Fab NHS Awards 2016

Hi everyone! I am blown away with powerful positivism after spending the afternoon at an award ceremony at O2 in Greenwich. The concept of sharing great ideas that are proven and already used anywhere in the NHS and deserve wider circulation and utility was the brainchild of Roy Lilley, Terri Porrett and Jon Wilks. And as a vehicle for positive change, it has already proven invaluable.

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I had a snack before leaving the venue. Guys on the next table saw my badges and lapel stickers. “Awards? Was it just the usual Corporate rubbish?”.  OK, it could’ve been, I said. But with magicians and bubbles and the NHS Choir…it wasn’t your average back slapper!

You had to feel the love. Most of the guest performers, the grand fromages from NHS, the award winners and nominees were quite visibly, emotionally involved. Some to the point of what my sister beautifully terms “happy hankie”.  Including the blogger…(it was the standing ovation for the NHS choir singing their 2015 Christmas number 1 that got me).

Dr. Phil Hammond, Private Eye medico, and West Country GP brought a Clanger. Acronym alert – Connect, Learn, Action, Notice stuff, Give, Eat well,  Relax, and Sleep. I love Clangers!  And had us all shouting out (in appalling West Country accents) “Our NHS”.  OK – this audience is on side already…but don’t underestimate the love, politicians….

Before I give you links to the award winners, through the Fab NHS web site, I just need to mention all if the performers and their simply fabulous metaphor links to what the NHS is and does…

Positive news doesn’t sell newspapers. You might not hear about this in the Daily Wail, or the Excess…but you can read it here. As Simon Stephens said “You 290 winners and your 1.3 million colleagues in the NHS are winning everyday”. Touching the lives of 650000 people directly, the NHS touches everyone…

So who performed – beautifully? Dancers, with Nye Bevan’s speech at the inception of the service. Sometimes it must feel like the troupe is all in time and in tune? A woman doing the splits on a tightrope…don’t want to stretch that too far (!), but the finances make it feel like the safety net needs fewer holes? A posh guy making impossible things happen with bubbles. “Bubbles have to make the most of every precious moment…like you all do”. Surely a perfect metaphor for some of the wondrous stuff that happens, hourly? And Nurse Pseud, the astonishing (you had to be there…) Hula Hoop queen. Sorry, she managed 10 at one point. And was naughty  and quirky and loud and very proud of being an NHS baby. And was moved by saying thank you. And finally a magician – please make your own metaphor link….it’s too obvious…

The roadies and crew were so like the NHS folk. Committed, quietly getting on with it, unobtrusively committed to excellence.  The sponsors are deeply embedded, excited to be so, and want it to grow and grow.

Twitter nearly broke. 857 729 people had interacted with tweets about #fabawards16. Wow.

And maybe a tweet summed up the objective of both the celebration and indeed, the vision of Academy of Fab NHS Stuff:

Enjoyed following on twitter. Some amazing people doing some incredible things

And finally (as the Two Ronnie’s would have said), I had the serendipitous joy of sitting next to one of the award winners. Lisa Webster  now with Wirral Community NHS Foundation Trust , (recently moved from Pennine Care NHS Trust) win the Mary Poppins Award. “Be Happy”, was the share. She was shocked. And so blown away. As was everyone who won. And all those who were nominated. Cliche it may be – but all are winners of course, because they were the chosen 4 out of 50 nominees for each category…and in the end, it’s is the NHS that wins, through this hugely positive sharing platform.

It works. It really works. Go check it out:

Here’s the categories – Fab Awards Categories

Here’s the nominees and winners – Nominations

Here’s the photos from the event – Photos

And couldn’t without the positive pushing and vision of Roy. Terri and Jon. And the sponsors. And the sharers.

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Fabulous.

