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When time has flown, we are left with the age of anxiety.
Can’t remember who said that, but it’s true.
We should all be worried and Cocidius should be even more so.
Charmer wasted years on a non-sense DH+NHSE re-dis-organisation and a bewildered looking Cooper is letting time slip through her fingers…
… she’s one job, cut NHS waits… alas it’s too late.
Since July 2024, the NHS has reduced the number of people waiting more than 18 weeks by about 450,000.
Well done, but…
… to get anywhere near the 92% target by March 2029, it now has to remove roughly four times that number… in less than three years, and…
… do it while new demand is running at around two million pathways a month. That’s not just maths. It’s a miracle.
The waiting list is not a waiting-list problem. It’s a sickness problem. Which leaves Burnham with about 30 months and awkward choices.
He can produce a plan, trajectories and promises, or…
…he can take four pieces of basic management advice that highlight; little things are the big things and Kaizen philosophy is just about all there is...
First.
Management by walking about.
It’s his instinct, he did in Manchester. Tricky for him now but and he can insist it is a management style he wants to see in ministers and managers in the NHS.
Get out of the office… go and look.
Visit diagnostics at seven in the evening. Sit with booking clerks. Stand in theatres between cases, and ask…
It's all doable but first you have to look for where the time disappears and add it back minute by minute.
Second.
Action over planning.
The NHS does not need another waiting-list strategy. It needs thousands of small things fixed quickly…
It sounds simple but it's not being universally achieved. Not another grand redesign… action.
Third.
Focus on the ‘customer’.
Waiting lists are not numbers. They’re…
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People in pain.
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People unable to work.
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People frightened about what a scan might show.
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People whose mobility is deteriorating.
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People ringing GP surgeries because nobody else can tell them what is happening, and…
… other people; staff, trying to hold the whole thing together. Protect the front line, pay it properly and make it fun to work there.
Pushing referrals back into primary care, simply to improve hospital statistics, and GP access will get worse.
If Advice&Guidance becomes a barrier, that queue gets longer, instead.
If referral is delayed, some people get sicker.
None of this is demand reduction. It’s queue relocation.
Design the system around the people, not the target.
Fourth.
Honesty…
… about failure… the most important.
For the next 30 months, waiting times are principally a capacity-and-productivity problem.
For the next 30 years, they are a demand problem.
Burnham can't rebuild the health of the nation before the election.
He can't manufacture thousands of radiologists, anaesthetists and GPs.
He can't make obesity, inactivity, smoking, poor housing, poverty and chronic illness disappear.
At some point, if nearly two million new pathways are arriving every month, the maths wins. He should say so.
Tell the public;
‘we’ll do our utmosts to see to it’…
...nobody should wait dangerously. The longest waits should fall. Diagnostics should happen faster. Every inch and hour of capacity should be properly used. we'll sweat the assets. Patients should be prioritised clinically, and…
… queues should not be shuffled around the system, simply to improve the numbers.
That’s not giving up. It's honest management. Four lessons…
- Go and see.
- Act.
- Care about people.
- Tell the truth.
For the next 30 months, make the machine work better.
For the next 30 years, stop feeding it so much illness.
Burnham will not be able to abolish the queue before the election. You know it, I know it and I suspect No10 knows it, but...
... he can make it safer, shorter, fairer, and…
…he can stop pretending that there is a magic plan that will defy the inevitability of time...
... and the rules of arithmetic.
-oOo-
Thanks for sharing your time and have the best weekend you can ...
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