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Health Service Journal
Blogs

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  • NHS news blog: Government names swine flu 'tsar'

    BBC: Government names swine flu ‘tsar’

  • Why the public sector shouldn't use head hunters

    Recruitment consultants will identify the right person for the post but this is not necessarily the best person, which is why the publci sector should not use them.

  • Your 18 week waits: November 2012 data

    The local picture on 18 week and one-year waiting times, for every English provider and commissioner, updated with the latest (November 2012) data.

  • 18-week performance slips in England

    18-weeks performance slipped back slightly in England, on the latest (June) figures. Probably just a blip.

  • 18-week waits still improving

    18-week waits continued to improve, but large reductions in long-waiters were offset by some relaxation in services that are already achieving the target.

  • '18-weeks' penalties change again: this time it's good

    At last: instead of punishing hospitals for treating their long-waiters, the latest NHS Contract prevents long-wait backlogs from building up in the first place.

  • 5 per cent increase?!?

    Where did Darling get his 5 per cent figure from?

  • 50 Shades of management

    What is a management restructuring but a way of gently but firmly forcing you to adopt a new position, testing your flexibility and willingness to please?

  • A commercial catch 22

    Behind every good business deal is a catch.

  • A death in a hostel

    A personal account of managing a home for “difficult” elderly male patients.

  • A decade of austerity should spur on fundamental care reform

    CCGs have the opportunity to reform patterns of service provision and ways of working.A decade of austerity could spur on some long overdue changes to our health and care system..

  • A guide to the NHS Commissioning Board’s Everyone Counts

    A review by the King’s Fund policy director Anna Dixon of the planning guidance for CCGs the board released in December.

  • A mandate for bad waiting list management

    The draft NHS Mandate will drive up waiting times, undermine the NHS Constitution, and be unfair to patients. Not what was intended, obviously.

  • 'A mysterious outbreak led to three nurses becoming infected'

    On 27 August 1977, the BMJ published an editorial on an outbreak of a severe haemorrhagic infectious disease.

  • A new look for NHS leaders in 2013

    Will the appearance of NHS managers follow trends from the Middle East in the coming year?

  • A picture is worth 1,000 hours of consultation

    End Game is fully supportive of the creative arts, and loves it when complex health policy is expressed in simple, visually appealing forms.So in theory we full approve of the whimsical cartoons that the Healthier Together reconfiguration programme’s Twitter account uses for its background.The programme is reviewing hospital services across Bedfordshire, Luton, Northamptonshire, and Milton Keynes.There’s a pair of handshaking hands, and a jolly looking chap with a magnify

  • A pinch of QIPP

    Having a strategy isn’t that helpful if people then forget to communicate the strategy. Nor will adding the word QIPP to everything we do ensure we deliver. We are at risk of ticking the box but missing the point.

  • 'A raft of scandals surfaced in hospitals for the elderly'

    On 24 November 1965 Lord Strabogli wrote to The Times. Public concern about the treatment of the elderly in hospitals had been growing, though apparently the government saw no problems.

  • A right royal day to bury bad news

    Of all days, the biggest royal wedding for 30 years must have seemed a ripe moment during which to sweep bad news under the carpet.

  • A rising management star crashes and burns

    Are managers being given too much credit for success and too much blame for failure?

  • A royal pain in the bahooka!

    I was going to write something witty and Christmassy in this blog but due to a temporary loss of wit on Monday this hasn’t been possible

  • A Shakespearian story at the top of the NHS

    Sir David Nicholson will no doubt be wondering who his friends are and who he can trust as the press clamours for his resignation.

  • A shocking indictment of corporate management culture

    A documentary on Gatwick Airport produced an eyebrow-raising insight into private secotor management culture.

  • A short course in leadership

    What is leadership all about, and how can you learn to be a better leader. Do you need to go on a course, read a book, or what?

  • 'A shortage of doctors was producing “a pretty ghastly awful picture”'

    It has always been wise to avoid involvement in medical manpower planning.

  • A week in the life of Harvard Business School

    What top teaching tips can we learn from Harvard Business School and what exactly do we mean by value in health care anyway?

  • A&E needs a sticking plaster as well as an overhaul

    A&E services a struggling to keep up with growing demand. Chris Hopson offers some possible solutions

  • Absurdism and the CSU project

    End Game will not hear it said that the new NHS commissioning system is exactly the same as the old one, except with less money and a few doctors getting in the way for the first year or so.Commissioning support units, for example, are nothing like anything that existed in the earlier age of primary care trusts and strategic health authorities.Ample evidence of this is provided by NHS South CSU, whose new website features an exciting use of absurdist principles on its “meet the

  • Abuse and negelect: what 2011 will be remembered for

    The year started badly with ombudsman Ann Abraham’s damning report into elderly person’s care; then the Winterbourne View abuse case made things a lot worse. 2011 never really recovered as the image of neglect in the NHS sharpened. Will 2012 be any better?

  • Accountable care organisations: revolution or business as usual?

    The Supreme Court ruling on the Affordable Care Act in the US could have wide ranging implications for the future of healthcare. Or could it?

  • Achieving high quality care at manageable costs: a lesson for GP consortia

    Lessons from the States are often relegated to the ‘too different to be useful’ box, but on closer inspection there are many similarities between American medical groups and the proposed GP consortia – as Paul Zollinger-Read learned on a recent visit to Boston.

  • Achieving 'one buttock' performance ..

    A conductor is a good example of leadership but I am not so sure it is as covert as some might think

  • Acquisitions are not just a business process

    Acquisitions won’t work unless attention is paid to issues other than just the business process of one organisation acquiring another.

  • 'Adams was convicted for prescription fraud'

    John Bodkin Adams was responsible for a new concept in medical management - “doing a Bodkin”.

  • After the transition, the anticlimax

    The transition is complete – primary care trusts and strategic health authorities are dead, making way for a clinically led insurgency that will sweep through the NHS like a wildfire of transparency, patient-centredness and integrated working.So get ready! Or, if you live in Wigan, don’t.The town’s new commissioning group tweeted this week: “It’s the second day of the new NHS and it’s already business as

  • 'Alcohol misuse is the most daunting of public health challenges'

    The cost of alcohol misuse is some £23bn, more than £3bn of which is borne by the NHS.

  • 'Ambrose made history by carrying out the first computed tomography scan'

    On 1 October 1971 Jamie Ambrose, a consultant radiologist at Atkinson Morley’s Hospital in Wimbledon, made medical history by carrying out the first computed tomography scan on a live patient, revealing a detailed image of a brain tumour. 

  • An NHS love story

    In which the NHS is the woman, a man with the trousers on his head is the private sector and government policy is the magic spell designed to open up the NHS.

  • And there goes £2.3bn....

    The Department of Health has been asked to contribute £2.3bn to the Treasury’s £5bn of public spending cuts in 2010-11.

  • Another record-breaking performance on 18 weeks

    All three 18-week targets were met again, with massive reductions in patients still waiting 18 weeks after referral.

  • Any sudden death

    Public sector agencies are being encouraged to work closer together.

  • Apple of the eye? Why leaders should never be seen as indispensible

    The announcement last month that Steve Jobs was stepping down as chief executive of Apple prompted discussion about whether it is good for a company to be so identified with one individual.

  • Arbinger Institute's Self Deception

    What if you had a problem, but you didn't know that you had a problem? Do you see people as people or as objects? Are you carrying around boxes that prevent you making the right choices in what you do?

  • Are leaders a product of their environment, or is it the other way round?

    The People Manager compares a recent report on NHS Top Leaders being “over confident” with an interview given by a chief executive this week.

  • Are managers too busy to manage?

    NHS managers are too busy to address staff health at work, according to this headline in HSJ. The report on the launch of the Healthcare Management unit code of conduct provided the opportunity for Dame Carol Black to express her disappointment and frustration at the lack of buy by the NHS. Of the 370 organisations signed up to date only eight are from the NHS. Dame C

  • Are online patients empowered patients?

    Liberating health data can stimulate innovation and get patients involved in their own health, according to one speaker at a US event. Pamela Garside blogs about whether this approach could take off in the UK as well.

  • Are there any leaders who don't do U-turns?

    Leaders clearly need a steady hand to take the wheel - but that doesn’t mean the road is always a straight one.

  • Are we expecting too much of the CQC?

    It has been open season on the Care Quality Commission for some time now.

  • Are we ready for the million-pound GP?

    While debate rages over whether GPs might double their salaries as a result of GP commissioning, a new type of service provider taking on a risk-sharing contract could see those in charge stand to make much, much more, writes Nick Goodwin.

  • Are we wasting money on care that patients don’t want?

    Getting patients invovled in the choosing of their services could produce big efficiencies and help the NHS provide services patients really need.

  • 'Arthroplasty of the hip transformed the treatment of hip osteoarthritis'

    On 27th May 1961 the Lancet published an article by John Charnley on Arthroplasty of the hip - a new operation.

  • 'Asking people to lead is one thing, actually leading is another'

    In the last few years, rather than address what are clearly structural failings, the NHS has had money ploughed into it.   I suspect the true level of the funding gap has been under egged and £15 – 20 billion is possibly a conservative estimate. 

  • Back in the saddle

    Far be it from me to tell Babs and Cynth how to run their new gaff, but if there’s one baby they don’t want to throw out with the HCC/CSCI merger bathwater it’s that CSCI website.

  • Be honest

    Every one of us can name at least one individual who is not performing or where we are not getting value for money. I don’t mean just administrators and managers, I mean all staff. I bet we could all name at least one individual. Be honest.

  • Bed pans and dangerous dogs

    Loose talk on FT and SoS freedoms

  • Being Bold

    In the current economic climate, cutting training budgets is an easy way to make savings, but is it really false economy?

  • Being free at the point of need is one of the NHS's greatest strengths

    Comparing the NHS to the US health system, and making a plea to retain the best of what the NHS offers at a time when “all change” may be seen as the holy grail

  • Better to seek forgiveness than ask permission

    Have you a management philosophy? Mine is if its not explicitly against the rules then I can probably get away with it.As a senior manager I told a large gathering of managers that they should not be asking HR or finance for permission to do what they wanted to do they should ask for advice and then accept or reject it. This caused a bit of a stir around the room especially as the HR and finance directors were sitting next to me on the conference platform!Just to ram home the po

  • 'Beyond samosas and reggae' - or, developing services with equal opportunities

    A short note recognising the equality campaigning by Nasa Begum.

  • Big Apple with the Big Heart

    How US healthcare isn't all Wall Street ...

  • Big Brother is Monitoring you

    Now that the NHS has been wrested from the cold dark hands of Whitehall civil servants (allegedly) the Department of Health’s surveillance function appears to have turned its evil eye to social media to keep track of what is going on out there.A few startled members of the NHS Twitteratti last week including HSJ’s very own Alastair McLellan and Shaun Lintern found themselves followed by a new and mysterious Twitter account called @DHMonitoring. Its description informs users its siniste

  • Bill announcement sparks web comments frenzy

    It isn’t every month that Health Service Journal gets to cover a newly announced Health and Social Care Bill.

  • Boards, micromanagement and failure

    ‘I think people who fail, fail because they’re not involved enough’. So said Sir Martin Sorrel of communications group WPP last month when discussing micromanagement. It’s an interesting dichotomy isn’t it?

  • Born on the 25th of July

    The world’s first “test tube baby”, Louise Brown, was born shortly before midnight in Oldham and District General Hospital on 25 July 1978.

  • 'Bourne agreed to perform an abortion and was prosecuted'

    On 27 October 1967 a private member’s bill, introduced by David Steel but backed by the government, was, after a heated debate and a free vote, passed. When the act came into effect, it made abortion legal in Great Britain.

  • BP, the NHS and Failure

    The NHS could learn from BP’s decision to establish a new safety division with sweeping powers to oversee and audit the company’s operations.

  • Bridging the financial gap

    The challenge of reducing spend continues and managers are looking ever more creatively at how to reduce the bottom line. I think I may have found a solution!

  • Britnellmania

    It’s Mark I’m talking about. Our Mark. Our Mark who has crossed to the dark side and is with us no more.

  • Brown bags Blue Hills as Coakley chokes

    The US’s flirtation with liberalism lasted precisely one year, the time it took to go from staring doe-eyed at the newly inaugurated Barack Obama to sucking the face off model republican Scott Brown.

  • Bullfighter takes on the NHS

    Who speaks more bull, commissioners or trusts?

  • Bunga-blunder

    Twitter has provided a little nugget of proof that the old order of strategic health authorities – among other things – is now disintegrating in real time before our eyes.Tweeting from a Reform event on “healthy innovation”, Robert Harris said he had asked the chief executive of private provider and Hinchingbrooke franchisee Circle, “why does everyone hate you” given the firm’s claims on improving outcomes.“Wouldn’t answer”, reported

  • Burnham's views on centralism

    National newspaper articles citing health secretary Andy Burnham and Monitor executive chair Bill Moyes raise intriguing questions about the government’sattitude to foundation trusts.

  • Businesspeople with medical degrees

    One of the biggest ongoing changes in the transformation of the NHS is the role of the GP.

  • C is for Culture - not Control

    The new Secretary of State for Health, Jeremy Hunt, should follow his decentralising instincts.

  • Cameron steals New Labour's clothes

    The Tories unveil their health manifesto

  • Can local authorities step up as good providers of care?

    Change must come as the public sector’s dominance and budget cuts in local authorities mean there is no way for the majority of the population to get, or afford, quality care.

  • Can social marketing campaigns lead a local public health revolution?

    With the government’s reforms aiming to put decision making power into the local community, the onus is on social marketing campaigns to drive a proper, positive shift in public health attitudes.

  • Can we still afford equality for women?

    The CBI wants all companies to disclose their targets for promoting women and then report on their progress.

  • Candy coated cartels, fear and loathing - is there a better way forward?

    How might policymakers, regulators and healthcare leaders work constructively to produce an informed and proportionate competition regime applied to the NHS?

  • Career coaching

    Why are we so backward in coming forward? Writing a list of our achievements doesn't come easily to most people - and now is the time to learn.

  • Castles in the air

    On 20 October 1975, in the middle of an economic crisis, a white paper, Better Services for the Mentally Ill, was published by Barbara Castle.

  • Challenge the myth of integrated care

    Integrated care is not immune from the problems that affect the existing health and social care system.

  • Challenging Mediocrity

    How do we know what makes a good leader? If we are to make a difference, then we have to be more than “good enough”.

  • Change agents for quality and productivity

    If we look globally at those healthcare systems that deliver outstanding performance in cost and quality, a common characteristic is a systematic approach to capability building for improvement. How do we build this in the NHS?

  • Change management, and changing definitions

    What does being a manager mean nowadays?

  • Change tracking with Andy Burnham

    A slip up at the Department of Health reminds us of the Microsoft Word “track changes” function - and reveals a last-minute omission from the health secretary’s swine flu speech.

  • Change, altruism and emotions

    There is always an expectation of government at times of change that altruism will prevail and managers will wait until the end of the change before determining their own future. This is naive.

  • Changing behaviour needs more than a 'nudge'

    Politicians and leadership like “nudge theory” - the idea that a “nudge” in the right direction can inspire behaviour change at a large level. But does it work?

  • Charismatic leadership isn't all it's cracked up to be

    He delivers great speeches. He paints a great vision. He motivates. But now he’s in power he’s said to be cautious, allowing others to take control of big discussions and struggling to enforce the difficult decisions he faces.

  • Charm might not be on the job description, but you won't get far without it

    An unspoken requirement for an increasingly familiar style of management in the public sector is being able to relate to and charm the colleagues below, above and alongside you.

  • Charting public health

    Can some graphs shed light on debate about NHS spending on prevention?

  • Chickens come home to roost

    Finally those of us tired of the tedious, high level, generic, tick box exercises that are averaged out into star ratings are vindicated. 

