Highlights of an NHS Week - 26th September 2014

Before I start... I've talked a lot about Individuals at the Centre, you can now see the five projects here..

Being heard http://youtu.be/Noq5R1Fn2KQ

Being the difference http://youtu.be/1I7ibVQnwzQ

Equality and diversity http://youtu.be/zSgrCfSNxuw

What about me http://youtu.be/-XjrjOlTM1w

Wheelchair users http://youtu.be/N_bXeMWjIl8

This weekend I'm off to watch the Ryder Cup (an opening remark that will have some people navigating away from this blog as fast as they can!).  I've been to the last three home Ryder Cups and they have all been fantastic; this one completes a tour of England, Ireland, Wales and Scotland.  The Ryder Cup is the only professional golf event I've every been to and it has fascinated me from being very young.

I have only seen Europe win - the first time was the most glorious week at the Belfry, bathed in sunshine watching Paul McGinley sinking the winning put on the 18th. Then things got progressively wetter at the K Club in Ireland before an onslaught of torrential rain at Celtic Manor in Wales meant a delay of the final round (this meant I was back in work on the Monday when the tense final day played out, which definitely wasn't a highlight).

So the perfect weekend this weekend will involve hearing only happy stories from the family at home, finding that the Travelodge in Edinburgh is ok, a hot day on Sunday, a good view and a win, but a close win with the winning putt happening right in front of us.  It is just as likely to be raining and that we are watching a meaningless shot as the crucial action is happening elsewhere, but I am going to back the thought that I'll be able to write next week that I was there when Garcia sunk that amazing bunker shot to win the cup again.

Next week's highlights might happen on holes 1,7,11, 14 and 18, but for those not excited by golf, I'll promise only one paragraph next week....

Highlights of the Week - 26th September 2014 (@jeclo)

Highlights of the Week 1: Discussing Right Care - is this the method to underpin our work major programmes of work?
Matthew Cripps from NHS Right Care came to run a workshop with us this week.  It is important that we have a sound methodology to underpin the major programmes of work that we are involved in and Right Care may be the thing we are looking for.  We looked at the commissioning for value pack last year - essentially Right Care points to the top areas where we could improve cost, quality or both by comparing us to other parts of the country and particularly the performance achieved by the top 20% and these aren't necessarily the same as the areas we are currently working on.

The analysis shows to gains we could make if we performed at the top quintile in diseases of circulation, cancer and orthopaedics.  It is vital that we verify that the data is pointing in the right direction and not just an anomaly compensated for somewhere else, but we know we are spending many millions more than our budget so there are definitely several areas where we need to improve.

The advice was not to look to take on too many areas at any one time, which is good advice and one we need to contemplate on as we embark on 9 simultaneous workstreams.  We do need to find the real issues that have significant enough potential for saving, but the level of overspend in our systems does mean that we can't afford to limit the number of issues too much.

Highlights of the Week 2: Locality Board in Tavistock - there are some very different places within our Locality, but many similar issues
I don't think many people, even those who don't know the south west very well, would be surprised to find out that Tavistock in West Devon is significantly different from Plymouth.  The leafy market town in Dartmoor is truly beautiful and the view from the moor on the way home down across Plymouth harbour is fabulous.  Not that Tavistock is more than 10 miles from the outskirts of the city and, as I have said several times before, Plymouth has some fantastic parts, most notably the view from the Hoe, but Tavistock is very different.

The Locality Board this week included the usual set of public questions and, despite there being different people there, the issues are the same.  People are concerned at the moment about what the future holds for the NHS and the sense that they need to be watchful to ward off any potential local service reductions.  They are grateful too and we get stories of what the NHS has done for them.

The things we discussed in Tavistock - future of community services, the safety of different elements of service and our financial position - were the same and ultimately we are working to ensure that the NHS in Tavistock or in Plymouth is delivering what people need.

