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Post by mercian on Dec 23, 2021 17:52:19 GMT
The trouble with people who know stuff is that they have no idea how to explain it in very, very, very easy stages to total suffers like me. I successfully linked to this post of yours! I clicked on the little arrowhead [1] next to the cogwheel on your post. A list of items came up. One of them said "Link to this post", so I clicked on it. A little box appeared with a message that I didn't understand, but one of the options was already selected, so I assumed that was the correct one, so closed that wee message box by clicking the "X" in the corner. The clever system recognised what I had brainlessly instructed it to do, so when I refreshed, I came staright back to you - surely the most positive feedback mechanism possible! All hail statgeek. [1] As a noted pedant I disdain calling it an arrow, as it has no shaft. Pedantry alert on. Strictly speaking, though it is loosely referred to as an arrow, it's not even an arrowhead. More like an upside-down triangle. |
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Post by alec on Dec 23, 2021 18:06:47 GMT
On a slightly less facetious note, I differ from others in that I actually think the NHS has done briliantly throughout the covid pandemic precisely because of it's management structure. Whether that translates as the best system in more normal times is a debate to be had, but the advantages of having a top down management, relatively centralized delivery model has really come to the fore during this crisis, on multiple fronts.
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oldnat
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Post by oldnat on Dec 23, 2021 18:12:32 GMT
Charles, it's the red arrows. I was looking for an interesting non copyright image in a hurry. It does perhaps come across as a bit combative Surely it represents dangerous, highly orchestrated, high speed manoeuvres, or possibly coming into land without the use of flaps.  Red Arrows aren't combative. Showy and putting out lots of smoke, while achieving little of value. Seems appropriate. |
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oldnat
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Post by oldnat on Dec 23, 2021 18:15:44 GMT
I successfully linked to this post of yours! I clicked on the little arrowhead [1] next to the cogwheel on your post. A list of items came up. One of them said "Link to this post", so I clicked on it. A little box appeared with a message that I didn't understand, but one of the options was already selected, so I assumed that was the correct one, so closed that wee message box by clicking the "X" in the corner. The clever system recognised what I had brainlessly instructed it to do, so when I refreshed, I came staright back to you - surely the most positive feedback mechanism possible! All hail statgeek. [1] As a noted pedant I disdain calling it an arrow, as it has no shaft. Pedantry alert on. Strictly speaking, though it is loosely referred to as an arrow, it's not even an arrowhead. More like an upside-down triangle. Well, if you want a pedantry competition!  A triangle remains a triangle, whatever its orientation. |
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Post by leftieliberal on Dec 23, 2021 18:17:30 GMT
@laszlo The problem with Google Books is that the previews are limited (in this case the preview ends at p26 and several of the pages before then are omitted). I think that there may be devious ways of getting at other pages, because I think that the principle is that they only allow 10% of the book to be read, but different users can access different parts of the book.
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Post by Deleted on Dec 23, 2021 18:21:39 GMT
Just very briefly on the NHS (and I highly appreciate the sarcastic remark by alecThe NHS operates in the structure of reciprocal departmental technology (and it has to) which results in capacity constraints at various points at various times. In addition, it a project-based organisation with resources used in multiple projects, inevitably creating further capacity constraints. The two sources of the capacity constraints are managed in two completely different managerial structures, so decisions are often made on the spur. Not only that but the NHS doesn't have enough managers. It is only about 3% of the employees (compare it to BT where it is now about 18%). Furthermore, the statistical fluctuations are much higher in the NHS in terms of demand. To have full availability to hospital beds (let's say through A&E) 5 out of 6 beds would be unused for most of the year, which would be very difficult to politically justify. Not only that a large number of staff would also be unused. The statistical fluctuation also affects the workforce. Nurses' absenteeism was very high before Covid. As a result, target numbers are used (waiting list, waiting time, operations, bed utilisation, etc.). This encourages local optimisation, which is not optimisation at all, just the opposite. The financial management is on a different managerial line too. There was a period when the use of agency nurses had to be pre-approved by the financial managers, and they rejected the applications. Professional managers learnt quickly, so they waited for the last minute and told the financial manager that it was a question of life or death. They had to approve the request and as it was in the last moment, it was more expensive. The reforms by the Blair era (2003 onwards) had many shortcomings but these could be addressed (I know that there were other problems). The coalition government practically abandoned any attempt of managerial, coordination and financial improvements in the NHS, and the May government actively boycotted any positive change. |
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oldnat
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Post by oldnat on Dec 23, 2021 18:23:43 GMT
Last night, the Trevs suggested that tables concerning the Covid pandemic were only mentioned if they showed England in a bad light. "Posturing as a victim" nonsense, of course.
