BLOG
Paul Grubic, Managing Director - A profile
Paul, a qualified social worker, has been working in the field of Health and Social Care for over 30 years both in the Public and Private sectors.
He has been a Director and Chief Executive of a number Private National Organisations providing services to Children and Older People and has held senior posts within the public sector including Head of Inspection and Registration of Older People and Children's Residential Services. Paul has worked extensively with Public Authorities throughout the UK and with Private and Voluntary providers of Care at National, Regional and Local levels.
He has worked as an associate consultant for KPMG and PricewaterhouseCoopers.
He and his team of associates provide a comprehensive service to any care organisation seeking to develop and improve their own services and position in the Health and Social Care Market Place.
Their knowledge and vision will assist you to achieve the success your business deserves.
Current Blog
2007-10-11
26th February 2008
World Class Commissioning – Re-engineering Health Services – and don’t forget the body parts
I was asked recently to contribute to the DoH World Class Commissioning (PCT’s) initiative, the formal outcome of which will be released later this year. The NHS plan set out a 10 year programme of reform, the proposals of which are enshrined in ‘Our Health, Our Care, Our Say’. The document sets out the strategic direction for delivering healthcare with a “greater focus on prevention, on promoting well being and on delivering services in settings that are more convenient to the people that use them”. A new NHS, looking “outwards and not upwards”. In a follow up study published last week to its report last year “Equal Treatment: Closing the Gap”, the Disability Rights Commission severely criticised the DoH for its continued failure to tackle ‘institutional discrimination’. Eight out of ten regional strategic health authorities were seen as not complying with their legal duties to produce adequate disability equality schemes. London and Yorkshire stand proud in not producing a scheme of any description. The Disability Rights Commission stated that the DoH created ‘conditions for allowing systematic discrimination to persist by default’. It called on the Commission for Equality and Human Rights (who now supersede the DRC) to take legal action on those authorities who failed to act. A spokesperson for the DoH was quoted as being “a little bit aggrieved” by the criticism.
Really? Shame.
So back to World Class Commissioning. It has, we are told, 3 Betters.
- Better Health and well being for all – Health inequalities are dramatically reduced
- Better care for all – People exercise choice and control in the services they receive
- Better value for all – Spending choices are made in an informed and considered way, ensuring that improvements are delivered within resources.
At the World Class Commissioning Forum late September 2007, the following key themes emerged.
- A focus on improving health outcomes and narrowing health inequalities
- Ensuring a joined up approach to Health and Social Care, including productive partnerships with local government and the ‘third sector’ (daft term don’t you think?)
- To manage the market – based on excellent data management, forecasting etc
- To make use of clinical engagement and public input to shape services
- To drive down unit costs
Great! Until you read an article in The Guardian, 3rd October 2007, by David Brindle. “But if politicians and the public are up for radical thinking, are the professionals? Local government leaders have had the temerity to suggest that ministers switch a trifling 0.5% of the NHS budget to social care to boost preventative services for older people (and thereby save hospital costs). From the reaction of the health hierarchy, you would have thought there was a fox in the chicken coop. ‘COUNCILS TRY TO GRAB HALF A PERCENT OF ALL NHS FUNDS’ screams the Health Service Journal. How profoundly depressing.” Indeed David. Here lies the rub, and also the reason for the title of this blog. If the initiative is the engine, and its high performance, can the adopting structures, (chassis, brakes and body) cope with it? Do they need modifying in advance? How will they be modified and will those modifications be ‘driven’ for the benefit of the end user? The engine is not enough. Ask the Disability Rights Commission. It is not enough to remove the self interest element inherent in organisations. It needs more to shape the ‘hearts and minds’ of professionals who so depressed The Guardian’s Mr Brindle.
I saw a Reliant Robin once with a V8 3.5 Rover engine shoehorned into its little engine bay. Never saw such acceleration. Fell apart though at the first corner it encountered. I imagine World Class Commissioning will have a number of these within its process. Time for a clean sheet of paper and a firm stick.....