LA QUESTION
Why is the emergency department always behind?
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pourquoi
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Every part of the system optimises its own budget
Meaning the recurring case, not one incident.
Rien n’a encore été dit.
famille sans nom — nommez-la si le groupe y voit un fil conducteur, ou laissez-la sans nom (2)
Winter money arrives in November for a plan needed in June
~ One-year funding buys…One-year funding buys agency staff, not permanent ones (15)
One-year funding buys agency staff, not permanent ones
~ Winter money arrives …Winter money arrives in November for a plan needed in June (15)
famille sans nom — nommez-la si le groupe y voit un fil conducteur, ou laissez-la sans nom (2)
Staff leave faster than we can hire them
~ We report to eleven b…We report to eleven bodies and none of them to each other (16)
We report to eleven bodies and none of them to each other
~ The data we report is…The data we report is a year old by the time it is published (14)
~ Staff leave faster th…Staff leave faster than we can hire them (16)
famille sans nom — nommez-la si le groupe y voit un fil conducteur, ou laissez-la sans nom (2)
We are measured on activity, so activity is what we produce
~ Capital and revenue c…Capital and revenue cannot be swapped, so we rent what we could own (21)
Capital and revenue cannot be swapped, so we rent what we could own
~ We cannot see the GP'…We cannot see the GP's data and they cannot see ours (18)
~ We are measured on ac…We are measured on activity, so activity is what we produce (21)
famille sans nom — nommez-la si le groupe y voit un fil conducteur, ou laissez-la sans nom (2)
Nobody is paid for the patient who did not need to come
~ Nobody owns the whole…Nobody owns the whole patient journey (17)
Nobody owns the whole patient journey
~ Nobody is paid for th…Nobody is paid for the patient who did not need to come (17)
famille sans nom — nommez-la si le groupe y voit un fil conducteur, ou laissez-la sans nom (2)
Procurement takes longer than the technology lasts
~ An improvement takes …An improvement takes two years and a chief executive lasts eighteen months (18)
An improvement takes two years and a chief executive lasts eighteen months
~ Procurement takes lon…Procurement takes longer than the technology lasts (18)
famille sans nom — nommez-la si le groupe y voit un fil conducteur, ou laissez-la sans nom (2)
The workforce plan was written before the last three years
~ We have never once be…We have never once been asked to plan for ten years (14)
We have never once been asked to plan for ten years
~ The workforce plan wa…The workforce plan was written before the last three years (14)
· pas encore dans une famille (22)
The incentive is to treat, never to prevent
The money for prevention sits in a different organisation
Every part of the system optimises its own budget
A nurse cannot afford to live within an hour of here
Politics changes the target every election
The data we report is a year old by the time it is published
~ We report to eleven b…We report to eleven bodies and none of them to each other (14)
~ We cannot see the GP'…We cannot see the GP's data and they cannot see ours (18)
We compete with the hospital down the road for the same nurses
Every inspection costs six weeks of senior time
A saving in social care is a cost here and nobody nets it
A ward closed for repair has never reopened
The regulator asks for the target and the auditor asks for the money
Beds were removed on a model that assumed community care that never came
The new system was chosen by people who will not use it
The same patients come back within a week
Nobody may open a bed without permission from three bodies
The estate is older than anyone working in it
Pay is set nationally and the housing market is not
Beds are full because nobody can be discharged
People wait hours in a corridor before anyone sees them
Training numbers were cut a decade ago and take a decade to fix
Vacancies are counted as savings in the same month they are a crisis
We cannot see the GP's data and they cannot see ours