View as Webpage

X Share This Email
LinkedIn Share This Email

nhsManagers.net

15th June 2026

What you need to know and what you need to think about - all in one place - for free!


News and comment from

Roy Lilley



Everything...

_____________

Short on time? Get yer ears-on and listen to Roy Lilley read this morning's eLetter... free!

An armchair, wedged ten-feet in the air, between a building and a wall!


An installation for Tate Modern? ‘The Chair’ emblematic of a Board, stuck between a rock and a hard place?


Twenty or so of us, pondered its meaning.  


Through the corridor windows, the next exhibit...


... a tasteful arrangement of huge, empty wooden, cable reels, with weeds growing around them, elegantly topped by a scattering of redundant scaffold poles… a metaphor for the NHS’ capital programme? 


‘Reeling, empty and propped up’.


It was 6.45am. Some of us had already met… wandering the hospital corridors. No patients parked, but precious little signage.  


By luck and instinct, we congregated. 

Most of us up since 5am, nil-by-mouth from midnight… ready, nervous, anxious for our 7am day-case-date.


We’d navigated the rubbish and detritus strewn across the site. The threatening car park signs. The neglected flea-grass savannah. Potholes. Ankle-breakers. 

Customers for A&E.


Just after seven the clinic’s electric doors unlocked and we pressed forward to do what the British do… queue.


Behind the desk, a sergeant-major. Smart with his name badge displayed even smarter… tucked out of sight in the fly front of his blue and white shirt...


Ignoring the computers the sergeant-major worked off a printed-out list. Pages spread across the desk, names in random order. 


As each of us approached the desk we stood a little straighter as we responded to the barks; ‘name’, ‘say again’, ‘spell it’.  


People with English, not their first language, managed by a sergeant major, who’s English appeared not his first language, results in a phonetic fiasco; ‘Are you saying ‘D’ or ‘B’. Tee, keeeee…. What?


Bewildered late comers swelled the queue. A sharp eyed, tall helpful, man, leaned across the counter and pointed to his name on the list. The sergeant major barked… ‘step back, this is not for you to see!’  


We all cowed and shuffled.


My turn… in a firm voice; ‘Lilley… L-I-L-L-E-Y… the biro scanned the list up and down. Down and up. Sideways. You’re not on the list. 


'Show me your papers….’ Errr…


… I don’t have any, sir.


My original booking was the end of June, the hospital clerk rang me 48hrs ago; ‘Could I come Friday?’ Yesssss! Here I was, not on the list and ‘no papers’.


‘Stand there. The nurses will sort you out.’  I froze, stood to attention.  


The lovely nurse did. Careful, reassuring, professionally.  


About seven the previous evening I’d been text’d a consent form. It named the consultant. The Nurse, now a female Sherlock Holmes, tracked it back from there.  


The lovely nurse said; 'it often happened. Some people just go home….'


… one way to reduce waiting lists…  


I’d been sent two consent forms. Duplicates; both describing my procedure… to insert a tube into my Vagina… I consented, twice.  


You can’t be too careful with the Equalities Act, these days.


The nurse said ‘it’s the Concentric system and things like that often happen, if people bother to read it.' 


Over two stressful hours later… I was on the list!


Whist nurse Sherlock was pounding the keyboard we were at a desk and computer, chairs and cabinets parked in front of two fire doors sporting a yellow and black sign, screaming ;


’415 Volts. This area is to be kept clear of obstructions at all times’.  


No staff had been electrocuted so far. Nor patients, but it’s...


… another way of getting waiting list down.


My phone rang; ‘This is the hospital, you are supposed to be here. Where are you?’


Errr...here!


Where? 


Actually, standing three feet way from the caller. We laughed and she zoomed off.


Sherlock asked; did I want to complain to the manager?  


I looked at the notice board full of thank you's and said; 'No, not really… ' 


But if you don’t, things like this will keep happening. They don’t do anything’.  


Reluctantly, I agreed why shouldn't I support these fabulous nurses? 


Later, Sherlock couldn’t look me in the eye when she reported; the manager was ‘in a meeting and too busy to come to the clinic’.  


That numpty reply was my trigger.  I’m doing something I have never done before. In over 3,000 eLetters. Laying blame, naming names… at… 


London's Whipps Cross Hospital? 


No… 


  • not at the penniless estates department, perhaps someone will donate a broom;
  • the sergeant major, lets hope he has a shredder and a GDPR certificate;
  • not the health and safety people and their lucky rabbit's foot;
  • neither the management ignoring the patient-risk-factors;
  • nor the chief executive who is obviously powerless in the hierarchy of the Bart’s Health Group… yes...


... Whipps is the orphan child of the lofty St Bartholomew’s.


I blame… Professor Ian Jacobs, the chair of the Barts Group…


… Ian, you need to get out more. Not with an entourage but with yer alarm clock. 


