Thursday, 26 March 2009

World Class Commissioning League Tables

The team at ND are struggling to cope with world class commissioning (WCC) to use the jargon initials as we thought it meant something useful in medicine called the white cell count. We still do not know what commissioning is other than a means of increasing unnecessary employment of managers to do something but we do not know what.

We have been told by the local Politburo’s commissars that they are overjoyed by the fact that they are in the top ten of “World Class Commissioning” Politburos.

No doubt they will be having a street party, a Soviet style parade, a Politburo wide extra holiday for being so efficient washed down by lashings of vodka and caviar to mark their collective achievement. But hang on, what have they achieved? Well we have reported that they can commission 60+ day waits for cancer care so they must be good or “world class” commissioners but we have also seen how countries do better without WCC.

Let us go to the heart of the league table which here in Northernshire will be followed more avidly by the population than the football league tables, the two codes of rugby, ferret and greyhound racing such is the pride locally at now being in the top 10 WCCers. As our patients never ceased to be amazed at the fact that “world class” treatment is only available if they go private rather than via the local NHS you can see that WCC is a “hot topic” in the bars and coffee shops of Northernshire at this moment in time.

Here is a link to the league table. (Takes a while to load all those pretty graphics that comrade graph and table commissars like so much). We are sure that you will all want to race and see how well your local Politburo is doing.

If you have time and want a laugh have a read of the HSJ from which it was taken here.

HSJ gives you lots of ideas where NHS money goes.

You can read the scientific scoring system used to compile the table here on the PCT competency score link.
Surely we are misreading this “Incompetency Score Tables”?

Those of us that work in Northernshire think that the legend on the left should read:

Locally destroy the NHS

Work not with community partners

Disengage with public and patients

Ignore clinicians

Mismanage knowledge and access needs

Ignore investment


Discourage any improvement or innovation

Destroy procurement skills

Mismanage the local health system.

You can marvel at the fact that the three areas added up to decide the “world class” rankings (did we miss a w?) are none other than:


SFB Virgil?

All the things that our patients consider while they are on a trolley with a burst appendix. You hear them say to each other as they wait hours for treatment because there are no beds:

“Never mind the pain comrade, our Politburo’s got a top Board.”
“But mine tops trumps yours as it is better with Strategy and Finance.

There is no mention of medical or nursing care or provision in these league tables. We wonder why?

Now a little more critical analysis shows a few interesting things.

If you look at the first twenty Politburos in the rankings you will see that 17 of them are North of Watford Gap an area we know is bathed in undreamt of affluence.

That of these top 20 Politburos no less than 14 are “Spearhead” PCTs.

Not heard of “Spearhead” PCTs? We like the word “Spearhead”. It sounds so well tough.

Surely these will be good ones given that name “Spearhead” and at the cutting edge as would any elite military unit given the “spearhead” prefix? They would be elite troops leading any offensive from the front, right?

Well no.

"Spearhead" PCTs are those PCTs with the “worst health and deprivation indicators” including least numbers of doctors per head of population. In terms of health and deprivation they are in the bottom fifth of PCTs.

A link to a list of these is here
with a nice letter explaining how good these “world class” “Spearhead” institutions are. We particularly liked the comment re life expectancies: “so the gap continues to widen, and it is widening more for women than men, in Spearheads”. Starting to see some patterns?

PCTs whose managers cannot “commission” enough GPs or adequate health care to meet their patients’ needs are now being called “world class”.

Look carefully at the list and see where your PCT is.

This is probably the best guide to save your life and give you good health care as the closer to the bottom of the list your PCT is the more likely your are to live longer. We would like to have spent more time analysing life expectancy and cancer survival rates to compare with this league table but local knowledge tells us most of the answers.

World class commissioning = world class bull =destroy/dumb down the NHS to the level of the new under class in quality healthcare provision the NHS manager who at best is 30 years of date with 2 less CSEs than one of us at ND Central has.

WCC= New Labour dumb down to the lowest and worst common denominator when it comes to health care. The World Class Commissioner.

Praise be to the Party for giving us WCC. You have been warned.

A few more funnies from the HSJ can be found here, here and here.

1 comment:

Jobbing Doctor said...

I agree with you.

PBC and WCC are a crock of shite