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In the consulting room: refreshing the plan


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, 6 April 2017

In the consulting room: refreshing the plan

In the latest in our occasional series of near-reality programmes, a bearded man visits a spin doctor to discuss an embarrassing problem.

Spin doctor: Good morning. What can I do for you today?

Simon Stevens: I’m worried about my plan – I think it’s stopped working.

Doctor: I see. Well I’m sure I can give you something for that. (Consults notes.) Last time I saw you – er, in 2014 – you seemed to be making good progress.

SS: Yes, it was all fine. Everyone was talking about a full recovery in five years.

Doctor: But you weren’t so sure?

SS: Of course not. That’s just what it said in the plan.

Doctor: And you’ve been sticking to the diet?

SS: It will only work if we all confront difficult choices. We can’t have everyone living on bail-outs.

Doctor: Yep, okay. And taking plenty of exercise?

SS: I’ve thrown out the old reinforcing cycle. It always had the right direction of travel but it wasn’t getting me anywhere.

Doctor: Excellent, so what’s next?

SS:  The thing is, I just feel people are a bit bored with my plan and have stopped believing it.

Doctor: Sorry, what were you saying? I zoned out for a moment. What you need is something to pep you up.

SS: Like a new plan?

Doctor: Oh, no. Nothing that radical.

SS: A revised one then?

Doctor: We don’t use that word any more. A refresh is a less invasive procedure that involves cutting out any really bad bits and glossing over the rest.

SS: What would I call it, this refresh?

Doctor: How about Five Year Forward Reset?

SS: No, we’ve used “reset”. That was one of Jim’s.

Doctor: We want a vigorous term that suggests progress.

SS: Five Year Forward View: Intense Step Suffer-fest?

Doctor: That could be your next plan. What about just Next Steps on the Five Year Forward View?

SS: It’s a bit boring. And, anyway, can a view have steps?

Doctor: Don’t worry about any of that. People love a mixed metaphor, the blander the better.

SS: You’re right. Thanks, doc. I feel a lot better already.

Doctor: So what’s going to be in the plan – a lot of detail?

SS: (Laughs.) You crack me up.

Doctor: Okay, I’m going to write you out a prescription. This should help you focus your mind, accelerate performance and scale back spending on locally unaffordable services. It should also stop things from running too hot and make it easier to take hard-nosed decisions.

SS: (Reads from piece of paper.) So are these like vanguards?

Doctor: No, you can stop taking them. These are much better. We call them accountable care systems. They’re a bit bigger – some people find them hard to swallow.

SS: How many do I need to take?

Doctor: Start with nine. If they have no effect, come back and see me in a few years and we’ll try something else.

SS: That’s really encouraging.

Doctor: Not really. That’s just the next available appointment.  Can you send in Mr Mackey on your way out? His results are back and it’s not looking good.

Medical editor: Julian Patterson


Anonymous says:
Apr 12, 2017 11:19 AM

Doctor: Hello, can I help you?
SC: We are from the Spinformation Commissioner's office - here to investigate a serious breach of patient confidentiality.
Doctor : Ha Ha! Too late - I'm leaving the profession for good!