Wake up! Three things...


  • Perception is everything, if it looks like a dump, it probably is.
  • Little things are the big things… doing them twice costs twice as much.
  • Starting with the patient and ... working backwards...


... fixes almost everything.

What's Wrong

with A&E?

PODCAST

Dr Ian Higgison


If there is one clear sign that the NHS is not working, it is the state of its accident and emergency departments.


Across the UK, under all sorts of different political regimes, the story is the same...


...patients spend many hours even days, many waiting for a bed and incontrovertible evidence that thousands of lives are being lost as a result.


In their latest podcast Niall and Roy hear from

Ian Higginson

President of the Royal College of Emergency Medicine...


...who voices his anger and frustration as a system that is failing patients and staff. But, he argues strongly that this Gordian Knot will not be untangled by discouraging patients from turning up at A and E but by dealing with the ‘back door of the hospital, and...


.. on that, he clearly believes that while there is more that hospitals themselves can do to improve discharge procedures, more attention and resources need to be directed at social care and community health services.


As for the former Secretary of State in England, he is determined to make sure that Wes Streeting’s commitment is not forgotten! 

For all the previous

In the Loop

podcasts with

Prof Jim Blair

Learning Disability expert

Andy Burnham

Mayor of Greater Manchester

Nichola Ranger

ChEx Gen Sec RCN

Tom Dolphin

Chair BMA

David Gregson

founder of BeeWell

Dr Charlotte Refsum

Tony Blair Institute

Rob Webster

ICB CHEx

Sarah Woolnough

CEO of the King's Fund

Sir Jim Mackey

Dame Jennifer Dixon

Lord Darzi

Professor Tas Qureshi

Dr Penny Dash,

chair NHSE

Richard Meddings,

former chair NHSE,

Sir Jeremy Hunt,

Sir Andrew Dilnot,

Paul Johnson IFS

CLICK HERE


-oOo-


Probably, the most listened to

Podcast in the NHS!

FREE!

Want to contact Roy Lilley?

Please 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,

up-date-your-profie,

and we'll keep mailing.

----------

GDPR

We don't sell or give access to your email address to any third parties.

You can unsubscribe at any time.

Click on the link right at the bottom of the page

---------

Disclaimer

... yes, 60 countries listen

to Roy Lilley's podcast, free.

You can, too.

Just click here

Dr Paul Lambden


Respiratory Syncytial Virus


The seriousness of the infection is most associated with infection of the lower respiratory tract where the small airways become blocked with inflammation and infected fluid. 

News and Other Stuff

---

>> King's Birthday Honours list - edited for NHS. Congratulations to you all.

>> Best and worst NHS trusts in England revealed as Manchester hospital trust surges into top 20 - congratulations to them and I guess it's come at the right time for Burnham's election prospects! What happened to purdah? However, the listings are weighted by financial performance which trumps everything else, so take 'em with a pinch of salt.

>> Thousands of young people - to be offered two-dose MenB vaccine.

>> Unsustainable situation’ drives senior lab scientist out of NZ hospitals - it seems global health systems are destined, forever, to repeat each other's mistakes.

Capacity Planning for Small Hospitals and Departments - Myths Around Length of Stay and Factors Influencing Costs and Funding.











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

__________


>> I'm hearing - Trusts are finding cash flow problems escalating. In business it usually means you're not selling enough, charging enough or customers aren't paying. In the NHS it means 'over-trading', doing more work that they are paid for. The only way out is a 'bail out' or stop doing things... meaning waiting times go up.

>> I'm hearing - University Brimingham FT is getting itself into trouble with ‘unfair’ bank pay cuts. Nurses are claiming that it they are demoralising. I bet it is, of course. They've started a petition to stop the stupid idea. I imagine a strike might be looming. What is happening to Boards? They will say it's all about the money pressures from NHSE... I'm sure it is but that's what the Confed (or whatever it is called now) is for.

More News

...

>> ‘Vital’ NHS research centres - face funding cut.

>> CQC downgrades County Durham trust’s leadership from good to inadequate. Some staff said they were actively discouraged from speaking up about concerns - I am sure this is at the heart of the Bart's/WCross issues that I write about today. When will these numpty managers listen to the people doing the job.

>> Corridor care cases - hit 90k in May. This is huge news, in May, not winter or summer. In the Spring! There is something radically wrong.

>> Political whim should not drive NHS restructures - interesting article by Natalie Berry but alas I fear it may fall on deaf ears.

As you know... I don't do adverts but this neat app caught my attention and I thought you might like to read about it.

A really useful tool for managers and Boards... this is a case study.


RateMyShift: findings from early NHS and community pilots.


It turns how people feel at the end of a shift into insight their managers can act on. 

Twitter  
Managers Logo