tag:blogger.com,1999:blog-7746061689746893784.comments2023-08-14T08:14:45.281-07:00FinchersFinchers Consultinghttp://www.blogger.com/profile/02585633183853596999noreply@blogger.comBlogger135125tag:blogger.com,1999:blog-7746061689746893784.post-52288584213639861072022-10-10T16:22:13.959-07:002022-10-10T16:22:13.959-07:00Thankss for sharing thisThankss for sharing thisHumidifiers Chicohttps://www.humiditycontractors.com/us/dehumidifiers-california/humidifiers-chico.shtmlnoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-42090211386924254622022-04-16T07:11:49.934-07:002022-04-16T07:11:49.934-07:00Very nicce blog you have hereVery nicce blog you have hereCooking by Alexhttps://www.cookingwithalex.com/noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-31957339381462067802016-11-26T06:56:27.832-08:002016-11-26T06:56:27.832-08:00Hi Brian
Thank you for your comment - you are so r...Hi Brian<br />Thank you for your comment - you are so right and sadly even though we tell clients this they don't always believe us or truly appreciate the value of the cover they have.Finchers Consultinghttps://www.blogger.com/profile/02585633183853596999noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-40123281069450946232016-11-26T03:22:20.186-08:002016-11-26T03:22:20.186-08:00Hi Marcia,
Another point is that, once older peop...Hi Marcia,<br /><br />Another point is that, once older people leave the PMI market, they tend not to come back because they have lost cover for pre-existing conditions. Thus, if the individual PMI subscriber base starts to contract more rapidly as a result of the IPT situation and the government realises that the NHS is being unnecessarily burdened as a result, exempting PMI from IPT will not reverse the situation. Brian Waltersnoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-28033030016095354052013-06-29T04:27:53.562-07:002013-06-29T04:27:53.562-07:00Completely agree.
Hospitals, like a business, pro...Completely agree.<br /><br />Hospitals, like a business, provide services (health care) to customers (patients) through qualified staff, yet the way they are operated has not progressed like other service industries (e.g. hospitality, airlines etc) who continue to innovate their practices in order to improve the quality and safety of their services.<br /><br />There seems to be one rule for every other industry and another for health, and health is the one that has a guaranteed demand for their services from the majority of the human population.<br /><br />We are more busy crying that health is special rather than looking at the successes that are being experienced in other industries that health could at least consider utilising, because, after all....isn't it the patient who's supposed to be special?<br /><br />SLhttp://www.linkedin.com/pub/sarah-low/57/150/b5b/noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-19694521494515625512013-04-29T08:17:36.108-07:002013-04-29T08:17:36.108-07:00Burnham is a fraud. Paul Corrigan sets it out well...Burnham is a fraud. Paul Corrigan sets it out well....<br /><br />http://www.pauldcorrigan.com/Blog/health-policy/how-do-andy-burnhams-proposals-stack-up-against-his-own-attacks-on-government-policy-2/Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-86372809895672866122013-02-18T04:02:58.508-08:002013-02-18T04:02:58.508-08:00Well said - and I'd add that numerous others c...Well said - and I'd add that numerous others currently in very senior positions should join him in collecting their P45s....Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-60148321405013310932013-02-06T08:17:29.257-08:002013-02-06T08:17:29.257-08:00Glad you enjoyed it! I think we could have done wi...Glad you enjoyed it! I think we could have done with slightly longer and had a better focus for discussions but it was encouraging to hear people contribute so readily - and not all negatively!<br /><br />Although the focus of the BoC review is necessarily wider, Directive 2011/24 EU (on patients' rights in cross-border healthcare) covers a lot of the issues you refer to above - reimbursement of EU medical costs, prior authorisation, pricing and charging, obligations on Member State of treatment, set up of National Contact Points, mutual recognition of prescriptions, European Reference Networks & centres of excellence, eHealth, sharing of information, etc etc....<br /><br />I would describe the Directive as complex, wide-ranging and potentially controversial (when understood properly). It is required to be implemented into national laws by 25 October this year and I'm just finalising the consultation process, which looks likely to start towards the end of February - so look out for that and a couple of consultation events that you (and others) might like to attend... Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-88034515374592548032013-01-24T05:38:38.188-08:002013-01-24T05:38:38.188-08:00Nobody comes out of this looking good. Have you se...Nobody comes out of this looking good. Have you seen the ballboy's tweets from before the game? <br /><br />https://twitter.com/TouchlineDrama/status/294202367069540352/photo/1/large<br /><br />I think everyone should just get a reprimand (except anyone who plays for Chelsea, who should be dragged out and shot....)<br /><br />:-)Chairman Chegwinhttps://www.blogger.com/profile/05121249354671874141noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-18315372060716980992012-12-03T03:08:40.043-08:002012-12-03T03:08:40.043-08:00Hmmm....as an enjoyer of the very occasional small...Hmmm....as an enjoyer of the very occasional small cigar(!), I'm not sure where I stand on this. Instinctively, I'm against the "nanny state" regime because for me, that's not what Government should be about. Plus such interventions usually have the opposite effect because people don't like having their lives micro-managed in this way.<br /><br />That said, our pubs, public transport and public places are much more enjoyable for the smoking ban. <br /><br />Ultimately, I don't see this happening here. The smuggling angle (and the resources it will take to police) will be a real concern and I also think that the tobacco industry must have a fairly solid case on the application of EU Competition Law (which is supposed to curb anti-competitive behaviours by Member States, not encourage them!). <br />Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-68881504402778988652012-11-13T23:45:22.766-08:002012-11-13T23:45:22.766-08:00The one responsible on those breast implants shoul...The one responsible on those <a href="http://www.nyccosmeticdermatology.com/breast-augmentation.htm" rel="nofollow">breast implants</a> should do the action at the soonest possible time to prevent further damage to the patients. Thanks for sharing this eye opening post.Anonymoushttps://www.blogger.com/profile/10171120577907793465noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-20809995656985075332012-11-05T04:12:46.063-08:002012-11-05T04:12:46.063-08:00I find the furore around this baffling. The LCP ha...I find the furore around this baffling. The LCP has been standard practice in most hospitals for a number of years and it has received recognition at both national and international level as an example of good practice. I referenced it when writing the 2008 national strategy for children’s palliative care. <br /><br />What we are talking about here is a model of care but all such models depend heavily on clinicians, medical and nursing staff doing the right thing. It seems to me that a lot of the noise surrounding this issue is about individual failings on the part of healthcare professionals – or of poor infrastructure (lack of training, low skill levels etc). <br /><br />The model of care can only do so much. For me, this is all about human failure – lack of communication, compassion, good management etc - it is not right to blame the model of care for that. <br /><br />Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-66273834463723196352012-10-23T11:04:45.691-07:002012-10-23T11:04:45.691-07:00I think you are conflating politics and healthcare...I think you are conflating politics and healthcare in this piece. Which evidence-based research did Mr Lansley ignore? His reforms were (are) reforms of systems, responsibilities and money flows. There was nothing inherently "clinical" in there? <br /><br />You can of course argue about whether system change was needed at this point in time but that was (for right or wrong) a political judgement. I don't think views on abortion or homeopathy (or anything else) inhabit the same space. <br /><br />I would also suggest that the "Lansley Reforms" are in fact Steve Field's reforms. The Bill (Act) that emerged post-"pause" was very different to what was presented to the populace before.