Patients, hospital, hallway, NHS.

Grown ups

Back in 2006; the Securitas robbery…

… around £53 million was stolen from their depot in Kent. The largest cash robbery in British crime history.

Rumour had it, it was Sir Nigel Crisp, head honcho at the NHS, who was under the cosh from the Treasury, to, somehow get the service back into financial balance… otherwise it looked like Crisp was toast.

He called for drastic action, ‘by noon on Monday February 27th’, to stop the health service chalking up an unacceptably large deficit when the financial year ended at the end of March.

Five of the robbers got long sentences. It wasn’t Crisp… he got a life peerage!

The DH were very coy about the extent of the overspend. In the previous December the service was heading for a net deficit of £623m.

There was a whole lot of palavering about.

Duncan Selby, who was the director of ‘programmes and performance’, called on trusts expecting a financial balance, to achieve a surplus…

… to help make good the deficits in other parts of the service. He called for ‘a forensic, immediate grip on avoiding all discretionary spend by everyone’.

Local NHS finance directors responded by cancelling orders for goods and services unless ‘critical for patient care’.

Directors were asked to use both sides of board-room lavatory paper.

The system was overheating because trusts were looking after more people than they were paid for. In the real world it’s called over-trading.

It’s the same-old-same-old this year.

This time, someone called Emily Lawson;

• ex-McKinsey,
• ex-Morrisons Grocery shops,
• ex-Kingfisher (Woolies and Screw-Fix),
• ex-NHSE vaccines,
• ex-BoJo’s Delivery unit (!) and…

…now back at NHSE as COO, getting heavy with Trusts.

The HSJ are reporting;

‘CEOs and COOs have been sent a form to sign, committing to deliver the A&E target for the final month of the financial year, and to not close any beds.

It also requests the direct phone number and email of the senior responsible officer.’

If that isn’t management by intimidation, tell me what is…. particularly as NHSE has no direct control over Trust’s managers.

… together with an ear bashing from Ms Lawson, who I doubt would know her A%E from her elbow.

Once the form has been signed and in the event of failure, then what? Dunno…

… I think if I were a trust boss, I’d be inclined to tell NHSE to stick their form where the sun-don’t shine.

Back to the HSJ;

‘Just 13 acute trusts met the target for January… average performance was 70%, with more than 20 trusts reporting less than 60%.’

No one seems interested in ‘why’? Operational management is so much more difficult that oppression.

It’s claimed Lawson said; delivery [of the 76% target] could impact on how the NHS is funded, and on the levels of ‘confidence’ in the service, including from staff and patients.

This is a blatant threat and total, utter unadulterated, 24crt gold $%£@…

… from someone who is obviously being intimidated by the Treasury, enthral to politicians, strong-arming the Trusts…

… the consequence of which is very likely to result in Boards browbeating senior management, who will…

… get heavy with their middle-management…

… who will put the boot into the front line…

… and then everyone will wonder why we have trouble with bullying and whistleblowing in the NHS. Why people end up thinking the NHS is a rotten place to work.

All because fish rots from the head.

It looks to me; Lawson has no idea what it is to run a hospital and no idea how to get the best out of people doing a job she is unqualified to even apply for.

If this is some sort of a performance hiatus… it’s certainly not a crisis. Except for Lawson’s career.

At a time like this, what people want is authentic leaders and more than they want anything else… they don’t want strangers sending them threatening letters.

At times like this they want ambassadors of hope. Inspiring people.

People who have the confidence to say; folks, we have a problem.

We want honest people.

People who have the confidence to say; there is an election coming, maybe earlier than we think. The pressure’s on to get the NHS looking in better shape and waiting in A&E is a very visible indicator. What can we do to up our game?

Trust bosses know they work in the flotsam of politics. That’s the way it is.

It is also the way to get them working for the biggest motivator of all… being part of success.

Not management by bonkers-billet-doux.

When will we see NHSE employ grown-ups?

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