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This site is no longer being updated, but all the content here and a new blog each week are available from the Beyond Blithering site.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

King slammed over handling of bubonic plague

March 1348 – The King has hit back at charges that he is failing to halt the progress of the plague, blaming “God’s will, blasphemers from the Orient and Genoese merchants” for the spread of the disease.

A spokesman for Edward III said: “No one has worked harder than the Privy Council to stop the pestilence”, pointing out that England had already endured a long war with Scotland and was just embarking on another, this time with France, both of which had diverted resources from public health.  

At a briefing for scribes held at Whitehall, the government said that reports of a great mortification that could wipe out a third of the population of Europe were “grossly exaggerated”. 

“This is no worse than a mild fever,” said the spokesman, who went on to denounce mischief makers, malcontents and witches for spreading panic among the population. “We’ve asked the Archbishops of York and Canterbury to hold special masses. The situation will be under control by Whitsuntide,” he added.  

July 1348 – The Privy Council says it is “working tirelessly” to loosen the plague’s grip on England, amid concerns that the decimation of the serf population is doing incalculable damage to landowners and could bring some of England’s greatest families to the brink of ruin.  

The King’s spokesman said that it had taken longer than expected to appease God, “who is clearly a bit angrier than we first thought”. He denied persistent rumours of a plot by Jews, pointing out that Edward I had expelled them all from England in 1290 “as a precaution”. 

At the daily Whitehall briefing the King’s physician described symptoms to look out for, including fever, headache, chills, bleeding from mouth, nose and rectum, hardening of lymph nodes and blackening of the extremities. Although these were generally not a cause for concern, he said, “they may cause death in a small majority of cases”. 

He added that while traditional treatments including bloodletting and purging may be effective, physicians were exploring a range of new remedies, including rubbing onions, herbs and chopped up snakes (where available) into infected areas. 

Every citizen had a duty to take preventive steps, the spokesman said, by retiring to their country estates, carrying a nosegay to ward off infection and cover the smell of putrefaction, and avoiding inns and bawdy houses in densely populated areas.

The rest of the population was urged to stay indoors, particularly when one member of the family became infected. “By staying at home in close proximity for 40 days, either the problem will go away or your entire family will,” said the physician.

The measure is to be reinforced by the slogan “Stay at home, protect the clergy, pray hard”.

The King’s spokesman said that quarantined families would be allowed out for a few minutes each day to bring out their dead and to join Clap for Clergy celebrations each Thursday evening.

He added that the government was confident that the plague would be in retreat by All Hallows with the onset of colder weather. 

February 1349 – The Privy Council has announced a range of new measures against the worsening plague situation and has declared a national emergency. Government sources, who did not wish to be named for fear of incurring the King’s displeasure, called the moves “too little, too late”.

Among the new measures, Parliament has finally agreed to quarantine merchant vessels entering English ports but stopped short of closing the country’s borders citing potential damage to the wool trade. The disruption has also temporarily halted the war with France, which some commentators now say could last a hundred years – a claim denounced as “ridiculous” by sources close to the King. 

The King’s physician gave a cautious welcome to the popular treatment of flagellation, which “showed promise”, but he warned against the growing number of roving so-called professional flagellants, many of whom are unqualified.

He also denounced the growing number of plague deniers and conspiracy theorists, many of whom argue that the plague has been fabricated by the government to subjugate the peasantry.

The King himself appeared to announce a new slogan “Shrouds, faith, graves” and promised that new plague pits would be opened on common land throughout the country. Responding to criticism that years of neglect of training and recruitment had created a shortage of grave diggers, the King renewed his pledge of a “robust workforce plan to ensure an adequate supply of frontline interment professionals in future”.

The daily briefing concluded with government reassurances that the plague had peaked. “We’ve got this pestilence on the run,” said a spokesman, confirming official estimates that no more than half the population was expected to die. 

“Everything could be back to normal as early as St Agatha’s day,” he said, but declined to be drawn on a particular century.  

