Really important statement from the head of Any Old Doctor

–  Please subscribe to keep reading or I’ll report you to the GMC – 

It’s very late here in Ireland, due to the time difference, but I thought it was vital to explain why the vital work done by Any Old Doctor is quite literally vital. 

Quite simply, the government isn’t doing ANYTHING and my frontline colleagues are dying – dying to join a network of more than 7 million doctors, who all agree that things MUST change. What those things are and HOW they must change is something I rely on you to tell me. 

And you have been telling me. 

“STOP,” you say. “Stop sending us offers of branded facemasks, stop telling us you represent us all, stop setting up JustGiving pages without telling us what you plan to spend the money on.” 

I understand your frustration, I really do. I understand the danger you put yourselves in every single day, which is why I think it’s important to leak emails to trusted journalists at responsible newspapers like the Mirror, who really care about the NHS and provide the sort of in-depth, quality coverage that helps us to continue our vital work. 

Only by telling the truth that no one else dares to tell can we make patients frightened to go to hospital and relieve the burden on our 9 million doctor-members. Only by revealing what REALLY happens on the frontline, can we make chief executives angry enough to take action, and bring services to a halt while Comms launches a full investigation. 

We can’t rely on the media, national bodies or the dozens of other so-called organisations that claim to represent doctors. Only by working together in Any Old Doctor can we hope to bring your struggles to the attention of the government and the public, who deserve to know the TRUTH. 

I took the last decade out from being a practising doctor because it was the only way I could make a difference. Being in Ireland as a full-time lobbyist gives me a bit of distance that some of you may not have. It helps me to see what’s really GOING ON at the front line, which means I can tell you.

You may be shocked to learn that a plague is sweeping the land, patients are sick, hospitals are barely able to cope and the government is doing NOTHING. 

This is why it’s vital that you send money, so I can carry on doing what is RIGHT. Of course, I respect YOUR right to disagree with me. That’s why I am blocking a lot of you on social media and threatening to report you to the GMC. Trust me, it’s for your own good. 

Please RT this message, send money, buy my Any Old Doctor “Save the NHS” Christmas jumper (hurry, only 2000 left) and join more than 11 million doctor-like colleagues so we can continue the fight for the vital things we need to campaign for together. Whatever they are.   

By “Dr” Julian Patterson

Longstay: plausibility and deniability will mark my tenure as chair

In an open letter to the Blithering Argus, Sir Trevor Longstay celebrates his first 100 days in charge of the ICS, and muses on his legacy

It is 100 days since I took the helm at the Blithering ICS and, by Jove, we’ve achieved a lot in that time.

I take huge pride and not a little credit for the vaccination programme, which has been delivered on our behalf by US-owned GP consortium the Rummage Group. Thanks to Dr Rummage and his dedicated team of shareholders, nearly 2 million doses of vaccine have already been administered – a not insignificant income-generating achievement in a population of just 360,000.

We were also among the first areas to start a large-scale programme of vaccination for children. This has been a huge success thanks to our out-of-area advertising, our ground-breaking TikTok campaign featuring John Craven of Newsround fame, and our “no questions asked” approach to eligibility. If you look 12 and you can give a verbal assurance of parental consent, that’s good enough for us.

And, of course, we are particularly focused on the needs of the most vulnerable. I and the rest of the Blithering ICS board were honoured and privileged to be first in the queue for covid boosters, flu jabs and complimentary mince pies when the Rummage Jabs’R’Us hub opened for its winter season last Saturday.

While it’s tempting to dwell on the success of the vaccination programme, I feel compelled to write a sentence or two about the significant challenges also facing the health system, such as critical staff shortages, extended waiting times for elective care and A&E services close to collapse. As leaders, we owe it to the public not to let these operational problems go on for longer than a paragraph.

We continue to respond to unprecedented demands in extraordinary ways. For example, we have seen health inequalities eradicated overnight by transforming them into disparities. We achieved this by adopting a breakthrough therapy that can improve the appearance of a disfiguring social problem by altering its fundamental semantic structure. I don’t pretend to understand the science, but it’s a game-changer.

I would be remiss if I didn’t refer to the work done by GPs, the tireless dedication of our nurses and the vital contribution of 999 services. Nothing could give a clearer illustration that I am both in touch with the reality of life on the frontline and redoubling my efforts to say something lasting and meaningful about it.

Have I mentioned winter, social care, genetic medicine? They will all be more important than ever in articles like this in the weeks and months to come. This is just the start.

While we have one eye on operational challenges, the other hand will be firmly on the future. I will personally be focused on harnessing digital technology and using it to drive the transformational change our patients and management consultancy colleagues so desperately need.

I like to think that it’s this combination of leadership and rhetoric, so clearly evident in the last 500 words, that will set the tone for this next phase of my career, the phase I sometimes refer to as the glide path to retirement.

