Anyone here work for the NHS?
Discussion
Not quite correct. Things are very fluid I admit, but PCTs are re-forming to provide support to consortia and existing staff will remain NHS employees and terms and conditions TUPED. Not yet sure about new staff, but I expect they will be employed by the new social enterprise etc. Unless you know differently of course?
And how many PCT staff do you see going over to a Consortium? I can still see huge cuts, and many people not quite making it over.
Re TUPE, you may go over on NHS terms, but as soon as they can legally change them, they will. I'm pretty sure TUPE doesn't give you the protection that many believe it does.
I work for a PCT by the way, and 'fluid' has to be one of the best management terms for this situation I've ever heard. Are you in politics?
Re TUPE, you may go over on NHS terms, but as soon as they can legally change them, they will. I'm pretty sure TUPE doesn't give you the protection that many believe it does.
I work for a PCT by the way, and 'fluid' has to be one of the best management terms for this situation I've ever heard. Are you in politics?
One should never discuss politics or religion on a car forum!
I anticipate a huge chunk of 'neccesary' PCT and SHA personnel moving to support consortia; they have to to make it work. This will cause a natural reduction in headcount that had been allowed to expand with little control causing spiralling, unsustainable costs. This is a normal business life-cycle; start off small and with best intentions, getter bigger over time in an attempt to do more but end up becoming too large and expensive reducing agility and ability to change quickly to meet emerging requirements. You then either have to close or create 'catastrophe' to force change; this is what is happening with the 'NHS'. A stronger, more focussed patient centric organisation should rise from the ashes. It has to for all our sakes.
I anticipate a huge chunk of 'neccesary' PCT and SHA personnel moving to support consortia; they have to to make it work. This will cause a natural reduction in headcount that had been allowed to expand with little control causing spiralling, unsustainable costs. This is a normal business life-cycle; start off small and with best intentions, getter bigger over time in an attempt to do more but end up becoming too large and expensive reducing agility and ability to change quickly to meet emerging requirements. You then either have to close or create 'catastrophe' to force change; this is what is happening with the 'NHS'. A stronger, more focussed patient centric organisation should rise from the ashes. It has to for all our sakes.
rog007 said:
One should never discuss politics or religion on a car forum!
I anticipate a huge chunk of 'neccesary' PCT and SHA personnel moving to support consortia; they have to to make it work. This will cause a natural reduction in headcount that had been allowed to expand with little control causing spiralling, unsustainable costs. This is a normal business life-cycle; start off small and with best intentions, getter bigger over time in an attempt to do more but end up becoming too large and expensive reducing agility and ability to change quickly to meet emerging requirements. You then either have to close or create 'catastrophe' to force change; this is what is happening with the 'NHS'. A stronger, more focussed patient centric organisation should rise from the ashes. It has to for all our sakes.
Without a doubt it needs to change to become more effective, but do you really think the GP model is the way forward? Why not reduce the amount of PCTs, reduce their size, etc? I could understand if the GPs actually wanted this change; but they don't.I anticipate a huge chunk of 'neccesary' PCT and SHA personnel moving to support consortia; they have to to make it work. This will cause a natural reduction in headcount that had been allowed to expand with little control causing spiralling, unsustainable costs. This is a normal business life-cycle; start off small and with best intentions, getter bigger over time in an attempt to do more but end up becoming too large and expensive reducing agility and ability to change quickly to meet emerging requirements. You then either have to close or create 'catastrophe' to force change; this is what is happening with the 'NHS'. A stronger, more focussed patient centric organisation should rise from the ashes. It has to for all our sakes.