Travelling Tabby has a daily table of the vaccination levels achieved by all 4 UK health administrations.
England is performing more than adequately, having given 3rd/booster jags to 53.6% of its over 12s compared to Wales's 52.9% and NI's 46.4%.
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bantams
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Post by bantams on Dec 23, 2021 18:24:32 GMT
Pedantry alert on. Strictly speaking, though it is loosely referred to as an arrow, it's not even an arrowhead. More like an upside-down triangle. Well, if you want a pedantry competition! A triangle remains a triangle, whatever its orientation. I'm hoping some of these triangles are coming my way in a couple of days.
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Post by leftieliberal on Dec 23, 2021 18:25:28 GMT
oldnat "A triangle remains a triangle, whatever its orientation." In this case the triangle appears to be a right-angled isoceles triangle, so only rotation through 360 degrees preserves its appearance (unlike an equilateral triangle which looks the same for 120 and 240 degree rotations as well). I think that mercian has outpedanted you.
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Post by barbara on Dec 23, 2021 18:34:58 GMT
The reforms by the Blair era (2003 onwards) had many shortcomings but these could be addressed (I know that there were other problems). The coalition government practically abandoned any attempt of managerial, coordination and financial improvements in the NHS, and the May government actively boycotted any positive change. Starve it of funds, expel all the EU staff who kept it going, watch satisfaction levels plummet, sell it off to your mates. Make sure you get your share of the profits. Job done. A well worn path trodden by previous Tory governments . |
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Post by lululemonmustdobetter on Dec 23, 2021 18:35:17 GMT
Evening all. Apologies to put a dampener on any festive cheer, but I do think the situation in Ukraine is getting really concerning. As I have mentioned before, wars tend to occur when actors miscalculate and misjudge other actors’ intentions etc. It’s clear that NATO would not interfere directly in the Ukraine, and that Moscow is increasingly concluding that the Ukraine is in general risk of being 'lost for good. Whilst I am sceptical of the notion that China and Russia are acting in a co-ordinated anti-Western manner, I do think China offers Russia the opportunity to mitigate the damage in the short/medium term of any economic sanctions. Moscow also currently thinks the West is weak, divided and lacking in resolve. Putin has already demonstrated that he is a student of the school of thought that war as an extension of politics by other means. The anti-Western tone and aggressiveness of the Russian press has been intensifying for a while. The English language version of Pravda is case in point. english.pravda.ru/world/ When you look at the Washington Post's website you have to scroll quite a way down - www.washingtonpost.com/Really hope my fears are unfounded, but the signs currently don’t look good. |
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Post by robert on Dec 23, 2021 18:42:22 GMT
Alec
I think the front line staff in the NHS do an amazing job but it is often despite, rather than because of....
I remember Gerry Robinson tearing his hair out trying to persuade management to organise more productively. I remember James Martin trying to get Scarborough hospital to up their game regarding the food they offered patients. It was inertia and resistance to change at every suggestion. The problem is, that just as the banks became to big to fail, the NHS has become too big to reorganise. Lansley was the last to try and look what a hash of it he made. Have they even replaced the Windows 95 software yet, that facilitated the hacking a few years ago?
