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Virtuous but not yet


Blog headlines

  • Risk stratifying elective care patients
    10 September 2020

    This blog has been shared by MBI healthcare technologies. As services are starting to treat routine patients those on waiting lists are making enquiries as to where they are on the list, and if they are still on the list.

  • Link of the week
    4 September 2020

    This week the link we would like to share are reflections from physiotherapy students on placement at Alzheimer Scotland https://letstalkaboutdementia.wordpress.com/

  • Link of the week
    28 August 2020

    This week we would like to share a blog published on the Mind website about being a BAME health worker in the pandemic.

  • Remote clinical triage model
    20 August 2020

    This week we are sharing how a remote clinical triage model was implemented at Tollgate Medical Centre. This has been shared with us by Sarah Portway, a Nurse, and Clinical Services Manager at Tollgate Medical Centre.

  • Can the Community Pharmacy become the gateway to integrated care in the NHS?
    13 August 2020

    The NHS is a continually evolving innovative demand led public service the role of the Community Pharmacist is becoming the public face on a journey to the more responsible public engagement in the personal care of individuals and their family. There are currently over 11000 Pharmacies many are single or small chain service providers, while multiples occupy the urban shopping centres and more densely populated conurbations, the value of the rural High Street can’t be understated.

  • Crunch time for patient involvement
    7 August 2020

    There are new challenges for primary care, which could really do with patient input. Mike Etkind, chair of a PPG and founding member of his PCN’s patient group, recognises the size of the task clinical directors have managed over the last few months but identifies two particular issues where patients have a necessary and valuable contribution, that need to be addressed now – the 2020 vaccination programme and primary care from a distance- total triage, remote consultations, and the use of telemedicine.

  • Link of the week - Visionbridge
    31 July 2020

    The link we are sharing this week was submitted by Julian Jackson, Visionbridge.

  • Links of the week
    23 July 2020

    This week we are sharing two articles with you.

  • Link of the week
    21 July 2020

    The blog is from the perspective of the Company Chemist Association's Chief Executive Malcolm Harrison.

  • Link of the week
    9 July 2020

    This week we are sharing a blog from the NHS Confederation’s “NHS Reset” looking at the work of Healthwatch, the role of volunteers in supporting patients being discharged from hospital and the importance of the community.

  • Virtual education sessions on spinal cord injury from Spinal Injuries Association
    2 July 2020

    This week Karen Mikalsen from the Spinal Injuries Association shares some information on their work and events for healthcare professionals.

  • Guest blog:Karen Chumley
    25 June 2020

    Thank you to Karen Chumley for a second blog –this time on the local use of an Electronic Palliative Care Coordination system during the Covid-19 pandemic. Karen is the Clinical Director and Deputy CEO at St Helena.

  • Link of the week
    19 June 2020

    This week's link of the week is article by Yasmin Khanagha published in Nursing Times – Why we need to open the conversation about racism.

  • Guest blog: Dr Karen Chumbley
    12 June 2020

    This week we have a guest blog submitted by Dr Karen Chumbley, clinical director and deputy chief executive at St Helena (https://www.sthelena.org.uk/)

  • Social care to become lifestyle brand
    16 April 2020

    Social care is to get a new brand identity as the government seeks to reverse the perception that it is the poor relation of the NHS.

  • Blithering Covid-19 bulletin plays vital role
    2 April 2020

    To fill a gap in the market for timely and relevant Covid-19 information, Martin Plackard, director of global crisis communications at NHS Blithering introduces his latest initiative to reach out to stakeholders during the outbreak.

  • Social distancing the Longstay way
    27 March 2020

    We asked Sir Trevor Longstay, chief executive of the NHS Blithering University Hospitals Foundation Trust and commander-in-chief of the Blithering Covid-19 Taskforce to give us some practical tips on social distancing. Here he shares some of the lessons learned over four decades of leadership – not all of them relevant or epidemiologically sound

  • Nothing left to shift: fears grow over NHS paradigm supply
    12 March 2020

    The government has issued a stark warning that stocks of paradigms and other basic supplies could soon run out if NHS managers continue panic-buying.

  • Matt Hancock’s diary – a week of levelling up
    27 February 2020

    Taking personal charge of global pandemics is one of the perks of this job. I’m referring to coronavirus, of course, and I’m booked to appear on Sky News to talk about it.