  • 'Clark received the first total replacement of an artificial heart'

    On 1 December 1982, a snowy night in Salt Lake City, Utah, Dr Barney Clark’s heart was giving out and he was moved up the operating list to receive the first total replacement of an artificial heart in an emergency all night operation.   

  • Clearing up confusion on commissioning

    Clearing up some confusion about commissioning, and a cautionary tale about public sector cooperation with the private sector.

  • Clinician involvement is key - but keep an eye on the cost

    It is vital that clinicials are involved in setting new organisation structures and plans, writes Dr Jonathan Fielden, but they must be committed to the cause.

  • Cliquey, self-absorbed and weak? Hardly.

    It’s hard when your commissioners say you’re cliquey, self-absorbed and weak in partnerships.

  • Cluster development

    What are people doing to support staff who will be working in clusters? What are the "must do" activities, and how can clusters share best practice?

  • coaching scmoching

    Let’s regulate coaching. Let’s make them pass exams and get certificates or ban them from practising. What the hell, let’s go the whole hog and give them a Royal College.

  • Collaboration with the private sector: a necessary evil?

    These days, being the chief executive of a public sector organisation means collaborating with the private sector.

  • Collective failures can hinder social care

    Hate crimes need to be treated more seriously by public sector services if tragedies like the one back in the spotlight this week are to be avoided.

  • Commissioning board changes '18-week wait' penalties

    The NHS Commissioning Board has made a small, but significant and welcome, change to the penalties for breaching 18-week waits.

  • Commissioning board fumbles on waiting times

    The draft NHS contract penalises hospitals who treat their long-waiters, but not if they keep them waiting. Why?

  • Commissioning board must safeguard the future of secure care services

    The Commissioning Board takes over responsibility for specialised services in April 2013 and needs to focus on designing a system without the blockage problems of today if it is to commissioning secure care successfully.

  • Common denominator politics

    So was that just the Conservative Party’s Bank of England moment?

  • Community organising, leading change and shifting power: why the NHS needs to build weak ties NOW

    This piece aims to introduce some fresh perspectives on NHS change from civic campaigners and community organisers. Much of the conventional wisdom of NHS improvement is based on “strong ties”, peer to peer spread of ideas for change through “people like us”. However, history suggest that we might get the best chance to deliver the scale of quality and cost improvements we seek if we also focus on “weak ties”.

  • 'Compassion doesn’t cost money'

    How would we like to be treated as a patient? Would we like to be kept waiting without being updated? Would we like to hear people talking about us but not to us? Would we like to be cared for by someone not making any eye contact?

  • Competence or expertise – you choose, if you have a choice

    Workforce planning is an ambiguous art made yet more ambiguous when set on a national scale with its unconnected, conflicting and changing priorities – still, we try.

  • Competence, trust and the making of leaders

    Interesting news from the private sector. A recent study by Booz & Company stated that nearly half (46%) of all senior managers surveyed doubted their chief executive’s capacity to navigate their organisation through the current economic crisis.

  • 'Complaining about the NHS shouldn't be futile'

    The independent inquiry into the high level of deaths at Mid Staffs found evidence of appalling patient care resulting from a preoccupation with cost cutting.

  • Concern that black staff are more likely to be disciplined

    In the NHS and other public sector organisations, black staff are involved in a disproportionate number of disciplinary cases

  • Confessions of an ex-amorphous blob

    In a couple of days, Helen Bevan will be leaving for Kangerlassauq in the Arctic Circle to take part in the Polar Circle Marathon, one of the toughest marathon races in the world. She reflects on her journey over the past six months from unhealthy “amorphous blob” to extreme marathon runner.

  • Cooperatives: easier said than done

    The proposal to introduce staff cooperatives to run services will work only if government remains focused on the vision and principle, and does not become distracted by the discussion of the detailed consequences.

  • Could the 'Rooney rule' work in the public sector?

    A look at how attitudes to race have changed in public sector recrutiment.

  • Courage vs 'the easy life'

    Where courage stops is where leadership stops

  • Creating diversion will improve mental health screening throughout the judicial system

    New evidence has shown that rates of mental ill health among offenders connected with probation services are worryingly high. An investment into diversion services can help provide these individuals with vital support services at the earliest opportunity, says Sean Duggan.

  • Crime doesn't pay... but it might get you free healthcare

    It sounds like a joke or a wind-up, but losing private healthcare is no laughing matter.

  • Crisis management, disequilibrium and thermostats

    ‘Keep your hand on the thermostat. If the heat is too low people won’t make difficult decisions. If it’s too high, they might panic.’

  • Culture is as intangible as the air we breathe

    Senior managers are fond of saying we need to change the culture of the organisation.They are saying it now in response to the introduction of commissioning and greater use of the private sector in the NHS. It has been repeatedly stated in local authorities as part of efficiency initiatives and outsourcing services. Now I hear it said in relation to the culling of posts and the focus on competence in the civil service.Commentators have expressed concern about the macho managemen

  • Customer knows best ... ?

    Keeping the customer happy is important in US healthcare - but at what cost?

  • Cut down on stress, be nice to each other

    Today I interviewed master of spin Alastair Campbell, who was speaking at the NHS Confederation conference in Liverpool.

  • Cut the Newspeak out of redundancy announcements

    Managers and politicians should be upfront and clear when announcing bad news, not hiding behind jargon.

  • Cut waiting times, breach the target

    How government targets deter hospitals from cutting waiting times, and how they could change for the better.

  • Cutting season

    All the parties have plans to cut NHS costs.

  • Daft or just too unpopular to contemplate?

    Last time I checked people were still becoming unwell seven days a week.

  • Dancing with the devil? Exorcism in the NHS

    A blog about the revelation that the NHS uses exorcism as an alternative form of treatment for some mental health patients.

  • Darzi's resignation

    Lord Darzi’s resignation brings to an end a bold experiment in reconnecting the health service with staff and the public.

  • Death in Swaziland

    Death is a funny thing. In almost four years as a performance manager and information manager in the NHS, I never really experienced death.

  • Debunking some myths about disruptive innovation in the NHS

    As the focus on innovation grows inside the NHS, some leaders have suggested that the really radical “disruptive” innovations that the NHS needs can only come from external sources. But where do the most radical, disruptive innovations come from?

  • December's waiting times data - the local picture

    Resources for analysing local waiting times pressures by trust, PCT and specialty.

  • Defining university hospital status

    In a previous post I talked about the need for the district general hospital to reinvent itself. And the same is true of the university hospital. Although the real prize is for ‘university’ status it should only be granted for FTs linked to biomedical research-based institutions.

  • Déjà vu

    To my surprise and somewhat consternation I find myself once again chief executive of a hospital 17 years after last running one and five years after stepping down as a chief executive. So what's it like?

  • Demystifying the I in QIPP

    We regard innovation as a critical part of the QIPP equation for delivering NHS quality and cost improvement goals. Yet in NHS reports and in the wider academic literature, the term gets used in a thousand different ways, with different meanings. In this blog, I describe a framework for making sense of innovation in an era of quality and cost improvement.

  • DES mess

    I’m a GP in England, so I really am surprised to find myself sympathising with the hard-pressed frontline administrators in my PCT.

  • Devaluing social work with adults will cause huge problems

    The NHS stands to lose big if local authorities begin cutting the number of social workers helping older patients and people with disabilities.

  • Developing integrated care at scale and pace: time to make it happen

    There is not one best way to develop integrated care. Politicians, NHS leaders and frontline staff should join together to test different approaches, writes the King’s Fund chief executive Chris Ham.

  • Developing the Healthcare Workforce

    Consultations come thick and fast, a bit like the current weather.

  • DH sweeps long-waits under the carpet

    Surely the deputy chief executive of the NHS in England cannot be encouraging Trusts to sweep their long-waiters under the carpet and ignore them?

  • Diary of an intrepid arctic marathon runner

    However meticulously you plan for big events, there are some things you just can’t plan for. Last weekend, Helen Bevan was due to compete in an extreme marathon in sub-zero temperatures in the Arctic Circle, something that she had prepared and planned for intensively for the last six months. Three days before the event, she came down with a severe cold. Read on to find out the outcome.

  • Did she jump or was she pushed?

    There have been a number of women resign from the Civil Service recently.

  • Differences in waiting times in Scotland and England

    England’s waiting time guarantees are more inclusive than Scotland’s. Why?

  • Disarray on waiting times targets

    By keeping the old, distorting waiting times targets in the new NHS Contract, the government has undermined its stated intention to tackle excessive waits.

  • Disney and the NHS

    Should the NHS emulate the Disney Corporation? Can we learn from the giants in the service industries in how we deliver services, and is there a holy grail in getting it right?

  • Do extroverts perform better at interview or do they just think they do?

    The interview process seems designed to favour the extrovert

  • Do you think you 'deserve sex'?

    The vetting and barring panel could strike you off  

  • Does cutting long-waits cause a jump in demand?

    Long-waits were sharply reduced under the last Labour Government. Did GP referrals spike as a result? Maybe.

  • Does the NHS need management consultants?

    As NHS management expenditure tightens, management consultancy costs are in the spotlight. Over the past period, the NHS has been big business for the consultancy industry. Whilst management consultants have made a significant contribution to NHS transformation, there have been many situations where the NHS investment in consultancy has not led to the outcomes we seek. Is there a future role for management consultancy in the NHS? How might we work more effectively with consultants in the futu

  • Dogged display from Peedell poodle

    The National Health Action Party, set up in response to last year’s Health Act, is going from strength to strength, End Game is pleased to report.First came their stunning by election performance in Eastleigh in February, where they won 392 votes, way out in front of the rest of the weirdo parties such as “Beer”, “Loonies” “Elvis” and the English Democrats.Now, two of the party’s activists have completed a 35 mile run to gently mock deputy prime minister Nick Clegg.The “C

  • Don Berwick’s appointment to CMS and the politics of “If we don’t have it, you don’t need it”

    Today, Don Berwick was sworn in as the new leader of the Centers for Medicare and Medicaid. While Berwick commands the widest respect, many feared that his appointment could be delayed or hampered in congressional hearings by opponents to health reform whose goal it is to make the countless next steps of implementing reform as difficult as possible.

  • Don't make me think...

    Telling people what to think and making people think are very different, and often bring different outcomes. But how do the approaches compare when it comes to disability?

  • Don't presume that racism is no longer a problem

    Racism has been top of the news agenda again in recent days thanks to the conviction of Stephen Lawrence’s murderers, but how far have things really moved on?

  • Double fantasy

    End Game has come across a rather confusing account of subversive activity on the site of Lewisham Hospital.The hospital has been the subject of intense debate this year due to plans to downgrade its facilities to help solve financial troubles at neighbouring South London Healthcare Trust.Weirdly named local paper the

  • Dr Dan's achievement map

    Since a disastrous appearance at Unite’s health visitor conference and

  • Early intervention is rightly at the heart of new mental health strategy

    The government’s new approach to mental health strategy is particularly welcome in its focus on children’s services.

  • Easy wins

    The financial services industry has come up with all sorts of “innovative” ways to make a buck or two, so what better place for think-tank Reform to host its jamboree on innovation in the NHS than at Bank of America Merrill Lynch.The investment bank took no chances on any of the hoi polloi getting into its plush Canary Wharf headquarters with burley bouncers on hand to escort delegates from the lobby to the fifth floor conference area.After chomping on a fine spread of assorted

  • Economic downturn and the opportunity for Foundation Trusts

    I suspect from recent comments on ways of handling the economic downturn that the pre-election phoney war is now beginning. Views against initiatives such as workforce reductions have started to emerge but perhaps based more on philosophical grounds rather than rigorous analysis.

  • Emergency at 170ft

    Usually, emergency treatments at nearly 200 feet in the air take place on low-flying aircraft. But not for one ambulance crew in London.

  • End Game

    When a bedpan is dropped anywhere in the NHS, End Game is sniffing around the mess. Email hsjnews@emap.com

  • Engagement matters - here's why

    “Evidence-based common sense” was how Peter Lees described the Fund’s new report on leadership in the NHS at our Summit on 23 May. The report draws on evidence demonstrating the relationship between staff engagement and organisational performance to make the case for a new style of leadership. If the NHS is to address

  • Engaging with grace

    What we spend on care at the end of life

  • English waiting times improve in April

    Longwaits went down in April, continuing the recovery after the winter.

  • Ensuring security for secure mental health services

    Nowhere is it more important to look critically at what we are spending now and finding ways of using money more wisely than in secure mental health services, writes Sean Duggan.

  • Enter the Tories

    The opening to the Conservatives’ conference in Manchester this morning was a strangely diffident affair.

  • Equal opportunities under the new CCGs

    The first week in October is a landmark for the NHS.This is the week when the new NHS commissioning board takes on its new responsibilities.The board has a massive budget of £60bn, most of which will be given to clinical commissioning groups for them to plan and pay for their population’s health needs.There are 212 CCGs across England made up of GPs, nurses and hospital doctors. Will they be any more successful than the primary care trusts they replace at meeting the need

  • Equipping managers for an uncertain future

    After savage budget cuts public sector organisations will look very different.They will require a very different type of manager.

  • Evidence, not newspaper exaggeration, should direct debates about care quality

    The Foundation Trust Network has evidence The Sunday Telegraph’s story about “dangerously low staffing levels” at NHS hospitals has been greatly exaggerated, as FTN chief executive Chris Hopson explains.

  • Explaining why candidates didn't get the job

    “Why didn’t I get the job?” is a difficult question - but there’s an easy answer.

  • Falling foul of FoI

    The NHS is struggling to come to terms with Freedom of Information.

  • False economies and raised expectations

    The prevention agenda

  • Fast, cheap and intimidating - the future of NHS services?

    Why the future of our public services is like a New York breakfast.

  • Fear not: Tories are more afraid of you than you of them

    Perhaps now is a good time to start asking what the Tories would do to the health service…

  • 'Fifty years passed before smoke-free public places were achieved'

    On 26 June 1954 the main article in the British Medical Journal was on the mortality of doctors in relation to their smoking habits.

  • FIlling the void

    Ignore the harbingers of doom; clinical leaders, by driving value and putting patients first, can not only address the challenges we face but lead healthcare towards a better future.

  • First do no harm: lessons from service reconfiguration in London

    King’s Fund chief executive Chris Ham reflects on attempts to reconfigure services in the capital

  • Fitter than a butcher's dog

    I’ve been ill again. And what did I turn to? Flat pop, that’s what. And did it work? Too right it did. 24 hours later and I’m fitter than a butcher’s dog.

  • Focus on the fat!

    How will the budget cuts affect public services? And where should the axe really fall? Answers on a postcard please…..

  • Focus on waiting list still delivering success

    The focus on incomplete pathways continues to break new records, according to the April 2012 figures just released.

  • 'Forty three people died from head injuries and traumatic asphyxia'

    On 28th February 1975, at 8.46 in the morning, a tube train failed to stop at Moorgate station and ploughed on into a brick wall, compacting the first three coaches into a tangle of metal.

  • Francis will likely say parts of the NHS aren’t good with people

    One of the messages from the Francis report on Wednesday will be that the NHS needs to focus more on people.

  • 'From our viewpoint the NHS looks like a nervous colony of ants'

    When the white paper on the reorganisation of the NHS in England appeared, the Lancet commented that it was ‘welcome and wise’.

  • Further details on GP scorecards

    Including the list of practices rated red on their PCT’s scorecard in more than a third of areas.

  • Genuine 'co-production' now needs 'coming together'

    A framework to help local organisations to deliver on the objectives of the Government’s mental health strategy for England is published this week.

  • Getting the message across

    With the reforms attempting to introduce competition into almost all facets of the NHS, it’s time for marketing in the health service to get with the times.

  • Go reconfigure?

    There was no “clever form of words” to spare the SoS’s blushes in the end.

  • Go Red Sox

    Reflections as my year as a Commonwealth Fund Harkness Fellow 2010-2011 draws to a close..

