Lots of managers but not much management

The meeting had lasted 1½ hours and was drawing to a close. We had been discussing the improvements in performance of a screening service that our PCT had taken over and then completely buggered up. Right at the end, they produced their performance report and in it were two graphs (which I have combined into one shown on the right).

You will see that routine referrals by the service to hospital consulants (the top line) oscillated between 38 and 225 a month. Urgent referrals also varied between 1 and 39 a month.

Everybody was really impressed with the report but then I spoilt it. I asked why there were such large variations from month to month.

Not a bloody clue!