21/09/2010 by Patrick Keady.

The health White Paper promises significant changes to primary care and the way that healthcare is delivered.  BMJ Masterclasses aimed at clinicians and managers in primary care will equip GPs and their practices to meet the challenges and take the opportunities that lie ahead.

Understanding GP Commissioning, is a new one day course providing practical skills and advice on general practice commissioning, as well as

an essential overview of the recent health White Paper. It takes place at BMA House, London, on 30th September.

Improving Quality in Your Practice, takes place at BMA House, on 1st December. It will help GPs identify areas in their practice where they can improve quality and safety by working smarter, not harder, and develop an action plan for their surgery.

For details, click www.betteroutcomes.org/events

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14/09/2010 by Patrick Keady.

The success of healthcare systems is often measured
in terms of quality, activity and cost. Compared with the
US, Germany and France, the NHS performs well. In
terms of GDP, we spend less.

However, things are less clear when we compare NHS
quality and activity. Statistics come to the fore. We
compare the NHS with the EU, north America and
Australasia. And we might be missing a trick.

Could it be that there are better healthcare systems
elsewhere in the World? Healthcare systems that
deliver more at less cost.

Take Japan for example. It stands at or near the top in
every comparative ranking of healthcare quality, activity
and cost.

Not alone is their healthy life expectancy 6% higher
than in the UK, they also have the best recovery rates
from just about all of the major diseases. Japan
leads the World in curing the diseases that
can be cured. Impressive.

The percentage of people dying from circulatory
diseases per 100,000, is 75% less than here. The
proportion of cardiac death is four times less. The birth
rate is 30% less and the proportion of the Japanese
population that is obese, is one seventh. Although the
percentage of daily smokers in Japan is higher -
30.3%, compared to 26% in the UK.

Cost control is one of the key drivers of Japan’s
success. It’s savings in the high-tech realm can be
awesome. An MRI scan of the neck region in Japan
routinely costs 9% of one in the US.

All 125 million residents have access to healthcare
services. The Japanese see a Doctor about three times
as often as people here in the UK, or those with
healthcare insurance in the US. The number of Nurses
per 1,000 people in Japan is less than in the UK : 7.8,
compared with 8.8 in the UK.

And they have almost three times as many hospital
beds per 1,000 people. The average hospital stay is
four times the US average. The Japanese get twice as
many prescriptions and three times as many MRI
scans.

And the cost of caring for every person living in Japan
is less than half that of caring for the 80% of Americans
with health insurance. Total expenditure is less
than in the UK too - 7.8% GDP versus 8.1%.

So what do you think?

Post your thoughts below.

Posted in Risk Management, Innovation, Creativity, Public Health, Safety, Health and, Governance, NHS, Strategy | Print | No Comments »

12/11/2009 by Patrick Keady.

One of the headlines on www.hsj.co.uk today, caught my eye. Managers anger at O’Brien’s name and shame threat.  And then it began to make sense. Mike O’Brien and David Nicholson seem to be speaking the same language!

In each year since 2000, Mike O’Brien and his colleagues in the Blair/Brown Governments, increased their funding of the NHS in England by almost 7% (on average).

And now we are preparing for annual funding increases that will be much closer to 0%. David Nicholson told us earlier this year that the NHS needs to find £15bn-£20bn of savings by 2014. The NHS has two options.

The first is to hit the target and miss the point.

By reducing inputs - cutting staff, closing buildings and increasing waiting lists. Its refreshing that Mike O’Brien does not want to see budgets and services slashed in response to the public sector funding squeeze.

Hitting the target and missing the point would be costly. Patients would not be interested in why NHS services were being cut. They would not want explanations as to why there were less staff on-duty.

Patients expect a return on their investment - for the National Insurance Contributions that they have and/or are making. And my guess is that patients will continue to expect better healthcare.

The second option is to hit the target …. and to hit the point.

By reducing waste in core processes, such as diagnosing, treating, and communicating with patients. By getting the care of patients right first time. By reducing unnecessary readmissions.

By ensuring that clinicians and managers feel empowered to achieve results, to make changes, to take decisions, to drive service improvement, to actively deal with risk.

The NHS is likely to reduce waste in core processes, when Directors of Finance and their colleagues become even more actively involved in process improvement and removing waste. When they continue allocating serious investment in the development of improvement capability. By continuing to focus on cost per unit, and not expecting increased funding from the Government or elsewhere.

My guess is that Mike O’Brien will not ‘name and shame’. Because the NHS will actively work to reduce waste in its core processes. And that the NHS will find the £15-£20bn of savings by 2014. And because Mike O’Brien and David Nicholson will continue to speak the same language.

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17/07/2009 by Patrick Keady.

Listening to Evan Davis on BBC Radio 4, I was particularly interested in the language of his guests.

James Dyson introduced himself as the founder of vacuum cleaners that work better.

Marta Lane Fox, recently appointed Champion of Digital Inclusion, is working to make life better for the six million economically and socially disadvantaged people in the UK that have no access to technology.

And Adrian Ringrose  the chief executive of a company that enables public sector organisations do what they do, by doing all the bits that these organisations don’t want to think about.

When introducing ourselves in the NHS, we tend to use different language. And this episode of BBC Radio 4’s The Bottom Line promised a lot. It was a discussion about creativity and innovation.

To be good at innovation and creativity, Martha Lane Fox said that boldness and self-confidence works for her. James Dyson added that innovation for him is caring about solving problems and taking little incremental steps to get there.

And Adrian Ringrose gave his insight into the public sector. He suggested that it is more important to do what we do in the public sector - by the rules, rather than focusing on the end game.

A generalisation perhaps, he reminded us that it is the end point that matters and we are more likely to get there by building on our mistakes.

And my guess is that this point resonates with you and many leaders in NHS risk management, governance and safety. I enjoyed this edition of BBC Radio 4’s The Bottom Line and I know that you will too.

Posted in Risk Management, Innovation, Creativity, Patrick Keady, NHS, Personal Development, Governance, Strategy | Print | No Comments »