  • Good to Great

    Andy Burnham’s vision for the NHS for the next 5 years - preventative, people-centred, productive. Oh, and computers….

  • 'GP commissioners will need to look beyond their community and take tough decisions'

    ‘I don’t want to see the PCT re-created for me to be then told what services I can have as opposed to the services I need for my patients.’ So said a GP commissioner I saw recently to discuss the merger of community health services with his local acute hospital trust.

  • Graduates need more than a degree from the university of life

    Why linking up practices and surgeries with local schools could help produce the next generation of medical graduates.

  • 'Gypsies and Travellers are the most disadvantaged minority within our society'

    There is a unpleasant smell of hypocrisy as the French government is condemned by other European governments for its mass expulsion of Romany Gypsies.

  • Hands off

    Charity Commission takes a stand on NHS charities’ accounts article in Third sector

  • Hannan's claims about managers: the unblinking truth

    The web is awash with commentary on Daniel Hannan’s incendiary comments on the NHS, thanks to the Twitter army.

  • Harassment has not gone away

    The whole Jimmy Savile scandal has made people think about sexual harassment at work.The workplace has changed since the 70s and 80s and many people assumed that even if there is still a pay gap between men and women sexual harassment was a thing of the past, but it is still a problem.Sexual harassment continues to be a subject difficult to speak out about. This is despite the fact that public sector organisations have explicit procedures for tackling complaints and – in theory

  • Harkness Fellows: can payment reform improve public health?

    Payment reform for healthcare delivery in the US could improve not only the service provided, but public health as well, writes Douglas Noble

  • Harkness Fellows: expect the unexpected

    In the first blog from the 2012-13 Harkness Fellows, Julia Murphy reflects on the first few months of her fellowship and her impressions of the US healthcare system

  • Harkness Fellowships: road trip not included

    Join the 2010-2011 Harkness Fellows as they set out on their year-long journey through the US health system

  • Harsh financial lessons for the public sector

    All local authorities are going to struggle due to the size of savings required.

  • Have your say on the NHS - 'an election in less than a year'

    The BBC news web page has a link to ‘have your say on the NHS’ this week; the NHS is back in the news as a political football.I don’t intend to add more to what has already been said by many on the BBC site.

  • Headhunters, beauty parades and trial by sherry

    For all the artificial glamour of senior management recruitment processes for local government, the gritty basics are usually most important things to remember.

  • Health policy for young people

    The long standing complaint that the central management of the NHS is no good at talking to ordinary people can finally be banished forever, End Game is thrilled to report.Someone has invented a learning tool that turns civil servant speak into young person speak.You type a web address into www.gizoogle.net and it comes out unintelligible in a different way to normal. Warning: it can be a bit sweary. To be honest we’re not really sure how it

  • Health system development plans

    In my report on Lincolnshire I recommended that health system development plans should be introduced across the NHS. This is quite deliberately a recommendation about process because when dysfunctional organisations or health systems are examined the single biggest issue is a breakdown in relationships.

  • Health twits

    Health on Twitter

  • Healthcare in the US election: fact, fiction and Big Bird

    While the focus of the 2008 US election was healthcare (and the colour of the candidates’ ties), the 2012 election is all about money (and the colour of the candidates’ ties).Over the past few weeks, money and jobs have typically dominated the presidential and vice presidential debates. That said, healthcare remains an extremely hot topic, with polls suggesting that it is the most important issue to voters after the economy

  • Healthy Lives, Healthy People....

    Ring fenced public health budgets may be too late for resources currently facing the axe in local government budget cuts

  • Helping tomorrow's healthcare innovators to thrive

    As Jeremy Hunt sets more technology targets for the NHS, it’s time for the service to both help its own and look to others for the solutions to its problems.

  • Here to help

    Working together in partnership

  • High-level anger management

    There’s nothing wrong with managers being angry about poor care, but they still need to be in control.

  • Hiring and firing at will

    I would have sacked a lot more people if I could have got away with it.

  • Holding a mirror up to the managers

    “Mirror mirror on the wall, am I a good manager after all?”

  • Hospital food is a recipe of contrary ingredients

    When heart attack patients can tuck into a fry up the morning after a bypass, the health service needs to re-examine its position on hospital food.

  • Hospital guides

    Basildon, Dr Foster and public information about the NHS.

  • Hospital inflicted virus

    University Hospital of South Manchester Foundation Trust have been so overwhelmed by the positive feedback they’ve had from patients that they felt moved to produce a video about it.“Viral video launch”, a press release proclaims. End Game humbly submits that might be a little presumptuous, since it’s not up to the producer whether or not a video goes “viral”, and to be attempting to contrive such an outcome risks looking, well… a bit contrived.

  • Hospitals strike back first over social care cuts

    The NHS’s concern about cuts in social care was not an expression of support for colleagues in social services…it was a pre-emptive strike from hospital trusts.

  • Houston we have a problem, can ACOs save us?

    Dear HSJ reader, As a lover of all things health-related, I am delighted to introduce you to 2 American health care acronyms from across the pond: IHI and the ACO. I hope both will bring you joy this Christmas!

  • How can managers keep staff happy amid pay freezes and layoffs?

    Happy staff work harder and achieve more. This is probably not a big surprise to most managers, nor I suspect is the view that if staff are unhappy it affects their work.

  • How do Trust Boards monitor waiting times?

    Trust board papers are often surprisingly coy about the state of the waiting list. If you were a non-executive director, would you even know if there was a problem at your Trust?

  • How good journalism can improve NHS waiting times

    There is plenty to hold the NHS and the government to account for, once we stop focusing on the wrong waiting times figures.

  • How hard is the new 18 week target?

    The new 18 week target can be achieved. In a few places it is going to be difficult. But most of the NHS could achieve it by improving patient scheduling alone.

  • How long does it take to do 100 minutes' work?

    There are 13,259 over-one-year waiters on the English waiting list. That’s only 100 minutes’ work for the NHS. Why not put an end to excessive waiting times once and for all?

  • How PR works

    It feels like a long time since we had a horrendously opportunistic press release to marvel at.Maybe the public relations industry is getting the hang of judging the boundaries of taste, or perhaps we’re getting better at hitting “block sender”.Anyway, the drought is over. Within a couple of hours of a teenage girl getting stabbed to death on a bus in Birmingham, Hillgrove PR had an offering about a

  • How public health can help the neediest parents

    Smart working by the new public health system, the NHS and schools can tackle children’s behavioural problems effectively

  • How to be successful at interview

    We were in a hotel bar the night before the interview, me, the three other shortlisted candidates and the recruitment consultant.

  • How to fail without really trying

    You need three ingredients to be really unsuccessful.

  • How to find a doctor

    One of the challenges facing us all as recently arrived Harkness Fellows is trying to understand how health care is organized and delivered in the US. 

  • How to win praise and influence people

    In busy, competitive environments, praise is often in short supply for anyone who thinks simply turning up deserves a shower of superlatives. But how do hardworking staff who feel undervalued get into a managers’ good books?

  • How well do you listen?

    Listening is not about being passive, nor is it an unspoken agreement with what the other person is saying; listening makes people feel valued and respected

  • How will doctors see fit to spend their budgets?

    Doctors may have a few things on their wishlists now they are supposed to be in charge of commissioning services.

  • How will Monitor judge waiting times performance?

    Monitor is out to consultation. My response explains why its approach to 18-week waits is perverse, and how to fix it.

  • Howe's that

    The latest summary of health ministers’ meetings and hospitality – covering July to September 2012 – emerged from the Richmond House fortress last week.

  • Hunt performs first u-turn

    Speaking to clinical commissioning group leaders at a recent conference in London, Jeremy Hunt admitted he had made at least one about-face since taking over the role of health secretary.It turned out that, en route to the Tottenham Court Road venue, he’d gone in the wrong door and found himself in the Trades Union Congress headquarters.That would have made him the first Conservative cabinet minister to set foot in the building for… well, a jolly long while, Mr Hunt observed wit

  • Hunt, health and airlines – half right and half wrong?

    We need a culture where staff feel empowered to act to mitigate risk and prevent avoidable harm without fear of recrimination and blame. It is time for a much more sophisticated debate, says Chris Hopson.

  • I’m missing the Proms already

    Working together and conflict resolution in tense times

  • If bullying doesn't bother staff, why are so many absent?

    Two articles published on HSJ.co.uk: one on bullying, the other on absenteeism. Surely I can’t be the only one putting two and two together…

  • If the NHS is doing well, why is it changing?

    A recent Commonwealth Fund survey saw respondents praise the NHS. So are the reforms aimed at addressing the right problems?

  • If the shark doesn’t get you HR will

    Managing an employee’s sick leave and return to work is never straightforward once you look into their individual circumstances.

  • If you can, do: if you can't....

    A tidal wave of conferences, seminars, webinars and more - how valuable are they, and how much do they contribute to the debate?

  • Impatient for change

    It’s time to change for WRVS and to make personalisation a reality

  • Imperial's waiting times holiday

    Imperial is taking a “reporting break” on 18-week waiters. Bad idea.

  • Improving comorbity care is a key challenge for mental health

    Better managment of care for people with both physical and mental health conditions would improve lives and save the NHS billions of pounds.

  • Improving the health of the poorest, fastest: why clusters of lifestyle behaviours matter

    When the coalition came to power I, like many others, was nervous about whether the government would see inequality reduction as one of its core aims.

  • In NHS board games, no one is safe

    Cynthia Bower’s resignation yesterday reminds us that the casualties of NHS boardroom powerplays go all the way to the top.

  • In response to relatively popular demand

    Why does it matter if GPs can earn interest from their “hard cash”?

  • In the boardroom: tough talks as reality sinks in

    Now that the size and implications of public sector cuts are sinking in, senior managers and board members are realising that efficiency savings will not be anywhere near enough to cover it.

  • In the drive for equality, culture eats strategy for breakfast

    Even the best laid strategies sometimes fall short of achieving their goals. With an issue like equality, cultural changes are just as important as putting official plans in place.

  • Inadvertent integration?

    Recent reports from the US and UK suggest primary care and hospitals merging on both sides of the Atlantic. But are we missing these opportunities to understand truly integrated care in the NHS?

  • Innovation and the NHS: the health entrepreneurs’ view

    HSJ talks to Zahid Latif, the Technology Strategy Board's head of healthcare about how the NHS can better embrace innovation

  • Innovation Eye

    Pamela Garside is a consultant at Newhealth and co-director of the Cambridge Health Network.

  • Innovation for higher quality and lower costs

    At no other time in its history has the NHS needed innovation for service delivery as badly as it does now. But innovation won’t just happen, even if we give it a high strategic priority. We need to take a systematic approach to innovation practice, building it into every aspect of daily work.

  • Innovation in healthcare: ‘There’s a way to do it better – find it’

    Alexandra Norrish on the lessons the UK can learn from the US health system’s long tradition of innovation

  • Inspections can only hope to inspire managers into stopping abuse

    Inspectors can’t realistically hope to “catch out” staff who abuse care home residents; it’s up to the managers to ensure their employees are all delivering good care.

  • Integrated care and why the NHS needs more deviant leaders

    Local leaders are ahead of the game, writes Chris Ham.

  • Integrating mental health and substance misuse services

    While there has long been a link between mental health problems and drugs and/or alcohol abuse, providing services for this group should be better integrated if outcomes are to improve.

  • Integration must not default to a box-ticking process

    Integrated care is a hot topic again thanks to the Health Bill’s passage through the House of Lords, but the NHS and Department of Health must ensure integration is not just a buzzword that falls out of use in the long-term.

  • Interim NHS managers can relate to Rafael Benitez

    Senior NHS managers are now considered like football coaches, no one expects them to be around for very long.

  • Is community care, as we know it, dead?

    Reports of the death of community care have not been exaggerated.

  • 'Is cost-cutting turning managers into bullies?'

    Is the harsh financial climate in the public sector leading to a return to the bad old ways of “macho” management in the NHS?

  • Is enthusiasm the key skill to look for in public sector recruitment?

    Surely departing from tradition and qualifications and embracing enthusiasm will make for a more successful public sector.

  • Is fiddling the figures all part of the game now?

    Mark was angry, and the more he read, the angrier he got.

  • Is it harder to be an honest senior manager in today’s NHS?

    League tables, naming and shaming and austerity have put more pressure on managers in the public sector, making if difficult for some to remain honest and open.

  • Is 'Just-in-time' the best way for pandemic flu planning?

    We’ve had a Pandemic Flu Plan since 2007 - and on paper are well prepared! Rhetoric and reality are different! All I can say is, many thanks for sending swine flu - instead of avian flu - this time!

  • 'Is the answer to have more black senior NHS managers?'

    Why do so few people from ethnic minorities make it into the top jobs in the public sector?

  • Is the betting off for Lansley's vision?

    David Cameron’s speech yesterday did little more than reaffirm the government’s commitment to pushing on with NHS reform. But will the prime minister show as much support to his beleaguered health secretary Andrew Lansley?

  • Is the NHS safe in the hands of the Competition Commission?

    The competition authorities must give due consideration to the interests of patients and taxpayers when considering NHS trust mergers.

  • Is the public sector running out of ideas?

    The changing role of chief executive’s requires a change in approach. But do the demands on management team leave them no room to manoeuvre?

  • Is the US ready for evidence based care?

    What does the controversy about mammography screening tell us?

  • Is there an I in success? Busting the team building myth

    A successful team of staff doesn’t mean that all of them have to be “team players”. In fact if they don’t get on with each other, they may get on better with the job in hand.

  • Is trust really the be all and end all of leading?

    You can’t be an effective leader if you don’t have the trust of your peers and the public.

  • Is your organisation accepting the unacceptable? Challenging 'ethical fading'

    They call it “ethical fading”. You and I call it going along with something you know is wrong.

  • It takes gumption to voice your views on the NHS

    Is having an opinion a disciplinary offence?

  • 'It was the nadir for the GPs, but they also had their supporters'

    The Collings Report published in 1950 led some to feel general practice was past saving and not worth the effort.

  • 'It won’t be lack of money that does for the public sector'

    In the end it won’t be lack of money that does for the public sector. It won’t be the loss of skills or the lack of experience due to early retirements and redundancies.

  • It’s a surplus Jim, but not as we know it

    Intrigue over that £1.5bn shaved off the DH’s departmental expenditure limit for 2008-09 continues

  • It’s adapt or die for the quality improvement movement

    -The healthcare quality improvement movement needs to step up to the challenge of cost constraint. It’s an “adapt or die” situation.

  • It's time to talk about values

    The public sector’s values have become aligned in recent times to those of the private sector. It’s time to get back to what the public sector should stand for: doing the right thing.

  • 'I've seen how innovation makes a difference from top to bottom'

    Forcing through innovative service changes might be met with resistance, but it worked for London’s stroke services, as Pamela Garside can testify first hand.

  • James Illman's Innovation Blog

    HSJ’s technology correspondent on the latest developments in healthcare IT and innovation

  • Jeremy Hunt's first hand NHS experience

    All the old cynics who dismissed ministers’ plans to spend time working on the NHS front line as a cheap and stupid publicity stunt were confounded this week by Jeremy Hunt.Reflecting on the time he spent on an accident and emergency department in Watford, the health secretary noted the “dramatic” growth in accident and emergency activity, and that non-elective services were under huge pressure.End Game wonders how long Mr Hunt must have been working in the NHS to observe and co

  • Just do it! (Subject to rules and regulations)

    I’m only a couple of months into my year in the USA, but I’ve quickly picked up how things are done here.

  • Keith Floyd and leadership

    Keith Floyd was hugely entertaining albeit with personal flaws such as occasional rudeness and arrogance. Translate this to leadership and it’s the Keith Floyd-esque characters who push the boundaries, always bounce back and rarely give up.

