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Blithering goes it alone


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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: NHS Networks   


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.