Click here to see the Health Chat broadcast
Marcel Levi – CEO UCLH
Well. We were promised an evening of conversation with Roy Lilley at The Kings Fund to give us an insight into what it’s like running one of the major NHS Trusts in the country. Roy did so himself in the past and that experience gives him a head start over most interviewers (although the Health Chats tend to feel somehow less confrontational than Humphries). We found what made Marcel tick. And I think that’s why University College Hospital seems to be trotting along quite nicely.
A rounded figure, I think. Firstly though, the final words said “thanks for being enormously frank and open”. He is Dutch. I’m sorry, I have never met anyone from The Netherlands who isn’t straight, forthright honest and startlingly open. Marcel Levi lived up to his countries genotype well, and then some.
He maybe CEO of one of the major Trusts in Britain, but he still manages to do a doctor shift or two. We got into his methodology here quickly. It’s all about style and MBWA. If you are going to do Management By Walking Around, then it’s quite useful to be hands on a little too? He did suggest that most of the the first 5 minutes when he was in the room or in the team was quite stilted, as everyone knows who he is (which in itself, is a huge positive), but then nurses start being very honest and straightforward. Junior doctors were faster. And students? Mega straight, instantly.
But is he a doctor or manager? “Both” is the easy answer. He still feels more doc than manager. The style and outcomes of both jobs are very similar. Like outpatients or managing – a 1 to 1 meeting, 20 minutes, dig for the problem, work out how to fix it (together sometimes), then work out how to monitor progress. So both disciplines help each other and dovetail well.
Dad was a doctor then hospital director back home in Netherlands. He knew he wanted to be a doctor as a young boy. Started at home. After qualifying, moved onto projects at University Medical centre. It was small enough in Amsterdam for him to know 75% of the staff names . As Roy said, that’s great, but far more important that the staff all knew who he was. And that I suppose is the key point.
He’s been around. Blimey, he has! Italy, USA , Belgium, Germany. Roy wanted to know if we were just too possessive, rose tinted, and precious about “our NHS”. Marcel thought not, interestingly. He prefers the Social Solidarity model, where the well support the ill. Loads of ideas for trying to curtail the overuse of ‘free services’. I liked the £15 fine for those triaged out at A&E who should have seen their GP. I enjoyed the empowering the patients idea, to get them to self check (near patient testing kit for warfarin then patient changes their own dose, is a perfect example). Good example too of a newer more expensive set of dugs for anti-coag being overall cheaper because there are no monitoring costs.
A bit of discussion on Commonwealth fund data and UK coming out low down the league on outcomes. Every time I hear this argument, the result is the same. We are just not comparing like with like.
Some other highlights? PFI? Government could pay it off. If it has decided to stop future contracts, then why are old ones ok now? Daft. And I bet every board meeting just has it on the agenda every darn meting if they are saddled with a large debt?
Loads of the main focus was on doing things differently. Not tied to a tired old Lansley model of privatised is best (Carilion anyone?).
Start with the patient and work backwards. There’s a worldwide shortage of all strands of healthcare professionals. So we have to do things differently. Train our own? Yes. Loads of great HCAs? Train and upgrade them, quickly. Co-payment? Maybe only logical way forward. It’s already happening in Social Care. Let’s get real here! (That’s my view…sorry…). Triage at the hospital gate – who may refer you to a GP for free, or if you want to wait 4 hours, then pay £15.
And let’s get thorny…IT interoperability. Yes, it will take time…but they are on their way. but would you start here with a blank sheet of paper?
Can I make a simpler suggestion? The machine learning algorithms will suit many a time pressured worker. But so will every smart phone owner being allowed to keep their own medical data, and let them decide who to show it to. With password break ins allowed by HC professionals. Why not? Why not? We can be trusted!
There’s lots of simple stuff we can do in between time. Ask Marcel. They have their own Bank Nurse. And very little agency spend. Primary Care Home will help fix much too. As could something similar to the Buurtzorg model from back home for the Prof?
Do you know – there’s more to see on the recording. But it really feels like there area lot of small things that could make a big difference. And a lot of big ideas that could do just as much. And guess what, it is happening already…
if you want to watch (it is a good cuppa builders and a hob nob!) click here