Those who know me well would say I am passionately committed to outcomes, but too modest to talk about them in detail. As ever, I leave others to judge my legacy. 

© 2021 Julian Patterson

THIS BLOG HAS MOVED

This site is no longer being updated, but all the content here and a new blog each week are available from the Beyond Blithering site. If you want a weekly email reminder when new blogs appear you can can sign up here. Don’t worry, we won’t use your address for any other purpose or share it with anyone else.

The NHS white paper: what it really means for patients

This week Joy Hunter, newly appointed lead for the Blithering ICS, answers more of your questions about forthcoming reforms to the NHS as set out in the government white paper ‘Integration and Innovation: working together to improve health and social care for all’

Why is the NHS being reformed?

Every so often we need to have an honest conversation with ourselves and ask some hard questions: What more could we do? Are we the best we could be? Are things fit for purpose? What does good like? Does it still look like that? How do we know?

The last time we asked these questions we made big structural changes that everyone agreed were the right thing to do at the time, but which some people – such as doctors, nurses, managers, patients, politicians and some members of the public – may now feel were “wrong” for them.

The white paper seeks to put that right in important ways, by making the NHS less bureaucratic, more accountable and more joined up.

Will this mean further reorganisation?

The answer in many ways is no, but in some key respects is yes.

Many of the things that were changed by the last reforms have evolved as part of our commitment to continuous improvement. Under the leadership of Sir Simon Stevens, the NHS took progressive steps to ignore the bits he didn’t like, such as the legal, regulatory and organisational aspects of the reforms, and to focus on the more important goal of writing plans.    

The new legislation will simply formalise the changes that we’ve been making behind the scenes. For example, people told us they didn’t understand what clinical commissioning groups do. Thanks to these new reforms, you won’t need to.

What difference will this make to me?

The NHS Blithering Integrated Care System has been working tirelessly to bring together all parts of the health and care system in a range of meetings, working alongside other partner organisations and communities, to improve the lives of local people.

For example, we’ve worked with the police and other agencies to reduce wheelie bin theft, which unfairly targets people in less deprived areas. Our Kinder Blithering campaign has recruited dozens of new Be Nice Ambassadors to train volunteers in small acts of kindness, such as spontaneous greeting. And we have started dozens of other initiatives to combat pet crime, improve community cohesion through singing, and encourage younger people to practise safer skateboarding, to name a few.

The fact that most people haven’t noticed these changes is a testament to the hard work of my team in making their introduction as seamless as possible.

How will the reforms enable real and lasting change?

Here at NHS Blithering we are right behind the government’s commitment to build back better. Over the coming months and years expect to see a number of equally powerful pledges from my team. My strategic lead for meaningful commitments and pledge co-development Martin Plackard and I have been working closely with a number of stakeholders, including a hand-picked member of the public, to actively listen to what you want. And we have actively heard what you had to say.

You told us you wanted us to “get on with it”, “leave us alone” and “go away”. In other words, you want us to

  • Build on the success of the Five Year Forward View, the NHS Long Term Plan and all the other plans and strategies that mean so much to local people and communities
  • Help you to live more independent lives knowing that we’re always there to hold your hand if you’d like us to
  • Go the extra mile in your shoes or someone else’s to learn what it feels like to go on a journey together.

Is Blithering ready for the challenge?

We will continue to reflect in the strongest possible documents the government’s determination to tackle obesity and the other causes of ill health, level up society, improve the quality of social care services, address the challenge of mental health, and ensure that we use the resources we have for the benefit of all. The key is collaboration.

Thanks to the new duty to collaborate, working together will no longer be a vague aspiration but a clearly delineated set of principles and processes that all partners in the ICS will be expected to learn and follow. It would be wrong to pre-empt the forthcoming collaboration guidance and assurance framework, but by continuing to work together in shadow form we are confident that no other health economy is ahead of Blithering in terms of readiness preparedness.

We won’t get there overnight, but by aiming to work together with purpose we will begin to map out what future nights might look like.

The 2021 Blithering Awards

The Blithering Awards were held online this year. For those unable to afford a virtual table at the live event, here is a transcript of the speech given by Blithering’s director of communications and recognition, Martin Plackard, who co-hosted the awards with hilarious local comedian and club performer Terry Crout. Please note that several – in fact most – of Mr Crout’s comments have been redacted after complaints about offensive content.

Martin Plackard: We were unable to hold the Blithering 2021 Health Awards at their usual venue for obvious reasons, but we hope to be back in the sumptuous surroundings of the ballroom at the Palace Hotel next year. Many of you will be aware that the Palace is undergoing major refurbishment works after a carelessly discarded cigar caused a fire on the evening of last year’s awards. The hotel’s management have since expressed gratitude to Sir Trevor Longstay for his generous contribution towards the cost of repairs and agreed to drop legal proceedings.

