Thursday, 21 January 2010


I’ve been sitting here racking my brains on things to update you with gentle reader, but nothing has occurred to me. I am a dull fairy indeed at the moment. I do think that’s mainly down to the fact I’ve been working really hard recently.

I love the job, and although I’ve been doing long days with little sleep (four to five hours a night most weekdays) I find the work energising and I really feel like I’m achieving something.

As I may have intimated before, gentle reader, that I work in the NHS for the health authority overseeing services in London. My recent promotion has seen me move from oversight of range of local services into an holistic London-side project management role.

In London we are implementing a five year strategy to transform services. It essentially involves changing the model from a 9-5 GP in the community and a hospital providing everything but to variable quality where you go into a multi-tiered model where as much as possible is provided in the community as close to the patient’s home as possible; and that specialist services are concentrated in centres of excellence.

Pharmacies; diagnostic; urgent care centres in the community combined with GP surgeries, community hospitals and community nursing/midwifery/social care in a hub-and-spoke model. Consultants holding their outpatient clinics in dedicated facilities in the community so, for example, elderly patients aren’t separated from their care structures and exposed to risk of infection…

Of course there’s contention around the model. Hence a recent media campaign in which several broadsheet newspapers report plans to cut back services and the BMA releases reports unhelpfully entitled things like “Why Everything is Shit Unless Doctor’s Are In Charge PS Stop Eating Butter.”

It’s exciting because my colleagues and I really want to drive forward changes that improve and expand care whilst also taking into account of the fact that we are experiencing the toughest financial conditions in history. Five years of zero real growth. Even under the most austere right wing days of Thatcherism the service had better funding growth than that.

My role is to midwife the first year of operating plans for each NHS organisation. Ensure they are robust, and that my organisation proactively manages the achievement of the aims set out in the plans. Not a small job. Or an easy one. But one I think is very worthwhile.

See? See how very busy and important I am? Do you?

Busy. Important. And Boring! Well, there’s fun planned for February so normal service will be restored ever so soon.


GaySocrates said...

I just want to give you a hug!
You've got a big job there!
Someone once said to me that working for the NHS is like a marathon race -you've got to know how to pace yourself!
Please be gentle with yourself and don't burn out

Mike said...

Thanks GS. Always appreciated... it's certainly a Long March! Perhaps I give myself too much credit, but you are right; I need to apply my skills to myself before I apply them elsewhere. X