NHS England. Prev. car industry ➡ Lean & QI in the NHS. ILM7 Exec Coach. Founding cohort #theQinitiative. My views only.
Coventry, England
Joined July 2010
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Bruce Gray retweeted
This weeks post: Labour’s Brexit stance is as untenable as their tax pledge mainlymacro.blogspot.com/202…
The size of the boost to living standards from either joining the EU's customs union or single market is likely to be much bigger than anything else this government could do.
Bruce Gray retweeted
The last few weeks I’ve been helping @goldstone_tony test his modelling tool for annual allowance & the £100k tax trap. What stands out are the crazy marginal tax rates for some - it’s pays not to work. A productive NHS needs people needs a sensible tax system. We don’t have one
Bruce Gray retweeted
This Guardian story has drawn some outraged comment about the state of the NHS: theguardian.com/society/2025…
To much misses the point...
Bruce Gray retweeted
Poor attention to the end-to-end process of patient care in @NHSEngland leads to worse outcomes, long waits, much higher costs, and perpetually stressed staff
hsj.co.uk/daily-insight/the-… via @sib313
Bruce Gray retweeted
As for the NHS it isn't having a single plan and sticking with it that would work. It is having a large enough dose of basic managerial competence that would make the most difference.
Bruce Gray retweeted
The waiting list change was +11,998 in August, worse than the latest trajectory for restoring 18 weeks which required -67,159. The waiting list size was overall 230,438 worse than the latest trajectory.
As a simple rule, the wait list must shrink every single month. #nhswaits
Bruce Gray retweeted
"If we are serious about building a modern, preventive, digital NHS, then investment in analysts and the networks that support them is not a matter of choice. It is essential."
hsj.co.uk/policy-and-regulat… ...
Bruce Gray retweeted
I wouldn't want to promote the idea there is only one design. The book is an argument that operational leaders need to pay attention to design and then continuously update it. For each process.
Bruce Gray retweeted
🎉Congrats to four elective surgical hubs awarded GIRFT accreditation for meeting the highest clinical standards:
🏥@HarrogateNHSFT
🏥@MTWnhs
🏥@WorcsAcuteNHS
🏥@CUH_NHS
52 hubs now accredited.
Read more:ow.ly/vC6J50WHzcv
#NHS #SurgicalHubs
@RCSnews @RCoANews
Bruce Gray retweeted
Great thread illustrating why good analysis of data can help focus improvement efforts for big NHS problems like A&E performance.
But access to and analysis of the data is far too uncommon in the NHS...
It feels like I'm making a bold claim when I say that the ED > AMU handover matters to patient flow above all other handovers. But when I say it out loud, people rarely disagree.
@DrLKVaughan @RCEMpresident @RCEM_VP @fourhourtarget
Bruce Gray retweeted
AMUs only exist to enable the compliance with an arbritary 4 hour rule invented by politicians. Being on a ward of the correct specialism providing the right treatment is what matters. AMU is just a buffer.
Bruce Gray retweeted
Of all the ‘handover points’ in the patient flow journey, the most important is probably the handover from the emergency department (ED) to the acute medical unit (AMU). Typically, about 30% of an ED’s patients will be admitted. And at least half of these will go to the AMU.
1/16
Bruce Gray retweeted
An entirely avoidable act of self-harm by the govt with predictable negative consequences
Sir Keir Starmer’s plan to overhaul the NHS has been thrown into chaos after no money has been set aside to cover the costs of making thousands of redundancies at ICBs thetimes.com/article/14b7f96…
Bruce Gray retweeted
One senior director: “I've known for weeks my role will be deleted & we've told other staff they will lose their jobs, & yet we’ve been told the national team is in chaos & there is no funding agreed to pay for it. But they've asked us not to tell staff, who are left in limbo."
Bruce Gray retweeted
Someone suggested exploring the relationship between ED crowding and four-hour compliance but splitting the patients into (red) admitted patients and (blue) non-admitted patients as if they were two completely separate queues that didn't interact with each other.
#rstats #ggplot2
ALT Two scatterplots on the same chart. The x-axis measures Emergency Department (ED) crowding - the average number of patients physically in the ED each day. The vertical axis measures four-hour compliance - the percentage of each day's attendances that were treated in less than four hours. There are red dots to show the experience for admitted patients and blue dots for non-admitted patients. Both the red and the blue cohorts show negative correlations, but the slope of the red dots is steep whereas the slope of the blue dots is shallow.
Bruce Gray retweeted
Yes! The ED crowding is caused by the (mainly AMU) beds beyond it being too full. The AMU is crowded because the specialty beds beyond it are too full. And the specialty beds are often crowded because of social care delays. And yet we hardly ever measure or report the downstream flow metrics that might help focus minds on what needs to be done...
Bruce Gray retweeted
Perpetually rising NHS costs are not inevitable: they are a product of an organisation that prefers to invest in shiny new stuff rather than process improvement:
hsj.co.uk/daily-insight/the-…
Bruce Gray retweeted
NHS Pension scheme increased surplus last year by £2bn - which goes back to the treasury
Still can’t afford the extra pay @wesstreeting @RachelReevesMP
NHS scheme takes in more £ than it pays out £6.3bn
Liabilities are huge but income higher vs costs
nhsbsa.nhs.uk/sites/default/…
Bruce Gray retweeted
I've just realised that what I'm droning on about here (in relation to maps) is what @brucejgray was pointing me to (much more concisely!) last month!
xitter.cf/brucejgray/status/1928…