Read about Developing a Home First Mindset; LEAD it In Leicester; Caring for Carers, Be Happy, Designing & Implementing an ‘Acute Hospitals @ Home’ Service #FutureHospitalsProgramme, Fab Change Day champions, and more on the Fab NHS site…and share something with everyone. Your little idea may be bigger than you think…

https://fabnhsstuff.net/

(All the links to the nominees are on this home page)

The Sponsors – and it couldn’t happen without them:

Cerner

Deloitte

IBM

IMS Maxims

Institute of Healthcare Management

Interserve

Quintiles

 

Dr Sir Sam Everington

If you’re not sure you have heard of Sam, or cant quite place him – click here and here (first is Kings Fund, second Wikipedia).  Those who attended, in person or via Periscope will have learnt more at last weeks Health chat with Roy Lilley.

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Sir Sam Everington

Less like a Sir, less like a doc, more like a visionary?  Roy Lilley certainly does get some crackers to his health chats.  Read on to find out more of what I think I found on that evening. (Available to watch again on You Tube link in case you didn’t catch it on Periscope).

I thought I might get the feel for a person who had moved from law to GP and find him a little highfalutin’ and pompous. Not likely for someone half Norwegian (and brought up by his madly hospitable, open house mum). He does wear that sort of jumper, normally only seen in Scandi Noir cop shows.. For work too…no ties on him! Trainee woodcarver to ships welder, through Called to the Bar, to GP. All before 23 or 4… Saw a fellow student killed by a crane when a welder. Formative moment. Resolved to become a GP.

Why general practitioner, asked Roy?. He knew that’s what he wanted in Medicine.  it’s a people need. “You need emotional Intelligence, not straight A* s to be a good GP.”.

The Practice he still works at 2 days a week (you got the feeling he needed it as a bed rock of his existence) is well visited by the great and the good.  Heavens, Roy has been there! Bromley by Bow, in Tower Hamlets. Deprived area. Hugely varied communities. And a beacon of excellent care.  The practice sounds as central to community life as a holistic social, health and cohesive service should be. Taking the place of pub, church football and maybe even family? Or just making that mix work better? Is Sam’s thrust just that? Maybe his powerfully political pushing and absolute moral conviction is the enzyme that allows others to have their head too? I know he doesn’t do it all, and says he can walk out of the practice and it will still flourish..but I think he just makes the space for the positive ideas to flow.  And the positive people to come to the fore.

Like Social Prescribing. I didn’t know what that was, really (description here). It starts with the the opposite of normal thinking.  Not “what’s the matter with somebody” but “what matters to somebody”. Like a lot of things – simple to say and to “get”. But harder to do?. Of course. But you have to start at the “what matters” question. Like their practice building. Church audience falling? What do our ageing parishioners want? They want social care.  Let’s bring the GP in here. Another practice defined many of their health issues were related to crime in the local estate. So bring two police officers permanently based into the building. Guess what? Crime reduced 80% and healthcare outcomes improved exponentially.

It is big joined up thinking.  It is all about mind set.  But don’t say it to Sam.  He doesn’t think what he does is the important bit.

Tough? It is. The passion makes it happen.  And others will now follow. Thank you.

Next? Making the High Street healthy….

Good luck, Sam. We get it.  You lead, and we will follow…truly an inspirational chat, and chap.

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Sam and Jumper Fans!

Matthew Syed. Black Box Thinker

Oh dear. Too many quotes, too quickly at this particular Roy Lilley NHS Managers.net Health Chat event.  Matthew – I apologise already if I misquote you – especially as you are a journalist. (Journo’s never misquote, I am told).  So scary.  Usual health warning – as ever, this will be my views of the evening. If you were there, or watching the event live, on the Periscope feed, or the whole thing on You Tube link, then I apologise.  (You Tube link herePeriscope is easy to add to mobile devices and computers – and now you don’t need a Twitter account to get it)

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…and so, it begins

I didn’t really expect so many sound bite quotes from a table tennis ace, of Pakistani and Welsh decent, who left school very early to pursue the love of sport, then taught himself “A” levels, went to Oxford and got a job as a writer for The Times by phoning Directory Inquiries and phoning the sports editor directly.  Not a lot surprises me except that sort of powerful self-belief, when it actively works.  Matthew doesn’t seem to know no as a concept.  Or “You can’t”.

