nhsManagers.net
Health news and comment
from
Roy Lilley
When you are dealing with a problem it’s not a bad idea to ask what would a solution look like. Going through a tough time; ask what ‘when it’s over, what will it look like’.

The terror-crisis; what will it look like when it’s over? Three thousand people interned, armed lollipop ladies and a McDonald’s in Raqqa High Street? What does over-and-done-with look like?

When we can say it’s finished; what can we expect? A truly multi-cultural, secular society. How far away is it and how do we get there?

It’s a question we need to ask ourselves about the NHS. When the present austerity is over, what can we expect. What will it look like.

A medicine cabinet and a self-care App distributed to every household or a leaner, more efficient health service with consistent outcomes and every one paying the right price for a bog-roll? Maybe!

The HSJ are providing us with a glimpse of what the future might look like. They have published a leak. It is interesting it has appeared 72 hours before we go to the polls.

This is a well-timed leak. An Exocet of a leak. A leak designed to do maximum damage. It shows us what the NHS will look like.

It reveals the little known ‘capped expenditure process’. The process designed to ensure this year’s expenditure targets are met. How to do that?

You can be more efficient, change skill-mix. Squeeze the pips. Might work but there is only one guaranteed way to do it; stop doing things and hire fewer people.

Bright ideas included in the leaked document are:

>> Dumping the NHS Constitution; extending waiting times.
>> Ending outsourcing contracts.
>> Closing theatres and wards and cutting staff.
>> Focussing on the ‘winter response’.
>> Dumping NICE recommendations for adopting new stuff and stop funding ‘low-value’ treatments.
>> Closing or downgrading A&E and maternity services; circling the wagons.
>> Crossing items off the prescription lists.
>> Flogging-off bits of the estate.

Paul Baumann and surprisingly, Bob Alexander are fingered… leading the work to find things to cut.

Apparently, they had hoped to keep the news hush-hush until after the election. If there wasn't so much other news this would certainly be headlining the 6 o’clock.

Let me confide in you; a week ago I had wind of this but dismissed it as election mischief. Now, I have no doubt it is true.

How should we look a this? I think there is only one way.

Health managers are being driven into a corner. There is not enough money in the system to deliver what is being asked of it. Framing a bleak future, as part of an incoming Minister’s induction pack, is a cunning plan!

Set the predicament against election promises and you don’t get very far. Pledges of post-election funding go nowhere near repairing the damage that has been done by seven years of austerity.

Undoubtedly, the NHS can be more efficient at being effective. The difficulty is, it will require innovation, which carries a risk and investment for which there is no funding.

Buying cheaper bog-rolls, flogging-off bits of the estate, making sure assets are sweated and regarding variation as the enemy of quality… is all good stuff… at any time. Let’s do it. But, let’s not do it with any expectation that it is going to be a game changer.

When any document is leaked, any secret made public, you have to ask why. I don’t think you need me to spell this out!

A bigger question; is this part of the journey or is this what the end looks like?
Read the full HSJ article here
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