DR ROBERT ROYCE

Independent Healthcare Consultant and Writer. Previously a Visiting Fellow at Kings Fund and a battle scarred NHS Director. Now retired. All views are my own.

[𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic @sib313]

For emergency care, for example, the 1.7m patients per year stuck for more than 12hr in A&E add huge costs to hospital budgets. That cost is pure waste compared to treating them inside 4hr as used to happen...

[Roy Lilley 💙 @RoyLilley]

It’s a word that has the same effect as scraping finger nails down a chalk-board.
'Transformation' has become detached from its meaning.

If you transform a caterpillar, you get a butterfly.

If you transform the NHS, what exactly does it become? https://t.co/ut587gcGzv

[Roy Lilley 💙 @RoyLilley]

The only 'strategy' should be execution… figuring out;
what we want to do,
putting things in place to get it,
>first time,
>all the time,
>every time,
>until we don’t want it anymore
it’s consistency, which is the secret to quality. https://t.co/ut587gcGzv

[Roy Lilley 💙 @RoyLilley]

We don’t need flashes of brilliance… we need flashes of the blindingly obvious.
We need to obsess over the quality of the front-line experience… for the people doing the job and for the people we do the job for. https://t.co/ut587gcGzv

[Roy Lilley 💙 @RoyLilley]

The NHS doesn't need transforming nearly as much as it needs running properly.

It’s not as glamorous as 'transforming'.
Running places well is the opposite, it is unglamorous, it is a grind, it is mind numbingly repetitive. https://t.co/ut587gcGzv

[Roy Lilley 💙 @RoyLilley]

The NHS has so often confused reorganisation with transformation and every hour spent discussing transformation is an hour not spent fixing something. https://t.co/ut587gcGzv

[DR ROBERT ROYCE @DRROBERTROYCE]

Roy Lilley is so right. During my time in the NHS one constant was the inability to do basic things properly and regularly. The 'transformation' projects were just incremental improvement initiatives. A lot of hype and very little transformation.

[Roy Lilley 💙 @RoyLilley]

The NHS doesn't need transforming nearly as much as it needs running properly.

It’s not as glamorous as 'transforming'.
Running places well is the opposite, it is unglamorous, it is a grind, it is mind numbingly repetitive. https://t.co/ut587gcGzv

[Ash Paul @pash22]

New ‘simpler’ @NHSEngland performance regime for @NHSProviders has 50% more metrics via @mattcmathers
https://t.co/FIT4WqlzWU

[DR ROBERT ROYCE @DRROBERTROYCE]

Should be increasing practical nusing time not reducing it.

[Nursing Standard @NurseStandard]

Is cutting nursing student placements by 500 hours a good idea?

The NMC is consulting on cutting nursing students’ practice learning time from 2,300 to 1,800 hours.

Here’s what our readers’ panel think about this > https://t.co/WSCEt4SVnO

[Ash Paul @pash22]

Overuse of diagnostic testing in healthcare: a systematic review
https://t.co/UiYp4cSCDw

[DR ROBERT ROYCE @DRROBERTROYCE]

Spending far too much time and energy on administrative reorganisations is a hallmark of the NHS since its creation. It's something you can always rely on (unfortunately).

[Roy Lilley 💙 @RoyLilley]

fix the centre.
Before launching another reform programme, or any initiative, or frankly anything, the DH+ and NHSE need to work out who ’s doing what.
Too much energy is being consumed by the machinery of reorganisation itself. https://t.co/0l8WBNOQKa

[Max Warner @MaxWarnerIFS]

New NHS waiting times data out today. The share of patients waiting ≤18 weeks for elective care dropped a little in Apr, but is still (with rounding!) 65%. List size has gone up a bit. See my thread from last month on how the NHS pushed hard to reach the 65% intermediate target

[Shaun Lintern @ShaunLintern]

Absolute tosh discussed in Parliament this morning over abolishing Healthwatch England. Ministers totally tone deaf on the well documented history of the NHS and DHSC diminishing patient voice. Their simple answer seems to be "we'll do it better this time, honest". They won't.

[DR ROBERT ROYCE @DRROBERTROYCE]

So true.

[𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic @sib313]

Cutting capital spending to fund other priorities is the dumbest but most persistent political habit in UK politics. It feels good now because nobody notices the short term effects but they multiply over time to generate catastrophe.

[Robert Colvile @rcolvile]

@HSJEditor I’m not sure the reforms ended up in the right place either - but it’s staggering how little attention they’ve had either way…

[Alastair McLellan @HSJEditor]

V few in the NHS will mourn Streeting's departure for the reasons I explain here: https://t.co/EdFF9wBRJb but @rcolvile is right that the service is as close to rudderless as I can remember in my 24 years as @HSJEditor

[Alison Moore @alijanemoore also on Bluesky @AliJaneMoore]

I'll be saying this again tomorrow but the CQC rating for safety ought to be the ceiling for any trust/service rating. However nice or responsive the staff are, if somewhere is unsafe that is what matters.

[Alyx Peters @AlyxPeters1]

The Nursing and Midwifery Council (NMC) faces backlash after failing to review health and criminal declarations for 18,000+ registrants – leaving some convicted nurses free to practise.

https://t.co/pzzVNnzCWs

[Robert Colvile @rcolvile]

In fact the Manchester integration body ended up being taken into special measures - hence 'absolute disaster' above https://t.co/RbqQi9Fuhj

[Robert Colvile @rcolvile]

When we produced this report on pilot schemes, the data was incredibly provisional. But it was startling how disillusioned the NHS high command were about Manchester/Burnham, urging us to look instead at West Yorks, which was run by NHS itself...
https://t.co/aS8t03pRN2