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NHS bureaucracy - a hard habit to kick?

NHS bureaucracy - a hard habit to kick?


August is a slow month. Not much gets done and nobody really moans about it because most people are either living it up in sunnier climbs or staring out of a rain soaked window wishing they were anywhere other than the office.

But we haven’t got the luxury of taking a whole month out of our diaries this year as the intensity of CCG authorisation is hotting up and the countdown is well and truly on.

But with nine months to go until CCGs become statutory bodies, and with 212 CCGs to authorise – can somebody tell that to the NHS Commissioning Board?

As CCGs prepare to jump through authorisation hoops and frantically try not to drown in an endless sea of paperwork and processes, it is particularly frustrating for many when the NHS CB proves to be the hold up.

The biggest delay on the road to CCG authorisation is the lack of offers coming out of NHS CB hosted CSSs - something that has been blamed on a lack of urgency by the NHS CB in appointing CSS managing directors.

A senior commissioning enthusiast told me the pace of change at the NHS CB is “surprisingly slow” as it has tied itself up in the same layers of bureaucracy the reforms were doing their best to shed.

“When it comes to making appointments, there are two or three rounds of interview stages – I think it’s a bit excessive considering the lack of time we have,” they said.

This is extremely worrying given the strict time frame for authorisation and also for the road ahead.

These reforms were supposed to herald a new age in the NHS but it seems the promises made by politicians may have been a bridge too far for the NHS.

CCGs need to readjust their expectations if they are going to stick this transition year out.

The same person told me that no matter how hard we try, the NHS will always be “bogged down” in bureaucracy.

Quite a depressing thought – but nevertheless a realistic one.

It seems some habits are proving too hard to kick – especially at the top.


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