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Initiatives shortage poses threat to NHS survival


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Friday, 16 October 2015

Initiatives shortage poses threat to NHS survival

The NHS is facing a critical shortage of initiatives, supplies of which could run out by the end of the decade, leading to department closures and the loss of thousands of jobs. These are the shocking findings of an unpublished report seen by NHS Networks.

The report, No More Burning Platforms: We’re Out of Job, produced by a leading think tank, paints a disturbing picture of a future health service where hundreds of millions of pounds a year currently devoted to transformation programmes, innovation schemes and reports that no one reads could be siphoned off by officials to fund wasteful and inefficient “frontline” services such as hospital A&E departments and GP surgeries.

The government immediately vowed to protect essential services by building a thick ring of special advisers and PR consultants round Richmond House.

Crisis of who cares

Officials at the Department of Health and NHS England privately admit to growing concerns that even if the government meets its commitment to fund the schemes that are already running, it will be unable to meet demand for new ones with catchy names. Experts blame an ageing civil service population, an acute shortage of ideas and rising demand for banner headlines for the looming crisis.

According to the report, supplies of tortuous acronyms, dreadful puns and second-hand slogans are at their lowest level since 1948 and could soon run out altogether. “This could place the future of critical NHS transformation programmes in dire jeopardy, leaving patients literally unaffected,” its authors claim.

Restricted view

The report blames the NHS Five Year Forward View for using up the last remaining supplies of jargon. “Most plans content themselves with one neologism but the Five Year Forward View produced seven new models of care, various synonyms for accountable care organisations (ACOs) and numerous other examples of newspeak. After multispecialty community providers (MCPs), primary and acute care systems (PACS) and acute care collaborations (ACC) there is literally nowhere left to go.”

Officials also worried about how to sustain the View “brand” itself in subsequent years. Already technically less than a four-year view, the document’s authors are already working on “refreshed” versions as interest in the current view begins to wane. Sources claim to have seen early drafts of the Three Year Vista, Two Year Spectacle and One Year Peer into the Abyss.                                                                              

Decisive action task force consultation

The government has unveiled a three point plan to tackle the initiative deficit, including:

  • Creation of a £1bn Initiatives Fund to encourage innovation and spread of new initiatives
  • A new Transformation Task Force to be headed up by a national director for strategic initiatives and new models of programme
  • The immediate removal of import restrictions to encourage an influx of initiatives from overseas.

Not waving but Downing Street

Officials welcome short-term initiatives to recycle existing initiatives, but worry that they can’t be kept going indefinitely. Patients could risk being literally bored to death by Wave 3 of the Prime Minister’s Challenge Fund, as policy advisers failed to come up with convincing new names for backdoor schemes to give GPs cash to stop them emigrating to Australia, a Downing Street source admitted.

Endless repeats

Experts warn that Vanguards could soon be eclipsed but that the government has no idea what to do for an encore. NHS England confirmed that the Eclipse and Encore programmes would be unveiled after the autumn spending review.

Programme editor: Julian Patterson


Les Scaife
Les Scaife says:
Oct 16, 2015 02:52 PM

How refreshing that at last someone has realised the commitment, skills and cost benefit the third sector can bring to the table on this problem, albeit years to late. We are at this moment trying to engage with our CCG and social services departments to provide a service 50% lower than the existing Proferred Provider.
Funds are wasted on the large charities who only provide a "signposting service" and who's overheads eat up a huge percentage of the funds.
These funds should be diverted to the third sector organisation who go into people houses and deliver care on the coalface. Unfortunately it is these organisation that are folding due to lack of funding, while the large charities continue to eat up funds but deliver no care.
We provide services to support people with dementia to live in there own home that has been featured in the DWP news letter. We provide care for people who have 24/7 care needs, but the CCG and social services have no wish to engage. If these services were to rolled out nationally there would be a huge cost benefit to local authorities and health services.
It would not be possible for government to engage with every small third sector organisation, but the funds could be handed to the CVS offices nationally, then small organisations could bid for the funds locally. The CVS know what services are required locally, so the money will go where it is needed. The CVS would be responsible to ensure the outcomes would be achieved, and deliver the report to the funders.

Julian Patterson
Julian Patterson says:
Oct 17, 2015 10:43 PM

Les, I'm not sure if you meant your post to land here. Your comments about the gravitational pull of large charities on funding and the difficulties of smaller third sector organisations in getting a place at the table are very familiar. I hear this a lot. It's hard to know which is the bigger problem: the inability of commissioners to work with smaller organisations or the inability of the latter to make themselves sufficiently "commissionable". I would bet that it's a bit of both.

