On Monday no one knew when or even whether, the NHS recovery plan was going to see the light of day.
An insider told me their dog had eaten it.
The Treasury was alleged to have shredded it; ‘not value for money’.
BoJo said he wanted tougher targets.
ITV said there was warfare between No10 and No11. Rishi wasn’t going to give BoJo the cash… there’s a leadership election in the offing.
It wasn’t ready, not tuff-enuff, wasn’t value for money, didn’t exist. Guess what…
… by Tuesday… it was published.
If this looks like a disorganised government, it’s because it is.
If this looks like a government that isn’t really on the ball, it’s because it’s not.
If this looks like a government that is putting its internal turmoil first and taking us for fools, it’s because it is.
It’s a good job the NHS is well organised, is on the ball and is run by some very sensible, well-grounded people who understand being on a waiting list is not about becoming collateral damage in a power struggle.
The plan… here it is. When I read it I thought it was pretty much as predicted. I think it is doable but it’s not without challenge. See what you think.
Here’s the top line;
- End one year waits by March 2025.
- End two year waits by July 2022.
- April 2023 no patient will wait over 18 months
- Reduce diagnostic waiting times, with the aim of least 95% of patients receiving tests within 6 weeks by March 2025.
- Deliver the cancer faster-diagnosis-standard, with at least 75% of urgent cancer referrals receiving a diagnosis within 28 days by March 2024.
- Return the 62 day backlog to pre-pandemic levels by March 2023.
There are no targets. There are ‘targeted actions’ but no targets… just ambitions. It’s a style thing…
In the old days we used to say targets had to be, SMART;
- Specific
- Measurable
- Achievable
- Realistic
- Timely
In the new age of ‘ambitions’, they need to be;
- Sensible
- Motivating
- Agreed
- Reasonable
- Tick the right boxes
This plan is sensible and even though it will need 30% more elective activity in two years time.
It is attainable because it is agreed by the people delivering it and that makes it reasonable to assume everyone is signed-up and will step up.
So, it ticks the right boxes… it plots a way out of the cul-de-sac the NHS has found itself in.
So, all good? You can read it and you can be the judge… but… if there was a tiny thing… a little thing… it’s this…
The plan needs a fair wind and for everything to go right, including some interim measures to put a sticking plaster over the workforce problem. Expect a workforce plan, is what I’m told.
Setting that aside, the plan is finely balanced. Delicately poised… on an assumption.
It’s the Rumsfeld dilemma. The known unknowns.
The plan makes a guess that 10m people have not come forward for diagnosis and treatment because of Covid. Is that the right number?
Right or wrong it underpins all the projections. It is the fulcrum-point assumption; half of the missing demand from the pandemic will return over the next three years.
The further assumption, the other half will have resolved, learned to ‘live with it’, paid for private treatment, or died.
It is an assumption. Fair enough but it could also mean the ten million figure is an overestimate and only 20% will come forward. Or, there might be more.
Who knows?
Right or wrong, the NHS will still need the hubs, the pop-up diagnostics, the digital fixes, the workforce, innovation and the money.
The timelines are long. There will still be a lot of waiting for a lot of people.
Long enough for patients to become impatient, MP’s to worry about elections and the press to find a horror story for the front pages.
Now is the time for the local Comm’s Teams to weave their magic with the local and regional press. Non-Exec’s to work the external boundaries with local clubs and associations.
The rest of us? Be like Syd Bishop, the original demolition man. His motto; stand back and ‘watch it come down’.
It’s time for the NHS to get into the demolition business. Demolishing the waiting lists; stand back and watch ‘em come down.
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.
