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Dear Bridget, I'm worried about my painful cluster

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Friday, 11 November 2011

Dear Bridget, I'm worried about my painful cluster

NHS Networks’ own agony aunt Bridget Overspend. This week: the NHS reforms.

When I became a CCG I was told I could buy commissioning support wherever I liked. Now I’ve been told I’ll have to buy it from a PCT cluster. What’s going on?
Brian, CCG manager

Oh dear, Brian. I can see you’re a bit confused. There is a big difference between being able to buy what you like and actually being able to procure it. The government has always said there would be a wide choice of commissioning support available from April 2013, but as a statutory body you will have to go through a long and complicated procurement process. These things can take years, but it’s best not to rush into an important purchase, particularly when times are hard.

We were told that the reforms would cut bureaucracy, but it doesn’t feel that way to me!
Rosie M, practice manager

Rome wasn’t built in a day, Rosie, and if the appropriate building regs had been enforced it probably wouldn’t have been built at all. Have you seen those crumbling ruins? Of course in the long run the idea is to speed things up and cut down on paperwork, but we’ll need a lot of people to make sure that the transition to the new system is well planned, orderly and safe for everyone concerned  – not least all the bureaucrats who don’t want to be looking for new jobs in a recession. 

How will you stop CCGs from reinventing PCTs?
Rashid, GP

It’s only natural to worry about this, Rashid. A lot of clever people have been working on the same problem, but the solution is really very simple. It you don’t really get rid of PCTs, reinventing them becomes unnecessary. 

Can I have my top down and my bottom up at the same time, revolution-wise?
David, NHS manager

I know where you’re coming from, David. You can’t have a grass roots revolution unless you manage it properly, otherwise you end up with a lot of out-of-control weeds. To stick with the gardening theme, you wouldn’t dream of planting a new lawn without  a few hundred managers to oversee the watering and application of fertiliser, would you?. It just wouldn’t make sense.

I’m a patient and I’m worried about the future of the NHS. By the way, what’s commissioning?
Kathleen, pensioner

There’s always one, isn’t there! We’re trying to have a serious debate here, we’re putting you at the heart of everything we do, making sure your voice is heard, and taking no decisions about you without running it past the CQC, Monitor, the clinical senate, the BMA, the CCG, the commissioning board, the cluster, the SHA, HealthWatch, the health and wellbeing board, the private sector and the district nurse.  Obviously you haven’t read the white paper.

Next week Bridget takes questions on the Italian debt crisis and the collapse of the eurozone.

harry.longman@gmail.com says:
Nov 11, 2011 08:24 AM
NHS Networks is in front, as ever, with why the reforms will fail before they have had time to fail.
It is the same the world over - but don't give up.
pdryder says:
Nov 11, 2011 09:28 AM
Do you think you could take a look at the looming Cocozza crisis whilst you're at it...?
juliamanning says:
Nov 11, 2011 09:44 PM
Brilliant and sharp as ever
ruthevans says:
Nov 12, 2011 09:19 AM
Very clever, made me smile.
Would like to thnk that the high ups might see it and understand the nuggets of truth it contains.
Please, Bridget, will you put some copies in your Christmas cards to andrew lamsely, david nicholson, david flory, david cameron...
They need to know what it's like out here!
nickjefferies says:
Nov 12, 2011 01:56 PM
Dear David

Just stop whingeing and Assume The Position... Oh no - sorry - you won't have to do that, it'll just be the poor sods who actually do the work. You can just reinvent your job plan with some revised ¨targets¨ and a new bonus scheme.
jyates says:
Nov 12, 2011 05:26 PM
From a patient viewpoint this farce is just not funny.
For 60 plus years I have been reliant of the services of the NHS when I needed them.It has saved my life a few times, and now I just want a healthy retirement. But nothing makes sense, GP's,CCG, PCT. MP(on Bill Committee) etc, they are all like headless chickens. The quantity of paperwork from the DoH , the number of different but uncoordinated subgroups supposedly advocating public and patient involvement -("bottom up" not "top down" )makes no sense at all.