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of primary care
NAPC News 17 May 2012
Great Leaders Required For A Time Of Great Change Says Roger Hymas
Nearly every day at the moment, the David Nicholson quote about the current NHS transformation being so large it can be seen from outer space comes to mind.
NHS England is by any measure one of the world’s largest enterprises. Its income of $200 billion would put it in the global FTSE top 20 and its headcount would place it among the world’s top five employers. Yet all similar sized organisations, such as GE, Toyota, Siemens and Ford, have taken up to 100 years to develop the sophisticate management practices and systems they employ to run their businesses. Every day they build their enterprises incrementally, introducing processes to make them more efficient, more effective, more profitable.
Not one of them at any time in their histories has ever decided to re-cast completely its total organisation, to dismantle the entire management structure and build a new one from the foundations up. Yet this is exactly what is envisaged for the NHS with the installation of Clinical Commissioning Groups (CCGs)
There are now 220 CCGs, with no tradition or experience of managing big businesses, being asked to deliver transformation. With 10 months to go to the changeover, what we are seeing are significant local variations in the state of preparedness, management support, which is uneven and quite reasonably often distracted. Like a huge migration, literally everyone on the commissioning side of the NHS is currently on his or her way to the next job, or out of the organisation completely. On the other side of the market are the large, stable provider organisations such as Foundation Trusts, with their management arrangements firmly in place, already embarked upon strategies which commissioners need to influence to reshape the local health economy. It will probably take many years to achieve an equilibrium in market forces.
Given all this, it is no surprise that this places great weight on ‘Great leaders’ as part of the CCG (and now CSS) authorisation process. So what should be the focus of great leaders over the next ten months or so? The text book solutions are in Google – you might wish to try:
Here is my few pennyworth (in no order of importance) from experience of both transforming organisations and 20 years of commissioning on both sides of the Atlantic.
•Send clear signals to all around you about priorities and the individual’s role in them.
•Introduce a culture of quick decision-making. GPs are good at this. Avoid committees wherever possible.
•Fix mistakes, particularly with people, quickly.
•Invest in team building and create a distinctive culture for your new organisationsn
•Be compassionate with staff issues; we are talking about people’s lives and futures.
•Make senior team available, readily available, all the time.
•Delegate the unimportant: let go of easy tasks.
•Catalyse: It is Ok to be disruptive but be careful with the execution of plans.
•Work out what are the critical drivers of success – for example, suggest you might wish to start with Commissioning Intentions for 2013/14 now, not leave it until the autumn.
•Empower – not a comfortable word – but you know what is meant.
•Grab the best talent wherever you can find it before others do
•Measure everything important – a follow up to correct variance. Never forget ‘what gets measured gets done’.
•At this stage, invest over the odds if you have to, so long as the Return on Investment is positive.
•Concede the small battles, but use them as bargaining chips for the big ones.
One in three diabetes patients admitted to hospital is given the wrong treatment, including the incorrect dose of insulin, according to a report by the Health and Social Care Information Centre.
The National Diabetes Inpatient Audit examined data for 19,400 patients over seven days last October. Results showed 32.4 per cent of patients in England had experienced at least one medication error during the previous seven days, down from 36.6 per cent in the previous years.
Hospitals Will Close Under NHS Reforms
Health authorities have indicated that struggling departments within hospitals that fail to attract patients will be closed under government plans, which give patients more choice about where they are treated.
These frank assessments were made by David Bennett, the chairman and chief executive of Monitor, which will regulate competition in the NHS, and Mike Farrar, the chief executive of the NHS Confederation, which represents trusts.
Health Gap Of Rich And Poor Pensioners
Data from the Office for National Statistics has revealed that while pensioners in prosperous areas have enjoyed a gradual increase in the time they stay healthy, those in deprived areas have experienced the opposite.
Analysts at the Office for National Statistics said the ability of the middle classes to ‘use the system’ to obtain the best care could account for the growing gap.
Differing attitudes towards smoking, drinking and obesity could also help to explain the disparity between rich and poor, they suggested.
Fat Taxes Of 20% May Cut Junk Food Intake
Research conducted at Oxford University has concluded that ‘fat taxes’ would have to increase the price of unhealthy food and drinks by as much as 20% in order to cut consumption by enough to reduce obesity and related illnesses.
Fewer Sick Days Taken Nationally
The Office for National Statistics revealed this week that people are calling into work sick less often, with the average Briton taking less than a week off per year.
Around 131 million working days were lost 2011, compared with 178 million in 1993 when records began. This means the average worker now takes just less than five days off each year – down from a peak of 7.2 days, 19 years ago.
The most common reasons given continue to be minor coughs and colds, and musculoskeletal issues, particularly back pain, neck and upper limb problems, account for the largest amount of absences, around a quarter of the total.
Therapy To Overcome The Baby Blues Goes National
The Oxford Parent Infant Project, known as Oxpip, has had great success in treating mothers suffering from depression, anxiety, the effect of traumatic birth, or other post natal problems, and is now to be made available nationwide.
Oxpip’s therapists believe that, in some cases, having a baby releases ‘ghosts in the nursery’ form the mother’s own childhood, which must be dealt with before she can enjoy motherhood.
Low Pay No Excuse For Poor Care
Low wage and poor staffing levels are no excuse for failing to treat elderly patients with dignity, nurses and healthcare assistants were told yesterday.
Sir Keith Pearson, head of the NHS Confederation, said that the neglect of vulnerable patients in hospitals and nursing home should not be dismissed as isolated incidents.
Addressing the annual conference of the Royal College of Nursing in Harrogate, Sir Keith said he accepted no nurse went into the NHS with the intention of delivering poor care, but that unacceptable episodes were cropping up too often.
Number Of Elderly Who Get Free Home Care Falls
Official data indicates that the number of vulnerable older and disabled people, who had home care services fully paid by the local authority in which they lived fell by 11% in the past two years.
Only One Fifth Eat Enough Fruit And Vegetables
New research has suggested that just 22 per cent of people manage to eat the recommended five a day portions of fruit and vegetables.
Only 17 per cent of people on low income homes eat the suggested amount versus 27 per cent in higher income groups according to the World Cancer Research Fund poll.
Autistic Adult Bullied And Not Supported At Work
The largest ever survey on autism has found that more than a third of adults with the condition have been bullied or discriminated against at work.
Meanwhile, 43 per cent said they had left or lost a job because of their autism, the poll by the National Autistic Society (NAS) concluded.
NAS said the findings highlighted the lack of support for people with autism in the workplace, and the lack of awareness of the condition among employers and colleagues.