NHS Lanarkshire’s Post

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

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…

With the UK General Election fast approaching, let’s talk about how the NHS is currently being funded. I stumbled upon this incredible video recently and it breaks things down quite well. 👇 Do check it out, but let me summarize: 1. 🏛 𝐇𝐨𝐰 𝐩𝐮𝐛𝐥𝐢𝐜 𝐦𝐨𝐧𝐞𝐲 𝐢𝐬 𝐬𝐩𝐞𝐧𝐭 𝐢𝐬 𝐝𝐞𝐭𝐞𝐫𝐦𝐢𝐧𝐞𝐝 𝐛𝐲 𝐏𝐚𝐫𝐥𝐢𝐚𝐦𝐞𝐧𝐭 𝐚𝐧𝐝 𝐦𝐨𝐫𝐞 𝐬𝐩𝐞𝐜𝐢𝐟𝐢𝐜𝐚𝐥𝐥𝐲 𝐭𝐡𝐞 𝐂𝐡𝐚𝐧𝐜𝐞𝐥𝐥𝐨𝐫 𝐨𝐟 𝐭𝐡𝐞 𝐄𝐱𝐜𝐡𝐞𝐪𝐮𝐞𝐫. Money allocated to #healthcare is determined by the Spending Review - which is usually every three years and amended annually by the budget report. 2. 🏢 𝐓𝐡𝐞 𝐠𝐨𝐯𝐞𝐫𝐧𝐦𝐞𝐧𝐭 𝐝𝐞𝐩𝐚𝐫𝐭𝐦𝐞𝐧𝐭 𝐫𝐞𝐬𝐩𝐨𝐧𝐬𝐢𝐛𝐥𝐞 𝐟𝐨𝐫 𝐡𝐞𝐚𝐥𝐭𝐡 𝐜𝐚𝐫𝐞 𝐢𝐬 𝐭𝐡𝐞 Department of Health and Social Care. They the largest amount of pre allocated public money, with an annual budget for 2023 to 2024 of £188bn. This is divided into £176bn of revenue funding to cover day to day running costs, such as staff salaries and medicines, and £12bn of capital funding to pay for infrastructure and maintenance costs. 3. 💰 𝐓𝐡𝐞 𝐃𝐞𝐩𝐚𝐫𝐭𝐦𝐞𝐧𝐭 𝐨𝐟 𝐇𝐞𝐚𝐥𝐭𝐡 𝐚𝐧𝐝 𝐒𝐨𝐜𝐢𝐚𝐥 𝐂𝐚𝐫𝐞 𝐡𝐚𝐬 𝐭𝐨 𝐩𝐚𝐲 𝐢𝐭𝐬 𝐢𝐧𝐭𝐞𝐫𝐧𝐚𝐥 𝐜𝐨𝐬𝐭𝐬 𝐚𝐧𝐝 𝐟𝐮𝐧𝐝 𝐬𝐞𝐯𝐞𝐫𝐚𝐥 𝐞𝐱𝐞𝐜𝐮𝐭𝐢𝐯𝐞 𝐚𝐠𝐞𝐧𝐜𝐢𝐞𝐬, 𝐬𝐩𝐞𝐜𝐢𝐚𝐥 𝐡𝐞𝐚𝐥𝐭𝐡 𝐚𝐮𝐭𝐡𝐨𝐫𝐢𝐭𝐢𝐞𝐬, 𝐚𝐧𝐝 𝐚𝐫𝐦'𝐬 𝐥𝐞𝐧𝐠𝐭𝐡 𝐛𝐨𝐝𝐢𝐞𝐬 𝐬𝐮𝐜𝐡 𝐚𝐬: NHS England NICE - National Institute for Health and Care Excellence Medicines and Healthcare products Regulatory Agency Care Quality Commission, etc 4. 💶 𝐍𝐇𝐒 𝐄𝐧𝐠𝐥𝐚𝐧𝐝 𝐫𝐞𝐜𝐞𝐢𝐯𝐞𝐝 𝐭𝐡𝐞 𝐦𝐚𝐣𝐨𝐫𝐢𝐭𝐲 𝐨𝐟 𝐭𝐡𝐞 𝐃𝐞𝐩𝐚𝐫𝐭𝐦𝐞𝐧𝐭 𝐨𝐟 𝐇𝐞𝐚𝐥𝐭𝐡 𝐛𝐮𝐝𝐠𝐞𝐭 𝐰𝐢𝐭𝐡 𝐟𝐮𝐧𝐝𝐢𝐧𝐠 𝐟𝐨𝐫 2023 𝐭𝐨 2024 𝐨𝐟 160 𝐛𝐢𝐥𝐥𝐢𝐨𝐧 𝐩𝐨𝐮𝐧𝐝𝐬. NHS England has a budget of 27 billion for directly commissioning services. It directly commissions military health care, health services in the justice system, for health care for children, young people and adults across secure and detained settings, and specialized services. There are 154 directly commissioned specialised services which are grouped into six programmes of care. 5. 📜 42 𝐢𝐧𝐭𝐞𝐠𝐫𝐚𝐭𝐞𝐝 𝐜𝐚𝐫𝐞 𝐬𝐲𝐬𝐭𝐞𝐦𝐬, 𝐈𝐂𝐒𝐬, 𝐰𝐞𝐫𝐞 𝐞𝐬𝐭𝐚𝐛𝐥𝐢𝐬𝐡𝐞𝐝 𝐨𝐧 𝐚 𝐬𝐭𝐚𝐭𝐮𝐭𝐨𝐫𝐲 𝐛𝐚𝐬𝐢𝐬 𝐨𝐧 𝐭𝐡𝐞 1𝐬𝐭 𝐨𝐟 𝐉𝐮𝐥𝐲 2022 𝐚𝐬 𝐩𝐚𝐫𝐭 𝐨𝐟 𝐭𝐡𝐞 𝐇𝐞𝐚𝐥𝐭𝐡 𝐚𝐧𝐝 𝐂𝐚𝐫𝐞 𝐁𝐢𝐥𝐥. The new ICS are led by an integrated care board (ICB) and an integrated care partnership (ICP). The majority of #NHS England's budget, 107.8 billion, is allocated to ICBs for commissioning local health services. Allocations are made from NHS #England to ICBs as a system funding envelope.  Organizations within ICSs have to adopt and adhere to a shared control total, which in effect binds them to meeting a collective target for financial performance 𝐓𝐋;𝐃𝐑: Money flows from Parliament ➡ Department of Health ➡ NHS England ➡ Integrated care boards ➡ Organisations that provide patient care. 

