My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

Read my statement in full »

Hospitals – keeping them open, or changing them radically.

Filed Under (Hospitals, Localities) by Paul on 30-01-2013

The last few days have seen some very important disagreements about the extent to which NHS hospitals need to be changed. Last week’s Guardian was full of the call for change from Bruce Keogh, the National Commissioning Board’s Medical Director. He took the fight to politicians by saying that by defending local interests MPs risked consigning their local hospital to “perpetual mediocrity”. Read the rest of this entry »

Take a few steps back to understand what failing hospitals really mean for the NHS – and why we need to do something serious when they do.

Filed Under (Francis Report, Healthcare delivery, Hospital Trusts, Localities) by Paul on 28-01-2013

Last week I drew the analogy between the role of the administrator in the NHS and the fact that someone with the same name – administrator – winds up High Street retail chains like HMV. The point I was trying to make was that the announcement of an administrator for HMV was recognised as being the end of the line for the current organisation of a failed chain of stores. However when an administrator  was announced for South London Healthcare Trust it was seen as another opportunity to develop the trust with the minimal amount of change. Read the rest of this entry »

Investing in the patient’s capacity to improve self-care – some more examples of better value healthcare for NHS patients.

Filed Under (Investment, Patient involvement, Self Management) by Paul on 23-01-2013

Last week I highlighted some of the work that Macmillan Cancer Support services provide for NHS patients and how their investment in increasing patient capacity for self-management will save NHS resources and improve patient care. Read the rest of this entry »

Administrators, in the NHS and in the real world

Filed Under (Hospital Trusts) by Paul on 21-01-2013

Over the last few months I have been bemused at how the politics of the NHS have tried to grapple with the report of the administrator sent in to deal with the failure of South London Health Care. It seems to me that the Government have positioned the role of the administrator entirely incorrectly.

This was brought into sharp relief by last Tuesday’s announcement that an administrator had been sent into deal with the failure of HMV. Look at the press and media comment on the role of this administrator. Read the rest of this entry »

Some arguments about political continuities and the creation of Foundation Trusts

Filed Under (BBC, Foundation Trusts) by Paul on 17-01-2013

Some commentators have been kind enough to suggest that I played a role in developing the NHS reform policy that created Foundation Trusts.

Some commentators on this blog have made the same point – only in a very different way – suggesting that this reform was the start of a process that the Tories have continued with their current reforms, and that all of this is bad for the NHS. Read the rest of this entry »

Opening up different ways of responding to the Francis Report

Filed Under (Alan Milburn, Francis Report, Regulation) by Paul on 16-01-2013

Both the Government and the NHS are gearing up to respond to the Francis Report on Mid-Staffs that will be published in the next few weeks. I am aware that some Trust Boards have already set aside dates to think through the report and their response to it. Given the importance of the way in which culture works in NHS organisations, it will be vital that they develop ways to reassure the public that they have a culture of care and safety. Culture – “the way we do things around here” – sets the parameters for the way in which staff and patients operate. Board leaders thinking through how they help set the tone for their staff is a crucial part of the response. Read the rest of this entry »

Some more examples of services aimed at improving NHS patient capacity to self-manage.

Filed Under (Patient involvement, Self Management) by Paul on 14-01-2013

Quite a lot of my day-to-day work with the NHS now centres on the ways in which NHS services need to be reconstructed to increase the capacity of patients to add much more value to their own health care. Last week I argued that the primary provider of most NHS healthcare was not the GP nor the GP practice nurse, nor even the community pharmacist, but was rather the patient and their family carer – who primarily cared for themselves. Read the rest of this entry »

A manifesto ‘to’ primary care or a manifesto ‘for’ primary care. Small change but a whole world of difference..

Filed Under (Healthcare delivery, Patient involvement, Reform of the NHS) by Paul on 10-01-2013

Today I am taking part in an interesting conference organised by the NHS Alliance about the future of primary care. They have asked me to develop challenges to an important set of chapters that clinicians and others are writing about the future of primary care.

Let me share some of the challenges that I will be making. Read the rest of this entry »

Is the ‘family and friends’ question really too hard for patients?

Filed Under (Health Policy, Public Health) by Paul on 09-01-2013

Reading some of the press reports on Monday, following the Prime Minister’s announcement of the extension of the ‘families and friends’ question to more organisations serving NHS patients, felt like an old and welcome friend from some years ago had returned. It made me wonder whether, after more than two and a half years of complete mayhem, the Government may be starting to find its touch with the politics of NHS reform. Read the rest of this entry »

The development of integrated services for patients may be being adversely affected by the passion that many feel for the forces that fragment NHS care.

Filed Under (Health Improvement, Integration) by Paul on 07-01-2013

2012 was the year when every part of the NHS that came under the powers of the new Health and Social Care Act had the duty to integrate services added to their statutory powers. In addition to the deluge of instructions to integrate, November’s mandate from the Secretary of State to the National Commissioning Board made it clear that he wanted the public’s money spent on the development of integrated services for NHS patients. Read the rest of this entry »