nhsManagers.net
7th May 2013 

Live Health News  |  Weather  |  Archive

 FREE job advertising beta site now live - advertise your job for FREE and tell us how it works for you.  Why spend �1000's on job adverts when you can do it yourself, here for FREE at the Managers' Network jobs market..

Nothing at all      
News and Comment from Roy Lilley
'Death is nothing at all...'  so said Canon Henry Scott-Holland in his Whitsunday sermon, in St Paul's Cathedral, 1910.  I'm not so sure.  I wouldn't argue with the Canon or with anyone who shares his faith but I am not so sure.

Families robbed of loved ones; wives, their life partners snatched from their embrace, husbands, brothers, sisters, cousins, neighbours, friends left. Lonely, confused.  Gone; the familiar voice, the laugh, the shared moments.  Unfinished thoughts, promises made and no time to keep them.  The sound of the key in the door.  The radio in the next room.  Life will never be the same.  Death is 'nothing'?  Death is crippling, sometimes a release but never joyful.  The pain of parting overshadows the celebration of what has gone before.  Memories so hard to bring into sharp focus, to tune into.  Death is not 'nothing'.

 

This weekend three families will be looking at an empty chair, the coat hanging in the hallway, the door-keys left on the side... and wondering.  Three people called the NHS 111 service for help and it appears they died waiting.  They called the 'Gold Standard' NHS 111.  Gold Standard?  So says the man who runs the NHS but doesn't use the NHS, Le Tache.  Too posh to be a patient.  Gold Standard?  If ever there was a more ill-judged boast in a press release I'd like to see it.  Peerless arrogance.  Insensitive, remote, conceited, contemptuous, disdainful, pompous, smug, supercilious, swaggering, brash, hubristic, snooty - take your pick.   

 

In 1998 after a skirmish with difficult doctors three pilot NHS Direct services came to life and later 30 nurse-led call centres were rolled out, with the facility for 170 nurses to add capacity by working from home.  It worked, 91% of callers said so.  Local services morphed into national.  At times of peak demand they could redirect flow to areas not so busy.  But, they couldn't call an ambulance and didn't connect with OOH services.

 

LaLa appeared on the scene and instead of changing the rules on connectivity with ambulances and OOH, smashed-up the whole service and put it out to tender.  We now have 40-odd independent call centres.  To save money and create a margin they are no longer nurse-led.  Call-handlers have been trained to use algorithms.  When nurse support is needed callers wait for a call-back.

 

Frankly, it's been a bloody-mess.  Manchester was in 'melt-down'.  I have a stream of emails from dissatisfied users and worried insiders working in the system.  The media is full of horror stories

 

The Department of Health say they don't know what's going on; it's the Carbuncle's job to run the NHS.  The Carbuncle say these are locally contracted services and they don't have a handle on the real-time situation.  Somewhere between 211 CCGs and 40-odd call centres three people have died, and 22 serious incidents have occurred but no one is responsible.

 

Aunt Bab's is palavering about with reports.  She doesn't seem to have the greatest track record on performance management.   I hear an �8m bung has gone in to bring back some NHS Direct staff and to supplement the service capacity at weekends.  Look at Bab's report; paragraphs 19 and 20 say to me, 'let's try and bring NHS Direct back'.

 

If ever there was a lesson in failure demand this is it.  NHS Direct is national - let's denationalise.  NHS Direct employs nurses - they are expensive let's use call handlers.  NHS Direct needs investment - let the private sector do it.  Break it up, smash it on the anvil of political ideology.  Evidence based management is not required.  Job done; it's cheaper and the costs off the books.

 

Result; it's melted, getting worse, people have died, it will consume management time, consultants costs, a capacity review, audit, fix and fiddle.  Everyone's lawyers will be involved.  Compensation paid.   An �8m bung is needed to prop it up.   Total cost?  Think of a number.

 

NHS Direct worked because it was 'national', could flex-to-demand and skilled people talked to the public at the front-line.  Consultant led A&Es work safest, cheapest and best for the same reason.  If 111 call-handlers was a good idea emergency departments would be staffed by Boy Scouts with first aid badges.

 

If BA killed three passengers there would be hell to pay.  But this is the NHS; no one will be blamed for this; no one will get the sack.  Consultants will make money, contractors will charge more and three families will follow a coffin. 

 

Death is nothing at all. 

-------------------------- 

 

Bingo! we have got our first job on the new
 Managers' Network Recruitment Page.

for a salaried GP in Norfolk!  Thank you!  
Post your job for free.  Don't spend goodness knows how much advertising jobs and using expensive agencies.  You can advertise any NHS or health related job right here.  We drop into close on 100,000 in-boxes a week and are read right across the NHS and health sector throughout the UK and overseas. 
Looking for a job why not start at the home of NHS Managers?  This is a beta site so if there are glitches or issues please tell us.  If there are features you'd like added, tell us
Give it a try -
It is entirely free - we think health pounds are best spent on patients.

----------------------------------------
have your say 2 Leave a comment on our Confidential Forum
 Or contact Roy -
Use this e-address

roy.lilley@nhsmanagers.net 

Know something I don't - email me in confidence.

Leaving the NHS, changing jobs - you don't have to say goodbye to us! You can update your Email Address from the link you'll find right at the bottom of the page, and we'll keep mailing.

MaM Logo
Medicine for Managers
2012 compendium here
-------------
Dr Paul Lambden
 The Diabetic Foot
You really don't want this.
----------------------
gateway logo
Let's talk about the NHS.
A new-style conference for suppliers to the NHS to help understand the reforms
Early Bird Booking still  open.
----------------
  News and Stuff
News boy
----------------
free 2
Exclusive Extra Content
on the managers' network

Open Surgeries
No appointment necessary.  Fascinating article on the impac of open surgeries on the GP and patients.  A really interesting read.
---------------
Gossip
shh
This is what I'm hearing;
if you know different,
tell me here
>>  Given all the kerfuffle over 111 - how can Aunt Babs sort it out as the contracts are held by CCGs?  Over the weekend Pulse reported the possibility of 20+ deaths.  Sky News tried to find out the truth.  The DH said it wasn't their job, the Carbuncle said they had no way of knowing and the only solution was to ring every CCG and ask them if they knew.  Is anyone in charge? 
More detail here.
>>  Staff well-being - does it impact patient care?  Too right.
>>  Dementia - choosing the right equipment.
>>  Care Claims backlog - excellent story by HSJ and comes with the hint that it will hit the nationals soon.
>>  Wales - NHS not good enough for staff familiesMore here.
>>  NICE - taking on more stuff.
>>  Oregon - part of the folk-lore of health planning; interesting revisit and study.
>>  Political donations to Tory Party with 'health' overtones - interesting spreadsheet.
>> Live well - 5 a day.
>>  Blundering Doctors - not being reported.
>>  New typeface - for doctors.
-----------------
Today's Larf
cartoon martin  
With Martin Shovel