Clive Spindley
Clive Spindley says:
Oct 21, 2015 09:09 PM

hi Julian, not sure I agree with this, the process to make yourself "commissionable" is a joke, the problem with the way the NHS works is all are focused on the big deal, loads of little deals = loads of work (but IT could save the taxpayer a fortune) as in technology, trust me, big has no advantage over small p.s. hope your dog is still keeping you healthy :-)

Clive Spindley
Clive Spindley says:
Oct 21, 2015 09:01 PM

The amount of money being wasted bi the NHS and bi organisations (funded in a similar way to the NHS) that support the NHS is laughable or criminal - I have no idea any more. I hope to be looking after a dog over Christmas so will exercise it bi running with it. Park runs have done more for the health of people in this country than anything these NHS supporting organisations have ever DONE. Sad but true.

Malcolm Goodson
Malcolm Goodson says:
Oct 17, 2015 09:25 AM

Ah Julian, you brighten my Saturday mornings like bright sunshine through the clouds. Although the issues of which you write are serious, damn serious, your wit often illuminates the absurdity of it all. Perhaps we need to forget everything that has been fed to us over the last 40 years by 'management gurus', who, like the 'old boss', are the 'same as the new boss' and start to recover everything that the NHS has lost over the years. Only the commitment of the staff has remained constant through time; I often wonder how they do it.

Julian Patterson
Julian Patterson says:
Oct 17, 2015 10:27 PM

I wonder about that too. Thanks for your post, Malcolm.

Peter Counter
Peter Counter says:
Oct 17, 2015 03:04 PM

Please do not worry. This is certainly a major issue, but one that has been foreseen in our rigorous risk assessment process, and we already have a programme up and running to address it. The Programme for Initiative Generation was commissioned in February, and our Outline Business Case was approved in August.

The original plan was to pseudonymise all the PID (Programme Identifiable Data), and thus be able to re-use initiatives and their buzzwords without anyone noticing. While this remains a viable solution, our innovation team has come up with something much better - more sustainable and thus eco-friendly. The staff have dubbed it the PIG Farm, but we are currently running a competition to see if we can find a much less expressive and more boring name. The prize, should you be interested to enter, is an all expenses paid trip to the business case recycling plant in the basement of Quarry House.

The Farm is based on some artificial intelligence technology we have been working on just in case it might be needed - for example if a glitch with Agenda for Change resulted in everyone being sacked. Of course, the system is not that intelligent (we have limited budgets like eveyone else) but is certainly enough for a bit of initiative innovation. The breakthrough came with the application of some Neuro-Linguistic Programming to the cognitive reasoning application processor, which (as you will have guessed) is built on an agile cloud framework.

The result is that we are now able to generate an endless stream of initiatives specifically designed for the health and care system. In phase 1, available at launch early next year, we will be able to provide a very exciting Jargon On Demand service. Phase 2, planned for 4Q 16, will be able to generate entire initiatives complete with faulty business case and plausible but ultimately unachievable benefits. We have ambitions for a Phase 3, not yet approved by the SRO, which will take the money and execute the initiatives without the need for costly and unpredictable human intervention.

So, please do not spread further panic. It is all in hand and we have our best people working on it.

Julian Patterson
Julian Patterson says:
Oct 17, 2015 10:34 PM

This is the reassurance we were all hoping for, Peter. I should have known better than to doubt the system. I'm very pleased to hear about Jargon On Demand and all the other cloud-based goodies on the horizon. We've relied on outmoded analogue twaddle for too long.
Great post. Thanks.

Clive Spindley
Clive Spindley says:
Oct 21, 2015 08:52 PM

Spot on, just what do they do for their significant salaries? move the money to the front line where IT really is needed (and bi the way patients are on the from line and they need IT too, specifically access to their health data)

Anthea P W Makepeace
Anthea P W Makepeace says:
Dec 10, 2015 11:57 AM

I have discovered a new tool: Called Kaleidoscopic intersectionality - you put the names of patients,diseases and agencies on separate coloured pieces of paper and place in a kaleidoscope, shake gently. You will instantly see a new model for health care where the individual pieces overlap. If that model doesn't satisfy NHS England just shake again and report on the new model Never Ending, endless fun guaranteed, try it as a family Christmas pastime!!