147,416 members

Skip to content. | Skip to navigation


Blithering goes it alone


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.

Friday, 27 May 2016

Blithering goes it alone

Things are hotting up for England’s most challenged STP area, as it barely has time to make plans for a combined authority before it finds itself on a fast-track to devolution.


Martin Plackard, strategic communications lead and chief digital evangelist for the Greater Blithering STP region, is holding his Monday morning briefing.

Today’s theme: “Towards an evolutionary strategy for a Blithering-wide combined authority for place-based person-centred care and total population health.”

Plackard grasps a handful of marker pens and peels back the flipchart cover.

“So, STP footprint, key stakeholders, very nearly aligned digital roadmaps, NHS Teeming Foundation Trust conceptually here but possibly also there once Morking and East Churlish CCGs are out of special measures, new risk-sharing and joint accountability arrangements – dotted line to local authority, expanded rubber-stamping and oversight role for health and wellbeing board, light-touch assurance by the regional team. That’s the high-level version. Any questions?”

Plackard surveys his handiwork.  The chart, now covered in lines, squiggles, overlapping circles and arrows, looks like the work of a man determined to use up his stash of legal highs before the law changes.

“So who’s actually going to be in charge?” asks Dr David Rummage.

“Everybody and nobody,” replies Plackard, stabbing at the flipchart with a black marker. “That’s the beauty of the combined authority concept.”


News arrives of revised funding for the Blithering STP. Letter from NHS England explains that the new figure is “as a result of expectations created by the Blithering Sustainability and Transformation Plan”, which are clearly very low.

Liz Wanhope, our accountable officer, has the job of explaining the situation to the Blithering Wellbeing Partnership, the vanguard run by David Rummage, which is to have its funding slashed. The raised voices and swearing coming from the board room suggest that he is not taking it well.


Tony Torvill from Finance has run the numbers on the Blithering allocation. The large negative figure on the bottom line refuses to disappear, even after Torvill has worked his legendary double-counting magic on the spreadsheet and made some optimistic assumptions about reduced transfer of care delays based on our soaring mortality rate.

We will need to invoke the Emergency Reconfiguration Plan with potentially devastating consequences for the area’s hospitals. The good news is that creative disposal of parts of the local NHS estate will allow for further expansion of the QuidSave hypermart, providing any remaining patients with easy access to improved shopping facilities including a well-stocked in-store pharmacy.


Whole team meeting to unveil the plan for Blithering’s combined authority structure.

Quick-fire slidedeck from Plackard, followed by baffled faces and rustling of hand-outs.

Liz Wanhope breaks the awkward silence. “So would we call this a top-down or bottom-up change?” she asks.

“In a very real sense it’s both,” replies Plackard, picking up a marker pen and heading for the flipchart.   


Great excitement as we learn that George Osborne has selected Blithering as the next area for devolution. We are to be given “unprecedented opportunities for self-determination as part of unique off-the-books pilot”, as the chancellor puts it in his letter.

“DevoBlith will be able to raise its own revenues through local taxation, seek new investment in services in partnership with private providers, and explore exciting new avenues to improved efficiency”, the letter goes on to explain.

The only disappointment is that the enclosed cheque (marked "in full and final settlement") seems to be for the wrong amount.

A paler than usual Liz Wanhope assures us that Mr Osborne is a busy man with a lot of cheques to write, which probably accounts for the missing zeroes. 

Diary editor: Julian Patterson   


Anonymous says:
May 27, 2016 03:54 PM

Thank goodness for the afternoon arrival of my weekly fix of mirth. I was about to start getting withdrawal symptoms! Happy bank holiday

Julian Patterson
Julian Patterson says:
May 27, 2016 04:15 PM

Glad to be of service. Happy bank holiday to you, too.