Can Santa deliver for the NHS

All I want for Christmas is….integrated care wrapped around communities and individual patients. Here’s hoping Santa can help us out although he may have to fight dissenting elves and reindeers who’ve lost their bearing.

My ideal present is simple enough.  If it wasn’t for the Grinch who has stolen the one system spirit and bought about a fragmented health and social care system. And then we have to contend with ever tightening purse strings. Like Scrooge I’m getting a terrible vision of the future if we don’t make changes now.

Santa’s reindeer appear to be clamouring to heed the call of the Sustainability and Transformation Plan (STP) with the sleigh taking off on a course that means my present gets delayed (will it ever arrive?). Then we have to deal with dissatisfied elves who are finding themselves being stretched in all sorts of directions with multiple targets to meet.

Who can blame the lack of direction from reindeers or the dissent among elves when the system doesn’t appear to be geared up to help to deliver the STP, stay within our budgets and manage expectations. Sounds like the kind of quandary that faces most at Christmas – managing budgets and expectations…

Santa himself seems to have gotten a bit too fat and is weighed down by regulation and perverse incentives….let alone his inability to follow simple public health advice!

Then again I noted something strange. A phenomenon which has come to these shores from our cousins over the pond. Last week it was Black Friday and here we were embracing American consumerism in the midst of talk of austerity.

And the remarkable thing (although there’s no evidence suggesting a link) our GP practice was quieter than normal. Were our patients busy hunting a bargain? It also suggested to me that my present could be delivered with the help of our local population supporting the elves and reindeers.

People could well find that they can look after themselves better and maybe everyday could feel like Black Friday minus the risk of excessive spending and possible debt problems this could bring. I’m hoping Santa joins us by cutting down on those things that have made him overweight.

This integrated system may be easier to achieve than my blog suggests so far. ‘Come on Gordon where’s your festive spirit?’, it appears to be returning. Maybe it’s the John Lewis advert or possibly the inspiring effort from Amazon showing how we can all work together that makes me feel that we might be on to something in our city.

In Leeds we are working with our staff on something called One Voice which means that organisations that plan and fund (commission) health and care do so with the same aims. This will enable all parts of the system to work better together, allowing us to corral the reindeers and steer the sleigh in the right direction.

One Voice, and collective will coupled with personal responsibility, may well help Santa to squeeze his way down the chimney especially with the promise of (low fat) mince pies and sherry (but not too much).

So the present of integrated care may not be with me this Christmas but sometimes the best things come to those who wait.

Merry Christmas to all and I hope Santa is kind to you, surely you’re wishlist is not as challenging as mine!


Dr Gordon Sinclair is the Clinical Chair for NHS Leeds West CCG as well as a practicing GP based at Burton Croft Surgery in Headingley, Leeds