Download Lectures on Biostatistics (1971).
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Download review of Lectures on Biostatistics (THES, 1973).

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Des Spence, a general practitioner in Glasgow, has revealed a memorandum that was allegedly leaked from the Department of Health. It was published in the Britsh Medical Journal (17 June 2009, doi:10.1136/bmj.b2466, BMJ 2009;338:b2466). It seemed to me to deserve wider publicity, so with the author’s permission, I reproduce it here. It may also provide a suitable introduction to a forthcoming analysis of a staff survey.

Re: The use of ‘note pads’ in the NHS and allied service based agencies.

Hi, all care providers, managers of care, care managers, professions allied to care providers, carers’ carers, and stakeholders whose care is in our care. (And a big shout to all those service users who know me.)

We report the findings from a quality based review, with a strong strategic overview, on the use of “note pads” across all service user interfaces. This involved extensive consultation with focus groups and key stakeholders at blue sky thinking events (previously erroneously known as brain storming). This quality assured activity has precipitated some heavy idea showers, allowing opinion leaders to generate a national framework of joined-up thinking. This will take this important quality agenda forward. A 1000 page report is available to cascade to all relevant stakeholders.

The concentric themes underpinning this review are of confidentiality. Notes have been found on the visual interface devices on computers and writing workstations throughout the NHS work space. Although no actual breach of confidentiality has been reported, the independent external consultants reported that note pads “present a clear and present danger” to the NHS, and therefore there is an overarching responsibility to protect service users from scribbled messages in felt tip pen. Accordingly all types of note pads will be phased out in the near time continuum. A validated algorithm is also attached to aid this process going forward.

This modernising framework must deliver a paradigm shift in the use of note pads. Care provider leaders must employ all their influencing and leverage talents to win the hearts and minds of the early adopter. A holistic cradle to grave approach is needed, with ownership being key, and with a 360 degree rethink of the old think. All remaining note pads must be handed over in the next four week ” note pad armistice” to be shredded by a facilitator (who is currently undergoing specialist training) and who will sign off and complete the audit trail.

(Please note that the NHS’s email system blocks all attachments, so glossy, sustainable, wood based hard copies will be sent directly to everyone’s waste recycling receptacles.)

Cite this as: BMJ 2009;338:b2466

Spence added a footnote, Note: The BMJ’s lawyers have insisted that I make it clear that this is a spoof, just in case you were wondering.


Here are a few more

There is an initiative underway to determine what we do as an organisation in the realms of drug discovery. The intention is to identify internal and appropriate external capabilities to foster a pipeline of competencies that enable some of our basic research outputs to better impact healthcare.


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4 Responses to Management speak strikes again

  • Meh. Too little, too late. The NHS must learn to deliver timely taxpayer value-for-money for our hard-working families.

  • This is clearly a spoof. It’s probably left over from an internal “April 1st memo” competition.

  • The trouble is these days that whenever I see or hear the word “stakeholder” I can’t displace from my mind’s eye the image of a madman clutching a large wooden spike above his head and about to plunge it into the corpse of some erstwhile paragon turned vampire. Complete with background thunderstorm.

    Although perhaps it’s not a bad metaphor.

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