Every year the Blithering Awards celebrates the success of local health service leaders and staff, not forgetting the patients who make it all possible. Their continuing endorsement of local services remains as strong as ever. During 2020, we saw a marked increase in the use of services, particularly ambulances and hospital beds, clearly demonstrating that we’re doing something right here in Blithering. On behalf of everyone who works in and uses our fabulous service I just want to say a big thank you.

Whether you have a long-term condition, an unhealthy lifestyle or an accident with a ladder or a power tool during lockdown, each of you is doing your bit to support the local health and care system. We salute you. We couldn’t do it without you.

Anyway, on with the awards.  

Terry Crout: [Long, smutty passage with racist and sexist comments redacted] The award for Worforce Initiative of the Year goes to Linda Hu

Linda Hu: Thank you, Terry. I’m delighted to accept this award for our work on employee satisfaction. Our aim was to increase the tangible joy of staff through a series of initiatives including virtual mindfulness sessions to support people to deal with stress caused by spending long periods in Teams and Zoom meetings, and virtual bliss workshops to enable staff to build on their personal resilience and reach a state of tangible joy during each and every working day. The success of the programme was reflected in this year’s staff survey results which saw a striking 0.6% decrease in the numbers of people who said they planned to leave the organisation “immediately” or “as soon as possible”.

Terry Crout: [Enquiry about the whereabouts of Tangible Joy redacted] The award for Transformation Leader of the Year goes to Bev Heaver.

Bev Heaver: It’s an honour and a privilege to accept this award on behalf of the Distant Vistas team, formerly the Forward Views Unit. In a year when we had to say goodbye to the old normal, we weren’t content to focus on the new normal but asked you to imagine what the next new normal and the one after that would look like. Then we asked you to co-work with us to plan the journey together. Remarkable numbers of you signed up for our virtual unconference series “New Power with Me at the Centre” and “My Leadership Role in an Asynchronous World”. You told us you were happy to give up your time if it meant you could learn to become better at avoiding “traditional” work.

We used powerful self-discovery tools, such as Sven Gonadssen’s “Which Donut Are You?” to determine how we feel at the start of meetings and what we can learn from other people’s donuts. In fact, I’ve got a set of unslides here which…

Terry Crout: [Interruption including innuendo about Bev Heaver’s “massive deck” redacted] Thanks, Bev. Now we’re going to hear from my co-host Martin Plackard, winner of Communications Initiative of the Year for his work on the vaccination programme. [Comment about Plackard’s tie redacted.]

Martin Plackard: Thanks Terry, it was a gift as it happens.

Well, I couldn’t be more shocked and surprised to be getting this award [interruption from Crout about Plackard’s role as chair of the judging panel redacted], but I’m humbled and obviously very proud. As you know, one of the biggest challenges of the past year has been to overcome the reluctance of some groups to receive the Covid vaccine in the face of a lot of anxiety and misinformation, much of it spread by irresponsible and ignorant people on social media.

So we designed a campaign to build awareness around the importance of getting the jab and asked Dr David Rummage, as a trusted representative of the clinical community, to take time away from his demanding frontline duties as a part-time PCN strategic adviser to front it. The videos of Dr Rummage vaccinating community leaders and our hard-hitting campaign slogans Do the Decent Thing, Try Not to Worry and We’ll Call You When We’re Good and Ready have made a huge difference to public opinion.

I’m particularly proud that our jargon-free campaign materials have managed to get important messages across in plain English – such as our recent letter asking people to maximise cohort penetration and help us ensure a flexible, scaled up and diversified service.

Terry Crout: [Numerous remarks about Plackard and penetration redacted.] So finally, to the most important part of the proceedings, I’d like to invite Sir Trevor Longstay to receive the award for Chief Executive of the Year. [Remarks about cigars and the fire brigade redacted.]   

Sir Trevor Longstay: I’m shocked and gratified to receive this award yet again. You will doubtless be aware that previous recipients of these awards have been embroiled in scandals. My predecessor Sir Hugh Spokes is, I believe, at liberty again after his unfortunate brush with the NHS Counter Fraud Authority, while the recipients of other major awards have suffered varying degrees of disgrace for alleged bullying, nepotism and witch-hunts against suspected whistleblowers – all, I’m afraid, symptoms of the intolerant times we very senior managers are obliged to live through.

Be that as it may, I can assure you that in the unlikely event that any skeletons are found in my closet, Plackard is under strict instructions to explain them away as participants in one of Joy Hunter’s schemes for deprived communities [nervous laughter redacted].

But seriously, I’m immensely proud that my leadership has been recognised by all of the staff who responded to my email setting out the voting procedure and reminding them of the impending deadline for their annual reviews. I asked you to vote with your conscience, and once again you did. Thank you all.

