Attempts to badmouth our Hospitals and their A&E department did not seem to put people off and attendances continue to climb.
A trusted Brand? So the Genius is going to pump £500m in, well a small sum compare to £42 billion for RBS.
It is important for SoS/Genius to recognise that the extra money should go directly to hospitals to salary employed staff and not for the likes of Harmoni or Serco to offer a service that punters (sorry, patients) no longer believe in. Did the Genius realise that for OOH and the like there is no control as to who was making the calls. If Serco could fake data.....Well!
Why not abandon NHS111 all together, prosecute Harmoni & Serco for gross breach and let Bevan smile.
While you are at it, cancel all UCCs as punters prefer A&E (so do not change the name to ED or worse, ER). Abandon the market system too.
In a Market system, A & Es are run by Hospitals and OOH by CCG/GPs; business rivals so to speak. Hospitals wants to maximize income and CCGs did not want anyone to attend A & E if at all possible. NHS A & E: Unpredictable, Unruly & UngainlyThe Genius knows that the GPs are too powerful and will not take back OOH unless there is a lot of money. so the funding to A&E should not be via CCGs although the hospitals have a system of charging CCGs and that was the bit CCGs do not like. Do not wait, Genius as the objections from the GPs will be coming. Employing more GPs does not cure the 24/7 coverage problem at all.
Also, why not cancel CCGs and let hospitals run everything. They are committed to 24/7 service, aren't they? -
‘There is no evidence that GPs as a group are empowered with supernatural abilities to manage large budgets and organisations’
The right configuration?
So what would be the main characteristics of an alternative system based on previous experience? The key features would be:
· Integration of service provision and planning around a defined population and individual patients.
· The best degree of fit possible with social care and other local government services.
· Integration of support services for the defined population, crucially finance and information, to reduce unnecessary overheads.
· Consistency of policy around the key indicators of health of populations, patient outcomes and their experience so comparisons can be made across organisations and time.
There is no right answer to the configuration of health organisations across
and the solution will
always be a compromise. However, experience would suggest that England London
is always a special case and should not influence the best arrangements for the
rest of . England
For the last 20 odd years, dividing the health service into commissioning (or purchasing) and provision has been the only show in town. First, NHS trusts were divided from health authorities and GP fundholders added to spice the brew. Then primary care trusts were created with practice based commissioning bolted on.
Interestingly, in both cases, GP purchasing/commissioning was run in competition to health authorities/PCTs; rather than to provide synergy. When this ran into difficulties, particularly in restraining the costs of acute trusts, the “world class commissioning” programme was created and PCTs were encouraged to buy in all the best brains in the private sector to smarten up their act. PCTs were even forced to divest themselves of direct management responsibility for community services in case this sullied the purity of their commissioning role.
Now all faith is being placed in clinical commissioning groups and GPs being the magic ingredient that will make commissioning the powerhouse of efficiency and effectiveness in the health service.
Read all here>>>Commissioning will never work in the NHS