MADDchester

We promised to return to NHS Blithering, where we have obtained exclusive access to the diary of a PCT manager, which charts the progress of an ordinary hard-working NHS organisation during a period of profound change.

MONDAY

Never mind the Range Rover, Loosely Park green fees, luxury timeshare in Tenerife and other goodies allegedly funded by pharmaceuticals giant Plutoxin Corporation, our medical director Dr David Rummage isn’t about to let a trivial issue like legality stand in the way of progress.

Local papers are eating out of his hand after he convinced the LMC that the unlicensed medicines dispensed from his surgery were all about “making Blithering a winner in the NHS postcode lottery”.

We even make our own snake oil in Blithering.

TUESDAY

Doctors don’t get prescribing. According to our latest leaflet, CCGs who get together with community pharmacists stand to make big savings. Then there are benefits to patients, fewer admissions, less waste of drugs, earlier entry into Heaven and so on. Like contraception and QIPP, it may be important but it’s not sexy.

The closest you’ll get to a “medicines use review” in Blithering is a comparison of locally sourced weed on Friday nights behind the cricket pavilion.  A “new medicines service” is the latest chancer selling £10 baggies in the Star and Garter on Church Street.

Main man for recreational medicine is young Jeremy Rummage, he of the pale complexion, unfeasibly low-slung jeans and numerous piercings. One way or another, the family firm has the town’s narcotics business sewn up.

WEDNESDAY

The government chooses the week of the Budget to sneak out the news that QIPP will not be a one-off but a rolling programme of savings, an endless productivity gap that even the bodies of washed-up managers will never fill. 

Louise Gant, our perpetually gloomy director of public health, draws a couple of charts showing rising life expectancy and the projected increase in the number of long-term conditions. Blithering infants will live to 150, but spend the last 70 years of their lives confined to wheelchairs with oxygen cylinders strapped to them, she says, adding that only a really successful flu pandemic or a complete relaxation of hospital hygiene policy can help us now.

Tony “Turnaround” Torvill, reinstated as finance director following his sabbatical in the US studying health economics, calls a meeting to discuss new QIPP targets. Torvill declares that the top rate of subsidy for an americano or latte in the canteen is to be “reduced by up to several pence” and the loyalty card scheme is to be closed for all managers below Band 7.

Torvill says that if it were scaled up across the country, the initiative could easily save the NHS a few hundred pounds a year or “literally as much as the cut in top rate tax will save in terms of tax avoiding millionaires”.

THURSDAY

PCT is called in to arbitrate in the acrimonious practice split at Dr Crosby and Partners, rumoured to have been caused by the torrid affair between Dr Nash and the never knowingly undersexed practice nurse Mrs Crosby.

To complicate an already difficult situation, Dr Stephanie (formerly Stephen) Stills, is alleging sexual discrimination, though on what grounds is unclear. Dr Stills has the unique distinction of unresolved discrimination cases in two genders. She is also suing the Argus for printing a pre-op picture of her buying cosmetics in Boots wearing a leather mini skirt and sporting a heavy beard.

New guidance arrives from Whitehall “to clarify the options for clinical commissioning groups under the emerging commissioning support offer”.

After wading through 214 pages of clarity, the comms team produces a summary for Blithering Care Partnership, our troublesome CCG.

1. You can buy commissioning support anywhere you like.
2. You will need to get the money from us.
3. We will tell you if we think you could get the same service from us.
4. If you insist on using a third party, applications for funding must be made in writing to Anthony Torvill using the multipart form provided on the PCT website. The deadline is 1 April 2012.

New head of comms Darren Stent explains how the guidance will ensure probity and quality. “We’ll release the information next Friday and bury the form somewhere on the website over the weekend,” he says.

FRIDAY

Councillor Alan Spume goes on local radio to defend the local authority in the wake of another scandal at the Sunnyside Rest care home for the elderly. “It must never happen again,” an earnest Spume tells morning talk show host Kieran Kampp, after details emerged of a three-year campaign of bullying and intimidation waged by elderly residents on terrified staff. 

Photographs of someone looking very much like Torvill in the exercise yard at Churlish Open Prison appear in the Argus under the headline “Health service boss – what I did in my gap year”. A blustering Turnaround calls it an outrageous libel but seems strangely reluctant to complain to the editor.

It is probably too late to make the news pages of The Sunday Times, but I scan a copy of the article and email it to the news desk just in case.