The number of deficit-hit organisations may be back up to 2005-6 levels and the first NHS trust staggering towards the cold arms of the special administrator, but fear not: Plan B has arrived!
Slipped out with bumph reassuringly illustrated with dull stock-shots of scientists gazing at test tubes, those tireless promoters of localism and autonomy sirs Ian Carruthers and David Nicholson have issued their manifesto for Fixing It Without Lansley Noticing.
On offer are Scottish-style heath boards, dissolving the pesky commissioner-provider split to facilitate cost-effective carve-ups of health resources and provision across the 12 to 17 health economies of England.
Sorry, what I meant was: Comrades Carruthers and Nicholson have set out how new academic health science networks will offer the NHS the chance to “work with industry to… improve the delivery of innovation… translating research into practice, education and training, wealth creation and service improvement”.
Sounds like something the Tories would like. Loose local networks of NHS commissioners, providers, universities, private providers and industry, all collaborating to push forward health science, commercialise NHS intellectual property and put the latest development into rapid practice.
And surely by the time the committed few have waded through to page five they will be sufficiently convinced by the cogent argument that a “broad definition of innovation and best practice” is what’s needed here. One broad enough to cover, well, basically everything: improving quality and productivity and improving patient outcomes and population health.
For that, AHSNs will need to have their own governance structure - a board, from which, incidentally, private industry will be excluded. They will also need an effective authorisation process so the centre can keep out the nutters, during which they may take the opportunity to “de-clutter” and “simplify” existing organisational structures.
If that doesn’t convince you, AHSNs will even be tasked with making those apocryphal “difficult decisions” and developing their own “levers” (for which read: bribes, bungs and penalties).
Timing in a revolution such as this will be crucial, but with all NHS organisations having the “opportunity” to join a network by March 2014 the AHSN movement will be fully mobilised just in time for the fragmentation of commissioning to really start causing problems - and for ministers to wonder if there is any road back before 7 May 2015.
Sally Gainsbury is a news reporter for the Financial Times.