Terry Crout: [Comments about Sir Trevor’s leadership style and sobriety redacted] Well, that’s it for another year ladies and gents. Now we’ve just got time to mention this year’s other winners after a few more words from my co-host Martin Plackard.

[Long monologue about compassion and the spirit of collaboration in the “year of Covid” by Plackard – redacted. Followed by brief slide show listing minor award-winners accompanied by Tina Turner’s Simply the Best at full volume.]

Freedom to Speak Up Organisation of the Year

Sir Trevor Longstay, whose Open Door policy helped Blithering to register the lowest number of safety related complaints of any organisation.

Health Service Local Government Partnership of the Year

NHS Blithering and Blithering District Council working together as the Building Back Better Blithering ICS – special “Stronger Together” award to council leader Alan Spume (received in his absence by Sir Trevor Longstay).

Twitter Clinical Leader of the Year

Dr David Rummage for his long-running #IHaveMyDoubts campaign questioning the safety of Covid vaccines and the efficacy of face masks on social media.

Primary Care Network of the Year

West Blithering Healthcare Collaborative for employing a community pharmacist to take care of hospital discharge letters and other paperwork, freeing up GPs to complete vital application forms for additional PCN funding.

Environmental Project of the Year

Sir Trevor Longstay for planting a tree at the Blithering Community Healthy Living Space (formerly the recreation ground at the back of the Asda superstore).

Integrated Service of the Year

ICS lead Joy Hunter for the Safer Car Parks scheme, which provided place-based drug counselling and sexual health services to young people from a specially converted ice-cream van.  

© 2021 Julian Patterson

The 2021 Blithering Awards

The Blithering Awards were held online this year. For those unable to afford a virtual table at the live event, here is a transcript of the speech given by Blithering’s director of communications and recognition, Martin Plackard, who co-hosted the awards with hilarious local comedian and club performer Terry Crout. Please note that several – in fact most – of Mr Crout’s comments have been redacted after complaints about offensive content.

Martin Plackard: We were unable to hold the Blithering 2021 Health Awards at their usual venue for obvious reasons, but we hope to be back in the sumptuous surroundings of the ballroom at the Palace Hotel next year. Many of you will be aware that the Palace is undergoing major refurbishment works after a carelessly discarded cigar caused a fire on the evening of last year’s awards. The hotel’s management have since expressed gratitude to Sir Trevor Longstay for his generous contribution towards the cost of repairs and agreed to drop legal proceedings.

Every year the Blithering Awards celebrates the success of local health service leaders and staff, not forgetting the patients who make it all possible. Their continuing endorsement of local services remains as strong as ever. During 2020, we saw a marked increase in the use of services, particularly ambulances and hospital beds, clearly demonstrating that we’re doing something right here in Blithering. On behalf of everyone who works in and uses our fabulous service I just want to say a big thank you.

Whether you have a long-term condition, an unhealthy lifestyle or an accident with a ladder or a power tool during lockdown, each of you is doing your bit to support the local health and care system. We salute you. We couldn’t do it without you.

Anyway, on with the awards.  

Terry Crout: [Long, smutty passage with racist and sexist comments redacted] The award for Worforce Initiative of the Year goes to Linda Hu

Linda Hu: Thank you, Terry. I’m delighted to accept this award for our work on employee satisfaction. Our aim was to increase the tangible joy of staff through a series of initiatives including virtual mindfulness sessions to support people to deal with stress caused by spending long periods in Teams and Zoom meetings, and virtual bliss workshops to enable staff to build on their personal resilience and reach a state of tangible joy during each and every working day. The success of the programme was reflected in this year’s staff survey results which saw a striking 0.6% decrease in the numbers of people who said they planned to leave the organisation “immediately” or “as soon as possible”.

Terry Crout: [Enquiry about the whereabouts of Tangible Joy redacted] The award for Transformation Leader of the Year goes to Bev Heaver.

Bev Heaver: It’s an honour and a privilege to accept this award on behalf of the Distant Vistas team, formerly the Forward Views Unit. In a year when we had to say goodbye to the old normal, we weren’t content to focus on the new normal but asked you to imagine what the next new normal and the one after that would look like. Then we asked you to co-work with us to plan the journey together. Remarkable numbers of you signed up for our virtual unconference series “New Power with Me at the Centre” and “My Leadership Role in an Asynchronous World”. You told us you were happy to give up your time if it meant you could learn to become better at avoiding “traditional” work.

We used powerful self-discovery tools, such as Sven Gonadssen’s “Which Donut Are You?” to determine how we feel at the start of meetings and what we can learn from other people’s donuts. In fact, I’ve got a set of unslides here which…

Terry Crout: [Interruption including innuendo about Bev Heaver’s “massive deck” redacted] Thanks, Bev. Now we’re going to hear from my co-host Martin Plackard, winner of Communications Initiative of the Year for his work on the vaccination programme. [Comment about Plackard’s tie redacted.]