Keir Starmer has made the prime target of the NHS is reducing waiting lists,  but will that stop the NHS Titanic from sinking? I heard a fabulous analogy today from Mark Burns today. (https://lnkd.in/e4KWvsCh ) "A ship is sinking and everyone is busy manning the pumps. The boat has now stopped sinking, but you cannot stop pumping or it will sink further. You are stuck, so you need to allow some people to stop pumping and go and fix the holes" This is an excellent analogy for public service and the NHS in particular. NHS waiting times are simply about bailing faster to stop the boat from sinking. Better pathways, more capacity, speedy everything. But we are not preventing the demand from coming in. We are measuring our ability to bail it out. The problem is our funding targets and KPIS are based on how much water we bail out of the boat. This is what makes Keir Starmer’s waiting time target for the NHS so odd. The idea that a busy NHS is a good NHS. That the more the work the NHS produces the better it must be. Whilst the core function of our NHS and the health and social care system is actually to maintain the health and wellbeing of society…. actually stopping the ship from sinking. Don't get me wrong we do need to keep bailing as fast as possible to keep the ship afloat, but we must also need to look at the wider problem. Why have the waiting lists got so bad? Where is the demand coming from? What can we do to reduce and better manage that demand? It is far less work to capture the demand quickly where and when it comes into the boat. Rather than chasing around scooping it off the floor. Also where does that water go? It seems like much of the problems the NHS ships out actually go straight back in. Unless we are careful, we are basically bailing water into our own boat! But also the more work we bail the more demand we are putting on social care. (Then blaming social care for not having capacity). Which also rebounds the water of demand back into the NHS. The best way to reduce waiting lists is to reduce pressure on the bailers. That can only be done by reducing demand. So the best way to reduce waiting lists is to focus on fixing the boat. NOT to focus funding and attention on treating people as fast as possible.  Leaders need to take the initiative in reducing waiting lists in not just creating creating a good flow of work, and optimising that, but actually seeing the big picture understanding how we can stop the waves of demand coming in. The KPIS and targets of the NHS and healthcare should not only focus on bailing faster, but how we navigate our ship to calm waters for our public services to be effective and productive. Creating a service that our public most need. #NHS #healthcare #health #funding #productivity

