Tag Archives: Roy Lilley
Will the NHS learn from this case – or will more patients be at risk?
Amongst all themedia hype, two aticles stand out.
The Daily Telegraph devotes its main page to Dr. Max Pemberton. Pemberton is respected amongst
Is it worth complaining?
You are going to hear a lot about CCGs
(Clinical Commissioning Group)
This is one of the new terms in LaLa’s weird vocabulary.
This week LaLa himself came out of his Whitehall bunker to appear at the RCNurses’ conference; bet he wishes he had stayed put.
One delegate reported on a comment to the Minister from the general secretary of the RCN, Peter Carter. As LaLa had used his jargon-filled speech to deny there was anything wrong with the NHS, a friend reports Carter rounded on him and told him:
“Because conference has been polite to you, do not leave here thinking we are happy, satisfied or relaxed about the future. We are not. We are very upset.” As one, the Congress rose; a standing ovation for their leader.
Other members of the audience used less elegant language; one nurse calling him “barmy”. Non-PC in today’s NHS jargon, but very apt.
LaLa and his minions seem to speak a different language to the English I learnt growing up. Understanding what is being said needs an interpreter to translate the jargon.
To find out more I go on the Dept. Health website for clarification. And had to give up before they carried me off screaming. The front page tells me about a raft of pages that will tell me everything from how they get their authorisation papers (don’t ask) through to the adult social care engagement exercise.
In other words, they daren’t explain why LaLa got rid of three tiers of admin to create five. Nor what the dictats mean. No wonder the NHS is a massive employer; they need the minions to think up these jargon-filled slogans.
Interpreting the jargon
So I turn to the invaluable Roy Lilley of nhsManagers.net, who tells me CCGs “are the new celebrities in the NHS. I’ve listened to a good few CCG chairs in the last few weeks and I think I’m beginning to get the hang of it”.
Emotions range from schoolboy enthusiasm to downright cussedness. The GP’s who want to commission care so that they can tidy-up some irritations and anomalies in local care pathways and others who seem to have old scores to settle with the local hospital. (Wish my doctor would copy them).
But your CCG may take some time to get going. Lilley says, “One CCG chair proudly announced they were having a ‘time-out’ to ‘develop their constitution’. When Lilley asked him why they were not adopting the DH model constitution, there was a pause and he replied; ‘What model constitution? No one’s told us about that”.
However, most CCGs have got their priorities in order. They have bought iPads. The funny thing is on recent visits to superb Consultants, I notice every one of them using an old-fashioned fountain pen to write up their notes; not a keyboard in sight. You could buy a pretty snazzy Mont Blanc for the cost of an iPad.
“We all know these are risky reforms, even in the hands of the experienced they would be a danger. In the hands of the well-intended part-timer they are a menace with the potential to be a hazard to health and a peril to the public purse. LaLa can’t say; ‘No one told me that.” But as patients we might cast a beady eye over the expensive gizmos that are going to be carried around by all the members of these CCGs, and question who authorised them. Then ask “what about data protection?” if CCG members go on about sharing info.
But to ensure that our local CCG gets off to a flying start, ‘my’ GP has been unavailable for three days a week for the past year, whilst she works at setting up the local group. I have done my bit to help; three times I have turned up for appointments, only to be told “Dr. X has cancelled your appointment – didn’t she tell you?” Instead, I have ended up with the newest drafted-in Locum; nice chap. I just need to train him to send off referral letters promptly.
Latest Jargon dictionary
Cancer Pathways The National Cancer Action Team is supporting a number of initiatives to help develop stronger commissioning of cancer services. Part of this process is to ensure there are clinically effective pathways, accessible through the Map of Medicine, against which cancer services can be commissioned.
Clusters – No, it’s not the nutty ones, although I am beginning to feel like one. It refers to what happens when lots of quangos join up together to make sure they can have even more meetings together. Very sociable over the tea and biscuits they are.
Development opportunity – what’s given to the new Outpatient receptionist who manages to lose all your notes
Mission statement – telling them to devise a mission statement has got to be the best way of giving someone employment to produce a fatuous statement highlighting the blindingly obvious.
moving forward – opposite of what happens after the hospital committee has put in ‘improvements’
NHS Choices – the appointments office whose job it is to confuse you so you are unable to make an appointment that suits you, With any luck the appointment is so much in the future you go privately, taking you off the list and saving the NHS money.
QA – quality assessment These are the reports hospitals now have to produce for their local LINks. Theory is they identify quality of hospital’s service. Actually, a test in how those who compile QAs manage to ‘overlook’ items of important to patients, such as MRSA, Mixed Wards, etc.
Stakeholder engagement – NHS website explains this is all about “building relationships with people who (sic) you affect through your work, or who could make an impact on your success. It is the foundation of effective organisational responsibility, and refers to the formal management of the human dimensions of change”.
Er – don’t they mean ‘getting on with people’?
