RESPONSE
The NonVerba ›› “4 A” approach
to governance, risk and compliance.
©NonVerba
England. A new public body, Public Health England, is planned to be established on 1 April 2013. One of the key objectives of the initial
White Paper proposing the act was to “empower health professionals, in particular GPs”, but one way of looking at this is to devolve responsibilities from the government to the new autonomous NHS Trusts or ‘Foundation Trusts’ as they will be known. Even before the new structure comes into play we are already seeing examples of some NHS Trusts facing bankruptcy as they are unable to sustain the service delivery with the budget received. This is only one risk that will come with taking ownership of the overall service delivery and funding. Some feel this is ‘privatisation by the back door’ but one thing is clear: this is no longer going to be a centrally delivered service – and unless clear standards are not only respected but also adopted and implemented in a
structured way, we run the risk of seeing a service evolve with many different levels of quality associated with the management of risk, business continuity planning and emergency response.
Key concerns One of the key concerns of physicians and other NHS employees is the bill’s intention to amend one of the founding pillars of the NHS to read “any willing provider” rather than the current language guaranteeing a needed service exclusively provided by the NHS. This effectively means other private sector companies will take on key responsibilities. These will need to integrate and offer comparable services and more importantly maintain the high standards we expect from the NHS and which has long made the UK’s public health service the ‘envy of the world’. As these new entities form, if they do
not move towards a common framework for resilience and integrate this into other city-wide or national agencies, the question is: how effective will we be to respond to a significant impact such as the devastating coastal flood we have seen in New York and, on a smaller scale, southwest England? Responding to a fire or flood is one thing but now consider a more extreme impact from a CBRN attack. To be effective in such a situation, all
14 CBNW 2013/01 services and national agencies need to be able to work as one.
Accountability As the NHS is broken up into these different elements, we must ask – who is in charge nationally and accountable for effective resilience?
THEREWILL BE FIVE KEY NATIONAL BODIES INVOLVED:
The Department of Health
The National Institute for Health and Clinical Excellence
The Care Quality Commission The NHS Commissioning Board The economic regulator MONITOR
Even though the scope of each organization is defined in
legislation, it is still not yet clear how these organizations will interact and more importantly how standardised processes and governance, risk and compliance systems will be deployed. The ultimate goal has to be coordinated and consistent
governance across the ‘new’ NHS. Now take into consideration the fact that the new service will be able to employ the services of “any willing provider” and you now have potentially many other critical private sector service partners that will also need to develop the same resilience culture, processes and integrated systems.
North West Ambulance Resilience being managed by NonVerba’s eSecurus System. ©NonVerba
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