Martin Plackard: Thanks Terry, it was a gift as it happens.

Well, I couldn’t be more shocked and surprised to be getting this award [interruption from Crout about Plackard’s role as chair of the judging panel redacted], but I’m humbled and obviously very proud. As you know, one of the biggest challenges of the past year has been to overcome the reluctance of some groups to receive the Covid vaccine in the face of a lot of anxiety and misinformation, much of it spread by irresponsible and ignorant people on social media.

So we designed a campaign to build awareness around the importance of getting the jab and asked Dr David Rummage, as a trusted representative of the clinical community, to take time away from his demanding frontline duties as a part-time PCN strategic adviser to front it. The videos of Dr Rummage vaccinating community leaders and our hard-hitting campaign slogans Do the Decent Thing, Try Not to Worry and We’ll Call You When We’re Good and Ready have made a huge difference to public opinion.

I’m particularly proud that our jargon-free campaign materials have managed to get important messages across in plain English – such as our recent letter asking people to maximise cohort penetration and help us ensure a flexible, scaled up and diversified service.

Terry Crout: [Numerous remarks about Plackard and penetration redacted.] So finally, to the most important part of the proceedings, I’d like to invite Sir Trevor Longstay to receive the award for Chief Executive of the Year. [Remarks about cigars and the fire brigade redacted.]   

Sir Trevor Longstay: I’m shocked and gratified to receive this award yet again. You will doubtless be aware that previous recipients of these awards have been embroiled in scandals. My predecessor Sir Hugh Spokes is, I believe, at liberty again after his unfortunate brush with the NHS Counter Fraud Authority, while the recipients of other major awards have suffered varying degrees of disgrace for alleged bullying, nepotism and witch-hunts against suspected whistleblowers – all, I’m afraid, symptoms of the intolerant times we very senior managers are obliged to live through.

Be that as it may, I can assure you that in the unlikely event that any skeletons are found in my closet, Plackard is under strict instructions to explain them away as participants in one of Joy Hunter’s schemes for deprived communities [nervous laughter redacted].

But seriously, I’m immensely proud that my leadership has been recognised by all of the staff who responded to my email setting out the voting procedure and reminding them of the impending deadline for their annual reviews. I asked you to vote with your conscience, and once again you did. Thank you all.

Terry Crout: [Comments about Sir Trevor’s leadership style and sobriety redacted] Well, that’s it for another year ladies and gents. Now we’ve just got time to mention this year’s other winners after a few more words from my co-host Martin Plackard.

[Long monologue about compassion and the spirit of collaboration in the “year of Covid” by Plackard – redacted. Followed by brief slide show listing minor award-winners accompanied by Tina Turner’s Simply the Best at full volume.]

Freedom to Speak Up Organisation of the Year

Sir Trevor Longstay, whose Open Door policy helped Blithering to register the lowest number of safety related complaints of any organisation.

Health Service Local Government Partnership of the Year

NHS Blithering and Blithering District Council working together as the Building Back Better Blithering ICS – special “Stronger Together” award to council leader Alan Spume (received in his absence by Sir Trevor Longstay).

Twitter Clinical Leader of the Year

Dr David Rummage for his long-running #IHaveMyDoubts campaign questioning the safety of Covid vaccines and the efficacy of face masks on social media.

Primary Care Network of the Year

West Blithering Healthcare Collaborative for employing a community pharmacist to take care of hospital discharge letters and other paperwork, freeing up GPs to complete vital application forms for additional PCN funding.

Environmental Project of the Year

Sir Trevor Longstay for planting a tree at the Blithering Community Healthy Living Space (formerly the recreation ground at the back of the Asda superstore).

Integrated Service of the Year

ICS lead Joy Hunter for the Safer Car Parks scheme, which provided place-based drug counselling and sexual health services to young people from a specially converted ice-cream van.  

© 2021 Julian Patterson

They’re all in it together, Twitter investigation reveals

Dido Harding will use part of the money she made from the Test and Trace programme to redecorate Boris Johnson’s Number 10 Downing Street flat, a Twitter investigation has revealed.

Baroness Harding, who is married to a man who once dined on children, has personally made £37 billion in her position as head of Test and Trace. She plans to spend at least £2 billion of this on Farrow and Ball paint and furniture from posh designers Florence Knoll and Michel Ducaroy.

The lavish spending spree, enough to buy every poor person in the world their own foodbank, will be a gift to Harding’s Tory chums Boris Johnson and Carrie Fisher, the multimillionaire Star Wars actress who faked her own death to move in with the Prime Minister. Fisher, a former alien from the future, is widely believed to be the real decision-maker at Number 10.

Dido’s personal income from Test and Trace was set out in small print in budget documents, the doctor who broke the story explained last night. “You have to ask why the Tory media, political commentators and economic experts missed it,” she tweeted. “Next they’ll be telling us it wasn’t there!”