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Post by Deleted on Dec 23, 2021 18:52:59 GMT
@laszlo The problem with Google Books is that the previews are limited (in this case the preview ends at p26 and several of the pages before then are omitted). I think that there may be devious ways of getting at other pages, because I think that the principle is that they only allow 10% of the book to be read, but different users can access different parts of the book. Yes, that's one way to do it (and yes, the general rule is that 10% of any work is freely available). There are less obvious one (playing with cookies), but I leave there. The particular book is available for download in one of the Latin American universities c-a-r-f-r-e-w and my Linux wasn't suspicious of the site, but I didn't make an attempt of downloading it as I have a hard copy. |
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oldnat
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Post by oldnat on Dec 23, 2021 18:54:35 GMT
oldnat "A triangle remains a triangle, whatever its orientation." In this case the triangle appears to be a right-angled isoceles triangle, so only rotation through 360 degrees preserves its appearance (unlike an equilateral triangle which looks the same for 120 and 240 degree rotations as well). I think that mercian has outpedanted you. But Mercian made no reference to the appearance of a triangle being identical in every orientation as being a necessary factor. A right angled isosceles triangle, remains a right angled isosceles triangle, however many degrees it is rotated through. Pedantry has strict rules, and it is as unwise for an amateur like yourself to pass commentary on the sport as it is for Danny to comment on most things. |
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Post by steamdrivenandy on Dec 23, 2021 18:54:43 GMT
On a slightly less facetious note, I differ from others in that I actually think the NHS has done briliantly throughout the covid pandemic precisely because of it's management structure. Whether that translates as the best system in more normal times is a debate to be had, but the advantages of having a top down management, relatively centralized delivery model has really come to the fore during this crisis, on multiple fronts. Have things improved from the 1970's when I was a hospital rep for Smith & Nephew Southalls travelling in surgical dressings, incontinence pads and nurses dresses plus a host of other products. Regional contracts for, say, X ray detectable swabs were quoted for and sometimes won, but the individual hospital groups would carry on ordering from their preferred suppliers, often at much higher list prices. It was a nonsense. |
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Post by robert on Dec 23, 2021 18:55:25 GMT
Oldnat
"A triangle remains a triangle, whatever its orientation."
Yes, I think JK Rowling would agree with that statement!
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c-a-r-f-r-e-w
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Post by c-a-r-f-r-e-w on Dec 23, 2021 18:56:08 GMT
Re: NHS funds, how much is PFI costing these days?
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Post by crossbat11 on Dec 23, 2021 18:56:47 GMT
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c-a-r-f-r-e-w
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A step on the way toward the demise of the liberal elite? Or just a blip…
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Post by c-a-r-f-r-e-w on Dec 23, 2021 19:07:00 GMT
@laszlo The problem with Google Books is that the previews are limited (in this case the preview ends at p26 and several of the pages before then are omitted). I think that there may be devious ways of getting at other pages, because I think that the principle is that they only allow 10% of the book to be read, but different users can access different parts of the book. Yes, that's one way to do it (and yes, the general rule is that 10% of any work is freely available). There are less obvious one (playing with cookies), but I leave there. The particular book is available for download in one of the Latin American universities c-a-r-f-r-e-w and my Linux wasn't suspicious of the site, but I didn't make an attempt of downloading it as I have a hard copy. thanks very much Laszlo, appreciate your help! |
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c-a-r-f-r-e-w
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Post by c-a-r-f-r-e-w on Dec 23, 2021 19:15:36 GMT
Pedantry alert on. Strictly speaking, though it is loosely referred to as an arrow, it's not even an arrowhead. More like an upside-down triangle. Well, if you want a pedantry competition! A triangle remains a triangle, whatever its orientation. Unless it’s edge on, when it becomes a line. |
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c-a-r-f-r-e-w
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Post by c-a-r-f-r-e-w on Dec 23, 2021 19:16:50 GMT
If you spin it round really fast it’s a circle.
