I don’t bother with the Times or the Telegraph. Both are pay-walled. Linking to their stories just fulls up my in-box with people telling me; ‘it’s pay-walled and I can’t read the story…’
… I know.
Having got that clear, over the weekend the Telegraph popped up with a story;
‘…Sajid Javid is setting up an ‘NHS delivery unit’ to oversee an efficiency drive in the health service, amid pressure to show that the proceeds of next April's National Insurance hike will not go to waste….’
That’s all I can show you without taking out a subscription and I’m unlikely to do that, so you’ll have to trust me… unless you’ve forked out for a subscription.
Normally, I would bother with it but there is more to this than meets the eye.
Fundamentally, this is a story about who runs the NHS. It looks like it’s the newspaper.
The Telegraph ran a campaign against BoJo putting up taxes. Quite how they expect HMG to pay for covid, furlough, PPE and five million operations for people on the waiting lists, is beyond me.
Anyway… BoJo and his sidekick, No19 have to get the Torygraph of their backs and a new department of ‘using both sides of the bog-roll’ is an easy wheeze. But...
... here are a few factoids;
The so-called, ‘new money’ for the NHS is hypothecated for use on Covid recovery and waiting list costs and doesn’t materialise until April.
Monitoring waiting lists, how they come down across England, is an obvious, transparent measurement, requiring no new departments of delivery.
On wider measures of efficiency, NHS revenues are largely spent on wages and consumables.
Wages are set by negotiations between the DHSC and the pay review bodies.
The NHS, the Trusts, are stuck with the upshot and have no say.
The principle rate-limiting step is workforce. The numbers of staff, training and recruitment, is organised by Health Education England and the universities.
Nothing to do with the Trusts, who have to put up with the upshot and there is a crisis.
NHS Supply Chain manages the sourcing, delivery and supply of healthcare products, services and food for NHS Trusts.
Supply Chain is managed by Supply Chain Co-ordination Ltd. It operates as a Limited company, wholly owned by the Department of Health and Social Care.
Trusts order their stuff from them and pay the bill.
No19’s 'delivery unit', its structure, cost and oversight, will be part of the DHSC and therefore, spend most of its time inspecting the work of organisations run by the DHSC, that means Number 19.
To make sure there is no waste at the front-line, perhaps a surgeon embroidering instead of stitching, or maybe, screwing in a hip prosthesis upside down, the NHS has the Getting It Right First Time (GIRFT) programme...
'... designed to improve the treatment and care of patients through in-depth reviews of services, benchmarking, and presenting a data-driven evidence base to support change.'
The delivery unit won’t have a clue about that, unless they want to recruit a duplicate GIRFT team to ensure the getting-it-right-first-time team, are getting-it-right-first-time.
Too many managers? The proportion of managers in the UK workforce as a whole... 15.4%. In the NHS it’s under 5%
The NHS in England is a £100 billion-a-year-plus 'business';
It sees one million patients every 36 hours, spending nearly £2 billion a week.
In most places is running at 90% of pre-covid levels, which is a miracle.
Aside from the banks, the only companies with a larger turnover in the FTSE 100 are Shell and BP.
If the NHS were a country it would be around the thirtieth largest in the world.
Big efficiency gains will only come from three headings;
A full, well-trained, highly workforce,
Investment in the management and delivery of services by the use of technology
Sharing best practice.
For a senior fellow at Harvard University, No19 is pretty dim about managing efficiency gains and as the secretary of state for health, he doesn’t seem to know very much about how the NHS works.
>> I'm hearing - nearly 20% of the most critically ill Covid patients are pregnant women who have not been vaccinated.
>> I'm hearing - about an in-patient, of a London Teaching Hospital, who was unable to be discharged because the ambulance booked to take him home didn’t have enough fuel