  • King's Fund 'boffin' in tabloid promotion shocker

    Fame at last for the King’s Fund’s esteemed chief economist John Appleby.The Irish Sun has run a short piece based on Professor Appleby’s findings that 40 per cent of girls born in Ireland in 2013 would live to be 100. The figure will hit 60 per cent of girls born in 2060, the paper reports.The paper’s website ran an enormous picture of Professor Appleby with “boff

  • Lansley and Neil in the waiting times trap

    Waiting times have come to mean the opposite of waiting lists, and this has turned public debate on the NHS upside down.

  • Lansley steps up to bat

    The health debate at the Conservative conference failed to hit the process target of starting on time. Shadow health secretary Andrew Lansley came into a half full auditorium almost an hour late.

  • Lansley’s devil is in his detail

    It’s a policy: real terms cuts to NHS pay

  • Lansley's sums

    No matter how many times shadow health secretary Andrew Lansley repeats his pledge that there will be real terms growth in NHS spending under a Tory government, the NHS is not convinced.

  • Latest on 18 week waits: better in December

    The December 2011 data for 18-week waits shows a continued improvement, not just in the total list size, but also in the number of long-waiters.

  • Latest on RTT waiting times - the May 2011 data is out

    RTT waiting times in England improved again in May. But you wouldn’t know it from the media. Or even the Department of Health.

  • Latest on waiting times - signs of recovery?

    Pressure on waiting times fell in March, as Trusts treated their long-waiting patients. As a result, the headline 18-week target deteriorated.

  • Latest RTT waiting time figures for England - July 2011

    It’s starting to get worse.

  • Latest RTT waiting times data - November 2011

    Data shows that waiting times improved in November.

  • Latest RTT waiting times: August 2011

    The NHS fended off its waiting time pressures in August, providing some much-needed breathing space as winter approaches.

  • Latest waiting time stats: one year waits halved in October

    One-year waiters halved in October; a spectacular success for the NHS. Otherwise, it’s steady as she goes as we head into winter.

  • Latest waiting times - a closer look

    The latest waiting times data, drilling down to Trust level; what's up and what's down

  • Latest waiting times, trust by trust

    A detailed look at the May 2011 RTT waiting times, at specialty and Trust level.

  • Leaders lack confidence in the changes they've been asked to make

    Transforming the public sector on the scale the government requires was always going to be difficult. The success looks more difficult still as the majority of leaders in the public sector have no confidence in the changes they’ve been asked to make.

  • Leadership and getting the right people on the bus

    If the wrong people are on the bus they should be dropped off at the next stop, they might need to catch a different bus.

  • Leadership in Mental Health

    Sean Duggan is chief executive at the Centre for Mental Health. 

  • Leadership lessons from the Thin White Duke

    The NHS is seeking to revive a familiar refrain with a return to “heroic leadership”.

  • Leadership needs to be more local than national

    The reputation of top leaders is not achieved by delivering national bottom-line outcomes. What does differentiate one top leader from another is the ability to deliver local change, innovation and transformation seen as important to local people.

  • Leadership: not as dangerous as some might make out

    The claim that “leadership is dangerous” needs some context, as the public sector doesn’t necessarily lend itself to all-guns-blazing macho men and women.

  • Learn anything new today?

    “What did you learn today?”  Well, quite a lot, actually.

  • Learning from a model medical leader

    The swift changing of the seasons in Boston accompanied an equally swift change in administrator for the Centres for Medicare and Medicaid Services.

  • Learning from Humpty Dumpty

    I don’t want to fall off the wall, I certainly don’t want to sit on the fence either. I’ve tried the fence, it’s uncomfortable and it makes my bottom hurt.

  • Learning lessons from north of the border

    The Scots have repeated England’s mistakes in setting their waiting time targets. But they still have a trick up their sleeve that England could learn from.

  • Learning lessons in mental health care from around the world

    A global call for action into mental health research has set out a list of priorities that identify the most pressing challenges to delivering improved mental health care and improving the lives of people with mental health in the UK

  • Learning the management lingo

    Ambitious managers need to learn a certain type of language to get ahead - the rest of us just need to try and work out what they’re saying.

  • Lessons for the care industry from the car industry

    The car industry and the health care industry have much in common. Both deal in body parts, and what are surgeons but mechanics, hospitals mere repair shops and people “soft” machines?

  • Lessons from Boston on integrated care

    Pamela Garside reports back from her trip to the US in winter last year to explore “value-based healthcare”.

  • Lessons to learn from Barclays

    Bob Diamond appears to have seen nothing, heard nothing or known nothing. So said the Treasury Select Committee. But is it possible for chief executives to know everything that is going on in their organisation? Clearly not, but they do need to know what they should know.

  • Letters from America: the 2010-2011 Harkness Fellows

    Established by the Commonwealth Fund and co-funded by the Nuffield Trust, Harkness Fellowships allow professionals to research health policy in the US. 

  • Life after senior management: it's not over for the over 50s

    The task of applying for a new job as a former manager may seem daunting, but the benefit of experience channelled the right way makes it very achievable.

  • Little known FoI exemptions, from CSU Cassander

    Fed up answering troublesome Freedom of Information requests? Worried that the old “commercial confidentiality” excuse is wearing a bit thin? Don’t worry - help is at hand. In this new occasional series, CSU Cassander points you towards some little known exemptions that can help you get on with your job uninhibited by the inconvenient light of scrutiny.Section 45: request written in Comic SansSection 49: response would only e

  • Little known FoI exemptions, from CSU Cassander

    This is the latest installment in End Game’s occasional series, in which the ever-resourceful CSU Cassander identifies some little known exemptions to the pesky Freedom of Information Act.Section 66: Archives hauntedSection 71: Information eaten by catsSection 75: NHS will be privatised from 1 AprilSection 84: We’ve always been at war with Eastasia

  • Little known FoI exemptions, from CSU Cassander

    End Game’s esteemed colleague CSU Cassander identifies some little known exemptions to the pesky Freedom of Information Act

  • 'Living on pizza saved my life'

    Only in America would a three-year long pizza-a-day habit put someone in hospital - for the right reasons.

  • Living with 'socialized medicine'

    Targets have reduced waiting times, but how else do they affect care in a nationally funded health care system?

  • Local picture on 18 week waits: April 2012

    Interactive maps and resources with detailed analysis of the 18-week pressures by Trust and PCT, by specialty.

  • Locating the right evidence for merger decisions

    Candace Imison asks whether potentially merging trusts’ evidence will meet the Competition and Cooperation panel’s exacting review standards, and what the challenge means for the 20 currently unviable trusts in the FT status pipeline.

  • Logan Five Arrives

    I landed in the States in the middle of the ‘NHS WOULD HAVE LET STEPHEN HAWKING DIE’ furore, and so was hardly harbouring high hopes for a rational health care debate.

  • Logging on early

    Buoyed by recent enthusiasm about personal health records, I’ve signed up for three.

  • London smog and a major advance in public health

    From 5 to 8 December 1952 smog (fog filled with smoke) of unusual density and persistence covered the Greater London area.

  • Look, it’s a Darzi vision – in multicolour!

    Roughly a year after the Darzi documents were published, it is time to look back. That process may be gratifying, inspiring or horrifying, but it will almost certainly be tedious.

  • Looking Out, Not Up

    How do we know if we are getting it right? Is it meeting targets? The people who really know whether our services are good or bad are the people who receive them.

  • Low morale: does it really matter?

    He had noticed the atmosphere in the office and knew that staff were unhappy.

  • Macho macho management

    Three quarters of the NHS workforce is female, half of GPs are women but commissioning is man’s work, according to workforce figures. Is this consciously unfair, or a simple by-product of the current climate?

  • Making savings through sackings - but who goes?

    A report published recently expresses concern that the eagerness to cut costs in the short term could seriously undermine the public sector’s ability to deliver in the long term.

  • Making sense of conflicting waiting times targets

    The NHS has been given conflicting waiting times targets this year. There is a solution, and it lies mainly in PCT clusters’ hands.

  • Making the case for a one-year limit on waiting times

    Rob Findlay and Anthony McKeever make the case for NHS trusts guaranteeing a one-year limit on referral to treatment waiting times.

  • Making time for successful management development

    Management development programmes have a vital part to play in achieving powerful organisational change - but only if they can be delivered properly, to the right people.

  • 'Managers need more than a short course to lead a diverse workforce'

    Managers in the public sector seldom have the confidence and skills to manage an increasingly diverse workforce.

  • Managers show their worth

    I was taken recently by the findings of a study of careers of NHS managers with 25 or more years experience. The findings are especially interesting because the careers of many of the managers interviewed pre-date the introduction of general management into the NHS in the 1990s.

  • Managing Change

    As the changes to the NHS continue to exercise the minds of NHS staff potentially "affected by change" what are the main themes emerging?

  • 'Many managers will be sweating on the beach over their future'

    ‘Some managers think decisions will be made in their absence about their department and their future if they go on holiday’

  • Many measures of waiting times

    Bewildered by the vast pick-and-mix of different waiting time measures? Here’s a fact checker that has them all.

  • Mapping swine flu

    As an experiment I have mapped swine flu figures for primary care trusts in the North East.

  • Mapping swine flu part two: The professionals

    Following my stunted effort a few weeks ago, the professionals have got stuck in to mapping swine flu.

  • Medicine for dummies

    “Paramedics and an air ambulance who raced to the scene of a report of a person not breathing in a locked car got the shock of their lives when they arrived,” a press release from the East of England Ambulance Service breathlessly informs us.What did they find? Presumably, the air ambulance having been marshaled, they could expect to be dealing with a life threatening situation?On arrival at Milton Road, Harwich, the reality turned out to be somewhat less dramatic.“Follow

  • 'Meeting big challenges means radically changing how people behave'

    We need to promote fairness in how we recruit people, fairness in how we select people for promotion, fairness in how we treat people at work, fairness in how we allocate scarce resources.

  • Meeting the NHS spending challenge - on a wing and a prayer

    You can own the best racing yacht money can buy. It can be the ideal weight, have the best gadgets and be the optimal structure but to win you need the right team. Unless people work together and want to win you won’t win.

  • Mental Health Diet

    The power of positive thinking – is your glass half full or half empty? You can choose your mood, and control your state of mind to improve outcomes for yourself and those around you. Is this just so much mumbo-jumbo, or is there something in it?

  • Mental health in 2011: challenges and opportunities

    After a year of political and policy change in 2010, the New Year will bring major challenges and opportunities for mental health services.

  • metamorphos-ising the metaphors

    It’s about time we moved on from the patriarchal sporting metaphors of the playing fields of Eton and got a bit more now, a bit more edgy, a bit more credit crunch.

  • Mid Staffs shows a foundation trust can go bust

    Is it possible for trusts provide excellent care while staying within budget?

  • Military-style leadership doesn't suit the public sector

    Why the armed forces’ show of force leadership style is the wrong type for the NHS and local government.

  • Minimum waiting times, and hopelessness

    The Co-operation and Competition Panel report that minimum waiting times are widespread. Why are minimum waits the wrong approach? And what is realistic?

  • Money can't buy an all-star team

    High-performing teams are rarely created but they evolve when all memebrs share responsibility, support their colleagyes and take it in turns to lead

  • More lessons from the banking sector

    Once again we have another fascinating story about the near-collapse of a bank, with the lessons again providing sound leadership learning for NHS corporate bodies.

  • More management, less leadership please

    Not everyone can be a leader but many more can be managers and take greater control of organisational life around them.

  • More Perspiration than Inspiration

    We are entering a different phase of NHS management that to be successful will have to be characterised by a stronger emphasis on management than leadership, more process and communication, and more perspiration than inspiration.

  • More than tea and sympathy

    It’s not just tea and sympathy that’s on offer. Advocacy, empowerment, peer-to-peer support are all available at WRVS’ hospital cafés.

  • More waiting list patients frozen in time

    There is something strange about the orthopaedic waiting list in Salisbury.

  • Motivation is needed to see clinical commissioning succeed

    Many aspects of the Health and Social Care Bill have given rise to heated debate, but one of the most controversial has been the question of whether GPs should have formal statutory responsibility for commissioning.

  • MPs and the EU elections- could someone get serious?

    Local and EU elections are being held on the 4th of June - but where are the manifestos dealing with important health or other issues? All political life seems to be handled the same way as strategy appears to be managed in the NHS, by political soundbite.

  • Mutual appreciation society

    Mutualism is the latest public sector reform craze, with all three parties talking it up. Could it work in healthcare?

  • My trusty little revenue raiser

    End Game is all for NHS hospitals diversifying as the squeeze on their traditional sources of income continues, but we’re starting to wonder just how far this is going to go.In a flurry of entrepreneurialism, Salisbury Foundation Trust has launched a line of moisturising creams, based on one used by the trust to help burns victims.“My Trusty Little Sunflower Cream” hit the market on April 12. It contains five per cent pure sunflower oil and no “parabens” – both attractive featur

  • National recognition for NHS individual - for the right reasons

    Not that many people in the NHS have gained national recognition this year for positive reasons.

  • Negative adjustments

    It looks like the Treasury are gearing up to remove funding for depreciation costs and capital charges from departmental budgets.

  • Net Health

    Dave West is HSJ’s acute care reporter.

  • Networking

    How effective are you at networking? Do you get the best out of it, and do you know what works best?

  • Never miss a minister's verbal gymnastics

    Is your life being ruined by missing health related items from the Today programme? Then I have the gadget for you.

  • New English waiting list data: view the interactive maps

    Where are the longest waits? What are waiting times like in your local NHS? How difficult is the new waiting time target? Here are some maps to help you find the answers.

  • New inflation forecasts imply NHS funding cut

    When the spending review was announced in October, the NHS budget faired reasonably well in comparison with other departments, with a real-terms increase of just under 0.1 per cent per year.

  • New record best for one-year-waiters (now let's go for zero)

    A fantastic result on one-year waiters: come on, let’s get them down to zero. Otherwise, everything on waiting times is pretty much treading water.

  • New target, new perversity

    The new RTT waiting times target is very welcome, but it brings new dangers of its own: distortion of clinical priorities, and hidden waiting lists.

  • NHS and Health Management News Blog

    Health management and policy news for NHS and independent sector health managers

  • NHS chief executive PA recognised in annual awards

    You may remember a few weeks ago that Christopher Juliff, PA to the NHS chief executive, was shortlisted for Hays and The Times PA of the Year 2011.

  • NHS consolidates its position on waiting times

    The NHS consolidated its position on waiting times, following the first ever achievement of all three 18-week targets in January. The number waiting over a year improved slightly, but is still too high.

  • NHS England's self fulfilling policy

    We at End Game know you’re terribly busy and don’t always have as much time as you would like to leaf through the latest 25 page drone-fest from NHS England.So we do it for you – and we were pleasantly surprised to find a little light relief tucked away in the mothership’s corporate governance framework.Amid the usual worthy but mirthless fare was a section on policies – NHS England has some, we

  • NHS England's Twitter handle tangle

    Jubilation rang out from Quarry House in the week before Easter as the government announced (curiously, in its response to the Francis report), that the NHS Commissioning Board would be allowed to drop its yawn-inducing title and be known henceforth as NHS England.Those running the self-described “biggest quango in the sky” – or at least the more trendy among them – hope that, now the organisation’s title includes no tedious description of what its actual function is, members of the pu

  • NHS enterprise has been given a freer rein

    Absurd restrictions on FT income have at last been lifted

  • NHS History Blog

    Geoffrey Rivett is vice-chair of the governors of Homerton foundation trust and author of From Cradle to Grave: fifty years of the NHS.

  • NHS holds the line on 18 weeks

    Small improvements meant new record-bests for long-waiters in November.

  • NHS leaders of the future: more Thatcher or Nyborg?

    NHS leaders could do worse than taking notes from Borgen prime minister Birgitte Nyborg on building alliances with others and finding unlikely common causes, says Chris Ham

  • NHS management vs NHS leadership

    Management is often based on the response to yesterday’s questions and whilst some of the responses remain valid for the here and now a good many do not, they are out of date and little is achieved by walking backwards.

