Handling Pocket Money was good training
Remember pocket money? We were probably never so rich as we were when we received this!
We didn’t pay for food, or rent. Someone else paid for clothes, fuel, heating and all those ‘grown up’ things.
Now, we’ve grown up we have the eternal worry not only about making our income go round, but we also worry that services such as the NHS are running out of cash. Yet looking at the way hospitals, etc. buy their goods, isn’t it time they went back to school and learnt old-fashioned economics?
You couldn’t make it up
Today, Hospitals constantly claim they are broke, yet commonsense budgeting seems to have run out. As a patient who ticks numerous disability boxes, I have to be collected by hospital transport. This week I was refused this, “because you can get in to a car so you can come by taxi. It costs us £80 to bring you in”. So I phone the local taxi company, and they quote £40 – £50 depending on waiting time.
So why not contract the local taxi company as using them would surely be cheaper? I ask the driver who picks me up, who just happens to be the owner. “Yes, I supply taxis when their drivers are sick. About 1,000 journeys per year. Lots of these are duplicated, so I put in a proposal that would provide multiple pick-ups with 3 – 4 patients and carers on each journey. This would save a lot of money, but they won’t do what I suggest and we get duplicates all the time”.
The same profligate spending goes on across the NHS, be it buying loo rolls, syringes, transport, maintenance – whatever. The contracts are handed out by hospital board members, with no experience in the relevant field, and no idea of using bulk buying discounts. Why should they? They have been appointed to the Board for other expertise.
As NHSmanagement comment “Every Trust I know has a ‘giss-yer-crutches-back‘ scheme. Hospitals aren’t stupid.
They know about ISO 11199-1:1999, load testing and infection control of walking aids.
By the time an eight quid pair of crutches has been returned, signed for, documented, stored, examined, cleaned, new handles and rubbers, tested, certified safe, labeled recycled and usable, put in the inventory, bar-coded and reissued they’ve probably cost £50.
Expect somebody to flog the NHS a piece of software to do all this… and a bill for ten million… and it’ll be as useful as a motel shower-curtain”.
What should be done to save NHS money?
The new Minister is IT mad (even pays to ‘visit’ his doctor on Babylon). So he wants to make the NHS go digital, and ensure every patients’ medical data be stored centrally, But before he wastes yet more billions, STOP thinking the US is the only place to go for expertise. Yes, we all know that visiting gurus from the NHS get luxury treatment, but this has got to stop. Try Australia and see what they are doing; according to Roy Lilley of NHSmanagement “man who used to do IT here is doing with IT, there. He’s got the basics soooo right”.
By Xmas, every Australian who wants it will have a pin-number. In the same way you decide who takes money from your bank account… Australians will decide who sees their health record… with a pin-number. Granting clinicians access.
With that we could know who had a walking frame and be able to ask for it back, patients in the chemist would be able to give the pharmacist access to records to confirm if they are entitled to free prescriptions (apparently this will save millions), etc
Focus on getting the basics right, not palavering around frittering money on more Apps and software to heap onto the electronic Tower of Babel we already have.
Yes, basics are boring but this is where money is saved. Ask Joe who does your job in the next door Trust how much he pays per loo roll – then see if together you get cost down.
Again, NHSmanagement says “We’re losing the knack of doing the B.A.S.I.C.S
Backwards; start with the patient and work backwards. Forget wrapping existing services around what you do. If you do that, you’ll get what you’ve got now and mostly, it’s not good enough. Zero-base all planning.
Accept there are problems; and problems are precious… find them happily and fix them cheerfully.
Speak to everyone face-to-face; a fast and dirty listening exercise. Ask; ‘To make this good enough for your family, what two things would you change, that need no more than petty cash to do?‘ Challenge yourself to deliver in 30 days.
Inspection; forget it. Inspect and it’s good… you’ve wasted your time. If it’s bad… it’s too late. Quality’s what you do when no-one’s looking.
Celebrate success; small things are big things to someone. The little things; the building blocks that shape us and our organisations.
Solutions; share them. You won’t be the only place with ‘that’ problem. Don’t reinvent the wheel, ask. (go to Australia)
Innovation is seductive but the basics are sexy.
And next time you need to order loo rolls, a new ambulance, syringes, etc. look down your list of patients in the last year, see who worked in that field, then ask if they can get whatever cheaper. I bet they can!