COMMENT
to do, but we did have an idea of some of the models of care, some of the technology, some of the standards, some of the behav- iours that we absolutely need to see much more firmly embedded within the health service.
“From last summer to about Christmas we convened a lot of these people who are quite strongly minded to act on sustainabil- ity, put them together and essentially had them have conversations saying, ‘if you do this, I’ll do that’.
“The resulting Route Map is deliberately non-specific. It doesn’t point the finger at people and give orders, but instead, it cov- ers three broad areas where action is need- ed: behaviours; governance; and technol- ogy and models of care.
“It’s a bit like opening a sash window. You’ve got to push evenly across the bot- tom of the window; if you push in one cor- ner but not the others, it’ll jam.
doing that, because you’re losing money and reputation, and you’re not going to be obeying the law’. But we say it’s up to them – survival is not compulsory!”
The unit earlier this year launched a ‘Route Map’ to sustainability, offering broad guidelines on service transforma- tion across NHS organisations.
“Earning one’s right to deliver services on behalf of the NHS is quite important now, so that saying ‘these are the rules’ and ‘these are the targets’ – that is not a function or ours, nor, funnily enough, is it any more the function of some parts of the historical regulators.
“If we ‘police’ in any way, it’s about helping those people who really are the NHS po- lice, by asking if they have thought about setting this as a benchmark, encouraging people to do this or that because there are so many multiple wins for the health service.”
But wouldn’t he feel obliged to point out particularly egregious examples of non- sustainable practice should he come across it?
“Well, we might tell them ‘you are nuts
Dr Pencheon explained: “The background to the Route Map was that sustainability had been a rapidly-growing issue within the health service for about two or three years with more and more people becom- ing engaged in it, but always engaged in their own particular way.
“The NHS is quite a tribal organisation. Very many different people have got very many different roles and we felt that a lot of people were picking up the baton, but they were picking it up and running with it – which is great – but running in their own direction. It needed a bit more refocusing to ensure that all the little bits added up to a coherent strategy and a coherent direction.
“Moreover, a lot of people were coming to us and saying ‘I think this is really im- portant in our trust, hospital, GP centre, ambulance station – what do you want me to do?’
“We didn’t have a long list of 100 things
“A lot of people are obsessed with one par- ticular area, say technology, or behaviour, and of course it’s not like that. They’re all important, but they’ve got to be pushed and encouraged to move along together.
“That’s the importance of having this Route Map, so people can identify where they are. If you are a person who makes money out of putting solar panels on hospital roofs that’s great, but that’s not the whole picture.
“Other people are looking at targets, or get- ting staff engaged, or getting staff to behave sustainably before we even mention it to public or patients.”
Would he rather see enthusiastic volunteers within each NHS organisation take up this challenge, or should it really be the respon- sibility of those with specific jobs?
He said: “You’ll always get some people who are very committed and passionate, which is fine, but what you really need is a corporate approach. Nothing’s really going to happen unless senior managers and cli- nicians take this seriously as part of their day jobs.
“We’ve been working with all the groups in the NHS, like finance managers, clinicians, GPs, governance managers, nurses, medi- cal students – there are very few groups we haven’t had some dealings with, in offering advice.
“Does one person need to take a lead? The most successful thing we’ve seen, in terms of people taking an executive role, is hav-
national health executive Mar/Apr 11 | 19
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