  • NHS news blog: Alan Johnson launches new rules on patient involvement

    Health secretary Alan Johnson has announced a series of policies to help avoid more NHS services falling to the “appalling” standards exposed at Mid Staffordshire foundation trust.Providers will have to publish the number of complaints they get and an annual statement on how they are involving patients and the public in improving services.The government outlined the measures in response to reports by national emergency care director Sir George Alber

  • NHS news blog: Baby P case 'hitting recruitment'

    BBC: Baby P case is making it harder to recruit social workers

  • NHS news blog: Baby P review reveals 'systemic failings' in NHS

    Trusts have been urged to ensure they are meeting child protection standards in a report revealing “systemic failings” in the NHS’s treatment of Baby Peter.

  • NHS news blog: Care Quality Commission completes its management team

    The Care Quality Commission has filled the remaining director posts on its senior management team. The new appointments are:David Johnstone, director of operationsKylie Kendrick, director of organisation development and human resourcesJohn Lappin, director of finance and corporate servicesDirector of operations David Johnstone has been executive director of adult and community services at Devon co

  • NHS news blog: Care Quality Commission will 'do a number' on weakest NHS performers

    The chair of the Care Quality Commission has pledged to get tough with NHS and social care organisations languishing in the bottom 10 per cent of performance tables.

  • NHS news blog: Careless disposal of confidential data is on the rise, says study

    Guardian: Careless disposal of confidential data is on the rise, says study

  • NHS news blog: Chief executives appointed at two SHAs

    Chief executives have been appointed to West Midlands and Yorkshire and Humber strategic health authorities.City of York council chief executive Bill McCarthy will lead NHS Yorkshire and Humber, while North Lancashire primary care trust chief executive Ian Cumming will head up NHS West Midlands.Mr McCarthy, a trained economist, replaces Margaret Edwards, who left in March to lead the new NHS productivity unit.He has operated at board level in

  • NHS news blog: Chief executives picked to lead integrated Welsh NHS

    Six chief executives have been appointed to lead the NHS in Wales as it takes a further stride away from the English system.They will lead local health boards, newly merged from existing primary-focused LHBs and trusts, which run acute, community and mental health services, from October.Care provision will be merged and the internal market scrapped, with services planned by NHS Wales in collaboration with the boards.The two chief executives hired from outside W

  • NHS news blog: Confed proposes peer review to avoid Mid Staffordshire repeat

    The NHS Confederation has called on hospital trusts to invite others trusts’ directors to inspect their services to help prevent failures such as those at Mid Staffordshire foundation trust and Maidstone and Tunbridge Wells trust.The confederation has proposed a series of steps that should be take voluntarily in response to the “appalling” care at Mid

  • NHS news blog: Dental surgeries could extend opening hours

    Primary care trusts are to begin a £150m procurement process which could see dental surgeries opening outside normal hours.National director for GP and dentistry access Mike Warburton said contracts for new work should focus on quality and access rather than activity and consider extended hours. PCTs would decide what hours were appropriate.He said the money would be used for “additional procurement and new services” but did not have to involve a new building as last

  • NHS news blog: DH publishes criteria for defining failure

    NHS providers with even small deficits or which get their financial forecasting wrong risk being placed “under review” through the Department of Health’s new criteria for its failure regime.The regime – published last year and now part of the Health Bill currently going through Parliament – sets out how a failing NHS organisation would be deemed “underperforming”, triggering a process which could see them taken over and potentially broken up by the DH.The criteria is

  • NHS news blog: DH refrains from standardising patient experience

    The Department of Health will not impose standards for “real time” measurement of patients’ experience, despite pressure to use results to help identify failing trusts.Guidance will be published on the use of fast-turnaround feedback, which many hospital trusts are beginning to collect, in coming weeks.But there will be no standard collection methods, questions or measures, meaning the results cannot be used for national benchmarking, performance management or patient

  • NHS news blog: Interview - David Nicholson talks leadership

    In an exclusive interview following the first meeting of the national leadership council last week, NHS chief executive David Nicholson tells HSJ what was discussed, why the council won’t become a “dustbin” for difficult issues and why all chief executives must take responsibility for leadership.

  • NHS news blog: Mid Staffs reports - new duties on NHS to prove patient involvement

    The government has announced that NHS organisations will have to publish information that proves they are involving patients to prevent a repeat of the failures at Mid Staffordshire foundation trust.A report for the Department of Health by national director for primary care David Colin-Thomé, published today, found that a significant reason that such poor care

  • NHS news blog: Mid Staffs scandal - confed says NHS must 'put its own house in order'

    The NHS Confederation has said the NHS must “put its own house in order” in response to the failures at Mid Staffordshire foundation trust.Two reports, on the trust’s progress since the highly critical Healthcare Commission investigation and lessons for the whole NHS, were published yesterday. Health secretary Alan Johnson announced a range of measures in resp

  • NHS news blog: Monitor appoints new chief and chair to 'challenged' foundation trust

    A foundation trust has been assigned a new chief executive by Monitor for the second time in eight months.The regulator has appointed Kirsty Matthews as interim chief of the Royal National Hospital for Rheumatic Diseases foundation trust, in Bath, it announced yesterday.The regulator hired Ms Matthews as interim chair of the trust in December. Stephen Cole, who was yesterday named interim chair, was hired in December as director of corporate strategy.All the ap

  • NHS news blog: NHS culture stifling innovation, Confed warns

    The NHS is stifling innovation through an organisational culture that places barriers in the way of staff with good ideas, the NHS Confederation has warned.In a report timed to coincide with the launch by Lord Darzi of a £220m fund to boost innovation in the health service, the confederation said NHS leaders must remove the hurdles that prevent innovative practices becoming mainstream.The report on leading innovation warned the payment by results tariff is seen as a b

  • NHS news blog: NHS governance 'reduced to paper chase' - Audit Commission

    Many NHS trust board members cannot be sure whether or not their hospital is operating within the law, the Audit Commission has found.

  • NHS news blog: NHS productivity on the rise

    NHS productivity has improved, with the growth in the quality and volume of treatment now exceeding the increase in NHS funding.Figures due to be published by the Office for National Statistics later this month will show that between 2003-04 to 2007-08 productivity growth was at worst static and at best grew by as much as 1.6 per cent a year. The greatest improvement was between 2004 and 2006.Report authors Professor Andrew Street and Padraic Ward attribute the improv

  • NHS news blog: PCT poll backs Alan Johnson on swine flu pandemic

    NHS organisations are backing up health secretary Alan Johnson’s assertion this week that the UK is one of the countries most prepared to deal with a flu pandemic.As cases of swine flu were confirmed in the UK, an HSJ straw poll of 15 primary care trusts this week revealed that, as required, all had plans in place to co-ordinate with councils, acute trusts and strategic health authorities, to communicate with the public and local businesses, to mobilise GPs and to distribute

  • NHS news blog: PCTs may face tests on financial competence

    A financial competence test could be reintroduced in next year’s round of world class commissioning competency assessments.Other changes on the cards include “tweaking” the definitions of tasks in the programme and moving panel assessments to April and May – traditionally a quieter time for primary care trusts.NHS Confederation PCT network director David Stout said the Department of Health was considering “introducing an actual measure of financial competence along wi

  • NHS news blog: PCTs spent £8.2m on suspended GPs in three years

    Primary care trusts have spent at least £8.2m over the last three years paying 134 GPs who were suspended pending investigations into complaints about their conduct.

  • NHS news blog: Plan to boost NHS purchasing power

    FT: Plan to boost NHS purchasing power

  • NHS news blog: Rising patient choice fails to improve NHS quality standards

    One year after the introduction of free choice, early trends suggest some patients are using choice - but it is not yet driving up standards in hospitals.HSJ and the Picker Institute analysed hospital episode statistic data supplied by the NHS Information Centre for the first three quarters of 2008-09 and for all of 2006-07 for 66 primary care trusts.Of the PCT results scrutinised, 11 had recorded a greater than 10 per cent change in the percentage of GP referrals going

  • NHS news blog: SHA chief appointed as national flu director

    North East strategic health authority chief executive Ian Dalton has been appointed to the new position of national director for NHS flu resilience.The appointment is a secondment from his position at the SHA, which will be temporarily filled by its director of finance and communications David Stout.Mr Dalton will report directly to NHS chief executive David Nicholson.

  • NHS news blog: Surge in women consuming harmful amounts of alcohol

    Guardian: Surge in women consuming harmful amounts of alcohol

  • NHS targets: from compliance to commitment

    The NHS is moving away from the “compliance” system of top-down national targets and standards. What should it be replaced with?

  • NHS underperformers: shape up or ship out

    I am not an ogre, I am not particularly harsh, I do not consider myself to be radical and I am not trying to be deliberately provocative but I do think that saying there will be no reduction in jobs is at best short sighted and at worst a lie.

  • Nick Clegg or Nigel Farage: who should NHS leaders model themselves on?

    NHS leaders need to decide whether to focus on what is in the best interests of their organisations, or be willing to share sovereignty and work with others.

  • Nightmare on Harley Street

    Unedifying news reaches End Game from Harley Street.It appears that the illustrious London thoroughfare has been the site of some rather unsavoury discoveries. The street is home to an array of medical clinics famous for charging loads of money to rich people who are unable to confront their own mortality to make them look weird and old rather than just old… er, we mean high quality private practices of international standing.Anyway, Westminster City Council reports that they ha

  • 'No other nation has had the chance to refashion its hospitals so comprehensively'

    The Hospital Plan will determine for many years to come the broad lines of development of the hospital service.

  • No U in team

    You don’t have to be a cricket fan to recognise the situation: your best player - who thinks he can do a better job of running the team - is bad mouthing you and his team mates to the opposition. Clearly this is not good for team spirit. However it is not unusual in sport - or in the office.

  • Non-geographically defined consortia: Further details

    GP practices in a significant minority of areas are forming groups with non-neighbouring practices. In some of those, data suggests one group is formed from better performing and/or less deprived practices.

  • Not sleeping your way to the top

    Separating fact from fiction about senior managers and their lives away from work

  • Not smelling of roses

    Quelle surprise - a political decision

  • Nuffield Trust website relaunches

    The think tank relaunches its website and adds new tools for the online audience.

  • number crunching leadership

    Leading and managing by numbers - or how to find a set of theories, skills, disciplines, habits or principles to fit whatever your burning issue is today.

  • Nursing, society and older people

    The argument about whether nursing should be a degree-based profession is merely a displacement activity. The real issue is about the link between nurse training and how society wants its older citizens to be cared for.

  • Obama's political leadership lesson

    So here we are just after a year in office and Barack Obama has pushed through a major piece of domestic policy. However, it is not solely an achievement in social domestic policy but just as importantly, a lesson in political leadership and management.

  • Off the hook on targets?

    Targets and top-down management are out, so are failing trusts now off the hook?

  • Olympic Legacy

    As Danny Boyle has higlighted, the NHS is one of our great institutions, one to be out centre stage as we open the Olympics. So much great effort and focus is going into the preparation and smooth running of the Olympics and the health response. Let us ensure that there is a lasting legacy within organisations - through great operational performance; for our staff and the public at large through the positive impact of exercise, great personal performance and the benefits of team work. The Olympi

  • On a mission to get tomorrow’s ideas today

    HSJ has joined 20 of the UK’s brightest entrepreneur-led companies on the Future Health Mission to Boston

  • On Arctic marathons and large scale change

    Training to run an Arctic marathon has made me reflect on the psychology of large scale change.

  • On being fierce

    The culture of an organisation is not nebulous. I am the culture. You are the culture.

  • On coaching and interference

    I’m part way through a coaching qualification. I’m learning a lot about others, but a whole lot more about myself! I’m not going to get into definitions of coaching, counselling and mentoring (that’s another whole blog on its own) but one of the fundamentals is that the agenda needs to be led by the coachee (the person being coached, for the uninitiated).

  • On organising to change the world: from Californian farm workers to Obama’s election campaign to NHS transformation - Part one

    The ideas of Marshall Ganz, Harvard academic, community organiser and unofficial “Mobiliser-in-Chief” for Obama’s election campaign, offer some poweful perspectives for NHS leaders.

  • On organising to change the world: from Californian farm workers to Obama’s election campaign to NHS transformation: part two

    The wisdom of Marshall Ganz, unofficial mobiliser-in-chief of Obama’s election campaign on how we can challenge the status quo, the vested interests and perverse incentives in the current NHS system that get in the way of delivering high quality, high value care for all.

  • On the road to Recovery

    The government made Recovery the mental health strategy’s defining goal in February - which gives mental health service providers to do something truly radical, says Sean Duggan.

  • One and twenty - a buttered scone and getting plenty: pension take up in bingo hall and tea bar

    Tackling povety in old age

  • One country, one surgeon

    A tiny Caribbean nation is looking for healthcare insights from the UK

  • One-year waits race towards zero

    One year waits continue to fall sharply. 18 week waits, and the waiting list overall, are steady. Orthopaedic long-waits are deteriorating.

  • One-year-waiters: real patients or data errors?

    The dramatic reduction in one-year-waiters was more down to validation than treating real patients. But it’s essential nonetheless: there were still plenty of real patients there.

  • Oomph!

    Everyone faces challenges. Every person, every career, every organisation, every family and every team have to overcome difficult periods; there are of course different levels of challenge but no one goes through life untested. We might not always be able to control events but we can control how we respond to them.

  • Ooooo I'm a leader!

    Whilst it might be possible to hide poor leadership in good times, it is less possible when times are hard. When the pressure isn’t on people can get away with a certain amount of incompetence or bumbling, when the pressure is on there should be no room for incompetence or bumbling.

  • Orthopaedics scrapes inside waiting target for first time

    Long waits are down again, but the total number waiting is a bit higher than usual. This will become worrying, if it carries on.

  • Parity of esteem

    The draft NHS Mandate will require the Commissioning Board to take steps to bring mental health on a par with physical health.

  • Partnerships - the Emperor's new clothes

    What cost partnerships? Will the Tories bite the bullet and save us a bundle?

  • Passion runneth over in the job search

    Employers have devalued passion as a word for describing how we feel about work.

  • Patients vs the business case

    The NHS is not subject to local democratic accountability. If you want to have more say in what happens to your local hospital maybe you should advocate a transfer to local government

  • Pausing for effect: clock pauses and waiting times targets

    Clock pauses - they don't make a massive difference to waiting times. Do they? Um, perhaps you'd better sit down...

  • PbR: A target by any other name...

    PbR as an abbreviation now lends itself to a much clearer redefinition for the providers of healthcare services in NHS England – ‘Patients bring Revenue’.

  • PCT fall guys

    PCTs are in the frame again - this time Dame Barbara Hakin warns GP consortia not to turn to them for support, highlighting other options available to them. How does this feel if you work in a PCT?

  • 'Pensioner crime wave challenges public sector leaders'

    Where life means life, in the USA, the problem of elderly prisoners has been around for a long time but it is a relatively new feature of British prisons.

  • Pensions propaganda?

    The government says many public sector workers will be better off under the changes to the pension scheme. How does this apply to the average NHS employee?

  • Personal health records continued

    Following my frustrated experiments with personal health records last week, a south London GP has drawn my attention to another option.

  • Personal Impact

    Self awareness and personal impact are hugely important, we must not underestimate this.

  • Pestilence and the art of public relations

    Heatherwood and Wexham Park Foundation Trust’s public relations people got in touch today to inform us that the trust “takes the issue of pest control very seriously”. Fantastic! Because so many other trusts treat pestilence as a great big giggle.“Any large organisation, including hospitals, will experience infestations on occasions, and, like every responsible organisation across the country, this trust takes an extremely active approach to pest control.”A quick Google n

  • PFI for an eye?

    It is, of course, not for HSJ to speculate why a months old PFI story appeared so prominently in the quality press yesterday.

  • Plan B - or not plan B?

