Matt Carter’s Post

A recent report highlighted that efforts to cut NHS Wales deficits are not working. This comes after reductions in spending and additional funds invested by the Welsh government. The Welsh NHS Confederation described this as a "wake-up call" for governments to be honest with the public "about the need for long-term service change and what this might look like". With financial pressures growing, will this be something we see happening in other regions too? Read more here: https://heyor.ca/PZlyhA #NHSWales #HealthcareFunding #PublicHealth #HealthcareChallenges

#uk #healthcare #politics #policy #economics New government, new possibilities, new politics! For those working in and with the NHS, now could be a great time of full potential. To invest in the enhancement of our national health system, improving access and quality for all, appropriately and free at the point of access. Let’s see how we can all support that goal to the best of our abilities. 💫⭐️

Important blog from Adam So much of our work focuses on shifting power dynamics, more power with, rather than over, and it is well supported by recognition of how the hierarchical nature of the NHS is deeply embedded and perpetuated. And…. the if you don’t do this you’ll be fired, is kinda top down. As Myron says the process you use to get to the future is the future you get. And to quote Mary Parker Follett ‘the job of the leader is to create more leaders’ and I’d argue this is by focusing on the context, structures and conditions which enable people to lead and less by threat and individualised development. #organisationdevelopment #organisationdesign #complexity #systems #change

Dr Becks Fisher of the Nuffield Trust makes the pertinent point that even if you implemented the reforms outlined in the report below, it wouldn't make much of a dent until you address the crisis in social care and public health. Investment into safe, affordable and sustainable housing is a key mechanism in terms of improving health outcomes. It's not just about the bricks and mortar. Homes, and decent affordable/social homes at that, are an invest to save proposition. Our own work at CIH Cymru, as part of the #backthebill campaign in Wales with Shelter Cymru and Tai Pawb to incorporat the right to adequate housing into Welsh law, showed that a decent and accessible home for everyone in Wales would save the public purse £11.5bn against an investment of £5bn. We need to be radical and look beyond the political cycle if we are to solve the twin crises in our NHS and housing system....we can't solve one without solving the other! We need to make housing a foundation mission of government, through a rights-based approach, as a means to improve public health and therefore drastically reduce demand on the NHS.

Read this and see if these statements about health care and the health system ring true in your part of the world: 1. Despite successive governments repeating a vision of health and care services focused on communities rather than hospitals, that vision is very far from being achieved. 2. The failure to grow and invest in primary and community health and care services ranks as one of the most significant and long-running failures of policy and implementation in the NHS and social care for more than 30 years. 3. Evidence shows that financial and workforce growth is not aligned to the vision, with larger growth in acute hospital sectors than in primary and community sectors. This report, "Making care closer to home a reality Refocusing the system to primary and community care" comes from The King's Fund in the UK. I think it likely resonates with citizens' and family caregivers' experiences in most countries. Access the report here https://bit.ly/3uQzCB1 Certainly, in my experience as a family caregiver over the last 26 since my husband had a stroke in 1997, I know family caregivers like me, are the de facto care coordinators dealing with the siloed health and community care systems. I think it is long past time to move integrated care closer to home. There are lots of reports, plans etc. In Alberta for example, we have Brad Bahler's THE INTEGRATED HEALTH NEIGHBOURHOOD OF THE FUTURE White Paper on Transforming Primary and Community-Based Care https://lnkd.in/gqGtDgGd More recently we have the Modernizing Alberta's Primary Health Care System (MAPS) initiative. https://lnkd.in/g5zGVK2z Don't you think it is time to act?

