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Towards a merry Christmas

Thursday, 22 December 2016

Towards a merry Christmas

The Department of Health has teamed up with NHS England, NHS Improvement and other national bodies to issue guidance to support commissioners, providers and key stakeholders to take appropriate action to kick-start implementation of Christmas at scale and pace in line with the ambitions of the Five Year Forward View, the GP Forward View and other potential forward views going forward.

Card planning and delivery

STP areas are asked to ensure that fully costed draft cards are submitted before the yuletide posting deadline (YPD) at 5pm today.

Draft final cards (DFCs) are to be assured in line with the draft final cards draft planning guidance (DFCDPG). Cards that satisfy NHS England’s three tests will be granted full delegated responsibility for posting.

Those that fail one or more of the tests will be designated proposed cards and will be subject to co-posting at an NHS England local office as part of Christmas Wave 2 in February.

The three tests are:

  1. Is it person-centred? It should fully meet the needs of the person it is addressed to and will ideally have been co-created with them
  2. Is it within the financial envelope? It must bear a stamp of sufficient value but ideally of much lower cost than the one used last year
  3. Is it actually deliverable? Remember to include a postcode.

Old chestnuts roasting on an open fire

Christmas 2016 will have a bigger footprint than ever.

Traditional notions of NHS families created unsustainable silos competing for the biggest share of the presents. The new STPs will see everyone in the same area come together in a new family, elect an accountable mum or dad and share all the presents according to locally agreed priorities.

The new mum will have no formal powers or qualifications for the role, but everyone will agree she is the best woman for the job. After lunch she will dress up as Santa Claus, a reindeer or an elf and give an ill-advised interview to the HSJ. Later the discovery of an empty sherry bottle in the cupboard under the stairs and a deluge of negative feedback on social media will confirm suspicions that she is not a fit and proper person to lead the STP into tea-time.

Young Simon (other children are available) will creep downstairs early to find 44 presents marked “secret” under the tree. His excitement will turn to disappointment as he discovers that they all contain the same far-fetched account of a fictional local health economy.

There will be tears before bedtime as miniature digital roadmaps stop working and expensive new care models end up in pieces. STP Dad will promise to buy new batteries and effect repairs, subject to affordability and value for money. Tomorrow he will fish the receipts out of the bin and head for Argos.

In the evening, everyone settles down to roast old chestnuts on an open fire, which is blazing merrily thanks to Simon’s discarded books.

The never again time of the year

NHS Improvement has released details of the Christmas success regime. 

Following the prime minister’s announcement that the government would remain “tough on Christmas and tough on the causes of Christmas”, ministers have been quick to deny opposition claims that it intends to privatise the whole of December.  

Despite the enormous financial pressures on the system, there are no plans to introduce co-payments or other upfront charges. “This government is committed to the principle that Christmas remains free at the point of use,” said the chancellor, Nigella Lawson. “For everything else, there’s public sector borrowing.” (Other credit cards are available.)

The government also denied claims that Christmas was to be declared a never event as part of a range of new austerity measures in the run-up to a hard, soft or medium firm Brexit.

Nevertheless, NHS England confirmed that there would have to be changes. “I worry that the traditional corner shop model of Christmas is unsustainable,” said Simon Stevens, announcing plans to deliver the season at scale in future.

Measures to reduce seasonal pressures being trialled in STP areas include combining Christmas and Easter to reduce costs, with some given powers to set their own holiday dates and others encouraged to shift funding to birthdays.

Changing the skill mix of the workforce is a vital element of the transformation programme. Easter bunnies are retraining as reindeer and a new role of elf assistant is being developed by Elf Education England to meet the shortfall of 5000 general elves. 

With the advent of multispecialty Christmas providers (MCPs) local leaders are taking care not to destabilise local turkeys, which are being urged to adapt, reconfigure or organise themselves into more efficient turkey chains.

NHS England confirmed that a consultation to establish to what extent turkeys wish to participate in Christmas is to be launched early in the new year.

Yule log editor: Julian Patterson


Acknowledgements for various borrowed or shamelessly stolen gags: @SteveKellGP, @HPIAndyCowper, @BillRussell3, @DoctorAngry and others.

We’d like to take this opportunity to wish readers a transformational Christmas and/or Hanukkah and a peaceful and sustainable new year. (Other festivals are available.)

david seabrooke
david seabrooke says:
Dec 22, 2016 03:11 PM

Big shout out @Dickensey - a couple of extracts below. (Other ghost stories are available.)

At Scrooge & Marley - a visit from the GP fund-raisers

``At this festive season of the year, Mr Scrooge,'' said the gentleman, taking up a pen, ``it is more than usually desirable that we should make some slight provision for the Poor and destitute, who suffer greatly at the present time. Many thousands are in want of common necessaries; hundreds of thousands are in want of common comforts, sir.''
``Are there no hospitals?'' asked Scrooge.
``Plenty of hospitals,'' said the gentleman, laying down the pen again.
``And the walk-in centres ?'' demanded Scrooge. ``Are they still in operation?''
``They are. Still,'' returned the gentleman, `` I wish I could say they were not.''
``The out of hours GPs and the community pharmacies are in full vigour, then?'' said Scrooge.
``All very busy, sir - but check seasonal opening times and call 111.'
``Oh! I was afraid, from what you said at first, that something had occurred to stop them in their useful course,'' said Scrooge. ``I'm very glad to hear it.'

The First of the three spirits

`Who, and what are you?' Scrooge demanded.
`I am the Ghost of funding decisions Past.'
`Decisions long past?'' inquired Scrooge.
``No. Your decisions.''

...you get the idea. Gawd Bless Us, Every One!

Julian Patterson
Julian Patterson says:
Dec 22, 2016 05:26 PM

And gawd bless you, David @Dickensey. Let's hope Scrooge sees the error of his funding ways before the poor and destitute pay the price. Merry Christmas!

Chris Harvey
Chris Harvey says:
Dec 23, 2016 07:42 AM

Thank you Julian, this is wonderful stuff :-) You have just made the last day of work before the break more cheerful. Happy Christmas.

Steve Benjamin
Steve Benjamin says:
Dec 23, 2016 08:18 AM

Nice one to finish the year off with Julian. Have a good Christmas. I look forward to reading more of the same next year. I wish I didn't need to say that because everything should get better, but the reality is.....

Louise Fowler
Louise Fowler says:
Dec 23, 2016 08:58 AM

Thanks Julian, a brilliant reimagining of our festive health service. I love rounding off the week reading your blogs. Looking forward to next years highlights of the week. Merry Christmas!!

Julian Patterson
Julian Patterson says:
Dec 23, 2016 06:02 PM

Thanks to all for the nice feedback. Here's wishing you a merry Christmas and a happy new year.