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The road to Rummylon

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Friday, 10 November 2017

The road to Rummylon

Martin Plackard, Blithering’s head of horizontal and vertical issues, gave his most engaging grin, a smile guaranteed to melt the heart of a mother hyena. Then he scanned the first few lines of the document and his smile faded.

“I’m not sure this is quite right, David,” he said. “Some may consider it unhelpful.”

“Hell’s teeth, Plackard!  Bad enough to warrant the U word?” replied Dr David Rummage, the CCG’s lead for general practice development and high impact change.

“I’m afraid so, David. There are significant messaging challenges here.”

Plackard proceeded to work through the rest of the press release for WhatsUpDoc, the virtual GP service soon to be launched by Rummage’s clinical innovation incubator Rummylon.

Plackard studied the screen. “This section definitely needs softening,” he said.

“What’s wrong with it?” asked Rummage.

Plackard read aloud: “Tired of waiting weeks for an appointment? Sick of hanging around while old people hog the doctor? Worried about what you’ll catch in the waiting room? With WhatsUpDoc you can jump the queue, get the service you deserve and get to that vital sales meeting ahead of all the other losers.”

Rummage shrugged. “We’re aiming this at working people who want more convenience and choice,” he said. “People who just want to get a jab, order some antibiotics or check that the embarrassing itch that came on after the Christmas party is nothing to worry about.”

Plackard nodded. “Put like that it sounds quite appealing, but the media are bound to ask what it means to disadvantaged and older people or those with complex conditions. What would you say to them?”

“Not our core demographic, old boy,” said Rummage breezily. “Not my patient.”

Hard lines

“Where’s David?” asked Liz Wanhope, interim deputy co-accountable officer of the Blithering STP.

“He sends his apologies. He’s training physician telesales assistants at the Rummylon operations centre,” replied Plackard.

Wanhope looked blank.

“What used to be the Poundland on Station Road. He’s got it on a short-term lease,” Plackard explained.

Wanhope started the meeting.

“I’m sure everyone would like to join me in thanking Sir Trevor Longstay, who has decided to resign as chair of the Blithering STP and return to his old role at South Selvedge to continue the magnificent work of the vanguard.

Wanhope’s words were greeted with the sound of exaggerated coughing and suppressed laughter as people recalled the recent “Carnage at Selvedge” and “Where did all the money go?” headlines in the HSJ.

“Some of you will also be aware that before he left, Sir Trevor gave a courageous interview to the Argus, expressing his profound desire for change and his regret that he was unable to do more to make it happen in his position as leader of the Blithering health system,” she continued.

More coughing at the memory of Sir Trevor’s frank and fearless article entitled “Nothing is my fault” in which he blamed “faceless bureaucrats” and “workshy colleagues” for Blithering’s dire financial situation and worsening health outcomes.   

“Sir Trevor’s greatest regret,” concluded Wanhope, “was that despite his repeated promises to crack down on bullying with a rod of iron that he was unable to complete his zero tolerance campaign. But I’m sure you’ll agree that since Sir Trevor left we’re beginning to see the start of a more compassionate culture.”

Everyone agreed that they would miss Sir Trevor’s robust sense of humour. “My door is always open. Close it on the way out,” was a particular favourite.

It will end in tiers

Plackard turned off the radio. The president of the Royal College of General Practitioners had just concluded an interview in which she expressed “profound concerns” about Rummylon.

“She obviously thought she was on Farming Today,” said Rummage, bitterly. “All that talk of cherry-picking destabilising the NHS. I don’t know why Humphrys let her get away with it. What’s bloody fruit got to do with general practice?”

“I think she was saying that WhatsUpDoc might appeal to the younger more affluent sections of the population, leaving other NHS services to deal with the difficult cases,” Plackard said mildly. “We don’t want to end up with a two-tier system, do we?”

“Of course we do, Plackard,” said Rummage crossly. “It’s all about risk stratification or what we medics like to call market segmentation. Far more efficient. Think about it. What are GPs doing? Closing their lists. What are we doing? Creating access, adding capacity in the system.

“The brass love it. Matthew’s already got the app on his iPhone.

“And don’t worry about stability. Hospitals don’t want GPs meddling in urgent care. We’ll make sure we keep sending plenty of business their way.” 

Plackard raised an eyebrow. “I must admit, David, you’ve thought of everything.”

The two men laughed.

Somewhere, on a distant African plain, a hyena pricked up her ears. 

Wildlife editor: Julian Patterson

@jtweeterson
julian.patterson@networks.nhs.uk

 
Anonymous says:
Nov 10, 2017 02:39 PM

Whatupdoc!? Priceless! :) Are we truly on the road to 'app-iness?

Julian Patterson
Julian Patterson says:
Nov 10, 2017 03:22 PM

The story obviously bears no relation to the news earlier this week about Babylon's GPatHand. But to answer your question, yes. Nobody objects to apps in general practice, the controversial part of the GPatHand service is that patients register as they would for any other practice but lose the benefits of a face to face service. So critics see it as good for young, healthy middle-class people, but not much use to anyone else. If you're older, for instance, it wouldn't be a case of WhatsUpDoc but ThatsAllFolks. My opinion, not that of my employer, etc.