Thursday, December 15, 2016

Gauntlet

We are here…ladies & gentlemen. The diabetes transformation funds- to the tune of £ 40 million. And in the main, its generated good feedback, energy and enthusiasm amongst many- though appreciably its been laced with a dash of misinformation, a slice of cynicism and a generous portion of cautiousness. To be honest, I don't mind any of that- and frankly, would be odd if there wasn't. We live in austere times- times when -depending on where you work- coming to work is a struggle. Constructive criticism of plans is always welcome and indeed should be. To beat the era of post-truth, we need healthy debate- and whatever strategy the diabetes team in NHS England has come up with- we are open to listening-as long as it doesn't descend into a swirl of simple negativity or even abuse.

So to where we are- 4 strands for money- each with a very singular focus:

Strand 1- about improving safety within hospitals- enough evidence to suggest too many errors - causing harm- we must try to change that. Enough talking, enough data collection, its now about the intervention. If YOU as a CCG feel you need to improve this, here's your chance
Strand 2 - about improving amputation rates.
Strand 3 - about improving structured education- Type 1 and Type 2
Strand 4- improving variation- this, to me, is a key area. What ideas do YOU have to improve this? is it about better access to specialists? Is it about different model of care? Is it about the right medications? Is it about the IT system or is it about the education? If you think the X needs investment, here is your opportunity!
Many talk about "evidence-base"- well, look at the National Diabetes Audit- and then let me know if investment in these areas lack the evidence, or not.

Now to the flip side- lets be honest- will this solve the problems? Not by a million miles- but can it help kickstart some stagnant processes? Absolutely. However, this should not mean such initiatives need to be greeted with negativity- as said before, constructive criticism is fundamentally different from the all corrosive negativity.

Here are some quick answers to the naysayers:

"Only 40 million?" - Well, I agree- it would be fab to have more- but in an environment when many, many other areas could do with even a fraction of that? Its a definite positive. We dance around junior doctors & "timely discharge summaries" when in our heart of hearts, we know, without social funding, its tinkering at its finest.

"Not enough time to fill out form" - Yes, its a tight timeline but at the same time, they also do focus the mine perhaps. If your CCG is swamped, then as a specialists or a GP lead, help them out. Also, you would have thought some plans would already be there- surely, if diabetes care is not good where you are, there are some plans which were simply waiting for an "investment"?

"Will we get the money?" - a critical question- and we would like to keep a close eye on this too. This money is NOT to fill out a CCG bottomline- categorically-its to improve diabetes care. More to come on that one!

"Its over 2 years, right?" - No-its 40 million- each year- check the Operating Framework Guidance. If  CCG say otherwise, we are happy to clarify

"What's the point?" - What shall I say? If you are someone who believes in improving diabetes care, then that question should not emerge. If you are someone in a position to improve it- and have that question, perhaps step down and ask someone who has the belief…there's always the point- its always worth the try.

Finally, to all- its a bidding process- so not everyone will get the money- and yes, there is the risk, some areas will be better than others.

To all commissioners, if not sure, ask your local teams, ask patients, come with plans to stand the best chance. To 1 care, it may not be anything to you in the bigger scale, but it could be too- without you involved, no model of care works- help your CCGs out if you can.

And specialists- this is where you have to pick up the gauntlet. THIS is why we do what we do- we are supposed to be the folks speaking for the patients we look after…step up to the plate, ladies & gentlemen- for this particular crossroad, forget the differences with your CCGs, the battles- and go try to see if you can help. Standing back helps no one, If we want to use this money well, we must- and I insist, we must, lead on this one.

Any questions, ask. But tips n the meanwhile? Be innovative, think broad, think across "Trusts", find allies- and I wish you all the best for the process. The bids will have to come via the STPs- but the CCGs will be the ones to help form them. Think broad, could it be the Trusts? Could it be the "Alliances"? Could they- hold on to my horses- work together to bid?

There are a few other things we have hopefully coming across in 2017 from the digital side of things…in the interim?  Will everything work? No. Nothing does. But is there enough to change where things stand at the moment regards diabetes care? Yes-absolutely

I have heard one thing continuously…"if only diabetes care had some money"….? I will give you my hypothesis...money alone will solve nothing. It will be the will to work together...and the money undoubtedly helps to kickstart the process. Diabetes- for ever- have asked for some transformation funds. We have now got the opportunity...go on...pick up that gauntlet.

Lets give this a go.




2 comments:

  1. Hi Partha - Are the rules posted online somewhere? As you know it's the details that must be considered in projects such as this given the incredible time and resource commitment to focus on the opportunity. Thank you for your aggressive stance in moving the bar for patients and providers!

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  2. If you are not in it you can't win it - give it a go!!

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