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The Key to Reform of UK’s National Health Service is in its Back-History

UK governmental plans for healthcare reform have been hotly contested by healthcare professionals and widely covered in the UK media.  As the National Health Service (NHS) gets to grips with the planned changes in commissioning and strives for increased efficiency through integration, Andy Ward told a London conference entitled ‘An NHS for patients: making clinical commissioning work’ that the NHS already has the breadth of experience and battle-scars to bring about considered and effective change.

Below is a summary of the speech he gave, reported in the conference brochure:

“However a health system is administered, overarching directional themes of improving access, safe, quality care and affordability are essential – there’s no choice given continued increasing demand and costs.  The NHS has invested huge effort and money developing capabilities and structures taking us in these directions with varying degrees of success, especially over the last 10 years.  The current reform is a little different in that the economic environment and mood to invest scarce resources in change are negative.

“The NHS already knows what it needs to do to reform itself – it’s out there in its corporate memory. The trick is going to be finding and directing the capabilities to great effect in the emergent organizational landscape.  Anyone setting up a new organization would be remiss not seeking out premium talent, depth of experience and ‘battle scars’, mainly residing within people ‘at risk’ of redundancy.


Making the most of organisations, systems and processes

I recently heard some PCT CEOs lamenting the passing of World Class Commissioning.  They definitely didn’t want it back, but they didn’t want to lose the ordered, benchmarked organizational and developmental rigor to address the challenges of running a health system.  It nurtured a huge cohort of skills, ready to be deployed.

Drawing on the massive pool of leadership across the clinical and managerial spectrum

Having skills is one element, but being able to apply these in the new world will make them relevant.  Some great development programs created a tranche of leaders across the health system and the opportunity to get return on these past investments is an opportunity too good to miss.

Adopting the innovation that is out there, not reinventing it

Emergent Clinical Commissioning Groups, whether large or small, can access huge pools of innovation.  A big role for the outgoing Strategic Health Authorities, Primary Care Trusts, other forms such as the Institute and Health Innovation and Education Clusters, and then the Commissioning Board, is to signpost these innovations to make the market an even playing field.  The UK is repeatedly slammed for uptake of innovation, and health particularly so; clever use of IT, proactive, early use of diagnostics, technology enabled self-care – all investments in disruptive innovations that can support the affordable, risk managed healthcare system transformation needed.

So, NHS, don’t you dare forget what you have learned and what you know on this journey.  That journey has been expensive and painful, but the pain of having to rediscover is higher.  Applied experience and capability are key elements of risk management, and even the smallest players can acquire expertise that’s out there to match the agility of their size with the scale of task they have taken on.”