Heartless health secretary Matt Hancock frolicking in a park in the midst of NHS budget cuts

A clap in the face

Harding, who regularly hunts pandas with health secretary Matt Hancock and once met Bill Gates, is a key part of the plan to destroy the NHS so it can be sold off to American mega-corporation Netflix.

Twitter sources revealed that she is a close ally of businessman Rishi Sunak, who is said to control the finances of a sinister £2 trillion consortium called “The UK” and is a neighbour and known associate of the prime minister. Investigators on social media said that Sunak’s crumbling empire was virtually bankrupt with debts in excess of its income and a long queue of angry creditors demanding their money back.

“That’s why the NHS budget is being slashed by £300 billion a year,” they concluded.

The savings will be used to pay for new public schools, new curtains for Mr Sunak’s swanky central London town house, and a high-speed rail link to Ms Fisher’s home planet Alderaan.

A spokesman for the British Medical Association described the NHS cuts as “a huge clap in the face for frontline NHS staff”.

Frolicking minister

While pandemic deaths soared and budget cuts raged, Matt Hancock, the man personally responsible for poverty, disease, economic disaster and outdated NHS IT systems was seen running in a London park, apparently oblivious to the global chaos he presides over.

As leading political commentator and Twitter paramedic Graham said: “Bloody typical. This proves he doesn’t care. They’re all in it together.”

(c) 2021 Julian Patterson

The NHS white paper: what it really means for patients

This week Joy Hunter, newly appointed lead for the Blithering ICS, answers more of your questions about forthcoming reforms to the NHS as set out in the government white paper ‘Integration and Innovation: working together to improve health and social care for all’

Why is the NHS being reformed?

Every so often we need to have an honest conversation with ourselves and ask some hard questions: What more could we do? Are we the best we could be? Are things fit for purpose? What does good like? Does it still look like that? How do we know?

The last time we asked these questions we made big structural changes that everyone agreed were the right thing to do at the time, but which some people – such as doctors, nurses, managers, patients, politicians and some members of the public – may now feel were “wrong” for them.

The white paper seeks to put that right in important ways, by making the NHS less bureaucratic, more accountable and more joined up.

Will this mean further reorganisation?

The answer in many ways is no, but in some key respects is yes.

Many of the things that were changed by the last reforms have evolved as part of our commitment to continuous improvement. Under the leadership of Sir Simon Stevens, the NHS took progressive steps to ignore the bits he didn’t like, such as the legal, regulatory and organisational aspects of the reforms, and to focus on the more important goal of writing plans.    

The new legislation will simply formalise the changes that we’ve been making behind the scenes. For example, people told us they didn’t understand what clinical commissioning groups do. Thanks to these new reforms, you won’t need to.

What difference will this make to me?

The NHS Blithering Integrated Care System has been working tirelessly to bring together all parts of the health and care system in a range of meetings, working alongside other partner organisations and communities, to improve the lives of local people.

For example, we’ve worked with the police and other agencies to reduce wheelie bin theft, which unfairly targets people in less deprived areas. Our Kinder Blithering campaign has recruited dozens of new Be Nice Ambassadors to train volunteers in small acts of kindness, such as spontaneous greeting. And we have started dozens of other initiatives to combat pet crime, improve community cohesion through singing, and encourage younger people to practise safer skateboarding, to name a few.

The fact that most people haven’t noticed these changes is a testament to the hard work of my team in making their introduction as seamless as possible.

How will the reforms enable real and lasting change?

Here at NHS Blithering we are right behind the government’s commitment to build back better. Over the coming months and years expect to see a number of equally powerful pledges from my team. My strategic lead for meaningful commitments and pledge co-development Martin Plackard and I have been working closely with a number of stakeholders, including a hand-picked member of the public, to actively listen to what you want. And we have actively heard what you had to say.

You told us you wanted us to “get on with it”, “leave us alone” and “go away”. In other words, you want us to

  • Build on the success of the Five Year Forward View, the NHS Long Term Plan and all the other plans and strategies that mean so much to local people and communities
  • Help you to live more independent lives knowing that we’re always there to hold your hand if you’d like us to
  • Go the extra mile in your shoes or someone else’s to learn what it feels like to go on a journey together.

Is Blithering ready for the challenge?

We will continue to reflect in the strongest possible documents the government’s determination to tackle obesity and the other causes of ill health, level up society, improve the quality of social care services, address the challenge of mental health, and ensure that we use the resources we have for the benefit of all. The key is collaboration.

Thanks to the new duty to collaborate, working together will no longer be a vague aspiration but a clearly delineated set of principles and processes that all partners in the ICS will be expected to learn and follow. It would be wrong to pre-empt the forthcoming collaboration guidance and assurance framework, but by continuing to work together in shadow form we are confident that no other health economy is ahead of Blithering in terms of readiness preparedness.