(c) 2021 Julian Patterson

The towpath to success: Joy Hunter takes the lead

Thursday morning: the fortnightly meeting of the Blithering ICS strategic projects team. The usual faces flicker into life on the video call: Sir Trevor Longstay, executive chairman of the NHS Blithering University Hospitals Foundation Trust; Liz Wanhope, careworn accountable officer of the endlessly restructured Blithering CCG; Dr David Rummage, acting director of public health and proprietor of PPE and ventilator start-up Rummage Covid Solutions; Bev Heaver, chief transformation officer and founder of the Blithering Leadership Academy; Linda Hu, chief people officer and head of workforce planning; and Martin Plackard, director of systemwide strategic communications and place-based messaging. 

An unreserved apology

Sir Trevor makes apologies on behalf of Blithering Council leader Alan Spume and hospital chief executive Karen Pike. 

“Karen can’t be with us for obvious reasons,” he says, gravely. 

Plackard winces at the memory of photos of a clearly inebriated Pike surrounded by partygoers at a local nightspot. The Mail headline had haunted him for weeks: “Hospital boss flouts Covid rules on birthday night out”. 

Ms Pike had gone on to make an unreserved apology in which she blamed others, claimed to be a victim of bullying and harassment, and referred inaccurately to a “previously unblemished record of service to the NHS and the people of Blithering”. She would be on sick leave until the fuss died down.

It was all Plackard could do to keep a shirtless Councillor Spume out of the press. In one shot, Spume is clearly visible in the background, taking part in a yard-of-ale contest and juggling what appear to be scotch eggs. 

His narrow escape from disgrace is all the excuse the council leader needs to duck out of ICS meetings. He doesn’t even bother to send a deputy.

Thrown to the wolves

Plackard tunes back into the meeting just in time to hear Sir Trevor Longstay say: “And so it gives me great pleasure to introduce Joy Hunter.” 

A vaguely familiar face fills the screen. It has piercing eyes and an effortless smile. Plackard is reminded of Rummage’s favourite saying about animals that charm their prey before killing them. He imagines that many of them look like Joy Hunter.

“As you know,” continues Longstay, “Joy will be carrying on the great work done by Nigel Bland and leading the ICS to bigger and better things.”

Rummage’s attempt to stifle laughter is apparent even over the shaky internet connection. The ICS, currently known as the Blithering Them and Us Health and Care Partnership, has had six or seven leaders in the past three years. Most of them come to grief within a few months, usually after discovering that Sir Trevor, despite his non-executive protestations – “I like to think of myself as a hands-off leader” – is unwilling, if not pathologically unable, to loosen his grip on the reins of the local health economy. 

Nigel Bland had lasted nearly a year – a record for Blithering – but only because he attended the same minor public school as Sir Trevor and they sometimes played golf together.

The Pike affair broke just as a manufacturing fault was discovered in the Rummage Breathe-Easy 2020 ventilator, the purchase of several hundred of which Bland had approved. It had been with his customary “great regret and not a little sadness”, that Sir Trevor had thrown his old friend to the wolves. 

Front runner

Joy Hunter is speaking. “A little bit about me,” she says, beginning a ten-minute monologue. Joy describes herself as a system leader and park runner – “though I’m very slow”, she adds. For Joy, integration is a journey, not a destination. Compassion is the thing that gets her out of bed in the morning, the force that spurs her on, her mission in life. Not for Hunter the simple desire to get up and go to work to avoid being fired. 

She has always relied on a brilliant team, and though she can’t take the credit for their achievements, she makes it clear that she would if she absolutely had to. It’s what leaders do. 

Hunter’s modest account of her sporting interests sparks a memory in Plackard. A quick Google confirms his suspicions. Three years ago, during the Blithering Fun Run, one of the participants, a woman with piercing eyes, is leading the field when another runner trips and falls into the canal while attempting to overtake her on the towpath. 

Plackard recalls the incident because he is one of a group of stragglers who pulls the faller from the water, where she has become snagged on a partially submerged shopping trolley. Fortunately, Rummage is on hand to administer the kiss of life, his first overtly medical act in several years.