He continues to be enlivened by sport. “Sport is a very broad canvas.  It is the tapestry of life.  And it has beauty.”  There you have it.  This is a man who not only showed impeccable emotional intelligence during the session, noticing when his metaphors had gone too off tangent for much of the audience, and redesigning them so we got it, but also showed and shared an awful lot of passion.  His own and other peoples.

(He had to rush off, as a working journalist, to write a piece on the passing of Carlos Alberto, who scored one of the best goals at any world cup, in 1970, for Brazil.  And he did so impeccably.) (I would normally say “death” not “passing”.  But if you watch the goal on lone from the 1970 World Cup, you will see why I chose the word…)

Roy and he agreed about Positive Deviance, and about sharing, and about learning from things that go wrong.  Matthew was quite outspoken about the reticence to be open in Healthcare – I felt he felt it worse than most professional environments?  Get the culture right, and you create success.  Roy begged to differ.  “You can’t change culture”.  I got the impression that they agreed that some things could be changed – there may be Marginal gains (like Sir Dave Brailsford and the British Cycling team) or big, disruptive change.  It doesn’t matter what we call it, guys, but if the atmosphere changes and the positively noisy angry individuals keep at it, we will get both marginal and major disruptive change.  I don’t care if you call it cultural change, micro or macro change, learning from failure, sharing, openness to change or whatever….just do it and stop trying to define it.  Not is a word that does’t help us move on.

How do we create high performance change?  “You can’t improve your golf in the dark”  Great metaphor.  Let’s switch the lights on!  That means valuing whistle blowers?  I think so.  We need to get beyond self justification protectionism and Group Think. (Please find out more about Group Think – wiki link here.  Janis will make you think differently…).  Continuous Improvement culture, openness and collaboration and the underpinnings of positive change.  And sharing.  We know we are not already perfect.  So that means trying to do things better.  Always..

You need data too.  And root cause analysis.  Central line infection caused 45 000 deaths per annum in USA.  Analysis showed that not sterilising the catheter site was the root cause.  Change in procedure – and the infection rate became zero.  It sounds like many people may have died unnecessarily whilst professional testudo was in place?  “These infections are due to a complication of the procedure itself”.  No, it wan’t it would seem.  I wonder how many things are going on today that this sort of knee jerk circling of the wagons, group think and not listening to voices of concern, is preventing better patient care and outcomes?

So, a few more quotes:

“You cannot create high performance through high blame”

“The organisations with the strongest learning culture have the best balance sheets”.

“Healthcare has real difficulties with senior people not admitting their mistakes and becoming defensive”

“We need to create openness to track unintended consequences”

Yes, if we change the model, if the noisy ones can stay noisy (and keep their jobs), if we are not threatened by our mistakes but use them to improve, we may get the behaviour change to keep happening.

One last thought from me?  What if we banned gagging orders from compromise agreements between Trusts and whistle blowers who have been pushed out?  Or at least, the Press Release must say “There is a no comment order attached to this case”.  Then the Press could speculate.  And I bet the Trusts would be more open, because the speculation is likely to be wilder than the truth…

 

Ed Smith NHS Improvement

NHS Heath Chat at The Kings Fund – always thought provoking, and Ed Smith gave as good as he got from Roy Lilley.

(Usual health warning – this blog is my view of the evening.  You may indeed have a different one.  You can check if you weren’t there by viewing the chat here – The Blonde seems to have done a sterling job despite some technical difficulties!)

Ed Smith CBE, FCA, CPFA, Hon DUniv, Hon LLDs

Ed Smith is Chairman of NHS Improvement.  Can one organisation be led well enough to actual live up to it’s title – which sounds like a mission statement in and of itself?  We sat and wondered…read on and find my view.

I call it ‘Not Monitor”. Roy’s insults did begin even before the official 6 pm start at the Kings Fund…but for once, the interlocutor / victim / silly for being there person, responded in kind.  Alternately ignoring or riposting – a fine tennis match!  (I still wonder why people do it…volunteering for this interrogation, gentle as it is?)

