John-Paul Crofton-Biwer’s Post

Zero Tolerance For Failure Under Package Of Tough NHS Reforms Unveiled League tables revealing failing NHS trusts and cancelled pay rises or dismissal for managers who don't turn things around are part of new plans to improve the health service. Health Secretary Wes Streeting is confirming new measures he hopes will boost failing hospital trusts and encourage successful ones, plans include turnaround teams sent into struggling hospitals, while best performers given greater freedoms over funding to modernise technology and equipment, no more rewards for failure, with reforms to ensure every penny of extra investment into NHS is well spent and waiting times for patients slashed NHS league tables will be introduced to help tackle the NHS crisis and ensure there are ‘no more rewards for failure’, as part of a tough package of reforms to be announced by the Health and Social Care Secretary Wes Streeting. NHS England will carry out a no holds barred sweeping review of NHS performance across the entire country, with providers to be placed into a league table. This will be made public and regularly updated to ensure leaders, policy makers and patients know which improvements need to be prioritised. Persistently failing managers will be replaced and turnaround teams of expert leaders will be deployed to help providers which are running big deficits or poor services for patients, offering them urgent, effective support so they can improve their service. High-performing providers will be given greater freedom over funding and flexibility. There is little incentive across the system to run budget surpluses as providers cannot benefit from it. The reforms today will reward top-performing providers and give them more capital and greater control over where to invest it in modernising their buildings, equipment and technology. The government will deliver a health service fit for the future, fixing the foundations while delivering change with investment and reform to deliver growth, get the NHS back on its feet and rebuild Britain. Health and Social Care Secretary, Wes Streeting, said: “The budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service. Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.” “There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.” “Our health service must attract top talent, be far more transparent to the public who pay for it and run as efficiently as global businesses.” “With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.” Amanda Pritchard, NHS Chief Executive, said: “While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development.” “The extensive package o…

Our NHS needs reform…🧐 This is something that has been highlighted numerous times, over DECADES Lets face it, the political colour at the time any of us need to access Our NHS is insignificant to us Having the NHS as an accessible provision to anyone needing it, at the time they need it is not disputed There are many stories which showcase the benefit of our health system and how it’s impacted positively in people’s lives So what does changing or reforming Our NHS actually mean and how do we avoid ‘throwing the baby out with the bath water’ I’m passionate about influencing education, health and social care across the ages I have a proven track record of changing systems which go on to demonstrate sustainable improvement for the people that use the services I’m willing to say the ‘unpopular’ thing for the improvement of safety, care and support across education, health and social care Taking this stance is not without personal and professional discomfort ‘Trouble makers’ are silenced in whatever way it takes to limit reputational damage for services I’ve been a lone voice at times and had my fair share of experiences which have led to attempts to discredit me or my businesses, without cause, just because I’ve seen the need for change and openly spoken about it I’ve created the model of L.O.V.E Leadership introduced in Draw A Heart Around It which I applied to Arterne Group businesses and have enjoyed experiencing the results There is ‘safety in numbers’ but what happens when the see-saw of balance tips in favour of keeping the peace, groups of people collude even when they know we need change, for fear of the individual consequences As a system… What if we really listened? What if we empowered the people delivering care and support to REALLY have a voice in shaping the future provisions? What if the people that used services gave feedback and we change the way we deliver our services? I’m not talking about predetermined ‘consultation’ where we, as systems, already know the outcome before we’ve had the discussions because it saves money or moves people in or out of positions which we THINK will work Complex systems requires collaboration and partnerships which are effective and transparent Problem solving for complex systems is not easy although some fairly simple solutions can be applied which help shape the direction we want to move in We can continue to play the roles as we SHOULD to keep the peace and ‘toe the party line’ But what if we didn’t… #drawaheartaroundit #love #leadership #arterne #changing #challenging #systems #health #socialcare #education

