Beyond Money

I’ve not said this before but I should say that all opinions in my blogs are my own.  For some reason I particularly feel obliged to say this before I go on and write.  I welcome challenge to my thoughts.  It is where I get my learning from.  The NHS is so big and complex that no individual person can possibly have a completely confident overview and for a middle manager like me that is certainly true.

So with my disclaimer said, I will carry on.

As we continue to wait for more detail on the process to access the £40m announced in the NHS England Operating and Contracting Framework it is giving rise to some interesting observations.

We are expecting bids for be for the following 4 areas:

1.       improving uptake of structured education

2.       improving access to specialist inpatient support to reduce length of stay for people with diabetes

3.       improving access to a multi-disciplinary foot team for people with diabetic foot disease to reduce amputations

4.       improving the achievement of the NICE recommended treatment targets.

 But also potentially a 5th category will be included called:

5.       Enhancing Pathways

The expectation of the need to quickly mobilise to submit robust bids has given rise to lots of interesting discussion.

During one such discussion it was agreed that clinical time would be needed to support the implementation of the planned work should a bid be approved.  In response one of the group said: “You can give me £1million, £2million, £3million but we still will not have the capacity; the available staff or the trainees in the pipeline to implement the work and increase capacity”. 

It made me pause.

Has the NHS gone beyond money?  We may have money to give to diabetes, which is a wonderful and exciting opportunity at this time of austerity but are there the people out there with the right skills and training?  With the potential implications of Brexit; the removal of grants for student nurses and no significant rise in NHS funding are we likely to see a dramatic increase in the wider pool of clinicians currently available to us?

These are competitive bids.  There is potential that not everywhere will receive funding.  We know, for example, that we have shortages of nurses and podiatrists in general.  In proposals looking to hire staff, even in the short term, could we end up just pinching staff from each other potentially de-fleecing other departments or neighbouring services who did not win funding? 

There certainly is a weight of responsibility for those who will be reviewing and approving bids and although tricky to ascertain, it may be reviewers need to check that they are not robbing Peter to pay Paul.  Just a thought.

A bit like Sir David Attenborough, sitting in the jungle and observing interesting behaviours, I have also witnessed other phenomena arising from the funding bids.

I recently attended a meeting where GP diabetes leads were introducing themselves, for the first time, to their neighbouring GP diabetes leads.  It was delightful to see.  There was a huge richness and shared learning in the conversations had.

So maybe there is something else this funding provokes beyond just money.  Something just as valuable as pounds and pence.  The opportunity to review where services are at; across boundary discussions; galvanising shared learning and new relationships.

All of value - beyond money.