We won’t get there overnight, but by aiming to work together with purpose we will begin to map out what future nights might look like.

The seven deadly signals – a Martin Plackard masterclass

NHS Improvement and NHS Horizons have teamed up with NHS Blithering’s digital emoting lead Martin Plackard to produce a bite-size guide to virtue signalling. This is the art of expressing opinions that demonstrate one’s compassion, good character and moral rectitude. 

Virtue signalling is a skill that all aspiring managers should cultivate and that the best NHS leaders display in everything they do. It is the key to optimal personal positioning on issues that matter. 

There are many kinds of virtue signal and this guide lists some of the main types. You may think of others. Write them down as you go or, better still, put them into practice on Twitter.   

The aim of the guide is to help you to maximise your personal signal strength. It will support you to become a more accomplished virtue signaller or even a qualified virtue signalling practitioner (VSP), an emerging role that is rapidly gaining professional status in NHS bodies. (See links at the end of this document to relevant courses offered by the NHS Leadership Academy and current vacancies on NHS Jobs.)  

The virtue signal has several uses:

  • Showing that you care
  • Demonstrating that you are right-thinking
  • Cultivating a sense of belonging with like-minded people
  • Implying that you’re prepared to put your words into action  
  • Easing feelings of guilt in yourself
  • Inducing feelings of guilt in others
  • Attacking the positions of others without appearing to be aggressive
  • Enhancing your reputation
  • Establishing your leadership credentials 
  • Increasing your following on social media.

Virtue domains – the seven deadly signals

  1. Heroic – in which the signaller exhibits such characteristics as being superhumanly busy and capable, long-suffering and impressively resilient. Choose whether to go for sympathy, admiration or both. (Example: “Just worked 14-hour shift in ICU, now helping my kids with their algebra homework, cooking gourmet meal and solving problems for my colleagues. Swim in icy lake later if time.”)
  2. Humble – the kindness of others, your brilliant colleagues and the suffering of others are all opportunities for self-deprecation and expressions of unworthiness, two of the virtue signallers most potent weapons. Humility provides the perfect cover for letting everyone know how great you are. (Example: “Honoured to be a small part of the amazing team that changes people’s lives on a daily basis. Thanks to my terrific colleagues for the opportunity to lead and inspire them. I couldn’t do it without you #MyTeam #MakingADifference #NotAboutMe”). See also Plackard’s Guide to Humblebragging.   
  3. Peacemaking – stepping in to resolve disputes without taking sides yourself shows enviable leadership qualities and is infuriating for the protagonists. This technique is particularly suited to those with highly developed passive aggressive skills. Don’t be afraid to use them.
  4. Righteous anger – possibly the most popular form of the genre. Being seen to be angry about a social injustice or political failing is a very effective way to build a large and rabid following on Twitter. This is one of the few areas in which it’s fine to resort to personal abuse without risking charges of bullying. (Example: “Millions rely on food banks while fat-cat politicians telling Brexit lies and cutting NHS budgets gorge on the profits from corrupt PPE deals and deprived families on zero-hours contracts die 50 years younger from Covid than people in affluent areas with no access to social care, basic sanitation or iPhones. Blood on your hands, Mr Johnson. Hang your head in shame #ToryLies #NotFair #VeryCross #BuyMyBook).    
  5. Victimhood – if you can’t be bothered to make the case for injustice to others, write yourself into the story. Try not to sound too sorry for yourself. The braver you pretend to be, the more sympathy you’ll get. (Example: “Don’t know how much more I can take of lockdown. Need more Palestinian olive oil but know I shouldn’t go to Waitrose and put others at risk as I was only there for Tuscan polenta yesterday. Own-brand extra virgin will just have to do! Know there are people worse off than me #Selfless #MakingDo”)  
  6. Disappointed – disappointment can be much more effective than anger when aiming for the guilt trip, which is one of the main goals of the virtue signaller. Disappointment is also a good way to raise the issue you want to discuss in contexts where it is not up for discussion – a tactic that emphasises just how heavily it weighs on you. (Example: “So disappointed to see nothing about gerbils in last night’s documentary about the history of aviation.”
  7. The reflected glory seeker – no cause is too big or small to make your own. Knowing nothing about something is not a disqualification from having a strong opinion about it. Find one you like and plagiarise it. The world is your mirror. It’s up to you how good it makes you look.

FAQs 

What’s the right amount to care?

It’s never enough to care. You have to care “passionately” or “very passionately”.  You may also be “reduced to tears” from time to time, but not too often or people may think you’re unstable.

Do I have to practice what I preach?

Absolutely not. Never confuse virtue signalling for virtue. They sound similar but are completely different. 

Is there such a thing as too humble?

No. Practice your humility in a mirror, film it on your phone or get a friend to watch you being humble. Take a break when it becomes unbearable.

