Tizzie (Liz Trus) is at an international knees-up in the US, the UN, I think.
The first news; the much-awaited and probably vital, UK-US trade deal is unlikely to come to fruition in my lifetime.
Back home we are left to wonder, what’s next?
Tax cuts for the well-off. Bognor, to become a free-port and the economy will be sprayed with GrowMore.
We’re learning about Tizzie-nomics.
In the meantime, No21 (Thérèse Coffey) is trying to fix the NHS with, a mnemonic; A,B,C,D…
- ambulance handovers,
- backlog-waiting,
- care… which might mean better care, more care, home-care, care-care or heaven forfend, social care…
- doctors and dentists.
Let’s have a look.
Improve Ambulance handovers… yup, easy.
Use a management technique called ‘push-back’. You push the problem back, out of A&E, into a tent in the car park.
However, without more skilled A&E people, to look after the people on the trolleys, in the tent, in the car park, all you’ll do is get the marquee suppliers excited.
This is a ‘flow’ problem and the way to improve ‘flow’ is to figure out why you can’t push the flow in the direction you want.
Time for a root-cause analysis… you’ll find the system isn’t ‘flowing’, coz social care can’t do their thing and get people home, safely.
This takes us to Care. (I’ll return to B)
Tizzie inherited the BoJo pledge, to invest an extra £1bn in funding and promised…
‘… that no one needing care has to sell their home to pay for it’.
The money was to come from the increase in National Insurance, mostly to fund the £86k cost-cap. Now Tizzie’s tax-cuts means that’s not happening.
What happens now? Dunno…
Domiciliary care companies have cancelled contracts with nearly half of the UK’s councils because they’re not paid enough to break even and one in four home care providers is on the verge of bankruptcy.
Fuel prices and the cost of living; making a bad situation worse for domiciliary care.
Last July, more than 7,000 advertised care jobs offered less than the Real Living Wage of £9.50 an hour in the UK and £10.85 in London.
Tesco pay more and give staff discounts on groceries, insurance and homeware.
Back-track to B for, Backlog…
Last month, a report by the DH+ and the Office for National Statistics, said;
‘… an estimated 10m patients hadn’t come forward during the pandemic…
…if around half of these return for care, waiting lists may not begin going down until March 2024.‘
To up their game the NHS needs capacity. Forty new hosptials? Let’s not even go there.
Buying kit-n-stuff is the easy bit. We just don’t have enough people. Neither do most healthcare systems in Europe nor globally.
That leads us, finally, to Doctors and dentists.
Per-head, we have just slightly more doctors than the Ukraine and a few more dentists than Slovakia.
It takes ten years to grow a GP and about eight for a dentist.
Nearly 600 GPs have left since Christmas 2019, huge numbers are going part-time. Nine in 10 NHS dental practices are not accepting new adult patients.
If we are to deliver A,B,C,D… we are likely to need a bit of E,F,G and H.
Expectations… they need to be managed. People have to know where they are on a waiting list.
Transparent clinical priorities otherwise, first come first served. Regular communications, keep waiters as healthy as we can and in the loop.
Finance… NHS and care managers must know how much money and when. Certainty. Then, they can plan and target the money, to give us the biggest bangs.
Getting… more people, I know, I know… unlikely. We’re already skirting the wrong side of WHO recruitment guidelines by bringing-in nurses from Nepal.
Looking after the people we have is key. The NHS must become a really, capital G, for good employer. And…
Honesty… dump targets, we can’t do any of them.
By all means, try ambition but most of all, let’s be stripped-pine, honest about what the public can expect and allow NHS people to be honest about what they can and can’t, deliver.
There are no magic, management techniques, no targets, no amount of political perfidy that will reduce the numbers of people waiting neither, recruit a bigger workforce.
The solution, if it will be found in the alphabet, is the four P’s…
… people, planning, pounds and patience.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
