Patrick Keady's Comments
Comment on: The knowns and the unknowns about how CCGs will work
Looking at organisations with a fresh pair of eyes provides so much detail about what is working well and what isn’t. From my own experience of leading reviews to compare 16 NHS organisations, I know that sieving copious data to find the nuggets is .... invigorating. The Kings Fund challenge of interfacing with circa 75 CCGs over the last year was probably much greater - and based on much less hard evidence. That said, I would have liked to have seen more in this article about what is working well and why. Why is it that some CCGs sprint while others limp when focusing on - outcomes, developing good relationships, developing practice engagement, having a plan B for high risk situations, working together using federated approaches and other models of relatively soft coordination, and so on. Perhaps these and other points can be addressed in a subsequent article ?
Comment on: Forced mergers create larger failures - Corrigan
Mergers promise savings and improvements in services that are rarely delivered, with plenty of examples in London and the Shires. The 'take-over' model appears to be much more successful e.g. Good Hope. The success of mergers can be improved by adequately addressing these eleven questions from the IIA : 1. What are the merged organisation’s high level objectives? 2. How will you know when strategic clarity of the newly merged organisation is aligned with the expectations of patients and other key stakeholders? 3. Will services in the merged organisation be best suited to strategic success and the providing better health services too? 4. How will the merged organisation know when its services meet and exceed the needs of patients? 5. Will the range of services in the merged organisation keep pace with changes in patients expectations and other developments? Will they help to shape demand? 6. Will the services and ‘markets’ be periodically reviewed to ensure that they are continuing to align well with strategic aims – aims which are likely to change over time? Or will services be blindly offered that don’t fully contribute to the future success of the merged organisation? 7. Will new services be subject to a thorough assessment of viability – including skill mix, operational costs and revenues and target ‘markets’? 8. Will new service ideas be assessed alongside each other rather than in isolation, so that the relative benefits of each one is identified, and informed choices made. 9. Will there be flexibility in the allocation of resources, or will new ideas fall by the wayside simply because existing resources do not accommodate good ideas that come along. 10. Will timescales for delivery be well-informed? Were the actual delivery dates for the previous initiatives ahead of, or behind schedule? 11. Are plans in place to discontinue declining services?
Comment on: The NHS has failed in efforts to improve health and reduce illness
Governments of all persuasions tend to carry out short-term tasks - such as white papers, organisational change (CCGs, SHAs, PCTs, PCGs, CHI, HC, CQC etc) which are relatively easy to implement and usually meet with public support - and at the expense of medium and long-term action. Public health challenges however, need more than the lifetime of one government - from implementation of policy to visible improvement in health outcomes. The way forward for public health seems to be about professionals demonstrating the value of Public Health in their Boroughs/Counties coupled with sustained long-term vision and support from Public Health England.
Comment on: Forty wasted years?
While all of the comments are valid, Governments of all persuasions tend to carry out short-term tasks - such as white papers, organisational change (CCGs, SHAs, PCTs, PCGs, CHI, HC, CQC etc) which are easier to implement and usually meet with public support - and at the expense of medium and long-term action. Public health challenges however, need more than the life of one government - from implementation of policy to visible improvement in health outcomes. The way forward for public health seems to be about professionals demonstrating the value of Public Health in their Boroughs/Counties coupled with sustained longterm vision and support from Public Health England.
Comment on: Mid Staffs inquiry report delayed until January
As Robert Francis says in his statement, completing the report is a complex and sensitive process. Many of the statements on the Inquiry website conflict with each other - and it is up to him to determine the roots causes and recommendations. Rather than intuitively deciding to publish a less than totally accurate and relevant report now, the delay seems a pragmatic analytical decision aimed at ensuring that the key root causes are identified and that proportionate recommendations are identified.
Comment on: Clinical assessment service joins litigation authority
The NHSLA has a good track-record of delivering service quality and value for money. NCAS becoming an operating division of the NHSLA is a good idea - it is likely to be beneficial to patients and both organisations.
Comment on: In the new NHS, you are what you tweet
Well-done to the growing number of senior clinicians and NHS Chief executives on Twitter, that are keen to share and learn from other Twitter'ers ! @better_outcomes
Comment on: 'Lansley is right to say that age trumps poverty'
What an interesting article! While the core NHS principles were very relevant in the independent-health-dominated late 1940s - meeting the needs of everyone, free at the point of delivery, based on clinical need not ability to pay - they don't seem to fully describe the impact that the NHS intends to have on patient care and the experience of patients in 2012. This article is a helpful catalyst towards identifying what it is that the NHS is about today - is the NHS vision to increase life expectancy, or is it something else?
Comment on: If the NHS is doing well, why is it changing?
Thanks Chris for including a link to the Report and the infographic is very helpful - the NHS is the best for chronically and seriously ill adults in terms of skipped care, gaps in care and errors in care. The survey compliments JRSM's report comparing health systems in the developed world in terms of lives saved versus expenditure, where the NHS is almost the best. Although the 2010 Inpatient Survey gives the views of 60,000 inpatients. 12% answered yes to Q75: During your hospital stay, were you ever asked to give your views on the quality of your care? 8% answered yes to Q77 Did you want to complain about the care you received in hospital? Clinically the NHS is doing well with the chronically and seriously ill, although patient experience for all patients could benefit from more attention.
Comment on: If the NHS is doing well, why is it changing?
Thanks Chris for including a link to the Report and the infographic is very helpful - the NHS is the best for chronically and seriously ill adults in terms of skipped care, gaps in care and errors in care. The survey compliments JRSM's report comparing health systems in the developed world in terms of lives saved versus expenditure, where the NHS is almost the best. Although the 2010 Inpatient Survey gives the views of 60,000 inpatients. 12% answered yes to Q75: During your hospital stay, were you ever asked to give your views on the quality of your care? 8% answered yes to Q77 Did you want to complain about the care you received in hospital? Clinically the NHS is doing well with the chronically and seriously ill, although patient experience for all patients could benefit from more attention.
View results 10 per page | 20 per page | 50 per page
