Memo to Gordon Brown
If you could change 5 things about how the NHS is led and managed what would they be? An American reader emailed this question to me yesterday and I've been mulling it over this evening, during a train journey to Edinburgh.
Here's my top 5 (for now at least):
- I'd invite all Trust, PCT and SHA Boards to consider reappointing all Chief Executives for a minimum of 7 years now;
- I'd insist that HR Directors had the achievement of productivity improvements listed as their number one priority in their job descriptions;
- I'd set one target for acute trusts. To reduce the mean amount of time it takes a qualified nurse to respond to a patient's call for attention at the bedside;
- I'd ask all PBC groups to disclose whether they are proposing to offer comprehensive access to NHS funded health check-ups to people over the age of 25 and if not, why not;?
- I'd expect all managers to participate in a development programme that has but one aim. To encourage participants to take more responsibility for getting things done rather than spending time re-framing the problem and sharing their analysis with senior colleagues.
Quite a little centralist aren't I? Do you think Gordon Brown's Advisors are reading this? Nope? I don't think so too. I wonder what his list might be? For that matter, what does your list look like?
Steve
nhs
gordon brown
Steve Pashley
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Reader Comments (2)
1. You must be joking! Stability can be achieved in other ways.
2. How do you propose to measure this? Targets? Number of bottoms wiped? Oh, I get it...number 3!
3. ....this would be so easily gamed. It's a laughable concept.
4. Have you bothered finding out whether this is in any way worthwhile? It's not even worthwhile for over 50s. Even over 75s is highly debatable. DO SOME BLOODY RESEARCH.
5. Why not just get rid of the middle manager instead if they're not useful?
Never mind 5 changes to management. How about one? Turn you into administrators. This should be your primary function. You should be answerable to clinicians. If the ward's not clean - your reponsibility. If there's not enough staff in clinic, your fault etc etc. If you don't do anything, you get made redundant. Simple eh? Keep senior management but turn all the middlers into useful people. Sounds good huh?
What has held us back over the years has been the management. What has changed them? Money and targets. Managers do not respond to clinical pressures. Doctors have to face dissatisfied patients every day. We do not want them to be dissatisfied. It's easier to give them what they need. Doctors need to be served by managers. Fortunately there is at least one large trust where this is now happening. Already the results are becoming apparent.
I am afraid I have to agree that you do not have a clue about where the problems of the NHS really lie.