Hurrah for people like Roy Lillie

Thanks to a streaming cold, he’s had to rest up – which has given him time to read the latest turgid announcement from the NHS Dept. of silly time-wasting ideas in Whitehall.

In the year when we celebrate the 200th Anniversary of Florence Nightingale’s birth, it seems Whitehall boffins could do well to copy her style.  Here is their latest epistle, with pithy comments from Roy, and my bemused musings.

These comments appeared in his latest article on – with apologies for copying, but he says it so much better…

Roy has come to the conclusion, whoever writes this stuff has had their chuckle-gene removed.  Had a double-dose of the ‘administration virus’.  Has Ambition taken out of their DNA.
This is a dull document, written in dull prose.  Laid-out, on the page, in slabs of text, justified right and left, that leaves nowhere for the eye to rest… designed not to be read.  You’ll go boss-eyed.
… and it is a pity because bits are nearly revolutionary.
Brace yourselves – we could be due for a 
‘… reduction of face-to-face outpatients… we are proposing reforms to the payment system to ensure providers do not lose income from doing so.’
Outpatients is the last remaining, unreformed, corner of healthcare.
Anyone who has visited one recently knows there should be a sign saying ‘Abandon hope ….’
Loads could be done on the phone, FaceTime, Skype.  There is no shortage of technology.  The problem is, how Trusts are paid.  The tariff reinforces; ‘kerching, thank you, visit again soon’!
Here’s the explanation (I’m sure you want one)  “‘Under the proposed 20/21 National Tariff Payment System, commissioners and providers will be expected to agree blended payments for outpatients that include advice and guidance and the uptake of non-face to face consultations”   
Agreeing blended payments’.  Code for a row?
Then comes the warning  
‘We expect to see a significant volume of unnecessary hospital outpatient attendances avoided in 2020/21.’
Er – what happens when some faceless jobsworth decides the appointment you have been waiting six months for is “unecessary”?
But – just to prove the Whitehall Mandarins are on the ball,  ‘The NHS will develop a national de-carbonisation and climate change plan during 2020 in the run-up to COP26.’ Isn’t that going to provide lots of tickboxes for all the P-Correct jobsworths to get their useless teeth in to.
Just to show they are all on-the-ball,   The NHS won’t buy anything unless it is carbon neutral.  Er- what’s going to happen to all the plastic IV tubes? 
Roy goes on to comment on the latest gimmick:  Integrated Care Systems.  Two core roles: system transformation and collective management of system performance.  He says “You may be interested to know, I once run an ICS.  They were called District Health Authorities.  What goes around, blah… blah.
And the rest?
Cap 92% occupancy rates (too high but realistic), eradicate 52 week waits, more emphasis on cancer.  I can’t find any reference to anything ‘dementia’, the primary cause of death in England.  Strange?
You’ll like this;
‘Ambulance services should ensure they meet the ambulance response time constitutional standards…’
… yeah, right.
There’ a flash of common sense;
NHSX will negotiate software licence agreements to drive best value for the NHS… also put in place deployment teams to help organisations effectively implement these applications.
Good luck with ‘deployment of teams’. More people?  More contractors?  Same people, more work?  Who knows?
And… like the stripe in the toothpaste, the most important bit; The People Plan.  We still don’t have one and if , when it arrives, I don’t work, if it’s not funded, all bets are off.  We ain’t got enough people…
“I’m relapsing,” 
Poor chap, I know how he feels

If anyone has managed to read this far, can they tell me why the NHS spends so much time trying to re-invent the wheel? The original worked well, so why does the NHS have to muck it up?

If you really want to read it for yourself, go to