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A softer centre


Blog headlines

  • UK’s National Health Service teams up with the Radio Society of Great Britain to improve health and wellbeing
    4 March 2021

    This week's blog is by Paul Devlin, Emergency Care Improvement Support Team (ECIST), NHS England and NHS Improvement.

  • Structuring a PCN Social Prescribing Service for the post COVID world
    25 February 2021

    This week we have a blog by Nick Sharples.

  • Community-Oriented Integrated Care
    18 February 2021

    The blog this week is a short extract from a paper considering an approach primary care networks could use to move towards community-oriented integrated care.

  • Strategy Unit releases opensource model for planning vaccine centre capacity
    11 February 2021

    This week's blog is from The Strategy Unit who are sharing an opensource model to help with vaccine centre capacity planning.

  • Time to talk day
    4 February 2021

    A small conversation about mental health has the power to make a big difference.

  • Supporting Staff: the emergence of ‘long-covid’
    28 January 2021

    As we are now well into a second, or is it now the third, wave of Covid-19 it is becoming apparent that Covid is something we have not experienced before and it has unique implications for staff management. It is not just the possibility that staff may become acutely ill with the virus, but that for some they may go on to develop persistent debilitating symptoms that will affect their ability to go back to work. This article looks at the implications of long-covid for HR and service managers when looking to support health care professionals (HCPs) return to work.

  • Link of the week: Clinically-Led workforce and Activity Redesign (CLEAR)
    21 January 2021

    This week we are sharing a link to the Clinically-Led workforce and Activity Redesign (CLEAR) site that is funded by Health Education England.

  • So much more than an extra pair of hands
    14 January 2021

    The introduction of the additional roles reimbursement scheme for primary care networks has started to grow capacity in general practice to address the unsustainably high workload that has put so much pressure on GPs.

  • Primary Care Networks – how did we get here?
    7 January 2021

    This week we are sharing a blog by PCC’s chairman David Colin-Thomé.

  • A year like no other
    17 December 2020

    On 5 July 1948 the NHS was born, over the last 72 years challenges and changes have been remarkable but the service has probably never been tested as much as in the last nine months. There have previously been numerous re-organisations, multiple changes to hospitals, mental health services and a shift from the family doctor towards more integrated primary care services delivered by a range of professionals. However, rapid transformation of services to embrace digital technologies, and a shift change to work differently has been forced upon all areas of the health service this year.

  • Guest blog: David Hotchin
    11 December 2020

    This week we have a guest blog that was submitted to us by David Hotchin, written by a retired friend....obviously, he's used a little poetic licence.

  • What now for commissioning?
    3 December 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What White people don’t see
    26 November 2020

    This year’s Black History Month (BHM) has, unfortunately, in its shadow another example of why campaigns like this exist.

  • Primary Care: Why don’t we talk about Racism?
    20 November 2020

    Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

  • Primary Care and the Health of the Public
    12 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What now for primary care
    4 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • Boosting your resilience
    30 October 2020

    The last year has been a difficult one, who would have imagined last Christmas that we would have been in lockdown, with the NHS seriously tested by a global pandemic. So much change has happened and the resilience of people working in and with health and care services has been seriously tested. Resilience is our ability to deal with, find strengths in and/or recover from difficult situations. Its sometimes referred to as “bounceabiliy” – but bouncing in what way?

  • Link of the week: National Cholesterol Month
    23 October 2020

    Every month or week of the year seems to be an awareness week, October has more than its fair share.

  • New redeployment service offers talent pool of motivated, work-ready individuals
    15 October 2020

    People 1st International have shared some of the work they are doing to support people displaced from industries due to the Covid-19 pandemic. There is an opportunity for health and care services to benefit from this workforce.

  • Link of the week
    9 October 2020

    Article published in the BMJ looking at the ability of the health service to quickly bounce back to pre-Covid levels of activity and considers if it is desirable.

Thursday, 8 March 2018

A softer centre

NHS England and NHS Improvement have announced a major strategy shift from central control to a new “light touch” and supportive approach to management. The move is designed to address concerns that hierarchical management structures and an obsession with control are impeding change.

