QIPP FOCUS
who deliver our services weren’t on board with it and didn’t own the changes, or didn’t recognise the value of doing it. So we wanted to make sure that all of our QIPP changes and improvements are being clinically-led and clinically-driven. We have put them in leadership positions and have got groups of clinicians together to come up with solutions themselves essentially.
“Lack of engagement could have been a potential barrier: we’ve tried to head that off right from the beginning and that’s informed our whole process.
“Obviously there is a spectrum of engagement: some people have to be very engaged, some are less so. We’ve got some very good examples in our region, and GPs have been absolutely part of the process all the way along; they’ve got a very strong process of clinical engagement which morphed very naturally into the new GP- led commissioning model emerging now.
“Another example is Nene Commissioning, a large commissioning group in Northamptonshire, which has recently described some huge value for money improvements, huge patient improvement, and it’s just very impressive really.”
A common question is the extent to which NHS organisations are prepared to ‘spend to save’ - investing in innovative solutions and transformation now to save money later, knowing that doing so just increases the savings that have to be found in the short term.
Dr McLean said: “This is absolutely the nub of the issue. That’s the key difference really between transformation and trans- actional change. We’ve all seen salami-slic- ing methods employed to make savings in the NHS – but our approach is that we can improve quality and change the way we do things, and therefore make savings.
“But it does require some investment up front. One thing we have done is use our innovation fund, applied to our QIPP agen- da. We’ve got lots of examples that we’ve published this year and last year, showing how we made these improvements.
“Our approach recognises that real transformation doesn’t happen unless every consultant and clinician actually embraces our
transformation change.”
“Some of these things have been taken up nationally as well: some of them are large, some of them are quite small, but you can find that multiplying something makes quite an impact.
“But we’ve all had to have some ‘pump priming’ investment to make savings.”
There will be inevitable upheaval in the NHS as the reforms embed themselves, but that doesn’t have to mean the QIPP agenda is blown off course, according to Dr McLean.
and that
She explained: “Interestingly, the PCTs have already clustered into five in our patch, and we’re already working with those five for the purposes of QIPP. That was just an evolution of where we’d got to.
“It should be pushed further into making sure that the GPs and local clinicians are much more involved and not just part of it, which they already were, but actually own- ing it, and becoming responsible for deliv- ering the change over the next few years.
“And then the next step of course is that the SHAs will cluster, so we’ll have to work on the reforms and with our colleagues who are driving those areas.
“Our whole focus is being sure that the new emerging bodies in the NHS – the GP-led clinical commissioning groups, the PCT clusters that now exist – that they all clear- ly understand their role and understand and properly own the plans they have to deliver the QIPP challenge, which means working with the existing organisations to make sure they’re handing off the new ones as effectively as possible.
“Plans are already in place and no doubt new plans will emerge, so we must make sure things aren’t lost in transi- tion.”
Dr Kathy McLean
FOR MORE INFORMATION Visit
www.eastmidlands.nhs.uk
national health executive Jul/Aug 11 | 29
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