  • Exceeding your expectations: the Blithering staff survey
    20 February 2020

    Staff at NHS Blithering feel listened to “at least once a year” and report that their expectations of taking part in surveys have been “met” or “exceeded” in the past 12 months.

Friday, 5 June 2015

Virtuous but not yet

Simon Stevens was on messianic form this week. His pronouncements in the wake of the general election are becoming more confident, more assertive. Which is just as well, because the NHS faces challenges of biblical proportions.

The NHS England chief executive’s address to the NHS Confederation came during a week of big announcements:  NICE abandoning its work on safe staffing standards, the removal of two waiting time targets, a renewed drive to improve procurement practices and “concerted” action to reduce spending on agency staff.

The Five Year Forward View has the backing of the government, which has signed up to the Faustian pact to trade £8bn in cash for £22bn in efficiencies. Still no due dates on the credit-line or the repayment schedule, but to be fair, nor is there much detail about the NHS’s side of the bargain either.

No one seems able to say exactly where the line is that separates too little and enough, why £30bn is the right number, or how the books can balance when there is not enough money in primary care, secondary care, social care or mental health.

But these are nit-picking details. It’s not, as Stevens said, “all about the money”.  It’s all about attitude.

A failure regime regards lack of money as a disaster and pulls the duvet over its head, whereas a success regime regards it as a challenge, gets up a bit earlier, has a cold shower and goes for a run.

Which is an opportune moment to mention the fight against obesity, the greatest health problem of our times, according to Mr Stevens. The NHS is tackling the problems posed by booze and fags, he said, but obesity is getting worse. It affects one in ten primary school starters, but one in five leavers.

Health education had little or no effect on smoking. It was only legislation that made a difference. The law changed people’s behaviour, not the other way around. Draconian legislation aimed at the food industry and laws restricting eating do not seem likely. Instead we’ll get more industry dialogue and initiatives, a bit of salt reduction here or signposting there, and a few more fruit and salad options for guilty parents at Macdonalds.

The war on obesity, like the war on terrorism, will be a long and difficult campaign, the work of decades, not of a single political cycle. It is vain to pretend it can be won but foolish not to try.

Even so, and despite the lack of evidence that public health campaigns make any real difference, it is a pointed irony that as Mr Stevens was speaking out about obesity, the Treasury was busy slimming down the public health budget by £200m. These are not the pounds Mr Stevens wants us to shed.

Or perhaps it isn’t an irony. Salvation must be chosen. Unlike reform, it can’t be imposed. Only half of Mr Stevens’ speech was aimed at NHS managers, the other half was aimed at the rest of us. Don’t expect public health budgets or hospitals to get you out of trouble. They may or may not be there.

Of course cynics and old campaigners will view the flurry of post-election business and speechifying as part of a familiar pattern. Sound the alarms, show you mean business, kick a few backsides then watch while everything settles back into the old groove.

That comforting scenario seems unlikely this time. Read Health Policy Insight’s transcript of Stevens’ speech and note how little reference it makes to strategy, structural solutions, innovation or even the “new models of care” the Five Year Forward View is so keen on. Change will not come from “how to do it” documents or “more Powerpoint slide decks”, Stevens said. That was the “David Brent approach”.

Warning his audience not to mistake the Five Year Forward View for “a fantasy of someone buying us a few more years of the status quo”, he said: “We don’t have five years.”

He also quoted St Augustine (a real saint, not a failing hospital):  “Oh Lord, make me virtuous, but not yet.”

And just to be clear, this is guidance Simon Stevens urges us to reject.

Religious affairs editor: Julian Patterson


With thanks to Andy Cowper at Health Policy Insight for the transcript, which is available here.

barry fitzgerald
barry fitzgerald says:
Jun 05, 2015 06:47 PM
I know the blog isn't about obesity but just as laws have changed smoking habits so laws have changed drink/driving. Some people say that societies attitudes have changed towards drink/driving. Maybe they have but I'll wager the main reason people don't drink drive is the threat of loss of license and prison time. If the drink/driving were removed then there would be more drink/driving.

Legislation aimed at the food industry is just one line of attack on the "war on obesity" and on its own it is doomed to fail just as the war on terror and the war on drugs have failed. For strategies that may have more success how about making cities more cycle friendly, stop selling off school playing fields, bringing back old fashioned Home Economics lessons in schools.

Just a thought.