Health care is always at the forefront of politics, it is the same in every country! The question is: Is our current system fit for purpose and if not how do we change it...? But not only from the political/funding point of view, but from the individual point of view - are we ready, as a society to play our individual part on a daily basis? We have enough evidence that smoking and drinking - kills, eating unhealthy - leads to various conditions, not exercising - contributes to poor health... So, are you ready to play your part? And once you do concurrently for 1 year - let's ask this questing 😉

This blog is well worth a read, as it highlights a fundamental issue within the health and social care sector: the incongruence between calls for greater autonomy and the pervasive ‘command-and-control’ culture. Far too often, we see individuals, particularly managers, ‘thrown under the bus’ to satisfy statistical targets and performance measures. The result? A succession of leaders who start initiatives but are unable to see them through, leaving a workforce lacking in identity, direction, and consistent guidance. Such a throwaway culture undermines stability and perpetuates failure. Instead of asking why managers ‘fail’ in isolation, we need to address the systemic factors driving this cycle. The Francis Report in 2013 highlighted many of these issues, yet here we are, still grappling with the same problems. Long-term change takes time—no doubt about it—but constant chopping and changing only creates further instability, ultimately compromising safety and care quality. We must choose a direction and commit to it, recognising that genuine, lasting improvement requires not just targets but an understanding of the cultural and structural forces at play.

Is the British Government Eroding Primary Care on Purpose? The Doctors’ Association UK has sent a new book written by its past co-chair, Dr Ellen Welch, to every Member of Parliament and to the chairs of NHS integrated care boards. The aim: putting general practice at the top of every manifesto in this 2024 election year. The book, Why Can't I See My GP – The past, present and future of general practice, published on 8 February, does not mince words. It outlines the current problems in general practice, how it has reached this point, and what needs to be done about it. #primarycare #healthpolicy #healthcare #familymedicine #communitycare #integratedcare https://lnkd.in/eyaG7yj7

Reactions to Lord Darzi’s Independent Investigation into the NHS have been mostly positive so I feel a bit of a party-pooper with this Blog. I argue that alongside the many reasons for its  current disrepair (austerity/Lansley’s reforms/Treasury cap on capital/ COVID-19/No social care fix etc etc) there has been a failure of patient & public involvement. What I mean is that all the worthy people representing their communities have – like the rest of us – acquiesced in the decade-long decline of the service. Instead of being campaigners and advocates for MORE and BETTER, they have been reduced to defending the service from proposals for LESS and WORSE. Darzi is an optimist and thinks all is not lost provided Government and medics invest in the right things. But Top-DOWN decisions have not worked. We need far more BOTTOM-UP pressure. Without public support and public involvement, the chances of restoring the NHS to the state we need is slim.  #consultation #consultationguru #NHS #LordDarzi #patientandpubicinvolvement #socialcare #Darzireport

“The NHS is more hierarchical than almost any other organisation I can think of.” It was a pretty striking phrase in Wes Streeting’s big speech yesterday. And he’s right. Creativity, innovation and simple good sense are routinely stifled by the pathological command-and-control that starts in the Department of Health and Social Care and cascades all the way down to the frontline. So, it has puzzled many, to put it mildly, that in the same speech Streeting announced the introduction of league tables and centralised performance management for NHS Trusts. He also did his best Alan Sugar impression with blood-curdling rhetoric about firing failing managers, left, right and centre. But for the Secretary of State there is no contradiction. Yes, he wants more autonomy across the NHS but it has to be earned. All the tough stuff is about making sure the various bits of the health service are grown up enough to be given the keys to the car. Will it work? I have doubts. We’ve seen this movie before. Local Government has spent the last fifteen years earning its autonomy. And the upshot is that there’s been an awful lot of earning and not much autonomy. The doubts are deepened by the fact that the SoS framed hierarchy very much in terms of structure. But the big driver of the NHS addiction to control is its culture - the mindsets and behaviours that shape its everyday existence. These are the very same mindsets and behaviours that permeate central government and which have always stymied efforts at public sector devolution before. Indeed, the very notion that autonomy must be earned owes more than a little to that culture. A lack of awareness around this is troubling. Much more detail in the blog below. As ever, comments - critical and supportive - very welcome. #NHS #Health #publicservices #localgov #DoWith #innovation #productivity The King's Fund Simon Kaye Chris Ham Samira Ben Omar Simon Parker Andrew McCracken Matthew Skinner Alex Fox OBE https://lnkd.in/esWwEgTd