harry.longman@patient-access.org.uk's Comments
Comment on: Chief executives are running scared
Profound, thought provoking and deeply worrying at the same time. If the climate of fear and the resulting selection of just the wrong kind of candidate prevails throughout the NHS, let me ask one question: where does responsibility lie?
Comment on: New IFR policy could 'snuff out' innovation
Show me an arbitrary target and I'll show you a perverse outcome. Why 5? 1 might be enough. 5 might be ridiculously low - we have no idea. Surely we pay professional people to think about complex matters like this, and make reasoned decisions. Then, when the evidence changes they may change the decisions. Pre-judging the matter with the number 5 is a dead end.
Comment on: Nicholson argues he should survive to implement Mid Staffs recommendations
Look at this quote: "the commissioning board’s legitimacy needs to come from its connection with patients and the public." That is dangerous. Its legitimacy comes from its accountability to a democratically elected government. Any dilution of this means they can spend our money for whatever interests they have, good bad or indifferent, and a written mandate will not hold them to account. Jeremy Hunt, you cannot duck this. There is no point me adding to the comments on Sir David, and I can see why many of you who are NHS employees may wish to remain anonymous. However, using this cloak to make personal attacks, one even calling for a charge of homicide, is disgraceful. You are the anonymice. HSJ Editor, time for action please.
Comment on: McKay: More jobs in system than staff at risk
Lansley's blaming of "the management" as a whole back in July 2010 has come home to roost. Sure, things needed to improve, as ever, but the demolition of the old house to build a new one out of the same bricks was bound to be an utter disaster. And we won't know for years whether the new edifice is any better, or even cheaper. Sorry to say I'm not surprised. But I do feel for all those affected at the human level, most of whom won't have the benefit of a working wife as I had when redisorganised out of the NHS.
Comment on: GP, phone home
It was a joy to find you early in 2011 when you were highlighted by your patients as "very easy to speak to the doctor". Pioneering innovators with a commitment to your patients, you were unbroken by penalties from the PCT. A thoroughly well deserved award for a beacon of fantastic patient service. Now you have shown lower emergency demand, will your CCG support other practices too?
Comment on: Full coverage: Commissioning board sets priorities and rules for 2013-14
Annex A is measures, some of them quite interesting. For example, under 75 mortality. Will this help to reduce healthcare inequalities? Will this be used to move funding from affluent to deprived areas where life expectancy is lower? Or will it be used to give bonuses to those with greatest life expectancy, stoking the inverse care law? Annex B is old fashioned targets, with the new name "rights and pledges". An arbitrary percentage for hitting an arbitrary number. Why 4 hours? Why 95%? I've written on the perverse effects of this target with comprehensive evidence. http://www.patient-access.org.uk/userfiles/file/A&E%20-%20is%20there%20a%20better%20way%20HL%20v3.pdf Who and why is driving this senseless policy? Lansley tried to ditch it. What happened?
Comment on: Lansley adviser criticises friends and family test focus
"What gets rewarded appears to get done, and what gets punished appears not to get done." The problem with fft is that providers will fall over themselves to get scores up, but because expectations vary between patients, between populations and over time (generally upwards), comparability between hospitals will always be fraught with confounding factors. So by all means try to do the right thing for patients, and ask them, but for meaningful measures we need to be objective. What matters? Speed, continuity, quality. Measure these. No fudge.
Comment on: Exclusive: Jim Easton's commissioning board role to be split up
It is telling, and sad, that Jim Easton is not being replaced. Reading the list of responsibilities being parcelled out, the overlaps are only too obvious. People will trip over each other, with the result of inaction. The NHS can't afford to take the foot of the improvement pedal. By the way, good morning Anonymice. I see you're out to play today. Be ready to scuttle back to your holes though, could be big boots about!
Comment on: Exclusive: Jim Easton's commissioning board role to be split up
It is telling, and sad, that Jim Easton is not being replaced. Reading the list of responsibilities being parcelled out, the overlaps are only too obvious. People will trip over each other, with the result of inaction. The NHS can't afford to take the foot of the improvement pedal. By the way, good morning Anonymice. I see you're out to play today. Be ready to scuttle back to your holes though, could be big boots about!
Comment on: Nicholson: More funding will be linked to quality
"Show me a target and I'll show you an unintended consequence." Of course they mean well by trying to reward quality but it gets screwed up by making people tick target boxes, rather than encouraging the freedom to innovate and improve. Hear hear to all the above, even the anonymous ones (but please come into the sunshine).
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