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Published: 27/06/2002, Volume II2, No. 5811 Page 18 19

Forty-nine teams gathered at Aston Villa football club for two HSJ events - the Management Challenge and Future Leaders Challenge.Just as in the World Cup, there were crucial lessons to learn.Paul Smith reports 'I t's a bit intense, is not it?' said a shell-shocked Jeremy Taylor, chief executive of the trust that runs Rampton Hospital.

No, he wasn't talking about the pressure of doing one of the toughest jobs in the NHS, but the HSJ Management Challenge, as he headed back to the hotel after the first day. And Mr Taylor was only one of the judges.

This year's simulation, at the Aston Villa conference centre in Birmingham, packed more NHS mayhem into a few hours than a no-star trust board with a body in the chapel would want to see in a lifetime.

The usual problems emerged - no cash, no staff, delayed discharges clogging up the local hospital, a doctor allegedly using his medical skills for a more than intimate examination of one of his female patients.

Then there was the sort of health scandal which would bring a hardened tabloid hack to tears. A young girl with learning difficulties lay trapped in a hospital bed for four months because the health community in the borough of 'Middlechester' couldn't provide her with any alternative care.

Jane Harris's anguished plight left the media foaming at the mouth with unsated bloodlust and it was the blood of the primary care trusts, social services, acute trust and the strategic health authority that they hungered for most of all.

There were two competitions:

the first - supported by Pfizer - was for managers already seasoned by the grind of the NHS and social services; the second for young, fresh-faced management trainees. It was a chance to compare innocence and experience.

From the start, senior managers burst into frenzied activity.

Ironically, the trainees looked more composed. For both groups, there were the perennial themes:

excessive sweet munching and a life-threatening intake of caffeine.

Central to the challenges - put together by Birmingham University's health services management centre - was to sort out the bed-blocking horror gripping Middlechester. They had to design what many in the NHS are already doing - an effective intermediate care service - but in eight hours.

A patient-centred approach would be crucial. This year, judges from patient groups were invited to ensure it was done properly.

And judges from social services were looking for proper joint working with local government.

With NHS-based teams representing Middlechester social services department, it would be a rare chance to experience life when the boot is on the other foot - it wasn't always pleasant.

'We just felt swamped, ' said one bemused management trainee taking the social services role.

Teams were also assessed on communication skills. Like the real world, it was important for them to deal effectively with the media, despite the distractions to their main work.

And that must have caused a genuine swamping feeling, especially when it came to the press conference. The questions were fired by the normally sweetnatured journalists of HSJ, disguised as half-wit hacks who couldn't distinguish a step-down service from a step aerobics class.

The editor underwent a particularly gruesome transformation.

The teams were there, under the hot and sticky lights of the Aston Villa press suite, to respond to the local newspaper's 'Free Jane Harris' campaign. There had not been such drama since Villa chair Doug Ellis sacked his last manager.

Sample press question: 'You have told us a great deal about your strategic whats-its and your intermediate thingy-me-bobs. Frankly, I do not know what you're going on about. But one thing is missing from all this mumbo jumbo, one word, and That is 'sorry'. Sorry for what you bureaucrats have done to poor Jane. Are you even going to apologise?'

When the blood returned to the team members' faces, they handled it brilliantly - not least, the trainees. With little or no media experience, in a situation never encountered before, all the judges were impressed by their abilities.

Management trainee Dawn Collier, representing Middlechester PCT stood out for her coolness. Afterwards, she admitted to one guilty HSJ journalist: 'I was really panicking underneath, it was horrendous.'

A final twist: by 3pm with a couple of hours left, Middlechester city council suddenly told social services it was slashing its budget, plunging everyone's grand plans into chaos. Though many normal men and women must have been thinking of telling their employer they wanted to 'spend more time with their family' in the hope of early retirement to the bar, everyone got stuck in.

When the awards were announced during dinner, winners punched the air with the insanity you would have witnessed if England had won the World Cup.

For the judges, it was a chance to talent spot the rising stars of NHS management. Wendy Saviour, chief executive of Melton, Rutland and Harborough PCT, said: 'It is just reassuring to know the talent of the people that in a few years' time will be taking over your job.'

Modernisation Agency director David Fillingham, who gave out prizes to the management trainees, said: 'It is a great opportunity for the teams to test themselves, to know what It is like operating in that kind of environment.' l The HSJ Management Challenge winners:

Joint winners of Partnership Working Blue cluster:

Uttesford primary care trust County Durham & Darlington Priority Services trust South Staffordshire Healthcare trust St George's Hospital team 1 Royal Wolverhampton Hospitals trust Yellow cluster:

Conwy borough council Guy's and St Thomas'Hospital trust NHS Information Authority Bedford Hospital trust University Hospital Birmingham team 1 Winner of User-Centred Perspective Blue cluster:

Uttesford PCT County Durham & Darlington Priority Services trust South Staffordshire Healthcare trust St George's Hospital team 1 Royal Wolverhampton Hospitals trust Winner of Communication and Public Relations Green cluster:

South East Sheffield PCT Oxleas trust Greater Manchester strategic health authority Milton Keynes General North Hampshire Hospital lParticipants in the Future Leaders Challenge came from NHS Leadership Centre training schemes, and represented a number of organisations and disciplines.