Born in Calcutta (as was), and had long history not in the NHS.  Visited hospital where he was born, and phoned his mum back in England from there.  Unusual to see something slightly different from one of these NHS Chats.  I usually witness people who are totally NHS born and bred, and so fully entrenched and committed to the cause, it becomes almost a given to be that driven.  What I saw on top of that with Ed Smith was someone whose passion also had emotion.  He is probably one of these people who become tearful watching certain films and TV.  I understand.  And I really don’t think there is enough passion and enough emotional involvement or the spending of emotional currency in organisations.  (I will return to this at the end.  Marketers call that a tease campaign…)

30 years in PWC after 4 with Coopers.  Straight into “Shouldn’t the NHS be able to sort itself out?”  Well, yes.  Sometimes needs expert help and advice – but some of the baseline is wrong.  Ed talked of the lack of a learning culture, no peer review and little peer engagement.  I thought there was some – but guess it is only at the rear view mirror level, not looking forward. The retrospectoscope always gives you 20:20 vision.  Planning for the future takes guts.  Taking action for the future takes balls.

He has brought a lot of his other experience emotional intelligence and passion from other roles.  WWF for Nature?  “We must learn we are tenant on this planet – not its owners”.  Perhaps the same could be said of the NHS?

I got lost in acronyms.  STPs?  Sustainability and Transformation Programmes.  Apparently, a web site explains (see here…) but it seems to come down to the people bits of the providing excellent care, s ever.  “We need a more collaborative approach.  More coaching and mentoring.  We need Lean and Process improvement.”  The mantra continued – positively.”  There needs to be more Clumsy Solutions (loved that – just do it and keep refining?)There is a common mind set?  Everyone wants better outcomes for patients – and remember, we can all be patients… but the prevailing atmosphere is of a set of people (the 1.2 million who work in the NHS) who seem more disillusioned, dispirited, disaffected and disillusioned than ever.  It is 1 minute to midnight to turn the NHS around, warned Ed.  So, how?

Managers and leaders must oxygenate their organisation.  Allow people to breathe their job. Get back to People, Process and Purpose.  Celebrate what we do, what we achieve every day.  Of course I agree.  It will never make the news.  Only bad stuff sells.  But at least we can do this for each other?  Get to the Fab NHS site for ideas, and to share.

I get the feeling that some of the amazing folk in senior positions in today’s NHS are coming together – coalescence of positive group thinking and for process and purpose.  If they can get that right between them, the NHS teams will get the rest right.  As Roy said yet again tonight, management’s job is to show people what good is, and get out of the way while they get on and make it even better.  And I was with Ed when he talked about the need for a 5, 10 and 15 year plan.  2030 is only 14 years away (and how scary is that??!).  2020 will happen, almost whatever we do now.  He argues cogently that we need to define the purpose for 2030, or it won’t happen at all.

Fascinatingly forthright, open and honest.  And the insult tennis was a score draw between them.  And you know what?

Roy and Ed want the same thing.  It is also what everyone in the audience wanted too.  Better patient care delivered by people who are loved and respected for what they do.  Let’s just do it?

 

Sir Andrew Dillon – NICE!

Sir Andrew Dillon & Roy Lilley

I’m sorry.  It is a bit childish, isn’t it. National Institute for Health and Care Excellence is no laughing matter. Originally, just the proper NICE acronym – in 1999 – “The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care”.  Laudable.  Then the remit changed in 2005 – after merging with the Health Development Agency, “we began developing public health guidance to help prevent ill health and promote healthier lifestyles. Our name changed to the National Institute for Health and Clinical Excellence”.  Proper Health Service, rather than a sickness service (which has always been my gripe with NHS as a name – more fixing the sick than stopping them getting sick first).

Yes, another health chat, with Roy Lilley being chatter in chief.  These are my reflections having watched on Periscope (easy to download onto your pad or phone) last week (I’m moving, hence a bit tardy!)

Another great way of seeing the whole thing is via the Academy of Fab NHS Stuff You Tube Channel – click anywhere on this coloured bit to take you to it.

Do you sometimes wonder why anyone ever gets to want to be interviewed – by anyone?  If your organisation is in crisis, the first thing any Crisis Management Organisation suggests is never appear live, or you will be hung out to dry.  Well, the insults started early.  I was already thinking “Why put yourself through this?”

