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nhsManagers.net

13th January 2025

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News and comment from

Roy Lilley



Blamer...

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It’s an outrage!


Hold the front page…


… that's what the £walled Sunday Times did when they discovered a hospital advertising for ‘corridor-care nurses’… the ad’ was previously on Twitter. (More here).


The rest of the media piled-in.


Presumably only skinny nurses need apply so they can squeeze past the catering trolleys, porters with patients in wheelchairs, a juggernaut of laundry…


… and procession of relatives looking for their granny.


As unacceptable as corridor care is, it has been a ‘thing’ since Covid. The NHS call it ‘temporary escalation spaces’… which of course makes everything sound... ‘managed’ and ok.


There’s indignation that valiant NHS estates people are plumbing in electricity and oxygen connectors, in corridors.


‘Normalising’ poor care. 


No. It's pragmatic and sensible, to prevent the dangers of trailing extension cables and the risk of oxygen cylinders. They've also been fitting curtains.


People got out of their prams when they discovered, corridor-nurses will be employed on 12 hour shifts… too long, too arduous and dangerously-exhausting they cried.


Please realise, 12hr shifts have been common since the 1980s and 90s, here, in the US and a lot of European systems.


It reduces handover costs and longer shifts can improve continuity of care. Staff shortages made 12hrs shifts part of a solution and nurses with families and second jobs seem to want it. Some don't and say it's unsafe.


Whatever, it’s a thing. Get over it.


Notable for his absence, over the weekend is our great leader…


… the RCN and others have have reminded us


… on taking up his role as secretary of state for health Wes Streeting promised to ‘end corridor care in the NHS’. 


Good luck with that, Wes... probably why he's in hiding.


Time to recognise reality, the cost of your inaction on social care and how different campaigning is when compared with actually doing the job.


Time to start thanking hospitals for their innovation, initiative and quick responses. 


As ugly as we all think it is, turning corridors, cupboards and in some cases offices, into safer, if undignified places, where the tsunami of patients can be looked after with some sort of structure by people who know what they’re doing, is pragmatic at the very least...


... and at most, in a perverse sort of way, the NHS at its best.


Streeting, has been invisible since the furore started. He knows he can only drivel on about a ten year plan and something on social care by 2028.  


There is nothing he can do. Well, maybe he could make sure the 30/40 new hospital programmes build places with wider corridors? 


Sensibly, right now, there's nothing anyone can do, more than is being done…


... other than saying thank you and well done for trying to keep us as safe as possible in incredibly difficult circumstances.


The NHS runs at close to capacity most of the time, around +90%. Safe levels are down in the eighties. Capacity is the euphemism for choc-a-bloc and the upshot is yer granny in a cupboard.


An immediate injection of cash into emergency community teams might help, but is likely too little, too late. As would be a push on vaccinations, masks and ventilation.


Commandeering beds from Wes’s friends in the private sector might help but they only have 8,000, mostly in wealthy areas. If they have to cancel operations to admit NHS medical patients, they’ll be looking at contractual issues and compensation… it’d probably need legislation.


Bring in the Army? 


The army is already ‘in’. The days of military hospitals are long-gone. Military nurses and doctors already work side-by-side with the NHS.


When real leaders are faced with difficult and intractable situations what do they do?


  • Reframe the problem; this is not a hospital problem it is a community and social care problem, so stop bad-mouthing hospitals.
  • Break it down; start with frailty indices and figure out how to make them meaningful.
  • Challenge assumptions; that this has to happen every year.
  • Find collaborators; stop picking fights and blame-shaming.
  • Involve diverse groups; employers could they help with family emergency leave, experts, families with experience, community leaders, gather insights, thoughts, ask for help.
  • Encourage cross-sector partnerships; schools, clubs, fire services, postal workers, retired NHS people, football clubs.
  • Find small, local initiatives; see if they are scale-able, replicable.
  • Recognise this is a dynamic problem; solutions will have to be iterated.
  • Not every experiment will succeed; so learn.
  • Reinforce core community systems; to withstand uncertainty.
  • Leverage Technology and Innovation; to keep people safe at home.
  • Look globally; for solutions.
  • Acknowledge complexity; be honest about the problem and the difficulties.


Share and celebrate success.


Try and inspire confidence, highlight commitment and success. Build a shared vision of what solutions looks like. Empower people and inspire hope.


Stop hiding Wes, be a leader, not a blamer.

Want to contact Roy Lilley?

Please use this e-address

roy.lilley@nhsmanagers.net 

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Disclaimer

Dr Paul Lambden


What Can Our Nails Tell Us?


'Clinical medicine depends so much on what one sees. A significant proportion of disorders signal their presence simply by looking at them, even before taking a history or doing the physical examination. This is often true with the fingernails or toenails and the observant clinician can appear very perceptive by directing any questioning to possible diseases, a feature of which may have been observed by identifying the nail changes.'


News and Other Stuff

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>> 'NHS worst ever seen' - as thousands of 'overspill' patients not counted.

>> 'True snow hero' praised - for rescuing 999 ambulance and getting NHS staff to work.

>> Somerset urges faster action - on delayed social care reform review.

>> NHS leaders unsure what would happen - if people of Preston reject new hospital location.

>> Only one in six A&Es in England say they could cope - with major incident.

>> Leicester's hospital flu cases mapped - as NHS could face worst ever winter flu season.

European Digest January


Roger Steer


'... the gist is that Labour advisers have lost faith in ‘deliverism’, and it appears that they are following the Trumpian line of making repeated announcements as a substitute, not necessarily to be taken literally but to signal that they are taking their supporters’ concerns seriously.' 

LETBY INQUIRY

Prof Brian Edwards


Weak signals and regulating managers.


'... a surprise witness, Ken Jarrold, a former NHS Chief Executive, Chair and Director of Personnel for the NHS.'

Let's go to......


the Edenbridge Memorial Health Centre...


... prompt support for older people...


Very topical!

⬇️ For more news, scroll down








This is what I'm hearing, unless you know different. In which case, tell me, in confidence.

__________


>> I'm hearing - National Minimum Wage to will increase to £12.21, also the NHS rate for the likes of  Neonatal Support workers (shifts), A&E Receptionists (shifts, dealing with drunks etc), Palliative Home Care Practitioners, Ambulance Cleaners... Asda are already paying £12.04 and Lidl £12.40…

More News

---------

>> Here's what the Nuff's say - about the elective reform plan.

>> It will take more than cash to repair the NHS - New Statesman.

>> Public health emergency declared over LA wildfires - updates


Dr Rodney Jones'... latest delve into the data, this time of maternity settings and bed occupancy...


'... how do we discharge a suitably rested healthy mother who is fully capable of caring for the newborn baby back into the community?


He demonstrates...


'... some of the difficulties in predicting future births and investigates trends in the average length of stay...


Also addresses...


'... some of the erroneous ideas around the dogma that reducing length of stay ‘saves’ money.


He explains...


'... turn-away is the proportion of times that there is not an immediately available bed for the next arriving inpatient. Data for maternity units show extreme and unexplained variation in turn-away.'

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