🛑 "The NHS, Britain’s Biggest Warehouse—And It’s Full" 🛑 Thank you, Tom Calver, for an insightful breakdown of the NHS’s storage crisis. If the NHS were an airline, it’d be flogging first-class tickets to passengers crammed into the cargo hold ✈️📦. With 12,000 hospital beds filled with patients medically fit for discharge (NHS England, 2024)—the equivalent of shutting down 24 full hospitals overnight—we’re hoarding people instead of healing them 🏥🚧. Britain, meanwhile, hobbles along with 2.5 beds per 1,000 people (OECD, 2024)—barely enough to swing a stethoscope—while France sprawls comfortably at 5.8 and Germany lounges at 7.9 🛏️📊. Add 22 million over-50s (ONS, 2024) and a rising tide of centenarians 🎂📈, and we’re fast becoming a nation of bed blockers—with nowhere to lie down. The NHS was never designed to be Britain’s most expensive storage unit 🚪📑. Yet here we are, treating hospitals like glorified parking lots for the frail while discharge forms gather more dust than the patients. The fix? Bulldoze the bottlenecks 🏗️, build step-down recovery hubs 🏡, and launch discharge processes faster than Amazon Prime 🚀. Right now, the NHS isn’t just running out of beds—it’s teetering on the edge of a full-blown gridlock 🆘. #NHSCrisis #HealthcareReform #AgeingPopulation #BedBlocking #BuildBetterCare #ModerniseTheNHS #FixTheFlow #HospitalBeds #HealthMatters #UKHealthcare

 “The 2010s were a lost decade for our NHS… which left the NHS unable to be there for patients today, and totally unprepared for the challenges and opportunities of tomorrow.” These are the words the Prime Minister used following the release of the Darzi NHS report. In it, Lord Darzi has pulled back the curtain on failing services, which he has suggested are as a result of funding shortages that have left hospitals with failing infrastructure, and outdated equipment, but has also spoken about the impact of reduced productivity. Hospital staffing increased by 17% between 2019 and 2023, he reported, yet he also noted that there was no comparable uplift in appointments, operations, or procedures. Both Lord Darzi, and Sir Keir Starmer agree that the NHS is spending in the wrong places, and that there needs to be a shift of care away from hospitals and into communities. But there is a problem here that neither addressed. To create this 'neighbourhood care', funding will need to be moved from Secondary Care and into Primary and Community Care. But while this process is being developed, existing care networks within hospitals will still need to be funded, creating a requirement for 'double funding' at least on a temporary basis. Prime Minister, Sir Keir Starmer, has stated no more funding without reforming, so once again it appears that fixing the NHS has reached an impasse over how to fund it. #nhs #darzi #funding #sirkierstarmer #efficiency #communitycare #hospitals #primarycare #productivity #nursing #doctors #generalpractice https://lnkd.in/e6wTREvS

I've had my fair share of involvement with the NHS over the last few years and, like many Brits, am very grateful we have it. But its problems are glaring, epitomised in yesterday's press release from the Kings Fund*, stating that we have a system "facing a toxic cocktail of pressures this winter," and confirmed by my own recent experiences (myself and family members), as follows: Waiting times We've all heard it, but waiting times can be truly are shocking, both for getting into the system, receiving operation dates, and more specifically, going through A&E (personal experience of 48 hours, last week). These waits are often coupled with poor communication about expected end-dates, leading to increased patient stress and further resource-drain for the NHS as we frantically ring/email/badger staff to try and get some answers. What must it be like to be on the front line trying to deal with this? Poor Communication See the above point about waiting times - sometimes there's none. But other times you get too much. An endless stream of appointment letters and app messages, some cancelling the last one, others making new ones. Some communication gives part-diagnoses with little explanation of what these mean. Silo'd Care and Rigid Metrics We're holistic, complex beings. Specialist care of course has its place, but who's there to advocate for the whole person? Someone having an overview (doesn't have to be specialist) could help us feel understood and avoid overly-relying on rigid metrics that are not be suitable for everyone. Overcrowded Hospitals Beds are like gold-dust. Just when you think you've got one, you could be turfed out and given only a chair to wait on until another bed is found (in my case, 11 hours later). A bit like musical chairs, without the music and party hats, and much much more stressful. Staying Immobile, Less Movement It seems as if once you're in a ward, the system really requires you to stay there. Endless streams of checks and visits means that it's difficult to leave. I'm not knocking the care, but what this means in reality is that you're trapped. You can't easily sit outside in the sun or go downstairs for a coffee, even if your health allows this. Not great for you physically and psychologically. So what's my point, apart from having a moan during a tough time? A question: in addition to more funding, what else do you think could be done to improve things? Let's hope that we all stay away from the system in 2025. And that Wes can deliver. *https://lnkd.in/gp5c2DNT #nhs #healthcare #publicsector #health

