It's an organisation, Jim, but not as we know it.

The Five Year Forward View is a bold document which Simon Stevens seems to hope will survive political changes and whims in order that the NHS actually really does honest to goodness transformation into a twenty first century organisation. 

There loads of good stuff in there, models and frameworks rather than dictat and ideology.  

One of the most interesting parts for me is the Multi Speciality Community Provider ( MSCP). It's a neat concept that sees the patient delivered of a seamless service following the principles of integrated, right place, right time care.  

There is a slight problem with this concept.  

I'm willing to bet that right now Chief Execs and senior leaders across England are thinking "we could be that organisation" or worse still, there are probably DoFs thinking "we could scupper that organisation" . 

In their own worlds that's probably a sensible, aligned view to have, however it is a concept that arises from the same level of consciousness as the one that generated the need for MSCPs in the first place.  

As Einstein pointed out, that's not going to give us the answer. 

Now, as it's nearly Christmas, we're probably looking to organisations like Amazon to solve our troubles when it comes to presents, so let's get a delivery from them. 

Amazon is a model that could actually work as an MSCP.  

Suspend your disbelief for a moment.  

Amazon is a brand, I buy from that brand because it's right place, right time, trusted, close to home, flexible in its delivery approach and convenient. I don't need to look anywhere else.  

Amazon also isn't just Amazon.  

There's a good chance that if I want a specialist product, odd, unusual or bespoke, I can get it from Amazon, but it will be sourced by another provider. Whether it be John Lewis or a small shop in the back end of Brighton, my parcel will arrive, sometimes in the Amazon box, sometimes in the John Lewis box, but it arrives as expected after my organisation choice of Amazon has said it will. 

Amazon does not own John Lewis, or the small shop in Brighton, they are not the same organisation. 

Consider what would happen if a community foundation trust, multiple practices and a specialist provider decided, that rather than waste time waiting for a new Organistional form to arrive or be mandated, they would just get on and do an Amazon. 

That would be amazing.