Roy Lilley, nhsManagers.net eLetter,15 May 2025, https://ihm.org.uk/nhsm/
Listen to Roy Lilley read this morning’s eLetter
Ko-Ko’s ‘little list’ song from Gilbert and Sullivan’s The Mikado, is a joy to listen to.
It’s smart, witty and often tweaked to be topical. The version from Opera Australia is particularly funny… if you can find five minutes…. here it is.
Ko-Ko isn’t the only one with a list.
The Jim Reaper has a little list. Actually, it’s not so little. It is a long list of stuff that ICBs, Trusts and others will no longer record the numbers for.
It’s a big list and warrants a big look.
Here’s the whole list but in short, it’s a list of data ICBs and Trusts will no longer be required to collect…
… axing dozens of performance indicators; workforce, inequalities and patient safety. The thinking… local organisations should be measured on ‘short-term priorities’ this year.
For instance;
• The average number of years people live in healthy life is not a measurable thing anymore.
Neither…
• Deaths with three or more emergency admissions in the last 90 days of life.
• Percentage of children to receive two doses of the MMR vaccine by age five.
• Percentage of trust staff to leave in the last 12 months.
• Number of staff having a flu-jab.
• People waiting over six weeks for a diagnostic procedure or test.
• Percentage of talking therapies patients achieving reliable recovery.
• Patients admitted as an emergency within 30 days of discharge.
There’s a lot more like this…
… in a consultation document on proposed changes to the ‘performance and assessment framework’ such as;
• The number of staff or GPs leaving in the last year.
There’s a paradox here.
Data collection is fundamental to identifying inefficiencies, measuring outcomes and driving evidence-based decisions.
Reducing data collection may lighten the administrative load in the short term but could undermine the ability to pinpoint problems, track trends, and implement targeted improvements in the long run.
NHSE have accepted this is short-termism. Dressing it up as a move to streamline operations.
Cutting unnecessary bureaucracy…
… risking undermining the very principles of evidence-based decision-making that underpin modern healthcare management.
Data is not the enemy of efficiency… it is the pathway to it.
Reducing data collection might seem like an easy win in the quest to reduce headcount. Sack the people whose job it is to collect data and analyse it… but it could very well be a false economy.
For instance, the decision to stop monitoring the percentage of patients who do not meet the ‘criteria to reside’, a key indicator of delayed discharge.
This data contributes to understanding the scale of so-called ‘bed-blocking’ (delayed transfers of care) and its impact on patient-flow.
Without these data points, NHSE are flying blind…
… losing vital tools for assessing how well discharge planning is working, potentially exacerbating delays and increasing costs as more patients occupy beds that could be used for acute care.
More sinister; not fully understanding how social care is performing. Something that Streeting has no interest in as he has no inclination to resolve the problems in adult social care.
This is stinkin-thinkin, assuming that data is a drain on resources rather than a tool for smarter, more targeted decision-making.
Perhaps the real question isn’t whether to collect the data but how to make it easier to collect…
… streamlining systems, integrating platforms, bar-codes, and ensuring frontline staff aren’t bogged down with cumbersome processes.
If the reason for not collecting data is that it is too much of a palaver to collect and we don’t have the resource to act on it… there is more to change than we thought.
Data needs to be relevant, actionable, and tied directly to outcomes that matter to patients and frontline staff.
The challenge isn’t to cut data but to cut through it.
They say data’s the new oil. It’s certainly precious. More, it is the golden thread that pulls the system together, darns the holes, and sews the hem around it all and if we use it well enough, create a tapestry, a picture of the future where there are no surprises.
As Gilbert and Sullivan wryly noted, there’s always ‘a little list’ of things deemed expendable…
… but in healthcare, data shouldn’t be it.