I am not sure whether this time last year anyone could have predicted what massive changes would have been wrought across commissioning in England – and not a single piece of legislation has been passed. We are moving from a dispersed form of governance, PCTs each with their own boards, with executive and non-executive directors, to a […]
Category: Martin McShane
Martin McShane: Mirror on the wall
Someone I know, who is not a health care professional but has dedicated most of their working life to supporting improvements in health and health care, recently shared with me their observations about general practice. Rather than focussing on poor performance they studied the good to find out what it was that made them different. […]
Martin McShane: One small step
Back in May 2010 the professional executive committee and NHS Lincolnshire board agreed to delegate the management of the minor surgery local enhanced service to the practice based commissioning (PBC) Groups. A lot of discussion and analysis had taken place prior to this decision. Practices had said that the historical budget was insufficient to meet […]
Martin McShane: Nietzsche and commissioning
As part of the development of our Clinical Commissioning Groups (CCGs) the seven GP CCG chairs now have a place at the NHS Lincolnshire Board meetings. The agenda was not particularly unusual. We were required to approve the Equality and Diversity Strategy. We had a couple of papers dealing with our legacy document and the […]
Martin McShane: Thought for the day
I enjoy Rabbi Lionel Blue’s thought for the day and one I caught recently seemed pertinent to the turmoil which the NHS is going through. He started his talk with, “Monday it’s kidneys, Tuesday heart, Thursday joints, and Friday blood and brains.” It wasn’t a recipe, he said, but the hospital appointments in his diary […]
Martin McShane: A tale of two citizens?
Four years ago I participated in scenario planning. The document that emerged is as relevant today as it was then – perhaps because it was looking “Over the Horizon,” taking a ten year view and considering plausible alternative futures for health care. We envisaged four scenarios: Fools Gold, Swimming Upstream, Red Arrows, and A Tale […]
Martin McShane: Appeasement
The changes the government is proposing in response to the NHS Future Forum might satisfy most of the people for some of the time but their implementation immediately struck me as posing a number of problems. Where the changes stick to principles, for instance around the NHS constitution, the role of the secretary of state, […]
Martin McShane: Director’s cut
I picked up a book recently co-authored by Colin Price, the essence of which can be found in this slide deck. One of the key points made is that if you are trying to transform the way you do things it is really important to have a clear narrative, a story which people can connect […]
Martin McShane: Toffee popcorn
I went to see a film with my son. He bought a packet of toffee popcorn. I love toffee popcorn but it has little nutritional value and in excess would be bad for you, but as it was available I couldn’t resist it! For some reason the experience came to mind when I read a […]
Martin McShane: No rules
I read the King’s fund paper on management in the NHS. It should be read widely. Some politicians and professionals understand that successful organisations have good management. Some even understand that bureaucracy is a product of a set of rules. A bureaucrat can’t be a bureaucrat without those rules. The rules I have to work […]