<br /><br />Whether you agree with Mr Hunt or not, it is a mistake to conflate those beliefs with what Mr Lansley was trying to do. As far as I can see, Mr Lansley didn't get involved in challenging "clinical" decision making - his priority was reforming a system (which many - including me - would say is dominated by the agendas of clinicians and ripe for REAL reform....) Chairman Chegwinhttps://www.blogger.com/profile/05121249354671874141noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-60449795454508861862012-10-16T09:37:13.700-07:002012-10-16T09:37:13.700-07:00I'm sorry that you've been through this to...I'm sorry that you've been through this too and it's shocking that this scenario is so common. At least it worked out well for you (most of my disasters turn out ok in the end). The disappointing thing is that so often the 'villains' get away with it and the decent people just move on.Finchers Consultinghttps://www.blogger.com/profile/02585633183853596999noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-90154650432538716372012-10-14T13:19:03.797-07:002012-10-14T13:19:03.797-07:00Yes, I have personal experience of this aswell - w...Yes, I have personal experience of this aswell - working as Private Secretary for a previous CMO, no less... I pondered long and hard about what to do but received no reassurance from anyone that anything would be done so that was that.<br /><br />I was "encouraged" to move on and take an alternative career path (which actually turned out to be much better, more successful and MUCH more fulfilling).<br /><br />But it taught me a lot about how people close ranks.... Chairman Chegwinhttps://www.blogger.com/profile/05121249354671874141noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-90796694358583474872012-09-26T09:25:16.819-07:002012-09-26T09:25:16.819-07:00I think the original question - ‘Can someone give ...I think the original question - ‘Can someone give me a clear definition of innovation in the NHS’? - hints at thinking on some higher plane but is actually somewhat nonsensical. Why do we need a definition? <br /><br />It is extremely vague what it is she means? We can easily define what innovation is - it is about introducing something new or different (which, incidentally COULD include reform!) and there have been many examples of this over the decades that the NHS has been in existence. For example, we didn't rid the nation of various diseases by following the same path as before so I'm struggling to understand what Ms Gerada is asking? <br /><br />Of course, given previous form, it is probably a veiled criticism about the NHS reforms. Reform is a consequence of government being faced with rising costs and growing demand, so they are constantly searching for methods of delivering higher productivity in healthcare, or, put more simply, ways of getting higher quality without increasing expenditure. <br /><br />Interestingly, it is GPs as a group that contribute significantly towards the rise in NHS costs. A big problem is the huge amount of over-prescribing that goes on. I put some stark figures as a reply to one of your previous blogs and will repeat them here:<br /><br />In 2010, nearly 927 million prescription items were dispensed; this is a 4.6 per cent rise on 2009 AND A 67.9 PER CENT RISE ON 2000.<br /><br />An average of 17.8 prescription items were dispensed per head of the population in 2010; compared to 17.1 in 2009 and 11.2 in 2000.<br /><br />I imagine these fiures will rise again for 2011 and 2012. So what does this tell us? I think it tells us two things:<br /><br />1. The uncomfortable truth is people these days want a pill for every ill and are prepared to ship up at the surgery at the drop of a hat to get what they want. In turn, GPs dole out what their patients want because it is very often less hassle to them than standing by what is clinically correct.<br /><br />2. This practice of giving the patient what they want creates a reliance on the system (and in particular the GP) that to me is unhealthy (excuse the pun!). And it costs us a great deal of money. For example, prescription charge exemption means that nearly 90% of all prescribed medicines are dispensed free due to condition-specific and low income exemptions, which obviously affects the yield that goes towards offsetting the drugs bill.<br /><br />Further, the pharmacist is paid per item on a script so in a world where GPs over-prescribe and the state picks up the tab for nearly 90% of prescriptions, there will always be a serious funding issue.<br /><br />Returning to the original question, I'd say let's see some "innovation" in primary care - and in particular, prescribing practice! Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-44906317297804555372012-09-12T01:49:05.171-07:002012-09-12T01:49:05.171-07:00Very well said - if the unions and professions att...Very well said - if the unions and professions attempt to rake over old ground and reopen old arguments rather that face the future and try to make things work, then the NHS will pay a heavy price in terms of preparation and readiness for 1 April and beyond. <br /><br />I think the public are confused about the reform programme and bored of all the in-fighting. So I suspect that the new SofS will look to step away from the reforms (after all, they're not his!) and look to concentrate his efforts elsewhere - perhaps on subjects and interventions that he think resonate much better with the public.