What is it about your job that you feel would surprise the public?
The diversity of my job is unusual. The other day, for instance, I ran from a meeting about nurse associates in Stratford to the Mayfair home of a philanthropist (no donation, but great biscuits) to a conference call with a tech company in the US.
What’s been the biggest change you’ve seen since you started working in the NHS and social care?
We have been talking about integrated care for so long, it’s easy to miss that now we are doing it. Whether it’s a moral conversion or sheer lack of money, there’s a much stronger sense across commissioners and providers – and health and care – that we are one team serving the public.
If you could make one change to the NHS and social care over the next 10 years, what would it be?
When we talk about a ‘workforce crisis’ and ‘care crisis’, we obscure a huge opportunity. We need to recruit new staff, treat them well enough that they stay and help them to lead productive, rewarding careers. If construction or manufacturing was booming like that, we would be shouting it from the rooftops.
Change from the top
If you could give Matt Hancock one piece of advice, what would it be?
Your job is vision, values and big strategic decisions and a guiding story about how we make them happen. That’s more than enough for anyone – leave the gadgets and the special projects to others.
What do you wish people at the top of the NHS understood?
I have worked right across public services, and I am blown away by the sheer brainpower of the NHS’s top leaders and clinicians. They understand it all – I want them to be as brave, confident and collaborative as they can be to shape a better system for everyone.
Policy in practice
What policy have you seen successfully implemented, and why did it work?
Care City is part of the test bed programme, run by NHS England and the Office for Life Sciences. In the first wave of our work, we and our partners prototyped a new pathway for finding and treating atrial fibrillation. We put mobile ECGs (electrocardiograms) in community pharmacies and enabled direct referral to Barts Hospital, remote triage and a one-stop atrial fibrillation (AF) clinic. It worked because we took time to understand the challenge, developed it incrementally with staff and service users, and were relentless about implementation and quality.
What policy have you seen fail, or not be as successful as first intended?
There is a lot of excitement about our ability to monitor and track people, to support their health and wellbeing. We have yet to see this work deliver quite as people hoped. Often, either there are friends, family and professionals ready to act on this data, and the data is not required – or there are not, and the data is not useful. These digital tools will be important in the future, but they are a small factor in any public service. The care of human beings – paid and unpaid – is as vital as ever.
What policy and/or change in behaviour are you currently trying to implement, and how’s it going?
Through our second test bed programme – independently evaluated by the Nuffield Trust – we are focused on putting cutting edge digital technology in the hands of support staff. Too often, people in non-clinical roles are the last to be given innovations, but they can make a massive difference to the help they can provide to patients, and to their careers. As an innovation centre for healthy ageing and regeneration, that kind of work is at the heart of Care City.
The NHS is under pressure because...
We expect Scandinavian public services and American rates of income tax. Staff across the country do incredible jobs trying to resolve this tension, but it still hugely shapes our public debate and public institutions.
John Craig is the Chief Executive of Care City.