    What happens if your department doesn’t make the savings?

  • Playing to the whistle?

    Are whistleblowers good people trying to do the right thing or are they persuing their own agenda, just trying to get someone else into trouble because they don’t like them or want their job?

  • PMQs and the truth about waiting times

    David Cameron and Ed Miliband traded waiting time statistics over the dispatch box today. Who was right?

  • Pointing the finger

    Pointing the finger of blame at one individual is often convenient for a lot or people, but

  • Pointing the finger of blame for A&E delays

    Waiting to be treated at A&E is no laughing matter. But there’s not much else you can do while someone gets their fingernail seen to.

  • Politics and satisfaction with the NHS

    To say the NHS is political is to state the obvious. But are the public’s views about the NHS shaped by, or linked to, identification with political parties?

  • Politics and the English language

    End Game has been a fan of minister for laughs Anna Soubry maverick style ever since she arrived at Richmond House.She’s a street walking cheetah with a heart full of napalm and she’s peppered her latest interview with hearty profanity.Limbering up, she declared a builder’s sign to be “fucking useless” and said the minister for public health “bloody well” wasn’t the “girly option”.All pretty standard pub vulgarity so far but Soubs is a moderniser, always looking to innova

  • Politics reopens the age-old leadership question

    What a fascinating week for politics and leadership with the leaders’ debate at the centre of the age-old question whether leadership is about personality or substance.

  • Polyoaks - can Radio 4 out-absurd the current reforms?

    The NHS is to be lampooned next month in a new Radio 4 satirical comedy co-written by Dr Phil Hammond.

  • Poor elderly care is more than circumstantial

    Addressing problems in care standards starts with changing the group mentality.

  • Post-budget confidence

    Phew, that was close.

  • Powerpoint presentations

    “Beware of anyone who says that they're "just going to talk to some slides" - because that's exactly what they'll do - without realising that they're spending most of their time with their backs to the audience.” So says Max Atkinson, author of “Speech making and Presentations made easy”, in BBC news Magazine on 19th August.

  • Pre-Budget predictions

    It’s dangerous I know, but I’m going to stick my neck out and make my Big Budget Prediction for 2009: Alistair Darling will use the term “confidence”, oh, let’s say, at least five times. Hmm, maybe I should hedge this a bit. Alistair Darling, or someone else from government, or a prominent Labour MP, will make prolific use of the C-word.

  • Preferred provider – the saga continues

    Preferred Provider - the saga continues

  • Preparing to roar like lions

    Preparing evidence for the DH’s Co-Operation and Competition Panel

  • Pressure? Andrew 'Chopper' Lansley isn't feeling it

    Andrew Lansley might have News International to thank for a relatively pressure-free few days - he certainly didn’t appear to be unduly worried during his latest press spot.

  • PRINCE2

    What does PRINCE2 mean to you?

  • Prioritising mental health commissioning is brave, but it's also sensible

    The decision to focus on mental health care, as Brighton GPs are doing, is indeed a brave one. But it is also one that makes a lot of business sense for any GP consortium, big or small, urban or rural, anywhere in England.

  • Profit and loss in the 'new' public sector

    It is very clear now that the new public sector is going to look very different to the old public sector.

  • Protecting the NHS brand or devaluing it?

    Sir David Nicholson has had to defend the role of the NHS’s new “head of brand”

  • Public health inside and outside of the School

    I like taking stairs, but must admit to having had second thoughts when I heard my office was on on the 11th floor. But then, a voice inside (that I wish I hadn’t heard) reminded me that the ground floor is already counted as the 1st floor in the US. That’s one less floor to worry about.

  • Push yourself to succeed, don't wait for someone to push you

    Until you try you don’t always know what you are capable of achieving.

  • Putting on wait: English waiting list looking big

    Some waiting times figures got a bit better in December, some a bit worse. But the size of the waiting list is starting to look worryingly big.

  • Putting the trust in technology

    The health service has a reputation – though perhaps not entirely warranted – for looking fondly to the past, particularly at times of great change.

  • Questionable aroma

    Hearty End Game congratulations go to the team of volunteers who achieved a “professional relaxation qualification” via George Eliot Hospitals Trust.A graduation ceremony took place in February to recognise the team, who work on the trust’s Oasis Project, all of whom received an A grade in the diploma assessments.The project is intended to help patients relax ahead of a stressful medical or surgical procedure, through creating a “calm, tranquil environment away from the clinical

  • Real terms cuts of 2.3% a year from 2011 onwards?

    Just got back from the Institute for Fiscal Studies’ annual post-budget briefing. Scary stuff… They reckon real terms cuts of 2.3% a year are looming

  • Reconfigure It Out

    Ben Clover is an HSJ reconfiguration reporter.

  • Reforms offer best chance to change managerial culture

    The Coalition's proposed reforms offer the best opportunity to change the managerial culture of the NHS but more so for providers than commissioners. Strengthening local leadership will always be limited because of the strong history of hierarchical management overlaid by political control.

  • Replacing the 'irreplaceable'

    If no one is indispensable, it is still vital an individual’s unique qualities are fully recognised to continue developing a strong staff, and an improving work ethic.

  • Resources for transformation are abundant, even in an era of austerity

    Social movement leaders typically don’t have the economic resources of conventional leaders so they have to grow their own

  • Retiring leadership

    As a senior clinician approaches retirement, colleagues arrange little or even large gatherings to mark the occasion.

  • 'Safe and secure housing is critical to the wellbeing of mental health patients'

    Housing needs for patients with mental health need to be properly addressed in order to improve mental health services and individuals’ health.

  • Say no to 'yes' men and women

    As the Liberal Democrat conference draws to a close, opposition ministers have again targeted Nick Clegg for reneging on party policies and ‘selling out’ in forming the Tory-Lib Dem coalition. Can he ever be more than a “yes man”?

  • Scotland's backlog still growing

    Scotland is growing a waiting list backlog, despite the new RTT waiting times target. Will the new Treatment Time Guarantee solve the problem?

  • Scotland's treatment time guarantee shows results

    Scotland’s inpatient and daycase waits, which are subject to a legally binding target, improved. Outpatient waits, which aren’t, didn’t.

  • Scotland's waiting times slide again

    Scotland’s long waits are worse again, though you wouldn’t know it from the media coverage.

  • Securing equal mental health investment is still a big task

    The Health and Social Care Act earlier this year included a new requirement on the secretary of state for health to give equal prominence to physical and mental health. This week, a report published by the LSE has reminded us of quite how big a task this is.

  • Seddon joins the Downing Street inner Circle

    End Game’s congratulations to Nick Seddon, who has been propelled from introspective think-tankery as the deputy director of Reform, to the heady position of advisor on health and social care policy to the prime minister.Mr Seddon – a former communications director for private health provider Circle – is media savvy.We are already enjoying his work – including this rather matter of fact retort in a newspaper piece highlighting some of his past comments about the NHS (extend char

  • Self Coaching - is it possible?

    Exploring the value of self coaching and whether it is a substitute for one to one coaching, and the support of a coaching style of management

  • Senior management was ‘incompetent and reckless’

    Blair McPherson on how we should judge managers

  • Senior managers need to get 'hands on' with customers

    Organisations need to return to the days without layers of middlemen when dealing with customers if they are to ensure their services are running properly.

  • Sex, gardening and leadership

    We can all articulate what we consider to be the essential characteristics of exemplary leaders; I am sure there would be some variation but I am equally sure that the similarities would beconsiderable.

  • Sharp increase in English waiting list

    The number of patients waiting rose sharply in March, and is now higher than in recent years and may indicate waiting time pressures to come. But bed pressures over winter do not explain all the increase

  • 'She looked like she was on a big ride at Alton Towers'

    The hospital porter was pulling the wheelchair at speed from the x-ray department to the ward. The elderly patient was tipped back in the chair, gripping the arms tightly, her face frozen in fear all she could see was the ceiling lights flashing past.

  • Should Rose Gibb be forced to pay all the legal costs?

    There was one aspect of the judgement against Rose Gibb that was harsh.

  • Should we eradicate dyslexia?

    There are some highly successful and influential people who have dyslexia, and some might argue that it is this that has given them the abilities they needed to succeed. What are the positive aspects?

  • So what’s wrong with wearing a dress to work?

    Ben had since adolescence felt uncomfortable in a man’s body, so after much careful thought and counselling had decided to have a sex change.

  • Sometimes the best thing to happen to a candidate is not getting the job

    “A few questions from the panel wouldn’t pose a problem to a candidate of this calibre,” I thought. But I was wrong.

  • 'Sometimes the small has a huge impact on delivering bigger goals'

    Don’t take your eye off the ball

  • 'Spending on the health service was to rise to the European average'

    On 16th January 2000 Tony Blair was interviewed by Sir David Frost. In what was described as the most expensive breakfast in British history, the PM announced that spending on the health service in the UK would rise, over five years, to the European average. 

  • Spending Review conspiracies

    Has the evil Treasury swiped £2.8bn from the NHS’s 2010-11 baseline?

  • Stairlifts on cell block H: who cares for older prisoners?

    The photograph was of a frail man in a wheelchair handcuffed to a prison officer. The article and accompanying photograph appeared in The Guardian highlighting the problem of caring for the increasing numbers of elderly and disabled prisoners.The story focused on the comments by the hospital consultant who criticised the care provide by the prison service claiming it has severely damaged the patient’s health.Concerns over the care of elderly and disable prisoners howeve

  • Stampede for the exit

    I am one of those people who says “I told you so”. The NHS Commissioning board has identified that it is struggling to find suitable people to fill its senior vacancies and there is a risk of posts remaining vacant.The NHS reforms have so far cut 18,000 senior posts. The determination to reduce the management headcount, the uncertainty about future posts and structure, the mach

  • Startling openness from NHS England

    The latest “bulletin” for clinical commissioning groups out of the Quarry House Quango In the Sky may have been a little bit too open.NHS England’s deputy chief executive Dame Barbara Hakin, writing about patient safety, writes: “Dr Don Berwick, in his advisory role as chief inspector of hospitals, spoke at a conference in London last week on how he and a panel of experts will try to offer guidance on the next steps following Mid-Staffordshire.”Although the missive stri

  • Stock up on painkillers. The Tories are coming.

    What will a new government mean for the health service? Hmmm, let me think….

  • Strategy is the key to provider survival

    It’s tempting to assume that surviving the economic downturn and implementation of the coalition’s health policy is the key to future provider organisational survival. Not so. It is strategy that will be the defining characteristic of provider organisations during the next decade.

  • Stuck in the middle

    Being in middle management often requires evasive action to avoid friendly fire from both directions.

  • Stuff happens

    Don’t worry. Be happy. Launching ‘The Worrier’s Guide to Risk’

  • Stuff the bags

    How many calico bags does it take to make a conference?

  • Supping with a long spoon

    A new Cabinet sub-committee will lift the barriers to third sector delivery of public services. The sector will need to learn new ways of influencing that retain its independence whilst making sure users of services and patients get the right services when and where they need them.

  • Supporting failure

    The tendency to support failure: A common theme in the health service’s ritual hand wringing about why it fails to stimulate radical changes and new market entrants. It was one inevitably raised at the Healthcare Innovation Expo this week, the bonanza of idea exchanging - and product flogging - held annualy in a shed on London’s eastern fringe.And so it was at one particular Expo break-out session that it was suggested the NHS Commissioning Board (the default home for all functions) sh

  • Survival of the fittest: will social enterprises thrive in the new world?

    How will an NHS opening up to “any qualified provider” fit into the government’s Big Society vision? King’s Fund senior research fellow Rachael Addicott looks at whether social enterprises can make the impression the government hopes for in the healthcare sector.

  • Surviving another recession

    Just as trees can be aged by their rings, people can now be aged by how many recessions they have survived.

  • Swine flu but still no flu plan! Is this World Class planning?

    Swine flu has arrived in my area! I know this because two patients, contacts with swab-proven swine flu, phoned for advice. We have received flu packs but no local plan: no instructions on managing contacts or accessing Tamiflu supplies - and no information that swine flu was around locally.

  • Taking action on workplace discrimination

    Two prominent sports commentators persistently make sexist comments to colleagues and guests off air. Why didn’t someone do something?

  • Taking the fight to bullies in the workplace

    If you need to exist in a culture of bullying until you’re able to move on elsewhere, The People Manager has some survival tips.

  • Talent Management

    How can we recruit and retain the very best people for the NHS? David Nicholson said in the foreword to “Inspiring leaders; leadership for quality” that it was imperative to align work on leadership with achievement on quality. He describes it as “Leadership with a purpose”. So how to identify and grow those leaders who will be critical in the achievement of high quality care for all?

  • Tantalos a l’americaine, wellness incentives and (no end to?) medical underwriting

    wellness incentives can be a useful part of prevention strategies, but proposals in the current health reform bills threaten to undermine affordability of care

  • Targets are here to stay

    The Tories have, inevitably, confirmed they would set central targets for health

  • Targets met, records broken: good news on waiting times

    The English NHS broke records with a superb performance on 18-week waiting times in January.

  • Tee tweets cockadoodledoo

    It is a little known fact about Matt Tee – the NHS Confederation’s soon to be chief operating officer – that he was once interviewed by David Frost as a child.Mr Tee, the former all-sorts-of-things in and around the NHS and current boss of something called “Reputate”, took to Twitter recently to tell all.“Saw Nixon Frost [sic] last night,” he twote.“It is a little known fact that I was interviewed by Frost when I was 4. He asked me to do some animal noises.”Mr Tee

  • The 18-week waits performance in your region

    The local picture on 18 weeks, with interactive maps showing the size of the challenge and where the long-waits are.

  • The active patient tracking list

    How active PTLs work to minimise waiting times continuously and safely for all patients.

  • The appeal of diversity - in theory

    Embracing diversity in the workplace is now a common goal for every organisation. Achieving it is much trickier than the cosy theory behind it, however.

  • The art of timing

    The secret of comedy is, famously… timing.And the same is true of that lesser branch of comedy: PR.Sometimes there is nothing you can do as a flack. You have a simple brief and timing is against you. Something else breaks and your press release subject line is an object of mirth in the newsroom.So maybe the PR who sent this particular release through this week took a reasoned decision that the horsemeat scandal would have passed through the nation’s imagination tract by n

  • The benefits of employment support to mental health patients

    The change in the way people with mental health problems are supported into work highlights just how vital it is for NHS organisations to be focused on employment as an outcome.

  • The blame game

    The blame game pendulum is swinging back from managers towards clinicians.

  • The blame game won't halt elderly care failings

    I don’t blame the nurses. I don’t blame the hospital managers. I don’t even blame the budget cuts for the pain and suffering inflicted on elderly patients.

  • The blip is over: waiting times break new records

    Waiting times resumed their downward trend, breaking new records for best-ever long-waits performance.

  • The blood and guts of cuts

    How well will managers cope with a spending cut? Hardly any NHS managers have been around long enough to experience government imposed cuts like this before.

  • 'The BMJ said it was demeaning for doctors to appear on the stage'

    On 11 February 1958, the BBC first televised Your Life in Their Hands, presented by Charles Fletcher from the Royal College of Physicians.

  • 'The BMJ saw dangers in a state medical service'

    The 5th of July is the most important date in the history of the NHS.

  • The Book of the Dead

    The Book of the Dead is the name of the current Egyptian exhibition at the British museum. It would have made a good alternative title for Dr Foster’s hospital guide.

  • The bottom line

    Patient involvement must not be lip service, a tick box exercise or a token gesture

  • The buck stops with you

    We have a tendency to blame politicians, other people and systems and processes when something is difficult to deliver or perhaps when we need a reason to resist change. The cynics amongst us might suggest that it is easy to object if you just don't really like what is being suggested. I've done it. Chances are you've done it.

  • The casualties of workplace conflict aren't just the staff

    Anxiety over the reforms is heightening conflict in the workplace, and that conflict is threatening to spill over into the quality of care.