Highlights of the Week 3: Communities of Practice meeting-an invited guest at someone else's gathering: hugely interesting
A day in London to finish the week as I had been invited to a Communities of Practice meeting with a group of integration pioneer organisations who have started getting together two or three times a year to talk through the challenges they are facing and to share the real successes they have had.

So I got to hear from Greenwich about their integrated teams, Eastern Cheshire about their Better Together programme and North West London about their work on primary care co-commissioning, as well as brief updates from a number of other areas.  They are doing some fantastic things and I have come away with some great new ideas of what we might be able to add to our thinking locally.

But I had a lot to say too (I guess many will not be surprised to hear); once you get past our financial challenges, the progress we are making on community services, on integration of both commissioning and provision in Plymouth and on our Local NHS Futures programme is good to share and people are very interested.  It is easy to describe where we are: everyone in the NHS knows Torbay, we are the bit of Devon and Plymouth that isn't that!

Highlights of the Week 4: @markmarriottydh has brought the capacity and skill we need to drive forward our programmes of change, but not singlehanded
I got a chance to spend a couple of days this week with Mark Marriott our new Programme Director for Local NHS Futures.  He is exactly what the programme needs and we are already starting to see the benefit of his first couple of weeks with us.  He brings great experience in running complex programmes and a focus on delivery that has been well honed within the navy.

We discussed the immense challenge that we have set ourselves with nine programmes of work to make significant progress with over the next couple of months.  Ultimately, everything needs to be able to feed in to next year's contract intentions - a different way of doing business between commissioners and providers in our system.

What is clear, though, with a programme of the size and scale that we are embarking on, is that Mark can't do this alone and we collectively need to make sure that we are putting enough resource in to the supporting programme office and to each project to ensure that we get the benefit of Mark's leadership.  It isn't easy with the number of competing challenges we have, but it is critical.

Highlights of the Week 5: Huge opportunities for Primary Care as we look towards next year's commissioning intentions
I get to do the introduction and context setting type of presentation at different events in the CCG and this week at our opening planning session for next year's planning round.  As I'm setting out how our Local NHS Futures programme working collaboratively with all our providers will guide how we work, it is important to try and give some examples of how things might be different next year.

So I start to describe, or speculate about, what outcomes based commissioning or capitation based funding systems might mean to how we commission or contract.  The examples include how we might do things differently around orthopaedics with secondary care providers, but the most exciting to me seem to be around how it might stimulate primary care to become more proactive in shaping the future care system.

We have a significant deficit, we don't have any money to invest without guarantees about value and return on the investment.  But we can invite primary care to think about the areas where we could share risk and as a result increase services provided around general practice.  I can describe real potential around different ways of looking at pharmacists or dermatology or diabetes - in fact the list is really long.  Let's hope we have some practices ready to take up the challenge!

You can read other blogs related to the work of the Western Locality of NEW Devon CCG

About our workplan: Western Locality Workplan

About our Locality business: Western Locality Business

Jerry Clough is Chief Operating Officer for Northern, Eastern and Western Devon Clinical Commissioning Group.  He is also Locality Managing Director for the Western Locality of the CCG covering Plymouth and the surrounding areas of South Hams and West Devon.

Previously Jerry has been a Chief Executive and Finance Director in the NHS before spending several years running his own business driving programmes of change and delivering executive coaching and team and Board development.

Highlights of an NHS Week - 19th Sepember 2014

This week has been dominated by the vote on Scottish independence.  I was in Edinburgh last weekend where a relaxing weekend break with beautiful views of castles and history were accompanied by the sounds of marching and campaigning.  Whichever way you look at the issue, it has been really encouraging to see so many people turning out in an election and the involvement in politics of 16 and 17 years olds.

There have been many issues throughout the campaign, including discussion around the changes that might be seen in the NHS in Scotland if the vote had been for independence.  There are already differences in healthcare between England, Wales and particularly Scotland, reflecting local variation in response to local needs or preferences - prescription charges, for example.

