The operating framework for the NHS has now been published. Reading through the detail I was struck by the tasks laid at the door of PCT clusters. These transitional organisations know the date of their death. Despite that, there is an expectation they will continue to deliver, whilst acting as a catalyst for the reforms: […]
Category: Martin McShane
Martin McShane: Integrated reflections concluded
Here is my third and final blog on the USA trip: After Seattle’s integrated care organisations, we visited CalPERS. They fund $6.7bn worth of healthcare for 1.3 million people (roughly twice what we have per person in Lincolnshire). They see themselves as “active” purchasers: managing the market to reduce costs. About two thirds of their members […]
Martin McShane: Integrated reflections continued
Following our visit to Kaiser Permanente, we travelled north to Seattle and visited the Virginia Mason hospital and Group Health. Linked but distinct, the relationship between the two provided a contrast to Kaiser Permanente – though, as organisations seeking integrated care, there were common themes. We spent a day at Group Health and yet again […]
Martin McShane: Integrated reflections
Sir William Osler advocated the concept of a “quinquennial brain dusting“: which was my justification for taking a week out to visit some integrated care organisations on the West Coast of the USA, with a group from the NHS. I know we feel challenged in the UK, but the scale and nature of the challenge […]
Martin McShane: A day at the Mid Staffordshire foundation trust enquiry
I was privileged to be invited to the patient experience seminar being held as part of the Mid Staffordshire enquiry. I felt as though I was participating in one of the best development sessions I have experienced as a clinician and manager. The morning was filled with three excellent presentations. First up was Paul Hodgkin […]
Martin McShane: Little and large
While I was a partner in general practice, we started to receive information about how we were performing compared to other practices. Whatever the data, we always looked at how we benchmarked against one particular practice. It was about the same size as ours, not far away (so serving the same sort of population), and we […]
Martin McShane: Care and cure
We are coming up to the annual contracting round. This year it will be led by Clinical Commissioning Groups (CCGs). Last year GPs were involved in the difficult, detailed negotiations with the acute sector alongside PCT staff. As one of them said, emerging into daylight, somewhat pale and drained, “I never realised how hard it […]
Martin McShane: Quis custodiet ipsos custodes?
There are about 38,000 primary care contracts. They are worth over £12 billion. All of them are going to be the responsibility of the National Commissioning Board. By 2013 every PCT cluster will have had to scrutinise every contract, blow the dust off the ones that no one has looked at in years, and make sure they are […]
Martin McShane: Why?
A frequent refrain is “we mustn’t recreate PCTs.” Increasingly, when I hear or see it said I want to ask five why’s. Let me give you an example. “We don’t want to recreate PCTs.” Why? “Because they were bureaucratic.” Why? “Because they made people jump through loads of hoops to get anything done.” Why? “Because […]
Martin McShane: Integration
I was recently asked to give a brief talk on the role of a commissioner in integrated care. Chris Ham, Judith Smith, and Elizabeth Eastmure’s paper on this issue highlights the factors on which commissioners need to focus on to make a success of commissioning integrated care and some of the barriers currently in place. […]