What do the results of the local elections tell us?
• There won’t be a general election any time soon?
• Labour winning the next General, is not a slam-dunk?
• Governments in trouble always hang-on for as long as they can.
Charmer will need a swing bigger than Blair, to form the next government and…
… he’s put his foot in it; during a radio interview he dodged calling for a cease fire in Gaza. The psephologists point out, that pulled the plug on a huge number of muslim votes.
Many a slip, twixt cup and lip… as yer granny would tell you.
The majority of the public are well-fed-up with politicians. There is no great flocking to Labour because of the quality of their plans, policies or charisma.
It’s more, fleeing from a knackered Tory party… as the electoral gains by the minor parties will tell you.
What do the technocrats tell us?
All of them, list the economy and NHS waiting, top of the nation’s concerns.
Local government and their elections have no purview over either. Indeed, they are victims of both. Economic performance is a principle indicator for their funding or lack of it and social care, or the lack of it, is a huge contributor to the woes of the NHS.
The up-shot, these election results may not tell us as much as we think.
Labour have no cohesive answer to fix waiting lists, other than; stopping a tax-dodge that will take a full-cycle of the economy to have any impact, in the hope the proceeds will fund overtime for NHS staff to ‘do more’.
That is not a plan, it’s a colander…
The Tories?
They don’t need a plan. All the time junior doctors keep striking, Sunak has the perfect excuse for not bringing down the lists. No one has no plan to end the strikes… and the JDs won’t talk unless there’s 35% on the table.
Mark my words; the temptation will be for a numpty to claim an NHS reorganisation will solve the problems.
Always a bad idea.
Most reorganisations fail the WIIFM test. What’s in it for me?
Transfer care from secondary to primary care. What’s in it for the Trusts… nothing. So, they’ll make sure it won’t work. The other way around… same answer.
Then there’s the ‘morale-thing’ and the ‘distraction-thing’. In a system as complex as the NHS generic solutions never work.
The issue for the NHS is capacity, and reorganisation doesn’t create capacity. Only cash and time can do that.
But, bet the farm, following political change comes the inevitable reorganisation.
Politicians oblivious to history, repeat it. Changing how the NHS is organised makes no difference to what happens in the surgery or clinic or operating theatre.
What makes a difference is more surgeries, operating theatres and more clinics.
We know reducing waiting is the number one demand from the public…
… which needs time, focus and total-list-management;
• Relentless revalidation; symptoms resolved, care elsewhere? Find out.
• Investigate every ‘did not attend’. Of 124.5 million outpatient appointments last year, eight million were no-shows. DNAs are more common among those with high deprivation scores. Think travel costs. Messaging patients 14 days before an appointment and a follow-up four days before, really works.
• Separate out diagnostic from treatment, create two lists. Then break them down into type. Publish the lot and celebrate successes, however small.
• Focus on the total patient pathway. Bottlenecks? Patient transport, test turn-around times, internal comm’s. Look at door-to-clinic-and-home-again, through the eyes of a patient.
• Plot the volume of referrals by the types of patient and look for daily, weekly and monthly patterns. Understand the resources required by one type of patient for their pathway (creating a process template) and measure this in consistent units of time… pool similar work and share staff resources.
• Avoid queue jumping, work in time-order. This reduces the overall waiting time.
• Look at the difference in waiting times; between the decision to admit and the date for treatment. Use this to discuss practice and process.
• Avoid patients having to come to hospital on different days for different tests
• Ask how can I make your job easier.
Every minute of every delay adds up to hours and days.
How do I know all this. No, it’s not me. I just read a very smart little booklet, written by some very smart people.
It’s called Seven Ways to No Delays. It is ten years old and is still as valid as the day it was written and as fresh as the milkman’s red top.
No reorganisation required just, the time and space to relentlessly focus on the detail.
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.
