Residential social care staff, residents, and their relatives would have been very pleased when, at the end of last week, the Government announced that staff and residents would at last be tested for the virus.
This pleasure somewhat diminished over the weekend when some care homes received instructions for their staff make round trips of up to 300 miles in order to get the test.
Similarly, as the Government’s quest to announce bigger and bigger numbers progressed, NHS staff will have noted another announcement on Monday that the total number of PPE items distributed had now reached 1 billion. But to employees without gowns – and still needing them – this news would not have sounded very impressive.
Both announcements are examples of people near, or at the centre of, a chain of distribution feeling that once they’d done their bit – it would all work.
Nowadays we live in an age of social media where staff in care homes, miles from test facilities and still without gowns, can get their reality heard. The daily reality of front line staff is now part of a public narrative.
“What really matters here is not the announcement…
What really matters here is not the announcement but a person actually being tested or having a gown. That is the output of all this work. Having a testing site or distributing 1 billion bits of kit looks important, but really doesn’t matter if tests don’t take place or staff still aren’t wearing gowns.
If the nation’s farmers congratulated themselves on producing a billion litres of milk, but some parts of the country just didn’t have any, there would be an uproar.
Or, to take an example from the private sector, if Nissan were told that a billion tyres had been produced but that unfortunately they were still 300 miles away from the factory, production would stop and consequences would ensue.
It is beyond dispute that day-after-day the Government are working hard (day and night). What they need to do is work a bit less hard and a lot smarter.
The problem is that developing end-to-end supply chains is not a skill that civil servants generally possess – nor is it one that Ministers bring to their jobs (Nor I might add, having been one for 6 years, is it one that special advisers have).
Which means doing one of two things, either look round the room and muddle through with the skills you have, or you find some of the few hundred people who know what they are doing and ask them to do it.
There are three main aspects of a successful supply chain that need very different skills.
The first is developing the raw materials and manufacturing the items. It would be great if this happened in one location of course. Having the raw materials and manufacturing side-by-side would make this a lot easier.
But in our distributed society this is not the case. (Only a few cows graze next to a dairy or next to a supermarket).This is a crucial problem for this highly centralised government and leads to their not having the skills to create supply chains.
Across the country there are tens of thousands of clothing manufacturing plants. (I know we get a lot of our clothes from China, but we still make clothes across the country). To build a supply chain all these different locations need to be contacted by someone they can contact easily and establish a good working relationship. They also need to understand that for the next few weeks, they are our key workers and their potential outputs could be the salvation of the nation.
In almost every part of the country, with both testing and PPE, stories have emerged of manufacturers who have offered their services to the NHS and the Government and not heard anything back. They have not heard back because no-one has been actively collecting their details, thanking them for making their offer, and calling them back. (“Thanks for your offer of gloves. We don’t need them, but can you make masks?”). Collating the information, doing the sums, checking back, talking, and above all creating the kind of relationships that solve problems. (“Have you got a problem with sourcing raw materials? I can help you with that.”).
Because none of this has happened many firms have given up. Others have decided, as did Barbour in the north-east, just to contact their local hospitals and do it themselves.
By creating good relationships with thousands of suppliers you create a highly decentralised start point for the supply chain. Given that you know the endpoint is also decentralised with over 50000 points of contact – both for PPE and testing – you also know that you need very good relationships with all of them.
In the middle you have a good piece of software that can handle both numbers and postcodes. Gloves being made in Birmingham should NOT be taken to a central depot. The software needs to decide that they can be taken to a local care home – in Birmingham. The “centralised” part of this model is an office that recognises that the important parts of the process are the decentralised manufacture and distribution. Being “central” is a lot less important.
The Government and its announcements are a lot less important than the outcomes and only really matter if they can get the decentralised parts to work
This is not easy for a centralised state. They are a bit bemused by all this power resting in the localities of manufacture and care delivery. But as a country we have proved we can make this work in many important aspects of our lives.
So point of this is NOT to add up how many bits of kit we have got, but to make sure that every person who needs kit gets it.
I’m labouring this point because there are 6 days to go before the Government’s target of 100,000 tests being available is due to be met.
If that target is reached, I’m a bit frightened that they might simply congratulate themselves on hitting that number. The fact that perhaps only 60,000 tests actually take place will not be seen as their fault. It will be other people’s fault for not taking up the opportunity.
Let’s be clear. On their own, having these tests available – if they are not being applied to human beings – does not matter very much. That is the crucial part of the process. That is rather the entire point of the 100,000 tests.
To claim otherwise is a cruel deception.