Manx Care

[Apple]

2 hours ago, Banker said:

Don’t worry Gold standard for care on the way 😀

Not yet.

We are still on the starting blocks and may be for some time. Sadly much still not ready. We really needed another year of preparation. Rushed probably for gong reasons ???😌

Proof of pudding etc.. Looking forward to hearing what standards and measures they are trying to attain in terms of positive outcomes, waiting lists, costs, value for money and lots more.

Edited March 29, 2021 by Apple

[Boris Johnson]

2 hours ago, Banker said:

Don’t worry Gold standard for care on the way 😀

https://www.manxradio.com/news/isle-of-man-news/manx-care-chair-sets-out-priorities-for-gold-standard-system/

What a crock

Its not possible on an island with 80k residents.

A general hospital needs a lot more, millions more, in the catchment area to have the very best care available.

 

[Uhtred]

2 hours ago, Boris Johnson said:

What a crock

Its not possible on an island with 80k residents.

A general hospital needs a lot more, millions more, in the catchment area to have the very best care available.

 

Ah...you misunderstand. He means the gold standard in a local context. The best that can be done here. You know...like the Corpy’s chewing gum removal machine.

[Dr. Grumpy]

Looking objectively, the following appear to be the benefits:

1. Promises to completely stop politicians meddling directly with patient care (do they know this?)

2. CQC is apparently definitely coming (not sure if it'll have statutory footing on the island)

3. 'The Mandate' looks promising if enforced

Downsides:

1. Purchaser-provider split in healthcare has been proven to add at least 8% to the cost without any tangible benefit

2. Large proportion of the board have never set foot on the island

3. Management consultants have already descended like locusts (but they do produce some glossy brochures)

4. Potential for downgrading services looms large

More later

Edited March 30, 2021 by Dr. Grumpy

[Uhtred]

6 hours ago, Dr. Grumpy said:

Looking objectively, the following appear to be the benefits:

1. Promises to completely stop politicians meddling directly with patient care (do they know this?)

2. CQC is apparently definitely coming (not sure if it'll have statutory footing on the island)

3. 'The Mandate' looks promising if enforced

Downsides:

1. Purchaser-provider split in healthcare has been proven to add at least 8% to the cost without any tangible benefit

2. Large proportion of the board have never set foot on the island

3. Management consultants have already descended like locusts (but they do produce some glossy brochures)

4. Potential for downgrading services looms large

More later

You list the involvement of CQC as a benefit. Now there’s an organisation that receives some distinctly mixed reviews.

[Dr. Grumpy]

1 hour ago, Uhtred said:

You list the involvement of CQC as a benefit. Now there’s an organisation that receives some distinctly mixed reviews.

Good point

[buncha wankas]

3 hours ago, Uhtred said:

You list the involvement of CQC as a benefit. Now there’s an organisation that receives some distinctly mixed reviews.

They appointed a new Care  Quality Director Nov 20 for new DHSC He promptly resigned and left the island not long after starting so then we saw the re advertising of the post, has it been filled yet?  

[wrighty]

3 hours ago, Uhtred said:

You list the involvement of CQC as a benefit. Now there’s an organisation that receives some distinctly mixed reviews.

I’ve had no direct experience of them, but from what I hear and read I don’t think they’re necessarily a good thing.  When they’re coming, organisations simply focus on the assessment to get their rating up, so concentrate on having all their policies updated and filed in order, rather than doing good basic healthcare.  A CQC assessment becomes a form of Goodhart’s law.

[Boris Johnson]

17 minutes ago, wrighty said:

I’ve had no direct experience of them, but from what I hear and read I don’t think they’re necessarily a good thing.  When they’re coming, organisations simply focus on the assessment to get their rating up, so concentrate on having all their policies updated and filed in order, rather than doing good basic healthcare.  A CQC assessment becomes a form of Goodhart’s law.

I have seen risk assessment/ written procedures  come into the engineering industry over the last 30+ years. I thought that way too but over time I have come to realise that it is 100% required to make sure you do the job right. In the commercial world it actually make you more profitable too.

Humans forget stuff, easily, you may think you are doing something correctly but over time the process may have "evolved" and no longer be that correct.

I have experience of a surgical item being left in a patient a long time ago, proper written and followed procedures should stop that type of thing happening.

Edited March 30, 2021 by Boris Johnson

[Uhtred]

1 hour ago, wrighty said:

I’ve had no direct experience of them, but from what I hear and read I don’t think they’re necessarily a good thing.  When they’re coming, organisations simply focus on the assessment to get their rating up, so concentrate on having all their policies updated and filed in order, rather than doing good basic healthcare.  A CQC assessment becomes a form of Goodhart’s law.

I’m sure you’re correct. I have a family member by marriage who is a surgeon at a large London teaching hospital. He has little time for CQC’s set-up, performance or outcomes. 