  • The CEO

    Born in a basement and brought up in a lift, Innate Prejudice is a CEO with a track record of failing to make sense of it all.

  • The challenge of acquisition

    Acquisition is one of the most challenging games currently at play in the NHS. Although there are a few applicable lessons from the private sector, public services demand a more considered approach. Understanding exactly why one organisation is interested in wanting to take over another is a good starting point.

  • The Charity Chief

    Charity chief Lynne Berry is transforming volunteering stalwart WRVS into an organisation that helps older people get the support they need.

  • The Clinical Leader

    Dr Jonathan Fielden is chief medical officer at Royal Berkshire Foundation Trust. 

  • 'The coalition’s distrust of managers means the usual options are closed'

    The health white paper has set out a clear direction of travel, but it is far from a done deal.

  • The Coalition's Managerial Approach

    The coalition government has set off to a good start with the mangerial approach of setting clear but ambitious priorities. By so doing they may avoid the death by policy approach of the 1997 government where there was a naïve belief in the correlation between policy volume and service improvement.

  • The Consultant

    Nadeem Moghal is a consultant paediatric nephrologist who manages and leads a tertiary regional service. He is currently pursuing an MBA.

  • The conundrum of personality driven leadership

    The media has reported that the beleaguered Trevor Phillips is to remain as head of the Equalities and Human Rights Commission after being criticised for his leadership style. This story highlights the conundrum of personality-driven leadership.

  • The culture shift required to achieve equality in the workplace

    How can you champion equal opportunities in the workplace if your staff aren’t comfortable enough to share the information?

  • The DH's epic quest

    The government’s Care Bill “will give people peace of mind in hospital, care homes and their own homes”, trumpets the headline of a recent Department of Health press release.Excellent. End Game is all in favour of peace of mind. How are ministers going to impart it to the nation?Helpfully, a sub-headline elaborates: “Swift action following Francis report and epic changes to care laws”.End Game is reliably informed that “epic” is young person speak for “good” and, on occas

  • The difference between what is said, and what is meant

    Language is important to get right - there is often a difference between words said, and meaning implied. Between the lines is where the truth lies…

  • The dilemma of appointing senior managers

    Sir David Nicholson’s admission to the Mid Staffordshire Inquiry that in retrospect the previous chief executive was the wrong appointment highlights a common dilemma when appointing people at this level.

  • The drama of being a whistleblower

    The potentially traumatic experience of being a public sector whistleblower, plus the dangers of NHS hospitals being “all most full”

  • The Editor

    Richard Vize is editor of HSJ. Follow Richard on Twitter twitter.com/RichardVizeHSJ 

  • The emotional leadership expectations of chief executives

    The White Paper changes will be more challenging for chief executives who will be expected to help manage the emotions of thousands of staff concerned about their future. This includes accepting that many staff will put themselves - rather than their organisation and perhaps the NHS - first.

  • The end of the start for personalisation in adult social care?

    With social workers critical of the idea, it looks like the government is quietly moving away from the idea of personalisation in social care before it has even been implemented.

  • The English waiting list: not growing after all?

    After adjusting for counting changes, it turns out the English waiting list might not be growing after all.

  • 'The estimated cost of the future National Health Service was £21 million'

    On 24th April 1944, before Victory in Europe, Mr Neville, of the Ministry of Health, signed on behalf of a committee of the great and the good a document outlining the demobilisation of the emergency hospital service.

  • 'The evidence of rape and the distress of the patient were clear'

    On 14th June 1938 Aleck Bourne (1886 - 1974), a prominent gynaecologist, was arrested after performing a termination of pregnancy, without fee, at St Mary’s Hospital Paddington.

  • The expenses scandal is heading your way

    The media is starting to bring expenses run up by senior NHS staff under the spotlight

  • The Facebook metric

    It’s hard to know if health secretary Jeremy Hunt’s performance is best assessed by his level of popularity, or whether his preferred measure of success is how obscure he can remain by keeping the NHS out of the news.If the latter is best, he seems to be doing very well indeed. A recent story in the Guardian reported that Facebook, the social networking site which young people use to orga

  • The fall of the Roman Empire

    Following a humiliating defeat, those in charge blame the rank and file.

  • The Fear Factor

    Managers in all NHS organisations need to overcome fears, we need the intuition to know when to ‘go against the flow’, we need to manage and take calculated risks and set stretching goals

  • The Finance Maven

    Sally Gainsbury is a former HSJ news editor.

  • The five laws for delivering integrated care

    The listening exercise is over and the results are in; the NHS Future Forum insists integrated care must underpin how health and social care is delivered – and they are right. But do we really understand what this means, and what it implies?

  • 'The formation of the RCGP followed letters in the medical press'

    On 19 November 1952 the College of General Practitioners was established quietly at a meeting at the Worshipful Society of Apothecaries.  

  • The Foundation Trust Network: you had to be there

    The FTN’s first annual conference heard that patient centred care has to be at the heart of the FT movement.

  • The funding must be available to help achieve public health outcomes

    The recently announced Public Health Outcomes Framework sets an effective set of measurements for performance - but if the resources aren’t there to achieve them, many services will step back from this opportunity for a step change in mental healthcare.

  • The future of nursing and midwifery

    As a commission looks at what skills and competencies nurses and midwives need for the future, Martha Lane Fox tells the NHS what it was like to be on the receiving end of the NHS following a major accident. Do nurses need a degree? What makes a good nurse? And where can you find out what patients think of their local hospital?

  • The government needs to listen harder if it wants to hear patient voices

    The Future Forum should have heralded the end of an era where patients found themselves on the outside, looking in.

  • The government shouldn't cut public health loose just yet

    A government’s role in public health campaigns is not only necessary, it is desired and it works, according to speakers at the World Social Marketing conference in Dublin.

  • The GP

    Unherdable Cat is a partner in a modern group practice that has survived two new contracts and many, many re-organisations of the NHS over the past 30 odd years.

  • The great care divide

    Funding for care, particularly older person’s care, is high on the agenda, and new proposals have divided opinion.

  • The Harkness Fellows 2009-2010

    Established by the Commonwealth Fund and co-funded by the Nuffield Trust, Harkness Fellowships allow professionals to research health policy in the US.

  • The Harkness Fellows 2012-13

    Established by the Commonwealth Fund and supported by the Nuffield Trust, Harkness Fellowships allow professionals to research health policy in the US. They blog their experiences and learning for HSJ and the Nuffield Trust. The 2012-13 fellows are Joan-Costa Font, Julia Murphy, Douglas Noble and Alexandra Norrish.

  • The Harkness Fellows: 2011-2012

    Established by the Commonwealth Fund and supported by the Nuffield Trust and the National Institute for Health Research Service Delivery and Organisation Programme, Harkness Fellowships allow professionals to research health policy in the US. They blog their experiences and learning for HSJ and the Nuffield Trust.

  • 'The health secretary is publishing dodgy figures in the name of transparency'

    Two of Andrew Lansley’s big summer announcements have irked some in the NHS for a number of reasons, and they were both information publications of sorts.

  • The Health Volunteer

    Samuel Johnson has worked in NHS performance and information management. He is currently volunteering in Swaziland’s health ministry.

  • 'The hospice movement was prepared to look death squarely in the face'

    On 24th July 1967 Princess Alexandra came to St Christopher’s Hospice in Sydenham to perform the official opening ceremony.

  • The HSJ anti-bullying hotline

    Thanks to recent HSJ articles about workplace bullying in the NHS, the newsdesk has started to feel more like a Samaritans service.

  • The importance of trust

    If there’s one issue that will be the touchstone for success during 2010 it has to be trust.

  • The introverted leader's time has come

    Has the time at last arrived for the introverted leader in this brash, noisy and personality driven world? I think so. In these uncertain times we need leaders who can project calm reassurance rather than attempt to rouse us with fine oratory or hector us with their visions of what may be.

  • The issue of heterosexual discrimination

    Issues of discrimination around employees’ sexuality can be common - but can organisation leaders make heterosexual employees feel uncomfortable?

  • The King's Fund

    The King’s Fund is a health policy think tank.

  • The Leadership Consultant

    Neil Goodwin is a director of GoodwinHannah and visiting professor of leadership studies at Manchester Business School.

  • The local detail on clock pauses

    The local detail on clock pauses, by specialty, by Trust and PCT.

  • The local picture on waiting times

    All the detail on 18 week waits: every specialty, every Trust, every PCT, all based on the latest (January 2012) data.

  • The local picture on waiting times

    Which trusts and PCTs have the biggest waiting times pressures? And how do we explain the trust whose patients are apparently frozen in time?

  • The long view on long waits

    A short history of waiting times: dramatic improvements under Labour, and a wobble followed by renewed improvement under the Coalition.

  • The lost opportunity to review management

    While the listening panel goes about its business and Number 10 takes a closer interest in the NHS, a golden opportunity to realign NHS management has been missed. Wouldn’t it be good if management requirements anticipated the future rather than reacted to the present?

  • The mandate provides a historic opportunity for better mental healthcare

    Board and CCGs tasked with tackling disparity between physical and mental health support

  • 'The massive death rate from pneumonia forced government action'

    The massive death rate from chest disease and pneumonia were among the factors that forced the government to pass the Clean Air Act in 1956.

  • The minister for charm and the NHS Valentine's ninjas

    Those incorrigible romantics at the Department of Health gave the nation £30m to get their teeth sorted as a Valentine’s gift this year.“A healthy smile and fresh breath are essential ingredients for those hoping to make a perfect impression,” a  spokesman blathered. “And with a smile being one of the first things you notice about a potential partner, it has never been more important.”Minister for charm Earl Howe even claimed better oral health was a “key priority of the governm

  • The money makers at the BMA

    The BMA campaign Look After Our NHS is a highly distorted portrayal of the health service

  • The mystery of the missing waiting list patients

    Thousands of patients are apparently missing from the English waiting list. February is 28 days long. Together, those facts help us work out what on earth might be going on.

  • The never asked question: 'What if I am wrong?'

    If managers are so sure they are right, does that mean everyone else is wrong?

  • The new culture of openness in action

    End Game was delighted to discover that as part of NHS England’s ongoing commitment to transparency, one of its senior managers has apparently started her own blog.It comes from Samantha Riley, the organisation’s director of insight. Title: “Samantha Riley’s Insight Blog (Which is Hopefully Insightful!)”Yes, hopefully it is.Actually, End Game hopes the blog continues to develop the literary voice evidenced in the most recent entry, which – although not particularly recent

  • The new government and health policy

    A new government and a new dawn. But what will the future hold for health and related policy?

  • The new minister's agenda

    The new group of ministers at the Department of Health will have a lot to take in as they begin work at Richmond House.

  • The new NHS can transform mental health care

    Under the NHS mandate, new commissioners have the chance to improve mental health care throughout the NHS.

  • The next NHS chief executive?

    The list of potential candidates for the chief executive of an independent NHS board has just got longer

  • The NHS Change Agent

    Helen Bevan is chief of service transformation at the NHS Institute for Innovation and Improvement. From 1 April 2013, she will be joining the delivery team of NHS Improving Quality. All views are personal

  • The NHS needs active listeners

    Active listening - it is said we are given two ears and one mouth, and should therefore listen twice as much as we speak. John Whitmore, in his book “Coaching for Performance” tells us that most people are not good at listening to others, and that it is a skill that requires both concentration and practice.

  • 'The NHS needs to recognise it is wasting talent'

    Apparently the NHS isn’t sexist. The fact that fewer than 30 per cent of consultants are women when they make up two thirds of doctors doesn’t indicate prejudice or discrimination.

  • The NHS should aim higher than "don't be evil"

    “Do no evil” seems a very modest ambition, but it’s one banks and multinationals have struggled to live up to. Surely the NHS can be better than this?

  • The One Hour Challenge

    Have you physically walked a pathway from emergency or elective admission to discharge?

  • The Patient's View

    Dr Paul Hodgkin is a former GP and is CEO of NHS feedback service Patient Opinion

  • The Pearl Catcher

    Kate Hall is a Health Foundation Leadership Fellow and has specific interests in leadership and quality improvement.  

  • The People Grower

    Anne Axford is associate director for learning and development at Portsmouth PCT.

  • The People Manager

    Blair McPherson is a former local authority director and author of a number of management books, including Equipping Managers for an Uncertain Future and An Elephant in the Room. Follow him on Twitter: @blairmcpherson1

  • The perfect storm for NHS management?

    Events are bringing about a perfect storm for confidence, trust and leadership

  • The Personal Care at Home Bill

    A step in the right direction

  • The power of an HSJ blog

    A trip to the health centre suggests local general practice staff have been reading my blog.

  • The power of the political placebo

    Are GPs prescribing placebos any more unethical than when politicians and managers talk about service closures?

  • The powers of the dynamic duo

    The role of the deputy is often underplayed, undervalued and sometimes, in the case of Nick Clegg, mocked. But this is to miss the vital part they play in partnerships, and without deputies, many leaders wouldn’t be where they are.

  • The pressing case for linking physical and mental health

    The link between physical and mental health is one all too often missed. But the example set by an acute hospital in Birmingham that has invested in high quality liaison psychiatry shows that integrating physical and mental health services has efficiency and financial benefits waiting to be discovered.

  • The problem with superficial inspections

    Some inspections of health and care providers are note much deepe than someone inspecting a second-hand car by going around and kicking the tyres.

  • The prospects for health and social care in 2013

    The pressure and demands on the NHS in 2013 will be so great it will be impossible to duck the big questions about what kind of health and care system we are willing to fund.

  • The reality of future challenges

    A recent seminar with a group of non-executive directors to discuss dysfunctional boards and corporate failure demonstrated how grounded they are about future challenges facing the NHS and their organisations.

  • The regulation game

    Learning to play the regulators is an essential part of the induction for senior managers. 

  • The Regulator

    As a regulatory worker and a sometimes-critical NHS patient, Inside Out knows the health sector, well, inside out.

  • 'The report established the principles of NHS management'

    The 1983 Griffiths review of management was the direct outcome of the chaos of industrial action.

  • 'The report had a world-wide effect on public health'

    On 10th September 1973, Marc Lalonde, the Canadian minister of national health and welfare, addressed the PanAmerican Health Organization conference in Ottawa.

  • The secret of the perfect leader

    There are three rules for creating great leaders

  • The shocking truth about anonymous comments

    You will often find on HSJ, and other professional publications, people responding to articles anonymously. Those who don’t put their names to their comments are invariably being rude, offensive or cynical.I am often shocked that professionals, or those who read professional journals, would express themselves in this way. I can’t imagine they talk like this to colleagues in the office - people just wouldn’t put up with it. Maybe they h

  • The Short-Termism of Acquisition

    The acquisition of ‘challenged’ trusts will offer a quick managerial fix but it won’t necessarily create strategically sustainable services and the operational problems that precipitated acquisition in the first place may well reoccur.

  • The sky's the limit for airport-style health services

    Ahead of the release of the Future Forum’s report into his NHS reforms, the health secretary decided to check-in to a fancy new health facility.

  • The Soubry channel

    It’s the Friday before the Oscars which can only mean one thing: another moving picture from those prolific film makers at Richmond House.Last week we were treated to a film about any qualified provider.

  • The strikes don't mean staff don't like doing their job

    Generally across the public sector, staff remain committed to providing a high standard of service to the client or end user. Keeping morale high should be a line manager’s priority in a time of organisational cuts and structure changes.

  • The surgical ninety day money back guarantee

    Geisinger promises to get surgery right first time or your money back

  • The trouble with PTLs

    When things get difficult, trusts often use PTLs to achieve their waiting time targets. But PTLs have unintended consequences.

  • The upside-down reporting of NHS waiting times

    When waiting times improve, the papers say they got worse. A closer look at the numbers shows why.