World class – NHS services on a par with Third world services
LaLa and his minions need to go back to school and learn to speak modern English. Not expect us to swallow the clap-trap the hierachy spouted to serfs behind the old Iron Curtain.
Prescriptions ‘contain possible fatal errors’
Recent research by the GMC (General Medical Council) came up with the fact that one in 500 prescriptions have a major error.
On the face of this, it might not seem much. But dig deeper into the story and you find it adds up to
- 1.8m foul-ups in UK prescriptions last year.
- Four in 10 patients aged 75 years or older had a prescription item with an error.
- One in twenty items prescribed gave cause for concern.
- And suppose you are one of the ‘one in 500’? Bearing in mind the millions of prescriptions every year, and the fact that many of us are on sevaral drugs, it doesn’t take long for our turn to come up.
So it’s no wonder that patients are turning to supplements, vitamins, fish oils and other products, that on the face of it are harmless – but have the potential to be very, very dicey in certain circumstances.
Dr. Catherine Ullbricht, a pharmacist at Massachusetts General Hospital, writing in Alternative and Complementary Therapies, says “Natural does not equal safe”.
And goes on to warn that “if something has a therapeutic action in a human body, this substance can also cause a reaction or an interaction”.
My favourite medical guru, source of sensible advice, has emailed to say “just eating a healthy diet gives one sufficient vitamins”.
And of course is much cheaper.
So what next?
The upshot of the fallout from the research into prescription errors was a recommendation from the President of the RPS, Martin Astbury, for a pharmacist in every surgery.
Of course! Just the job at a time when the NHS is struggling to find enough money to keep going.
In my layman’s view, surely the GMC should go back to basics and ensure GPs prescribe safely? Shouldn’t years of training, the best education money can buy, a welter of guidance and stuff from NICE, the National Prescribing Centre, drug companies and the medical trade press should give them enough back-up to be able to prescribe safely? So, as Roy Llley says on nhsManagers.net, “why do they have trouble doing what they are trained to do?”
And goes on to say “Is it too much to expect that they will come to work and do what lorry drivers do, airline pilots do, road-sweepers do, rocket scientist and the people on the checkouts at supermarkets do? I mean; what they are paid to do”.
He says he is fully expecting an Inbox of angry emails – but personally I totally agree with him. When I worked in travel I expected the coach driver to drive thousands of kilometers safely, the Airline Pilot to fly me across the world and understand all the different equations of wind, atmosphere, barometic pressure, local regs, etc. and deliver me and 400 others safely.
The coach driver was probably paid the same as a Junior Doctor, and had 40+ people’s lives in his hands.
The Pilot was paid on the same scale as a Senior Surgeon, with around 400+ lives in his hands.
Both did their jobs to the best of their abilities, looked after the people in their care, and knew that their job entained not only driving or piloting, but also understanding complex international health and safety rules.
GPs have prescribing support, computers, access to online advice and if they are really pushed they could ask the nurse! Or even (a revolutionary idea) listen to an informed patient.
The boss of the GMC, Sir Peter Rubin is quoted as saying “GPs are typically very busy’.
Well, as Roy says – whoopee-doo.
So are school teachers, prison officers and bin men. They all seem to be able to do their job-fundamentals without too much trouble. Anyway, GPS are self-employed, small business people, they need to be busy.
So be warned!
- Take your current crop of pills to your Pharmacist for a review.
- Check with your medical team that any supplements you are taking don’t conflict with anything else
- and read http://after-cancer.com/cancer-news-latest/gps-make-too-many-mistakes-when-prescribing
There comes a time in all our lives when we are spitting about lack of help and/or information we can find from health professionals.
In Britain, everyone from drug companies to nurses abdicates responsibility and says, “ask your GP”. So when your GP has just told you, “you know more about cancer than I do”, one of these websites might be able to deflect anger – and even give you helpful information.
So before you send an email in UPPER CASE, click on one or two of the addresses below:
A BETTER NHS Written by an NHS doctor, this has been set up to inform twitterers and others about the real scandal going on with the NHS, which is its conversion into a pre-1948 (start of the NHS) market economy as a result of steady lobbying from UK and US private health insurers. www.abetternhs.wordpress.com
DANA-FARBER My favcurite American Cancer Hospital has launched Insight, a blog providing expert commentary on the latest news in cancer research and care, and insight on issues relevant to cancer patients and their families. Dana-Farber is the first New England hospital to publish a blog that focuses exclusively on cancer-related topics, and will cover the latest scientific advances and treatment options, practical tips for patients and families coping with cancer, and patient stories. It will also feature on-the-scene commentary from some of the nation’s largest medical conferences. www.dana-farber.org then key Insight into search window.
GERMAN website: for German readers – www.medien-doktor.de
GOOGLE SCHOLAR A good source of medical information when you need details of clinical trials, and other stuff to shove under doctor’s noses when they turn them up because you aren’t medically qualified. www.scholar.google.com
ROY LILLEY, well-known as a blogger extraordinaire, edits www.nhsmanagers.net . His comments are always to the point (although Cameron and Lansley must wince when they get a digest), and I often laugh out loud when I read this.