The NHS holds on to the notion of being a universal, equal offering across England, so that wherever you are in the country, you can expect an ambulance to reach you in the same amount of time, for your local A&E to treat you within the same 4 hour window and for your access to potentially life saving stroke treatment to be equally expedited.  But, to what extent is that the reality of how things are now or, indeed, that this is truly the expectation of the public.

Many people will know, or be able to deduce, that the ambulance response time figures quoted for different services are averages that are typically made up of very fast responses in city centres, offset by much slower response times to outlying rural areas.  The volume of the city centre calls will offset the occasional longer trip to the coast or moor in Devon.  It would be economically impractical to station ambulances at every point to guarantee the same response everywhere - a remote community may only phone for one ambualance a year - and to some extent people do understand that.

We are in the middle of the community hospital debate in Devon as a result of publishing our community services strategy.  In looking to develop more services that help people to stay in their own home and deal with the projected increase in the over 75 population - set to rise by 22,000 in our CCG over the next 7 years - we think we need to consolidate beds from smaller cottage hospitals to larger community units.  We have a lot of community hospitals in Devon - you would expect that with the rural nature of the county and the type of population who are able to support their local units.  It is not an easy discussion, communities rightly care passionately about local facilities and it is not a "one size fits all" debate - we aren't basing the discussion on what happens in London or Dorset or anywhere else, but it is about what this population needs and expects from its local NHS.

Highlights of an NHS Week - 19th Spetember 2014 (@jeclo)

Highlights of the Week 1: Senior Leadership Team welcomes a new member; a calm, reflective, thinking environment space
The entry of a new member to the Leadership Team to ensure we continue to have good representation from the Partnerships Commissioning Team - the part of the CCG that oversees joint commissioning - gave us the opportunity to revisit the 10 components of Nancy Kline's Thinking Environment.  We have used her approach consistently as a Leadership Team over the last 18 months, but it is always useful to remind ourselves of the principles from time to time - the components are listed on the inside cover of our agenda pack.

It has been a busy week; there is a lot on, but I've made that comment in previous blogs so there is nothing new in that and it will be a permanent state.  As I keep saying, there is nothing clever about being busy. But you can approach things in different ways and this process for carrying out meetings really does create a calm 3 hour space, rather than a pressured, hurried and dispiriting morning.

There was good feedback from our new member on its impact and the feel of the room. More of that then!

Highlights of the Week 2: Governing Body development session- to what extent are we like any other Board; how does our membership change that?
Take an approach that is designed for NHS Trust and Foundation Trust Boards and apply it to our Governing Body and it won't take long before someone raises the obvious truth that we are different, we are a GP Practice membership organisation and that changes the way we need to work.

I agree we are different, but I don't think that fundamentally changes our role as a Governing Board (Body). It is still about assurance, formulating strategy and engaging stakeholders and at a Board level, that feels pretty consistent.  There will, of course, be some change to who the stakeholders are or how we engage with them and our assurance processes are different as we hold responsibility for budgets where we have no direct control over the people that are spending the money.

It was a good session exploring that area though and every time the Governing Body does manage to find time to think about purpose and role I think we move forward.  It is so easy to get sucked in to the business of the operational role that these moments of reflection are crucial.

Highlights of the Week 3: @NEWDevonCCG AGM gives us time to reflect. you can watch http://youtu.be/qSSRETEHbmw
It was our AGM this week and we attracted an audience of around 100 to listen to the review of our last year (though I suspect numbers were swelled by the launch of the community services strategy that followed in the second half of the meeting, as described below).

We went through the usual formal process with an overview of performance for the year and the presentation of the annual accounts - we tried to explain these figures, rather than just present the accounts in the required format which can be hard to interpret.

We have used new media over the last 18 months and our youtube channel (you should subscribe!) shows the various different clips we have created to try and make our messages more accessible to reach a wider audience.

This video summarises our annual report in a great film - all produced in house.  I think it sums it up really well!

