QIPP FOCUS
NHE discusses the QIPP agenda with one of its regional strategic leads, Dr Kathy McLean, medical director of NHS East Midlands and QIPP Director for that strategic health authority.
As
everyone in the NHS knows by now, saving billions of pounds
in just a few years while the entire health service is being reorganised and while the long-term unsustainability of current care models still needs addressing is a very big ask indeed.
NHE spoke with one of the people leading the QIPP agenda – NHS East Midlands medical director Dr Kathy McLean.
We asked her to describe her own role as QIPP director for the strategic health au- thority – and to tell us how free she feels to carry out the role, considering the impor- tance of QIPP to the Department of Health and the commonly quoted intervention from the centre.
She said: “I’ve been the QIPP Director since we set off on this journey back in 2009, and have become head of the team at a regional level of what we’ve called our ‘Towards Ex- cellence’ programme.
“On freedom versus central direction: that’s a good question, but I think that eventually, how we direct it is very much up to our- selves and our constituent parts, because at the end of the day we’re very conscious that delivery of anything only happens at the front line.
“So the exact methodology of how QIPP directors have gone about that is probably very different across the country. However, there has been a co-ordinated approach from the centre, of which we have been absolutely part, to ensure that we are all
28 | national health executive Jul/Aug 11
working towards similar goals. We report on the separate ways in which we have been working towards those same goals, and on our progress, and that’s galvanised us into making sure we maintain momentum.”
She said she and her team have a close re- lationship with Jim Easton, national NHS director for improvement and efficiency, as well as with other QIPP directors, with whom there has been much “sharing of notes” over the past 18 months.
Although the different SHAs have adopted different approaches to QIPP, there is plen- ty they can learn from each other, she said.
But it has not been smooth sailing in every part of the country. The NHS Top Leaders organisation is planning to let out a con- tract to improve service transformation and delivery, noting in the tender notice in the Official Journal of the European Union that some of its members are experiencing “barriers” to the delivery of QIPP and need expert help in change management and skills transfer.
We put that point to Dr McLean, and she said: “We see QIPP as having two major stages: one is planning, and one is imple- mentation. I think we’ve probably moved into implementation, but this early on in the process, that is quite challenging. Anyone can try anything frankly, but it’s a question of how you implement.
“I’m not sure we have seen barriers as such. Some things have been more helpful than others; some of the support nation-
ally has been helpful, and some of that has been less helpful, because they’re not really things you can really enforce from the na- tional level.
“At a local level, we have very much turned to supporting the new commissioners and the PCT clusters, so we’re focusing on mak- ing sure that they’re helping their commis- sioning groups get a grip of this and deliver at a local level.
“So, our role has morphed with time, and we can now actually support people to do things, and where people come up with things that aren’t going well we try to un- block things for them.”
Some surveys – including that by Silicon Bridge Research, featured on page 34 – have suggested a lack of GP and clinician involvement in the formal QIPP process, even if they are signed up to the more gen- eral need to change, save money and inno- vate.
Dr McLean said a key strength of the QIPP approach in the East Midlands, however, has been the level of their clinician involve- ment.
She said: “Our approach is about recognis- ing that real transformation doesn’t hap- pen unless every consultant and clinician, who interact with patients every day, actu- ally embraces our transformation and that change.
“It could have been a real barrier to QIPP if the doctors and nurses and clinicians
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84