meeting White Paper opportunities

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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who provides the best healthcare?

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.

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Yokoso Japan - sights, sakura, food and more

01/05/2010 by Patrick Keady.

   

Just returned from a 21 day holiday in Japan, that was extended to 35 days !.  And this is my list of favourites from Japan. Elsewhere on this blog, you will find comparisons of health services in Japan and the UK.

 

 

Favourite City/Town: Nara

 

Other Cities and towns visited: Tokyo, Hakata, Kagoshima, Nara, Kyoto, Koyasan, Nagoya, Hakone-Yumoto, Hakodate and Sapporo

 

 

Favourite Historic Sight: Senganen

 

Other historic sights visited:

Nara - Todaiji Daibutsuden, Tempura Asuka, Ninjatsudo Hall, Sangatsudo Hall, Tamukeyama-Hachimangu, Kasuga Taisha, Gangoji, Kofukuji, Kaneiji and Toshogu

Koyasan - Daito, Kondo, Saito, Fukuchiin, Ichijin, Tokugawa, Kongobu-Ji, Treasure Museum, Reihokan Museum, Fudoudo, Kompan Daito, Daimon and Daighi Kyokai
Kyoto - Higashi Honganji, Nishi Honganji, Kinkakuji, Ninnaji and Ryoanji.
Kagoshima – Reimeikan and Tenmonkan

Tokyo - Imperial Palace, Sensoji and Asakusajinja

 

 

Favourite Sights: Sakura and Shinjuku Gyoen

 

Other sights visited:

Kagoshima - Sakurajima volcano
Tokyo - Sony Building, Nissan Building, Toyota Auto-Salon, Tokyo Tower, Rappongi Hills, Asahi TV, Marunouchi Building, Imperial Theater, International Forum, Metropolitian Art Space, Sunshine City Observatory, Metropolitian Government Building Observatory, Midtown, Meijijingu, Nihombashi bridge, Electric City, Ueno Onshi and Nakanise

Nagoya - Toyota Plant

Sapporo - TV Tower, Morning Market and Clock Tower
Hakodate - Mount Ropeway and Red Brick Warehouses

 

 

Favourite Food: Shojin-ryori

 

Other memorable food - Crab, Kagoshima Ramen, Mochi, Tontsuka, Ekiban Bentobox, Sukiya

 

 

Favourite accommodation: Rengejoin

Other accommodation:

Ryokan Matsumae - Nara

Ryokan Kyoraku - Kyoto
Tokyo House, Ikebukuru

Ichinoyu Honkan, Hakone

Cassiopeia, Tokyo to Sapporo

Toyoko-Inn - Hakata-guchi ekimae 2, Kagoshima Chuoeki Higashi-guchi, Nagoya-eki Sakura-guchi Honkan, Sapporo-eki Kitaguchi, Hakodate Ekimae Asaichi, Akabane Iwabuchi Ekimae and Tozai-Sen Nishi-kasai

 

Favourite train: Shinkansen Tsubame – between Kagoshima and Shinyatsushiro

 

Other trains travelled: Cassiopeia, Narita Express, Shinkansen Yatsushiro, Relay Tsubame, Shinkansen Tsubame, Shinkansen Hikari Railstar, Shinkansen Kodama, JR Nara Line, JR Yamatoji Line, Nankai Koya, JR Osaka-Loop Line, JR Special, Rapid Service, Hakonetozan Railroad, Odakayu Hakone, JR Saikyo Line, Super-Hokuto, Hakucho, Hayate, Spacia Nikko and Shinkansen Hikari

 

 

Other helpful Websites:

Spring 2010 in Japan

Toyota Plant tour

 

Shinkansen N700

 

Hyperdia

The Japan Times

NHK World

Japan International Broadcasting Inc

Updated  27th October 2010

 

About Patrick Keady

 

Patrick helps NHS organisations make better decisions. A former NHS Director of Governance and Strategy, he received awards from the BMA and IOSH. Patrick is a Company Director, a Trustee at a Chartered professional body and Editorial Board member at a peer-reviewed Journal. For more information, click www.betteroutcomes.org

 

 

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NHS National Quality Board - interim report

15/04/2010 by Patrick Keady.