“You were described once as having less personality than a paper clip”.  Well fielded by the Knight of the Realm…”Yes. Paper clips are useful.  That was how you rebooted your phone, remember? I took it as a extraordinary compliment…”.  The softening up is always so nice from Roy – and you learn a lot about how the person formed to fit the high ranking role they are now in.  Always so pleasing to see that many of the people Roy interviews are actually long term NHS stalwarts, and many jumped into the organisation at teenage or new graduate input.  Andrew Dillon was no exception.

His trail was blazed with moving from unit to unit to hospital – and they all seemed to close after he left…except The Royal London.  I’m sure it was just coincidence – but Manchester and environs may have heaved a sigh of relief as he took the M6/M1 route to London.

There was lots of political interference and ‘leaning on’ from Big Pharma.  An early spat involved a Flu treatment from GSK – Relenza, I think?  The Rapid Assessment system (cost benefit analysis linked to clinical utility – or maybe more complicated than that?) resulted in a ‘no’ from NICE and the head of Glaxo demanding to see the PM (Tony Bliar, star of recent 1.5 million word historical document), I assume to ask for some part of Andrew Dillon’s anatomy?  (Head?).  It certainly seemed to get them known.  There was a lot of flummery and anger about pulling investment and people out of the UK (this sounds awfully familiar), but that didn’t seem to happen.

Reforms create pluses and minuses – winners and losers.  The Griffiths Report (1983 – wow…feels like yesterday – and the link is to an HSJ 30 years on review).  One thing that both Roy and Sir Andrew agreed on was regretting the demise of The Firm within hospital specialisms. Teams always seem to have the prospect of fulfilling the promise of better results – better care, lower morbidity and mortality.  (Prof. Michael West’s work when at Lancaster, for the Kings Fund – super set of slides here – “A positive organisational climate is associated with low and declining levels of patient mortality”  Good to know?)

Maybe that’s what it boils down to then.  NICE remit and objectives felt a little bit ethereal and ephemeral to me – I still couldn’t fully describe what it was all for. I got a bit lost in the enormity of the scope of the remit. So I asked Roy Lilley. “It puts a rationale behind the use of resources”. I like it!  Maybe, like most of the super talks I have been to or watched remotely in the past year of the Health Chats with Roy, they have proven to me that, yes the NHS is a behemothic highly complex beast.  But some of the fixes are simple in essence.  Like getting back to The Firm as the central structure with ward rounds and teaching and learning and team work and support and job satisfaction and better outcomes and more effective use of resources and and and…

We just need to stop messing about, and start taking action, not just talking about it.

 

Duncan Selbie – Public Health England

Another evening at The Kings Fund in central London.  These Heath Chats where Roy Lilley (of nhsmanagers.net fame) ekes out more than Paxman ever did, by being both disarming and opinionated and sometimes rude for the sake of it…are always a good thing to attend, or catch live on Periscope, or even watch the whole again on Fab Nhs Stuff Web site You Tube channel.  As ever – these are my views of the session, so are bound to be different from your own.

Duncan Selbie

Duncan Selbi-

 

I have to start with the other great reason to go. Networking.  You can chat with like and not like-minded folk, whose common denominator is wanting to keep health care in the UK at the top of the world tree.  If only the politicians would get out-of-the-way and let those who know and love it to just do it.  But I had a worrying chat with a GP leader from the East Midlands area.  They told me how the service was near breaking point. 6 surgeries had closed their doors in the last year.  That of course puts more strain on the remaining practices, and probably A&E and secondary care and all the social services too.  They told me that it wasn’t early retiring GPs that was creating the problem – which is what I had assumed.  The problem was many younger doctors leaving the profession completely. Most were under 45.  Female GP burnout was even younger – before 40.  And it does take 10 years to grow a GP – and not enough are entering training too.

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Duncan, Roy and The Sheffield Massive

 

I didn’t ask why.  I could guess being unloved and unsupported by your ultimate boss, Jeremy Hunt, being berated by the press, being accused of greed and of being overpaid, having over inspection by a non-understanding CQC, having to buy services via the CCG system, and trying to run a viable business and wanting to give excellence in service with squeezed resource (both money and people), and being choked by regulation and form-filling cannot make for a fulfilling work experience.