Highlights of the Week 4: Launch of our engagement around Community Services @NEWDevonCCG #NEWDevonTCS 12 weeks for us to listen
The second half of the AGM saw us launch the next phase of engagement around community services.  This was a strategy revised following a round of public discussion, together with 3 locality strategies that explain the detail of how this strategy will impact on our different communities.

Our focus is clear with an emphasis on keeping people at home and creating integrated care organisations that can respond to needs more holistically.  The detail does include discussions about the right number of community hospital beds and the right size for different units.  Small units are more expensive and harder to staff and we are consulting on changing the use of some of the community hospitals in Eastern and Northern Devon with a greater ambulatory focus and the closure of inpatient beds that will be reprovided in neighbouring units.

This is of course where there will be a lot of focus.  The community hospital debate, both locally and nationally, is extremely vociferous.  We have been through a lot of clinical debate and discussion to get to this point and we think we have the right balance.  12 weeks now to listen to the public and hear their views.

Highlights of the Week 5: One Plymouth - it's about how we collectively lead on fairness and the Plymouth offer and ask

A smaller meeting of One Plymouth this week, with various leave and absences, but important discussions about fairness and about Plymouth's position.

In response to the Fairness Commission report, led by Dame Suzi Leather, what will be the One Plymouth collective response?  What would we as leaders within the city want to say jointly?  Do we share common positions?  We think we do and we do want to construct a reply, so we talked about what that would be and, more importantly, what that would mean we would each individually have to do a result - there is no point in signing a piece of paper if it doesn't change our behaviours.

Plymouth doesn't get the rub of the green in many areas (though you need to be careful as most areas would be able to point to the areas they lose out in).  Whether it is the speed and reliability of the rail network or the level of funding for public health in the city, it doesn't feel as though things are fair.  But it is no use just asking for more money and the discussion was around how a case is made for what more Plymouth could offer with a bit more national support.  And if we all made that case consistently, what different impact might that bring?

Things are slightly different in Plymouth, compared to the surrounding areas of Devon, you would expect that, but we do need to make sure it is fair.

You can read other blogs related to the work of the Western Locality of NEW Devon CCG

About our workplan: Western Locality Workplan

About our Locality business: Western Locality Business

Jerry Clough is Chief Operating Officer for Northern, Eastern and Western Devon Clinical Commissioning Group.  He is also Locality Managing Director for the Western Locality of the CCG covering Plymouth and the surrounding areas of South Hams and West Devon.

Previously Jerry has been a Chief Executive and Finance Director in the NHS before spending several years running his own business driving programmes of change and delivering executive coaching and team and Board development.

Highlights of the Week – 12th September 2014

It is obviously a great week.  I mean, there are just some things that happen in some weeks that will, almost despite all other news, mean it is a good week.  And this week it is of course the launch of new Apple products and most intriguingly of all the iWatch.

I’m a bit of a sucker for Apple these days.  I was a firm PC man up until I left the NHS in 2007 and decided that one of the things that was going to mark out my new found freedom was running my company based on slightly less establishment IT.  I had an iPod mini as a leaving present too, so I set off in to the new world.

And then the iPhone arrived.  By that stage I had loved my iMac and Macbook; they were just great – so easy to use and worked each and every time you needed them to without fail.  But the iPhone changed everything, not just for me, but for the way we use technology and what we can do.

Whether I need all that functionality on a watch, I’m not so sure (but I do remember a conversation in which I confidently predicted that people who were moving towards buying 50 and 60 inch televisions simply wouldn’t watch films and TV on a four inch screen).  That isn’t the real excitement.  The news that Apple are working with key partners in the States to attack the healthcare market is.

What would happen to healthcare if the world’s largest company decided to use its wearable technology to change the landscape in the same way that they did with the iPhone.  I have no idea what they would do, but I can dream about something monitoring heartbeat or ECGs automatically on my wrist and predicting risk in a way that I can only dream about or automatically booking me an appointment when I’m free in my diary when the watch notices a particular reading.