The half-drowned runner alleges foul play, but a stewards’ enquiry is inconclusive. The winner is exonerated. She is Joy Hunter, a former county middle distance champion. The local press pictures her clutching her winner’s medal. An accompanying quote expresses her gratitude, humility and surprise at the outcome.

Kinder bus lanes

Plackard drags his attention back to the call, where Joy is still “sharing insights” about herself. 

Early in her career she is seconded to the Greater Manchester devolution project, where she is responsible for Be Nice Day, a multimillion-pound celebration of intergenerational hugging. Later, when she moves to Blithering Council, Hunter is the driving force behind the Kinder Bus Lanes initiative. She goes on to lead the community trust where she inaugurates the Blithering Earth Summit, an annual event dedicated to finding local solutions to problems of climate change, health inequality and global poverty.  

Despite himself, Plackard is impressed. Hunter’s appetite for expensive, eye-catching projects appears to be insatiable. Her ascent of the career ladder is dizzying. 

As leader of the ICS, Hunter has even bigger plans. She acknowledges Sir Trevor Longstay’s achievement in making Blithering internationally recognised as one of the most challenged health economies in the world, but now she wants to make it the most fully integrated. When Hunter asks “What does integration mean to you? What would it mean to your children, your parents, your neighbours, your pets?” Bev Heaver is visibly moved.

Hu, what and when

Hunter spreads her hands, palms upward, in a messianic gesture that declares her to be open for business and ready to take questions. 

Linda Hu would like to know how the ICS will tackle the local workforce crisis. Joy Hunter reassures her that there will be a credible plan, building upon and indeed flowing from the national plan, a definitive version of which, she assures Hu, is “if not imminent then in the final stages of imminence”. 

Liz Wanhope, head of the soon to be redundant CCG, asks what is to become of the hundreds of staff who work in commissioning when ICSs finally become legal entities. “We’ll still need a CCG-like function operating at a strategic level. Don’t think of it as a reorganisation, think of it as an opportunity,” Hunter replies, skilfully avoiding anything that might be construed as an answer.   

Rummage asks about rumours that the ICS will take over primary care. “Absolutely not,” replies Hunter. “No one wants to run NHS dentistry, not even dentists, but we do see general practice operating at scale with PCNs as strategic care hubs, perhaps with the ICS taking over the day-to-day management of contracts to leave GPs free to develop portfolio careers, take up new hobbies and retrain as population health managers,” she says. 

“So, some bits will be integrated, others not so much,” says Rummage. “What about community pharmacy, district nursing, mental health, social care?” 

“Details, Rummage, details,” says Sir Trevor, sending a clear signal that there is a time and a place for searching questions, but it is not on a strategy call and never this close to lunchtime.  

Towards empowerment

Hunter, unaware that Sir Trevor’s patience is in shorter supply than Rummage SnugFit face masks, isn’t finished yet. 

“No doubt you are all wondering what immediate changes we plan to make to the ICS,” she says, posing the question on no one’s lips. 

“After exploring new branding ideas with focus groups and an experienced patient leader, we co-produced an identity that properly reflects the ambition of all the key stakeholders in the system.”

Hunter pauses to give her words time to sink in.

“The people of Blithering told us they wanted to be consulted, involved and empowered,” she continues, before revealing a colourful logo bearing the legend “All of Us in Charge”.

Sir Trevor nods approvingly as Hunter explains how the childlike drawing represents the inclusive nature of the new ICS board and its commitment to listening. Bev Heaver’s eyes are shining; she appears to be on the verge of ecstasy.  

Longstay concludes the meeting with a personal pledge of support for the new head of the ICS. “I’m sure I speak for us all when I say we will be right behind you, every step of the way,” he says.  

Plackard smiles to himself. Sir Trevor might want to hang back a few paces if they’re going anywhere near the canal, he thinks.

(c) 2021 Julian Patterson