I have a strategy for dealing with odd socks as they come out of the wash. I put them into my sock drawer, and wait for the other sock to arrive in due course. I am of the view that things will generally work themselves out eventually.
It became apparent recently that my wife also has a strategy for dealing with odd socks. She puts them into a little bag by the washing basket, and waits for the other sock to arrive. Essentially, she takes the odd socks out of circulation until they are paired up.
You will realise the implications of this on my own strategy. I could be waiting some time before my socks get paired, with one in my sock drawer and one in the little bag.
I would maintain that both strategies have merit. You may prefer one method over the other, but on their own they both should work. It becomes a problem with both strategies are employed together.
We were recently thinking about the various strategies and work streams we have in motion at the CCG. In particular we were thinking about the development of new clinical pathways. It became apparent that we were approaching this in a number of ways simultaneously. None of the approaches was ‘wrong’, in fact they all have merit. Until recently we have had a Clinical Pathways Action Group led by a secondary care consultant with input from other consultants and GPs. We have developed an Expert Patient Reference Group and an Expert Professionals Expert Group (just now being merged into one Expert Reference Group). We have asked our GP practices to form into clusters and asked the clusters to use Right Care to consider new pathways to increase value locally. We have a CCG-driven Sustainability Action Group looking to see what we could put in place to make our local health economy sustainable long term. All of these groups are thinking about how to change pathways – to improve the patient experience, to ensure value for money, to reduce duplication and waste and to make our system run smoothly.
Individually, they are all a good idea.
Together, we have a problem. Some lack of coordination. Some lack of communication. Some lack of oversight. There is a risk that we run out of capacity to run all the projects. There is a risk of duplication. There is a risk that some projects get completed but never actually enacted (nothing more frustrating than asking how to refer into the pathway you helped create last year that now doesn’t seem to exist).
We realised that we needed to take some action. In simple terms, just communicating and overseeing the work is probably all that is required. In the same way that we are trying to join up care for invidious patients, we need to join up the work of commissioning new pathways.
It’s time to streamline and get this sorted.
Realisation of this brought with it a big sigh of relief. Things suddenly became clearer and more achievable.
Just as I have greater confidence in being able to wear matching socks, I have greater confidence that our pathways work will not look mismatched.
Dr Jonathan is a GP and Clinical Commissioning Group Chair.
Follow Jonathan on Twitter @DrJonGriffiths