class Decommissioning) by Paul on 15-10-2009

All staff in Primary Care Trusts should recognise the structure of this post on my blog.

Between now and December 18th all PCTs are preparing their Commissioning Strategy Plans. In the New Year they will be visited by a Panel chaired by their SHA, and will for a day, be inspected against a set of criteria. This will lead to a judgment about where they are in terms of their competency as world class commissioners. There are 11 competencies that they will be judged against.
Read the rest of this entry »

World Class decommissioning “having an argument” Step 1

Filed Under (Primary Care Trusts, Reform of the NHS, World Class Commissioning) by Paul on 25-09-2009

But first…

World class decommissioning an explanation of why it is so important.

Using the phrase world class decommissioning on my blog has started to alarm some people. It’s as if I am saying that the whole of a PCTs job is decommissioning. That’s not the case; the organisation s will go on buying new things and hopefully will do so in a way that increasingly approaches worldclassness.
Read the rest of this entry »

NHS resources and how to use them from 2010 onwards (3)

Filed Under (Expenditure, Health Improvement, Primary Care Trusts, Public service reform, Resources, World Class Commissioning) by Paul on 22-09-2009

What are the parameters of world class decommissioning?

If world class commissioning consists in part of PCTs commissioning services that provide very good health and health care outcomes and doing it really well, then world class decommissioning involves stopping the provision of services that are less than optimal in health care outcomes or value for money and doing this very well.
Read the rest of this entry »

Commissioning in a cold climate

Filed Under (Culture of the NHS, Health Policy, Primary Care Trusts, Speaking, World Class Commissioning) by Paul on 14-06-2009

Went to the Confederation conference in Liverpool where I chaired a session about Commissioning when there is less money to commission health with. Matthew Swindells from Tribal and Malcolm Scott Chief Exec of  Westminster PCT spoke.

The whole conference took place against the backdrop of what will be a radical change in the resource available to the NHS. I will discuss some of the content but first its interesting to chart the different groups of responses to the issue of what to do about the money .
Read the rest of this entry »