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Post by mercian on Dec 23, 2021 19:40:17 GMT
The coalition government practically abandoned any attempt of managerial, coordination and financial improvements in the NHS, and the May government actively boycotted any positive change. I worked in the NHS until 2016 and there were several reorganisations after 2010. Whether these were good or bad is perhaps moot, but there were certainly attempts to improve things. www.nuffieldtrust.org.uk/health-and-social-care-explained/nhs-reform-timeline |
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Post by Deleted on Dec 23, 2021 19:45:45 GMT
The coalition government practically abandoned any attempt of managerial, coordination and financial improvements in the NHS, and the May government actively boycotted any positive change. I worked in the NHS until 2016 and there were several reorganisations after 2010. Whether these were good or bad is perhaps moot, but there were certainly attempts to improve things. www.nuffieldtrust.org.uk/health-and-social-care-explained/nhs-reform-timeline2010s. Forever associated with Mid Staffs. |
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Post by mercian on Dec 23, 2021 19:52:19 GMT
One NHS project I was involved with cost hundreds of millions of pounds, and I think got abandoned in the end. The idea was that District Nurses would take laptops round with them to record their visits during their rounds, rather than using a (paper) notebook and entering details on a computer later in the day. Of course, no-one asked the nurses about this. The places that they had to go were often such that they would be a target if they carried laptops, so they kept them in the office and carried on more or less as before. They generally did their rounds in the morning and spent the afternoons recording visits, drinking tea and gossiping.
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Post by mercian on Dec 23, 2021 19:54:11 GMT
2010s. Forever associated with Mid Staffs. From my link, the first report on Mid-Staffs was published under the Labour government. |
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Post by robert on Dec 23, 2021 20:06:46 GMT
Re: NHS funds, how much is PFI costing these days? That's a very good point. Big improvements made at the time, as @ Alec stated but which are being paid for now, leaving less money now to make further improvements now. There's no such thing as free money and whatever is available will never be enough as new scientific discoveries, drugs and treatment, are being discovered all the time. |
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Post by Deleted on Dec 23, 2021 20:10:42 GMT
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Post by Deleted on Dec 23, 2021 20:23:59 GMT
The coalition government practically abandoned any attempt of managerial, coordination and financial improvements in the NHS, and the May government actively boycotted any positive change. I worked in the NHS until 2016 and there were several reorganisations after 2010. Whether these were good or bad is perhaps moot, but there were certainly attempts to improve things. www.nuffieldtrust.org.uk/health-and-social-care-explained/nhs-reform-timelineYes, there were - they were called redisorganisation... This classification is a bit unfair, but I was asked (heading three different teams) to evaluate the procurement process in one trust, the labour allocation planning in another one, and the metrics of performance measurement in the third. And I had to agree with the classification. The government rep didn't even attend the meetings after 2017, and earlier their slogan was "there is no crisis, is there" for which the answer was obviously no, but it is not how runs a complex organisation. mercian as you were involved you then know that NHS Trusts in 2014 had to give a five-minute presentation to the government, and were allowed only to use the argument of productive use of public finance when describing the situation. It is called financialisation, effectively using the processes of the stock markets. Well, Tesla is over any other car manufacturers - it is an excellent parallel. |
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domjg
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Post by domjg on Dec 23, 2021 20:49:20 GMT
@tw I would have absolutely agreed that we have to 'learn to live with it' with if asked, what on earth would 'not' learning to live with it even look like? Part of learning to live with it is the willingness to put strict measures in place where and when necessary to mitigate the worst consequences of living with it. In other stating the bleedin' obvious news the sky is blue and grass is green. Dammit, I made a covid related comment, something I swore not to do.. |
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oldnat
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Post by oldnat on Dec 23, 2021 20:55:03 GMT
While there may be organisations who are unconcerned as to whether they operate efficiently or not, most in both the public and private sector sometimes do reorganise their structures to facilitate greater efficiency.
Those that do so successfully, generally manage to engage with and often empower their staff in the process of change.
A gentle reminder to those talking about "the NHS" - you are talking only about the structure operating in England. There are structural and operating differences between it and the other three systems in the UK, as well as how the management of change is implemented.
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