Efficiency is fun

There’s no shortage of advice being dished out to the new old health secretary with the start of a new government.  Most of it boils down to more people and money, and most of it misses the point. I’m absorbing Geoffrey Moore’s “Dealing with Darwin” at the moment which is brilliant on what form of […]

In the lull: how will general practice inspire?

The GP explained how he would see one patient every five minutes, all day.   Many have infectious diseases but the burden of chronic conditions is growing.  He loves his work, and his patients love him, most affording the flat fee of a few rupees, some free at his discretion. In the brief lull between election […]

What are they queuing for?

Newspapers know how to build a story around a picture.  At times irresponsibly, sometimes showing what we need to understand. The one of the queue outside the GP has done the rounds, and does show the reality outside many practices at 8am.  Even if few are standing outside the door, many more are trying to […]

Are you suffering from anxiety demand?

Someone very close to me whom I have known all his life (we shall call him S) has had recurring headaches for three weeks.  He has seen the GP, who diagnosed viral sinusitis, nothing to be done except OTC pain relief.  See again in a month if no change. Someone else even closer to me whom […]

Soldiers to work 8-8, seven days a week

“Soldiers to work 8-8, seven days a week in government directive” “Armed forces guarantee response to attack within 48 hours” “All wars must start within 18 weeks of a referral from parliament” Faintly ridiculous?  It’s ironic that the arm of the state occasionally tasked with shooting at things is less subject to targets than the […]

Dot Community Health honoured in Daily Mail

It is with great pleasure that I announce our award today of the coveted DDM - Dissed in the Daily Mail.  It has taken over three years to reach this moment, so let us savour it. Readers will wonder how they managed to spin bad news eliminating the wait to see a GP but they […]

It’s time to ban competition in the NHS

The campaign has officially started and with the NHS a key battleground Labour fires the first shot, capping the profit that private providers can make at 5%. What were they thinking of?  It’s a small enough margin to keep out innovative private competition, who simply won’t be bothered.  That may be enough to ensure mediocrity […]

Eclipse cancelled in government IT project failure

Just musing on why such a mashup of last Friday’s headlines sounds strange.  It challenges our notions of predictability, whether the latest government IT project would fail, or the eclipse would happen on 20th March. I often ask a practice team, “Which is more predictable, your 10,000 random patients or your six dedicated professionals?”  There’s […]

Vanguards: how will we know they are working?

Paraphrasing Alice’s Cat, “If you don’t know where you are going, any road will get you there.”  This week 29 Vanguard sites have set off with high intentions of getting somewhere near a Five Year Forward View, but where is this? I suspect we will see broad consensus on the purpose, high quality care and […]

A manifesto for primary care - the three R’s

I don’t know about you, but in the unfolding election campaign I see an unhealthy lack of debate and challenge on how the NHS should work.  The parties argue about money, and that only at the margins, but the opportunity for improvement lies in function, not form, and no party has understood. Now see this week’s […]