I don’t know what will happen, but I do know something will and somehow it will just work intuitively for me. Exciting times.

Highlights of the Week – 12^th September 2014 (@jeclo)

Highlights of the Week 1: Organisational Resilience and Capacity Plan Face-to-Face Challenge- surely not a highlight!

The Organisational Resilience and Capacity  Plan (winter plan plus how we will hit elective targets for those not up to speed with latest terminology) for our locality (the area in the catchment of Derriford Hospital) has been designated as high risk.

We got this rating because of the level of challenge we have to deliver referral to treatment targets and it is a fair assessment, given our start point.  We also have had a few months of missing the A&E target too, following a year of really strong performance – Plymouth Hospitals had been one of the best performers on the A&E 4 hour wait last winter. So, to be blunt, you can expect the face-to-face challenge meeting to be challenging on both fronts.

The highlight was the feeling that as a community we are aware of the scale of the challenge, we know our numbers and trajectories really well and we are working collectively to resolve the issues we face.  There is not perfect harmony – compared to a winter allocation last year of £5.5 million, this year we are getting £2.3 million (and release of this is subject to our delivery), so we can’t meet everyone’s expectations and that does cause tension.  But on the day, we spoke consistently and showed the reward of the joint work we have done in planning to date.

Highlights of the Week 2: Local NHS Futures Programme moves forward and our Programme Director has (almost) started

A group of Chief Executives who will be leading projects within our “Local NHS Futures Programme –Transforming Care in Devon and Plymouth” met this week to finalise the details of the projects and arrangements in advance of the first Programme Board in a couple of week’s time.

We made real progress and we are now very much moving in to the delivery phase.  Something new is going to happen in the Devon and Plymouth health and care system with a systematic approach to large-scale transformational change.  It has happened in many other areas, but it hasn’t happened here on this scale.

We shouldn’t celebrate until there are tangible results from the programme, but it does feel like a major step forward.  We had discussions about the right way to cut the matrix – urgent care and planned care or frailty – but in the end we got passed the planning phase and it feels like there is real appetite for moving to delivery.

Mark Marriott has also joined us as Programme Director (he starts on Monday) and he will bring a real co-ordinating force that helps us to stay out of enjoyable, but purposeless and circular discussions, by staying sharp to project purpose.  It is a big challenge – lots of organisations with their own positions, but optimism is rising.

Highlights of the Week 3: Sunshine and a chance to think about creating possibilities with @annjamesnhs

There just isn’t enough time to think; rushing from one meeting to the next, stuck in air conditioned (or sweaty) boxes all day, staying out of the sunlight. 

This week Ann James and I managed to find an hour or so away from the office to reflect on how things are for each of us personally, our organisations and the NHS more widely.  The relationship between our two organisations – the CCG and Plymouth Hospitals – is a challenge; it is bound to be we are both in deficit so we never have any room to negotiate or compromise.

This week though, we did get to think of what could be different, what options their might be for different ways of working and how we could work differently to get different outcomes.  We are both interested in how the behaviours of our organisations impact on others and this was a good chance to reflect on that too.

No big agreements, no new announcements, but a sense of a few more seeds scattered on fertile ground and we may both get to harvest the result.

Highlights of the Week 4: CCG Executive meeting finishes on time- do we want to explore the relationship between numbers and speed?

I’m an advocate of small meetings; less people, stay focussed, make progress.  But of course, as an introvert that is bound to be my preference and it doesn’t mean that that is the most effective way.  As you place clinical leadership front and central to the way we run NHS organisations, there is a acceptance that there will be more people in the room, whether in CCGs or in NHS providers.

And that does mean that we are able to make more rounded decisions that take account more directly of the clinical dimensions, are better informed and hopefully place patient safety and quality to the fore.

But they are bigger and if you are not very careful, they are longer. Time can drag.

