My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

Read my statement in full »

The core business in which we are involved..

Filed Under (Health Improvement, Public Health) by Paul on 30-01-2012

It’s very easy to forget what our core business is. It’s not the governance arrangements of CCGs nor is it even my quest for anyone to tell me what ‘clinical senates’ might be when they are at home. Read the rest of this entry »

So what can telehealth and telecare achieve for NHS patients?

Filed Under (Health Improvement, Telecare) by Paul on 15-12-2011

I sometimes feel that there is a conspiracy within the NHS against the implementation of step change. Those who do not want to change the way in which they work are always seeking evidence against the new. They show that the ways in which they do things are the best ways and that there is no evidence for new-fangled ways of working being any good at all. All these new ideas not only don’t save money – but are unsafe as well.

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Markets, business and the creation of innovative value for money health care for NHS patients.

Filed Under (Creating public value, Health Improvement, Innovation, Private Health Care) by Paul on 10-11-2011

A small story last Friday exemplified a much bigger issue. The story concerned the results of research from the University of Birmingham on how the effectiveness of different weight loss schemes. Read the rest of this entry »

Migrant Health Care

Filed Under (Health Improvement, Migrant Health Care) by Paul on 30-09-2011

Last Friday I spoke at a conference organised by the Migrant Rights Network on the subject of migrant access to health care. I was asked to run a session on the role that the new clinical commissioning groups have in improving that access.

My argument was based partly on how the Health and Social Care Bill is framed at the moment – that is a duty of the clinical commissioning group to the population covered by their geographical boundaries, and not just their registered population. In many parts of the country this duty must lead CCGs to seek out the hard to reach groups in their localities to ensure that the CCG is commissioning care for them and not just for a part of their population. Read the rest of this entry »

The hospital is dead, long live the hospital: Sustainable English NHS hospitals in the modern world

Filed Under (Health and Social Care Bill, Health Improvement, Hospitals, Reform of the NHS) by Paul on 15-09-2011

Today, September 15th, we are publishing, through the think tank Reform, a pamphlet about the necessity to convert the work of NHS hospitals into a much more sustainable set of business models. These changes will be difficult for both those inside the NHS and for those outside. However not facing up to the need for these changes will build into the NHS much greater inefficiencies, and outcomes that fail to reach the level of safety that we have come to expect. Read the rest of this entry »

Abolishing “politically motivated targets”. One year on, when is a target a target?

Filed Under (BMA, Health Improvement, Kings Fund, Narrative of reform, Reform of the NHS, Secretary of State) by Paul on 25-07-2011

One of the constant conversations that the current Secretary of State had with the leadership of doctors’ organisations over the six years of his apprenticeship as shadow secretary of state concerned how much they hated waiting times targets.

From 2001 onwards they had railed ineffectually against a Government that won the 2001 and 2005 elections partially on the promise to reduce maximum waiting times for NHS patients. The capability and capacity of the NHS to reduce maximum waiting times was one of the core public reform narratives that brought about change in the NHS over that period. Read the rest of this entry »

Listening Group 2 – Patient involvement in their long term conditions – How care planning involves the patient and their lives.

Filed Under (Health Improvement, Listening Groups, Patient involvement) by Paul on 28-04-2011

One of the many things that Ara Darzi got right in his 2008 report was the importance of care planning for people with long term conditions. The crucial issue if you have a long term condition is the very specific way in which the disease interacts with you and your life. Having asthma or depression affects you in different ways from me. Your body has different lungs for coping with asthma and might also react to depression in a different way.  And your mind will deal with the stresses of both conditions in a different way from mine. Your life, your friends and your family will give and take different things from you. Of course given the millions suffering from these conditions, there are patterns but each sufferer also needs to be understood as an individual – differing from patient to patient. Read the rest of this entry »

Listening Group 2 – Patient involvement in their long term conditions – the case for co-production of good mental health

Filed Under (Health Improvement, Health Policy, Patient Choice, Patient involvement, Public Health) by Paul on 19-04-2011

There is quite rightly a great deal of discussion about the public’s need to be active in the prevention of diseases that could ruin or even shorten their lives. It is of course much more sensible to, for example, lose weight before you get type 2 diabetes; or start an exercise programme before you get very depressed. But for many the motivation to do something to prevent the onset of something bad in the future is just not high enough. People don’t believe that it will happen, and given how hard it is to change their behaviour, don’t bother. Read the rest of this entry »

Listening Group 2 – Patient Governance and Patient Involvement

Filed Under (Accountability, Health Improvement, Health Policy, Listening Groups) by Paul on 18-04-2011

I am running through the four different groups that the Government have set up to organise listening during their 2 month gap.

As I did with the previous listening group, the way in which I would like to frame this policy discussion is controversial. Read the rest of this entry »

The politics of last Saturday’s march – a Tory MP muses

Filed Under (Conservative party, Expenditure, Health Improvement, Health Service Unions, Reform of the NHS, Trades Unions) by Paul on 02-04-2011

Luckily this blog does not have to engage too deeply with the politics surrounding the Coalition Government’s policy on public expenditure cuts. That means the efficacy or otherwise of last Saturday’s TUC march and the Labour Opposition’s policy on the cuts is not a core issue for us. Read the rest of this entry »

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