An exemplar in how not to

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An American sociologist, Harold Garfinkel, famously encouraged his students to go out and deliberately breach social rules (like being very shouty in public) to make visible the strength of these unwritten rules. When I was a student we could do this for one assignment and report how those present responded, or write an essay. I didn’t have the nerve to do the former.

The sacking of Katrina Percy (and the earlier unfoldings leading up to this) has been a kind of breaching exercise. Making visible the deep flaws in the organisation of the NHS. The internet/social media didn’t exist when Garfinkel developed his breaching experiments. These days, the ripples of (public sector) ‘rule breaching’ spread far with an unimagined immediacy. People are rightly outraged about the £200k pay off. How patients denied treatment or operations because of the cost must be feeling about this news is impossible to imagine. It’s simply obscene.

The handling of the Sloven debacle is worse than extraordinarily poor. On December 10 2015, Hunt stood up in the Commons and promised a series of measures in response to the publication of the Mazars review. The CQC so far seem to be sticking to their gig (albeit without using the powers they have effectively). NHS Improvement (NHSI) were tasked with sorting out the rot among the Sloven exec. They have bungled this task spectacularly. The wrong person was appointed to troubleshoot (alarmingly, Tim Smart has always maintained he contacted NHSI offering his help after seeing Tom question the board on BBC News). It was clear NHSI missed an opportunity to appoint a clear headed, sharp thinking, deeply experienced, no nonsense type of person.

Smart, as we know, failed to lift any stones (leaving it to campaigners and journalists to reveal the howlers that were in full view with the sending of the odd FOI request or ten), and decided the board were fit to practice. Etc, etc, etc.

What an almighty fuck up. The NHSI press statement is simply embarrassing.  I’m reminded of Shaun Picken, a trustee of My Life My Choice asking Percy: “Katrina, why didn’t you ask for help? You clearly needed it”, at the January board meeting. NHSI. You clearly need help.

I’m a lay person with no experience in public sector management (and currently on leave in Berlin for the weekend…Brilliant timing as always) but it strikes me there are some fairly straightforward things that should happen. Including:

  • Thorough scrutiny of financial irregularities around the Talentworks contract which, I’m sure, would provide evidence that Percy, supported by a bunch of longstanding exec-mates, has mismanaged public money.
  • A thorough review of the Sloven exec and removal of the remaining muppetry (Spires, Berryman, Stevens, Gordon, etc).
  • The appointment of replacement execs with mental health and learning disability expertise.
  • Full engagement with the public and a clear demonstration of a willingness to be open, transparent, honest and robust.
  • Stop relying on ‘reassurance’ and demand evidence. A reliance on ‘reassurance’ contributed to LB’s death.

Jim Mackey, Jeremy Hunt and others, you should feel ashamed at the handling of this. It’s an exemplar in how not to.

The Shaw Report

Start writing a book with determination. A new evening activity. This means digging out all the FOI stuff, documents, reports and paperwork. It feels like the right timing given LB’s inquest started a year ago today. Two harrowing weeks, a jury determination of neglect and no action. Still.

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Revisiting these documents (post LB’s death, I can’t bear to return to the earlier stuff yet), in the light of what has unfolded is pretty revelatory. I just wanted to single out one of the many individuals who have stuck with the campaign from the start here. Graham Shaw. Graham, the CEO of the DIPEx Charity until a couple of years ago, has consistently written letters about what’s happened. To all those implicated. Incredibly sharp and dripping in sense, his letters generate responses.

This one, written to Jeremy Hunt in April 2014 was prophetic really.

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The Sloven Head of External Communications responded in a tawdry and deeply inappropriate way asking [redacted] to “support the drafting of any response to Mr Shaw” [16.4.4 13:46]. Extraordinary evidence of the blurring of boundaries and positioning of NHS trusts as above questioning.