So we finished on time this week at the CCG Executive which has had a habit of running very late with a gallop over the second half of the agenda in half the time given to the first.  We all had a say, we got the information we needed and got to go home.

Now was that effective?

Highlights of the Week 5: Collaborative Services Board Development-We like what we have in house-how to make it even better

NEW Devon CCG is one of only a few CCGs that has the vast majority of its services provided by in-house staff rather than through a contract with a Commissioning Services Unit.  It works really well for us and was one of the key reasons for creating an organisation of our scale.

It isn’t the national flavour and there is an underlying concern that we will get sucked it to some arrangements that we don’t think will work as well. The development session allowed us some time out to really think about our approach and how we want it to develop.

We do buy some services in: procurement advice is one example where not only do we want specialist advice, but we also want people who have experience in other areas.

The most exciting development is our joint ownership with Plymouth City Council of a new company – Delt – that will provide IT services to both our organisations and the GP community across Devon and Plymouth. From that base we hope it will grow in terms of public sector organisations and in terms of other services.  It helps to retain high skill jobs within Plymouth and that does impact on the economy and therefore health and prosperity.

So, we are not a protective island, but we are clear on the benefits of the approach we have adopted and more to come.

Now, how will Apple change that?

ou can read other blogs related to the work of the Western Locality of NEW Devon CCG

About our workplan: Western Locality Workplan

About our Locality business: Western Locality Business

Jerry Clough is Chief Operating Officer for Northern, Eastern and Western Devon Clinical Commissioning Group.  He is also Locality Managing Director for the Western Locality of the CCG covering Plymouth and the surrounding areas of South Hams and West Devon.

Previously Jerry has been a Chief Executive and Finance Director in the NHS before spending several years running his own business driving programmes of change and delivering executive coaching and team and Board development.

Highlights of the Week - 5th September 2014

I have spent a couple of days this week at the HSJ Commissioning Summit - a frank and open discussion between NHS commissioners and senior people within NHS England about how the new commissioning architecture is bedding in and to consider what may or needs to happen next.

It started with a reminder about Chatham House Rules.The definition is pretty simple:

When a meeting, or part thereof, is held under the Chatham House Rule, participants are free to use the information received, but neither the identity nor the affiliation of the speaker(s), nor that of any other participant, may be revealed.

I am therefore unclear whether I am even able to confirm that the Editor of the Health Service Journal, in introducing the event, announced that it would be carried out under this system. He went on to say, or perhaps I should say that I was left with the impression that, this clearly also applied to social media interactions.

Which is all a bit of a shame as there were some interesting and stark reflections on the current challenges and likely changes for the future that would have figured here. They still do, but do remember that the only thoughts recorded will be my own!

Highlights of the Week - 5th September 2014 (@jeclo)

Highlights of the Week 1: Appointed a Programme Director to lead our "Local NHS Futures" work - starts in a fortnight

You may recall that a few weeks ago, in fact in the mad rush to complete a set of tasks before heading off on leave, we had thought we had appointed to our Programme Director role, before this fell through just as I was heading off to the airport (it didn't ruin the holiday, but was a huge disappointment).

This week we interviewed three more candidates and were delighted with the quality we were able to choose from.  Our new Programme Director (name will follow when there is dry ink on some paperwork!) will suit the programme's needs really well and am looking forward to the drive he will bring when he starts on 15th September.  

There is real optimism too about recent progress across all organisations with project briefs and clarifying roles, so hopefully momentum that has ebbed and flowed over the work of the Financially Challenged Health Economy programme is now firmly moving us towards concerted collective effort.

Highlights of the Week 2: Working supper with @plymouthcc to look at integration "wicked issues". We collectively resolve to solve.

As we look at our ambitious timeline for the integration of commissioning between NEW Devon CCG and Plymouth City Council, we can see just how much we are setting out to achieve by March 2015.  And that is before we look at the project to integrate the delivery of out of hospital health and care services over the same time period.