🤔Why does a cabinet minister have to force cost savings on NHS trusts? 🚑NHS providers are still expecting to miss waiting time targets by the end of this parliament 💸We are beginning to see the limits of Wes Streeting's tough talk on NHS reform Ever since it became clear that he was going to be the next Health Secretary, Wes Streeting has made a point of ‘talking tough’ on NHS performance. Streeting said that we should treat the NHS as a health service, not a shrine. That we risked killing the NHS with kindness. That we cannot just keep throwing money at it. He even went on a fact-finding mission to Australia and Singapore to learn about other health systems. Now, I don’t want to dismiss Streeting’s statements as mere abstract waffle of the above variety. I don’t want to say that talk is cheap, because this is a case where talk is not cheap at all. When it comes to the NHS, talk can actually be quite expensive. Until very recently, saying anything about the NHS other than showering it with love and affection was extremely controversial, even if it only happened at the most abstract level. It still triggers a lot of hysteria in some circles today. Pointing out weaknesses in NHS performance is an easy thing to do if, like me, you are a Tufton Street villain, and everyone assumes that you have worst possible motives, because you will only come under attack from people who hate you anyway. But if, like Wes Streeting, you are on the centre-left of politics, it takes some genuine courage, because you will upset people who might otherwise be broadly on your side. On Twitter, Streeting is constantly under attack from high-profile NHS cultists who accuse him of secretly plotting to destroy the NHS from within. One of his most vocal opponents is a former Labour shadow health secretary, Diane Abbott. So, kudos to Wes Streeting for challenging his own side! But I nonetheless never expected him to become much of an actual health reformer. His reform rhetoric has always been too general, and too abstract. What does it mean, in policy terms, to stop treating the NHS like a shrine? What would a non-shrine health policy look like? What is the point of travelling to Australia or Singapore, and pointing at shiny hospital buildings, if you are not actually interested in the features of those health systems that make them outperform the NHS? ✍️Kristian Niemietz https://lnkd.in/e9Wrv8NA

The more I research the NHS and where they spend the money the more I suspect that more money is not the answer but a fundamental change in how money is spent. The attached research shows how the acute care sector ie hospitals have swallowed nearly all the increased funding leaving primary healthcare and community healthcare starved. Micro sums are spent on health prevention and wellness and the primary care sector funding restricts their operation throwing even more pressure on the ultra expensive hospital sector A return to community health with cottage hospitals or health hubs are a part of the answer. However in return for more funding the primary care sector has to accept more public oversight. A local village school or secondary Acageny has to account to a board of non executives drawn from local community. Every pound spent is subject to scrutiny GP practices have no similar oversight Talking to local GP’s it appears that mistrust of GP’s means that money is allocated in small ring fenced sums with no incentive for efficiency. GP’s refused to join the NHS when first founded and they have remained a private contracted service since Now is time to apply a carrot or a stick and in return for more oversight more of the pie should be spent in the Non acute sector #NHS.

The UK’s healthcare system is in deep crisis and is facing unprecedented pressures. Around 6.24m individuals are waiting for 7.54m National Health Service (NHS) hospital appointments in England alone. Some 300,000 people a year are dying whilst waiting for a hospital appointment. Some 2.7m are chronically ill and there is a shortage of dentists, doctors, nurses and hospital beds. The crisis is due to policies of the state which has eroded people’s disposable income through never-ending austerity, low wages and cuts to public services, whilst implementing regressive taxation policies. Some 6.2 million workers are in insecure jobs. Workers’ share of GDP has declined. 12m people live in poverty. With low incomes, people are unable to access good food, housing, healthcare and essential goods and services. Millions have succumbed to poor health. Malnutrition, scurvy and rickets, once banished have returned. Ambulances do not reach patients in good time. Britons die sooner from cancer and heart disease than people in many other rich countries. The underfunded healthcare system is unable to cope. Last year some 14,000 people died in Accident & Emergency departments. Better healthcare is a necessary condition for any economic revival. It can’t be achieved without eradication of poverty and that in turn requires equitable distribution of income and wealth, and investment in social infrastructure. Neoliberals object to greater public investment in the NHS with the claims that ‘we can’t afford it’. Interestingly, they never objected to the state bailing out banks and energy companies and handing billions in quantitative easing to capital markets. The state also found money to fund wars in Ukraine, Afghanistan, Iraq and elsewhere, and continues to hand billions in subsidy to rail, steel, oil, gas, auto, internet and other companies. Any state that can fund wars and corporate subsidies can also fund investment in healthcare to save lives and relieve misery. It can do this through borrowing, quantitative easing and/or by eliminating tax anomalies and perks which benefit the wealthy elites.

