COMMENT
ing a lead on the executive. That could be a non-executive, or a director of finance, al- lied to someone who’s got an operational responsibility within the organisation. It’s often been someone like a director of es- tate, because that’s where sustainability ‘starts’ – around energy or resource use.
“But, interestingly, a lot of directors of estate have said to us, ‘we’ve done all we can’.
“As an example, at an acute trust, you can do a lot of things to pursue the efficiency agenda – energy use, cutting down on travel, procuring better – but that doesn’t tend to do enough to really make a big im- pact.
“A truly sustainable health service, both environmentally and financially, is re- ally addressing the next layer of the onion, which is around the models of care. How do we cope with long-term conditions, how do we cope with an ageing population, how do we cope an obesity epidemic?
“We need to look at really quite different ways of delivering healthcare. What does care look like when it’s done largely closer to home, with a much more sophisticated use of information technology, and much more ‘shared responsibility’ between the NHS, the patients and the public?
“We’ve got a good track record in the health service of infantilising the public and not helping them manage their own illness or their own health. We tend to suck peo- ple away from their homes into buildings – big, hot hospitals – rather too quickly.
“We don’t have a great track record of us- ing IT smartly in the health service; if you compare the National Programme for IT with, say, how Tesco Clubcard works – they’re very different. I’m not trying to at- tack the NHS, I think it does a lot of things very well, but we don’t have a great track
20 | national health executive Mar/Apr 11
record for large scale of implementation of IT – but then neither does air traffic con- trol. We’re not particular on that.”
Pencheon admitted that the timelines involved in reforming the NHS to an all- round sustainable organisation were very long-term. So how confident is he of mak- ing a real difference?
“It’s a very long journey,” he said. “I’m very confident the message will get through – what I’m less confident about is whether it will get through quickly enough, and ‘smoothly’ enough, whether it’ll embed it- self naturally in the health service. People will see the win-wins.
“The thing that really excites me is that we know that those models of care that are more appropriate to the 21st
century
happen to be, fortuitously, more sustainable.”
“What tends to deliver good healthcare, closer to home, in the way we envision, also happens to be sustainable. We’d never deliver healthcare just because it was more sustainable – we do it because it’s better for patients and drives better outcomes. The thing that really excites me is that we know that those models of care that are more appropriate to the 21st
century hap-
pen to be, fortuitously, more sustainable.
“We need to make clear that this is high- quality, good, patient-engaged care and fortunately it happens that it’s all envi- ronmentally and financially sustainability, and isn’t that great!
“There’s still a huge communication chal- lenge. It’s one thing having a great idea; it’s another trying to articulate it in a way that grabs your audience.”
Dr Pencheon’s own background gives an insight into the changes the NHS has been experiencing, and what is to come.
He told NHE: “I’m an NHS doctor, and have been for 25 years, although I have worked overseas too, and in public health, and in research and development, and at a research facility in Cambridge. The inter- esting thing about my background is that I worked as a clinician in the NHS for a long time, and in my spare time I was very engaged in the environmental movement. Interestingly, I never put the two together, until about ten years ago, when I suddenly saw that we can be so busy in the NHS that we don’t raise our eyes from the grind- stone. The environment and health are so closely allied.
“There is a real opportunity for modern- ising health services in this country in a way that benefits patients and the health system; benefits them financially and en- vironmentally.
“So many of these things are not com- peting – they’re not trade-offs. They re- inforce each other.”
David Pencheon
FOR MORE INFORMATION Visit
www.sdu.nhs.uk
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