In the new regime, dubbed the Soft Centre, out go command and control, assurance, operational guidance, mandatory reporting, inspection and all other forms of micromanagement. In come trust, sympathy, friendship and complete freedom for NHS organisations to run their own affairs as they see fit.

NHS England and NHS Improvement are to work together more closely, but a formal merger has been ruled out.

Here to help

“Think of it as a loving co-parenting arrangement between an unmarried couple living in a nice part of north London,” a spokesperson said, adding that the two bodies would present a unified front under the brand name NHS Here to Help.

Among other changes, STPs will become Someone to Turn to Partnerships, whose main role, much as it is today, will be to provide somewhere for lonely, hopeless people to meet, have a hot drink, chat and make new friends.

The changes come in the wake of a major review of health policy by Mary Berry. Her report, Nicer Together: It’s so important that we all get along, makes a number of recommendations for improving NHS strategic and operational management. It also includes a recipe for cheese scones that has already been widely adopted by CCGs.

Please yourself

Judgemental terms such as "failure regime" are to be avoided as are aspirational terms such as "success regime", which may make people who continue to fail feel inadequate. “If we must have regimes – and to us the very word has totalitarian connotations – they need to be as inclusive as possible,” said the report’s authors, who suggest “branding that encourages ownership without coercion such as ‘your NHS, your way’.”

The report also says: “For too long we’ve been telling people what to do and it isn’t working. From now on the message from the centre will change from ‘do as you’re told’ to ‘do what you like’. NHS bodies will be asked to do their best and not get too hung up on the details.”    

Formal guidance will be replaced by helpful suggestions and top tips. Commissioners and providers will be encouraged to do something else if they have a better idea. Control totals and other financial targets, the source of so much unhappiness for vulnerable people such as finance directors and chief executives, will be scrapped.

Do your best

“No one will be penalised for trying their hardest. Everyone knows how easy it is to let the bills mount up when you’re running a hospital. Our role is to help people who have got into financial difficulties to get their heads above water again,” said new head of NHS Here to Help’s confidential financial planning and debt management helpline Lord Carter.

Under a light-touch assurance regime, the centre will ask for information only on a need to know basis. “If we don’t need to know, or you don’t think we’ll like the answer, then don’t tell us,” said Here to Help’s chief executive Simon Stevens.

Reporting and monitoring is to be simplified. “We expect chief executives to check in once in a while for an informal chat about how things are going, but if they’re too busy, we’ll understand. They probably have better things to do than talk to politicians,” said Jeremy Hunt, who went on to announce yet another change of name for the recently rebranded Department of Health and Social Care, which is to be renamed the Department of Love.

Minister of love

The department’s logo will now include the ubiquitous heart symbol, which will also become a permanent fixture in NHS branding. “Everyone loves the NHS and since we stopped throwing money at it, we’re increasingly finding that love and silly slogans are pretty much the only thing keeping it going,” said Mr Hunt or “Hello, my name is Jeremy” as he insists on being known from now on.

Dramatic changes are expected at the Care Quality Commission, which will become the We Really Care Commission and move into a purely advisory role. Inspectors are to be replaced by customer advisers, whose role will be to encourage a spirit of improvement through self-worth. They will call hospitals and ask “What are you most proud of in your organisation today?” while GP practices can expect to be asked “Are you being your very best self?”

We really care

Ms Berry said that the current rating system was divisive and bad for morale. Nobody wants to go to work for an organisation that has been branded “inadequate” or “needs improvement”, she said.

We Really Care advisers will treat all providers as “outstanding” regardless of the standards of care they aspire to or the quality of service they deliver. “We’re all special in our own way,” Berry said. 

Editor: Julian Patterson


Sygal Amitay
Sygal Amitay says:
Mar 09, 2018 10:09 AM

For a moment there I actually allowed myself to dream this was a news item instead of a satirical blog... Then reality hit again, and I have to submit a 50-page report that will be neatly filed away to never be looked at, only so that my efforts can be branded "inadequate" and my trust penalised by a few million (because obviously if we couldn't do it with what we had, it had to be taken away so we will do better!).

Rollo Moore
Rollo Moore says:
Mar 09, 2018 03:52 PM

World Delirium Day
Wednesday 14 March is World Delirium Day