The evening workshop we held between key councillors, our Board and key Clinical Lead GPs was a really useful checkpoint on progress and to ensure we all understand the scope of the work we are engaged in.

This was the second in the series of events during the integration programme and this time we wanted to start a discussion on some of the "wicked issues". These included, for example, how we would create budgets and share underspends or overspends, how we would vote on issues and jointly create strategic plans and the differing role of politicians and GPs in their own respective organisations.

Nothing with this amount of detail and importance gets solved in one night, but it really did feel like we made significant progress.  Mostly this was because there is a clear sense that there will be lots and lots of policies, systems and procedures to work through, but that there was a bigger and more important prize that we will and should keep focussed on.

Highlights of the Week 3: Live with zero workshop 2 - how will this change the stress of emails in the Northern Locality? 

Following on from good evaluation of the first of the workshops about choosing the type of inbox you want, rather than just accepting the one you have, this week saw the second workshop at South Molton in Northern Devon.

There are no magic bullets, but I do firmly believe that you can choose to see your email traffic in a different way, accept the ways in which you make the management of your inbox easier or harder and set a realisable ambition for the future.

And that is what we explored with almost 20 of our staff.  Some came away with a bit of a disappointment that the workshop wasn't more of a "how to use outlook" session - there are a few tips on using technology, but that isn't the point of the workshop.  But there was a lot of really positive feedback and evidence both that plenty of people had found it food for thought and that they would be looking to change some things in their work.

Highlights of the Week 4: We've made the HSJ Top 100 Best Places to Work in the NHS - who knew?A good piece of news to celebrate

The benefits of being at the HSJ Commissioning summit is that you get a copy of the magazine hot off the press.  This week there was a supplement that used an independent company to research the best places to working the NHS, based on a set of measures and feedback.  I was casually flicking through in the break and realised there was a section on CCGs. Suddenly, there we were in black and white on the list.  The surprise was both because I hadn't known this was coming (I don't think anyone did) and because when you live in a challenged health economy you do get used to a different set of expectations about recognition or success.

So in all honesty, I don't really know what it means or what we have done right to end up here, but it is really encouraging, just for once, to be looking at that question when we are in the list, rather than pondering how others have ended up there with our name absent.  Let's celebrate a little!

Highlights of the Week 5: An evening at the HSJ Commissioning Summit with like-minded souls to reflect on where we really are in the NHS

The sessions I really enjoyed at the HSJ Commissioning Summit included a full and frank debate about the Better Care Fund - where I reflected on both the importance of positive ambition and also the danger of over stating plans, based on a national requirement that then turn sour on delivery; a discussion session on choice and competition - where within the strict confidentiality rules, we were able to discuss with Monitor their role in co-operation and competition; and a session with Stephen Dorrell, who is just an immensely impressive and experienced politician, engaging, intellectual and witty.

And then, like we now discuss with long-term conditions, it is not looking at each one in turn that matters, it is how you consider them all together; it is the totality of how all issues impact that I am really most interested in discussing.  And fortunately, that is what most other people are interested in too; enjoyable company in a convivial atmosphere.

And their view....? Well I am clearly not able to comment; what I can say though, is that I feel like there is such a significant challenge for the NHS and public services ahead, that it would be amazing if there weren't major policy battles in the lead up to the next election and that we might start to glimpse these at the party conferences this autumn.  If we don't see that, there aren't many who can see how we maintain the whole system sustainably, carrying on doing more of what we are currently doing.

You can read other blogs related to the work of the Western Locality of NEW Devon CCG

About our workplan: Western Locality Workplan

About our Locality business: Western Locality Business

Jerry Clough is Chief Operating Officer for Northern, Eastern and Western Devon Clinical Commissioning Group.  He is also Locality Managing Director for the Western Locality of the CCG covering Plymouth and the surrounding areas of South Hams and West Devon.

Previously Jerry has been a Chief Executive and Finance Director in the NHS before spending several years running his own business driving programmes of change and delivering executive coaching and team and Board development.