Runs

It seems to me, it is increasingly unlikely Wes Streeting will be Health Secretary come the election.

Labour was elected to cut NHS waiting lists. In 2024, NHS staff delivered a record 18 million treatments…

… but it’s not enough. As far as I can see… 

On average just over 1.5 million people join NHS waiting lists every month.  

And…

… give or take 1.48 million patients start their treatments every month. 

It’s pretty much, one in and one out.

Streeting’s mission is clear; generate headroom, space, clarity, focus, funding, workforce and the ways and means to reverse these numbers. 

He’s not doing that.

The NHS has stalled.

An aircraft doesn’t fall from the sky because it stops flying…

… it stalls, before it stops flying, because it loses lift… often while it’s still under power. 

The engines roar, the controls move, the dials rotate but if it’s not flying at the right angle… the plane will begin to sink. 

It’s the same with organisations.

They can be full of noise, activity, even energy but if they lose their sense of direction, they sink.

Lose their alignment with a purpose, they begin to stall. Momentum fades, decisions become erratic and panic takes over.  

In a plane, no matter how hard the pilot pulls back on the stick… and in an organisation no matter how hard leaders double down, and push for results, mistaking effort for effectiveness…

… the plane will crash and the organisation will come to a sticky end.

Recovering a plane from a stall doesn’t come from more thrust. It comes from regaining the right angle of attack. 

Recovering an organisation from a stall comes from realigning with its purpose and trusting in the fundamentals that once gave it lift. 

Until then, the organisation might look like it’s flying, may even feel like it is but the reality… it’s sinking slowly through the clouds, unaware it’s already begun to fall.

It’s not uncommon.

Strategic drift, where day-to-day operations slowly get overshadowed by the to-do-list, becomes rudderless in the face of mounting complexity…

… which gives way to…

Mission Amnesia, where caught in the churn of managing an agenda that is far too big, the original purpose gets forgotten. Buried under the rubble of the day-to-day.

The fog of the day job, clarity gives way to confusion. The organisation stumbles on, busy but directionless.

• Without the consent of Parliament, or a moment of consultation, NHSE is closing,
• DH+ are making people redundant. 
• ICBs are withering on the vine. 
• People are seeing their careers crashed, ambition thwarted. 
• Redundancy drags on,
• good people are jumping ship.  
• The new NHSE board are yet to meet,
• let alone recruit their compliment of NEDs…

… who in their right mind would take-on the job. The mortician.   

The institution is busy… busy dying

Over time it is not uncommon for organisations and governments to lose their way. It seldom happens with a a bang. It’s usually a quiet, creeping mist that settles over the day-to-day.

What starts as a clear mission gradually dissolves into a blur of meetings, metrics, and maintenance. 

Saving 50% of running costs and keeping over 200 NHSE live systems working, is not possible. It will consume a disproportionate amount of fruitless energy.

ICBs and Trusts once full of ambition, will descend into chaos. Not through incompetence, but by being consumed by the machinery of their day today and at the same time reengineering their own existence. 

Slowly they will forget their purpose. Deliver cuts and savings instead of continuity and security.  

Institutions rarely collapse in a moment. They unravel, quietly, lost in a haar of their own making. 

The mission dies the death of slow suffocation.

Streeting has…

… created confusion, slashed budgets and at the same time demolished careers and built uncertainty. 

Yes, there is plenty of activity. Our great leader announces this-n-that. The promise of new treatments, initiatives and gizmos, yet be sure; the NHS is stalling, the trajectory is wrong. There is no lift beneath its wings.

Promises and pictures on the telly have become a substitute for progress. 

People are waiting… too many of them…

… with little hope of seeing the end of the queue…

… there are just over 50 months before the latest a UK election can take place… do the maths… time is running out to get waiting down.

Streeting has confused the mission, banjaxed everyone’s thinking and deviated from the true north… the principal task, waiting lists, crowded out.

Charmer will have to find someone to explain the failure, unpick the confusion and help the NHS to take-off, again.

Announcements and noise, are not a proxy for direction. The DH+ drifts… breathless and blinded by pointless political ambition.

The NHS is a machine that hums but no longer knows why it runs.

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.