Turbulent reorganisations,rising debt and critical staff shortages – no wonder there is a growing scarcity of the much-maligned ‘bureaucrats’ who struggle to sustain the machine running, writes Polly ToynbeeOpen the trapdoor into NHS engine rooms, and you see the sheer complexity of the financial machine created by serial re-disorganisations. By far the most radical has been the 2012 Health and Social Care Act,disconnecting its cogs and pistons. Only dedicated mechanics sustain the machine working, despite fragmentation and a gaping £2.5bn underlying funding gap.
Chief engineer in any NHS unit is its finance director, and few contain a tougher technical task than Trevor Shipman of Central and North West London trust (CNWL). Sprawling and diverse,providing services for approximately 3 million people in south-east England, including London, and Hampshire,Milton Keynes and Buckinghamshire, this trust is the unseen beating heart of the NHS where 90% of treatment happens – in the community.
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Source: theguardian.com