Meet the New Boss, Same as the…Oh Wait, it IS the OLD Boss!

Here’s a shocker, the new GP commissioning bodies are…wait for it…rehiring the old PCT managers to do the commissioning.

Research by the Health Service Journal reveals that managers from the defunct primary care trusts are being rehired to lead the new clinical commissioning groups made up of GPs. Of 81 CCGs to have made appointments, 50 have chosen a manager.

Andrew Lansley, the Health Secretary, wrote to health workers last week, urging them to use their clinical expertise and their knowledge to ensure NHS services meet the needs of patients. “My ambition is for a clinically-led NHS that delivers the best possible care for patients. Politicians should not be able to tell clinicians how to do their jobs.”

But emerging evidence suggests the reforms, hugely rewritten in the face of opposition from Lib Dem peers and medical bodies, will put in place new complex management structures. Liz Kendall, a Labour Health spokesperson, said the next year will be focused on “creating a huge new bureaucracy”, including 240 CCGs, local education and training boards, a National Commissioning Board, an NHS Trust Development Agency and clinical senates across the country.

Oh well done, Mr Lansley, you have not empowered the GPs to take control of NHS decisions. You have shuffled some chairs around and created another layer of bureaucracy, at a time when the NHS can least afford it.

Who saw that coming, eh? Oh wait, everyone.

What a complete and utter Lansley.

NHS #RiskRegister Leaked

So, the much-debated Risk Register for the NHS reforms has been leaked onto the Internet.

Personally, I’m still trying to interpret and digest its contents, and therefore my immediate thoughts aren’t more cogent than, “Wow, that’s a lot of stuff marked red!”

Some areas marked as red (i.e likely to happen, and would have a high impact) include, to take a couple of random examples:

By dismantling the current management structures and
controls, more failures, including financial, eg GP consortia
go bust or have to cut services, and credibility of the system
declines as a result.

 

Risk that transition is managed by people who are
themselves at risk, eg in organisations such as SHAs, PCTS,
may not be effectively managed, with risk of delays,
performance dips and key staff lost as a consequence.

 

There is a lack of clarity during the transition in terms of
accountability e.g. between board, PCTs, and Consortia
during the transition years and the first year of the new
system. This leads to delays and increased costs and poor
BAU performance.

Okay, I know that the point of this risk register is to identify such risks and therefore work to eliminate them, but there really do seem to be a lot of them.