Here is the unfolding exchange. About as Stinky McStink as you get really, particularly given the timing of the responses and redactions. Emails 3 and 4 probably hold some significant clues to the continued lack of action against Percy and the board.

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Two and a half years ago.

A year and a half before LB’s inquest.

No words really. Other than Graham Shaw, we salute you. Keep writing the letters matey.

Another dirty day down Sloven way

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Got the background details (via a Freedom of Information request) about the commissioning of the study into families’ experiences of Sloven’s serious investigation process yesterday. I’ve written about being invited to take part in this study. And of Lesley Steven’s defence around the magic wand stuff.

It turns out Sloven decided up front that this study should take the form of an Appreciative Inquiry. David Snowden offers a critique of this approach which includes:

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It ain’t a big surprise Sloven like this approach. They don’t engage with their failings at any level or allow patients or families to express how they feel. Setting aside the criticisms identified by David Snowden, Appreciative Inquiry ain’t an appropriate approach for bereaved families. Unilaterally choosing an approach that only focuses ‘on the bright side‘ when looking at patient deaths is simply wrong. And risks causing more distress to people.

It turns out that the consultant who got the gig was recommended to Lesley Stevens and commissioned on the basis of a couple of emails and meetings:

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Shudder. At the March board meeting, in response to mention of the commissioning of external ‘work’, Mike Petter, then Sloven chair, quipped: This is a company we haven’t worked with before – there is one out there. No joking matter. We know the sizeable chunk of Sloven expenditure over the past few years spent on commissioning ‘consultants’ or legal professionals to help dig them out out hole after hole after hole.

The cost of this latest venture?  £27,000 for 40 days work. Yep. Really.

Sloven have rules (like any public organisation) around the spending of public money on external services. There has to be justification for why there is no competitive process. Any spend of more than £25k has to go to the next Audit Committee for review…

The £27k agreed for this gig includes VAT so I assume the £22.5k (excluding VAT) figure (handily) means it doesn’t make the Audit Committee bar. As for the lack of competitive process… the excuse is presented on the Single Tender Waiver form here:

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Ah. Bloody hilarious. Though it ain’t of course. Recommendation about the supplier is surely the reason procurement rules were implemented. Recommendation by whom? [Handily redacted in the FOI info]. Pace required following Mazars and CQC..? Sloven first got sight of the Mazars review last summer. Not much pace here. Lesley Stevens gifted the job to the consultant in February 2016 after it must have  (eventually) dawned on senior Sloven muppetry that the CQC inspection did not go well. So competitive processes to protect public money are swept aside because of continued Sloven crapness, denial and arrogance… A circularity that makes my brain weep. And for the record, alternative suppliers are plentiful/Appreciative Inquiry philosophy ain’t essential. Quite the opposite.

What’s particularly chilling? (I dunno, running out of words/thoughts here, it’s all so utterly shite) is that Sloven think this ditsy review is an appropriate response to either the Mazars review or CQC inspection.To commission it in such a shoddy, careless and piecemeal way underlines how unfit for purpose the Sloven senior team are.  It’s actually flagged up by Katrina Percy in a letter to NHS Improvement (who she still calls Monitor here) as progress on their enforcement undertakings:

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Further demonstration of how devoid of understanding, ability, empathy, willingness, whatever the senior team are. As if any more is needed. These people simply shouldn’t be running this organisation. There’s a superficiality so obvious, documented so publicly and repeatedly, leading to such serious failings it is extraordinary.

Getting a colleague of a colleague, a mate of a mate or whatever combination to write some nonsense, bypassing processes in place to make sure public money is spent with caution and transparency and demonstrating a complete lack of understanding about bereavement is so wrong it almost defies words.

Work on this ‘review’ is due to be finished in the next week. I don’t suppose for one moment the consultant has been able to do anything approaching what she outlines in communication with Lesley Stevens. I hope Victoria Keilthy reads whatever puff that reaches her with a sharp lens and reflects on the commissioning of this crap. This is a public body.

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