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nhsManagers.net

6th August 2025


News and comment from

Roy Lilley



Estate agent...

_____________

If you are a manager, or an administrator or any one of the hidden army of people who don’t actually stand at a bedside…


… but you make sure: 


… a bed is available; the space is clean; the person in the bed has the all machines that go beep, they might need, calibrated and ready; has their special diet; clean linen...


... theatres ready when they are; their pills and potions arrive; their visitors can find somewhere to park; the signs direct them where to go; the lights are on and the place is safe… even thought in some parts, the roof is falling in…


… right now, the NHS is a rotten place to work.


Geoff knows all about it.


In the twenty eight years since serving in Kosovo, with the Royal Logistics Corp, he had worked in the NHS. 


Procurement, logistics, organising. His army background served him well. They'd paid for and put him through his MBA. Later the NHS graduate management scheme had given him a whole new perspective on life.


He had served the Army and the NHS well. His talent and character rewarded with training and promotion.


It had been a tough day.


Everyone was working in the shadow of redundancy. No one’s heart was really in it. 


Three of his key people had bailed-out. One was working their notice and another was wavering. Why not? Young talented people won’t hang around for the arrogant, invisibles at the centre to screw-up their lives.


Geoff joked he was adding 'organising leaving-do’s' to his CV.


The army was a tough life but he was a lot younger and didn’t have a wife, two youngsters at Uni and a mortgage. 


The NHS is brutal. The unheralded, unplanned-for, disorganised announcement that half the staff would have to go by Christmas had caused catastrophic damage.  


Demolished morale. The rumour-mill was grinding. Days sick were coinciding with Fridays and Mondays. People leaving early. Cliques emerging.  


He’d found a page of a CV, accidentally left in the Xerox and decided to quietly bin it.


He got his people together and was brutally honest. No, he had no idea who was for the chop and who wasn’t.  


‘Be honest’, he said… ‘if you want to go, tip me off. It won’t go any further but it’ll help me keep the show in the road…


Geoff had no idea if he was going to be around to keep ‘the show on the road’. Like everyone, he was working with his new best-friend, Damocles.


It was tricky for him. Not quite old enough to retire. Still with commitments and bills to pay. He could see his department being crunched with a couple of others. 


Maybe, sell the house and downsize? Cancel the holiday plans while he could still get a refund. Dump his car and share one with June, his wife.  


She worked in the Trust as a Band 7 but had been down-banded to 6. Either that or try and find another job.


It was late. It had been a long day. He looked across the open plan office. A screen saver glowed in the dark. It was quiet and still. He liked this part of the day... gave him time to think.  


Geoff reached into the bottom drawer of his desk and took out a small box of cards. He wrote a message and sealed the envelope. On the way out, dropped it on a desk, in the corner, by the door.


He was soon across the car park, keyed the ignition and decided, he’d hang onto to his car if he could… he was home in twenty minutes.


The next morning Aisha was first in… at her desk in the corner, by the door...


... she was always the early bird. Dropping two kids off at her Mum’s on the way. Like everyone else she was worried sick about her job. She'd sent her CV to an estate agent. Their ad' was in the local paper.


She saw her name on the envelope, opened it and read the confident sweeps of handwriting;


‘I know this is a worrying time for you but I just wanted to say I think you are doing a fabulous job and I appreciate it… thank you.’ 


It was signed, simply, Geoff.


Her eyes welled and a crystal tear ran down her cheek.


She didn't ever want to be an estate agent.


… never forget the

the power of the handwritten note.

Our most listened to podcast...


FREE - PODCAST


Former BBC Health Editor, GMC chief Executive and Confed boss,

Niall Dickson

and

Roy Lilley

In a frank and revealing conversation with


Professor Tas Qureshi


In this episode of In the Loop

Niall and Roy step on to new ground in a fascinating discussion with

Professor Tas Qureshi.

A General and Gastro-intestinal Surgeon at Poole Hospital in Dorset.

Tas has made a number of trips to Gaza as a volunteer, giving up his free time to support his fellow surgeons there as they deal with the most horrifying of trauma injuries, as well as helping to train staff in the treatment of cancer.  

This is a personal story, not a political statement but by telling it Tas hopes to highlight the plight of all those who are suffering, including so many children.

In doing so he gives us a mental picture of what it is like to operate, medically and in every other way, in a war zone. 


You will have seen many terrible pictures of the suffering in Gaza, but this account, with words only, is in some ways more illuminating, more powerful. 


He reveals the impossible choices he and his colleagues face of which child to treat and which ones must be left to die, sometimes in agony, the so called safe houses which are not safe from bombs and bullets, and the resilience of humans in the face of impossible odds. 

Many UK doctors do incredibly valuable pro bono work, but Tas is one of a smaller band who are also prepared to risk their lives to relieve suffering.

And like Tas, they are not keen to promote themselves, but are keen to tell the story of what they have witnessed. 

For all the previous

In the Loop

podcasts with

Dr Penny Dash, chair NHSE

Richard Meddings,

former chair NHSE,

Sir Jeremy Hunt,

Sir Andrew Dilnot,

Paul Johnson IFS

CLICK HERE


-oOo-

Coming Soon


Lord Darzi


... the background to his report and the data that supports it


Probably the most listened to

Podcast in the NHS!

FREE!

Want to contact Roy Lilley?

Please use this e-address

roy.lilley@nhsmanagers.net 

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Dr Paul Lambden


Rotator Cuff


'... rest and other therapies will allow a rotator cuff injury to heal, but recovery is protracted if symptoms are ignored and continued shoulder use will make such injuries worse.' 


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With his twin brother, former NHSE chair, Richard Meddings is cycling from Land’s End to John O’Groats in mid August.

980 miles, lots of hills, an old fashioned bike... no not an electric one!

Raising money for Prostate Cancer UK... well done, Richard, make sure you have plenty of Nivea!

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The service offers a robust way of supporting people who make frequent use of health services, in particular A&E, primary care and mental health services. For those who just fancy an informal chat, the team can help with that too.

Alternative European Healthcare Perspectives August 2025


Roger Steer


'...It’s true of Trump’s tariffs, cost-cutting and peace deals; it’s true of the EU budget presented by Ursula von der Leyen intended to make the EU more competitive and reverse its relative decline; and its true of the NHS ten-year plan...'









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

__________


>> I'm hearing - GPs using AI tools have been warned to watch out for 'inaccurate or fabricated' information and to report suspected adverse incidents via the Medicines and Healthcare products Regulatory Agency yellow card scheme.

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