December 5, 2011

Yesterday, I spent an hour and a half with Alasdair Henderson, the Chief Executive of the Academy of Royal Medical Colleges. He is a career bureaucrat who came to the Academy from a senior role in workforce in the NHS.
The Academy has been around for 25 yrs and is in the process of consolidating its position. Its main roles are as a forum for consensus around issues that are common, or should be common to most of the Medical Colleges, as a voice for doctors in policy development that is separate from that of the British Medical Association and to "promote, facilitate and where appropriate co-ordinate the work of the Medical Royal Colleges and their Faculties for the benefit of patients and healthcare".
Currently, the Academy is contributing to the discussion of the risks and benefits of competition in clinical commissioning and to the need for leadership training for doctors to enhance their ability to contribute to decision-making and leading change. They are also in the process of writing a position statement on the need for consultant presence after hours in addressing safety and quality following a number of high profile incidents.
He made a number of interesting points:
1) The contribution of doctors is underappreciated, in particular the unpaid contribution. Doctors contribute to education, quality improvement and redesign, management and leadership. If they demanded to be paid, the NHS could not afford to pay them.
2) Doctors did not take up the challenge of New Public Management in the 1980s following the Griffith Report and instead retreated into the clinical world. Management was left to managers. In the ensuing 20 years, managers became better educated and expereinced and the gap between the management skills of doctors and managers widened. Doctors now need to address this gap and take a more effective role in leading and managing.

December 1, 2011

Hello again. I'm on the train back to London. It's 4.30pm and pitch dark outside!
The GP Commissioning Conference was excellent, with lots of parallels with HealthPathways and loads of lessons for us.
There were many messages, but I think the overwhelming one was that the change from Primary Care Trusts to Commissioning Groups represents a "revolution"in healthcare in the UK. This word was used over and over again along with the exhortation to seize this once in a lifetime chance. The main political players spoke and all were, to me, startlingly deferential to clinicians! The Secretary of State for Health (Minister) Andrew Lansley, said that he had worked hard to hand back control to GPs and other clinicians because he realized that only those delivering care could truly lead the changes that need to occur. Along with the Medical Director of the NHS, Sir Bruce Keogh, Sir David Nicholson, the CE of the NHS and others, he said that the role of the bureaucracy was to support clinicians to lead.
The other strong messages were about localising care for patients and the need to break down traditional barriers. Despite the positivity, there was also a sense of fatigue amongst some who had been working at this for a number of years.
Will elaborate over the next few blogs as I digest all the new information!