Would you go out on a hazardous journey, with barely enough food to survive on, and with no map or compass? It could be argued that this is precisely what has been asked of the NHS since funding stopped keeping pace with our country’s rising health and social care needs and the Health and Social Care Act undermined the strategic leadership of the NHS.
It is no surprise then that the Five Year Forward View has been welcomed with open arms. It begins to fill the strategic vacuum and signals a direction that speaks to core NHS values. It has also topped up our meagre rations with the prospect of some additional funding. However, the journey ahead still has its, not insignificant, hazards. The first of which is the next election, which despite current political protestations, could bring another major top-down reorganisation.
A challenging time ahead
Under any organisational scenario we face a funding gap that will require ‘heroic’ productivity improvements. These in turn rely on scarce managerial and improvement capabilities; system wide collaboration that current regulatory structures make difficult; and employee engagement under threat from staff burnout and continued pay restraint.
Perversely, and happily, while the NHS faces these enormous challenges, it is also stepping into an era of huge opportunity. A time in which we could at last see the long-heralded shift from “industrial age medicine to information age healthcare” and a time when we begin to properly mobilise the power of patients and communities. It is this landscape that we will be exploring at our next annual Health Policy Summit later this week.
Health Policy Summit 2015: Who to look out for
Those of us at the Summit and watching via livestream will hear from Simon Stevens how he plans to make the vision set out in the Five Year Forward View a reality. He, along with fellow speakers Jeremy Hunt and Andy Burnham, would do well to listen to our keynote speaker Dr Ashish Jha, Professor of Health Policy and Management at Harvard School of Public Health, who will be exploring lessons from organisational change and what makes change happen. The Forward View leaves unanswered questions about the “theory of change” behind the vision. How will the NHS get from here to there, especially in such financially straitened times?
Every organisation in the NHS would benefit from hearing Brent James, Chief Quality Officer at Intermountain Healthcare in the United States of America, when he talks about the improvement journey at Intermountain. Intermountain has made improvement capability a core competence of all managerial staff and consequently delivered significant quality improvements and savings.
For those that know technology should drive improvement, but have difficulty understanding what or how, we will hear about the power of “Big Data”; the use of technology to transform general practice and how technology can help services reach out to and support vulnerable people and their carers. We will also hear about people power in the form of volunteers and social community ventures. The Forward View has great expectations of the role they can play.
Opportunities in sight
This then is the terrain that a future government will have to negotiate their way through, caught between balancing the national budget and protecting a service that is “the closest thing this country has to a religion”. The challenges are very visible. Our Annual Summit will put a spotlight on opportunities and potential solutions. If we are to stand any chance of navigating the dangerous road ahead we need to keep these firmly in sight.
Imison C (2015) ‘The NHS is in an era of opportunity; let’s not lose sight’. Nuffield Trust comment, 24 February 2015. https://www.nuffieldtrust.org.uk/news-item/the-nhs-is-in-an-era-of-opportunity-let-s-not-lose-sight