‘… the fact or condition of being regarded or treated as more important than others.’
The important words in the definition are 'the fact'. ‘The fact’ is singular.
Priority cannot be defined by the plural… ipso facto; there cannot be more than one priority. It is a sine-qua-non that an essential condition of ‘priority’ is that it is singular.
This would appear to be something, unknown, to; David Prior, Mike Coupe, Ara Darzi, Susan Kilsby, Jeremy Townsend and Laura Wade-Grey. They are the non-execs on the NHSE board.
They, surely, must know, you cannot say an organisation has more than one priority. It is an oxymoron. However...
To summarise the priorities; do more of everything. More covid, more operations, more growth, more access, more integration, more responsiveness…
… more increasing, more investing, more improving, more digitising, more data-ing, more doing and more working together.
But, not more Integrated Care Systems - they’ve been shelved until July. Parliament can’t pull its finger out and pass the legislation.
Schoolboy error. We can’t plan a year not knowing when the management framework is going to change and into what?
It’s clear to me the NHSE Board knows there’s a shed-load of stuff to sort out but they can’t decide how to go about it. They’ve worked themselves into a fog.
Lack of clarity and leadership. Schoolboy error.
You cannot have more than one priority and you cannot rank priorities, so what to do?
All organisations have to consider three variables;
timing,
resource
and objectives.
Think of them as a triangle. Pull one variable and you have to adjust, or stretch the other two.
The shape of the triangle changes… it’s called shape shifting. The ten ‘priorities' will each have a different shape.
Of the three variables, it is resources that are most important. Without resources, the rest is fantasy management.
For the NHS, right now, money is not the overriding resource issue, it is the resource called, people. Workforce.
The NHS ‘priorities’ list (ugh) mentions workforce in these terms;
“... strengthening the compassionate and inclusive culture needed to deliver outstanding care”.
I know culture is important but honestly? This is not planing or prioritising, it's pitiful non-sense.
The awkward fact… there is no NHS workforce plan and without one the NHS is, frankly, screwed.
The blunt truth if we don’t fix ‘people’ we can’t fix anything because of 6 killer facts…
We came into covid without enough people, covid has depleted the numbers.
At the end of February we’ll know the impact of obligatory vaccinations. It’s the last point in the timeline to get people fully vaccinated by the April deadline.
Nurses? We can’t rely on imports, there’s a global shortage of care workers.
We lose 1:5 in training and 1:3 in the first year on the job.
Half of nurses are over 50, retirement beckons.
We will not recruit 50k nurses by 2025, 18k of them depends on the ones who usually leave, staying.
Unless the resource leg of the triangle is resolved, within a time-frame, no objectives will be met.
Once that’s clear you can decide what’s critical, what’s important and what is desirable. Shape-shifting.
What is the bust-a-gut priority.
That leaves us with, what’s important, meaning; what will have a positive impact on the performance of the NHS but the objectives are variable and the time-frame flexible.
Finally, desirable; things for which resource and time are both variables.
Measure the ‘ten priorities’ in this way and you end up with something that is manageable and doable and you can write something like this…
We think Covid is going to be a priority until the spring.
Between now and then we need to focus on workforce retention and recruitment.
We have to organise to have electives come back strongly by the summer.
Covid taught us the importance of data to inform decisions and plan. Let’s make data a habit and the NHS, digital first, wherever we can.
>> I'm hearing - the £walled Times is reporting Hancock and 'partner' were at that No10 'cheese and wine' office do in the garden.
>> I'm hearing - from a retiree, anxious to come back and help. Had a letter from Ruth May via NMC on December 16th asking for help via NHS professionals which she duly responded to positively. Since then... nothing. I doubt it's Ruth's fault but somebody needs to give the system a kick.