<br /><br />We'll see... Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-11067639186117471152012-09-06T07:28:09.561-07:002012-09-06T07:28:09.561-07:00I don't necessarily see health as a deal break...I don't necessarily see health as a deal breaker in the Coalition although some of health policy issues emanating from Europe might hasten things along when they come into view....Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-11002693943622456692012-09-06T06:05:14.291-07:002012-09-06T06:05:14.291-07:00As always you have summed things up beautifully Ro...As always you have summed things up beautifully Rob! Alas the muddled mess seems to reflect everything going on in the coalition right now..<br />Finchers Consultinghttps://www.blogger.com/profile/02585633183853596999noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-4406179273090117412012-09-06T05:13:03.493-07:002012-09-06T05:13:03.493-07:00Health SofS's rarely come out of the job with ...Health SofS's rarely come out of the job with reputations enhanced - Stephen Dorrell and Ken Clarke being notable recent exceptions. <br /><br />I'm no particular fan of Mr Lansley but surely no one can argue that (at least amongst politicians) he had the widest knowledge of the NHS and health policy in general. His mistake was not sticking to his guns on his original plans. What we have now is the result of meddling (the Future Forum), lobbying (BMA etc) and undermining from the top (Cameron) - as a consequence, from the highly decentralised approach of the original White Paper, we now have the most centralised NHS in living memory. <br /><br />Ultimately, it was the wrong plan at the wrong time and was probably continued with to provide his "legacy". Now we all have to make sense of it....<br /><br />Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-17631378460078620972012-08-24T04:04:12.752-07:002012-08-24T04:04:12.752-07:00Of course, cancer services in recent years have be...Of course, cancer services in recent years have benefited from a National Cancer Plan, an effective cancer "tzar" and accompanying dedicated resource, so I'm fairly confident that the good results we are seeing now are not a coincidence. <br /><br />But when one particular sector benefits, others lose out. While cancer services have been "flavour of the month" for some time, areas like CAMHS and children's services in general receive much less attention. Plus, across the service, we see much more in the way of rationing and non-availability of routine treatments. <br /><br />Is the balance right? <br /><br />You've also pointed to the real area of weakness - GP services. Once the flagship NHS service, standards are nowadays very patchy and referral rates to secondary care are very inconsistent. <br /><br />Like you, I hope the new system architecture works but we are entering unchartered waters.... <br /><br /> Rob Dickmannoreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-89810504707439380332012-08-13T14:30:20.042-07:002012-08-13T14:30:20.042-07:00Thanks Jessica. I am fascinated by healthcare in t...Thanks Jessica. I am fascinated by healthcare in the US too and follow your reforms with interestFinchers Consultinghttps://www.blogger.com/profile/02585633183853596999noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-27680392807216719312012-08-13T09:52:09.691-07:002012-08-13T09:52:09.691-07:00Thank you for your kind words Patrick. yes - as yo...Thank you for your kind words Patrick. yes - as you say - the training is crucial. Perhaps this would be a good opportunity for the private sector and commerce to support the NHS - offering free customer service training.Finchers Consultinghttps://www.blogger.com/profile/02585633183853596999noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-47398540962868042962012-08-13T09:51:33.998-07:002012-08-13T09:51:33.998-07:00Your blog post is very informative for the sport a...Your blog post is very informative for the sport and fitness.<br /><a href="http://www.mybodhi.com/" rel="nofollow">Internist NYC</a><br />Jassicahttps://www.blogger.com/profile/15657090671194656888noreply@blogger.comtag:blogger.com,1999:blog-7746061689746893784.post-36033354813088100672012-08-13T07:25:29.425-07:002012-08-13T07:25:29.425-07:00Thank you for another excellent post. Having seen ...Thank you for another excellent post. Having seen #gamesmakers in Manchester and London, they were exceptional because of their focus - just like NHS volunteers. But they had so much more - training (from McDonalds I think?), practical uniform for all eventualities and lots of support - with these three ingredients, NHS volunteers can achieve so much more.Patrick Keadyhttp://www.patrickkeady.orgnoreply@blogger.com