Tuesday 25 October 2011

Reflection

It's been quite a few weeks for reflection as Chair of a Clinical Commissioning Group.  We have, as a team, been through a thorough and well conducted review of our capabilities, been shortlisted for an award and I've attended some excellent events for a broader view of the world.

We continue to develop as a CCG, and the diagnostic tool provided an excellent opportunity to review progress and future needs.  While the tool itself is open to some differences in translation (one person's 4/5 is another's 2/5) it did allow us to sit as a team and openly discuss where we felt we were strong and where we could improve.  We then used this tool as a basis for a Confirm and Challenge with our Cluster - a genuine challenge to our Governance arrangements, performance and engagement.  A useful insight for authorisation.  Fortunately we seemed to reassure those present, and we await formal delegation of roles and accountability.  Nationally, some have complained that the process is bureaucratic and we will replicate PCTs - true in some respects but we are responsible for health, patient safety and a large sum of public money, and with that comes a duty to fulfill duties and provide good Governance.  Personally, it helps me sleep at night.

After all this, it was refreshing to leave base briefly and head to the HSJ Summit.  The debates were excellent, the company good and it was a chance to reflect rather than leap from one meeting into another.  The passion for the NHS was palpable, and there was a definite sense of transition to clinical commissioning and increasing partnership. Can we succeed and continue the excellent work managers have done?  Can we finally work towards the seemingly impossible goal of true integration?  I hope so, but there was a huge sense of responsibility as I drove away from the meeting.  I believe we can, but only if we work with the managers who have delivered an NHS we can (mostly) be proud of.

Yesterday, my practice team reviewed cases of some patients diagnosed with significant illnesses in the last year.  It was noticeable that for these patients the system worked, that patients had appointments and treatment rapidly, and that clinicians had worked together.  To discuss patients with colleagues was a welcome break from establishing an organisation, and something we must  continue to do regularly.  We need to build on the system, improve where we can and reduce the inefficiencies in care that we see all around us (including Primary Care).  Quality and patients first, with faster more appropriate care are what matter to managers, clinicians and patients.  We have to deliver.