MAMMOGRAMS There is a huge debate going on in medical circles about to screen – or not to screen. i am NOT medically qualified, but if you want to find out about information not to screen, Mitzi Blennerhassett has a very informative blog about screening mammography at www.evenstarsexplode.wordpress.com
MEDICAL LESSONS is a serious blog, really aimed at doctors, but worth reading because if you happen to have what it’s blogging about, you learn an awful lot! http://www.medicallessons.net/
JUDITH POTTS Judith was an actress, had breast cancer, and now produces a lively blog for the Telegraph http://blogs.telegraph.co.uk/news/judithpotts/100140789/nhs-improvement-helping-change-cancer-care-in-britain/
PUBMED This site comprises more than 21 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites. Doctors use this, so they can’t turn up their noses if you cite PubMed as your source. And, what doctors in UK don’t tell you, it is an American site, set up and run under US Government. So info is really up-to-date. http://www.ncbi.nlm.nih.gov/pubmed/
THE CANCER MADE ME DO IT It’s Carol’s blog, and she has no hesitation in taking on High School kids who laugh at her strange headgear, or so-called friends who discuss her medical condition and think she can’t hear – right in front of them. We can all remember ‘friends’ who utter crass statements; when this happens, just log on to this website and have a wry laugh. www.thecancermademedoit.com
And if you know a good blog – add it to the Comments box please.
This website is well worth watching.
Edited by Roy Lilley, PPA ‘Columnist of the Year’ – Finalist, he manages to make sense of what is happening to the Health Bill, that LaLa doesn’t want you to know.
Roy’s latest article comments that in this new commercial world, if the Department of Health were looking for a logo, they could do no better than “choose a gold plated sieve”.
Why? Roy says “there’s been another major leak”.
Then says, “you have to ask why people leak things.
Why do they risk disciplinary action, maybe even their jobs and careers to do it?
It’s easy to think it is because people think something is wrong and they want to bring it to wider public attention. It’s a bit about that but I think it is more”.
It takes a lot to shove a document into a scanner, put it on a stick, take it home, set up a Hot Mail account with a gobbledygook name and send it out. You have to be brave, determined and thoroughly aware of what you are doing and the consequences. And, you have to be pretty hacked off.
On a Scale of 1 – 10
It is impossible to measure ‘hacked-off-ness’. For convenience I have invented the Lilley Hacked-Off Scale; one to ten. Judging by my post-bag I take the general level of most readers hacked-off-ness to be about eleven out of ten. I’m thinking of recalibrating already.
I don’t think anyone has recovered from LaLa’s pledge of no more top-down reorganisations only to be faced with the lunacy of what followed; redundancies, 364 pages of Bill and the ‘Pause Fandango’.
Then a creeping realisation that the NHS will have all of its hospitals run off-shore as FTs, community services hived-off and the excesses of Monitor who seems to think the NHS should be run as a utility company.
Channel 4 gets in on the act
Throughout it all I was daft enough to think GPs would come good and do the right thing. That went out of the window when Ch4 did its Go-Johnny expose and Lovely-Jubbly appeared in the NHS lexicon.
Well, Ch4 have done it again. Any thoughts that GPs would have any real influence over commissioning has gone out of the same window. Somebody who is about 15 on the ten scale of hacked-off-ness has leaked a document. They made a programme insert about it on the Ch4 news, last night.
We have a copy; here it is. It is the final draft of a document being developed by the DH called ‘Towards Service Excellence’.
In any other setting it would be comical in that it recognises what we all know; GPs can’t commission healthcare or run commissioning. Under the arrangements proposed in the document they will have precious little to do with it. It understands that buying healthcare has to be done at scale and pretty well reinvents SHAs.
PCTs will keep going, providing interim commissioning ‘support’, doing what the GPs know they can’t do, but it is clear that the expectation is they will prepare the way for the private sector to come in and take over most of the commissioning and back office functions and provide a service to several CCGs. An elaborate pathway is mapped out for their entrance. PCTs may have a shot at evolving themselves into commissioning support businesses but they won’t stand a prayer against the McKPMGs of this world.
The document makes depressing reading
Not depressing because it is about the private sector. Depressing in that it describes a convoluted, wasteful, labyrinthine attempt to stick together the broken fragments of the NHS and put it back on the shelf, where it started.
It has a desperate tone and seems to me to be driven by the knowledge that the NHS is on the brink of a nervous breakdown. If you are a Go-Johnny you won’t like it either. It describes an NHS far removed from LaLa’s original idea. GPs will have little to do with anything.
I read it more in sorrow than in anger. What a terrible waste of money and time this has been.
As Roy says, take some time, see for yourself what it says and whisper a silent thank you to the brave soul who was hacked-off enough to see if you’re as hacked-off as they are.