PCTs are not really the issue; too many large, expensive and poorly performing hospitals are the problem. SHAs and PCTs were unable to break the model for the better so GPs are now given a chance to improve things. By giving them the cash the intent is that they will buy what is best for the patient and not what was needed to sustain all of the hospitals we have. By buying only that what is needed without having to prop us poorly performing hospitals will be cheaper and will force the weak hospitals to close, leaving only the good ones, just like in any other industry. It should work, but will of course, like any major change programme, create pain for some. Hope is that only the best will survive rather than the current model which is paying to keep weak performers in the game.
rog007 said:
PCTs are not really the issue; too many large, expensive and poorly performing hospitals are the problem. SHAs and PCTs were unable to break the model for the better so GPs are now given a chance to improve things. By giving them the cash the intent is that they will buy what is best for the patient and not what was needed to sustain all of the hospitals we have. By buying only that what is needed without having to prop us poorly performing hospitals will be cheaper and will force the weak hospitals to close, leaving only the good ones, just like in any other industry. It should work, but will of course, like any major change programme, create pain for some. Hope is that only the best will survive rather than the current model which is paying to keep weak performers in the game.
I think overall that's a short-sighted view, but we don't know who is right.For one, GPs will potentially have less buying power. They're not established as buyers, and there will likely be more consortia than PCTs.
In addition, you suggest that forcing hospitals to close would be a good thing. How? There is a reason for hospitals. Of course there will be some negatives, as with anything, but destabilise and/or close hospitals, and you'll soon find the business model is unsustainable. Take one example of the work currently being cherry-picked by the ISTCs. They take the easy work (with very strict criteria), and leave the harder work to hospitals. Hospitals make money on the easy procedures, and lose money on the more complex ones, but often there isn't much in it (if at all) except the CC codes within the PbR tariffs. However, I'll gladly be proven wrong.
PCTs by the way are totally inefficient. This is talking from personal experience. Too many people that have worked their way up the NHS but really don't know what they are doing, added to the fact the system is never left alone to truly mature. It's like teaching a child how to do something, and then putting them back to being 1 month old again.
Pulse said:
PCTs by the way are totally inefficient. This is talking from personal experience. Too many people that have worked their way up the NHS but really don't know what they are doing, added to the fact the system is never left alone to truly mature. It's like teaching a child how to do something, and then putting them back to being 1 month old again.
I would agree with this. I worked for the NHS in the late 90s when the split between Purchaser/Provider was being put into place. All it resulted in was a huge amount of beaurocracy with invoices being sent left right and centre. We seem to have gone full circle in 15 years 
Countdown said:
Pulse said:
PCTs by the way are totally inefficient. This is talking from personal experience. Too many people that have worked their way up the NHS but really don't know what they are doing, added to the fact the system is never left alone to truly mature. It's like teaching a child how to do something, and then putting them back to being 1 month old again.
I would agree with this. I worked for the NHS in the late 90s when the split between Purchaser/Provider was being put into place. All it resulted in was a huge amount of beaurocracy with invoices being sent left right and centre. We seem to have gone full circle in 15 years The main benefit is that, in the quest for money saving, the top tier of management are given VER. A new structure is designed which has several extra posts at Board level. The previous 2nd tier management are then promoted and this process is repeated several times. It is great for morale, but sadly not so for efficiency.
Quote attributed to Petronius Arbiter, a Roman centurion;
"We trained hard, but it seemed that every time we were beginning
to form up into teams, we would be reorganized. I was to learn later
in life that we tend to meet any new situation by reorganizing;
and a wonderful method it can be for creating the illusion of progress
while producing confusion, inefficiency, and demoralization."
Quote attributed to Petronius Arbiter, a Roman centurion;
"We trained hard, but it seemed that every time we were beginning
to form up into teams, we would be reorganized. I was to learn later
in life that we tend to meet any new situation by reorganizing;
and a wonderful method it can be for creating the illusion of progress
while producing confusion, inefficiency, and demoralization."
Countdown said:
Quote attributed to Petronius Arbiter, a Roman centurion;
"We trained hard, but it seemed that every time we were beginning
to form up into teams, we would be reorganized. I was to learn later
in life that we tend to meet any new situation by reorganizing;
and a wonderful method it can be for creating the illusion of progress
while producing confusion, inefficiency, and demoralization."
I will be sending this to a few colleagues! "We trained hard, but it seemed that every time we were beginning
to form up into teams, we would be reorganized. I was to learn later
in life that we tend to meet any new situation by reorganizing;
and a wonderful method it can be for creating the illusion of progress
while producing confusion, inefficiency, and demoralization."
ETA: In work's time, of course.
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