Bruce Gray

NHS England. Prev. car industry ➡ Lean & QI in the NHS. ILM7 Exec Coach. Founding cohort #theQinitiative. My views only.

[Bruce Gray @brucejgray]

@BoveFromAbove

[Bruce Gray @brucejgray]

@floboflo @mancunianmedic They don't like it up 'em!

[simon wren-lewis @sjwrenlewis]

This weeks post: Labour’s Brexit stance is as untenable as their tax pledge https://t.co/7FPrHeZRYZ
The size of the boost to living standards from either joining the EU's customs union or single market is likely to be much bigger than anything else this government could do.

[Andy Pow @medicaccountant]

The last few weeks I’ve been helping @goldstone_tony test his modelling tool for annual allowance & the £100k tax trap. What stands out are the crazy marginal tax rates for some - it’s pays not to work. A productive NHS needs people needs a sensible tax system. We don’t have one

[𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic @sib313]

This Guardian story has drawn some outraged comment about the state of the NHS: https://t.co/z3skqJch9j

To much misses the point...

[Bruce Gray @brucejgray]

@unusual_whales I just looked up the data, and GM had 162,000 employees in 2024.

Is the 170k/month for all US?

For GM, 200 = 0.12% of the workforce.

[Bruce Gray @brucejgray]

@ProfBrianCox They didn't do a very good job of making you look like you in Succession, though?

😉

[Ash Paul @pash22]

Poor attention to the end-to-end process of patient care in @NHSEngland leads to worse outcomes, long waits, much higher costs, and perpetually stressed staff
https://t.co/UaoSh6M8OA via @sib313

[Bruce Gray @brucejgray]

@Acyn Beliefs like this are a feature, not a bug, of all religions, in order to set up in group/out group cultures and behaviours.

If we're lucky, they keep it to themselves (humility).

If we're unlucky, they use it to persecute.

[Bruce Gray @brucejgray]

@atrupar Preppers......for a 3rd term.

Terrifying.

[𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic @sib313]

@pash22 @mancunianmedic @IanKirk49801321 @NHSEngland @WGHealthandCare @NHSScotland @HSC_NI @DHSCgovuk @wesstreeting As for the NHS it isn't having a single plan and sticking with it that would work. It is having a large enough dose of basic managerial competence that would make the most difference.

[Gooroo @ Insource @gooroohealth]

The waiting list change was +11,998 in August, worse than the latest trajectory for restoring 18 weeks which required -67,159. The waiting list size was overall 230,438 worse than the latest trajectory.

As a simple rule, the wait list must shrink every single month. #nhswaits

[𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic @sib313]

"If we are serious about building a modern, preventive, digital NHS, then investment in analysts and the networks that support them is not a matter of choice. It is essential."
https://t.co/stwqXX0hnK ...

[𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic @sib313]

@brucejgray @pash22 @drvk_voice @RCEMvp_Salwa @Molly2323232323 @RCollEM @HelenMorganMP @LibDems @DannyVet @BrianMathewLD @NHSEngland @HSJnews I wouldn't want to promote the idea there is only one design. The book is an argument that operational leaders need to pay attention to design and then continuously update it. For each process.

[Bruce Gray @brucejgray]

@pash22 @sib313 @drvk_voice @RCEMvp_Salwa @Molly2323232323 @RCollEM @HelenMorganMP @LibDems @DannyVet @BrianMathewLD @NHSEngland @HSJnews From Steve's accurate piece;  “…until you fix the design...."

Important to note, this implies there's 1 design that will fix all the problems forever.

Continuous improvement based on balanced measures is always required, and sometimes further step change redesign.

[Bruce Gray @brucejgray]

@HSJnews If a CEO (or anyone) wants to help flow in the ED, they should walk the patient pathway in reverse starting at discharge, ending up in the ED, asking staff 'what are the barriers preventing patients being moved closer to safe discharge'. Much to be learnt.

[Bruce Gray @brucejgray]

@mancunianmedic @NHSBeeky @markbritnell @HPIAndyCowper Definitionally vague (wtf is "implied" productivity), statistically meaningless (comparison of 2 data points a year apart), and only higher is better (what if an organisation already has high "implied" productivity?).

[Seth Abramson @SethAbramson]

As accurate a description of Donald Trump as you will ever see

[Getting It Right First Time (GIRFT) @NHSGIRFT]

🎉Congrats to four elective surgical hubs awarded GIRFT accreditation for meeting the highest clinical standards:

🏥@HarrogateNHSFT
🏥@MTWnhs
🏥@WorcsAcuteNHS
🏥@CUH_NHS

52 hubs now accredited.

Read more:https://t.co/xth2Vy9AMU

#NHS #SurgicalHubs

@RCSnews @RCoANews

[𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic @sib313]

Great thread illustrating why good analysis of data can help focus improvement efforts for big NHS problems like A&E performance.

But access to and analysis of the data is far too uncommon in the NHS...