Ok, it’s Monday.
Shall I start the week… whistling a happy tune?
How d’ya feel? Did the alarm wake you, or the kids, or the dog?
Did you spring out of your kipper or did you drag your sorry backside into the shower… each leaden step an effort of will.
How about a motivational saying?
‘This is the first day of the rest of your life’.
Groan…. how about;
‘Someday isn’t a day of the week but Monday is… so get a grip.’
Me? I’m starting out gripped by paradox.
If you look at NHSE’s latest board papers, you’d come to the conclusion, there isn’t much to worry about.
A sort of; ‘nothing to see here… move along’… story. But…
… talk to the people at the sharp-end and they’ll tell you all about being knackered, unsustainable effort, patients backing-up in the system and don’t mention the word ‘winter’.
On the other hand, NHSE tell us;
• Ambulance services … faced an ‘extremely busy’ month but response times ‘improved’.
• Industrial action in the NHS has had a ‘significant’ impact on patients… almost 400,000 appointments rescheduled during June, July and August.
Who writes this stuff?
Who was it thought it was OK to use the phrase… ‘extreme busy’ when we know it is cripplingly, overwhelmingly, sweating, knackering, exhausting… busy.
Only a person who’d never been anywhere near an ambulance.
Who dares to describe the impact of the strikes on patients as ‘significant’ when we know the impact, in many cases, is life changing, disastrous, disruptive at the very least and probably, when the numbers catch-up… we will discover… is killing people.
NHSE says;
Good progress… made in activity levels in general practice. In July… 27.8m GP appointments… 43.6% … on the same day.
I know GP land is busting-a-gut but 43%… under half. Really?
The average ambulance response time for a category-two call was 31 minutes and 30 seconds…
… that includes heart attack, stroke, sepsis or major burns… half an hour?
In August, the average number of patients… in a hospital bed for 14 or more days, decreased by over 13% since January…
… where’ve they gone?
Social care is in crisis and getting a care plan is as rare as finding a copy of The Gutenberg Bible.
Don’t get me wrong… I’m the first in the queue as cheer-leader for the NHS and the people doing the job but I find the calm serenity of NHSE’s board reports… well, unnerving.
NHSE board-paper scribes seem to inhabit a world of glossy TV ad’s for building societies, package holidays and furniture showrooms…
… whilst the real world struggles with credit cards, a weekend in Rhyl and sofas as plump as seat on an East Berlin bus.
If the reports were written by anyone other than NHSE, they’d have to be an estate agent.
You know;
• ‘requires modernisation’. .. code for ‘a slum’.
• Compact… shoe box.
• Rustic… outside toilet.
• Good access to transport… in the flight path.
NHSE;
• Working hard… ‘going home ready to drop’.
• Keeping up… ‘running behind’.
• More people than ever… ‘overwhelmed’.
• Making progress… better than it was… ‘but it was &^**!$ awful’.
• Virtual care… ‘dumping people with an iPad’.
Curiously, the BRCA programme, report (Para 52, genes testing), looking at the numbers…
… seems to me like it’s managed to lose track of more saliva-packs that it’s had results?
Howerver, the real push-shove and heave-ho that’s actually going on, is made very clear in the finance report (Table 1).
To cut a complex story short… we’re about a billion quid adrift. NHSE is reported to be ‘in talks with the Treasury’… code for ‘street-fight’.
Interest on HMT’s borrowing costs has gone up. The war in Ukraine is still messing with commodity and energy costs. A middle-east conflagration will inflate fuel-cost. Right now, UK debt to GDP ratio is 100.5%.
NHS running costs are up, salary costs… up. Strikes make everything screwed-up.
The likelihood of the DH settling the strikes is between no chance and nothing and an injection of operating cash… slim.
With winter on it’s way… prepare for the mother-of-all-months.
Whoever writes NHSE’s Board papers is going to need a much bigger lexicon of euphemisms or…
… sub-contract the whole thing to an estate agent.
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.