Speaking following the publication of Lord Darzi’s Independent Investigation of the NHS in England, our Social Partnerships Director Stephen Sorrell MBE said: “While social care is out of Lord Darzi’s scope, he has rightly highlighted it as a root cause of pressures in our health system. A big part of the problem is that retirement housing is seen by many as a last resort. This isn’t a baseless fear – the dearth of affordable or appealing older people’s housing is what causes people to stay in their own homes for as long as possible. Rather than making a pre-emptive move to specialist accommodation, they often end up in hospital. Some 13% of NHS beds are occupied by people who should be in more appropriate settings – creating a backlog and inefficiency in the system. “To ease this blockage and foster the community care that the Health Secretary has championed, the government must back the development of affordable and fit-for-purpose housing for older people. Homes which promote accessibility and autonomy improve health and wellbeing, while accommodation that is not suitable leads to increased care needs and diminished independence. Poor housing is currently causing major health issues – for individuals and for the country. Good quality, care-focused accommodation can act as a powerful prevention and ease the NHS’ burden.” https://lnkd.in/eSYnEtSe https://lnkd.in/eAHY2RZP

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 Future of the NHS: Reform or Collapse?⭐️ The recent Darzi NHS report has sent shockwaves through the UK, as Prime Minister Keir Starmer addressed a critical issue: 100,000 avoidable deaths due to overstretched NHS services. This shocking statistic leaves the public rightfully angry, as the outgoing government has been blamed for failing to protect one of the country's most cherished institutions. We are becoming an increasingly sick society, with 2.8 million people now inactive due to long-term health issues. It’s not just a health crisis but an economic one, and a return to good health must be a priority. Labour, under Starmer, has been given a clear mandate for change, and in his words, "The NHS might be broken but not beaten." What happens next could determine whether the NHS survives or collapses. 🔷The Need for Reform: A Health System at a Crossroads The NHS, founded 76 years ago, promised free care at the point of use—a model that remains fundamentally right. However, it’s no longer adapting to the current challenges. The answer to saving the NHS is not just pouring more money into it but fixing broken systems. This includes upgrading outdated technologies, streamlining discharges to free up hospital beds, and ensuring that social care supports rather than hinders this process. 🔷A 10-Year Plan for NHS Transformation The government is now working on a 10-year plan, focusing on three core areas: 1. Analog to Digital Transformation: The NHS must move fully into the digital age. This includes using technology to detect and manage conditions, empowering patients through the NHS app for referrals and appointments, and fully integrating digital records across services. 2. Shift from Hospital to Community Care: Too much care is still centered around hospitals, but for the NHS to survive, there must be a shift towards community care. This means integrating health and social care so people can be cared for safely at home. 3. Prevention over Cure: Bold steps must be taken to focus on preventing illness rather than just treating it. With the rapid development of new technologies, there is a growing opportunity to address issues before they become chronic. 🔷A Future of "Challenge, Change, and Hope" Starmer ended his address with the hopeful slogan: “Challenge, change, and hope.” This encapsulates the vision for a reimagined NHS. However, while social care was acknowledged as a critical partner to the health system, it was notably absent from any concrete future plans or funding strategies. This remains a significant gap in the broader conversation about healthcare reform. The road ahead is challenging, but with a clear focus on reform, technology, and prevention, the NHS may still have a future worth fighting for. The stakes couldn’t be higher, and time is of the essence. Now, the public waits to see if the government’s words translate into meaningful action.