HSJ reported today that there is lack of information on the safety and effectiveness of much NHS care and that this has been spelled out in an interim report from members of the NHS National Quality Board.

One of the NHSs prevailing beliefs seems to be, that individuals will perform better and their organisations will flourish …. when we reward the behaviours that we seek … and punish the behaviours that we dislike. This approach works well for simple, routine, rule-based work.

But NHS workers undertake other types of work, where non-routine creative and conceptual capabilities are also required.

I believe that Quality in the NHS will improve significantly when PCTs and Trusts demonstrate to their staff, that they understand what it is that really motivates their employees - the motivation of making progress in their work, improving quality and the simple satisfaction of getting better at what matters.

We know that businesses with transcendent purposes survive and continue to deliver excellent services to their customers. Too bad that ICI, Boeing and some of the large banks focussed too much on targets, and too little on purpose.

NHS targets are good. They continue to challenge clinical teams and Trusts. They have played a key role in improving the NHS. But more and more we are seeing that targets, potent as they are, can be an insufficient impetus for NHS staff and organisations. They do not get everyone leaping out of bed in the morning and racing to the wards, patients homes, theatres and meetings …. to do deliver excellent patient care.

The BBC’s Panorama team discovered earlier this year, that Trusts were incorrectly assessing performance, potentially distorting their standing in the CQC’s Annual Health Check. 17 out of the 28 Trusts visited by the CQC in 2009, made incorrect assessments. Did Mid-Staffs and Maidstone & Tunbridge Wells focus too much on targets, and too little on purpose?

While much has been written on aspects of Quality in the NHS, I would like the outputs from the NHS Quality Board to be short and to the point. To focus on Quality outcomes from the perspectives of the Treasury/National Insurance contributors, patients and employees.

And while the NHS focuses on purpose, that its satisfied employees will be racing to the wards, peoples homes, theatres and meetings …. to continue doing what motivates them best - making progress in their work, improving quality and the simple satisfaction of getting better at what matters.

 

About Patrick Keady

Patrick helps NHS organisations make better decisions. A former NHS Director of Governance and Strategy, he received awards from the BMA and IOSH. Patrick is a Company Director, a Trustee at a Chartered professional body and Editorial Board member at a peer-reviewed Journal. For more information, click www.betteroutcomes.org

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Does the NHS need management consultants?

21/12/2009 by Patrick Keady.

 

Every week, I receive two or three phonecalls about assignments in NHS risk management, governance and safety. However, many of the proposed assignments would be a waste of NHS time and NHS money.

 

Earlier this year, a PCT asked me to lead on corporate governance, health & safety, risk management, information management, health records, complaints, claims, moving and handling and commissioning strategy.

 

I challenged the potential client to describe in a few short sentences, what they wanted me to achieve, and by when. They were unable to see or tell me what success might look like.

 

So, I offered them telephone coaching, free-of-charge. The PCT soon saw that my input would be very worthwhile in one discreet project, where my independent insight and skill-set was just right.

 

The project is mission-critical to the PCT. They were happy with my daily rates too ! And during the course of the phone conversations, the potential client identified in-house people that could lead on many of the other pieces of work.

 

NHS organisations need to clearly think about what they want to achieve, before contacting independent consultants.

 

 

About Patrick Keady

Patrick helps NHS organisations make better decisions. A former NHS Director of Governance and Strategy, he received awards from the BMA and IOSH. Patrick is a Company Director, a Trustee at a Chartered professional body and Editorial Board member at a peer-reviewed Journal. For more information, click www.betteroutcomes.org

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Mike O’Brien to “name and shame”

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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Innovation and Creativity

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.

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