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Organograms, holograms and a bonfire – the NHS in 2023

I’m no Nostradamus, but I do have some predictive ability. Here are my highlights for the NHS in 2023.

Jon Restell portrait 2021

January

During a random breath test during the festive season, Suffolk Police find a quarter of a ton of antibiotics in the boot of Thérèse Coffey’s car. The former health secretary is reported to say, “They’re for personal use and giving to family and friends. I know the law, sonny, as in I know the chief constable.”

The first chief organogram officer is appointed by an NHS trust, as producing the Barclay organograms takes higher priority than operational effectiveness.

February

The front page of the Daily Mail announces the appointment of the Millionth NHS Manager. There are now 100 managers to every nurse. An incandescent Steve Barclay responds by expanding his organogramisation policy.

March

Patricia Hewitt’s bureaucracy review, Re-liberating the NHS, recommends the abolition of all national targets bar five core objectives. She also suggests that ICBs are renamed Perfectly Coterminous Teams and grouped into nine Simply Holistic Alliances. Savings from reusing old supplies of stationery are “the low hanging fruit”, she says.

April

The government announces it is rejecting the NHS Pay Review Body recommendation as “too low” and instructs the hapless reviewers to come back with a higher figure.

The DHSC then admits it’s an April Fools’ joke. On Twitter, the famously jovial Jordan Peterson invites outraged nurses to get a sense of humour.

May

MiP’s plans for a Million Manager March, demanding the restoration of extensive national targets (and an intermediate pay point in Bands 8 and 9), are abandoned when guidance on the Hewitt 5 includes hundreds of Mandatory Service Suggestions, and the source of the Mail’s February scoop is revealed to be “a bloke down the pub, who was pretty pissed, but seemed to know what he was talking about”.

June

Roger Kline publishes The ‘Snowy White Peaks’ of the NHS: Snowier and Peakier, as a follow-up to his original 2014 report on race equality.

Elsewhere in academe, an analysis of NHS organograms by Professors Hoddit and Doddit of Strathclyde University concludes that “the NHS is dangerously under-managed”. Everyone stares blankly and carries on regardless.

July

Steve Barclay wins the coveted HSJ Penpusher of the Year Award. The incandescent health secretary instructs the Health Service Journal’s owner, Wilmington Healthcare, to publish an organogram so the Daily Telegraph can name and shame faceless event organisers.

Meanwhile, in private Barclay expresses doubts about his organogramisation policy for the first time.

August

‘NHS – The Musical’ opens in the West End, inspired by the ABBA show, ‘Voyage’. All parts are played by a hologram Jeremy Hunt. An incandescent Steve Barclay orders the production company to publish an organogram so the Daily Telegraph can name and shame faceless creatives.

September

General secretaries of Britain’s trade unions go on indefinite strike until their ruling bodies stop asking, “Why can’t you be more like Mick Lynch? He’s funny and people like him.”

October

In a shock Commons statement Steve Barclay announces that the organogramisation policy has been a ghastly waste of time and money.

North of the border, health unions reject the Scottish Government’s ninth Full and Final Offer of the 2023–24 pay negotiations.

November

A repentant Steve Barclay sets fire to a massive bonfire of NHS organograms in Whitehall. Officials stop him throwing himself on the conflagration. He resigns to be replaced by Deputy Prime Minister Matt Hancock, back from the political dead because he ate animal genitals on TV.

December

In an act of atonement, Steve Barclay crawls to Wellington House to kneel before Amanda Pritchard in the snow. He then applies for the NHS management training scheme, but is persuaded instead to retrain as an orthopaedic surgeon.

I solemnly swear I shall eat a box of mince pies for every prediction that does not come to pass.

Have a great festive break! You deserve it.

  • Jon Restell is chief executive of Managers in Partnership.

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