A year to the day

peter-littlejohnsThis week has been hectic…but fun and interesting. Not so a year ago when the last week in October was also busy but not pleasurable. I remember going from clinic to clinic, having a series of scans and biopsies to diagnose my throat cancer. 12 months later I am well and in total remission, albeit with a few minor teething (or lack of them) problems.

The 2016 week started well – on Monday I delivered the Royal College of Physicians Milroy Lecture. This annual lecture and bursary was founded in 1888 by a bequest from the Scottish physician and writer Dr Gavin Milroy, with the intention of ‘promoting the advancement of medical science along with the interests of philanthropic benevolence and of social welfare’.

The title of my lecture was ‘NHS Quality 1998–2013: why did it go so wrong?’ In the lecture, I argued that the NHS is facing the greatest funding challenge in its history and set out the challenges of maintaining quality in care and public health, and in particular, looked at the role of the state. I drew on one of my research projects which used in-depth interviews with senior leaders of major organisations that were established in 1999 to set standards and monitor quality in the NHS – the Commission for Healthcare Improvement, the Commission for Health Audit an Inspection, the Quality Care Commission and the National Institute for Clinical Excellence (now the National Institute for Health and Care Excellence). I sought to understand the political and organisational influences on the organisations and in the lecture I discussed some of the common themes that emerged, including the relevance of the socio-political environment, governance, clarity of purpose, leadership, the quality of external relationships and organisational reputation. My slides can be found here http://www.clahrc-southlondon.nihr.ac.uk/files/Milroy_Lecture_2016.pdf

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