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 »

Today NHS England….. tomorrow the world (or is this too far?)

Filed Under (Health Policy, Reform of the NHS) by Paul on 08-07-2011

None of the posts in my blog derive from leaked documents. Many people ask me where I get the material from, and nearly all of it is a combination of information in the public domain and an understanding of how people in power actually operate. So sometimes I can provide a different interpretation from the way in which an official document is published (for example the initial response from the Government to the Future Forum – where the panic fumes off the page), and most of the time there is so much going on in the public domain that it is unnecessary to delve any deeper.

But then something outrageous comes along and, provided I can be sure that there are hundreds of copies in existence so that no individual gets into trouble, I just can’t resist it

The Government’s considered response to the Future Forum report explained that David Nicholson was of course going to publish a paper shortly, outlining the role of the NHS Commissioning Board. That’s a bit odd in itself because the Chair of the Board has not yet been appointed, but never mind – in the lurching nature of the current reforms this is a relatively small consideration.

A couple of weeks ago I saw a draft of this document and it was one of those times where a single paragraph and comment just sum up the current reform world

Here they are,

“The NHS Commissioning Board has to have a statutory Board but and (sic) this is potentially confusing. It may therefore be more appropriate for the NHS Commissioning Board to be referred to by another name in practice, so that confusion between the organisation and its Board does not arise. It is common practice for organisations to adopt a different name for operational purposes from that set out in legislation and this is something to be considered as we establish and develop the organisation. In a similar way, Consortia remain named as such in legislation, but the Government response to the Future Forum requires these groups to have the NHS prefix, a geographical description and be referred to as clinical commissioning groups. An alternative description for the NHS Commissioning Board, based on this rationale, could be NHS England.


I quote this in full because of the beauty of both the conceit and the anxiety. It demonstrates that there really are those drafting the role of the Board that believe it is in charge of the whole NHS in England. Such a title would of course demonstrate the complete failure of the Government’s policy to localise power within the NHS. It would show that NHS England would run the whole show.

But then comes the lovely hesitation “IS THIS TOO FAR.?”

Somewhere there is still the recognition that giving this central organisation such a hubristic title might be going too far.

That there might somewhere be a Foundation Trust still clinging to the vestiges of its independence from the centre – from NHS England.

That there might be an MP who recognises that they were elected to localise, rather than centralise the NHS.

I wanted to hang on to this until the final document is published because I was fascinated by how David Nicholson would answer the question of IS THIS TOO FAR.?

I suspect that some in the NHS Commissioning Board thinks it fits just about right.

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