  • The vision thing's gone missing

    The Party Conference season is over

  • The Voice of Trusts

    Chris Hopson is chief executive of the Foundation Trust Network. It represents more than 200 members delivering acute, specialist, mental health, ambulance, and community services in hospitals, in the community and at home

  • The Waiting Time Guru

    Rob Findlay is founder of Gooroo Ltd and a specialist in waiting time dynamics.

  • The Workforce Watchdog

    Charlotte Santry is HSJ’s chief reporter.

  • There is now a pattern in the government's approach to competition

    The Department of Health is trying to silence the cooperation and competition panel, to stop health secretary Andy Burnham’s “preferred provider” policy being exposed as illegal.

  • There's something fishy about all this change...

    Ambitious managers are like sharks. They need to keep moving or they die.

  • They're Goodfellas at the CQC

    I wonder what the NHS will make of Baroness Young’s announcement that the Care Quality Commission wants to “do a number” on failing organisations. It’s the kind of shadowy threat you’d expect from a Martin Scorsese g

  • Thing One and Thing Two

    Over the past few weeks the legislative spotlight has moved from the Senate to the House, and members of the lower house have been revelling in it.

  • Thinking differently about quality and cost

    "Revolution begins with a transformation of consciousness". Innovation, doing things differently, is becoming a high priority activity in the NHS. Innovation has a critical pre-requisite: thinking differently. If we are going to sustain a universal healthcare system for future generations, we need to think differently about the relationship between cost and quality.

  • 'This was the beginning of care in the community'

    On 9th March 1961 Enoch Powell, the Minister of Health, addressed the annual conference of the National Association of Mental Health.

  • Thrive, survive and take control

    How to manage the changes that you may not have chosen and emerge positively

  • Time to acknowledge NHS managers' crucial role

    After 13 years of institutionalisation under the previous administration and now having to respond to a crisis largely not of their making, now would be a good time to acknowledge the crucial contribution of managers in leading the future changes. Changes that will have human consequences for many people including for themselves.

  • Time to change: challenging the stigma around mental health

    The latest survey on the public attitude to mental health shows some encouraging figures, but also highlights how prevalent ignorance and fear toward mental illness remains. There is, says Sean Duggan, still some way to go in tackling mental health stigma.

  • To coach or not to coach…

    There’s many different forms of coaching, from the informal, “water cooler” conversation, through manager coaching to more formal internal or external coaching. Coaching as a style of management is now accepted as effective, but there is a growing trend towards formal coaching, because of the growing evidence of its worth.

  • Too many chiefs

    At the excellent health policy wonkathon (TM: Dr Phil Hammond) that is the Nuffield Trust summit, talk turned to the impending arrival of a chief inspector of hospitals.As night follows day, the delegates then began debating what other areas of the service needed a chief inspector and which members of the good and great should be honoured with the various roles.“What about air ambulances, who are we going to get for that?” asked one wag.“What about Prince Harry? I believe

  • Tory press caught napping

    A special End Game hat tip goes to Jayne Morris today, for causing a media ruckus with some harmlessly irrelevant workplace tips.Both the Daily Mail and the

  • Toynbee exposes the waiting list cheats

    Polly Toynbee was right to expose waiting list cheats. But let’s fix the system, not start a witch-hunt against hospitals.

  • Transforming real waiting lists with better scheduling

    How a rules-based approach to patient scheduling can dramatically reduce waiting times.

  • Treasury tricks and accountancy acronyms

    I have a strange fascination with NHS accountancy. I don’t know whether it’s the edge it gives me over my colleagues every time we play NHS acronym bingo (their PBCs and WCCs are nothing to my IFRICs and EBITDAs) or just the opportunity to try and talk sagely about the difference between “cash” and “resource”.

  • Trick or treat ...

    The spectre of the US mid-term elections will be lingering well past Halloween. But are there any lessons in all this for how we handle our own health reforms?

  • Trouble on the road to Confed

    Travel to Confed conference from London was derailed by signalling faults.

  • Trust chief executives have one of toughest jobs there is

    The people in the hottest seats around need more support

  • Trying to force equality in leadership is an unbalanced approach

    The NHS breakthrough programme of putting a small number - around 60 - of black and minority ethnic managers through a leadership programme and hoping this will result in more BME senior managers isn’t working. It was a little naive to think it would.

  • Two days, 52 TFAs?

    Two working days to go until the end of September and one of the trusts HSJ reported was too small to go it alone has announced its decision.

  • 'Tylenol became a classic example of healthcare crisis management'

    12-year-old Mary Kellerman of Elk Grove Village, Illinois, woke up at dawn and went into her parents’ bedroom. She complained of having a sore throat and a runny nose. Her parents gave her one extra-strength Tylenol capsule.

  • Tyranny of When

    How many of us have thought, at some time, I'll really feel happy when (I've got the promotion, bought the new car, been on a world cruise...or whatever) and see happiness as something over the horizon - when what we already have is something to celebrate?

  • Undercover boss

    How do you know what is really going on in your organisation?

  • Undermanaged NHS needs step change in appointment process

    The King’s Fund report is right to suggest the “undermanaged” NHS is needs a new style of leadership - but the way managers are appointed needs to change first if the balance is to be successfully redressed.

  • Un-learning leadership in the NHS

    The traditional view of leadership is a charismatic individual who - by sheer force of personality and will - drives through change and makes things happen; a heroic figure.

  • 'Urgent action is needed to tackle mental health life expectancy inequalities'

    Stark new figures have revealed the inequality in life expectancy between people with, and people without, mental health problems.

  • US health care reform: I know it's over (and it never really began)

    US legislators finally passed health care reform. Or, at least, extensive health care tinkering.

  • Use the files - save the child

    As an increase in residential children’s homes is mooted, are we heading for a change? Inside Out argues it’s not before time.

  • Virtual public relations

    Being a web-savvy lot, End Game readers will have heard of Second Life, the online role-playing game that was big in the giddy, wasteful days before the recession.For those who were doing other things, we will explain. The game allowed players to design an outlandish character (or “avatar”) and stroll around a fantastical virtual world complete with alien landscapes and thousands of fellow players.Licensed to do entirely as they pleased, participants built palaces, foug

  • Voluntary groups shouldn't take funding for granted

    It is only natural when deciding which voluntary groups’ budgets to cut to go for the ones that have the least popular support.

  • Volunteers win support in Borders

    What can be done when our vision is shared

  • Waiting list 'gap' is growing

    One-year-waits improved, 18-week-waits are steady, the total waiting list is looking ever larger for the time of year.

  • Waiting times improve again in May - England RTT stats released today

    English RTT waiting times improved again in May

  • Waiting times soar as Scotland's backstop fails

    Scotland “achieves the target” while its waiting times get worse.

  • Waiting times steady in June

    A detailed analysis of the June 2011 referral-to-treatment waiting time figures.

  • Waiting times tread water

    18-week waits didn't improve in July. Nor did they get markedly worse. It's probably still just a seasonal blip.

  • Waiting times: 'strong' or 'a huge embarrassment'?

    Are waiting times up or down? It depends who you ask, but some answers are more meaningful than others.

  • Wales waits and waits

    Welsh waiting lists are soaring. Why?

  • We need to celebrate best practice in tough financial times

    Should we be spending scarce resource on award ceremonies that recognise achievements and effort? I think this is money well spent.

  • We will let you know by the weekend...

    How do you prolong the torture that is ‘the interview process’?

  • What can civil rights leaders teach us about strategy for transformation?

    Healthcare leaders can learn greatly from civil rights and anti-apartheid leaders who typically had few economic resources, yet were able to strategise to change their worlds and enable profound change

  • What causes seasonal variations in elective admissions?

    Elective admissions go up and down like a yo-yo. Why? Nearly everything is explained by the calendar.

  • What do NHS managers do?

    An article on the BBC news site this weekend asked, “What does a pope do?” The same could apply to NHS managers, says Neil Goodwin.

  • What does it feel like to be a PCT manager?

    PCTs will disappear from 2013 - what does it feel like to be a manager in one?

  • What does success look like?

    Success doesn’t necessarily mean getting to the top. What is the top anyway? Top of what?

  • What happens when chief executives are slow to pick up on patient complaints?

    The answer: patients are left believing they have cancer purely because consulting rooms are busy, as I was unfortunate enough to discover.

  • What happens when pleasing the boss goes too far?

    Managers who surround themselves with “Yes Men” are even harder to please when the answer should be “no”…

  • What on earth is MBTI?

    “I’m ENTP – I’m guessing you are ESFJ – but what do you think J Is? ISTJ or INTP?” What on earth is this gibberish? If you’ve never been “MBTI’d” it will mean absolutely nothing. If you have – you will immediately be leaping to a set of information about me and the others, based on the Myers Briggs type Indicator.

  • What the Francis report means for mental healthcare

    The Francis report’s recommendations will have a huge impact on all parts of the NHS, not least mental health services, says Sean Duggan.

  • What went wrong at Mid Staffs?

    Yet again we have a badly under-performing hospital, resulting in the deaths of hundreds of, mainly elderly, patients.

  • What will 2012 have in store for mental health?

    Sean Duggan looks at the opportunities and challenges ahead for mental health.

  • What's so hard about saying sorry?

    Most people who complain just want an apology or explanation. They are not looking for compensation or staff to be disciplined.

  • When customer care alone is not enough

    Apparantly the saviour of public sector finances is better customer care. Is that really enough? Please hold while I connect you to an advisor.

  • When is whistleblowing not whistleblowing?

    I was recently surprised to hear an NHS board member described as a whistleblower, given their position and power.

  • When looking the part goes too far

    It’s always said that appearances can be decieving - but surely looking your best for your employer should never be frowned upon?

  • When the long-waiters are forgotten

    When patients are forgotten on waiting lists, anything can happen. Sometimes comical errors, sometimes awful tragedies.

  • 'Wherever there was social disparity, there was disparity in health'

    August 1980 will forever be remembered by public health doctors for it was then that the Department of Health published the Black report.

  • Who cares what they think?

    Leaders pushing through decisions without consulting patients or even staff suggest a disregard for what people think. Is engagement just a pipedream for the NHS?

  • Why can’t health and social care services get it together?

    Everyone is talking about integration, but why haven’t we got it together yet?

  • Why did Rose Gibb lose?

    There is considerable surprise at the high court ruling against Rose Gibb in her claim for breach of contract.

  • Why HSJ.co.uk is changing

    The imminent move to make HSJ’s website “subscriber only” will help us expand our services.

  • Why you should keep the 'smiling assassins' in HR on your side

    HR get a lot of criticism from staff and managers alike. But they function in the best interests of the organisation, not individuals or groups of employees, so it may be wiser to keep them onside than wage war.

  • Why you should reframe your strategy as transformational

    Leaders need to combine coercion with a sense of shared purpose to bring about real change in their organisations

  • Wicked whispers

    Which outspoken advocate of accurate data turned up late to a seminar recently because they wrote down the wrong time?End Game would love to tell you, but the event was held under solemn Chatham House rule conditions.

  • Wider lessons from Imperial's long waits

    How can we make the NHS more resilient against the risk of waiting times failures?

  • Will 2012 be the year of the accountable care organization?

    Setting aside the controversy over reform, the hot topic for 2012 will be integrated care. In the US, accountable care organizations could help drive integration - as long as they are given time to demonstrate their value.

  • Will new waiting time records be broken?

    In Thursday’s figures, will the number of long-waiting patients being admitted finally fall below the general election level? It looks like it will.

  • Will the bean counters kill PBC?

    £1.2bn reasons to wonder if they’ve done so already

  • Will the bill halt the integration of vital services outside health and social care?

    Now it looks as though the bill is - in some guise - here to stay, Sean Duggan asks how it will affect the integration of the NHS and its many partners in making a difference beyond health and social care.

  • Will the government's plans improve GP performance?

    The hope is that pressure from respected and credible peers in the form of GP consortia will help to improve performance in primary care. But will it?

  • Winning charities still battling among public sector cuts

    The King’s Fund IMPACT Awards has been celebrating and rewarding outstanding health charities for 14 years. But it has never felt more important than in 2011.

  • Winning is for quitters

    The people of Lincolnshire are being encouraged to give up smoking with a prize draw for successful quitters.Lincolnshire Community Health Services Trust invited locals to “swap fags for swag in big ticket giveaway”.Sounds great! We like swag. All you have to do is kick the ciggies for four weeks.Prizes on offer include a family ticket to Pleasure Island, Cleethorpes, a family ticket to Natureland Seal Sanctuary, Skegness, and ticket to tour Lincoln on an open top sightse

  • Winter pressures, week by week

    Good planning and monitoring can reduce the risk of crises this winter. We look at a worked example of week-by-week interactive profiling for beds and waiting times.

  • Winterbourne View was shocking but hardly surprising

    Some people will be genuinely shocked at the prison sentences handed out to staff who worked at the Winterbourne View home for people with learning disabilities.

  • Word on the Web

    Tim Miller is assistant online editor for HSJ.

  • Worskett case scenario

    End Game received an email a couple of weeks ago that filled us with admiration for the hard work and long hours put in by NHS Partners Network chief executive David Worskett, who represents the views of private providers to the NHS.It was the night of the Lords debate on a Labour motion to strike down the controversial “Section 75” regulations, which set the rules for competition in the NHS.The debate pushed on late into the evening, and it was past 10pm when peers finally vote

  • Yes, we do talk about you

    My colleague on the senior management team seemed surprised - shocked, even: “Do you mean to say you talk about me and members of my team during your meetings?” as if this was slightly improper, unprofessional and indiscrete.

  • Yet another opportunity to reinvent the acute hospital

    In the new world an old challenge will quickly emerge driven by implementation of the reforms. Is it time for the acute hospital to be reinvented? The answer is an unequivocal yes.

  • Young's departure exposes cracks in the system

    The rows in the last few days over regulation, death rates and patient safety, culminating in the resignation of Care Quality Commission chair Barbara Young, are a public display of dysfunction by some of the most powerful organisations in healthcare.

  • Your 18 week waits: August 2012 data

    Interactive maps showing where the long-waits are, and where the most clock pausing is happening, by specialty, and by NHS Trust, independent sector provider, and PCT.

  • Your 18 week waits: February 2013 data

    The local picture on one-year and 18-week waits across England, updated with the latest data.

  • Your 18 week waits: January 2013 data

    Interactive maps showing the local picture on waiting times, with click-through to detailed reports. Fully updated with the latest data for January 2013.

  • Your 18 week waits: July 2012 data

    All the local detail on 18 week waits: full specialty-level analysis by Trust and PCT, and interactive maps showing where the longest-waiters and highest levels of clock pausing are.

  • Your 18 week waits: June 2012 data

    Interactive maps and resources with detailed analysis of the 18-week pressures by Trust and PCT, by specialty.

  • Your 18 week waits: March 2013 data

    The local picture on one-year and 18-week waits across England, updated with the latest (March 2013) data.

  • Your 18 week waits: May 2012

    Interactive maps and resources with detailed analysis of the 18-week pressures by Trust and PCT, by specialty.

  • Your 18 week waits: October 2012 data

    Interactive maps showing where the very-long-waiters are, how organisations fare against the “92 per cent within 18 weeks” target, and where the most clock pausing is happening. All updated with the latest October 2012 data.

  • Your 18 week waits: September 2012 data

    Interactive maps show where the long-waits are, the waiting time pressures and where the most “clock pausing” is happening: by specialty, by trust and independent sector provider and PCT.

  • Your 18-week waits

    18 week pressures fully analysed, by Trust and PCT, and by specialty: updated with February 2012 data.

  • Your 18-week waits: December 2012 data

    Interactive maps showing where the long-wait pressures are, for NHS and independent sector providers and for commissioners.

  • Your flight has been cancelled (by your employer)

    When staff shortages mean organisations cancel their employees’ holidays, there are bound to be issues with people management.

  • your worst decision

    What's the worst decision you have ever made?

  • 'You're going home': improving the interview process

    Interview days are usually so boring, something should be done to shake up the process.

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