If this is being repeated country-wide, then nothing that Duncan Selbie and his team will do will have any effect.  I suppose the Tory Party knows that the voting public will never forgive a government that damages the NHS beyond repair.  And will not vote for them.  I can but hope.  You can’t be short termist and always making the Austerity choice when it takes 10 years to grow a GP.  It is not a tap we can just switch on. Here’s an off the wall suggestion. Be nice. They may not leave then.  That’s my only short-term suggestion.  And get the inspectors to hell out of there.

I liked Duncan.  Not being racist here, but it does sound interesting when a Scottish accent tells you he is Chief Exec of Public Health England…it may just be me!  He’s been a legal immigrant to The Southern Country for quite a while now…

As ever, we get more about the man with Roy Lilley’s avuncular, been there and done it, approach.  (And Happy Birthday to Roy – 70 today. Only a bit older than the NHS…).

Both Duncan and Roy had risen through the NHS ranks without the burden of a Degree.  Left school as early as they could (and I don’t mean 3:25 pm).  This sort of rise might still happen in the NHS – it seems Apprenticeships are making a comeback.  Being able to rise through the echelons of a public service seems a great way of self-improvement and making leaps across class and glass ceiling and old school tie divides.  If you are good enough, and committed enough, you should be able to break through, not just because you went to Oxbridge?

Duncan Selbie started in the NHS in 1980.  He was 17.  As a Clerk. At 19, moved to London (to keep having a job), as a Cashier at The Queens in Croydon.  Starting low, and building, as you can see.  One of the huge strengths of the NHS as an organisation.  And myriads of the audience were nodding along – because they were the same. (We have got to fight for this to be perpetuated). Hospital Administrator was the next role. with Bollingbroke saying “the old don’t need to be in hospital”.  We still need to work on this. (I am convinced that the Buurtzorg model of home care must have some utility in our system?). A move into Mental Health sounded like it was one of his favourite jobs – (Mental Health Trust in South west London out of St Georges.) He is very people centred – 3 homicides in 12 months, one a member of staff, killed.  He knew when he was on TV being interviewed that what he was saying was for his staff, not the geenral listener, who had to come in that day and do the same job knowing what happened…a great dollop of emotional intelligence.  Nigel Crisp quote from his time here?  “No-one will bring everything to a job.  What you bring will be unique.  And so will everyone else”.

When he moved on to being Performance Director of the NHS, he didn’t realise he was crossing the line to becoming a Civil Servant. Off to Brighton. Which he loved.  Being in control of nothing and totally in charge!  It was 15 minutes from disaster when he arrived.  By the time he left, Duncan said he had improved that to 30 minutes.  I bet it was nearer to an hour…His PA, Ros visited him. After observing for a day she said. “You’re having a laugh.  It’s like you are on your hols.  You only do  three things.  You wave at people.  You say ‘good morning’.  And you send thank-you notes”.  “And what’s your point?”, he said.  Listen and learn, dear reader.

Public Health England?  As Roy said – covering everything from Porton Down to Pork Sausages.  He couldn’t tell us much about Porton Down – or he’d have to wipe us all out…so we didn’t ask any more questions.  I think my conclusion was I am glad thay are so professional and on our side. At one end we have Protection of Public Health.  At the sausage end, Improvement of Public Health.  I loved their Sugar App – it reads bar codes and tells you how many sugar lumps are in the product.  2 Million users – and kids love it. The app had caused angst – amongst food producers.  So they must be heading in the right direction.  We are talking evidence led campaigns here, from Sugar levy, to other aspects of childhood obesity, to plain packaging on fags, to air quality, to smoking itelf.  And social aspects of mental health – people have to have someone to care for, somewhere to live and to have a job.  The remit sounds almost too wide to me.  Luckily, he seems to have a fantastic and well loved and respected team. (Can you go and mentor some people in the Department, please Duncan?).