NHS - National Health Service or National Horor Show? As somebody with more to thank the NHS for than most, I am in total dismay as I listen to the endless reports of its impending demise. The thing that hurts most, is the futility of the efforts of the totally outstanding frontline staff, those who truly care about the standards of service and its delivery, day-in, day-out! I have been around a long time, and as a Veteran I genuinely appreciate growing old, because not everybody gets that chance. Over the last 3 years I have been in and out of hospital more times than I care to remember, being ill for the first time in my life; again, I’m thankful for my recovery and owe my life to the NHS. However, I feel that there is insufficient clarity around why the NHS is in the state that it undoubtedly is. Putting the political grandstanding to one side, I feel the people deserve to be focused on the facts, which in my view can be summarised as follows: - throughout its 75 year life the NHS has lacked a sustained level of investment, irrespective of the government of the day. FACT - the organisation is no longer FFP and must be reviewed and restructured as a national priority. - the level of bureaucracy within the organisation has increased year-on-year (note: currently c47% of NHS FTE are not clinically qualified). FACT - there is a total imbalance in the numbers of clinical versus non-clinical staff. This must feature in the review and be reduced significantly. Money will be saved. - the current NHS budget is now set at £192bn, a real-time increase of £21bn in cash terms; according to the Health Secretary, Wes Streeting, this will only “paper over the cracks”. FACT - the “blame game” and point scoring must stop. The problem must be given cross-party priority; if ever there was a “joint” responsibility, this is it! - the growth of the UK population has not been controlled appropriately in recent years and a working solution must be identified and implemented as soon as possible. FACT - the current strain on the NHS and its A&E capability is costing lives NOW; this is inhumane and unacceptable. This needs immediate attention and resolution, so if the politicians are listening STOP THE POINT SCORING, PULL TOGETHER AND GET IT DONE BEFORE OUR NHS IS CONDEMNED TO HISTORY! #supportnfixourNHS

NHS Leaders Facing “Drastic Measures” To Make Ends Meet Health leaders in England are calling on the next government to protect local NHS organisations from having to further cut staffing levels to make ends meet at a time when the needs of their patients are so high. In a survey of NHS leaders across trusts, integrated care boards (ICBs) and primary care in England, some local NHS organisations are already cutting or freezing posts to balance their books. They fear local services are trapped in a cycle of short-termism where immediate cuts to meet financial targets are having to be prioritised over long term plans to improve and transform local services. The survey was carried out during late April and early May – a time when the NHS has been coming to terms with the “flat” revenue settlement set in the Spring Budget. The NHS has been set an annual efficiency target of 2.2%, despite many organisations starting the financial year in a worse underlying state due to industrial action and other cost pressures. As the NHS Confederation survey shows, many local NHS organisations are facing much higher efficiency targets that will impact on their staffing levels. The rate of NHS productivity growth has averaged 0.9 per cent over the past 25 years, with the NHS often delivering higher productivity improvements than the wider economy. However, the NHS leaders responding to the survey said that they need, on average, to make efficiency savings of 6% in 2024/25, with local services facing targets ranging from 1.6% all the way up to 11%. Recently, the Institute for Fiscal Studies found that real-terms spending on the NHS had risen less quickly than was pledged at the last general election five years ago. This squeeze on NHS spending is likely to be compounded by the main political parties committing this week to no further tax increases, which the IFS say will further constrain spending on public services. In response to this, some health leaders are having to take “drastic measures” to balance the books, with cuts to agency spending, freezing vacancies and cuts to clinical and managerial and administrative staff the most effected. This is to cover what is estimated to be a larger projected deficit in the financial plans of local integrated care systems (ICS) than has been seen in recent years. This could lead to further cuts to capital and other budgets. Cuts to staff come at a time when the latest data shows there are over 100,000 vacancies across the NHS in England, including nearly 9,000 medical posts. This short-term risk to freeze or cut posts could be seen to go against the NHS Long Term Workforce Plan’s commitment to grow the NHS’s headcount so that it can meet the needs of patients and respond to rising demand. The main political parties appear to agree that the NHS must grow its workforce, yet without appropriate levels of funding locally that are matched to the efficiency asks of the NHS, many health leaders feel as though they have no…