Sunday, 5 December 2010

NHS Cuts – now it’s getting personal…

A few days ago I wrote about some of the behaviours that are emerging with the NHS as people start to watch their backs and wonder where the axe may fall.

Staff within Primary Care Trusts are particularly sensitive at this time as in theory, their organisations will be replaced by GP consortia. Rather than throw the baby out with the bath water, it is expected that GPs will recognise that there is a great deal of valuable expertise within PCTs and will employ many of the experienced personnel to assist with commissioning and quality assurance initiatives. Basically the same people could be doing the same job, but with a different line manager and different title.

But where should the cuts take place? Andrew Lansley (UK Secretary of State for Health) is actively targeting ‘layers of management’ and as Providers (Hospital Trusts) and all bodies associated with provision and monitoring of care try to achieve these savings, the use of business consultants and interims comes under scrutiny.

As pressure on cost containment increases, resentments and bias may come into play.

I experienced a perfect example of this at a party last weekend attended by several family members and many friends who work within the NHS, private healthcare and insurance organisations. At dinner I sat next to a charming consultant physician from a London teaching hospital who agreed with me that we can be proud of many achievements in secondary care over the past few years. He was very interested about my work with pathway mapping and service improvements and was concerned about the shift of so much ‘power’ to GP consortia.

A little later I was introduced to another guest, an equally charming GP who is just about to retire. Naturally the conversation turned to healthcare and we discussed his plans for part time work with his practice and my recent project aimed at improving the patient pathways for TIA (‘mini stroke’). This gentleman was very impressed to hear that this project resulted in the adoption of new improved pathways by nearly 100% of emergency departments and 80% of GPs across North West London. ‘Yes – there has been some fantastic progress with Stroke in the past few years’ he enthused – ‘and which PCT are you employed by?’  I explained that I had been working as an interim manager.

The genial expression turned to more of a sneer as he quipped – ‘so you are one of those very expensive consultants that we shall enjoy getting rid of…’


Lesson re-learned – do not mix business with pleasure. But I didn’t let it spoil the party.  Great wine, great food, great music, and in the main, great company!


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