Naturally, there are occasions when the advice is considered by the great and good as being rather Nanny State.  “Who are you to tell me when I should die” someone asked.  “Not everyone has your choices, Professor”, was the sensibly controlled response.

He is driven by attempting to reduce the gap betwen longevity of the affluent and those living in degradation.  The same for survival rates with various cancers.  Laudable, and grand.  But it might all start with getting Home Economics back onto the school curriculum.  Central and to the fore.

It’s the first time I have been to one of the Health Chats and left thinking, not only do I think this man will really carry on making a difference, but also, I’d love to work with him and help.

A smiley journey home…

Lord Carter Health Chat – reflections

OK. I’ve been on holiday, and just catching up on Roy Lilley’s friendly chat with Lord Carter.  (You can watch the whole thing on the NHS Managers.net You Tube channel by clicking here )

Patrick Robert Carter, Baron Carter of Coles, otherwise flagged as “Lord carter of Bog Rolls” by Roy Lilley.  I think Roy may have swallowed too many pieces in Private Eye for his own good…but I do understand good procurement can save a lot of wasted cash, so why not simplify it to the bog-rolls metaphor?

It is bigger than that, of course.  The interim report and the final report (here) is about operational efficiency varaitions across English acute hospitals.  I’ve heard Roy say many many times that all we have to do is show people what good looks like, and they will do it and maybe do it better.  It was quite strange to not see Roy’s lips move (and any who know him realise this probably only happens when he is asleep…), but I heard almost exactly the same words falling from Patrick’s lips.

Here’s my favourite sentence from the Executive summary of The Carter report (as it will always be called.  “Operational productivity and performance in English NHS Acute hospital: Unwarranted variations.” – is more of a mouthful, but does provide a neat summary of it’s own, as a report title should!)

“We conclude that there is significant unwarranted variation across all of the main resource areas, and although we found many examples of good practice, no one hospital is good at everything. resource areas, and although we found many examples of good practice, no one hospital is good at everything.”

One of my constants beefs about the contagion that is report writing is that is what many will remain.  A report.  Not an action plan.  Not helpful.  Not going to change anything.  Why could and should this be any different?  There’s the same pressures in other health care systems.  As Lord Carter said in the report, the NHS ranks as the best value health care system in the world.  Guys – he is on the same side as you!

His work life seemed to revolve about being the go-to person when something is very broken. Wembley stadium anyone?  I suppose we should have noted the project may be late when the Australian workforce started betting on the due dates being missed!  But he got in there and helped sort it.  He was also on the bid team for the 2012 Olympics – and I’m guessing the IOC would welcome some help with Rio now.

Already some of his attitudinal philosophy was spilling out. “There are a lot of good policy decisions (plans to the writers mind) being made.  Execution is often boring and bad.  Attention to detail and keeping at it are key”.  “Keep the confidence of the politicians, and get the money right”.

I loved the simplification thinking.  “What does a good rota look like?”  This really isn’t leading edge and scary – it’s day to day and practical.  “Most people respond to data”.  Don’t you love that?  Other questions on what is the appropriate level of care, which varies by ward, by hour, by specialisation.  Not a blanket “6 patients per nurse”  or whatever.

Some randomly disjointed thoughts – but all allied to simple management:

  • Everything is about management
  • It’s how you run a business
  • We need to deal with local conditions
  • Just need hospitals to spend the money right
  • Acute hospital is the dominant partner in the system (and don’t forget that, please, I say!)
  • We need basic information that people we are talking with will respect
  • We need to pool and share data
  • NHSI (i.e. Not Monitor) need to be sitting down with Trusts and help them to switch to better buying

The NHS is a noble cause.  I just get the feeling that Lord Carter’s approach has identified the right bottoms to be kicked, as well as giving a super charge to the sharing and using of great methodologies and ideas.

Let’s just get the data, share what good looks like, and let them – the front line – get on with it.  Can it happen?  Yes.

One last statistic of the night.  The live feed trended on Twitter.  Roy has never managed that himself, so I suspect was deeply jealous!

(And one other place for sharing great ideas? – Lilley, Jon and the Blonde have a very fast growing forum: The Academy of Fab NHS Stuff. Go see)