The solvent business operates under the realism that cash is sanity and profit is vanity. You cannot pay the bills with profit. So, cash is (and has always been) king, in business, but is it the same in healthcare? Frontline professionals or services generate cash, and they consume it. A single service can influence financial … Continued
The Big Announcement Seismic Shift or Cosmic Fantasy In late March 2018, Theresa May announced that the NHS would get a multi-year funding settlement and that it “could not wait” until the Autumn, setting it up nicely for a 70th Birthday release. That announcement was met with what can only be described as near-complete apathy … Continued
If Clinically-led is the Answer, Kill It Swiftly & Remorselessly When you examine the performance of Trusts in our current system, you can’t help but notice that the majority of financially stable acute providers are clinically- or service-led. Admittedly it’s a very small group, but then so is the number of Trusts that can claim … Continued
In the first part of this 2-part explanation of the importance of chronology in transformation, we examined transformation first by splitting it into 3 distinct forms, so that we could understand the chronological relationship of those forms. On closer examination, it becomes patently obvious why Trusts are constantly fire-fighting when they have not undertaken the … Continued
There is a very real and worrying common reality emerging across the Acute Trust sector, in that many are facing concurrent deficit positions and/ or declining financial health, coupled to variable or declining clinical quality. Whether we have a system sliding towards financial failure or clinical failure (or both) and whether one is a worse … Continued
This week saw one of the most interesting events of recent times take place. No, it definitely wasn’t the Conservative Party Conference but the issuance of a notice by University Hospitals Birmingham NHS Foundation Trust to West Midlands GPs announcing that it will no longer accept out-of-area referrals for secondary care that could be done … Continued
Party season is upon us. No, not festive parties but political ones. With those, especially in sight of a general election, comes a stark illustration of the importance of collaboration in leadership and a difficult lesson about what it might take to produce a win-win solution. More importantly, this week’s competitive posturing suggests that not … Continued
So, what would or should you do? You’re sitting in the back seat of the family car, minding your own business, in fog (it is the Autumn of our discontent, after all) and you suddenly become aware that there’s a very near cliff and the driver seems oblivious. Naturally, you’d point it out. But what … Continued
This article is provocative but necessary, dealing with an emerging NHS issue that falls under the cloak of politically correctness but inside of which is a brewing catastrophe that will touch every service in the land. I’m describing it using the Ebola story in illustration but make no mistake this is a UK crisis coming … Continued
This week saw the release of the final report by the Commission on the Future of Health and Social Care in England, an initiative sponsored by The King’s Fund and led by a respected economist, Dame Kate Barker CBE. Having expended considerable effort in calling for greater debate on the sustainability of our health and … Continued