[wrighty]

3 hours ago, Boris Johnson said:

I have seen risk assessment/ written procedures  come into the engineering industry over the last 30+ years. I thought that way too but over time I have come to realise that it is 100% required to make sure you do the job right. In the commercial world it actually make you more profitable too.

Humans forget stuff, easily, you may think you are doing something correctly but over time the process may have "evolved" and no longer be that correct.

I have experience of a surgical item being left in a patient a long time ago, proper written and followed procedures should stop that type of thing happening.

I agree with all that, but when it comes to the CQC (and other agencies) they seem to focus on the unimportant minutiae rather than the procedures to prevent retained surgical materials.  There was a piece in the BMJ recently bemoaning the excessive policies insisted upon by the various inspectors - GP practices being checked to see if they had an up to date policy on assistance dogs for example.  They did, but it was virtually certain that it, like multiple other policies, had been written purely for the inspection and probably never read by anyone bar its author.

[Apple]

Ashford seemed to be struggling a little bit in Tynwald this morning when several members noted the Duty of Candour had nothing to do with the complaints procedures. He didn't really clarify why not.

Also he supported the changes advocated for the complaints process, when it gets done, that will enable complainants to access not only clinical records but also organisational records such as DATIX, HR and training records, bed states and staffing level records etc

Several speakers acknowledged their frustrations using the current procedures on behalf of their constituents but to my knowledge this is the fist time members have declared serious problems. I can not remember any questions on this before. 

The changes to Manx Care is, let's face it, based on dissatisfaction with the current DHSC model - style of management, costs, culture and in general failure to deliver a high quality service to all. (outside of Covid).

I welcome the CQC for the only reason that we have had internal audits, review, consultants and managerial staff merry go round and almost regular examples of a poor organisation. We can not let the DHSC police themselves any more.

Vigourous, robust regular external inspections by people with the stamina and abilities to challenge at the highest levels are what is needed. That can only be done by people who have no connection to the clinical services provided here and can not be intimidated or undermined by political  / clinical alliances. Not that there are any of course.

[Manx Bean]

8 hours ago, Apple said:

Ashford seemed to be struggling a little bit in Tynwald this morning when several members noted the Duty of Candour had nothing to do with the complaints procedures. He didn't really clarify why not.

Also he supported the changes advocated for the complaints process, when it gets done, that will enable complainants to access not only clinical records but also organisational records such as DATIX, HR and training records, bed states and staffing level records etc

Several speakers acknowledged their frustrations using the current procedures on behalf of their constituents but to my knowledge this is the fist time members have declared serious problems. I can not remember any questions on this before. 

The changes to Manx Care is, let's face it, based on dissatisfaction with the current DHSC model - style of management, costs, culture and in general failure to deliver a high quality service to all. (outside of Covid).

I welcome the CQC for the only reason that we have had internal audits, review, consultants and managerial staff merry go round and almost regular examples of a poor organisation. We can not let the DHSC police themselves any more.

Vigourous, robust regular external inspections by people with the stamina and abilities to challenge at the highest levels are what is needed. That can only be done by people who have no connection to the clinical services provided here and can not be intimidated or undermined by political  / clinical alliances. Not that there are any of course.

Yes, but what concerns me is that we could well find we have spent tens of millions on this new Manx Care (which to me is little more than a rebranding exercise and job creation scheme for a bunch of high salary posts) and ultimately carry on as normal.

It's still going to be staffed by the same health professionals and the same administrative personnel and middle management - they are just going to be "employed" by a new name. If you look back in time, no matter how you try to change or re-brand a Government Department it doesn't normally take too long for the newbies to have their enthusiasm knocked out of them.

[Albert Tatlock]

6 minutes ago, Manx Bean said:

Yes, but what concerns me is that we could well find we have spent tens of millions on this new Manx Care (which to me is little more than a rebranding exercise and job creation scheme for a bunch of high salary posts) and ultimately carry on as normal.

It's still going to be staffed by the same health professionals and the same administrative personnel and middle management - they are just going to be "employed" by a new name. If you look back in time, no matter how you try to change or re-brand a Government Department it doesn't normally take too long for the newbies to have their enthusiasm knocked out of them.

This - especially when job applications are 'Internal only'.

Manx Care for the Isle of Man - it's just like the film 'Groundhog day' - given the number of restructures that have taken place over the years - more about which you can find by simply searching these forums.

You can almost guarantee we will all be back in this loop within 3 years. 

[TerryFuchwit]

16 minutes ago, Albert Tatlock said:

This - especially when job applications are 'Internal only'.

Manx Care for the Isle of Man - it's just like the film 'Groundhog day' - given the number of restructures that have taken place over the years - more about which you can find by simply searching these forums.

You can almost guarantee we will all be back in this loop within 3 years. 

Internal only?