Is there a risk that other people will dislike me?

Yes, but the important thing is that they won’t be able to show it without exposing their own envy, aggression or small-mindedness. The skilled VSP may induce feelings of hostility in others but remember that if these feelings are expressed in public you’ve won. (Top tip: When you win, show empathy for the loser. Say: “It’s not the winning that counts”, “It’s not a competition” or “We’re all losers when one of us loses”.) The more people who hate you, the more “likes” you’ll get in social media.

Do I have what it takes?

Almost anyone can learn to virtue signal. Don’t worry if you feel uncomfortable at first. Study the technique of experienced virtue signallers and copy what they do.  Originality is not necessary or even desirable, so start by simply retweeting the posts of signalling leaders. Passive virtue signalling embodies some of the best attributes of the art, including humility and positive groupthink. Try tweeting: “I’m so impressed that [insert name] has had the courage to share [insert impressive achievement, heart-warming anecdote or sanctimonious statement]. I’d like to think we would all follow their example and stand up for [insert cause].”  

Are some people just not cut out for it?

Sadly, there is a small minority of individuals who will tell you that virtue signalling is “embarrassing” or “fake”. Try not to listen to negative voices. Better still, reach out to these people on social media to let them know you’re not judging but just feel sorry for them. 

Is it okay to invent anecdotes that show me in a good light?

If you need to ask this, you may need to consider whether virtue signalling is for you.

Towards the direction of travel: NHS Blithering response to the integrated care white paper

The government has published its long-awaited white paper setting out a number of refinements to the ground-breaking reforms introduced by Andrew Lansley in 2012. 

In the document entitled “Integrated and Innovative Something or Other: working together and so on and so forth” [working title], the government explains how “certain aspects” of the Lansley reforms – or what it goes on to identify as “all of them” – have, in the fullness of time, fallen short of their intended goal: the wholesale reform of the NHS to put competition and choice at the heart of things, empower patients, help taxpayers to sleep at night and inspire a new generation of ministerial special advisers to come up with catchy slogans and money-saving wheezes. 

This time around, government sources say, ministers will be expected to read the white paper before putting it before Parliament, a radical departure from the process that resulted in the Health and Social Care Act of 2012. A specially commissioned statue of Lord Lansley, paid for by abolishing most of the organisations created by his legislation, is to be unveiled at a ceremony attended by Prince Harry and Meghan Markle (both registered trademarks of Royal Appearances and Promotions Inc), and watched by a hand-picked group of health tourists. The statue will then be thrown into the Thames at Westminster following a short apology by former prime minister David Cameron. 

The senior team at NHS Blithering have issued the following statements. For interview opportunities, photos and copies of the Blithering Roadmap to Integrated Care (BRIC), please contact head of integrated system-level communications Martin Plackard.

Sir Trevor Longstay, executive chairman of the University of Blithering Hospital Trust, said: “I told that bloody fool Lansley his reforms wouldn’t work and thanks to people like me they haven’t. There’s a place for markets, but it’s not the health service, where we know best about how to spend taxpayers’ money. Bureaucratic procurement processes have just made it harder to appoint the right provider, which was almost always the one who employed me in an advisory capacity or was run by a chap I was at school with. 

“I welcome the very real challenges set out in the white paper, namely the creation of a new duty to collaborate, which I look forward to seeing defined and, at some point in future, perhaps even enforced. Meanwhile I’m pleased to see that some of the most pressing problems confronting us all, such as workforce planning, have been robustly acknowledged. This is a very significant development and a vital first step on the road to discussing them further.”

Joy Hunter, leader of the Blithering Integrated Care System, All of Us in Charge, said: “We now have an opportunity to work towards inclusive leadership styles at system, place and neighbourhood levels where we plan to embed meaningful change and put compassion at the heart of everything we do. With the power to hold our own budget at last, the ICS will be able to fund the local initiatives that make a real difference to people’s lives, including the vegan wellbeing academy and community aerobics ambassador schemes that are so close to my heart. 

“I look forward to working with place-based leaders to ensure that we’re managing population health at a scale and on a footprint that not only involves local people but is fully accountable to them. To that end, I’m proud, humble and excited to announce the creation of the Blithering Assembly, which will provide a forum for local leaders to share their experiences, plan their aspirations and socialise their strategies. The assembly will meet twice a year at the Blithering Leisure Centre, with light refreshments provided free of charge and a very reasonably priced buffet lunch courtesy of Rummage Catering Ltd.”

To download a copy of Joy Hunter’s slide deck “Putting Me in Charge: my priorities for the local health economy” or for a draft copy of the Blithering collaboration assurance framework and accompanying guidance: “Top Tips for Working Together: it’s not a choice, it’s a duty”, please go to the NHS Blithering website.   

© 2021 Julian Patterson