Why have plans to reform the NHS consistently failed? There have been many attempts to reform the NHS in recent years. All have failed to achieve their goals. Why is that? How do we escape the mistakes of the past? All the solutions proposed by Lord Darzi's report into the NHS have been in previous plans. Indeed prevention has been a priority of NHS in every plan since the 1960's. Even the report itself frequently refers to previous plans not being acted on and delivered. But why did the previous plans fail? Well the details may be different, but they all shared the same overriding problem. The thinking didn’t change. To change not only do we have to do things differently, we have to think differently. If a plan is created by a minority of people at the top of a system. Then it can’t be surprising when everyone else has to implement it, they stick to what they know. Without changing our thinking, we are all biased when given a choice, to go to the certainty of the comfortable & familiar. We do this rather risk the uncertainty of change. This is why in reorganisations the NHS leaders may change job titles and sometimes even organisations. But fundamentally it is all the same people thinking & doing things in the same old ways. Even if enormous resources were put into the upcoming reorganisation, the same thinking will mean that the old system will reinvent itself, decision by decision. When the local integrated systems were established, they were told to share budgets and invest on shared work on local problems over several years. Instead they divided money into the same 1 year budgets as before. So we need to change our thinking. Sadly I’ve been struck by the absence of the necessary debate after Lord Darzis damning report: We need to be asking what is the NHS for!? What kind of healthcare do we want? What do we need the NHS to stop doing? What role does wider society have in improving health and wellbeing? Instead of discussion, too much focus has been attributed to not enough resources and magical thinking about the potential of technology. As Darzis report also points out what little new resources that have gone into the NHS have been put into hospitals rather than communities, treatment rather prevention. Directly conflicting with the stated aims of NHS planners. If we don't have the hard conversations about why the preceding plans have failed, we simply doom ourselves to repeat the thinking that has created today’s current situation. We need to have discussion and debate around the NHS. To make sense of the current systems. Challenge our assumptions. Create new ways to do things better. The health and wellbeing of society is everyone's problem and it affects us all. But as Lord Darzi's report makes clear, everything is going in the wrong direction. What do you think we should be discussing to make things better? What fresh thinking do we need? #nhs #changemanagement #decisionmaking #leadership #innovation

Signs Integrated Care Systems Are Making Progress Greater Local Flexibility Needed To Realise Potential Two years since integrated care systems (ICSs) were formally created and with the new government confirming it is committed to the current structure of the NHS, The King’s Fund is calling on national bodies to do more to create an environment in which ICSs can succeed. Despite facing staff and budget cuts shortly after their inception, researchers at the health and care think tank found that many ICSs are showing signs of progress. However, in a new report from The King's Fund Realising the potential of integrated care systems, the authors warn that incredibly high pressures on health and care services, an intense political focus on hitting key national targets such as driving down waiting lists, and extremely difficult economic circumstances could derail the improvements ICSs are intended to bring about. The King’s Fund argues that for ICSs to reach their full potential, the new government and national bodies will need to give them the best possible chance of success by ensuring they are held to account in a way that reinforces local partnership working rather than undermines it, and by giving them greater flexibility to use national funding in ways that best meet the needs of local people. ICSs bring together NHS organisations, local authorities, charities and other partners in an area. As well as commissioning local health and care services, ICSs were set up to tackle long-standing issues in the health and care system, such as workforce shortages, in a more joined-up way, and to deliver more co-ordinated care for patients across services. The 42 ICSs that cover England are responsible for spending over £100bn of NHS funding. The report’s authors studied how partner organisations in several ICSs are working together to tackle workforce challenges, such as the recruitment, training and retention of health and care staff in their area. They found clear signs that progress is being made, such as organising local partners around a shared purpose, scaling and spreading success, and using resources more effectively. But success has been uneven and difficult – with the past two years being among the most challenging in the NHS’s history. The authors conclude that ICS progress has been slowed by the need to focus on resolving immediate issues – for example, industrial action has meant that NHS trusts have often been focused on maintaining safe staffing levels rather than supporting their ICS to do the transformative work needed to redesign the workforce of the future. ICSs became statutory bodies under the 2022 Health and Care Act, although health and care organisations have been taking a more joined-up approach to planning and delivering services for more than a decade. The formalisation of ICSs marked a major shift away from the doctrine of competition between different organisations towards collaboration and co-ordination across services…

 “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